Calm Ingredients & Drug Interactions
What is this page for?
First and foremost: checking Calm 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
Calm is a dietary supplement by Martin Avenue Pharmacy with 10 active ingredients. Its ingredients are commonly taken for preventing or treating thiamine deficiency, beriberi, wernicke-korsakoff syndrome (alcohol-related).Based on those ingredients, 1,172 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are Valerian, Passion Flower, Magnesium. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against Calm by Martin Avenue Pharmacy
Ask about any prescription or over-the-counter medication and we check it for interactions with Calm by Martin Avenue Pharmacy — 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 Calm by Martin Avenue Pharmacy
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
Calm by Martin Avenue Pharmacy contains 10 active ingredients. Thiamine (vitamin B1) is included to support energy metabolism and help with thiamine deficiency.
Pantothenic acid (vitamin B5) supports energy production and may help with skin health. Calcium and magnesium are minerals important for bone health, muscle function, and nervous system support.
Niacinamide (vitamin B3) supports cellular energy and skin health. The herbal components — valerian, passion flower, and a proprietary blend — are traditionally used to promote relaxation and sleep.
Glutamic acid and raw brain concentrate are also included. The tablet also contains inactive ingredients: cellulose, vegetable stearate, and silica, which are common binders and flow agents.
Does it work?
Strong evidence
Thiamine is effective for treating thiamine deficiency and Wernicke-Korsakoff syndrome; it's possibly effective for menstrual cramps (dysmenorrhea) but possibly ineffective for heart failure. Pantothenic acid is effective for pantothenic acid deficiency but lacks sufficient evidence for hay fever, alcoholism, and hair loss.
Calcium is effective for treating low blood calcium (hypocalcemia), kidney failure-related issues, and heartburn, and is likely effective for osteoporosis. Magnesium is effective for heartburn, constipation, and low magnesium (hypomagnesemia), and was effective in clinical trials for preventing seizures in eclampsia during pregnancy.
Niacinamide is likely effective for pellagra (a niacin-deficiency disease) and possibly effective for acne, high blood phosphate levels, and joint arthritis. Valerian is possibly effective for insomnia and pre-procedural anxiety.
Passion flower is possibly effective for insomnia and anxiety before medical procedures. We hold no effectiveness data on glutamic acid, raw brain concentrate, or the proprietary herbal blend.
How safe is it?
Well-documented data
Thiamine is generally very safe at normal doses; it's needed in pregnancy and breastfeeding, so use supplement doses only as your doctor advises. Pantothenic acid is considered safe at typical supplement doses; in pregnancy and breastfeeding, food amounts and prenatal vitamins are fine, but talk to your doctor before high-dose supplements.
Calcium is generally safe at recommended amounts; very high doses may raise concerns about kidney stones and (with some evidence) cardiovascular and prostate health, so stay within advised limits. Niacinamide is usually well tolerated at recommended amounts, though high doses can cause dizziness, drowsiness, itching, rash, and gastrointestinal upset; it's likely safe in pregnancy and breastfeeding at normal dietary and prenatal-vitamin levels.
Valerian is generally well tolerated short-term but should be avoided in pregnancy and breastfeeding due to insufficient safety data; it can cause drowsiness, dizziness, and headache, and if you take it long-term and stop suddenly, you may experience withdrawal symptoms like anxiety and insomnia. Magnesium is generally safe at recommended amounts and is needed in pregnancy, though supplements require your doctor's guidance; at normal dietary levels it's well tolerated, though high doses may cause diarrhea and, rarely, gastrointestinal complications.
Passion flower is generally well tolerated short-term but should be avoided in pregnancy and breastfeeding; it commonly causes drowsiness and dizziness. We hold no pregnancy and breastfeeding safety data on glutamic acid, raw brain concentrate, or the proprietary herbal blend.
Meds to double-check
Major interaction found
Check with your pharmacist before taking Calm if you take HIV medications like dolutegravir (Tivicay), elvitegravir (Vitekta), or raltegravir (Isentress); the antibiotic ceftriaxone (Rocephin) given intravenously; Parkinson's medications like levodopa/carbidopa (Sinemet); or blood thinners such as warfarin (Coumadin). Also check if you take heart or blood pressure medications (diltiazem, sotalol, calcium channel blockers), thyroid medication (levothyroxine/Synthroid), muscle relaxants, the antibiotic trimethoprim (Proloprim), seizure medications (carbamazepine, primidone), sedatives (alprazolam/Xanax, other CNS depressants), or quinolone antibiotics — all have documented interactions with one or more ingredients in this product.
The bottom line
Scorecard at a glanceFully disclosed formula with strong clinical evidence behind its ingredients' uses. Major medication interactions have been identified, and safety information is well characterized.
Calm may appeal to people looking for a multi-ingredient support for relaxation and sleep, with B vitamins and minerals for general wellness. However, if you take any prescription medications — especially antiretrovirals, heart medicines, thyroid medication, blood thinners, seizure drugs, or sedatives — you need to check your exact medications with the tool on this page before starting.
Talk to your pharmacist or doctor about whether Calm is right for you, especially if you're pregnant, breastfeeding, or managing any chronic condition.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 7 of 10 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Feb 25, 2013.
This Scorecard evaluates available label information, ingredient evidence, and known medication-safety considerations. It does not independently verify product identity, purity, potency, contamination, or manufacturing quality. How these ratings are computed
General information
Key facts about Calm, straight from the product label.
| Brand | Martin Avenue Pharmacy |
|---|---|
| Net contents | 60 Tablet(s) |
| Market status | On market |
| Date entered into DSLD | Feb 25, 2013 |
| DSLD ID | 18837 |
| Product type | Other Combinations |
| Supplement form | Tablet Or Pill |
| Dietary claims / uses | All Other, Structure/Function |
| Intended target group(s) | Adult (18 - 50 Years), Dairy Free, Sugar 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 Calm by Martin Avenue Pharmacy, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Thiamine | 50 mg | 3333% |
| Pantothenic Acid | 50 mg | 500% |
| Calcium | 50 mg | 5% |
| Niacinamide | 100 mg | 500% |
| Glutamic Acid | 50 mg | -- |
| Valerian | 200 mg | -- |
| Magnesium | 100 mg | 25% |
| Raw Brain Concentrate | 500 mg | -- |
| Passion Flower | 200 mg | -- |
| Proprietary Herbal Blend | 75 mg | -- |
Other ingredients: Cellulose, Vegetable Stearate, Silica
Tap any ingredient to jump to its full detail below.
