Medication interaction hub

What Supplements Interact with Pancrelipase (prescription drug)?

Pancrelipase (prescription drug) brand names: Viokace, Cotazym ECS 4, Pancrease, Cotazym ECS 65B, Cotazym ECS 8, and others. Every interaction below applies to the brands too.

19 Interactions 2 Major 8 Moderate 9 Minor
Curated & coded by · Clinical Pharmacist · Updated September 30, 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 Pancrelipase (prescription drug)? 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 Pancrelipase (prescription drug) 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.

Pancrelipase (Viokace, Pancrease, Cotazym) replaces digestive enzymes a failing pancreas cannot supply, and since it does all of its work inside the gut, the 19 supplement interactions on file deserve real attention rather than a shrug. Most involve fibers, gums, and mucilage-rich herbs that can slow or reduce absorption of oral medicines, but two carry a major rating, activated charcoal and St. John's wort, and those are the ones to understand first.

Of the remaining seventeen, eight rate moderate and nine minor, psyllium being the everyday example, and for most of them the answer is simple separation, taking the fiber product well apart from each enzyme dose. Charcoal is different because it can adsorb medicines and reduce exposure no matter how they are taken, so spacing alone may not be enough. St. John's wort acts through another route entirely, speeding up the body's drug-clearing enzymes and lowering drug levels enough to blunt a medicine's effect.

— , Clinical Pharmacist · July 18, 2026

Major 2 Moderate 8 Minor 9 No known interaction 1,433

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

Pancrelipase (prescription drug): Top Interactions at a Glance

The most significant Pancrelipase (prescription drug) supplement & herbal interactions, colored by severity. Tap any ingredient to open the full report for that pair.

Showing the 12 highest-ranked of 19 interacting ingredients — plus 1,433 more checked with no known interaction. See the complete ranked list.

Start here

The Major Interactions to Know About

The most clinically significant Pancrelipase (prescription drug) + supplement combinations in our database, best-documented first. Open any card for the full report.

Major Likelihood Likely St. John's Wort + Pancrelipase (prescription drug)i

St.

Read the full interaction Major Likelihood Probable Activated Charcoal + Pancrelipase (prescription drug)i

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 Pancrelipase (prescription drug)

All 1,452 ingredients in our database, ranked by severity — 19 with a Pancrelipase (prescription drug) interaction on file and 1,433 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 Pancrelipase (prescription drug)?

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 Activated Charcoal with Pancrelipase (prescription drug)?

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 + Pancrelipase (prescription drug) answer

Can you take European Mandrake with Pancrelipase (prescription drug)?

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 + Pancrelipase (prescription drug) answer

Can you take Glucomannan with Pancrelipase (prescription drug)?

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 + Pancrelipase (prescription drug) answer

Can you take Garlic with Pancrelipase (prescription drug)?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, garlic products containing allicin might decrease levels of PIs.

Full Garlic + Pancrelipase (prescription drug) answer

Can you take Guar Gum with Pancrelipase (prescription drug)?

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 + Pancrelipase (prescription drug) answer

Can you take Gum Arabic with Pancrelipase (prescription drug)?

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 + Pancrelipase (prescription drug) answer

Can you take Slippery Elm with Pancrelipase (prescription drug)?

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 + Pancrelipase (prescription drug) answer

Can you take Tragacanth with Pancrelipase (prescription drug)?

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 + Pancrelipase (prescription drug) answer

Can you take Thyroid Extract with Pancrelipase (prescription drug)?

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 + Pancrelipase (prescription drug) answer

Can you take Agar with Pancrelipase (prescription drug)?

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 + Pancrelipase (prescription drug) answer

Can you take Algin with Pancrelipase (prescription drug)?

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 + Pancrelipase (prescription drug) answer

Can you take Black Psyllium with Pancrelipase (prescription drug)?

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 + Pancrelipase (prescription drug) answer

Can you take Blond Psyllium with Pancrelipase (prescription drug)?

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 + Pancrelipase (prescription drug) answer

Can you take Carob with Pancrelipase (prescription drug)?

