Interactions on record — worth a quick check against your medications. Based on 10 of 11 ingredients. Check your meds →
Dietary supplement

Fibo-Trim Ingredients & Drug Interactions

by AdvoCare

Fibo-Trim label
See full label image
Capsule Category: Other Combinations
Most serious interaction: Moderate
Clinical methodology reviewed by · Updated Sep 9, 2026 · Label data from the NIH DSLD
What is this page for?

First and foremost: checking Fibo-Trim 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

The interaction bottom line Most serious interaction: Moderate

Fibo-Trim is a dietary supplement by AdvoCare with 11 active ingredients. Its ingredients are commonly taken for constipation, diarrhea, high cholesterol.Based on those ingredients, 2,185 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Dietary Fiber, Guar Gum, Xanthan Gum. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

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Check Your Meds Against Fibo-Trim by AdvoCare

Ask about any prescription or over-the-counter medication and we check it for interactions with Fibo-Trim by AdvoCare — and tell you which ingredient is responsible.

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HelloPharmacist Scorecard of Fibo-Trim by AdvoCare

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.

From our pharmacy team — supplement deep dive

Generated from HelloPharmacist’s pharmacist-curated databases and editorial rules · Last generated Jul 30, 2026

What’s inside

Full disclosure
Ingredient Transparency · database check
Full

Every active ingredient lists its own amount on the label.

Why this rating?
  • The label discloses an exact amount for 11 of its 11 active ingredients.
  • No proprietary blends here — you can verify the dose of every single component.

Fibo-Trim contains 10 active ingredients. Xanthan gum and guar gum are soluble fibers used to support digestive health and cholesterol levels.

Vitamin E is an antioxidant that may help with certain conditions; niacin (a B vitamin) supports energy metabolism and cholesterol management; L-taurine is an amino acid that may support heart and liver function; and beta-sitosterol is a plant compound that may help with cholesterol and prostate health. Vitamin C supports immune function, chitosan is derived from shellfish and may support weight management, and garlic has been used traditionally for cardiovascular and metabolic support.

Psyllium husk powder is a soluble fiber similar to xanthan and guar gum. The product also contains inactive ingredients — gelatin, rice flour, magnesium stearate, and silicon dioxide — which serve as capsule material and flow agents.

Does it work?

Moderate evidence
Evidence for Intended Use · database check
By FDA rules, dietary supplements can’t claim to treat, cure, or prevent disease — so labels speak in careful marketing language. We discern each product’s intended use from its name, label claims, and label statements, then grade the clinical evidence for that use. How these ratings are computed
Moderate

Some clinical evidence supports this product's ingredients for its stated purpose, but it isn't conclusive.

Why this rating?
  • The label markets this product for: reduce fat absorption and maintain cholesterol levels.
  • We looked for evidence on: Atherosclerosis, Cardiovascular disease (CVD), Dyslipidemia, High cholesterol.
  • The strongest evidence on file: Garlic is rated "Possibly Effective" for Atherosclerosis (Natural Medicines).
  • Also on file: Niacin is rated "Possibly Effective" for HIV/AIDS-related dyslipidemia.
  • Also on file: Vitamin E is rated "Possibly Ineffective" for Atherosclerosis.

Evidence for these ingredients is mixed. Xanthan gum is possibly effective for constipation and swallowing dysfunction, though evidence is insufficient for diabetes and dry eye conditions.

Guar gum is possibly effective for high blood pressure, high cholesterol, irritable bowel syndrome, and constipation. Vitamin E is effective for vitamin E deficiency and a related neurological condition (AVED), and possibly effective for Alzheimer disease, beta-thalassemia, and G6PD deficiency.

Niacin is likely effective for pellagra (a deficiency disease) and possibly effective for metabolic syndrome and certain HIV-related lipid problems. L-taurine is possibly effective for hepatitis and congestive heart failure, but possibly ineffective for obesity.

Beta-sitosterol is likely effective for benign prostatic hyperplasia and possibly effective for familial high cholesterol and heart disease. Chitosan is possibly effective for obesity, post-operative recovery, and high blood pressure, though evidence is insufficient for Crohn disease and dry eye.

Vitamin C is effective for vitamin C deficiency and possibly effective for anemia, atrial fibrillation, cataracts, and exercise-related respiratory infections. Garlic is possibly effective for periodontitis, fatty liver disease, diabetes, high blood pressure, and atherosclerosis.

Evidence for psyllium husk powder is not established in the data we hold.

The evidence, ingredient by ingredient Black Psyllium Xanthan Gum Guar Gum Vitamin E Taurine Niacin Beta-sitosterol Chitosan

How safe is it?

