Feel Free Ingredients & Drug Interactions
What is this page for?
First and foremost: checking Feel Free 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
Feel Free is a dietary supplement by Botanic Tonics with 4 active ingredients. Its ingredients are commonly taken for preventing or treating low potassium (hypokalemia), supporting healthy blood pressure, muscle cramps.Based on those ingredients, 1,296 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are Kava root extract, Kratom, Iron. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against Feel Free by Botanic Tonics
Ask about any prescription or over-the-counter medication and we check it for interactions with Feel Free by Botanic Tonics — 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 Feel Free by Botanic Tonics
Our pharmacy team’s full take, with four database checks built into the cards below — a summary of what is known, not a grade of the product itself.
What’s inside
Full disclosure
Feel Free contains 4 active ingredients. Potassium supports heart and muscle function.
Iron is used to treat or prevent low iron and anemia. Kratom alkaloids are compounds from kratom leaf.
The product also lists kavalactones, though we hold no interaction data for this ingredient. Several inactive ingredients — water, pineapple juice, stevia, and natural flavors — are included as fillers and flavorings.
Does it work?
Strong evidence
In our data, iron is rated Effective for iron deficiency anemia, anemia of chronic disease, and pregnancy-related iron deficiency. It is rated Possibly Effective for heart failure.
Potassium and kratom alkaloids have no effectiveness ratings in our records. For potassium's role in this product and for kratom's claimed uses (anxiety, depression, athletic performance, cough, sexual dysfunction, and diabetes), the evidence isn't established in the data we hold.
How safe is it?
Well-documented data
Potassium from a normal diet is safe, but supplements can cause dangerously high blood levels in some people — especially those with kidney disease — so use only under medical guidance. Iron is generally well tolerated at recommended doses, but excess iron can be toxic.
Common side effects of both include nausea, vomiting, abdominal pain, and diarrhea. Kratom carries significant safety concerns: it is possibly unsafe for oral use, is linked to dependence, and carries risks of serious liver damage, seizures, respiratory depression, and cardiac problems.
Kratom is considered unsafe in pregnancy and should be avoided while breastfeeding.
Meds to double-check
Moderate interaction found
Before taking Feel Free, check with your pharmacist if you take ACE inhibitors (lisinopril, enalapril) or ARBs (losartan, valsartan) — potassium could raise your blood potassium to unsafe levels. Also flag potassium-sparing diuretics, levothyroxine, any tetracycline or quinolone antibiotics, levodopa, methyldopa, bisphosphonates, penicillamine, or CNS depressants (opioids, sedatives, alcohol).
Iron reduces absorption of many of these; kratom may interact with liver enzyme systems and specific medications like quetiapine, modafinil, naltrexone, and venlafaxine. A full medication check is essential.
The bottom line
Scorecard at a glanceFully disclosed formula with strong clinical evidence behind its ingredients' uses. Moderate medication interactions have been identified, and safety information is well characterized.
If you take ACE inhibitors, ARBs, diuretics, thyroid medication, antibiotics, or any blood pressure or heart medication, talk to your pharmacist before using Feel Free. The potassium and iron content could interfere with how your drugs work or create dangerous blood levels.
Kratom alkaloids add further interaction risk. This product is not appropriate for pregnancy or breastfeeding.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 3 of 4 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Sep 22, 2022.
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 Feel Free, straight from the product label.
| Brand | Botanic Tonics |
|---|---|
| Net contents | 2 Fluid Ounce(s) |
| Market status | On market |
| Date entered into DSLD | Sep 22, 2022 |
| DSLD ID | 277537 |
| Product type | Botanical With Nutrients |
| Supplement form | Liquid |
| Dietary claims / uses | All Other |
| 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 Feel Free by Botanic Tonics, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Potassium | 54 mg | 2% |
| Iron | 0.6 mg | 4% |
| Proprietary Blend | 2600 mg | -- |
| Kavalactones | 250 mg | -- |
| Kava root extract | 0 NP | -- |
| Kratom | 0 NP | -- |
| Kratom Alkaloids | 25 mg | -- |
Other ingredients: Water, Pineapple Juice, Stevia, Natural Flavors
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
Plant based
FDA Statement of Identity
Herbal Supplement
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Feel Free by Botanic Tonics 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 Feel Free by Botanic Tonics
These are the 4 active ingredients this product is made of. Select any to open its full monograph.
Serving size1 Ounce(s) Dosage formLiquid Servings per container2 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.
Potassium
Interacts with62 drugs
Potassium is an essential mineral your body needs for nerve signals, muscle function, and a steady heartbeat, and most people get enough from a balanc...
Potassium monograph & interactionsIron
Interacts with80 drugs
Iron is an essential mineral your body needs to make hemoglobin and carry oxygen in the blood. Supplements are mainly useful for treating or preventin...
Iron monograph & interactionsProprietary Blend
Other (inactive) ingredients: Water, Pineapple Juice, Stevia, Natural Flavors. These complete the product’s ingredient list but are not active constituents.
Feel Free by Botanic Tonics Drug Interactions
HelloPharmacist Interaction Report
Feel Free by Botanic Tonics contains potassium, iron, and kratom alkaloids — all three have documented interactions with medications.
The most serious concern is potassium's Moderate-severity risk of dangerously high blood potassium levels (hyperkalemia) when combined with ACE inhibitors (blood pressure drugs like lisinopril), which reduce how much potassium your kidneys remove. The same Moderate risk applies to angiotensin receptor blockers (ARBs, such as losartan) and potassium-sparing diuretics (water pills that preserve potassium).
Read the full breakdown — every affected drug type, severity by severity
Iron in this product can reduce how well your body absorbs several medications — all Moderate severity. These include levothyroxine (thyroid hormone), tetracycline and quinolone antibiotics, levodopa (for Parkinson's), methyldopa (blood pressure), bisphosphonates (bone health), and penicillamine (for Wilson's disease).
The usual advice is to space iron doses 2–4 hours away from these drugs.
Kratom alkaloids carry Moderate-severity interactions with CNS depressants (sedatives, opioids, alcohol), drugs metabolized by liver enzymes CYP2D6, CYP1A2, and CYP3A4 (a very large group), and specific medications including quetiapine, modafinil, naltrexone, and venlafaxine. Altogether, these interactions span 1,094 individual medications.
We could not check kavalactones — no data is on file for it. Use the medication checker on this page to confirm whether your exact prescriptions and over-the-counter drugs are affected before you start Feel Free.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against Feel Free?
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 Feel Free interact with 1,296 drugs. Click any drug to see the details.
4 of the 4 ingredients in Feel Free interact with drugs. Each result below shows which ingredient is responsible. Kava root extract Kratom Iron Potassium
AcepromazineAtravet
How Acepromazine interacts with Feel Free — through 2 ingredients. Tap an ingredient for the detail:
Kava Root ExtractCns Depressants Major
Interaction Summary
Combining kava with CNS depressants can have additive sedative effects.
