Centrum Sleep Ingredients & Drug Interactions
by Centrum
What is this page for?
First and foremost: checking Centrum Sleep 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
Centrum Sleep is a dietary supplement by Centrum with 17 active ingredients. Its ingredients are commonly taken for trouble falling asleep (insomnia), jet lag, delayed sleep phase syndrome.Based on those ingredients, 1,623 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are Melatonin, Chamomile extract, Beet. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against Centrum Sleep by Centrum
Ask about any prescription or over-the-counter medication and we check it for interactions with Centrum Sleep by Centrum — 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 Centrum Sleep by Centrum
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
Centrum Sleep contains 17 active ingredients: kale, broccoli, apple, tomato, beet, blueberry, raspberry, strawberry, spinach, melatonin, carrot, chamomile extract, parsley, lemon balm extract, passionflower extract, magnesium, green cabbage, and an organic herbal blend. These are combined with inactive ingredients including organic rice flour, hypromellose (a capsule material), L-leucine, and silica.
Melatonin is the primary sleep-supporting ingredient in the formula. The vegetables (kale, broccoli, apple, tomato, beet, spinach, carrot, green cabbage) and berries (blueberry, strawberry, raspberry) provide antioxidants and phytonutrients.
Chamomile, lemon balm, passionflower, and parsley are herbal extracts traditionally used for relaxation. Magnesium supports sleep and numerous body functions.
Does it work?
Moderate evidence
Melatonin is rated Likely Effective for delayed sleep phase syndrome and non-24-hour sleep-wake disorder, and Possibly Effective for pre-procedural anxiety. Passionflower is rated Possibly Effective for insomnia and pre-procedural anxiety.
Lemon balm is rated Possibly Effective for stress and depression. For the other ingredients in this formula — the vegetables, berries, and remaining herbs — the evidence we hold is insufficient to rate them for sleep or related conditions.
This means their effectiveness for sleep has not been established in the data available to us.
How safe is it?
Well-documented data
Melatonin is generally well tolerated for short-term use, but long-term safety is less certain, and product quality varies across brands. Safety data during pregnancy and breastfeeding is not established — the facts advise avoiding it unless a doctor directs otherwise.
Common side effects include dizziness, drowsiness, headache, and nausea. Chamomile may cause allergic reactions in people sensitive to ragweed and related plants and is best avoided in pregnancy without medical approval.
Passionflower can cause drowsiness and is best avoided during pregnancy and breastfeeding. Magnesium is generally safe at recommended doses but commonly causes diarrhea, nausea, and gastrointestinal irritation; pregnancy use requires doctor guidance.
Lemon balm is generally well tolerated short-term but lacks long-term safety data; pregnancy and breastfeeding use requires medical advice. The vegetable and berry ingredients are generally well tolerated as foods, though concentrated supplement forms are less studied.
Meds to double-check
Major interaction found
Before taking Centrum Sleep, double-check with your pharmacist or doctor if you take any of the following: blood thinners or antiplatelet drugs (warfarin, aspirin, clopidogrel — interactions from apple, strawberry, spinach, parsley, and melatonin); blood pressure medications (atenolol, nifedipine, aliskiren, and other antihypertensives — apple, beet, melatonin); diabetes drugs (apple, spinach, blueberry, parsley, broccoli, cabbage, and melatonin); seizure medications (melatonin); immunosuppressants (melatonin); muscle relaxants (magnesium); levodopa/carbidopa for Parkinson's disease (magnesium); quinolone antibiotics (magnesium); or thyroid hormone replacement (lemon balm). Apple and melatonin carry the most serious documented interactions.
The bottom line
Scorecard at a glanceFormula with limited ingredient disclosure with some supporting evidence for its stated purpose. Major medication interactions have been identified, and safety information is well characterized.
Centrum Sleep may appeal to people looking for a multi-ingredient sleep support formula combining melatonin, herbal extracts, and plant nutrients. However, the presence of apple, melatonin, chamomile, magnesium, and other ingredients that interact with common medications means you should check your exact prescriptions with the medication checker below before starting — especially if you take blood thinners, diabetes medications, blood pressure drugs, seizure medications, or drugs metabolized by your liver.
Talk to your pharmacist or doctor if you take any regular medications or have questions about whether this product is right for you.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 16 of 17 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Nov 19, 2021.
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 Centrum Sleep, straight from the product label.
| Brand | Centrum |
|---|---|
| Barcode (UPC) | 300054477606 |
| Net contents | 60 Vegetarian Capsule(s) |
| Market status | On market |
| Date entered into DSLD | Nov 19, 2021 |
| DSLD ID | 256990 |
| Product type | Other Combinations |
| Supplement form | Capsule |
| Dietary claims / uses | All Other, Structure/Function |
| Intended target group(s) | Adult (18 - 50 Years) |
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.
Supplement Facts
The label details for Centrum Sleep by Centrum, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Kale | 0 NP | -- |
| Broccoli | 0 NP | -- |
| Apple | 0 NP | -- |
| Tomato | 0 NP | -- |
| Beet | 0 NP | -- |
| Blueberry | 0 NP | -- |
| Raspberry | 0 NP | -- |
| Strawberry | 0 NP | -- |
| Spinach | 0 NP | -- |
| Melatonin | 3 mg | -- |
| Carrot | 0 NP | -- |
| Chamomile extract | 0 NP | -- |
| Parsley | 0 NP | -- |
| Lemon Balm extract | 0 NP | -- |
| Passionflower extract | 0 NP | -- |
| Magnesium | 42 mg | 10% |
| organic whole Fruit and Vegetable Blend | 25 mg | -- |
| Green Cabbage | 0 NP | -- |
| Organic Herbal Blend | 150 mg | -- |
Other ingredients: organic Rice Flour, Hypromellose, L-Leucine, Silica
Tap any ingredient to jump to its full detail below.
These statements are the manufacturer’s wording, reproduced from the product label — the label is saying it, not HelloPharmacist. We don’t verify or endorse them.
Formula
Whole food benefit blend Melatonin & botanicals
Chamomile, lemon balm & passionflower traditionally used to help soothe & relax.
FDA Statement of Identity
Dietary Supplement
FDA Disclaimer Statement
This statement has not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.
Suggested/Recommended/Usage/Directions
Directions: Adults: Take 1 (one) capsule 30 minutes before bedtime, as needed, for occasional sleeplessness. Do not exceed suggested use. Not formulated for use in children.
Precautions
Do not exceed suggested use.
Not formulated for use in children.
As with any supplement, if you are pregnant, nursing, or taking medication, including sleep medication, consult your doctor before use. Do not consume if pregnant or nursing.
Keep out of reach of children.
If taking other supplements, read label, since supplements may contain the same ingredient. Warnings Do not consume any alcohol while taking melatonin. Do not drive or operate heavy machinery while taking melatonin. Do not take other melatonin-containing products. Consult a healthcare professional if you are experiencing long-term sleep difficulties.
Bottle sealed with printed foil under cap. Do not use if foil is torn.
Storage
Store at room temperature. Protect from heat, light, and moisture. Keep bottle tightly closed.
Brand IP Statement(s)
2020 Pfizer Inc.
General Statements
Questions? Comments? Call 1-877-CENTRUM (236-8786) For most recent product information, visit www.centrum.com
Formulation
Melatonin helps support a healthy sleep cycle.
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Centrum Sleep by Centrum 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 Centrum Sleep by Centrum
These are the 17 active ingredients this product is made of. Select any to open its full monograph.
Serving size1 Capsule(s) Dosage formCapsule Servings per container60 Amounts shown are per serving.
Most supplement products combine several ingredients, and a medication can interact with the product through any one of them. Each ingredient below shows whether it has known drug interactions.
Melatonin
Interacts with1,461 drugs
Melatonin is a hormone your body makes naturally to help control your sleep-wake cycle, and the supplement form is widely used to help with sleep timi...
Melatonin 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 & interactionsOrganic whole Fruit and Vegetable Blend
Organic Herbal Blend
Other (inactive) ingredients: Organic Rice Flour, Hypromellose, L-Leucine, Silica. These complete the product’s ingredient list but are not active constituents.
Centrum Sleep by Centrum Drug Interactions
HelloPharmacist Interaction Report
Centrum Sleep contains 17 ingredients, several of which interact with medications.
The most serious interaction involves apple, which can significantly reduce blood levels of drugs transported by OATP (organic anion-transporting polypeptide substrates) — a Major severity effect. This includes fexofenadine (an allergy medication), atenolol (a beta-blocker for blood pressure and heart conditions), and aliskiren (a blood pressure drug), with reductions in drug levels ranging from 58% to 78%.
Read the full breakdown — every affected drug type, severity by severity
Moderate interactions affect multiple drug categories. Melatonin can interact with blood thinners (anticoagulants/antiplatelet drugs), blood pressure medications, diabetes drugs, seizure medications, and immunosuppressants.
Strawberry may increase bleeding risk with anticoagulants or blood thinners and could affect drugs transported by p-glycoprotein. Spinach contains vitamin K, which interferes with warfarin (a blood thinner), and may lower blood sugar with diabetes medications.
Chamomile extract affects sedative drugs, multiple liver enzymes (CYP2D6, CYP2C9, CYP3A4), birth control pills, hormone therapy, and warfarin. Parsley affects multiple liver enzymes and blood thinners.
