Drug & supplement interaction

Diatomaceous Earth + Ferric Citrate

Ferric Citrate brand name: Auryxia.

No Known Interaction
The bottom line No known interaction

We found no known interaction between Diatomaceous Earth and Ferric Citrate 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 Ferric Citrate states a food rule worth keeping to.

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Interaction report

Diatomaceous Earth and Ferric Citrate

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 Ferric Citrate and Diatomaceous Earth 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.

Worth understanding: our licensed dataset holds no drug-interaction record for Diatomaceous Earth at all — not against Ferric Citrate, and not against any other medication we track. This verdict therefore rests on the absence of any recorded data, not on research that looked at this combination and found nothing. We cannot rule an interaction out.

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.

Diatomaceous Earth safety at a glance

Diatomaceous Earth overall Use caution Only food-grade products should be ingested, and human safety data is limited.
Pregnancy Avoid Safety has not been studied in pregnancy, so it is best avoided.
Breastfeeding Avoid There is no reliable safety data during breastfeeding, so avoid use.

Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Ferric Citrate and Diatomaceous Earth? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
What to actually watch for

What Ferric Citrate’s Own FDA Label Lists

This is not an interaction — none of it involves Diatomaceous Earth. These are the most notable effects listed in the ADVERSE REACTIONS section of Ferric Citrate’s own FDA label, for the medication by itself. Knowing the drug’s own list makes it easier to work out the likely cause if something new turns up while you take both. 3 of them are worth acting on rather than waiting out — marked below.

  • High potassium Worth acting on
  • Kidney problems Worth acting on
  • Anemia Worth acting on
  • Cough
  • Constipation
  • Stomach pain
  • Diarrhea
  • Vomiting
  • Nausea

From the ADVERSE REACTIONS section of the FDA label for Ferric Citrate. Read the label on DailyMed › Diatomaceous Earth’s licensed record lists no adverse effects our clinical vocabulary could match, so there is no Diatomaceous Earth side to compare — that is a limit of the record, not a statement that Diatomaceous Earth has no side effects.

How to take them

Some Ferric Citrate Products Have a Food Rule — Diatomaceous Earth Should Not Break It

At least one FDA label for a product containing Ferric Citrate says to take it with food. If you take Diatomaceous Earth on an empty stomach out of habit, keep them separate — and take Ferric Citrate 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 Ferric Citrate 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.

( 2.2 ) 2.1 Dosage for Hyperphosphatemia in Chronic Kidney Disease on Dialysis The recommended starting dose is 2 tablets, swallowed whole, 3 times per day with meals.

From the Dosage and Administration section of the FDA label we read for Ferric Citrate — 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.

Everything else you take

See Every Supplement That Interacts With Ferric Citrate

This page covers Diatomaceous Earth only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Ferric Citrate page lists 17 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Coffee Charcoal (moderate), European Mandrake (moderate), Glucomannan (moderate) and Guar Gum (moderate).

By severity: 1 major · 7 moderate · 9 minor.

From our pharmacist’s overview on the Ferric Citrate page

“Ferric citrate (Auryxia) does its work in the gut, binding dietary phosphate in kidney disease or supplying iron, and all 17 supplements on this list can interfere with how oral medicines get absorbed. That is worth real caution, starting with the single major-rated entry, activated charcoal, which adsorbs many drugs directly and can m…”

Reviewed by 2 · Jul 18, 2026

Open the Ferric Citrate interaction page

How much people look this up

Where Diatomaceous Earth and Ferric Citrate 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 Diatomaceous Earth
Steady interest

#1,372 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Ferric Citrate
Steady interest

#1,788 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 Diatomaceous Earth reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 20, 2026. The Diatomaceous Earth and Ferric Citrate records this page draws on were last updated July 10, 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 Diatomaceous Earth

What is Diatomaceous Earth?

  • Digestive cleansing or 'detox'
  • Intestinal parasite support
  • Skin, hair, and nail health (silica)
  • Cholesterol support
  • Toxin or heavy metal binding

Diatomaceous earth is a fine powder made from the fossilized shells of tiny algae called diatoms. Only food-grade diatomaceous earth should ever be swallowed, and human evidence for its health claims (detox, parasites, cholesterol) is very limited. Never inhale the dust, and talk to a pharmacist or doctor before taking it.

