Cardio Igniter Pineapple Mango Ingredients & Drug Interactions
What is this page for?
First and foremost: checking Cardio Igniter Pineapple Mango 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
Cardio Igniter Pineapple Mango is a dietary supplement by Top Secret Nutrition with 21 active ingredients. Its ingredients are commonly taken for morning sickness in pregnancy, premenstrual syndrome (pms), preventing or treating b6 deficiency.Based on those ingredients, 1,579 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are Bitter Orange Extract, Kelp, Beet Root Extract. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against Cardio Igniter Pineapple Mango by Top Secret Nutrition
Ask about any prescription or over-the-counter medication and we check it for interactions with Cardio Igniter Pineapple Mango by Top Secret Nutrition — 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 Cardio Igniter Pineapple Mango by Top Secret Nutrition
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
Low disclosure
Cardio Igniter contains 20 active ingredients. The main components include B vitamins (Vitamin B6, Vitamin B12, Niacin) to support energy and metabolism, amino acids (L-Tyrosine, Beta-Alanine, L-Norvaline, Taurine, L-Carnitine L-Tartrate) for muscle and cardiovascular function, and D-Ribose, a sugar that supports cellular energy.
The blend also includes Magnesium, Potassium, Sodium, and Choline Bitartrate for electrolyte and nerve function; herbal extracts (Kelp, Uva-Ursi, Beet Root Extract, Bitter Orange Extract, Evodiamine, Raspberry Ketones); and Caffeine Anhydrous for mental alertness. A proprietary lipobolic blend completes the formula.
The powder also contains inactive ingredients including maltodextrin, citric acid, natural and artificial flavors, silicon dioxide, malic acid, sucralose, acesulfame potassium, and FD&C Yellow #5.
Does it work?
Strong evidence
Evidence for the ingredients varies. Vitamin B6 is effective for sideroblastic anemia and vitamin B6 deficiency, and likely effective for lowering homocysteine.
Niacin is likely effective for pellagra and possibly effective for metabolic syndrome. Vitamin B12 is effective for B12 deficiency.
Caffeine is likely effective for mental alertness and athletic performance. Beet Root Extract is possibly effective for athletic performance and exercise-induced muscle soreness.
L-Carnitine is effective for L-carnitine deficiency and possibly effective for congestive heart failure and angina. Other ingredients like D-Ribose, L-Tyrosine, Beta-Alanine, Taurine, Choline, Kelp, Uva-Ursi, Raspberry Ketones, and Magnesium show varying ratings from possibly effective to insufficient evidence or even possibly ineffective.
The product's claimed "cardio" benefits are not fully supported by strong evidence across all ingredients.
How safe is it?
Well-documented data
Most ingredients are generally well tolerated at standard doses, but several warrant caution. Vitamin B6 at high doses (over 1000 mg daily) can cause nerve damage (sensory neuropathy).
D-Ribose can lower blood sugar, and nausea or anxiety may occur. Beta-Alanine commonly causes harmless skin tingling (paresthesia) and flushing.
Niacin often causes flushing, gastrointestinal upset, and at high doses can harm the liver. Caffeine in excess causes anxiety, insomnia, tremor, and serious cardiovascular effects.
Taurine is generally well tolerated short-term but long-term safety is uncertain. Kelp's high iodine content can disrupt thyroid function and cause goiter or hyperthyroidism.
Uva-Ursi is safe only short-term and can be toxic at high doses. Raspberry Ketones resembles a stimulant and may cause heart palpitations or elevated blood pressure.
Bitter Orange contains stimulant-like compounds and can raise heart rate and blood pressure. Pregnancy and lactation safety varies: Vitamin B6 is likely safe in pregnancy but possibly unsafe at high doses; D-Ribose, Beta-Alanine, L-Tyrosine, and Caffeine lack sufficient safety data and should be avoided in pregnancy; Kelp and Uva-Ursi are possibly or likely unsafe in pregnancy; Raspberry Ketones and Bitter Orange lack safety data and should be avoided.
Meds to double-check
Major interaction found
Check before taking if you use: MAOIs or any psychiatric medication (major risk with caffeine and bitter orange); heart or blood-pressure medications, particularly if you take ephedrine, antihypertensives, amiodarone, or calcium channel blockers; levodopa/carbidopa for Parkinson's; blood thinners like warfarin; antidiabetes or insulin therapy; seizure medications like phenytoin, phenobarbital, or carbamazepine; lithium for bipolar disorder; antithyroid drugs or thyroid hormone supplements; quinolone antibiotics; and diuretics or potassium-sparing drugs. These represent the worst documented interactions.
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.
Cardio Igniter is a multi-ingredient pre-workout formula with stimulants, amino acids, and micronutrients. It's designed for athletes seeking energy and cardiovascular support, but the evidence supporting many ingredients is weak or mixed.
Before taking this product, run your current medications through the interaction checker on this page—it has major interactions with certain psychiatric and cardiac drugs, and moderate interactions with blood-pressure and diabetes medications, anticoagulants, and many others. Talk to your pharmacist about whether this is right for you, especially if you have heart disease, high blood pressure, diabetes, or take prescription medications.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 18 of 20 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Jan 23, 2025.
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 Cardio Igniter Pineapple Mango, straight from the product label.
| Brand | Top Secret Nutrition |
|---|---|
| Barcode (UPC) | 811226021850 |
| Net contents | 6.35 Ounce(s); 180 Gram(s) |
| Market status | On market |
| Date entered into DSLD | Jan 23, 2025 |
| DSLD ID | 323446 |
| Product type | Other Combinations |
| Supplement form | Powder |
| Dietary claims / uses | All Other, Structure/Function |
| Intended target group(s) | Adult (18 - 50 Years), Women (not pregnant or lactating) |
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 Cardio Igniter Pineapple Mango by Top Secret Nutrition, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Calories | 5 Calorie(s) | -- |
| Total Carbohydrates | 1 Gram(s) | 1% |
| Sugar | 1 Gram(s) | -- |
| Vitamin B6 | 8 mg | 400% |
| D-Ribose | 0 NP | -- |
| L-Tyrosine | 0 NP | -- |
| Beta-Alanine | 0 NP | -- |
| Niacin | 17 mg | 85% |
| Vitamin B12 | 10 mcg | 168% |
| Choline Bitartrate | 0 NP | -- |
| Caffeine Anhydrous | 150 mg | -- |
| L-Norvaline | 0 NP | -- |
| Taurine | 0 NP | -- |
| Kelp | 0 NP | -- |
| Sodium | 110 mg | 5% |
| Potassium | 230 mg | 7% |
| Evodiamine | 0 NP | -- |
| Raspberry Ketones | 0 NP | -- |
| Uva-Ursi, Powder | 0 NP | -- |
| Beet Root Extract | 0 NP | -- |
| L-Carnitine L-Tartrate | 0 NP | -- |
| Magnesium | 33 mg | 8% |
| Proprietary Lipobolic Blend | 2137 mg | -- |
| Bitter Orange Extract | 0 NP | -- |
Other ingredients: Maltodextrin, Citric Acid, Natural & Artificial Flavors, Silicon Dioxide, Malic Acid, Sucralose, Acesulfame Potassium, FD&C Yellow #5
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.
Formulation
Aerobic capacity booster Performance enhancing diet aid Improved endurance Cardio Igniter is a new type of pre-workout, performance-enhancing supplement that focuses on supporting aerobic capacity and losing weight. Use Cardio Igniter to protect lean muscle mass, support weight loss, and provide long lasting energy.
Professional grade performance enhancer
Formula
Cardio Igniter Pineapple Mango Naturally & artificially flavored
FDA Statement of Identity
Dietary Supplement
Suggested/Recommended/Usage/Directions
Directions: Mix one (1) scoop with 8-12 oz. of cold water 20-30 minutes before training. Begin with one (1) scoop to assess your tolerance. Increase servings to no more than (2) two scoops per day for desired effect. This is a stimulant based supplement, always check with a physician or health care provider prior to taking supplements and exercising.
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.
Precautions
Warning: Not intended for use by persons under age 18.
Do not exceed recommended dose. Do not consume synephrine or caffeine from other sources, including but not limited to: coffee, tea, soda and other dietary supplements or medications containing phenylephrine or caffeine. Contains caffeine. Do not use for more than 8 weeks. Discontinue 2 weeks prior to surgery or if you experience rapid heartbeat, dizziness, severe headache or shortness or breath.
Do not use if you are pregnant, nursing or contemplating becoming pregnant. Consult with your physician prior to use if you are taking medication, including but not limited to: MAO inhibitors, antidepressants, aspirin, nonsteroidal anti-inflammatory drugs or products containing phylephrine, ephedrine, pseudoephedrine, or other stimulants. Consult your physician prior to use if you have a medical condition, including but not limited to: heart, liver, kidney, or thyroid disease, psychiatric or epileptic disorders, difficulty urinating, diabetes, high blood pressure, cardiac arrhythmia, recurrent headaches, enlarged prostate or glaucoma.
Storage
Store in a cool, dry place.
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Cardio Igniter Pineapple Mango by Top Secret Nutrition 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 Cardio Igniter Pineapple Mango by Top Secret Nutrition
These are the 21 active ingredients this product is made of. Select any to open its full monograph.
Serving size6 Gram(s) Dosage formPowder 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.
Sugar
Vitamin B6
Interacts with210 drugs
Vitamin B6 (pyridoxine) is an essential water-soluble vitamin that your body needs for metabolism, brain function, and making red blood cells. It is b...
Vitamin B6 monograph & interactionsNiacin
Interacts with727 drugs
Niacin (vitamin B3) is an essential nutrient your body needs for energy and metabolism, and deficiency is uncommon in most developed countries. Prescr...
Niacin monograph & interactionsVitamin B12
Interacts with20 drugs
Vitamin B12 (cobalamin) is an essential nutrient your body needs to make red blood cells, keep nerves healthy, and support DNA. Supplements are very h...
Vitamin B12 monograph & interactionsSodium
Interacts with205 drugs
Sodium is an essential mineral and electrolyte your body needs to balance fluids, support nerves, and help muscles work. Most people in modern diets g...
Sodium monograph & interactionsPotassium
Interacts with62 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 balanc...
Potassium 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 & interactionsProprietary Lipobolic Blend
- › D-Ribose
- › L-Tyrosine
- › Beta-Alanine
- › Choline Bitartrate
- › Caffeine Anhydrous
- › L-Norvaline
- › Taurine
- › Kelp
- › Evodiamine
- › Raspberry Ketones
- › Uva-Ursi, Powder
- › Beet Root Extract
- › L-Carnitine L-Tartrate
- › Bitter Orange Extract
Other (inactive) ingredients: Maltodextrin, Citric Acid, Natural & Artificial Flavors, Silicon Dioxide, Malic Acid, Sucralose, Acesulfame Potassium, FD&C Yellow #5. These complete the product’s ingredient list but are not active constituents.
