Daily Fiber + Digestive Enzymes Ingredients & Drug Interactions
by Hilma
What is this page for?
First and foremost: checking Daily Fiber + Digestive Enzymes 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
Daily Fiber + Digestive Enzymes is a dietary supplement by Hilma with 11 active ingredients. Its ingredients are commonly taken for bone health and osteoporosis prevention, dietary calcium deficiency, heartburn relief (calcium carbonate antacids).Based on those ingredients, 2,040 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are Dietary Fiber, Calcium. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against Daily Fiber + Digestive Enzymes by Hilma
Ask about any prescription or over-the-counter medication and we check it for interactions with Daily Fiber + Digestive Enzymes by Hilma — 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 Daily Fiber + Digestive Enzymes by Hilma
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
This powder contains 10 active ingredients. Calcium is included for bone and mineral support.
The digestive enzymes—cellulase, pectinase, invertase, xylanase, hemicellulase, beta-glucanase, and phytase—help break down different components of food to aid digestion. Fiber, which comes from a blend including psyllium husk and acacia gum, supports digestive health and regularity.
The inactive ingredients are rice flour and monk fruit extract.
Does it work?
Strong evidence
Calcium in this product is effective for kidney failure, dyspepsia (upset stomach), hypocalcemia (low blood calcium), hyperkalemia (high potassium), and is likely effective for osteoporosis. The digestive enzymes and fiber components aim to support digestion, though for the enzymes—cellulase, pectinase, invertase, xylanase, hemicellulase, beta-glucanase, and phytase—we hold insufficient reliable evidence in our data to rate their effectiveness for any condition.
Fiber generally supports digestive function, but the facts don't specify an effectiveness rating for the fiber blend itself in this product.
How safe is it?
Well-documented data
Calcium is generally well tolerated at recommended doses, though high amounts can cause problems. The most common side effects from oral calcium are belching, constipation, diarrhea, flatulence, and stomach upset.
Rare serious effects include kidney stones and calciphylaxis. Some research raises concerns that very high calcium intake—over 1500 to 2000 mg daily—might increase risk of prostate cancer and cardiovascular disease, though these findings have been debated in the scientific literature.
Phytase, one of the enzymes in this product, has limited safety data in supplement form. Occupational exposure to airborne phytase powder in animal-feed workers has triggered allergic asthma and hypersensitivity pneumonitis (a lung inflammation), though this relates to inhalation in industrial settings, not oral supplements.
For pregnancy, adequate calcium is important and safe at recommended amounts. For breastfeeding, calcium needs can be met through recommended doses.
Phytase has insufficient data on breastfeeding safety, so check with your provider.
Meds to double-check
Major interaction found
Before taking this product, have your pharmacist check your medications against the major interactions with dolutegravir, elvitegravir, and ceftriaxone (especially intravenous), as well as moderate interactions with levothyroxine, sotalol, raltegravir, diltiazem, and calcipotriene. For the enzymes cellulase, pectinase, invertase, xylanase, beta-glucanase, phytase, and hemicellulase, and for the fiber components psyllium husk and acacia gum, no interactions are documented in our data—but that doesn't guarantee none exist, so ask your pharmacist to verify your full medication list.
The bottom line
Scorecard at a glanceFormula with limited ingredient disclosure with clinical evidence supporting its stated purpose. Major medication interactions have been identified, and safety information is well characterized.
This product is a reasonable choice if you're looking to support digestion and get calcium, but it's not right for everyone. If you take any HIV medications, thyroid medication, heart medications, or ceftriaxone (an antibiotic), you need to talk with your pharmacist or doctor first—timing and dosing matter.
Check your exact medications with the tool on this page before you start.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 4 of 11 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Jul 24, 2025.
This Scorecard evaluates available label information, ingredient evidence, and known medication-safety considerations. It does not independently verify product identity, purity, potency, contamination, or manufacturing quality. How these ratings are computed
General information
Key facts about Daily Fiber + Digestive Enzymes, straight from the product label.
| Brand | Hilma |
|---|---|
| Net contents | 225 Gram(s); 7.94 Ounce(s) |
| Market status | On market |
| Date entered into DSLD | Jul 24, 2025 |
| DSLD ID | 335656 |
| Product type | Other Combinations |
| Supplement form | Powder |
| Dietary claims / uses | Nutrient, All Other, Structure/Function |
| Intended target group(s) | Vegetarian, Adult (18 - 50 Years), Gluten Free, Sugar Free |
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.
Supplement Facts
The label details for Daily Fiber + Digestive Enzymes by Hilma, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Calories | 20 Calorie(s) | -- |
| Total Carbohydrates | 6 Gram(s) | 2% |
| Sugar | 0 Gram(s) | -- |
| Calcium | 52 mg | 4% |
| Added Sugars | 0 Gram(s) | -- |
| Dietary Fiber | 6 Gram(s) | 21% |
| Cellulase | 0 NP | -- |
| Pectinase | 0 NP | -- |
| Invertase | 0 NP | -- |
| Xylanase | 0 NP | -- |
| Fiber | 6 Gram(s) | -- |
| Beta-Glucanase | 0 NP | -- |
| Phytase | 0 NP | -- |
| Hemicellulase | 0 NP | -- |
| Fiber Blend | 7.6 Gram(s) | -- |
| Psyllium Husk, Powder | 0 NP | -- |
| Acacia Gum, Powder | 0 NP | -- |
| Digestive Enzyme Blend | 100 mg | -- |
Other ingredients: Rice Flour, Monk Fruit Extract
Tap any ingredient to jump to its full detail below.
These statements are the manufacturer’s wording, reproduced from the product label — the label is saying it, not HelloPharmacist. We don’t verify or endorse them.
Formulation
No sugar, made with Monkfruit
For sensitive stomachs
Dairy + gluten digestive aid
Always proudly Third party tested Carbon offset
No sugar Certified Carbon free carbonfund.org Non-GMO Gluten free
100% vegetarian
Formula
No sugar, made with Monkfruit
6 g of plant-based, prebiotic fiber to regulate digestion, plus enzymes to help you digest fiber. Made with acacia gum fiber, psyllium husk fiber, digestive enzymes, and pure Monkfruit extract
General Statements
HSA/FSA approved
Made with only the good stuff. Inside our formula
Brand IP Statement(s)
Hilma Natural remedies backed by science
FDA Statement of Identity
Dietary Supplement
Seals/Symbols
Certified Carbon free carbonfund.org
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Daily Fiber + Digestive Enzymes by Hilma 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 Daily Fiber + Digestive Enzymes by Hilma
These are the 11 active ingredients this product is made of. Select any to open its full monograph.
Serving size2 Tbsp Dosage formPowder Servings per container30 Amounts shown are per serving.
Most supplement products combine several ingredients, and a medication can interact with the product through any one of them. Each ingredient below shows whether it has known drug interactions.
Sugar
Calcium
Interacts with168 drugs
Calcium is an essential mineral your body needs for strong bones, nerve signaling, and muscle function, and supplements can help fill gaps when diet f...
Calcium monograph & interactionsDietary Fiber
Interacts with2,025 drugs
Black psyllium is a soluble-fiber supplement made from the seeds of a Plantago plant, used mostly to ease constipation and support digestive health. I...