Well-documented data
Safety Information · database check
Well characterized

Adverse-effect, pregnancy, and general safety data are on file for most of these ingredients.

Why this rating?
  • We hold adverse-effect (side-effect) data for 10 of the 10 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 10 of 10.
  • General safety write-ups exist for 10 of 10.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

Most ingredients in Fibo-Trim are generally well tolerated at the doses typically used. Xanthan gum commonly causes bloating, flatulence, and abdominal distention; guar gum can cause similar digestive effects plus rare severe bowel obstruction if taken without adequate water.

Vitamin E is well tolerated but high doses carry a rare risk of bleeding and hemorrhagic stroke. Niacin frequently causes flushing (up to 70% of users), and large doses can cause liver problems, muscle pain, and low platelet counts.

L-taurine is generally well tolerated short-term but may rarely trigger allergic reactions in sensitive people; long-term safety is less certain. Beta-sitosterol may cause constipation, diarrhea, gas, or indigestion; rarely, it has been associated with acute pancreatitis.

Chitosan commonly causes digestive upset and constipation; garlic commonly causes stomach upset, flatulence, and breath odor; vitamin C can cause heartburn, nausea, and diarrhea at high doses, and may trigger kidney stones in prone individuals. Regarding pregnancy and breastfeeding: Xanthan gum, guar gum (possibly safe in pregnancy), and niacin have insufficient data or are likely safe; vitamin E is possibly safe in pregnancy and likely safe during breastfeeding; L-taurine and vitamin C are likely safe in both; beta-sitosterol and chitosan lack adequate safety data and should be avoided.

Garlic is likely safe in pregnancy but possibly unsafe if taken as a supplement (food amounts are fine), and likely safe during breastfeeding.

Side effects, ingredient by ingredient Black Psyllium Xanthan Gum Guar Gum Vitamin E Taurine Niacin Beta-sitosterol Chitosan

Meds to double-check

Moderate interaction found
Known Interaction Concern · database check
Moderate identified

The most serious documented interaction for these ingredients is Moderate. Check your medications for a personalized result.

Why this rating?
  • 9 of the 10 matched ingredients can interact with medications — Black Psyllium, Garlic, Xanthan Gum, Chitosan, Guar Gum, among others.
  • The most serious interaction on file is rated Moderate.
  • Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs; immunosuppressants / transplant drugs; cancer treatments; diabetes medications; heart-rhythm medications; lithium.
  • For scale: 2,186 individual medications appear in the full list. A big number alone doesn't make a product dangerous — what matters is whether YOUR medication is on it, so run yours through the interaction checker on this page.

Before taking Fibo-Trim, check with your doctor or pharmacist if you take any blood thinners (warfarin, anticoagulants, or antiplatelet drugs) — vitamin E, vitamin C, garlic, and chitosan may increase bleeding risk. If you take medications for high blood pressure, diabetes, or heart conditions, several ingredients may affect their action.

Also flag any antibiotics (especially penicillin), birth control pills, thyroid medication, cancer chemotherapy, lithium, or HIV protease inhibitors — each has documented interactions with one or more of these ingredients. Finally, if you take bile acid sequestrants for cholesterol or any drug metabolized by liver enzymes (ask your pharmacist), garlic and vitamin E may affect how those drugs work.

Use the medication checker on this page to confirm your specific medications.

Check your own medication Run your meds through the checker above

The bottom line

Scorecard at a glanceFully disclosed formula with some supporting evidence for its stated purpose. Moderate medication interactions have been identified, and safety information is well characterized.

Fibo-Trim is a multi-ingredient formula combining fibers, vitamins, and plant compounds with mixed evidence of benefit. If you take any prescription medications — particularly blood thinners, antihypertensives, diabetes drugs, antibiotics, or birth control — you need to check your specific drugs against the interactions listed here before starting.

The fibers may interfere with absorption of oral medications, and several ingredients carry Moderate-severity risks with certain drug classes. Talk with your own doctor or pharmacist about whether Fibo-Trim is right for you and your current health situation.

Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI

Assessment coverage: 10 of 11 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Sep 25, 2023.

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

At a glance

General information

Key facts about Fibo-Trim, straight from the product label.

Brand AdvoCare
Net contents 180 Capsule(s)
Market status On market
Date entered into DSLD Sep 25, 2023
DSLD ID 296893
Product type Other Combinations
Supplement form Capsule
Dietary claims / uses All Other, Structure/Function
Intended target group(s) Adult (18 - 50 Years), Women (not pregnant or lactating)
From the label
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 Fibo-Trim by AdvoCare, sourced from the NIH Dietary Supplement Label Database.