Cardio Igniter Pineapple Mango by Top Secret Nutrition Drug Interactions
HelloPharmacist Interaction Report
Cardio Igniter Pineapple Mango by Top Secret Nutrition is a 20-ingredient powder with documented interactions affecting many medications.
The most serious concern is Caffeine Anhydrous, which carries a Major severity interaction with ephedrine—concomitant use increases the risk of serious life-threatening stimulant effects including hypertension, heart attack, and arrhythmia.
Read the full breakdown — every affected drug type, severity by severity
Bitter Orange Extract also carries Major severity interactions: with monoamine oxidase inhibitors (MAOIs), where synephrine content may trigger hypertensive crisis, and with midazolam, where it may raise drug levels significantly. Additionally, Magnesium has a Major interaction with levodopa/carbidopa, reducing levodopa bioavailability by up to 35%.
Moderate severity interactions span multiple drug types. Vitamin B6 may reduce blood pressure additively with antihypertensives and may interfere with phenobarbital and phenytoin levels.
D-Ribose and Niacin both interact with antidiabetes drugs and insulin, raising hypoglycemia risk. L-Tyrosine competes with levodopa for absorption and may potentiate thyroid hormones.
Taurine and Niacin both risk additive blood-pressure lowering with antihypertensives. Kelp (Fucus vesiculosus) interacts with lithium, antithyroid drugs, amiodarone, and thyroid hormones due to high iodine content.
Sodium and Potassium each carry multiple Moderate interactions with blood-pressure drugs, diuretics, lithium, and ACE inhibitors or ARBs. Caffeine additionally interacts with pentobarbital, dipyridamole, clozapine, cimetidine, quinolone antibiotics, phenobarbital, and carbamazepine.
Uva-Ursi, Beet Root, L-Carnitine L-Tartrate, and Bitter Orange each interact with CYP450 substrates and other drug classes. Altogether, these interactions span 1,556 individual medications.
We could not check L-Norvaline and Evodiamine—no interaction data is on file for them. For your exact medications, use the search tool on this page before starting.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against Cardio Igniter Pineapple Mango?
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 Cardio Igniter Pineapple Mango interact with 1,579 drugs. Click any drug to see the details.
17 of the 21 ingredients in Cardio Igniter Pineapple Mango interact with drugs. Each result below shows which ingredient is responsible. Bitter Orange Extract Kelp Beet Root Extract Uva-Ursi, Powder Niacin Caffeine Anhydrous Magnesium Vitamin B6 Sodium Raspberry Ketones Taurine D-Ribose Potassium L-Tyrosine Vitamin B12 L-Carnitine L-Tartrate Choline Bitartrate
Aminophylline, Amobarbital, EphedrineAmesec
How Aminophylline, Amobarbital, Ephedrine interacts with Cardio Igniter Pineapple Mango — through 3 ingredients. Tap an ingredient for the detail:
Caffeine AnhydrousEphedrine, Stimulant Drugs Major
Interaction Summary
Theoretically, concomitant use might increase the risk for stimulant adverse effects.
Read the full Caffeine Anhydrous + Aminophylline, Amobarbital, Ephedrine interactionRaspberry KetonesStimulant Drugs Moderate
Interaction Summary
Theoretically, raspberry ketone might increase the risk of adverse cardiovascular effects with stimulant drugs.
Read the full Raspberry Ketones + Aminophylline, Amobarbital, Ephedrine interactionBitter Orange ExtractStimulant Drugs Moderate
Interaction Summary
Theoretically, bitter orange might increase the risk of hypertension and adverse cardiovascular effects when taken with stimulant drugs.
Read the full Bitter Orange Extract + Aminophylline, Amobarbital, Ephedrine interactionAmphetamineAdensys XR-ODT, Adzenys ER, Dyanavel XR, Mydayis
How Amphetamine interacts with Cardio Igniter Pineapple Mango — through 4 ingredients. Tap an ingredient for the detail:
Bitter Orange ExtractCytochrome P450 2d6 (cyp2d6) Substrates, Stimulant Drugs +1 Major
Interaction Summary
Theoretically, bitter orange might increase levels of drug metabolized by CYP2D6.
Read the full Bitter Orange Extract + Amphetamine interactionRaspberry KetonesStimulant Drugs Moderate
Interaction Summary
Theoretically, raspberry ketone might increase the risk of adverse cardiovascular effects with stimulant drugs.
Read the full Raspberry Ketones + Amphetamine interactionCaffeine AnhydrousMonoamine Oxidase Inhibitors (maois), Stimulant Drugs Moderate
Interaction Summary
Theoretically, concomitant use might increase the risk of a hypertensive crisis.
Read the full Caffeine Anhydrous + Amphetamine interactionKelpCytochrome P450 2d6 (cyp2d6) Substrates Minor
Interaction Summary
Theoretically, concomitant use of Fucus vesiculosus with CYP2D6 substrates might alter the effects of these substrates.
Read the full Kelp + Amphetamine interactionBenserazide, LevodopaMadopar, Prolopa
How Benserazide, Levodopa interacts with Cardio Igniter Pineapple Mango — through 3 ingredients. Tap an ingredient for the detail:
MagnesiumLevodopa/carbidopa (sinemet) Major
Interaction Summary
Magnesium can reduce the bioavailability of levodopa/carbidopa.
Read the full Magnesium + Benserazide, Levodopa interactionL-tyrosineLevodopa Moderate
Interaction Summary
Theoretically, tyrosine might decrease the effectiveness of levodopa.
Read the full L-tyrosine + Benserazide, Levodopa interactionVitamin B6Levodopa Minor
Interaction Summary
Vitamin B6 may increase the metabolism of levodopa when taken alone, but not when taken in conjunction with carbidopa.
Read the full Vitamin B6 + Benserazide, Levodopa interactionCarbetapentane Tannate, Chlorpheniramine Tannate, Ephedrine Tannate, Phenylephrine TannateQuadratuss, Ry Tuss, Rynatuss, Tri Tannate Plus
How Carbetapentane Tannate, Chlorpheniramine Tannate, Ephedrine Tannate, Phenylephrine Tannate interacts with Cardio Igniter Pineapple Mango — through 6 ingredients. Tap an ingredient for the detail:
Caffeine AnhydrousEphedrine, Stimulant Drugs Major
Interaction Summary
Theoretically, concomitant use might increase the risk for stimulant adverse effects.
Read the full Caffeine Anhydrous + Carbetapentane Tannate, Chlorpheniramine Tannate, Ephedrine Tannate, Phenylephrine Tannate interactionUva-ursi, PowderCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, uva ursi may decrease the metabolism of CYP3A4 substrates.
Read the full Uva-ursi, Powder + Carbetapentane Tannate, Chlorpheniramine Tannate, Ephedrine Tannate, Phenylephrine Tannate interactionBeet Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, beet might increase the levels of CYP3A4 substrates.
Read the full Beet Root Extract + Carbetapentane Tannate, Chlorpheniramine Tannate, Ephedrine Tannate, Phenylephrine Tannate interactionRaspberry KetonesStimulant Drugs Moderate
Interaction Summary
Theoretically, raspberry ketone might increase the risk of adverse cardiovascular effects with stimulant drugs.
Read the full Raspberry Ketones + Carbetapentane Tannate, Chlorpheniramine Tannate, Ephedrine Tannate, Phenylephrine Tannate interactionBitter Orange ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Stimulant Drugs Moderate
Interaction Summary
Bitter orange might increase levels of drugs metabolized by CYP3A4.
Read the full Bitter Orange Extract + Carbetapentane Tannate, Chlorpheniramine Tannate, Ephedrine Tannate, Phenylephrine Tannate interactionKelpCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, concomitant use of Fucus vesiculosus with CYP3A4 substrates might increase the risk for adverse effects.
Read the full Kelp + Carbetapentane Tannate, Chlorpheniramine Tannate, Ephedrine Tannate, Phenylephrine Tannate interactionCarbidopaLodosyn
How Carbidopa interacts with Cardio Igniter Pineapple Mango — 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 Cardio Igniter Pineapple Mango — through 3 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 interactionL-tyrosineLevodopa Moderate
Interaction Summary
Theoretically, tyrosine might decrease the effectiveness of levodopa.
Read the full L-tyrosine + Carbidopa, Levodopa interactionVitamin B6Levodopa Minor
Interaction Summary
Vitamin B6 may increase the metabolism of levodopa when taken alone, but not when taken in conjunction with carbidopa.
Read the full Vitamin B6 + Carbidopa, Levodopa interactionCarbidopa, Levodopa, EntacaponeStalevo
How Carbidopa, Levodopa, Entacapone interacts with Cardio Igniter Pineapple Mango — through 4 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 interactionL-tyrosineLevodopa Moderate
Interaction Summary
Theoretically, tyrosine might decrease the effectiveness of levodopa.
Read the full L-tyrosine + Carbidopa, Levodopa, Entacapone interactionUva-ursi, PowderGlucuronidated Drugs Moderate
Interaction Summary
Theoretically, uva ursi may increase levels of drugs metabolized by glucuronidation.
Read the full Uva-ursi, Powder + Carbidopa, Levodopa, Entacapone interactionVitamin B6Levodopa Minor
Interaction Summary
Vitamin B6 may increase the metabolism of levodopa when taken alone, but not when taken in conjunction with carbidopa.
Read the full Vitamin B6 + Carbidopa, Levodopa, Entacapone interactionDyphylline, Ephedrine, Guaifenesin, PhenobarbitalLufyllin-EPG
How Dyphylline, Ephedrine, Guaifenesin, Phenobarbital interacts with Cardio Igniter Pineapple Mango — through 4 ingredients. Tap an ingredient for the detail:
Caffeine AnhydrousStimulant Drugs, Phenobarbital (luminal) +1 Major
Interaction Summary
Theoretically, concomitant use might increase stimulant adverse effects.
Read the full Caffeine Anhydrous + Dyphylline, Ephedrine, Guaifenesin, Phenobarbital interactionRaspberry KetonesStimulant Drugs Moderate
Interaction Summary
Theoretically, raspberry ketone might increase the risk of adverse cardiovascular effects with stimulant drugs.
Read the full Raspberry Ketones + Dyphylline, Ephedrine, Guaifenesin, Phenobarbital interactionVitamin B6Phenobarbital (luminal) Moderate
Interaction Summary
High doses of vitamin B6 may reduce the levels and clinical effects of phenobarbital.
Read the full Vitamin B6 + Dyphylline, Ephedrine, Guaifenesin, Phenobarbital interactionBitter Orange ExtractStimulant Drugs Moderate
Interaction Summary
Theoretically, bitter orange might increase the risk of hypertension and adverse cardiovascular effects when taken with stimulant drugs.
