Major interaction on record — check this product against your medications before combining. Based on 10 of 17 ingredients. Check your meds →
Dietary supplement

Bone Health Daily Fundamentals Ingredients & Drug Interactions

by SP Standard Process

Other (e.g. Tea Bag) Category: Other Combinations
Most serious interaction: Major
The interaction bottom line Most serious interaction: Major

Bone Health Daily Fundamentals is a dietary supplement by SP Standard Process with 17 active ingredients. Its ingredients are commonly taken for constipation, diarrhea, high cholesterol.Based on those ingredients, 2,138 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are Dietary Fiber, Vitamin D, Vitamin A. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

HelloPharmacist Scorecard of Bone Health Daily Fundamentals by SP Standard Process

Our pharmacy team’s full take, with four database checks built into the cards below — a summary of what is known, not a grade of the product itself.

From our pharmacy team — supplement deep dive

What’s inside

Low disclosure
Ingredient Transparency · database check
Low

Most active ingredients don't disclose an individual amount — you can't tell how much of each you're getting.

Why this rating?
  • The label discloses an exact amount for 8 of its 17 active ingredients.
  • “Proprietary Blend” is a proprietary blend — the label gives one combined amount (2,275 mg) without saying how much of each component you get.

Bone Health Daily Fundamentals contains 16 ingredients. The active ones are potassium, calcium, vitamin K1, carrot, manganese, vitamin A, and vitamin D, along with proprietary blend components.

Potassium and calcium support bone and electrolyte balance. Vitamin K1 and vitamin D are essential for bone mineralization and clotting factors.

Manganese and vitamin A contribute to bone structure and immune function. The product also includes whole-food extracts from veal bone, kale, brussels sprouts, sweet potato, rice, and date to provide additional nutrient cofactors.

Inactive ingredients—honey, dicalcium phosphate, bovine bone, cellulose, and others—serve as binders, fillers, and capsule materials.

Does it work?

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

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

Why this rating?
  • The label markets this product for: Support healthy bone structure and function.
  • We looked for evidence on: Corticosteroid-induced osteoporosis, Fall prevention, Fractures, Fetal bone mineralization, Osteoporosis, Bone density — and 1 related terms.
  • The strongest evidence on file: Calcium is rated "Likely Effective" for Corticosteroid-induced osteoporosis (Natural Medicines).
  • Also on file: Calcium is rated "Likely Effective" for Osteoporosis.
  • Also on file: Vitamin D is rated "Likely Effective" for Corticosteroid-induced osteoporosis.

Our data shows calcium is likely effective for osteoporosis and effective for other conditions including kidney failure and low blood calcium. Vitamin K1 is effective for bleeding disorders and possibly effective for osteoporosis.

Vitamin D is effective for rickets, renal bone disease, and related mineral imbalances. Vitamin A is effective for vitamin A deficiency and possibly effective for measles, skin aging, and certain inflammatory conditions.

Manganese is effective for manganese deficiency but has insufficient evidence for osteoporosis, allergies, or other claims. Carrot shows insufficient evidence for cancer prevention or other conditions we hold data on.

Kale and date palm have insufficient evidence for their listed uses in our database. Potassium's effectiveness ratings are not on file for the conditions typically associated with bone health.

The evidence, ingredient by ingredient Black Psyllium Potassium Calcium Carrot Kale Date Palm Vitamin K Manganese

How safe is it?

Well-documented data
Safety Information · database check
Well characterized

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

Why this rating?
  • We hold adverse-effect (side-effect) data for 9 of the 10 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 10 of 10.
  • General safety write-ups exist for 10 of 10.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

Potassium is generally well tolerated orally, though high doses can cause serious heart rhythm problems and confusion; it's safe from food but supplements require medical guidance, especially in kidney disease. Pregnancy dietary potassium is fine, but avoid supplements unless directed.

Calcium is well tolerated at recommended doses but can cause constipation, bloating, or rarely kidney stones; stay within recommended amounts in pregnancy and breastfeeding. Vitamin K1 is generally safe in food and most supplements; check with your doctor before taking supplements in pregnancy or breastfeeding.

