{ "name": "Health Britannica Supplement and Medication Interaction Dataset", "verified": "2026-10-13", "license": "https://healthbritannica.com/license", "severityRubric": { "major": "The source calls the pair serious, dangerous or harmful, says not to combine them, or lists the drug among \"crucially important medicines\" the supplement weakens.", "moderate": "The source names a specific clinical consequence (bleeding, low blood sugar, lower drug levels, high potassium, a deficiency) or gives a specific management step (spacing doses, monitoring, medical supervision).", "minor": "The source describes the interaction as possible, theoretical, preliminary, conflicting or of unknown clinical significance, or reports only a level change.", "none-known": "The source addresses the pair and describes it as acceptable for most people." }, "core": [ "ssri-snri", "maoi", "anticoagulants", "antiplatelets", "statins", "thyroid", "diabetes", "blood-pressure", "sedatives", "immunosuppressants", 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"nccih-feverfew" }, { "org": "NCCIH", "name": "National Center for Complementary and Integrative Health, S-Adenosyl-L-Methionine (SAMe): In Depth", "url": "https://www.nccih.nih.gov/health/sadenosyllmethionine-same-in-depth", "cache": "nccih-sadenosyllmethionine-same-in-depth.txt", "id": "nccih-same" }, { "org": "NCCIH", "name": "National Center for Complementary and Integrative Health, Glucosamine and Chondroitin for Osteoarthritis", "url": "https://www.nccih.nih.gov/health/glucosamine-and-chondroitin-for-osteoarthritis", "cache": "nccih-glucosamine-and-chondroitin-for-osteoarthritis.txt", "id": "nccih-glucosamine" } ], "classes": [ { "id": "antidepressants", "name": "Antidepressants (any type)", "short": "antidepressants", "parent": null, "examples": [ "sertraline", "amitriptyline", "bupropion", "phenelzine" ], "aliases": [] }, { "id": "ssri-snri", "name": "SSRIs and SNRIs", "short": "SSRIs/SNRIs", "parent": "antidepressants", "examples": [ "sertraline (Zoloft)", "fluoxetine (Prozac)", "escitalopram (Lexapro)", "citalopram (Celexa)", "paroxetine (Paxil)", "venlafaxine (Effexor)", "duloxetine (Cymbalta)", "desvenlafaxine (Pristiq)" ], "aliases": [ "sertraline", "zoloft", "fluoxetine", "prozac", "escitalopram", "lexapro", "citalopram", "celexa", "paroxetine", "paxil", "venlafaxine", "effexor", "duloxetine", "cymbalta", "desvenlafaxine", "pristiq", "fluvoxamine", "luvox", "vortioxetine", "trintellix", "ssri", "snri" ] }, { "id": "maoi", "name": "MAOIs (monoamine oxidase inhibitors)", "short": "MAOIs", "parent": "antidepressants", "examples": [ "phenelzine (Nardil)", "tranylcypromine (Parnate)", "isocarboxazid (Marplan)", "selegiline (Emsam)" ], "aliases": [ "phenelzine", "nardil", "tranylcypromine", "parnate", "isocarboxazid", "marplan", "selegiline", "emsam", "maoi" ] }, { "id": "tca", "name": "Tricyclic antidepressants", "short": "tricyclics", "parent": "antidepressants", "examples": [ "amitriptyline", "nortriptyline (Pamelor)", "imipramine (Tofranil)", "doxepin" ], "aliases": [ "amitriptyline", "elavil", "nortriptyline", "pamelor", "imipramine", "tofranil", "doxepin", "clomipramine", "anafranil", "desipramine", "tricyclic" ] }, { "id": "bupropion", "name": "Bupropion", "short": "bupropion", "parent": "antidepressants", "examples": [ "bupropion (Wellbutrin, Zyban)" ], "aliases": [ "bupropion", "wellbutrin", "zyban" ] }, { "id": "anticoagulants", "name": "Anticoagulants (blood thinners)", "short": "anticoagulants", "parent": null, "examples": [ "warfarin (Coumadin, Jantoven)", "apixaban (Eliquis)", "rivaroxaban (Xarelto)", "dabigatran (Pradaxa)" ], "aliases": [ "blood thinner", "anticoagulant", "heparin", "enoxaparin", "lovenox" ] }, { "id": "warfarin", "name": "Warfarin and other vitamin K antagonists", "short": "warfarin", "parent": "anticoagulants", "examples": [ "warfarin (Coumadin, Jantoven)", "phenprocoumon", "acenocoumarol" ], "aliases": [ "warfarin", "coumadin", "jantoven", "phenprocoumon", "acenocoumarol" ] }, { "id": "doac", "name": "Direct oral anticoagulants (DOACs)", "short": "DOACs", "parent": "anticoagulants", "examples": [ "apixaban (Eliquis)", "rivaroxaban (Xarelto)", "dabigatran (Pradaxa)", "edoxaban (Savaysa)" ], "aliases": [ "apixaban", "eliquis", "rivaroxaban", "xarelto", "dabigatran", "pradaxa", "edoxaban", "savaysa" ] }, { "id": "antiplatelets", "name": "Antiplatelet drugs", "short": "antiplatelets", "parent": null, "examples": [ "aspirin", "clopidogrel (Plavix)", "prasugrel (Effient)", "ticagrelor (Brilinta)" ], "aliases": [ "aspirin", "clopidogrel", "plavix", "prasugrel", "effient", "ticagrelor", "brilinta" ] }, { "id": "statins", "name": "Statins (cholesterol)", "short": "statins", "parent": null, "examples": [ "atorvastatin (Lipitor)", "simvastatin (Zocor)", "rosuvastatin (Crestor)", "pravastatin (Pravachol)", "lovastatin (Mevacor, Altoprev)" ], "aliases": [ "atorvastatin", "lipitor", "simvastatin", "zocor", "rosuvastatin", "crestor", "pravastatin", "pravachol", "lovastatin", "mevacor", "altoprev", "pitavastatin", "livalo", "statin" ] }, { "id": "thyroid", "name": "Thyroid medicines (any)", "short": "thyroid medicines", "parent": null, "examples": [ "levothyroxine", "methimazole" ], "aliases": [] }, { "id": "levothyroxine", "name": "Thyroid hormone (levothyroxine)", "short": "levothyroxine", "parent": "thyroid", "examples": [ "levothyroxine (Synthroid, Levoxyl, Unithroid, Tirosint)" ], "aliases": [ "levothyroxine", "synthroid", "levoxyl", "unithroid", "tirosint", "euthyrox", "levothroid", "liothyronine", "cytomel", "armour thyroid", "thyroid hormone" ] }, { "id": "antithyroid", "name": "Antithyroid medicines", "short": "antithyroid drugs", "parent": "thyroid", "examples": [ "methimazole (Tapazole)", "propylthiouracil" ], "aliases": [ "methimazole", "tapazole", "propylthiouracil", "ptu" ] }, { "id": "diabetes", "name": "Diabetes medicines (any)", "short": "diabetes medicines", "parent": null, "examples": [ "metformin", "insulin", "glipizide", "sitagliptin (Januvia)", "semaglutide (Ozempic)" ], "aliases": [ "glipizide", "glucotrol", "glyburide", "glimepiride", "amaryl", "sitagliptin", "januvia", "semaglutide", "ozempic", "wegovy", "rybelsus", "tirzepatide", "mounjaro", "empagliflozin", "jardiance", "dapagliflozin", "farxiga", "pioglitazone", "actos", "diabetes" ] }, { "id": "metformin", "name": "Metformin", "short": "metformin", "parent": "diabetes", "examples": [ "metformin (Glucophage, Glumetza, Fortamet)" ], "aliases": [ "metformin", "glucophage", "glumetza", "fortamet", "riomet", "janumet" ] }, { "id": "insulin", "name": "Insulin", "short": "insulin", "parent": "diabetes", "examples": [ "insulin glargine (Lantus)", "insulin lispro (Humalog)", "insulin aspart (Novolog)" ], "aliases": [ "insulin", "lantus", "basaglar", "humalog", "novolog", "levemir", "tresiba", "toujeo" ] }, { "id": "blood-pressure", "name": "Blood pressure medicines (any)", "short": "blood pressure medicines", "parent": null, "examples": [ "lisinopril", "losartan", "metoprolol", "hydrochlorothiazide", "amlodipine (Norvasc)" ], "aliases": [ "amlodipine", "norvasc", "diltiazem", "cardizem", "verapamil", "hydralazine", "clonidine", "blood pressure", "hypertension" ] }, { "id": "ace-inhibitors", "name": "ACE inhibitors", "short": "ACE inhibitors", "parent": "blood-pressure", "examples": [ "benazepril (Lotensin)", "lisinopril (Prinivil, Zestril)", "fosinopril", "enalapril (Vasotec)", "ramipril (Altace)" ], "aliases": [ "benazepril", "lotensin", "lisinopril", "prinivil", "zestril", "fosinopril", "monopril", "enalapril", "vasotec", "ramipril", "altace", "quinapril", "accupril", "captopril" ] }, { "id": "arbs", "name": "Angiotensin receptor blockers (ARBs)", "short": "ARBs", "parent": "blood-pressure", "examples": [ "losartan (Cozaar)", "valsartan (Diovan)", "irbesartan (Avapro)", "olmesartan (Benicar)" ], "aliases": [ "losartan", "cozaar", "valsartan", "diovan", "irbesartan", "avapro", "olmesartan", "benicar", "telmisartan", "micardis", "candesartan", "atacand" ] }, { "id": "beta-blockers", "name": "Beta-blockers", "short": "beta-blockers", "parent": "blood-pressure", "examples": [ "nadolol (Corgard)", "metoprolol (Lopressor, Toprol XL)", "atenolol (Tenormin)", "propranolol (Inderal)" ], "aliases": [ "nadolol", "corgard", "metoprolol", "lopressor", "toprol", "atenolol", "tenormin", "propranolol", "inderal", "carvedilol", "coreg", "bisoprolol" ] }, { "id": "diuretics", "name": "Diuretics (water pills, any)", "short": "diuretics", "parent": "blood-pressure", "examples": [ "furosemide", "hydrochlorothiazide", "spironolactone" ], "aliases": [ "water pill", "diuretic" ] }, { "id": "loop-diuretics", "name": "Loop diuretics", "short": "loop diuretics", "parent": "diuretics", "examples": [ "furosemide (Lasix)", "bumetanide (Bumex)", "torsemide" ], "aliases": [ "furosemide", "lasix", "bumetanide", "bumex", "torsemide", "demadex", "ethacrynic acid", "edecrin" ] }, { "id": "thiazide-diuretics", "name": "Thiazide diuretics", "short": "thiazide diuretics", "parent": "diuretics", "examples": [ "hydrochlorothiazide (Microzide)", "chlorthalidone (Hygroton, Thalitone)", "chlorothiazide (Diuril)", "indapamide (Lozol)", "metolazone (Zaroxolyn)" ], "aliases": [ "hydrochlorothiazide", "hctz", "microzide", "chlorthalidone", "hygroton", "thalitone", "chlorothiazide", "diuril", "indapamide", "lozol", "metolazone", "zaroxolyn" ] }, { "id": "k-sparing-diuretics", "name": "Potassium-sparing diuretics", "short": "potassium-sparing diuretics", "parent": "diuretics", "examples": [ "spironolactone (Aldactone)", "amiloride (Midamor)", "eplerenone (Inspra)", "triamterene" ], "aliases": [ "spironolactone", "aldactone", "amiloride", "midamor", "eplerenone", "inspra", "triamterene", "dyrenium" ] }, { "id": "sedatives", "name": "Benzodiazepines and other sedatives", "short": "benzodiazepines/sedatives", "parent": null, "examples": [ "alprazolam (Xanax)", "lorazepam (Ativan)", "diazepam (Valium)", "clonazepam (Klonopin)", "zolpidem (Ambien)" ], "aliases": [ "alprazolam", "xanax", "lorazepam", "ativan", "diazepam", "valium", "clonazepam", "klonopin", "temazepam", "restoril", "zolpidem", "ambien", "eszopiclone", "lunesta", "benzodiazepine", "sedative", "sleeping pill" ] }, { "id": "immunosuppressants", "name": "Immunosuppressants", "short": "immunosuppressants", "parent": null, "examples": [ "cyclosporine (Neoral, Sandimmune)", "tacrolimus (Prograf)", "mycophenolate (CellCept)", "azathioprine (Imuran)" ], "aliases": [ "cyclosporine", "neoral", "sandimmune", "tacrolimus", "prograf", "mycophenolate", "cellcept", "azathioprine", "imuran", "sirolimus", "rapamune", "immunosuppressant", "transplant" ] }, { "id": "oral-contraceptives", "name": "Birth control pills (oral contraceptives)", "short": "birth control pills", "parent": null, "examples": [ "combined estrogen and progestin pills", "progestin-only pills" ], "aliases": [ "birth control", "the pill", "oral contraceptive", "yaz", "yasmin", "loestrin", "lo loestrin", "sprintec", "ortho tri-cyclen", "norethindrone", "levonorgestrel", "ethinyl estradiol", "drospirenone" ] }, { "id": "antibiotics", "name": "Antibiotics (any)", "short": "antibiotics", "parent": null, "examples": [ "amoxicillin", "azithromycin", "cephalexin", "doxycycline", "ciprofloxacin" ], "aliases": [ "amoxicillin", "augmentin", "azithromycin", "zithromax", "z-pak", "cephalexin", "keflex", "cefoperazone", "clindamycin", "penicillin", "pivampicillin", "nitrofurantoin", "macrobid", "sulfamethoxazole", "bactrim", "antibiotic" ] }, { "id": "tetracyclines", "name": "Tetracycline antibiotics", "short": "tetracyclines", "parent": "antibiotics", "examples": [ "doxycycline (Vibramycin)", "demeclocycline (Declomycin)", "minocycline", "tetracycline" ], "aliases": [ "doxycycline", "vibramycin", "doryx", "demeclocycline", "declomycin", "minocycline", "minocin", "solodyn", "tetracycline" ] }, { "id": "fluoroquinolones", "name": "Quinolone (fluoroquinolone) antibiotics", "short": "quinolones", "parent": "antibiotics", "examples": [ "ciprofloxacin (Cipro)", "levofloxacin (Levaquin)", "moxifloxacin (Avelox)", "gemifloxacin (Factive)" ], "aliases": [ "ciprofloxacin", "cipro", "levofloxacin", "levaquin", "moxifloxacin", "avelox", "gemifloxacin", "factive", "ofloxacin", "quinolone", "fluoroquinolone" ] }, { "id": "tb-drugs", "name": "Tuberculosis drugs", "short": "tuberculosis drugs", "parent": "antibiotics", "examples": [ "isoniazid", "pyrazinamide", "cycloserine (Seromycin)" ], "aliases": [ "isoniazid", "pyrazinamide", "rifater", "cycloserine", "seromycin" ] }, { "id": "acid-reducers", "name": "Stomach acid reducers (PPIs and H2 blockers)", "short": "acid reducers", "parent": null, "examples": [ "omeprazole (Prilosec)", "lansoprazole (Prevacid)", "famotidine (Pepcid)", "cimetidine (Tagamet)" ], "aliases": [ "acid reducer", "heartburn" ] }, { "id": "ppis", "name": "Proton pump inhibitors (PPIs)", "short": "PPIs", "parent": "acid-reducers", "examples": [ "omeprazole (Prilosec)", "esomeprazole (Nexium)", "lansoprazole (Prevacid)", "pantoprazole (Protonix)" ], "aliases": [ "omeprazole", "prilosec", "esomeprazole", "nexium", "lansoprazole", "prevacid", "pantoprazole", "protonix", "rabeprazole", "aciphex", "dexlansoprazole", "dexilant", "ppi" ] }, { "id": "h2-blockers", "name": "H2 blockers", "short": "H2 blockers", "parent": "acid-reducers", "examples": [ "famotidine (Pepcid)", "cimetidine (Tagamet)" ], "aliases": [ "famotidine", "pepcid", "cimetidine", "tagamet", "nizatidine" ] }, { "id": "chemotherapy", "name": "Cancer