These statements are the manufacturer’s wording, reproduced from the product label — the label is saying it, not HelloPharmacist. We don’t verify or endorse them.
General Statements
"We Make It Better..."
Natural Relaxing Formula For support of healthy nerve and brain function
QUALITY AND POTENCY GUARANTEED
Formulation
This product contains NO yeast, wheat gluten, soy protein, milk/dairy, corn, sodium, sugar, starch, artificial coloring, preservatives or flavoring.
Suggested/Recommended/Usage/Directions
Suggested Usage: As a dietary supplement, adults take 2 tablets daily or as directed by physician.
Precautions
Keep out of reach of children.
Tamper resistant package, do not use if outer seal is missing.
Storage
Store in a cool, dry place.
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.
General
#10028
FDA Statement of Identity
Dietary Supplement
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Calm by Martin Avenue Pharmacy 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 Calm by Martin Avenue Pharmacy
These are the 10 active ingredients this product is made of. Select any to open its full monograph.
Serving size2 Tablet(s) Dosage formTablet Or Pill Servings per container30 Amounts shown are per serving.
Most supplement products combine several ingredients, and a medication can interact with the product through any one of them. Each ingredient below shows whether it has known drug interactions.
Thiamine
Interacts with3 drugs
Thiamine (vitamin B1) is an essential nutrient your body needs to turn food into energy and to keep your nerves and heart healthy. Most people get eno...
Thiamine monograph & interactionsPantothenic Acid
No knowninteractions
Pantothenic acid is vitamin B5, an essential nutrient your body uses to turn food into energy. True deficiency is very rare because it is found in nea...
Pantothenic Acid 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 & interactionsNiacinamide
Interacts with124 drugs
Niacinamide (also called nicotinamide) is a form of vitamin B3 used in supplements and skin-care products. It is well established for preventing and t...
Niacinamide monograph & interactionsGlutamic Acid
Valerian
Interacts with902 drugs
Valerian is an herb whose root is widely used as a natural sleep aid and for calming nerves. The evidence is mixed and often weak, so it may help some...
Valerian monograph & interactionsMagnesium
Interacts with295 drugs
Magnesium is an essential mineral your body needs for muscles, nerves, blood pressure, and many other functions, and supplements are useful for preven...
Magnesium monograph & interactionsRaw Brain Concentrate
Passion Flower
Interacts with836 drugs
Passion flower is a traditional calming herb that many people use for anxiety and sleep. Early studies hint it may help with mild anxiety and restless...
Passion Flower monograph & interactionsProprietary Herbal Blend
Other (inactive) ingredients: Cellulose, Vegetable Stearate, Silica. These complete the product’s ingredient list but are not active constituents.
Calm by Martin Avenue Pharmacy Drug Interactions
HelloPharmacist Interaction Report
Martin Avenue Pharmacy's Calm contains multiple ingredients with documented interactions with medications.
The most serious concern is calcium, which has a Major interaction with the HIV integrase inhibitor dolutegravir (Tivicay) — calcium can reduce dolutegravir levels by nearly 40%, requiring doses to be separated by at least 2 hours before or 6 hours after. Calcium also has Major interactions with the antiretroviral elvitegravir (Vitekta) and the antibiotic ceftriaxone (Rocephin) given intravenously, both of which require careful timing or avoidance.
Read the full breakdown — every affected drug type, severity by severity
Magnesium has a Major interaction with levodopa/carbidopa (Sinemet), reducing levodopa availability by 35%, which can significantly affect symptom control in Parkinson's disease. Several ingredients carry Moderate interactions: calcium with the blood thinner warfarin (Coumadin), heart medications like diltiazem and the antiarrhythmic sotalol, and the thyroid medication levothyroxine (Synthroid); niacinamide with the blood thinner warfarin, the seizure medication carbamazepine, and drugs processed through specific liver pathways; valerian with sedatives including alprazolam (Xanax) and alcohol; magnesium with muscle relaxants, potassium-sparing diuretics, quinolone antibiotics, and others; and passion flower with sedative medications.
Thiamine has a Minor interaction with the antibiotic trimethoprim (Proloprim), which may raise thiamine levels. Valerian and passion flower both have Minor interactions with certain enzyme-metabolized drugs.
We could not check three ingredients — glutamic acid, raw brain concentrate, and proprietary herbal blend — because we hold no interaction data for them.
Altogether, these interactions span 1,173 individual medications. Use the medication checker below to verify your exact prescriptions before taking this product.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against Calm?
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 Calm interact with 1,172 drugs. Click any drug to see the details.
6 of the 10 ingredients in Calm interact with drugs. Each result below shows which ingredient is responsible. Valerian Passion Flower Magnesium Calcium Niacinamide Thiamine
Benserazide, LevodopaMadopar, Prolopa
How Benserazide, Levodopa interacts with Calm — through 1 ingredient. Tap an ingredient for the detail:
MagnesiumLevodopa/carbidopa (sinemet) Major
Interaction Summary
Magnesium can reduce the bioavailability of levodopa/carbidopa.
Read the full Magnesium + Benserazide, Levodopa interactionCarbidopaLodosyn
How Carbidopa interacts with Calm — through 1 ingredient. Tap an ingredient for the detail:
MagnesiumLevodopa/carbidopa (sinemet) Major
Interaction Summary
Magnesium can reduce the bioavailability of levodopa/carbidopa.