Magnesium reduces absorption of Parkinson's medication (levodopa/carbidopa), muscle relaxants, certain antibiotics, and bone medications, and increases effects of diabetes drugs. Broccoli, beet, blueberry, and other ingredients affect additional drug-metabolizing enzymes.
Raspberry and the organic whole fruit and vegetable blend could not be checked for interactions, as we hold no monograph data for them. Kale, tomato, and carrot show no documented interactions in our data, though this is not a guarantee none exist.
Altogether, these interactions span 1,603 individual medications. Use the medication checker on this page to verify your exact prescriptions before starting this product.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against Centrum Sleep?
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 Centrum Sleep interact with 1,623 drugs. Click any drug to see the details.
13 of the 17 ingredients in Centrum Sleep interact with drugs. Each result below shows which ingredient is responsible. Melatonin Chamomile extract Beet Passionflower extract Parsley Green Cabbage Strawberry Apple Magnesium Lemon Balm extract Broccoli Blueberry Spinach
AlfentanilAlfenta
How Alfentanil interacts with Centrum Sleep — through 5 ingredients. Tap an ingredient for the detail:
Chamomile ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cns Depressants Moderate
Interaction Summary
Theoretically, German chamomile might inhibit CYP3A4 and increase levels of drugs metabolized by these enzymes.
Read the full Chamomile Extract + Alfentanil interactionMelatoninCytochrome P450 3a4 (cyp3a4) Substrates, Seizure Threshold Lowering Drugs +1 Moderate
Interaction Summary
Theoretically, melatonin might increase levels of drugs metabolized by CYP3A4.
Read the full Melatonin + Alfentanil interactionBeetCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, beet might increase the levels of CYP3A4 substrates.
Read the full Beet + Alfentanil interactionPassionflower ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cns Depressants Moderate
Interaction Summary
Theoretically, passion flower might decrease the effects of CYP3A4 substrates.
Read the full Passionflower Extract + Alfentanil interactionLemon Balm ExtractCns Depressants Moderate
Interaction Summary
Theoretically, concomitant use of lemon balm might have additive effects with CNS depressant drugs.
Read the full Lemon Balm Extract + Alfentanil interactionAlfuzosinUroxatral
How Alfuzosin interacts with Centrum Sleep — through 4 ingredients. Tap an ingredient for the detail:
BeetCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, beet might increase the levels of CYP3A4 substrates.
Read the full Beet + Alfuzosin interactionChamomile ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, German chamomile might inhibit CYP3A4 and increase levels of drugs metabolized by these enzymes.
Read the full Chamomile Extract + Alfuzosin interactionMelatoninCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, melatonin might increase levels of drugs metabolized by CYP3A4.
Read the full Melatonin + Alfuzosin interactionPassionflower ExtractCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, passion flower might decrease the effects of CYP3A4 substrates.
Read the full Passionflower Extract + Alfuzosin interactionAlginic Acid, Aluminum HydroxideRafton
How Alginic Acid, Aluminum Hydroxide interacts with Centrum Sleep — through 1 ingredient. Tap an ingredient for the detail:
MagnesiumAntacids Moderate
Interaction Summary
Use of acid reducers may reduce the laxative effect of magnesium oxide.
Read the full Magnesium + Alginic Acid, Aluminum Hydroxide interactionAliskirenTekturna
How Aliskiren interacts with Centrum Sleep — through 5 ingredients. Tap an ingredient for the detail:
Chamomile ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, German chamomile might inhibit CYP3A4 and increase levels of drugs metabolized by these enzymes.
Read the full Chamomile Extract + Aliskiren interactionMelatoninAntihypertensive Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, taking melatonin with antihypertensive drugs might increase the risk of hypotension or hypertension.
Read the full Melatonin + Aliskiren interactionBeetCytochrome P450 3a4 (cyp3a4) Substrates, Antihypertensive Drugs Moderate
Interaction Summary
Theoretically, beet might increase the levels of CYP3A4 substrates.
Read the full Beet + Aliskiren interactionAppleAliskiren (tekturna, Rasilez), Antihypertensive Drugs Moderate
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of aliskiren.
Read the full Apple + Aliskiren interactionPassionflower ExtractCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, passion flower might decrease the effects of CYP3A4 substrates.
Read the full Passionflower Extract + Aliskiren interactionAlmotriptanAlmogran, Axert
How Almotriptan interacts with Centrum Sleep — through 4 ingredients. Tap an ingredient for the detail:
Chamomile ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, German chamomile might inhibit CYP3A4 and increase levels of drugs metabolized by these enzymes.
Read the full Chamomile Extract + Almotriptan interactionBeetCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, beet might increase the levels of CYP3A4 substrates.
Read the full Beet + Almotriptan interactionMelatoninCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, melatonin might increase levels of drugs metabolized by CYP3A4.
Read the full Melatonin + Almotriptan interactionPassionflower ExtractCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, passion flower might decrease the effects of CYP3A4 substrates.
Read the full Passionflower Extract + Almotriptan interactionAlogliptinNesina
How Alogliptin interacts with Centrum Sleep — through 9 ingredients. Tap an ingredient for the detail:
BeetCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, beet might increase the levels of CYP3A4 substrates.
Read the full Beet + Alogliptin interactionGreen CabbageAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, cabbage might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Read the full Green Cabbage + Alogliptin interactionAppleAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, consuming apple juice with antidiabetes drugs might interfere with blood glucose control.
Read the full Apple + Alogliptin interactionSpinachAntidiabetes Drugs Moderate
Interaction Summary
There are claims that spinach leaves have hypoglycemic effects.
Read the full Spinach + Alogliptin interactionParsleyAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, parsley might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Read the full Parsley + Alogliptin interactionMelatoninCytochrome P450 3a4 (cyp3a4) Substrates, Antidiabetes Drugs Moderate
Interaction Summary
Theoretically, melatonin might increase levels of drugs metabolized by CYP3A4.
Read the full Melatonin + Alogliptin interactionChamomile ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, German chamomile might inhibit CYP3A4 and increase levels of drugs metabolized by these enzymes.
Read the full Chamomile Extract + Alogliptin interactionPassionflower ExtractCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, passion flower might decrease the effects of CYP3A4 substrates.
Read the full Passionflower Extract + Alogliptin interactionBlueberryAntidiabetes Drugs Minor
Interaction Summary
Theoretically, blueberries or blueberry leaf extracts might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Read the full Blueberry + Alogliptin interactionAlogliptin, MetforminKazano
How Alogliptin, Metformin interacts with Centrum Sleep — through 6 ingredients. Tap an ingredient for the detail:
ParsleyAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, parsley might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Read the full Parsley + Alogliptin, Metformin interactionSpinachAntidiabetes Drugs Moderate
Interaction Summary
There are claims that spinach leaves have hypoglycemic effects.
Read the full Spinach + Alogliptin, Metformin interactionAppleAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, consuming apple juice with antidiabetes drugs might interfere with blood glucose control.
Read the full Apple + Alogliptin, Metformin interactionGreen CabbageAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, cabbage might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Read the full Green Cabbage + Alogliptin, Metformin interactionMelatoninAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, taking melatonin with antidiabetes drugs might increase the risk of hypoglycemia.
Read the full Melatonin + Alogliptin, Metformin interactionBlueberryAntidiabetes Drugs Minor
Interaction Summary
Theoretically, blueberries or blueberry leaf extracts might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Read the full Blueberry + Alogliptin, Metformin interactionAlogliptin, PioglitazoneOseni
How Alogliptin, Pioglitazone interacts with Centrum Sleep — through 9 ingredients. Tap an ingredient for the detail:
MelatoninAntidiabetes Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, taking melatonin with antidiabetes drugs might increase the risk of hypoglycemia.
Read the full Melatonin + Alogliptin, Pioglitazone interactionSpinachAntidiabetes Drugs Moderate
Interaction Summary
There are claims that spinach leaves have hypoglycemic effects.
Read the full Spinach + Alogliptin, Pioglitazone interactionParsleyAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, parsley might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Read the full Parsley + Alogliptin, Pioglitazone interactionChamomile ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, German chamomile might inhibit CYP3A4 and increase levels of drugs metabolized by these enzymes.
Read the full Chamomile Extract + Alogliptin, Pioglitazone interactionGreen CabbageAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, cabbage might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Read the full Green Cabbage + Alogliptin, Pioglitazone interactionAppleAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, consuming apple juice with antidiabetes drugs might interfere with blood glucose control.
Read the full Apple + Alogliptin, Pioglitazone interactionBeetCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, beet might increase the levels of CYP3A4 substrates.
Read the full Beet + Alogliptin, Pioglitazone interactionBlueberryAntidiabetes Drugs Minor
Interaction Summary
Theoretically, blueberries or blueberry leaf extracts might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Read the full Blueberry + Alogliptin, Pioglitazone interactionPassionflower ExtractCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, passion flower might decrease the effects of CYP3A4 substrates.
Read the full Passionflower Extract + Alogliptin, Pioglitazone interactionAlpelisibPiqray
How Alpelisib interacts with Centrum Sleep — through 4 ingredients. Tap an ingredient for the detail:
Chamomile ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, German chamomile might inhibit CYP3A4 and increase levels of drugs metabolized by these enzymes.