chemotherapy", "short": "chemotherapy", "parent": null, "examples": [ "cyclophosphamide", "doxorubicin", "cisplatin", "fluorouracil", "irinotecan", "imatinib", "docetaxel" ], "aliases": [ "chemotherapy", "chemo", "cyclophosphamide", "doxorubicin", "cisplatin", "fluorouracil", "5-fu", "irinotecan", "imatinib", "gleevec", "docetaxel", "taxotere", "chlorambucil", "carmustine", "busulfan", "thiotepa", "radiation" ] }, { "id": "lithium", "name": "Lithium", "short": "lithium", "parent": null, "examples": [ "lithium (Lithobid, Eskalith)" ], "aliases": [ "lithium", "lithobid", "eskalith" ] }, { "id": "anticonvulsants", "name": "Anticonvulsants (seizure medicines)", "short": "anticonvulsants", "parent": null, "examples": [ "phenytoin (Dilantin)", "carbamazepine (Tegretol)", "valproate (Depakote, Depakene)", "phenobarbital", "primidone (Mysoline)" ], "aliases": [ "phenytoin", "dilantin", "carbamazepine", "tegretol", "valproate", "valproic acid", "depakote", "depakene", "phenobarbital", "primidone", "mysoline", "levetiracetam", "keppra", "lamotrigine", "lamictal", "anticonvulsant", "seizure" ] }, { "id": "bisphosphonates", "name": "Bisphosphonates (osteoporosis)", "short": "bisphosphonates", "parent": null, "examples": [ "alendronate (Fosamax)", "risedronate (Actonel)", "ibandronate (Boniva)" ], "aliases": [ "alendronate", "fosamax", "risedronate", "actonel", "ibandronate", "boniva", "bisphosphonate" ] }, { "id": "raloxifene", "name": "Raloxifene", "short": "raloxifene", "parent": null, "examples": [ "raloxifene (Evista)" ], "aliases": [ "raloxifene", "evista" ] }, { "id": "levodopa", "name": "Levodopa (Parkinson disease)", "short": "levodopa", "parent": null, "examples": [ "carbidopa/levodopa (Sinemet, Stalevo)" ], "aliases": [ "levodopa", "l-dopa", "carbidopa", "sinemet", "stalevo", "rytary" ] }, { "id": "corticosteroids", "name": "Corticosteroids", "short": "corticosteroids", "parent": null, "examples": [ "prednisone", "prednisolone", "methylprednisolone (Medrol)", "dexamethasone" ], "aliases": [ "prednisone", "deltasone", "rayos", "prednisolone", "methylprednisolone", "medrol", "dexamethasone", "hydrocortisone", "steroid" ] }, { "id": "orlistat", "name": "Orlistat (weight loss)", "short": "orlistat", "parent": null, "examples": [ "orlistat (Alli, Xenical)" ], "aliases": [ "orlistat", "alli", "xenical" ] }, { "id": "hiv", "name": "HIV medicines (named in the sources)", "short": "HIV medicines", "parent": null, "examples": [ "dolutegravir (Tivicay, Dovato)", "indinavir", "nevirapine", "saquinavir" ], "aliases": [ "dolutegravir", "tivicay", "dovato", "triumeq", "indinavir", "crixivan", "nevirapine", "viramune", "saquinavir", "invirase" ] }, { "id": "heart-rhythm", "name": "Digoxin and ivabradine (heart medicines)", "short": "digoxin/ivabradine", "parent": null, "examples": [ "digoxin (Lanoxin)", "ivabradine (Corlanor)" ], "aliases": [ "digoxin", "lanoxin", "ivabradine", "corlanor", "cardiac glycoside" ] }, { "id": "methotrexate", "name": "Methotrexate", "short": "methotrexate", "parent": null, "examples": [ "methotrexate (Trexall, Rheumatrex)" ], "aliases": [ "methotrexate", "trexall", "rheumatrex", "otrexup" ] }, { "id": "retinoids", "name": "Oral retinoids", "short": "oral retinoids", "parent": null, "examples": [ "acitretin (Soriatane)", "bexarotene (Targretin)" ], "aliases": [ "acitretin", "soriatane", "bexarotene", "targretin", "isotretinoin", "accutane", "absorica", "claravis" ] }, { "id": "penicillamine", "name": "Penicillamine", "short": "penicillamine", "parent": null, "examples": [ "penicillamine (Cuprimine, Depen)" ], "aliases": [ "penicillamine", "cuprimine", "depen" ] }, { "id": "sulfasalazine", "name": "Sulfasalazine", "short": "sulfasalazine", "parent": null, "examples": [ "sulfasalazine (Azulfidine)" ], "aliases": [ "sulfasalazine", "azulfidine" ] }, { "id": "theophylline", "name": "Theophylline", "short": "theophylline", "parent": null, "examples": [ "theophylline (Elixophyllin, Theolair)" ], "aliases": [ "theophylline", "elixophyllin", "theolair", "theo-24", "uniphyl" ] }, { "id": "bile-acid-sequestrants", "name": "Bile acid sequestrants", "short": "bile acid sequestrants", "parent": null, "examples": [ "cholestyramine (Questran)", "colestipol (Colestid)" ], "aliases": [ "cholestyramine", "questran", "colestipol", "colestid", "colesevelam", "welchol" ] }, { "id": "migraine", "name": "Migraine medicines", "short": "migraine medicines", "parent": null, "examples": [ "sumatriptan (Imitrex)", "rizatriptan (Maxalt)" ], "aliases": [ "sumatriptan", "imitrex", "rizatriptan", "maxalt", "migraine" ] } ], "supplements": [ { "id": "ashwagandha", "name": "Ashwagandha", "aka": [ "withania somnifera", "ksm-66", "sensoril" ], "sources": [ "ods-ashwagandha", "nccih-ashwagandha" ], "guide": "/articles/guides/ashwagandha-guide/", "notes": [] }, { "id": "magnesium", "name": "Magnesium", "aka": [ "magnesium glycinate", "magnesium citrate", "magnesium oxide", "magnesium threonate" ], "sources": [ "ods-magnesium" ], "guide": "/articles/roundups/best-magnesium-supplement/", "notes": [] }, { "id": "vitamin-d", "name": "Vitamin D", "aka": [ "vitamin d3", "cholecalciferol", "vitamin d2", "ergocalciferol" ], "sources": [ "ods-vitamin-d" ], "guide": "/articles/roundups/best-vitamin-d-supplement/", "notes": [] }, { "id": "fish-oil", "name": "Fish oil (omega-3)", "aka": [ "omega-3", "omega 3", "epa", "dha", "krill oil" ], "sources": [ "ods-omega3" ], "guide": "/articles/roundups/best-omega-3-supplement/", "notes": [] }, { "id": "probiotics", "name": "Probiotics", "aka": [ "lactobacillus", "bifidobacterium", "saccharomyces", "acidophilus" ], "sources": [ "ods-probiotics", "nccih-probiotics" ], "guide": "/articles/roundups/best-probiotics/", "notes": [ { "src": "ods-probiotics", "quote": "most of these cases involved individuals who were severely ill or immunocompromised", "text": "NIH ODS: rare serious bloodstream infections linked to probiotics mostly involved people who were severely ill or immunocompromised." } ] }, { "id": "creatine", "name": "Creatine", "aka": [ "creatine monohydrate" ], "sources": [ "ods-exercise" ], "guide": "/articles/roundups/best-creatine-supplement/", "notes": [] }, { "id": "zinc", "name": "Zinc", "aka": [ "zinc gluconate", "zinc picolinate" ], "sources": [ "ods-zinc" ], "guide": null, "notes": [] }, { "id": "vitamin-c", "name": "Vitamin C", "aka": [ "ascorbic acid" ], "sources": [ "ods-vitamin-c" ], "guide": null, "notes": [] }, { "id": "vitamin-b12", "name": "Vitamin B12", "aka": [ "b12", "cobalamin", "methylcobalamin", "cyanocobalamin" ], "sources": [ "ods-b12" ], "guide": "/articles/roundups/best-b12-for-metformin-users/", "notes": [] }, { "id": "lions-mane", "name": "Lion's mane", "aka": [ "lions mane", "hericium erinaceus" ], "sources": [], "guide": "/articles/guides/lions-mane-guide/", "notes": [] }, { "id": "turmeric", "name": "Turmeric (curcumin)", "aka": [ "curcumin" ], "sources": [ "nccih-turmeric" ], "guide": "/articles/guides/best-turmeric-curcumin/", "notes": [ { "src": "nccih-turmeric", "quote": "liver damage has been reported in some people who have consumed these bioavailable formulations", "text": "NCCIH: liver damage has been reported with curcumin products made more bioavailable; it names no specific drug interaction." } ] }, { "id": "st-johns-wort", "name": "St. John's wort", "aka": [ "st johns wort", "hypericum" ], "sources": [ "nccih-sjw" ], "guide": null, "notes": [] }, { "id": "ginkgo", "name": "Ginkgo", "aka": [ "ginkgo biloba" ], "sources": [ "nccih-ginkgo" ], "guide": null, "notes": [] }, { "id": "melatonin", "name": "Melatonin", "aka": [], "sources": [ "nccih-melatonin" ], "guide": null, "notes": [ { "src": "nccih-melatonin", "quote": "people with epilepsy and those taking blood thinner medications need to be under medical supervision", "text": "NCCIH: people with epilepsy also need medical supervision when taking melatonin." } ] }, { "id": "berberine", "name": "Berberine", "aka": [], "sources": [], "guide": "/articles/guides/berberine-guide/", "notes": [ { "src": "nccih-goldenseal", "quote": "The berberine constituent of goldenseal", "text": "NIH publishes no berberine fact sheet. NCCIH documents a metformin interaction for goldenseal, an herb that contains berberine (see Goldenseal below); that finding is for goldenseal extract, not purified berberine." } ] }, { "id": "boswellia", "name": "Boswellia", "aka": [ "indian frankincense", "boswellia serrata" ], "sources": [ "nccih-boswellia" ], "guide": "/articles/guides/boswellia-guide/", "notes": [ { "src": "nccih-boswellia", "quote": "If you take medicine for asthma, talk with your provider before starting to take a dietary supplement.", "text": "NCCIH: if you take asthma medicine, talk with your provider before starting a supplement. It names no specific drug interaction." } ] }, { "id": "iron", "name": "Iron", "aka": [ "ferrous sulfate", "ferrous gluconate", "iron bisglycinate" ], "sources": [ "ods-iron" ], "guide": null, "notes": [] }, { "id": "calcium", "name": "Calcium", "aka": [ "calcium carbonate", "calcium citrate" ], "sources": [ "ods-calcium" ], "guide": null, "notes": [] }, { "id": "vitamin-k", "name": "Vitamin K", "aka": [ "vitamin k1", "vitamin k2", "phylloquinone", "menaquinone", "mk-7" ], "sources": [ "ods-vitamin-k" ], "guide": null, "notes": [] }, { "id": "coq10", "name": "CoQ10 (coenzyme Q10)", "aka": [ "coenzyme q10", "ubiquinol", "ubiquinone" ], "sources": [ "nccih-coq10" ], "guide": null, "notes": [] }, { "id": "rhodiola", "name": "Rhodiola", "aka": [ "rhodiola rosea", "golden root" ], "sources": [ "nccih-rhodiola" ], "guide": "/articles/guides/rhodiola-guide/", "notes": [] }, { "id": "valerian", "name": "Valerian", "aka": [ "valerian root" ], "sources": [ "nccih-valerian" ], "guide": null, "notes": [] }, { "id": "kava", "name": "Kava", "aka": [ "kava kava" ], "sources": [ "nccih-kava" ], "guide": null, "notes": [] }, { "id": "garlic", "name": "Garlic", "aka": [ "garlic extract", "aged garlic" ], "sources": [ "nccih-garlic" ], "guide": null, "notes": [] }, { "id": "ginseng", "name": "Ginseng (Asian)", "aka": [ "panax ginseng", "korean ginseng", "red ginseng" ], "sources": [ "nccih-ginseng", "ods-exercise" ], "guide": null, "notes": [ { "src": "nccih-ginseng", "quote": "Some evidence suggests that Asian ginseng might lower blood sugar levels.", "text": "NCCIH: Asian ginseng might lower blood sugar, so people with diabetes should consult a provider first." } ] }, { "id": "green-tea", "name": "Green tea extract", "aka": [ "green tea", "egcg", "camellia sinensis" ], "sources": [ "nccih-green-tea", "ods-weightloss" ], "guide": null, "notes": [] }, { "id": "5-htp", "name": "5-HTP", "aka": [ "5-hydroxytryptophan" ], "sources": [], "guide": null, "notes": [] }, { "id": "folate", "name": "Folate (folic acid)", "aka": [ "folic acid", "methylfolate", "l-methylfolate" ], "sources": [ "ods-folate" ], "guide": null, "notes": [] }, { "id": "selenium", "name": "Selenium", "aka": [], "sources": [ "ods-selenium" ], "guide": null, "notes": [] }, { "id": "vitamin-a", "name": "Vitamin A", "aka": [ "retinol", "beta-carotene" ], "sources": [ "ods-vitamin-a" ], "guide": null, "notes": [] }, { "id": "vitamin-e", "name": "Vitamin E", "aka": [ "tocopherol" ], "sources": [ "ods-vitamin-e" ], "guide": null, "notes": [] }, { "id": "vitamin-b6", "name": "Vitamin B6", "aka": [ "b6", "pyridoxine", "p5p" ], "sources": [ "ods-b6" ], "guide": null, "notes": [] }, { "id": "niacin", "name": "Niacin (vitamin B3)", "aka": [ "vitamin b3", "nicotinic acid", "niacinamide" ], "sources": [ "ods-niacin" ], "guide": null, "notes": [] }, { "id": "potassium", "name": "Potassium", "aka": [ "potassium chloride", "potassium citrate" ], "sources": [ "ods-potassium" ], "guide": null, "notes": [] }, { "id": "chromium", "name": "Chromium", "aka": [ "chromium picolinate" ], "sources": [ "ods-chromium" ], "guide": null, "notes": [] }, { "id": "iodine", "name": "Iodine (potassium iodide)", "aka": [ "potassium iodide", "kelp" ], "sources": [ "ods-iodine" ], "guide": null, "notes": [] }, { "id": "thiamin", "name": "Thiamin (vitamin B1)", "aka": [ "thiamine", "vitamin b1", "benfotiamine" ], "sources": [ "ods-thiamin" ], "guide": null, "notes": [] }, { "id": "biotin", "name": "Biotin", "aka": [ "vitamin b7" ], "sources": [ "ods-biotin" ], "guide": null, "notes": [] }, { "id": "carnitine", "name": "L-carnitine", "aka": [ "carnitine", "acetyl-l-carnitine", "alcar" ], "sources": [ "ods-carnitine" ], "guide": null, "notes": [] }, { "id": "goldenseal", "name": "Goldenseal", "aka": [ "hydrastis" ], "sources": [ "nccih-goldenseal" ], "guide": null, "notes": [] }, { "id": "echinacea", "name": "Echinacea", "aka": [], "sources": [ "nccih-echinacea" ], "guide": null, "notes": [] }, { "id": "licorice", "name": "Licorice root", "aka": [ "licorice", "glycyrrhizin" ], "sources": [ "nccih-licorice" ], "guide": null, "notes": [ { "src": "nccih-licorice", "quote": "in people with hypertension, and in people with heart or kidney conditions", "text": "NCCIH: glycyrrhizin in licorice has been linked to severe adverse effects in people with hypertension or heart or kidney conditions." } ] }, { "id": "cranberry", "name": "Cranberry", "aka": [], "sources": [ "nccih-cranberry" ], "guide": null, "notes": [] }, { "id": "flaxseed", "name": "Flaxseed (flaxseed oil)", "aka": [ "flaxseed oil", "linseed" ], "sources": [ "nccih-flaxseed" ], "guide": null, "notes": [] }, { "id": "cinnamon", "name": "Cinnamon", "aka": [ "cassia" ], "sources": [ "nccih-cinnamon" ], "guide": null, "notes": [] }, { "id": "chamomile", "name": "Chamomile", "aka": [], "sources": [ "nccih-chamomile" ], "guide": null, "notes": [] }, { "id": "bitter-orange", "name": "Bitter orange", "aka": [ "synephrine", "citrus aurantium" ], "sources": [ "nccih-bitter-orange", "ods-weightloss" ], "guide": null, "notes": [] }, { "id": "yohimbe", "name": "Yohimbe", "aka": [ "yohimbine" ], "sources": [ "nccih-yohimbe" ], "guide": null, "notes": [] }, { "id": "lavender", "name": "Lavender", "aka": [ "silexan" ], "sources": [ "nccih-lavender" ], "guide": null, "notes": [] }, { "id": "soy", "name": "Soy", "aka": [ "soy isoflavones" ], "sources": [ "nccih-soy" ], "guide": null, "notes": [] }, { "id": "aloe", "name": "Aloe (aloe latex)", "aka": [ "aloe vera" ], "sources": [ "nccih-aloe" ], "guide": null, "notes": [] }, { "id": "dandelion", "name": "Dandelion", "aka": [], "sources": [ "nccih-dandelion" ], "guide": null, "notes": [] }, { "id": "astragalus", "name": "Astragalus", "aka": [], "sources": [ "nccih-astragalus" ], "guide": null, "notes": [] }, { "id": "feverfew", "name": "Feverfew", "aka": [], "sources": [ "nccih-feverfew" ], "guide": null, "notes": [] }, { "id": "same", "name": "SAMe", "aka": [ "s-adenosyl-l-methionine", "s-adenosylmethionine" ], "sources": [ "nccih-same" ], "guide": null, "notes": [] }, { "id": "glucosamine", "name": "Glucosamine and chondroitin", "aka": [ "glucosamine", "chondroitin" ], "sources": [ "nccih-glucosamine" ], "guide": null, "notes": [] }, { "id": "black-cohosh", "name": "Black cohosh", "aka": [], "sources": [ "nccih-black-cohosh" ], "guide": null, "notes": [] }, { "id": "milk-thistle", "name": "Milk thistle", "aka": [ "silymarin" ], "sources": [ "nccih-milk-thistle" ], "guide": null, "notes": [] }, { "id": "saw-palmetto", "name": "Saw palmetto", "aka": [], "sources": [ "nccih-saw-palmetto" ], "guide": null, "notes": [] }, { "id": "ginger", "name": "Ginger", "aka": [], "sources": [ "nccih-ginger" ], "guide": null, "notes": [] }, { "id": "elderberry", "name": "Elderberry", "aka": [ "sambucus" ], "sources": [ "nccih-elderberry" ], "guide": null, "notes": [] }, { "id": "hawthorn", "name": "Hawthorn", "aka": [], "sources": [ "nccih-hawthorn" ], "guide": null, "notes": [ { "src": "nccih-hawthorn", "quote": "one possibility is that hawthorn might have interacted with drugs the patients were taking", "text": "NCCIH: one study of a hawthorn preparation in heart failure patients raised the possibility of an interaction with their drugs; no drug is named." } ] }, { "id": "red-yeast-rice", "name": "Red yeast rice", "aka": [ "monacolin k" ], "sources": [ "nccih-red-yeast-rice" ], "guide": null, "notes": [ { "src": "nccih-red-yeast-rice", "quote": "Red yeast rice products can have the same types of drug interactions as statin drugs", "text": "NCCIH: red yeast rice can contain monacolin K, which is identical to lovastatin, so it can have the same types of drug interactions as statin drugs." } ] } ], "interactions": [ { "id": "ashwagandha--levothyroxine", "supplement": "ashwagandha", "drugClass": "levothyroxine", "severity": "moderate", "kind": "affects-drug", "examples": "thyroid hormone medicines such as levothyroxine", "mechanism": "Ashwagandha may raise thyroid hormone levels: NIH ODS cites trials showing higher T3 and T4 and three case reports of thyrotoxicosis.", "whatToDo": "Ask your prescriber before combining them and expect thyroid levels to be rechecked if you start or stop it.", "source": "ods-ashwagandha", "quote": "These findings suggest that ashwagandha might interact with thyroid hormone medications.", "sourceUrl": "https://ods.od.nih.gov/factsheets/Ashwagandha-HealthProfessional/", "sourceOrg": "NIH ODS", "verified": "2026-10-13" }, { "id": "ashwagandha--diabetes", "supplement": "ashwagandha", "drugClass": "diabetes", "severity": "minor", "kind": "affects-drug", "examples": "diabetes medicines", "mechanism": "NIH lists diabetes medicines among the drugs ashwagandha might interact with; it does not describe the size of the effect.", "whatToDo": "Tell your prescriber and watch your blood sugar readings when you start or stop it.", "source": "nccih-ashwagandha", "quote": "There is evidence that ashwagandha might interact with some medications, including those for diabetes and high blood pressure", "sourceUrl": "https://www.nccih.nih.gov/health/ashwagandha", "sourceOrg": "NCCIH", "verified": "2026-10-13" }, { "id": "ashwagandha--blood-pressure", "supplement": "ashwagandha", "drugClass": "blood-pressure", "severity": "minor", "kind": "affects-drug", "examples": "high blood pressure medicines", "mechanism": "NIH lists blood pressure medicines among the drugs ashwagandha might interact with; it does not describe the size of the effect.", "whatToDo": "Tell your prescriber and keep checking your blood pressure if you start it.", "source": "nccih-ashwagandha", "quote": "There is evidence that ashwagandha might interact with some medications, including those for diabetes and high blood pressure", "sourceUrl": "https://www.nccih.nih.gov/health/ashwagandha", "sourceOrg": "NCCIH", "verified": "2026-10-13" }, { "id": "ashwagandha--immunosuppressants", "supplement": "ashwagandha", "drugClass": "immunosuppressants", "severity": "minor", "kind": "affects-drug", "examples": "immunosuppressants", "mechanism": "NIH lists immunosuppressants among the drugs ashwagandha might interact with, and NCCIH does not recommend it for people with autoimmune disorders.", "whatToDo": "Do not add it without asking the doctor who prescribes your immunosuppressant.", "source": "nccih-ashwagandha", "quote": "medicines that decrease the immune system response (immunosuppressants)", "sourceUrl": "https://www.nccih.nih.gov/health/ashwagandha", "sourceOrg": "NCCIH", "verified": "2026-10-13" }, { "id": "ashwagandha--sedatives", "supplement": "ashwagandha", "drugClass": "sedatives", "severity": "minor", "kind": "affects-drug", "examples": "sedatives", "mechanism": "Ashwagandha can cause drowsiness, and NIH lists sedatives among the drugs it might interact with.", "whatToDo": "Ask your pharmacist before combining it with a sedative or sleep medicine.", "source": "nccih-ashwagandha", "quote": "sedatives, anti-seizure medications (anticonvulsants), and thyroid hormone medications", "sourceUrl": "https://www.nccih.nih.gov/health/ashwagandha", "sourceOrg": "NCCIH", "verified": "2026-10-13" }, { "id": "ashwagandha--anticonvulsants", "supplement": "ashwagandha", "drugClass": "anticonvulsants", "severity": "minor", "kind": "affects-drug", "examples": "anti-seizure medicines", "mechanism": "NCCIH lists anti-seizure medicines among the drugs ashwagandha might interact with; it does not describe the size of the effect.", "whatToDo": "Ask your neurologist or pharmacist before adding it.", "source": "nccih-ashwagandha", "quote": "sedatives, anti-seizure medications (anticonvulsants), and thyroid hormone medications", "sourceUrl": "https://www.nccih.nih.gov/health/ashwagandha", "sourceOrg": "NCCIH", "verified": "2026-10-13" }, { "id": "magnesium--tetracyclines", "supplement": "magnesium", "drugClass": "tetracyclines", "severity": "moderate", "kind": "affects-drug", "examples": "demeclocycline (Declomycin), doxycycline (Vibramycin)", "mechanism": "Magnesium binds tetracyclines in the gut into insoluble complexes, so less antibiotic is absorbed.", "whatToDo": "Take the antibiotic at least 2 hours before or 4 to 6 hours after the magnesium.", "source": "ods-magnesium", "quote": "These antibiotics should be taken at least 2 hours before or 4 to 6 hours after a magnesium-containing supplement", "sourceUrl": "https://ods.od.nih.gov/factsheets/Magnesium-HealthProfessional/", "sourceOrg": "NIH ODS", "verified": "2026-10-13" }, { "id": "magnesium--fluoroquinolones", "supplement": "magnesium", "drugClass": "fluoroquinolones", "severity": "moderate", "kind": "affects-drug", "examples": "ciprofloxacin (Cipro), levofloxacin (Levaquin)", "mechanism": "Magnesium binds quinolone antibiotics in the gut into insoluble complexes, so less antibiotic is absorbed.", "whatToDo": "Take the antibiotic at least 2 hours before or 4 to 6 hours after the magnesium.", "source": "ods-magnesium", "quote": "These antibiotics should be taken at least 2 hours before or 4 to 6 hours after a magnesium-containing supplement", "sourceUrl": "https://ods.od.nih.gov/factsheets/Magnesium-HealthProfessional/", "sourceOrg": "NIH ODS", "verified": "2026-10-13" }, { "id": "magnesium--bisphosphonates", "supplement": "magnesium", "drugClass": "bisphosphonates", "severity": "moderate", "kind": "affects-drug", "examples": "alendronate (Fosamax)", "mechanism": "Magnesium-rich supplements can decrease the absorption of oral bisphosphonates.", "whatToDo": "Take magnesium at least 2 hours before or after the bisphosphonate.", "source": "ods-magnesium", "quote": "Taking magnesium-rich supplements or medications at least 2 hours before or after oral bisphosphonates can minimize this interaction", "sourceUrl": "https://ods.od.nih.gov/factsheets/Magnesium-HealthProfessional/", "sourceOrg": "NIH ODS", "verified": "2026-10-13" }, { "id": "magnesium--loop-diuretics", "supplement": "magnesium", "drugClass": "loop-diuretics", "severity": "moderate", "kind": "depletes", "examples": "furosemide (Lasix), bumetanide (Bumex)", "mechanism": "Long-term loop diuretic use increases magnesium loss in urine and can lead to magnesium depletion.", "whatToDo": "Ask your prescriber whether your magnesium level should be checked.", "source": "ods-magnesium", "quote": "can increase the loss of magnesium in urine and lead to magnesium depletion", "sourceUrl": "https://ods.od.nih.gov/factsheets/Magnesium-HealthProfessional/", "sourceOrg": "NIH ODS", "verified": "2026-10-13" }, { "id": "magnesium--thiazide-diuretics", "supplement": "magnesium", "drugClass": "thiazide-diuretics", "severity": "moderate", "kind": "depletes", "examples": "hydrochlorothiazide, ethacrynic acid (Edecrin)", "mechanism": "Long-term thiazide use increases magnesium loss in urine and can lead to magnesium depletion.", "whatToDo": "Ask your prescriber whether your magnesium level should be checked.", "source": "ods-magnesium", "quote": "can increase the loss of magnesium in urine and lead to magnesium depletion", "sourceUrl": "https://ods.od.nih.gov/factsheets/Magnesium-HealthProfessional/", "sourceOrg": "NIH ODS", "verified": "2026-10-13" }, { "id": "magnesium--k-sparing-diuretics", "supplement": "magnesium", "drugClass": "k-sparing-diuretics", "severity": "minor", "kind": "affects-drug", "examples": "amiloride (Midamor), spironolactone (Aldactone)", "mechanism": "Potassium-sparing diuretics reduce how much magnesium the kidneys excrete, the opposite of loop and thiazide diuretics.", "whatToDo": "Ask your prescriber before adding magnesium, since less of it is lost in urine.", "source": "ods-magnesium", "quote": "reduce magnesium excretion", "sourceUrl": "https://ods.od.nih.gov/factsheets/Magnesium-HealthProfessional/", "sourceOrg": "NIH ODS", "verified": "2026-10-13" }, { "id": "magnesium--ppis", "supplement": "magnesium", "drugClass": "ppis", "severity": "moderate", "kind": "depletes", "examples": "esomeprazole (Nexium), lansoprazole (Prevacid)", "mechanism": "PPIs taken for more than about a year can cause low blood magnesium; in a quarter of FDA-reviewed cases supplements did not correct it.", "whatToDo": "FDA advises checking magnesium before and periodically during long-term PPI treatment; ask your prescriber.", "source": "ods-magnesium", "quote": "can cause hypomagnesemia when taken for prolonged periods (typically more than a year)", "sourceUrl": "https://ods.od.nih.gov/factsheets/Magnesium-HealthProfessional/", "sourceOrg": "NIH ODS", "verified": "2026-10-13" }, { "id": "vitamin-d--statins", "supplement": "vitamin-d", "drugClass": "statins", "severity": "moderate", "kind": "affects-drug", "examples": "atorvastatin (Lipitor), lovastatin, simvastatin (Zocor)", "mechanism": "High vitamin D intakes and these statins appear to compete for the same metabolizing enzyme, which might reduce statin potency.", "whatToDo": "Tell your prescriber if you take high-dose vitamin D so cholesterol results can be read in context.", "source": "ods-vitamin-d", "quote": "might reduce the potency of atorvastatin (Lipitor), lovastatin (Altoprev and Mevacor), and simvastatin", "sourceUrl": "https://ods.od.nih.gov/factsheets/VitaminD-HealthProfessional/", "sourceOrg": "NIH ODS", "verified": "2026-10-13" }, { "id": "vitamin-d--thiazide-diuretics", "supplement": "vitamin-d", "drugClass": "thiazide-diuretics", "severity": "moderate", "kind": "affects-drug", "examples": "Hygroton, Lozol, Microzide", "mechanism": "Thiazides lower urinary calcium loss while vitamin D raises calcium absorption, which together can push blood calcium too high.", "whatToDo": "Ask your clinician before combining them, especially if you are older or have kidney problems.", "source": "ods-vitamin-d", "quote": "might lead to hypercalcemia, especially among older adults", "sourceUrl": "https://ods.od.nih.gov/factsheets/VitaminD-HealthProfessional/", "sourceOrg": "NIH ODS", "verified": "2026-10-13" }, { "id": "vitamin-d--corticosteroids", "supplement": "vitamin-d", "drugClass": "corticosteroids", "severity": "moderate", "kind": "depletes", "examples": "prednisone", "mechanism": "Corticosteroids can reduce calcium absorption and impair vitamin D metabolism; deficiency was twice as common in oral steroid users in