Read the full Kava Root Extract + Acepromazine interactionKratom AlkaloidsCns Depressants Moderate
Interaction Summary
Theoretically, concomitant use might increase the risk for adverse CNS depressant effects.
Read the full Kratom Alkaloids + Acepromazine interactionAcetaminophen, Butalbital, Caffeine, CodeineEsgic with Codeine, Fioricet w/ Codeine
How Acetaminophen, Butalbital, Caffeine, Codeine interacts with Feel Free — through 2 ingredients. Tap an ingredient for the detail:
Kava Root ExtractCytochrome P450 2e1 (cyp2e1) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +4 Major
Interaction Summary
Kava might increase levels of CYP2E1 substrates.
Read the full Kava Root Extract + Acetaminophen, Butalbital, Caffeine, Codeine interactionKratom AlkaloidsCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 2d6 (cyp2d6) Substrates +2 Moderate
Interaction Summary
Theoretically, kratom might increase the levels and clinical effects of drugs metabolized by CYP1A2.
Read the full Kratom Alkaloids + Acetaminophen, Butalbital, Caffeine, Codeine interactionAcetaminophen, Butalbital, CodeineBancap w/ Codeine
How Acetaminophen, Butalbital, Codeine interacts with Feel Free — through 2 ingredients. Tap an ingredient for the detail:
Kava Root ExtractCytochrome P450 2d6 (cyp2d6) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates +3 Major
Interaction Summary
It is unclear if kava inhibits CYP1A2; research is conflicting.
Read the full Kava Root Extract + Acetaminophen, Butalbital, Codeine interactionKratom AlkaloidsCytochrome P450 2d6 (cyp2d6) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Moderate
Interaction Summary
Theoretically, kratom might increase the levels and clinical effects of drugs metabolized by CYP2D6.
Read the full Kratom Alkaloids + Acetaminophen, Butalbital, Codeine interactionAcetaminophen, Butalbital, Codeine PhosphatePhrenilin #3
How Acetaminophen, Butalbital, Codeine Phosphate interacts with Feel Free — through 2 ingredients. Tap an ingredient for the detail:
Kava Root ExtractCytochrome P450 2e1 (cyp2e1) Substrates, Cns Depressants +3 Major
Interaction Summary
Kava might increase levels of CYP2E1 substrates.
Read the full Kava Root Extract + Acetaminophen, Butalbital, Codeine Phosphate interactionKratom AlkaloidsCns Depressants, Cytochrome P450 2d6 (cyp2d6) Substrates +1 Moderate
Interaction Summary
Theoretically, concomitant use might increase the risk for adverse CNS depressant effects.
Read the full Kratom Alkaloids + Acetaminophen, Butalbital, Codeine Phosphate interactionAcetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, PhenylephrineHycomine Compound
How Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interacts with Feel Free — through 2 ingredients. Tap an ingredient for the detail:
Kava Root ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cns Depressants +4 Major
Interaction Summary
It is unclear if kava inhibits CYP1A2; research is conflicting.
Read the full Kava Root Extract + Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interactionKratom AlkaloidsCytochrome P450 3a4 (cyp3a4) Substrates, Cns Depressants +2 Moderate
Interaction Summary
Kratom might increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Kratom Alkaloids + Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interactionAcetaminophen, Caffeine, CodeineGesic C15, Gesic C30, Gesic C8, Lenoltec 1, Lenoltec 2, Lenoltec 3 +1 more
How Acetaminophen, Caffeine, Codeine interacts with Feel Free — through 2 ingredients. Tap an ingredient for the detail:
Kava Root ExtractCytochrome P450 2e1 (cyp2e1) Substrates, Cytochrome P450 2d6 (cyp2d6) Substrates +4 Major
Interaction Summary
Kava might increase levels of CYP2E1 substrates.
Read the full Kava Root Extract + Acetaminophen, Caffeine, Codeine interactionKratom AlkaloidsCytochrome P450 2d6 (cyp2d6) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates +2 Moderate
Interaction Summary
Theoretically, kratom might increase the levels and clinical effects of drugs metabolized by CYP2D6.
Read the full Kratom Alkaloids + Acetaminophen, Caffeine, Codeine interactionAcetaminophen, Caffeine, Codeine, SalicylamideCodalan No.1, Codalan No.2, Codalan No.3
How Acetaminophen, Caffeine, Codeine, Salicylamide interacts with Feel Free — through 2 ingredients. Tap an ingredient for the detail:
Kava Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cns Depressants +4 Major
Interaction Summary
It is unclear if kava inhibits CYP3AA; research is conflicting.
Read the full Kava Root Extract + Acetaminophen, Caffeine, Codeine, Salicylamide interactionKratom AlkaloidsCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates +2 Moderate
Interaction Summary
Kratom might increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Kratom Alkaloids + Acetaminophen, Caffeine, Codeine, Salicylamide interactionAcetaminophen, Caffeine, DihydrocodeineDHC Plus, Panlor DC, Panlor SS
How Acetaminophen, Caffeine, Dihydrocodeine interacts with Feel Free — through 2 ingredients. Tap an ingredient for the detail:
Kava Root ExtractCytochrome P450 2e1 (cyp2e1) Substrates, Hepatotoxic Drugs +4 Major
Interaction Summary
Kava might increase levels of CYP2E1 substrates.
Read the full Kava Root Extract + Acetaminophen, Caffeine, Dihydrocodeine interactionKratom AlkaloidsCytochrome P450 2d6 (cyp2d6) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates +2 Moderate
Interaction Summary
Theoretically, kratom might increase the levels and clinical effects of drugs metabolized by CYP2D6.
Read the full Kratom Alkaloids + Acetaminophen, Caffeine, Dihydrocodeine interactionAcetaminophen, Chlorpheniramine, Codeine, PhenylephrineColrex
How Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interacts with Feel Free — through 2 ingredients. Tap an ingredient for the detail:
Kava Root ExtractCytochrome P450 2d6 (cyp2d6) Substrates, Hepatotoxic Drugs +4 Major
Interaction Summary
It is unclear if kava inhibits CYP1A2; research is conflicting.
Read the full Kava Root Extract + Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interactionKratom AlkaloidsSerotonergic Drugs, Cns Depressants +3 Moderate
Interaction Summary
Theoretically, taking kratom in combination with serotonergic drugs may increase levels of serotonin, increasing the risk of serotonin syndrome.
Read the full Kratom Alkaloids + Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interactionAcetaminophen, Chlorpheniramine, Phenylpropanolamine, OpiumHista-Derfule
How Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium interacts with Feel Free — through 2 ingredients. Tap an ingredient for the detail:
Kava Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates +3 Major
Interaction Summary
It is unclear if kava inhibits CYP3AA; research is conflicting.
