Fiber Essentials Ingredients & Drug Interactions
What is this page for?
First and foremost: checking Fiber Essentials 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
Fiber Essentials is a dietary supplement by Indiana Botanic Gardens with 8 active ingredients. Its ingredients are commonly taken for constipation, diarrhea, high cholesterol.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, Apple Pectin. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against Fiber Essentials by Indiana Botanic Gardens
Ask about any prescription or over-the-counter medication and we check it for interactions with Fiber Essentials by Indiana Botanic Gardens — 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 Fiber Essentials by Indiana Botanic Gardens
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
Fiber Essentials contains 6 active ingredients. Calcium supports bone health and several body functions — it's rated effective for preventing kidney stones, treating low blood calcium (hypocalcemia), managing high potassium levels (hyperkalemia), and helping with osteoporosis.
The product also includes two sources of pectin — apple pectin and grapefruit pectin — both of which show modest evidence for cholesterol support. You'll also find psyllium husk powder, oat bran, and other carbohydrates as fiber sources to support digestive regularity.
The tablet also contains inactive ingredients like sorbitol, xylitol, and fruit powders for taste and texture.
Does it work?
Strong evidence
Calcium in this product is well established for bone health and is rated effective for osteoporosis and likely effective for preventing fractures. It's also effective at correcting low blood calcium and managing high potassium.
The pectin ingredients are rated possibly effective for supporting cholesterol levels, though the evidence is modest. The evidence for pectin's effect on blood sugar control (prediabetes) isn't yet established in our data, as is the case for radiation exposure.
How safe is it?
Well-documented data
Calcium is generally well tolerated at recommended doses, though high amounts can cause problems. Most common side effects are mild — belching, constipation, diarrhea, gas, or stomach upset.
Rarely, very high doses have been linked to kidney stones and a condition called calciphylaxis. There's also some concern that very high calcium intake (over 1500 mg daily from all sources) might increase the risk of advanced prostate cancer, though this remains debated in the research.
Pectin is generally well tolerated from food and typical supplement amounts. Most people experience only mild gas, loose stools, or cramping.
Rarely, sensitive individuals can have allergic reactions, including severe ones. In pregnancy, dietary amounts of pectin are fine, but concentrated supplements haven't been well studied — check with your doctor.
For breastfeeding, dietary amounts are likely okay, but supplement safety isn't established. For calcium, adequate intake is important in pregnancy; stay within recommended amounts unless your doctor says otherwise, and calcium needs can be met during breastfeeding with recommended amounts.
Meds to double-check
Major interaction found
Before taking this, double-check if you're on dolutegravir, elvitegravir, or ceftriaxone (Major interactions with calcium). Also verify any use of raltegravir, levothyroxine, sotalol, calcipotriene, or diltiazem (Moderate calcium interactions), as well as lovastatin, tetracycline antibiotics, or digoxin (Moderate pectin interactions).
If you take any of these, you may need to space doses carefully or avoid the product altogether.
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 straightforward fiber and calcium supplement, but the calcium creates several important drug interactions — especially with HIV medications, certain antibiotics, and heart drugs. If you take any prescription medications, check them against the interaction tool on this page before you start.
Talk with your pharmacist or doctor about your complete medication list and whether the timing adjustments needed for calcium are manageable for you.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 4 of 7 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Nov 25, 2013.
This Scorecard evaluates available label information, ingredient evidence, and known medication-safety considerations. It does not independently verify product identity, purity, potency, contamination, or manufacturing quality. How these ratings are computed
General information
Key facts about Fiber Essentials, straight from the product label.
| Brand | Indiana Botanic Gardens |
|---|---|
| Net contents | 60 Tablet(s) |
| Market status | On market |
| Date entered into DSLD | Nov 25, 2013 |
| DSLD ID | 27547 |
| Product type | Fiber And Other Nutrients |
| Supplement form | Tablet Or Pill |
| Dietary claims / uses | All Other, Structure/Function |
| Intended target group(s) | Adult (18 - 50 Years) |
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.