NHANES.", "whatToDo": "Ask whether your vitamin D status should be checked on long-term steroids.", "source": "ods-vitamin-d", "quote": "These medications can reduce calcium absorption and impair vitamin D metabolism", "sourceUrl": "https://ods.od.nih.gov/factsheets/VitaminD-HealthProfessional/", "sourceOrg": "NIH ODS", "verified": "2026-10-13" }, { "id": "vitamin-d--orlistat", "supplement": "vitamin-d", "drugClass": "orlistat", "severity": "minor", "kind": "depletes", "examples": "orlistat (Xenical, alli)", "mechanism": "Orlistat with a reduced-fat diet can reduce vitamin D absorption from food and supplements.", "whatToDo": "Ask your clinician whether you need a vitamin D supplement while on orlistat.", "source": "ods-vitamin-d", "quote": "can reduce the absorption of vitamin D from food and supplements", "sourceUrl": "https://ods.od.nih.gov/factsheets/VitaminD-HealthProfessional/", "sourceOrg": "NIH ODS", "verified": "2026-10-13" }, { "id": "fish-oil--warfarin", "supplement": "fish-oil", "drugClass": "warfarin", "severity": "minor", "kind": "affects-drug", "examples": "warfarin (Coumadin)", "mechanism": "High-dose fish oil has antiplatelet effects and might raise INR, though most research finds 3 to 6 g a day does not significantly change anticoagulation.", "whatToDo": "Keep your usual INR checks; FDA labels for omega-3 drugs advise periodic INR monitoring with anticoagulants.", "source": "ods-omega3", "quote": "Fish oil might prolong clotting times, as indicated by an elevated international normalized ratio (INR), when it is taken with warfarin", "sourceUrl": "https://ods.od.nih.gov/factsheets/Omega3FattyAcids-HealthProfessional/", "sourceOrg": "NIH ODS", "verified": "2026-10-13" }, { "id": "probiotics--antibiotics", "supplement": "probiotics", "drugClass": "antibiotics", "severity": "none-known", "kind": "reviewed-safe", "examples": "antibiotics in general", "mechanism": "Probiotics are often given alongside antibiotics to lower the chance of antibiotic-associated diarrhea.", "whatToDo": "NCCIH considers the pair safe except for people who are very weak or immunocompromised; ask first if that applies to you.", "source": "nccih-probiotics", "quote": "the use of probiotics along with antibiotics appears to be safe, except for patients who are very weak or have poorly functioning immune systems", "sourceUrl": "https://www.nccih.nih.gov/health/probiotics-usefulness-and-safety", "sourceOrg": "NCCIH", "verified": "2026-10-13" }, { "id": "zinc--fluoroquinolones", "supplement": "zinc", "drugClass": "fluoroquinolones", "severity": "moderate", "kind": "affects-drug", "examples": "ciprofloxacin (Cipro)", "mechanism": "Zinc and quinolone antibiotics bind in the gut, which can reduce absorption of both.", "whatToDo": "Take the antibiotic at least 2 hours before or 4 to 6 hours after the zinc.", "source": "ods-zinc", "quote": "Taking the antibiotic at least 2 hours before or 4 to 6 hours after the zinc supplement minimizes this interaction", "sourceUrl": "https://ods.od.nih.gov/factsheets/Zinc-HealthProfessional/", "sourceOrg": "NIH ODS", "verified": "2026-10-13" }, { "id": "zinc--tetracyclines", "supplement": "zinc", "drugClass": "tetracyclines", "severity": "moderate", "kind": "affects-drug", "examples": "tetracycline (Achromycin, Sumycin)", "mechanism": "Zinc and tetracycline antibiotics bind in the gut, which can reduce absorption of both.", "whatToDo": "Take the antibiotic at least 2 hours before or 4 to 6 hours after the zinc.", "source": "ods-zinc", "quote": "Taking the antibiotic at least 2 hours before or 4 to 6 hours after the zinc supplement minimizes this interaction", "sourceUrl": "https://ods.od.nih.gov/factsheets/Zinc-HealthProfessional/", "sourceOrg": "NIH ODS", "verified": "2026-10-13" }, { "id": "zinc--penicillamine", "supplement": "zinc", "drugClass": "penicillamine", "severity": "moderate", "kind": "affects-drug", "examples": "penicillamine", "mechanism": "Zinc can reduce the absorption and action of penicillamine.", "whatToDo": "Take zinc and penicillamine at least 1 hour apart.", "source": "ods-zinc", "quote": "people should take zinc supplements and penicillamine at least 1 hour apart", "sourceUrl": "https://ods.od.nih.gov/factsheets/Zinc-HealthProfessional/", "sourceOrg": "NIH ODS", "verified": "2026-10-13" }, { "id": "zinc--thiazide-diuretics", "supplement": "zinc", "drugClass": "thiazide-diuretics", "severity": "minor", "kind": "depletes", "examples": "chlorthalidone, hydrochlorothiazide", "mechanism": "Thiazide diuretics increase zinc loss in urine and lower serum zinc.", "whatToDo": "Ask your prescriber whether your zinc status needs attention on long-term thiazides.", "source": "ods-zinc", "quote": "increase zinc excretion in the urine", "sourceUrl": "https://ods.od.nih.gov/factsheets/Zinc-HealthProfessional/", "sourceOrg": "NIH ODS", "verified": "2026-10-13" }, { "id": "vitamin-c--chemotherapy", "supplement": "vitamin-c", "drugClass": "chemotherapy", "severity": "minor", "kind": "affects-drug", "examples": "cyclophosphamide, chlorambucil, carmustine, busulfan, thiotepa, doxorubicin", "mechanism": "Whether antioxidants protect tumor cells from chemotherapy is controversial, and it is unclear oral vitamin C changes levels enough to matter.", "whatToDo": "Consult your oncologist before taking vitamin C, especially in high doses.", "source": "ods-vitamin-c", "quote": "Individuals who are undergoing chemotherapy or radiation should consult with their oncologist prior to taking vitamin C or other antioxidant supplements", "sourceUrl": "https://ods.od.nih.gov/factsheets/VitaminC-HealthProfessional/", "sourceOrg": "NIH ODS", "verified": "2026-10-13" }, { "id": "vitamin-c--statins", "supplement": "vitamin-c", "drugClass": "statins", "severity": "minor", "kind": "affects-drug", "examples": "simvastatin (Zocor) with niacin", "mechanism": "Vitamin C with other antioxidants may blunt the HDL rise from niacin plus simvastatin; other regimens are not known to be affected.", "whatToDo": "Your clinician may monitor lipid levels if you take antioxidants with a statin.", "source": "ods-vitamin-c", "quote": "may attenuate the increase in high-density lipoprotein levels that result from taking combination niacin/simvastatin (Zocor) therapy", "sourceUrl": "https://ods.od.nih.gov/factsheets/VitaminC-HealthProfessional/", "sourceOrg": "NIH ODS", "verified": "2026-10-13" }, { "id": "vitamin-b12--acid-reducers", "supplement": "vitamin-b12", "drugClass": "acid-reducers", "severity": "moderate", "kind": "depletes", "examples": "omeprazole (Prilosec), lansoprazole (Prevacid), cimetidine (Tagamet)", "mechanism": "Acid reducers slow gastric acid release, which interferes with B12 absorption from food and can lead to deficiency.", "whatToDo": "Ask your clinician about checking B12 on long-term acid reducers.", "source": "ods-b12", "quote": "thereby lead to vitamin B12 deficiency", "sourceUrl": "https://ods.od.nih.gov/factsheets/VitaminB12-HealthProfessional/", "sourceOrg": "NIH ODS", "verified": "2026-10-13" }, { "id": "vitamin-b12--metformin", "supplement": "vitamin-b12", "drugClass": "metformin", "severity": "moderate", "kind": "depletes", "examples": "metformin", "mechanism": "Metformin might reduce B12 absorption and significantly lower serum B12 levels.", "whatToDo": "Ask your clinician whether your B12 level should be checked while you take metformin.", "source": "ods-b12", "quote": "might reduce the absorption of vitamin B12 and significantly reduce serum vitamin B12 concentrations", "sourceUrl": "https://ods.od.nih.gov/factsheets/VitaminB12-HealthProfessional/", "sourceOrg": "NIH ODS", "verified": "2026-10-13" }, { "id": "iron--levodopa", "supplement": "iron", "drugClass": "levodopa", "severity": "moderate", "kind": "affects-drug", "examples": "levodopa (Sinemet, Stalevo)", "mechanism": "Iron may bind levodopa and reduce how much reaches the body; US levodopa labels carry this warning.", "whatToDo": "Take iron at a different time of day than levodopa and ask your pharmacist about timing.", "source": "ods-iron", "quote": "the labels for levodopa warn that iron-containing dietary supplements might reduce the amount of levodopa available to the body", "sourceUrl": "https://ods.od.nih.gov/factsheets/Iron-HealthProfessional/", "sourceOrg": "NIH ODS", "verified": "2026-10-13" }, { "id": "iron--levothyroxine", "supplement": "iron", "drugClass": "levothyroxine", "severity": "moderate", "kind": "affects-drug", "examples": "levothyroxine (Synthroid, Levoxyl, Unithroid, Tirosint)", "mechanism": "Taking iron and levothyroxine together can significantly reduce levothyroxine absorption.", "whatToDo": "Do not take levothyroxine within 4 hours of an iron supplement.", "source": "ods-iron", "quote": "advise against administering levothyroxine within 4 hours of iron supplements", "sourceUrl": "https://ods.od.nih.gov/factsheets/Iron-HealthProfessional/", "sourceOrg": "NIH ODS", "verified": "2026-10-13" }, { "id": "iron--ppis", "supplement": "iron", "drugClass": "ppis", "severity": "minor", "kind": "depletes", "examples": "lansoprazole (Prevacid), omeprazole (Prilosec)", "mechanism": "PPIs reduce stomach acid, which can reduce iron absorption; people with normal iron stores are not depleted.", "whatToDo": "If you are iron deficient and on a PPI, tell your clinician, since response to iron can be weaker.", "source": "ods-iron", "quote": "patients with iron deficiency taking proton pump inhibitors can have suboptimal responses to iron supplementation", "sourceUrl": "https://ods.od.nih.gov/factsheets/Iron-HealthProfessional/", "sourceOrg": "NIH ODS", "verified": "2026-10-13" }, { "id": "calcium--hiv", "supplement": "calcium", "drugClass": "hiv", "severity": "moderate", "kind": "affects-drug", "examples": "dolutegravir (Tivicay, Dovato)", "mechanism": "Calcium can substantially lower dolutegravir blood levels, apparently by binding it.", "whatToDo": "Take dolutegravir 2 hours before or 6 hours after calcium, as the FDA label advises.", "source": "ods-calcium", "quote": "advise patients to take dolutegravir 2 hours before or 6 hours after taking calcium supplements", "sourceUrl": "https://ods.od.nih.gov/factsheets/Calcium-HealthProfessional/", "sourceOrg": "NIH ODS", "verified": "2026-10-13" }, { "id": "calcium--levothyroxine", "supplement": "calcium", "drugClass": "levothyroxine", "severity": "moderate", "kind": "affects-drug", "examples": "levothyroxine (Synthroid, Levoxyl)", "mechanism": "Calcium carbonate can interfere with levothyroxine absorption.", "whatToDo": "Do not take levothyroxine within 4 hours of calcium carbonate.", "source": "ods-calcium", "quote": "avoid taking levothyroxine within 4 hours of taking the supplement", "sourceUrl": "https://ods.od.nih.gov/factsheets/Calcium-HealthProfessional/", "sourceOrg": "NIH ODS", "verified": "2026-10-13" }, { "id": "calcium--lithium", "supplement": "calcium", "drugClass": "lithium", "severity": "moderate", "kind": "affects-drug", "examples": "lithium (Eskalith, Lithobid)", "mechanism": "Long-term lithium can cause high blood calcium, and calcium supplements could add to that risk.", "whatToDo": "Ask your prescriber before taking calcium supplements with lithium.", "source": "ods-calcium", "quote": "use of both lithium and calcium supplements could increase this risk", "sourceUrl": "https://ods.od.nih.gov/factsheets/Calcium-HealthProfessional/", "sourceOrg": "NIH ODS", "verified": "2026-10-13" }, { "id": "calcium--fluoroquinolones", "supplement": "calcium", "drugClass": "fluoroquinolones", "severity": "moderate", "kind": "affects-drug", "examples": "ciprofloxacin (Cipro), gemifloxacin (Factive), moxifloxacin (Avelox)", "mechanism": "Taking calcium at the same time can reduce absorption of quinolone antibiotics.", "whatToDo": "Take the antibiotic 2 hours before or 2 hours after calcium.", "source": "ods-calcium", "quote": "Taking the antibiotic 2 hours before or 2 hours after calcium supplements prevents this effect", "sourceUrl": "https://ods.od.nih.gov/factsheets/Calcium-HealthProfessional/", "sourceOrg": "NIH ODS", "verified": "2026-10-13" }, { "id": "vitamin-k--warfarin", "supplement": "vitamin-k", "drugClass": "warfarin", "severity": "major", "kind": "affects-drug", "examples": "warfarin (Coumadin), phenprocoumon, acenocoumarol", "mechanism": "Warfarin works by blocking vitamin K, so a sudden change in vitamin K intake can raise or lower its effect.", "whatToDo": "Do not start or stop vitamin K supplements on warfarin without your prescriber; keep your vitamin K intake consistent.", "source": "ods-vitamin-k", "quote": "Vitamin K can have a serious and potentially dangerous interaction with anticoagulants such as warfarin", "sourceUrl": "https://ods.od.nih.gov/factsheets/VitaminK-HealthProfessional/", "sourceOrg": "NIH ODS", "verified": "2026-10-13" }, { "id": "vitamin-k--antibiotics", "supplement": "vitamin-k", "drugClass": "antibiotics", "severity": "minor", "kind": "depletes", "examples": "cephalosporins such as cefoperazone", "mechanism": "Antibiotics can kill vitamin K-producing gut bacteria; cephalosporins may also block vitamin K action.", "whatToDo": "Supplements are usually not needed unless antibiotics run for several weeks with a poor vitamin K intake.", "source": "ods-vitamin-k", "quote": "Vitamin K supplements are usually not needed unless antibiotic use is prolonged (beyond several weeks) and accompanied by poor vitamin K intake", "sourceUrl": "https://ods.od.nih.gov/factsheets/VitaminK-HealthProfessional/", "sourceOrg": "NIH