Read the full Kava Root Extract + Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium interactionKratom AlkaloidsSerotonergic Drugs, Cytochrome P450 1a2 (cyp1a2) Substrates +2 Moderate
Interaction Summary
Theoretically, taking kratom in combination with serotonergic drugs may increase levels of serotonin, increasing the risk of serotonin syndrome.
Read the full Kratom Alkaloids + Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium interactionAcetaminophen, Chlorzoxazone, CodeineAcetazone Forte C8, Parafon Forte C8
How Acetaminophen, Chlorzoxazone, Codeine interacts with Feel Free — through 2 ingredients. Tap an ingredient for the detail:
Kava Root ExtractCytochrome P450 2e1 (cyp2e1) Substrates, Hepatotoxic Drugs +3 Major
Interaction Summary
Kava might increase levels of CYP2E1 substrates.
Read the full Kava Root Extract + Acetaminophen, Chlorzoxazone, Codeine interactionKratom AlkaloidsCytochrome P450 2d6 (cyp2d6) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Moderate
Interaction Summary
Theoretically, kratom might increase the levels and clinical effects of drugs metabolized by CYP2D6.
Read the full Kratom Alkaloids + Acetaminophen, Chlorzoxazone, Codeine interactionAcetaminophen, CodeineTylenol No.3, Tylenol w/ Codeine
How Acetaminophen, Codeine interacts with Feel Free — through 2 ingredients. Tap an ingredient for the detail:
Kava Root ExtractCns Depressants, Hepatotoxic Drugs +3 Major
Interaction Summary
Combining kava with CNS depressants can have additive sedative effects.
Read the full Kava Root Extract + Acetaminophen, Codeine interactionKratom AlkaloidsCns Depressants, Cytochrome P450 2d6 (cyp2d6) Substrates +1 Moderate
Interaction Summary
Theoretically, concomitant use might increase the risk for adverse CNS depressant effects.
Read the full Kratom Alkaloids + Acetaminophen, Codeine interactionAcetaminophen, Codeine, DoxylamineMersyndol
How Acetaminophen, Codeine, Doxylamine interacts with Feel Free — through 2 ingredients. Tap an ingredient for the detail:
Kava Root ExtractCytochrome P450 2e1 (cyp2e1) Substrates, Cytochrome P450 2d6 (cyp2d6) Substrates +3 Major
Interaction Summary
Kava might increase levels of CYP2E1 substrates.
Read the full Kava Root Extract + Acetaminophen, Codeine, Doxylamine interactionKratom AlkaloidsCytochrome P450 2d6 (cyp2d6) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Moderate
Interaction Summary
Theoretically, kratom might increase the levels and clinical effects of drugs metabolized by CYP2D6.
Read the full Kratom Alkaloids + Acetaminophen, Codeine, Doxylamine interactionAcetaminophen, Codeine, MethocarbamolAcetaminophen, Codeine, Methocarbamol, Robaxacet 8
How Acetaminophen, Codeine, Methocarbamol interacts with Feel Free — through 2 ingredients. Tap an ingredient for the detail:
Kava Root ExtractHepatotoxic Drugs, Cytochrome P450 2d6 (cyp2d6) Substrates +3 Major
Interaction Summary
Theoretically, using kava with hepatotoxic drugs might increase the risk of liver damage.
Read the full Kava Root Extract + Acetaminophen, Codeine, Methocarbamol interactionKratom AlkaloidsCytochrome P450 2d6 (cyp2d6) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Moderate
Interaction Summary
Theoretically, kratom might increase the levels and clinical effects of drugs metabolized by CYP2D6.
Read the full Kratom Alkaloids + Acetaminophen, Codeine, Methocarbamol interactionAcetaminophen, Dichloralantipyrine, IsomethepteneAmidrine, Midchlor, Migquin, Migratine
How Acetaminophen, Dichloralantipyrine, Isometheptene interacts with Feel Free — through 2 ingredients. Tap an ingredient for the detail:
Kava Root ExtractHepatotoxic Drugs, Cns Depressants +2 Major
Interaction Summary
Theoretically, using kava with hepatotoxic drugs might increase the risk of liver damage.
Read the full Kava Root Extract + Acetaminophen, Dichloralantipyrine, Isometheptene interactionKratom AlkaloidsCytochrome P450 1a2 (cyp1a2) Substrates, Cns Depressants Moderate
Interaction Summary
Theoretically, kratom might increase the levels and clinical effects of drugs metabolized by CYP1A2.
Read the full Kratom Alkaloids + Acetaminophen, Dichloralantipyrine, Isometheptene interactionAcetaminophen, Dichloralphenazone, IsomethepteneMidrin
How Acetaminophen, Dichloralphenazone, Isometheptene interacts with Feel Free — through 2 ingredients. Tap an ingredient for the detail:
Kava Root ExtractCytochrome P450 2e1 (cyp2e1) Substrates, Cns Depressants +2 Major
Interaction Summary
Kava might increase levels of CYP2E1 substrates.
Read the full Kava Root Extract + Acetaminophen, Dichloralphenazone, Isometheptene interactionKratom AlkaloidsCytochrome P450 1a2 (cyp1a2) Substrates, Cns Depressants Moderate
Interaction Summary
Theoretically, kratom might increase the levels and clinical effects of drugs metabolized by CYP1A2.
Read the full Kratom Alkaloids + Acetaminophen, Dichloralphenazone, Isometheptene interactionAcetaminophen, Dichlorophenazone, IsometheptaneIsocom
How Acetaminophen, Dichlorophenazone, Isometheptane interacts with Feel Free — through 2 ingredients. Tap an ingredient for the detail:
Kava Root ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cns Depressants +2 Major
Interaction Summary
It is unclear if kava inhibits CYP1A2; research is conflicting.
Read the full Kava Root Extract + Acetaminophen, Dichlorophenazone, Isometheptane interactionKratom AlkaloidsCns Depressants, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, concomitant use might increase the risk for adverse CNS depressant effects.
Read the full Kratom Alkaloids + Acetaminophen, Dichlorophenazone, Isometheptane interactionAcetaminophen, DiphenhydramineTylenol PM, Tylenol PM Ex Strength
How Acetaminophen, Diphenhydramine interacts with Feel Free — through 2 ingredients. Tap an ingredient for the detail:
Kava Root ExtractCytochrome P450 2e1 (cyp2e1) Substrates, Hepatotoxic Drugs +2 Major
Interaction Summary
Kava might increase levels of CYP2E1 substrates.
Read the full Kava Root Extract + Acetaminophen, Diphenhydramine interactionKratom AlkaloidsCytochrome P450 1a2 (cyp1a2) Substrates, Cns Depressants Moderate
Interaction Summary
Theoretically, kratom might increase the levels and clinical effects of drugs metabolized by CYP1A2.
