Medication interaction hub

What Supplements Interact with Neostigmine Methylsulfate?

Neostigmine Methylsulfate brand name: Bloxiverz. Every interaction below applies to the brands too.

22 Interactions 21 Moderate 1 Minor
Curated & coded by · Clinical Pharmacist · Updated September 17, 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 Neostigmine Methylsulfate? 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 Neostigmine Methylsulfate 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.

Betel nut sits at the top of my concerns for anyone on neostigmine (Bloxiverz), a medication that boosts acetylcholine to strengthen nerve-to-muscle signaling. Nearly all 22 supplements on file work the same way the drug does, blocking the enzyme that clears acetylcholine, so stacking them can pile on cholinergic side effects like cramping, sweating, drooling, or a slowed heart rate. None rates major, and most people can handle these pairings, though each deserves a watchful eye rather than a shrug.

Huperzine A merits its own mention because it is sold as a memory supplement and blocks that same enzyme in its own right. European barberry leans the opposite direction and could blunt neostigmine's effect. Twenty-one of the 22 entries rate moderate and one minor, and most rest on lab or animal data, which is why noticing how a combination affects you matters more than avoiding it outright.

— , Clinical Pharmacist · July 18, 2026

Moderate 21 Minor 1 No known interaction 1,430

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

Neostigmine Methylsulfate: Top Interactions at a Glance

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

Showing the 12 highest-ranked of 22 interacting ingredients — plus 1,430 more checked with no known interaction. See the complete ranked list.

Start here

The Moderate Interactions to Know About

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

Moderate Likelihood Probable Betel Nut + Neostigmine Methylsulfatei

In vitro and animal research suggests that betel nut extract can inhibit acetylcholinesterase activity.

Read the full interaction Moderate Likelihood Possible Arenaria Rubra + Neostigmine Methylsulfatei

Arenaria rubra, by inhibiting acetylcholinesterase, may theoretically interact with other acetylcholinesterase inhibitors like donepezil and rivastigmine, commo...

Read the full interaction Moderate Likelihood Possible Bacopa + Neostigmine Methylsulfatei

Theoretically, concurrent use of bacopa with other cholinergic drugs might have additive effects.

Read the full interaction Moderate Likelihood Possible Bael + Neostigmine Methylsulfatei

Bael leaf extract shows acetylcholinesterase (AChE) inhibitory activity in vitro.

Read the full interaction Moderate Likelihood Possible Boxwood + Neostigmine Methylsulfatei

Evidence from in vitro research suggests that boxwood extract can inhibit acetylcholinesterase activity.

Read the full interaction Moderate Likelihood Possible Calamus + Neostigmine Methylsulfatei

Theoretically, concurrent use of cholinergic drugs and calamus might have an additive effect and increase the risk of cholinergic effects.

Read the full interaction
The complete list

Every Supplement Checked Against Neostigmine Methylsulfate

All 1,452 ingredients in our database, ranked by severity — 22 with a Neostigmine Methylsulfate interaction on file and 1,430 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 Neostigmine Methylsulfate?

One-line answers, one card per combination — scroll through today’s 20 and tap any card for the full report. A different set rotates in daily until every combination has had its turn.

Can you take Iboga with Neostigmine Methylsulfate?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, iboga might have additive effects with cholinergic drugs.

Full Iboga + Neostigmine Methylsulfate answer

Can you take Dimethylsulfoxide (dmso) with Neostigmine Methylsulfate?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, DMSO might increase the risk of cholinergic adverse effects when taken with cholinergic drugs.

Full Dimethylsulfoxide (dmso) + Neostigmine Methylsulfate answer

Can you take European Barberry with Neostigmine Methylsulfate?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, taking European barberry with cholinergic drugs might decrease the effects of cholinergic drugs.

Full European Barberry + Neostigmine Methylsulfate answer

Can you take Huperzine A with Neostigmine Methylsulfate?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, concurrent use of huperzine A with cholinergic drugs might increase the effects and side effects of these medications.

Full Huperzine A + Neostigmine Methylsulfate answer

Can you take Marjoram with Neostigmine Methylsulfate?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. In vitro research suggests that marjoram extract can inhibit acetylcholinesterase activity.

Full Marjoram + Neostigmine Methylsulfate answer

Can you take Nutmeg with Neostigmine Methylsulfate?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, concomitant use of nutmeg with other cholinergic drugs might have additive effects and increase the risk of cholinergic side...

Full Nutmeg + Neostigmine Methylsulfate answer

Can you take Phosphatidylserine with Neostigmine Methylsulfate?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, phosphatidylserine might have additive effects with cholinergic drugs.

Full Phosphatidylserine + Neostigmine Methylsulfate answer

Can you take Poria Mushroom with Neostigmine Methylsulfate?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, poria mushroom might have additive effects when used with cholinergic drugs.

