Manganese Drug Interactions, Uses, Effectiveness, Safety & More
What is this page for?
First and foremost: how Manganese interacts with medications. The heart of this page is the interaction list — every drug Manganese is known to interact with, and how serious each one is.
But these pages have grown well beyond that into a full monograph — what Manganese is, what people use it for and how strong the evidence is, its safety and side effects, and answers to the questions we’re asked most — written and reviewed by the clinical staff at HelloPharmacist. It’s educational information from our licensed clinical databases, not medical advice, and we don’t sell or endorse products. Our editorial policy
Check Manganese against your medication
Add one medicationManganese Drug Interactions: The Bottom Line
From the HelloPharmacist Editorial Team · Updated July 2026Based on the available evidence, the overall risk of a clinically significant Manganese drug interaction appears low for most people. None of the listed interactions are rated major, and nearly all rest on theoretical or limited evidence rather than well-controlled human studies.
The best-supported concerns involve quinolone antibiotics and tetracycline antibiotics. Manganese is a mineral that can bind to these antibiotics in the gut, and similar minerals like calcium and iron have been shown to reduce how much antibiotic the body absorbs, which could make an infection treatment less effective. There is also a weaker signal with antipsychotic medications, based mainly on a single report of hallucinations and behavior changes in a patient with liver disease who took manganese with haloperidol, so researchers speculate the combination might raise the risk of manganese toxicity.
Although the number of medications on the list looks large, it mostly reflects these few drug categories rather than dozens of separate problems. Most of the concerns are predicted from how manganese behaves as a mineral, not from proven harm in people, so many combinations may never cause a meaningful effect.
Based on HelloPharmacist’s Manganese interaction data and reviewed under our editorial standards.
Drugs that interact with Manganese
83 medications have a known interaction with Manganese, graded by severity. Select any drug for the full evidence-based detail.
Don’t want to scroll the list? Just ask.
Tell us the medications you take and we’ll check each one against Manganese using our pharmacist-reviewed interaction data.
AI summaries are generated from our Manganese interaction data for education only — always confirm with your pharmacist. How we use AI
No drugs match “”.
What Severity, Likelihood & Evidence Mean
Severity — How Serious It Can Be
- Major. Clinically significant; generally best avoided, or used only under direct professional supervision.
- Moderate. May need monitoring, a dose adjustment, or separating the times you take each one.
- Minor. Generally not clinically significant, but still worth noting and mentioning to your pharmacist.
- No known interaction. Checked against our sources with nothing documented — not the same as proven safety.
Likelihood — How Well It’s Documented
- Likely. Well-controlled human studies have demonstrated the likely existence of this interaction
- Probable. 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.
- Possible. Interaction 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
- Unlikely. Interaction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Where This Data Comes From
- Interaction records are evidence-graded and sourced from the Natural Medicines database (TRC Healthcare), the same reference used by pharmacists and hospitals.
- Each drug listed above links to the full report for that exact Manganese combination — clinical detail, likelihood, evidence level, and citations.
- Content is reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.
The kinds of drugs Manganese affects
Every type of medication (drug category) Manganese is known to interact with. Open any category for the detail — or search your exact drug in the checker above.
Antipsychotic Drugs
Theoretically, the risk for manganese toxicity might increase when taken with antipsychotic drugs.
Hallucinations and behavioral changes have been reported in a patient with liver disease who was taking haloperidol and manganese. Researchers speculate that taking manganese along with haloperidol, phenothiazine-derivatives, or other antipsychotic medications might increase the risk of manganese toxicity in some patients.
Quinolone Antibiotics
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.
Tetracycline Antibiotics
Theoretically, manganese might reduce the absorption of tetracycline antibiotics.
Manganese is a multivalent cation. Interactions resulting in reduced tetracycline absorption have been reported between tetracyclines and other multivalent cations, such as calcium and iron.
Manganese: Uses, Safety & Side Effects
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.

- Part used
- Mineral (dietary trace element)
- Common forms
- Tablets, capsules, gummies, liquid drops, part of multivitamin/mineral and bone-health products
- Bone health support
- Antioxidant and enzyme support
- Filling dietary gaps
- Metabolism support
- Wound healing
Popular and traditional uses — not proof it works. See “Uses & effectiveness” below for the evidence.
Safe in normal dietary amounts, but high-dose supplements can be harmful.
Amounts in foods and prenatal vitamins are appropriate, but avoid extra high-dose supplements unless advised.
When used orally and appropriately. Manganese is safe when used in doses below the tolerable upper intake level (UL) of 11 mg daily during pregnancy o...
