Medication interaction hub

What Supplements Interact with Maralixibat?

Maralixibat brand name: Livmarli. Every interaction below applies to the brands too.

17 Interactions 1 Major 7 Moderate 9 Minor
Curated & coded by · Clinical Pharmacist · Updated September 24, 2026

Drug–supplement interaction data sourced from Natural Medicines Pro, the licensed clinical database from TRC Healthcare / Therapeutic Research, with additional analysis by the HelloPharmacist Pharmacist Team. Our sources · Editorial policy

What is this page for?

One answer, for one medication: what supplements and herbal products interact with Maralixibat? Every vitamin, herb, and supplement ingredient we’ve checked against it is on this page, ranked by severity, each linking to the full report for that exact pair.

This page covers supplement interactions only — to check Maralixibat against your other medications, use the drug–drug interaction checker. Educational information from our licensed clinical databases, not medical advice. Our editorial policy

HelloPharmacist Bottom Line
Our Pharmacist Explains
What is this? The interaction data in the HelloPharmacist supplement database is licensed from Natural Medicines Pro by TRC Healthcare (Therapeutic Research). HelloPharmacist pharmacists often add our own analysis and context on top of that licensed data — such as this Bottom Line summary and the notes on individual interaction pages — and any such commentary is noted as ours.

Maralixibat (Livmarli) relieves the severe itching caused by rare childhood liver diseases like Alagille syndrome, and since it does its job inside the intestine, this list warrants genuine vigilance, not a shrug. All 17 supplement entries share one mechanism, ingredients that trap or slow drugs in the gut and change how much of a dose gets through. Activated charcoal carries the lone major rating because it adsorbs medications in the digestive tract and can sharply reduce their effect, so sort out that pairing first.

The remaining 16, seven moderate and nine minor, are mostly fibers, gums, and mucilage-rich plants like psyllium and glucomannan, the same materials used in bulk laxatives and thickeners. None demands outright avoidance, but each can blunt or shift absorption if swallowed with your dose. Space them well apart and let your pharmacist confirm how much separation your particular product needs.

— , Clinical Pharmacist · July 18, 2026

Major 1 Moderate 7 Minor 9 No known interaction 1,435

This box checks one ingredient at a time (like turmeric or magnesium). Taking a supplement product with a whole label of ingredients? Search the product instead — we check every ingredient on it ↓

Top Ingredient Interactions

Maralixibat: Top Interactions at a Glance

The most significant Maralixibat supplement & herbal interactions, colored by severity. Tap any ingredient to open the full report for that pair.

Showing the 12 highest-ranked of 17 interacting ingredients — plus 1,435 more checked with no known interaction. See the complete ranked list.

Start here

The Major Interactions to Know About

The most clinically significant Maralixibat + supplement combinations in our database, best-documented first. Open any card for the full report.

Major Likelihood Probable Activated Charcoal + Maralixibati

Activated charcoal reduces systemic exposure to many drugs, including those that undergo enterohepatic recirculation, regardless of the route of administration.

Read the full interaction
The complete list

Every Supplement Checked Against Maralixibat

All 1,452 ingredients in our database, ranked by severity — 17 with a Maralixibat interaction on file and 1,435 with none found. Filter by severity or search any ingredient; hover the for what each ingredient is.

Looking for an interaction with a specific supplement product? Search products instead ↓

Straight answers

Can You Take It With Maralixibat?

One-line answers, one card per combination — scroll through today’s 18 and tap any card for the full report. A different set rotates in daily until every combination has had its turn.

Can you take Xanthan Gum with Maralixibat?

Minor Usually — this is a minor-rated interaction, generally not clinically significant but worth mentioning to your pharmacist. Theoretically, xanthan gum can alter the absorption of oral drugs due to its fiber qualities.

Full Xanthan Gum + Maralixibat answer

Can you take Activated Charcoal with Maralixibat?

Major Use real caution — this is a major-rated interaction, generally best avoided or used only under close supervision. Activated charcoal reduces systemic exposure to many drugs, including those that undergo enterohepatic recirculation, regardless of the rout...

Full Activated Charcoal + Maralixibat answer

Can you take Coffee Charcoal with Maralixibat?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Coffee charcoal can reduce the absorption of orally administered drugs and should be separated from oral drug administration by at least two...

