Drug & supplement interaction

Devil's Claw + Ketoprofen

Ketoprofen brand names: Orudis, Oruvail Gel, Powergel, Oruvail Injection.

No Known Interaction
The bottom line No known interaction

We found no known interaction between Devil's Claw and Ketoprofen in our sources. Absence of a documented interaction is not the same as proven safety, and does not guarantee one does not exist. Do not start, stop, or change a medication or supplement based on this page; confirm with your pharmacist or doctor first. Additionally, although there is no interaction, the label for Ketoprofen states a food rule worth keeping to, and the two are separately associated with some of the same side effects, which would make a new symptom harder to attribute to one or the other.

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Interaction report

Devil's Claw and Ketoprofen

We checked these two against our interaction database. Here is what we found.

No Known Interaction Found

We did not find a documented interaction between Ketoprofen and Devil's Claw in our sources. This does not guarantee that the combination is completely free of risk — there is often limited research on supplements and herbal products, especially around drug interactions.

If you decide to take both, the practical routine is simple: add one new thing at a time and note the date you started it. If the combination is going to disagree with you, it usually shows in the first days to a couple of weeks — and a start date turns “I’ve been feeling off” into something a pharmacist can actually work with. Do not stop a prescribed medicine on your own.

Always talk with your pharmacist or doctor before making changes to your medications or supplements, particularly if you take several medications or have an ongoing health condition.

Devil's Claw safety at a glance

Devil's Claw overall Use caution Generally well tolerated for short-term use in healthy adults, but it can cause digestive upset and isn't right for everyone.
Pregnancy Possibly Unsafe When used orally. Anecdotal evidence suggests that devil's claw has oxytocic effects in humans. Also, in vitro research shows that moderate to high doses of dev... Read the full pregnancy detail
Breastfeeding Avoid Avoid while breastfeeding because there is not enough safety information.

Pregnancy & breastfeeding ratings are from Natural Medicines (Therapeutic Research Center) — the full detail is in the Special populations card below. Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Ketoprofen and Devil's Claw? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
How we checked

Why No Interaction Is Listed for Ketoprofen

Interactions in our licensed database are recorded against drug classes, not just single drug names. Ketoprofen is filed under 8 classifications — including nonsteroidal anti-inflammatory drugs (nsaids), anticoagulant/antiplatelet drugs, organic anion transporter 3 (oat3) substrates. Devil's Claw has documented interactions with 7 drug classes — the most serious being cytochrome p450 2c19 (cyp2c19) substrates (moderate), cytochrome p450 2c9 (cyp2c9) substrates (moderate) and cytochrome p450 3a4 (cyp3a4) substrates (moderate) — and none of Ketoprofen’s classifications are among them.

Classification data comes from our licensed Natural Medicines dataset. A medication can belong to classes beyond those recorded there, so this describes how the check was run — it is not a safety guarantee.

Keep it in perspective

Devil's Claw Does Interact With Other Medications

Devil's Claw has 731 moderate, 73 minor known drug interactions in our database — Ketoprofen isn’t one of them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Devil's Claw

Covers the 2,830 medications we’ve checked against Devil's Claw. Pick one to open its full report.

What to actually watch for

No Interaction Found — But Data Suggests Devil's Claw and Ketoprofen May Share Several of the Same Side Effects

This is not an interaction. Neither one changes how your body handles the other, and nothing here says they react together. What our sources do show is that each has separately been linked to the effects below — so taking both can make those effects more likely to turn up, and harder to pin on one or the other if they do. 4 of them are worth acting on rather than waiting out — marked below.

  • Bleeding in the gut / Bleeding or bruising Worth acting on Additional detail

    Devil's Claw

    “Gastrointestinal side effects, including mild gastrointestinal upset, diarrhea, anorexia, acid reflux, or loss of taste, have been reported in some individuals receiving devil's claw, especially at high doses.”

    Devil's Claw · Natural Medicines adverse-effect record, reported in anorexia.