Read the full Bitter Orange Extract + Dyphylline, Ephedrine, Guaifenesin, Phenobarbital interactionEphedrine, Guaifenesin (otc Drug)Ephedrine Formula 400, Ephedrine Plus Tabs
How Ephedrine, Guaifenesin (otc Drug) interacts with Cardio Igniter Pineapple Mango — through 3 ingredients. Tap an ingredient for the detail:
Caffeine AnhydrousStimulant Drugs, Ephedrine Major
Interaction Summary
Theoretically, concomitant use might increase stimulant adverse effects.
Read the full Caffeine Anhydrous + Ephedrine, Guaifenesin (otc Drug) interactionBitter Orange ExtractStimulant Drugs Moderate
Interaction Summary
Theoretically, bitter orange might increase the risk of hypertension and adverse cardiovascular effects when taken with stimulant drugs.
Read the full Bitter Orange Extract + Ephedrine, Guaifenesin (otc Drug) interactionRaspberry KetonesStimulant Drugs Moderate
Interaction Summary
Theoretically, raspberry ketone might increase the risk of adverse cardiovascular effects with stimulant drugs.
Read the full Raspberry Ketones + Ephedrine, Guaifenesin (otc Drug) interactionEphedrine, Guaifenesin, Phenobarbital, TheophyllineMudrane GG
How Ephedrine, Guaifenesin, Phenobarbital, Theophylline interacts with Cardio Igniter Pineapple Mango — through 5 ingredients. Tap an ingredient for the detail:
Caffeine AnhydrousTheophylline, Phenobarbital (luminal) +2 Major
Interaction Summary
Theoretically, caffeine might increase the levels and adverse effects of theophylline.
Read the full Caffeine Anhydrous + Ephedrine, Guaifenesin, Phenobarbital, Theophylline interactionRaspberry KetonesStimulant Drugs Moderate
Interaction Summary
Theoretically, raspberry ketone might increase the risk of adverse cardiovascular effects with stimulant drugs.
Read the full Raspberry Ketones + Ephedrine, Guaifenesin, Phenobarbital, Theophylline interactionBitter Orange ExtractStimulant Drugs Moderate
Interaction Summary
Theoretically, bitter orange might increase the risk of hypertension and adverse cardiovascular effects when taken with stimulant drugs.
Read the full Bitter Orange Extract + Ephedrine, Guaifenesin, Phenobarbital, Theophylline interactionVitamin B6Phenobarbital (luminal) Moderate
Interaction Summary
High doses of vitamin B6 may reduce the levels and clinical effects of phenobarbital.
Read the full Vitamin B6 + Ephedrine, Guaifenesin, Phenobarbital, Theophylline interactionBeet Root ExtractCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, beet might decrease the levels and clinical effects of CYP1A2 substrates.
Read the full Beet Root Extract + Ephedrine, Guaifenesin, Phenobarbital, Theophylline interactionEphedrine, Hydroxyzine, TheophyllineAmi Rax, Marax
How Ephedrine, Hydroxyzine, Theophylline interacts with Cardio Igniter Pineapple Mango — through 4 ingredients. Tap an ingredient for the detail:
Caffeine AnhydrousStimulant Drugs, Theophylline +1 Major
Interaction Summary
Theoretically, concomitant use might increase stimulant adverse effects.
Read the full Caffeine Anhydrous + Ephedrine, Hydroxyzine, Theophylline interactionBitter Orange ExtractStimulant Drugs Moderate
Interaction Summary
Theoretically, bitter orange might increase the risk of hypertension and adverse cardiovascular effects when taken with stimulant drugs.
Read the full Bitter Orange Extract + Ephedrine, Hydroxyzine, Theophylline interactionRaspberry KetonesStimulant Drugs Moderate
Interaction Summary
Theoretically, raspberry ketone might increase the risk of adverse cardiovascular effects with stimulant drugs.
Read the full Raspberry Ketones + Ephedrine, Hydroxyzine, Theophylline interactionBeet Root ExtractCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, beet might decrease the levels and clinical effects of CYP1A2 substrates.
Read the full Beet Root Extract + Ephedrine, Hydroxyzine, Theophylline interactionEphedrine, Phenobarbital, Potassium Iodide, TheophyllineMudrane, Quadrinal
How Ephedrine, Phenobarbital, Potassium Iodide, Theophylline interacts with Cardio Igniter Pineapple Mango — through 4 ingredients. Tap an ingredient for the detail:
Caffeine AnhydrousStimulant Drugs, Theophylline +2 Major
Interaction Summary
Theoretically, concomitant use might increase stimulant adverse effects.
Read the full Caffeine Anhydrous + Ephedrine, Phenobarbital, Potassium Iodide, Theophylline interactionBitter Orange ExtractStimulant Drugs Moderate
Interaction Summary
Theoretically, bitter orange might increase the risk of hypertension and adverse cardiovascular effects when taken with stimulant drugs.
Read the full Bitter Orange Extract + Ephedrine, Phenobarbital, Potassium Iodide, Theophylline interactionVitamin B6Phenobarbital (luminal) Moderate
Interaction Summary
High doses of vitamin B6 may reduce the levels and clinical effects of phenobarbital.
Read the full Vitamin B6 + Ephedrine, Phenobarbital, Potassium Iodide, Theophylline interactionRaspberry KetonesStimulant Drugs Moderate
Interaction Summary
Theoretically, raspberry ketone might increase the risk of adverse cardiovascular effects with stimulant drugs.
Read the full Raspberry Ketones + Ephedrine, Phenobarbital, Potassium Iodide, Theophylline interactionEphedrine, Phenobarbital, TheophyllineTedral
How Ephedrine, Phenobarbital, Theophylline interacts with Cardio Igniter Pineapple Mango — through 4 ingredients. Tap an ingredient for the detail:
Caffeine AnhydrousStimulant Drugs, Theophylline +2 Major
Interaction Summary
Theoretically, concomitant use might increase stimulant adverse effects.
Read the full Caffeine Anhydrous + Ephedrine, Phenobarbital, Theophylline interactionRaspberry KetonesStimulant Drugs Moderate
Interaction Summary
Theoretically, raspberry ketone might increase the risk of adverse cardiovascular effects with stimulant drugs.
Read the full Raspberry Ketones + Ephedrine, Phenobarbital, Theophylline interactionBitter Orange ExtractStimulant Drugs Moderate
Interaction Summary
Theoretically, bitter orange might increase the risk of hypertension and adverse cardiovascular effects when taken with stimulant drugs.
Read the full Bitter Orange Extract + Ephedrine, Phenobarbital, Theophylline interactionVitamin B6Phenobarbital (luminal) Moderate
Interaction Summary
High doses of vitamin B6 may reduce the levels and clinical effects of phenobarbital.
Read the full Vitamin B6 + Ephedrine, Phenobarbital, Theophylline interactionIsocarboxazidMarplan
How Isocarboxazid interacts with Cardio Igniter Pineapple Mango — through 2 ingredients. Tap an ingredient for the detail:
Bitter Orange ExtractMonoamine Oxidase Inhibitors (maois) Major
Interaction Summary
Theoretically, taking MAOIs with synephrine-containing bitter orange preparations might increase the hypertensive effects of synephrine, potentially leading to hypertensive crisis.
Read the full Bitter Orange Extract + Isocarboxazid interactionCaffeine AnhydrousMonoamine Oxidase Inhibitors (maois) Moderate
Interaction Summary
Theoretically, concomitant use might increase the risk of a hypertensive crisis.
Read the full Caffeine Anhydrous + Isocarboxazid interactionLevodopaInbrija, Larodopa
How Levodopa interacts with Cardio Igniter Pineapple Mango — through 3 ingredients. Tap an ingredient for the detail:
MagnesiumLevodopa/carbidopa (sinemet) Major
Interaction Summary
Magnesium can reduce the bioavailability of levodopa/carbidopa.
Read the full Magnesium + Levodopa interactionL-tyrosineLevodopa Moderate
Interaction Summary
Theoretically, tyrosine might decrease the effectiveness of levodopa.
Read the full L-tyrosine + Levodopa interactionVitamin B6Levodopa Minor
Interaction Summary
Vitamin B6 may increase the metabolism of levodopa when taken alone, but not when taken in conjunction with carbidopa.
Read the full Vitamin B6 + Levodopa interactionLevodopa, CarbidopaDuodopa
How Levodopa, Carbidopa interacts with Cardio Igniter Pineapple Mango — through 3 ingredients. Tap an ingredient for the detail:
MagnesiumLevodopa/carbidopa (sinemet) Major
Interaction Summary
Magnesium can reduce the bioavailability of levodopa/carbidopa.
Read the full Magnesium + Levodopa, Carbidopa interactionL-tyrosineLevodopa Moderate
Interaction Summary
Theoretically, tyrosine might decrease the effectiveness of levodopa.
Read the full L-tyrosine + Levodopa, Carbidopa interactionVitamin B6Levodopa Minor
Interaction Summary
Vitamin B6 may increase the metabolism of levodopa when taken alone, but not when taken in conjunction with carbidopa.
Read the full Vitamin B6 + Levodopa, Carbidopa interactionMidazolamNayzilam, Seizalam, Versed
How Midazolam interacts with Cardio Igniter Pineapple Mango — through 4 ingredients. Tap an ingredient for the detail:
Bitter Orange ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Midazolam (versed) Major
Interaction Summary
Bitter orange might increase levels of drugs metabolized by CYP3A4.
Read the full Bitter Orange Extract + Midazolam interactionBeet Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, beet might increase the levels of CYP3A4 substrates.
Read the full Beet Root Extract + Midazolam interactionUva-ursi, PowderCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, uva ursi may decrease the metabolism of CYP3A4 substrates.
Read the full Uva-ursi, Powder + Midazolam interactionKelpCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, concomitant use of Fucus vesiculosus with CYP3A4 substrates might increase the risk for adverse effects.
Read the full Kelp + Midazolam interactionMoclobemideManerix, Moclobemide
How Moclobemide interacts with Cardio Igniter Pineapple Mango — through 3 ingredients. Tap an ingredient for the detail:
Bitter Orange ExtractMonoamine Oxidase Inhibitors (maois) Major
Interaction Summary
Theoretically, taking MAOIs with synephrine-containing bitter orange preparations might increase the hypertensive effects of synephrine, potentially leading to hypertensive crisis.
Read the full Bitter Orange Extract + Moclobemide interactionCaffeine AnhydrousMonoamine Oxidase Inhibitors (maois) Moderate
Interaction Summary
Theoretically, concomitant use might increase the risk of a hypertensive crisis.
Read the full Caffeine Anhydrous + Moclobemide interactionUva-ursi, PowderCytochrome P450 2c19 (cyp2c19) Substrates Moderate
Interaction Summary
Theoretically, uva ursi may decrease the metabolism of CYP2C19 substrates.