Supplement Facts
The label details for Fiber Essentials by Indiana Botanic Gardens, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Calories | 24 {Calories} | 1% |
| Total Carbohydrates | 9 Gram(s) | 3% |
| Sugar | 0.5 Gram(s) | -- |
| Dietary Fiber | 4 Gram(s) | 16% |
| Calcium | 20 mg | 2% |
| Sugar Alcohols | 4 Gram(s) | -- |
| Other Carbohydrates | 0.5 Gram(s) | -- |
| Psyllium husk powder | 0 NP | -- |
| Apple Pectin | 0 NP | -- |
| Grapefruit Pectin | 0 NP | -- |
| Proprietary Natural Fiber Blend | 4.6 Gram(s) | -- |
| Oat Bran | 0 NP | -- |
Other ingredients: Sorbitol, Xylitol, Maltodextrin, Stearic Acid, Microcrystalline Cellulose, Grape juice powder, Dextrose, Blueberry fruit powder, Vegetable Magnesium Stearate, Sodium Citrate, Raspberry fruit powder, Acai berry powder, Beet juice powder, Silicon Dioxide, Stevia rebaudiana leaf extract, Natural flavors, Triacetin, Modified Cornstarch, Propylene Glycol, Vegetable Glycerin
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.
Precautions
Warning: If you are taking any medications or are pregnant or nursing do not use prior to consulting a physician.
For your protection, this container has an outer safety seal. (Do not accept if missing or broken.)
KEEP OUT OF REACH OF CHILDREN
Storage
Store in a dry, cool place.
Seals/Symbols
IBG INDIANA BOTANIC GARDENS(R)
FDA Statement of Identity
Dietary Supplement
FDA Disclaimer Statement
This statement has not been evaluated by the Food & Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.
Suggested/Recommended/Usage/Directions
Suggested Use: Chew 3 tablets daily, with a meal, as a dietary supplement, or as directed by a physician.
General Statements
Total Health Support
Best if used by date on bottle.
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Fiber Essentials by Indiana Botanic Gardens 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 Fiber Essentials by Indiana Botanic Gardens
These are the 8 active ingredients this product is made of. Select any to open its full monograph.
Serving size3 Tablet(s) Dosage formTablet Or Pill Servings per container10 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
Dietary 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 & interactionsCalcium
Interacts with168 drugs
Calcium is an essential mineral your body needs for strong bones, nerve signaling, and muscle function, and supplements can help fill gaps when diet f...
Calcium monograph & interactionsOther Carbohydrates
Proprietary Natural Fiber Blend
- › Psyllium husk powder
- › Apple Pectin
- › Grapefruit Pectin
- › Oat Bran
Other (inactive) ingredients: Sorbitol, Xylitol, Maltodextrin, Stearic Acid, Microcrystalline Cellulose, Grape juice powder, Dextrose, Blueberry fruit powder, Vegetable Magnesium Stearate, Sodium Citrate, Raspberry fruit powder, Acai berry powder, Beet juice powder, Silicon Dioxide, Stevia rebaudiana leaf extract, Natural flavors, Triacetin, Modified Cornstarch, Propylene Glycol, Vegetable Glycerin. These complete the product’s ingredient list but are not active constituents.
Fiber Essentials by Indiana Botanic Gardens Drug Interactions
HelloPharmacist Interaction Report
Fiber Essentials by Indiana Botanic Gardens contains ingredients that interact with a number of medications, most notably calcium.
The calcium in this product can significantly reduce blood levels of two HIV integrase inhibitors: dolutegravir (Tivicay) and elvitegravir (Vitekta). Both are Major interactions.
With dolutegravir, calcium can lower levels by nearly 40%; you'd need to take dolutegravir either 2 hours before or 6 hours after this supplement. Elvitegravir requires 2 hours before or 2 hours after.
