Alpha King Supreme Ingredients & Drug Interactions
by Force Factor
What is this page for?
First and foremost: checking Alpha King Supreme 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
Alpha King Supreme is a dietary supplement by Force Factor with 22 active ingredients. Its ingredients are commonly taken for high cholesterol, vitamin b3 deficiency (pellagra), heart health support.Based on those ingredients, 1,611 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are KSM-66 Ashwagandha root extract, BioPerine, Horny Goat Weed Aerial Parts Extract. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against Alpha King Supreme by Force Factor
Ask about any prescription or over-the-counter medication and we check it for interactions with Alpha King Supreme by Force Factor — 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 Alpha King Supreme by Force Factor
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
Alpha King Supreme contains 22 active ingredients spanning vitamins, minerals, botanical extracts, and amino acids. The vitamin and mineral group includes niacin, vitamins B6, B12, and D, zinc, manganese, magnesium, selenium, and boron.
The botanical actives are black pepper (BioPerine), stinging nettle root extract, black maca, horny goat weed, ashwagandha (in two branded forms—KSM-66 and NooGandha), fenugreek (AlphaFen), saw palmetto fruit, pumpkin seed, and lion's mane mushroom powder. L-citrulline, an amino acid, is also included.
Several ingredients are proprietary blends—the "Total Testosterone Maximum Strength Matrix," "Nootropic Anti-Cortisol Body Recomposition Complex," "DHT Modulation Blend," and "Advanced Blood Flow and Bioavailability System"—meaning their exact amounts are not disclosed. Inactive ingredients include cellulose, stearic acid, silica, and food colorants.
Does it work?
Moderate evidence
The evidence for Alpha King Supreme's ingredients is mixed. Niacin is likely effective for pellagra (a vitamin B deficiency disease) and possibly effective for HIV-related cholesterol problems and metabolic syndrome.
Vitamin B6 is effective for certain types of anemia and B6 deficiency itself, and possibly effective for pregnancy-related nausea. Vitamin B12 is effective for its own deficiency and possibly helpful for canker sores.
Vitamin D is effective for bone and mineral metabolism disorders like rickets and osteomalacia. Zinc is effective for zinc deficiency and possibly helpful for acne.
Magnesium is effective for constipation and heartburn. For the botanical ingredients, evidence is sparse: stinging nettle and ashwagandha are possibly effective for their respective uses (diabetes, anxiety, stress, and sleep), but fenugreek, horny goat weed, maca, saw palmetto, lion's mane, pumpkin seed, and black pepper all lack reliable evidence or are rated insufficient to establish effectiveness.
L-citrulline is possibly effective for athletic performance but possibly ineffective for muscle loss. The product's proprietary blends contain no disclosed effectiveness data.
How safe is it?
Well-documented data
Most ingredients are generally well tolerated at recommended doses. However, several carry cautions.
Niacin can cause flushing (up to 70% of people at higher doses), gastrointestinal upset, and at high doses, liver damage—the safety notes advise against high-dose supplements unless prescribed. Vitamin B6 is safe at normal amounts but can cause nerve damage (sensory neuropathy) at very high doses over time.
Vitamin D is safe at recommended doses but toxic at very high intakes. Zinc, manganese, magnesium, and boron all have upper safe limits; excess can cause problems ranging from nausea and diarrhea to neurological damage (manganese) or developmental harm (boron in pregnancy).
Ashwagandha and horny goat weed have limited long-term safety data and carry pregnancy warnings. Stinging nettle is traditionally avoided in pregnancy due to uterine concerns, and rare cases of liver injury have been reported.
Black pepper, fenugreek, saw palmetto, and lion's mane have incomplete long-term safety profiles. The adverse effects most commonly reported across ingredients are gastrointestinal (nausea, diarrhea, abdominal discomfort).
Meds to double-check
Major interaction found
Before taking Alpha King Supreme, double-check your medications against these drug types. Major severity: warfarin (blood thinner).
Moderate severity (worst first): blood pressure medications, diabetes drugs, seizure medications (phenytoin, phenobarbital), cholesterol-lowering statins, gout medications, antibiotics (quinolones, tetracyclines, cephalosporins, rifampin), heart rhythm or blood pressure control drugs (verapamil, diltiazem, digoxin, amiodarone), thyroid hormone, sedatives and anti-anxiety drugs, immunosuppressants, and drugs affected by liver metabolism (theophylline, cyclosporine, pentobarbital). Minor severity: levodopa (if not combined with carbidopa), metformin, and oral contraceptives.
If you take any of these, run them through the interaction checker below.
The bottom line
Scorecard at a glanceFully disclosed formula with some supporting evidence for its stated purpose. Major medication interactions have been identified, and safety information is well characterized.
Alpha King Supreme is a complex multi-ingredient supplement aimed at testosterone support and athletic performance; however, it carries significant medication interactions—most critically with warfarin and several classes of common drugs (blood pressure, diabetes, seizure, antibiotic, and heart medications). If you take any prescription drugs, check each one against the interaction tool on this page before use.
The evidence for most botanical ingredients is weak or absent, and some carry pregnancy/breastfeeding cautions or liver concerns. Talk to your pharmacist or doctor before adding this to your routine, especially if you're on any regular medications.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 22 of 22 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Jun 16, 2022.
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 Alpha King Supreme, straight from the product label.
| Brand | Force Factor |
|---|---|
| Net contents | 120 Tablet(s) |
| Market status | On market |
| Date entered into DSLD | Jun 16, 2022 |
| DSLD ID | 260837 |
| Product type | Other Combinations |
| Supplement form | Tablet Or Pill |
| Dietary claims / uses | Nutrient, All Other, Structure/Function |
| Intended target group(s) | Adult Male (18-50 Years) |
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 Alpha King Supreme by Force Factor, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Niacin | 10 mg | 63% |
| Vitamin B6 | 5 mg | 294% |
| Vitamin B12 | 15 mcg | 625% |
| Vitamin D | 84 mcg | 420% |
| Zinc | 30 mg | 272% |
| Manganese | 2 mg | 87% |
| BioPerine | 5 mg | -- |
| Vitamin K2 | 50 mcg | 42% |
| Magnesium | 100 mg | 24% |
| Stinging Nettle root extract | 100 mg | -- |
| L-Citrulline | 1500 mg | -- |
| KSM-66 Ashwagandha root extract | 600 mg | -- |
| Black Maca extract | 100 mg | -- |
| Horny Goat Weed Aerial Parts Extract | 100 mg | -- |
| Selenium | 50 mcg | 91% |
| Total Testosterone Maximum Strength Matrix | 900 mg | -- |
| AlphaFen | 500 mg | -- |
| Boron Citrate | 200 mg | -- |
| Nootropic Anti-Cortisol Body Recomposition Complex | 800 mg | -- |
| NooGandha | 100 mg | -- |
| Lion's Mane powder | 100 mg | -- |
| DHT Modulation Blend | 500 mg | -- |
| Saw Palmetto Fruit Extract | 300 mg | -- |
| Pumpkin seed extract | 100 mg | -- |
| Advanced Blood Flow and Bioavailability System | 1605 mg | -- |
| Pine bark extract | 100 mg | -- |
Other ingredients: Microcrystalline Cellulose, Stearic Acid, Silicon Dioxide, Croscarmellose Sodium, Magnesium Stearate, FD&C Yellow #6, FD&C Red #40, FD&C Blue #1, Natural and Artificial flavor
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.
General Statements
The King of Kings Building on the breakthrough innovation of Alpha King, the scientists at Force Factor sought to formulate a superior vitality and virility supplement. Their goal: engineer a testosterone booster that maximizes your chance of be coming the ideal man — the king of kings. Alpha King Supreme is their legacy.
New & improved formula
Formulation
But what exactly does it take to loft men to supremacy? The researchers targeted four primary benefits: Deliver a boost to libido and desire unlike any previously experienced. Enable the ability to take advantage of this increased passion and drive with enhanced blood flow when and where you need it most, plus stamina to go the distance. Spark the masculinity and determination exhibited by the most confident, powerful men. Provide the muscle, strength, and presence of mind you need to command your realm.
Most remarkably, Force Factor’s scientists managed to pack some of the most premium men’s health compounds into a single supplement. You would need to combine several disparate vitality products to achieve similar results, but the ingredient ratios would be all wrong. If you are looking for the ultimate testosterone booster, you found it. Increased libido and lean muscle. Improved sexual performance, strength, and endurance. Less every day stress, a better mood, and more mental clarity and alertness.
Unleash Your Potential Alpha King Supreme contains elite ingredients, at precisely chosen dosages, to help elevate your masculinity to new heights. Not only do the selected compounds individually influence the formula’s results, but the ratio of the constituents to one another is also critical, and often overlooked in less worthy male vitality supplements.
Proudly manufactured in the U.S. from foreign and domestic ingredients.
Elite testosterone booster Premium drive & vitality Compelling muscle & strength Mind-blowing sexual performance Lowers estrogen
Suggested/Recommended/Usage/Directions
All of this and more was encapsulated into a once-daily, easy-to-take formula .
Select Series Stacking To help you achieve a jaw-dropping physical transformation, consider stacking Alpha King Supreme with LeanFire Ultimate. LeanFire Ultimate’s incredible energy and powerful thermogenesis, combined with Alpha King Supreme’s lean muscle building power and strength amplification, will help you burn fat in the gym and sculpt a body women can’t resist.
Directions Take 4 tablets daily with breakfast.
Formula
For men not afraid to claim the throne a nd rise above, Alpha King Supreme is the formula for greatness.
500 mg of AlphaFen is included in every dose. A recent clinical study shows that this extra 100 mg of fenugreek seed extract produces not only a meaningful boost to free testosterone in the gym, but also an increase in total testosterone.
A recent clinical study shows that this extra 100 mg of fenugreek seed extract produces not only a meaningful boost to free testosterone in the gym, but also an increase in total testosterone. Simultaneously, AlphaFen works to decrease estrogen levels, bolster strength, and improve your mood.
Specialized NooGandha is paired with the super mushroom Lion’s Mane and KSM-66 — a proprietary ashwagandha root extract which additionally helps support total testosterone levels, increase strength and endurance, relieve everyday stress, and improve mental clarity and alertness.
Newly added saw palmetto, stinging nettle, and pumpkin seed extract are believed to help prevent optimal levels of testosterone from being converted to dihydrotestosterone (DHT), which produces undesirable results, especially as men age. But perhaps the best feature of Alpha King Supreme is the 1,500 mg of L-citrulline, a vasodilating nitric oxide catalyst that increases blood flow to help you achieve mind-blowing sexual performance that’s guaranteed to satisfy your partner. Alpha King Supreme’s premium ingredients quickly and efficiently permeate your body, allowing you to fully Unleash Your Potential.