Read the full Magnesium + Carbidopa interactionCarbidopa, LevodopaDhivy, Rytary, Sinemet, Sinemet CR
How Carbidopa, Levodopa interacts with Calm — through 1 ingredient. Tap an ingredient for the detail:
MagnesiumLevodopa/carbidopa (sinemet) Major
Interaction Summary
Magnesium can reduce the bioavailability of levodopa/carbidopa.
Read the full Magnesium + Carbidopa, Levodopa interactionCarbidopa, Levodopa, EntacaponeStalevo
How Carbidopa, Levodopa, Entacapone interacts with Calm — through 2 ingredients. Tap an ingredient for the detail:
MagnesiumLevodopa/carbidopa (sinemet) Major
Interaction Summary
Magnesium can reduce the bioavailability of levodopa/carbidopa.
Read the full Magnesium + Carbidopa, Levodopa, Entacapone interactionValerianGlucuronidated Drugs Moderate
Interaction Summary
Valerian might weakly inhibit glucuronidation and increase concentrations of drugs metabolized by UGT1A1 and UGT2B7.
Read the full Valerian + Carbidopa, Levodopa, Entacapone interactionCeftriaxoneRocephin
How Ceftriaxone interacts with Calm — 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 Calm — through 4 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 interactionMagnesiumBictegravir/emtricitabine/tenofovir Alafenamide (biktarvy) Moderate
Interaction Summary
Magnesium might decrease levels of bictegravir/emtricitabine/tenofovir alafenamide by reducing its absorption.
Read the full Magnesium + Cobicistat, Elvitegravir, Emtricitabine, Tenofovir Alafenamide Fumarate interactionPassion FlowerCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, passion flower might decrease the effects of CYP3A4 substrates.
Read the full Passion Flower + Cobicistat, Elvitegravir, Emtricitabine, Tenofovir Alafenamide Fumarate interactionValerianCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Valerian does not seem to have a clinically relevant effect on levels of drugs metabolized by CYP3A4.
Read the full Valerian + Cobicistat, Elvitegravir, Emtricitabine, Tenofovir Alafenamide Fumarate interactionDolutegravirTivicay
How Dolutegravir interacts with Calm — 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 interactionValerianGlucuronidated Drugs Moderate
Interaction Summary
Valerian might weakly inhibit glucuronidation and increase concentrations of drugs metabolized by UGT1A1 and UGT2B7.
Read the full Valerian + Dolutegravir interactionDolutegravir, Emtricitabine, Tenofovir AlafenamideDolutegravir, Emtricitabine, Tenofovir Alafenamide
How Dolutegravir, Emtricitabine, Tenofovir Alafenamide interacts with Calm — through 3 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 interactionValerianGlucuronidated Drugs Moderate
Interaction Summary
Valerian might weakly inhibit glucuronidation and increase concentrations of drugs metabolized by UGT1A1 and UGT2B7.
Read the full Valerian + Dolutegravir, Emtricitabine, Tenofovir Alafenamide interactionMagnesiumBictegravir/emtricitabine/tenofovir Alafenamide (biktarvy) Moderate
Interaction Summary
Magnesium might decrease levels of bictegravir/emtricitabine/tenofovir alafenamide by reducing its absorption.
Read the full Magnesium + Dolutegravir, Emtricitabine, Tenofovir Alafenamide interactionDolutegravir, RilpivirineJuluca
How Dolutegravir, Rilpivirine interacts with Calm — through 3 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 interactionValerianCytochrome P450 3a4 (cyp3a4) Substrates, Glucuronidated Drugs Moderate
Interaction Summary
Valerian does not seem to have a clinically relevant effect on levels of drugs metabolized by CYP3A4.
Read the full Valerian + Dolutegravir, Rilpivirine interactionPassion FlowerCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, passion flower might decrease the effects of CYP3A4 substrates.
Read the full Passion Flower + Dolutegravir, Rilpivirine interactionElvitegravirVitekta
How Elvitegravir interacts with Calm — through 3 ingredients. Tap an ingredient for the detail:
CalciumElvitegravir (vitekta) Major
Interaction Summary
Calcium seems to reduce levels of elvitegravir.
Read the full Calcium + Elvitegravir interactionValerianCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Valerian does not seem to have a clinically relevant effect on levels of drugs metabolized by CYP3A4.
Read the full Valerian + Elvitegravir interactionPassion FlowerCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, passion flower might decrease the effects of CYP3A4 substrates.
Read the full Passion Flower + Elvitegravir interactionElvitegravir, Cobicistat, Emtricitabine, Tenofovir Disoproxil FumarateStribild
How Elvitegravir, Cobicistat, Emtricitabine, Tenofovir Disoproxil Fumarate interacts with Calm — through 4 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 interactionMagnesiumBictegravir/emtricitabine/tenofovir Alafenamide (biktarvy) Moderate
Interaction Summary
Magnesium might decrease levels of bictegravir/emtricitabine/tenofovir alafenamide by reducing its absorption.
Read the full Magnesium + Elvitegravir, Cobicistat, Emtricitabine, Tenofovir Disoproxil Fumarate interactionPassion FlowerCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, passion flower might decrease the effects of CYP3A4 substrates.
Read the full Passion Flower + Elvitegravir, Cobicistat, Emtricitabine, Tenofovir Disoproxil Fumarate interactionValerianCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Valerian does not seem to have a clinically relevant effect on levels of drugs metabolized by CYP3A4.
Read the full Valerian + Elvitegravir, Cobicistat, Emtricitabine, Tenofovir Disoproxil Fumarate interactionLevodopaInbrija, Larodopa
How Levodopa interacts with Calm — through 1 ingredient. Tap an ingredient for the detail:
MagnesiumLevodopa/carbidopa (sinemet) Major
Interaction Summary
Magnesium can reduce the bioavailability of levodopa/carbidopa.
