100% Whey Protein Fuel Chocolate Surge Ingredients & Drug Interactions
by Twinlab
What is this page for?
First and foremost: checking 100% Whey Protein Fuel Chocolate Surge against your medications. The heart of this page is the interaction checker and the full interaction report — how this product’s ingredients may interact with prescription and over-the-counter medicines you may be taking.
Around that, we add a pharmacist’s high-level view of the product as a whole — what’s inside, the evidence for its stated use, how transparent the label is, and what safety data exists — so you can see the full picture in one place. It’s educational information from our licensed clinical databases and the clinical staff at HelloPharmacist — not medical advice — and we don’t sell or endorse products. Our editorial policy
100% Whey Protein Fuel Chocolate Surge is a dietary supplement by Twinlab with 28 active ingredients. Its ingredients are commonly taken for replacing fluids and electrolytes, preventing dehydration during exercise or illness, treating low blood sodium (under medical care).Based on those ingredients, 1,334 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are Theobromine, L-Arginine, L-Tryptophan. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against 100% Whey Protein Fuel Chocolate Surge by Twinlab
Ask about any prescription or over-the-counter medication and we check it for interactions with 100% Whey Protein Fuel Chocolate Surge by Twinlab — and tell you which ingredient is responsible.
AI summaries are generated from our interaction database for education only — always confirm with your pharmacist. How we use AI
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HelloPharmacist Scorecard of 100% Whey Protein Fuel Chocolate Surge by Twinlab
Our pharmacy team’s full take, with four database checks built into the cards below — a summary of what is known, not a grade of the product itself.
What’s inside
Full disclosure
This powder contains 26 ingredients, of which the active components are a blend of whey protein (concentrate and isolate) plus amino acids and minerals. The amino acids include L-leucine, L-arginine, L-alanine, L-isoleucine, L-methionine, L-tyrosine, L-phenylalanine, L-valine, L-proline, L-aspartic acid, L-histidine, L-glutamic acid, L-threonine, L-tryptophan, L-lysine, and L-serine.
The mineral content includes sodium, potassium, phosphorus, calcium, iron, and magnesium. The remaining ingredients are inactive fillers and flavorings: cocoa powder, chocolate flavor, guar gum, acesulfame potassium, sucralose, and soy lecithin.
Does it work?
Not established
The whey protein itself is well established for muscle building and recovery — that's the backbone of this product. Regarding specific amino acids, the evidence is mixed.
L-phenylalanine shows possibly ineffective for ADHD, while L-tyrosine is possibly effective for cognitive function and memory, though possibly ineffective for athletic performance. L-tryptophan is possibly ineffective for depression.
L-serine is possibly effective for schizophrenia. L-histidine is possibly effective for cholera but has insufficient evidence for most other uses.
The minerals have clearer roles: sodium is necessary for nerve and muscle function but is over-consumed in typical diets; calcium is likely effective for osteoporosis and bone health; iron is effective for iron deficiency anemia; and magnesium is effective for constipation and pre-eclampsia. Many of the other amino acids carry insufficient evidence for their proposed effects.
How safe is it?
Well-documented data
This product is generally well tolerated at recommended doses. Sodium in normal dietary amounts is fine, but the combination of sodium in this product plus other dietary sources can contribute to high blood pressure and heart strain — avoid supplementing sodium further without medical advice.
Potassium from food is safe, but supplements can raise blood levels dangerously in people with kidney disease; check with your doctor if you have kidney concerns. Calcium, iron, and magnesium are safe at recommended levels, though excess iron can be toxic and high doses of any mineral warrant medical guidance.
L-phenylalanine should be avoided entirely by people with phenylketonuria (PKU). L-tryptophan caused a serious contamination scare in the past (eosinophilia-myalgia syndrome in contaminated batches from one manufacturer in the 1980s); modern products are now regulated more closely, but the history remains a caution.
Regarding pregnancy and lactation: sodium's safety is likely safe overall but possibly unsafe in some contexts; potassium is likely safe; calcium is likely safe but possibly unsafe in high doses; iron is likely safe in pregnancy and likely unsafe while breastfeeding; magnesium is likely safe in pregnancy and possibly safe while breastfeeding; L-arginine is possibly safe in pregnancy with no data on lactation; L-phenylalanine is likely safe in pregnancy but unsafe while breastfeeding; L-tryptophan is likely safe in pregnancy but possibly unsafe and unsafe while breastfeeding; and several other amino acids lack sufficient data for pregnancy or breastfeeding — talk with your healthcare provider before use during these periods.
Meds to double-check
Major interaction found
Before taking this product, double-check any prescription medications, especially: blood pressure drugs and ACE inhibitors or ARBs (sodium and L-arginine may lower pressure too much; potassium may cause dangerous elevation); thyroid medication (calcium and iron reduce absorption; L-tyrosine may interfere); HIV medications like dolutegravir or elvitegravir (calcium reduces their levels); Parkinson's medication, levodopa or carbidopa (L-phenylalanine and magnesium reduce effectiveness); lithium (sodium alters blood levels); corticosteroids (sodium increases retention risk); muscle relaxants (magnesium prolongs effects); antidiabetes drugs (L-arginine may lower blood sugar too much); quinolone or tetracycline antibiotics (iron and magnesium reduce absorption); and any sedating medications (L-tryptophan may add drowsiness). No interactions are documented for the few ingredients we could not check.
The bottom line
Scorecard at a glanceFully disclosed formula with no established evidence rating for its marketed use. Major medication interactions have been identified, and safety information is well characterized.
This whey protein powder is a solid choice for muscle support if you don't take medications — whey is well studied and effective. But if you're on any blood pressure drugs, heart medications, thyroid medication, antibiotics, lithium, or diabetes drugs, you need to check your specific medications with the tool on this page before you start.
The amino acid L-phenylalanine is particularly risky with Parkinson's medication. If you have kidney disease, high blood pressure, or are pregnant or breastfeeding, talk with your pharmacist or doctor first.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 20 of 26 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Jan 25, 2012.
This Scorecard evaluates available label information, ingredient evidence, and known medication-safety considerations. It does not independently verify product identity, purity, potency, contamination, or manufacturing quality. How these ratings are computed
General information
Key facts about 100% Whey Protein Fuel Chocolate Surge, straight from the product label.
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.
Supplement Facts
The label details for 100% Whey Protein Fuel Chocolate Surge by Twinlab, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Calories | 140 {Calories} | -- |
| Total Carbohydrates | 5 g | 2% |
| Sugar | 1 g | -- |
| Calories from Fat | 20 {Calories} | -- |
| Total Fat | 2 g | 3% |
| Protein | 25 g | 50% |
| Saturated Fat | 1 g | 5% |
| Sodium | 60 mg | 3% |
| Trans Fat | 0 g | -- |
| Potassium | 310 mg | 9% |
| Cholesterol | 60 mg | 21% |
| Phosphorus | 112 mg | 12% |
| Vitamin A | 109 IU | 2% |
| Calcium | 128 mg | 13% |
| Iron | 0.4 mg | 2% |
| Glycine | 450 mg | -- |
| Magnesium | 33 mg | 8% |
| L-Leucine | 2650 mg | -- |
| L-Arginine | 600 mg | -- |
| L-Alanine | 1280 mg | -- |
| L-Isoleucine | 1610 mg | -- |
| L-Methionine | 620 mg | -- |
| L-Tyrosine | 770 mg | -- |
| L-Phenylalanine | 830 mg | -- |
| L-Valine | 1480 mg | -- |
| L-Proline | 1600 mg | -- |
| L-Aspartic Acid | 3310 mg | -- |
| L-Histidine | 470 mg | -- |
| L-Glutamic Acid | 4640 mg | -- |
| L-Threonine | 1810 mg | -- |
| L-Tryptophan | 560 mg | -- |
| Alpha-Glucan Oligosaccharide | 720 mg | -- |
| L-Lysine | 2180 mg | -- |
| L-Serine | 1280 mg | -- |
| Theobromine | 63 mg | -- |
Other ingredients: Whey protein concentrate and isolate, Cocoa powder, Chocolate flavor, Guar Gum, Acesulfame Potassium, Sucralose, Soy Lecithin
Tap any ingredient to jump to its full detail below.
These statements are the manufacturer’s wording, reproduced from the product label — the label is saying it, not HelloPharmacist. We don’t verify or endorse them.
FDA Statement of Identity
DIETARY SUPPLEMENT
Suggested/Recommended/Usage/Directions
Directions: Add 1 scoop to 6 fl. oz. of cold water or 2 scoops to 12 fl. oz. of cold water. Consume 1-2 servings daily. For best results, use as part of a proper diet and exercise program.
Precautions
KEEP OUT OF REACH OF CHILDREN
WARNING: Do not use if pregnant or nursing. Consult a health care professional before use if you are taking any medication or have a medical condition.
Contains milk and soy ingredients.
Produced in a facility that also processes egg, wheat, treenut, peanut, fish and shellfish ingredients.
Notice: Use this product as a food supplement only. Do not use for weight reduction.
FDA Disclaimer Statement
*These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.
Formula
50g PROTEIN! (2 SERVINGS)
TYPICAL AMINO ACID PROFILE PER SERVING L-Alanine. . . . . . . . . . . . . . . . 1,280 mg L-Arginine . . . . . . . . . . . . . . . . .600 mg L-Aspartic Acid . . . . . . . . . . . 3,310 mg L-Cystine . . . . . . . . . . . . . . . . . 720 mg L-Glutamic Acid . . . . . . . . . . .4,640 mg Glycine . . . . . . . . . . . . . . . . . . . 450 mg L-Histidine . . . . . . . . . . . . . . . . . . . . . . . .470 mg L-Isoleucine (BCAA) †† . . . . . . . . . . . . .1,610 mg L-Leucine (BCAA) †† . . . . . . . . . . . . . . 2,650 mg L-Lysine †† . . . . . . . . . . . . . . . . . . . . . 2,180 mg L-Methionine †† . . . . . . . . . . . . . . . . . . . 620 mg L-Phenylalanine †† . . . . . . . . . . . . . . . . . 830 mg L-Proline . . . . . . . . . . . . . . . . . . . . 1,600 mg L-Serine . . . . . . . . . . . . . . . . . . . . .1,280 mg L-Threonine ††. . . . . . . . . . . . . . . .1,810 mg L-Tryptophan #†† . . . . . . . . . . . . . . . 560 mg L-Tyrosine . . . . . . . . . . . . . . . . . . . . .770 mg Mass L-Valine (BCAA) ††. . . . . . . . . . . . . 1,480 mg †† Essential Amino Acids # Naturally Occuring. Not added or manufactured.
General Statements
100% INSTANTIZED, QUICK DISSOLVING STIMULATES MUSCLE GROWTH AND IMPROVES POST-WORKOUT RECOVERY*
Best if used by date shown on container.
BEST TASTING…COMPARE!
