AREDS2 Select Formula Ingredients & Drug Interactions
by VisiVite
What is this page for?
First and foremost: checking AREDS2 Select Formula 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
AREDS2 Select Formula is a dietary supplement by VisiVite with 7 active ingredients. Its ingredients are commonly taken for common cold and immune support, antioxidant support, skin health and collagen formation.Based on those ingredients, 1,020 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are Vitamin E, Vitamin C, Calcium. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against AREDS2 Select Formula by VisiVite
Ask about any prescription or over-the-counter medication and we check it for interactions with AREDS2 Select Formula by VisiVite — 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 AREDS2 Select Formula by VisiVite
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
AREDS2 Select Formula contains 7 active ingredients: vitamin C, zinc, vitamin E, calcium, copper, lutein (branded FloraGLO), and zeaxanthin (branded OmniXan). These are the eye-health nutrients studied in the AREDS2 clinical trial for age-related macular degeneration.
The capsule also contains inactive ingredients—modified cellulose, silica, stearate, and calcium silicate—which are fillers and binders that hold the formula together.
Does it work?
Moderate evidence
Vitamin C is effective for preventing vitamin C deficiency and possibly effective for anemia of chronic disease, atrial fibrillation, cataracts, and exercise-induced infections. Zinc is effective for zinc deficiency and likely effective for Wilson disease; it's also possibly effective for acne, age-related macular degeneration, and diabetes.
Vitamin E is effective for vitamin E deficiency and ataxia with vitamin E deficiency; it's possibly effective for Alzheimer disease and several other conditions. Calcium is effective for kidney failure, heartburn relief, and low blood calcium, and likely effective for osteoporosis.
Copper is likely effective for copper deficiency. Lutein (FloraGLO) is possibly effective for age-related macular degeneration and cataracts.
Zeaxanthin is possibly effective for age-related macular degeneration, though evidence for other conditions we hold is insufficient.
How safe is it?
Well-documented data
Vitamin C is generally well tolerated at normal doses but can cause abdominal cramps, heartburn, diarrhea, nausea, and kidney stones at very high doses above 2 grams daily. Zinc is well tolerated below 40 mg daily but may cause nausea, diarrhea, and metallic taste at higher doses; very high long-term zinc can lead to copper deficiency.
Vitamin E is generally well tolerated but high doses (especially above 400 IU daily) raise the risk of bleeding, and there is concern about increased hemorrhagic stroke risk in male smokers taking synthetic vitamin E long-term. Calcium is well tolerated at recommended amounts and causes only mild stomach upset or constipation; high doses may increase kidney stone risk.
Copper is safe at normal amounts but excess is toxic. Lutein and zeaxanthin are generally well tolerated at typical supplement doses.
In pregnancy, vitamin C and calcium at normal dietary amounts are likely safe; avoid high-dose vitamin C supplements. Zinc is likely safe in pregnancy but possibly unsafe at high doses.
Vitamin E is possibly safe in pregnancy. Copper is likely safe but possibly unsafe at high doses.
Lutein and zeaxanthin are likely safe. For breastfeeding, vitamin C, zinc, calcium, copper, and lutein are generally considered safe at normal amounts; vitamin E lactation data is mixed.
Talk with your doctor or pharmacist about any concerns specific to your health.
Meds to double-check
Major interaction found
Before starting this product, check whether you take: HIV integrase inhibitors (dolutegravir, elvitegravir, raltegravir)—calcium can significantly reduce their levels; blood thinners like warfarin—vitamin C and vitamin E may increase bleeding risk; estrogen-based contraceptives or hormone therapy—vitamin C may raise estrogen levels; tetracycline, quinolone, or cephalosporin antibiotics—zinc reduces their absorption; levothyroxine (thyroid medication)—both vitamin C and calcium can interfere; or chemotherapy drugs—vitamin C and vitamin E may theoretically reduce their effectiveness. No interactions are documented in our data for lutein.
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.
This is an AREDS2-based formula, so it's a reasonable choice if you're interested in the eye-health nutrients from that clinical trial—especially if you have or are at risk for age-related macular degeneration. If you take any prescription medications, especially blood thinners, antiretroviral drugs, antibiotics, or thyroid medication, check your exact drugs with the tool on this page before you start.
The ingredient amounts matter too—high doses can cause side effects or interactions. Talk to your pharmacist before adding it to your routine.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 7 of 7 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Jun 22, 2023.
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 AREDS2 Select Formula, straight from the product label.
| Brand | VisiVite |
|---|---|
| Barcode (UPC) | 899205000225 |
| Net contents | 60 Capsule(s) |
| Market status | On market |
| Date entered into DSLD | Jun 22, 2023 |
| DSLD ID | 292314 |
| Product type | Other Combinations |
| Supplement form | Capsule |
| Dietary claims / uses | Nutrient, All Other, Structure/Function |
| Intended target group(s) | Adult (18 - 50 Years), Gluten Free, Dairy Free |
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 AREDS2 Select Formula by VisiVite, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Vitamin C | 500 mg | 556% |
| Zinc | 40 mg | 364% |
| Vitamin E | 268 mg | 1787% |
| Calcium | 40 mg | 3% |
| Copper | 1 mg | 111% |
| FloraGLO | 10 mg | -- |
| OmniXan | 2 mg | -- |
Other ingredients: Modified Cellulose, Silica, Stearate, Non-Hydrogenated, Calcium Silicate
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.
Formula
VisiVite AREDS2 Select Formula promotes maximum ocular nutrition with Natural FloraGlo brand Lutein, Natural OmniXan brand Zeaxanthin, highly concentrated Antioxidant Vitamins and 40 mg of Zinc. Clear vegetarian capsules ensure high tolerability.