Read the full Chamomile Extract + Alpelisib interactionBeetCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, beet might increase the levels of CYP3A4 substrates.
Read the full Beet + Alpelisib interactionMelatoninCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, melatonin might increase levels of drugs metabolized by CYP3A4.
Read the full Melatonin + Alpelisib interactionPassionflower ExtractCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, passion flower might decrease the effects of CYP3A4 substrates.
Read the full Passionflower Extract + Alpelisib interactionAlprazolamNiravam, Xanax
How Alprazolam interacts with Centrum Sleep — through 5 ingredients. Tap an ingredient for the detail:
MelatoninCns Depressants, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, taking melatonin might increase the sedative effects of CNS depressants.
Read the full Melatonin + Alprazolam interactionPassionflower ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cns Depressants Moderate
Interaction Summary
Theoretically, passion flower might decrease the effects of CYP3A4 substrates.
Read the full Passionflower Extract + Alprazolam interactionBeetCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, beet might increase the levels of CYP3A4 substrates.
Read the full Beet + Alprazolam interactionChamomile ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cns Depressants Moderate
Interaction Summary
Theoretically, German chamomile might inhibit CYP3A4 and increase levels of drugs metabolized by these enzymes.
Read the full Chamomile Extract + Alprazolam interactionLemon Balm ExtractCns Depressants Moderate
Interaction Summary
Theoretically, concomitant use of lemon balm might have additive effects with CNS depressant drugs.
Read the full Lemon Balm Extract + Alprazolam interactionAlteplase, TpaActilyse, Activase
How Alteplase, Tpa interacts with Centrum Sleep — through 4 ingredients. Tap an ingredient for the detail:
ParsleyAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, parsley might increase the risk of bleeding when taken with anticoagulant or antiplatelet drugs.
Read the full Parsley + Alteplase, Tpa interactionStrawberryAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
In vitro and animal research suggests that strawberry extract can inhibit platelet aggregation due to its phenolic content.
Read the full Strawberry + Alteplase, Tpa interactionMelatoninAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, melatonin may have anticoagulant effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Melatonin + Alteplase, Tpa interactionMagnesiumAnticoagulant/antiplatelet Drugs Minor
Interaction Summary
Theoretically, magnesium may have antiplatelet effects, but the evidence is conflicting.
Read the full Magnesium + Alteplase, Tpa interactionAluminum HydroxideAlu-Cap, Amphojel, Gaviscon
How Aluminum Hydroxide interacts with Centrum Sleep — through 1 ingredient. Tap an ingredient for the detail:
MagnesiumAntacids Moderate
Interaction Summary
Use of acid reducers may reduce the laxative effect of magnesium oxide.
Read the full Magnesium + Aluminum Hydroxide interactionAluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium HydroxideAscriptin Codeine #2
How Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide interacts with Centrum Sleep — through 7 ingredients. Tap an ingredient for the detail:
MagnesiumAntacids, Anticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Use of acid reducers may reduce the laxative effect of magnesium oxide.
Read the full Magnesium + Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide interactionChamomile ExtractCns Depressants, Cytochrome P450 2d6 (cyp2d6) Substrates Moderate
Interaction Summary
Theoretically, German chamomile might have additive effects when used with CNS depressants.
Read the full Chamomile Extract + Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide interactionLemon Balm ExtractCns Depressants Moderate
Interaction Summary
Theoretically, concomitant use of lemon balm might have additive effects with CNS depressant drugs.
Read the full Lemon Balm Extract + Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide interactionParsleyAspirin, Anticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, aspirin might increase the severity of allergic reactions to parsley.
Read the full Parsley + Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide interactionPassionflower ExtractCns Depressants Moderate
Interaction Summary
Concomitant use of passion flower with sedative drugs might cause additive effects and side effects.
Read the full Passionflower Extract + Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide interactionStrawberryAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
In vitro and animal research suggests that strawberry extract can inhibit platelet aggregation due to its phenolic content.
Read the full Strawberry + Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide interactionMelatoninCns Depressants, Seizure Threshold Lowering Drugs +2 Moderate
Interaction Summary
Theoretically, taking melatonin might increase the sedative effects of CNS depressants.
Read the full Melatonin + Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide interactionAluminum Hydroxide, Aspirin, Magnesium HydroxideAscriptin
How Aluminum Hydroxide, Aspirin, Magnesium Hydroxide interacts with Centrum Sleep — through 4 ingredients. Tap an ingredient for the detail:
MelatoninAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, melatonin may have anticoagulant effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Melatonin + Aluminum Hydroxide, Aspirin, Magnesium Hydroxide interactionStrawberryAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
In vitro and animal research suggests that strawberry extract can inhibit platelet aggregation due to its phenolic content.
Read the full Strawberry + Aluminum Hydroxide, Aspirin, Magnesium Hydroxide interactionParsleyAspirin, Anticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, aspirin might increase the severity of allergic reactions to parsley.
Read the full Parsley + Aluminum Hydroxide, Aspirin, Magnesium Hydroxide interactionMagnesiumAnticoagulant/antiplatelet Drugs, Antacids Moderate
Interaction Summary
Theoretically, magnesium may have antiplatelet effects, but the evidence is conflicting.
Read the full Magnesium + Aluminum Hydroxide, Aspirin, Magnesium Hydroxide interactionAluminum Hydroxide, Magnesium Hydroxide (otc Drug)Maalox, Mucogel
How Aluminum Hydroxide, Magnesium Hydroxide (otc Drug) interacts with Centrum Sleep — through 1 ingredient. Tap an ingredient for the detail:
MagnesiumAntacids Moderate
Interaction Summary
Use of acid reducers may reduce the laxative effect of magnesium oxide.
Read the full Magnesium + Aluminum Hydroxide, Magnesium Hydroxide (otc Drug) interactionAluminum Hydroxide, Magnesium Hydroxide, Simethicone (otc Drug)Mylanta
How Aluminum Hydroxide, Magnesium Hydroxide, Simethicone (otc Drug) interacts with Centrum Sleep — through 1 ingredient. Tap an ingredient for the detail:
MagnesiumAntacids Moderate
Interaction Summary
Use of acid reducers may reduce the laxative effect of magnesium oxide.
Read the full Magnesium + Aluminum Hydroxide, Magnesium Hydroxide, Simethicone (otc Drug) interactionAluminum, Magnesium (otc Drug)Almagel
How Aluminum, Magnesium (otc Drug) interacts with Centrum Sleep — through 1 ingredient. Tap an ingredient for the detail:
MagnesiumAntacids Moderate
Interaction Summary
Use of acid reducers may reduce the laxative effect of magnesium oxide.
Read the full Magnesium + Aluminum, Magnesium (otc Drug) interactionAlvimopanEntereg
How Alvimopan interacts with Centrum Sleep — through 1 ingredient. Tap an ingredient for the detail:
StrawberryP-glycoprotein Substrates Moderate
Interaction Summary
In vitro research suggests that strawberry extract can inhibit p-glycoprotein efflux.
Read the full Strawberry + Alvimopan interactionAmbrisentanLetairis, Volibris
How Ambrisentan interacts with Centrum Sleep — through 6 ingredients. Tap an ingredient for the detail:
StrawberryP-glycoprotein Substrates Moderate
Interaction Summary
In vitro research suggests that strawberry extract can inhibit p-glycoprotein efflux.
Read the full Strawberry + Ambrisentan interactionChamomile ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, German chamomile might inhibit CYP3A4 and increase levels of drugs metabolized by these enzymes.
Read the full Chamomile Extract + Ambrisentan interactionMelatoninCytochrome P450 3a4 (cyp3a4) Substrates, Antihypertensive Drugs Moderate
Interaction Summary
Theoretically, melatonin might increase levels of drugs metabolized by CYP3A4.
Read the full Melatonin + Ambrisentan interactionBeetCytochrome P450 3a4 (cyp3a4) Substrates, Antihypertensive Drugs Moderate
Interaction Summary
Theoretically, beet might increase the levels of CYP3A4 substrates.
Read the full Beet + Ambrisentan interactionAppleAntihypertensive Drugs Moderate
Interaction Summary
Consuming apple juice with antihypertensive drugs might interfere with blood pressure control.
Read the full Apple + Ambrisentan interactionPassionflower ExtractCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, passion flower might decrease the effects of CYP3A4 substrates.
Read the full Passionflower Extract + Ambrisentan interactionAmifampridineRuzurgi
How Amifampridine interacts with Centrum Sleep — through 1 ingredient. Tap an ingredient for the detail:
MelatoninSeizure Threshold Lowering Drugs Moderate
Interaction Summary
Theoretically, taking melatonin with drugs that lower the seizure threshold might increase the risk of seizure activity.
Read the full Melatonin + Amifampridine interactionAmifampridine PhosphateFirdapse
How Amifampridine Phosphate interacts with Centrum Sleep — through 1 ingredient. Tap an ingredient for the detail:
MelatoninSeizure Threshold Lowering Drugs Moderate
Interaction Summary
Theoretically, taking melatonin with drugs that lower the seizure threshold might increase the risk of seizure activity.
Read the full Melatonin + Amifampridine Phosphate interactionAmikacinAmikin, Arikayce
How Amikacin interacts with Centrum Sleep — through 1 ingredient. Tap an ingredient for the detail:
MagnesiumAminoglycoside Antibiotics Moderate
Interaction Summary
Concomitant use of aminoglycoside antibiotics and magnesium can increase the risk for neuromuscular weakness.