Read the full Kratom Alkaloids + Acetaminophen, Diphenhydramine interactionAcetaminophen, Diphenhydramine, PseudoephedrineChildren's Tylenol Allergy, Cold Control, Contac Night Allergy Relief
How Acetaminophen, Diphenhydramine, Pseudoephedrine interacts with Feel Free — through 2 ingredients. Tap an ingredient for the detail:
Kava Root ExtractCns Depressants, Hepatotoxic Drugs +2 Major
Interaction Summary
Combining kava with CNS depressants can have additive sedative effects.
Read the full Kava Root Extract + Acetaminophen, Diphenhydramine, Pseudoephedrine interactionKratom AlkaloidsCytochrome P450 1a2 (cyp1a2) Substrates, Cns Depressants Moderate
Interaction Summary
Theoretically, kratom might increase the levels and clinical effects of drugs metabolized by CYP1A2.
Read the full Kratom Alkaloids + Acetaminophen, Diphenhydramine, Pseudoephedrine interactionAcetaminophen, HydrocodoneAnexsia, Anodynos DHC, Azdone, Co-Gesic, Doucet, Lorcet +9 more
How Acetaminophen, Hydrocodone interacts with Feel Free — through 2 ingredients. Tap an ingredient for the detail:
Kava Root ExtractHepatotoxic Drugs, Cns Depressants +4 Major
Interaction Summary
Theoretically, using kava with hepatotoxic drugs might increase the risk of liver damage.
Read the full Kava Root Extract + Acetaminophen, Hydrocodone interactionKratom AlkaloidsCns Depressants, Cytochrome P450 3a4 (cyp3a4) Substrates +2 Moderate
Interaction Summary
Theoretically, concomitant use might increase the risk for adverse CNS depressant effects.
Read the full Kratom Alkaloids + Acetaminophen, Hydrocodone interactionAcetaminophen, MeperidineDemerol APAP
How Acetaminophen, Meperidine interacts with Feel Free — through 2 ingredients. Tap an ingredient for the detail:
Kava Root ExtractHepatotoxic Drugs, Cns Depressants +3 Major
Interaction Summary
Theoretically, using kava with hepatotoxic drugs might increase the risk of liver damage.
Read the full Kava Root Extract + Acetaminophen, Meperidine interactionKratom AlkaloidsCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 2d6 (cyp2d6) Substrates +2 Moderate
Interaction Summary
Theoretically, kratom might increase the levels and clinical effects of drugs metabolized by CYP1A2.
Read the full Kratom Alkaloids + Acetaminophen, Meperidine interactionAcetaminophen, OxycodonePercocet, Roxicet, Tylox, Xartemis XR
How Acetaminophen, Oxycodone interacts with Feel Free — through 2 ingredients. Tap an ingredient for the detail:
Kava Root ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Hepatotoxic Drugs +3 Major
Interaction Summary
It is unclear if kava inhibits CYP1A2; research is conflicting.
Read the full Kava Root Extract + Acetaminophen, Oxycodone interactionKratom AlkaloidsCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 2d6 (cyp2d6) Substrates +1 Moderate
Interaction Summary
Theoretically, kratom might increase the levels and clinical effects of drugs metabolized by CYP1A2.
Read the full Kratom Alkaloids + Acetaminophen, Oxycodone interactionAcetaminophen, PentazocineTalacen
How Acetaminophen, Pentazocine interacts with Feel Free — through 2 ingredients. Tap an ingredient for the detail:
Kava Root ExtractHepatotoxic Drugs, Cytochrome P450 1a2 (cyp1a2) Substrates +2 Major
Interaction Summary
Theoretically, using kava with hepatotoxic drugs might increase the risk of liver damage.
Read the full Kava Root Extract + Acetaminophen, Pentazocine interactionKratom AlkaloidsCytochrome P450 1a2 (cyp1a2) Substrates, Cns Depressants Moderate
Interaction Summary
Theoretically, kratom might increase the levels and clinical effects of drugs metabolized by CYP1A2.
Read the full Kratom Alkaloids + Acetaminophen, Pentazocine interactionAcetaminophen, PropoxypheneDarvocet-N 100, Darvocet-N 50, E-Lor, Wygesic
How Acetaminophen, Propoxyphene interacts with Feel Free — through 2 ingredients. Tap an ingredient for the detail:
Kava Root ExtractHepatotoxic Drugs, Cytochrome P450 2d6 (cyp2d6) Substrates +3 Major
Interaction Summary
Theoretically, using kava with hepatotoxic drugs might increase the risk of liver damage.
Read the full Kava Root Extract + Acetaminophen, Propoxyphene interactionKratom AlkaloidsCytochrome P450 2d6 (cyp2d6) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Moderate
Interaction Summary
Theoretically, kratom might increase the levels and clinical effects of drugs metabolized by CYP2D6.
Read the full Kratom Alkaloids + Acetaminophen, Propoxyphene interactionAcetazolamideAk-Zol, Diamox
How Acetazolamide interacts with Feel Free — through 2 ingredients. Tap an ingredient for the detail:
Kava Root ExtractCns Depressants Major
Interaction Summary
Combining kava with CNS depressants can have additive sedative effects.
Read the full Kava Root Extract + Acetazolamide interactionKratom AlkaloidsCns Depressants Moderate
Interaction Summary
Theoretically, concomitant use might increase the risk for adverse CNS depressant effects.
Read the full Kratom Alkaloids + Acetazolamide interactionAlfentanilAlfenta
How Alfentanil interacts with Feel Free — through 2 ingredients. Tap an ingredient for the detail:
Kava Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cns Depressants Major
Interaction Summary
It is unclear if kava inhibits CYP3AA; research is conflicting.
Read the full Kava Root Extract + Alfentanil interactionKratom AlkaloidsCns Depressants, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, concomitant use might increase the risk for adverse CNS depressant effects.
Read the full Kratom Alkaloids + Alfentanil interactionAlprazolamNiravam, Xanax
How Alprazolam interacts with Feel Free — through 2 ingredients. Tap an ingredient for the detail:
Kava Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cns Depressants Major
Interaction Summary
It is unclear if kava inhibits CYP3AA; research is conflicting.
Read the full Kava Root Extract + Alprazolam interactionKratom AlkaloidsCytochrome P450 3a4 (cyp3a4) Substrates, Cns Depressants Moderate
Interaction Summary
Kratom might increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Kratom Alkaloids + Alprazolam interactionAluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium HydroxideAscriptin Codeine #2
How Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide interacts with Feel Free — through 2 ingredients. Tap an ingredient for the detail:
Kava Root ExtractCns Depressants, Cytochrome P450 2d6 (cyp2d6) Substrates Major
Interaction Summary
Combining kava with CNS depressants can have additive sedative effects.
Read the full Kava Root Extract + Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide interactionKratom AlkaloidsCns Depressants, Cytochrome P450 2d6 (cyp2d6) Substrates Moderate
Interaction Summary
Theoretically, concomitant use might increase the risk for adverse CNS depressant effects.