FloraGLO Lutein OmniXan Zeaxanthin
Formulation
The National Eye Institute's AREDS2 trial demonstrated in supporting the health of the macula and maintaining healthy eye function.
Doctor recommended for healthy eye function
This product contains no milk, egg, peanuts, crustacean shellfish (lobster, crab, or shrimp), tree nuts, wheat, yeast, gluten or rice. Contains no artificial sweeteners, flavors, colors or preservatives.
Manufactured under US Federal Good Manufacturing Practice (GMP)
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.
Suggested/Recommended/Usage/Directions
Recommended intake: Take two capsules daily all at once, or one capsule twice daily with meals.
Precautions
Keep out of reach of children
Tamper resistant package. Do not use if outer seal is broken.
Brand IP Statement(s)
FloraGLO is a registered trademark of Kemin Industries, Inc. OmniXan is a registered trademark of OmniActive Health Technologies Ltd.
VisiVite Vitamin Science INC.
Storage
Store at room temperature
FDA Statement of Identity
Dietary Supplement
General Statements
Toll Free: 1-800-427-7660 Web Site: www.visivite.com
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
AREDS2 Select Formula by VisiVite 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 AREDS2 Select Formula by VisiVite
These are the 7 active ingredients this product is made of. Select any to open its full monograph.
Serving size2 Capsule(s) Dosage formCapsule 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.
Vitamin C
Interacts with207 drugs
Vitamin C (ascorbic acid) is an essential nutrient your body needs but cannot make, so you must get it from food or supplements. It's important for im...
Vitamin C 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 & interactionsVitamin E
Interacts with764 drugs
Vitamin E is an essential fat-soluble vitamin and antioxidant that most people get in adequate amounts from a normal diet. Supplements can help correc...
Vitamin E monograph & interactionsCalcium
Interacts with168 drugs
Calcium is an essential mineral your body needs for strong bones, nerve signaling, and muscle function, and supplements can help fill gaps when diet f...
Calcium monograph & interactionsCopper
Interacts with31 drugs
Copper is an essential trace mineral your body needs in small amounts for making red blood cells, supporting nerves and bones, and helping enzymes wor...
Copper monograph & interactionsFloraGLO
No knowninteractions
Lutein is a plant-based antioxidant pigment that concentrates in the eye, and the best evidence suggests it (often combined with zeaxanthin) may help...
FloraGLO monograph & interactionsOmniXan
Interacts with86 drugs
Zeaxanthin is a carotenoid pigment that, along with lutein, concentrates in the macula of the eye and may help support long-term eye health. The stron...
OmniXan monograph & interactionsOther (inactive) ingredients: Modified Cellulose, Silica, Stearate, Non-Hydrogenated, Calcium Silicate. These complete the product’s ingredient list but are not active constituents.
AREDS2 Select Formula by VisiVite Drug Interactions
HelloPharmacist Interaction Report
AREDS2 Select Formula by VisiVite contains several ingredients with documented interactions to medications.
The most serious interaction involves calcium, which can significantly reduce levels of two HIV integrase inhibitors—dolutegravir and elvitegravir—by up to 40% through chelation. This is a Major severity interaction; if you take either of these drugs, separate calcium dosing by at least 2 hours before or (for dolutegravir) 6 hours after.
Read the full breakdown — every affected drug type, severity by severity
Vitamin C, zinc, and vitamin E each interact with multiple medication types at Moderate severity. Vitamin C may increase estrogen levels in oral contraceptives and hormone therapy by up to 55%, reduce warfarin effectiveness, interfere with chemotherapy drugs (alkylating agents and antitumor antibiotics), and increase aluminum absorption.
Zinc reduces absorption of several antibiotics—quinolones, cephalexin, tetracyclines—and can lower levels of the HIV drug ritonavir and the cancer drug cisplatin; take zinc at least 2 hours before or 4–6 hours after these antibiotics. Vitamin E at high doses increases bleeding risk with blood thinners like warfarin and other anticoagulants, and may reduce effectiveness of chemotherapy and certain HIV drugs.
Calcium also interacts with the thyroid drug levothyroxine, the heart drug diltiazem, and several antibiotics—separate these by at least 2–4 hours. Copper and lutein (FloraGLO) have minor or no documented interactions; zeaxanthin theoretically increases hypoglycemia risk with diabetes medications, though population data do not support this.
Altogether, these interactions span 1,008 individual medications. Use the medication checker on this page to verify your specific drugs before starting.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against AREDS2 Select Formula?
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 AREDS2 Select Formula interact with 1,020 drugs. Click any drug to see the details.
6 of the 7 ingredients in AREDS2 Select Formula interact with drugs. Each result below shows which ingredient is responsible. Vitamin E Vitamin C Calcium OmniXan Zinc Copper
CeftriaxoneRocephin
How Ceftriaxone interacts with AREDS2 Select Formula — through 1 ingredient. Tap an ingredient for the detail:
CalciumCeftriaxone (rocephin) Major
Interaction Summary
Co-administration of intravenous calcium and ceftriaxone can result in precipitation of a ceftriaxone-calcium salt in the lungs and kidneys.
Read the full Calcium + Ceftriaxone interactionCobicistat, Elvitegravir, Emtricitabine, Tenofovir Alafenamide FumarateGenvoya
How Cobicistat, Elvitegravir, Emtricitabine, Tenofovir Alafenamide Fumarate interacts with AREDS2 Select Formula — through 3 ingredients. Tap an ingredient for the detail:
CalciumElvitegravir (vitekta), Bictegravir/emtricitabine/tenofovir Alafenamide (biktarvy) Major
Interaction Summary
Calcium seems to reduce levels of elvitegravir.