Full Coffee Charcoal + Maralixibat answer

Can you take European Mandrake with Maralixibat?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, concurrent use might increase absorption of some drugs because of inhibited gastrointestinal (GI) motility caused by European...

Full European Mandrake + Maralixibat answer

Can you take Glucomannan with Maralixibat?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, glucomannan may decrease absorption of drugs taken orally.

Full Glucomannan + Maralixibat answer

Can you take Guar Gum with Maralixibat?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Guar gum might reduce the absorption of some oral drugs, potentially decreasing their effectiveness.

Full Guar Gum + Maralixibat answer

Can you take Gum Arabic with Maralixibat?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, gum arabic can alter the absorption of oral drugs due to its fiber content.

Full Gum Arabic + Maralixibat answer

Can you take Slippery Elm with Maralixibat?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, slippery elm may slow the absorption and reduce serum levels of oral drugs.

Full Slippery Elm + Maralixibat answer

Can you take Tragacanth with Maralixibat?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, tragacanth might alter absorption of oral drugs.

Full Tragacanth + Maralixibat answer

Can you take Thyroid Extract with Maralixibat?

Minor Usually — this is a minor-rated interaction, generally not clinically significant but worth mentioning to your pharmacist. Food and medications can interfere with thyroid hormone absorption.

Full Thyroid Extract + Maralixibat answer

Can you take Agar with Maralixibat?

Minor Usually — this is a minor-rated interaction, generally not clinically significant but worth mentioning to your pharmacist. Agar forms a thick gel, which may disrupt the absorption of nutrients and medications.

Full Agar + Maralixibat answer

Can you take Algin with Maralixibat?

Minor Usually — this is a minor-rated interaction, generally not clinically significant but worth mentioning to your pharmacist. Theoretically, algin can alter the absorption of oral drugs.

Full Algin + Maralixibat answer

Can you take Black Psyllium with Maralixibat?

Minor Usually — this is a minor-rated interaction, generally not clinically significant but worth mentioning to your pharmacist. Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.

Full Black Psyllium + Maralixibat answer

Can you take Blond Psyllium with Maralixibat?

Minor Usually — this is a minor-rated interaction, generally not clinically significant but worth mentioning to your pharmacist. Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.

Full Blond Psyllium + Maralixibat answer

Can you take Carob with Maralixibat?

Minor Usually — this is a minor-rated interaction, generally not clinically significant but worth mentioning to your pharmacist. Theoretically, carob might also impair the absorption of oral drugs.

Full Carob + Maralixibat answer

Can you take Karaya Gum with Maralixibat?

Minor Usually — this is a minor-rated interaction, generally not clinically significant but worth mentioning to your pharmacist. Co-administration of oral drugs with bulk forming laxatives such as karaya gum may decrease, increase, or have no effect on the absorption o...

Full Karaya Gum + Maralixibat answer

Can you take Marshmallow with Maralixibat?

Minor Usually — this is a minor-rated interaction, generally not clinically significant but worth mentioning to your pharmacist. Theoretically, mucilage in marshmallow might impair absorption of oral drugs.

Full Marshmallow + Maralixibat answer

Can you take Xanthan Gum with Maralixibat?

Minor Usually — this is a minor-rated interaction, generally not clinically significant but worth mentioning to your pharmacist. Theoretically, xanthan gum can alter the absorption of oral drugs due to its fiber qualities.

Full Xanthan Gum + Maralixibat answer
Read the list like a pharmacist

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 entry links to a full report with the clinical detail, likelihood, evidence level, and citations for that exact combination.
  • Content is reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

How Does Our Interaction Checker Work?

Behind every verdict on this page is a category system. Our source database doesn’t document supplement interactions drug-by-drug — it documents them against groups of medications that behave the same way (for example, “drugs processed by the CYP3A4 liver enzyme” or “blood-thinning medications”).

So the check works in three steps: (1) Maralixibat is classified into the pharmacology categories it belongs to, (2) every supplement interaction documented against any of those categories is inherited by Maralixibat, and (3) each ingredient keeps its own severity, likelihood, and evidence grades from the underlying record. That’s why one supplement can carry several records for one drug — it may interact through more than one category.

Maralixibat sits in 1 interaction category. Open any one to see what the group means:

Oral Drugs 17 ingredients

A pharmacology grouping from our source database: medications in this group share a property that certain supplements are known to interact with, so an interaction documented for the group applies to every drug in it.