Vitamin A is safe at recommended amounts but builds up in the body—high doses can cause birth defects (especially as retinol), liver toxicity, and neurological symptoms; avoid high-dose supplements in pregnancy. Vitamin D is safe at recommended doses but excessive amounts cause toxicity with symptoms of high calcium levels; use only under doctor guidance in pregnancy.

Manganese is safe at dietary amounts but high-dose supplements risk neurotoxicity and irreversible Parkinson-like symptoms. Carrot as food is safe; concentrated supplements or seed products should be avoided in pregnancy and breastfeeding.

Kale and date as foods are safe in pregnancy and breastfeeding; concentrated supplements are less studied.

Side effects, ingredient by ingredient Black Psyllium Potassium Calcium Carrot Kale Date Palm Vitamin K Manganese

Meds to double-check

Major interaction found
Known Interaction Concern · database check
Major identified

At least one ingredient has a documented Major-severity interaction. Check your medications for a personalized result.

Why this rating?
  • 7 of the 10 matched ingredients can interact with medications — Black Psyllium, Manganese, Calcium, Potassium, Vitamin D, among others.
  • The most serious interaction on file is rated Major.
  • Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs; heart-rhythm medications; lithium.
  • For scale: 2,139 individual medications appear in the full list. A big number alone doesn't make a product dangerous — what matters is whether YOUR medication is on it, so run yours through the interaction checker on this page.

If you take warfarin (a blood thinner), do not start this product without checking first—both vitamin K1 and vitamin A can reduce its effectiveness. If you take dolutegravir or elvitegravir (HIV drugs), the calcium can drop your blood levels dangerously; separate doses by 2–6 hours.

If you take levothyroxine (thyroid medication), sotalol (heart rhythm drug), or atorvastatin (cholesterol medication), calcium reduces their absorption—space doses apart. If you take ACE inhibitors, ARBs, or potassium-sparing diuretics, the potassium raises your risk of dangerously high potassium levels.

If you take thiazide diuretics, verapamil, diltiazem, or digoxin, high-dose vitamin D can cause harmful high calcium levels. If you take antipsychotics, quinolone antibiotics, or tetracycline antibiotics, manganese may cause problems.

If you take ceftriaxone by IV, avoid IV calcium within 48 hours. If you take calcipotriene (psoriasis topical), calcium and vitamin D together increase hypercalcemia risk.

If you take any tetracycline antibiotics, avoid high-dose vitamin A. If you take hepatotoxic drugs or retinoids, check first—vitamin A toxicity is a real risk.

Check your own medication Run your meds through the checker above

The bottom line

Scorecard at a glanceFormula with limited ingredient disclosure with clinical evidence supporting its stated purpose. Major medication interactions have been identified, and safety information is well characterized.

This product is aimed at supporting bone health through minerals and vitamins. If you take warfarin, HIV medications, thyroid medication, heart rhythm drugs, or antipsychotics, talk to your pharmacist before starting—several ingredients can interfere with how these work.

Kidney disease or high potassium levels are red flags. Pregnancy, breastfeeding, or liver disease warrant a conversation with your doctor first.

Check your exact medications against the tool on this page.

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

Assessment coverage: 10 of 17 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

At a glance

General information

Key facts about Bone Health Daily Fundamentals, straight from the product label.

Brand SP Standard Process
Barcode (UPC) 812122012515
Net contents 60 Pack(s); 351 Gram(s); 12.38 Ounce(s)
Market status On market
Date entered into DSLD Jun 22, 2023
DSLD ID 292100
Product type Other Combinations
Supplement form Other (e.g. Tea Bag)
Dietary claims / uses All Other, Structure/Function
Intended target group(s) Adult (18 - 50 Years)
From the label
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.

Supplement Facts

The label details for Bone Health Daily Fundamentals by SP Standard Process, sourced from the NIH Dietary Supplement Label Database.