Dietary Fiber monograph & interactionsFiber Blend
- › Fiber
Digestive Enzyme Blend
- › Cellulase
- › Pectinase
- › Invertase
- › Xylanase
- › Beta-Glucanase
- › Phytase
- › Hemicellulase
Other (inactive) ingredients: Rice Flour, Monk Fruit Extract. These complete the product’s ingredient list but are not active constituents.
Daily Fiber + Digestive Enzymes by Hilma Drug Interactions
HelloPharmacist Interaction Report
Hilma's Daily Fiber + Digestive Enzymes contains calcium, which interacts with a number of medications.
The most serious concerns are HIV integrase inhibitors — dolutegravir (Tivicay) and elvitegravir (Vitekta) — where calcium can reduce blood levels of these drugs by a significant amount. You'd need to separate doses by at least 2 hours before or 6 hours after calcium.
The antibiotic ceftriaxone (Rocephin) poses a major risk too, especially if given intravenously; calcium can cause dangerous precipitation in your lungs and kidneys, so intravenous calcium must be avoided within 48 hours of this antibiotic.
Read the full breakdown — every affected drug type, severity by severity
Calcium also moderately reduces absorption of levothyroxine (Synthroid, used for thyroid conditions), sotalol (a heart rhythm medication), and raltegravir (Isentress, another HIV drug). It may theoretically lower the effectiveness of diltiazem (a blood pressure and heart medication) and raise the risk of high blood calcium (hypercalcemia) if you're also using calcipotriene (Dovonex, a topical psoriasis treatment).
The other active ingredients—cellulase, pectinase, invertase, xylanase, beta-glucanase, phytase, and hemicellulase—we could not check for interactions, and the fiber components (psyllium husk, acacia gum) we also have no interaction data for.
Altogether, these interactions span 167 individual medications. Use the medication checker below to verify your exact drugs before starting this product.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against Daily Fiber + Digestive Enzymes?
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 Daily Fiber + Digestive Enzymes interact with 2,040 drugs. Click any drug to see the details.
2 of the 11 ingredients in Daily Fiber + Digestive Enzymes interact with drugs. Each result below shows which ingredient is responsible. Dietary Fiber Calcium
CeftriaxoneRocephin
How Ceftriaxone interacts with Daily Fiber + Digestive Enzymes — through 1 ingredient. Tap an ingredient for the detail:
CalciumCeftriaxone (rocephin) Major
Interaction Summary
Co-administration of intravenous calcium and ceftriaxone can result in precipitation of a ceftriaxone-calcium salt in the lungs and kidneys.
Read the full Calcium + Ceftriaxone interactionCobicistat, Elvitegravir, Emtricitabine, Tenofovir Alafenamide FumarateGenvoya
How Cobicistat, Elvitegravir, Emtricitabine, Tenofovir Alafenamide Fumarate interacts with Daily Fiber + Digestive Enzymes — through 3 ingredients. Tap an ingredient for the detail:
CalciumElvitegravir (vitekta), Bictegravir/emtricitabine/tenofovir Alafenamide (biktarvy) Major
Interaction Summary
Calcium seems to reduce levels of elvitegravir.
Read the full Calcium + Cobicistat, Elvitegravir, Emtricitabine, Tenofovir Alafenamide Fumarate interactionAcacia Gum, PowderOral Drugs Moderate
Interaction Summary
Theoretically, gum arabic can alter the absorption of oral drugs due to its fiber content.
Read the full Acacia Gum, Powder + Cobicistat, Elvitegravir, Emtricitabine, Tenofovir Alafenamide Fumarate interactionDietary FiberOral Drugs Minor
Interaction Summary
Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Read the full Dietary Fiber + Cobicistat, Elvitegravir, Emtricitabine, Tenofovir Alafenamide Fumarate interactionDolutegravirTivicay
How Dolutegravir interacts with Daily Fiber + Digestive Enzymes — through 3 ingredients. Tap an ingredient for the detail:
CalciumDolutegravir (tivicay) Major
Interaction Summary
Calcium seems to reduce levels of dolutegravir.
Read the full Calcium + Dolutegravir interactionAcacia Gum, PowderOral Drugs Moderate
Interaction Summary
Theoretically, gum arabic can alter the absorption of oral drugs due to its fiber content.
Read the full Acacia Gum, Powder + Dolutegravir interactionDietary FiberOral Drugs Minor
Interaction Summary
Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Read the full Dietary Fiber + Dolutegravir interactionDolutegravir, Emtricitabine, Tenofovir AlafenamideDolutegravir, Emtricitabine, Tenofovir Alafenamide
How Dolutegravir, Emtricitabine, Tenofovir Alafenamide interacts with Daily Fiber + Digestive Enzymes — through 3 ingredients. Tap an ingredient for the detail:
CalciumDolutegravir (tivicay), Bictegravir/emtricitabine/tenofovir Alafenamide (biktarvy) Major
Interaction Summary
Calcium seems to reduce levels of dolutegravir.
Read the full Calcium + Dolutegravir, Emtricitabine, Tenofovir Alafenamide interactionAcacia Gum, PowderOral Drugs Moderate
Interaction Summary
Theoretically, gum arabic can alter the absorption of oral drugs due to its fiber content.
Read the full Acacia Gum, Powder + Dolutegravir, Emtricitabine, Tenofovir Alafenamide interactionDietary FiberOral Drugs Minor
Interaction Summary
Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Read the full Dietary Fiber + Dolutegravir, Emtricitabine, Tenofovir Alafenamide interactionDolutegravir, RilpivirineJuluca
How Dolutegravir, Rilpivirine interacts with Daily Fiber + Digestive Enzymes — through 3 ingredients. Tap an ingredient for the detail:
CalciumDolutegravir (tivicay) Major
Interaction Summary
Calcium seems to reduce levels of dolutegravir.
Read the full Calcium + Dolutegravir, Rilpivirine interactionAcacia Gum, PowderOral Drugs Moderate
Interaction Summary
Theoretically, gum arabic can alter the absorption of oral drugs due to its fiber content.
Read the full Acacia Gum, Powder + Dolutegravir, Rilpivirine interactionDietary FiberOral Drugs Minor
Interaction Summary
Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Read the full Dietary Fiber + Dolutegravir, Rilpivirine interactionElvitegravirVitekta
How Elvitegravir interacts with Daily Fiber + Digestive Enzymes — through 3 ingredients. Tap an ingredient for the detail:
CalciumElvitegravir (vitekta) Major
Interaction Summary
Calcium seems to reduce levels of elvitegravir.
Read the full Calcium + Elvitegravir interactionAcacia Gum, PowderOral Drugs Moderate
Interaction Summary
Theoretically, gum arabic can alter the absorption of oral drugs due to its fiber content.
Read the full Acacia Gum, Powder + Elvitegravir interactionDietary FiberOral Drugs Minor
Interaction Summary
Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Read the full Dietary Fiber + Elvitegravir interactionElvitegravir, Cobicistat, Emtricitabine, Tenofovir Disoproxil FumarateStribild
How Elvitegravir, Cobicistat, Emtricitabine, Tenofovir Disoproxil Fumarate interacts with Daily Fiber + Digestive Enzymes — through 3 ingredients. Tap an ingredient for the detail:
CalciumElvitegravir (vitekta), Bictegravir/emtricitabine/tenofovir Alafenamide (biktarvy) Major
Interaction Summary
Calcium seems to reduce levels of elvitegravir.