ODS", "verified": "2026-10-13" }, { "id": "vitamin-k--bile-acid-sequestrants", "supplement": "vitamin-k", "drugClass": "bile-acid-sequestrants", "severity": "minor", "kind": "depletes", "examples": "cholestyramine (Questran), colestipol (Colestid)", "mechanism": "Bile acid sequestrants can reduce absorption of vitamin K and other fat-soluble vitamins.", "whatToDo": "Ask whether vitamin K status should be monitored if you take these for many years.", "source": "ods-vitamin-k", "quote": "although the clinical significance of this effect is not clear", "sourceUrl": "https://ods.od.nih.gov/factsheets/VitaminK-HealthProfessional/", "sourceOrg": "NIH ODS", "verified": "2026-10-13" }, { "id": "vitamin-k--orlistat", "supplement": "vitamin-k", "drugClass": "orlistat", "severity": "minor", "kind": "depletes", "examples": "orlistat (Alli, Xenical)", "mechanism": "Orlistat reduces fat absorption and with it the absorption of fat-soluble vitamins such as vitamin K.", "whatToDo": "Clinicians usually recommend a multivitamin with vitamin K while on orlistat; ask yours.", "source": "ods-vitamin-k", "quote": "it can also reduce the absorption of fat-soluble vitamins, such as vitamin K", "sourceUrl": "https://ods.od.nih.gov/factsheets/VitaminK-HealthProfessional/", "sourceOrg": "NIH ODS", "verified": "2026-10-13" }, { "id": "folate--methotrexate", "supplement": "folate", "drugClass": "methotrexate", "severity": "moderate", "kind": "affects-drug", "examples": "methotrexate (Rheumatrex, Trexall)", "mechanism": "Methotrexate is a folate antagonist, so folate could interfere with its anticancer effect; at low doses for arthritis or psoriasis folate may reduce side effects.", "whatToDo": "If you take methotrexate for cancer, consult your oncologist before taking folate.", "source": "ods-folate", "quote": "Patients taking methotrexate for cancer should consult their oncologist before taking folate supplements", "sourceUrl": "https://ods.od.nih.gov/factsheets/Folate-HealthProfessional/", "sourceOrg": "NIH ODS", "verified": "2026-10-13" }, { "id": "folate--anticonvulsants", "supplement": "folate", "drugClass": "anticonvulsants", "severity": "moderate", "kind": "affects-drug", "examples": "phenytoin (Dilantin), carbamazepine (Tegretol), valproate (Depacon)", "mechanism": "These drugs can lower folate levels, and folate supplements might lower blood levels of the drugs.", "whatToDo": "Check with your prescriber before taking folate with an antiepileptic drug.", "source": "ods-folate", "quote": "folate supplements might reduce serum levels of these medications", "sourceUrl": "https://ods.od.nih.gov/factsheets/Folate-HealthProfessional/", "sourceOrg": "NIH ODS", "verified": "2026-10-13" }, { "id": "folate--sulfasalazine", "supplement": "folate", "drugClass": "sulfasalazine", "severity": "moderate", "kind": "depletes", "examples": "sulfasalazine (Azulfidine)", "mechanism": "Sulfasalazine blocks folate absorption in the gut and can cause folate deficiency.", "whatToDo": "Ask your prescriber whether you need more dietary folate, a supplement, or both.", "source": "ods-folate", "quote": "It inhibits the intestinal absorption of folate and can cause folate deficiency", "sourceUrl": "https://ods.od.nih.gov/factsheets/Folate-HealthProfessional/", "sourceOrg": "NIH ODS", "verified": "2026-10-13" }, { "id": "selenium--chemotherapy", "supplement": "selenium", "drugClass": "chemotherapy", "severity": "minor", "kind": "depletes", "examples": "cisplatin", "mechanism": "Cisplatin can lower selenium levels; whether that matters clinically is not known.", "whatToDo": "Ask your oncologist before adding selenium during cisplatin treatment.", "source": "ods-selenium", "quote": "whether these reductions have a clinically significant impact is not known", "sourceUrl": "https://ods.od.nih.gov/factsheets/Selenium-HealthProfessional/", "sourceOrg": "NIH ODS", "verified": "2026-10-13" }, { "id": "vitamin-a--retinoids", "supplement": "vitamin-a", "drugClass": "retinoids", "severity": "moderate", "kind": "affects-drug", "examples": "acitretin (Soriatane), bexarotene (Targretin)", "mechanism": "Oral retinoids are derived from vitamin A, so adding vitamin A supplements raises the risk of vitamin A toxicity.", "whatToDo": "Do not add vitamin A supplements to an oral retinoid without your prescriber.", "source": "ods-vitamin-a", "quote": "Retinoids can increase the risk of hypervitaminosis A when taken in combination with vitamin A supplements", "sourceUrl": "https://ods.od.nih.gov/factsheets/VitaminA-HealthProfessional/", "sourceOrg": "NIH ODS", "verified": "2026-10-13" }, { "id": "vitamin-a--orlistat", "supplement": "vitamin-a", "drugClass": "orlistat", "severity": "minor", "kind": "depletes", "examples": "orlistat (Alli, Xenical)", "mechanism": "Orlistat can decrease absorption of vitamin A and beta-carotene.", "whatToDo": "The manufacturers recommend a multivitamin with vitamin A and beta-carotene; ask your clinician about timing.", "source": "ods-vitamin-a", "quote": "can decrease the absorption of vitamin A, other fat-soluble vitamins, and beta-carotene", "sourceUrl": "https://ods.od.nih.gov/factsheets/VitaminA-HealthProfessional/", "sourceOrg": "NIH ODS", "verified": "2026-10-13" }, { "id": "vitamin-e--anticoagulants", "supplement": "vitamin-e", "drugClass": "anticoagulants", "severity": "moderate", "kind": "affects-drug", "examples": "warfarin (Coumadin)", "mechanism": "Vitamin E can inhibit platelets and oppose vitamin K clotting factors; large doses (probably over 400 IU a day) can raise bleeding risk.", "whatToDo": "Ask your prescriber before taking high-dose vitamin E with a blood thinner.", "source": "ods-vitamin-e", "quote": "can increase the risk of bleeding", "sourceUrl": "https://ods.od.nih.gov/factsheets/VitaminE-HealthProfessional/", "sourceOrg": "NIH ODS", "verified": "2026-10-13" }, { "id": "vitamin-e--antiplatelets", "supplement": "vitamin-e", "drugClass": "antiplatelets", "severity": "moderate", "kind": "affects-drug", "examples": "antiplatelet medicines", "mechanism": "Vitamin E can inhibit platelet aggregation, so large doses with antiplatelet drugs can raise bleeding risk.", "whatToDo": "Ask your prescriber before taking high-dose vitamin E with an antiplatelet drug.", "source": "ods-vitamin-e", "quote": "taking large doses with anticoagulant or antiplatelet medications, such as warfarin (Coumadin), can increase the risk of bleeding", "sourceUrl": "https://ods.od.nih.gov/factsheets/VitaminE-HealthProfessional/", "sourceOrg": "NIH ODS", "verified": "2026-10-13" }, { "id": "vitamin-e--statins", "supplement": "vitamin-e", "drugClass": "statins", "severity": "minor", "kind": "affects-drug", "examples": "simvastatin (Zocor) with niacin", "mechanism": "An antioxidant mix including vitamin E blunted the HDL rise in people on simvastatin plus niacin.", "whatToDo": "Tell your clinician if you take antioxidant supplements with this combination.", "source": "ods-vitamin-e", "quote": "blunted the rise in high-density lipoprotein (HDL) cholesterol levels", "sourceUrl": "https://ods.od.nih.gov/factsheets/VitaminE-HealthProfessional/", "sourceOrg": "NIH ODS", "verified": "2026-10-13" }, { "id": "vitamin-e--chemotherapy", "supplement": "vitamin-e", "drugClass": "chemotherapy", "severity": "moderate", "kind": "affects-drug", "examples": "chemotherapy and radiotherapy", "mechanism": "Antioxidants might reduce how well chemotherapy and radiation damage cancer cells; a systematic review has questioned this.", "whatToDo": "Oncologists generally advise against antioxidant supplements during treatment; ask yours.", "source": "ods-vitamin-e", "quote": "Oncologists generally advise against the use of antioxidant supplements during cancer chemotherapy or radiotherapy", "sourceUrl": "https://ods.od.nih.gov/factsheets/VitaminE-HealthProfessional/", "sourceOrg": "NIH ODS", "verified": "2026-10-13" }, { "id": "vitamin-b6--anticonvulsants", "supplement": "vitamin-b6", "drugClass": "anticonvulsants", "severity": "moderate", "kind": "affects-drug", "examples": "phenytoin (Dilantin), phenobarbital, valproic acid, carbamazepine", "mechanism": "High-dose pyridoxine (200 mg a day) can lower phenytoin and phenobarbital levels, and these drugs also lower B6.", "whatToDo": "Tell your neurologist before taking high-dose B6 with an antiepileptic drug.", "source": "ods-b6", "quote": "can reduce serum concentrations of phenytoin and phenobarbital", "sourceUrl": "https://ods.od.nih.gov/factsheets/VitaminB6-HealthProfessional/", "sourceOrg": "NIH ODS", "verified": "2026-10-13" }, { "id": "vitamin-b6--tb-drugs", "supplement": "vitamin-b6", "drugClass": "tb-drugs", "severity": "moderate", "kind": "depletes", "examples": "cycloserine (Seromycin)", "mechanism": "Cycloserine increases B6 loss in urine, which might worsen its seizure and nerve side effects.", "whatToDo": "B6 supplements can help prevent these effects; take them as your prescriber directs.", "source": "ods-b6", "quote": "Pyridoxine supplements can help prevent these adverse effects.", "sourceUrl": "https://ods.od.nih.gov/factsheets/VitaminB6-HealthProfessional/", "sourceOrg": "NIH ODS", "verified": "2026-10-13" }, { "id": "vitamin-b6--theophylline", "supplement": "vitamin-b6", "drugClass": "theophylline", "severity": "minor", "kind": "depletes", "examples": "theophylline", "mechanism": "People on theophylline often have low B6 (PLP) levels, which could contribute to its nervous system side effects.", "whatToDo": "Ask your prescriber whether your B6 status matters on theophylline.", "source": "ods-b6", "quote": "Patients treated with theophylline often have low plasma PLP concentrations", "sourceUrl": "https://ods.od.nih.gov/factsheets/VitaminB6-HealthProfessional/", "sourceOrg": "NIH ODS", "verified": "2026-10-13" }, { "id": "niacin--diabetes", "supplement": "niacin", "drugClass": "diabetes", "severity": "moderate", "kind": "affects-drug", "examples": "any antidiabetes medicine", "mechanism": "Large doses of nicotinic acid (1.5 g a day or more) can raise blood glucose by worsening insulin resistance.", "whatToDo": "Have blood glucose monitored if you take high-dose niacin with diabetes medicine; doses may need adjusting.", "source": "ods-niacin", "quote": "People who take any antidiabetes medications should have their blood glucose levels monitored if they take high-dose nicotinic acid supplements concomitantly", "sourceUrl": "https://ods.od.nih.gov/factsheets/Niacin-HealthProfessional/", "sourceOrg": "NIH ODS", "verified": "2026-10-13" }, { "id": "niacin--tb-drugs", "supplement": "niacin", "drugClass": "tb-drugs", "severity": "moderate", "kind": "depletes", "examples": "isoniazid, pyrazinamide (Rifater)", "mechanism": "These TB drugs interfere with the body making niacin, and pellagra can occur.", "whatToDo": "Ask your prescriber about extra niacin during TB treatment.", "source": "ods-niacin", "quote": "it can be prevented with increased intakes of niacin", "sourceUrl": "https://ods.od.nih.gov/factsheets/Niacin-HealthProfessional/", "sourceOrg": "NIH ODS", "verified": "2026-10-13" }, { "id": "potassium--ace-inhibitors", "supplement": "potassium", "drugClass": "ace-inhibitors", "severity": "moderate", "kind": "affects-drug", "examples": "benazepril (Lotensin)", "mechanism": "ACE inhibitors reduce potassium loss in urine, so extra potassium can lead to high blood potassium.", "whatToDo": "Do not take potassium supplements with an ACE inhibitor unless your prescriber says so; potassium should be monitored.", "source": "ods-potassium", "quote": "These medications reduce urinary potassium excretion, which can lead to hyperkalemia.", "sourceUrl": "https://ods.od.nih.gov/factsheets/Potassium-HealthProfessional/", "sourceOrg": "NIH ODS", "verified": "2026-10-13" }, { "id": "potassium--arbs", "supplement": "potassium", "drugClass": "arbs", "severity": "moderate", "kind": "affects-drug", "examples": "losartan (Cozaar)", "mechanism": "ARBs reduce potassium loss in urine, so extra potassium can lead to high blood potassium.", "whatToDo": "Do not take potassium supplements with an ARB unless your prescriber says so; potassium should be monitored.", "source": "ods-potassium", "quote": "These medications reduce urinary potassium excretion, which can lead to hyperkalemia.", "sourceUrl": "https://ods.od.nih.gov/factsheets/Potassium-HealthProfessional/", "sourceOrg": "NIH ODS", "verified": "2026-10-13" }, { "id": "potassium--k-sparing-diuretics", "supplement": "potassium", "drugClass": "k-sparing-diuretics", "severity": "moderate", "kind": "affects-drug", "examples": "amiloride (Midamor), spironolactone (Aldactone)", "mechanism": "These diuretics hold potassium in the body and can cause high blood potassium on their own.", "whatToDo": "Do not add potassium supplements unless your prescriber says so; potassium should be monitored.", "source": "ods-potassium", "quote": "reduce the excretion of potassium in the urine and can cause hyperkalemia", "sourceUrl": "https://ods.od.nih.gov/factsheets/Potassium-HealthProfessional/", "sourceOrg": "NIH ODS", "verified": "2026-10-13" }, { "id": "potassium--loop-diuretics", "supplement": "potassium", "drugClass": "loop-diuretics", "severity": "moderate", "kind": "depletes", "examples": "furosemide (Lasix), bumetanide (Bumex)", "mechanism": "Loop diuretics increase potassium loss in urine and can cause low blood potassium.", "whatToDo": "Potassium is monitored on these drugs and supplements are started only if warranted; follow your prescriber.", "source": "ods-potassium", "quote": "increases