Supplement Facts

Daily Value (DV) Target Group(s):
Adults and children 4 or more years of age
Minimum serving Sizes:
1 Pack
Maximum serving Sizes:
1 Pack
Servings per container
60
UPC/BARCODE
812122012515
IngredientAmount% DV
Dietary Fiber1 Gram(s)1%
Potassium10 mg1%
Calcium370 mg28%
Proprietary Blend2275 mg--
Calories20 Calorie(s)--
Total Sugars1 Gram(s)--
Vitamin K14 mcg3%
Carrot0 NP--
Sweet Potato0 NP--
Rice0 NP--
Manganese8 mg348%
Phosphorus80 mg6%
Veal Bone0 NP--
Vitamin A150 mcg RAE17%
Veal Bone PMG extract0 NP--
Vitamin D20 mcg100%
defatted Wheat0 NP--
Kale0 NP--
Brussel Sprouts0 NP--
Date0 NP--

Other ingredients: Honey, Dicalcium Phosphate, Bovine Bone, Cellulose, Calcium Lactate, Gelatin, Milk, Powder, Manganese Lactate, Calcium Stearate, Potassium Citrate, Arabic Gum, Glycerine, Water, Cholecalciferol, Sucrose, Starch, Vitamin A Palmitate, Ascorbic Acid

Tap any ingredient to jump to its full detail below.

Label statements
These statements are the manufacturer’s wording, reproduced from the product label — the label is saying it, not HelloPharmacist. We don’t verify or endorse them.
FDA Statement of Identity

Dietary Supplement

General Statements

60 - 5.9 g (0.21 oz) packs

Whole Food Supplement Since 1929

Suggested/Recommended/Usage/Directions

Suggested Use: Contents of 1 pack each morning and evening.

Precautions

Warning: This product contains naturally occurring vitamin K1. All forms of vitamin K may interact with blood thinning medications. If you are taking such medicines, please consult with your health care professional before taking this product.

Caution: This product is processed in a facility that manufacturers other products containing soy, milk, egg, wheat, peanut, tree nuts, fish, and shellfish.

Formula

Calcifood (three wafers)- Provides calcium Cataplex D (one tablet)- Supports and maintains healthy bone density Cruciferous Complete (one capsule)- Helps move calcium into bones Ostrophin PMG (two tablets)- Supports healthy bone function

FDA Disclaimer Statement

These statements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure, or prevent any disease.

See for yourself

Bone Health Daily Fundamentals by SP Standard Process label

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

What’s inside

The Ingredients in Bone Health Daily Fundamentals by SP Standard Process

These are the 17 active ingredients this product is made of. Select any to open its full monograph.

Serving size1 Pack Dosage formOther (e.g. Tea Bag) Servings per container60 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.

Dietary Fiber

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

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

Dietary Fiber monograph & interactions

Potassium

Interacts with
62 drugs
10 mg per serving

Potassium is an essential mineral your body needs for nerve signals, muscle function, and a steady heartbeat, and most people get enough from a balanc...

Potassium monograph & interactions

Calcium

Interacts with
168 drugs
370 mg per serving

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 & interactions

Proprietary Blend

2275 mg per serving
  • Carrot
  • › Sweet Potato
  • › Rice
  • › Veal Bone
  • › Veal Bone PMG extract
  • › Defatted Wheat
  • Kale
  • › Brussel Sprouts
  • Date

Vitamin K1

Interacts with
2 drugs
4 mcg per serving

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 K1 monograph & interactions

Manganese

Interacts with
83 drugs
8 mg per serving

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 & interactions

Phosphorus

80 mg per serving

Vitamin A

Interacts with
387 drugs
150 mcg RAE per serving

Vitamin A is an essential nutrient important for vision, skin, immune function, and growth. Most people get enough from a balanced diet, and supplemen...

Vitamin A monograph & interactions

Vitamin D

Interacts with
715 drugs
20 mcg per serving

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 & interactions

Other (inactive) ingredients: Honey, Dicalcium Phosphate, Bovine Bone, Cellulose, Calcium Lactate, Gelatin, Milk, Powder, Manganese Lactate, Calcium Stearate, Potassium Citrate, Arabic Gum, Glycerine, Water, Cholecalciferol, Sucrose, Starch, Vitamin A Palmitate, Ascorbic Acid. These complete the product’s ingredient list but are not active constituents.