Read the full Uva-ursi, Powder + Moclobemide interactionOzanimod HydrochlorideZeposia
How Ozanimod Hydrochloride interacts with Cardio Igniter Pineapple Mango — through 4 ingredients. Tap an ingredient for the detail:
Bitter Orange ExtractMonoamine Oxidase Inhibitors (maois), Qt Interval-prolonging Drugs Major
Interaction Summary
Theoretically, taking MAOIs with synephrine-containing bitter orange preparations might increase the hypertensive effects of synephrine, potentially leading to hypertensive crisis.
Read the full Bitter Orange Extract + Ozanimod Hydrochloride interactionCaffeine AnhydrousMonoamine Oxidase Inhibitors (maois) Moderate
Interaction Summary
Theoretically, concomitant use might increase the risk of a hypertensive crisis.
Read the full Caffeine Anhydrous + Ozanimod Hydrochloride interactionNiacinHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Ozanimod Hydrochloride interactionKelpCytochrome P450 2c8 (cyp2c8) Substrates Minor
Interaction Summary
Theoretically, concomitant use of Fucus vesiculosus with CYP2C8 substrates might increase the risk for adverse effects.
Read the full Kelp + Ozanimod Hydrochloride interactionPhenelzine SulfateNardil
How Phenelzine Sulfate interacts with Cardio Igniter Pineapple Mango — through 2 ingredients. Tap an ingredient for the detail:
Bitter Orange ExtractMonoamine Oxidase Inhibitors (maois) Major
Interaction Summary
Theoretically, taking MAOIs with synephrine-containing bitter orange preparations might increase the hypertensive effects of synephrine, potentially leading to hypertensive crisis.
Read the full Bitter Orange Extract + Phenelzine Sulfate interactionCaffeine AnhydrousMonoamine Oxidase Inhibitors (maois) Moderate
Interaction Summary
Theoretically, concomitant use might increase the risk of a hypertensive crisis.
Read the full Caffeine Anhydrous + Phenelzine Sulfate interactionRasagilineAzilect
How Rasagiline interacts with Cardio Igniter Pineapple Mango — through 3 ingredients. Tap an ingredient for the detail:
Bitter Orange ExtractMonoamine Oxidase Inhibitors (maois) Major
Interaction Summary
Theoretically, taking MAOIs with synephrine-containing bitter orange preparations might increase the hypertensive effects of synephrine, potentially leading to hypertensive crisis.
Read the full Bitter Orange Extract + Rasagiline interactionCaffeine AnhydrousMonoamine Oxidase Inhibitors (maois) Moderate
Interaction Summary
Theoretically, concomitant use might increase the risk of a hypertensive crisis.
Read the full Caffeine Anhydrous + Rasagiline interactionBeet Root ExtractCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, beet might decrease the levels and clinical effects of CYP1A2 substrates.
Read the full Beet Root Extract + Rasagiline interactionSafinamide MesylateXadago
How Safinamide Mesylate interacts with Cardio Igniter Pineapple Mango — through 2 ingredients. Tap an ingredient for the detail:
Bitter Orange ExtractMonoamine Oxidase Inhibitors (maois) Major
Interaction Summary
Theoretically, taking MAOIs with synephrine-containing bitter orange preparations might increase the hypertensive effects of synephrine, potentially leading to hypertensive crisis.
Read the full Bitter Orange Extract + Safinamide Mesylate interactionCaffeine AnhydrousMonoamine Oxidase Inhibitors (maois) Moderate
Interaction Summary
Theoretically, concomitant use might increase the risk of a hypertensive crisis.
Read the full Caffeine Anhydrous + Safinamide Mesylate interactionSelegilineCarbex, Eldepryl, Emsam, Zelapar
How Selegiline interacts with Cardio Igniter Pineapple Mango — through 2 ingredients. Tap an ingredient for the detail:
Bitter Orange ExtractMonoamine Oxidase Inhibitors (maois) Major
Interaction Summary
Theoretically, taking MAOIs with synephrine-containing bitter orange preparations might increase the hypertensive effects of synephrine, potentially leading to hypertensive crisis.
Read the full Bitter Orange Extract + Selegiline interactionCaffeine AnhydrousMonoamine Oxidase Inhibitors (maois) Moderate
Interaction Summary
Theoretically, concomitant use might increase the risk of a hypertensive crisis.
Read the full Caffeine Anhydrous + Selegiline interactionTranylcypromineParnate
How Tranylcypromine interacts with Cardio Igniter Pineapple Mango — through 2 ingredients. Tap an ingredient for the detail:
Bitter Orange ExtractMonoamine Oxidase Inhibitors (maois) Major
Interaction Summary
Theoretically, taking MAOIs with synephrine-containing bitter orange preparations might increase the hypertensive effects of synephrine, potentially leading to hypertensive crisis.
Read the full Bitter Orange Extract + Tranylcypromine interactionCaffeine AnhydrousMonoamine Oxidase Inhibitors (maois) Moderate
Interaction Summary
Theoretically, concomitant use might increase the risk of a hypertensive crisis.
Read the full Caffeine Anhydrous + Tranylcypromine interaction6-mercaptopurinePurinethol
How 6-mercaptopurine interacts with Cardio Igniter Pineapple Mango — through 1 ingredient. Tap an ingredient for the detail:
NiacinHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + 6-mercaptopurine interactionAdo-trastuzumab EmtansineKadcyla
How Ado-trastuzumab Emtansine interacts with Cardio Igniter Pineapple Mango — through 4 ingredients. Tap an ingredient for the detail:
Bitter Orange ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Bitter orange might increase levels of drugs metabolized by CYP3A4.
Read the full Bitter Orange Extract + Ado-trastuzumab Emtansine interactionBeet Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, beet might increase the levels of CYP3A4 substrates.
Read the full Beet Root Extract + Ado-trastuzumab Emtansine interactionUva-ursi, PowderCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, uva ursi may decrease the metabolism of CYP3A4 substrates.
Read the full Uva-ursi, Powder + Ado-trastuzumab Emtansine interactionKelpCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, concomitant use of Fucus vesiculosus with CYP3A4 substrates might increase the risk for adverse effects.
Read the full Kelp + Ado-trastuzumab Emtansine interactionAbacavir Sulfate, Dolutegravir, LamivudineTriumeq
How Abacavir Sulfate, Dolutegravir, Lamivudine interacts with Cardio Igniter Pineapple Mango — through 1 ingredient. Tap an ingredient for the detail:
NiacinHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Abacavir Sulfate, Dolutegravir, Lamivudine interactionAbacavir, LamivudineEpzicom
How Abacavir, Lamivudine interacts with Cardio Igniter Pineapple Mango — through 1 ingredient. Tap an ingredient for the detail:
NiacinHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Abacavir, Lamivudine interactionAbciximabReoPro
How Abciximab interacts with Cardio Igniter Pineapple Mango — through 4 ingredients. Tap an ingredient for the detail:
Caffeine AnhydrousAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, caffeine may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Caffeine Anhydrous + Abciximab interactionNiacinAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, niacin may have additive effects when used with anticoagulant or antiplatelet drugs.
Read the full Niacin + Abciximab interactionMagnesiumAnticoagulant/antiplatelet Drugs Minor
Interaction Summary
Theoretically, magnesium may have antiplatelet effects, but the evidence is conflicting.
Read the full Magnesium + Abciximab interactionKelpAnticoagulant/antiplatelet Drugs Minor
Interaction Summary
Theoretically, taking Fucus vesiculosus with antiplatelet or anticoagulant drugs might increase the risk of bruising and bleeding.
Read the full Kelp + Abciximab interactionAbemaciclibVerzenio
How Abemaciclib interacts with Cardio Igniter Pineapple Mango — through 4 ingredients. Tap an ingredient for the detail:
Uva-ursi, PowderCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, uva ursi may decrease the metabolism of CYP3A4 substrates.
Read the full Uva-ursi, Powder + Abemaciclib interactionBeet Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, beet might increase the levels of CYP3A4 substrates.
Read the full Beet Root Extract + Abemaciclib interactionBitter Orange ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Bitter orange might increase levels of drugs metabolized by CYP3A4.
Read the full Bitter Orange Extract + Abemaciclib interactionKelpCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, concomitant use of Fucus vesiculosus with CYP3A4 substrates might increase the risk for adverse effects.
Read the full Kelp + Abemaciclib interactionEach ingredient & the kinds of drugs it affects
For each ingredient in Cardio Igniter Pineapple Mango 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.
Bitter Orange Extract
Midazolam (Versed)
Bitter orange might increase blood levels of midazolam.
One small clinical study shows that bitter orange juice can increase midazolam levels, likely through inhibition of cytochrome P450 3A4 (CYP3A4). Theoretically, bitter orange might increase the risk of midazolam-related adverse effects.
Monoamine Oxidase Inhibitors (Maois)
Theoretically, taking MAOIs with synephrine-containing bitter orange preparations might increase the hypertensive effects of synephrine, potentially leading to hypertensive crisis.
Bitter orange contains tyramine, octopamine, and synephrine, which are MAO substrates.
Antidiabetes Drugs
Theoretically, bitter orange might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Some clinical research shows that drinking a tea containing bitter orange and Indian snakeroot reduces fasting and postprandial glucose levels in patients with type 2 diabetes who are using antidiabetes drugs. However, it is unclear if these effects are due to bitter orange, Indian snakeroot, or the combination. An animal study also shows that p-synephrine in combination with gliclazide , a sulfonylurea, causes an additional 20% to 44% decrease in glucose levels when compared with gliclazide alone.
Caffeine
Bitter orange might increase blood pressure and heart rate when taken with caffeine.
Small clinical studies show that taking bitter orange in combination with caffeine can increase blood pressure and heart rate in otherwise healthy normotensive adults. Theoretically, this might increase the risk of serious cardiovascular adverse effects.
Colchicine
Bitter orange might affect colchicine levels.
Colchicine is a substrate of P-glycoprotein and cytochrome P450 3A4 (CYP3A4). Bitter orange has been reported to inhibit CYP3A4 and increase levels of CYP3A4 substrates. However, one small clinical study in healthy adults shows that drinking bitter orange juice 240 mL twice daily for 4 days and taking a single dose of colchicine 0.6 mg on the 4th day decreases colchicine peak serum levels by 24%, time to peak serum level by 1 hour, and overall exposure to colchicine by 20%. The clinical significance of this finding is unclear.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Bitter orange might increase levels of drugs metabolized by CYP3A4.