Read the full Calcium + Elvitegravir, Cobicistat, Emtricitabine, Tenofovir Disoproxil Fumarate interactionAcacia Gum, PowderOral Drugs Moderate
Interaction Summary
Theoretically, gum arabic can alter the absorption of oral drugs due to its fiber content.
Read the full Acacia Gum, Powder + Elvitegravir, Cobicistat, Emtricitabine, Tenofovir Disoproxil Fumarate interactionDietary FiberOral Drugs Minor
Interaction Summary
Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Read the full Dietary Fiber + Elvitegravir, Cobicistat, Emtricitabine, Tenofovir Disoproxil Fumarate interaction"phentolamineOraVerse, Rogitine, Ryzumvi
How "phentolamine interacts with Daily Fiber + Digestive Enzymes — through 2 ingredients. Tap an ingredient for the detail:
Acacia Gum, PowderOral Drugs Moderate
Interaction Summary
Theoretically, gum arabic can alter the absorption of oral drugs due to its fiber content.
Read the full Acacia Gum, Powder + "phentolamine interactionDietary FiberOral Drugs Minor
Interaction Summary
Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Read the full Dietary Fiber + "phentolamine interaction6-mercaptopurinePurinethol
How 6-mercaptopurine interacts with Daily Fiber + Digestive Enzymes — through 2 ingredients. Tap an ingredient for the detail:
Acacia Gum, PowderOral Drugs Moderate
Interaction Summary
Theoretically, gum arabic can alter the absorption of oral drugs due to its fiber content.
Read the full Acacia Gum, Powder + 6-mercaptopurine interactionDietary FiberOral Drugs Minor
Interaction Summary
Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Read the full Dietary Fiber + 6-mercaptopurine interactionAbacavirZiagen
How Abacavir interacts with Daily Fiber + Digestive Enzymes — through 2 ingredients. Tap an ingredient for the detail:
Acacia Gum, PowderOral Drugs Moderate
Interaction Summary
Theoretically, gum arabic can alter the absorption of oral drugs due to its fiber content.
Read the full Acacia Gum, Powder + Abacavir interactionDietary FiberOral Drugs Minor
Interaction Summary
Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Read the full Dietary Fiber + Abacavir interactionAbacavir Sulfate, Dolutegravir, LamivudineTriumeq
How Abacavir Sulfate, Dolutegravir, Lamivudine interacts with Daily Fiber + Digestive Enzymes — through 2 ingredients. Tap an ingredient for the detail:
Acacia Gum, PowderOral Drugs Moderate
Interaction Summary
Theoretically, gum arabic can alter the absorption of oral drugs due to its fiber content.
Read the full Acacia Gum, Powder + Abacavir Sulfate, Dolutegravir, Lamivudine interactionDietary FiberOral Drugs Minor
Interaction Summary
Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Read the full Dietary Fiber + Abacavir Sulfate, Dolutegravir, Lamivudine interactionAbacavir, LamivudineEpzicom
How Abacavir, Lamivudine interacts with Daily Fiber + Digestive Enzymes — through 2 ingredients. Tap an ingredient for the detail:
Acacia Gum, PowderOral Drugs Moderate
Interaction Summary
Theoretically, gum arabic can alter the absorption of oral drugs due to its fiber content.
Read the full Acacia Gum, Powder + Abacavir, Lamivudine interactionDietary FiberOral Drugs Minor
Interaction Summary
Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Read the full Dietary Fiber + Abacavir, Lamivudine interactionAbciximabReoPro
How Abciximab interacts with Daily Fiber + Digestive Enzymes — through 2 ingredients. Tap an ingredient for the detail:
Acacia Gum, PowderOral Drugs Moderate
Interaction Summary
Theoretically, gum arabic can alter the absorption of oral drugs due to its fiber content.
Read the full Acacia Gum, Powder + Abciximab interactionDietary FiberOral Drugs Minor
Interaction Summary
Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Read the full Dietary Fiber + Abciximab interactionAbemaciclibVerzenio
How Abemaciclib interacts with Daily Fiber + Digestive Enzymes — through 2 ingredients. Tap an ingredient for the detail:
Acacia Gum, PowderOral Drugs Moderate
Interaction Summary
Theoretically, gum arabic can alter the absorption of oral drugs due to its fiber content.
Read the full Acacia Gum, Powder + Abemaciclib interactionDietary FiberOral Drugs Minor
Interaction Summary
Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Read the full Dietary Fiber + Abemaciclib interactionAbiraterone
How Abiraterone interacts with Daily Fiber + Digestive Enzymes — through 2 ingredients. Tap an ingredient for the detail:
Acacia Gum, PowderOral Drugs Moderate
Interaction Summary
Theoretically, gum arabic can alter the absorption of oral drugs due to its fiber content.
Read the full Acacia Gum, Powder + Abiraterone interactionDietary FiberOral Drugs Minor
Interaction Summary
Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Read the full Dietary Fiber + Abiraterone interactionAbiraterone AcetateYonsa, Zytiga
How Abiraterone Acetate interacts with Daily Fiber + Digestive Enzymes — through 2 ingredients. Tap an ingredient for the detail:
Acacia Gum, PowderOral Drugs Moderate
Interaction Summary
Theoretically, gum arabic can alter the absorption of oral drugs due to its fiber content.
Read the full Acacia Gum, Powder + Abiraterone Acetate interactionDietary FiberOral Drugs Minor
Interaction Summary
Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Read the full Dietary Fiber + Abiraterone Acetate interactionAbrocitinibCibinqo
How Abrocitinib interacts with Daily Fiber + Digestive Enzymes — through 2 ingredients. Tap an ingredient for the detail:
Acacia Gum, PowderOral Drugs Moderate
Interaction Summary
Theoretically, gum arabic can alter the absorption of oral drugs due to its fiber content.
Read the full Acacia Gum, Powder + Abrocitinib interactionDietary FiberOral Drugs Minor
Interaction Summary
Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Read the full Dietary Fiber + Abrocitinib interactionAcalabrutinibCalquence
How Acalabrutinib interacts with Daily Fiber + Digestive Enzymes — through 2 ingredients. Tap an ingredient for the detail:
Acacia Gum, PowderOral Drugs Moderate
Interaction Summary
Theoretically, gum arabic can alter the absorption of oral drugs due to its fiber content.
Read the full Acacia Gum, Powder + Acalabrutinib interactionDietary FiberOral Drugs Minor
Interaction Summary
Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Read the full Dietary Fiber + Acalabrutinib interactionAcamprosateCampral
How Acamprosate interacts with Daily Fiber + Digestive Enzymes — through 2 ingredients. Tap an ingredient for the detail:
Acacia Gum, PowderOral Drugs Moderate
Interaction Summary
Theoretically, gum arabic can alter the absorption of oral drugs due to its fiber content.
Read the full Acacia Gum, Powder + Acamprosate interactionDietary FiberOral Drugs Minor
Interaction Summary
Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Read the full Dietary Fiber + Acamprosate interactionAcarboseGlucobay, Prandase, Precose
How Acarbose interacts with Daily Fiber + Digestive Enzymes — through 2 ingredients. Tap an ingredient for the detail:
Acacia Gum, PowderOral Drugs Moderate
Interaction Summary
Theoretically, gum arabic can alter the absorption of oral drugs due to its fiber content.