Calcium also poses a Major risk with ceftriaxone (Rocephin), an intravenous antibiotic — combining them can cause a dangerous precipitate in your lungs and kidneys, so these must be separated by at least 48 hours.
Read the full breakdown — every affected drug type, severity by severity
Calcium creates Moderate interactions with several other drugs. It can reduce how well your body absorbs raltegravir (Isentress, another HIV medication), levothyroxine (Synthroid, for thyroid), and sotalol (Betapace, for heart rhythm).
It may also increase the risk of high blood calcium (hypercalcemia) if you're using calcipotriene (Dovonex) for psoriasis, and it could theoretically reduce the effectiveness of diltiazem (Cardizem, a blood pressure and heart medication). The pectin ingredients — apple pectin and grapefruit pectin — can reduce absorption of lovastatin (a cholesterol drug), tetracycline antibiotics, and digoxin (Lanoxin, a heart medication), all Moderate interactions.
We couldn't check Other Carbohydrates, Psyllium husk powder, or Oat Bran — no data is on file for these. Altogether, these interactions span 169 individual medications.
Use the medication checker on this page to verify your exact prescriptions before starting this product.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against Fiber Essentials?
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 Fiber Essentials interact with 2,040 drugs. Click any drug to see the details.
3 of the 8 ingredients in Fiber Essentials interact with drugs. Each result below shows which ingredient is responsible. Dietary Fiber Calcium Apple Pectin
Guanethidine, HydrochlorothiazideEsimil
How Guanethidine, Hydrochlorothiazide interacts with Fiber Essentials — through 2 ingredients. Tap an ingredient for the detail:
CalciumThiazide Diuretics Moderate
Interaction Summary
Taking calcium along with thiazides might increase the risk of hypercalcemia and renal failure.
Read the full Calcium + Guanethidine, Hydrochlorothiazide 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 + Guanethidine, Hydrochlorothiazide interactionHydralazine, HydrochlorothiazideApresazide, Apresoline-Esidrix
How Hydralazine, Hydrochlorothiazide interacts with Fiber Essentials — through 2 ingredients. Tap an ingredient for the detail:
CalciumThiazide Diuretics Moderate
Interaction Summary
Taking calcium along with thiazides might increase the risk of hypercalcemia and renal failure.
Read the full Calcium + Hydralazine, Hydrochlorothiazide 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 + Hydralazine, Hydrochlorothiazide interactionHydralazine, Hydrochlorothiazide, ReserpineSer-Ap-Es, Unipres, Uniserp
How Hydralazine, Hydrochlorothiazide, Reserpine interacts with Fiber Essentials — through 2 ingredients. Tap an ingredient for the detail:
CalciumThiazide Diuretics Moderate
Interaction Summary
Taking calcium along with thiazides might increase the risk of hypercalcemia and renal failure.
Read the full Calcium + Hydralazine, Hydrochlorothiazide, Reserpine 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 + Hydralazine, Hydrochlorothiazide, Reserpine interactionHydrochlorothiazideAquazide, Aquazide H, Esidrix, HCTZ, Hydro, Hydro-D +3 more
How Hydrochlorothiazide interacts with Fiber Essentials — through 2 ingredients. Tap an ingredient for the detail:
CalciumThiazide Diuretics Moderate
Interaction Summary
Taking calcium along with thiazides might increase the risk of hypercalcemia and renal failure.
Read the full Calcium + Hydrochlorothiazide 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 + Hydrochlorothiazide interactionHydrochlorothiazide, IrbesartanAvalide
How Hydrochlorothiazide, Irbesartan interacts with Fiber Essentials — through 2 ingredients. Tap an ingredient for the detail:
CalciumThiazide Diuretics Moderate
Interaction Summary
Taking calcium along with thiazides might increase the risk of hypercalcemia and renal failure.
Read the full Calcium + Hydrochlorothiazide, Irbesartan 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 + Hydrochlorothiazide, Irbesartan interactionHydrochlorothiazide, LabetalolTrandate HCT
How Hydrochlorothiazide, Labetalol interacts with Fiber Essentials — through 2 ingredients. Tap an ingredient for the detail:
CalciumThiazide Diuretics Moderate
Interaction Summary
Taking calcium along with thiazides might increase the risk of hypercalcemia and renal failure.