CHOCOLATE SURGE Natural and Artificial Flavors
Mass
General
2024676.4
Brand IP Statement(s)
1 As measured by the Protein Digestibility-Corrected Amino Acid Score. 2 Based on physically active 70 kg (154 lb) person. 3 Adapted from Lemon PWR. Effect of Exercise on Dietary Protein Requirements. Intl. J. Sport Nutrition (1998) 8:426-447. 4 Based on 70 kg (154 lb) person and adapted from Boirie Y. et al. Slow and Fast Dietary Proteins Differently Modulate Postprandial Protein Accretion. Proc. Nat’l. Acad. Sci. USA (1997) 94:14930-14935.
EFFECT OF 100% WHEY PROTEIN INTAKE2 ON RATE OF MUSCLE PROTEIN SYNTHESIS3 EFFECT OF 100% WHEY PROTEIN INTAKE ON AMINO ACID LEVELS4 MUSCLE PROTEIN SYNTHESIS RATE (g/hr) AMINO ACID APPEARANCE RATE (µmol/min) PROTEIN INTAKE (g/day) HOURS AFTER INGESTION
THE SCIENCE BEHIND THE SIZE: • PRODUCT: A superior blend of high quality, bioavailable 100% Whey Proteins: WPC and WPI. A premier concentrate that is 100% instantized, quick dissolving and easy-to-mix with a rich, refreshing taste. • RESULT: Stimulates muscle protein anabolism, which maximizes muscle growth that occurs after exercise, by enhancing muscle building and lean tissue mass.* Also, increases muscle performance and improves post-workout recovery.* • SCIENCE: Clinical studies show that 100% whey protein is one of the most anabolic muscle building proteins available, providing a rapid drive of amino acids to skeletal muscle tissue, thereby increasing the anabolic effects of weight training.* Enhanced muscle protein anabolism increases muscle growth, to maximize gains.* Research also shows that 100% whey protein has one of the highest protein qualities of all proteins1, and has one of the highest Protein Efficiency Ratios, providing more amino acids than most other proteins.
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
100% Whey Protein Fuel Chocolate Surge by Twinlab label
The label scan from the NIH Dietary Supplement Label Database. Tap to enlarge.
Label images are published by the NIH Dietary Supplement Label Database for the version of this product on file. Always read your actual product label.
View the full label (PDF)The Ingredients in 100% Whey Protein Fuel Chocolate Surge by Twinlab
These are the 28 active ingredients this product is made of. Select any to open its full monograph.
Serving size35 Gram(s) Dosage formPowder Servings per container26 Amounts shown are per serving.
Most supplement products combine several ingredients, and a medication can interact with the product through any one of them. Each ingredient below shows whether it has known drug interactions.
Sugar
Protein
Sodium
Interacts with205 drugs
Sodium is an essential mineral and electrolyte your body needs to balance fluids, support nerves, and help muscles work. Most people in modern diets g...
Sodium monograph & interactionsPotassium
Interacts with62 drugs
Potassium is an essential mineral your body needs for nerve signals, muscle function, and a steady heartbeat, and most people get enough from a balanc...
Potassium monograph & interactionsPhosphorus
Vitamin A
Interacts with387 drugs
Vitamin A is an essential nutrient important for vision, skin, immune function, and growth. Most people get enough from a balanced diet, and supplemen...
Vitamin A monograph & interactionsCalcium
Interacts with168 drugs
Calcium is an essential mineral your body needs for strong bones, nerve signaling, and muscle function, and supplements can help fill gaps when diet f...
Calcium monograph & interactionsIron
Interacts with80 drugs
Iron is an essential mineral your body needs to make hemoglobin and carry oxygen in the blood. Supplements are mainly useful for treating or preventin...
Iron monograph & interactionsGlycine
Interacts with1 drug
Glycine is a non-essential amino acid your body makes on its own and that also appears in protein-rich foods. It is most studied for improving sleep q...
Glycine monograph & interactionsMagnesium
Interacts with295 drugs
Magnesium is an essential mineral your body needs for muscles, nerves, blood pressure, and many other functions, and supplements are useful for preven...
Magnesium monograph & interactionsL-Leucine
L-Arginine
Interacts with403 drugs
L-arginine is an amino acid that the body uses to make nitric oxide, a substance that helps blood vessels relax and widen. It is popularly used for bl...
L-Arginine monograph & interactionsL-Alanine
No knowninteractions
Alpha-alanine (usually called alanine) is a non-essential amino acid your body can make on its own and that you also get from protein foods. Most peop...
L-Alanine monograph & interactionsL-Isoleucine
L-Methionine
No knowninteractions
Methionine is an essential amino acid that your body needs for protein building and many basic chemical reactions. Most people get enough from a norma...
L-Methionine monograph & interactionsL-Tyrosine
Interacts with21 drugs
L-tyrosine is an amino acid your body uses to make brain chemicals like dopamine and norepinephrine. Some studies suggest it may help mental performan...
L-Tyrosine monograph & interactionsL-Phenylalanine
Interacts with16 drugs
Phenylalanine is an essential amino acid the body uses to make brain chemicals like dopamine and norepinephrine. Some people take it for mood, vitilig...
L-Phenylalanine monograph & interactionsL-Valine
L-Proline
No knowninteractions
Proline is a non-essential amino acid that your body can make on its own and that you also get from protein-rich foods. It is a key building block of...
L-Proline monograph & interactionsL-Aspartic Acid
No knowninteractions
Aspartic acid is a common amino acid your body makes on its own and gets from protein-rich foods, so a true deficiency is rare. D-aspartic acid is hea...
L-Aspartic Acid monograph & interactionsL-Histidine
No knowninteractions
Histidine is an essential amino acid your body needs to build proteins and to make compounds like histamine and carnosine. Most people get enough from...
L-Histidine monograph & interactionsL-Glutamic Acid
L-Threonine
Interacts with3 drugs
Threonine is an essential amino acid your body needs but cannot make, so you must get it from food or supplements. Most people get plenty from a norma...
L-Threonine monograph & interactionsL-Tryptophan
Interacts with394 drugs
L-tryptophan is an essential amino acid the body uses to make serotonin and melatonin, and people take it to support sleep and mood. The evidence for...
L-Tryptophan monograph & interactionsAlpha-Glucan Oligosaccharide
L-Lysine
Interacts with1 drug
Lysine is an essential amino acid your body cannot make on its own, so it must come from food or supplements. People most often take extra lysine to t...
L-Lysine monograph & interactionsL-Serine
No knowninteractions
Serine is an amino acid your body can make on its own and also gets from protein-rich foods, so most people do not need a supplement. L-serine has bee...
L-Serine monograph & interactionsTheobromine
Interacts with661 drugs
Cocoa is rich in plant compounds called flavanols that may modestly support blood vessel function and blood pressure, but most chocolate products are...
Theobromine monograph & interactionsOther (inactive) ingredients: Whey protein concentrate and isolate, Cocoa powder, Chocolate flavor, Guar Gum, Acesulfame Potassium, Sucralose, Soy Lecithin. These complete the product’s ingredient list but are not active constituents.
100% Whey Protein Fuel Chocolate Surge by Twinlab Drug Interactions
HelloPharmacist Interaction Report
Twinlab's 100% Whey Protein Fuel Chocolate Surge contains several ingredients with documented medication interactions.
The most serious is L-phenylalanine, which carries a Major-severity interaction with levodopa (Sinemet) — the amino acid competes with the drug for transport into the brain, potentially worsening Parkinson symptoms like tremor and rigidity.
Read the full breakdown — every affected drug type, severity by severity
Sodium, potassium, calcium, iron, magnesium, L-arginine, L-tyrosine, L-threonine, and L-tryptophan all have Moderate-severity interactions across multiple drug classes. Sodium may reduce the effectiveness of blood pressure medications and can increase the risk of dangerously high sodium levels with corticosteroids, lithium, and HIV medications like didanosine.
Potassium can cause dangerously high blood levels when combined with blood pressure drugs (ACE inhibitors and ARBs) or potassium-sparing water pills. Calcium reduces absorption of certain HIV medications, thyroid hormones, and some heart drugs.
Iron decreases absorption of antibiotics, thyroid medication, and several other drugs. Magnesium interacts with Parkinson's medication, muscle relaxants, and diabetes drugs.
L-arginine, L-tyrosine, and L-tryptophan each affect blood pressure control, thyroid hormones, or sedating medications. L-threonine theoretically affects NMDA antagonists (ketamine-type drugs).
Additionally, glycine, L-lysine carry Minor interactions. Altogether, these interactions span 1,316 individual medications.
Several ingredients — L-leucine, L-isoleucine, L-valine, L-glutamic acid, and alpha-glucan oligosaccharide — we could not check because we hold no data for them. Use the medication checker below to verify your exact prescriptions before starting this product.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against 100% Whey Protein Fuel Chocolate Surge?
Ask about interactions with your drugs in plain English — “Can I take it with lisinopril?” — and we find you the answer in seconds, ingredient by ingredient.
Go to the checkerIngredients driving the most interactions
Individual Drug Interactions
The ingredients in 100% Whey Protein Fuel Chocolate Surge interact with 1,334 drugs. Click any drug to see the details.
14 of the 28 ingredients in 100% Whey Protein Fuel Chocolate Surge interact with drugs. Each result below shows which ingredient is responsible. Theobromine L-Arginine L-Tryptophan Vitamin A Magnesium Sodium Calcium Iron Potassium L-Tyrosine L-Phenylalanine L-Threonine Glycine L-Lysine
AcepromazineAtravet
How Acepromazine interacts with 100% Whey Protein Fuel Chocolate Surge — through 2 ingredients. Tap an ingredient for the detail:
L-tryptophanCns Depressants Major
Interaction Summary
Theoretically, concomitant use of L-tryptophan with CNS depressants might cause additive sedative effects.
Read the full L-tryptophan + Acepromazine interactionTheobrominePhenothiazines Minor
Interaction Summary
Theoretically, phenothiazines might increase the levels and adverse effects of caffeine.
Read the full Theobromine + Acepromazine interactionAcetaminophen, Butalbital, Caffeine, CodeineEsgic with Codeine, Fioricet w/ Codeine
How Acetaminophen, Butalbital, Caffeine, Codeine interacts with 100% Whey Protein Fuel Chocolate Surge — through 3 ingredients. Tap an ingredient for the detail:
L-tryptophanCns Depressants Major
Interaction Summary
Theoretically, concomitant use of L-tryptophan with CNS depressants might cause additive sedative effects.
Read the full L-tryptophan + Acetaminophen, Butalbital, Caffeine, Codeine interactionTheobromineStimulant Drugs Moderate
Interaction Summary
Theoretically, concomitant use might increase stimulant adverse effects.
Read the full Theobromine + Acetaminophen, Butalbital, Caffeine, Codeine interactionVitamin AHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking high doses of vitamin A in combination with other potentially hepatotoxic drugs might increase the risk of liver disease.
Read the full Vitamin A + Acetaminophen, Butalbital, Caffeine, Codeine interactionAcetaminophen, Butalbital, CodeineBancap w/ Codeine
How Acetaminophen, Butalbital, Codeine interacts with 100% Whey Protein Fuel Chocolate Surge — through 2 ingredients. Tap an ingredient for the detail:
L-tryptophanCns Depressants Major
Interaction Summary
Theoretically, concomitant use of L-tryptophan with CNS depressants might cause additive sedative effects.