Newly added saw palmetto, stinging nettle, and pumpkin seed extract are believed to help prevent optimal levels of testosterone from being converted to dihydrotestosterone (DHT), which produces undesirable results, especially as men age. But perhaps the best feature of Alpha King Supreme is the 1,500 mg of L-citrulline, a vasodilating nitric oxide catalyst that increases blood flow to help you achieve mind-blowing sexual performance that’s guaranteed to satisfy your partner.
Select Ingredient AlphaFen KSM-66 Ashwagandha [NOO] Gandha
Brand IP Statement(s)
Unleash Your Potential
Lalmin is a registered trademark of Danstar Ferment AG. TRAACS is a registered trademark of Albion International, Inc. AlphaFen and NooGandha are registered trademarks of SpecNova, LLC. KSM-66 is a registered trademark of Ixoreal Biomed Inc. BioPerine is a registered trademark of Sabinsa Corporation.
Select Series
Precautions
In conjunction with a resistance training program Ask your doctor if your heart is strong enough for exercise and sex.
Keep out of reach of children.
For adult use only.
Allergen Warning: Manufactured by equipment which processes products containing milk, eggs, soybeans, wheat, shellfish, fish oil, tree nuts, and peanut flavor.
Precautions: Use only as directed.
Consult a healthcare professional before use if you are pregnant or nursing, have a medical condition, or use prescription medications.
Discontinue use two weeks prior to surgery.
FDA Statement of Identity
Dietary Supplement
Storage
Store in a cool, dry place. Protect from heat, light, and moisture.
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.
Alpha King Supreme by Force Factor 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 Alpha King Supreme by Force Factor
These are the 22 active ingredients this product is made of. Select any to open its full monograph.
Serving size4 Tablet(s) Dosage formTablet Or Pill Servings per container30 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.
Niacin
Interacts with727 drugs
Niacin (vitamin B3) is an essential nutrient your body needs for energy and metabolism, and deficiency is uncommon in most developed countries. Prescr...
Niacin monograph & interactionsVitamin B6
Interacts with210 drugs
Vitamin B6 (pyridoxine) is an essential water-soluble vitamin that your body needs for metabolism, brain function, and making red blood cells. It is b...
Vitamin B6 monograph & interactionsVitamin B12
Interacts with20 drugs
Vitamin B12 (cobalamin) is an essential nutrient your body needs to make red blood cells, keep nerves healthy, and support DNA. Supplements are very h...
Vitamin B12 monograph & interactionsVitamin D
Interacts with715 drugs
Vitamin D is a fat-soluble vitamin that helps your body absorb calcium and is important for healthy bones, muscles, and immune function. Many people,...
Vitamin D monograph & interactionsZinc
Interacts with67 drugs
Zinc is an essential mineral that your body needs for immune function, wound healing, taste, and smell. Most people get enough from food, but suppleme...
Zinc monograph & interactionsManganese
Interacts with83 drugs
Manganese is an essential trace mineral your body needs in small amounts for bone formation, metabolism, and antioxidant defense, and most people get...
Manganese monograph & interactionsVitamin K2
Interacts with2 drugs
Vitamin K is an essential nutrient your body needs for normal blood clotting and to support healthy bones. Most people get enough from food, but suppl...
Vitamin K2 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 & interactionsSelenium
Interacts with321 drugs
Selenium is an essential trace mineral your body needs in small amounts for thyroid function, antioxidant defense, and immune health. Most people who...
Selenium monograph & interactionsTotal Testosterone Maximum Strength Matrix
Nootropic Anti-Cortisol Body Recomposition Complex
DHT Modulation Blend
Advanced Blood Flow and Bioavailability System
Other (inactive) ingredients: Microcrystalline Cellulose, Stearic Acid, Silicon Dioxide, Croscarmellose Sodium, Magnesium Stearate, FD&C Yellow #6, FD&C Red #40, FD&C Blue #1, Natural and Artificial flavor. These complete the product’s ingredient list but are not active constituents.
Alpha King Supreme by Force Factor Drug Interactions
HelloPharmacist Interaction Report
Alpha King Supreme by Force Factor contains 22 ingredients, several of which interact with medications.
The most serious interaction is with warfarin (Coumadin), a blood thinner: vitamin K2 in this product can directly counteract warfarin's effects and reduce your bleeding protection to dangerous levels.
Read the full breakdown — every affected drug type, severity by severity
Niacin, the first listed ingredient, interacts with multiple drug types at Moderate severity. It can lower blood pressure beyond what blood pressure medications do, raise blood sugar in people taking diabetes drugs, increase the risk of muscle damage when combined with cholesterol-lowering statins, and interfere with gout medications like allopurinol and probenecid.
Vitamin B6 may reduce levels of seizure medications (phenytoin and phenobarbital) and interact with amiodarone, a heart rhythm drug. Vitamin D at high doses can raise calcium dangerously when combined with certain heart or blood pressure medications, or with thiazide diuretics.
Zinc, magnesium, and manganese can all reduce absorption of antibiotics—quinolones, tetracyclines, and cephalosporins—if you take them at the same time. Black pepper (piperine) increases blood levels of several medications including phenytoin, rifampin, and theophylline.
Ashwagandha (in two forms here) may worsen low blood sugar with diabetes drugs, lower blood pressure further, and increase drowsiness with sedatives or anti-anxiety drugs. Additional interactions involve selenium, fenugreek, lion's mane, and saw palmetto with anticoagulants, antidiabetes drugs, and immune-suppressing medications.
Altogether, these interactions span 1,588 individual medications. Use the interaction checker below with your complete medication list before starting this product.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against Alpha King Supreme?
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 Alpha King Supreme interact with 1,611 drugs. Click any drug to see the details.
19 of the 22 ingredients in Alpha King Supreme interact with drugs. Each result below shows which ingredient is responsible. KSM-66 Ashwagandha root extract BioPerine Horny Goat Weed Aerial Parts Extract Niacin Vitamin D AlphaFen Lion's Mane powder Pine bark extract Selenium Magnesium Vitamin B6 L-Citrulline Saw Palmetto Fruit Extract Stinging Nettle root extract Manganese Zinc Vitamin B12 Vitamin K2 Pumpkin seed extract
Benserazide, LevodopaMadopar, Prolopa
How Benserazide, Levodopa interacts with Alpha King Supreme — through 2 ingredients. Tap an ingredient for the detail:
MagnesiumLevodopa/carbidopa (sinemet) Major
Interaction Summary
Magnesium can reduce the bioavailability of levodopa/carbidopa.
Read the full Magnesium + Benserazide, Levodopa interactionVitamin B6Levodopa Minor
Interaction Summary
Vitamin B6 may increase the metabolism of levodopa when taken alone, but not when taken in conjunction with carbidopa.
Read the full Vitamin B6 + Benserazide, Levodopa interactionCarbidopaLodosyn
How Carbidopa interacts with Alpha King Supreme — through 1 ingredient. Tap an ingredient for the detail:
MagnesiumLevodopa/carbidopa (sinemet) Major
Interaction Summary
Magnesium can reduce the bioavailability of levodopa/carbidopa.
Read the full Magnesium + Carbidopa interactionCarbidopa, LevodopaDhivy, Rytary, Sinemet, Sinemet CR
How Carbidopa, Levodopa interacts with Alpha King Supreme — through 2 ingredients. Tap an ingredient for the detail:
MagnesiumLevodopa/carbidopa (sinemet) Major
Interaction Summary
Magnesium can reduce the bioavailability of levodopa/carbidopa.
Read the full Magnesium + Carbidopa, Levodopa interactionVitamin B6Levodopa Minor
Interaction Summary
Vitamin B6 may increase the metabolism of levodopa when taken alone, but not when taken in conjunction with carbidopa.
Read the full Vitamin B6 + Carbidopa, Levodopa interactionCarbidopa, Levodopa, EntacaponeStalevo
How Carbidopa, Levodopa, Entacapone interacts with Alpha King Supreme — through 2 ingredients. Tap an ingredient for the detail:
MagnesiumLevodopa/carbidopa (sinemet) Major
Interaction Summary
Magnesium can reduce the bioavailability of levodopa/carbidopa.
Read the full Magnesium + Carbidopa, Levodopa, Entacapone interactionVitamin B6Levodopa Minor
Interaction Summary
Vitamin B6 may increase the metabolism of levodopa when taken alone, but not when taken in conjunction with carbidopa.
Read the full Vitamin B6 + Carbidopa, Levodopa, Entacapone interactionLevodopaInbrija, Larodopa
How Levodopa interacts with Alpha King Supreme — through 2 ingredients. Tap an ingredient for the detail:
MagnesiumLevodopa/carbidopa (sinemet) Major
Interaction Summary
Magnesium can reduce the bioavailability of levodopa/carbidopa.
Read the full Magnesium + Levodopa interactionVitamin B6Levodopa Minor
Interaction Summary
Vitamin B6 may increase the metabolism of levodopa when taken alone, but not when taken in conjunction with carbidopa.
Read the full Vitamin B6 + Levodopa interactionLevodopa, CarbidopaDuodopa
How Levodopa, Carbidopa interacts with Alpha King Supreme — through 2 ingredients. Tap an ingredient for the detail:
MagnesiumLevodopa/carbidopa (sinemet) Major
Interaction Summary
Magnesium can reduce the bioavailability of levodopa/carbidopa.
Read the full Magnesium + Levodopa, Carbidopa interactionVitamin B6Levodopa Minor
Interaction Summary
Vitamin B6 may increase the metabolism of levodopa when taken alone, but not when taken in conjunction with carbidopa.
Read the full Vitamin B6 + Levodopa, Carbidopa interactionWarfarinWarfarin
How Warfarin interacts with Alpha King Supreme — through 13 ingredients. Tap an ingredient for the detail:
Vitamin K2Warfarin (coumadin) Major
Interaction Summary
Vitamin K can antagonize and reverse the therapeutic effects of warfarin.
Read the full Vitamin K2 + Warfarin interactionAlphafenAnticoagulant/antiplatelet Drugs, Warfarin (coumadin) Moderate
Interaction Summary
Theoretically, fenugreek might have additive effects when used with anticoagulant or antiplatelet drugs.
Read the full Alphafen + Warfarin interactionHorny Goat Weed Aerial Parts ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Anticoagulant/antiplatelet Drugs +1 Moderate
Interaction Summary
Theoretically, horny goat weed might increase the effects and side effects of CYP1A2 substrates.
Read the full Horny Goat Weed Aerial Parts Extract + Warfarin interactionStinging Nettle Root ExtractWarfarin (coumadin) Moderate
Interaction Summary
There is some concern that stinging nettle might decrease the effects of anticoagulant drugs such as warfarin.
Read the full Stinging Nettle Root Extract + Warfarin interactionBioperineCytochrome P450 3a4 (cyp3a4) Substrates, Anticoagulant/antiplatelet Drugs +1 Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP3A4.