Read the full Calcium + Cobicistat, Elvitegravir, Emtricitabine, Tenofovir Alafenamide Fumarate interactionZincBictegravir/emtricitabine/tenofovir Alafenamide (biktarvy) Moderate
Interaction Summary
Theoretically, zinc might decrease levels of bictegravir/emtricitabine/tenofovir alafenamide by reducing its absorption.
Read the full Zinc + Cobicistat, Elvitegravir, Emtricitabine, Tenofovir Alafenamide Fumarate interactionVitamin ECytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Vitamin E + Cobicistat, Elvitegravir, Emtricitabine, Tenofovir Alafenamide Fumarate interactionDolutegravirTivicay
How Dolutegravir interacts with AREDS2 Select Formula — through 1 ingredient. Tap an ingredient for the detail:
CalciumDolutegravir (tivicay) Major
Interaction Summary
Calcium seems to reduce levels of dolutegravir.
Read the full Calcium + Dolutegravir interactionDolutegravir, Emtricitabine, Tenofovir AlafenamideDolutegravir, Emtricitabine, Tenofovir Alafenamide
How Dolutegravir, Emtricitabine, Tenofovir Alafenamide interacts with AREDS2 Select Formula — through 2 ingredients. Tap an ingredient for the detail:
CalciumDolutegravir (tivicay), Bictegravir/emtricitabine/tenofovir Alafenamide (biktarvy) Major
Interaction Summary
Calcium seems to reduce levels of dolutegravir.
Read the full Calcium + Dolutegravir, Emtricitabine, Tenofovir Alafenamide interactionZincBictegravir/emtricitabine/tenofovir Alafenamide (biktarvy) Moderate
Interaction Summary
Theoretically, zinc might decrease levels of bictegravir/emtricitabine/tenofovir alafenamide by reducing its absorption.
Read the full Zinc + Dolutegravir, Emtricitabine, Tenofovir Alafenamide interactionDolutegravir, RilpivirineJuluca
How Dolutegravir, Rilpivirine interacts with AREDS2 Select Formula — through 2 ingredients. Tap an ingredient for the detail:
CalciumDolutegravir (tivicay) Major
Interaction Summary
Calcium seems to reduce levels of dolutegravir.
Read the full Calcium + Dolutegravir, Rilpivirine interactionVitamin ECytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Vitamin E + Dolutegravir, Rilpivirine interactionElvitegravirVitekta
How Elvitegravir interacts with AREDS2 Select Formula — through 2 ingredients. Tap an ingredient for the detail:
CalciumElvitegravir (vitekta) Major
Interaction Summary
Calcium seems to reduce levels of elvitegravir.
Read the full Calcium + Elvitegravir interactionVitamin ECytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Vitamin E + Elvitegravir interactionElvitegravir, Cobicistat, Emtricitabine, Tenofovir Disoproxil FumarateStribild
How Elvitegravir, Cobicistat, Emtricitabine, Tenofovir Disoproxil Fumarate interacts with AREDS2 Select Formula — through 3 ingredients. Tap an ingredient for the detail:
CalciumElvitegravir (vitekta), Bictegravir/emtricitabine/tenofovir Alafenamide (biktarvy) Major
Interaction Summary
Calcium seems to reduce levels of elvitegravir.
Read the full Calcium + Elvitegravir, Cobicistat, Emtricitabine, Tenofovir Disoproxil Fumarate interactionVitamin ECytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Vitamin E + Elvitegravir, Cobicistat, Emtricitabine, Tenofovir Disoproxil Fumarate interactionZincBictegravir/emtricitabine/tenofovir Alafenamide (biktarvy) Moderate
Interaction Summary
Theoretically, zinc might decrease levels of bictegravir/emtricitabine/tenofovir alafenamide by reducing its absorption.
Read the full Zinc + Elvitegravir, Cobicistat, Emtricitabine, Tenofovir Disoproxil Fumarate interactionAdo-trastuzumab EmtansineKadcyla
How Ado-trastuzumab Emtansine interacts with AREDS2 Select Formula — through 1 ingredient. Tap an ingredient for the detail:
Vitamin ECytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Vitamin E + Ado-trastuzumab Emtansine interactionAbciximabReoPro
How Abciximab interacts with AREDS2 Select Formula — through 1 ingredient. Tap an ingredient for the detail:
Vitamin EAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Concomitant use of vitamin E and anticoagulant or antiplatelet agents might increase the risk of bleeding.
Read the full Vitamin E + Abciximab interactionAbemaciclibVerzenio
How Abemaciclib interacts with AREDS2 Select Formula — through 1 ingredient. Tap an ingredient for the detail:
Vitamin ECytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Vitamin E + Abemaciclib interactionAbiraterone
How Abiraterone interacts with AREDS2 Select Formula — through 1 ingredient. Tap an ingredient for the detail:
Vitamin ECytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Vitamin E + Abiraterone interactionAbiraterone AcetateYonsa, Zytiga
How Abiraterone Acetate interacts with AREDS2 Select Formula — through 1 ingredient. Tap an ingredient for the detail:
Vitamin ECytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Vitamin E + Abiraterone Acetate interactionAbrocitinibCibinqo
How Abrocitinib interacts with AREDS2 Select Formula — through 1 ingredient. Tap an ingredient for the detail:
Vitamin EAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Concomitant use of vitamin E and anticoagulant or antiplatelet agents might increase the risk of bleeding.
Read the full Vitamin E + Abrocitinib interactionAcalabrutinibCalquence
How Acalabrutinib interacts with AREDS2 Select Formula — through 1 ingredient. Tap an ingredient for the detail:
Vitamin ECytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Vitamin E + Acalabrutinib interactionAcarboseGlucobay, Prandase, Precose
How Acarbose interacts with AREDS2 Select Formula — through 1 ingredient. Tap an ingredient for the detail:
OmnixanAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, taking zeaxanthin with antidiabetes drugs might increase the risk of hypoglycemia.