Read the full L-tryptophan + Acetaminophen, Butalbital, Codeine interactionVitamin AHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking high doses of vitamin A in combination with other potentially hepatotoxic drugs might increase the risk of liver disease.
Read the full Vitamin A + Acetaminophen, Butalbital, Codeine interactionAcetaminophen, Butalbital, Codeine PhosphatePhrenilin #3
How Acetaminophen, Butalbital, Codeine Phosphate interacts with 100% Whey Protein Fuel Chocolate Surge — through 2 ingredients. Tap an ingredient for the detail:
L-tryptophanCns Depressants Major
Interaction Summary
Theoretically, concomitant use of L-tryptophan with CNS depressants might cause additive sedative effects.
Read the full L-tryptophan + Acetaminophen, Butalbital, Codeine Phosphate interactionVitamin AHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking high doses of vitamin A in combination with other potentially hepatotoxic drugs might increase the risk of liver disease.
Read the full Vitamin A + Acetaminophen, Butalbital, Codeine Phosphate interactionAcetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, PhenylephrineHycomine Compound
How Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interacts with 100% Whey Protein Fuel Chocolate Surge — through 3 ingredients. Tap an ingredient for the detail:
L-tryptophanCns Depressants Major
Interaction Summary
Theoretically, concomitant use of L-tryptophan with CNS depressants might cause additive sedative effects.
Read the full L-tryptophan + Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interactionVitamin AHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking high doses of vitamin A in combination with other potentially hepatotoxic drugs might increase the risk of liver disease.
Read the full Vitamin A + Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interactionTheobromineStimulant Drugs Moderate
Interaction Summary
Theoretically, concomitant use might increase stimulant adverse effects.
Read the full Theobromine + Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interactionAcetaminophen, Caffeine, CodeineGesic C15, Gesic C30, Gesic C8, Lenoltec 1, Lenoltec 2, Lenoltec 3 +1 more
How Acetaminophen, Caffeine, Codeine interacts with 100% Whey Protein Fuel Chocolate Surge — through 3 ingredients. Tap an ingredient for the detail:
L-tryptophanCns Depressants Major
Interaction Summary
Theoretically, concomitant use of L-tryptophan with CNS depressants might cause additive sedative effects.
Read the full L-tryptophan + Acetaminophen, Caffeine, Codeine interactionVitamin AHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking high doses of vitamin A in combination with other potentially hepatotoxic drugs might increase the risk of liver disease.
Read the full Vitamin A + Acetaminophen, Caffeine, Codeine interactionTheobromineStimulant Drugs Moderate
Interaction Summary
Theoretically, concomitant use might increase stimulant adverse effects.
Read the full Theobromine + Acetaminophen, Caffeine, Codeine interactionAcetaminophen, Caffeine, Codeine, SalicylamideCodalan No.1, Codalan No.2, Codalan No.3
How Acetaminophen, Caffeine, Codeine, Salicylamide interacts with 100% Whey Protein Fuel Chocolate Surge — through 3 ingredients. Tap an ingredient for the detail:
L-tryptophanCns Depressants Major
Interaction Summary
Theoretically, concomitant use of L-tryptophan with CNS depressants might cause additive sedative effects.
Read the full L-tryptophan + Acetaminophen, Caffeine, Codeine, Salicylamide interactionTheobromineStimulant Drugs Moderate
Interaction Summary
Theoretically, concomitant use might increase stimulant adverse effects.
Read the full Theobromine + Acetaminophen, Caffeine, Codeine, Salicylamide interactionVitamin AHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking high doses of vitamin A in combination with other potentially hepatotoxic drugs might increase the risk of liver disease.
Read the full Vitamin A + Acetaminophen, Caffeine, Codeine, Salicylamide interactionAcetaminophen, Caffeine, DihydrocodeineDHC Plus, Panlor DC, Panlor SS
How Acetaminophen, Caffeine, Dihydrocodeine interacts with 100% Whey Protein Fuel Chocolate Surge — through 3 ingredients. Tap an ingredient for the detail:
L-tryptophanCns Depressants Major
Interaction Summary
Theoretically, concomitant use of L-tryptophan with CNS depressants might cause additive sedative effects.
Read the full L-tryptophan + Acetaminophen, Caffeine, Dihydrocodeine interactionVitamin AHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking high doses of vitamin A in combination with other potentially hepatotoxic drugs might increase the risk of liver disease.
Read the full Vitamin A + Acetaminophen, Caffeine, Dihydrocodeine interactionTheobromineStimulant Drugs Moderate
Interaction Summary
Theoretically, concomitant use might increase stimulant adverse effects.
Read the full Theobromine + Acetaminophen, Caffeine, Dihydrocodeine interactionAcetaminophen, Chlorpheniramine, Codeine, PhenylephrineColrex
How Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interacts with 100% Whey Protein Fuel Chocolate Surge — through 3 ingredients. Tap an ingredient for the detail:
L-tryptophanSerotonergic Drugs, Cns Depressants Major
Interaction Summary
Theoretically, combining L-tryptophan with serotonergic drugs might cause additive serotonergic effects.
Read the full L-tryptophan + Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interactionVitamin AHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking high doses of vitamin A in combination with other potentially hepatotoxic drugs might increase the risk of liver disease.
Read the full Vitamin A + Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interactionTheobromineStimulant Drugs Moderate
Interaction Summary
Theoretically, concomitant use might increase stimulant adverse effects.
Read the full Theobromine + Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interactionAcetaminophen, Chlorpheniramine, Phenylpropanolamine, OpiumHista-Derfule
How Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium interacts with 100% Whey Protein Fuel Chocolate Surge — through 3 ingredients. Tap an ingredient for the detail:
L-tryptophanSerotonergic Drugs, Cns Depressants Major
Interaction Summary
Theoretically, combining L-tryptophan with serotonergic drugs might cause additive serotonergic effects.
Read the full L-tryptophan + Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium interactionVitamin AHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking high doses of vitamin A in combination with other potentially hepatotoxic drugs might increase the risk of liver disease.
Read the full Vitamin A + Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium interactionTheobromineStimulant Drugs, Phenylpropanolamine Moderate
Interaction Summary
Theoretically, concomitant use might increase stimulant adverse effects.
Read the full Theobromine + Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium interactionAcetaminophen, Chlorzoxazone, CodeineAcetazone Forte C8, Parafon Forte C8
How Acetaminophen, Chlorzoxazone, Codeine interacts with 100% Whey Protein Fuel Chocolate Surge — through 3 ingredients. Tap an ingredient for the detail:
L-tryptophanCns Depressants Major
Interaction Summary
Theoretically, concomitant use of L-tryptophan with CNS depressants might cause additive sedative effects.
Read the full L-tryptophan + Acetaminophen, Chlorzoxazone, Codeine interactionVitamin AHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking high doses of vitamin A in combination with other potentially hepatotoxic drugs might increase the risk of liver disease.
Read the full Vitamin A + Acetaminophen, Chlorzoxazone, Codeine interactionMagnesiumSkeletal Muscle Relaxants Moderate
Interaction Summary
Parenteral magnesium alters the pharmacokinetics of skeletal muscle relaxants, increasing their effects and accelerating the onset of effect.
Read the full Magnesium + Acetaminophen, Chlorzoxazone, Codeine interactionAcetaminophen, CodeineTylenol No.3, Tylenol w/ Codeine
How Acetaminophen, Codeine interacts with 100% Whey Protein Fuel Chocolate Surge — through 2 ingredients. Tap an ingredient for the detail:
L-tryptophanCns Depressants Major
Interaction Summary
Theoretically, concomitant use of L-tryptophan with CNS depressants might cause additive sedative effects.
Read the full L-tryptophan + Acetaminophen, Codeine interactionVitamin AHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking high doses of vitamin A in combination with other potentially hepatotoxic drugs might increase the risk of liver disease.
Read the full Vitamin A + Acetaminophen, Codeine interactionAcetaminophen, Codeine, DoxylamineMersyndol
How Acetaminophen, Codeine, Doxylamine interacts with 100% Whey Protein Fuel Chocolate Surge — through 2 ingredients. Tap an ingredient for the detail:
L-tryptophanCns Depressants Major
Interaction Summary
Theoretically, concomitant use of L-tryptophan with CNS depressants might cause additive sedative effects.
Read the full L-tryptophan + Acetaminophen, Codeine, Doxylamine interactionVitamin AHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking high doses of vitamin A in combination with other potentially hepatotoxic drugs might increase the risk of liver disease.
Read the full Vitamin A + Acetaminophen, Codeine, Doxylamine interactionAcetaminophen, Codeine, MethocarbamolAcetaminophen, Codeine, Methocarbamol, Robaxacet 8
How Acetaminophen, Codeine, Methocarbamol interacts with 100% Whey Protein Fuel Chocolate Surge — through 3 ingredients. Tap an ingredient for the detail:
L-tryptophanCns Depressants Major
Interaction Summary
Theoretically, concomitant use of L-tryptophan with CNS depressants might cause additive sedative effects.
Read the full L-tryptophan + Acetaminophen, Codeine, Methocarbamol interactionVitamin AHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking high doses of vitamin A in combination with other potentially hepatotoxic drugs might increase the risk of liver disease.
Read the full Vitamin A + Acetaminophen, Codeine, Methocarbamol interactionMagnesiumSkeletal Muscle Relaxants Moderate
Interaction Summary
Parenteral magnesium alters the pharmacokinetics of skeletal muscle relaxants, increasing their effects and accelerating the onset of effect.
Read the full Magnesium + Acetaminophen, Codeine, Methocarbamol interactionAcetaminophen, Dichloralantipyrine, IsomethepteneAmidrine, Midchlor, Migquin, Migratine
How Acetaminophen, Dichloralantipyrine, Isometheptene interacts with 100% Whey Protein Fuel Chocolate Surge — through 3 ingredients. Tap an ingredient for the detail:
L-tryptophanCns Depressants Major
Interaction Summary
Theoretically, concomitant use of L-tryptophan with CNS depressants might cause additive sedative effects.
Read the full L-tryptophan + Acetaminophen, Dichloralantipyrine, Isometheptene interactionVitamin AHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking high doses of vitamin A in combination with other potentially hepatotoxic drugs might increase the risk of liver disease.
Read the full Vitamin A + Acetaminophen, Dichloralantipyrine, Isometheptene interactionTheobromineStimulant Drugs Moderate
Interaction Summary
Theoretically, concomitant use might increase stimulant adverse effects.
Read the full Theobromine + Acetaminophen, Dichloralantipyrine, Isometheptene interactionAcetaminophen, Dichloralphenazone, IsomethepteneMidrin
How Acetaminophen, Dichloralphenazone, Isometheptene interacts with 100% Whey Protein Fuel Chocolate Surge — through 3 ingredients. Tap an ingredient for the detail:
L-tryptophanCns Depressants Major
Interaction Summary
Theoretically, concomitant use of L-tryptophan with CNS depressants might cause additive sedative effects.
Read the full L-tryptophan + Acetaminophen, Dichloralphenazone, Isometheptene interactionTheobromineStimulant Drugs Moderate
Interaction Summary
Theoretically, concomitant use might increase stimulant adverse effects.
Read the full Theobromine + Acetaminophen, Dichloralphenazone, Isometheptene interactionVitamin AHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking high doses of vitamin A in combination with other potentially hepatotoxic drugs might increase the risk of liver disease.
