Interactions on record — worth a quick check against your medications. Based on 2 of 4 ingredients. Check your meds →
Dietary supplement

Acacia Fiber Ingredients & Drug Interactions

by NOW

Acacia Fiber label
See full label image
Powder Category: Botanical With Nutrients
Most serious interaction: Moderate
Clinical methodology reviewed by · Updated Sep 9, 2026 · Label data from the NIH DSLD
What is this page for?

First and foremost: checking Acacia Fiber 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

The interaction bottom line Most serious interaction: Moderate

Acacia Fiber is a dietary supplement by NOW with 4 active ingredients. Its ingredients are commonly taken for constipation, diarrhea, high cholesterol.Based on those ingredients, 2,025 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Dietary Fiber, Acacia Gum Powder. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

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Check Your Meds Against Acacia Fiber by NOW

Ask about any prescription or over-the-counter medication and we check it for interactions with Acacia Fiber by NOW — and tell you which ingredient is responsible.

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HelloPharmacist Scorecard of Acacia Fiber by NOW

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.

From our pharmacy team — supplement deep dive

Generated from HelloPharmacist’s pharmacist-curated databases and editorial rules · Last generated Jul 11, 2026

What’s inside

Full disclosure
Ingredient Transparency · database check
Full

Every active ingredient lists its own amount on the label.

Why this rating?
  • The label discloses an exact amount for 2 of its 2 active ingredients.
  • No proprietary blends here — you can verify the dose of every single component.

This product contains just one active ingredient: acacia gum powder, a soluble fiber sourced from the acacia tree. It's used in foods and supplements as a thickener and fiber source.

Does it work?

Strong evidence
Evidence for Intended Use · database check
By FDA rules, dietary supplements can’t claim to treat, cure, or prevent disease — so labels speak in careful marketing language. We discern each product’s intended use from its name, label claims, and label statements, then grade the clinical evidence for that use. How these ratings are computed
Strong

Clinical evidence supports at least one of this product's ingredients for its stated purpose.

Why this rating?
  • The label markets this product for: intestinal health.
  • We looked for evidence on: Constipation, Diarrhea, Irritable bowel syndrome (IBS), bowel regularity, digestive health, gut health.
  • The strongest evidence on file: Black Psyllium is rated "Effective" for Constipation (Natural Medicines).
  • Also on file: Black Psyllium is rated "Insufficient Reliable Evidence To Rate" for Diarrhea.
  • Also on file: Gum Arabic is rated "Insufficient Reliable Evidence To Rate" for Irritable bowel syndrome (IBS).

The evidence for acacia gum isn't established in our data for the conditions tested — metabolic syndrome, kidney failure, sickle cell disease, obesity, gingivitis, and peristomal lesions all show insufficient reliable evidence to rate it as effective.

The evidence, ingredient by ingredient Black Psyllium Gum Arabic

How safe is it?

Well-documented data
Safety Information · database check
Well characterized

Adverse-effect, pregnancy, and general safety data are on file for most of these ingredients.

Why this rating?
  • We hold adverse-effect (side-effect) data for 2 of the 2 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 2 of 2.
  • General safety write-ups exist for 2 of 2.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

Acacia gum is generally recognized as safe as a food additive. At supplemental doses, though, it hasn't been well studied, so it's worth checking with your doctor before you start.

Side effects in the digestive tract are common when you first take it. Most people report abdominal bloating, flatulence, mild diarrhea, nausea, and sometimes vomiting — one study found these in a significant number of participants — but they often settle down within 2 weeks of continued use.

There isn't enough information on the safety of supplement doses while breastfeeding; talk to your doctor or pharmacist for personalized guidance.

Side effects, ingredient by ingredient Black Psyllium Gum Arabic

Meds to double-check

Moderate interaction found
Known Interaction Concern · database check
Moderate identified

The most serious documented interaction for these ingredients is Moderate. Check your medications for a personalized result.

Why this rating?
  • 2 of the 2 matched ingredients can interact with medications — Black Psyllium, Gum Arabic.
  • The most serious interaction on file is rated Moderate.
  • Some involve high-stakes drug classes: heart-rhythm medications; lithium.
  • For scale: 2,026 individual medications appear in the full list. A big number alone doesn't make a product dangerous — what matters is whether YOUR medication is on it, so run yours through the interaction checker on this page.