Read the full breastfeeding detailPregnancy & breastfeeding ratings are from Natural Medicines (Therapeutic Research Center). Safety guidance is general; always confirm with your pharmacist or doctor for your situation.
Overview
Manganese is an essential trace mineral, meaning your body needs it in very small amounts to stay healthy. It is not the same as magnesium, even though the names look alike. Your body cannot make manganese, so you must get it from food.
Manganese is found naturally in many foods, including whole grains, nuts, seeds, leafy green vegetables, legumes, and tea. Because it is so widespread in the diet, most people who eat a varied diet get plenty of it.
People take manganese supplements—often as part of a multivitamin or a bone-health formula—to support bones, metabolism, and the body's natural antioxidant defenses. Standalone high-dose manganese supplements are usually not necessary for most people.
How it works
Manganese works mainly as a helper for enzymes. Several enzymes need manganese to do their jobs, including ones involved in metabolism, bone and cartilage formation, and the breakdown of certain nutrients.
One important example is an antioxidant enzyme called manganese superoxide dismutase (MnSOD), which helps protect cells from damage caused by unstable molecules. Manganese also supports the formation of connective tissue and helps the body process carbohydrates, proteins, and fats.
Because manganese supports these basic functions, having enough is important. However, this does not mean that taking more than your body needs gives extra benefits—and very high amounts can actually be harmful.
Does Manganese work?
How to read these evidence grades
Natural Medicines’ 7-point scale. We show each rating’s label word-for-word.
Effective Manganese deficiency
Oral and intravenous manganese can prevent and treat manganese deficiency.
Also studied for 8 conditions — evidence insufficient to rate
Insufficient Reliable Evidence To Rate Allergic rhinitis (hay fever)
It is unclear if intranasal manganese is beneficial in patients with allergic rhinitis.
Insufficient Reliable Evidence To Rate Chronic obstructive pulmonary disease (COPD)
Intravenous manganese has only been evaluated in combination with other ingredients; its effect when used alone is unclear.
Insufficient Reliable Evidence To Rate Metabolic syndrome
It is unclear if oral intake of or environmental exposure to manganese decreases the risk of metabolic syndrome.
Insufficient Reliable Evidence To Rate Obesity
Oral manganese has only been evaluated in combination with other ingredients; its effect when used alone is unclear.
Insufficient Reliable Evidence To Rate Osteoarthritis
Oral manganese has only been evaluated in combination with other ingredients; its effect when used alone is unclear.
Insufficient Reliable Evidence To Rate Osteoporosis
Oral manganese has only been evaluated in combination with other ingredients; its effect when used alone is unclear.
Insufficient Reliable Evidence To Rate Premenstrual syndrome (PMS)
Oral manganese has only been evaluated in combination with other ingredients; its effect when used alone is unclear.
Insufficient Reliable Evidence To Rate Wound healing
Topical manganese has only been evaluated in combination with other ingredients; its effect when used alone is unclear.
Source & disclaimer. Effectiveness ratings and evidence summaries are provided by Natural Medicines (Therapeutic Research Center) and shown as licensed. Where Natural Medicines hasn’t rated a use, HelloPharmacist’s pharmacists may add their own reviewed rating and evidence (each such entry is labeled). This is educational information, not medical advice — talk with your pharmacist or doctor before starting, stopping, or changing a supplement.
Safety & precautions
In the small amounts found in food and standard supplements, manganese is generally considered safe for most people. The bigger concern is getting too much, since high intakes can build up and affect the nervous system over time.
People who should be especially careful include those with liver disease (the liver helps clear manganese), people receiving long-term intravenous (IV) nutrition, and anyone with high environmental exposure, such as certain industrial or welding work. Children and people with iron deficiency may also absorb more manganese.
For pregnancy and breastfeeding, the manganese found in foods and standard prenatal vitamins is appropriate, but extra high-dose manganese supplements should be avoided unless a doctor specifically recommends them. When in doubt, choose caution and check with your healthcare provider.
Side effects
Manganese from food rarely causes problems. With supplements, the main risk comes from taking too much over time.
Very high or prolonged intake of manganese can cause a serious condition affecting the brain and nervous system called manganism, with symptoms that can resemble Parkinson's disease—such as tremor, muscle stiffness, slowed movement, balance problems, and mood or memory changes. This is most often linked to high inhaled exposure or excessive intake, not normal diets.
If you notice new tremors, trouble walking, stiffness, or unusual mood changes while taking a manganese supplement, stop and contact a healthcare professional.