Read the full Acacia Gum, Powder + Acarbose interactionDietary FiberOral Drugs Minor
Interaction Summary
Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Read the full Dietary Fiber + Acarbose interactionAcebutololRhotral, Sectral
How Acebutolol interacts with Daily Fiber + Digestive Enzymes — through 2 ingredients. Tap an ingredient for the detail:
Acacia Gum, PowderOral Drugs Moderate
Interaction Summary
Theoretically, gum arabic can alter the absorption of oral drugs due to its fiber content.
Read the full Acacia Gum, Powder + Acebutolol interactionDietary FiberOral Drugs Minor
Interaction Summary
Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Read the full Dietary Fiber + Acebutolol interactionAcenocoumarolSintrom
How Acenocoumarol interacts with Daily Fiber + Digestive Enzymes — through 2 ingredients. Tap an ingredient for the detail:
Acacia Gum, PowderOral Drugs Moderate
Interaction Summary
Theoretically, gum arabic can alter the absorption of oral drugs due to its fiber content.
Read the full Acacia Gum, Powder + Acenocoumarol interactionDietary FiberOral Drugs Minor
Interaction Summary
Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Read the full Dietary Fiber + Acenocoumarol interactionAcepromazineAtravet
How Acepromazine interacts with Daily Fiber + Digestive Enzymes — through 2 ingredients. Tap an ingredient for the detail:
Acacia Gum, PowderOral Drugs Moderate
Interaction Summary
Theoretically, gum arabic can alter the absorption of oral drugs due to its fiber content.
Read the full Acacia Gum, Powder + Acepromazine interactionDietary FiberOral Drugs Minor
Interaction Summary
Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Read the full Dietary Fiber + Acepromazine interactionAcetaminophenChildren's Tylenol, Children's Tylenol Meltaways, Tylenol, Tylenol Ex Strength
How Acetaminophen interacts with Daily Fiber + Digestive Enzymes — through 2 ingredients. Tap an ingredient for the detail:
Acacia Gum, PowderOral Drugs Moderate
Interaction Summary
Theoretically, gum arabic can alter the absorption of oral drugs due to its fiber content.
Read the full Acacia Gum, Powder + Acetaminophen interactionDietary FiberOral Drugs Minor
Interaction Summary
Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Read the full Dietary Fiber + Acetaminophen interactionAcetaminophen, AspirinGemnisyn
How Acetaminophen, Aspirin interacts with Daily Fiber + Digestive Enzymes — through 2 ingredients. Tap an ingredient for the detail:
Acacia Gum, PowderOral Drugs Moderate
Interaction Summary
Theoretically, gum arabic can alter the absorption of oral drugs due to its fiber content.
Read the full Acacia Gum, Powder + Acetaminophen, Aspirin interactionDietary FiberOral Drugs Minor
Interaction Summary
Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Read the full Dietary Fiber + Acetaminophen, Aspirin interactionAcetaminophen, Aspirin, CaffeineExcedrin, Excedrin Extra Strength, Excedrin Migraine
How Acetaminophen, Aspirin, Caffeine interacts with Daily Fiber + Digestive Enzymes — through 2 ingredients. Tap an ingredient for the detail:
Acacia Gum, PowderOral Drugs Moderate
Interaction Summary
Theoretically, gum arabic can alter the absorption of oral drugs due to its fiber content.
Read the full Acacia Gum, Powder + Acetaminophen, Aspirin, Caffeine interactionDietary FiberOral Drugs Minor
Interaction Summary
Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Read the full Dietary Fiber + Acetaminophen, Aspirin, Caffeine interactionAcetaminophen, Brompheniramine, PhenylpropanolamineDimetapp Cold and Flu
How Acetaminophen, Brompheniramine, Phenylpropanolamine interacts with Daily Fiber + Digestive Enzymes — through 2 ingredients. Tap an ingredient for the detail:
Acacia Gum, PowderOral Drugs Moderate
Interaction Summary
Theoretically, gum arabic can alter the absorption of oral drugs due to its fiber content.
Read the full Acacia Gum, Powder + Acetaminophen, Brompheniramine, Phenylpropanolamine interactionDietary FiberOral Drugs Minor
Interaction Summary
Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Read the full Dietary Fiber + Acetaminophen, Brompheniramine, Phenylpropanolamine interactionAcetaminophen, ButalbitalAxocet, Bancap, Bucet, Butex Forte, Esgic CF, Orbivan CF +5 more
How Acetaminophen, Butalbital interacts with Daily Fiber + Digestive Enzymes — through 2 ingredients. Tap an ingredient for the detail:
Acacia Gum, PowderOral Drugs Moderate
Interaction Summary
Theoretically, gum arabic can alter the absorption of oral drugs due to its fiber content.
Read the full Acacia Gum, Powder + Acetaminophen, Butalbital interactionDietary FiberOral Drugs Minor
Interaction Summary
Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Read the full Dietary Fiber + Acetaminophen, Butalbital interactionAcetaminophen, Butalbital, CaffeineEsgic, Esgic Plus, Fiogesic, Fioricet, Repan, Tecnal +1 more
How Acetaminophen, Butalbital, Caffeine interacts with Daily Fiber + Digestive Enzymes — through 2 ingredients. Tap an ingredient for the detail:
Acacia Gum, PowderOral Drugs Moderate
Interaction Summary
Theoretically, gum arabic can alter the absorption of oral drugs due to its fiber content.
Read the full Acacia Gum, Powder + Acetaminophen, Butalbital, Caffeine interactionDietary FiberOral Drugs Minor
Interaction Summary
Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Read the full Dietary Fiber + Acetaminophen, Butalbital, Caffeine interactionAcetaminophen, Butalbital, Caffeine, CodeineEsgic with Codeine, Fioricet w/ Codeine
How Acetaminophen, Butalbital, Caffeine, Codeine interacts with Daily Fiber + Digestive Enzymes — through 2 ingredients. Tap an ingredient for the detail:
Acacia Gum, PowderOral Drugs Moderate
Interaction Summary
Theoretically, gum arabic can alter the absorption of oral drugs due to its fiber content.
Read the full Acacia Gum, Powder + Acetaminophen, Butalbital, Caffeine, Codeine interactionDietary FiberOral Drugs Minor
Interaction Summary
Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Read the full Dietary Fiber + Acetaminophen, Butalbital, Caffeine, Codeine interactionEach ingredient & the kinds of drugs it affects
For each ingredient in Daily Fiber + Digestive Enzymes with known interactions, here are the types of medications they can affect. Open any type for the detail — or search your exact drug in the checker above.
Dietary Fiber
Carbamazepine (Tegretol)
Theoretically, black psyllium might reduce the effects of carbamazepine and increase the risk for convulsions.
Theoretically, black psyllium might reduce carbamazepine absorption. A preliminary study using blond psyllium reported decreased carbamazepine bioavailability due to binding of the drug to psyllium, as well as reduction of available fluid in the gut for dissolution of the drug. This interaction may also occur with black psyllium.
Lithium
Theoretically, taking black psyllium at the same time as lithium might reduce lithium absorption.
The fiber in black psyllium might reduce lithium absorption and plasma levels. Some case reports describe a reduction in plasma lithium levels with concomitant administration of blond psyllium. This was reversed when psyllium was stopped. This interaction may also occur with black psyllium.