Separate this supplement from amoxicillin and other oral antibiotics by at least 2 hours — acacia gum can reduce their absorption and make them less effective. More broadly, avoid taking any oral medication within 30 minutes before or 2 hours after your acacia fiber dose to protect drug absorption.

Check your own medication Run your meds through the checker above

The bottom line

Scorecard at a glanceFully disclosed formula with clinical evidence supporting its stated purpose. Moderate medication interactions have been identified, and safety information is well characterized.

NOW Acacia Fiber is a plain soluble fiber supplement with no proven benefits in our data for the conditions studied. It does interact with several medications, especially antibiotics.

If you take any oral drugs, check them against this product's interaction tool before you start, and space doses apart by at least 2 hours. A pharmacist can help you time it right.

Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI

Assessment coverage: 2 of 2 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Dec 24, 2013.

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

At a glance

General information

Key facts about Acacia Fiber, straight from the product label.

Brand NOW
Barcode (UPC) 733739059062
Net contents 12 oz.; 340 Gram(s)
Market status On market
Date entered into DSLD Dec 24, 2013
DSLD ID 28630
Product type Botanical With Nutrients
Supplement form Powder
Dietary claims / uses Structure/Function
Intended target group(s) Vegan, Vegetarian, Adult (18 - 50 Years), Gluten Free, Dairy Free
From the 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 Acacia Fiber by NOW, sourced from the NIH Dietary Supplement Label Database.

Supplement Facts

Daily Value (DV) Target Group(s):
Adults and children 4 or more years of age
Minimum serving Sizes:
0.33 Tbsp
Maximum serving Sizes:
1 Tbsp
Servings per container
52
UPC/BARCODE
733739059062
IngredientAmount% DV
Calories5 {Calories}--
Total Carbohydrates6 Gram(s)2%
Sugar0 Gram(s)--
Dietary Fiber6 Gram(s)24%
Protein0 Gram(s)--
Total Fat0 Gram(s)--
Acacia Gum Powder6.5 Gram(s)--

Other ingredients: None

Tap any ingredient to jump to its full detail below.

Label statements
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.
Suggested/Recommended/Usage/Directions

SUGGESTED USAGE: As a dietary supplement, mix 1 level tablespoon per day into at least 8 oz. of water or juice. Due to fiber content, be sure to drink plenty of additional fluids throughout the day. For those sensitive to fiber, start with 1 teaspoon daily, and gradually increase to 1 tablespoon. Consider taking these other NOW(R) products: Gr8-Dophilus(TM), Triphala and Detox Support(TM).

Brand IP Statement(s)

NOW(R) Acacia Fiber Powder is a natural, pure, soluble dietary fiber produced from the gum of the Acacia tree.

General

CODE 5906 V1

General Statements

INTESTINAL HEALTH*

Pure Powder - Highly Soluble, Mixes Instantly - Gentle Fiber

For more product information visit www.nowfoods.com/5906

100% Pure.

This product is sold by weight not volume.

Please Recycle.

Scientific studies have shown that as part of the diet, soluble fiber can help to encourage intestinal regularity. Acacia Powder is also known to be an excellent prebiotic, as it supports healthy gut flora. Because it actually slows fermentation and decreases gas and bloating, Acacia Powder is well tolerated.*

FDA Statement of Identity

A Dietary Supplement

Formulation

Vegetarian/Vegan

Not manufactured with yeast, wheat, gluten, soy, milk, egg, fish, shellfish or tree nut ingredients.

NOW(R) Acacia Fiber Powder can be used daily and contains no GI irritants or stimulants.

Seals/Symbols

GMP QUALITY ASSURED

Precautions

Not manufactured with yeast, wheat, gluten, soy, milk, egg, fish, shellfish or tree nut ingredients. Produced in a GMP facility that processes other ingredients containing these allergens.

Storage

Store in a cool, dry place after opening.

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.

Is this label outdated? Report a formula or label change and our pharmacy team will review it.

See for yourself

Acacia Fiber by NOW label

The label scan from the NIH Dietary Supplement Label Database. Tap to enlarge.

Acacia Fiber label

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)
What’s inside

The Ingredients in Acacia Fiber by NOW

These are the 4 active ingredients this product is made of. Select any to open its full monograph.

Serving size0.33 Tbsp Dosage formPowder Servings per container52 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

0 Gram(s) per serving

Dietary Fiber

Interacts with
2,025 drugs
6 Gram(s) per serving

Black psyllium is a soluble-fiber supplement made from the seeds of a Plantago plant, used mostly to ease constipation and support digestive health. I...