Read the full Magnesium + Levodopa interactionLevodopa, CarbidopaDuodopa
How Levodopa, Carbidopa interacts with Calm — through 1 ingredient. Tap an ingredient for the detail:
MagnesiumLevodopa/carbidopa (sinemet) Major
Interaction Summary
Magnesium can reduce the bioavailability of levodopa/carbidopa.
Read the full Magnesium + Levodopa, Carbidopa interactionAbciximabReoPro
How Abciximab interacts with Calm — through 2 ingredients. Tap an ingredient for the detail:
NiacinamideAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, niacinamide may have additive effects when used with anticoagulant or antiplatelet drugs, especially in patients on hemodialysis.
Read the full Niacinamide + Abciximab interactionMagnesiumAnticoagulant/antiplatelet Drugs Minor
Interaction Summary
Theoretically, magnesium may have antiplatelet effects, but the evidence is conflicting.
Read the full Magnesium + Abciximab interactionAbrocitinibCibinqo
How Abrocitinib interacts with Calm — through 2 ingredients. Tap an ingredient for the detail:
NiacinamideAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, niacinamide may have additive effects when used with anticoagulant or antiplatelet drugs, especially in patients on hemodialysis.
Read the full Niacinamide + Abrocitinib interactionMagnesiumAnticoagulant/antiplatelet Drugs Minor
Interaction Summary
Theoretically, magnesium may have antiplatelet effects, but the evidence is conflicting.
Read the full Magnesium + Abrocitinib interactionAcenocoumarolSintrom
How Acenocoumarol interacts with Calm — through 2 ingredients. Tap an ingredient for the detail:
NiacinamideAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, niacinamide may have additive effects when used with anticoagulant or antiplatelet drugs, especially in patients on hemodialysis.
Read the full Niacinamide + Acenocoumarol interactionMagnesiumAnticoagulant/antiplatelet Drugs Minor
Interaction Summary
Theoretically, magnesium may have antiplatelet effects, but the evidence is conflicting.
Read the full Magnesium + Acenocoumarol interactionAcepromazineAtravet
How Acepromazine interacts with Calm — through 2 ingredients. Tap an ingredient for the detail:
ValerianCns Depressants Moderate
Interaction Summary
Valerian can have additive sedative effects when used concomitantly with CNS depressant drugs.
Read the full Valerian + Acepromazine interactionPassion FlowerCns Depressants Moderate
Interaction Summary
Concomitant use of passion flower with sedative drugs might cause additive effects and side effects.
Read the full Passion Flower + Acepromazine interactionAcetaminophenChildren's Tylenol, Children's Tylenol Meltaways, Tylenol, Tylenol Ex Strength
How Acetaminophen interacts with Calm — through 1 ingredient. Tap an ingredient for the detail:
ValerianGlucuronidated Drugs Moderate
Interaction Summary
Valerian might weakly inhibit glucuronidation and increase concentrations of drugs metabolized by UGT1A1 and UGT2B7.
Read the full Valerian + Acetaminophen interactionAcetaminophen, AspirinGemnisyn
How Acetaminophen, Aspirin interacts with Calm — through 3 ingredients. Tap an ingredient for the detail:
ValerianGlucuronidated Drugs Moderate
Interaction Summary
Valerian might weakly inhibit glucuronidation and increase concentrations of drugs metabolized by UGT1A1 and UGT2B7.
Read the full Valerian + Acetaminophen, Aspirin interactionNiacinamideAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, niacinamide may have additive effects when used with anticoagulant or antiplatelet drugs, especially in patients on hemodialysis.
Read the full Niacinamide + Acetaminophen, Aspirin interactionMagnesiumAnticoagulant/antiplatelet Drugs Minor
Interaction Summary
Theoretically, magnesium may have antiplatelet effects, but the evidence is conflicting.
Read the full Magnesium + Acetaminophen, Aspirin interactionAcetaminophen, Aspirin, CaffeineExcedrin, Excedrin Extra Strength, Excedrin Migraine
How Acetaminophen, Aspirin, Caffeine interacts with Calm — through 4 ingredients. Tap an ingredient for the detail:
NiacinamideAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, niacinamide may have additive effects when used with anticoagulant or antiplatelet drugs, especially in patients on hemodialysis.
Read the full Niacinamide + Acetaminophen, Aspirin, Caffeine interactionValerianGlucuronidated Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Valerian might weakly inhibit glucuronidation and increase concentrations of drugs metabolized by UGT1A1 and UGT2B7.
Read the full Valerian + Acetaminophen, Aspirin, Caffeine interactionMagnesiumAnticoagulant/antiplatelet Drugs Minor
Interaction Summary
Theoretically, magnesium may have antiplatelet effects, but the evidence is conflicting.
Read the full Magnesium + Acetaminophen, Aspirin, Caffeine interactionPassion FlowerCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, passion flower might decrease the effects of CYP3A4 substrates.
Read the full Passion Flower + Acetaminophen, Aspirin, Caffeine interactionAcetaminophen, Brompheniramine, PhenylpropanolamineDimetapp Cold and Flu
How Acetaminophen, Brompheniramine, Phenylpropanolamine interacts with Calm — through 1 ingredient. Tap an ingredient for the detail:
ValerianGlucuronidated Drugs Moderate
Interaction Summary
Valerian might weakly inhibit glucuronidation and increase concentrations of drugs metabolized by UGT1A1 and UGT2B7.
Read the full Valerian + Acetaminophen, Brompheniramine, Phenylpropanolamine interactionAcetaminophen, ButalbitalAxocet, Bancap, Bucet, Butex Forte, Esgic CF, Orbivan CF +5 more
How Acetaminophen, Butalbital interacts with Calm — through 1 ingredient. Tap an ingredient for the detail:
ValerianGlucuronidated Drugs Moderate
Interaction Summary
Valerian might weakly inhibit glucuronidation and increase concentrations of drugs metabolized by UGT1A1 and UGT2B7.