    6 sources cited
    1. 6472. Chantre P, Cappelaere A, Leblan D, et al. Efficacy and tolerance or Harpagophytum procumbens versus diacerhein in treatment of osteoarthritis. Phytomedicine 2000;7:177-83.
    2. 8608. Chrubasik S, Thanner J, Kunzel O, et al. Comparison of outcome measures during treatment with the proprietary Harpagophytum extract doloteffin in patients with pain in the lower back, knee or hip. Phytomedicine 2002;9:181-94. PubMed
    3. 8613. Grahame R, Robinson BV. Devils's claw (Harpagophytum procumbens): pharmacological and clinical studies. Ann Rheum Dis 1981;40:632. PubMed
    4. 14332. Wegener T, Lupke NP. Treatment of patients with arthrosis of hip or knee with an aqueous extract of devil's claw (Harpagophytum procumbens DC). Phytother Res 2003;17:1165-72.
    5. 14418. Chrubasik S, Kunzel O, Thanner J, et al. A 1-year follow-up after a pilot study with Doloteffin for low back pain. Phytomedicine 2005;12:1-9. PubMed
    6. 47112. Chrubasik, S., Junck, H., Breitschwerdt, H., Conradt, C., and Zappe, H. Effectiveness of Harpagophytum extract WS 1531 in the treatment of exacerbation of low back pain: a randomized, placebo-controlled, double- blind study. Eur.J Anaesthesiol. 1999;16(2 DOI

    Ketoprofen

    Listed in the ADVERSE REACTIONS section of the FDA label for Ketoprofen. Read the label on DailyMed ›

  • Low sodium Worth acting on Additional detail

    Devil's Claw

    “In one case report, a 65-year-old female developed psychomotor agitation, nausea, and distress from euvolemic hyponatremia secondary to inappropriate secretion of antidiuretic hormone (SIADH) within 1 month of starting daily treatment with devil's claw. Within 5 days of discontinuing the product and receiving sodium replacement, the symptoms resolved.”

    Devil's Claw · Natural Medicines adverse-effect record, reported in nausea and vomiting.

    1 source cited
    1. 96747. Carvalho RR, Donadel CD, Cortez AF, Valviesse VR, Vianna PF, Correa BB. J Bras Nefrol. 2017 Mar;39(1):79-81.

    Ketoprofen

    Listed in the ADVERSE REACTIONS section of the FDA label for Ketoprofen. Read the label on DailyMed ›

  • Raised blood pressure Worth acting on Additional detail

    Devil's Claw

    “In one case report, a healthy patient with normal blood pressure presented with hypertension after taking devil's claw 250 mg twice daily for 2 weeks. It gradually resolved after discontinuation of devil's claw. Some animal research shows that devil's claw might have negative chronotropic, as well as positive and negative inotropic, effects. However, these effects have not been documented in humans.”

    Devil's Claw · Natural Medicines adverse-effect record, reported in hypertension.

    2 sources cited
    1. 92017. Cuspidi C, Sala C, Tadic M, et al. Systemic hypertension induced by Harpagophytum procumbens (devil's claw): a case report. J Clin Hypertens (Greenwich) 2015;17(11):908-10.
    2. 8609. Circosta C, Occhiuto F, Ragusa S, et al. A drug used in traditional medicine: Harpagophytum procumbens DC. II. Cardiovascular activity. J Ethnopharmacol 1984;11:259-74. PubMed

    Ketoprofen

    Listed in the ADVERSE REACTIONS section of the FDA label for Ketoprofen. Read the label on DailyMed ›

  • Ringing in the ears / Drowsiness / Trouble sleeping Additional detail

    Devil's Claw

    “In a trial of devil's claw, one patient withdrew after 4 days of therapy due to a throbbing frontal headache, as well as tinnitus, anorexia, and loss of taste. Rarely, dizziness, somnolence, and insomnia have been reported. It is unclear if these symptoms were caused by devil's claw.”

    Devil's Claw · Natural Medicines adverse-effect record, reported in anorexia.