Read the full Kratom Alkaloids + Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide interactionAminoglutethimideCytadren
How Aminoglutethimide interacts with Feel Free — through 2 ingredients. Tap an ingredient for the detail:
Kava Root ExtractCns Depressants Major
Interaction Summary
Combining kava with CNS depressants can have additive sedative effects.
Read the full Kava Root Extract + Aminoglutethimide interactionKratom AlkaloidsCns Depressants Moderate
Interaction Summary
Theoretically, concomitant use might increase the risk for adverse CNS depressant effects.
Read the full Kratom Alkaloids + Aminoglutethimide interactionAminophylline, Amobarbital, EphedrineAmesec
How Aminophylline, Amobarbital, Ephedrine interacts with Feel Free — through 2 ingredients. Tap an ingredient for the detail:
Kava Root ExtractCns Depressants Major
Interaction Summary
Combining kava with CNS depressants can have additive sedative effects.
Read the full Kava Root Extract + Aminophylline, Amobarbital, Ephedrine interactionKratom AlkaloidsCns Depressants Moderate
Interaction Summary
Theoretically, concomitant use might increase the risk for adverse CNS depressant effects.
Read the full Kratom Alkaloids + Aminophylline, Amobarbital, Ephedrine interactionEach ingredient & the kinds of drugs it affects
For each ingredient in Feel Free 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.
Kava root extract
Cns Depressants
Combining kava with CNS depressants can have additive sedative effects.
Kava has CNS depressant effects. Concomitant use of kava with other CNS depressants can increase the risk of drowsiness and motor reflex depression. Clinical practice guidelines from a joint taskforce of the World Federation of Societies of Biological Psychiatry (WFSBP) and the Canadian Network for Mood and Anxiety Treatments (CANMAT) recommend that CNS depressants, including alcohol and benzodiazepines, not be used with kava.
Alcohol (Ethanol)
Combining kava with alcohol may increase the risk of sedation and/or hepatotoxicity.
Kava has CNS depressant effects. Concomitant use of kava with other CNS depressants can increase the risk of drowsiness and motor reflex depression. Additionally, kava has been associated with over 100 cases of hepatotoxicity. There is some concern that kava can adversely affect the liver, especially when used in combination with hepatotoxic drugs. Clinical practice guidelines from a joint taskforce of the World Federation of Societies of Biological Psychiatry (WFSBP) and the Canadian Network for Mood and Anxiety Treatments (CANMAT) recommend that alcohol not be used with kava.
Cytochrome P450 2C19 (Cyp2C19) Substrates
Theoretically, kava might increase levels of CYP2C19 substrates.
In vitro research shows that kava significantly inhibits CYP2C19 enzymes. This effect has not yet been reported in humans.
Cytochrome P450 2C9 (Cyp2C9) Substrates
Theoretically, kava might increase levels of CYP2C9 substrates.
In vitro research shows that kava significantly inhibits CYP2C9 enzymes. This effect has not yet been reported in humans.
Cytochrome P450 2E1 (Cyp2E1) Substrates
Kava might increase levels of CYP2E1 substrates.
In a clinical study in healthy volunteers, taking kava 1000 mg twice daily (containing a daily dose of 138 mg kavalactones) for 28 days inhibited the metabolism of CYP2E1 substrates.
Haloperidol (Haldol)
Combining kava and haloperidol might increase the risk of cardiovascular adverse effects and hypoxia.
Atrial flutter and hypoxia has been reported for a patient who received intramuscular injections of haloperidol and lorazepam after using kava orally. The side effects were attributed to kava-induced inhibition of CYP2D6, but might also have been related to additive adverse effects with the concomitant use of haloperidol, lorazepam, and kava.
Hepatotoxic Drugs
Theoretically, using kava with hepatotoxic drugs might increase the risk of liver damage.
Kava has been linked with over 100 cases of hepatotoxicity. Most cases occur with excessive and prolonged use. There is some concern that kava can adversely affect the liver, especially when used in combination with hepatotoxic drugs.
P-Glycoprotein Substrates
It is unclear if kava inhibits P-glycoprotein (P-gp); research is conflicting.
In vitro research shows that kava can inhibit P-gp efflux. However, a clinical study in healthy volunteers shows that taking kava standardized to provide 225 mg kavalactones daily for 14 days does not affect the pharmacokinetics of digoxin, a P-gp substrate. It is possible that the use of other P-gp substrates or higher doses of kava might still inhibit P-gp.
Ropinirole (Requip)
Taking kava with ropinirole might increase the risk for dopaminergic toxicity.
A case of visual hallucinations and paranoid delusions has been reported for a patient who used kava in combination with ropinirole. The adverse effects were attributed to kava-induced inhibition of CYP1A2, which may have reduced the metabolism of ropinirole, resulting in excessive dopaminergic stimulation.
Cytochrome P450 1A2 (Cyp1A2) Substrates
It is unclear if kava inhibits CYP1A2; research is conflicting.
Although in vitro research and a case report suggest that kava inhibits CYP1A2, more robust clinical evidence shows that kava has no effect on CYP1A2. In a clinical study in healthy volunteers, taking kava 1000 mg twice daily (containing a daily dose of 138 mg kavalactones) for 28 days had no effect on CYP1A2 activity.
Cytochrome P450 2D6 (Cyp2D6) Substrates
It is unclear if kava inhibits CYP1A2; research is conflicting.
In vitro research shows that kava extract significantly inhibits CYP2D6. However, clinical research shows that kava does not affect the metabolism of CYP2D6 substrates in humans.
Cytochrome P450 3A4 (Cyp3A4) Substrates
It is unclear if kava inhibits CYP3AA; research is conflicting.
Although in vitro research suggests that kava inhibits CYP3A4, more robust clinical evidence shows that kava has no effect on CYP3A4. In a clinical study in healthy volunteers, taking kava 1000 mg twice daily (containing a daily dose of 138 mg kavalactones) for 28 days had no effect on CYP3A4 activity.
Kratom
Cns Depressants
Theoretically, concomitant use might increase the risk for adverse CNS depressant effects.
Kratom contains mitragynine, a mu-receptor agonist that may cause respiratory depression. Although results from animal research suggest that mitragynine causes less respiratory depression than the CNS depressant codeine, fatalities have been reported for patients who ingested a combination of kratom and O-desmethyltramadol, another mu-receptor agonist. Additionally, observational research suggests that adverse effects such as drowsiness and coma are more likely to occur in individuals taking kratom in combination with agents such as opioids and sedatives. Theoretically, ingesting kratom along with other CNS depressants can increase the risk of adverse effects, including drowsiness, coma, and/or severe or fatal respiratory depression.
Cytochrome P450 1A2 (Cyp1A2) Substrates
Theoretically, kratom might increase the levels and clinical effects of drugs metabolized by CYP1A2.