Interaction report

Bone Health Daily Fundamentals by SP Standard Process Drug Interactions

Want to check YOUR meds against Bone Health Daily Fundamentals?

Ask about interactions with your drugs in plain English — “Can I take it with lisinopril?” — and we find you the answer in seconds, ingredient by ingredient.

Go to the checker
2,138Drugs
18 Major 572 Moderate 1,548 Minor

Ingredients driving the most interactions

Vitamin D 715
Vitamin A 387
Calcium 168

Each ingredient & the kinds of drugs it affects

For each ingredient in Bone Health Daily Fundamentals with known interactions, here are the types of medications they can affect. Open any type for the detail — or search your exact drug in the checker above.

Dietary Fiber7 drug types · 2,025 drugs

Carbamazepine (Tegretol)

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

Likelihood Probable Evidence D
Lithium

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

Likelihood Probable Evidence D
Metformin (Glucophage)

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

Likelihood Possible Evidence D
Olanzapine (Zyprexa)

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

Likelihood Possible Evidence D
Digoxin (Lanoxin)

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

Likelihood Unlikely Evidence B
Ethinyl Estradiol

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

Likelihood Unlikely Evidence D
Oral Drugs

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

Likelihood Possible Evidence B

Vitamin D8 drug types · 715 drugs

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.

Likelihood Probable Evidence B
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.

Likelihood Probable Evidence B
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.

Likelihood Probable Evidence D
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.

Likelihood Possible Evidence D
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.

Likelihood Probable Evidence B
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.

Likelihood Probable Evidence D
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.

Likelihood Probable Evidence B
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.

Likelihood Possible Evidence D

Vitamin A4 drug types · 387 drugs

Retinoids

Concomitant use of retinoids with vitamin A supplements might produce supratherapeutic vitamin A levels.
Retinoids, which are vitamin A derivatives, could have additive toxic effects when taken with vitamin A supplements.

Likelihood Probable Evidence D
Hepatotoxic Drugs

Theoretically, taking high doses of vitamin A in combination with other potentially hepatotoxic drugs might increase the risk of liver disease.
The tolerable upper intake level (UL) is the highest level of intake that is likely to pose no risk of adverse effects. Doses of vitamin A above the UL can cause hepatotoxicity, ranging from elevated liver enzymes to liver failure.

Likelihood Possible Evidence C
Tetracycline Antibiotics

Theoretically, taking tetracycline antibiotics with high doses of vitamin A can increase the risk of pseudotumor cerebri.
Benign intracranial hypertension (pseudotumor cerebri) can occur with tetracyclines and with acute or chronic vitamin A toxicity. Case reports suggest that taking tetracyclines and vitamin A concurrently can increase the risk of this condition. Avoid high doses of vitamin A in people taking tetracyclines chronically.

Likelihood Possible Evidence D
Warfarin (Coumadin)

Theoretically, high doses of vitamin A could increase the risk of bleeding with warfarin.
Vitamin A toxicity is associated with hemorrhage and hypoprothrombinemia, possibly due to vitamin K antagonism. Advise patients taking warfarin to avoid doses of vitamin A above the tolerable upper intake level of 10,000 IU/day for adults.

Likelihood Possible Evidence D

Calcium18 drug types · 168 drugs

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.

Likelihood Probable Evidence D
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.

Likelihood Probable Evidence B
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.

Likelihood Probable Evidence B
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.

Likelihood Possible Evidence B
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.

Likelihood Probable Evidence D
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.

Likelihood Probable Evidence C
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.

Likelihood Possible Evidence B
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.

Likelihood Possible Evidence B
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.

Likelihood Probable Evidence D
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.

Likelihood Probable Evidence B
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.

Likelihood Possible Evidence B
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.

Likelihood Probable Evidence B
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.

Likelihood Possible Evidence B
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.

Likelihood Possible Evidence B
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.

Likelihood Probable Evidence C
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.

Likelihood Probable Evidence C
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.

Likelihood Probable Evidence D
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.

Likelihood Unlikely Evidence D

Manganese3 drug types · 83 drugs

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.

Likelihood Possible Evidence D
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.