Dietary Fiber monograph & interactions

Protein

0 Gram(s) per serving

Acacia Gum Powder

Interacts with
2,022 drugs
6.5 Gram(s) per serving

Gum arabic is a soluble dietary fiber from the acacia tree that is widely used as a safe food additive and is sometimes taken as a supplement for dige...

Acacia Gum Powder monograph & interactions

Other (inactive) ingredients: None. These complete the product’s ingredient list but are not active constituents.

Interaction report

Acacia Fiber by NOW Drug Interactions

Want to check YOUR meds against Acacia Fiber?

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 checker
2,025Drugs
2,022 Moderate 3 Minor

Ingredients driving the most interactions

Dietary Fiber 2,025
Acacia Gum Powder 2,022

Individual Drug Interactions

The ingredients in Acacia Fiber interact with 2,025 drugs. Click any drug to see the details.

2 of the 4 ingredients in Acacia Fiber interact with drugs. Each result below shows which ingredient is responsible. Dietary Fiber Acacia Gum Powder

Each ingredient & the kinds of drugs it affects

For each ingredient in Acacia Fiber 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.

Dietary Fiber7 drug types · 2,025 drugs

Carbamazepine (Tegretol)

Theoretically, black psyllium might reduce the effects of carbamazepine and increase the risk for convulsions.
Theoretically, black psyllium might reduce carbamazepine absorption. A preliminary study using blond psyllium reported decreased carbamazepine bioavailability due to binding of the drug to psyllium, as well as reduction of available fluid in the gut for dissolution of the drug. This interaction may also occur with black psyllium.

Likelihood Probable Evidence D
Lithium

Theoretically, taking black psyllium at the same time as lithium might reduce lithium absorption.
The fiber in black psyllium might reduce lithium absorption and plasma levels. Some case reports describe a reduction in plasma lithium levels with concomitant administration of blond psyllium. This was reversed when psyllium was stopped. This interaction may also occur with black psyllium.

Likelihood Probable Evidence D
Metformin (Glucophage)

Theoretically, black psyllium might increase the therapeutic and adverse effects of metformin.
Animal research shows that concurrent consumption of blond psyllium with metformin slows and increases the absorption of metformin. This interaction may also occur with black psyllium. To avoid changes in absorption, take psyllium 30-60 minutes after metformin.

Likelihood Possible Evidence D
Olanzapine (Zyprexa)

Theoretically, taking black psyllium at the same time as olanzapine might reduce olanzapine absorption.
The fiber in black psyllium might decrease the absorption of olanzapine. A single case report describes a reduction in the effectiveness of olanzapine when it was concomitantly administered with an unspecified type of psyllium 3 grams orally twice daily. This effect was reversed when psyllium was stopped.

Likelihood Possible Evidence D
Digoxin (Lanoxin)

Theoretically, taking black psyllium at the same time as digoxin might reduce digoxin absorption and decrease digoxin levels.
Psyllium might bind digoxin in the gut. However, some clinical evidence suggests that psyllium does not impact digoxin absorption.

Likelihood Unlikely Evidence B
Ethinyl Estradiol

Theoretically, taking black psyllium at the same time as ethinyl estradiol might alter levels of estradiol.
Concurrent use of blond psyllium with ethinyl estradiol results in a slight increase in the extent of ethinyl estradiol absorption and a slower rate of absorption. This is unlikely to be clinically significant.

Likelihood Unlikely Evidence D
Oral Drugs

Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Psyllium seems to have variable effects on drug absorption. To avoid changes in absorption, take psyllium 30-60 minutes after oral medications. Animal research shows that blond psyllium delays and increases the absorption of metformin and ethinyl estradiol. Case reports and animal research suggest that blond psyllium might reduce absorption of lithium, digoxin, olanzapine, and carbamazepine. Finally, some pharmacokinetic studies show that psyllium does not affect the absorption of levothyroxine or warfarin. Although many of these studies evaluated blond psyllium, the fiber content in black psyllium may have similar effects.

Likelihood Possible Evidence B
Dietary Fiber full monograph & interactions

Acacia Gum Powder2 drug types · 2,022 drugs

Amoxicillin (Amoxil, Trimox)

Gum arabic can reduce the absorption of amoxicillin.
A small study in healthy volunteers shows that taking amoxicillin and gum arabic concurrently significantly reduces the absorption of amoxicillin. Separate doses of amoxicillin from gum arabic by at least 2 hours.