In vitro research suggests that kratom extract inhibits the activity of CYP1A2. In one case report, a 63-year-old male presented with possible serotonin syndrome after taking an unknown dose of kratom for up to 3 months along with serotonergic prescription medications bupropion, buspirone, desvenlafaxine, trazodone, and ziprasidone. It was hypothesized that kratom inhibited CYP1A2-mediaed metabolism of ziprasidone which consequently increased systemic exposure to serotonin.
Cytochrome P450 2D6 (Cyp2D6) Substrates
Theoretically, kratom might increase the levels and clinical effects of drugs metabolized by CYP2D6.
In vitro research suggests that kratom extract inhibits CYP2D6 enzyme activity. However, human research shows that a single low dose of kratom tea 2 grams does not inhibit CYP2D6 activity. However, this kratom dose is lower than what is normally taken for psychoactive effects. In one case report, a 63-year-old male presented with possible serotonin syndrome after taking an unknown dose of kratom for up to 3 months along with serotonergic prescription medications bupropion, buspirone, desvenlafaxine, trazodone, and ziprasidone. It was hypothesized that kratom inhibited CYP2D6-mediated metabolism of buspirone and consequently increased systemic exposure to serotonin. In another case, a 37-year-old male stable for 15 years on amitriptyline presented with anticholinergic symptoms including xerostomia, dry eyes, and constipation, along with mildly elevated bilirubin and liver enzymes after taking progressively higher doses of up to 14 grams of kratom daily for 12 weeks. It was hypothesized that the adverse effects of amitriptyline were precipitated by CYP2D6 inhibition by kratom.
Cytochrome P450 3A4 (Cyp3A4) Inhibitors
CYP3A4 inhibitors might increase the concentrations and clinical effects of kratom's primary active alkaloid mitragynine.
A pharmacokinetic study in healthy adults suggests that CYP3A4 inhibition with itraconazole increases the peak plasma concentration (Cmax) of mitragynine by about 1.5-fold. However, CYP3A4 inhibition reduces the Cmax and area under the plasma concentration time curve (AUC) over 72 hours of 7-hydroxymitragynine, one of kratom's active constituents, by about 3-fold, possibly by decreasing the metabolism of mitragynine to 7-hydroxymitragynin.
Animal research suggests that CYP3A4 inhibition with ketoconazole reduces the metabolism and clearance of kratom, increasing the Cmax of the active metabolite mitragynine by 130%, time to reach maximum plasma concentration (Tmax) from 1 to 2.6 hours, and AUC by 120%. Additionally, CYP3A4-mediated conversion of mitragynine into 7-hydroxymitragynine increases systematic exposure by 130%. However, other CYP isoforms are likely involved in this conversion. CYP3A4 inhibition could lead to increased adverse effects and mu-opioid-receptor-mediated behavioral effects associated with kratom and its metabolites.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Kratom might increase the levels and clinical effects of drugs metabolized by CYP3A4.
In vitro research shows that kratom extract inhibits CYP3A4 enzyme activity. A pharmacokinetic study in adults shows that taking kratom tea 2 grams modestly increases the plasma concentration time-curve (AUC) and maximum concentration (Cmax) of CYP3A4 probe midazolam by 40-50% and its CYP3A4-mediated metabolites 18-27%. However, a lack of change in the half-life of midazolam and a simulation of the kratom-midazolam interaction suggest that kratom inhibits CYP3A4 enzymes in the small intestine but not the liver. Additionally, there is one case report of a 27-year-old male who died from neuroleptic malignant-like symptoms after concomitant use of kratom and quetiapine, a CYP3A4 substrate. Although it did not appear that the patient had consumed large quantities of quetiapine, postmortem plasma levels were in the lethal range, indicating possible inhibition of CYP3A4 by kratom. In another case report, a 63-year-old male presented with possible serotonin syndrome after taking an unknown dose of kratom for up to 3 months along with serotonergic prescription medications bupropion, buspirone, desvenlafaxine, trazodone, and ziprasidone. It is hypothesized that CYP3A4 inhibition by kratom reduced metabolism of desvenlafaxine, trazodone, and ziprasidone and consequently increased systemic exposure to serotonin.
Modafinil (Provigil)
Theoretically, taking kratom in combination with modafinil may increase the risk of seizures.
A 43-year-old male patient experienced generalized tonic-clonic seizures after adding modafinil 100 mg to his chronic ingestion of kratom tea four times daily to further improve alertness and as a self-treatment for opioid withdrawal. The exact mechanism by which this interaction may occur is unknown.
Naltrexone (Vivitrol)
Taking kratom in combination with naltrexone might precipitate withdrawal.
Animal research shows that, while naltrexone does not antagonize the primary kratom alkaloid mitragynine, it does inhibit the behavioral effects of the metabolite 7-hyroxymitragynine by antagonizing its binding at the mu-opioid receptor. In humans, taking naltrexone has precipitated withdrawal from kratom. In one case, a patient chronically consuming kratom developed agitation, hallucinations, and delirium within about 2 hours of beginning oral naltrexone therapy. In another case, a 38-year-old male who was admitted to a residential rehabilitation treatment program for polysubstance abuse experienced opioid withdrawal after administration of intramuscular naltrexone. Although the patient reported discontinuing kratom, continued use was confirmed through positive urine mitragynine tests. Manufacturer guidance states that patients should be opioid-free for a minimum of 7-10 days prior to initiating treatment with naltrexone; this case report suggests that kratom use should be given similar consideration.
Quetiapine (Seroquel)
Theoretically, taking kratom in combination with quetiapine may increase levels and adverse effects of quetiapine.
A 27-year-old male was found deceased due to neuroleptic malignant-like symptoms after concomitant consumption of quetiapine and kratom. Although it did not appear that he had consumed large quantities of the medication, he was found to have a lethal plasma level of quetiapine. It is hypothesized that kratom inhibited cytochrome P450 (CYP) 3A4, the primary metabolic pathway for quetiapine. Also, a 36-year-old male presented to the emergency department with serotonin syndrome and QT interval prolongation after concomitant use of quetiapine, venlafaxine, and kratom. It is hypothesized that kratom may have inhibited the metabolism of both venlafaxine and quetiapine.
Serotonergic Drugs
Theoretically, taking kratom in combination with serotonergic drugs may increase levels of serotonin, increasing the risk of serotonin syndrome.
A 63-year-old male presented with possible serotonin syndrome after taking an unknown dose of kratom for up to 3 months along with serotonergic prescription medications bupropion, buspirone, desvenlafaxine, trazodone, and ziprasidone. It was hypothesized that kratom inhibited the cytochrome P450 3A4-, 2C9-, 2D6-, and 1A2-mediated metabolism of several of these serotonergic medications, consequently increasing systemic exposure to serotonin.
Venlafaxine (Effexor)
Theoretically, taking kratom in combination with venlafaxine may increase levels and clinical effects of venlafaxine.