Read the full Magnesium + Amikacin interactionAmilorideAmilamont, Midamor
How Amiloride interacts with Centrum Sleep — through 4 ingredients. Tap an ingredient for the detail:
MagnesiumPotassium-sparing Diuretics Moderate
Interaction Summary
Potassium-sparing diuretics decrease excretion of magnesium, possibly increasing magnesium levels.
Read the full Magnesium + Amiloride interactionMelatoninAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, taking melatonin with antihypertensive drugs might increase the risk of hypotension or hypertension.
Read the full Melatonin + Amiloride interactionAppleAntihypertensive Drugs Moderate
Interaction Summary
Consuming apple juice with antihypertensive drugs might interfere with blood pressure control.
Read the full Apple + Amiloride interactionBeetAntihypertensive Drugs Minor
Interaction Summary
Beet and beetroot contain nitrates, which can cause vasodilation, potentially leading to lower blood pressure.
Read the full Beet + Amiloride interactionAmiloride, HydrochlorothiazideAmil-Co, Amilzide, Moduret 25, Moduretic
How Amiloride, Hydrochlorothiazide interacts with Centrum Sleep — through 5 ingredients. Tap an ingredient for the detail:
AppleAntihypertensive Drugs Moderate
Interaction Summary
Consuming apple juice with antihypertensive drugs might interfere with blood pressure control.
Read the full Apple + Amiloride, Hydrochlorothiazide interactionMagnesiumPotassium-sparing Diuretics Moderate
Interaction Summary
Potassium-sparing diuretics decrease excretion of magnesium, possibly increasing magnesium levels.
Read the full Magnesium + Amiloride, Hydrochlorothiazide interactionParsleyDiuretic Drugs Moderate
Interaction Summary
Theoretically, parsley might enhance or interfere with the effects of diuretic drugs.
Read the full Parsley + Amiloride, Hydrochlorothiazide interactionMelatoninAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, taking melatonin with antihypertensive drugs might increase the risk of hypotension or hypertension.
Read the full Melatonin + Amiloride, Hydrochlorothiazide interactionBeetAntihypertensive Drugs Minor
Interaction Summary
Beet and beetroot contain nitrates, which can cause vasodilation, potentially leading to lower blood pressure.
Read the full Beet + Amiloride, Hydrochlorothiazide interactionAminoglutethimideCytadren
How Aminoglutethimide interacts with Centrum Sleep — through 4 ingredients. Tap an ingredient for the detail:
MelatoninCns Depressants Moderate
Interaction Summary
Theoretically, taking melatonin might increase the sedative effects of CNS depressants.
Read the full Melatonin + Aminoglutethimide interactionChamomile ExtractCns Depressants Moderate
Interaction Summary
Theoretically, German chamomile might have additive effects when used with CNS depressants.
Read the full Chamomile Extract + Aminoglutethimide interactionLemon Balm ExtractCns Depressants Moderate
Interaction Summary
Theoretically, concomitant use of lemon balm might have additive effects with CNS depressant drugs.
Read the full Lemon Balm Extract + Aminoglutethimide interactionPassionflower ExtractCns Depressants Moderate
Interaction Summary
Concomitant use of passion flower with sedative drugs might cause additive effects and side effects.
Read the full Passionflower Extract + Aminoglutethimide interactionAminophylline, Amobarbital, EphedrineAmesec
How Aminophylline, Amobarbital, Ephedrine interacts with Centrum Sleep — through 4 ingredients. Tap an ingredient for the detail:
Passionflower ExtractCns Depressants Moderate
Interaction Summary
Concomitant use of passion flower with sedative drugs might cause additive effects and side effects.
Read the full Passionflower Extract + Aminophylline, Amobarbital, Ephedrine interactionLemon Balm ExtractCns Depressants Moderate
Interaction Summary
Theoretically, concomitant use of lemon balm might have additive effects with CNS depressant drugs.
Read the full Lemon Balm Extract + Aminophylline, Amobarbital, Ephedrine interactionMelatoninCns Depressants, Anticonvulsants Moderate
Interaction Summary
Theoretically, taking melatonin might increase the sedative effects of CNS depressants.
Read the full Melatonin + Aminophylline, Amobarbital, Ephedrine interactionChamomile ExtractCns Depressants Moderate
Interaction Summary
Theoretically, German chamomile might have additive effects when used with CNS depressants.
Read the full Chamomile Extract + Aminophylline, Amobarbital, Ephedrine interactionAmiodaroneCordarone, Pacerone
How Amiodarone interacts with Centrum Sleep — through 4 ingredients. Tap an ingredient for the detail:
Chamomile ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, German chamomile might inhibit CYP3A4 and increase levels of drugs metabolized by these enzymes.
Read the full Chamomile Extract + Amiodarone interactionBeetCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, beet might increase the levels of CYP3A4 substrates.
Read the full Beet + Amiodarone interactionPassionflower ExtractCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, passion flower might decrease the effects of CYP3A4 substrates.
Read the full Passionflower Extract + Amiodarone interactionMelatoninCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, melatonin might increase levels of drugs metabolized by CYP3A4.
Read the full Melatonin + Amiodarone interactionAmitriptylineElavil
How Amitriptyline interacts with Centrum Sleep — through 8 ingredients. Tap an ingredient for the detail:
MelatoninCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates +3 Moderate
Interaction Summary
Theoretically, melatonin might increase levels of drugs metabolized by CYP3A4.
Read the full Melatonin + Amitriptyline interactionPassionflower ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cns Depressants Moderate
Interaction Summary
Theoretically, passion flower might decrease the effects of CYP3A4 substrates.
Read the full Passionflower Extract + Amitriptyline interactionChamomile ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cns Depressants +3 Moderate
Interaction Summary
Theoretically, German chamomile might inhibit CYP3A4 and increase levels of drugs metabolized by these enzymes.
Read the full Chamomile Extract + Amitriptyline interactionBroccoliCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, broccoli might reduce the levels and effects of drugs metabolized by CYP1A2.
Read the full Broccoli + Amitriptyline interactionLemon Balm ExtractCns Depressants Moderate
Interaction Summary
Theoretically, concomitant use of lemon balm might have additive effects with CNS depressant drugs.
Read the full Lemon Balm Extract + Amitriptyline interactionParsleyCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, parsley might increase serum levels of CYP1A2 substrates.
Read the full Parsley + Amitriptyline interactionBeetCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, beet might increase the levels of CYP3A4 substrates.
Read the full Beet + Amitriptyline interactionGreen CabbageCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, cabbage might decrease levels of drugs metabolized by CYP1A2.
Read the full Green Cabbage + Amitriptyline interactionAmitriptyline, ChlordiazepoxideLimbitrol DS
How Amitriptyline, Chlordiazepoxide interacts with Centrum Sleep — through 8 ingredients. Tap an ingredient for the detail:
BeetCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, beet might decrease the levels and clinical effects of CYP1A2 substrates.
Read the full Beet + Amitriptyline, Chlordiazepoxide interactionGreen CabbageCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, cabbage might decrease levels of drugs metabolized by CYP1A2.
Read the full Green Cabbage + Amitriptyline, Chlordiazepoxide interactionChamomile ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 2c9 (cyp2c9) Substrates +3 Moderate
Interaction Summary
Theoretically, German chamomile might inhibit CYP1A2 and increase levels of drugs metabolized by these enzymes.
Read the full Chamomile Extract + Amitriptyline, Chlordiazepoxide interactionBroccoliCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, broccoli might reduce the levels and effects of drugs metabolized by CYP1A2.
Read the full Broccoli + Amitriptyline, Chlordiazepoxide interactionMelatoninCytochrome P450 2d6 (cyp2d6) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +3 Moderate
Interaction Summary
Theoretically, melatonin might increase levels of drugs metabolized by CYP2D6.
Read the full Melatonin + Amitriptyline, Chlordiazepoxide interactionPassionflower ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cns Depressants Moderate
Interaction Summary
Theoretically, passion flower might decrease the effects of CYP3A4 substrates.
Read the full Passionflower Extract + Amitriptyline, Chlordiazepoxide interactionLemon Balm ExtractCns Depressants Moderate
Interaction Summary
Theoretically, concomitant use of lemon balm might have additive effects with CNS depressant drugs.
Read the full Lemon Balm Extract + Amitriptyline, Chlordiazepoxide interactionParsleyCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, parsley might increase serum levels of CYP1A2 substrates.
Read the full Parsley + Amitriptyline, Chlordiazepoxide interactionAmitriptyline, PerphenazineEtrafon, Etrafon-A, Etrafon-Forte, Triavil
How Amitriptyline, Perphenazine interacts with Centrum Sleep — through 8 ingredients. Tap an ingredient for the detail:
ParsleyCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, parsley might increase serum levels of CYP1A2 substrates.
Read the full Parsley + Amitriptyline, Perphenazine interactionPassionflower ExtractCns Depressants, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Concomitant use of passion flower with sedative drugs might cause additive effects and side effects.
Read the full Passionflower Extract + Amitriptyline, Perphenazine interactionLemon Balm ExtractCns Depressants Moderate
Interaction Summary
Theoretically, concomitant use of lemon balm might have additive effects with CNS depressant drugs.