Read the full Valerian + Acetaminophen, Butalbital interactionAcetaminophen, Butalbital, CaffeineEsgic, Esgic Plus, Fiogesic, Fioricet, Repan, Tecnal +1 more
How Acetaminophen, Butalbital, Caffeine interacts with Calm — through 2 ingredients. Tap an ingredient for the detail:
ValerianGlucuronidated Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Valerian might weakly inhibit glucuronidation and increase concentrations of drugs metabolized by UGT1A1 and UGT2B7.
Read the full Valerian + Acetaminophen, Butalbital, Caffeine interactionPassion FlowerCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, passion flower might decrease the effects of CYP3A4 substrates.
Read the full Passion Flower + Acetaminophen, Butalbital, Caffeine interactionAcetaminophen, Butalbital, Caffeine, CodeineEsgic with Codeine, Fioricet w/ Codeine
How Acetaminophen, Butalbital, Caffeine, Codeine interacts with Calm — through 2 ingredients. Tap an ingredient for the detail:
ValerianCytochrome P450 2d6 (cyp2d6) Substrates, Glucuronidated Drugs +2 Moderate
Interaction Summary
Valerian does not seem to have a clinically relevant effect on levels of drugs metabolized by CYP2D6.
Read the full Valerian + Acetaminophen, Butalbital, Caffeine, Codeine interactionPassion FlowerCns Depressants, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Concomitant use of passion flower with sedative drugs might cause additive effects and side effects.
Read the full Passion Flower + Acetaminophen, Butalbital, Caffeine, Codeine interactionAcetaminophen, Butalbital, CodeineBancap w/ Codeine
How Acetaminophen, Butalbital, Codeine interacts with Calm — through 2 ingredients. Tap an ingredient for the detail:
ValerianCytochrome P450 2d6 (cyp2d6) Substrates, Glucuronidated Drugs +1 Moderate
Interaction Summary
Valerian does not seem to have a clinically relevant effect on levels of drugs metabolized by CYP2D6.
Read the full Valerian + Acetaminophen, Butalbital, Codeine interactionPassion FlowerCns Depressants Moderate
Interaction Summary
Concomitant use of passion flower with sedative drugs might cause additive effects and side effects.
Read the full Passion Flower + Acetaminophen, Butalbital, Codeine interactionAcetaminophen, Butalbital, Codeine PhosphatePhrenilin #3
How Acetaminophen, Butalbital, Codeine Phosphate interacts with Calm — through 2 ingredients. Tap an ingredient for the detail:
ValerianCns Depressants, Cytochrome P450 2d6 (cyp2d6) Substrates +1 Moderate
Interaction Summary
Valerian can have additive sedative effects when used concomitantly with CNS depressant drugs.
Read the full Valerian + Acetaminophen, Butalbital, Codeine Phosphate interactionPassion FlowerCns Depressants Moderate
Interaction Summary
Concomitant use of passion flower with sedative drugs might cause additive effects and side effects.
Read the full Passion Flower + Acetaminophen, Butalbital, Codeine Phosphate interactionAcetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, PhenylephrineHycomine Compound
How Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interacts with Calm — through 2 ingredients. Tap an ingredient for the detail:
ValerianGlucuronidated Drugs, Cytochrome P450 2d6 (cyp2d6) Substrates +2 Moderate
Interaction Summary
Valerian might weakly inhibit glucuronidation and increase concentrations of drugs metabolized by UGT1A1 and UGT2B7.
Read the full Valerian + Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interactionPassion FlowerCytochrome P450 3a4 (cyp3a4) Substrates, Cns Depressants Moderate
Interaction Summary
Theoretically, passion flower might decrease the effects of CYP3A4 substrates.
Read the full Passion Flower + 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 Calm — through 2 ingredients. Tap an ingredient for the detail:
ValerianCytochrome P450 3a4 (cyp3a4) Substrates, Cns Depressants +2 Moderate
Interaction Summary
Valerian does not seem to have a clinically relevant effect on levels of drugs metabolized by CYP3A4.
Read the full Valerian + Acetaminophen, Caffeine, Codeine interactionPassion FlowerCns Depressants, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Concomitant use of passion flower with sedative drugs might cause additive effects and side effects.
Read the full Passion Flower + Acetaminophen, Caffeine, Codeine interactionAcetaminophen, Caffeine, Codeine, SalicylamideCodalan No.1, Codalan No.2, Codalan No.3
How Acetaminophen, Caffeine, Codeine, Salicylamide interacts with Calm — through 2 ingredients. Tap an ingredient for the detail:
ValerianGlucuronidated Drugs, Cytochrome P450 2d6 (cyp2d6) Substrates +2 Moderate
Interaction Summary
Valerian might weakly inhibit glucuronidation and increase concentrations of drugs metabolized by UGT1A1 and UGT2B7.
Read the full Valerian + Acetaminophen, Caffeine, Codeine, Salicylamide interactionPassion FlowerCytochrome P450 3a4 (cyp3a4) Substrates, Cns Depressants Moderate
Interaction Summary
Theoretically, passion flower might decrease the effects of CYP3A4 substrates.
Read the full Passion Flower + Acetaminophen, Caffeine, Codeine, Salicylamide interactionAcetaminophen, Caffeine, DihydrocodeineDHC Plus, Panlor DC, Panlor SS
How Acetaminophen, Caffeine, Dihydrocodeine interacts with Calm — through 2 ingredients. Tap an ingredient for the detail:
ValerianGlucuronidated Drugs, Cytochrome P450 2d6 (cyp2d6) Substrates +2 Moderate
Interaction Summary
Valerian might weakly inhibit glucuronidation and increase concentrations of drugs metabolized by UGT1A1 and UGT2B7.