Supplement Facts

Daily Value (DV) Target Group(s):
Adults and children 4 or more years of age
Minimum serving Sizes:
3 Capsule(s)
Maximum serving Sizes:
3 Capsule(s)
Servings per container
60
IngredientAmount% DV
Calories10 Calorie(s)--
Total Carbohydrates1 Gram(s)1%
Dietary Fiber1 Gram(s)2%
Xanthan Gum400 mg--
Guar Gum400 mg--
Vitamin E12.4 mg83%
L-Taurine50 mg--
Niacin12 mg75%
Beta-Sitosterol100 mg--
Chitosan600 mg--
Vitamin C37 mg41%
Psyllium husk powder350 mg--
odorless Garlic100 mg--

Other ingredients: Gelatin, Rice Flour, Magnesium Stearate, Silicon Dioxide

Tap any ingredient to jump to its full detail below.

Label statements
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

Fibo-Trim may help reduce fat absorption by binding some dietary fatty acids and helping to eliminate them from the digestive system. Also, Fibo-Trim helps maintain cholesterol levels that are already within the normal range and helps lessen appetite by providing a feeling of fullness.

Helps limit fat absorption Facilitates a feeling of fullness Supports the elimination of fatty waste materials

Suggested/Recommended/Usage/Directions

Directions for use: Take three capsules 10 to 15 minutes before a meal. Take with a full glass of water and continue to drink water throughout the day. Do not use Fibo-Trim at the same meal as CorePlex, OmegaPlex, or MNS.

Precautions

Caution: Check with your healthcare professional before using this product.

This product is not intended for pregnant or nursing women.

Keep out of reach of children.

Contains: Crustacean shellfish (crab, lobster, shrimp) and soy. Contains bioengineered ingredients.

Storage

Store away from excessive heat, light and humidity.

General Statements

For more information visit advocare.com

FDA Disclaimer Statement

These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.

FDA Statement of Identity

Vitamin and Herbal Supplement

Is this label outdated? Report a formula or label change and our pharmacy team will review it.

See for yourself

Fibo-Trim by AdvoCare label

The label scan from the NIH Dietary Supplement Label Database. Tap to enlarge.

Fibo-Trim label

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)
What’s inside

The Ingredients in Fibo-Trim by AdvoCare

These are the 11 active ingredients this product is made of. Select any to open its full monograph.

Serving size3 Capsule(s) Dosage formCapsule Servings per container60 Amounts shown are per serving.

Most supplement products combine several ingredients, and a medication can interact with the product through any one of them. Each ingredient below shows whether it has known drug interactions.

Dietary Fiber

Interacts with
2,025 drugs
1 Gram(s) per serving

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 & interactions

Xanthan Gum

Interacts with
2,022 drugs
400 mg per serving

Xanthan gum is a fermentation-made fiber widely used to thicken and stabilize foods and to thicken liquids for people with swallowing difficulties. It...

Xanthan Gum monograph & interactions

Guar Gum

Interacts with
2,025 drugs
400 mg per serving

Guar gum is a soluble, gel-forming fiber from the guar bean that may modestly help with cholesterol, blood sugar, and bowel regularity. It is generall...

Guar Gum monograph & interactions

Vitamin E

Interacts with
764 drugs
12.4 mg per serving Form: D-Alpha-Tocopheryl Succinate

Vitamin E is an essential fat-soluble vitamin and antioxidant that most people get in adequate amounts from a normal diet. Supplements can help correc...

Vitamin E monograph & interactions

L-Taurine

Interacts with
173 drugs
50 mg per serving

Taurine is an amino acid your body makes naturally and that you also get from animal foods. It is widely used in energy drinks and sports supplements,...

L-Taurine monograph & interactions

Niacin

Interacts with
727 drugs
12 mg per serving Form: Niacinamide Ascorbate

Niacin (vitamin B3) is an essential nutrient your body needs for energy and metabolism, and deficiency is uncommon in most developed countries. Prescr...

Niacin monograph & interactions

Beta-Sitosterol

No known
interactions
100 mg per serving

Beta-sitosterol is a plant sterol that may modestly lower LDL ('bad') cholesterol and may help ease urinary symptoms from an enlarged prostate. Eviden...

Beta-Sitosterol monograph & interactions

Chitosan

Interacts with
3 drugs
600 mg per serving Form: Crab, Lobster, Shrimp

Chitosan is a fiber-like substance made from the shells of shrimp, crabs, and other shellfish, often marketed for weight loss and cholesterol. The evi...

