With concomitant use of niacinamide and alcohol, toxic delirium and lactic acidosis have been noted. Concomitant use of niacinamide and nicotine has been reported to cause increased flushing and dizziness. Since pyridoxine is noted to have effects on dopamine, drug interactions are possible. A drug interaction with Levodopa is noted, but can be avoided if Levodopa is given in combination with a decarboxylase inhibitor. Serum phenytoin and phenobarbital levels have been reported to decrease in patients receiving 80 to 200 mg/day of pyridoxine. Use of anticonvulsants and sulfasalazine has been associated with folate deficiency, even when folic acid is supplied orally. Prothrombin times are decreased when ascorbic acid is used concomitantly with anticoagulants.
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