Read the full Vitamin A + Acetaminophen, Dichloralphenazone, Isometheptene interactionAcetaminophen, Dichlorophenazone, IsometheptaneIsocom
How Acetaminophen, Dichlorophenazone, Isometheptane interacts with 100% Whey Protein Fuel Chocolate Surge — through 3 ingredients. Tap an ingredient for the detail:
L-tryptophanCns Depressants Major
Interaction Summary
Theoretically, concomitant use of L-tryptophan with CNS depressants might cause additive sedative effects.
Read the full L-tryptophan + Acetaminophen, Dichlorophenazone, Isometheptane interactionTheobromineStimulant Drugs Moderate
Interaction Summary
Theoretically, concomitant use might increase stimulant adverse effects.
Read the full Theobromine + Acetaminophen, Dichlorophenazone, Isometheptane interactionVitamin AHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking high doses of vitamin A in combination with other potentially hepatotoxic drugs might increase the risk of liver disease.
Read the full Vitamin A + Acetaminophen, Dichlorophenazone, Isometheptane interactionAcetaminophen, DiphenhydramineTylenol PM, Tylenol PM Ex Strength
How Acetaminophen, Diphenhydramine interacts with 100% Whey Protein Fuel Chocolate Surge — through 2 ingredients. Tap an ingredient for the detail:
L-tryptophanCns Depressants Major
Interaction Summary
Theoretically, concomitant use of L-tryptophan with CNS depressants might cause additive sedative effects.
Read the full L-tryptophan + Acetaminophen, Diphenhydramine interactionVitamin AHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking high doses of vitamin A in combination with other potentially hepatotoxic drugs might increase the risk of liver disease.
Read the full Vitamin A + Acetaminophen, Diphenhydramine interactionAcetaminophen, Diphenhydramine, PseudoephedrineChildren's Tylenol Allergy, Cold Control, Contac Night Allergy Relief
How Acetaminophen, Diphenhydramine, Pseudoephedrine interacts with 100% Whey Protein Fuel Chocolate Surge — through 3 ingredients. Tap an ingredient for the detail:
L-tryptophanCns Depressants Major
Interaction Summary
Theoretically, concomitant use of L-tryptophan with CNS depressants might cause additive sedative effects.
Read the full L-tryptophan + Acetaminophen, Diphenhydramine, Pseudoephedrine interactionVitamin AHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking high doses of vitamin A in combination with other potentially hepatotoxic drugs might increase the risk of liver disease.
Read the full Vitamin A + Acetaminophen, Diphenhydramine, Pseudoephedrine interactionTheobromineStimulant Drugs Moderate
Interaction Summary
Theoretically, concomitant use might increase stimulant adverse effects.
Read the full Theobromine + Acetaminophen, Diphenhydramine, Pseudoephedrine interactionAcetaminophen, HydrocodoneAnexsia, Anodynos DHC, Azdone, Co-Gesic, Doucet, Lorcet +9 more
How Acetaminophen, Hydrocodone interacts with 100% Whey Protein Fuel Chocolate Surge — through 2 ingredients. Tap an ingredient for the detail:
L-tryptophanCns Depressants Major
Interaction Summary
Theoretically, concomitant use of L-tryptophan with CNS depressants might cause additive sedative effects.
Read the full L-tryptophan + Acetaminophen, Hydrocodone interactionVitamin AHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking high doses of vitamin A in combination with other potentially hepatotoxic drugs might increase the risk of liver disease.
Read the full Vitamin A + Acetaminophen, Hydrocodone interactionAcetaminophen, MeperidineDemerol APAP
How Acetaminophen, Meperidine interacts with 100% Whey Protein Fuel Chocolate Surge — through 2 ingredients. Tap an ingredient for the detail:
L-tryptophanSerotonergic Drugs, Cns Depressants Major
Interaction Summary
Theoretically, combining L-tryptophan with serotonergic drugs might cause additive serotonergic effects.
Read the full L-tryptophan + Acetaminophen, Meperidine interactionVitamin AHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking high doses of vitamin A in combination with other potentially hepatotoxic drugs might increase the risk of liver disease.
Read the full Vitamin A + Acetaminophen, Meperidine interactionAcetaminophen, OxycodonePercocet, Roxicet, Tylox, Xartemis XR
How Acetaminophen, Oxycodone interacts with 100% Whey Protein Fuel Chocolate Surge — through 2 ingredients. Tap an ingredient for the detail:
L-tryptophanCns Depressants Major
Interaction Summary
Theoretically, concomitant use of L-tryptophan with CNS depressants might cause additive sedative effects.
Read the full L-tryptophan + Acetaminophen, Oxycodone interactionVitamin AHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking high doses of vitamin A in combination with other potentially hepatotoxic drugs might increase the risk of liver disease.
Read the full Vitamin A + Acetaminophen, Oxycodone interactionAcetaminophen, PentazocineTalacen
How Acetaminophen, Pentazocine interacts with 100% Whey Protein Fuel Chocolate Surge — through 2 ingredients. Tap an ingredient for the detail:
L-tryptophanCns Depressants Major
Interaction Summary
Theoretically, concomitant use of L-tryptophan with CNS depressants might cause additive sedative effects.
Read the full L-tryptophan + Acetaminophen, Pentazocine interactionVitamin AHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking high doses of vitamin A in combination with other potentially hepatotoxic drugs might increase the risk of liver disease.
Read the full Vitamin A + Acetaminophen, Pentazocine interactionAcetaminophen, PropoxypheneDarvocet-N 100, Darvocet-N 50, E-Lor, Wygesic
How Acetaminophen, Propoxyphene interacts with 100% Whey Protein Fuel Chocolate Surge — through 2 ingredients. Tap an ingredient for the detail:
L-tryptophanCns Depressants Major
Interaction Summary
Theoretically, concomitant use of L-tryptophan with CNS depressants might cause additive sedative effects.
Read the full L-tryptophan + Acetaminophen, Propoxyphene interactionVitamin AHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking high doses of vitamin A in combination with other potentially hepatotoxic drugs might increase the risk of liver disease.
Read the full Vitamin A + Acetaminophen, Propoxyphene interactionAcetazolamideAk-Zol, Diamox
How Acetazolamide interacts with 100% Whey Protein Fuel Chocolate Surge — through 4 ingredients. Tap an ingredient for the detail:
L-tryptophanCns Depressants Major
Interaction Summary
Theoretically, concomitant use of L-tryptophan with CNS depressants might cause additive sedative effects.
Read the full L-tryptophan + Acetazolamide interactionSodiumAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, a high intake of dietary sodium might reduce the effectiveness of antihypertensive drugs.
Read the full Sodium + Acetazolamide interactionL-arginineAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, concomitant use of L-arginine and antihypertensive drugs may increase the risk of hypotension.
Read the full L-arginine + Acetazolamide interactionTheobromineAntihypertensive Drugs, Diuretic Drugs Moderate
Interaction Summary
Theoretically, taking cocoa with antihypertensive drugs might increase the risk of hypotension.
Read the full Theobromine + Acetazolamide interactionAcitretinSoriatane
How Acitretin interacts with 100% Whey Protein Fuel Chocolate Surge — through 1 ingredient. Tap an ingredient for the detail:
Vitamin ARetinoids Major
Interaction Summary
Concomitant use of retinoids with vitamin A supplements might produce supratherapeutic vitamin A levels.
Read the full Vitamin A + Acitretin interactionAlfentanilAlfenta
How Alfentanil interacts with 100% Whey Protein Fuel Chocolate Surge — through 1 ingredient. Tap an ingredient for the detail:
L-tryptophanCns Depressants Major
Interaction Summary
Theoretically, concomitant use of L-tryptophan with CNS depressants might cause additive sedative effects.
Read the full L-tryptophan + Alfentanil interactionAlitretinoinPanretin
How Alitretinoin interacts with 100% Whey Protein Fuel Chocolate Surge — through 1 ingredient. Tap an ingredient for the detail:
Vitamin ARetinoids Major
Interaction Summary
Concomitant use of retinoids with vitamin A supplements might produce supratherapeutic vitamin A levels.
Read the full Vitamin A + Alitretinoin interactionAlprazolamNiravam, Xanax
How Alprazolam interacts with 100% Whey Protein Fuel Chocolate Surge — through 1 ingredient. Tap an ingredient for the detail:
L-tryptophanCns Depressants Major
Interaction Summary
Theoretically, concomitant use of L-tryptophan with CNS depressants might cause additive sedative effects.
Read the full L-tryptophan + Alprazolam interactionAluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium HydroxideAscriptin Codeine #2
How Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide interacts with 100% Whey Protein Fuel Chocolate Surge — through 5 ingredients. Tap an ingredient for the detail:
L-tryptophanCns Depressants Major
Interaction Summary
Theoretically, concomitant use of L-tryptophan with CNS depressants might cause additive sedative effects.
Read the full L-tryptophan + Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide interactionMagnesiumAntacids, Anticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Use of acid reducers may reduce the laxative effect of magnesium oxide.
Read the full Magnesium + Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide interactionTheobromineAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, cocoa may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Theobromine + Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide interactionCalciumAluminum Moderate
Interaction Summary
Calcium citrate might increase aluminum absorption and toxicity.
Read the full Calcium + Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide interactionL-arginineAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, concomitant use of L-arginine with anticoagulant and antiplatelet drugs might have additive effects and increase the risk of bleeding.
Read the full L-arginine + Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide interactionEach ingredient & the kinds of drugs it affects
For each ingredient in 100% Whey Protein Fuel Chocolate Surge with known interactions, here are the types of medications they can affect. Open any type for the detail — or search your exact drug in the checker above.
Theobromine
Ace Inhibitors (Aceis)
Theoretically, taking cocoa with ACEIs might increase the risk of adverse effects.
Human research shows that dark chocolate can inhibit ACE. Additionally, prolonged angioedema in an elderly patient on an ACE inhibitor was precipitated with intake of diabetic chocolate.
Adenosine (Adenocard)
Theoretically, cocoa might decrease the vasodilatory effects of adenosine and interfere with its use prior to stress testing.
Cocoa contains caffeine. Caffeine is a competitive inhibitor of adenosine at the cellular level. However, caffeine does not seem to affect supplemental adenosine because high interstitial levels of adenosine overcome the antagonistic effects of caffeine. It is recommended that methylxanthines and methylxanthine-containing products be stopped 24 hours prior to pharmacological stress tests. However, methylxanthines appear more likely to interfere with dipyridamole than adenosine-induced stress testing.
Alcohol (Ethanol)
Theoretically, concomitant use might increase levels and adverse effects of caffeine.
Cocoa contains caffeine. Alcohol reduces caffeine metabolism. Concomitant use of alcohol can increase caffeine serum concentrations and the risk of caffeine adverse effects.
Anticoagulant/Antiplatelet Drugs
Theoretically, cocoa may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Clinical research shows that intake of cocoa can inhibit platelet adhesion, aggregation, and activity and increase aspirin-induced bleeding time. For patients on dual antiplatelet therapy, cocoa may enhance the inhibitory effect of clopidogrel, but not aspirin, on platelet aggregation.