Read the full Valerian + Acetaminophen, Caffeine, Dihydrocodeine interactionPassion FlowerCytochrome P450 3a4 (cyp3a4) Substrates, Cns Depressants Moderate
Interaction Summary
Theoretically, passion flower might decrease the effects of CYP3A4 substrates.
Read the full Passion Flower + Acetaminophen, Caffeine, Dihydrocodeine interactionEach ingredient & the kinds of drugs it affects
For each ingredient in Calm 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.
Valerian
Alcohol (Ethanol)
Valerian can have additive sedative effects when used concomitantly with alcohol.
Valerian has sedative effects. Theoretically, valerian might have an additive sedative effect when combined with alcohol. Excessive sedation has been reported in an alcohol-abusing individual who took valerian and Gingko biloba. However, the potential interaction between valerian and alcohol has been disputed in other research. Limited evidence suggests that a combination of valerian 160 mg and lemon balm 80 mg (Euvegal) does not cause further deterioration in reaction ability and reaction rate when taken with alcohol as compared to the effects of alcohol alone.
Alprazolam (Xanax)
Valerian can have additive sedative effects when used with alprazolam. Also, valerian in high doses might modestly increase alprazolam levels, though this is not likely to be clinically significant.
Valerian has sedative effects. Theoretically, valerian might cause additive sedation when combined with alprazolam. Also, a small pharmacokinetic study shows that taking valerian extract 1000 mg daily (providing 11 mg valerenic acid) might increase alprazolam levels by about 19%. This might be due to valerian's mild inhibition of cytochrome P450 3A4 (CYP3A4). Despite being statistically significant, this increase is not likely to be clinically significant.
Cns Depressants
Valerian can have additive sedative effects when used concomitantly with CNS depressant drugs.
Theoretically, concomitant use of valerian and drugs with sedative and anesthetic properties may cause additive therapeutic and adverse effects.
Glucuronidated Drugs
Valerian might weakly inhibit glucuronidation and increase concentrations of drugs metabolized by UGT1A1 and UGT2B7.
In vitro research shows that methanolic valerian extract and valerenic acid might competitively inhibit UDP-glucuronosyltransferase (UGT) 1A1 (UGT1A1) and UGT2B7.
Cytochrome P450 2D6 (Cyp2D6) Substrates
Valerian does not seem to have a clinically relevant effect on levels of drugs metabolized by CYP2D6.
Although some in vitro evidence suggests that valerian affects CYP2D6, clinical pharmacokinetic (PK) studies show that valerian is unlikely to affect the CYP2D6 enzyme. In one PK study, taking valerian 1000 mg (providing about 11 mg valerenic acid) nightly for 14 days did not affect the metabolism of dextromethorphan, a CYP2D6 substrate. In another PK study, taking valerian 125 mg three times daily for 28 days did not affect metabolism of debrisoquine, an accepted CYP2D6 probe-substrate.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Valerian does not seem to have a clinically relevant effect on levels of drugs metabolized by CYP3A4.
Although some in vitro evidence suggests that valerian extract might inhibit or induce CYP3A4, clinical pharmacokinetic (PK) studies show that valerian does not have a clinically significant effect on the CYP3A4 enzyme. In one PK study, taking valerian 125 mg three times daily for 28 days did not affect metabolism of midazolam, an accepted CYP3A4 probe-substrate. In another PK study, taking valerian 1000 mg (providing about 11 mg valerenic acid) nightly for 14 days modestly increases levels of alprazolam, a CYP3A4 substrate, suggesting mild inhibition of CYP3A4. However, this mild inhibition is unlikely to be clinically relevant.
Passion Flower
Cns Depressants
Concomitant use of passion flower with sedative drugs might cause additive effects and side effects.
Research in animals and humans shows that passion flower has sedative effects which can be additive when used with sedative medications like lorazepam.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, passion flower might decrease the effects of CYP3A4 substrates.
In vitro research suggests that passion flower can induce CYP3A4 enzymes, albeit to a much lower degree than rifampin, a known CYP3A4 inducer.
Organic Anion-Transporting Polypeptide Substrates (Oatp)
Theoretically, passion flower might reduce the bioavailability of OATP2B1 and OATP1A2 substrates.
In vitro research shows that the passion flower constituents apigenin and vitexin inhibit OATP2B1 and OATP1A2. This inhibition may be dose-dependent. One specific high-flavonoid passion flower extract (Valverde) seems to inhibit OATP2B1 and OATP1A2, while another extract with a lower flavonoid concentration (Arkocaps) shows less potent inhibition. OATPs are responsible for the uptake of drugs and other compounds into the body; however, the specific activities of OATP2B1 and OATP1A2 are not well characterized.
Magnesium
Levodopa/Carbidopa (Sinemet)
Magnesium can reduce the bioavailability of levodopa/carbidopa.
Clinical research in healthy volunteers shows that taking magnesium oxide 1000 mg with levodopa 100 mg/carbidopa 10 mg reduces the area under the curve (AUC) of levodopa by 35% and of carbidopa by 81%. In vitro and animal research shows that magnesium produces an alkaline environment in the digestive tract, which might lead to degradation and reduced bioavailability of levodopa/carbidopa.
Aminoglycoside Antibiotics
Concomitant use of aminoglycoside antibiotics and magnesium can increase the risk for neuromuscular weakness.
Both aminoglycosides and magnesium reduce presynaptic acetylcholine release, which can lead to neuromuscular blockade and possible paralysis. This is most likely to occur with high doses of magnesium given intravenously.
Antacids
Use of acid reducers may reduce the laxative effect of magnesium oxide.
A retrospective analysis shows that, in the presence of H2 receptor antagonists (H2RAs) or proton pump inhibitors (PPIs), a higher dose of magnesium oxide is needed for a laxative effect. This may also occur with antacids. Under acidic conditions, magnesium oxide is converted to magnesium chloride and then to magnesium bicarbonate, which has an osmotic laxative effect. By reducing acidity, antacids may reduce the conversion of magnesium oxide to the active bicarbonate salt.