Read the full Bioperine + Warfarin interactionPine Bark ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, maritime pine bark extract might increase the risk of bleeding when used with antiplatelet or anticoagulant drugs.
Read the full Pine Bark Extract + Warfarin interactionLion's Mane PowderAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, lion's mane mushroom may increase the risk of bleeding when used with anticoagulant/antiplatelet drugs.
Read the full Lion's Mane Powder + Warfarin interactionSeleniumWarfarin (coumadin), Anticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, selenium might interfere with warfarin activity.
Read the full Selenium + Warfarin interactionNiacinAnticoagulant/antiplatelet Drugs, Warfarin (coumadin) Moderate
Interaction Summary
Theoretically, niacin may have additive effects when used with anticoagulant or antiplatelet drugs.
Read the full Niacin + Warfarin interactionSaw Palmetto Fruit ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Saw palmetto might increase the risk of bleeding with anticoagulant or antiplatelet drugs.
Read the full Saw Palmetto Fruit Extract + Warfarin interactionVitamin DCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Vitamin D might induce CYP3A4 enzymes and reduce the bioavailability of CYP3A4 substrates.
Read the full Vitamin D + Warfarin interactionNoogandhaCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, ashwagandha might decrease the levels and clinical effects of CYP3A4 substrates.
Read the full Noogandha + Warfarin interactionMagnesiumAnticoagulant/antiplatelet Drugs Minor
Interaction Summary
Theoretically, magnesium may have antiplatelet effects, but the evidence is conflicting.
Read the full Magnesium + Warfarin interactionWarfarin SodiumCoumadin, Panwarfin, Sofarin
How Warfarin Sodium interacts with Alpha King Supreme — through 13 ingredients. Tap an ingredient for the detail:
Vitamin K2Warfarin (coumadin) Major
Interaction Summary
Vitamin K can antagonize and reverse the therapeutic effects of warfarin.
Read the full Vitamin K2 + Warfarin Sodium interactionSeleniumWarfarin (coumadin), Anticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, selenium might interfere with warfarin activity.
Read the full Selenium + Warfarin Sodium interactionPine Bark ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, maritime pine bark extract might increase the risk of bleeding when used with antiplatelet or anticoagulant drugs.
Read the full Pine Bark Extract + Warfarin Sodium interactionLion's Mane PowderAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, lion's mane mushroom may increase the risk of bleeding when used with anticoagulant/antiplatelet drugs.
Read the full Lion's Mane Powder + Warfarin Sodium interactionHorny Goat Weed Aerial Parts ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Moderate
Interaction Summary
Theoretically, horny goat weed might increase the effects and side effects of CYP3A4 substrates.
Read the full Horny Goat Weed Aerial Parts Extract + Warfarin Sodium interactionAlphafenAnticoagulant/antiplatelet Drugs, Warfarin (coumadin) Moderate
Interaction Summary
Theoretically, fenugreek might have additive effects when used with anticoagulant or antiplatelet drugs.
Read the full Alphafen + Warfarin Sodium interactionStinging Nettle Root ExtractWarfarin (coumadin) Moderate
Interaction Summary
There is some concern that stinging nettle might decrease the effects of anticoagulant drugs such as warfarin.
Read the full Stinging Nettle Root Extract + Warfarin Sodium interactionBioperineAnticoagulant/antiplatelet Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Moderate
Interaction Summary
Theoretically, black pepper might increase the risk of bleeding when taken with antiplatelet or anticoagulant drugs.
Read the full Bioperine + Warfarin Sodium interactionSaw Palmetto Fruit ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Saw palmetto might increase the risk of bleeding with anticoagulant or antiplatelet drugs.
Read the full Saw Palmetto Fruit Extract + Warfarin Sodium interactionNiacinAnticoagulant/antiplatelet Drugs, Warfarin (coumadin) Moderate
Interaction Summary
Theoretically, niacin may have additive effects when used with anticoagulant or antiplatelet drugs.
Read the full Niacin + Warfarin Sodium interactionNoogandhaCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, ashwagandha might decrease the levels and clinical effects of CYP1A2 substrates.
Read the full Noogandha + Warfarin Sodium interactionMagnesiumAnticoagulant/antiplatelet Drugs Minor
Interaction Summary
Theoretically, magnesium may have antiplatelet effects, but the evidence is conflicting.
Read the full Magnesium + Warfarin Sodium interactionVitamin DCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Vitamin D might induce CYP3A4 enzymes and reduce the bioavailability of CYP3A4 substrates.
Read the full Vitamin D + Warfarin Sodium interactionEach ingredient & the kinds of drugs it affects
For each ingredient in Alpha King Supreme 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.
KSM-66 Ashwagandha root extract
Antidiabetes Drugs
Theoretically, taking ashwagandha with antidiabetes drugs might increase the risk of hypoglycemia.
There is preliminary clinical evidence suggesting that ashwagandha might lower blood glucose levels. Theoretically, ashwagandha might have additive effects when used with antidiabetes drugs and increase the risk of hypoglycemia.
Antihypertensive Drugs
Theoretically, taking ashwagandha with antihypertensive drugs might increase the risk of hypotension.
Animal research suggests that ashwagandha might lower systolic and diastolic blood pressure. Theoretically, ashwagandha might have additive effects when used with antihypertensive drugs and increase the risk of hypotension.
Benzodiazepines
Theoretically, taking ashwagandha might increase the sedative effects of benzodiazepines.
There is preliminary evidence that ashwagandha might have an additive effect with diazepam (Valium) and clonazepam (Klonopin). This may also occur with other benzodiazepines.
Cns Depressants
Theoretically, taking ashwagandha might increase the sedative effects of CNS depressants.
Ashwagandha seems to have sedative effects. Theoretically, this may potentiate the effects of barbiturates, other sedatives, and anxiolytics.
Hepatotoxic Drugs
Theoretically, taking ashwagandha with hepatotoxic drugs might increase the risk of liver damage.
Ashwagandha has been linked to cases of acute hepatitis, liver failure, hepatic encephalopathy, autoimmune hepatitis, the need for liver transplantation, and death due to liver failure.
Immunosuppressants
Theoretically, taking ashwagandha might decrease the effects of immunosuppressants.
Ashwagandha has demonstrated immunostimulant effects in humans. Animal research has shown that ashwagandha can attenuate the immunosuppression caused by cyclophosphamide.
Thyroid Hormone
Ashwagandha might increase the effects and adverse effects of thyroid hormone.
Concomitant use of ashwagandha with thyroid hormones may cause additive therapeutic and adverse effects. Preliminary clinical research and animal studies suggest that ashwagandha boosts thyroid hormone synthesis and secretion. In one clinical study, ashwagandha increased triiodothyronine (T3) and thyroxine (T4) levels by 41.5% and 19.6%, respectively, and reduced serum TSH levels by 17.4% from baseline in adults with subclinical hypothyroidism.
Cytochrome P450 1A2 (Cyp1A2) Substrates
Theoretically, ashwagandha might decrease the levels and clinical effects of CYP1A2 substrates.
In vitro research shows that ashwagandha extract induces CYP1A2 enzymes.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, ashwagandha might decrease the levels and clinical effects of CYP3A4 substrates.
In vitro research shows that ashwagandha extract induces CYP3A4 enzymes.
Serotonergic Drugs
Some animal studies have reported that ashwagandha can enhance serotonergic transmission by altering certain serotonin (5-HT) receptors. However, there is no evidence to suggest that ashwagandha increases the risk of serotonin-related effects, and there have been no published case reports of serotonin syndrome when combined with other serotonergic drugs. Nevertheless, due to the lack of extensive studies on the matter and the fact that ashwagandha appears to affect serotonergic pathways, it would be prudent to exercise caution when combining it with drugs that affect serotonin. [References: - Effects of Withania somnifera (Ashwaga ndha) on Stress and the Stress-Related Neuropsychiatric Disorders Anxiety, Depression, and Insomnia. Curr Neuropharmacol. 2021 Sep 14; 19: 1468–1495. - A Prospective, Randomized Double-Blind, Placebo-Controlled Study of Safety and Efficacy of a High-Concentration Full-Spectrum Extract of Ashwagandha Root in Reducing Stress and Anxiety in Adults. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3573577/]
BioPerine
Anticoagulant/Antiplatelet Drugs
Theoretically, black pepper might increase the risk of bleeding when taken with antiplatelet or anticoagulant drugs.
In vitro research shows that piperine, a constituent of black pepper, seems to inhibit platelet aggregation. This has not been reported in humans.
Antidiabetes Drugs
Theoretically, black pepper might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Animal research shows that piperine, a constituent of black pepper, can reduce blood glucose levels. Monitor blood glucose levels closely. Dose adjustments might be necessary.
Atorvastatin (Lipitor)
Theoretically, black pepper might increase blood levels of atorvastatin.
Animal research shows that taking piperine, a constituent of black pepper, 35 mg/kg can increase the maximum serum concentration of atorvastatin three-fold. This has not been reported in humans.
Cyclosporine (Neoral, Sandimmune)
Theoretically, black pepper might increase the effects and side effects of cyclosporine.
In vitro research shows that piperine, a constituent of black pepper, increases the bioavailability of cyclosporine. This has not been reported in humans.
Cytochrome P450 2D6 (Cyp2D6) Substrates
Theoretically, black pepper might increase levels of drugs metabolized by CYP2D6.
In vitro research suggests that some constituents of black pepper inhibit CYP2D6. This has not been reported in humans.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, black pepper might increase levels of drugs metabolized by CYP3A4.
In vitro research and pharmacokinetic simulation data suggest that piperine, a constituent of black pepper, as well as the pepper fruit seem to inhibit CYP3A4. This has not been reported in humans.
Lithium
Theoretically, black pepper might increase blood levels of lithium due to its diuretic effects. The dose of lithium might need to be reduced.
Black pepper is thought to have diuretic properties.
Nevirapine (Viramune)
Black pepper might increase blood levels of nevirapine.
Clinical research shows that piperine, a constituent of black pepper, increases the plasma concentration of nevirapine. However, no adverse effects were observed in this study.
P-Glycoprotein Substrates
Theoretically, black pepper might increase levels of P-glycoprotein substrates.
In vitro research shows that piperine, a constituent of black pepper, seems to inhibit P-glycoprotein.
Pentobarbital (Nembutal)
Theoretically, black pepper might increase the sedative effects of pentobarbital.
Animal research shows that piperine, a constituent of black pepper, increases pentobarbital-induced sleeping time.
Phenytoin (Dilantin)
Black pepper might increase blood levels of phenytoin.
Clinical research shows that piperine, a constituent of black pepper, seems to increase absorption, slow elimination, and increase levels of phenytoin. Taking a single dose of black pepper 1 gram along with phenytoin seems to double the serum concentration of phenytoin. Consuming a soup with black pepper providing piperine 44 mg/200 mL of soup along with phenytoin also seems to increase phenytoin levels when compared with consuming the same soup without black pepper.