Manganese: Reported Adverse Effects
Documented safety reports on Manganese from the evidence-graded Natural Medicines (TRC Healthcare) database, shown word-for-word from the licensed record.
Orally and parenterally, manganese is generally well tolerated when used in appropriate doses. High doses might be unsafe.
Serious Adverse Effects (Rare):
All routes of administration: Neurotoxicity, including Parkinson-like extrapyramidal symptoms, when used in high doses.
Alcohol-related liver disease Neurologic/CNS
Orally, there is concern that higher doses of manganese might increase the risk of neurotoxicity, including Parkinson-like extrapyramidal symptoms. One severe case of irreversible Parkinson disease possibly related to taking manganese 100 mg daily for 2-4 years has been reported. In another case, a 13-year-old female with manganese intoxication (diagnosed from blood manganese levels and cranial MRI evidence) developed severe neurological symptoms including loss of consciousness, decorticate posture, clonus, increased reflexes in the extremities, isochoric pupils, and no painful stimulus response. Liver biopsy also showed incomplete cirrhosis and microvesicular steatosis. The patient was intubated, and chelation therapy and multiple rounds of therapeutic plasma exchange were required before symptoms resolved. The source of the child's manganese exposure was not identified. Individuals with impaired manganese excretion can also experience these effects even with very low manganese intake. Manganese accumulation due to chronic liver disease seems to cause Parkinson-like extrapyramidal symptoms, encephalopathy, and psychosis. One review recommends stopping supplementation if aminotransferase or alkaline phosphatase levels rise beyond twice normal.
Chronic occupational exposure to manganese dust or fumes can also cause extrapyramidal reactions. In 1837, Couper observed that exposure to manganese dust particles produces a neurological syndrome characterized by muscle weakness, tremor, bent posture, whispered speech, and excess salivation. Additionally, observational research in children has found that elevated manganese levels detected in the hair and fingernails due to environmental exposure may be associated with impaired neurocognitive function or development. A meta-analysis of 11 observational studies in adults also suggests that increased environmental exposure to airborne manganese sources is associated with lower cognitive function scores.
Intravenously, manganese might increase the risk of neurotoxicity when administered at high doses or for an extended duration. Cases of Parkinson-like symptoms have been reported in patients receiving parenteral nutrition containing more than 60 mcg of manganese daily. Moderate MRI intensity uptake for manganese in the globus pallidus and basal ganglion areas of the brain has been shown in patients receiving parenteral manganese.
- Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. Washington, DC: National Academy Press, 2002.
- Lee JW. Manganese intoxication. Arch Neurol 2000;57:597-9..
- Powers KM, Smith-Weller T, Franklin GM, et al. Parkinson's disease risks associated with dietary iron, manganese, and other nutrient intakes. Neurology 2003;60:1761-6..
- Schuh MJ. Possible Parkinson's disease induced by chronic manganese supplement ingestion. Consult Pharm. 2016;31(12):698-703. doi: 10.4140/TCP.n.2016.698.
- Uyar E, Gurkas E, Aksu AU, et al. Can therapeutic plasma exchange be life-saving in life-threatening manganese intoxication?. Transfus Apher Sci 2022;61(4):103417.
- Hauser RA, Zesiewicz TA, Martinez C, et al. Blood manganese correlates with brain magnetic resonance imaging changes in patients with liver disease. Can J Neurol Sci 1996;23:95-8.
- Baker B, Ali A, Isenring L. Recommendations for manganese supplementation to adult patients receiving long-term home parenteral nutrition: an analysis of the supporting evidence. Nutr Clin Pract 2016;31(2):180-5. doi: 10.1177/0884533615591600.
- Barrington WW, Angle CR, Willcockson NK, et al. Autonomic function in manganese alloy workers. Environ Res 1998;78:50-8.
- McMillan, D. E. A brief history of the neurobehavioral toxicity of manganese: some unanswered questions. Neurotoxicology 1999;20(2-3):499-507.
- Martin KV, Sucharew H, Dietrich KN, et al. Co-exposure to manganese and lead and pediatric neurocognition in East Liverpool, Ohio. Environ Res 2021;202:111644.
- Ruiz-Azcona L, Fernández-Olmo I, Expósito A, et al. Impact of environmental airborne manganese exposure on cognitive and motor functions in adults: a systematic review and meta-analysis. Int J Environ Res Public Health 2021;18(8):4075.