Chitosan monograph & interactions

Vitamin C

Interacts with
207 drugs
37 mg per serving Form: Niacinamide Ascorbate

Vitamin C (ascorbic acid) is an essential nutrient your body needs but cannot make, so you must get it from food or supplements. It's important for im...

Vitamin C monograph & interactions

Psyllium husk powder

350 mg per serving

Odorless Garlic

Interacts with
989 drugs
100 mg per serving

Garlic is a common food and supplement that may modestly help with blood pressure and cholesterol, though the evidence is mixed and effects are usuall...

Odorless Garlic monograph & interactions

Other (inactive) ingredients: Gelatin, Rice Flour, Magnesium Stearate, Silicon Dioxide. These complete the product’s ingredient list but are not active constituents.

Interaction report

Fibo-Trim by AdvoCare Drug Interactions

Want to check YOUR meds against Fibo-Trim?

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 checker
2,185Drugs
2,185 Moderate

Ingredients driving the most interactions

Dietary Fiber 2,025
Guar Gum 2,025
Xanthan Gum 2,022
odorless Garlic 989
Vitamin E 764

Individual Drug Interactions

The ingredients in Fibo-Trim interact with 2,185 drugs. Click any drug to see the details.

9 of the 11 ingredients in Fibo-Trim interact with drugs. Each result below shows which ingredient is responsible. Dietary Fiber Guar Gum Xanthan Gum odorless Garlic Vitamin E Niacin Vitamin C L-Taurine Chitosan

Each ingredient & the kinds of drugs it affects

For each ingredient in Fibo-Trim 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 Fiber7 drug types · 2,025 drugs

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.

Likelihood Probable Evidence D
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.

Likelihood Probable Evidence D
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.

Likelihood Possible Evidence D
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.

Likelihood Possible Evidence D
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.

Likelihood Unlikely Evidence B
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.

Likelihood Unlikely Evidence D
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.

Likelihood Possible Evidence B
Dietary Fiber full monograph & interactions

Guar Gum5 drug types · 2,025 drugs

Ethinyl Estradiol

Theoretically, guar gum might reduce the absorption of ethinyl estradiol, potentially decreasing its effectiveness.
Animal research shows that taking guar gum with ethinyl estradiol decreases ethinyl estradiol absorption. However, this effect has not been reported in humans.

Likelihood Possible Evidence D
Metformin (Glucophage)

Guar gum might reduce the absorption of metformin, potentially decreasing its effectiveness.
A small study in healthy volunteers shows that guar gum reduces the absorption rate of metformin.

Likelihood Probable Evidence B
Oral Drugs

Guar gum might reduce the absorption of some oral drugs, potentially decreasing their effectiveness.
Clinical research shows that guar gum reduces or slows absorption of medications such as penicillin and metformin. To avoid changes in absorption, take guar gum 30-60 minutes after oral medications.

Likelihood Possible Evidence B
Penicillin

Guar gum might reduce the absorption of penicillin, potentially decreasing its effectiveness.
A small clinical study in healthy volunteers shows that taking guar gum with penicillin results in decreased penicillin absorption and reduced penicillin levels.

Likelihood Probable Evidence B
Digoxin (Lanoxin)

Guar gum might slow digoxin absorption, but it does not seem to impact how much digoxin is absorbed overall.
Two small studies in healthy volunteers show no change in the overall extent of digoxin absorption, although early absorption was slowed, when taken with guar gum.

Likelihood Possible Evidence B
Guar Gum full monograph & interactions

Xanthan Gum1 drug type · 2,022 drugs

Oral Drugs

Theoretically, xanthan gum can alter the absorption of oral drugs due to its fiber qualities. Xanthan gum slows gastric emptying and has been used to control the release of drugs in tablet formulations. To avoid any alterations in drug absorption, xanthan gum should be taken 30-60 minutes after oral medications.

Likelihood Possible Evidence D
Xanthan Gum full monograph & interactions

odorless Garlic12 drug types · 989 drugs

Anticoagulant/Antiplatelet Drugs

Garlic may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Raw garlic and a variety of garlic extracts have antiplatelet activity and can increase prothrombin time.

Likelihood Possible Evidence D
Antidiabetes Drugs

Theoretically, taking garlic with antidiabetes drugs might increase the risk of hypoglycemia.
Clinical research suggests that garlic and garlic extract lower blood glucose levels in healthy and diabetic individuals.

Likelihood Possible Evidence B
Antihypertensive Drugs

Theoretically, taking garlic with antihypertensive drugs might increase the risk of hypotension.
In human research, both garlic and garlic extracts have blood pressure-lowering effects.

