Drug & supplement interaction

Picamilon + Methylnaltrexone

Methylnaltrexone brand name: Relistor.

No Known Interaction
The bottom line No known interaction

We found no known interaction between Picamilon and Methylnaltrexone 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 Methylnaltrexone states a food rule worth keeping to.

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Interaction report

Picamilon and Methylnaltrexone

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 Methylnaltrexone and Picamilon 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.

Picamilon safety at a glance

Picamilon overall Use caution Human safety data are limited and its legal status as a supplement is questionable in some countries.
Pregnancy Avoid No reliable safety data exist, so it should be avoided during pregnancy.
Breastfeeding Avoid No safety information is available, so avoid while breastfeeding.

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

Still wondering about combining Methylnaltrexone and Picamilon? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
How we checked

Why No Interaction Is Listed for Methylnaltrexone

Interactions in our licensed database are recorded against drug classes, not just single drug names. Methylnaltrexone is filed under a single classification — cytochrome p450 2d6 (cyp2d6) inhibitors. Picamilon has documented interactions with 1 drug class — the most serious being niacin (moderate) — and none of Methylnaltrexone’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

Picamilon Does Interact With Other Medications

Picamilon has 3 moderate known drug interactions in our database — Methylnaltrexone 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 Picamilon

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

What to actually watch for

What Methylnaltrexone’s Own FDA Label Lists

This is not an interaction — none of it involves Picamilon. These are the most notable effects listed in the ADVERSE REACTIONS section of Methylnaltrexone’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.

  • Chills
  • Tremor or shakiness
  • Flushing
  • Bloating or gas
  • Sweating
  • Anxiety or restlessness
  • Muscle pain
  • Stomach upset
  • Constipation
  • Stomach pain

Showing the 10 most notable of 15 label-listed effects — ranked by how unusual each one is across medicines generally, with serious effects weighted up.

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

How to take them

Some Methylnaltrexone Products Have a Food Rule — Picamilon Should Not Break It

At least one FDA label for a product containing Methylnaltrexone says to take it on an empty stomach. Most supplements — Picamilon included — are taken with a meal, so the easy mistake is swallowing both together at breakfast. Where that rule applies, keep Methylnaltrexone on its own and move Picamilon to a meal later in the day.

This may not be true of your version. Food instructions belong to the product, not the ingredient: two Methylnaltrexone 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.

o In patients with chronic non-cancer pain and OIC, take RELISTOR tablets with water on an empty stomach at least 30 minutes before the first meal of the day.

From the Dosage and Administration section of the FDA label we read for Methylnaltrexone — 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 Methylnaltrexone

This page covers Picamilon only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Methylnaltrexone page lists 3 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Fever Bark (moderate), Iboga (moderate) and Yohimbe (moderate).

By severity: 3 moderate.

From our pharmacist’s overview on the Methylnaltrexone page

“If you take methylnaltrexone (Relistor) for opioid-induced constipation, the supplement list to know is short: three ingredients, all rated moderate, none major. Yohimbe, fever bark, and iboga are all cleared by the same liver enzyme, CYP2D6, and methylnaltrexone can slow that enzyme, letting their active compounds build up in your blood.”

Reviewed by 2 · Jul 18, 2026

Open the Methylnaltrexone interaction page

One more smart check

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

We hold 135 real supplement products containing Picamilon, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Picamilon. Even though Picamilon itself has no known interaction with Methylnaltrexone, 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 Picamilon and Methylnaltrexone 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 Picamilon
Top half

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

29 days ago today
Medication Methylnaltrexone
Steady interest

#2,278 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 Picamilon reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 13, 2026. The Picamilon and Methylnaltrexone records this page draws on were last updated June 22, 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 Picamilon

What is Picamilon?

  • Anxiety and stress
  • Mental focus and cognition
  • Low mood
  • Migraine or headache
  • Fatigue and energy

Picamilon is a synthetic compound made by joining niacin (vitamin B3) and GABA, originally developed in the former Soviet Union as a prescription drug. It is sold in some countries as a supplement for anxiety, focus, and mood, but high-quality human evidence is very limited, and U.S. regulators have stated it does not qualify as a legal dietary supplement ingredient. Talk to a pharmacist or doctor before using it.

Synthetic compound (not from a plant) · Capsules, tablets, powder

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

Picamilon: dosing

There is no officially established or standardized dose of picamilon for supplement use, and quality control of products is uncertain.If a product is available to you, follow the directions on the label and do not exceed them.

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

Read the full Picamilon monograph & all interactions
Medication

About Methylnaltrexone

What Is Methylnaltrexone Used For?

Brand name: Relistor

Methylnaltrexone, sold as Relistor, treats opioid-induced constipation (OIC) — constipation caused by opioid pain medications. Both Relistor tablets and Relistor injection are approved for adults with chronic non-cancer pain, including those with pain related to a prior cancer or its treatment who do not need frequent opioid dose increases.

Relistor injection is also approved for adults with advanced illness or active cancer pain who require increasing opioid doses as part of palliative care.

See full Methylnaltrexone drug information
Keep checking

Other Drugs & Picamilon

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

0Major
3Moderate
0Minor
2,826No known interaction
Moderate

3 interactions

No interaction 2,826 drugs checked — show the list
Evidence & sources

Picamilon References

The 3 references that drive our Picamilon 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. Avula B, Chittiboyina AG, Sagi S, et al. Identification and quantification of vinpocetine and picamilon in dietary supplements sold in the United States. Drug Test Anal. 2016;8(3-4):334-43. PubMed
  2. Vishnevskii EL, Guseva NB. Validation of the treatment of the neurogenic bladder in children with myelodysplasia using pikamilon [abstract only]. Urol Nefrol (Mosk) 1998;(2):27-30.
  3. Kolomoitseva EM, Ermakova VN, Abdulkadyrova MZh. Results of pikamilon use in the treatment of patients with open-angle glaucoma [abstract only]. Vestn Oftalmol 1994;110(4):4-7.

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 Picamilon and Methylnaltrexone Together: Common Questions

Is it safe to take Picamilon with Methylnaltrexone?
We do not list a known interaction between Picamilon and Methylnaltrexone. 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 Picamilon and Methylnaltrexone at the same time of day?
At least one FDA label for a product containing Methylnaltrexone says to take it on an empty stomach, and supplements are usually taken with a meal — so taking them together at breakfast is the easy mistake. Where that applies, keep Methylnaltrexone on its own and move Picamilon to a meal later in the day. Food instructions belong to the product rather than the ingredient, so check the directions on your own box. This is about absorption, not an interaction.
How was the Picamilon and Methylnaltrexone combination checked?
Interactions in our licensed database are recorded against drug classes. Methylnaltrexone is filed under 1 classification, and Picamilon has documented interactions with 1 drug class — none of Methylnaltrexone'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 Picamilon interact with any other medications?
Yes. Picamilon has 3 documented drug interactions in our database — Methylnaltrexone 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 Methylnaltrexone interact with any supplements?
Yes. Methylnaltrexone has documented interactions with 3 supplements in our database — Picamilon is not one of them. The Methylnaltrexone 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 Methylnaltrexone and Picamilon?

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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.