Likelihood Probable Evidence B
Oral Drugs

Theoretically, gum arabic can alter the absorption of oral drugs due to its fiber content.
Gum arabic has been used as a suspending osmotic agent in drug formulations. It might improve bioavailability of water-insoluble drugs like naproxen, but reduce absorption of polar drugs like amoxicillin. To avoid changes in absorption, take gum arabic 30-60 minutes after oral medications.

Likelihood Possible Evidence B
Acacia Gum Powder full monograph & interactions
The maker

Brand information

Manufacturer and brand details for Acacia Fiber, from the product label.

NOW

See all NOW products
Web Address
www.nowfoods.com
Pharmacist Counseling Corner

Acacia Fiber by NOW: Common Questions

Does Acacia Fiber by NOW interact with any medications?
Yes. Based on its ingredients, Acacia Fiber has a known interaction with 2,025 medications. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Acacia Fiber contains 4 active ingredients, and an interaction can come from any of them. We check every ingredient, combine the results into one list per medication, and show which ingredient and mechanism is responsible.
Where does this information come from?
The product label data comes from the NIH Dietary Supplement Label Database (DSLD); the interaction data is built on the Natural Medicines database and reviewed by HelloPharmacist pharmacists.
Will this supplement really help with weight, blood sugar, or kidney function?
The evidence we have isn't solid enough to say yes. Studies on acacia gum for obesity, metabolic syndrome, kidney failure, and other conditions show insufficient reliable evidence to rate it as effective.
What side effects might I get?
You may notice bloating, gas, mild diarrhea, nausea, or vomiting — especially at first. In one study, these happened in a significant number of people, but most side effects usually fade within 2 weeks as your body adjusts.
Is it safe to take acacia gum long-term?
Food amounts of acacia gum are safe, but supplemental doses haven't been well studied for long-term use. Talk to your doctor about whether it's right for you.
Can I take this while pregnant or breastfeeding?
There isn't enough data on supplement doses during pregnancy or breastfeeding. Check with your doctor or pharmacist for personalized guidance before you start.

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

Not sure if Acacia Fiber is safe with your meds?

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Label information is sourced from the NIH Dietary Supplement Label Database and reflects the product version on file; always read your actual product label. This page is for education only and is not a substitute for professional medical advice. Confirm with your pharmacist or doctor before combining supplements and medications.

Acacia Fiber label
Go deeper

The Full Monographs Behind Acacia Fiber’s Ingredients

Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.

Herb & supplement monograph

Black Psyllium

Interacts with 2,025 drugs

Black psyllium is a soluble-fiber supplement made from the seeds of a Plantago plant, used mostly to ease constipation and support digestive health. It is best known and most studied for rel...

Read the full Black Psyllium monograph → Herb & supplement monograph

Gum Arabic

Interacts with 2,022 drugs

Gum arabic is a soluble dietary fiber from the acacia tree that is widely used as a safe food additive and is sometimes taken as a supplement for digestive health and as a prebiotic. Early s...

Read the full Gum Arabic monograph →
Sources

Sources & How We Checked

Acacia Fiber'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.

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 26 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.

