Drug & supplement interaction

Carob + Alvimopan

Alvimopan brand name: Entereg.

Minor Interaction
The bottom line Minor

Carob has a minor interaction with Alvimopan. Theoretically, carob might also impair the absorption of oral drugs.

Read the full interaction report
SeverityMinor
LikelihoodPossible
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Carob and Alvimopan

Here is the interaction we found between these two, with the evidence behind it.

Minor

ORAL DRUGS

Why this applies to Alvimopan

Alvimopan falls under ORAL DRUGS — the group Carob interacts with.

Theoretically, carob might also impair the absorption of oral drugs.
Laboratory research shows that carob, when consumed as part of the diet or used as a thickening agent in infant formula, reduces the absorption of certain minerals. Take carob 30-60 minutes after oral medications.
Severity Minor Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the gist with carob and alvimopan (Entereg). Carob is loaded with fiber and tannins, and those can grab onto things in your gut. The concern, which is only theoretical and based on lab work, is that carob might bind up a swallowed medicine and keep some of it from being absorbed. For alvimopan, that could mean a little less of the drug gets into your system, so it may not work quite as well at getting your bowels moving again after surgery.

The simple fix is timing. If you eat carob, try to space it out and take it 30 to 60 minutes after your alvimopan dose. Honestly, this is a minor, low-evidence interaction, but since alvimopan is given in a short hospital window, just run it by your pharmacist or surgical team first.

References
  1. Bosscher, D., Caillie-Bertrand, M., and Deelstra, H. Effect of thickening agents, based on soluble dietary fiber, on the availability of calcium, iron, and zinc from infant formulas. Nutrition 2001;17(7-8):614-618. PubMed
  2. Harmuth-Hoene, A. E. and Schelenz, R. Effect of dietary fiber on mineral absorption in growing rats. J Nutr 1980;110(9):1774-1784. PubMed
  3. Bosscher D, Van Caillie-Bertrand M, Van Cauwenbergh R, Deelstra H. Availabilities of calcium, iron, and zinc from dairy infant formulas is affected by soluble dietary fibers and modified starch fractions. Nutrition. 2003;19(7-8):641-5. PubMed

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Carob Also Interacts With Other Medications

Carob has 2,021 minor known drug interactions in our database — the Alvimopan one above is one of them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Carob

Covers the 2,830 medications we’ve checked against Carob. Pick one to open its full report.

Everything else you take

See Every Supplement That Interacts With Alvimopan

This page covers Carob only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Alvimopan page lists 54 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), St. John's Wort (major), Bitter Melon (moderate), Black Pepper (moderate) and Bulbine Natalensis (moderate).

By severity: 2 major · 35 moderate · 17 minor.

From our pharmacist’s overview on the Alvimopan page

“Alvimopan (Entereg) is given for a few days after bowel surgery to help the gut start moving again, and its supplement list warrants genuine care, with two entries rated major. St.”

Reviewed by 2 · Jul 18, 2026

Open the Alvimopan interaction page

One more smart check

Taking Carob as Part of a Dietary Supplement Product? Check It for Interactions

We hold 161 real supplement products containing Carob, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Carob. Your product may carry other ingredients that interact with Alvimopan too, on top of Carob — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Carob and Alvimopan Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Carob
Top half

#672 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Alvimopan
Steady interest

#1,835 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Carob

What is Carob?

Carob
  • Diarrhea (especially in children)
  • Cocoa/chocolate substitute
  • Digestive upset
  • Acid reflux/heartburn
  • Source of dietary fiber

Carob is a Mediterranean tree whose pods are widely used as a caffeine-free, naturally sweet cocoa alternative and as a thickener (carob gum). It is mostly eaten as a food and is generally well tolerated, and carob pod preparations have some traditional and limited research use for diarrhea, but evidence for most medicinal claims is limited. Check with your pharmacist or doctor before using it as a treatment, especially for infants or children.

Read the full Carob monograph & all interactions
Medication

About Alvimopan

What Is Alvimopan Used For?

Brand name: Entereg

Alvimopan capsules are used in hospitals to help the digestive tract recover more quickly after surgery that involves removing part of the bowel (partial bowel resection with primary anastomosis — meaning the remaining ends are reconnected). After this type of surgery, the bowel often temporarily stops working, a condition called postoperative ileus.

This medication is only given during a short hospital stay and is not for long-term or home use.

See full Alvimopan drug information
Keep checking

Other Drugs & Carob

Browse every other medication we’ve checked against Carob — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
0Moderate
2,021Minor
808No known interaction
Minor

2,021 interactions

Showing 60 of 2,021 minor interactions — see all 2,021 on the Carob page.

No interaction 808 drugs checked — show the list
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

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Pharmacist Counseling Corner

Taking Carob and Alvimopan Together: Common Questions

Can you take Carob with Alvimopan?
There is only a minor interaction, which is usually not serious. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Carob and Alvimopan interaction?
We rate it Minor. This interaction is generally not clinically significant, but it remains worth noting and discussing with your pharmacist.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Alvimopan and Carob?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.