    3 sources cited
    1. 8613. Grahame R, Robinson BV. Devils's claw (Harpagophytum procumbens): pharmacological and clinical studies. Ann Rheum Dis 1981;40:632. PubMed
    2. 47116. Laudahn, D. and Walper, A. Efficacy and tolerance of Harpagophytum extract LI 174 in patients with chronic non-radicular back pain. Phytother.Res. 2001;15(7):621-624.
    3. 47169. Chrubasik S, Model A, Black A, and et al. A randomized double-blind pilot study comparing Doloteffin® and Vioxx® in the treatment of low back pain. Rheumatology 2003;42:141-148.

    Ketoprofen

    Listed in the ADVERSE REACTIONS section of the FDA label for Ketoprofen. Read the label on DailyMed ›

  • Anxiety or restlessness Additional detail

    Devil's Claw

    “Rarely, anxiety has been reported in patients taking devil's claw.”

    Devil's Claw · Natural Medicines adverse-effect record, reported in anxiety.

    1 source cited
    1. 8608. Chrubasik S, Thanner J, Kunzel O, et al. Comparison of outcome measures during treatment with the proprietary Harpagophytum extract doloteffin in patients with pain in the lower back, knee or hip. Phytomedicine 2002;9:181-94. PubMed

    Ketoprofen

    Listed in the ADVERSE REACTIONS section of the FDA label for Ketoprofen. Read the label on DailyMed ›

  • Reduced appetite Additional detail

    Devil's Claw

    Recorded for Devil's Claw in the same Natural Medicines adverse-effect record shown under Ringing in the ears / Drowsiness / Trouble sleeping above.

    Ketoprofen

    Listed in the ADVERSE REACTIONS section of the FDA label for Ketoprofen. Read the label on DailyMed ›

  • Stomach upset Additional detail

    Devil's Claw

    Recorded for Devil's Claw in the same Natural Medicines adverse-effect record shown under Bleeding in the gut / Bleeding or bruising above.

    Ketoprofen

    Listed in the ADVERSE REACTIONS section of the FDA label for Ketoprofen. Read the label on DailyMed ›

Showing the 10 most notable of 14 shared effects — ranked by how unusual each one is, not just whether both lists mention it.

Reported for Devil's Claw but not commonly for Ketoprofen: a change in taste and heartburn.

Effects for Ketoprofen come from the ADVERSE REACTIONS section of its FDA label; effects for Devil's Claw come from the Natural Medicines adverse-effect record, quoted above. Where a percentage is shown, it is the share of 13,040 voluntary FDA FAERS reports for Ketoprofen that mention that effect — a reporting proportion, not an incidence rate and not evidence the drug caused it. Wording is matched across sources by our own clinical vocabulary, so treat this as a prompt to pay attention, not a diagnosis.

Special populations

Devil's Claw in Pregnancy & Breastfeeding

Pregnancy Possibly Unsafe

When used orally. Anecdotal evidence suggests that devil's claw has oxytocic effects in humans. Also, in vitro research shows that moderate to high doses of devil's claw root extract induce contractions of isolated uterine muscle from pregnant and nonpregnant rats; avoid using.

DISCLAIMER: This tool is intended for informational purposes only, and should not be interpreted as specific medical advice. Patients should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.© 2026 Therapeutic Research Center

How to take them

Some Ketoprofen Products Have a Food Rule — Devil's Claw Should Not Break It

At least one FDA label for a product containing Ketoprofen says to take it with food. If you take Devil's Claw on an empty stomach out of habit, keep them separate — and take Ketoprofen with a meal where the label says to.

This may not be true of your version. Food instructions belong to the product, not the ingredient: two Ketoprofen products can carry different directions, and extended-release forms often differ from immediate-release ones. The label we read is quoted below — check the directions on your own box or bottle, or ask your pharmacist, for how to take the exact product you were given.

Although food delays the absorption of both formulations (see CLINICAL PHARMACOLOGY ) in most of the clinical trials ketoprofen was taken with food or milk.