Full Poria Mushroom + Neostigmine Methylsulfate answer

Can you take Purple Nut Sedge with Neostigmine Methylsulfate?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. In vitro, purple nut sedge dose-dependently inhibits acetylcholinesterase (AChE).

Full Purple Nut Sedge + Neostigmine Methylsulfate answer

Can you take Sage with Neostigmine Methylsulfate?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, sage might have additive effects when used with cholinergic drugs.

Full Sage + Neostigmine Methylsulfate answer

Can you take Syrian Rue with Neostigmine Methylsulfate?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, Syrian rue might increase the effects and adverse effects of cholinergic drugs.

Full Syrian Rue + Neostigmine Methylsulfate answer

Can you take Teazle with Neostigmine Methylsulfate?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. In vitro research suggests that teazle extract can inhibit acetylcholinesterase activity.

Full Teazle + Neostigmine Methylsulfate answer

Can you take Thyme with Neostigmine Methylsulfate?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, concurrent use of cholinergic drugs and thyme essential oil might cause additive cholinergic effects.

Full Thyme + Neostigmine Methylsulfate answer

Can you take Toothed Clubmoss with Neostigmine Methylsulfate?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Huperzine A, a constituent of toothed clubmoss, has demonstrated acetylcholinesterase inhibitory properties.

Full Toothed Clubmoss + Neostigmine Methylsulfate answer

Can you take Deanol with Neostigmine Methylsulfate?

Minor Usually — this is a minor-rated interaction, generally not clinically significant but worth mentioning to your pharmacist. Theoretically, deanol might increase the effects and adverse effects of cholinergic drugs.

Full Deanol + Neostigmine Methylsulfate answer

Can you take Betel Nut with Neostigmine Methylsulfate?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. In vitro and animal research suggests that betel nut extract can inhibit acetylcholinesterase activity.

Full Betel Nut + Neostigmine Methylsulfate answer

Can you take Arenaria Rubra with Neostigmine Methylsulfate?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Arenaria rubra, by inhibiting acetylcholinesterase, may theoretically interact with other acetylcholinesterase inhibitors like donepezil and...

Full Arenaria Rubra + Neostigmine Methylsulfate answer

Can you take Bacopa with Neostigmine Methylsulfate?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, concurrent use of bacopa with other cholinergic drugs might have additive effects.

Full Bacopa + Neostigmine Methylsulfate answer

Can you take Bael with Neostigmine Methylsulfate?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Bael leaf extract shows acetylcholinesterase (AChE) inhibitory activity in vitro.

Full Bael + Neostigmine Methylsulfate answer

Can you take Boxwood with Neostigmine Methylsulfate?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Evidence from in vitro research suggests that boxwood extract can inhibit acetylcholinesterase activity.

Full Boxwood + Neostigmine Methylsulfate 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) Neostigmine Methylsulfate is classified into the pharmacology categories it belongs to, (2) every supplement interaction documented against any of those categories is inherited by Neostigmine Methylsulfate, 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.

Neostigmine Methylsulfate sits in 2 interaction categories. Open any one to see what the group means:

Cholinergic Drugs 21 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.

21 of the supplement ingredients on this page reach Neostigmine Methylsulfate through this category.

Acetylcholinesterase (Ache) Inhibitors 2 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.

2 of the supplement ingredients on this page reach Neostigmine Methylsulfate through this category.

Check a real product

Take a Supplement Product? Check the Whole Bottle Against Neostigmine Methylsulfate

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 Neostigmine Methylsulfate.

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Pharmacist Counseling Corner

Neostigmine Methylsulfate & Supplements: Common Questions

What supplements interact with Neostigmine Methylsulfate?
Our database currently documents 22 ingredients with a known Neostigmine Methylsulfate interaction (0 major, 21 moderate, 1 minor). The practical move: scan the major group first, then look up the exact supplements you take rather than reading all 22. The highest-ranked right now: Betel Nut, Arenaria Rubra, Bacopa.
Which Neostigmine Methylsulfate supplement interactions are the most serious?
None of the Neostigmine Methylsulfate supplement interactions on file are currently rated major. The most significant are the 21 moderate-rated ones — combinations that may need monitoring, a dose adjustment, or separated timing. Still worth a quick look through the ranked list for anything you take daily. Jump to the ranked list.
Can I take vitamins or supplements while on Neostigmine Methylsulfate?
Plenty of supplements coexist fine with Neostigmine Methylsulfate; a shorter list does not. Rather than memorizing it, check the specific ingredients on your labels — the ranked list above covers every one we've checked, and multi-ingredient products can be checked label-by-label with our scanner. Try the label scanner or the interaction checker.
Do brands like Bloxiverz have the same supplement interactions as Neostigmine Methylsulfate?
Yes — Bloxiverz all contain Neostigmine Methylsulfate, 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 Neostigmine Methylsulfate and my other medications?
This page covers Neostigmine Methylsulfate against supplements and herbal ingredients. Checking Neostigmine Methylsulfate 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.

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 17, 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.