Propranolol (Inderal)
Black pepper might increase blood levels of propranolol.
Clinical research shows that piperine, a constituent of black pepper, seems to increase absorption and slow elimination of propranolol.
Rifampin (Rifadin)
Black pepper might increase blood levels of rifampin.
Clinical research shows that piperine, a constituent of black pepper, seems to increase absorption and serum levels of rifampin.
Theophylline
Black pepper might increase blood levels of theophylline.
Clinical research shows that piperine, a constituent of black pepper, seems to increase absorption and slow elimination of theophylline.
Amoxicillin (Amoxil, Trimox)
Theoretically, black pepper might increase the effects and side effects of amoxicillin.
Animal research shows that taking piperine, a constituent of black pepper, with amoxicillin increases plasma levels of amoxicillin. This has not been reported in humans.
Carbamazepine (Tegretol)
Theoretically, black pepper might increase blood levels of carbamazepine, potentially increasing the effects and side effects of carbamazepine.
One clinical study in patients taking carbamazepine 300 mg or 500 mg twice daily shows that taking a single 20 mg dose of purified piperine, a constituent of black pepper, increases carbamazepine levels. Piperine may increase carbamazepine absorption by increasing blood flow to the GI tract, increasing the surface area of the small intestine, or inhibiting cytochrome P450 3A4 (CYP3A4) in the gut wall. Absorption was significantly increased by 7-10 mcg/mL/hour. The time to eliminate carbamazepine was also increased by 4-8 hours. Although carbamazepine levels were increased, this did not appear to increase side effects. In vitro research also shows that piperine can increase carbamazepine levels by 11% in a time-dependent manner.
Cytochrome P450 1A2 (Cyp1A2) Substrates
Theoretically, black pepper might decrease levels and clinical effects of drugs metabolized by CYP1A2.
In vitro research suggests that black pepper induces CYP1A2. This has not been reported in humans.
Horny Goat Weed Aerial Parts Extract
Anticoagulant/Antiplatelet Drugs
Theoretically, horny goat weed might increase the risk of bleeding.
In vitro research and animal research shows that horny goat weed can inhibit platelet aggregation and thrombus formation. This effect has not been reported in humans.
Antihypertensive Drugs
Theoretically, horny goat weed might increase the risk of hypotension.
Laboratory research suggests that horny goat weed might have hypotensive effects. This effect has not been reported in humans.
Cytochrome P450 1A2 (Cyp1A2) Substrates
Theoretically, horny goat weed might increase the effects and side effects of CYP1A2 substrates.
In vitro, horny goat weed leaf extract inhibits CYP1A2. This effect has not been reported in humans.
Cytochrome P450 2B6 (Cyp2B6) Substrates
Theoretically, horny goat weed might increase the effects and side effects of CYP2B6 substrates.
In vitro, horny goat weed leaf extract inhibits CYP2B6. This effect has not been reported in humans.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, horny goat weed might increase the effects and side effects of CYP3A4 substrates.
In vitro, horny goat weed extract inhibits CYP3A4 and suppresses CYP3A4 mRNA expression. This effect has not been reported in humans.
Estrogens
Theoretically, concomitant use of horny goat weed with estrogens might increase their therapeutic and adverse effects.
In vitro evidence suggests that horny goat weed has estrogenic activity. In clinical research, horny goat weed has been shown to increase blood levels of estrogen in some females.
Niacin
Alcohol (Ethanol)
Concomitant use of alcohol and niacin might increase the risk of flushing and hepatotoxicity.
Alcohol can exacerbate the flushing and pruritus associated with niacin. Large doses of niacin might also exacerbate liver dysfunction associated with chronic alcohol use. A case report describes delirium and lactic acidosis in a patient taking niacin 3 grams daily who ingested 1 liter of wine. Advise patients to avoid large amounts of alcohol while taking niacin.
Allopurinol (Zyloprim)
Theoretically, niacin might antagonize the therapeutic effects of uricosurics such as allopurinol.
Large doses of niacin can reduce urinary excretion of uric acid, potentially resulting in hyperuricemia. Doses of uricosurics such as allopurinol might need to be increased to maintain control of gout in patients who start taking niacin. People who have frequent attacks of gout despite uricosuric therapy should avoid niacin.
Anticoagulant/Antiplatelet Drugs
Theoretically, niacin may have additive effects when used with anticoagulant or antiplatelet drugs.
Several cases of clotting factor synthesis deficiency and coagulopathy have been reported in patients taking sustained-release niacin. Also, thrombocytopenia has been reported in patients treated with niacin or niacin plus lovastatin.
Antidiabetes Drugs
Niacin can increase blood glucose levels and may diminish the effects of antidiabetes drugs.
Niacin impairs glucose tolerance in a dose-dependent manner, probably by causing or aggravating insulin resistance and increasing hepatic production of glucose. In diabetes patients, niacin 4.5 grams daily for 5 weeks can increase plasma glucose by an average of 16% and glycated hemoglobin (HbA1c) by 21%. However, lower doses of 1.5 grams daily or less appear to have minimal effects on blood glucose. In some patients, glucose levels increase when niacin is started, but then return to baseline when a stable dose is reached. Up to 35% of patients with diabetes may need adjustments in hypoglycemic therapy when niacin is added.
Antihypertensive Drugs
Theoretically, niacin may increase the risk of hypotension when used with antihypertensive drugs.
The vasodilating effects of niacin can cause hypotension. Furthermore, some clinical evidence suggests that a one-hour infusion of niacin can reduce systolic, diastolic, and mean blood pressure in hypertensive patients. This effect is not observed in normotensive patients.
Bile Acid Sequestrants
Bile acid sequestrants can bind niacin and decrease absorption. Separate administration by 4-6 hours to avoid an interaction.
In vitro studies show that colestipol (Colestid) binds about 98% of available niacin and cholestyramine (Questran) binds 10% to 30%.
Gemfibrozil (Lopid)
Theoretically, concomitant use of niacin and gemfibrozil might increase the risk of myopathy in some patients.
A case of myopathy from concomitant use of niacin and gemfibrozil has been reported. Niacin alone has also been associated with cases of myopathy. Using gemfibrozil with niacin might further increase the risk of developing myopathy.
Hepatotoxic Drugs
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Niacin has been associated with cases of liver toxicity, especially when used in pharmacologic doses. Sustained-release niacin preparations appear to be associated with a higher risk of hepatotoxicity than immediate-release niacin.
Hmg-Coa Reductase Inhibitors ("Statins")
Theoretically, concomitant use of niacin and statins might increase the risk of myopathy and rhabdomyolysis in some patients.
Some case reports have raised concerns that niacin might increase the risk of myopathy and rhabdomyolysis when combined with statins. However, a significantly increased risk of myopathy has not been demonstrated in clinical trials, including those using an FDA-approved combination of lovastatin and niacin (Advicor).
Probenecid (Benemid)
Theoretically, niacin might antagonize the therapeutic effects of uricosurics such as probenecid.
Large doses of niacin reduce urinary excretion of uric acid, potentially causing hyperuricemia. Doses of uricosurics such as probenecid might need to be increased to maintain control of gout in patients who start taking niacin. People who have frequent attacks of gout despite uricosuric therapy should avoid niacin.
Sulfinpyrazone (Anturane)
Theoretically, niacin might antagonize the therapeutic effects of uricosurics such as sulfinpyrazone.
Large doses of niacin reduce urinary excretion of uric acid, potentially causing hyperuricemia. Doses of uricosurics such as sulfinpyrazone might need to be increased to maintain control of gout in patients who start taking niacin. People who have frequent attacks of gout despite uricosuric therapy should avoid niacin.
Thyroid Hormone
Theoretically, niacin might antagonize the therapeutic effects of thyroid hormones.
Clinical research and case reports suggests that taking niacin can reduce serum levels of thyroxine-binding globulin by up to 25% and moderately reduce levels of thyroxine (T4). Patients taking thyroid hormone for hypothyroidism might need dose adjustments when using niacin.
Transdermal Nicotine (Nicoderm)
Theoretically, concomitant use of niacin and transdermal nicotine might increase the risk of flushing and dizziness.
Niacin and nicotine can both cause flushing and dizziness.
Warfarin (Coumadin)
There is limited evidence that niacin may increase the anticoagulant effects of warfarin.
In a case report, a patient on warfarin developed an elevated international normalized ratio (INR) of 3.9 after taking niacin for two weeks. The patient's INR was previously stable, ranging between 2 and 3 in recent months, and no other medication changes were identified. The elevated INR returned to therapeutic range within 4 days following the discontinuation of niacin.
Aspirin
Large doses of aspirin might alter the clearance of niacin.
Aspirin is often used with niacin to reduce niacin-induced flushing. Doses of 80-975 mg aspirin have been used, but 325 mg appears to be optimal. Aspirin also seems to reduce the clearance of niacin by competing for glycine conjugation. Taking aspirin 1 gram seems to reduce niacin clearance by 45%. This is probably a dose-related effect and not clinically significant with the more common aspirin dose of 325 mg.
Vitamin D
Aluminum
Vitamin D might increase aluminum absorption and toxicity, but this has only been reported in people with renal failure.
The protein that transports calcium across the intestinal wall can also bind and transport aluminum. This protein is stimulated by vitamin D, which may therefore increase aluminum absorption. This mechanism may contribute to increased aluminum levels and toxicity in people with renal failure, when they take vitamin D and aluminum-containing phosphate binders chronically.
Atorvastatin (Lipitor)
Vitamin D might reduce absorption of atorvastatin.
A small, low-quality clinical study shows that taking vitamin D reduces levels of atorvastatin and its active metabolites by up to 55%. However, while atorvastatin levels decreased, total cholesterol, low-density lipoprotein (LDL) cholesterol, and high-density lipoprotein (HDL) cholesterol levels did not substantially change. Atorvastatin is metabolized in the gut by CYP3A4 enzymes, and researchers theorized that vitamin D might induce CYP3A4, causing reduced levels of atorvastatin. However, this proposed mechanism was not specifically studied.
Calcipotriene (Dovonex)
Taking calcipotriene with vitamin D increases 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 vitamin D supplements might increase the risk of hypercalcemia.
Digoxin (Lanoxin)
Theoretically, hypercalcemia induced by high-dose vitamin D can increase the risk of arrhythmia from digoxin.
High doses of vitamin D can cause hypercalcemia. Hypercalcemia increases the risk of fatal cardiac arrhythmias with digoxin. Avoid vitamin D doses above the tolerable upper intake level (4000 IU daily for adults) and monitor serum calcium levels in people taking vitamin D and digoxin concurrently.