Read the full Omnixan + Acarbose interactionAcenocoumarolSintrom
How Acenocoumarol interacts with AREDS2 Select Formula — through 1 ingredient. Tap an ingredient for the detail:
Vitamin EAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Concomitant use of vitamin E and anticoagulant or antiplatelet agents might increase the risk of bleeding.
Read the full Vitamin E + Acenocoumarol interactionAcetaminophen, AspirinGemnisyn
How Acetaminophen, Aspirin interacts with AREDS2 Select Formula — through 2 ingredients. Tap an ingredient for the detail:
Vitamin EAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Concomitant use of vitamin E and anticoagulant or antiplatelet agents might increase the risk of bleeding.
Read the full Vitamin E + Acetaminophen, Aspirin interactionVitamin CAcetaminophen (tylenol, Others), Aspirin Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C + Acetaminophen, Aspirin interactionAcetaminophen, Aspirin, CaffeineExcedrin, Excedrin Extra Strength, Excedrin Migraine
How Acetaminophen, Aspirin, Caffeine interacts with AREDS2 Select Formula — through 2 ingredients. Tap an ingredient for the detail:
Vitamin EAnticoagulant/antiplatelet Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Concomitant use of vitamin E and anticoagulant or antiplatelet agents might increase the risk of bleeding.
Read the full Vitamin E + Acetaminophen, Aspirin, Caffeine interactionVitamin CAcetaminophen (tylenol, Others), Aspirin Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C + Acetaminophen, Aspirin, Caffeine interactionAcetaminophen, Butalbital, CaffeineEsgic, Esgic Plus, Fiogesic, Fioricet, Repan, Tecnal +1 more
How Acetaminophen, Butalbital, Caffeine interacts with AREDS2 Select Formula — through 2 ingredients. Tap an ingredient for the detail:
Vitamin ECytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Vitamin E + Acetaminophen, Butalbital, Caffeine interactionVitamin CAcetaminophen (tylenol, Others) Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C + Acetaminophen, Butalbital, Caffeine interactionAcetaminophen, Butalbital, Caffeine, CodeineEsgic with Codeine, Fioricet w/ Codeine
How Acetaminophen, Butalbital, Caffeine, Codeine interacts with AREDS2 Select Formula — through 2 ingredients. Tap an ingredient for the detail:
Vitamin ECytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Vitamin E + Acetaminophen, Butalbital, Caffeine, Codeine interactionVitamin CAcetaminophen (tylenol, Others) Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C + Acetaminophen, Butalbital, Caffeine, Codeine interactionAcetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, PhenylephrineHycomine Compound
How Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interacts with AREDS2 Select Formula — through 2 ingredients. Tap an ingredient for the detail:
Vitamin ECytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Vitamin E + Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interactionVitamin CAcetaminophen (tylenol, Others) Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C + Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interactionAcetaminophen, Caffeine, CodeineGesic C15, Gesic C30, Gesic C8, Lenoltec 1, Lenoltec 2, Lenoltec 3 +1 more
How Acetaminophen, Caffeine, Codeine interacts with AREDS2 Select Formula — through 2 ingredients. Tap an ingredient for the detail:
Vitamin ECytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Vitamin E + Acetaminophen, Caffeine, Codeine interactionVitamin CAcetaminophen (tylenol, Others) Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C + Acetaminophen, Caffeine, Codeine interactionAcetaminophen, Caffeine, Codeine, SalicylamideCodalan No.1, Codalan No.2, Codalan No.3
How Acetaminophen, Caffeine, Codeine, Salicylamide interacts with AREDS2 Select Formula — through 2 ingredients. Tap an ingredient for the detail:
Vitamin ECytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Vitamin E + Acetaminophen, Caffeine, Codeine, Salicylamide interactionVitamin CAcetaminophen (tylenol, Others) Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C + Acetaminophen, Caffeine, Codeine, Salicylamide interactionAcetaminophen, Caffeine, DihydrocodeineDHC Plus, Panlor DC, Panlor SS
How Acetaminophen, Caffeine, Dihydrocodeine interacts with AREDS2 Select Formula — through 2 ingredients. Tap an ingredient for the detail:
Vitamin ECytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Vitamin E + Acetaminophen, Caffeine, Dihydrocodeine interactionVitamin CAcetaminophen (tylenol, Others) Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C + Acetaminophen, Caffeine, Dihydrocodeine interactionAcetaminophen, Caffeine, IsomethepteneMigralam
How Acetaminophen, Caffeine, Isometheptene interacts with AREDS2 Select Formula — through 2 ingredients. Tap an ingredient for the detail:
Vitamin ECytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Vitamin E + Acetaminophen, Caffeine, Isometheptene interactionVitamin CAcetaminophen (tylenol, Others) Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C + Acetaminophen, Caffeine, Isometheptene interactionAcetaminophen, Caffeine, PyrilamineMidol Max Strength Menstrual
How Acetaminophen, Caffeine, Pyrilamine interacts with AREDS2 Select Formula — through 2 ingredients. Tap an ingredient for the detail:
Vitamin ECytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Vitamin E + Acetaminophen, Caffeine, Pyrilamine interactionVitamin CAcetaminophen (tylenol, Others) Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C + Acetaminophen, Caffeine, Pyrilamine interactionAcetaminophen, Chlorpheniramine Maleate, Dextromethorphan HbrVicks Formula 44M Cough, Cold & Flu Relief
How Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interacts with AREDS2 Select Formula — through 2 ingredients. Tap an ingredient for the detail:
Vitamin ECytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Vitamin E + Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interactionVitamin CAcetaminophen (tylenol, Others) Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C + Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interactionAcetaminophen, Chlorpheniramine, Codeine, PhenylephrineColrex
How Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interacts with AREDS2 Select Formula — through 2 ingredients. Tap an ingredient for the detail:
Vitamin ECytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Vitamin E + Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interactionVitamin CAcetaminophen (tylenol, Others) Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C + Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interactionAcetaminophen, Chlorpheniramine, DextromethorphanCoricidin II Extra Strength Cold and Flu
How Acetaminophen, Chlorpheniramine, Dextromethorphan interacts with AREDS2 Select Formula — through 2 ingredients. Tap an ingredient for the detail:
Vitamin ECytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Vitamin E + Acetaminophen, Chlorpheniramine, Dextromethorphan interactionVitamin CAcetaminophen (tylenol, Others) Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C + Acetaminophen, Chlorpheniramine, Dextromethorphan interactionAcetaminophen, Chlorpheniramine, Dextromethorphan HydrobromideCoricidin HBP Maximum Strength Flu
How Acetaminophen, Chlorpheniramine, Dextromethorphan Hydrobromide interacts with AREDS2 Select Formula — through 2 ingredients. Tap an ingredient for the detail:
Vitamin ECytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Vitamin E + Acetaminophen, Chlorpheniramine, Dextromethorphan Hydrobromide interactionVitamin CAcetaminophen (tylenol, Others) Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C + Acetaminophen, Chlorpheniramine, Dextromethorphan Hydrobromide interactionEach ingredient & the kinds of drugs it affects
For each ingredient in AREDS2 Select Formula 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.