urinary potassium excretion and can lead to hypokalemia", "sourceUrl": "https://ods.od.nih.gov/factsheets/Potassium-HealthProfessional/", "sourceOrg": "NIH ODS", "verified": "2026-10-13" }, { "id": "potassium--thiazide-diuretics", "supplement": "potassium", "drugClass": "thiazide-diuretics", "severity": "moderate", "kind": "depletes", "examples": "chlorothiazide (Diuril), metolazone (Zaroxolyn)", "mechanism": "Thiazide diuretics increase potassium loss in urine and can cause low blood potassium.", "whatToDo": "Potassium is monitored on these drugs and supplements are started only if warranted; follow your prescriber.", "source": "ods-potassium", "quote": "increases urinary potassium excretion and can lead to hypokalemia", "sourceUrl": "https://ods.od.nih.gov/factsheets/Potassium-HealthProfessional/", "sourceOrg": "NIH ODS", "verified": "2026-10-13" }, { "id": "chromium--insulin", "supplement": "chromium", "drugClass": "insulin", "severity": "moderate", "kind": "affects-drug", "examples": "insulin", "mechanism": "Chromium might increase insulin sensitivity, adding to the glucose-lowering effect of insulin.", "whatToDo": "Ask your prescriber first and watch for low blood sugar.", "source": "ods-chromium", "quote": "Taking chromium concomitantly with insulin could increase the risk of hypoglycemia", "sourceUrl": "https://ods.od.nih.gov/factsheets/Chromium-HealthProfessional/", "sourceOrg": "NIH ODS", "verified": "2026-10-13" }, { "id": "chromium--diabetes", "supplement": "chromium", "drugClass": "diabetes", "severity": "moderate", "kind": "affects-drug", "examples": "metformin and other antidiabetes medicines", "mechanism": "Chromium might lower blood glucose, adding to the effect of diabetes medicines.", "whatToDo": "Ask your prescriber first and watch for low blood sugar.", "source": "ods-chromium", "quote": "might have an additive effect with metformin or other antidiabetes medications and thus might increase the risk of hypoglycemia", "sourceUrl": "https://ods.od.nih.gov/factsheets/Chromium-HealthProfessional/", "sourceOrg": "NIH ODS", "verified": "2026-10-13" }, { "id": "chromium--levothyroxine", "supplement": "chromium", "drugClass": "levothyroxine", "severity": "moderate", "kind": "affects-drug", "examples": "levothyroxine", "mechanism": "In a small study, chromium picolinate taken at the same time as levothyroxine decreased its absorption.", "whatToDo": "Do not take them at the same time; ask your pharmacist how far apart to space them.", "source": "ods-chromium", "quote": "taking chromium picolinate supplements at the same time as levothyroxine (used to treat hypothyroidism) decreases levothyroxine absorption over 6 hours", "sourceUrl": "https://ods.od.nih.gov/factsheets/Chromium-HealthProfessional/", "sourceOrg": "NIH ODS", "verified": "2026-10-13" }, { "id": "iodine--antithyroid", "supplement": "iodine", "drugClass": "antithyroid", "severity": "moderate", "kind": "affects-drug", "examples": "methimazole (Tapazole)", "mechanism": "High-dose iodine adds to the effect of antithyroid drugs and could cause hypothyroidism.", "whatToDo": "Do not take high-dose iodine with an antithyroid drug unless your prescriber says so.", "source": "ods-iodine", "quote": "Taking high doses of iodine with antithyroid medications can have an additive effect", "sourceUrl": "https://ods.od.nih.gov/factsheets/Iodine-HealthProfessional/", "sourceOrg": "NIH ODS", "verified": "2026-10-13" }, { "id": "iodine--ace-inhibitors", "supplement": "iodine", "drugClass": "ace-inhibitors", "severity": "moderate", "kind": "affects-drug", "examples": "benazepril (Lotensin), lisinopril (Prinivil, Zestril), fosinopril (Monopril)", "mechanism": "Potassium iodide adds potassium while ACE inhibitors reduce its loss, raising the risk of high blood potassium.", "whatToDo": "Ask your prescriber before taking potassium iodide with an ACE inhibitor.", "source": "ods-iodine", "quote": "Taking potassium iodide with ACE inhibitors can increase the risk of hyperkalemia", "sourceUrl": "https://ods.od.nih.gov/factsheets/Iodine-HealthProfessional/", "sourceOrg": "NIH ODS", "verified": "2026-10-13" }, { "id": "iodine--k-sparing-diuretics", "supplement": "iodine", "drugClass": "k-sparing-diuretics", "severity": "moderate", "kind": "affects-drug", "examples": "spironolactone (Aldactone), amiloride (Midamor)", "mechanism": "Potassium iodide adds potassium while these diuretics hold it in, raising the risk of high blood potassium.", "whatToDo": "Ask your prescriber before taking potassium iodide with a potassium-sparing diuretic.", "source": "ods-iodine", "quote": "Taking potassium iodide with potassium-sparing diuretics, such as spironolactone (Aldactone) and amiloride (Midamor), can increase the risk of hyperkalemia", "sourceUrl": "https://ods.od.nih.gov/factsheets/Iodine-HealthProfessional/", "sourceOrg": "NIH ODS", "verified": "2026-10-13" }, { "id": "thiamin--loop-diuretics", "supplement": "thiamin", "drugClass": "loop-diuretics", "severity": "minor", "kind": "depletes", "examples": "furosemide (Lasix)", "mechanism": "Furosemide increases thiamin loss in urine, possibly to deficient levels.", "whatToDo": "Ask your clinician; whether thiamin supplements prevent this has not been established.", "source": "ods-thiamin", "quote": "Research has linked the use of furosemide to decreases in thiamin concentrations", "sourceUrl": "https://ods.od.nih.gov/factsheets/Thiamin-HealthProfessional/", "sourceOrg": "NIH ODS", "verified": "2026-10-13" }, { "id": "thiamin--chemotherapy", "supplement": "thiamin", "drugClass": "chemotherapy", "severity": "moderate", "kind": "depletes", "examples": "fluorouracil (5-FU, Adrucil)", "mechanism": "Fluorouracil might speed thiamin breakdown; cases of beriberi and Wernicke encephalopathy have been reported.", "whatToDo": "Ask your oncologist whether thiamin is appropriate during fluorouracil treatment.", "source": "ods-thiamin", "quote": "The published literature includes several cases of beriberi or Wernicke’s encephalopathy resulting from treatment with this drug", "sourceUrl": "https://ods.od.nih.gov/factsheets/Thiamin-HealthProfessional/", "sourceOrg": "NIH ODS", "verified": "2026-10-13" }, { "id": "biotin--anticonvulsants", "supplement": "biotin", "drugClass": "anticonvulsants", "severity": "moderate", "kind": "depletes", "examples": "carbamazepine, primidone, phenytoin, phenobarbital", "mechanism": "Long-term anticonvulsant use was linked to significantly lower biotin levels, likely from faster biotin breakdown.", "whatToDo": "Ask your clinician whether your biotin status needs attention on long-term anticonvulsants.", "source": "ods-biotin", "quote": "anticonvulsant treatment for at least 1 year was associated with significantly lower serum biotin levels", "sourceUrl": "https://ods.od.nih.gov/factsheets/Biotin-HealthProfessional/", "sourceOrg": "NIH ODS", "verified": "2026-10-13" }, { "id": "carnitine--anticonvulsants", "supplement": "carnitine", "drugClass": "anticonvulsants", "severity": "minor", "kind": "depletes", "examples": "valproic acid, phenobarbital, phenytoin, carbamazepine", "mechanism": "These anticonvulsants lower blood carnitine levels.", "whatToDo": "Ask your neurologist whether carnitine is relevant to your treatment.", "source": "ods-carnitine", "quote": "Treatment with the anticonvulsants valproic acid, phenobarbital, phenytoin, and carbamazepine reduces blood levels of carnitine", "sourceUrl": "https://ods.od.nih.gov/factsheets/Carnitine-HealthProfessional/", "sourceOrg": "NIH ODS", "verified": "2026-10-13" }, { "id": "carnitine--antibiotics", "supplement": "carnitine", "drugClass": "antibiotics", "severity": "minor", "kind": "depletes", "examples": "pivalate-conjugated antibiotics such as pivampicillin", "mechanism": "Long-term use of these antibiotics can deplete carnitine, but no illness from it has been described.", "whatToDo": "No action is described by the source; mention it to your prescriber if you take these antibiotics long term.", "source": "ods-carnitine", "quote": "no cases of illness due to carnitine deficiency in this population have been described", "sourceUrl": "https://ods.od.nih.gov/factsheets/Carnitine-HealthProfessional/", "sourceOrg": "NIH ODS", "verified": "2026-10-13" }, { "id": "st-johns-wort--ssri-snri", "supplement": "st-johns-wort", "drugClass": "ssri-snri", "severity": "major", "kind": "affects-drug", "examples": "antidepressants that affect serotonin", "mechanism": "St. John's wort with drugs that affect serotonin may cause serotonin-related side effects, which can be serious.", "whatToDo": "Do not combine them without your prescriber; ask your pharmacist before taking any St. John's wort product.", "source": "nccih-sjw", "quote": "may lead to increased serotonin-related side effects, which can be serious", "sourceUrl": "https://www.nccih.nih.gov/health/st-johns-wort", "sourceOrg": "NCCIH", "verified": "2026-10-13" }, { "id": "st-johns-wort--maoi", "supplement": "st-johns-wort", "drugClass": "maoi", "severity": "major", "kind": "affects-drug", "examples": "antidepressants that affect serotonin", "mechanism": "St. John's wort with drugs that affect serotonin may cause serotonin-related side effects, which can be serious.", "whatToDo": "Do not combine them without your prescriber.", "source": "nccih-sjw", "quote": "may lead to increased serotonin-related side effects, which can be serious", "sourceUrl": "https://www.nccih.nih.gov/health/st-johns-wort", "sourceOrg": "NCCIH", "verified": "2026-10-13" }, { "id": "st-johns-wort--tca", "supplement": "st-johns-wort", "drugClass": "tca", "severity": "major", "kind": "affects-drug", "examples": "amitriptyline", "mechanism": "St. John's wort can weaken the effect of some antidepressants, including amitriptyline.", "whatToDo": "Do not combine them without your prescriber.", "source": "nccih-sjw", "quote": "St. John’s wort can weaken the effects of many medicines, including crucially important medicines such as", "sourceUrl": "https://www.nccih.nih.gov/health/st-johns-wort", "sourceOrg": "NCCIH", "verified": "2026-10-13" }, { "id": "st-johns-wort--bupropion", "supplement": "st-johns-wort", "drugClass": "bupropion", "severity": "major", "kind": "affects-drug", "examples": "bupropion", "mechanism": "St. John's wort can weaken the effect of some antidepressants, including bupropion.", "whatToDo": "Do not combine them without your prescriber.", "source": "nccih-sjw", "quote": "St. John’s wort can weaken the effects of many medicines, including crucially important medicines such as", "sourceUrl": "https://www.nccih.nih.gov/health/st-johns-wort", "sourceOrg": "NCCIH", "verified": "2026-10-13" }, { "id": "st-johns-wort--oral-contraceptives", "supplement": "st-johns-wort", "drugClass": "oral-contraceptives", "severity": "major", "kind": "affects-drug", "examples": "birth control pills", "mechanism": "St. John's wort can weaken the effect of birth control pills.", "whatToDo": "Do not rely on the pill alone while taking it; talk to your prescriber or pharmacist.", "source": "nccih-sjw", "quote": "St. John’s wort can weaken the effects of many medicines, including crucially important medicines such as", "sourceUrl": "https://www.nccih.nih.gov/health/st-johns-wort", "sourceOrg": "NCCIH", "verified": "2026-10-13" }, { "id": "st-johns-wort--immunosuppressants", "supplement": "st-johns-wort", "drugClass": "immunosuppressants", "severity": "major", "kind": "affects-drug", "examples": "cyclosporine", "mechanism": "St. John's wort can weaken cyclosporine, which prevents rejection of transplanted organs.", "whatToDo": "Do not take it with cyclosporine unless your transplant team approves.", "source": "nccih-sjw", "quote": "St. John’s wort can weaken the effects of many medicines, including crucially important medicines such as", "sourceUrl": "https://www.nccih.nih.gov/health/st-johns-wort", "sourceOrg": "NCCIH", "verified": "2026-10-13" }, { "id": "st-johns-wort--anticonvulsants", "supplement": "st-johns-wort", "drugClass": "anticonvulsants", "severity": "major", "kind": "affects-drug", "examples": "phenytoin, carbamazepine", "mechanism": "St. John's wort can weaken some seizure medicines, including phenytoin and carbamazepine.", "whatToDo": "Do not combine them without your neurologist.", "source": "nccih-sjw", "quote": "St. John’s wort can weaken the effects of many medicines, including crucially important medicines such as", "sourceUrl": "https://www.nccih.nih.gov/health/st-johns-wort", "sourceOrg": "NCCIH", "verified": "2026-10-13" }, { "id": "st-johns-wort--heart-rhythm", "supplement": "st-johns-wort", "drugClass": "heart-rhythm", "severity": "major", "kind": "affects-drug", "examples": "digoxin, ivabradine", "mechanism": "St. John's wort can weaken some heart medicines, including digoxin and ivabradine.", "whatToDo": "Do not combine them without your cardiologist.", "source": "nccih-sjw", "quote": "St. John’s wort can weaken the effects of many medicines, including crucially important medicines such as", "sourceUrl": "https://www.nccih.nih.gov/health/st-johns-wort", "sourceOrg": "NCCIH", "verified": "2026-10-13" }, { "id": "st-johns-wort--hiv", "supplement": "st-johns-wort", "drugClass": "hiv", "severity": "major", "kind": "affects-drug", "examples": "indinavir, nevirapine", "mechanism": "St. John's wort can weaken some HIV drugs, including indinavir and nevirapine.", "whatToDo": "Do not combine them without your HIV care team.", "source": "nccih-sjw", "quote": "St. John’s wort can