Read the full Lemon Balm Extract + Amitriptyline, Perphenazine interactionMelatoninCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 2c19 (cyp2c19) Substrates +4 Moderate
Interaction Summary
Theoretically, melatonin might increase levels of drugs metabolized by CYP1A2.
Read the full Melatonin + Amitriptyline, Perphenazine interactionGreen CabbageCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, cabbage might decrease levels of drugs metabolized by CYP1A2.
Read the full Green Cabbage + Amitriptyline, Perphenazine interactionBeetCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, beet might decrease the levels and clinical effects of CYP1A2 substrates.
Read the full Beet + Amitriptyline, Perphenazine interactionChamomile ExtractCytochrome P450 2d6 (cyp2d6) Substrates, Cns Depressants +3 Moderate
Interaction Summary
Theoretically, German chamomile might inhibit CYP2D6 and increase levels of drugs metabolized by these enzymes.
Read the full Chamomile Extract + Amitriptyline, Perphenazine interactionBroccoliCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, broccoli might reduce the levels and effects of drugs metabolized by CYP1A2.
Read the full Broccoli + Amitriptyline, Perphenazine interactionEach ingredient & the kinds of drugs it affects
For each ingredient in Centrum Sleep 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.
Melatonin
Anticoagulant/Antiplatelet Drugs
Theoretically, melatonin may have anticoagulant effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
There are isolated case reports of minor bleeding and decreased prothrombin activity in people taking melatonin with warfarin (Coumadin). The mechanism, if any, of this interaction is unknown. Taking melatonin orally seems to decrease coagulation activity within one hour of dosing in healthy men.
Anticonvulsants
Theoretically, melatonin may reduce the effects of anticonvulsants. Some clinical research suggests that melatonin may increase the frequency of seizures in certain patients, particularly children with neurological impairment.
Antidiabetes Drugs
Theoretically, taking melatonin with antidiabetes drugs might increase the risk of hypoglycemia.
Some clinical research shows that melatonin reduces levels of fasting blood glucose and improves glycemic control. However, other research suggests that melatonin might impair glucose utilization and increase insulin resistance, while other research has found no effect on glucose levels. Until more is known, use melatonin cautiously in combination with antidiabetes drugs.
Antihypertensive Drugs
Theoretically, taking melatonin with antihypertensive drugs might increase the risk of hypotension or hypertension.
Some clinical research suggests that taking melatonin decreases blood pressure in healthy adults. Also, melatonin seems to lower systolic and diastolic blood pressure in individuals with high blood pressure at nighttime or untreated essential hypertension. However, melatonin seems to worsen blood pressure in patients who are taking antihypertensive medications. Immediate-release melatonin 5 mg at night in combination with nifedipine GITS (Procardia XL) increases systolic blood pressure an average of 6.5 mmHg, diastolic blood pressure by an average of 4.9 mmHg, and heart rate by 3.9 bpm. Also, results from animal research suggest that melatonin reduces the effectiveness of certain antihypertensive drugs, including methoxamine and clonidine.
Caffeine
Theoretically, taking caffeine with melatonin might increase levels of melatonin.
Some evidence suggests that caffeine consumption can decrease endogenous melatonin levels, while other evidence suggests that caffeine increases endogenous melatonin levels. When administered in combination with melatonin supplements, caffeine seems to increase melatonin effects and levels. The reason for this discrepancy is not completely clear. Part of the discrepancy may result from the fact that caffeine can inhibit melatonin synthesis as well as inhibit melatonin metabolism. By functioning as an adenosine receptor antagonist, caffeine may indirectly inhibit the synthesis of melatonin. Conversely, because melatonin and caffeine are both metabolized by cytochrome P450 1A2 (CYP1A2) enzyme, concomitant use of melatonin and caffeine may reduce the metabolism of melatonin, resulting in higher serum levels.
Cns Depressants
Theoretically, taking melatonin might increase the sedative effects of CNS depressants.
Melatonin has sedative effects. Theoretically, concomitant use of melatonin with alcohol, benzodiazepines, or other sedative drugs might cause additive sedation.
Contraceptive Drugs
Theoretically, taking contraceptive drugs with melatonin might increase the effects and adverse effects of melatonin.
Contraceptive drugs can increase the levels of endogenous melatonin. Theoretically, these drugs may increase the effects and adverse effects of oral melatonin.
Cytochrome P450 1A2 (Cyp1A2) Substrates
Theoretically, melatonin might increase levels of drugs metabolized by CYP1A2. Also, other CYP1A2 substrates might decrease the metabolism of melatonin, increasing melatonin levels.
Melatonin is metabolized in the liver primarily by the CYP2C19 and CYP1A2 enzymes. Theoretically, combined administration of melatonin with drugs metabolized by the CYP1A2 enzyme might reduce the metabolism of these drugs, resulting in increased serum levels. Conversely, some drugs metabolized by CYP1A2 may inhibit the metabolism of melatonin, resulting in increased serum levels of melatonin. Until more is known, use melatonin cautiously in patients taking drugs metabolized by these enzymes.
Cytochrome P450 2C19 (Cyp2C19) Substrates
Theoretically, melatonin might increase levels of drugs metabolized by CYP2C19. Also, other CYP2C19 substrates might decrease the metabolism of melatonin, increasing melatonin levels.
Melatonin is metabolized in the liver primarily by the CYP2C19 and CYP1A2 enzymes. Theoretically, combined administration of melatonin with certain drugs metabolized by the CYP2C19 enzyme may reduce the metabolism of these drugs, resulting in increased serum levels. Conversely, some drugs metabolized by CYP2C19 may inhibit the metabolism of melatonin, resulting in increased serum levels of melatonin. Until more is known, use melatonin cautiously in patients taking drugs metabolized by these enzymes.
Fluvoxamine (Luvox)
Theoretically, taking fluvoxamine with melatonin might increase levels of melatonin.
Fluvoxamine can significantly increase melatonin levels. In some cases, fluvoxamine might increase bioavailability of exogenously administered melatonin by up to 20 times. Some researchers think this might be a beneficial interaction and be potentially useful for cases of refractory insomnia. However, this interaction might also cause unwanted excessive drowsiness and possibly other adverse effects. Fluvoxamine is known to increase endogenous melatonin secretion. It seems to increase serum levels of exogenously administered melatonin possibly by decreasing melatonin metabolism by inhibiting cytochrome P450 (CYP450) 1A2 and 2C19 or by inhibiting melatonin elimination. This effect has been found in healthy people taking fluvoxamine 50-75 mg and melatonin 5 mg.
Immunosuppressants
Theoretically, melatonin might interfere with immunosuppressive therapy.
Melatonin can stimulate immune function. Theoretically, melatonin might interfere with immunosuppressive therapy.
Methamphetamine (Desoxyn)
Theoretically, taking melatonin with methamphetamine may increase the adverse effects of methamphetamine.
Animal research suggests that melatonin exacerbates the adverse effects of methamphetamine, resulting in greater depression of tryptophan hydroxylase (TPH) and tyrosine hydroxylase (TH) activity, as well as a significant reduction in dopamine levels. This has not been shown in humans.
Nifedipine Gits (Procardia Xl)
Theoretically, taking melatonin with extended release nifedipine reduces the effects of nifedipine.
Melatonin can decrease the effectiveness of extended release nifedipine (GITS). Immediate-release melatonin 5 mg at night in combination with nifedipine GITS 30-60 mg daily increases systolic and blood pressure by an average of 6.5 mmHg and 4.9 mmHg, respectively. Concomitant use with melatonin also increases heart rate by 3.9 bpm. The mechanism of this interaction is not known.
Seizure Threshold Lowering Drugs
Theoretically, taking melatonin with drugs that lower the seizure threshold might increase the risk of seizure activity.
Some clinical evidence suggests that melatonin may increase the frequency of seizures in certain patients, particularly children with neurological disabilities.
Warfarin (Coumadin)
Theoretically, melatonin may have antiplatelet effects and may increase the risk of bleeding with warfarin.
Three cases of increased prothrombin time have been reported for patients aged 48-72 years who took melatonin orally in combination with warfarin. However, three cases of decreased prothrombin time have also been reported for patients aged 51-84 years who took melatonin orally in combination with warfarin. Until more is known, use melatonin cautiously in patients taking warfarin.
Cytochrome P450 2D6 (Cyp2D6) Substrates
Theoretically, melatonin might increase levels of drugs metabolized by CYP2D6.
Laboratory research suggests that certain lots of melatonin inhibit CYP2D6. Theoretically, combined administration of melatonin with certain drugs metabolized by the CYP2D6 enzyme may reduce the metabolism of these drugs, resulting in increased serum levels. Until more is known, use melatonin cautiously in patients taking drugs metabolized by these enzymes.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, melatonin might increase levels of drugs metabolized by CYP3A4.
Laboratory research shows that certain lots of melatonin inhibit CYP3A4. Theoretically, combined administration of melatonin with certain drugs metabolized by CYP3A4 may reduce the metabolism of these drugs, resulting in increased serum levels. Until more is known, use melatonin cautiously in patients taking drugs metabolized by these enzymes.
Flumazenil (Romazicon)
Theoretically, taking flumazenil with melatonin might reduce the effects of melatonin.
Animal research shows that flumazenil may inhibit the effect of melatonin.