Likelihood Probable Evidence D
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.

Likelihood Probable Evidence D

Potassium3 drug types · 62 drugs

Ace Inhibitors (Aceis)

Using ACEIs with high doses of potassium increases the risk of hyperkalemia.
ACEIs block the actions of the renin-angiotensin-aldosterone system and reduce potassium excretion. Concomitant use of these drugs with potassium supplements increases the risk of hyperkalemia. However, concomitant use of these drugs with moderate dietary potassium intake (about 3775-5200 mg daily) does not increase serum potassium levels.

Likelihood Likely Evidence C
Angiotensin Receptor Blockers (Arbs)

Using ARBs with high doses of potassium increases the risk of hyperkalemia.
ARBs block the actions of the renin-angiotensin-aldosterone system and reduce potassium excretion. Concomitant use of these drugs with potassium supplements increases the risk of hyperkalemia. However, concomitant use of these drugs with moderate dietary potassium intake (about 3775-5200 mg daily) does not increase serum potassium levels.

Likelihood Likely Evidence C
Potassium-Sparing Diuretics

Concomitant use increases the risk of hyperkalemia.
Using potassium-sparing diuretics with potassium supplements increases the risk of hyperkalemia.

Likelihood Likely Evidence C

Vitamin K11 drug type · 2 drugs

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.

Likelihood Likely Evidence C
The maker

Brand information

Manufacturer and brand details for Bone Health Daily Fundamentals, from the product label.

SP Standard Process

See all SP Standard Process products
Name
Standard Process Inc.
Street Address
1200 West Royal Lee Drive
City
Palmyra
State
WI
ZipCode
53156
Web Address
www.standardprocess.com
Pharmacist Counseling Corner

Bone Health Daily Fundamentals by SP Standard Process: Common Questions

Does Bone Health Daily Fundamentals by SP Standard Process interact with any medications?
Yes. Based on its ingredients, Bone Health Daily Fundamentals has a known interaction with 2,138 medications, including 18 rated major. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Bone Health Daily Fundamentals contains 17 active ingredients, and an interaction can come from any of them. We check every ingredient, combine the results into one list per medication, and show which ingredient and mechanism is responsible.
Where does this information come from?
The product label data comes from the NIH Dietary Supplement Label Database (DSLD); the interaction data is built on the Natural Medicines database and reviewed by HelloPharmacist pharmacists.
Can I take this if I'm pregnant?
Most ingredients are listed as likely safe at normal dietary and recommended supplement amounts—calcium, vitamin K1, carrot, and kale are considered appropriate. However, vitamin A and vitamin D require caution at high doses due to birth defect risk (vitamin A) and potential toxicity (vitamin D), and potassium and manganese supplements should be used only under your doctor's guidance. Talk with your provider before starting, especially if you'll be taking more than the recommended amount.
Can I take this while breastfeeding?
Dietary amounts of most ingredients are appropriate—calcium, vitamin K1, carrot, and kale are considered safe when breastfeeding. However, potassium and manganese supplements should be discussed with your clinician first, and high-dose vitamin A and vitamin D should be avoided unless directed. Vitamin D at recommended doses is considered acceptable. Check with your provider about concentrated supplement forms of any ingredient.
What does each main ingredient do for bone health?
Calcium and vitamin D work together: calcium provides the mineral structure of bone, and vitamin D helps your body absorb and use calcium. Vitamin K1 activates bone proteins needed for mineralization. Potassium and manganese support bone structure. Vitamin A contributes to bone cell function. The whole-food extracts (kale, carrot, etc.) provide additional cofactors and nutrients that support overall skeletal health.
Is there good evidence this product works for osteoporosis?
Calcium is likely effective for osteoporosis, and vitamin K1 is possibly effective. Vitamin D is effective for related bone diseases like rickets and renal bone disease. The evidence for manganese and the vegetable extracts for osteoporosis is insufficient in our data. The combination approach makes sense, but individual results vary—talk with your doctor about whether this product fits your bone health plan.
What are the most common side effects?
Calcium commonly causes constipation, bloating, or stomach upset. Potassium can cause abdominal pain, diarrhea, nausea, or gas. Vitamin A in high doses causes dry skin, rashes, and hair loss. Vitamin K1 may cause mild nausea or diarrhea. Manganese at recommended doses is generally well tolerated. If you experience persistent GI upset or skin changes, mention it to your pharmacist.
Will this interact with my blood pressure or heart medications?
Possibly, depending on which medication you take. Potassium interacts with certain blood pressure drugs (ACE inhibitors, ARBs, potassium-sparing diuretics) and raises your risk of dangerously high potassium. Vitamin D can interact with calcium channel blockers and thiazide diuretics. Calcium can reduce the effectiveness of some heart rhythm medications. Use the medication checker on this page with your exact prescription names before you start.