Read the full Calcium + Hydrochlorothiazide, Labetalol 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 + Hydrochlorothiazide, Labetalol interactionHydrochlorothiazide, LisinoprilPrinzide, Zestoretic
How Hydrochlorothiazide, Lisinopril interacts with Fiber Essentials — through 2 ingredients. Tap an ingredient for the detail:
CalciumThiazide Diuretics Moderate
Interaction Summary
Taking calcium along with thiazides might increase the risk of hypercalcemia and renal failure.
Read the full Calcium + Hydrochlorothiazide, Lisinopril 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 + Hydrochlorothiazide, Lisinopril interactionHydrochlorothiazide, Losartan PotassiumHyzaar
How Hydrochlorothiazide, Losartan Potassium interacts with Fiber Essentials — through 2 ingredients. Tap an ingredient for the detail:
CalciumThiazide Diuretics Moderate
Interaction Summary
Taking calcium along with thiazides might increase the risk of hypercalcemia and renal failure.
Read the full Calcium + Hydrochlorothiazide, Losartan Potassium 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 + Hydrochlorothiazide, Losartan Potassium interactionHydrochlorothiazide, MethyldopaAldoril 15, Aldoril 25, Aldoril D30, Methazide
How Hydrochlorothiazide, Methyldopa interacts with Fiber Essentials — through 2 ingredients. Tap an ingredient for the detail:
CalciumThiazide Diuretics Moderate
Interaction Summary
Taking calcium along with thiazides might increase the risk of hypercalcemia and renal failure.
Read the full Calcium + Hydrochlorothiazide, Methyldopa 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 + Hydrochlorothiazide, Methyldopa interactionHydrochlorothiazide, MetoprololLopressor HCT
How Hydrochlorothiazide, Metoprolol interacts with Fiber Essentials — through 2 ingredients. Tap an ingredient for the detail:
CalciumThiazide Diuretics Moderate
Interaction Summary
Taking calcium along with thiazides might increase the risk of hypercalcemia and renal failure.
Read the full Calcium + Hydrochlorothiazide, Metoprolol 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 + Hydrochlorothiazide, Metoprolol interactionHydrochlorothiazide, MoexiprilUniretic
How Hydrochlorothiazide, Moexipril interacts with Fiber Essentials — through 2 ingredients. Tap an ingredient for the detail:
CalciumThiazide Diuretics Moderate
Interaction Summary
Taking calcium along with thiazides might increase the risk of hypercalcemia and renal failure.
Read the full Calcium + Hydrochlorothiazide, Moexipril 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 + Hydrochlorothiazide, Moexipril interactionHydrochlorothiazide, PindololViskazide
How Hydrochlorothiazide, Pindolol interacts with Fiber Essentials — through 2 ingredients. Tap an ingredient for the detail:
CalciumThiazide Diuretics Moderate
Interaction Summary
Taking calcium along with thiazides might increase the risk of hypercalcemia and renal failure.
Read the full Calcium + Hydrochlorothiazide, Pindolol 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 + Hydrochlorothiazide, Pindolol interactionHydrochlorothiazide, PropranololInderide
How Hydrochlorothiazide, Propranolol interacts with Fiber Essentials — through 2 ingredients. Tap an ingredient for the detail:
CalciumThiazide Diuretics Moderate
Interaction Summary
Taking calcium along with thiazides might increase the risk of hypercalcemia and renal failure.
Read the full Calcium + Hydrochlorothiazide, Propranolol 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 + Hydrochlorothiazide, Propranolol interactionHydrochlorothiazide, QuinaprilAccuretic
How Hydrochlorothiazide, Quinapril interacts with Fiber Essentials — through 2 ingredients. Tap an ingredient for the detail:
CalciumThiazide Diuretics Moderate
Interaction Summary
Taking calcium along with thiazides might increase the risk of hypercalcemia and renal failure.