Bictegravir/Emtricitabine/Tenofovir Alafenamide (Biktarvy)
Magnesium might decrease levels of bictegravir/emtricitabine/tenofovir alafenamide by reducing its absorption.
Advise patients that bictegravir/emtricitabine/tenofovir alafenamide should be taken at least 2 hours before or 6 hours after magnesium containing products.
Bisphosphonates
Magnesium can decrease absorption of bisphosphonates.
Cations, including magnesium, can decrease bisphosphonate absorption. Advise patients to separate doses of magnesium and these drugs by at least 2 hours.
Calcium Channel Blockers
Magnesium can have additive effects with calcium channel blockers, although evidence is conflicting.
Magnesium inhibits calcium entry into smooth muscle cells and may therefore have additive effects with calcium channel blockers. Severe hypotension and neuromuscular blockades may occur when nifedipine is used with intravenous magnesium, although some contradictory evidence suggests that concurrent use of magnesium with nifedipine does not increase the risk of neuromuscular weakness. High doses of magnesium could theoretically have additive effects with other calcium channel blockers.
Digoxin
Magnesium salts may reduce absorption of digoxin.
Clinical evidence suggests that treatment with oral magnesium hydroxide or magnesium trisilicate reduces absorption of digoxin from the intestines. This may reduce the blood levels of digoxin and decrease its therapeutic effects.
Potassium-Sparing Diuretics
Potassium-sparing diuretics decrease excretion of magnesium, possibly increasing magnesium levels.
Potassium-sparing diuretics also have magnesium-sparing properties, which can counteract the magnesium losses associated with loop and thiazide diuretics. Theoretically, increased magnesium levels could result from concomitant use of potassium-sparing diuretics and magnesium supplements.
Quinolone Antibiotics
Magnesium decreases absorption of quinolones.
Magnesium can form insoluble complexes with quinolones and decrease their absorption. Advise patients to take these drugs at least 2 hours before, or 4 to 6 hours after, magnesium supplements.
Skeletal Muscle Relaxants
Parenteral magnesium alters the pharmacokinetics of skeletal muscle relaxants, increasing their effects and accelerating the onset of effect.
Parenteral magnesium shortens the time to onset of skeletal muscle relaxants by about 1 minute and prolongs the duration of action by about 2 minutes. Magnesium potentiates the effects of skeletal muscle relaxants by decreasing calcium-mediated release of acetylcholine from presynaptic nerve terminals, reducing postsynaptic sensitivity to acetylcholine, and having a direct effect on the membrane potential of myocytes. Magnesium also has vasodilatory actions and increases cardiac output, allowing a greater amount of muscle relaxant to reach the motor end plate. A clinical study found that low-dose rocuronium (0.45 mg/kg), when given after administration of magnesium 30 mg/kg over 10 minutes, has an accelerated onset of effect, which matches the onset of effect seen with a full-dose rocuronium regimen (0.6 mg/kg). In another clinical study, onset times for rocuronium doses of 0.3, 0.6, and 1.2 mg/kg were 86, 76, and 50 seconds, respectively, when given alone, but were reduced to 66, 44, and 38 seconds, respectively, when the doses were given after a 15-minute infusion of magnesium sulfate 60 mg/kg. Giving intraoperative intravenous magnesium sulfate, 50 mg/kg loading dose followed by 15 mg/kg/hour, reduces the onset time of rocuronium, enhances its clinical effects, reduces the dose of intraoperative opiates, and prolongs the spontaneous recovery time. It does not affect the activity of subsequently administered neostigmine.
Sulfonylureas
Magnesium increases the systemic absorption of sulfonylureas, increasing their effects and side effects.
Clinical research shows that administration of magnesium hydroxide with glyburide increases glyburide absorption, increases maximal insulin response by 35-fold, and increases the risk of hypoglycemia, when compared with glyburide alone. A similar interaction occurs between magnesium hydroxide and glipizide. The mechanism of this effect appears to be related to the elevation of gastrointestinal pH by magnesium-based antacids, increasing solubility and enhancing absorption of sulfonylureas.
Tetracycline Antibiotics
Magnesium decreases absorption of tetracyclines.
Magnesium can form insoluble complexes with tetracyclines in the gut and decrease their absorption and antibacterial activity. Advise patients to take these drugs 1 hour before or 2 hours after magnesium supplements.
Anticoagulant/Antiplatelet Drugs
Theoretically, magnesium may have antiplatelet effects, but the evidence is conflicting.
In vitro evidence shows that magnesium sulfate inhibits platelet aggregation, even at low concentrations. Some preliminary clinical evidence shows that infusion of magnesium sulfate increases bleeding time by 48% and reduces platelet activity. However, other clinical research shows that magnesium does not affect platelet aggregation, although inhibition of platelet-dependent thrombosis can occur.
Gabapentin (Neurontin)
Gabapentin absorption can be decreased by magnesium.
Clinical research shows that giving magnesium oxide orally along with gabapentin decreases the maximum plasma concentration of gabapentin by 33%, time to maximum concentration by 36%, and area under the curve by 43%. Advise patients to take gabapentin at least 2 hours before, or 4 to 6 hours after, magnesium supplements.
Sevelamer (Renagel, Renvela)
Sevelamer may increase serum magnesium levels.
In patients on hemodialysis, sevelamer use was associated with a 0.28 mg/dL increase in serum magnesium. The mechanism of this interaction remains unclear.
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.
Niacinamide
Anticoagulant/Antiplatelet Drugs
Theoretically, niacinamide may have additive effects when used with anticoagulant or antiplatelet drugs, especially in patients on hemodialysis.
Several cases of thrombocytopenia have been reported for hemodialysis patients treated with niacinamide 1 gram daily. Hemodialysis patients receiving niacinamide had almost a three-fold higher risk of developing thrombocytopenia when compared with those receiving placebo.