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.

Bone Health Daily Fundamentals label
Go deeper

The Full Monographs Behind Bone Health Daily Fundamentals’s Ingredients

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

Herb & supplement monograph

Black Psyllium

Interacts with 2,025 drugs

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

Read the full Black Psyllium monograph →
Herb & supplement monograph

Potassium

Interacts with 62 drugs

Potassium is an essential mineral your body needs for nerve signals, muscle function, and a steady heartbeat, and most people get enough from a balanced diet rich in fruits and vegetables. P...

Read the full Potassium monograph →
Herb & supplement monograph

Calcium

Interacts with 168 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 falls short. Most people do best getting...

Read the full Calcium monograph →
Herb & supplement monograph

Carrot

Carrot is a common food vegetable that is a rich source of beta-carotene (which the body turns into vitamin A) and other nutrients. Eating carrots is safe and nutritious for most people, but...

Read the full Carrot monograph →
Herb & supplement monograph

Kale

Kale is a nutrient-dense leafy green vegetable that is rich in vitamins, minerals, fiber, and antioxidants. Eaten as a normal food it is very healthy for most people, but it is a whole food...

Read the full Kale monograph →
Herb & supplement monograph

Date Palm

Date palm fruit is a nutritious food rich in natural sugars, fiber, and antioxidants, and is widely eaten as part of a healthy diet. Beyond its value as food, evidence for medicinal benefits...

Read the full Date Palm monograph →
Herb & supplement monograph

Vitamin K

Interacts with 2 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 supplements are sometimes used for deficiency...

Read the full Vitamin K monograph →
Herb & supplement monograph

Manganese

Interacts with 83 drugs

Manganese 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 monograph

Vitamin A

Interacts with 387 drugs

Vitamin A is an essential nutrient important for vision, skin, immune function, and growth. Most people get enough from a balanced diet, and supplements are mainly useful for correcting a tr...

Read the full Vitamin A monograph →
Herb & supplement monograph

Vitamin D

Interacts with 715 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, especially those with low sun exposure,...

Read the full Vitamin D monograph →
Sources

Sources & How We Checked

Bone Health Daily Fundamentals's label data comes from the NIH Dietary Supplement Label Database; the ingredient interaction data is from the Natural Medicines database, reviewed by our pharmacists.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

The 206 references behind this product’s interaction data

Every citation that drives the interaction findings for this product’s ingredients, from the evidence-graded Natural Medicines (TRC Healthcare) database. Open an ingredient to browse its citations — links open the study on PubMed or the publisher’s site.