Small clinical studies suggest that single or multiple doses of freshly squeezed bitter orange juice 200-240 mL can inhibit CYP3A4 metabolism of drugs, causing increased drug levels and potentially increasing the risk of adverse effects. However, the extent of the effect of bitter orange on CYP3A4-mediated drug interactions is unknown. Some evidence suggests that bitter orange selectively inhibits intestinal CYP3A4, but not hepatic CYP3A4. Its effect on P-glycoprotein, which strongly overlaps with CYP3A4 interactions, is unclear. One small clinical study shows that drinking 8 ounces of freshly squeezed bitter orange juice has no effect on cyclosporine, which seems to be more dependent on hepatic CYP3A4 and P-glycoprotein than intestinal CYP3A4.
Dextromethorphan (Robitussin Dm, Others)
Bitter orange might increase blood levels of dextromethorphan.
One small clinical study shows that bitter orange juice increases dextromethorphan levels, likely through cytochrome P450 3A4 (CYP3A4) inhibition. Theoretically, bitter orange might increase the risk for dextromethorphan-related adverse effects.
Felodipine (Plendil)
Bitter orange might increase blood levels of felodipine.
One small clinical study shows that bitter orange juice increases felodipine levels, likely through cytochrome P450 3A4 (CYP3A4) inhibition. Theoretically, bitter orange might increase the risk for felodipine-related adverse effects.
Indinavir (Crixivan)
Bitter orange might increase blood levels of indinavir.
One small clinical study shows that bitter orange juice slightly increases indinavir levels, but this effect is likely to be clinically insignificant. Bitter orange selectively inhibits intestinal cytochrome P450 3A4 (CYP3A4); however, the metabolism of indinavir seems to be more dependent on hepatic CYP3A4. The effect of bitter orange on other protease inhibitors has not been studied.
Qt Interval-Prolonging Drugs
Theoretically, bitter orange might have an additive effect when combined with drugs that prolong the QT interval, potentially increasing the risk of ventricular arrhythmias.
One case report suggests that taking bitter orange in combination with other stimulants such as caffeine might prolong the QT interval in some patients.
Sildenafil (Viagra)
Bitter orange juice might increase blood levels of sildenafil.
A small clinical study in healthy adult males shows that drinking freshly squeezed bitter orange juice 250 mL daily for 3 days and taking a single dose of sildenafil 50 mg on the 3rd day increases the peak plasma concentration of sildenafil by 18% and the overall exposure to sildenafil by 44%. Theoretically, this may be due to inhibition of cytochrome P450 3A4 by bitter orange.
Stimulant Drugs
Theoretically, bitter orange might increase the risk of hypertension and adverse cardiovascular effects when taken with stimulant drugs.
Bitter orange appears to have stimulant effects.
Cytochrome P450 2D6 (Cyp2D6) Substrates
Theoretically, bitter orange might increase levels of drug metabolized by CYP2D6.
In vitro research shows that octopamine, a constituent of bitter orange, weakly inhibits CYP2D6 enzymes. This effect has not been reported in humans.
Kelp
Amiodarone (Cordarone)
Theoretically, combining Fucus vesiculosus with amiodarone might cause excessively high iodine levels.
Fucus vesiculosus contains high concentrations of iodine. Amiodarone contains 37.3% iodine and can increase iodine levels. Concomitant use might increase the risk of having excessive iodine levels and adversely affecting thyroid function. Monitor thyroid function.
Antithyroid Drugs
Due to its iodine content, Fucus vesiculosus might alter the effects of antithyroid drugs.
Fucus vesiculosus contains high concentrations of iodine. Iodine in high doses has been reported to cause both hyperthyroidism and hypothyroidism, depending on the individual's past medical history. Taking Fucus vesiculosus while using antithyroid drugs could alter the effects of the antithyroid drugs.
Lithium
Concomitant use of Fucus vesiculosus and lithium has resulted in hyperthyroidism.
There is a case of hyperthyroidism occurring in a patient taking Fucus vesiculosus and lithium. Monitor thyroid hormones closely in patients taking lithium and Fucus vesiculosus concomitantly.
Thyroid Hormone
Due to its iodine content, Fucus vesiculosus might alter the effects of thyroid hormone.
Fucus vesiculosus contains high concentrations of iodine. Iodine in high doses has been reported to cause both hyperthyroidism and hypothyroidism, depending on the individual's past medical history. Taking Fucus vesiculosus while using thyroid hormone could alter the effects of thyroid hormone.
Anticoagulant/Antiplatelet Drugs
Theoretically, taking Fucus vesiculosus with antiplatelet or anticoagulant drugs might increase the risk of bruising and bleeding.
In vitro evidence suggests that a constituent of Fucus vesiculosus, known as fucoidan, has anticoagulant effects. However, in clinical research, fucoidan does not seem to have significant anticoagulant activity when taken orally, possibly due to poor absorption.
Cytochrome P450 2C8 (Cyp2C8) Substrates
Theoretically, concomitant use of Fucus vesiculosus with CYP2C8 substrates might increase the risk for adverse effects.
In vitro research shows that fucoidan, a constituent of Fucus vesiculosus, inhibits CYP2C8. This interaction has not been reported in humans.
Cytochrome P450 2C9 (Cyp2C9) Substrates
Theoretically, concomitant use of Fucus vesiculosus with CYP2C9 substrates might increase the risk for adverse effects.
In vitro research shows that fucoidan, a constituent of Fucus vesiculosus, inhibits CYP2C9. This interaction has not been reported in humans.
Cytochrome P450 2D6 (Cyp2D6) Substrates
Theoretically, concomitant use of Fucus vesiculosus with CYP2D6 substrates might alter the effects of these substrates.
In vitro research shows that fucoidan, a constituent of Fucus vesiculosus, both inhibits and induces CYP2D6. This interaction has not been reported in humans.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, concomitant use of Fucus vesiculosus with CYP3A4 substrates might increase the risk for adverse effects.
In vitro research shows that fucoidan, a constituent of Fucus vesiculosus, inhibits CYP3A4. This interaction has not been reported in humans.
Beet Root Extract
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, beet might increase the levels of CYP3A4 substrates.
In vitro research suggests that betanin, the major pigment in beet, competitively inhibits CYP3A4 in a dose-dependent manner similarly to strong CYP3A4 inhibitor ketoconazole.
Antihypertensive Drugs
Beet and beetroot contain nitrates, which can cause vasodilation, potentially leading to lower blood pressure. However, a study published in the European Journal of Clinical Nutrition using concentrated beetroot juice found no significant impact on blood pressure or heart rate in different age groups. Other small clinical studies suggest that while beet consumption might transiently lower blood pressure due to vessel dilation, there's no consistent evidence of a lasting effect. Overall, the theoretical risk of reduced blood pressure due to beet's nitrate content exists, but studies generally indicate a low and temporary impact rather than a sustained decrease.
Cytochrome P450 1A2 (Cyp1A2) Substrates
Theoretically, beet might decrease the levels and clinical effects of CYP1A2 substrates.
In vitro research suggests that beet induces CYP1A2 enzymes.
Uva-Ursi, Powder
Cytochrome P450 2C19 (Cyp2C19) Substrates
Theoretically, uva ursi may decrease the metabolism of CYP2C19 substrates.
In vitro, uva ursi appears to inhibit cytochrome CYP2C19. This effect has not been reported in humans.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, uva ursi may decrease the metabolism of CYP3A4 substrates.
In vitro, uva ursi appears to inhibit CYP3A4. This effect has not been reported in humans.
Glucuronidated Drugs
Theoretically, uva ursi may increase levels of drugs metabolized by glucuronidation.
In vitro, uva ursi extract appears to strongly inhibit UDP-glucuronosyltransferase (UGT) 1A1 (UGT1A1). However, uva ursi extract does not appear to inhibit UGT1A1 in animal models. This effect has not been reported in humans.
Lithium
Theoretically, uva ursi may increase lithium levels, necessitating a decrease in dose.
Uva ursi may have diuretic properties. Diuretics may increase lithium reabsorption with sodium in the proximal tubule of the kidney. Theoretically, uva ursi might reduce excretion and increase levels of lithium.
Urinary Acidifying Agents
Effects of uva ursi in the urinary tract may be reduced by urinary acidifying agents.
Uva ursi seems to work best in alkaline urine. Theoretically, taking uva ursi with medications known to acidify the urine may decrease any effects of uva ursi on the urinary tract.
P-Glycoprotein Substrates
Theoretically, uva ursi may alter the levels of drugs transported by P-glycoprotein.
In vitro, uva ursi appears to inhibit the multi-drug transporter protein, P-glycoprotein. This effect has not been reported in humans.
Niacin
Alcohol (Ethanol)
Concomitant use of alcohol and niacin might increase the risk of flushing and hepatotoxicity.
Alcohol can exacerbate the flushing and pruritus associated with niacin. Large doses of niacin might also exacerbate liver dysfunction associated with chronic alcohol use. A case report describes delirium and lactic acidosis in a patient taking niacin 3 grams daily who ingested 1 liter of wine. Advise patients to avoid large amounts of alcohol while taking niacin.
Allopurinol (Zyloprim)
Theoretically, niacin might antagonize the therapeutic effects of uricosurics such as allopurinol.
Large doses of niacin can reduce urinary excretion of uric acid, potentially resulting in hyperuricemia. Doses of uricosurics such as allopurinol might need to be increased to maintain control of gout in patients who start taking niacin. People who have frequent attacks of gout despite uricosuric therapy should avoid niacin.
Anticoagulant/Antiplatelet Drugs
Theoretically, niacin may have additive effects when used with anticoagulant or antiplatelet drugs.
Several cases of clotting factor synthesis deficiency and coagulopathy have been reported in patients taking sustained-release niacin. Also, thrombocytopenia has been reported in patients treated with niacin or niacin plus lovastatin.
Antidiabetes Drugs
Niacin can increase blood glucose levels and may diminish the effects of antidiabetes drugs.
Niacin impairs glucose tolerance in a dose-dependent manner, probably by causing or aggravating insulin resistance and increasing hepatic production of glucose. In diabetes patients, niacin 4.5 grams daily for 5 weeks can increase plasma glucose by an average of 16% and glycated hemoglobin (HbA1c) by 21%. However, lower doses of 1.5 grams daily or less appear to have minimal effects on blood glucose. In some patients, glucose levels increase when niacin is started, but then return to baseline when a stable dose is reached. Up to 35% of patients with diabetes may need adjustments in hypoglycemic therapy when niacin is added.
Antihypertensive Drugs
Theoretically, niacin may increase the risk of hypotension when used with antihypertensive drugs.
The vasodilating effects of niacin can cause hypotension. Furthermore, some clinical evidence suggests that a one-hour infusion of niacin can reduce systolic, diastolic, and mean blood pressure in hypertensive patients. This effect is not observed in normotensive patients.
Bile Acid Sequestrants
Bile acid sequestrants can bind niacin and decrease absorption. Separate administration by 4-6 hours to avoid an interaction.
In vitro studies show that colestipol (Colestid) binds about 98% of available niacin and cholestyramine (Questran) binds 10% to 30%.