Read the full Calcium + Hydrochlorothiazide, Quinapril 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 + Hydrochlorothiazide, Quinapril interactionHydrochlorothiazide, ReserpineHydropres, Serpasil-Esidrix, Serpasil-Esidrix #1, Serpasil-Esidrix #2
How Hydrochlorothiazide, Reserpine interacts with Fiber Essentials — through 2 ingredients. Tap an ingredient for the detail:
CalciumThiazide Diuretics Moderate
Interaction Summary
Taking calcium along with thiazides might increase the risk of hypercalcemia and renal failure.
Read the full Calcium + Hydrochlorothiazide, Reserpine 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 + Hydrochlorothiazide, Reserpine interactionHydrochlorothiazide, SpironolactoneAldactazide, Aldactide 25, Aldactide 50, Spirozine
How Hydrochlorothiazide, Spironolactone interacts with Fiber Essentials — through 2 ingredients. Tap an ingredient for the detail:
CalciumThiazide Diuretics Moderate
Interaction Summary
Taking calcium along with thiazides might increase the risk of hypercalcemia and renal failure.
Read the full Calcium + Hydrochlorothiazide, Spironolactone 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 + Hydrochlorothiazide, Spironolactone interactionHydrochlorothiazide, TimololTimolide
How Hydrochlorothiazide, Timolol interacts with Fiber Essentials — through 2 ingredients. Tap an ingredient for the detail:
CalciumThiazide Diuretics Moderate
Interaction Summary
Taking calcium along with thiazides might increase the risk of hypercalcemia and renal failure.
Read the full Calcium + Hydrochlorothiazide, Timolol 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 + Hydrochlorothiazide, Timolol interactionHydrochlorothiazide, TriamtereneDyazide, Maxzide, Maxzide-25, Triamzide, Triazide
How Hydrochlorothiazide, Triamterene interacts with Fiber Essentials — through 2 ingredients. Tap an ingredient for the detail:
CalciumThiazide Diuretics Moderate
Interaction Summary
Taking calcium along with thiazides might increase the risk of hypercalcemia and renal failure.
Read the full Calcium + Hydrochlorothiazide, Triamterene 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 + Hydrochlorothiazide, Triamterene interactionHydrochlorothiazide, ValsartanDiovan HCT
How Hydrochlorothiazide, Valsartan interacts with Fiber Essentials — through 2 ingredients. Tap an ingredient for the detail:
CalciumThiazide Diuretics Moderate
Interaction Summary
Taking calcium along with thiazides might increase the risk of hypercalcemia and renal failure.
Read the full Calcium + Hydrochlorothiazide, Valsartan 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 + Hydrochlorothiazide, Valsartan interactionHydroflumethiazideSaluron
How Hydroflumethiazide interacts with Fiber Essentials — through 2 ingredients. Tap an ingredient for the detail:
CalciumThiazide Diuretics Moderate
Interaction Summary
Taking calcium along with thiazides might increase the risk of hypercalcemia and renal failure.
Read the full Calcium + Hydroflumethiazide 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 + Hydroflumethiazide interactionHydroflumethiazide, ReserpineSalutensin, Salutensin-Demi
How Hydroflumethiazide, Reserpine interacts with Fiber Essentials — through 2 ingredients. Tap an ingredient for the detail:
CalciumThiazide Diuretics Moderate
Interaction Summary
Taking calcium along with thiazides might increase the risk of hypercalcemia and renal failure.
Read the full Calcium + Hydroflumethiazide, Reserpine 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 + Hydroflumethiazide, Reserpine interactionIbandronateBoniva, Boniva IV
How Ibandronate interacts with Fiber Essentials — through 2 ingredients. Tap an ingredient for the detail:
CalciumBisphosphonates Moderate
Interaction Summary
Calcium reduces the absorption of bisphosphonates.