Metformin (Glucophage)
Theoretically, black psyllium might increase the therapeutic and adverse effects of metformin.
Animal research shows that concurrent consumption of blond psyllium with metformin slows and increases the absorption of metformin. This interaction may also occur with black psyllium. To avoid changes in absorption, take psyllium 30-60 minutes after metformin.
Olanzapine (Zyprexa)
Theoretically, taking black psyllium at the same time as olanzapine might reduce olanzapine absorption.
The fiber in black psyllium might decrease the absorption of olanzapine. A single case report describes a reduction in the effectiveness of olanzapine when it was concomitantly administered with an unspecified type of psyllium 3 grams orally twice daily. This effect was reversed when psyllium was stopped.
Digoxin (Lanoxin)
Theoretically, taking black psyllium at the same time as digoxin might reduce digoxin absorption and decrease digoxin levels.
Psyllium might bind digoxin in the gut. However, some clinical evidence suggests that psyllium does not impact digoxin absorption.
Ethinyl Estradiol
Theoretically, taking black psyllium at the same time as ethinyl estradiol might alter levels of estradiol.
Concurrent use of blond psyllium with ethinyl estradiol results in a slight increase in the extent of ethinyl estradiol absorption and a slower rate of absorption. This is unlikely to be clinically significant.
Oral Drugs
Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Psyllium seems to have variable effects on drug absorption. To avoid changes in absorption, take psyllium 30-60 minutes after oral medications. Animal research shows that blond psyllium delays and increases the absorption of metformin and ethinyl estradiol. Case reports and animal research suggest that blond psyllium might reduce absorption of lithium, digoxin, olanzapine, and carbamazepine. Finally, some pharmacokinetic studies show that psyllium does not affect the absorption of levothyroxine or warfarin. Although many of these studies evaluated blond psyllium, the fiber content in black psyllium may have similar effects.
Calcium
Ceftriaxone (Rocephin)
Co-administration of intravenous calcium and ceftriaxone can result in precipitation of a ceftriaxone-calcium salt in the lungs and kidneys.
Avoid administering intravenous calcium in any form, such as parenteral nutrition or Lactated Ringers, within 48 hours of intravenous ceftriaxone. Case reports in neonates show that administering intravenous ceftriaxone and calcium can result in precipitation of a ceftriaxone-calcium salt in the lungs and kidneys. In several cases, neonates have died as a result of this interaction. So far there are no reports in adults; however, there is still concern that this interaction might occur in adults.
Dolutegravir (Tivicay)
Calcium seems to reduce levels of dolutegravir.
Advise patients to take dolutegravir either 2 hours before or 6 hours after taking calcium supplements. Pharmacokinetic research suggests that taking calcium carbonate 1200 mg concomitantly with dolutegravir 50 mg reduces plasma levels of dolutegravir by almost 40%. Calcium appears to decrease levels of dolutegravir through chelation.
Elvitegravir (Vitekta)
Calcium seems to reduce levels of elvitegravir.
Advise patients to take elvitegravir either 2 hours before or 2 hours after taking calcium supplements. Pharmacokinetic research suggests that taking calcium along with elvitegravir can reduce blood levels of elvitegravir through chelation.
Aluminum
Calcium citrate might increase aluminum absorption and toxicity. Other types of calcium do not increase aluminum absorption.
Calcium citrate can increase the absorption of aluminum when taken with aluminum hydroxide. The increase in aluminum levels may become toxic, particularly in individuals with kidney disease. However, the effect of calcium citrate on aluminum absorption is due to the citrate anion rather than calcium cation. Calcium acetate does not appear to increase aluminum absorption.
Bictegravir/Emtricitabine/Tenofovir Alafenamide (Biktarvy)
Calcium might decrease levels of bictegravir/emtricitabine/tenofovir alafenamide by reducing its absorption when taken in a fasting state.
Advise patients that bictegravir/emtricitabine/tenofovir alafenamide and calcium can be taken together if taken with food. However, if taken on an empty stomach, bictegravir/emtricitabine/tenofovir alafenamide should not be taken with, or 2 hours after, calcium containing products.
Bisphosphonates
Calcium reduces the absorption of bisphosphonates.
Advise patients to take bisphosphonates at least 30 minutes before calcium, but preferably at a different time of day. Calcium supplements decrease absorption of bisphosphonates.
Calcipotriene (Dovonex)
Taking calcipotriene with calcium might increase the risk for hypercalcemia.
Calcipotriene is a vitamin D analog used topically for psoriasis. It can be absorbed in sufficient amounts to cause systemic effects, including hypercalcemia. Theoretically, combining calcipotriene with calcium supplements might increase the risk of hypercalcemia.
Digoxin (Lanoxin)
Using intravenous calcium with digoxin might increase the risk of fatal cardiac arrhythmias.
Hypercalcemia increases the risk of fatal cardiac arrhythmias with digoxin. However, one retrospective analysis of clinical data suggests that intravenous calcium does not increase the risk of dysrhythmias or mortality in patients receiving digoxin.
Diltiazem (Cardizem, Others)
Theoretically, calcium may reduce the therapeutic effects of diltiazem.
Hypercalcemia can reduce the effectiveness of verapamil in atrial fibrillation. Theoretically, calcium might increase this risk of hypercalcemia and reduce the effectiveness of diltiazem.
Levothyroxine (Synthroid, Others)
Calcium seems to reduce the absorption and effectiveness of levothyroxine.
Advise patients to take levothyroxine and calcium supplements at least 4 hours apart. Calcium reduces levothyroxine absorption, probably by forming insoluble complexes. Calcium carbonate supplements reduce effectiveness of levothyroxine in patients with hypothyroidism.
Lithium
Theoretically, concomitant use of calcium and lithium may increase this risk of hypercalcemia.
Clinical research suggests that long-term use of lithium may cause hypercalcemia in 10% to 60% of patients. Theoretically, concomitant use of lithium and calcium supplements may further increase this risk.
Quinolone Antibiotics
Calcium seems to reduce the absorption of quinolone antibiotics.
Advise patients to take oral quinolones at least 2 hours before or 4-6 hours after calcium supplements or calcium-fortified foods. Taking calcium at the same time as oral quinolones can reduce quinolone absorption. Calcium binds to quinolones in the gut.
Raltegravir (Isentress)
Calcium may reduce levels of raltegravir.
Pharmacokinetic research shows that taking a single dose of calcium carbonate 3000 mg along with raltegravir 400 mg twice daily modestly decreases the mean area under the curve of raltegravir, but the decrease does not necessitate a dose adjustment of raltegravir. However, a case of elevated HIV-1 RNA levels and documented resistance to raltegravir has been reported for a patient taking calcium carbonate 1 gram three times daily plus vitamin D3 (cholecalciferol) 400 IU three times daily in combination with raltegravir 400 mg twice daily for 11 months. It is thought that calcium reduced raltegravir levels by chelation, leading to treatment failure.
Sotalol (Betapace)
Calcium seems to reduce the absorption of sotalol.
Advise patients to separate doses by at least 2 hours before or 4-6 hours after calcium. Calcium appears to reduce the absorption of sotalol, probably by forming insoluble complexes.