From the Dosage and Administration section of the FDA label we read for Ketoprofen — where that label names a specific product, the instruction is that product's. Read the label on DailyMed ›

A food rule is not an interaction — it is about how much of the medicine you absorb. The directions that came with your own product, and your pharmacist, outrank anything on this page.

Overlapping uses

What Ketoprofen Is Prescribed For, and What Devil's Claw Has Been Studied For

These two come up together because they touch the same health topic — not because they do the same job. Ketoprofen is a prescription medicine with approved uses on its FDA label. Devil's Claw is a supplement: what follows is what researchers have looked at it for, and how strong that evidence is.

Ketoprofen is prescribed for: Ketoprofen capsules (including the brand Orudis) are used to manage the signs and symptoms of rheumatoid arthritis and osteoarthritis, to treat pain, and to treat primary dysmenorrhea (painful menstrual periods). Ketoprofen extended-release capsules are approved for rheumatoid arthritis and osteoarthritis only. Because of the way they slowly release the drug, ketoprofen extended-release capsules are not recommended for treating acute (sudden) pain.

Devil's Claw has been studied for:

  • Osteoarthritis Natural Medicines rates the evidence for Devil's Claw: Possibly Effective Read what the research shows

    Devil's Claw for osteoarthritis

    Taking devil's claw orally, alone or in conjunction with nonsteroidal anti-inflammatory drugs (NSAIDs), seems to help decrease osteoarthritis pain.

  • Dysmenorrhea studied, not established Devil's Claw has been studied for this. Natural Medicines rates the evidence: Insufficient Reliable Evidence To Rate Read what the research shows

    Devil's Claw for dysmenorrhea

    Although there is interest in using oral devil's claw for dysmenorrhea, there is insufficient reliable information about the clinical effects of devil's claw for this purpose.

Effectiveness ratings and the research summaries above are the verbatim record from the Natural Medicines database, which grades evidence from “Effective” down to “Insufficient Reliable Evidence To Rate”. A rating below the top of that scale means researchers have looked at it — not that it works, and never that it can stand in for a prescribed medicine. Do not stop or replace Ketoprofen on your own; if you are taking Devil's Claw for the same health topic, tell your prescriber, especially if the medicine is being adjusted to a target.

Everything else you take

See Every Supplement That Interacts With Ketoprofen

This page covers Devil's Claw only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Ketoprofen page lists 252 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Asarabacca (major), Beer (major), Danshen (major) and Piracetam (major).

By severity: 7 major · 217 moderate · 28 minor.

From our pharmacist’s overview on the Ketoprofen page

“Bleeding is what worries me most with ketoprofen (Orudis, Oruvail Gel). As an NSAID, it already irritates the stomach lining and slows clotting, and 202 of the 252 supplements and herbs on this page can push that bleeding risk further.”

Reviewed by 2 · Jul 18, 2026

Open the Ketoprofen interaction page

One more smart check

Taking Devil's Claw as Part of a Dietary Supplement Product? Check It for Interactions

We hold 585 real supplement products containing Devil's Claw, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Devil's Claw. Even though Devil's Claw itself has no known interaction with Ketoprofen, another ingredient on your label might. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Devil's Claw and Ketoprofen 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 Devil's Claw
Top 25%

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

29 days ago today
Medication Ketoprofen
Top half

#1,075 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.

Where does our data come from?
  • Source: the Natural Medicines (TRC Healthcare) clinical database — the evidence-graded professional reference for herb & supplement interactions.
  • Citation library: 103,510 references behind our interaction content, 65,311 of them resolved to verified PubMed/DOI sources. See every Devil's Claw reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 13, 2026. The Devil's Claw and Ketoprofen records this page draws on were last updated July 11, 2026.
  • What “no known interaction” means: no documented interaction in the sources above — not a guarantee of safety. Supplements are studied far less than prescription drugs, so we say exactly what the evidence supports, and nothing more.
Data structure & sourcing designed and verified by .
Supplement

About Devil's Claw

What is Devil's Claw?