Antihypertensive Drugs
Theoretically, taking cocoa with antihypertensive drugs might increase the risk of hypotension.
Clinical research shows that cocoa can modestly decrease blood pressure in hypertensive and normotensive patients.
Beta-Adrenergic Agonists
Theoretically, large amounts of cocoa might increase the cardiac inotropic effects of beta-agonists.
Cocoa contains caffeine. Theoretically, large amounts of caffeine might increase cardiac inotropic effects of beta-agonists. A case of atrial fibrillation associated with consumption of large quantities of chocolate in a patient with chronic albuterol inhalation abuse has also been reported.
Cytochrome P450 1A2 (Cyp1A2) Inhibitors
Theoretically, concomitant use might increase the levels and adverse effects of caffeine.
Cocoa contains caffeine. Caffeine is metabolized by cytochrome P450 1A2 (CYP1A2),. Theoretically, drugs that inhibit CYP1A2 may decrease the clearance rate of caffeine from cocoa and increase caffeine levels.
Dipyridamole (Persantine)
Theoretically, cocoa might decrease the vasodilatory effects of dipyridamole and interfere with its use prior to stress testing.
Cocoa contains caffeine. Caffeine may inhibit dipyridamole-induced vasodilation. It is recommended that methylxanthines and methylxanthine-containing products be stopped 24 hours prior to pharmacological stress tests. Methylxanthines appear more likely to interfere with dipyridamole than adenosine-induced stress testing.
Disulfiram (Antabuse)
Theoretically, disulfiram might increase the risk of adverse effects from caffeine.
Cocoa contains caffeine. In human research, disulfiram decreases the rate of caffeine clearance.
Diuretic Drugs
Theoretically, using cocoa with diuretic drugs might increase the risk of hypokalemia.
Cocoa contains caffeine. In excessive amounts, caffeine can reduce potassium levels due to stimulation of the sodium-potassium pump. Diuretics can also cause lower potassium levels.
Ephedrine
Theoretically, concomitant use might increase the risk for stimulant adverse effects.
Cocoa contains caffeine. There is evidence that using ephedrine with caffeine might increase the risk of serious life-threatening or debilitating adverse effects such as hypertension, myocardial infarction, stroke, seizures, and death.
Estrogens
Theoretically, estrogens might increase the levels and adverse effects of caffeine.
Cocoa contains caffeine. Estrogen inhibits caffeine metabolism.
Flutamide (Eulexin)
Theoretically, cocoa might increase the levels and adverse effects of flutamide.
Cocoa contains caffeine. In vitro evidence suggests that caffeine can inhibit the metabolism of flutamide.
Fluvoxamine (Luvox)
Theoretically, fluvoxamine might increase the levels and adverse effects of caffeine.
Cocoa contains caffeine. Fluvoxamine reduces caffeine metabolism.
Lithium
Theoretically, abrupt cocoa withdrawal might increase the levels and adverse effects of lithium.
Cocoa contains caffeine. There are two case reports of lithium tremor that worsened upon abrupt coffee withdrawal.
Monoamine Oxidase Inhibitors (Maois)
Theoretically, concomitant use might increase the risk of a hypertensive crisis.
Cocoa contains caffeine. Large amounts of caffeine with MAOIs might precipitate a hypertensive crisis.
Nicotine
Theoretically, concomitant use might increase the risk of hypertension.
Cocoa contains caffeine. Concomitant use of caffeine and nicotine has been shown to have additive cardiovascular effects, including increased heart rate and blood pressure. Blood pressure was increased by 10.8/12.4 mmHg when the agents were used concomitantly.
Pentobarbital (Nembutal)
Theoretically, cocoa might decrease the effects of pentobarbital.
Cocoa contains caffeine. Caffeine might negate the hypnotic effects of pentobarbital.
Phenobarbital (Luminal)
Theoretically, cocoa might reduce the effects of phenobarbital and increase the risk for convulsions.
Cocoa contains caffeine. Animal research suggests that caffeine can decrease the anticonvulsant activity of phenobarbital. The exact mechanism of this interaction is unclear.
Phenylpropanolamine
Theoretically, phenylpropanolamine might increase the risk of hypertension, as well as the levels and adverse effects of caffeine.
Cocoa contains caffeine. Concomitant use of phenylpropanolamine and caffeine might cause an additive increase in blood pressure. Phenylpropanolamine also seems to increase caffeine serum levels.
Phenytoin (Dilantin)
Theoretically, cocoa might reduce the effects of phenytoin and increase the risk for convulsions.
Cocoa contains caffeine. Animal research suggests that caffeine can decrease the anticonvulsant activity of phenytoin. The effect does not seem to be related to the seizure threshold-lowering effects of caffeine. However, the exact mechanism of this interaction is unclear.
Quinolone Antibiotics
Theoretically, quinolone antibiotics might increase the levels and adverse effects of caffeine.
Cocoa contains caffeine. Quinolones (also referred to as fluoroquinolones) decrease caffeine clearance.
Riluzole (Rilutek)
Theoretically, concomitant use might increase the levels and adverse effects of both caffeine and riluzole.
Cocoa contains caffeine. Caffeine and riluzole are both metabolized by cytochrome P450 1A2, and concomitant use might reduce metabolism of one or both agents.
Stimulant Drugs
Theoretically, concomitant use might increase stimulant adverse effects.
Cocoa contains caffeine. Concomitant use might increase the risk of stimulant adverse effects.
Theophylline
Theoretically, cocoa might increase the levels and adverse effects of theophylline.
Cocoa contains caffeine. Large amounts of caffeine might inhibit theophylline metabolism. Caffeine decreases theophylline clearance 23% to 29%.
L-Arginine
Ace Inhibitors (Aceis)
Theoretically, concomitant use of L-arginine and ACE inhibitors may increase the risk for hypotension and hyperkalemia.
Combining L-arginine with some antihypertensive drugs, especially ACE inhibitors, seems to have additive vasodilating and blood pressure-lowering effects. Furthermore, ACE inhibitors can increase potassium levels. Use of L-arginine has been associated with hyperkalemia in some patients. Theoretically, concomitant use of ACE inhibitors with L-arginine may increases the risk of hyperkalemia.
Angiotensin Receptor Blockers (Arbs)
Theoretically, concomitant use of L-arginine and ARBs may increase the risk of hypotension and hyperkalemia.
L-arginine increases nitric oxide, which causes vasodilation. Combining L-arginine with ARBs seems to increase L-arginine-induced vasodilation. Furthermore, ARBs can increase potassium levels. Use of L-arginine has been associated with hyperkalemia in some patients. Theoretically, concomitant use of ARBs with L-arginine may increases the risk of hyperkalemia.
Anticoagulant/Antiplatelet Drugs
Theoretically, concomitant use of L-arginine with anticoagulant and antiplatelet drugs might have additive effects and increase the risk of bleeding.
Preliminary research suggests that L-arginine infusions reduce platelet aggregation in humans. The clinical significance of this effect is unclear.
Antidiabetes Drugs
Theoretically, concomitant use of L-arginine might have additive effects with antidiabetes drugs.
Preliminary clinical research shows that L-arginine decreases blood glucose levels in patients with type 2 diabetes.
Antihypertensive Drugs
Theoretically, concomitant use of L-arginine and antihypertensive drugs may increase the risk of hypotension.
L-arginine increases nitric oxide, which causes vasodilation. Clinical evidence shows that L-arginine can reduce blood pressure in some individuals with hypertension. Furthermore, combining L-arginine with some antihypertensive drugs seems to have additive vasodilating and blood pressure-lowering effects.
Isoproterenol (Isuprel)
Theoretically, concurrent use of isoproterenol and L-arginine might result in additive effects and hypotension.
Preliminary clinical evidence suggests that L-arginine enhances isoproterenol-induced vasodilation in patients with essential hypertension or a family history of essential hypertension.
Potassium-Sparing Diuretics
Theoretically concomitant use of potassium-sparing diuretics with L-arginine may increases the risk of hyperkalemia.
Potassium-sparing diuretics can increase potassium levels. Use of L-arginine has been associated with hyperkalemia in some patients.
Sildenafil (Viagra)
Theoretically, concurrent use of sildenafil and L-arginine might increase the risk for hypotension.
In vivo, concurrent use of L-arginine and sildenafil has resulted in increased vasodilation. Theoretically, concurrent use might have additive vasodilatory and hypotensive effects. However, in studies evaluating the combined use of L-arginine and sildenafil for erectile dysfunction, hypotension was not reported.
Testosterone
Theoretically, concomitant use of L-arginine and testosterone might have additive effects.
In clinical research, L-arginine increases the level of testosterone in male patients with erectile dysfunction. The clinical significance of this finding is unclear.
L-Tryptophan
Cns Depressants
Theoretically, concomitant use of L-tryptophan with CNS depressants might cause additive sedative effects.
Clinical research shows that L-tryptophan can cause fatigue and drowsiness.
Serotonergic Drugs
Theoretically, combining L-tryptophan with serotonergic drugs might cause additive serotonergic effects.
L-tryptophan is a precursor to serotonin. Theoretically, combining serotonergic drugs with L-tryptophan might increase the risk of serotonergic side effects, including serotonin syndrome and cerebral vasoconstrictive disorders.
Vitamin A
Retinoids
Concomitant use of retinoids with vitamin A supplements might produce supratherapeutic vitamin A levels.
Retinoids, which are vitamin A derivatives, could have additive toxic effects when taken with vitamin A supplements.
Hepatotoxic Drugs
Theoretically, taking high doses of vitamin A in combination with other potentially hepatotoxic drugs might increase the risk of liver disease.
The tolerable upper intake level (UL) is the highest level of intake that is likely to pose no risk of adverse effects. Doses of vitamin A above the UL can cause hepatotoxicity, ranging from elevated liver enzymes to liver failure.
Tetracycline Antibiotics
Theoretically, taking tetracycline antibiotics with high doses of vitamin A can increase the risk of pseudotumor cerebri.
Benign intracranial hypertension (pseudotumor cerebri) can occur with tetracyclines and with acute or chronic vitamin A toxicity. Case reports suggest that taking tetracyclines and vitamin A concurrently can increase the risk of this condition. Avoid high doses of vitamin A in people taking tetracyclines chronically.
Warfarin (Coumadin)
Theoretically, high doses of vitamin A could increase the risk of bleeding with warfarin.
Vitamin A toxicity is associated with hemorrhage and hypoprothrombinemia, possibly due to vitamin K antagonism. Advise patients taking warfarin to avoid doses of vitamin A above the tolerable upper intake level of 10,000 IU/day for adults.
Magnesium
Levodopa/Carbidopa (Sinemet)
Magnesium can reduce the bioavailability of levodopa/carbidopa.
Clinical research in healthy volunteers shows that taking magnesium oxide 1000 mg with levodopa 100 mg/carbidopa 10 mg reduces the area under the curve (AUC) of levodopa by 35% and of carbidopa by 81%. In vitro and animal research shows that magnesium produces an alkaline environment in the digestive tract, which might lead to degradation and reduced bioavailability of levodopa/carbidopa.
Aminoglycoside Antibiotics
Concomitant use of aminoglycoside antibiotics and magnesium can increase the risk for neuromuscular weakness.