Vitamin E
Alkylating Agents
Theoretically, antioxidant effects of vitamin E might reduce the effectiveness of alkylating agents.
There's concern that antioxidants could reduce the activity of chemotherapy drugs which generate free radicals, such as cyclophosphamide, chlorambucil, carmustine, busulfan, and thiotepa. However, some researchers theorize that antioxidants might make chemotherapy more effective by reducing oxidative stress that might interfere with apoptosis (cell death) of cancer cells. More evidence is needed to determine what effect, if any, antioxidants such as vitamin E have on chemotherapy. Advise patients to consult their oncologist before using vitamin E supplements, especially in high doses.
Anticoagulant/Antiplatelet Drugs
Concomitant use of vitamin E and anticoagulant or antiplatelet agents might increase the risk of bleeding.
Vitamin E seems to inhibit of platelet aggregation and antagonize the effects of vitamin K-dependent clotting factors. These effects appear to be dose-dependent, and are probably only likely to be clinically significant with doses of at least 800 units daily. Mixed tocopherols, such as those found in food, might have a greater antiplatelet effect than alpha-tocopherol. RRR alpha-tocopherol (natural vitamin E) 1000 IU daily antagonizes vitamin K-dependent clotting factors. Advise patients to avoid high doses of vitamin E, especially in people with low vitamin K intake or other risk factors for bleeding.
Antitumor Antibiotics
Theoretically, antioxidant effects of vitamin E might reduce the effectiveness of antitumor antibiotics.
There's concern that antioxidants could reduce the activity of antitumor antibiotic drugs such as doxorubicin, which generate free radicals. However, some researchers theorize that antioxidants might make chemotherapy more effective by reducing oxidative stress that might interfere with apoptosis (cell death) of cancer cells. More evidence is needed to determine what effect, if any, antioxidants such as vitamin E have on chemotherapy involving antitumor antibiotics. Advise patients to consult their oncologist before using vitamin E supplements, especially in high doses.
Cyclosporine (Neoral, Sandimmune)
A specific form of vitamin E might increase absorption and levels of cyclosporine.
There is some evidence that one specific formulation of vitamin E (D-alpha-tocopheryl-polyethylene glycol-1000 succinate, TPGS, tocophersolan, Liqui-E) might increase absorption of cyclosporine. This vitamin E formulation forms micelles which seems to increase absorption of cyclosporine by 40% to 72% in some patients. However, this interaction is unlikely to occur with the usual forms of vitamin E.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Vitamin E appears to bind with the nuclear receptor, pregnane X receptor (PXR), which results in increased expression of CYP3A4. Although the clinical significance of this is not known, use caution when considering concomitant use of vitamin E and other drugs affected by these enzymes.
Selumetinib (Koselugo)
Taking selumetinib with vitamin E can result in a total daily dose of vitamin E that exceeds safe limits and therefore might increase the risk of bleeding.
Selumetinib contains 48-54 IU vitamin E per capsule. The increased risk of bleeding with vitamin E appears to be dose-dependent. Be cautious when using selumetinib in combination with supplemental vitamin E, especially in patients at higher risk of bleed, such as those with chronic conditions and those taking antiplatelet drugs.
Warfarin (Coumadin)
Using vitamin E with warfarin might increase the risk of bleeding.
Due to interference with production of vitamin K-dependent clotting factors, use of more than 400 IU of vitamin E daily with warfarin might increase prothrombin time (PT), INR, and the risk of bleeding,. At a dose of 1000 IU per day, vitamin E can antagonize vitamin K-dependent clotting factors even in people not taking warfarin. Limited clinical evidence suggests that doses up to 1200 IU daily may be used safely by patients taking warfarin, but this may not be applicable in all patient populations.
Niacin
Vitamin E might decrease the beneficial effects of niacin on high-density lipoprotein (HDL) cholesterol levels.
A combination of niacin and simvastatin (Zocor) effectively raises high-density lipoprotein (HDL) cholesterol levels in people 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%. Vitamin E alone combined with a statin does not seem to decrease HDL levels. It is not known whether the adverse effect on HDL is due to one of the other antioxidants or to the combination. It also is not known whether it will occur in other patient populations.
Vitamin C
Alkylating Agents
Theoretically, antioxidant effects of vitamin C might reduce the effectiveness of alkylating agents.