Chamomile extract
Cns Depressants
Theoretically, German chamomile might have additive effects when used with CNS depressants.
German chamomile has mild sedative effects. Theoretically, concomitant use with drugs with sedative properties can cause additive effects and side effects.
Contraceptive Drugs
Theoretically, large amounts of German chamomile might reduce the effectiveness of oral contraceptives.
In vitro, German chamomile has demonstrated antiestrogenic activity. Theoretically, concomitant use of large amounts of German chamomile might interfere with contraceptive drugs through competition for estrogen receptors.
Cytochrome P450 2C9 (Cyp2C9) Substrates
Theoretically, German chamomile might inhibit CYP2C9 and increase levels of drugs metabolized by these enzymes.
In vitro evidence shows that German chamomile might inhibit CYP2C9. So far, this interaction has not been reported in humans. However, there might be an increase in the levels of drugs metabolized by CYP2C9 in patients taking German chamomile.
Cytochrome P450 2D6 (Cyp2D6) Substrates
Theoretically, German chamomile might inhibit CYP2D6 and increase levels of drugs metabolized by these enzymes.
In vitro evidence shows that German chamomile might inhibit CYP2D6. So far, this interaction has not been reported in humans. However, there might be an increase in the levels of drugs metabolized by CYP2D6 in patients taking German chamomile.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, German chamomile might inhibit CYP3A4 and increase levels of drugs metabolized by these enzymes.
In vitro evidence shows that German chamomile might inhibit CYP3A4. So far, this interaction has not been reported in humans. However, there might be an increase in the levels of drugs metabolized by CYP3A4 in patients taking German chamomile.
Estrogens
Theoretically, large amounts of German chamomile might reduce the effectiveness of estrogens.
In vitro, German chamomile has demonstrated antiestrogenic activity. Theoretically, large amounts of German chamomile might interfere with hormone replacement therapy through competition for estrogen receptors.
Tamoxifen (Nolvadex)
Theoretically, large amounts of German chamomile might interfere with the activity of tamoxifen.
In vitro, German chamomile has demonstrated antiestrogenic activity.
Warfarin (Coumadin)
German chamomile might increase the effects of warfarin and increase the risk of bleeding.
In one case, a 70-year-old female taking warfarin developed retroperitoneal hematoma and bilateral recti muscle bleeding along with an INR of 7.9 following ingestion of German chamomile tea 4-5 cups daily and use of a topical chamomile-based lotion applied 4-5 times daily.
Cytochrome P450 1A2 (Cyp1A2) Substrates
Theoretically, German chamomile might inhibit CYP1A2 and increase levels of drugs metabolized by these enzymes.
In vitro and animal research shows that German chamomile might inhibit CYP1A2. So far, this interaction has not been reported in humans. However, there might be an increase in the levels of drugs metabolized by CYP1A2 in patients taking German chamomile.
Beet
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.
Passionflower extract
Cns Depressants
Concomitant use of passion flower with sedative drugs might cause additive effects and side effects.
Research in animals and humans shows that passion flower has sedative effects which can be additive when used with sedative medications like lorazepam.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, passion flower might decrease the effects of CYP3A4 substrates.
In vitro research suggests that passion flower can induce CYP3A4 enzymes, albeit to a much lower degree than rifampin, a known CYP3A4 inducer.
Organic Anion-Transporting Polypeptide Substrates (Oatp)
Theoretically, passion flower might reduce the bioavailability of OATP2B1 and OATP1A2 substrates.
In vitro research shows that the passion flower constituents apigenin and vitexin inhibit OATP2B1 and OATP1A2. This inhibition may be dose-dependent. One specific high-flavonoid passion flower extract (Valverde) seems to inhibit OATP2B1 and OATP1A2, while another extract with a lower flavonoid concentration (Arkocaps) shows less potent inhibition. OATPs are responsible for the uptake of drugs and other compounds into the body; however, the specific activities of OATP2B1 and OATP1A2 are not well characterized.
Parsley
Anticoagulant/Antiplatelet Drugs
Theoretically, parsley might increase the risk of bleeding when taken with anticoagulant or antiplatelet drugs.
Animal research suggests that parsley has antiplatelet effects.
Antidiabetes Drugs
Theoretically, parsley might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Animal research suggests that parsley might decrease blood glucose. Monitor blood glucose levels closely. Dose adjustments might be necessary.
Cytochrome P450 1A2 (Cyp1A2) Substrates
Theoretically, parsley might increase serum levels of CYP1A2 substrates.
Laboratory research suggests that parsley can inhibit CYP1A2.
Diuretic Drugs
Theoretically, parsley might enhance or interfere with the effects of diuretic drugs.
Animal research suggests that parsley seed extract increases urine elimination. Parsley leaf and root might also interfere with diuretic therapy due their purported aquaretic effects.
Pentobarbital (Nembutal)
Theoretically, parsley might increase the duration of pentobarbital effects.
Animal research suggests that parsley juice prolongs the action of pentobarbital, perhaps by decreasing cytochrome P450 levels. It is not known if this occurs in humans or if this applies to other barbiturates or sedatives.
Sirolimus (Rapamune)
Theoretically, large quantities of parsley might increase sirolimus levels.
In one case report, an adult female with a history of kidney transplant presented with elevated blood sirolimus levels, approximately 4-7 times greater than previous measures, after daily consumption of a juice containing approximately 30 grams of parsley for 7 days. Sirolimus levels returned to normal a week after the parsley juice was discontinued.
Warfarin (Coumadin)
Theoretically, large amounts of parsley leaf and root might decrease the effects of warfarin.
Parlsey contains vitamin K.
Aspirin
Theoretically, aspirin might increase the severity of allergic reactions to parsley.
In one case, severe urticaria and swelling were reported after taking aspirin with parsley in an individual with a known mild parsley allergy.
Green Cabbage
Acetaminophen (Tylenol, Others)
Cabbage might increase clearance and reduce the effects of acetaminophen.
A small clinical study shows that daily consumption of cabbage and Brussels sprout decreases acetaminophen levels by as much as 16%, with some evidence suggesting that this effect is due to increased elimination through glucuronide conjugation.
Antidiabetes Drugs
Theoretically, cabbage might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Animal and in vivo research suggests that cabbage might have hypoglycemic effects.
Cytochrome P450 1A2 (Cyp1A2) Substrates
Theoretically, cabbage might decrease levels of drugs metabolized by CYP1A2.
Some animal research suggests that cabbage or its constituent indole-3-carbinol might increase drug metabolism and elimination by stimulating CYP1A2 activity.
Glucuronidated Drugs
Theoretically, cabbage might increase clearance and decrease the effects of drugs metabolized through glucuronide conjugation.
A small clinical study shows that daily consumption of cabbage and Brussels sprout decreases levels of some drugs metabolized through glucuronide conjugation.
Oxazepam (Serax)
Cabbage might increase clearance and reduce the effects of oxazepam.
A small clinical study shows that daily consumption of cabbage and brussels sprout decreases oxazepam levels by as much as 17%, with some evidence suggesting that this effect is due to increased elimination through glucuronide conjugation.
Warfarin (Coumadin)
Theoretically, cabbage might decrease the anticoagulant effects of warfarin.
Cabbage contains vitamin K. If consumed in large quantities, cabbage might decrease the anticoagulant effects of warfarin.
Strawberry
Anticoagulant/Antiplatelet Drugs
In vitro and animal research suggests that strawberry extract can inhibit platelet aggregation due to its phenolic content. Theoretically, strawberry might increase the risk of bleeding when used with antiplatelet or anticoagulant drugs.
Some anticoagulant or antiplatelet drugs include aspirin, clopidogrel (Plavix), dalteparin (Fragmin), enoxaparin (Lovenox), heparin, ticlopidine (Ticlid), warfarin (Coumadin), and others.
P-Glycoprotein Substrates
In vitro research suggests that strawberry extract can inhibit p-glycoprotein efflux. Theoretically, strawberry might inhibit p-glycoprotein mediated drug efflux and potentially increase levels of drugs that are substrates of p-glycoprotein. Until more is known, strawberry should be used cautiously in people taking p-glycoprotein substrates.
Drugs that might be affected include some chemotherapeutic agents (etoposide, paclitaxel, vinblastine, vincristine, vindesine), antifungals (ketoconazole, itraconazole), protease inhibitors (amprenavir, indinavir, nelfinavir, saquinavir), H2 antagonists (cimetidine, ranitidine), some calcium channel blockers (diltiazem, verapamil), corticosteroids, erythromycin, cisapride (Propulsid), fexofenadine (Allegra), cyclosporine, loperamide (Imodium), quinidine, and others.
Apple
Organic Anion-Transporting Polypeptide Substrates (Oatp)
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Research shows that consuming apple juice inhibits OATP, which reduces bioavailability of oral drugs that are substrates of OATP. Fexofenadine, atenolol, and aliskiren are substrates of OATP. Clinical research shows that coadministration of apple juice decreases bioavailability of fexofenadine by up to 78%, aliskiren by 63%, and atenolol by up to 82%. These effects appear to increase with larger quantities of apple juice. It is thought that apple juice might affect OATP for only a short time. Therefore, separating drug administration and consumption of apple juice by at least 4 hours might avoid this interaction.
Aliskiren (Tekturna, Rasilez)
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of aliskiren.