Diltiazem (Cardizem, Others)
Theoretically, hypercalcemia induced by high-dose vitamin D can reduce the therapeutic effects of diltiazem for arrhythmia.
High doses of vitamin D can cause hypercalcemia. Hypercalcemia can reduce the effectiveness of verapamil in atrial fibrillation. Theoretically this could also occur with diltiazem. Avoid vitamin D doses above the tolerable upper intake level (4000 IU daily for adults) and monitor serum calcium levels in people taking vitamin D and diltiazem concurrently.
Thiazide Diuretics
Theoretically, taking thiazide diuretics and high-dose vitamin D can increase the risk of hypercalcemia.
Thiazide diuretics decrease urinary calcium excretion, which could lead to hypercalcemia if vitamin D supplements are taken concurrently. This has been reported in people being treated with vitamin D for hypoparathyroidism, and also in elderly people with normal parathyroid function who were taking a thiazide, vitamin D, and calcium-containing antacids daily.
Verapamil (Calan, Others)
Hypercalcemia induced by high-dose vitamin D can reduce the therapeutic effects of verapamil for arrhythmia.
Hypercalcemia due to high doses of vitamin D can reduce the effectiveness of verapamil in atrial fibrillation. Avoid vitamin D doses above the tolerable upper intake level (4000 IU daily for adults) and monitor serum calcium levels in people taking vitamin D and verapamil concurrently.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Vitamin D might induce CYP3A4 enzymes and reduce the bioavailability of CYP3A4 substrates.
There is some concern that vitamin D might induce CYP3A4. In vitro research suggests that vitamin D induces CYP3A4 transcription. Additionally, observational research has found that increased UV light exposure and serum vitamin D levels are associated with decreased serum levels of CYP3A4 substrates such as tacrolimus and sirolimus, while no association between UV light exposure or vitamin D levels and levels of mycophenolic acid, a non-CYP3A4 substrate, was found. A small, low-quality clinical study shows that taking vitamin D reduces levels of the CYP3A4 substrate atorvastatin and its active metabolites by up to 55%; however, the clinical effects of atorvastatin were not reduced. While researchers theorized that vitamin D might induce CYP3A4, this proposed mechanism was not specifically studied.
AlphaFen
Anticoagulant/Antiplatelet Drugs
Theoretically, fenugreek might have additive effects when used with anticoagulant or antiplatelet drugs.
Some of the constituents in fenugreek have antiplatelet effects in animal and in vitro research. However, common fenugreek products might not contain sufficient concentrations of these constituents for clinical effects. A clinical study in patients with coronary artery disease or diabetes shows that taking fenugreek seed powder 2.5 grams twice daily for 3 months does not affect platelet aggregation, fibrinolytic activity, or fibrinogen levels .
Antidiabetes Drugs
Theoretically, fenugreek seed might have additive hypoglycemic effects when used with antidiabetes drugs.
Clinical research shows that fenugreek seed can reduce fasting blood glucose and 2-hour postprandial glucose levels in adults with type 2 diabetes.
Clopidogrel (Plavix)
Theoretically, fenugreek seed might alter the clinical effects of clopidogrel by inhibiting its conversion to the active form.
Animal research shows that fenugreek seed 200 mg/kg daily for 14 days increases the maximum serum concentration of clopidogrel by 21%. It is unclear how this affects the pharmacokinetics of the active metabolite of clopidogrel; however, this study found that concomitant use of fenugreek seed and clopidogrel prolonged bleeding time by an additional 11%.
Metoprolol (Toprol)
Theoretically, fenugreek seed might have additive hypotensive effects when used with metoprolol.
Animal research shows that fenugreek seed 300 mg/kg daily for 2 weeks decreases systolic and diastolic blood pressure by 9% and 11%, respectively, when administered alone, and by 15% and 22%, respectively, when given with metoprolol 10 mg/kg.
Phenytoin (Dilantin)
Theoretically, fenugreek might decrease plasma levels of phenytoin.
Animal research shows that taking fenugreek seeds for 1 week decreases maximum concentrations and the area under the curve of a single dose of phenytoin by 44% and 72%, respectively. This seems to be related to increased clearance. So far, this interaction has not been reported in humans.
Sildenafil (Viagra)
Theoretically, concurrent use of sildenafil and fenugreek might reduce levels and therapeutic effects of sildenafil.
Animal research shows that taking fenugreek seeds for 1 week reduces maximum concentrations and the area under the curve of a single dose of sildenafil by 27% and 48%, respectively. So far, this interaction has not been reported in humans.
Theophylline
Theoretically, fenugreek may reduce the levels and clinical effects of theophylline.
Animal research shows that fenugreek 50 grams daily for 7 days reduces the maximum serum concentration (Cmax) of theophylline by 28% and the area under the plasma drug concentration-time curve (AUC) by 22%.
Warfarin (Coumadin)
Theoretically, fenugreek might have additive effects with warfarin and increase the international normalized ratio (INR).
Some fenugreek constituents have antiplatelet effects, although these might not be present in concentrations that are clinically significant. In one case report, a patient taking warfarin experienced an increased INR when starting to take fenugreek in combination with boldo.
Antihypertensive Drugs
Fenugreek may also have an additive effect on blood pressure-lowering medications. Studies on animals have shown that fenugreek seed can decrease both systolic and diastolic blood pressure by up to 22% when combined with metoprolol. Therefore, it is essential to monitor your blood pressure regularly if you are taking fenugreek and metoprolol together or any other antihypertensive drugs.
Lion's Mane powder
Anticoagulant/Antiplatelet Drugs
Theoretically, lion's mane mushroom may increase the risk of bleeding when used with anticoagulant/antiplatelet drugs.
In vitro research suggests that lion's mane mushroom extracts can inhibit platelet aggregation.
Antidiabetes Drugs
Theoretically, lion's mane mushroom may have additive effects when used with antidiabetes drugs.
Animal research suggests that an aqueous extract of lion's mane mushroom can reduce serum glucose and increase serum insulin.
Immunosuppressants
Theoretically, concurrent use of lion's mane mushroom might interfere with immunosuppressive therapy.
In animal and in vitro research, lion's mane mushroom polysaccharides stimulate the immune system.
Pine bark extract
Anticoagulant/Antiplatelet Drugs
Theoretically, maritime pine bark extract might increase the risk of bleeding when used with antiplatelet or anticoagulant drugs.
Clinical research suggests that maritime pine bark extract inhibits platelet aggregation. However, the clinical significance of this effect is unclear.
Antidiabetes Drugs
Theoretically, maritime pine bark extract might increase the risk of hypoglycemia when used with antidiabetes drugs.
One clinical study shows that maritime pine bark extract decreases blood sugar in patients with diabetes being treated with antidiabetes agents. Monitor blood glucose levels closely. Dose adjustments might be necessary.
Immunosuppressants
Theoretically, maritime pine bark extract might decrease the effectiveness of immunosuppressant therapy.
In vitro and animal research suggests that maritime pine bark extract has immunostimulant activity. This effect has not been reported in humans.
Selenium
Anticoagulant/Antiplatelet Drugs
Selenium may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Clinical research suggests that taking selenium 10 mcg/kg/day can increase bleeding times by increasing prostacyclin production, which inhibits platelet activity. Other clinical research suggests that taking selenium 75 mcg daily, in combination with ascorbic acid 600 mg, alpha-tocopherol 300 mg, and beta-carotene 27 mg, reduces platelet aggregation.
Barbiturates
Theoretically, selenium might prolong the sedating effects of barbiturates.
Laboratory research suggests that selenium can inhibit the hepatic metabolism of barbiturates. Selenium seems to prolong the sedative effect of pentobarbital in animal models.
Immunosuppressants
Theoretically, selenium supplementation may reduce the effectiveness of immunosuppressant therapy.
In vitro research and preliminary clinical evidence suggests that selenium may stimulate the immune system.
Warfarin (Coumadin)
Theoretically, selenium might interfere with warfarin activity.
Animal research suggests that selenium can increase warfarin activity. Selenium might interact with warfarin by displacing it from albumin binding sites, reducing its metabolism in the liver, or by decreasing production of vitamin K-dependent clotting factors. Selenium can also prolong bleeding times in humans by increasing prostacyclin production, which inhibits platelet activity.
Contraceptive Drugs
Contraceptive drugs might increase levels of selenium, although the clinical significance of this effect is unclear.
Some research suggests that oral contraceptives increase serum selenium levels in women taking oral contraceptives; however, other research shows no change in selenium levels. It is suggested that an increase could be due to increased carrier proteins, indicating a redistribution of selenium rather than a change in total body selenium.
Niacin
Selenium might reduce the beneficial effects of niacin on high-density lipoprotein (HDL) levels.
A combination of niacin and simvastatin (Zocor) effectively raises HDL cholesterol levels in patients with coronary disease and low HDL levels. Clinical research shows that taking a combination of antioxidants (vitamin C, vitamin E, beta-carotene, and selenium) along with niacin and simvastatin (Zocor) attenuates this rise in HDL, specifically the HDL-2 and apolipoprotein A1 fractions, by more than 50% in patients with coronary disease. It is not known whether this adverse effect is due to a single antioxidant such as selenium, or to the combination. It also is not known whether it will occur in other patient populations.
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.
Vitamin B6
Amiodarone (Cordarone)
Theoretically, vitamin B6 might increase the photosensitivity caused by amiodarone.
Despite initial case reports suggesting that pyridoxine may have a protective effect against amiodarone-induced photosensitivity, preliminary clinical research suggests that pyridoxine may actually exacerbate this adverse effect.
Antihypertensive Drugs
Theoretically, vitamin B6 may have additive effects when used with antihypertensive drugs.
Research in hypertensive rats shows that vitamin B6 can decrease systolic blood pressure. Similarly, clinical research in patients with hypertension shows that taking high doses of vitamin B6 may reduce systolic and diastolic blood pressure, possibly by reducing plasma levels of epinephrine and norepinephrine.
Phenobarbital (Luminal)
High doses of vitamin B6 may reduce the levels and clinical effects of phenobarbital.
Preliminary clinical evidence suggests that vitamin B6 200 mg daily can reduce plasma levels of phenobarbital, possibly by increasing metabolism. It is not known whether lower doses have any effect. Advise people taking phenobarbital to avoid high doses of vitamin B6.
Phenytoin (Dilantin)
High doses of vitamin B6 may reduce the levels and clinical effects of phenytoin.
Preliminary clinical evidence suggests that vitamin B6 200 mg daily can reduce plasma levels of phenytoin, possibly by increasing metabolism. It is not known whether lower doses have any effect. Advise people taking phenytoin to avoid high doses of vitamin B6.
Levodopa
Vitamin B6 may increase the metabolism of levodopa when taken alone, but not when taken in conjunction with carbidopa.