Gemfibrozil (Lopid)
Theoretically, concomitant use of niacin and gemfibrozil might increase the risk of myopathy in some patients.
A case of myopathy from concomitant use of niacin and gemfibrozil has been reported. Niacin alone has also been associated with cases of myopathy. Using gemfibrozil with niacin might further increase the risk of developing myopathy.
Hepatotoxic Drugs
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Niacin has been associated with cases of liver toxicity, especially when used in pharmacologic doses. Sustained-release niacin preparations appear to be associated with a higher risk of hepatotoxicity than immediate-release niacin.
Hmg-Coa Reductase Inhibitors ("Statins")
Theoretically, concomitant use of niacin and statins might increase the risk of myopathy and rhabdomyolysis in some patients.
Some case reports have raised concerns that niacin might increase the risk of myopathy and rhabdomyolysis when combined with statins. However, a significantly increased risk of myopathy has not been demonstrated in clinical trials, including those using an FDA-approved combination of lovastatin and niacin (Advicor).
Probenecid (Benemid)
Theoretically, niacin might antagonize the therapeutic effects of uricosurics such as probenecid.
Large doses of niacin reduce urinary excretion of uric acid, potentially causing hyperuricemia. Doses of uricosurics such as probenecid might need to be increased to maintain control of gout in patients who start taking niacin. People who have frequent attacks of gout despite uricosuric therapy should avoid niacin.
Sulfinpyrazone (Anturane)
Theoretically, niacin might antagonize the therapeutic effects of uricosurics such as sulfinpyrazone.
Large doses of niacin reduce urinary excretion of uric acid, potentially causing hyperuricemia. Doses of uricosurics such as sulfinpyrazone might need to be increased to maintain control of gout in patients who start taking niacin. People who have frequent attacks of gout despite uricosuric therapy should avoid niacin.
Thyroid Hormone
Theoretically, niacin might antagonize the therapeutic effects of thyroid hormones.
Clinical research and case reports suggests that taking niacin can reduce serum levels of thyroxine-binding globulin by up to 25% and moderately reduce levels of thyroxine (T4). Patients taking thyroid hormone for hypothyroidism might need dose adjustments when using niacin.
Transdermal Nicotine (Nicoderm)
Theoretically, concomitant use of niacin and transdermal nicotine might increase the risk of flushing and dizziness.
Niacin and nicotine can both cause flushing and dizziness.
Warfarin (Coumadin)
There is limited evidence that niacin may increase the anticoagulant effects of warfarin.
In a case report, a patient on warfarin developed an elevated international normalized ratio (INR) of 3.9 after taking niacin for two weeks. The patient's INR was previously stable, ranging between 2 and 3 in recent months, and no other medication changes were identified. The elevated INR returned to therapeutic range within 4 days following the discontinuation of niacin.
Aspirin
Large doses of aspirin might alter the clearance of niacin.
Aspirin is often used with niacin to reduce niacin-induced flushing. Doses of 80-975 mg aspirin have been used, but 325 mg appears to be optimal. Aspirin also seems to reduce the clearance of niacin by competing for glycine conjugation. Taking aspirin 1 gram seems to reduce niacin clearance by 45%. This is probably a dose-related effect and not clinically significant with the more common aspirin dose of 325 mg.
Caffeine Anhydrous
Ephedrine
Theoretically, concomitant use might increase the risk for stimulant adverse effects.
Use of ephedrine with caffeine can increase the risk of stimulatory adverse effects. There is evidence that using ephedrine with caffeine might increase the risk of serious life-threatening or debilitating adverse effects such as hypertension, myocardial infarction, stroke, seizures, and death.
Adenosine (Adenocard)
Theoretically, caffeine might decrease the vasodilatory effects of adenosine and interfere with its use prior to stress testing.
Some evidence shows that caffeine is a competitive inhibitor of adenosine and can reduce the vasodilatory effects of adenosine in humans. However, other research shows that caffeine does not seem to affect supplemental adenosine because high interstitial levels of adenosine overcome the antagonistic effects of caffeine. It is recommended that methylxanthines and methylxanthine-containing products be stopped 24 hours prior to pharmacological stress tests. However, methylxanthines appear more likely to interfere with dipyridamole (Persantine) than adenosine-induced stress testing.
Anticoagulant/Antiplatelet Drugs
Theoretically, caffeine may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Caffeine is reported to have antiplatelet activity. Theoretically, it might increase the risk of bleeding when used concomitantly with these agents; however, this interaction has not been reported in humans.
Beta-Adrenergic Agonists
Theoretically, large amounts of caffeine might increase the cardiac inotropic effects of beta-agonists.
Carbamazepine (Tegretol)
Theoretically, caffeine might reduce the effects of carbamazepine and increase the risk for convulsions.
Animal research suggests that taking caffeine can lower the anticonvulsant effects of carbamazepine and can induce seizures when taken in doses above 400 mg/kg. Human research has shown that taking caffeine 300 mg in three divided doses along with carbamazepine 200 mg reduces the bioavailability of carbamazepine by 32% and prolongs the plasma half-life of carbamazepine 2-fold in healthy individuals.
Cimetidine (Tagamet)
Theoretically, cimetidine might increase the levels and adverse effects of caffeine.
Cimetidine decreases the rate of caffeine clearance by 31% to 42%.
Clozapine (Clozaril)
Caffeine might increase the levels and adverse effects of clozapine and acutely exacerbate psychotic symptoms.
Caffeine might increase the effects and toxicity of clozapine. Caffeine doses of 400-1000 mg per day inhibit clozapine metabolism. Clozapine is metabolized by cytochrome P450 1A2 (CYP1A2). Although researchers speculate that caffeine might inhibit CYP1A2, there is no reliable evidence that caffeine affects CYP1A2. There is also speculation that genetic factors might make some patients more sensitive to an interaction between clozapine and caffeine. In one case report, severe, life-threatening clozapine toxicity and multiorgan system failure occurred in a patient with schizophrenia stabilized on clozapine who consumed caffeine 600 mg daily.
Dipyridamole (Persantine)
Theoretically, caffeine might decrease the vasodilatory effects of dipyridamole and interfere with its use prior to stress testing.
Caffeine inhibits dipyridamole-induced vasodilation. It is recommended that methylxanthines and methylxanthine-containing products be stopped 24 hours prior to pharmacological stress tests. Methylxanthines appear more likely to interfere with dipyridamole (Persantine) than adenosine-induced stress testing.
Disulfiram (Antabuse)
Theoretically, disulfiram use might increase the levels and adverse effects of caffeine.
Disulfiram decreases the rate of caffeine clearance.
Diuretic Drugs
Theoretically, using caffeine with diuretic drugs might increase the risk of hypokalemia.
Caffeine, especially in excessive amounts, can reduce potassium levels due to stimulation of the sodium-potassium pump. Diuretics can also cause lower potassium levels.
Estrogens
Theoretically, estrogens might increase the levels and adverse effects of caffeine.
Estrogen inhibits caffeine metabolism.
Ethosuximide (Zarontin)
Theoretically, caffeine might reduce the effects of ethosuximide and increase the risk for convulsions.
Animal research suggests that caffeine 92.4 mg/kg can decrease the anticonvulsant activity of ethosuximide. However, this effect has not been reported in humans.
Felbamate (Felbatol)
Theoretically, caffeine might reduce the effects of felbamate and increase the risk for convulsions.
Animal research suggests that a high dose of caffeine 161.7 mg/kg can decreases the anticonvulsant activity of felbamate. However, this effect has not been reported in humans.
Flutamide (Eulexin)
Theoretically, caffeine might increase the levels and adverse effects of flutamide.
In vitro evidence suggests that caffeine can inhibit the metabolism of flutamide. However, this effect has not been reported in humans.
Fluvoxamine (Luvox)
Theoretically, fluvoxamine might increase the levels and adverse effects of caffeine.
Fluvoxamine reduces caffeine metabolism.
Lithium
Abrupt caffeine withdrawal might increase the levels and adverse effects of lithium.
Caffeine has diuretic activity. When abruptly discontinued, caffeine may alter the clearance of lithium. There are two case reports of lithium tremor that worsened upon abrupt coffee withdrawal and 6 case reports of elevated serum lithium levels after reducing or eliminating caffeine intake. In one case, a male with schizoaffective disorder stabilized on lithium had an elevated lithium level after reducing his caffeine intake by 87%. At a later date, he increased his caffeine intake by 6-fold, resulting in a subtherapeutic lithium level and a recurrence of psychiatric symptoms.
Monoamine Oxidase Inhibitors (Maois)
Theoretically, concomitant use might increase the risk of a hypertensive crisis.
Caffeine has been shown to inhibit monoamine oxidase (MAO) A and B in laboratory studies. Concomitant intake of large amounts of caffeine with MAOIs might precipitate a hypertensive crisis. In a case report, a patient that consumed 10-12 cups of caffeinated coffee and took the MAOI tranylcypromine presented with severe hypertension. Hypertension was resolved after the patient switched to drinking decaffeinated coffee.
Nicotine
Theoretically, concomitant use might increase the risk of hypertension.
Concomitant use of caffeine and nicotine has been shown to have additive cardiovascular effects, including increased heart rate and blood pressure. Blood pressure was increased by 10.8/12.4 mmHg when the agents were used concomitantly.
Pentobarbital (Nembutal)
Theoretically, caffeine might decrease the effects of pentobarbital.
Caffeine might negate the hypnotic effects of pentobarbital.
Phenobarbital (Luminal)
Theoretically, caffeine might reduce the effects of phenobarbital and increase the risk for convulsions.
Animal research suggests that caffeine can decrease the anticonvulsant activity of phenobarbital. However, the exact mechanism of this interaction is unclear.
Phenylpropanolamine
Theoretically, phenylpropanolamine might increase the risk of hypertension, as well as the levels and adverse effects of caffeine.
Concomitant use of phenylpropanolamine and caffeine might cause an additive increase in blood pressure. Phenylpropanolamine also seems to increase caffeine serum levels.
Phenytoin (Dilantin)
Theoretically, caffeine might reduce the effects of phenytoin and increase the risk for convulsions.
Animal research suggests that caffeine can decrease the anticonvulsant activity of phenytoin. The effect does not seem to be related to the seizure threshold-lowering effects of caffeine. However, the exact mechanism of this interaction is unclear.
Pioglitazone (Actos)
Theoretically, caffeine might increase the levels and clinical effects of pioglitazone.
Animal research suggests that caffeine can modestly increase the maximum concentration, area under the curve, and half-life of pioglitazone, and also reduce its clearance. This increased the antidiabetic effects of pioglitazone. However, the exact mechanism of this interaction is unclear.
Quinolone Antibiotics
Theoretically, quinolone antibiotics might increase the levels and adverse effects of caffeine.