The use of antioxidants like vitamin C during chemotherapy is controversial. There is concern that antioxidants could reduce the activity of chemotherapy drugs that generate free radicals, such as cyclophosphamide, chlorambucil, carmustine, busulfan, and thiotepa. In contrast, some researchers theorize that antioxidants might make chemotherapy more effective by reducing oxidative stress that could interfere with apoptosis (cell death) of cancer cells. More evidence is needed to determine what effect, if any, antioxidants such as vitamin C have on chemotherapy.
Aluminum
Vitamin C can increase the amount of aluminum absorbed from aluminum compounds.
Research in animals and humans shows that vitamin C increases aluminum absorption, theoretically by chelating aluminum and keeping it in solution where it is available for absorption. In people with normal renal function, urinary excretion of aluminum will likely increase, making aluminum retention and toxicity unlikely. Patients with renal failure who take aluminum-containing compounds such as phosphate binders should avoid vitamin C supplements in doses above the recommended dietary allowances.
Antitumor Antibiotics
Theoretically, the antioxidant effects of vitamin C might reduce the effectiveness of antitumor antibiotics.
The use of antioxidants like vitamin C during chemotherapy is controversial. There is concern that antioxidants could reduce the activity of chemotherapy drugs which generate free radicals, such as doxorubicin. In contrast, some researchers theorize that antioxidants might make chemotherapy more effective by reducing oxidative stress that could interfere with apoptosis (cell death) of cancer cells. More evidence is needed to determine what effects, if any, antioxidants such as vitamin C have on chemotherapy.
Estrogens
Vitamin C might increase blood levels of estrogens.
Increases in plasma estrogen levels of up to 55% occur under some circumstances when vitamin C is taken concurrently with oral contraceptives or hormone replacement therapy, including topical products. It is suggested that vitamin C prevents oxidation of estrogen in the tissues, regenerates oxidized estrogen, and reduces sulfate conjugation of estrogen in the gut wall. When tissue levels of vitamin C are high, these processes are already maximized and supplemental vitamin C does not have any effect on estrogen levels. Increases in plasma estrogen levels may occur when patients who are deficient in vitamin C take supplements. Monitor these patients for estrogen-related side effects.
Fluphenazine (Prolixin)
Theoretically, vitamin C might decrease levels of fluphenazine.
In one patient there was a clinically significant decrease in fluphenazine levels when vitamin C (500 mg twice daily) was started. The mechanism is not known, and there is no further data to confirm this interaction.
Indinavir (Crixivan)
Vitamin C can modestly reduce indinavir levels.
One pharmacokinetic study shows that taking vitamin C 1 gram orally once daily along with indinavir 800 mg orally three times daily reduces the area under the concentration-time curve of indinavir by 14%. The mechanism of this interaction is unknown, but it is unlikely to be clinically significant in most patients. The effect of higher doses of vitamin C on indinavir levels is unknown.
Levothyroxine (Synthroid, Others)
Vitamin C can increase levothyroxine absorption.
Two clinical studies in adults with poorly controlled hypothyroidism show that swallowing levothyroxine with a glass of water containing vitamin C 500-1000 mg in solution reduces thyroid stimulating hormone (TSH) levels and increases thyroxine (T4) levels when compared with taking levothyroxine alone. This suggests that vitamin C increases the oral absorption of levothyroxine, possibly due to a reduction in pH.
Warfarin (Coumadin)
High-dose vitamin C might reduce the levels and effectiveness of warfarin.
Vitamin C in high doses may cause diarrhea and possibly reduce warfarin absorption. There are reports of two people who took up to 16 grams daily of vitamin C and had a reduction in prothrombin time. Lower doses of 5-10 grams daily can also reduce warfarin absorption. In many cases, this does not seem to be clinically significant. However, a case of warfarin resistance has been reported for a patient who took vitamin C 500 mg twice daily. Cessation of vitamin C supplementation resulted in a rapid increase in international normalized ratio (INR). Tell patients taking warfarin to avoid taking vitamin C in excessively high doses (greater than 10 grams daily). Lower doses may be safe, but the anticoagulation activity of warfarin should be monitored. Patients who are stabilized on warfarin while taking vitamin C should avoid adjusting vitamin C dosage to prevent the possibility of warfarin resistance.
Acetaminophen (Tylenol, Others)
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
A small pharmacokinetic study in healthy volunteers shows that taking high-dose vitamin C (3 grams) 1.5 hours after taking acetaminophen 1 gram slightly increases the apparent half-life of acetaminophen from around 2.3 hours to 3.1 hours. Ascorbic acid competitively inhibits sulfate conjugation of acetaminophen. However, to compensate, elimination of acetaminophen glucuronide and unconjugated acetaminophen increases. This effect is not likely to be clinically significant.
Aspirin
Acidification of the urine by vitamin C might increase aspirin levels.
It has been suggested that acidification of the urine by vitamin C could increase reabsorption of salicylates by the renal tubules, and increase plasma salicylate levels. However, short-term use of up to 6 grams daily of vitamin C does not seem to affect urinary pH or salicylate excretion, suggesting this interaction is not clinically significant.
Choline Magnesium Trisalicylate (Trilisate)
Acidification of the urine by vitamin C might increase choline magnesium trisalicylate levels.
It has been suggested that acidification of the urine by vitamin C could increase reabsorption of salicylates by the renal tubules, and increase plasma salicylate levels. However, short-term use of up to 6 grams daily of vitamin C does not seem to affect urinary pH or salicylate excretion, suggesting this interaction probably is not clinically significant.
Niacin
Vitamin C might decrease the beneficial effects of niacin on high-density lipoprotein (HDL) cholesterol 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 vitamin C, or to the combination. It also is not known whether it will occur in other patient populations.