A 36-year-old male presented to the emergency department with serotonin syndrome and QT interval prolongation after concomitant use of venlafaxine, quetiapine, and kratom. It is hypothesized that kratom may have inhibited the cytochrome P450 (CYP) metabolism of both venlafaxine and quetiapine.
Cytochrome P450 2C19 (Cyp2C19) Substrates
Theoretically, kratom might increase the levels of drugs metabolized by CYP2C19.
In vitro research shows that kratom extract weakly inhibits CYP2C19 enzyme activity.
Iron
Bictegravir/Emtricitabine/Tenofovir Alafenamide (Biktarvy)
Iron 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 iron 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, iron containing products.
Bisphosphonates
Iron reduces the absorption of bisphosphonates.
Advise patients that doses of bisphosphonates should be separated by at least two hours from doses of all other medications, including supplements such as iron. Divalent cations, including iron, can decrease absorption of bisphosphonates by forming insoluble complexes in the gastrointestinal tract.
Denosumab (Prolia, Others)
Administration of intravenous iron within one month of denosumab administration might increase the risk of severe hypophosphatemia and hypocalcemia.
A case of severe hypocalcemia (albumin corrected calcium 6.88 mg/dL, ionized calcium 3.68 mg/dL) and hypophosphatemia (<0.5 mg/dL) with respiratory acidosis, QT interval prolongation, and nonsustained ventricular tachycardia was reported in a 76-year-old male who had received an iron polymaltose infusion within 2 weeks of a subcutaneous injection of denosumab. Serum parathyroid hormone was also elevated (348 pg/mL). Subsequent iron infusions with iron polymaltose and ferric carboxymaltose were followed by transient hypophosphatemia, but without hypocalcemia. Additionally, a literature review describes 6 additional cases of hypophosphatemia and hypocalcemia in patients 52-92 years of age who had been administered intravenous iron as either ferric carboxymaltose or iron polymaltose and subcutaneous denosumab within 1-4 weeks of each other.
Dolutegravir (Tivicay)
Iron might decrease dolutegravir levels by reducing its absorption.
Advise patients to take dolutegravir at least 2 hours before or 6 hours after taking iron. Pharmacokinetic research shows that iron can decrease the absorption of dolutegravir from the gastrointestinal tract through chelation. When taken under fasting conditions, a single dose of ferrous fumarate 324 mg orally along with dolutegravir 50 mg reduces overall exposure to dolutegravir by 54%.
Integrase Inhibitors
Theoretically, taking iron along with integrase inhibitors might decrease the levels and clinical effects of these drugs.
Iron is a divalent cation. There is concern that iron may decrease the absorption of integrase inhibitors from the gastrointestinal tract through chelation. One pharmacokinetic study shows that iron can decrease blood levels of the specific integrase inhibitor dolutegravir through chelation. Also, other pharmacokinetic research shows that other divalent cations such as calcium can decrease the absorption and levels of some integrase inhibitors through chelation.
Levodopa
Iron might decrease levodopa levels by reducing its absorption.
Advise patients to separate doses of levodopa and iron as much as possible. There is some evidence in healthy people that iron forms chelates with levodopa, reducing the amount of levodopa absorbed by around 50%. The clinical significance of this hasn't been determined.
Levothyroxine (Synthroid, Others)
Iron might decrease levothyroxine levels by reducing its absorption.
Advise patients to separate levothyroxine and iron doses by at least 2 hours. Iron can decrease the absorption and efficacy of levothyroxine by forming insoluble complexes in the gastrointestinal tract.
Methyldopa (Aldomet)
Iron might decrease methyldopa levels by reducing its absorption.
Advise patients to separate methyldopa and iron doses by at least 2 hours. Iron can decrease the absorption of methyldopa from the gastrointestinal tract through chelation, resulting in increases in blood pressure.
Mycophenolate Mofetil (Cellcept)
Theoretically, iron might decrease mycophenolate mofetil levels by reducing its absorption.
Advise patients to take iron 4-6 hours before, or 2 hours after, mycophenolate mofetil. It has been suggested that a decrease of absorption is possible, probably by forming nonabsorbable chelates. However, mycophenolate pharmacokinetics are not affected by iron supplementation in available clinical research.
Penicillamine (Cuprimine, Depen)
Iron might decrease penicillamine levels by reducing its absorption.
Advise patients to separate penicillamine and iron doses by at least 2 hours. Oral iron supplements can reduce absorption of penicillamine by 30% to 70%, probably due to chelate formation. In people with Wilson's disease, this interaction has led to reduced efficacy of penicillamine.
Quinolone Antibiotics
Iron might decrease levels of quinolone antibiotics by reducing their absorption.
Advise patients to separate quinolone antibiotics and iron doses by at least 2 hours. Iron decreases the absorption of quinolones due to formation of insoluble complexes in the gastrointestinal tract.
Tetracycline Antibiotics
Iron might decrease levels of tetracycline antibiotics by reducing their absorption.
Advise patients to take iron at least 2 hours before or 4 hours after tetracycline antibiotics. Concomitant use can decrease absorption of tetracycline antibiotics from the gastrointestinal tract by 50% to 90%.
Chloramphenicol
Theoretically, taking chloramphenicol with iron might reduce the response to iron therapy in iron deficiency anemia.
Chloramphenicol interferes with erythrocyte maturation. However, since chloramphenicol isn't usually taken for prolonged periods, this isn't likely to be clinically significant.
Potassium
Ace Inhibitors (Aceis)
Using ACEIs with high doses of potassium increases the risk of hyperkalemia.
ACEIs block the actions of the renin-angiotensin-aldosterone system and reduce potassium excretion. Concomitant use of these drugs with potassium supplements increases the risk of hyperkalemia. However, concomitant use of these drugs with moderate dietary potassium intake (about 3775-5200 mg daily) does not increase serum potassium levels.
Angiotensin Receptor Blockers (Arbs)
Using ARBs with high doses of potassium increases the risk of hyperkalemia.
ARBs block the actions of the renin-angiotensin-aldosterone system and reduce potassium excretion. Concomitant use of these drugs with potassium supplements increases the risk of hyperkalemia. However, concomitant use of these drugs with moderate dietary potassium intake (about 3775-5200 mg daily) does not increase serum potassium levels.
Potassium-Sparing Diuretics
Concomitant use increases the risk of hyperkalemia.
Using potassium-sparing diuretics with potassium supplements increases the risk of hyperkalemia.
Brand information
Manufacturer and brand details for Feel Free, from the product label.
Feel Free by Botanic Tonics: Common Questions
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The Full Monographs Behind Feel Free’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Potassium
Interacts with 62 drugsPotassium is an essential mineral your body needs for nerve signals, muscle function, and a steady heartbeat, and most people get enough from a balanced diet rich in fruits and vegetables. P...