weaken the effects of many medicines, including crucially important medicines such as", "sourceUrl": "https://www.nccih.nih.gov/health/st-johns-wort", "sourceOrg": "NCCIH", "verified": "2026-10-13" }, { "id": "st-johns-wort--chemotherapy", "supplement": "st-johns-wort", "drugClass": "chemotherapy", "severity": "major", "kind": "affects-drug", "examples": "irinotecan, imatinib, docetaxel", "mechanism": "St. John's wort can weaken some cancer medicines, including irinotecan, imatinib and docetaxel.", "whatToDo": "Do not take it during cancer treatment without your oncologist.", "source": "nccih-sjw", "quote": "St. John’s wort can weaken the effects of many medicines, including crucially important medicines such as", "sourceUrl": "https://www.nccih.nih.gov/health/st-johns-wort", "sourceOrg": "NCCIH", "verified": "2026-10-13" }, { "id": "st-johns-wort--warfarin", "supplement": "st-johns-wort", "drugClass": "warfarin", "severity": "major", "kind": "affects-drug", "examples": "warfarin", "mechanism": "St. John's wort can weaken the anticoagulant warfarin.", "whatToDo": "Do not combine them without your prescriber.", "source": "nccih-sjw", "quote": "St. John’s wort can weaken the effects of many medicines, including crucially important medicines such as", "sourceUrl": "https://www.nccih.nih.gov/health/st-johns-wort", "sourceOrg": "NCCIH", "verified": "2026-10-13" }, { "id": "st-johns-wort--statins", "supplement": "st-johns-wort", "drugClass": "statins", "severity": "major", "kind": "affects-drug", "examples": "simvastatin", "mechanism": "St. John's wort can weaken certain statins, including simvastatin.", "whatToDo": "Do not combine them without your prescriber.", "source": "nccih-sjw", "quote": "St. John’s wort can weaken the effects of many medicines, including crucially important medicines such as", "sourceUrl": "https://www.nccih.nih.gov/health/st-johns-wort", "sourceOrg": "NCCIH", "verified": "2026-10-13" }, { "id": "ginkgo--anticoagulants", "supplement": "ginkgo", "drugClass": "anticoagulants", "severity": "moderate", "kind": "affects-drug", "examples": "warfarin", "mechanism": "Ginkgo may increase the risk of bleeding in people taking anticoagulants.", "whatToDo": "Ask your prescriber before combining them.", "source": "nccih-ginkgo", "quote": "Ginkgo may increase the risk of bleeding in people who are taking anticoagulant drugs, such as warfarin.", "sourceUrl": "https://www.nccih.nih.gov/health/ginkgo", "sourceOrg": "NCCIH", "verified": "2026-10-13" }, { "id": "valerian--sedatives", "supplement": "valerian", "drugClass": "sedatives", "severity": "major", "kind": "affects-drug", "examples": "sedatives", "mechanism": "Valerian might have a sleep-inducing effect that adds to sedatives.", "whatToDo": "NCCIH says not to take valerian with alcohol or sedatives.", "source": "nccih-valerian", "quote": "it should not be taken along with alcohol or sedatives", "sourceUrl": "https://www.nccih.nih.gov/health/valerian", "sourceOrg": "NCCIH", "verified": "2026-10-13" }, { "id": "kava--sedatives", "supplement": "kava", "drugClass": "sedatives", "severity": "major", "kind": "affects-drug", "examples": "benzodiazepines", "mechanism": "Kava adds to the effect of other sedating substances.", "whatToDo": "NCCIH says not to use kava with benzodiazepines, other sedatives or alcohol.", "source": "nccih-kava", "quote": "Kava should not be used together with other substances that have sedative effects, such as benzodiazepines or alcohol.", "sourceUrl": "https://www.nccih.nih.gov/health/kava", "sourceOrg": "NCCIH", "verified": "2026-10-13" }, { "id": "garlic--anticoagulants", "supplement": "garlic", "drugClass": "anticoagulants", "severity": "moderate", "kind": "affects-drug", "examples": "anticoagulants", "mechanism": "Garlic supplements may increase the risk of bleeding, adding to drugs that affect bleeding.", "whatToDo": "Tell your prescriber you take garlic supplements, especially before surgery.", "source": "nccih-garlic", "quote": "if you take medicines, such as anticoagulants or aspirin, that may also affect bleeding", "sourceUrl": "https://www.nccih.nih.gov/health/garlic", "sourceOrg": "NCCIH", "verified": "2026-10-13" }, { "id": "garlic--antiplatelets", "supplement": "garlic", "drugClass": "antiplatelets", "severity": "moderate", "kind": "affects-drug", "examples": "aspirin", "mechanism": "Garlic supplements may increase the risk of bleeding, adding to drugs that affect bleeding.", "whatToDo": "Tell your prescriber you take garlic supplements, especially before surgery.", "source": "nccih-garlic", "quote": "if you take medicines, such as anticoagulants or aspirin, that may also affect bleeding", "sourceUrl": "https://www.nccih.nih.gov/health/garlic", "sourceOrg": "NCCIH", "verified": "2026-10-13" }, { "id": "ginseng--warfarin", "supplement": "ginseng", "drugClass": "warfarin", "severity": "moderate", "kind": "affects-drug", "examples": "warfarin (Coumadin, Jantoven)", "mechanism": "Ginseng can reduce the anticoagulant effect of warfarin.", "whatToDo": "Talk to your prescriber before combining them.", "source": "ods-exercise", "quote": "Ginseng can reduce the anticoagulant effects of the blood thinner warfarin (Coumadin or Jantoven)", "sourceUrl": "https://ods.od.nih.gov/factsheets/ExerciseAndAthleticPerformance-HealthProfessional/", "sourceOrg": "NIH ODS", "verified": "2026-10-13" }, { "id": "green-tea--beta-blockers", "supplement": "green-tea", "drugClass": "beta-blockers", "severity": "moderate", "kind": "affects-drug", "examples": "nadolol (Corgard)", "mechanism": "High-dose green tea has been shown to lower blood levels, and so the effectiveness, of nadolol.", "whatToDo": "Ask your prescriber before taking green tea supplements with nadolol.", "source": "nccih-green-tea", "quote": "Green tea at high doses has been shown to reduce blood levels and, therefore, the effectiveness of the drug nadolol", "sourceUrl": "https://www.nccih.nih.gov/health/green-tea", "sourceOrg": "NCCIH", "verified": "2026-10-13" }, { "id": "green-tea--statins", "supplement": "green-tea", "drugClass": "statins", "severity": "moderate", "kind": "affects-drug", "examples": "atorvastatin (Lipitor)", "mechanism": "Green tea extract can lower blood levels of atorvastatin.", "whatToDo": "Ask your prescriber before taking green tea extract with atorvastatin.", "source": "nccih-green-tea", "quote": "Green tea extract can reduce blood levels of the cholesterol-lowering drug atorvastatin.", "sourceUrl": "https://www.nccih.nih.gov/health/green-tea", "sourceOrg": "NCCIH", "verified": "2026-10-13" }, { "id": "green-tea--raloxifene", "supplement": "green-tea", "drugClass": "raloxifene", "severity": "minor", "kind": "affects-drug", "examples": "raloxifene (Evista)", "mechanism": "An NCCIH-funded study showed an interaction between green tea and raloxifene; the size of the effect is not stated.", "whatToDo": "Ask your prescriber before taking green tea supplements with raloxifene.", "source": "nccih-green-tea", "quote": "showed an interaction between green tea and the drug raloxifene", "sourceUrl": "https://www.nccih.nih.gov/health/green-tea", "sourceOrg": "NCCIH", "verified": "2026-10-13" }, { "id": "green-tea--chemotherapy", "supplement": "green-tea", "drugClass": "chemotherapy", "severity": "minor", "kind": "affects-drug", "examples": "chemotherapy drugs", "mechanism": "NIH ODS states green tea could interact with chemotherapy drugs without describing the effect.", "whatToDo": "Ask your oncologist before taking green tea extract during treatment.", "source": "ods-weightloss", "quote": "Green tea could interact with chemotherapy drugs", "sourceUrl": "https://ods.od.nih.gov/factsheets/WeightLoss-HealthProfessional/", "sourceOrg": "NIH ODS", "verified": "2026-10-13" }, { "id": "melatonin--anticoagulants", "supplement": "melatonin", "drugClass": "anticoagulants", "severity": "moderate", "kind": "affects-drug", "examples": "blood thinners", "mechanism": "NCCIH flags blood thinners as a combination that needs medical supervision; it does not describe the mechanism.", "whatToDo": "Use melatonin with a blood thinner only under medical supervision.", "source": "nccih-melatonin", "quote": "people with epilepsy and those taking blood thinner medications need to be under medical supervision when taking melatonin supplements", "sourceUrl": "https://www.nccih.nih.gov/health/melatonin-what-you-need-to-know", "sourceOrg": "NCCIH", "verified": "2026-10-13" }, { "id": "goldenseal--metformin", "supplement": "goldenseal", "drugClass": "metformin", "severity": "moderate", "kind": "affects-drug", "examples": "metformin", "mechanism": "Goldenseal extract lowered metformin levels about 25 percent in an NCCIH-funded study of healthy adults.", "whatToDo": "Ask your prescriber before using goldenseal; it may hinder glucose control.", "source": "nccih-goldenseal", "quote": "This drop was enough to potentially hinder glucose control in people with type 2 diabetes taking metformin.", "sourceUrl": "https://www.nccih.nih.gov/health/goldenseal", "sourceOrg": "NCCIH", "verified": "2026-10-13" }, { "id": "echinacea--immunosuppressants", "supplement": "echinacea", "drugClass": "immunosuppressants", "severity": "minor", "kind": "affects-drug", "examples": "immunosuppressants", "mechanism": "There are theoretical reasons to suspect echinacea might interact with immunosuppressants.", "whatToDo": "Ask the doctor who prescribes your immunosuppressant before taking it.", "source": "nccih-echinacea", "quote": "there are theoretical reasons to suspect that echinacea might interact with immunosuppressants or caffeine", "sourceUrl": "https://www.nccih.nih.gov/health/echinacea", "sourceOrg": "NCCIH", "verified": "2026-10-13" }, { "id": "licorice--corticosteroids", "supplement": "licorice", "drugClass": "corticosteroids", "severity": "minor", "kind": "affects-drug", "examples": "corticosteroids", "mechanism": "Interactions between licorice and corticosteroids have been reported; the source does not describe them.", "whatToDo": "Ask your prescriber before taking licorice root products with a corticosteroid.", "source": "nccih-licorice", "quote": "Interactions between licorice and corticosteroids have been reported.", "sourceUrl": "https://www.nccih.nih.gov/health/licorice-root", "sourceOrg": "NCCIH", "verified": "2026-10-13" }, { "id": "cranberry--warfarin", "supplement": "cranberry", "drugClass": "warfarin", "severity": "minor", "kind": "affects-drug", "examples": "warfarin", "mechanism": "Evidence conflicts on whether cranberry interacts with warfarin.", "whatToDo": "Talk with your prescriber before using cranberry products on warfarin.", "source": "nccih-cranberry", "quote": "There is conflicting evidence about whether cranberry interacts with the anticoagulant (blood thinner) warfarin.", "sourceUrl": "https://www.nccih.nih.gov/health/cranberry", "sourceOrg": "NCCIH", "verified": "2026-10-13" }, { "id": "flaxseed--anticoagulants", "supplement": "flaxseed", "drugClass": "anticoagulants", "severity": "minor", "kind": "affects-drug", "examples": "anticoagulants", "mechanism": "There are theoretical reasons to suspect flaxseed might interact with anticoagulants.", "whatToDo": "Ask your prescriber before combining them.", "source": "nccih-flaxseed", "quote": "There are theoretical reasons to suspect that flaxseed or flaxseed oil might interact with other drugs, such as anticoagulant or antiplatelet drugs.", "sourceUrl": "https://www.nccih.nih.gov/health/flaxseed-and-flaxseed-oil", "sourceOrg": "NCCIH", "verified": "2026-10-13" }, { "id": "flaxseed--antiplatelets", "supplement": "flaxseed", "drugClass": "antiplatelets", "severity": "minor", "kind": "affects-drug", "examples": "antiplatelet drugs", "mechanism": "There are theoretical reasons to suspect flaxseed might interact with antiplatelet drugs.", "whatToDo": "Ask your prescriber before combining them.", "source": "nccih-flaxseed", "quote": "There are theoretical reasons to suspect that flaxseed or flaxseed oil might interact with other drugs, such as anticoagulant or antiplatelet drugs.", "sourceUrl": "https://www.nccih.nih.gov/health/flaxseed-and-flaxseed-oil", "sourceOrg": "NCCIH", "verified": "2026-10-13" }, { "id": "cinnamon--chemotherapy", "supplement": "cinnamon", "drugClass": "chemotherapy", "severity": "minor", "kind": "affects-drug", "examples": "an anticancer medicine (not named)", "mechanism": "There are theoretical reasons to suspect some components of cinnamon may interact with an anticancer medicine.", "whatToDo": "Ask your oncologist before taking cinnamon supplements.", "source": "nccih-cinnamon", "quote": "there are theoretical reasons to suspect that some components of cinnamon may interact with an anticancer medicine or nicotine", "sourceUrl": "https://www.nccih.nih.gov/health/cinnamon", "sourceOrg": "NCCIH", "verified": "2026-10-13" }, { "id": "rhodiola--arbs", "supplement": "rhodiola", "drugClass": "arbs", "severity": "minor", "kind": "affects-drug", "examples": "losartan", "mechanism": "Interactions between rhodiola and losartan have been reported; the source does not describe them.", "whatToDo": "Ask your prescriber before taking rhodiola with losartan.", "source": "nccih-rhodiola", "quote": "Interactions between rhodiola and losartan (a drug used for high blood pressure) have been reported.", "sourceUrl": "https://www.nccih.nih.gov/health/rhodiola", "sourceOrg": "NCCIH", "verified": "2026-10-13" }, { "id": "coq10--warfarin", "supplement": "coq10", "drugClass": "warfarin", "severity": "minor", "kind": "affects-drug", "examples": "warfarin", "mechanism": "NCCIH