Pharmacokinetic research shows that coadministration of apple juice 200 mL along with aliskiren 150 mg decreases the bioavailability of aliskiren by 63%. Apple juice seems to inhibit organic anion transporting polypeptide (OATP), which is involved in drug uptake in the gut, liver, and kidney. It is thought that apple juice might affect OATP for only a short time. Therefore, separating drug administration and consumption of apple juice by at least 4 hours might avoid this interaction.
Antidiabetes Drugs
Theoretically, consuming apple juice with antidiabetes drugs might interfere with blood glucose control.
Clinical research suggests that consuming apples or drinking apple juice can raise blood glucose levels, with the effects of drinking apple juice being more significant than consuming apples.
Antihypertensive Drugs
Consuming apple juice with antihypertensive drugs might interfere with blood pressure control.
Some clinical evidence suggests that consuming apple and cherry juice can increase blood pressure in elderly patients.
Atenolol (Tenormin)
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of atenolol.
Pharmacokinetic research shows that coadministration of apple juice 600-1200 mL decreases levels of atenolol by 58% to 82% in a dose-dependent manner. Apple juice seems to inhibit organic anion transporting polypeptide (OATP), which is involved in drug uptake in the gut, liver, and kidney. It is thought that apple juice might affect OATP for only a short time. Therefore, separating drug administration and consumption of apple juice by at least 4 hours might avoid this interaction.
Fexofenadine (Allegra)
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of fexofenadine.
Pharmacokinetic research shows that coadministration of apple juice 400-1200 mL along with fexofenadine 60-120 mg decreases bioavailability of fexofenadine by up to 78%. Coadministration with smaller quantities of apple juice (150 mL or less) does not appear to affect the bioavailability of fexofenadine. Apple juice seems to inhibit organic anion transporting polypeptide (OATP), which is involved in drug uptake in the gut, liver, and kidney. It is thought that apple juice might affect OATP for only a short time. Therefore, separating drug administration and consumption of apple juice by at least 4 hours might avoid this interaction.
Lithium
There is some concern that concomitant consumption of apple juice might decrease oral absorption and blood levels of lithium.
In one case report, a patient had an undetectable serum lithium level when lithium citrate was administered with apple juice. When lithium was administered with an alternative beverage, the lithium level became detectable and the patient demonstrated clinical improvement.
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.
Lemon Balm extract
Cns Depressants
Theoretically, concomitant use of lemon balm might have additive effects with CNS depressant drugs.
Lemon balm seems to have CNS depressant activity in animals and in humans.
Thyroid Hormone
Theoretically, lemon balm might interfere with thyroid hormone replacement therapy.
In vitro, constituents of lemon balm extract bind to thyroid stimulating hormone (TSH), preventing TSH receptor-binding and leading to the inhibition of TSH-stimulated adenylate cyclase activity. In animals, lemon balm extract has been shown to decrease levels of circulating TSH and inhibit thyroid secretion.
Broccoli
Cytochrome P450 1A2 (Cyp1A2) Substrates
Theoretically, broccoli might reduce the levels and effects of drugs metabolized by CYP1A2.
Pharmacokinetic research in humans shows that eating 500 grams of fresh broccoli daily for 6-12 days can increase CYP1A2 activity by 10% to 200%. Induction of CYP1A2 activity by broccoli is attributed to its glucosinolate constituents.
Cytochrome P450 2A6 (Cyp2A6) Substrates
Theoretically, broccoli might reduce the levels and effects of drugs metabolized by CYP2A6.
Pharmacokinetic research in humans shows that eating 500 grams of broccoli daily for 6 days increases CYP2A6 activity by 135% to 550%. Induction of CYP2A6 activity is attributed to its glucosinolate constituents.
Blueberry
Antidiabetes Drugs
Theoretically, blueberries or blueberry leaf extracts might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Animal and in vitro research suggests that blueberry and/or blueberry leaf extracts can lower blood glucose levels.
Buspirone (Buspar)
Theoretically, blueberry juice might increase blood levels of buspirone.
In vitro research shows that blueberry juice can inhibit the metabolism of buspirone, possibly by inhibiting cytochrome P450 3A (CYP3A) enzymes. However, pharmacokinetic research in humans shows that drinking 300 mL of blueberry juice 30 minutes before taking buspirone hydrochloride 10 mg does not significantly affect the concentration or clearance of buspirone.
Flurbiprofen (Ansaid, Others)
Theoretically, blueberry juice might increase blood levels of flurbiprofen.
In vitro research shows that blueberry juice can inhibit the metabolism of flurbiprofen, possibly by inhibiting cytochrome P450 2C9 (CYP2C9) enzymes. However, pharmacokinetic research in humans shows that drinking 300 mL of blueberry juice 30 minutes before taking flurbiprofen 100 mg does not significantly affect the concentration or clearance of flurbiprofen.
Spinach
Antidiabetes Drugs
There are claims that spinach leaves have hypoglycemic effects. Evidence from clinical research suggests that consumption of a spinach-rich meal reduces post-meal blood glucose levels. Theoretically, spinach might have additive effects with antidiabetes drugs and increase the risk of hypoglycemia. Monitor blood glucose levels closely. Dose adjustments might be necessary. Some antidiabetes drugs include glimepiride (Amaryl), glyburide (DiaBeta, Glynase PresTab, Micronase), insulin, pioglitazone (Actos), rosiglitazone (Avandia), and others.
Warfarin (Coumadin)
Spinach contains vitamin K, which can interfere with the activity of warfarin.
In human research, although eating spinach with one meal does not result in coagulation test results outside the therapeutic range, daily consumption for one week necessitates dose adjustment of warfarin. Individuals using anticoagulants should consume a consistent daily amount of spinach to maintain the effect of anticoagulant therapy.
Brand information
Manufacturer and brand details for Centrum Sleep, from the product label.
Centrum
- Name
- Pfizer
- City
- Madison
- State
- NJ
- ZipCode
- 07940
- Phone Number
- 1-877-236-8786
- Web Address
- www.centrum.com
Centrum Sleep by Centrum: 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 Centrum Sleep’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Melatonin
Interacts with 1,461 drugsMelatonin is a hormone your body makes naturally to help control your sleep-wake cycle, and the supplement form is widely used to help with sleep timing problems and jet lag. The evidence is...
Read the full Melatonin 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 monographKale
Kale is a nutrient-dense leafy green vegetable that is rich in vitamins, minerals, fiber, and antioxidants. Eaten as a normal food it is very healthy for most people, but it is a whole food...
Read the full Kale monograph → Herb & supplement monographBroccoli
Interacts with 187 drugsBroccoli is a nutritious cruciferous vegetable rich in fiber, vitamins, and plant compounds like sulforaphane that have drawn scientific interest for health benefits. Eating broccoli as food...
Read the full Broccoli monograph → Herb & supplement monographApple
Interacts with 300 drugsApples are a nutritious whole food that provides fiber, vitamins, and antioxidant plant compounds, and eating them regularly fits well into a healthy diet. While research suggests apples may...
Read the full Apple monograph → Herb & supplement monographTomato
Tomato is a common food rich in vitamins, potassium, and the antioxidant lycopene, and eating it as part of a balanced diet is healthy for most people. Concentrated tomato or lycopene supple...
Read the full Tomato 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 monographBlueberry
Interacts with 88 drugsBlueberries are a nutritious fruit rich in antioxidants called anthocyanins, and eating them as part of a balanced diet is healthy and safe for most people. Concentrated supplements are mark...
Read the full Blueberry monograph → Herb & supplement monographStrawberry
Interacts with 316 drugsStrawberry is a popular, nutrient-rich fruit that supplies vitamin C, fiber, and antioxidant plant compounds. Eating strawberries as part of a balanced diet is healthy for most people, but c...
Read the full Strawberry monograph → Herb & supplement monographSpinach
Interacts with 88 drugsSpinach is a nutrient-dense leafy green that is a healthy part of a balanced diet, providing vitamins, minerals, fiber, and antioxidants. While it is very safe as a food, concentrated supple...
Read the full Spinach monograph → Herb & supplement monographCarrot
Carrot is a common food vegetable that is a rich source of beta-carotene (which the body turns into vitamin A) and other nutrients. Eating carrots is safe and nutritious for most people, but...
Read the full Carrot monograph → Herb & supplement monographParsley
Interacts with 443 drugsParsley is a popular culinary herb that is safe to eat in normal food amounts and is a good source of vitamins K and C. It is traditionally used as a diuretic and for digestion, but solid hu...
Read the full Parsley monograph → Herb & supplement monographCabbage
Interacts with 325 drugsCabbage is a nutritious, low-calorie vegetable that is safe to eat as food and is sometimes applied to the skin as a leaf wrap for breast engorgement or sore joints. Most medicinal claims ar...
Read the full Cabbage monograph → Herb & supplement monographGerman Chamomile
Interacts with 960 drugsGerman chamomile is a widely used herbal remedy taken mainly as a tea for calming, sleep, and digestive complaints. Early research suggests possible benefits for mild anxiety and some skin o...
Read the full German Chamomile monograph → Herb & supplement monographLemon Balm
Interacts with 264 drugsLemon balm is a gentle, lemon-scented mint-family herb traditionally used to ease stress, support sleep, and calm digestion, and topically for cold sores. Early studies are promising but gen...