Both aminoglycosides and magnesium reduce presynaptic acetylcholine release, which can lead to neuromuscular blockade and possible paralysis. This is most likely to occur with high doses of magnesium given intravenously.
Antacids
Use of acid reducers may reduce the laxative effect of magnesium oxide.
A retrospective analysis shows that, in the presence of H2 receptor antagonists (H2RAs) or proton pump inhibitors (PPIs), a higher dose of magnesium oxide is needed for a laxative effect. This may also occur with antacids. Under acidic conditions, magnesium oxide is converted to magnesium chloride and then to magnesium bicarbonate, which has an osmotic laxative effect. By reducing acidity, antacids may reduce the conversion of magnesium oxide to the active bicarbonate salt.
Bictegravir/Emtricitabine/Tenofovir Alafenamide (Biktarvy)
Magnesium might decrease levels of bictegravir/emtricitabine/tenofovir alafenamide by reducing its absorption.
Advise patients that bictegravir/emtricitabine/tenofovir alafenamide should be taken at least 2 hours before or 6 hours after magnesium containing products.
Bisphosphonates
Magnesium can decrease absorption of bisphosphonates.
Cations, including magnesium, can decrease bisphosphonate absorption. Advise patients to separate doses of magnesium and these drugs by at least 2 hours.
Calcium Channel Blockers
Magnesium can have additive effects with calcium channel blockers, although evidence is conflicting.
Magnesium inhibits calcium entry into smooth muscle cells and may therefore have additive effects with calcium channel blockers. Severe hypotension and neuromuscular blockades may occur when nifedipine is used with intravenous magnesium, although some contradictory evidence suggests that concurrent use of magnesium with nifedipine does not increase the risk of neuromuscular weakness. High doses of magnesium could theoretically have additive effects with other calcium channel blockers.
Digoxin
Magnesium salts may reduce absorption of digoxin.
Clinical evidence suggests that treatment with oral magnesium hydroxide or magnesium trisilicate reduces absorption of digoxin from the intestines. This may reduce the blood levels of digoxin and decrease its therapeutic effects.
Potassium-Sparing Diuretics
Potassium-sparing diuretics decrease excretion of magnesium, possibly increasing magnesium levels.
Potassium-sparing diuretics also have magnesium-sparing properties, which can counteract the magnesium losses associated with loop and thiazide diuretics. Theoretically, increased magnesium levels could result from concomitant use of potassium-sparing diuretics and magnesium supplements.
Quinolone Antibiotics
Magnesium decreases absorption of quinolones.
Magnesium can form insoluble complexes with quinolones and decrease their absorption. Advise patients to take these drugs at least 2 hours before, or 4 to 6 hours after, magnesium supplements.
Skeletal Muscle Relaxants
Parenteral magnesium alters the pharmacokinetics of skeletal muscle relaxants, increasing their effects and accelerating the onset of effect.
Parenteral magnesium shortens the time to onset of skeletal muscle relaxants by about 1 minute and prolongs the duration of action by about 2 minutes. Magnesium potentiates the effects of skeletal muscle relaxants by decreasing calcium-mediated release of acetylcholine from presynaptic nerve terminals, reducing postsynaptic sensitivity to acetylcholine, and having a direct effect on the membrane potential of myocytes. Magnesium also has vasodilatory actions and increases cardiac output, allowing a greater amount of muscle relaxant to reach the motor end plate. A clinical study found that low-dose rocuronium (0.45 mg/kg), when given after administration of magnesium 30 mg/kg over 10 minutes, has an accelerated onset of effect, which matches the onset of effect seen with a full-dose rocuronium regimen (0.6 mg/kg). In another clinical study, onset times for rocuronium doses of 0.3, 0.6, and 1.2 mg/kg were 86, 76, and 50 seconds, respectively, when given alone, but were reduced to 66, 44, and 38 seconds, respectively, when the doses were given after a 15-minute infusion of magnesium sulfate 60 mg/kg. Giving intraoperative intravenous magnesium sulfate, 50 mg/kg loading dose followed by 15 mg/kg/hour, reduces the onset time of rocuronium, enhances its clinical effects, reduces the dose of intraoperative opiates, and prolongs the spontaneous recovery time. It does not affect the activity of subsequently administered neostigmine.
Sulfonylureas
Magnesium increases the systemic absorption of sulfonylureas, increasing their effects and side effects.
Clinical research shows that administration of magnesium hydroxide with glyburide increases glyburide absorption, increases maximal insulin response by 35-fold, and increases the risk of hypoglycemia, when compared with glyburide alone. A similar interaction occurs between magnesium hydroxide and glipizide. The mechanism of this effect appears to be related to the elevation of gastrointestinal pH by magnesium-based antacids, increasing solubility and enhancing absorption of sulfonylureas.
Tetracycline Antibiotics
Magnesium decreases absorption of tetracyclines.
Magnesium can form insoluble complexes with tetracyclines in the gut and decrease their absorption and antibacterial activity. Advise patients to take these drugs 1 hour before or 2 hours after magnesium supplements.
Anticoagulant/Antiplatelet Drugs
Theoretically, magnesium may have antiplatelet effects, but the evidence is conflicting.
In vitro evidence shows that magnesium sulfate inhibits platelet aggregation, even at low concentrations. Some preliminary clinical evidence shows that infusion of magnesium sulfate increases bleeding time by 48% and reduces platelet activity. However, other clinical research shows that magnesium does not affect platelet aggregation, although inhibition of platelet-dependent thrombosis can occur.
Gabapentin (Neurontin)
Gabapentin absorption can be decreased by magnesium.
Clinical research shows that giving magnesium oxide orally along with gabapentin decreases the maximum plasma concentration of gabapentin by 33%, time to maximum concentration by 36%, and area under the curve by 43%. Advise patients to take gabapentin at least 2 hours before, or 4 to 6 hours after, magnesium supplements.
Sevelamer (Renagel, Renvela)
Sevelamer may increase serum magnesium levels.
In patients on hemodialysis, sevelamer use was associated with a 0.28 mg/dL increase in serum magnesium. The mechanism of this interaction remains unclear.
Sodium
Antihypertensive Drugs
Theoretically, a high intake of dietary sodium might reduce the effectiveness of antihypertensive drugs.
High intake of dietary sodium can increase systolic and diastolic blood pressure. Also, high intake of sodium may necessitate increased use of antihypertensive medications to achieve blood pressure control in some patients, such as those with chronic kidney disease.
Corticosteroids
Concomitant use of mineralocorticoids and some glucocorticoids with sodium supplements might increase the risk of hypernatremia.
Mineralocorticoids and some glucocorticoids (corticosteroids) cause sodium retention. This effect is dose-related and depends on mineralocorticoid potency. It is most common with hydrocortisone, cortisone, and fludrocortisone, followed by prednisone and prednisolone.
Didanosine (Videx)
Concomitant use of didanosine with additional sodium from dietary or supplemental sources may increase the risk of hypernatremia.
Didanosine formulations contain a significant amount of sodium.
Lithium
Altering dietary intake of sodium might alter the levels and clinical effects of lithium.
High sodium intake can reduce plasma concentrations of lithium by increasing lithium excretion. Reducing sodium intake can significantly increase plasma concentrations of lithium and cause lithium toxicity in patients being treated with lithium carbonate. Stabilizing sodium intake is shown to reduce the percentage of patients with lithium level fluctuations above 0.8 mEq/L. Patients taking lithium should avoid significant alterations in their dietary intake of sodium.
Sodium Phosphates
Theoretically, concomitant use of sodium phosphate with sodium supplements might increase the risk of hypernatremia.
Use of high doses (> 45 mL in 24 hours) of sodium phosphate, such as those used for bowel cleansing before surgery, can lead to serious electrolyte disturbances, including hypernatremia. The risk of hypernatremia is highest in the elderly and people with other risk factors for electrolyte disturbances.
Sodium-Containing Drugs
Concomitant use of sodium-containing drugs with additional sodium from dietary or supplemental sources may increase the risk of hypernatremia and long-term sodium-related complications.
The Chronic Disease Risk Reduction (CDRR) intake level of 2.3 grams of sodium daily indicates the intake at which it is believed that chronic disease risk increases for the apparently healthy population. Some medications contain high quantities of sodium. When used in conjunction with sodium supplements or high-sodium diets, the CDRR may be exceeded. Additionally, concomitant use may increase the risk for hypernatremia; this risk is highest in the elderly and people with other risk factors for electrolyte disturbances.
Tolvaptan (Samsca)
Theoretically, concomitant use of tolvaptan with sodium might increase the risk of hypernatremia.
Tolvaptan is a vasopressin receptor 2 antagonist that is used to increase sodium levels in patients with hyponatremia. Patients taking tolvaptan should use caution with the use of sodium salts such as sodium chloride.
Calcium
Ceftriaxone (Rocephin)
Co-administration of intravenous calcium and ceftriaxone can result in precipitation of a ceftriaxone-calcium salt in the lungs and kidneys.
Avoid administering intravenous calcium in any form, such as parenteral nutrition or Lactated Ringers, within 48 hours of intravenous ceftriaxone. Case reports in neonates show that administering intravenous ceftriaxone and calcium can result in precipitation of a ceftriaxone-calcium salt in the lungs and kidneys. In several cases, neonates have died as a result of this interaction. So far there are no reports in adults; however, there is still concern that this interaction might occur in adults.
Dolutegravir (Tivicay)
Calcium seems to reduce levels of dolutegravir.
Advise patients to take dolutegravir either 2 hours before or 6 hours after taking calcium supplements. Pharmacokinetic research suggests that taking calcium carbonate 1200 mg concomitantly with dolutegravir 50 mg reduces plasma levels of dolutegravir by almost 40%. Calcium appears to decrease levels of dolutegravir through chelation.
Elvitegravir (Vitekta)
Calcium seems to reduce levels of elvitegravir.
Advise patients to take elvitegravir either 2 hours before or 2 hours after taking calcium supplements. Pharmacokinetic research suggests that taking calcium along with elvitegravir can reduce blood levels of elvitegravir through chelation.
Aluminum
Calcium citrate might increase aluminum absorption and toxicity. Other types of calcium do not increase aluminum absorption.
Calcium citrate can increase the absorption of aluminum when taken with aluminum hydroxide. The increase in aluminum levels may become toxic, particularly in individuals with kidney disease. However, the effect of calcium citrate on aluminum absorption is due to the citrate anion rather than calcium cation. Calcium acetate does not appear to increase aluminum absorption.
Bictegravir/Emtricitabine/Tenofovir Alafenamide (Biktarvy)
Calcium might decrease levels of bictegravir/emtricitabine/tenofovir alafenamide by reducing its absorption when taken in a fasting state.
Advise patients that bictegravir/emtricitabine/tenofovir alafenamide and calcium can be taken together if taken with food. However, if taken on an empty stomach, bictegravir/emtricitabine/tenofovir alafenamide should not be taken with, or 2 hours after, calcium containing products.
Bisphosphonates
Calcium reduces the absorption of bisphosphonates.
Advise patients to take bisphosphonates at least 30 minutes before calcium, but preferably at a different time of day. Calcium supplements decrease absorption of bisphosphonates.