Likelihood Possible Evidence D
Atazanavir (Reyataz)

Theoretically, garlic might decrease levels and effects of atazanavir.
In a case report, a patient consuming six stir-fried garlic cloves three times weekly developed suboptimal atazanavir levels and increases in HIV viral load. While the exact cause of this interaction is unclear, there is speculation that garlic might decrease the intestinal absorption of atazanavir or increase its metabolism by inducing cytochrome P450 3A4 (CYP3A4). Until more is known, advise patients not to consume large amounts of garlic while taking atazanavir.

Likelihood Possible Evidence D
Cytochrome P450 2E1 (Cyp2E1) Substrates

Garlic might increase levels of drugs metabolized by CYP2E1.
Clinical research suggests garlic oil can inhibit the activity of CYP2E1 by 39%. Use garlic oil cautiously in patients taking drugs metabolized by these enzymes.

Likelihood Probable Evidence B
Cytochrome P450 3A4 (Cyp3A4) Substrates

Theoretically, garlic products containing allicin might induce intestinal CYP3A4 and inhibit hepatic CYP3A4. This may increase or decrease levels of drugs metabolized by CYP3A4.
Some human research suggests that garlic may induce INTESTINAL CYP3A4, reducing levels of drugs metabolized by this enzyme. This is primarily based on a study showing that taking a specific allicin-containing garlic product (GarliPure Maximum Allicin Formula, Natrol Inc.) twice daily for 3 days reduces saquinavir levels by approximately 50%. It is speculated that the allicin constituent induced CYP3A4 in the gut mucosa. Another study shows that giving docetaxel intravenously, bypassing the CYP3A4 enzymes in the gut mucosa, along with the same specific garlic product for 12 consecutive days, does not affect docetaxel levels. Conversely, there is concern that garlic may inhibit HEPATIC CYP3A4. In a single case report, increased tacrolimus levels and liver injury occurred in a liver transplant patient after taking a specific garlic supplement (Garlicin Cardio, Nature's Way) at up to three times the manufacturer recommended dose for 7 days. Several other studies have evaluated the impact of other garlic formulations on CYP3A4 substrates and have found no effect. Most of the products in these studies provided little or no allicin.

Likelihood Possible Evidence B
Isoniazid

Theoretically, garlic might decrease levels of isoniazid.
Animal research suggests that an aqueous extract of garlic reduces isoniazid levels by about 65%. Garlic reduced the maximum concentration (Cmax) and area under the curve (AUC), but not the half-life, of isoniazid. This suggests that garlic extract might inhibit isoniazid absorption across the intestinal mucosa; however, the exact mechanism of this potential interaction is not known.

Likelihood Possible Evidence D
Protease Inhibitors (Pis)

Theoretically, garlic products containing allicin might decrease levels of PIs.
Protease inhibitors are metabolized by cytochrome P450 3A4 (CYP3A4) isoenzymes. There is concern that garlic products containing allicin might induce intestinal CYP3A4, reducing plasma levels of protease inhibitors. This is primarily based on a study showing that taking a specific garlic product (GarliPure Maximum Allicin Formula, Natrol Inc.) twice daily for 3 days reduces levels of saquinavir, a PI, by approximately 50%. It is speculated that the allicin constituent induce CYP3A4 in the gut mucosa. Several studies have evaluated the impact of other garlic formulations on CYP3A4 substrates and have found no effect. Most of the products in these studies provided little or no allicin.

Likelihood Possible Evidence B
Saquinavir (Fortovase, Invirase)

Theoretically, garlic containing allicin might decrease levels of saquinavir.
Saquinavir is a substrate of cytochrome P450 3A4 (CYP3A4) isoenzymes. There is concern that garlic products containing allicin might induce intestinal CYP3A4 and cause subtherapeutic levels of saquinavir. This is primarily based on a pharmacokinetic study showing that taking a specific garlic product (GarliPure Maximum Allicin Formula, Natrol Inc.) twice daily for 3 days reduces saquinavir levels by approximately 50%. It is speculated that the allicin constituent induces CYP3A4 in the gut mucosa. Several pharmacokinetic studies have evaluated the impact of other garlic formulations on CYP3A4 substrates and have found no effect. Most of the products in these studies provided little or no allicin. Until more is known about this potential interaction, use garlic containing allicin cautiously in patients taking saquinavir.