Read the full Lemon Balm monograph → Herb & supplement monographPassion Flower
Interacts with 836 drugsPassion flower is a traditional calming herb that many people use for anxiety and sleep. Early studies hint it may help with mild anxiety and restlessness, but the evidence is limited and mo...
Read the full Passion Flower monograph →Sources & How We Checked
Centrum Sleep'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 367 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.
Kale 2 references
Broccoli 5 references
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- Chakrabarti A, Prais L, Foulds IS. Allergic contact dermatitis to broccoli. Br J Dermatol 2003;148:172-3. PubMed
- Hakooz, N. and Hamdan, I. Effects of dietary broccoli on human in vivo caffeine metabolism: a pilot study on a group of Jordanian volunteers. Curr Drug Metab 2007;8(1):9-15. PubMed
- Kall MA, Vang O, Clausen J. Effects of dietary broccoli on human drug metabolising activity. Cancer Lett. 1997;114(1-2):169-70. PubMed
- Bauman JE, Hsu CH, Centuori S, et al. Randomized Crossover Trial Evaluating Detoxification of Tobacco Carcinogens by Broccoli Seed and Sprout Extract in Current Smokers. Cancers (Basel). 2022;14(9):2129. Published 2022 Apr 24. PubMed
Apple 16 references
- The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999.
- Bailey DG, Dresser GK, Munoz C, et al. Reduction of fexofenadine bioavailability by fruit juices. Clin Pharmacol Ther 2001;69:P21.
- Rodriguez J, Crespo JF, Lopez-Rubio A, et al. Clinical cross-reactivity among foods of the Rosaceae family. J Allergy Clin Immunol 2000;106:183-189. PubMed
- Greenblatt DJ. Analysis of drug interactions involving fruit beverages and organic anion-transporting polypeptides. J Clin Pharmacol 2009;49:1403-7. PubMed
- Bailey DG. Fruit juice inhibition of uptake transport: a new type of food-drug interaction. Br J Clin Pharmacol 2010;70:645-55. PubMed
- Kamath AV, Yao M, Zhang Y, Chong S. Effect of fruit juices on the oral bioavailability of fexofenadine in rats. J Pharm Sci 2005;94:233-9. PubMed
- Tapaninen T, Neuvonen PJ, Niemi M. Orange and apple juice greatly reduce the plasma concentrations of the OATP2B1 substrate aliskiren. Br J Clin Pharmacol 2011;71:718-26. PubMed
- Jeon H, Jang IJ, Lee S, et al. Apple juice greatly reduces systemic exposure to atenolol. Br J Clin Pharmacol 2012 May 11. doi: 10.1111/j.1365-2125.2012.04324.x. [Epub ahead of print]. PubMed
- Visvanathan, R., Chen, R., Horowitz, M., and Chapman, I. Blood pressure responses in healthy older people to 50 g carbohydrate drinks with differing glycaemic effects. Br J Nutr 2004;92(2):335-340. PubMed
- Asp, N. G., Agardh, C. D., Ahren, B., Dencker, I., Johansson, C. G., Lundquist, I., Nyman, M., Sartor, G., and Schersten, B. Dietary fibre in type II diabetes. Acta Med Scand Suppl 1981;656:47-50. PubMed
- Akamine Y, Miura M, Komori H, et al. Effects of one-time apple juice ingestion on the pharmacokinetics of fexofenadine enantiomers. Eur J Clin Pharmacol. 2014 Sep;70(9):1087-95. PubMed
- Luo J, Imai H, Ohyama T, et al. The Pharmacokinetic Exposure to Fexofenadine is Volume-Dependently Reduced in Healthy Subjects Following Oral Administration With Apple Juice. Clin Transl Sci. 2016 Aug;9(4):201-6. PubMed
- Tsiougkos N, Vovolis V. Repeated anaphylactic episodes to orange and apple. Eur Ann Allergy Clin Immunol. 2013 May;45(3):113-5.
- Rubido S, García-Caballero L, Abeleira MT, Limeres J, García M, Diz P. Effect of chewing an apple on dental plaque removal and on salivary bacterial viability. PLoS One. 2018;13(7):e0199812. PubMed
- Krishnasamy S, Lomer MCE, Marciani L, et al. Processing apples to puree or juice speeds gastric emptying and reduces postprandial intestinal volumes and satiety in healthy adults. J Nutr 2020;150(11):2890-9. PubMed
- Awan S, Abelleira A, Khehra L, Hieber R. Undetectable serum lithium concentrations after coadministration of liquid lithium citrate and apple juice: A case report. Ment Health Clin. 2021;11(1):27-30. PubMed
Tomato 3 references
- Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.
- Asero R, Mistrello G, Amato S. Airborne allergy to tomato proteins. Allergy. 2010;65(12):1626-7. PubMed
- Friedman M. Tomato Glycoalkaloids: Role in the Plant and in the Diet. J Agric Food Chem. 2002;50(21):5751-80. PubMed
Beet 14 references
- Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.
- Clifford T, Berntzen B, Davison GW, et al. Effects of beetroot juice on recovery of muscle function and performance between bouts of repeated sprint exercise. Nutrients 2016;8. pii: E506. PubMed
- Siervo M, Lara J, Ogbonmwan I, Mathers JC. Inorganic nitrate and beetroot juice supplementation reduces blood pressure in adults: a systematic review and meta-analysis. J Nutr 2013;143:818-26. PubMed
- Clifford T, Howatson G, West DJ, Stevenson EJ. Beetroot juice is more beneficial than sodium nitrate for attenuating muscle pain after strenuous eccentric-bias exercise. Appl Physiol Nutr Metab. 2017;42(11):1185-1191. PubMed
- Clifford T, Bell O, West DJ, Howatson G, Stevenson EJ. The effects of beetroot juice supplementation on indices of muscle damage following eccentric exercise. Eur J Appl Physiol. 2016;116(2):353-62. PubMed
- Wylie LJ, Kelly J, Bailey SJ, et al. Beetroot juice and exercise: pharmacodynamic and dose-response relationships. J Appl Physiol (1985). 2013;115(3):325-36. PubMed
- Garnacho-Castaño MV, Palau-Salvà G, Cuenca E, et al. Effects of a single dose of beetroot juice on cycling time trial performance at ventilatory thresholds intensity in male triathletes. J Int Soc Sports Nutr. 2018;15(1):49. PubMed
- Rasica L, Porcelli S, Marzorati M, et al. Ergogenic effects of beetroot juice supplementation during severe-intensity exercise in obese adolescents. Am J Physiol Regul Integr Comp Physiol. 2018;315(3):R453-R460. PubMed
- Henrohn D, Björkstrand K, Lundberg JO, et al. Effects of oral supplementation with nitrate-rich beetroot juice in patients with pulmonary arterial hypertension-results from BEET-PAH, an exploratory randomized, double-blind, placebo-controlled, crosso
- Serra-Payá N, Garnacho-Castaño MV, Sánchez-Nuño S, et al. The relationship between resistance exercise performance and ventilatory efficiency after beetroot juice intake in well-trained athletes. Nutrients 2021;13(4):1094. PubMed
- Haron MH, Dale O, Martin K, et al. Evaluation of the Herb-Drug Interaction Potential of Commonly Used Botanicals on the US Market with Regard to PXR- and AhR-Mediated Influences on CYP3A4 and CYP1A2. J Diet Suppl 2022. PubMed
- Hemmatinafar M, Zaremoayedi L, Koushkie Jahromi M, et al. Effect of Beetroot Juice Supplementation on Muscle Soreness and Performance Recovery after Exercise-Induced Muscle Damage in Female Volleyball Players. Nutrients 2023;15(17):3763. PubMed
- Lim SH, Bae S, Lee HS, Han HK, Choi CI. Effect of Betanin, the Major Pigment of Red Beetroot (Beta vulgaris L.), on the Activity of Recombinant Human Cytochrome P450 Enzymes. Pharmaceuticals (Basel) 2023;16(9):1224. PubMed
- Oscherwitz M, Tamayo RM, Heudebert A, Centor R. A Case of Pseudo-Hematochezia from Beet Supplement Ingestion. Am J Med 2023;136(9):e177-e178. PubMed
Blueberry 7 references
- Cignarella A, Nastasi M, Cavalli E, Puglisi L. Novel lipid-lowering properties of Vaccinium myrtillus L. leaves, a traditional antidiabetic treatment, in several models of rat dyslipidaemia: a comparison with ciprofibrate. Thromb Res 1996;84:311-22. PubMed
- Wang SY, Lin HS. Antioxidant activity in fruits and leaves of blackberry, raspberry, and strawberry varies with cultivar and developmental stage. J Agric Food Chem 2000;48:140-6.. PubMed
- Martineau, L. C., Couture, A., Spoor, D., Benhaddou-Andaloussi, A., Harris, C., Meddah, B., Leduc, C., Burt, A., Vuong, T., Mai, Le P., Prentki, M., Bennett, S. A., Arnason, J. T., and Haddad, P. S. Anti-diabetic properties of the Canadian lowbush bluebe
- Vuong, T., Martineau, L. C., Ramassamy, C., Matar, C., and Haddad, P. S. Fermented Canadian lowbush blueberry juice stimulates glucose uptake and AMP-activated protein kinase in insulin-sensitive cultured muscle cells and adipocytes. Can J Physiol Pharma
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