Salsalate (Disalcid)
Acidification of the urine by vitamin C might increase salsalate levels.
It has been suggested that acidification of the urine by vitamin C could increase reabsorption of salicylates by the renal tubules, and increase plasma salicylate levels. However, short-term use of up to 6 grams/day vitamin C does not seem to affect urinary pH or salicylate excretion, suggesting this interaction probably is not clinically significant.
Calcium
Ceftriaxone (Rocephin)
Co-administration of intravenous calcium and ceftriaxone can result in precipitation of a ceftriaxone-calcium salt in the lungs and kidneys.
Avoid administering intravenous calcium in any form, such as parenteral nutrition or Lactated Ringers, within 48 hours of intravenous ceftriaxone. Case reports in neonates show that administering intravenous ceftriaxone and calcium can result in precipitation of a ceftriaxone-calcium salt in the lungs and kidneys. In several cases, neonates have died as a result of this interaction. So far there are no reports in adults; however, there is still concern that this interaction might occur in adults.
Dolutegravir (Tivicay)
Calcium seems to reduce levels of dolutegravir.
Advise patients to take dolutegravir either 2 hours before or 6 hours after taking calcium supplements. Pharmacokinetic research suggests that taking calcium carbonate 1200 mg concomitantly with dolutegravir 50 mg reduces plasma levels of dolutegravir by almost 40%. Calcium appears to decrease levels of dolutegravir through chelation.
Elvitegravir (Vitekta)
Calcium seems to reduce levels of elvitegravir.
Advise patients to take elvitegravir either 2 hours before or 2 hours after taking calcium supplements. Pharmacokinetic research suggests that taking calcium along with elvitegravir can reduce blood levels of elvitegravir through chelation.
Aluminum
Calcium citrate might increase aluminum absorption and toxicity. Other types of calcium do not increase aluminum absorption.
Calcium citrate can increase the absorption of aluminum when taken with aluminum hydroxide. The increase in aluminum levels may become toxic, particularly in individuals with kidney disease. However, the effect of calcium citrate on aluminum absorption is due to the citrate anion rather than calcium cation. Calcium acetate does not appear to increase aluminum absorption.
Bictegravir/Emtricitabine/Tenofovir Alafenamide (Biktarvy)
Calcium might decrease levels of bictegravir/emtricitabine/tenofovir alafenamide by reducing its absorption when taken in a fasting state.
Advise patients that bictegravir/emtricitabine/tenofovir alafenamide and calcium can be taken together if taken with food. However, if taken on an empty stomach, bictegravir/emtricitabine/tenofovir alafenamide should not be taken with, or 2 hours after, calcium containing products.
Bisphosphonates
Calcium reduces the absorption of bisphosphonates.
Advise patients to take bisphosphonates at least 30 minutes before calcium, but preferably at a different time of day. Calcium supplements decrease absorption of bisphosphonates.
Calcipotriene (Dovonex)
Taking calcipotriene with calcium might increase the risk for hypercalcemia.
Calcipotriene is a vitamin D analog used topically for psoriasis. It can be absorbed in sufficient amounts to cause systemic effects, including hypercalcemia. Theoretically, combining calcipotriene with calcium supplements might increase the risk of hypercalcemia.
Digoxin (Lanoxin)
Using intravenous calcium with digoxin might increase the risk of fatal cardiac arrhythmias.
Hypercalcemia increases the risk of fatal cardiac arrhythmias with digoxin. However, one retrospective analysis of clinical data suggests that intravenous calcium does not increase the risk of dysrhythmias or mortality in patients receiving digoxin.
Diltiazem (Cardizem, Others)
Theoretically, calcium may reduce the therapeutic effects of diltiazem.
Hypercalcemia can reduce the effectiveness of verapamil in atrial fibrillation. Theoretically, calcium might increase this risk of hypercalcemia and reduce the effectiveness of diltiazem.
Levothyroxine (Synthroid, Others)
Calcium seems to reduce the absorption and effectiveness of levothyroxine.
Advise patients to take levothyroxine and calcium supplements at least 4 hours apart. Calcium reduces levothyroxine absorption, probably by forming insoluble complexes. Calcium carbonate supplements reduce effectiveness of levothyroxine in patients with hypothyroidism.
Lithium
Theoretically, concomitant use of calcium and lithium may increase this risk of hypercalcemia.
Clinical research suggests that long-term use of lithium may cause hypercalcemia in 10% to 60% of patients. Theoretically, concomitant use of lithium and calcium supplements may further increase this risk.
Quinolone Antibiotics
Calcium seems to reduce the absorption of quinolone antibiotics.
Advise patients to take oral quinolones at least 2 hours before or 4-6 hours after calcium supplements or calcium-fortified foods. Taking calcium at the same time as oral quinolones can reduce quinolone absorption. Calcium binds to quinolones in the gut.
Raltegravir (Isentress)
Calcium may reduce levels of raltegravir.
Pharmacokinetic research shows that taking a single dose of calcium carbonate 3000 mg along with raltegravir 400 mg twice daily modestly decreases the mean area under the curve of raltegravir, but the decrease does not necessitate a dose adjustment of raltegravir. However, a case of elevated HIV-1 RNA levels and documented resistance to raltegravir has been reported for a patient taking calcium carbonate 1 gram three times daily plus vitamin D3 (cholecalciferol) 400 IU three times daily in combination with raltegravir 400 mg twice daily for 11 months. It is thought that calcium reduced raltegravir levels by chelation, leading to treatment failure.
Sotalol (Betapace)
Calcium seems to reduce the absorption of sotalol.
Advise patients to separate doses by at least 2 hours before or 4-6 hours after calcium. Calcium appears to reduce the absorption of sotalol, probably by forming insoluble complexes.
