Drug & supplement interaction

Manganese + Nalidixic Acid

Nalidixic Acid brand name: NegGram.

Moderate Interaction
Medically reviewed by · Updated September 2026
The bottom line Moderate

Manganese has a moderate interaction with Nalidixic Acid. Theoretically, manganese might reduce the absorption of quinolone antibiotics.

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

Manganese and Nalidixic Acid

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

Moderate

QUINOLONE ANTIBIOTICS

Why this applies to Nalidixic Acid

Nalidixic Acid falls under QUINOLONE ANTIBIOTICS — the group Manganese interacts with.

Theoretically, manganese might reduce the absorption of quinolone antibiotics.
Manganese is a multivalent cation. Interactions resulting in reduced quinolone absorption have been reported between quinolones and other multivalent cations, such as calcium and iron.
Severity Moderate Likelihood Probable Evidence D

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 concern with taking manganese alongside nalidixic acid. Manganese is a charged mineral (what we call a multivalent cation), and minerals like this have a habit of binding to quinolone antibiotics right in your gut. If they grab onto each other, less of the antibiotic gets absorbed into your bloodstream, which can leave you with too little to fully knock out the urinary infection you're treating.

I'll be honest that this one is theoretical for manganese specifically. We've clearly seen it with calcium and iron, and manganese behaves similarly, so it's a reasonable caution rather than a proven problem. An easy fix is spacing them out, usually taking the antibiotic a couple of hours apart from the mineral. Check with your pharmacist on the exact timing before changing anything.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Hansten PD, Horn JR. Hansten and Horn's Drug Interactions Analysis and Management. Vancouver, CAN:Appl Therapeut, 1999.

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

Manganese Also Interacts With Other Medications

Manganese has 82 moderate known drug interactions in our database — the Nalidixic Acid one above is one of them. If you take anything else, check it against the full list below.

Moderate 82 No known interaction 2,748 (incl. Nalidixic Acid)
Taking anything else?

Check Another of Your Medications Against Manganese

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

Everything else you take

See Every Supplement That Interacts With Nalidixic Acid

This page covers Manganese only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Nalidixic Acid page lists 146 supplements it has a documented interaction with, worst first, each one explained.

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

By severity: 8 major · 118 moderate · 20 minor.

Open the Nalidixic Acid interaction page

One more smart check

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

We hold 16,006 real supplement products containing Manganese, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Manganese. Your product may carry other ingredients that interact with Nalidixic Acid too, on top of Manganese — 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 Manganese and Nalidixic Acid 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 Manganese
Top 5%

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

29 days ago today
Medication Nalidixic Acid
Top half

#1,166 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 Manganese

What is Manganese?

Manganese
  • Bone health support
  • Antioxidant and enzyme support
  • Filling dietary gaps
  • Metabolism support
  • Wound healing

Manganese is an essential trace mineral your body needs in small amounts for bone formation, metabolism, and antioxidant defense, and most people get enough from a normal diet. Supplements may help if you have a genuine deficiency, but too much can be harmful—especially to the nervous system—so do not take high doses without guidance from a pharmacist or doctor.

Read the full Manganese monograph & all interactions
Keep checking

Other Drugs & Manganese

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

0Major
82Moderate
0Minor
2,747No known interaction
82 Moderate 2,747 No interaction
Moderate

82 interactions

Showing 60 of 82 moderate interactions — see all 82 on the Manganese page.

No interaction 2,747 drugs checked — show the list

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

Showing the 60 most looked-up of 2,747 medications checked with no known interaction — see the full Manganese list.

See the full Manganese interactions page
See every supplement checked against Nalidixic Acid, ranked by severity
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

Keep exploring
Manganese monograph › Uses, safety, and every drug interaction in one place Nalidixic Acid supplement interactions › Every supplement checked against Nalidixic Acid, ranked by severity Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Manganese and Nalidixic Acid Together: Common Questions

Can you take Manganese with Nalidixic Acid?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Manganese and Nalidixic Acid interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

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

Still Have a Question About Nalidixic Acid and Manganese?

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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.