Likelihood Possible Evidence B
Sofosbuvir (Sovaldi)

Theoretically, taking garlic with sofosbuvir might decrease its effectiveness.
Animal research in rats shows that giving aged garlic extract 120 mg/kg orally daily for 14 days decreases the area under the concentration time curve (AUC) after a single sofosbuvir dose of 40 mg/kg by 36%, increases the clearance by 63%, and decreases the plasma concentrations at 1 and 8 hours by 35% and 58%, respectively. This interaction is hypothesized to be due to induction of intestinal P-glycoprotein expression by garlic.

Likelihood Possible Evidence D
Tacrolimus (Prograf)

Theoretically, garlic might increase levels of tacrolimus.
In one case report, a liver transplant patient taking tacrolimus experienced increased tacrolimus levels and liver injury after taking a specific garlic supplement (Garlicin Cardio, Nature's Way) at up to three times the manufacturer recommended dose for 7 days. It is speculated that garlic inhibited hepatic cytochrome P450 3A4 (CYP3A4), which increased plasma levels of tacrolimus.

Likelihood Possible Evidence B
Warfarin (Coumadin)

Theoretically, garlic might increase the risk of bleeding with warfarin.
Raw garlic and a variety of garlic extracts have antiplatelet activity and can increase prothrombin time. In addition, there is a report of two patients who experienced an increase in a previously stabilized international normalized ratio (INR) with concomitant garlic and warfarin use. However, this report has been subsequently debated due to limited clinical information. Other clinical studies have not identified an effect of garlic on INR, warfarin pharmacokinetics, or bleeding risk. More evidence is needed to determine the safety of using garlic with warfarin.

Likelihood Possible Evidence D
odorless Garlic full monograph & interactions

Vitamin E8 drug types · 764 drugs

Alkylating Agents

Theoretically, antioxidant effects of vitamin E might reduce the effectiveness of alkylating agents.
There's concern that antioxidants could reduce the activity of chemotherapy drugs which generate free radicals, such as cyclophosphamide, chlorambucil, carmustine, busulfan, and thiotepa. However, some researchers theorize that antioxidants might make chemotherapy more effective by reducing oxidative stress that might interfere with apoptosis (cell death) of cancer cells. More evidence is needed to determine what effect, if any, antioxidants such as vitamin E have on chemotherapy. Advise patients to consult their oncologist before using vitamin E supplements, especially in high doses.

Likelihood Possible Evidence D
Anticoagulant/Antiplatelet Drugs

Concomitant use of vitamin E and anticoagulant or antiplatelet agents might increase the risk of bleeding.
Vitamin E seems to inhibit of platelet aggregation and antagonize the effects of vitamin K-dependent clotting factors. These effects appear to be dose-dependent, and are probably only likely to be clinically significant with doses of at least 800 units daily. Mixed tocopherols, such as those found in food, might have a greater antiplatelet effect than alpha-tocopherol. RRR alpha-tocopherol (natural vitamin E) 1000 IU daily antagonizes vitamin K-dependent clotting factors. Advise patients to avoid high doses of vitamin E, especially in people with low vitamin K intake or other risk factors for bleeding.

Likelihood Possible Evidence B
Antitumor Antibiotics

Theoretically, antioxidant effects of vitamin E might reduce the effectiveness of antitumor antibiotics.
There's concern that antioxidants could reduce the activity of antitumor antibiotic drugs such as doxorubicin, which generate free radicals. However, some researchers theorize that antioxidants might make chemotherapy more effective by reducing oxidative stress that might interfere with apoptosis (cell death) of cancer cells. More evidence is needed to determine what effect, if any, antioxidants such as vitamin E have on chemotherapy involving antitumor antibiotics. Advise patients to consult their oncologist before using vitamin E supplements, especially in high doses.

Likelihood Possible Evidence D
Cyclosporine (Neoral, Sandimmune)

A specific form of vitamin E might increase absorption and levels of cyclosporine.
There is some evidence that one specific formulation of vitamin E (D-alpha-tocopheryl-polyethylene glycol-1000 succinate, TPGS, tocophersolan, Liqui-E) might increase absorption of cyclosporine. This vitamin E formulation forms micelles which seems to increase absorption of cyclosporine by 40% to 72% in some patients. However, this interaction is unlikely to occur with the usual forms of vitamin E.

Likelihood Unlikely Evidence B
Cytochrome P450 3A4 (Cyp3A4) Substrates

Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Vitamin E appears to bind with the nuclear receptor, pregnane X receptor (PXR), which results in increased expression of CYP3A4. Although the clinical significance of this is not known, use caution when considering concomitant use of vitamin E and other drugs affected by these enzymes.