states CoQ10 may interact with warfarin without describing the effect.", "whatToDo": "Ask your prescriber before starting CoQ10 on warfarin.", "source": "nccih-coq10", "quote": "CoQ10 may interact with the anticoagulant (blood thinner) warfarin and the diabetes drug insulin, and it may not be compatible with some types of cancer treatment.", "sourceUrl": "https://www.nccih.nih.gov/health/coenzyme-q10", "sourceOrg": "NCCIH", "verified": "2026-10-13" }, { "id": "coq10--insulin", "supplement": "coq10", "drugClass": "insulin", "severity": "minor", "kind": "affects-drug", "examples": "insulin", "mechanism": "NCCIH states CoQ10 may interact with insulin without describing the effect.", "whatToDo": "Ask your prescriber before starting CoQ10 with insulin.", "source": "nccih-coq10", "quote": "CoQ10 may interact with the anticoagulant (blood thinner) warfarin and the diabetes drug insulin, and it may not be compatible with some types of cancer treatment.", "sourceUrl": "https://www.nccih.nih.gov/health/coenzyme-q10", "sourceOrg": "NCCIH", "verified": "2026-10-13" }, { "id": "coq10--chemotherapy", "supplement": "coq10", "drugClass": "chemotherapy", "severity": "minor", "kind": "affects-drug", "examples": "some types of cancer treatment", "mechanism": "NCCIH states CoQ10 may not be compatible with some types of cancer treatment.", "whatToDo": "Ask your oncologist before taking CoQ10 during treatment.", "source": "nccih-coq10", "quote": "CoQ10 may interact with the anticoagulant (blood thinner) warfarin and the diabetes drug insulin, and it may not be compatible with some types of cancer treatment.", "sourceUrl": "https://www.nccih.nih.gov/health/coenzyme-q10", "sourceOrg": "NCCIH", "verified": "2026-10-13" }, { "id": "chamomile--oral-contraceptives", "supplement": "chamomile", "drugClass": "oral-contraceptives", "severity": "minor", "kind": "affects-drug", "examples": "birth control pills", "mechanism": "Chamomile might have estrogen-like effects; preliminary studies suggest it might decrease the effect of birth control pills.", "whatToDo": "Ask your prescriber or pharmacist before taking chamomile supplements on the pill.", "source": "nccih-chamomile", "quote": "Preliminary studies suggest that taking chamomile along with birth control pills might decrease the effects of birth control pills.", "sourceUrl": "https://www.nccih.nih.gov/health/chamomile", "sourceOrg": "NCCIH", "verified": "2026-10-13" }, { "id": "chamomile--warfarin", "supplement": "chamomile", "drugClass": "warfarin", "severity": "minor", "kind": "affects-drug", "examples": "warfarin", "mechanism": "Interactions between chamomile and warfarin have been reported.", "whatToDo": "Ask your prescriber before taking chamomile supplements on warfarin.", "source": "nccih-chamomile", "quote": "Interactions between chamomile and some drugs metabolized by the liver and warfarin (a blood thinner) have been reported", "sourceUrl": "https://www.nccih.nih.gov/health/chamomile", "sourceOrg": "NCCIH", "verified": "2026-10-13" }, { "id": "chamomile--sedatives", "supplement": "chamomile", "drugClass": "sedatives", "severity": "minor", "kind": "affects-drug", "examples": "sedatives", "mechanism": "There are theoretical reasons to suspect chamomile might interact with sedatives.", "whatToDo": "Ask your pharmacist before combining them.", "source": "nccih-chamomile", "quote": "there are theoretical reasons to suspect that chamomile might interact with other drugs as well, such as sedatives", "sourceUrl": "https://www.nccih.nih.gov/health/chamomile", "sourceOrg": "NCCIH", "verified": "2026-10-13" }, { "id": "bitter-orange--immunosuppressants", "supplement": "bitter-orange", "drugClass": "immunosuppressants", "severity": "moderate", "kind": "affects-drug", "examples": "cyclosporine", "mechanism": "Bitter orange inhibits the CYP3A4 enzyme, raising blood levels of cyclosporine.", "whatToDo": "Do not take it with cyclosporine unless your transplant team approves.", "source": "ods-weightloss", "quote": "Bitter orange has also been shown to inhibit CYP3A4 activity, leading to increased blood levels of certain drugs, such as cyclosporine and saquinavir", "sourceUrl": "https://ods.od.nih.gov/factsheets/WeightLoss-HealthProfessional/", "sourceOrg": "NIH ODS", "verified": "2026-10-13" }, { "id": "bitter-orange--hiv", "supplement": "bitter-orange", "drugClass": "hiv", "severity": "moderate", "kind": "affects-drug", "examples": "saquinavir", "mechanism": "Bitter orange inhibits the CYP3A4 enzyme, raising blood levels of saquinavir.", "whatToDo": "Do not take it with saquinavir without your HIV care team.", "source": "ods-weightloss", "quote": "Bitter orange has also been shown to inhibit CYP3A4 activity, leading to increased blood levels of certain drugs, such as cyclosporine and saquinavir", "sourceUrl": "https://ods.od.nih.gov/factsheets/WeightLoss-HealthProfessional/", "sourceOrg": "NIH ODS", "verified": "2026-10-13" }, { "id": "yohimbe--maoi", "supplement": "yohimbe", "drugClass": "maoi", "severity": "major", "kind": "affects-drug", "examples": "MAOIs", "mechanism": "Yohimbe can interact with MAOI antidepressants, and yohimbine itself is linked to blood pressure problems and arrhythmia.", "whatToDo": "Do not use yohimbe if you take an MAOI.", "source": "nccih-yohimbe", "quote": "Do not use yohimbe if you are taking types of antidepressant medications called monoamine oxidase inhibitors or tricyclic antidepressants.", "sourceUrl": "https://www.nccih.nih.gov/health/yohimbe", "sourceOrg": "NCCIH", "verified": "2026-10-13" }, { "id": "yohimbe--tca", "supplement": "yohimbe", "drugClass": "tca", "severity": "major", "kind": "affects-drug", "examples": "tricyclic antidepressants", "mechanism": "Yohimbe can interact with tricyclic antidepressants.", "whatToDo": "Do not use yohimbe if you take a tricyclic antidepressant.", "source": "nccih-yohimbe", "quote": "Do not use yohimbe if you are taking types of antidepressant medications called monoamine oxidase inhibitors or tricyclic antidepressants.", "sourceUrl": "https://www.nccih.nih.gov/health/yohimbe", "sourceOrg": "NCCIH", "verified": "2026-10-13" }, { "id": "lavender--sedatives", "supplement": "lavender", "drugClass": "sedatives", "severity": "minor", "kind": "affects-drug", "examples": "sedative drugs", "mechanism": "There are theoretical reasons to suspect lavender might interact with some sedatives.", "whatToDo": "Ask your pharmacist before combining them, especially before surgery.", "source": "nccih-lavender", "quote": "There are theoretical reasons to suspect that lavender might interact with some sedative drugs or herbs", "sourceUrl": "https://www.nccih.nih.gov/health/lavender", "sourceOrg": "NCCIH", "verified": "2026-10-13" }, { "id": "soy--maoi", "supplement": "soy", "drugClass": "maoi", "severity": "major", "kind": "affects-drug", "examples": "MAOIs", "mechanism": "High-tyramine soy foods such as tofu and soy sauce with MAOIs have caused dangerously high blood pressure.", "whatToDo": "If you take an MAOI, follow your prescriber's tyramine diet advice, which covers these soy products.", "source": "nccih-soy", "quote": "have been reported (i.e., dangerously high blood pressure)", "sourceUrl": "https://www.nccih.nih.gov/health/soy", "sourceOrg": "NCCIH", "verified": "2026-10-13" }, { "id": "aloe--heart-rhythm", "supplement": "aloe", "drugClass": "heart-rhythm", "severity": "moderate", "kind": "affects-drug", "examples": "digoxin (cardiac glycosides)", "mechanism": "Overuse of aloe latex may increase the risk of adverse effects from digoxin.", "whatToDo": "Do not use aloe latex products with digoxin without your prescriber.", "source": "nccih-aloe", "quote": "Overuse of aloe latex may increase the risk of adverse effects from cardiac glycosides, such as digoxin", "sourceUrl": "https://www.nccih.nih.gov/health/aloe-vera", "sourceOrg": "NCCIH", "verified": "2026-10-13" }, { "id": "dandelion--diabetes", "supplement": "dandelion", "drugClass": "diabetes", "severity": "minor", "kind": "affects-drug", "examples": "antidiabetes drugs", "mechanism": "There are theoretical reasons to suspect dandelion might interact with diabetes drugs.", "whatToDo": "Ask your prescriber before combining them.", "source": "nccih-dandelion", "quote": "There are theoretical reasons to suspect that dandelion might interact with antidiabetes, anticoagulant, antiplatelet, and water pill drugs, among others.", "sourceUrl": "https://www.nccih.nih.gov/health/dandelion", "sourceOrg": "NCCIH", "verified": "2026-10-13" }, { "id": "dandelion--anticoagulants", "supplement": "dandelion", "drugClass": "anticoagulants", "severity": "minor", "kind": "affects-drug", "examples": "anticoagulants", "mechanism": "There are theoretical reasons to suspect dandelion might interact with anticoagulants.", "whatToDo": "Ask your prescriber before combining them.", "source": "nccih-dandelion", "quote": "There are theoretical reasons to suspect that dandelion might interact with antidiabetes, anticoagulant, antiplatelet, and water pill drugs, among others.", "sourceUrl": "https://www.nccih.nih.gov/health/dandelion", "sourceOrg": "NCCIH", "verified": "2026-10-13" }, { "id": "dandelion--antiplatelets", "supplement": "dandelion", "drugClass": "antiplatelets", "severity": "minor", "kind": "affects-drug", "examples": "antiplatelet drugs", "mechanism": "There are theoretical reasons to suspect dandelion might interact with antiplatelet drugs.", "whatToDo": "Ask your prescriber before combining them.", "source": "nccih-dandelion", "quote": "There are theoretical reasons to suspect that dandelion might interact with antidiabetes, anticoagulant, antiplatelet, and water pill drugs, among others.", "sourceUrl": "https://www.nccih.nih.gov/health/dandelion", "sourceOrg": "NCCIH", "verified": "2026-10-13" }, { "id": "dandelion--diuretics", "supplement": "dandelion", "drugClass": "diuretics", "severity": "minor", "kind": "affects-drug", "examples": "water pills", "mechanism": "There are theoretical reasons to suspect dandelion might interact with diuretics.", "whatToDo": "Ask your prescriber before combining them.", "source": "nccih-dandelion", "quote": "There are theoretical reasons to suspect that dandelion might interact with antidiabetes, anticoagulant, antiplatelet, and water pill drugs, among others.", "sourceUrl": "https://www.nccih.nih.gov/health/dandelion", "sourceOrg": "NCCIH", "verified": "2026-10-13" }, { "id": "astragalus--immunosuppressants", "supplement": "astragalus", "drugClass": "immunosuppressants", "severity": "minor", "kind": "affects-drug", "examples": "immunosuppressants", "mechanism": "Astragalus may interact with drugs that suppress the immune system.", "whatToDo": "Ask the doctor who prescribes your immunosuppressant before taking it.", "source": "nccih-astragalus", "quote": "Also, astragalus may interact with medications that suppress the immune system.", "sourceUrl": "https://www.nccih.nih.gov/health/astragalus", "sourceOrg": "NCCIH", "verified": "2026-10-13" }, { "id": "feverfew--migraine", "supplement": "feverfew", "drugClass": "migraine", "severity": "minor", "kind": "affects-drug", "examples": "migraine medicines", "mechanism": "NCCIH states feverfew may interact with some medicines, including those used for migraine, without describing the effect.", "whatToDo": "Ask your prescriber or pharmacist before combining them.", "source": "nccih-feverfew", "quote": "Feverfew may interact with some medicines, including those used for migraine.", "sourceUrl": "https://www.nccih.nih.gov/health/feverfew", "sourceOrg": "NCCIH", "verified": "2026-10-13" }, { "id": "same--levodopa", "supplement": "same", "drugClass": "levodopa", "severity": "moderate", "kind": "affects-drug", "examples": "levodopa (L-dopa)", "mechanism": "SAMe may decrease the effects of levodopa.", "whatToDo": "Ask your neurologist before taking SAMe with levodopa.", "source": "nccih-same", "quote": "SAMe may decrease the effects of levodopa (L-dopa), a drug used to treat Parkinson’s disease.", "sourceUrl": "https://www.nccih.nih.gov/health/sadenosyllmethionine-same-in-depth", "sourceOrg": "NCCIH", "verified": "2026-10-13" }, { "id": "same--ssri-snri", "supplement": "same", "drugClass": "ssri-snri", "severity": "minor", "kind": "affects-drug", "examples": "antidepressants that raise serotonin", "mechanism": "It is possible SAMe might interact with drugs that increase serotonin, such as antidepressants.", "whatToDo": "Ask your prescriber before combining SAMe with an antidepressant.", "source": "nccih-same", "quote": "SAMe might interact with drugs and dietary supplements that increase levels of serotonin", "sourceUrl": "https://www.nccih.nih.gov/health/sadenosyllmethionine-same-in-depth", "sourceOrg": "NCCIH", "verified": "2026-10-13" }, { "id": "glucosamine--warfarin", "supplement": "glucosamine", "drugClass": "warfarin", "severity": "moderate", "kind": "affects-drug", "examples": "warfarin", "mechanism": "Glucosamine and chondroitin have been associated with an increased risk of bleeding in people taking warfarin.", "whatToDo": "Ask your prescriber before taking them with warfarin.", "source": "nccih-glucosamine", "quote": "glucosamine and chondroitin have been associated with an increased risk of bleeding in people who are taking the anticoagulant warfarin", "sourceUrl": "https://www.nccih.nih.gov/health/glucosamine-and-chondroitin-for-osteoarthritis", "sourceOrg": "NCCIH", "verified": "2026-10-13" } ] }