Devil's Claw
  • Osteoarthritis pain
  • Lower back pain
  • Joint pain and stiffness
  • General inflammation
  • Digestive upset and loss of appetite

Devil's claw is a southern African plant used mainly for arthritis and back pain, and some studies suggest it may help ease these types of discomfort. The evidence is moderate at best, and product strength varies, so talk with your pharmacist or doctor before trying it, especially if you have a health condition or take medications.

Harpagophytum procumbens · Pedaliaceae · Dried secondary (tuberous) roots · Capsules, tablets, dried root, tea, liquid extracts, and tinctures

An interaction check asks whether these two react with each other — it does not ask whether Devil's Claw is a good idea for someone in your situation. Here is what our Devil's Claw record says about it on its own.

Devil's Claw: dosing

There is no single official dose for devil's claw. Many products are standardized to their harpagoside content, but the amount varies a lot from one brand to another.The safest approach is to follow the directions on the product label and not take more than recommended.

From our Devil's Claw monograph — the full record covers uses, side effects and every documented interaction.

Read the full Devil's Claw monograph & all interactions
Medication

About Ketoprofen

What Is Ketoprofen Used For?

Brand names: Orudis, Oruvail Gel, Powergel, Oruvail Injection

Ketoprofen capsules (including the brand Orudis) are used to manage the signs and symptoms of rheumatoid arthritis and osteoarthritis, to treat pain, and to treat primary dysmenorrhea (painful menstrual periods).

Ketoprofen extended-release capsules are approved for rheumatoid arthritis and osteoarthritis only. Because of the way they slowly release the drug, ketoprofen extended-release capsules are not recommended for treating acute (sudden) pain.

Most-Reported Side Effects for Ketoprofen

From FAERS, the FDA’s public side-effect reporting system (13,040 reports, all brands). Reports are voluntary and are not proof the drug caused the effect.

Headache 1,232 reports
Fatigue 932 reports
Nausea 799 reports
Infusion site pain 764 reports
Fever 756 reports
See full Ketoprofen drug information
Keep checking

Other Drugs & Devil's Claw

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

0Major
731Moderate
73Minor
2,025No known interaction
Moderate

731 interactions

Showing 60 of 731 moderate interactions — see all 731 on the Devil's Claw page.

Minor

73 interactions

Showing 60 of 73 minor interactions — see all 73 on the Devil's Claw page.

No interaction 2,025 drugs checked — show the list
Evidence & sources

Devil's Claw References

The 18 references that drive our Devil's Claw monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