Calcipotriene (Dovonex)
Taking calcipotriene with calcium might increase the risk for hypercalcemia.
Calcipotriene is a vitamin D analog used topically for psoriasis. It can be absorbed in sufficient amounts to cause systemic effects, including hypercalcemia. Theoretically, combining calcipotriene with calcium supplements might increase the risk of hypercalcemia.
Digoxin (Lanoxin)
Using intravenous calcium with digoxin might increase the risk of fatal cardiac arrhythmias.
Hypercalcemia increases the risk of fatal cardiac arrhythmias with digoxin. However, one retrospective analysis of clinical data suggests that intravenous calcium does not increase the risk of dysrhythmias or mortality in patients receiving digoxin.
Diltiazem (Cardizem, Others)
Theoretically, calcium may reduce the therapeutic effects of diltiazem.
Hypercalcemia can reduce the effectiveness of verapamil in atrial fibrillation. Theoretically, calcium might increase this risk of hypercalcemia and reduce the effectiveness of diltiazem.
Levothyroxine (Synthroid, Others)
Calcium seems to reduce the absorption and effectiveness of levothyroxine.
Advise patients to take levothyroxine and calcium supplements at least 4 hours apart. Calcium reduces levothyroxine absorption, probably by forming insoluble complexes. Calcium carbonate supplements reduce effectiveness of levothyroxine in patients with hypothyroidism.
Lithium
Theoretically, concomitant use of calcium and lithium may increase this risk of hypercalcemia.
Clinical research suggests that long-term use of lithium may cause hypercalcemia in 10% to 60% of patients. Theoretically, concomitant use of lithium and calcium supplements may further increase this risk.
Quinolone Antibiotics
Calcium seems to reduce the absorption of quinolone antibiotics.
Advise patients to take oral quinolones at least 2 hours before or 4-6 hours after calcium supplements or calcium-fortified foods. Taking calcium at the same time as oral quinolones can reduce quinolone absorption. Calcium binds to quinolones in the gut.
Raltegravir (Isentress)
Calcium may reduce levels of raltegravir.
Pharmacokinetic research shows that taking a single dose of calcium carbonate 3000 mg along with raltegravir 400 mg twice daily modestly decreases the mean area under the curve of raltegravir, but the decrease does not necessitate a dose adjustment of raltegravir. However, a case of elevated HIV-1 RNA levels and documented resistance to raltegravir has been reported for a patient taking calcium carbonate 1 gram three times daily plus vitamin D3 (cholecalciferol) 400 IU three times daily in combination with raltegravir 400 mg twice daily for 11 months. It is thought that calcium reduced raltegravir levels by chelation, leading to treatment failure.
Sotalol (Betapace)
Calcium seems to reduce the absorption of sotalol.
Advise patients to separate doses by at least 2 hours before or 4-6 hours after calcium. Calcium appears to reduce the absorption of sotalol, probably by forming insoluble complexes.
Tetracycline Antibiotics
Calcium seems to reduce the absorption of tetracycline antibiotics.
Advise patients to take oral tetracyclines at least 2 hours before, or 4-6 hours after calcium supplements. Taking calcium at the same time as oral tetracyclines can reduce tetracycline absorption. Calcium binds to tetracyclines in the gut.
Thiazide Diuretics
Taking calcium along with thiazides might increase the risk of hypercalcemia and renal failure.
Thiazides reduce calcium excretion by the kidneys. Using thiazides along with moderately large amounts of calcium carbonate increases the risk of milk-alkali syndrome (hypercalcemia, metabolic alkalosis, renal failure). Patients may need to have their serum calcium levels and/or parathyroid function monitored regularly.
Verapamil (Calan, Others)
Theoretically, calcium may reduce the therapeutic effects of verapamil.
Hypercalcemia can reduce the effectiveness of verapamil in atrial fibrillation. Theoretically, use of calcium supplements may increase this risk of hypercalcemia and reduce the effectiveness of verapamil.
Calcium Channel Blockers
Intravenous calcium may decrease the effects of calcium channel blockers; oral calcium is unlikely to have this effect.
Intravenous calcium is used to decrease the effects of calcium channel blockers in the management of overdose. Intravenous calcium gluconate has been used before intravenous verapamil (Isoptin) to prevent or reduce the hypotensive effects without affecting the antiarrhythmic effects. But there is no evidence that dietary or supplemental calcium when taken orally interacts with calcium channel blockers.
Iron
Bictegravir/Emtricitabine/Tenofovir Alafenamide (Biktarvy)
Iron might decrease levels of bictegravir/emtricitabine/tenofovir alafenamide by reducing its absorption when taken in a fasting state.
Advise patients that bictegravir/emtricitabine/tenofovir alafenamide and iron can be taken together if taken with food. However, if taken on an empty stomach, bictegravir/emtricitabine/tenofovir alafenamide should not be taken with, or 2 hours after, iron containing products.
Bisphosphonates
Iron reduces the absorption of bisphosphonates.
Advise patients that doses of bisphosphonates should be separated by at least two hours from doses of all other medications, including supplements such as iron. Divalent cations, including iron, can decrease absorption of bisphosphonates by forming insoluble complexes in the gastrointestinal tract.
Denosumab (Prolia, Others)
Administration of intravenous iron within one month of denosumab administration might increase the risk of severe hypophosphatemia and hypocalcemia.
A case of severe hypocalcemia (albumin corrected calcium 6.88 mg/dL, ionized calcium 3.68 mg/dL) and hypophosphatemia (<0.5 mg/dL) with respiratory acidosis, QT interval prolongation, and nonsustained ventricular tachycardia was reported in a 76-year-old male who had received an iron polymaltose infusion within 2 weeks of a subcutaneous injection of denosumab. Serum parathyroid hormone was also elevated (348 pg/mL). Subsequent iron infusions with iron polymaltose and ferric carboxymaltose were followed by transient hypophosphatemia, but without hypocalcemia. Additionally, a literature review describes 6 additional cases of hypophosphatemia and hypocalcemia in patients 52-92 years of age who had been administered intravenous iron as either ferric carboxymaltose or iron polymaltose and subcutaneous denosumab within 1-4 weeks of each other.
Dolutegravir (Tivicay)
Iron might decrease dolutegravir levels by reducing its absorption.
Advise patients to take dolutegravir at least 2 hours before or 6 hours after taking iron. Pharmacokinetic research shows that iron can decrease the absorption of dolutegravir from the gastrointestinal tract through chelation. When taken under fasting conditions, a single dose of ferrous fumarate 324 mg orally along with dolutegravir 50 mg reduces overall exposure to dolutegravir by 54%.
Integrase Inhibitors
Theoretically, taking iron along with integrase inhibitors might decrease the levels and clinical effects of these drugs.
Iron is a divalent cation. There is concern that iron may decrease the absorption of integrase inhibitors from the gastrointestinal tract through chelation. One pharmacokinetic study shows that iron can decrease blood levels of the specific integrase inhibitor dolutegravir through chelation. Also, other pharmacokinetic research shows that other divalent cations such as calcium can decrease the absorption and levels of some integrase inhibitors through chelation.
Levodopa
Iron might decrease levodopa levels by reducing its absorption.
Advise patients to separate doses of levodopa and iron as much as possible. There is some evidence in healthy people that iron forms chelates with levodopa, reducing the amount of levodopa absorbed by around 50%. The clinical significance of this hasn't been determined.
Levothyroxine (Synthroid, Others)
Iron might decrease levothyroxine levels by reducing its absorption.
Advise patients to separate levothyroxine and iron doses by at least 2 hours. Iron can decrease the absorption and efficacy of levothyroxine by forming insoluble complexes in the gastrointestinal tract.
Methyldopa (Aldomet)
Iron might decrease methyldopa levels by reducing its absorption.
Advise patients to separate methyldopa and iron doses by at least 2 hours. Iron can decrease the absorption of methyldopa from the gastrointestinal tract through chelation, resulting in increases in blood pressure.
Mycophenolate Mofetil (Cellcept)
Theoretically, iron might decrease mycophenolate mofetil levels by reducing its absorption.
Advise patients to take iron 4-6 hours before, or 2 hours after, mycophenolate mofetil. It has been suggested that a decrease of absorption is possible, probably by forming nonabsorbable chelates. However, mycophenolate pharmacokinetics are not affected by iron supplementation in available clinical research.
Penicillamine (Cuprimine, Depen)
Iron might decrease penicillamine levels by reducing its absorption.
Advise patients to separate penicillamine and iron doses by at least 2 hours. Oral iron supplements can reduce absorption of penicillamine by 30% to 70%, probably due to chelate formation. In people with Wilson's disease, this interaction has led to reduced efficacy of penicillamine.
Quinolone Antibiotics
Iron might decrease levels of quinolone antibiotics by reducing their absorption.
Advise patients to separate quinolone antibiotics and iron doses by at least 2 hours. Iron decreases the absorption of quinolones due to formation of insoluble complexes in the gastrointestinal tract.
Tetracycline Antibiotics
Iron might decrease levels of tetracycline antibiotics by reducing their absorption.
Advise patients to take iron at least 2 hours before or 4 hours after tetracycline antibiotics. Concomitant use can decrease absorption of tetracycline antibiotics from the gastrointestinal tract by 50% to 90%.
Chloramphenicol
Theoretically, taking chloramphenicol with iron might reduce the response to iron therapy in iron deficiency anemia.
Chloramphenicol interferes with erythrocyte maturation. However, since chloramphenicol isn't usually taken for prolonged periods, this isn't likely to be clinically significant.
Potassium
Ace Inhibitors (Aceis)
Using ACEIs with high doses of potassium increases the risk of hyperkalemia.
ACEIs block the actions of the renin-angiotensin-aldosterone system and reduce potassium excretion. Concomitant use of these drugs with potassium supplements increases the risk of hyperkalemia. However, concomitant use of these drugs with moderate dietary potassium intake (about 3775-5200 mg daily) does not increase serum potassium levels.
Angiotensin Receptor Blockers (Arbs)
Using ARBs with high doses of potassium increases the risk of hyperkalemia.
ARBs block the actions of the renin-angiotensin-aldosterone system and reduce potassium excretion. Concomitant use of these drugs with potassium supplements increases the risk of hyperkalemia. However, concomitant use of these drugs with moderate dietary potassium intake (about 3775-5200 mg daily) does not increase serum potassium levels.
Potassium-Sparing Diuretics
Concomitant use increases the risk of hyperkalemia.
Using potassium-sparing diuretics with potassium supplements increases the risk of hyperkalemia.
L-Tyrosine
Levodopa
Theoretically, tyrosine might decrease the effectiveness of levodopa.
Tyrosine and levodopa compete for absorption in the proximal duodenum by the large neutral amino acid (LNAA) transport system. Advise patients to separate doses of tyrosine and levodopa by at least 2 hours.
Thyroid Hormone
Theoretically, tyrosine might have additive effects with thyroid hormone medications.
Tyrosine is a precursor to thyroxine and might increase levels of thyroid hormones.
L-Phenylalanine
Levodopa
Phenylalanine, especially in high doses, can reduce the effectiveness of levodopa.