Carbamazepine (Tegretol)
Niacinamide might increase the levels and adverse effects of carbamazepine.
Plasma levels of carbamazepine were increased in two children given high-dose niacinamide, 60-80 mg/kg/day. This might be due to inhibition of the cytochrome P450 enzymes involved in carbamazepine metabolism. There is not enough data to determine the clinical significance of this interaction.
Primidone (Mysoline)
Niacinamide might increase the levels and adverse effects of primidone.
Case reports in children suggest niacinamide 60-100 mg/kg/day reduces hepatic metabolism of primidone to phenobarbital, and reduces the overall clearance rate of primidone; however, there is not enough data to determine the clinical significance of this potential interaction.
Warfarin (Coumadin)
There is limited evidence that niacinamide may increase the anticoagulant effects of warfarin.
In a case report, a patient on warfarin developed an elevated international normalized ratio (INR) of 8.4 after taking niacinamide 500 mg twice daily for 10 days. The patient's INR was previously stable, ranging between 2 and 3, with no other changes to current medications or diet reported. The elevated INR returned to the therapeutic range after receiving vitamin K and discontinuing niacinamide.
Thiamine
Trimethoprim (Proloprim)
Trimethoprim might increase blood levels of thiamine.
In vitro, animal, and clinical research suggest that trimethoprim inhibits intestinal thiamine transporter ThTR-2, hepatic transporter OCT1, and renal transporters OCT2, MATE1, and MATE2, resulting in paradoxically increased thiamine plasma concentrations.
Brand information
Manufacturer and brand details for Calm, from the product label.
Martin Avenue Pharmacy
See all Martin Avenue Pharmacy products- Name
- Martin Avenue Pharmacy, Inc.
- City
- Naperville
- State
- IL
- ZipCode
- 60540
- Phone Number
- (630) 355-6400
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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 Calm’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Thiamine
Interacts with 3 drugsThiamine (vitamin B1) is an essential nutrient your body needs to turn food into energy and to keep your nerves and heart healthy. Most people get enough from food, but supplements are clear...
Read the full Thiamine monograph → Herb & supplement monographPantothenic Acid
Pantothenic acid is vitamin B5, an essential nutrient your body uses to turn food into energy. True deficiency is very rare because it is found in nearly all foods, and most people meet thei...
Read the full Pantothenic Acid 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 monographNiacinamide
Interacts with 124 drugsNiacinamide (also called nicotinamide) is a form of vitamin B3 used in supplements and skin-care products. It is well established for preventing and treating vitamin B3 deficiency, and there...
Read the full Niacinamide monograph → Herb & supplement monographValerian
Interacts with 902 drugsValerian is an herb whose root is widely used as a natural sleep aid and for calming nerves. The evidence is mixed and often weak, so it may help some people sleep but does not work reliably...
Read the full Valerian monograph → Herb & supplement monographMagnesium
Interacts with 295 drugsMagnesium is an essential mineral your body needs for muscles, nerves, blood pressure, and many other functions, and supplements are useful for preventing or correcting deficiency. Some othe...
Read the full Magnesium monograph → Herb & supplement monographPassion Flower
Interacts with 836 drugsPassion flower is a traditional calming herb that many people use for anxiety and sleep. Early studies hint it may help with mild anxiety and restlessness, but the evidence is limited and mo...
Read the full Passion Flower monograph →Sources & How We Checked
Calm'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 240 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.
Thiamine 7 references
- McEvoy GK, ed. AHFS Drug Information. Bethesda, MD: American Society of Health-System Pharmacists, 1998.
- Yates AA, Schlicker SA, Suitor CW. Dietary reference intakes: The new basis for recommendations for calcium and related nutrients, B vitamins, and choline. J Am Diet Assoc 1998;98:699-706. PubMed
- Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline (2000). Washington, DC: National Academy Press, 2000. Available at: http://b
- Rogovik, A. L., Vohra, S., and Goldman, R. D. Safety considerations and potential interactions of vitamins: should vitamins be considered drugs? Ann.Pharmacother. 2010;44(2):311-324. PubMed
- Arruti N, Bernedo N, Audicana MT, Villarreal O, Uriel O, Muñoz D. Systemic allergic dermatitis caused by thiamine after iontophoresis. Contact Dermatitis. 2013 Dec;69(6):375-6. PubMed
- Thiamine hydrochloride injection package insert. Lake Zurich, IL: Fresenius Kabi, LLC; September 2019.
- Vora B, Wen A, Yee SW, et al. The Effect of Trimethoprim on Thiamine Absorption: A Transporter-Mediated Drug-Nutrient Interaction. Clin Pharmacol Ther 2023;114(2):381-392.
Pantothenic Acid 11 references
- McEvoy GK, ed. AHFS Drug Information. Bethesda, MD: American Society of Health-System Pharmacists, 1998.
- Yates AA, Schlicker SA, Suitor CW. Dietary reference intakes: The new basis for recommendations for calcium and related nutrients, B vitamins, and choline. J Am Diet Assoc 1998;98:699-706. PubMed
- Debourdeau PM, Djezzar S, Estival JL, et al. Life-threatening eosinophilic pleuropericardial effusion related to vitamins B5 and H. Ann Pharmacother 2001;35:424-6. DOI
- Schmuth, M., Wimmer, M. A., Hofer, S., Sztankay, A., Weinlich, G., Linder, D. M., Elias, P. M., Fritsch, P. O., and Fritsch, E. Topical corticosteroid therapy for acute radiation dermatitis: a prospective, randomized, double-blind study. Br.J.Dermatol. 2 PubMed
- Schreck, U., Paulsen, F., Bamberg, M., and Budach, W. Intraindividual comparison of two different skin care conceptions in patients undergoing radiotherapy of the head-and-neck region. Creme or powder? Strahlenther.Onkol. 2002;178(6):321-329. PubMed
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