- Vanek VW, Borum P, Buchman A, et al. A.S.P.E.N. position paper: recommendations for changes in commercially available parenteral multivitamin and multi-trace element products. Nutr Clin Pract. 2012;27:440-491.doi: 10.1177/0884533612446706
Alcohol-related liver disease Hepatic
Manganese intoxication may cause cirrhosis and hepatic steatosis. In one case, a 13-year-old female with manganese intoxication developed severe, life-threatening neurological symptoms, with liver biopsy indicating incomplete cirrhosis and microvesicular steatosis. Chelation therapy and multiple rounds of therapeutic plasma exchange were required before symptoms resolved. The source of manganese exposure was not identified, and it is not clear if the impaired liver function contributed to the manganese accumulation or if elevated manganese exposure led to the liver damage.
Bone loss Musculoskeletal
Chronic occupational exposure to manganese dust or fumes has been associated with lower bone quality in females, but not males, suggesting that prolonged manganese exposure might increase the risk of osteoporosis in females. A meta-analysis of 11 observational studies in adults also suggests that increased environmental exposure to airborne manganese sources is associated with lower motor function scores.
- Li D, Ge X, Liu Z, et al. Association between long-term occupational manganese exposure and bone quality among retired workers. Environ Sci Pollut Res Int 2020;27(1):482-9.
- Ruiz-Azcona L, Fernández-Olmo I, Expósito A, et al. Impact of environmental airborne manganese exposure on cognitive and motor functions in adults: a systematic review and meta-analysis. Int J Environ Res Public Health 2021;18(8):4075.
Cognitive impairment Psychiatric
Chronic occupational exposure to manganese dust or fumes can cause mood disturbance and dementia. A case report describes a man who presented with confusion, psychosis, dystonic limb movements, and cognitive impairment after chronic industrial manganese exposure. Symptoms of manganese toxicity from inhalational exposure develop slowly with initial fatigue and personality changes, progressing to hallucinations, delusions, hyperexcitability, Parkinson-like symptoms, dystonia, and dementia. Additionally, observational research has found that chronic environmental exposure to manganese sources such as mining operations and various industrial processes may be associated with a greater risk for developing symptoms of depression.
- Barrington WW, Angle CR, Willcockson NK, et al. Autonomic function in manganese alloy workers. Environ Res 1998;78:50-8.
- Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. Washington, DC: National Academy Press, 2002.
- Ho CSH, Ho RCM, Quek AML. Chronic manganese toxicity associated with voltage-gated potassium channel complex antibodies in a relapsing neuropsychiatric disorder. Int J Environ Res Public Health 2018;15(4). pii: E783. doi: 10.3390/ijerph15040783.
- Racette BA, Nelson G, Dlamini WW, et al. Depression and anxiety in a manganese-exposed community. Neurotoxicology 2021;85:222-33.
Hypotension Cardiovascular
Chronic occupational exposure to manganese dust or fumes can cause orthostatic hypotension, and heart rate and rhythm disturbances.
Pregnancy-related edema Pulmonary/Respiratory
Chronic occupational exposure to manganese dust or fumes can cause acute chemical pneumonitis, pulmonary edema, or acute tracheobronchitis.
Adverse-effects data: Natural Medicines, Therapeutic Research Center
Dosing
There is no single "treatment dose" of manganese for most health goals. Health authorities have set recommended daily intakes for general nutrition and an upper limit that you should not exceed, because higher amounts increase the risk of harm.
Most people meet their needs through food alone. If a supplement is recommended, the amount in a typical multivitamin or bone-health product is usually enough. Avoid taking standalone high-dose manganese supplements without professional advice.
Because the right amount depends on your diet, age, and health, follow the product label and ask your pharmacist or doctor before adding a manganese supplement—especially if you have liver problems.
Manganese & Breastfeeding
© 2026 Therapeutic Research Center
Pregnancy & lactation ratings: Natural Medicines, Therapeutic Research Center
References & further reading
The 21 references that drive our Manganese 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.
- Hansten PD, Horn JR. Hansten and Horn's Drug Interactions Analysis and Management. Vancouver, CAN:Appl Therapeut, 1999.
- Barrington WW, Angle CR, Willcockson NK, et al. Autonomic function in manganese alloy workers. Environ Res 1998;78:50-8. PubMed
- Hauser RA, Zesiewicz TA, Martinez C, et al. Blood manganese correlates with brain magnetic resonance imaging changes in patients with liver disease. Can J Neurol Sci 1996;23:95-8. PubMed
- Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. Washington, DC: National Academy Press, 2002.
- Lee JW. Manganese intoxication. Arch Neurol 2000;57:597-9.. PubMed
- Powers KM, Smith-Weller T, Franklin GM, et al. Parkinson's disease risks associated with dietary iron, manganese, and other nutrient intakes. Neurology 2003;60:1761-6.. PubMed
- McMillan, D. E. A brief history of the neurobehavioral toxicity of manganese: some unanswered questions. Neurotoxicology 1999;20(2-3):499-507.