Phenylalanine competes with levodopa for carrier-mediated transport into the brain. The resulting reduction in levels of levodopa in the brain can exacerbate tremor, rigidity, and the "on-off" phenomenon in patients with Parkinson disease.
Baclofen
Concomitant intake of phenylalanine may reduce the intestinal absorption of baclofen.
Phenylalanine and baclofen share the same intestinal carrier for absorption; phenylalanine competitively inhibits the absorption of baclofen, reducing its plasma levels.
Monoamine Oxidase Inhibitors (Maois)
Theoretically, concomitant use of L-phenylalanine and non-selective MAOIs might increase the risk of hypertensive crisis.
L-phenylalanine is metabolized to tyrosine. Some evidence suggests that L-phenylalanine, given with the non-selective MAOI pargyline, might prevent the elimination of tyramine, increasing the risk of hypertensive crisis. However, this was not reported in a small number of patients when using L-phenylalanine with the partially selective MAO-B inhibitor, selegiline.
L-Threonine
Nmda Antagonists
Theoretically, threonine might decrease the effects of NMDA antagonists.
Threonine increases central nervous system (CNS) glycine levels. Glycine seems to bind a site on NMDA receptors and enhance the activity of the receptors.
Glycine
Clozapine (Clozaril)
Theoretically, glycine might decrease the effectiveness of clozapine.
One small clinical study in patients with schizophrenia shows that adding glycine to clozapine therapy worsens symptoms of schizophrenia when compared with clozapine alone. The mechanism of this interaction is unclear.
L-Lysine
5-Ht4 Agonists
Theoretically, lysine may reduce the effects of 5-HT4 agonists.
Animal research suggests that L-lysine is a partial serotonin receptor 4 (5-HT4) antagonist and inhibits diarrhea induced by the 5-HT4 agonist, 5-hydroxytryptophane.
Brand information
Manufacturer and brand details for 100% Whey Protein Fuel Chocolate Surge, from the product label.
Twinlab
See all Twinlab products- Name
- IDEASPHERE INC.
- City
- AMERICAN FORK
- State
- UT
- ZipCode
- 84003
- Phone Number
- 1-800-645-5626
100% Whey Protein Fuel Chocolate Surge by Twinlab: Common Questions
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Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
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The Full Monographs Behind 100% Whey Protein Fuel Chocolate Surge’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Sodium
Interacts with 205 drugsSodium is an essential mineral and electrolyte your body needs to balance fluids, support nerves, and help muscles work. Most people in modern diets get more than enough—often too much—from...
Read the full Sodium monograph → Herb & supplement monographPotassium
Interacts with 62 drugsPotassium is an essential mineral your body needs for nerve signals, muscle function, and a steady heartbeat, and most people get enough from a balanced diet rich in fruits and vegetables. P...
Read the full Potassium monograph → Herb & supplement monographVitamin A
Interacts with 387 drugsVitamin A is an essential nutrient important for vision, skin, immune function, and growth. Most people get enough from a balanced diet, and supplements are mainly useful for correcting a tr...
Read the full Vitamin A monograph → Herb & supplement monographCalcium
Interacts with 168 drugsCalcium is an essential mineral your body needs for strong bones, nerve signaling, and muscle function, and supplements can help fill gaps when diet falls short. Most people do best getting...
Read the full Calcium monograph → Herb & supplement monographIron
Interacts with 80 drugsIron is an essential mineral your body needs to make hemoglobin and carry oxygen in the blood. Supplements are mainly useful for treating or preventing iron deficiency and iron-deficiency an...
Read the full Iron monograph → Herb & supplement monographGlycine
Interacts with 1 drugGlycine is a non-essential amino acid your body makes on its own and that also appears in protein-rich foods. It is most studied for improving sleep quality, where early research is promisin...
Read the full Glycine monograph → Herb & supplement monographMagnesium
Interacts with 295 drugsMagnesium is an essential mineral your body needs for muscles, nerves, blood pressure, and many other functions, and supplements are useful for preventing or correcting deficiency. Some othe...
Read the full Magnesium monograph → Herb & supplement monographL-arginine
Interacts with 403 drugsL-arginine is an amino acid that the body uses to make nitric oxide, a substance that helps blood vessels relax and widen. It is popularly used for blood pressure, erectile dysfunction, and...
Read the full L-arginine monograph → Herb & supplement monographAlpha-alanine
Alpha-alanine (usually called alanine) is a non-essential amino acid your body can make on its own and that you also get from protein foods. Most people do not need a supplement, and strong...
Read the full Alpha-alanine monograph → Herb & supplement monographMethionine
Methionine is an essential amino acid that your body needs for protein building and many basic chemical reactions. Most people get enough from a normal diet, and supplements are generally no...
Read the full Methionine monograph → Herb & supplement monographTyrosine
Interacts with 21 drugsL-tyrosine is an amino acid your body uses to make brain chemicals like dopamine and norepinephrine. Some studies suggest it may help mental performance during short-term stress, sleep loss,...
Read the full Tyrosine monograph → Herb & supplement monographPhenylalanine
Interacts with 16 drugsPhenylalanine is an essential amino acid the body uses to make brain chemicals like dopamine and norepinephrine. Some people take it for mood, vitiligo, or pain, but the evidence is mostly l...
Read the full Phenylalanine monograph → Herb & supplement monographProline
Proline is a non-essential amino acid that your body can make on its own and that you also get from protein-rich foods. It is a key building block of collagen, but strong human evidence that...
Read the full Proline monograph → Herb & supplement monographAspartic Acid
Aspartic acid is a common amino acid your body makes on its own and gets from protein-rich foods, so a true deficiency is rare. D-aspartic acid is heavily marketed for boosting testosterone...
Read the full Aspartic Acid monograph → Herb & supplement monographHistidine
Histidine is an essential amino acid your body needs to build proteins and to make compounds like histamine and carnosine. Most people get enough from a normal diet, and good-quality researc...
Read the full Histidine monograph → Herb & supplement monographThreonine
Interacts with 3 drugsThreonine is an essential amino acid your body needs but cannot make, so you must get it from food or supplements. Most people get plenty from a normal diet, and high-quality evidence for ta...
Read the full Threonine monograph → Herb & supplement monographL-tryptophan
Interacts with 394 drugsL-tryptophan is an essential amino acid the body uses to make serotonin and melatonin, and people take it to support sleep and mood. The evidence for supplement use is limited and mixed, and...
Read the full L-tryptophan monograph → Herb & supplement monographLysine
Interacts with 1 drugLysine is an essential amino acid your body cannot make on its own, so it must come from food or supplements. People most often take extra lysine to try to prevent or shorten cold sores, but...
Read the full Lysine monograph → Herb & supplement monographSerine
Serine is an amino acid your body can make on its own and also gets from protein-rich foods, so most people do not need a supplement. L-serine has been studied for certain neurological condi...
Read the full Serine monograph → Herb & supplement monographCocoa
Interacts with 661 drugsCocoa is rich in plant compounds called flavanols that may modestly support blood vessel function and blood pressure, but most chocolate products are high in sugar, fat, and calories, which...
Read the full Cocoa monograph →Sources & How We Checked
100% Whey Protein Fuel Chocolate Surge's label data comes from the NIH Dietary Supplement Label Database; the ingredient interaction data is from the Natural Medicines database, reviewed by our pharmacists.
- NIH Dietary Supplement Label Database (DSLD) — The official product label on file for this supplement.
- Natural Medicines (Therapeutic Research Center) — Evidence-graded clinical reference behind the ingredient interaction data.
Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.
The 568 references behind this product’s interaction data
Every citation that drives the interaction findings for this product’s ingredients, from the evidence-graded Natural Medicines (TRC Healthcare) database. Open an ingredient to browse its citations — links open the study on PubMed or the publisher’s site.
Sodium 38 references
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
- Food and Drug Administration Science Background: Safety of Sodium Phosphates Oral Solution. September 17, 2001. Available at: http://www.fda.gov/cder/drug/safety/sodiumphospate.htm
- Coton T, Mallaret C, Coilliot C, Carre D, Guisset M. Severe acute ulcerated gastritis induced by salt. Presse Med 2009;38(3):499-500. PubMed
- Frings-Meuthen P, Buehlmeier J, Baecker N, et al. High sodium chloride intake exacerbates immobilization-induced bone resorption and protein losses. J Appl Physiol 2011;111(2):537-542. PubMed
- Frings-Meuthen P, Baecker N, Heer M. Low-grade metabolic acidosis may be the cause of sodium chloride-induced exaggerated bone resorption. J Bone Miner Res 2008;23(4):517-524. PubMed
- Alam S, Johnson AG. A meta-analysis of randomised controlled trials (RCT) among healthy normotensive and essential hypertensive elderly patients to determine the effect of high salt (NaCl) diet of blood pressure. J Hum Hypertens 1999;13(6):367-74.
- Boudville N, Ward S, Benaroia M, House AA. Increased sodium intake correlates with greater use of antihypertensive agents by subjects with chronic kidney disease. Am J Hypertens 2005;18(10):1300-5. PubMed
- Bennett WM. Drug interactions and consequences of sodium restriction. Am J Clin Nutr 1997;65(2 Suppl):678S-681S. PubMed
- Okusa MD, Crystal LJ. Clinical manifestations and management of acute lithium intoxication. Am J Med 1994;97(4):383-9. PubMed
- Food and Nutrition Board, Institute of Medicine. Dietary reference intakes for water, potassium, sodium, chloride, and sulfate. Washington, DC: National Academy Press, 2005. Available at: http://www.nap.edu/openbook.php?record_id=10925. DOI
- D'Elia L, Rossi G, Ippolito R, Cappuccio FP, Strazzullo P. Habitual salt intake and risk of gastric cancer: a meta-analysis of prospective studies. Clin Nutr 2012;31(4):489-98. PubMed
- Goldsmith SR. Hyponatremia in heart failure: time for a trial. J Card Fail 2013;19(6):398-400. PubMed
- Willocks L, Brettle R, Keen J, Valentine C, Pinching AJ. Formulations of didanosine (ddI) and salt overload. Lancet 1992;339(8786):190.
- Chen L, Zhang Z, Chen W, Whelton PK, Appel LJ. Lower Sodium Intake and Risk of Headaches: Results From the Trial of Nonpharmacologic Interventions in the Elderly. Am J Public Health. 2016;106(7):1270-5. PubMed
- Cook NR, Appel LJ, Whelton PK. Lower levels of sodium intake and reduced cardiovascular risk. Circulation. 2014;129(9):981-9. PubMed
- Cook NR, Appel LJ, Whelton PK. Sodium Intake and All-Cause Mortality Over 20 Years in the Trials of Hypertension Prevention. J Am Coll Cardiol. 2016;68(15):1609-1617. PubMed
- Mente A, O'Donnell M, Rangarajan S, et al. Associations of urinary sodium excretion with cardiovascular events in individuals with and without hypertension: a pooled analysis of data from four studies. Lancet. 2016;388(10043):465-75. PubMed
- Moosavian SP, Haghighatdoost F, Surkan PJ, Azadbakht L. Salt and obesity: a systematic review and meta-analysis of observational studies. Int J Food Sci Nutr. 2017;68(3):265-277. PubMed
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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.
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