Drug & supplement interaction

Magnesium + Carbidopa, Levodopa

Carbidopa, Levodopa brand names: Sinemet CR, Sinemet, Rytary, Dhivy.

Major Interaction
The bottom line Major

Magnesium has a major interaction with Carbidopa, Levodopa. Magnesium can reduce the bioavailability of levodopa/carbidopa.

Read the full interaction report
SeverityMajor
LikelihoodProbable
EvidenceB
What do Severity, Likelihood & Evidence mean?
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Interaction report

Magnesium and Carbidopa, Levodopa

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

Major

LEVODOPA/CARBIDOPA (Sinemet)

Magnesium can reduce the bioavailability of levodopa/carbidopa.
Clinical research in healthy volunteers shows that taking magnesium oxide 1000 mg with levodopa 100 mg/carbidopa 10 mg reduces the area under the curve (AUC) of levodopa by 35% and of carbidopa by 81%. In vitro and animal research shows that magnesium produces an alkaline environment in the digestive tract, which might lead to degradation and reduced bioavailability of levodopa/carbidopa.
Severity Major Likelihood Probable Evidence B

Interaction 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..

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

Here's the practical issue: magnesium supplements (especially magnesium oxide) make your stomach and gut more alkaline, and that environment can break down your Sinemet before your body absorbs it. In one study with healthy volunteers, taking 1000 mg of magnesium oxide alongside a dose of levodopa/carbidopa cut levodopa absorption by about a third and carbidopa by a striking 81%. In plain terms, less of your medicine actually gets in.

For Parkinson's, that can mean your symptoms come back stronger: more tremor, stiffness, slowness, or those rough "off" periods between doses. This is rated a major, likely interaction. I wouldn't stop either one on your own. Instead, ask your pharmacist about separating the timing of your magnesium and your Sinemet, which often helps.

References
  1. Kashihara Y, Terao Y, Yoda K, et al. Effects of magnesium oxide on pharmacokinetics of L-dopa/carbidopa and assessment of pharmacodynamic changes by a model-based simulation. Eur J Clin Pharmacol. 2019;75(3):351-361. 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

Magnesium Also Interacts With Other Medications

Magnesium has 5 major, 175 moderate, 114 minor known drug interactions in our database — the Carbidopa, Levodopa 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 Magnesium

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

From our Q&A

Questions About Magnesium or Carbidopa, Levodopa

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Magnesium or Carbidopa, Levodopa, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Carbidopa, Levodopa

This page covers Magnesium only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Carbidopa, Levodopa page lists 43 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Branched-chain Amino Acids (bcaa) (major), Cowhage (major), Indian Snakeroot (major) and Phenylalanine (major).

By severity: 8 major · 24 moderate · 11 minor.

From our pharmacist’s overview on the Carbidopa, Levodopa page

“Carbidopa/levodopa (Sinemet, Rytary) anchors Parkinson's treatment, and because symptom control hinges on how much levodopa actually reaches the brain, the 43 supplements and herbs on this list deserve real respect before you add any of them. Eight carry a major rating, and almost all of the serious entries weaken the drug rather than…”

Reviewed by 2 · Jul 18, 2026

Open the Carbidopa, Levodopa interaction page

One more smart check

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

We hold 29,718 real supplement products containing Magnesium, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Magnesium. Your product may carry other ingredients that interact with Carbidopa, Levodopa too, on top of Magnesium — 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 Magnesium and Carbidopa, Levodopa 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 Magnesium
Top 10

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

29 days ago today
Medication Carbidopa, Levodopa
Top 25%

#352 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 Magnesium

What is Magnesium?

Magnesium
  • Preventing or treating magnesium deficiency
  • Constipation
  • Muscle cramps
  • Sleep support
  • Anxiety and stress
  • Migraine prevention

Magnesium is an essential mineral your body needs for muscles, nerves, blood pressure, and many other functions, and supplements are useful for preventing or correcting deficiency. Some other uses, like easing constipation or preventing migraines, have reasonable support, while uses for sleep and anxiety are less proven. It is generally safe for most healthy people at recommended amounts, but talk to your pharmacist or doctor before starting, especially if you have kidney problems.

Read the full Magnesium monograph & all interactions
Medication

About Levodopa and Carbidopa

What Is Levodopa and Carbidopa Used For?

Brand names: Sinemet CR, Sinemet, Rytary, Dhivy

Levodopa and carbidopa treats Parkinson’s disease, post-encephalitic parkinsonism (parkinsonism after brain inflammation), and parkinsonism that may follow carbon monoxide or manganese intoxication. This applies to the oral tablets, orally disintegrating tablets, and extended-release tablets and capsules.

Duopa (enteral suspension) is used specifically for motor fluctuations in people with advanced Parkinson’s disease. Crexont is labeled for adults.

See full Levodopa and Carbidopa drug information
Keep checking

Other Drugs & Magnesium

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

5Major
175Moderate
114Minor
2,535No known interaction
Major

5 interactions

Moderate

175 interactions

Showing 60 of 175 moderate interactions — see all 175 on the Magnesium page.

Minor

114 interactions

Showing 60 of 114 minor interactions — see all 114 on the Magnesium page.

No interaction 2,535 drugs checked — show the list

We also checked Magnesium against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,535 medications checked with no known interaction — see the full Magnesium 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 Magnesium and Carbidopa, Levodopa Together: Common Questions

Can you take Magnesium with Carbidopa, Levodopa?
This is rated a major interaction, so the combination is best avoided unless your doctor or pharmacist has specifically told you otherwise. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Magnesium and Carbidopa, Levodopa interaction?
We rate it Major. This is a clinically significant combination that is generally best avoided, or used only under the direct supervision of your physician or pharmacist.

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

Still Have a Question About Carbidopa, Levodopa and Magnesium?

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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.