17 of the supplement ingredients on this page reach Maralixibat through this category.

About Maralixibat

Maralixibat (Livmarli) is an IBAT inhibitor used to treat cholestatic pruritus — severe itch caused by bile acid buildup — in patients with Alagille syndrome or progressive familial intrahepatic cholestasis.

Generic name: Maralixibat  ·  Brand name: Livmarli.

See the full Maralixibat drug information
Check a real product

Take a Supplement Product? Check the Whole Bottle Against Maralixibat

Most supplements are combination products — and the interaction may come from an ingredient you didn’t buy it for. Search any product below (or scan its label) and we’ll check every ingredient on it against Maralixibat.

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Products that contain Maralixibat-interacting ingredients

Real supplements from the NIH label database that contain the top interacting ingredients on this page — each one is worth a full label check before combining with Maralixibat.

SunFiber by Tomorrow's Nutrition Pro contains Guar Gum Fiber Fusion Daily 3.1 g by Nature's Way contains Guar Gum Mightiest Vite Tasty Fruit Punch Flavor by Little DaVinci contains Guar Gum Digestion Support by NaturesPlus AgeLoss contains Guar Gum
Pharmacist Counseling Corner

Maralixibat & Supplements: Common Questions

What supplements interact with Maralixibat?
More than you might expect — 17 in total, though they are far from equal: 1 are rated major, 7 moderate, and 9 minor. The ranked list on this page puts the ones that genuinely matter first, and every entry opens a full report on that exact pair. The highest-ranked right now: Activated Charcoal, Coffee Charcoal, European Mandrake.
Which Maralixibat supplement interactions are the most serious?
The 1 major-rated combination — led by Activated Charcoal — deserve real caution: these are the ones generally best avoided, or used only with your prescriber watching. If you take any of them today, don't panic and don't stop anything abruptly — call your pharmacist first. Jump to the ranked list.
Can I take vitamins or supplements while on Maralixibat?
Usually yes — most people on Maralixibat can take most supplements. The catch is the exceptions, and they aren't always the exotic ones (St. John's Wort trips up more prescriptions than almost anything sold next to it). Look up each ingredient you actually take in the list above, and treat "no known interaction" as a green-ish light, not a guarantee. Try the label scanner or the interaction checker.
Do brands like Livmarli have the same supplement interactions as Maralixibat?
Yes — Livmarli all contain Maralixibat, so everything on this page applies to them equally. Interactions belong to the active drug, never to the brand on the box; the same is true of generics.
Where do these interaction ratings come from?
Every rating comes from the Natural Medicines database — the same evidence-graded reference pharmacists and hospitals use — and each interaction carries three separate grades: severity (how bad it can be), likelihood (how well it's documented in studies and case reports), and an evidence level. Our pharmacists review the content; we never let an AI decide an interaction. See how to read the ratings and our editorial policy.
What about Maralixibat and my other medications?
This page covers Maralixibat against supplements and herbal ingredients. Checking Maralixibat against your other prescription or OTC medications is a different tool — our drug interaction checker covers that side. Head to the drug–drug interaction checker, or read the full Maralixibat drug information.

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

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Sourcing

Where This Data Comes From — and Why You Can Trust It

🧪 Licensed clinical database

Every interaction verdict on this page comes from Natural Medicines Pro (TRC Healthcare / Therapeutic Research) — the same evidence-graded reference used by pharmacists and hospitals. We license this data directly; we do not scrape it, and no AI invents an interaction.

🧑‍⚕️ Pharmacist review

This page is curated and coded by , Clinical Pharmacist, with additional analysis by the HelloPharmacist Pharmacist Team. Editorial commentary is ours; the licensed interaction records are shown as sourced.

🔄 Kept current

Our interaction database refreshes on a weekly cycle, and this page re-checks the live database every time it’s rebuilt — what you see reflects the database as of September 24, 2026.

🔍 Full transparency

How every dataset on this site is sourced, licensed, and updated is documented publicly: our data sources · editorial policy · how we use AI.

Educational information, not medical advice. An interaction being on file does not mean it will happen to you — and absence of one is not proof of safety. Never start or stop a medication or supplement without talking to your pharmacist or doctor.