Quinolones (also called fluoroquinolones) can decrease caffeine clearance by inhibiting cytochrome P450 1A2 (CYP1A2) enzyme.
Riluzole (Rilutek)
Theoretically, concomitant use might increase the levels and adverse effects of both caffeine and riluzole.
Caffeine and riluzole are both metabolized by cytochrome P450 1A2 (CYP1A2), and concomitant use might reduce the metabolism of one or both agents.
Magnesium
Levodopa/Carbidopa (Sinemet)
Magnesium can reduce the bioavailability of levodopa/carbidopa.
Clinical research in healthy volunteers shows that taking magnesium oxide 1000 mg with levodopa 100 mg/carbidopa 10 mg reduces the area under the curve (AUC) of levodopa by 35% and of carbidopa by 81%. In vitro and animal research shows that magnesium produces an alkaline environment in the digestive tract, which might lead to degradation and reduced bioavailability of levodopa/carbidopa.
Aminoglycoside Antibiotics
Concomitant use of aminoglycoside antibiotics and magnesium can increase the risk for neuromuscular weakness.
Both aminoglycosides and magnesium reduce presynaptic acetylcholine release, which can lead to neuromuscular blockade and possible paralysis. This is most likely to occur with high doses of magnesium given intravenously.
Antacids
Use of acid reducers may reduce the laxative effect of magnesium oxide.
A retrospective analysis shows that, in the presence of H2 receptor antagonists (H2RAs) or proton pump inhibitors (PPIs), a higher dose of magnesium oxide is needed for a laxative effect. This may also occur with antacids. Under acidic conditions, magnesium oxide is converted to magnesium chloride and then to magnesium bicarbonate, which has an osmotic laxative effect. By reducing acidity, antacids may reduce the conversion of magnesium oxide to the active bicarbonate salt.
Bictegravir/Emtricitabine/Tenofovir Alafenamide (Biktarvy)
Magnesium might decrease levels of bictegravir/emtricitabine/tenofovir alafenamide by reducing its absorption.
Advise patients that bictegravir/emtricitabine/tenofovir alafenamide should be taken at least 2 hours before or 6 hours after magnesium containing products.
Bisphosphonates
Magnesium can decrease absorption of bisphosphonates.
Cations, including magnesium, can decrease bisphosphonate absorption. Advise patients to separate doses of magnesium and these drugs by at least 2 hours.
Calcium Channel Blockers
Magnesium can have additive effects with calcium channel blockers, although evidence is conflicting.
Magnesium inhibits calcium entry into smooth muscle cells and may therefore have additive effects with calcium channel blockers. Severe hypotension and neuromuscular blockades may occur when nifedipine is used with intravenous magnesium, although some contradictory evidence suggests that concurrent use of magnesium with nifedipine does not increase the risk of neuromuscular weakness. High doses of magnesium could theoretically have additive effects with other calcium channel blockers.
Digoxin
Magnesium salts may reduce absorption of digoxin.
Clinical evidence suggests that treatment with oral magnesium hydroxide or magnesium trisilicate reduces absorption of digoxin from the intestines. This may reduce the blood levels of digoxin and decrease its therapeutic effects.
Potassium-Sparing Diuretics
Potassium-sparing diuretics decrease excretion of magnesium, possibly increasing magnesium levels.
Potassium-sparing diuretics also have magnesium-sparing properties, which can counteract the magnesium losses associated with loop and thiazide diuretics. Theoretically, increased magnesium levels could result from concomitant use of potassium-sparing diuretics and magnesium supplements.
Quinolone Antibiotics
Magnesium decreases absorption of quinolones.
Magnesium can form insoluble complexes with quinolones and decrease their absorption. Advise patients to take these drugs at least 2 hours before, or 4 to 6 hours after, magnesium supplements.
Skeletal Muscle Relaxants
Parenteral magnesium alters the pharmacokinetics of skeletal muscle relaxants, increasing their effects and accelerating the onset of effect.
Parenteral magnesium shortens the time to onset of skeletal muscle relaxants by about 1 minute and prolongs the duration of action by about 2 minutes. Magnesium potentiates the effects of skeletal muscle relaxants by decreasing calcium-mediated release of acetylcholine from presynaptic nerve terminals, reducing postsynaptic sensitivity to acetylcholine, and having a direct effect on the membrane potential of myocytes. Magnesium also has vasodilatory actions and increases cardiac output, allowing a greater amount of muscle relaxant to reach the motor end plate. A clinical study found that low-dose rocuronium (0.45 mg/kg), when given after administration of magnesium 30 mg/kg over 10 minutes, has an accelerated onset of effect, which matches the onset of effect seen with a full-dose rocuronium regimen (0.6 mg/kg). In another clinical study, onset times for rocuronium doses of 0.3, 0.6, and 1.2 mg/kg were 86, 76, and 50 seconds, respectively, when given alone, but were reduced to 66, 44, and 38 seconds, respectively, when the doses were given after a 15-minute infusion of magnesium sulfate 60 mg/kg. Giving intraoperative intravenous magnesium sulfate, 50 mg/kg loading dose followed by 15 mg/kg/hour, reduces the onset time of rocuronium, enhances its clinical effects, reduces the dose of intraoperative opiates, and prolongs the spontaneous recovery time. It does not affect the activity of subsequently administered neostigmine.
Sulfonylureas
Magnesium increases the systemic absorption of sulfonylureas, increasing their effects and side effects.
Clinical research shows that administration of magnesium hydroxide with glyburide increases glyburide absorption, increases maximal insulin response by 35-fold, and increases the risk of hypoglycemia, when compared with glyburide alone. A similar interaction occurs between magnesium hydroxide and glipizide. The mechanism of this effect appears to be related to the elevation of gastrointestinal pH by magnesium-based antacids, increasing solubility and enhancing absorption of sulfonylureas.
Tetracycline Antibiotics
Magnesium decreases absorption of tetracyclines.
Magnesium can form insoluble complexes with tetracyclines in the gut and decrease their absorption and antibacterial activity. Advise patients to take these drugs 1 hour before or 2 hours after magnesium supplements.
Anticoagulant/Antiplatelet Drugs
Theoretically, magnesium may have antiplatelet effects, but the evidence is conflicting.
In vitro evidence shows that magnesium sulfate inhibits platelet aggregation, even at low concentrations. Some preliminary clinical evidence shows that infusion of magnesium sulfate increases bleeding time by 48% and reduces platelet activity. However, other clinical research shows that magnesium does not affect platelet aggregation, although inhibition of platelet-dependent thrombosis can occur.
Gabapentin (Neurontin)
Gabapentin absorption can be decreased by magnesium.
Clinical research shows that giving magnesium oxide orally along with gabapentin decreases the maximum plasma concentration of gabapentin by 33%, time to maximum concentration by 36%, and area under the curve by 43%. Advise patients to take gabapentin at least 2 hours before, or 4 to 6 hours after, magnesium supplements.
Sevelamer (Renagel, Renvela)
Sevelamer may increase serum magnesium levels.
In patients on hemodialysis, sevelamer use was associated with a 0.28 mg/dL increase in serum magnesium. The mechanism of this interaction remains unclear.
Vitamin B6
Amiodarone (Cordarone)
Theoretically, vitamin B6 might increase the photosensitivity caused by amiodarone.
Despite initial case reports suggesting that pyridoxine may have a protective effect against amiodarone-induced photosensitivity, preliminary clinical research suggests that pyridoxine may actually exacerbate this adverse effect.
Antihypertensive Drugs
Theoretically, vitamin B6 may have additive effects when used with antihypertensive drugs.
Research in hypertensive rats shows that vitamin B6 can decrease systolic blood pressure. Similarly, clinical research in patients with hypertension shows that taking high doses of vitamin B6 may reduce systolic and diastolic blood pressure, possibly by reducing plasma levels of epinephrine and norepinephrine.
Phenobarbital (Luminal)
High doses of vitamin B6 may reduce the levels and clinical effects of phenobarbital.
Preliminary clinical evidence suggests that vitamin B6 200 mg daily can reduce plasma levels of phenobarbital, possibly by increasing metabolism. It is not known whether lower doses have any effect. Advise people taking phenobarbital to avoid high doses of vitamin B6.
Phenytoin (Dilantin)
High doses of vitamin B6 may reduce the levels and clinical effects of phenytoin.
Preliminary clinical evidence suggests that vitamin B6 200 mg daily can reduce plasma levels of phenytoin, possibly by increasing metabolism. It is not known whether lower doses have any effect. Advise people taking phenytoin to avoid high doses of vitamin B6.
Levodopa
Vitamin B6 may increase the metabolism of levodopa when taken alone, but not when taken in conjunction with carbidopa.
Vitamin B6 (pyridoxine) enhances the metabolism of levodopa, reducing its clinical effects. However, this interaction does not occur when carbidopa is used concurrently with levodopa (Sinemet). Therefore, it is not likely to be a problem in most people.
Sodium
Antihypertensive Drugs
Theoretically, a high intake of dietary sodium might reduce the effectiveness of antihypertensive drugs.
High intake of dietary sodium can increase systolic and diastolic blood pressure. Also, high intake of sodium may necessitate increased use of antihypertensive medications to achieve blood pressure control in some patients, such as those with chronic kidney disease.
Corticosteroids
Concomitant use of mineralocorticoids and some glucocorticoids with sodium supplements might increase the risk of hypernatremia.
Mineralocorticoids and some glucocorticoids (corticosteroids) cause sodium retention. This effect is dose-related and depends on mineralocorticoid potency. It is most common with hydrocortisone, cortisone, and fludrocortisone, followed by prednisone and prednisolone.
Didanosine (Videx)
Concomitant use of didanosine with additional sodium from dietary or supplemental sources may increase the risk of hypernatremia.
Didanosine formulations contain a significant amount of sodium.
Lithium
Altering dietary intake of sodium might alter the levels and clinical effects of lithium.
High sodium intake can reduce plasma concentrations of lithium by increasing lithium excretion. Reducing sodium intake can significantly increase plasma concentrations of lithium and cause lithium toxicity in patients being treated with lithium carbonate. Stabilizing sodium intake is shown to reduce the percentage of patients with lithium level fluctuations above 0.8 mEq/L. Patients taking lithium should avoid significant alterations in their dietary intake of sodium.
Sodium Phosphates
Theoretically, concomitant use of sodium phosphate with sodium supplements might increase the risk of hypernatremia.
Use of high doses (> 45 mL in 24 hours) of sodium phosphate, such as those used for bowel cleansing before surgery, can lead to serious electrolyte disturbances, including hypernatremia. The risk of hypernatremia is highest in the elderly and people with other risk factors for electrolyte disturbances.
Sodium-Containing Drugs
Concomitant use of sodium-containing drugs with additional sodium from dietary or supplemental sources may increase the risk of hypernatremia and long-term sodium-related complications.