- Gerber, G. B., Leonard, A., and Hantson, P. Carcinogenicity, mutagenicity and teratogenicity of manganese compounds. Crit Rev Oncol Hematol. 2002;42(1):25-34. PubMed
- Jiang, Y. and Zheng, W. Cardiovascular toxicities upon manganese exposure. Cardiovasc.Toxicol 2005;5(4):345-354. PubMed
- Mehta, R. and Reilly, J. J. Manganese levels in a jaundiced long-term total parenteral nutrition patient: potentiation of haloperidol toxicity? Case report and literature review. JPEN J Parenter.Enteral Nutr 1990;14(4):428-430. PubMed
- Nemery, B. Metal toxicity and the respiratory tract. Eur Respir.J 1990;3(2):202-219. DOI
- Vanek VW, Borum P, Buchman A, et al. A.S.P.E.N. position paper: recommendations for changes in commercially available parenteral multivitamin and multi-trace element products. Nutr Clin Pract. 2012;27:440-491.doi: 10.1177/0884533612446706 PubMed
- Schuh MJ. Possible Parkinson's disease induced by chronic manganese supplement ingestion. Consult Pharm. 2016;31(12):698-703. doi: 10.4140/TCP.n.2016.698. PubMed
- Baker B, Ali A, Isenring L. Recommendations for manganese supplementation to adult patients receiving long-term home parenteral nutrition: an analysis of the supporting evidence. Nutr Clin Pract 2016;31(2):180-5. doi: 10.1177/0884533615591600. PubMed
- Ho CSH, Ho RCM, Quek AML. Chronic manganese toxicity associated with voltage-gated potassium channel complex antibodies in a relapsing neuropsychiatric disorder. Int J Environ Res Public Health 2018;15(4). pii: E783. doi: 10.3390/ijerph15040783. PubMed
- Yamamoto M, Sakurai K, Eguchi A, et al.; Japan Environment and Children's Study Group: Association between blood manganese level during pregnancy and birth size: the Japan environment and children's study (JECS). Environ Res 2019;172:117-26. PubMed
- Li D, Ge X, Liu Z, et al. Association between long-term occupational manganese exposure and bone quality among retired workers. Environ Sci Pollut Res Int 2020;27(1):482-9. PubMed
- Martin KV, Sucharew H, Dietrich KN, et al. Co-exposure to manganese and lead and pediatric neurocognition in East Liverpool, Ohio. Environ Res 2021;202:111644. PubMed
- Racette BA, Nelson G, Dlamini WW, et al. Depression and anxiety in a manganese-exposed community. Neurotoxicology 2021;85:222-33. PubMed
- Ruiz-Azcona L, Fernández-Olmo I, Expósito A, et al. Impact of environmental airborne manganese exposure on cognitive and motor functions in adults: a systematic review and meta-analysis. Int J Environ Res Public Health 2021;18(8):4075. PubMed
- Uyar E, Gurkas E, Aksu AU, et al. Can therapeutic plasma exchange be life-saving in life-threatening manganese intoxication?. Transfus Apher Sci 2022;61(4):103417. PubMed
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.
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
Brands that make products with Manganese
1,404 brands in our database make a supplement containing Manganese.
Supplement products with Manganese
16,039 products in our database contain Manganese. Open any to see its full ingredient list and every drug interaction we check.
Manganese: Common Questions
What is Manganese used for, and does it work?
Does Manganese interact with prescription medications?
How are Manganese interactions rated?
Is it safe to take Manganese with my medications?
Where does this Manganese interaction information come from?
What is Manganese used for?
Is Manganese the same as magnesium?
Can I get enough Manganese from food?
Can taking too much Manganese be dangerous?
Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
Products that contain Manganese
A rotating sample of real supplements in our database that list Manganese — open any to see its full ingredients and every drug interaction we check.
- Electrolyte Supreme Fruit Punch by Jigsaw Health
- Total Mitochondria by Nutri-West
- OptiCleanse GHI Creamy Chocolate by XYMOGEN
- Coral Joint & Collagen by Coral
- Centravites 50 Plus Iron Free Formula by Optimum
- NanoMinerals by BioPharma Scientific
- High Potency Multi-Vitamin (C+E+Calcium+B1+B2) by NewtonEverett
- Complexin Super Supplement by Complexin
- MNS 3 by AdvoCare
- Ultra Protein Plus Natural Chocolate Flavor by Douglas Laboratories
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