Likelihood Possible Evidence D
Selumetinib (Koselugo)

Taking selumetinib with vitamin E can result in a total daily dose of vitamin E that exceeds safe limits and therefore might increase the risk of bleeding.
Selumetinib contains 48-54 IU vitamin E per capsule. The increased risk of bleeding with vitamin E appears to be dose-dependent. Be cautious when using selumetinib in combination with supplemental vitamin E, especially in patients at higher risk of bleed, such as those with chronic conditions and those taking antiplatelet drugs.

Likelihood Possible Evidence D
Warfarin (Coumadin)

Using vitamin E with warfarin might increase the risk of bleeding.
Due to interference with production of vitamin K-dependent clotting factors, use of more than 400 IU of vitamin E daily with warfarin might increase prothrombin time (PT), INR, and the risk of bleeding,. At a dose of 1000 IU per day, vitamin E can antagonize vitamin K-dependent clotting factors even in people not taking warfarin. Limited clinical evidence suggests that doses up to 1200 IU daily may be used safely by patients taking warfarin, but this may not be applicable in all patient populations.

Likelihood Possible Evidence B
Niacin

Vitamin E might decrease the beneficial effects of niacin on high-density lipoprotein (HDL) cholesterol levels.
A combination of niacin and simvastatin (Zocor) effectively raises high-density lipoprotein (HDL) cholesterol levels in people with coronary disease and low HDL levels. Clinical research shows that taking a combination of antioxidants (vitamin C, vitamin E, beta-carotene, and selenium) along with niacin and simvastatin (Zocor) attenuates this rise in HDL, specifically the HDL-2 and apolipoprotein A1 fractions, by more than 50%. Vitamin E alone combined with a statin does not seem to decrease HDL levels. It is not known whether the adverse effect on HDL is due to one of the other antioxidants or to the combination. It also is not known whether it will occur in other patient populations.

Likelihood Possible Evidence A
Vitamin E full monograph & interactions

Niacin15 drug types · 727 drugs

Alcohol (Ethanol)

Concomitant use of alcohol and niacin might increase the risk of flushing and hepatotoxicity.
Alcohol can exacerbate the flushing and pruritus associated with niacin. Large doses of niacin might also exacerbate liver dysfunction associated with chronic alcohol use. A case report describes delirium and lactic acidosis in a patient taking niacin 3 grams daily who ingested 1 liter of wine. Advise patients to avoid large amounts of alcohol while taking niacin.

Likelihood Probable Evidence D
Allopurinol (Zyloprim)

Theoretically, niacin might antagonize the therapeutic effects of uricosurics such as allopurinol.
Large doses of niacin can reduce urinary excretion of uric acid, potentially resulting in hyperuricemia. Doses of uricosurics such as allopurinol might need to be increased to maintain control of gout in patients who start taking niacin. People who have frequent attacks of gout despite uricosuric therapy should avoid niacin.

Likelihood Probable Evidence C
Anticoagulant/Antiplatelet Drugs

Theoretically, niacin may have additive effects when used with anticoagulant or antiplatelet drugs.
Several cases of clotting factor synthesis deficiency and coagulopathy have been reported in patients taking sustained-release niacin. Also, thrombocytopenia has been reported in patients treated with niacin or niacin plus lovastatin.

Likelihood Possible Evidence D
Antidiabetes Drugs

Niacin can increase blood glucose levels and may diminish the effects of antidiabetes drugs.
Niacin impairs glucose tolerance in a dose-dependent manner, probably by causing or aggravating insulin resistance and increasing hepatic production of glucose. In diabetes patients, niacin 4.5 grams daily for 5 weeks can increase plasma glucose by an average of 16% and glycated hemoglobin (HbA1c) by 21%. However, lower doses of 1.5 grams daily or less appear to have minimal effects on blood glucose. In some patients, glucose levels increase when niacin is started, but then return to baseline when a stable dose is reached. Up to 35% of patients with diabetes may need adjustments in hypoglycemic therapy when niacin is added.

Likelihood Probable Evidence B
Antihypertensive Drugs

Theoretically, niacin may increase the risk of hypotension when used with antihypertensive drugs.
The vasodilating effects of niacin can cause hypotension. Furthermore, some clinical evidence suggests that a one-hour infusion of niacin can reduce systolic, diastolic, and mean blood pressure in hypertensive patients. This effect is not observed in normotensive patients.

Likelihood Possible Evidence B
Bile Acid Sequestrants

Bile acid sequestrants can bind niacin and decrease absorption. Separate administration by 4-6 hours to avoid an interaction.
In vitro studies show that colestipol (Colestid) binds about 98% of available niacin and cholestyramine (Questran) binds 10% to 30%.