Vitamin B6 (pyridoxine) enhances the metabolism of levodopa, reducing its clinical effects. However, this interaction does not occur when carbidopa is used concurrently with levodopa (Sinemet). Therefore, it is not likely to be a problem in most people.
L-Citrulline
Antihypertensive Drugs
Theoretically, concomitant use of L-citrulline with antihypertensive drugs might have additive effects and increase the chance of hypotension.
L-citrulline is converted to L-arginine, which can increase nitric oxide and cause vasodilation. However, a meta-analysis of 5 small clinical studies suggests that taking L-citrulline 3-6 grams daily for 1-8 weeks does not lower blood pressure when compared with control.
Phosphodiesterase-5 Inhibitors
Theoretically, concurrent use of phosphodiesterase-5 (PDE-5) inhibitors and L-citrulline might result in additive vasodilation.
L-citrulline is converted to L-arginine, which can increase nitric oxide and cause vasodilation. Theoretically, taking L-arginine with PDE-5 inhibitors 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.
Saw Palmetto Fruit Extract
Anticoagulant/Antiplatelet Drugs
Saw palmetto might increase the risk of bleeding with anticoagulant or antiplatelet drugs.
Saw palmetto is reported to prolong bleeding time. Theoretically, it might increase the risk of bleeding when used concomitantly with anticoagulant or antiplatelet drugs.
Contraceptive Drugs
Saw palmetto might reduce the effectiveness of contraceptive drugs.
Saw palmetto might have antiestrogenic effects. Theoretically, it might interfere with contraceptive drugs taken concomitantly.
Estrogens
Saw palmetto might reduce the effectiveness of estrogens.
Saw palmetto might have antiestrogenic effects. Theoretically, it might interfere with estrogens taken concomitantly.
Stinging Nettle root extract
Antidiabetes Drugs
Theoretically, stinging nettle might have additive effects with antidiabetes drugs.
Clinical research shows that stinging nettle might decrease blood glucose levels in patients with diabetes.
Diuretic Drugs
Theoretically, combining stinging nettle with diuretic drugs may have additive effects.
Animal research suggests that the above ground parts and roots of stinging nettle may have a diuretic effect.
Lithium
Theoretically, stinging nettle might reduce excretion and increase levels of lithium.
Animal research suggests that stinging nettle has diuretic and natriuretic properties, which could alter the excretion of lithium. The dose of lithium might need to be decreased.
Warfarin (Coumadin)
There is some concern that stinging nettle might decrease the effects of anticoagulant drugs such as warfarin.
Stinging nettle contains a significant amount of vitamin K. When taken in large quantities, this might interfere with the activity of warfarin.
Manganese
Antipsychotic Drugs
Theoretically, the risk for manganese toxicity might increase when taken with antipsychotic drugs.
Hallucinations and behavioral changes have been reported in a patient with liver disease who was taking haloperidol and manganese. Researchers speculate that taking manganese along with haloperidol, phenothiazine-derivatives, or other antipsychotic medications might increase the risk of manganese toxicity in some patients.
Quinolone Antibiotics
Theoretically, manganese might reduce the absorption of quinolone antibiotics.
Manganese is a multivalent cation. Interactions resulting in reduced quinolone absorption have been reported between quinolones and other multivalent cations, such as calcium and iron.
Tetracycline Antibiotics
Theoretically, manganese might reduce the absorption of tetracycline antibiotics.
Manganese is a multivalent cation. Interactions resulting in reduced tetracycline absorption have been reported between tetracyclines and other multivalent cations, such as calcium and iron.
Zinc
Bictegravir/Emtricitabine/Tenofovir Alafenamide (Biktarvy)
Theoretically, zinc 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 zinc containing products.
Cephalexin (Keflex)
Zinc might decrease cephalexin levels by chelating with cephalexin in the gut and preventing its absorption.
A pharmacokinetic study shows that zinc sulfate 250 mg taken concomitantly with cephalexin 500 mg decreases peak levels of cephalexin by 31% and reduces the exposure to cephalexin by 27%. Also, taking zinc sulfate 3 hours before cephalexin decreases peak levels of cephalexin by 11% and reduces the exposure to cephalexin by 18%. By decreasing cephalexin levels, zinc might increase the risk of treatment failure. This effect does not occur when zinc is taken 3 hours after the cephalexin dose. To avoid an interaction, advise patients take zinc sulfate 3 hours after taking cephalexin.
Cisplatin (Platinol-Aq)
Theoretically, zinc might interfere with the therapeutic effects of cisplatin.
Animal research suggests that zinc stimulates tumor cell production of the protein metallothionein, which binds and inactivates cisplatin. It is not known whether zinc supplements or high dietary zinc intake can cause clinically significant interference with cisplatin therapy. Cisplatin might also increase zinc excretion.
Integrase Inhibitors
Theoretically, taking zinc along with integrase inhibitors might decrease the levels and clinical effects of these drugs.
Zinc is a divalent cation. Pharmacokinetic studies have shown that other divalent cations such as calcium and iron can decrease blood levels of the integrase inhibitor dolutegravir through chelation.
Penicillamine (Cuprimine, Depen)
Zinc might reduce the levels and clinical effects of penicillamine.
By forming an insoluble complex with penicillamine, zinc interferes with penicillamine absorption and activity. Zinc supplements reduce the efficacy of low-dose penicillamine (0.5-1 gram/day), but do not seem to affect higher doses (1-2.75 gram/day), provided dosing times are separated. Advise patients to take zinc and penicillamine at least 2 hours apart.
Quinolone Antibiotics
Zinc can decrease the levels and clinical effects of quinolones antibiotics.
Quinolones form complexes with zinc in the gastrointestinal tract, reducing absorption of both the quinolone and zinc if taken at the same time. Advise patients to take these drugs at least 2 hours before, or 4-6 hours after, zinc supplements.
Ritonavir (Norvir)
Zinc modestly reduces levels of ritonavir.
Clinical research shows that zinc might reduce serum ritonavir levels by chelating with ritonavir in the gut and preventing its absorption. In patients with HIV, ritonavir is taken with atazanavir to prevent the metabolism and increase the effects of atazanavir. A pharmacokinetic study shows that, in patients being treated with atazanavir/ritonavir, co-administration of zinc sulfate (Solvazinc tablets) 125 mg as a single dose or as multiple daily doses for 2 weeks reduces plasma levels of ritonavir by about 16%. However, atazanavir levels still remains high enough to prevent HIV virus replication. Therefore, the decrease in ritonavir levels is not likely to be clinically significant.
Tetracycline Antibiotics
Zinc might reduce levels of tetracycline antibiotics.
Tetracyclines form complexes with zinc in the gastrointestinal tract, which can reduce absorption of both the tetracycline and zinc when taken at the same time. Taking zinc sulfate 200 mg with tetracycline reduces absorption of the antibiotic by 30% to 40%. Demeclocycline and minocycline cause a similar interaction. However, doxycycline does not seem to interact significantly with zinc. Advise patients to take tetracyclines at least 2 hours before, or 4-6 hours after, zinc supplements to avoid any interactions.
Amiloride (Midamor)
Amiloride can modestly reduce zinc excretion and increase zinc levels.
Clinical research shows that amiloride can reduce urinary zinc excretion, especially at doses of 10 mg per day or more. This zinc-sparing effect can help to counteract zinc losses caused by thiazide diuretics, but it is unlikely to cause zinc toxicity at usual amiloride doses. The other potassium-sparing diuretics, spironolactone (Aldactone) and triamterene (Dyrenium), do not seem to have a zinc-sparing effect.
Atazanavir (Reyataz)
Zinc modestly reduces levels of atazanavir, although this effect does not seem to be clinically significant.
Clinical research shows that zinc might decrease serum atazanavir levels by chelating with atazanavir in the gut and preventing its absorption. Although a single dose of zinc sulfate (Solvazinc tablets) 125 mg orally does not affect atazanavir concentrations in patients being treated with atazanavir/ritonavir, co-administration of zinc sulfate 125 mg daily for 2 weeks reduces plasma levels of atazanavir by about 22% in these patients. However, despite this decrease, atazanavir levels still remain at high enough concentrations for the prevention of HIV virus replication.
Vitamin B12
Metformin (Glucophage)
Metformin, a common medication used to manage type 2 diabetes, has been associated with lower vitamin B12 levels in some individuals. Prolonged use of metformin can interfere with the absorption of B12 in the digestive system, potentially leading to a deficiency in this essential vitamin.
Vitamin K2
Warfarin (Coumadin)
Vitamin K can antagonize and reverse the therapeutic effects of warfarin.
Vitamin K antagonizes the effects of warfarin. Excessive vitamin K intake, either from supplements or from changes in the diet, can reduce the anticoagulant effect of warfarin.
Pumpkin seed extract
Lithium
Pumpkin might reduce excretion and increase levels of lithium.
Pumpkin is thought to have diuretic properties. Theoretically, this might reduce excretion and increase levels of lithium. The dose of lithium might need to be decreased.
Brand information
Manufacturer and brand details for Alpha King Supreme, from the product label.
Force Factor
- Name
- Force Factor, LLC
- City
- Boston
- State
- MA
- ZipCode
- 02210
- Phone Number
- 1-866-443-6723
- Web Address
- www.forcefactor.com
Alpha King Supreme by Force Factor: Common Questions
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Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
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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.
The Full Monographs Behind Alpha King Supreme’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Niacin
Interacts with 727 drugsNiacin (vitamin B3) is an essential nutrient your body needs for energy and metabolism, and deficiency is uncommon in most developed countries. Prescription-strength niacin has been used to...
Read the full Niacin monograph → Herb & supplement monographVitamin B6
Interacts with 210 drugsVitamin B6 (pyridoxine) is an essential water-soluble vitamin that your body needs for metabolism, brain function, and making red blood cells. It is best known for helping with pregnancy-rel...
Read the full Vitamin B6 monograph → Herb & supplement monographVitamin B12
Interacts with 20 drugsVitamin B12 (cobalamin) is an essential nutrient your body needs to make red blood cells, keep nerves healthy, and support DNA. Supplements are very helpful for people who are deficient — su...
Read the full Vitamin B12 monograph → Herb & supplement monographVitamin D
Interacts with 715 drugsVitamin D is a fat-soluble vitamin that helps your body absorb calcium and is important for healthy bones, muscles, and immune function. Many people, especially those with low sun exposure,...
Read the full Vitamin D monograph → Herb & supplement monographZinc
Interacts with 67 drugsZinc is an essential mineral that your body needs for immune function, wound healing, taste, and smell. Most people get enough from food, but supplements can help correct or prevent a defici...
Read the full Zinc monograph → Herb & supplement monographManganese
Interacts with 83 drugsManganese is an essential trace mineral your body needs in small amounts for bone formation, metabolism, and antioxidant defense, and most people get enough from a normal diet. Supplements m...
