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Pyridoxine reduces the effects of levodopa but this does not occur if a dopa decarboxylase inhibitor is also given. Pyridoxine reduces activity of altretamine. It has also been reported to decrease serum concentrations of phenobarbital and phenytoin. Many drugs may increase requirements for pyridoxine; such drugs include hydralazine, isoniazid, penicillamine, and oral contraceptives.
Absorption of vitamin B12 from the gastrointestinal tract may be reduced by neomycin, aminosalicylic acid, histamine H2-antagonists, omeprazole, and colchicine. Serum concentrations may be decreased by use of oral contraceptives. Many of these interactions are unlikely to be of clinical significance but should be taken into account when performing assays for blood concentrations. Parenteral chloramphenicol may attenuate the effect of vitamin B12 anemia.
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