Read the full Potassium monograph → Herb & supplement monographIron
Interacts with 80 drugsIron is an essential mineral your body needs to make hemoglobin and carry oxygen in the blood. Supplements are mainly useful for treating or preventing iron deficiency and iron-deficiency an...
Read the full Iron monograph → Herb & supplement monographKava
Interacts with 1,166 drugsKava is a Pacific Island plant traditionally used to promote relaxation and ease anxiety, and some studies suggest it may help mild anxiety. However, kava has been linked to rare but serious...
Read the full Kava monograph → Herb & supplement monographKratom
Interacts with 995 drugsKratom is a Southeast Asian plant whose leaves act on the brain's opioid receptors and can produce both stimulant-like and opioid-like effects. It is not approved or proven safe by health re...
Read the full Kratom monograph →Sources & How We Checked
Feel Free'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 232 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.
Potassium 12 references
- McEvoy GK, ed. AHFS Drug Information. Bethesda, MD: American Society of Health-System Pharmacists, 1998.
- Gennaro A. Remington: The Science and Practice of Pharmacy. 19th ed. Lippincott: Williams & Wilkins, 1996.
- Whelton PK, He J, Cutler JA, et al. Effects of oral potassium on blood pressure. Meta-analysis of randomized controlled clinical trials. JAMA 1997;277:1624-32. PubMed
- Phillips, C. O., Kashani, A., Ko, D. K., Francis, G., and Krumholz, H. M. Adverse effects of combination angiotensin II receptor blockers plus angiotensin-converting enzyme inhibitors for left ventricular dysfunction: a quantitative review of data from ra DOI
- Altieri, P. I., Herrero, C., Suero, R., and Ortiz, A. Bleeding duodenal ulcer in a patient taking slow-releasing potassium tablets. Bol.Asoc.Med P.R. 1977;69(8):276.
- Raf, L. E. Enteric-coated potassium chloride tablets and ulcer of the small intestine. Acta Chir Scand Suppl 1967;(374):1-87.
- Potassium chloride oral solution [package insert]. Allentown, PA: Lehigh Valley Technologies, Inc.; 2014.
- Potassium chloride injection [package insert]. Lake Forest, IL: Hospira Inc.; 2009.
- Patel RB, Tannenbaum S, Viana-Tejedor A, et al. Serum potassium levels, cardiac arrhythmias, and mortality following non-ST-elevation myocardial infarction or unstable angina: insights from MERLIN-TIMI 36. Eur Heart J Acute Cardiovasc Care 2017 Feb;6(1):1 PubMed
- Malta D, Arcand J, Ravindran A, Floras V, Allard JP, Newton GE. Adequate intake of potassium does not cause hyperkalemia in hypertensive individuals taking medications that antagonize the renin angiotensin aldosterone system. Am J Clin Nutr 2016 Oct;104(4 PubMed
- Keskin M, Kaya A, Tatlisu MA, et al. The effect of serum potassium level on in-hospital and long-term mortality in ST elevation myocardial infarction. Int J cardiol. 2016 Oct 15;221:505-10.
- Stallings VA, Harrison M, Oria M; Committee to Review the Dietary Reference Intakes for Sodium and Potassium, Food and Nutrition Board, Health and Medicine Division, National Academies of Sciences, Engineering, and Medicine. Washington (DC): National Acad
Iron 72 references
- McEvoy GK, ed. AHFS Drug Information. Bethesda, MD: American Society of Health-System Pharmacists, 1998.
- Bruner AB, Joffe A, Duggan AK, et al. Randomized study of cognitive effects of iron supplementation in non- anaemic iron-deficient adolescent girls. Lancet 1996;348:992-6.
- Ullen H, Augustsson K, Gustavsson C, Steineck G. Supplementary iron intake and risk of cancer: reversed causality? Cancer Lett 1997;114:215-6.
- Reunanen A, Takkunen H, Knekt P, et al. Body iron stores, dietary iron intake and coronary heart disease mortality. J Intern Med 1995;238:223-30. PubMed
- Lund EK, Wharf SG, Fairweather-Tait SJ, Johnson IT. Oral ferrous sulfate supplements increase the free radical-generating capacity of feces from healthy volunteers. Am J Clin Nutr 1999;69:250-5.
- Rehman A, Collis CS, Yang M, et al. The effects of iron and vitamin C co-supplementation on oxidative damage to DNA in healthy volunteers. Biochem Biophys Res Comm 1998;246:293-8. PubMed
- Klipstein-Grobusch K, Grobbee DE, den Breeijen JH, et al. Dietary iron and risk of myocardial infarction in the Rotterdam Study. Am J Epidemiol 1999;149:421-8. PubMed
- Hansten PD, Horn JR. Drug Interactions Analysis and Management. Vancouver, WA: Applied Therapeutics Inc., 1997 and updates.
- Tatro DS, ed. Drug Interactions Facts. Facts and Comparisons Inc., St. Louis, MO. 1999.
- Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. Washington, DC: National Academy Press, 2002.
- Campbell N, Paddock V, Sundaram R. Alteration of methyldopa absorption, metabolism, and blood pressure control by ferrous sulfate and ferrous gluconate. Clin Pharmacol Ther 1988;43:381-6..
- Schumann K, Borch-Iohnsen B, Hentze MW, Marx JJ. Tolerable upper intakes for dietary iron set by the US Food and Nutrition Board (commentary). Am J Clin Nutr 2002;76:499-500. PubMed
- Tuomainen TP, Punnonen K, Nyyssonen K, Salonen JT. Association between body iron stores and the risk of acute myocardial infarction in men. Circulation 1998;97:1461-6.. PubMed
- Salonen JT, Nyyssonen K, Korpela H, et al. High stored iron levels are associated with excess risk of myocardial infarction in Eastern Finnish men. Circulation 1992;86:803-11.. PubMed
- Campbell NRC, Hasinoff B. Ferrous sulfate reduces levodopa bioavailability: Chelation as a possible mechanism. Clin Pharmacol Ther 1989;45:220-5.. PubMed
- Campbell NRC, Hasinoff BB, Stalts H, et al. Ferrous sulfate reduces thyroxine efficacy in patients with hypothyroidism. Ann Int Med 1992;117:1010-3.. PubMed
- Kiechl S, Willeit J, Egger G, et al. Body iron stores and the risk of carotid atherosclerosis: prospective results from the Bruneck study. Circulation 1997;96:3300-07. PubMed
- Comparison of oral iron supplements. Pharmacist's Letter / Prescriber's Letter 2008;24(8):240811.
- Tran T., Wax J. R., Philput C., Steinfeld J. D., Ingardia C. J. Intentional iron overdose in pregnancy--management and outcome. J Emerg Med 2000;18(2):225-228. PubMed
- Toblli J. E., Brignoli, R. Iron(III)-hydroxide polymaltose complex in iron deficiency anemia / review and meta-analysis. Arzneimittelforschung 2007;57(6A):431-438. PubMed
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DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.
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