Read the full Manganese monograph → Herb & supplement monographVitamin K
Interacts with 2 drugsVitamin K is an essential nutrient your body needs for normal blood clotting and to support healthy bones. Most people get enough from food, but supplements are sometimes used for deficiency...
Read the full Vitamin K 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 monographSelenium
Interacts with 321 drugsSelenium is an essential trace mineral your body needs in small amounts for thyroid function, antioxidant defense, and immune health. Most people who eat a varied diet get enough, and supple...
Read the full Selenium monograph → Herb & supplement monographMaca
Maca is a nutrient-rich Andean root often used for energy, libido, and menopause symptoms. Early studies suggest it may modestly help sexual desire and some menopause symptoms, but the evide...
Read the full Maca monograph → Herb & supplement monographHorny Goat Weed
Interacts with 963 drugsHorny goat weed (Epimedium) is a traditional Chinese herb most often marketed for low libido and erectile problems, but solid human evidence for these uses is lacking. While short-term use s...
Read the full Horny Goat Weed monograph → Herb & supplement monographFenugreek
Interacts with 389 drugsFenugreek is a common kitchen spice that is also taken as a supplement, mainly for blood sugar, cholesterol, and to support breast milk production. Some early research is encouraging for blo...
Read the full Fenugreek monograph → Herb & supplement monographBoron
Boron is a trace mineral found in many plant foods and sold as a supplement, mainly promoted for bone, joint, and hormone health. The human evidence for most of these uses is limited or prel...
Read the full Boron monograph → Herb & supplement monographAshwagandha
Interacts with 1,372 drugsAshwagandha is an Ayurvedic herb most often taken to help with stress, anxiety, and sleep, and some small studies suggest it may help, though the evidence is still limited. It is generally w...
Read the full Ashwagandha monograph → Herb & supplement monographLion's Mane Mushroom
Interacts with 327 drugsLion's mane is an edible mushroom that is popular as a 'nootropic' for memory, focus, and nerve health, but solid human evidence is still limited and early. It is generally well tolerated as...
Read the full Lion's Mane Mushroom monograph → Herb & supplement monographStinging Nettle
Interacts with 164 drugsStinging nettle is a common plant used as food and in traditional medicine, most often for prostate symptoms, allergies, and joint pain. The evidence is mixed and mostly preliminary, so it i...
Read the full Stinging Nettle monograph → Herb & supplement monographSaw Palmetto
Interacts with 174 drugsSaw palmetto is a plant extract most often used for urinary symptoms linked to an enlarged prostate (BPH). The best research suggests it works no better than a placebo for most men, though i...
Read the full Saw Palmetto monograph → Herb & supplement monographPumpkin
Interacts with 1 drugPumpkin is a nutritious squash, and its seeds and seed oil are the parts most often used as supplements, mainly for urinary and prostate symptoms. The evidence for these uses is limited and...
Read the full Pumpkin monograph → Herb & supplement monographBlack Pepper
Interacts with 1,019 drugsBlack pepper is a common kitchen spice that is generally safe in the amounts used in food. Its extract, piperine, is mostly added to supplements to help the body absorb other ingredients (li...
Read the full Black Pepper monograph → Herb & supplement monographL-citrulline
Interacts with 178 drugsL-citrulline is an amino acid that the body turns into L-arginine to help make nitric oxide, which relaxes blood vessels and may improve blood flow. It is popular for exercise performance an...
Read the full L-citrulline monograph → Herb & supplement monographMaritime Pine
Interacts with 327 drugsMaritime pine bark extract (often sold as Pycnogenol) is a plant-based antioxidant most studied for circulation, vein, and skin health. Some research is promising, but many studies are small...
Read the full Maritime Pine monograph →Sources & How We Checked
Alpha King Supreme'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 579 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.
Niacin 66 references
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- Anon. Inositol hexaniacinate. Altern Med Rev 1998;3:222-3.
- Knodel LC, Talbert RL. Adverse effects of hypolipidaemic drugs. Med Toxicol 1987;2:10-32. PubMed
- Guyton JR, Blazing MA, Hagar J, et al. Extended-release niacin vs gemfibrozil for the treatment of low levels of high-density lipoprotein cholesterol. Niaspan-Gemfibrozil Study Group. Arch Intern Med 2000;160:1177-84. PubMed
- Gibbons LW, Gonzalez V, Gordon N, Grundy S. The prevalence of side effects with regular and sustained-release nicotinic acid. Am J Med 1995;99:378-85. PubMed
- Whelan AM, Price SO, Fowler SF, Hainer BL. The effect of aspirin on niacin-induced cutaneous reactions. J Fam Pract 1992;34:165-8.
- Jungnickel PW, Maloley PA, Vander Tuin EL, et al. Effect of two aspirin pretreatment regimens on niacin-induced cutaneous reactions. J Gen Intern Med 1997;12:591-6. PubMed
- Capuzzi DM, Guyton JR, Morgan JM, et al. Efficacy and safety of an extended-release niacin (Niaspan): a long-term study. Am J Cardiol 1998;82:74-81;disc. 85U-6U. PubMed
- Gray DR, Morgan T, Chretien SD, Kashyap ML. Efficacy and safety of controlled-release niacin in dyslipoproteinemic veterans. Ann Intern Med 1994;121:252-8. PubMed
- McKenney JM, Proctor JD, Harris S, Chinchili VM. A comparison of the efficacy and toxic effects of sustained- vs immediate-release niacin in hypercholesterolemic patients. JAMA 1994;271:672-7. DOI
- Knopp RH, Alagona P, Davidson M, et al. Equivalent efficacy of a time-release form of niacin (Niaspan) given once-a-night versus plain niacin in the management of hyperlipidemia. Metabolism 1998;47:1097-104. PubMed
- Knopp RH. Clinical profiles of plain versus sustained-release niacin (Niaspan) and the physiologic rationale for nighttime dosing. Am J Cardiol 1998;82:24U-28U;discussion 39U-41U. PubMed
- Garg A, Grundy SM. Nicotinic acid as therapy for dyslipidemia in non-insulin-dependent diabetes mellitus. JAMA 1990;264:723-6. DOI
- Leighton RF, Gordon NF, Small GS, et al. Dental and gingival pain as side effects of niacin therapy. Chest 1998;114:1472-4. PubMed
- American Society of Health-System Pharmacists. ASHP Therapeutic Position Statement on the safe use of niacin in the management of dyslipidemias. Am J Health Syst Pharm 1997;54:2815-9. DOI
- Vega GL, Grundy SM. Lipoprotein responses to treatment with lovastatin, gemfibrozil, and nicotinic acid in normolipidemic patients with hypoalphalipoproteinemia. Arch Intern Med 1994;154:73-82. DOI
- Guyton JR, Goldberg AC, Kreisberg RA, et al. Effectiveness of once-nightly dosing of extended-release niacin alone and in combination for hypercholesterolemia. Am J Cardiol 1998;82:737-43.
- Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline (2000). Washington, DC: National Academy Press, 2000. Available at: http://b
- Brown BG, Zhao XQ, Chait A, et al. Simvastatin and niacin, antioxidant vitamins, or the combination for the prevention of coronary disease. N Engl J Med 2001;345:1583-93. DOI
- Bays HE, Dujovne CA. Drug interactions of lipid-altering drugs. Drug Saf 1998;19:355-71. PubMed
- Rader JI, Calvert RJ, Hathcock JN. Hepatic toxicity of unmodified and time-release preparations of niacin. Am J Med 1992;92:77-81. PubMed
- Kahn SE, Beard JC, Schwartz MW, et al. Increased B-cell secretory capacity as mechanism for islet adaptation to nicotinic acid-induced insulin resistance. Diabetes 1989;38:562-8.
- Schwartz ML. Severe reversible hyperglycemia as a consequence of niacin therapy. Arch Int Med 1993;153:2050-2. DOI
- Raising HDL and Niacin Use. Pharmacist's Letter/Prescriber's Letter 2004;20(5):200504.
- McKenney J. New perspectives on the use of niacin in the treatment of lipid disorders. Arch Intern Med 2004;164:697-705. PubMed
- Reaven P, Witztum JL. Lovastatin, nicotinic acid and rhabdomyolysis (letter). Ann Int Med 1988;109:597-8. PubMed
- Ito MK. Advances in the understanding and management of dyslipidemia: using niacin-based therapies. Am J Health-Syst Pharm 2003;60(suppl 2):s15-21. PubMed
- Schwab RA, Bachhuber BH. Delirium and lactic acidosis caused by ethanol and niacin coingestion. Am J Emerg Med 1991;9:363-5. PubMed
- Product information: Niaspan. Kos Pharmaceuticals. Cranbury, NJ. 2005. Available at www.niaspan.com/professional/content/pdfs/productinfo.pdf. (Accessed 3 March 2006).
- Ding RW, Kolbe K, Merz B, et al. Pharmacokinetics of nicotinic acid-salicylic acid interaction. Clin Pharmacol Ther 1989;46:642-7. PubMed
- NIH News. NIH stops clinical trial on combination cholesterol treatment. May 26, 2011. http://www.nih.gov/news/health/may2011/nhlbi-26.htm. (Accessed 3 June 2011).