Black Psyllium 18 references
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  3. Covington TR, et al. Handbook of Nonprescription Drugs. 11th ed. Washington, DC: American Pharmaceutical Association, 1996.
  4. Etman M. Effect of a bulk forming laxative on the bioavailablility of carbamazepine in man. Drug Dev Ind Pharm 1995;21:1901-6.
  5. Perlman BB. Interaction between lithium salts and ispaghula husk. Lancet 1990;335:416.
  6. Vaswani SK, Hamilton RG, Valentine MD, Adkinson NF. Psyllium laxative-induced anaphylaxis, asthma, and rhinitis. Allergy 1996;51:266-8. PubMed
  7. Lantner RR, Espiritu BR, Zumerchik P, Tobin MC. Anaphylaxis following ingestion of a psyllium-containing cereal. JAMA 1990;264:2534-6. DOI
  8. Kaplan MJ. Anaphylactic reaction to "Heartwise." N Engl J Med 1990;323:1072-3. DOI
  9. Nordstrom M, Melander A, Robertsson E, Steen B. Influence of wheat bran and of a bulk-forming ispaghula cathartic on the bioavailability of digoxin in geriatric in-patients. Drug Nutr Interact 1987;5:67-9..
  10. Robinson DS, Benjamin DM, McCormack JJ. Interaction of warfarin and nonsystemic gastrointestinal drugs. Clin Pharmacol Ther 1971;12:491-5. PubMed
  11. Garcia JJ, Fernandez N, Diez MJ, et al. Influence of two dietary fibers in the oral bioavailability and other pharmacokinetic parameters of ethinyloestradiol. Contraception 2000;62:253-7. PubMed
  12. Fernandez N, Lopez C, Díez R, et al. Drug interactions with the dietary fiber Plantago ovata husk. Expert Opin Drug Metab Toxicol 2012;8(11):1377-86.
  13. Semen plantaginis in: WHO Monographs on Selected Medicinal Plants, volume 1. World Health Organization, Geneva, 1999. Available at http://apps.who.int/medicinedocs/en/d/Js2200e/. Accessed November 26, 1026.
  14. Code of Federal Regulations, Title 21 (21CFR 101.17). Food labeling warning, notice, and safe handling statements. Available at www.ecfr.gov/cgi-bin/text-idx?SID=20f647d3b74161501f46564b915b4048&mc=true&node=se21.2.101_117&rgn=div8. Accessed December 3, 2
  15. Code of Federal Regulations, Title 21 (21CFR 201.319). Specific labeling requirements - water-soluble gums, hydrophilic gums, and hydrophilic mucilloids. Available at www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?fr=201.319. Accessed Dece
  16. Diez R, Garcia JJ, Diez MJ, Sierra M, Sahagun AM, Fernandez N. Influence of Plantago ovata husk (dietary fiber) on the bioavailability and other pharmacokinetic parameters of metformin in diabetic rabbits. BMC Complement Altern Med. 2017 Jun 7;17(1):298. PubMed
  17. Chiu AC, Sherman SI. Effects of pharmacological fiber supplements on levothyroxine absorption. Thyroid. 1998;8(8):667-71. PubMed
  18. Merrick C, Madden CA, Capurso NA. A Case of Blunted Orally Disintegrating Olanzapine Effect Due to Coadministered Psyllium. J Clin Psychiatry 2021;82(2):20cr13633. PubMed

See these in context on the Black Psyllium monograph →

Potassium 12 references
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  3. Whelton PK, He J, Cutler JA, et al. Effects of oral potassium on blood pressure. Meta-analysis of randomized controlled clinical trials. JAMA 1997;277:1624-32. PubMed
  4. Phillips, C. O., Kashani, A., Ko, D. K., Francis, G., and Krumholz, H. M. Adverse effects of combination angiotensin II receptor blockers plus angiotensin-converting enzyme inhibitors for left ventricular dysfunction: a quantitative review of data from ra DOI
  5. Altieri, P. I., Herrero, C., Suero, R., and Ortiz, A. Bleeding duodenal ulcer in a patient taking slow-releasing potassium tablets. Bol.Asoc.Med P.R. 1977;69(8):276.
  6. Raf, L. E. Enteric-coated potassium chloride tablets and ulcer of the small intestine. Acta Chir Scand Suppl 1967;(374):1-87.
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  10. Malta D, Arcand J, Ravindran A, Floras V, Allard JP, Newton GE. Adequate intake of potassium does not cause hyperkalemia in hypertensive individuals taking medications that antagonize the renin angiotensin aldosterone system. Am J Clin Nutr 2016 Oct;104(4 PubMed
  11. Keskin M, Kaya A, Tatlisu MA, et al. The effect of serum potassium level on in-hospital and long-term mortality in ST elevation myocardial infarction. Int J cardiol. 2016 Oct 15;221:505-10.
  12. Stallings VA, Harrison M, Oria M; Committee to Review the Dietary Reference Intakes for Sodium and Potassium, Food and Nutrition Board, Health and Medicine Division, National Academies of Sciences, Engineering, and Medicine. Washington (DC): National Acad