Read the full Calcium + Ibandronate 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 + Ibandronate interactionIndapamideLozide, Lozol
How Indapamide interacts with Fiber Essentials — through 2 ingredients. Tap an ingredient for the detail:
CalciumThiazide Diuretics Moderate
Interaction Summary
Taking calcium along with thiazides might increase the risk of hypercalcemia and renal failure.
Read the full Calcium + Indapamide 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 + Indapamide interactionIrbesartan, HydrochlorothiazideCoAprovel
How Irbesartan, Hydrochlorothiazide interacts with Fiber Essentials — through 2 ingredients. Tap an ingredient for the detail:
CalciumThiazide Diuretics Moderate
Interaction Summary
Taking calcium along with thiazides might increase the risk of hypercalcemia and renal failure.
Read the full Calcium + Irbesartan, Hydrochlorothiazide 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 + Irbesartan, Hydrochlorothiazide interactionLamivudine, RaltegravirDutrebis
How Lamivudine, Raltegravir interacts with Fiber Essentials — through 2 ingredients. Tap an ingredient for the detail:
CalciumRaltegravir (isentress) Moderate
Interaction Summary
Calcium may reduce levels of raltegravir.
Read the full Calcium + Lamivudine, Raltegravir 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 + Lamivudine, Raltegravir interactionLamivudine, Tenofovir Disoproxil FumarateTemixys
How Lamivudine, Tenofovir Disoproxil Fumarate interacts with Fiber Essentials — through 2 ingredients. Tap an ingredient for the detail:
CalciumBictegravir/emtricitabine/tenofovir Alafenamide (biktarvy) Moderate
Interaction Summary
Calcium might decrease levels of bictegravir/emtricitabine/tenofovir alafenamide by reducing its absorption when taken in a fasting state.
Read the full Calcium + Lamivudine, 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 + Lamivudine, Tenofovir Disoproxil Fumarate interactionLevofloxacinLeva-pak, Levaquin, Levaquin Injection
How Levofloxacin interacts with Fiber Essentials — through 2 ingredients. Tap an ingredient for the detail:
CalciumQuinolone Antibiotics Moderate
Interaction Summary
Calcium seems to reduce the absorption of quinolone antibiotics.
Read the full Calcium + Levofloxacin 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 + Levofloxacin interactionLevofloxacin (ophthalmic)Levofloxacin
How Levofloxacin (ophthalmic) interacts with Fiber Essentials — through 1 ingredient. Tap an ingredient for the detail:
CalciumQuinolone Antibiotics Moderate
Interaction Summary
Calcium seems to reduce the absorption of quinolone antibiotics.
Read the full Calcium + Levofloxacin (ophthalmic) interactionLevothyroxineEltroxin, Estre, Euthyrox, Levo-T, Levolet, Levothroid +5 more
How Levothyroxine interacts with Fiber Essentials — through 2 ingredients. Tap an ingredient for the detail:
CalciumLevothyroxine (synthroid, Others) Moderate
Interaction Summary
Calcium seems to reduce the absorption and effectiveness of levothyroxine.
Read the full Calcium + Levothyroxine 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 + Levothyroxine interactionLevothyroxine SodiumErmez, Thyquidity, Tirosint-Sol
How Levothyroxine Sodium interacts with Fiber Essentials — through 2 ingredients. Tap an ingredient for the detail:
CalciumLevothyroxine (synthroid, Others) Moderate
Interaction Summary
Calcium seems to reduce the absorption and effectiveness of levothyroxine.
Read the full Calcium + Levothyroxine Sodium 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 + Levothyroxine Sodium interactionEach ingredient & the kinds of drugs it affects
For each ingredient in Fiber Essentials 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.
Apple Pectin
Digoxin (Lanoxin)
Theoretically, pectin might reduce the absorption of digoxin, potentially decreasing its effectiveness.
A small clinical study shows that taking digoxin with a kaolin-pectin suspension reduces the absorption of digoxin by about 62%. It is unclear if these effects are due to pectin, kaolin, or the combination.