Tetracycline Antibiotics
Calcium seems to reduce the absorption of tetracycline antibiotics.
Advise patients to take oral tetracyclines at least 2 hours before, or 4-6 hours after calcium supplements. Taking calcium at the same time as oral tetracyclines can reduce tetracycline absorption. Calcium binds to tetracyclines in the gut.
Thiazide Diuretics
Taking calcium along with thiazides might increase the risk of hypercalcemia and renal failure.
Thiazides reduce calcium excretion by the kidneys. Using thiazides along with moderately large amounts of calcium carbonate increases the risk of milk-alkali syndrome (hypercalcemia, metabolic alkalosis, renal failure). Patients may need to have their serum calcium levels and/or parathyroid function monitored regularly.
Verapamil (Calan, Others)
Theoretically, calcium may reduce the therapeutic effects of verapamil.
Hypercalcemia can reduce the effectiveness of verapamil in atrial fibrillation. Theoretically, use of calcium supplements may increase this risk of hypercalcemia and reduce the effectiveness of verapamil.
Calcium Channel Blockers
Intravenous calcium may decrease the effects of calcium channel blockers; oral calcium is unlikely to have this effect.
Intravenous calcium is used to decrease the effects of calcium channel blockers in the management of overdose. Intravenous calcium gluconate has been used before intravenous verapamil (Isoptin) to prevent or reduce the hypotensive effects without affecting the antiarrhythmic effects. But there is no evidence that dietary or supplemental calcium when taken orally interacts with calcium channel blockers.
Brand information
Manufacturer and brand details for Daily Fiber + Digestive Enzymes, from the product label.
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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 Daily Fiber + Digestive Enzymes’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Calcium
Interacts with 168 drugsCalcium is an essential mineral your body needs for strong bones, nerve signaling, and muscle function, and supplements can help fill gaps when diet falls short. Most people do best getting...
Read the full Calcium monograph → Herb & supplement monographBlack Psyllium
Interacts with 2,025 drugsBlack psyllium is a soluble-fiber supplement made from the seeds of a Plantago plant, used mostly to ease constipation and support digestive health. It is best known and most studied for rel...
Read the full Black Psyllium monograph → Herb & supplement monographPhytase
Phytase is an enzyme that breaks down phytic acid (phytate) found in grains, beans, nuts, and seeds, which can free up minerals like iron, zinc, and calcium for absorption. It is widely used...
Read the full Phytase monograph →Sources & How We Checked
Daily Fiber + Digestive Enzymes'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 95 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.
Calcium 62 references
- Shils M, Olson A, Shike M. Modern Nutrition in Health and Disease. 8th ed. Philadelphia, PA: Lea and Febiger, 1994.
- Hernandez-Avila M, Gonzalez-Cossio T, Hernandez-Avila JE, et al. Dietary calcium supplements to lower blood lead levels in lactating women: a randomized placebo-controlled trial. Epidemiology 2003;14:206-12.. PubMed
- Thys-Jacobs S, Ceccarelli S, Bierman A, et al. Calcium supplementation in premenstrual syndrome: a randomized crossover trial. J Gen Intern Med 1989;4:183-9. PubMed
- Maton PN, Burton ME. Antacids revisited: a review of their clinical pharmacology and recommended therapeutic use. Drugs 1999;57:855-70.
- Clemens JD, Feinstein AR. Calcium carbonate and constipation: a historical review of medical mythopoeia. Gastroenterology 1977;72:957-61. DOI
- Saunders D, Sillery J, Chapman R. Effect of calcium carbonate and aluminum hydroxide on human intestinal function. Dig Dis Sci 1988;33:409-13. PubMed
- Friedman PA, Bushinsky DA. Diuretic effects on calcium metabolism. Semin Nephrol 1999;19:551-6.
- Koo WK, Walters JC, Esterlitz J, et al. Maternal calcium supplementation and fetal bone mineralization. Obstet Gynecol 1999;94:577-82. DOI
- Raman L, Rajalakshmi K, Krishnamachari KAVR, et al. Effect of calcium supplementation to undernourished mothers during pregnancy on the bone density of the neonates. Am J Clin Nutr 1978; 31:466-9. DOI
- Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
- Chan JM, Giovannucci E, Andersson SO, et al. Dairy products, calcium, phosphorous, vitamin D, and risk of prostate cancer. Cancer Causes Control 1998;9:559-66.
- Butner LE, Fulco PP, Feldman G, et al. Calcium carbonate-induced hypothyroidism. Ann Intern Med 2000:132:595. PubMed
- Schneyer CR. Calcium carbonate and reduction of levothyroxine efficacy. JAMA 1998;279:750. PubMed
- Moser LR, Smythe MA, Tisdale JE. The use of calcium salts in the prevention and management of verapamil-induced hypotension. Ann Pharmacother 2000;34:622-9. PubMed
- Singh N, Singh PN, Hershman JM. Effect of calcium carbonate on the absorption of levothyroxine. JAMA 2000;283:2822-5. PubMed
- Kahela P, Anttila M, Tikkanen R, Sundquist H. Effect of food, food constituents and fluid volume on the bioavailability of sotalol. Acta Pharmacol Toxicol (Copenh) 1979;44:7-12.. PubMed
- Pletz MW, Petzold P, Allen A, et al. Effect of calcium carbonate on bioavailability of orally administered gemifloxacin. Antimicrob Agents Chemother 2003;47:2158-60.. PubMed
- Bar-Or D, Yoel G. Calcium and calciferol antagonize effect of verapamil in atrial fibrillation. Br Med J 1981;282:1585-6.
- Decktor DL, Robinson M, Maton PN, et al. Effects of aluminum/magnesium hydroxide and calcium carbonate on esophageal and gastric pH in subjects with heartburn. Am J Ther 1995;2:546-52. PubMed
- Simoneau G. Absence of rebound effect with calcium carbonate. Eur J Drug Metab Pharmacokinet 1996;21:351-7. PubMed
- Peters ML, Leonard M, Licata AA. Role of alendronate and risedronate in preventing and treating osteoporosis. Cleve Clin J Med 2001;68:945-51. PubMed
- Bourke JF, Mumford R, Whittaker P, et al. The effects of topical calcipotriol on systemic calcium homeostasis in patients with chronic plaque psoriasis. J Am Acad Dermatol 1997;37:929-34.
- Gueguen L, Pointillart A. The bioavailability of dietary calcium. J Am Coll Nutr 2000;19:119s-136s. PubMed
- Vella A, Gerber TC, Hayes DL, Reeder GS. Digoxin, hypercalcaemia, and cardiac conduction. Postgrad Med J 1999;75:554-6. PubMed
- Bania TC, Blaufeux B, Hughes S, et al. Calcium and digoxin vs. calcium alone for severe verapamil toxicity. Acad Emerg Med 2000;7:1089-96. PubMed
- Tseng M, Breslow RA, Graubard BI, Ziegler RG. Dairy, calcium, and vitamin D intakes and prostate cancer risk in the National Health and Nutrition Examination Epidemiologic Follow-up Study cohort. Am J Clin Nutr 2005;81:1147-54. PubMed
- Weingarten MA, Zalmanovici A, Yaphe J. Dietary calcium supplementation for preventing colorectal cancer and adenomatous polyps. Cochrane Database Syst Rev 2004;(1):CD003548. PubMed
- Tavani A, Bertuccio P, Bosetti C, et al. Dietary intake of calcium, vitamin D, phosphorus and the risk of prostate cancer. Eur Urol 2005;48:27-33. PubMed
- Giovannucci E, Liu Y, Stampfer MJ, Willett WC. A prospective study of calcium intake and incident and fatal prostate cancer. Cancer Epidemiol Biomarkers Prev 2006;15:203-10. PubMed
- Rocephin (ceftriaxone) and calcium interaction. Pharmacist's Letter / Prescriber's Letter 2007;23(10):231005.