- Dearing BD, Lavie CJ, Lohmann TP, Genton E. Niacin-induced clotting factor synthesis deficiency with coagulopathy. Arch Intern Med. 1992;152(4):861-3. DOI
- O'Brien T, Silverberg JD, Nguyen TT. Nicotinic acid-induced toxicity associated with cytopenia and decreased levels of thyroxine-binding globulin. Mayo Clin Proc. 1992;67(5):465-8. PubMed
- Gadegbeku CA, Dhandayuthapani A, Shrayyef MZ, Egan BM. Hemodynamic effects of nicotinic acid infusion in normotensive and hypertensive subjects. Am J Hypertens. 2003;16(1):67-71. PubMed
- Garnett WR. Interactions with hydroxymethylglutaryl-coenzyme A reductase inhibitors. Am J Health Syst Pharm. 1995;52(15):1639-45. PubMed
- Litin SC, Anderson CF. Nicotinic acid-associated myopathy: a report of three cases. Am J Med. 1989;86(4):481-3. PubMed
- Dunn RT, Ford MA, Rindone JP, Kwiecinski FA. Low-Dose Aspirin and Ibuprofen Reduce the Cutaneous Reactions Following Niacin Administration. Am J Ther. 1995;2(7):478-480. PubMed
- Cashin-Hemphill L, Spencer CA, Nicoloff JT, et al. Alterations in serum thyroid hormonal indices with colestipol-niacin therapy. Ann Intern Med. 1987;107(3):324-9. PubMed
- Drinka PJ. Alterations in thyroid and hepatic function tests associated with preparations of sustained-release niacin. Mayo Clin Proc. 1992;67(12):1206. PubMed
- Shakir KM, Kroll S, Aprill BS, Drake AJ 3rd, Eisold JF. Nicotinic acid decreases serum thyroid hormone levels while maintaining a euthyroid state. Mayo Clin Proc. 1995;70(6):556-8. PubMed
- Etchason JA, Miller TD, Squires RW, et al. Niacin-induced hepatitis: a potential side effect with low-dose time-release niacin. Mayo Clin Proc. 1991;66(1):23-8. PubMed
- Henkin Y, Johnson KC, Segrest JP. Rechallenge with crystalline niacin after drug-induced hepatitis from sustained-release niacin. JAMA. 1990;264(2):241-3. DOI
- Henkin Y, Oberman A, Hurst DC, Segrest JP. Niacin revisited: clinical observations on an important but underutilized drug. Am J Med. 1991;91(3):239-46. PubMed
- Brown BG, Bardsley J, Poulin D, et al. Moderate dose, three-drug therapy with niacin, lovastatin, and colestipol to reduce low-density lipoprotein cholesterol <100 mg/dl in patients with hyperlipidemia and coronary artery disease. Am J Cardiol. 1997;80(2)
- Goldberg A, Alagona P Jr, Capuzzi DM, et al. Multiple-dose efficacy and safety of an extended-release form of niacin in the management of hyperlipidemia. Am J Cardiol. 2000;85(9):1100-5. PubMed
- Aronov DM, Keenan JM, Akhmedzhanov NM, et al. Clinical trial of wax-matrix sustained-release niacin in a Russian population with hypercholesterolemia. Arch Fam Med. 1996;5(10):567-75. PubMed
- Morgan JM, Capuzzi DM, Guyton JR, et al. Treatment Effect of Niaspan, a Controlled-release Niacin, in Patients With Hypercholesterolemia: A Placebo-controlled Trial. J Cardiovasc Pharmacol Ther. 1996;1(3):195-202. PubMed
- Andersson RG, Aberg G, Brattsand R, Ericsson E, Lundholm L. Studies on the mechanism of flush induced by nicotinic acid. Acta Pharmacol Toxicol (Copenh). 1977 Jul;41(1):1-10. PubMed
- Brown WV. Niacin for lipid disorders. Indications, effectiveness, and safety. Postgrad Med. 1995 Aug;98(2):185-9, 192-3. PubMed
- O'REILLY PO, CALLBECK MJ, HOFFER A. Sustained-release nicotinic acid (nicospan); effect on (1) cholesterol levels and (2) leukocytes. Can Med Assoc J. 1959;80(5):359-62.
- Gharavi AG, Diamond JA, Smith DA, Phillips RA. Niacin-induced myopathy. Am J Cardiol. 1994;74(8):841-2. PubMed
- Litin SC, Anderson CF. Nicotinic acid-associated myopathy: a report of three cases. Am J Med. 1989;86(4):481-3. PubMed
- Fraunfelder FW, Fraunfelder FT, Illingworth DR. Adverse ocular effects associated with niacin therapy. Br J Ophthalmol 1995;79:54-56. PubMed
- Ali EH, McJunkin B, Jubelirer S, Hood W. Niacin induced coagulopathy as a manifestation of occult liver injury. W V Med J. 2013 Jan-Feb;109(1):12-4
- Aramwit P, Srisawadwong R, Supasyndh O. Effectiveness and safety of extended-release nicotinic acid for reducing serum phosphorus in hemodialysis patients. J Nephrol. 2012 May-Jun;25(3):354-62. PubMed
- Bassan M. A case for immediate-release niacin. Heart Lung. 2012 Jan-Feb;41(1):95-8. PubMed
- Davidson MH, Rooney M, Pollock E, Drucker J, Choy Y. Effect of colesevelam and niacin on low-density lipoprotein cholesterol and glycemic control in subjects with dyslipidemia and impaired fasting glucose. J Clin Lipidol. 2013 Sep-Oct;7(5):423-32. PubMed
- Guyton JR, Fazio S, Adewale AJ, Jensen E, Tomassini JE, Shah A, Tershakovec AM. Effect of extended-release niacin on new-onset diabetes among hyperlipidemic patients treated with ezetimibe/simvastatin in a randomized controlled trial. Diabetes Care. 2012 PubMed
- Loebl T, Raskin S. A novel case report: acute manic psychotic episode after treatment with niacin. J Neuropsychiatry Clin Neurosci. 2013 Fall;25(4):E14. PubMed
- Teo KK, Goldstein LB, Chaitman BR, Grant S, Weintraub WS, Anderson DC, Sila CA, Cruz-Flores S, Padley RJ, Kostuk WJ, Boden WE; AIM-HIGH Investigators. Extended-release niacin therapy and risk of ischemic stroke in patients with cardiovascular disease: the
- Goldie C, Taylor AJ, Nguyen P, McCoy C, Zhao XQ, Preiss D. Niacin therapy and the risk of new-onset diabetes: a meta-analysis of randomized controlled trials. Heart. 2016 Feb;102(3):198-203.
- Schandelmaier S, Briel M, Saccilotto R, Olu KK, Arpagaus A, Hemkens LG, Nordmann AJ. Niacin for primary and secondary prevention of cardiovascular events. Cochrane Database Syst Rev. 2017 Jun 14;6:CD009744. PubMed
- Jenkins DJA, Spence JD, Giovannucci EL, et al. Supplemental vitamins and minerals for CVD prevention and treatment. J Am Coll Cardiol 2018;71(22):2570-84. PubMed
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Boron 6 references
- Ellenhorn MJ, et al. Ellenhorn's Medical Toxicology: Diagnoses and Treatment of Human Poisoning. 2nd ed. Baltimore, MD: Williams & Wilkins, 1997.
- Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. Washington, DC: National Academy Press, 2002.
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Lion's Mane Mushroom 6 references
- Product information for <em>Niaspan</em>. Abbott Laboratories. North Chicago, IL 60064. April 2015.
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See these in context on the Lion's Mane Mushroom monograph →
Saw Palmetto 22 references
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- Carraro JC, Raynaud JP, Koch G, et al. Comparison of phytotherapy (Permixon) with finasteride in the treatment of benign prostate hyperplasia: a randomized international study of 1,098 patients. Prostate 1996;29:231-40. DOI
- Di Silverio F, D'Eramo G, Lubrano C, et al. Evidence that Serenoa repens extract displays an antiestrogenic activity in prostatic tissue of benign prostatic hypertrophy patients. Eur Urol 1992;21:309-14. PubMed
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- Agbabiaka, T. B., Pittler, M. H., Wider, B., and Ernst, E. Serenoa repens (saw palmetto): a systematic review of adverse events. Drug Saf 2009;32(8):637-647. PubMed
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- Mantovani, F. Serenoa repens in benign prostatic hypertrophy: analysis of 2 Italian studies. Minerva Urol.Nefrol. 2010;62(4):335-340.
- Hanaka, M., Yoshii, C., Yatera, K., Ito, C., Chojin, Y., Nagata, S., Yamasaki, K., Nishida, C., Kawanami, T., Kawanami, Y., Ishimoto, H., and Mukae, H. [A case of rhabdomyolysis caused by saw palmetto of healthy foods]. J.UOEH. 6-1-2012;34(2):193-199. PubMed
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- Braeckman J. The extract of Serenoa repens in the treatment of benign prostatic hyperplasia: a multicenter open study. Current Therapeutic Research 1994;55(7):776-785. DOI
- Jipescu D, Patel A, Bohra H, Pientka A. Rare case of saw palmetto induced heart block. JACC 2017;69(11) supplement:2310.
- Morabito P, Miroddi M, Giovinazzo S, Spina E, Calapai G. Serenoa repens as an endocrine disruptor in a 10-year-Old young girl: a new case report. Pharmacology. 2015;96(1-2):41-3. doi: 10.1159/000431327.
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Pumpkin 5 references
- Marks L, Partin AW, Epstein JI, et al. Effects of a saw palmetto herbal blend in men with symptomatic benign prostatic hyperplasia. J Urol 2000;163:1451-6. DOI
- Cho YH, Lee SY, Jeong DW, et al. Effect of pumpkin seed oil on hair growth in men with androgenetic alopecia: a randomized, double-blind, placebo-controlled trial. Evid Based Complement Alternat Med 2014;2014:549721. PubMed
- Vahlensieck W, Theurer C, Pfitzer E, Patz B, Banik N, Engelmann U. Effects of pumpkin seed in men with lower urinary tract symptoms due to benign prostatic hyperplasia in the one-year, randomized, placebo-controlled GRANU study. Urol Int 2015;94(3):286-95 PubMed
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Maritime Pine 14 references
- Rice-Evans CA, Packer L, eds. Flavonoids in Health and Disease. Manhattan, NY: Marcel Dekker, Inc., 1998.
- Liu FJ, Zhang YX, Lau BH. Pycnogenol enhances immune and haemopoietic functions in senescence-accelerated mice. Cell Mol Life Sci 1998;54:1168-72. PubMed
- Putter M, Grotemeyer KH, Wurthwein G, et al. Inhibition of smoking-induced platelet aggregation by aspirin and pycnogenol. Thromb Res 1999;95:155-61. PubMed
- Kohama T, Inoue M. Pycnogenol alleviates pain associated with pregnancy. Phytother Res 2006;20:232-4.
- Liu X, Zhou HJ, Rohdewald P. French maritime pine bark extract pycnogenol dose-dependently lowers glucose in type 2 diabetic patients (letter). Diabetes Care 2004;27:839. PubMed
- Liu X, Wei J, Tan F, et al. Antidiabetic effect of Pycnogenol French maritime pine bark extract in patients with diabetes type II. Life Sci 2004;75:2505-13. PubMed
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- Araghi-Niknam, M., Hosseini, S., Larson, D., Rohdewald, P., and Watson, R. R. Pine bark extract reduces platelet aggregation. Integr.Med. 3-21-2000;2(2):73-77. PubMed
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- Cisar, P., Jany, R., Waczulikova, I., Sumegova, K., Muchova, J., Vojtassak, J., Durackova, Z., Lisy, M., and Rohdewald, P. Effect of pine bark extract (Pycnogenol) on symptoms of knee osteoarthritis. Phytother.Res. 2008;22(8):1087-1092.
- Enseleit, F., Sudano, I., Periat, D., Winnik, S., Wolfrum, M., Flammer, A. J., Frohlich, G. M., Kaiser, P., Hirt, A., Haile, S. R., Krasniqi, N., Matter, C. M., Uhlenhut, K., Hogger, P., Neidhart, M., Luscher, T. F., Ruschitzka, F., and Noll, G. Effects
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- Wang S, Tan D Zhao Y et al. The effect of pycnogenol on the microcirculation, platelet function and ischemic myocardium in patients with coronary artery diseases. Eur Bull Drug Res 1999;7:19-25.
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