Fossilized remains of diatoms (a type of algae) · Food-grade powder, capsules, mixed into water or smoothies

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

Diatomaceous Earth: dosing

There is no official, standardized dose of diatomaceous earth, and it is not approved as a medicine. Amounts vary widely between products and brands.If you choose to use it, follow the directions on a clearly labeled food-grade product, start low, and drink plenty of water.

From our Diatomaceous Earth monograph — the full record covers uses, side effects and every documented interaction.

Read the full Diatomaceous Earth monograph & all interactions
Medication

About Ferric Citrate

What Is Ferric Citrate Used For?

Brand name: Auryxia

Ferric citrate tablets — sold as Auryxia and under the generic name Ferric Citrate — are approved for two related uses in adults with chronic kidney disease (CKD).

For patients on dialysis, they work as a phosphate binder to control high phosphorus (hyperphosphatemia) levels in the blood. For patients with CKD who are not on dialysis, they serve as an iron replacement to treat iron deficiency anemia.

Most-Reported Side Effects for Ferric Citrate

From FAERS, the FDA’s public side-effect reporting system (0 reports, all brands). Reports are voluntary and are not proof the drug caused the effect.

Diarrhea 307 reports
Serum ferritin increased 228 reports
Transferrin saturation increased 169 reports
Faeces discoloured 118 reports
Constipation 83 reports
See full Ferric Citrate drug information
Keep checking

Other Drugs & Diatomaceous Earth

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

0Major
0Moderate
0Minor
2,829No known interaction
No interaction 2,829 drugs checked — show the list
Evidence & sources

Diatomaceous Earth References

The 6 references that drive our Diatomaceous Earth 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. Rushton L. Chronic obstructive pulmonary disease and occupational exposure to silica. Rev Environ Health 2007;22(4):255-72. PubMed
  2. Gallagher LG, Park RM, Checkoway H. Extended follow-up of lung cancer and non-malignant respiratory disease mortality among California diatomaceous earth workers. Occup Environ Med. 2015;72(5):360-5. PubMed
  3. Moisan S, Rucay P, Ghali A, Penneau-Fontbonne D, Lavigne C. Silica-associated limited systemic sclerosis after occupational exposure to calcined diatomaceous earth. Joint Bone Spine. 2010;77(5):472-3. PubMed
  4. Park R, Rice F, Stayner L, Smith R, Gilbert S, Checkoway H. Exposure to crystalline silica, silicosis, and lung disease other than cancer in diatomaceous earth industry workers: a quantitative risk assessment. Occup Environ Med. 2002;59(1):36-43. PubMed
  5. Nattrass C, Horwell CJ, Damby DE, Kermanizadeh A, Brown DM, Stone V. The global variability of diatomaceous earth toxicity: a physicochemical and in vitro investigation. J Occup Med Toxicol. 2015 10;10:23. PubMed
  6. Wachter H, Lechleitner M, Artner-Dworzak E, Hausen A, Jarosch E, Widner B, Patsch J, Pfeiffer K, Fuchs D. Diatomaceous earth lowers blood cholesterol concentrations. Eur J Med Res. 1998 8;3(4):211-5.

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 Diatomaceous Earth and Ferric Citrate Together: Common Questions

Is it safe to take Diatomaceous Earth with Ferric Citrate?
We do not list a known interaction between Diatomaceous Earth and Ferric Citrate. 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.
Should I take Diatomaceous Earth and Ferric Citrate at the same time of day?
At least one FDA label for a product containing Ferric Citrate says to take it with food. If you take Diatomaceous Earth on an empty stomach out of habit, keep them separate and take Ferric Citrate with a meal where the label says to. Food instructions belong to the product rather than the ingredient — two Ferric Citrate products can differ — so check the directions on your own box. This is about absorption, not an interaction.
Does Ferric Citrate interact with any supplements?
Yes. Ferric Citrate has documented interactions with 17 supplements in our database — Diatomaceous Earth is not one of them. The Ferric Citrate 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 Ferric Citrate and Diatomaceous Earth?

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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.