  1. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
  2. Shaw D, Leon C, Kolev S, Murray V. Traditional remedies and food supplements: a 5-year toxicological study (1991-1995). Drug Saf 1997;17:342-56.
  3. Chantre P, Cappelaere A, Leblan D, et al. Efficacy and tolerance or Harpagophytum procumbens versus diacerhein in treatment of osteoarthritis. Phytomedicine 2000;7:177-83.
  4. Chrubasik S, Thanner J, Kunzel O, et al. Comparison of outcome measures during treatment with the proprietary Harpagophytum extract doloteffin in patients with pain in the lower back, knee or hip. Phytomedicine 2002;9:181-94. PubMed
  5. Circosta C, Occhiuto F, Ragusa S, et al. A drug used in traditional medicine: Harpagophytum procumbens DC. II. Cardiovascular activity. J Ethnopharmacol 1984;11:259-74. PubMed
  6. Grahame R, Robinson BV. Devils's claw (Harpagophytum procumbens): pharmacological and clinical studies. Ann Rheum Dis 1981;40:632. PubMed
  7. Unger M, Frank A. Simultaneous determination of the inhibitory potency of herbal extracts on the activity of six major cytochrome P450 enzymes using liquid chromatography/mass spectrometry and automated online extraction. Rapid Commun Mass Spectrom 2004;1 PubMed
  8. Wegener T, Lupke NP. Treatment of patients with arthrosis of hip or knee with an aqueous extract of devil's claw (Harpagophytum procumbens DC). Phytother Res 2003;17:1165-72.
  9. Chrubasik S, Kunzel O, Thanner J, et al. A 1-year follow-up after a pilot study with Doloteffin for low back pain. Phytomedicine 2005;12:1-9. PubMed
  10. Romiti N, Tramonti G, Corti A, Chieli E. Effects of Devil's Claw (Harpagophytum procumbens) on the multidrug transporter ABCB1/P-glycoprotein. Phytomedicine 2009;16:1095-100. PubMed
  11. Chrubasik, S., Junck, H., Breitschwerdt, H., Conradt, C., and Zappe, H. Effectiveness of Harpagophytum extract WS 1531 in the treatment of exacerbation of low back pain: a randomized, placebo-controlled, double- blind study. Eur.J Anaesthesiol. 1999;16(2 DOI
  12. Laudahn, D. and Walper, A. Efficacy and tolerance of Harpagophytum extract LI 174 in patients with chronic non-radicular back pain. Phytother.Res. 2001;15(7):621-624.
  13. Belaiche P. Etude clinique de 630 cas d'artrose traites par le nebulisat aqueux d'Harpagophytum procumbens (Radix). Phytotherapy 1982;1:22-28.
  14. Chrubasik S, Model A, Black A, and et al. A randomized double-blind pilot study comparing Doloteffin® and Vioxx® in the treatment of low back pain. Rheumatology 2003;42:141-148.
  15. Cuspidi C, Sala C, Tadic M, et al. Systemic hypertension induced by Harpagophytum procumbens (devil's claw): a case report. J Clin Hypertens (Greenwich) 2015;17(11):908-10.

Medication overviews come from MedlinePlus (NIH); supplement label data from the NIH Dietary Supplement Label Database. Content is written and reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

Pharmacist Counseling Corner

Taking Devil's Claw and Ketoprofen Together: Common Questions

Is it safe to take Devil's Claw with Ketoprofen?
We do not list a known interaction between Devil's Claw and Ketoprofen. That does not guarantee the combination is risk-free, so confirm with your pharmacist or doctor — especially if you take other medications or have a health condition.
Do Devil's Claw and Ketoprofen have any of the same side effects?
Yes — our sources link each of them separately to 10 of the same effects. That is not an interaction: neither changes how your body handles the other. It does mean that if one of those effects turns up, it can be harder to tell which one is behind it. They are listed on this page with the source behind each.
Should I take Devil's Claw and Ketoprofen at the same time of day?
At least one FDA label for a product containing Ketoprofen says to take it with food. If you take Devil's Claw on an empty stomach out of habit, keep them separate and take Ketoprofen with a meal where the label says to. Food instructions belong to the product rather than the ingredient — two Ketoprofen products can differ — so check the directions on your own box. This is about absorption, not an interaction.
Are Devil's Claw and Ketoprofen used for the same thing?
They overlap in purpose, which usually means the real question is whether you need both rather than whether they are safe together. This page lists the shared uses and how strong the evidence is for Devil's Claw in each. That is a conversation for your prescriber, especially if Ketoprofen is being adjusted to a target.
How was the Devil's Claw and Ketoprofen combination checked?
Interactions in our licensed database are recorded against drug classes. Ketoprofen is filed under 8 classifications, and Devil's Claw has documented interactions with 7 drug classes — none of Ketoprofen's classifications are among them. A medication can belong to classes beyond those recorded in our dataset, so this describes how the check was run rather than guaranteeing safety.
Does Devil's Claw interact with any other medications?
Yes. Devil's Claw has 804 documented drug interactions in our database — Ketoprofen is simply not one of them. If you take anything else, it is worth checking each one; they are all listed on this page.
Does Ketoprofen interact with any supplements?
Yes. Ketoprofen has documented interactions with 252 supplements in our database — Devil's Claw is not one of them. The Ketoprofen interaction page linked on this page lists every one, ranked by severity.

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

Still Have a Question About Ketoprofen and Devil's Claw?

Our pharmacists answer your medication & supplement questions — free.

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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.