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 + Pancrelipase (prescription drug) answer

Can you take Karaya Gum with Pancrelipase (prescription drug)?

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 + Pancrelipase (prescription drug) answer

Can you take Marshmallow with Pancrelipase (prescription drug)?

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 + Pancrelipase (prescription drug) answer

Can you take Xanthan Gum with Pancrelipase (prescription drug)?

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 + Pancrelipase (prescription drug) answer

Can you take St. John's Wort with Pancrelipase (prescription drug)?

Major Use real caution — this is a major-rated interaction, generally best avoided or used only under close supervision. St.

Full St. John's Wort + Pancrelipase (prescription drug) answer

Can you take Coffee Charcoal with Pancrelipase (prescription drug)?

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 + Pancrelipase (prescription drug) answer

Can you take European Mandrake with Pancrelipase (prescription drug)?

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 + Pancrelipase (prescription drug) 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) Pancrelipase (prescription drug) is classified into the pharmacology categories it belongs to, (2) every supplement interaction documented against any of those categories is inherited by Pancrelipase (prescription drug), 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.

Pancrelipase (prescription drug) sits in 2 interaction categories. 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 Pancrelipase (prescription drug) through this category.

Protease Inhibitors (Pis) 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 Pancrelipase (prescription drug) through this category.

About Pancrelipase (prescription drug)

Pancrelipase replaces the digestive enzymes your pancreas isn't making enough of, so your body can properly absorb fats, proteins, and carbohydrates.

Generic name: Pancrelipase (prescription drug)  ·  Brand names: Viokace, Cotazym ECS 4, Pancrease, Cotazym ECS 65B, Cotazym ECS 8, Cotazym, Cotazym ECS 20, CREON, Ultrase MT, Ultrase, Pertzye, Pancreaze, Zenpep.

See the full Pancrelipase drug information

Related: does Pancrelipase (prescription drug) deplete any nutrients?

Pancrelipase (prescription drug) has 26 reported nutrient associations in the research literature — see the Pancrelipase (prescription drug) nutrient depletion report.

Check a real product

Take a Supplement Product? Check the Whole Bottle Against Pancrelipase (prescription drug)

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 Pancrelipase (prescription drug).

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Products that contain Pancrelipase (prescription drug)-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 Pancrelipase (prescription drug).

Standardized St. John's Wort 600 mg by Nature's Truth contains St. John's Wort St. John's Wort-IMT by SP Standard Process contains St. John's Wort St John's Wort Extract by SuperSmart contains St. John's Wort St John's Wort 400 mg by Signature Supplements contains St. John's Wort
Pharmacist Counseling Corner

Pancrelipase (prescription drug) & Supplements: Common Questions

What supplements interact with Pancrelipase (prescription drug)?
Our database currently documents 19 ingredients with a known Pancrelipase (prescription drug) interaction (2 major, 8 moderate, 9 minor). The practical move: scan the major group first, then look up the exact supplements you take rather than reading all 19. The highest-ranked right now: St. John's Wort, Activated Charcoal, Coffee Charcoal.
Which Pancrelipase (prescription drug) supplement interactions are the most serious?
The 2 major-rated combinations — led by St. John's Wort and 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 Pancrelipase (prescription drug)?
Plenty of supplements coexist fine with Pancrelipase (prescription drug); 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 Viokace have the same supplement interactions as Pancrelipase (prescription drug)?
Yes — Viokace, Cotazym ECS 4, Pancrease, Cotazym ECS 65B, Cotazym ECS 8 and other brands all contain Pancrelipase (prescription drug), 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.
Does Pancrelipase (prescription drug) deplete any vitamins or nutrients?
It might — Pancrelipase (prescription drug) has 26 reported nutrient-depletion associations in the research literature, which is a different question from interactions: instead of a supplement changing the drug, the drug may lower a nutrient over time. See the Pancrelipase (prescription drug) nutrient depletion report for the specifics and what to discuss with your pharmacist.
What about Pancrelipase (prescription drug) and my other medications?
This page covers Pancrelipase (prescription drug) against supplements and herbal ingredients. Checking Pancrelipase (prescription drug) 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 Pancrelipase 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 30, 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.