Lovastatin (Mevacor)
Theoretically, pectin might reduce the absorption of lovastatin, potentially decreasing its effectiveness.
Case reports suggest that concomitant use of pectin and lovastatin might reduce the cholesterol-lowering effect of lovastatin, possibly due to reduced intestinal absorption of lovastatin.
Tetracycline Antibiotics
Theoretically, pectin might reduce the absorption of tetracycline antibiotics, potentially decreasing their effectiveness.
A small clinical study shows that taking tetracycline with bismuth subsalicylate in a kaolin-pectin suspension reduces the absorption of tetracycline by about 34%. It is unclear if these effects are due to pectin, kaolin, bismuth subsalicylate, or the combination.
Brand information
Manufacturer and brand details for Fiber Essentials, from the product label.
Indiana Botanic Gardens
See all Indiana Botanic Gardens products- Name
- Indiana Botanic Gardens, Inc.
- Street Address
- 3401 W. 37th Ave.
- City
- Hobart
- State
- IN
- ZipCode
- 46342
Fiber Essentials by Indiana Botanic Gardens: Common Questions
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Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
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Label information is sourced from the NIH Dietary Supplement Label Database and reflects the product version on file; always read your actual product label. This page is for education only and is not a substitute for professional medical advice. Confirm with your pharmacist or doctor before combining supplements and medications.
The Full Monographs Behind Fiber Essentials’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Black 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 monographCalcium
Interacts with 168 drugsCalcium is an essential mineral your body needs for strong bones, nerve signaling, and muscle function, and supplements can help fill gaps when diet falls short. Most people do best getting...
Read the full Calcium monograph → Herb & supplement monographPectin
Interacts with 23 drugsPectin is a natural soluble fiber found in fruits like apples and citrus, and it is widely used in foods and as a fiber supplement. It may modestly help with cholesterol, blood sugar, and di...
Read the full Pectin monograph →Sources & How We Checked
Fiber Essentials'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 91 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.
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
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.
Pectin 11 references
- Jaakkola MS, et al. Asthma caused by occupational exposure to pectin. J Allergy Clin Immunol 1997;100:575-6. PubMed
- Westphal W, et al. [Exogenous allergic asthma following pectin exposure-a new occupational allergen]. Pneumologie 1990;44(Suppl 1):337-8.
- Baldwin JL, et al. Pectin-induced occupational asthma. Chest 1993;104:1936-7. PubMed
- Cohen AJ, Forse MS, Tarlo SM. Occupational asthma caused by pectin inhalation during the manufacture of jam. Chest 1993;103:309-11.
- Kraut A, et al. Christmas candy maker's asthma. IgG4-mediated pectin allergy. Chest 1992;102:1605-7. PubMed
- Richter WO, Jacob BG, Schwandt P. Interaction between fibre and lovastatin. Lancet 1991;338:706.
- Albert KS, Ayres JW, DiSanto AR, et al. Influence of kaolin-pectin suspension on digoxin bioavailability. J Pharm Sci 1978;67:1582-6. PubMed
- Albert KS, Welch RD, DeSante KA, et al. Decreased tetracycline bioavailability caused by a bismuth subsalicylate antidiarrheal mixture. J Pharm Sci 1979;68:586-8. PubMed
- Electronic Code of Federal Regulations. Title 21. Part 182 -- Substances Generally Recognized As Safe. Available at: https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?CFRPart=182
- Federal Register April 17,2003. Anti-Diarrheal Products for over-the-counter human use; final monograph. Available at: http://www.fda.gov/OHRMS/DOCKETS/98fr/03-9380.pdf (Accessed 27 December 2004).
- Washio K, Nakamura M, Sato N, et al. Anaphylaxis in a pectin- and cashew nut-allergic child caused by a citrus bath. Allergol Int 2022;71(1):155-157. PubMed
Parts of this content are provided by the Therapeutic Research Center, LLC.
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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