The Chronic Disease Risk Reduction (CDRR) intake level of 2.3 grams of sodium daily indicates the intake at which it is believed that chronic disease risk increases for the apparently healthy population. Some medications contain high quantities of sodium. When used in conjunction with sodium supplements or high-sodium diets, the CDRR may be exceeded. Additionally, concomitant use may increase the risk for hypernatremia; this risk is highest in the elderly and people with other risk factors for electrolyte disturbances.
Tolvaptan (Samsca)
Theoretically, concomitant use of tolvaptan with sodium might increase the risk of hypernatremia.
Tolvaptan is a vasopressin receptor 2 antagonist that is used to increase sodium levels in patients with hyponatremia. Patients taking tolvaptan should use caution with the use of sodium salts such as sodium chloride.
Raspberry Ketones
Stimulant Drugs
Theoretically, raspberry ketone might increase the risk of adverse cardiovascular effects with stimulant drugs.
Structurally, raspberry ketone resembles synephrine, a known stimulant agent. Heart palpitations, elevated blood pressure, coronary vasospasm, pulseless electrical activity arrest, and resistant polymorphic ventricular tachycardia have been reported in patients taking raspberry ketone.
Warfarin (Coumadin)
Theoretically, raspberry ketone might increase warfarin dose requirements.
In one case report, a patient taking warfarin 55 mg per week had a decrease in INR over a period of one month while taking raspberry ketone 250 mg daily. A warfarin dose increase to 70 mg per week was necessary to maintain a therapeutic INR while taking raspberry ketone. The mechanism for this potential interaction is not known.
Taurine
Antihypertensive Drugs
Theoretically, taurine might increase the risk of hypotension when taken with antihypertensive drugs.
Some clinical evidence suggests that taurine can reduce both systolic and diastolic blood pressure.
Lithium
Theoretically, taurine might reduce excretion and increase plasma levels of lithium.
Taurine is thought to have diuretic properties, which might reduce the excretion of lithium.
D-Ribose
Antidiabetes Drugs
Theoretically, taking ribose in combination with antidiabetes drugs might increase the risk of hypoglycemia.
In clinical research, ribose decreases serum glucose levels in a dose-dependent manner.
Insulin
Theoretically, taking ribose with insulin could increase the hypoglycemic effect of insulin.
In clinical pharmacokinetic studies, oral administration of ribose modestly increased serum insulin levels.
Potassium
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.
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.
Potassium-Sparing Diuretics
Concomitant use increases the risk of hyperkalemia.
Using potassium-sparing diuretics with potassium supplements increases the risk of hyperkalemia.
L-Tyrosine
Levodopa
Theoretically, tyrosine might decrease the effectiveness of levodopa.
Tyrosine and levodopa compete for absorption in the proximal duodenum by the large neutral amino acid (LNAA) transport system. Advise patients to separate doses of tyrosine and levodopa by at least 2 hours.
Thyroid Hormone
Theoretically, tyrosine might have additive effects with thyroid hormone medications.
Tyrosine is a precursor to thyroxine and might increase levels of thyroid hormones.
Vitamin B12
Metformin (Glucophage)
Metformin, a common medication used to manage type 2 diabetes, has been associated with lower vitamin B12 levels in some individuals. Prolonged use of metformin can interfere with the absorption of B12 in the digestive system, potentially leading to a deficiency in this essential vitamin.
L-Carnitine L-Tartrate
Acenocoumarol (Sintrom)
Theoretically, L-carnitine might increase the anticoagulant effects of acenocoumarol.
L-carnitine might enhance the anticoagulant effects of acenocoumarol, an oral anticoagulant similar to warfarin, but shorter-acting. There are at least two case reports of INR elevation with concomitant use. In one case, a 33-year-old male with a previously stable INR had an elevated INR of 4.65 after L-carnitine was started and continued for 10 weeks. INR normalized after discontinuation of the L-carnitine-containing product.
Thyroid Hormone
Theoretically, L-carnitine might decrease the effectiveness of thyroid hormone replacement.
L-carnitine appears to act as a peripheral thyroid hormone antagonist by inhibiting entry of thyroid hormone into the nucleus of cells. Taking L-carnitine also seems to diminish some of the symptoms of hyperthyroidism.
Warfarin (Coumadin)
Theoretically, L-carnitine might increase the anticoagulant effects of warfarin.
L-carnitine might increase the anticoagulant effects of acenocoumarol, a shorter-acting oral anticoagulant similar to warfarin. There is not enough information to know whether this interaction occurs with L-carnitine and warfarin.
Choline Bitartrate
Atropine
Theoretically, choline might decrease the effects of atropine in the brain.
Animal research shows that administering choline one hour before administering atropine can attenuate atropine-induced decreases in brain levels of acetylcholine. Theoretically, concomitant use of choline and atropine may decrease the effects of atropine.
Brand information
Manufacturer and brand details for Cardio Igniter Pineapple Mango, from the product label.
Top Secret Nutrition
See all Top Secret Nutrition products- Name
- Top Secret Nutrition, LLC.
- Street Address
- 6015 - B Unity Dr.
- City
- Norcross
- State
- GA
- ZipCode
- 30071
- Phone Number
- 888.855.7919
- Web Address
- TopSecretNutrition.com
Cardio Igniter Pineapple Mango by Top Secret Nutrition: Common Questions
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Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
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Label information is sourced from the NIH Dietary Supplement Label Database and reflects the product version on file; always read your actual product label. This page is for education only and is not a substitute for professional medical advice. Confirm with your pharmacist or doctor before combining supplements and medications.
The Full Monographs Behind Cardio Igniter Pineapple Mango’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Vitamin B6
Interacts with 210 drugsVitamin B6 (pyridoxine) is an essential water-soluble vitamin that your body needs for metabolism, brain function, and making red blood cells. It is best known for helping with pregnancy-rel...
Read the full Vitamin B6 monograph → Herb & supplement monographNiacin
Interacts with 727 drugsNiacin (vitamin B3) is an essential nutrient your body needs for energy and metabolism, and deficiency is uncommon in most developed countries. Prescription-strength niacin has been used to...
Read the full Niacin monograph → Herb & supplement monographVitamin B12
Interacts with 20 drugsVitamin B12 (cobalamin) is an essential nutrient your body needs to make red blood cells, keep nerves healthy, and support DNA. Supplements are very helpful for people who are deficient — su...
Read the full Vitamin B12 monograph → Herb & supplement monographSodium
Interacts with 205 drugsSodium is an essential mineral and electrolyte your body needs to balance fluids, support nerves, and help muscles work. Most people in modern diets get more than enough—often too much—from...
Read the full Sodium monograph → Herb & supplement monographPotassium
Interacts with 62 drugsPotassium 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 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 monographRibose
Interacts with 86 drugsRibose (D-ribose) is a simple sugar your body makes naturally and uses to build energy molecules like ATP. Some people take it for fatigue, fibromyalgia, exercise recovery, or heart conditio...
Read the full Ribose monograph → Herb & supplement monographTyrosine
Interacts with 21 drugsL-tyrosine is an amino acid your body uses to make brain chemicals like dopamine and norepinephrine. Some studies suggest it may help mental performance during short-term stress, sleep loss,...
Read the full Tyrosine monograph → Herb & supplement monographBeta-alanine
Beta-alanine is an amino acid taken mostly by athletes to raise muscle carnosine, which may help buffer acid and reduce fatigue during short, high-intensity exercise. The evidence is moderat...
Read the full Beta-alanine monograph → Herb & supplement monographCholine
Interacts with 16 drugsCholine is an essential nutrient your body needs for liver function, brain health, and nerve signaling, and many people get enough from foods like eggs, meat, and fish. Supplements may help...
Read the full Choline monograph → Herb & supplement monographCaffeine
Interacts with 655 drugsCaffeine is a natural stimulant found in coffee, tea, and many other plants and products. In moderate amounts it can boost alertness and reduce tiredness for most healthy adults, but too muc...
Read the full Caffeine monograph → Herb & supplement monographTaurine
Interacts with 173 drugsTaurine is an amino acid your body makes naturally and that you also get from animal foods. It is widely used in energy drinks and sports supplements, and short-term use appears generally sa...
Read the full Taurine monograph → Herb & supplement monographFucus Vesiculosus
Interacts with 891 drugsFucus vesiculosus (bladderwrack) is a brown seaweed rich in iodine that has been used traditionally for thyroid concerns, weight, and skin. There is little solid human evidence to support mo...
Read the full Fucus Vesiculosus monograph → Herb & supplement monographRaspberry Ketone
Interacts with 174 drugsRaspberry ketone is a natural aroma compound found in red raspberries that is heavily marketed for weight loss, but there is no good human evidence that it helps people lose weight. Most cla...
Read the full Raspberry Ketone monograph → Herb & supplement monographUva Ursi
Interacts with 803 drugsUva ursi is a traditional herb used mainly for urinary tract infections, and its leaves contain a compound called arbutin that may have antimicrobial effects in the urine. Evidence in people...
Read the full Uva Ursi monograph → Herb & supplement monographBeet
Interacts with 861 drugsBeet, especially beetroot juice, is a nitrate-rich food that may modestly lower blood pressure and slightly improve exercise performance in some people. It is generally safe as a food, but s...
Read the full Beet monograph → Herb & supplement monographL-carnitine
Interacts with 19 drugsL-carnitine is a compound your body makes naturally and also gets from foods like meat. It helps cells turn fat into energy, and supplements are most clearly useful for people with a true ca...
Read the full L-carnitine monograph → Herb & supplement monographBitter Orange
Interacts with 957 drugsBitter orange is a citrus fruit whose extracts contain synephrine, a mild stimulant often added to weight-loss and energy supplements. Evidence that it works for weight loss or performance i...
Read the full Bitter Orange monograph →Sources & How We Checked
Cardio Igniter Pineapple Mango'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 685 references behind this product’s interaction data
Every citation that drives the interaction findings for this product’s ingredients, from the evidence-graded Natural Medicines (TRC Healthcare) database. Open an ingredient to browse its citations — links open the study on PubMed or the publisher’s site.
Vitamin B6 32 references
- Hansten PD, Horn JR. Drug Interactions Analysis and Management. Vancouver, WA: Applied Therapeutics Inc., 1997 and updates.
- 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
- Geerling BJ, Dagnelie PC, Badart-Smook A, et al. Diet as a risk factor for the development of ulcerative colitis. Am J Gastroenterol 2000;95:1008-13. PubMed
- South M. Neonatal seizures after pyridoxine use -- reply. Lancet 1999;354:2083. 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
- Baxter P, Aicardi J. Neonatal seizures after pyridoxine use. Lancet 1999;354:2082-3. PubMed
- Bendich A, Cohen M. Vitamin B6 safety issues. Ann N Y Acad Sci 1990;585:321-30.
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