Tetracycline Antibiotics
Calcium seems to reduce the absorption of tetracycline antibiotics.
Advise patients to take oral tetracyclines at least 2 hours before, or 4-6 hours after calcium supplements. Taking calcium at the same time as oral tetracyclines can reduce tetracycline absorption. Calcium binds to tetracyclines in the gut.
Thiazide Diuretics
Taking calcium along with thiazides might increase the risk of hypercalcemia and renal failure.
Thiazides reduce calcium excretion by the kidneys. Using thiazides along with moderately large amounts of calcium carbonate increases the risk of milk-alkali syndrome (hypercalcemia, metabolic alkalosis, renal failure). Patients may need to have their serum calcium levels and/or parathyroid function monitored regularly.
Verapamil (Calan, Others)
Theoretically, calcium may reduce the therapeutic effects of verapamil.
Hypercalcemia can reduce the effectiveness of verapamil in atrial fibrillation. Theoretically, use of calcium supplements may increase this risk of hypercalcemia and reduce the effectiveness of verapamil.
Calcium Channel Blockers
Intravenous calcium may decrease the effects of calcium channel blockers; oral calcium is unlikely to have this effect.
Intravenous calcium is used to decrease the effects of calcium channel blockers in the management of overdose. Intravenous calcium gluconate has been used before intravenous verapamil (Isoptin) to prevent or reduce the hypotensive effects without affecting the antiarrhythmic effects. But there is no evidence that dietary or supplemental calcium when taken orally interacts with calcium channel blockers.
OmniXan
Antidiabetes Drugs
Theoretically, taking zeaxanthin with antidiabetes drugs might increase the risk of hypoglycemia.
In an animal diabetic model, zeaxanthin has hypoglycemic effects. However, population research has found that increasing intake of dietary zeaxanthin plus lutein does not decrease the risk of developing type 2 diabetes.
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.
Copper
Penicillamine (Cuprimine, Depen)
Theoretically, taking copper with penicillamine might decrease the absorption of penicillamine; separate dosing by at least 2 hours.
Copper chelates penicillamine, which decreases its absorption and may reduce its clinical effects.
Contraceptive Drugs
Theoretically, taking copper with contraceptive drugs might increase the levels and toxic effects of copper.
A meta-analysis of clinical studies suggests that chronic use of oral contraceptives increases serum copper levels by a mean of 57 mcg/dL. In most people, this resulted in levels above the normal reference range for copper.
Brand information
Manufacturer and brand details for AREDS2 Select Formula, from the product label.
VisiVite
See all VisiVite products- Name
- Vitamin Science, Inc.
- City
- Huntington
- State
- NY
- ZipCode
- 11743
- Phone Number
- 1-800-427-7660
- Web Address
- www.visivite.com
AREDS2 Select Formula by VisiVite: 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 AREDS2 Select Formula’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Vitamin C
Interacts with 207 drugsVitamin C (ascorbic acid) is an essential nutrient your body needs but cannot make, so you must get it from food or supplements. It's important for immune function, collagen, and acts as an...
Read the full Vitamin C 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 monographVitamin E
Interacts with 764 drugsVitamin E is an essential fat-soluble vitamin and antioxidant that most people get in adequate amounts from a normal diet. Supplements can help correct a true deficiency, but high-dose vitam...
Read the full Vitamin E monograph → Herb & supplement monographCalcium
Interacts with 168 drugsCalcium is an essential mineral your body needs for strong bones, nerve signaling, and muscle function, and supplements can help fill gaps when diet falls short. Most people do best getting...
Read the full Calcium monograph → Herb & supplement monographCopper
Interacts with 31 drugsCopper is an essential trace mineral your body needs in small amounts for making red blood cells, supporting nerves and bones, and helping enzymes work. Most people get enough copper from fo...
Read the full Copper monograph → Herb & supplement monographLutein
Lutein is a plant-based antioxidant pigment that concentrates in the eye, and the best evidence suggests it (often combined with zeaxanthin) may help slow progression of age-related macular...
Read the full Lutein monograph → Herb & supplement monographZeaxanthin
Interacts with 86 drugsZeaxanthin is a carotenoid pigment that, along with lutein, concentrates in the macula of the eye and may help support long-term eye health. The strongest evidence relates to slowing progres...
Read the full Zeaxanthin monograph →Sources & How We Checked
AREDS2 Select Formula'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 282 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.
Vitamin C 51 references
- McEvoy GK, ed. AHFS Drug Information. Bethesda, MD: American Society of Health-System Pharmacists, 1998.
- Back DJ, Breckenridge AM, MacIver M, et al. Interaction of ethinyloestradiol with ascorbic acid in man. Br Med J (Clin Res Ed) 1981;282:1516.
- Morris JC, Beeley L, Ballantine N. Interaction of ethinyloestradiol with ascorbic acid in man [letter]. Br Med J (Clin Res Ed) 1981;283:503.
- Labriola D, Livingston R. Possible interactions between dietary antioxidants and chemotherapy. Oncology 1999;13:1003-8.
- Dwyer JH, Merz NB, Shirocre AM, et al. Progression of early atherosclerosis and intake of vitamin C and vitamin E from supplements and food. The Los Angeles Atherosclerosis Study. 41st Annual Conference on Cardiovascular Disease Epidemiology and Prevent
- Levine M, Rumsey SC, Daruwala R, et al. Criteria and recommendations for vitamin C intake. JAMA 1999;281:1415-23. PubMed
- Hansten PD, Horn JR. Drug Interactions Analysis and Management. Vancouver, WA: Applied Therapeutics Inc., 1997 and updates.
- Segal S, Kaminski S. Drug-nutrient interactions. American Druggist 1996 Jul;42-8.
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DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.
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