- Bolland MJ, Barber PA, Doughty RN, et al. Vascular events in healthy older women receiving calcium supplementation: randomised control trial. BMJ 2008;336:262-6.
- Bolland MJ, Avenell A, Baron JA, et al. Effect of calcium supplements on risk of myocardial infarction and cardiovascular events: meta-analysis. BMJ 2010;341:c3691. PubMed
- Calcium supplementation and vascular events. Pharmacist's Letter / Prescriber's Letter 2008;24(3):240306.
- Dietary reference intakes for calcium and vitamin D. Institute of Medicine, November 30, 2010. Available at: http://www.iom.edu/~/media/Files/Report%20Files/2010/Dietary-Reference-Intakes-for-Calcium-and-Vitamin-D/Vitamin%20D%20and%20Calcium%202010%20Repo
- Coburn JW, Mischel MG, Goodman WG, et al. Calcium citrate markedly enhances aluminum absorption from aluminum hydroxide. Am J Kidney Dis. 1991;17(6):708-11. PubMed
- Bradley JS, Wassel RT, Lee L, et al. Intravenous ceftriaxone and calcium in the neonate: assessing the risk for cardiopulmonary adverse events. Pediatrics. 2009;123(4):e609-13. PubMed
- Kays MB, Overholser BR, Mueller BA, et al. Effects of sevelamer hydrochloride and calcium acetate on the oral bioavailability of ciprofloxacin. Am J Kidney Dis. 2003;42(6):1253-9. PubMed
- Neuhofel, A. L., Wilton, J. H., Victory, J. M., Hejmanowsk, L. G., and Amsden, G. W. Lack of bioequivalence of ciprofloxacin when administered with calcium-fortified orange juice: a new twist on an old interaction. J Clin Pharmacol. 2002;42(4):461-466. DOI
- Dickinson, H. O., Nicolson, D. J., Cook, J. V., Campbell, F., Beyer, F. R., Ford, G. A., and Mason, J. Calcium supplementation for the management of primary hypertension in adults. Cochrane.Database.Syst.Rev. 2006;(2):CD004639. PubMed
- Jones, B. J. and Twomey, P. J. Requesting patterns for serum calcium concentration in patients on long-term lithium therapy. Int J Clin Pract. 2009;63(1):170-172. PubMed
- Levine, M., Nikkanen, H., and Pallin, D. J. The effects of intravenous calcium in patients with digoxin toxicity. J Emerg.Med. 2011;40(1):41-46. PubMed
- Castelo-Branco, C., Ciria-Recasens, M., Cancelo-Hidalgo, M. J., Palacios, S., Haya-Palazuelos, J., Carbonell-Abello, J., Blanch-Rubio, J., Martinez-Zapata, M. J., Manasanch, J., and Perez-Edo, L. Efficacy of ossein-hydroxyapatite complex compared with ca
- Li K, Kaaks R, Linseisen J, Rohrmann S. Associations of dietary calcium intake and calcium supplementation with myocardial infarction and stroke risk and overall cardiovascular mortality in the Heidelberg cohort of the European Prospective Investigation i
- Chung M, Tang AM, Fu Z. Calcium Intake and Cardiovascular Disease Risk: An Updated Systematic Review and Meta-analysis. Ann Intern Med. 2016 Oct 25. PubMed
- Nolan CR, Califano JR, Butzin CA. Influence of calcium acetate or calcium citrate on intestinal aluminum absorption. Kidney Int. 1990;38(5):937-41. PubMed
- Lewis JR, Radavelli-Bagatini S, Rejnmark L, et al. The effects of calcium supplementation on verified coronary heart disease hospitalization and death in postmenopausal women: a collaborative meta-analysis of randomized controlled trials. J Bone Miner Res PubMed
- Jalloh MA, Gregory PJ, Hein D, et al. Dietary supplement interactions with antiretrovirals: a systematic review. Int J STD AIDS. 2017 Jan;28(1):4-15. PubMed
- Lappe J, Watson P, Travers-Gustafson D, Recker R, Garland C, Gorham E, Baggerly K, McDonnell SL. Effect of Vitamin D and Calcium Supplementation on Cancer Incidence in Older Women: A Randomized Clinical Trial. JAMA. 2017 Mar 28;317(12):1234-1243. PubMed
- Grove ML, Cook D. Calcium and heart attacks. Doesn't apply to most calcium prescriptions. BMJ. 2010;341:c5003. PubMed
- Insentress [package insert]. Whitehouse Station, NJ: Merck Sharp & Dohme Corp.; 2014.
- Roberts JL, Kiser JJ, Hindman JT, Meditz AL. Virologic failure with a raltegravir-containing antiretroviral regimen and concomitant calcium administration. Pharmacotherapy 2011;31(10):298e-302e. DOI
- Vitekta [package insert]. Foster City, CA: Gilead Sciences, Inc.; 2014.
- Storan ER, O'Gorman SM, Murphy A, Laing M. Case Report of Calciphylaxis Secondary to Calcium and Vitamin D<sub>3</sub> Supplementation. J Cutan Med Surg. 2017;21(2):162-163. DOI
- Jenkins DJA, Spence JD, Giovannucci EL, et al. Supplemental vitamins and minerals for CVD prevention and treatment. J Am Coll Cardiol 2018;71(22):2570-84. PubMed
- Borkenhagen JF, Connor EL, Stafstrom CE. Neonatal hypocalcemic seizures due to excessive maternal calcium ingestion. Pediatr Neurol 2013;48(6):469-71. PubMed
- WHO recommendations on antenatal care for a positive pregnancy experience. Geneva: World Health Organization; 2016 (http://www.who.int/reproductivehealth/publications/maternal_perinatal_health/ anc-positive-pregnancy-experience/en/).
- Aune D, Navarro Rosenblatt DA, Chan DS, et al. Dairy products, calcium, and prostate cancer risk: a systematic review and meta-analysis of cohort studies. Am J Clin Nutr. 2015;101(1):87-117. PubMed
- Lan T, Park Y, Colditz GA, et al. Adolescent dairy product and calcium intake in relation to later prostate cancer risk and mortality in the NIH-AARP Diet and Health Study. Cancer Causes Control. 2020;31(10):891-904. PubMed
- Zhang Y, Li Y, Liu J, et al. Association of Vitamin D or Calcium Supplementation with Cardiovascular Outcomes and Mortality: A Meta-Analysis with Trial Sequential Analysis. J Nutr Health Aging 2021;25(2):263-270. PubMed
- Myung SK, Kim HB, Lee YJ, Choi YJ, Oh SW. Calcium Supplements and Risk of Cardiovascular Disease: A Meta-Analysis of Clinical Trials. Nutrients 2021;13(2):368. PubMed
- Hetaimish B. Neonatal Calcinosis Cutis After Treatment of Hypocalcemia with Calcium Gluconate: A Report of 2 Cases. Am J Case Rep 2024;25:e943397. PubMed
- US Food and Drug Administration (FDA). Biktarvy Prescribing Information. October 2024. Available at: https://www.accessdata.fda.gov/drugsatfda_docs/label/2024/210251Orig1s020lbl.pdf. Accessed July 16, 2025.