See these in context on the Potassium monograph →

Calcium 62 references
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See these in context on the Calcium monograph →

Vitamin K 11 references
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  2. 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.
  3. Crowther MA, Ageno W, Garcia D, et al. Oral vitamin K versus placebo to correct excessive anticoagulation in patients receiving warfarin: a randomized trial. Ann Intern Med. 2009;150(5):293-300. PubMed
  4. Dietary vitamin K guidance: an effective strategy for stable control of oral anticoagulation? Nutr Rev. 2010;68(3):178-81. PubMed
  5. Kim JS, Nafziger AN, Gaedigk A, et al. Effects of oral vitamin K on S- and R-warfarin pharmacokinetics and pharmacodynamics: enhanced safety of warfarin as a CYP2C9 probe. J Clin Pharmacol. 2001 Jul;41(7):715-22. PubMed
  6. Riegert-Johnson, D. L. and Volcheck, G. W. The incidence of anaphylaxis following intravenous phytonadione (vitamin K1): a 5-year retrospective review. Ann.Allergy Asthma Immunol. 2002;89(4):400-406. PubMed
  7. Dezee, K. J., Shimeall, W. T., Douglas, K. M., Shumway, N. M., and O'malley, P. G. Treatment of excessive anticoagulation with phytonadione (vitamin K): a meta-analysis. Arch.Intern.Med. 2-27-2006;166(4):391-397. DOI
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See these in context on the Vitamin K monograph →

Carrot 14 references
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Manganese 21 references
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Vitamin A 31 references
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Vitamin D 26 references
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  10. Demontis R, Reissi D, Noel C, et al. Indirect clinical evidence that 1alphaOH vitamin D<SUB>3</SUB> increases the intestinal absorption of aluminum. Clin Nephrol 1989;31:123-7.
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Kale 2 references
  1. Vitamin K - Health Professional Fact Sheet — NIH Office of Dietary Supplements Source
  2. Lutein and Zeaxanthin — NIH Office of Dietary Supplements Source

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Date Palm 9 references
  1. Kwaasi, A. A., Harfi, H. A., Parhar, R. S., Saleh, S., Collison, K. S., Panzani, R. C., Al Sedairy, S. T., and Al Mohanna, F. A. Cross-reactivities between date palm (Phoenix dactylifera L.) polypeptides and foods implicated in the oral allergy syndrome.
  2. Bener, A., Safa, W., Abdulhalik, S., and Lestringant, G. G. An analysis of skin prick test reactions in asthmatics in a hot climate and desert environment. Allerg.Immunol.(Paris) 2002;34(8):281-286.
  3. Bauza, E., Dal Farra, C., Berghi, A., Oberto, G., Peyronel, D., and Domloge, N. Date palm kernel extract exhibits antiaging properties and significantly reduces skin wrinkles. Int.J.Tissue React. 2002;24(4):131-136.
  4. Blanco, C., Carrillo, T., Quiralte, J., Pascual, C., Martin, Esteban M., and Castillo, R. Occupational rhinoconjunctivitis and bronchial asthma due to Phoenix canariensis pollen allergy. Allergy 1995;50(3):277-280.
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  7. Bagherzadeh Karimi A, Elmi A, Mirghafourvand M, Baghervand Navid R. Effects of date fruit (Phoenix dactylifera L.) on labor and delivery outcomes: a systematic review and meta-analysis. BMC Pregnancy Childbirth. 2020 Apr 14;20(1):210. PubMed
  8. Al Jaouni SK, Hussein A, Alghamdi N, et al. Effects of Phoenix dactylifera Ajwa on infection, hospitalization, and survival among pediatric cancer patients in a university hospital: A nonrandomized controlled trial. Integr Cancer Ther. 2019;18:15347354198
  9. Royani I, As'ad S, Mappaware NA, Hatta M, Rabia. Effect of Ajwa dates consumption to inhibit the progression of preeclampsia threats on mean arterial pressure and roll-over test. Biomed Res Int. 2019 Dec 10;2019:2917895. PubMed

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

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