Black Psyllium 18 references
  1. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
  2. Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.
  3. Covington TR, et al. Handbook of Nonprescription Drugs. 11th ed. Washington, DC: American Pharmaceutical Association, 1996.
  4. Etman M. Effect of a bulk forming laxative on the bioavailablility of carbamazepine in man. Drug Dev Ind Pharm 1995;21:1901-6.
  5. Perlman BB. Interaction between lithium salts and ispaghula husk. Lancet 1990;335:416.
  6. Vaswani SK, Hamilton RG, Valentine MD, Adkinson NF. Psyllium laxative-induced anaphylaxis, asthma, and rhinitis. Allergy 1996;51:266-8. PubMed
  7. Lantner RR, Espiritu BR, Zumerchik P, Tobin MC. Anaphylaxis following ingestion of a psyllium-containing cereal. JAMA 1990;264:2534-6. DOI
  8. Kaplan MJ. Anaphylactic reaction to "Heartwise." N Engl J Med 1990;323:1072-3. DOI
  9. Nordstrom M, Melander A, Robertsson E, Steen B. Influence of wheat bran and of a bulk-forming ispaghula cathartic on the bioavailability of digoxin in geriatric in-patients. Drug Nutr Interact 1987;5:67-9..
  10. Robinson DS, Benjamin DM, McCormack JJ. Interaction of warfarin and nonsystemic gastrointestinal drugs. Clin Pharmacol Ther 1971;12:491-5. PubMed
  11. Garcia JJ, Fernandez N, Diez MJ, et al. Influence of two dietary fibers in the oral bioavailability and other pharmacokinetic parameters of ethinyloestradiol. Contraception 2000;62:253-7. PubMed
  12. Fernandez N, Lopez C, Díez R, et al. Drug interactions with the dietary fiber Plantago ovata husk. Expert Opin Drug Metab Toxicol 2012;8(11):1377-86.
  13. Semen plantaginis in: WHO Monographs on Selected Medicinal Plants, volume 1. World Health Organization, Geneva, 1999. Available at http://apps.who.int/medicinedocs/en/d/Js2200e/. Accessed November 26, 1026.
  14. Code of Federal Regulations, Title 21 (21CFR 101.17). Food labeling warning, notice, and safe handling statements. Available at www.ecfr.gov/cgi-bin/text-idx?SID=20f647d3b74161501f46564b915b4048&mc=true&node=se21.2.101_117&rgn=div8. Accessed December 3, 2
  15. Code of Federal Regulations, Title 21 (21CFR 201.319). Specific labeling requirements - water-soluble gums, hydrophilic gums, and hydrophilic mucilloids. Available at www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?fr=201.319. Accessed Dece
  16. Diez R, Garcia JJ, Diez MJ, Sierra M, Sahagun AM, Fernandez N. Influence of Plantago ovata husk (dietary fiber) on the bioavailability and other pharmacokinetic parameters of metformin in diabetic rabbits. BMC Complement Altern Med. 2017 Jun 7;17(1):298. PubMed
  17. Chiu AC, Sherman SI. Effects of pharmacological fiber supplements on levothyroxine absorption. Thyroid. 1998;8(8):667-71. PubMed
  18. Merrick C, Madden CA, Capurso NA. A Case of Blunted Orally Disintegrating Olanzapine Effect Due to Coadministered Psyllium. J Clin Psychiatry 2021;82(2):20cr13633. PubMed

See these in context on the Black Psyllium monograph →

Gum Arabic 8 references
  1. Jensen CD, Spiller GA, Gates JE, et al. The effect of acacia gum and a water-soluble dietary fiber mixture on blood lipids in humans. J Am Coll Nutr 1993;12:147-54. PubMed
  2. Eltayeb IB, Awad AI, Elderbi MA, Shadad SA. Effect of gum arabic on the absorption of a single oral dose of amoxicillin in healthy Sudanese volunteers. J Antimicrob Chemother 2004;54:577-8. PubMed
  3. Babiker R, Merghani TH, Elmusharaf K, et al. Effects of gum Arabic ingestion on body mass index and body fat percentage in healthy adult females: two-arm randomized, placebo controlled, double-blind trial. Nutr J 2012;11:111. PubMed
  4. Babiker R, Elmusharaf K, Keogh MB, Banaga AS, Saeed AM. Metabolic effect of gum Arabic (Acacia senegal) in patients with type 2 diabetes mellitus (T2DM): randomized, placebo controlled double blind trial. Functional Foods in Health and Disease. 2017;7(3): DOI
  5. Beneke CE, Viljoen AM, Hamman JH. Polymeric plant-derived excipients in drug delivery. Molecules. 2009;14(7):2602-20. PubMed
  6. Ali NE, Kaddam LA, Alkarib SY, et al. Gum Arabic (Acacia Senegal) Augmented Total Antioxidant Capacity and Reduced C-Reactive Protein among Haemodialysis Patients in Phase II Trial. Int J Nephrol. 2020;2020:7214673.
  7. Mortensen A, Aguilar F, Crebelli R, et al. Re-evaluation of acacia gum (E 414) as a food additive. EFSA J. 2017;15(4):e04741. PubMed
  8. Larson R, Nelson C, Korczak R, et al. Acacia Gum Is Well Tolerated While Increasing Satiety and Lowering Peak Blood Glucose Response in Healthy Human Subjects. Nutrients 2021;13(2):618. PubMed

See these in context on the Gum Arabic monograph →

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

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