Black Psyllium 18 references
- McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
- Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.
- Covington TR, et al. Handbook of Nonprescription Drugs. 11th ed. Washington, DC: American Pharmaceutical Association, 1996.
- Etman M. Effect of a bulk forming laxative on the bioavailablility of carbamazepine in man. Drug Dev Ind Pharm 1995;21:1901-6.
- Perlman BB. Interaction between lithium salts and ispaghula husk. Lancet 1990;335:416.
- Vaswani SK, Hamilton RG, Valentine MD, Adkinson NF. Psyllium laxative-induced anaphylaxis, asthma, and rhinitis. Allergy 1996;51:266-8. PubMed
- Lantner RR, Espiritu BR, Zumerchik P, Tobin MC. Anaphylaxis following ingestion of a psyllium-containing cereal. JAMA 1990;264:2534-6. DOI
- Kaplan MJ. Anaphylactic reaction to "Heartwise." N Engl J Med 1990;323:1072-3. DOI
- Nordstrom M, Melander A, Robertsson E, Steen B. Influence of wheat bran and of a bulk-forming ispaghula cathartic on the bioavailability of digoxin in geriatric in-patients. Drug Nutr Interact 1987;5:67-9..
- Robinson DS, Benjamin DM, McCormack JJ. Interaction of warfarin and nonsystemic gastrointestinal drugs. Clin Pharmacol Ther 1971;12:491-5. PubMed
- Garcia JJ, Fernandez N, Diez MJ, et al. Influence of two dietary fibers in the oral bioavailability and other pharmacokinetic parameters of ethinyloestradiol. Contraception 2000;62:253-7. PubMed
- Fernandez N, Lopez C, Díez R, et al. Drug interactions with the dietary fiber Plantago ovata husk. Expert Opin Drug Metab Toxicol 2012;8(11):1377-86.
- Semen plantaginis in: WHO Monographs on Selected Medicinal Plants, volume 1. World Health Organization, Geneva, 1999. Available at http://apps.who.int/medicinedocs/en/d/Js2200e/. Accessed November 26, 1026.
- Code of Federal Regulations, Title 21 (21CFR 101.17). Food labeling warning, notice, and safe handling statements. Available at www.ecfr.gov/cgi-bin/text-idx?SID=20f647d3b74161501f46564b915b4048&mc=true&node=se21.2.101_117&rgn=div8. Accessed December 3, 2
- Code of Federal Regulations, Title 21 (21CFR 201.319). Specific labeling requirements - water-soluble gums, hydrophilic gums, and hydrophilic mucilloids. Available at www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?fr=201.319. Accessed Dece
- Diez R, Garcia JJ, Diez MJ, Sierra M, Sahagun AM, Fernandez N. Influence of Plantago ovata husk (dietary fiber) on the bioavailability and other pharmacokinetic parameters of metformin in diabetic rabbits. BMC Complement Altern Med. 2017 Jun 7;17(1):298. PubMed
- Chiu AC, Sherman SI. Effects of pharmacological fiber supplements on levothyroxine absorption. Thyroid. 1998;8(8):667-71. PubMed
- Merrick C, Madden CA, Capurso NA. A Case of Blunted Orally Disintegrating Olanzapine Effect Due to Coadministered Psyllium. J Clin Psychiatry 2021;82(2):20cr13633. PubMed
Phytase 7 references
- Lei XG, Weaver JD, Mullaney E, Ullah AH, Azain MJ. Phytase, a new life for an "old" enzyme. Annu Rev Anim Biosci. 2013;1:283-309. PubMed
- Smuts CM, Matsungo TM, Malan L, et al. Effect of small-quantity lipid-based nutrient supplements on growth, psychomotor development, iron status, and morbidity among 6- to 12-mo-old infants in South Africa: a randomized controlled trial. Am J Clin Nutr. 2 PubMed
- van Heemst RC, Sander I, Rooyackers J, et al. Hypersensitivity pneumonitis caused by occupational exposure to phytase. Eur Respir J. 2009;33(6):1507-9. PubMed
- Baur X, Melching-Kollmuss S, Koops F, Strassburger K, Zober A. IgE-mediated allergy to phytase -- a new animal feed additive. Allergy. 2002;57(10):943-5. PubMed
- Doekes G, Kamminga N, Helwegen L, Heederik D. Occupational IgE sensitisation to phytase, a phosphatase derived from Aspergillus niger. Occup Environ Med. 1999;56(7):454-9. PubMed
- Brnic M, Hurrell RF, Songré-Ouattara LT, et al. Effect of phytase on zinc absorption from a millet-based porridge fed to young Burkinabe children. Eur J Clin Nutr. 2017;71(1):137-141. PubMed
- Koshy JC, Sharabi SE, Feldman EM, Hollier LH Jr, Patrinely JR, Soparkar CN. Effect of dietary zinc and phytase supplementation on botulinum toxin treatments. J Drugs Dermatol. 2012;11(4):507-12.
Gum Arabic 8 references
- Jensen CD, Spiller GA, Gates JE, et al. The effect of acacia gum and a water-soluble dietary fiber mixture on blood lipids in humans. J Am Coll Nutr 1993;12:147-54. PubMed
- Eltayeb IB, Awad AI, Elderbi MA, Shadad SA. Effect of gum arabic on the absorption of a single oral dose of amoxicillin in healthy Sudanese volunteers. J Antimicrob Chemother 2004;54:577-8. PubMed
- Babiker R, Merghani TH, Elmusharaf K, et al. Effects of gum Arabic ingestion on body mass index and body fat percentage in healthy adult females: two-arm randomized, placebo controlled, double-blind trial. Nutr J 2012;11:111. PubMed
- Babiker R, Elmusharaf K, Keogh MB, Banaga AS, Saeed AM. Metabolic effect of gum Arabic (Acacia senegal) in patients with type 2 diabetes mellitus (T2DM): randomized, placebo controlled double blind trial. Functional Foods in Health and Disease. 2017;7(3): DOI
- Beneke CE, Viljoen AM, Hamman JH. Polymeric plant-derived excipients in drug delivery. Molecules. 2009;14(7):2602-20. PubMed
- Ali NE, Kaddam LA, Alkarib SY, et al. Gum Arabic (Acacia Senegal) Augmented Total Antioxidant Capacity and Reduced C-Reactive Protein among Haemodialysis Patients in Phase II Trial. Int J Nephrol. 2020;2020:7214673.
- Mortensen A, Aguilar F, Crebelli R, et al. Re-evaluation of acacia gum (E 414) as a food additive. EFSA J. 2017;15(4):e04741. PubMed
- Larson R, Nelson C, Korczak R, et al. Acacia Gum Is Well Tolerated While Increasing Satiety and Lowering Peak Blood Glucose Response in Healthy Human Subjects. Nutrients 2021;13(2):618. PubMed
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