Likelihood Possible Evidence D
Gemfibrozil (Lopid)

Theoretically, concomitant use of niacin and gemfibrozil might increase the risk of myopathy in some patients.
A case of myopathy from concomitant use of niacin and gemfibrozil has been reported. Niacin alone has also been associated with cases of myopathy. Using gemfibrozil with niacin might further increase the risk of developing myopathy.

Likelihood Possible Evidence D
Hepatotoxic Drugs

Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Niacin has been associated with cases of liver toxicity, especially when used in pharmacologic doses. Sustained-release niacin preparations appear to be associated with a higher risk of hepatotoxicity than immediate-release niacin.

Likelihood Possible Evidence D
Hmg-Coa Reductase Inhibitors ("Statins")

Theoretically, concomitant use of niacin and statins might increase the risk of myopathy and rhabdomyolysis in some patients.
Some case reports have raised concerns that niacin might increase the risk of myopathy and rhabdomyolysis when combined with statins. However, a significantly increased risk of myopathy has not been demonstrated in clinical trials, including those using an FDA-approved combination of lovastatin and niacin (Advicor).

Likelihood Possible Evidence D
Probenecid (Benemid)

Theoretically, niacin might antagonize the therapeutic effects of uricosurics such as probenecid.
Large doses of niacin reduce urinary excretion of uric acid, potentially causing hyperuricemia. Doses of uricosurics such as probenecid might need to be increased to maintain control of gout in patients who start taking niacin. People who have frequent attacks of gout despite uricosuric therapy should avoid niacin.

Likelihood Probable Evidence C
Sulfinpyrazone (Anturane)

Theoretically, niacin might antagonize the therapeutic effects of uricosurics such as sulfinpyrazone.
Large doses of niacin reduce urinary excretion of uric acid, potentially causing hyperuricemia. Doses of uricosurics such as sulfinpyrazone might need to be increased to maintain control of gout in patients who start taking niacin. People who have frequent attacks of gout despite uricosuric therapy should avoid niacin.

Likelihood Probable Evidence C
Thyroid Hormone

Theoretically, niacin might antagonize the therapeutic effects of thyroid hormones.
Clinical research and case reports suggests that taking niacin can reduce serum levels of thyroxine-binding globulin by up to 25% and moderately reduce levels of thyroxine (T4). Patients taking thyroid hormone for hypothyroidism might need dose adjustments when using niacin.

Likelihood Probable Evidence D
Transdermal Nicotine (Nicoderm)

Theoretically, concomitant use of niacin and transdermal nicotine might increase the risk of flushing and dizziness.
Niacin and nicotine can both cause flushing and dizziness.

Likelihood Possible Evidence D
Warfarin (Coumadin)

There is limited evidence that niacin may increase the anticoagulant effects of warfarin.
In a case report, a patient on warfarin developed an elevated international normalized ratio (INR) of 3.9 after taking niacin for two weeks. The patient's INR was previously stable, ranging between 2 and 3 in recent months, and no other medication changes were identified. The elevated INR returned to therapeutic range within 4 days following the discontinuation of niacin.

Likelihood Possible Evidence D
Aspirin

Large doses of aspirin might alter the clearance of niacin.
Aspirin is often used with niacin to reduce niacin-induced flushing. Doses of 80-975 mg aspirin have been used, but 325 mg appears to be optimal. Aspirin also seems to reduce the clearance of niacin by competing for glycine conjugation. Taking aspirin 1 gram seems to reduce niacin clearance by 45%. This is probably a dose-related effect and not clinically significant with the more common aspirin dose of 325 mg.

Likelihood Likely Evidence B
Niacin full monograph & interactions

Vitamin C13 drug types · 207 drugs

Alkylating Agents

Theoretically, antioxidant effects of vitamin C might reduce the effectiveness of alkylating agents.
The use of antioxidants like vitamin C during chemotherapy is controversial. There is concern that antioxidants could reduce the activity of chemotherapy drugs that generate free radicals, such as cyclophosphamide, chlorambucil, carmustine, busulfan, and thiotepa. In contrast, some researchers theorize that antioxidants might make chemotherapy more effective by reducing oxidative stress that could interfere with apoptosis (cell death) of cancer cells. More evidence is needed to determine what effect, if any, antioxidants such as vitamin C have on chemotherapy.

Likelihood Possible Evidence D
Aluminum

Vitamin C can increase the amount of aluminum absorbed from aluminum compounds.
Research in animals and humans shows that vitamin C increases aluminum absorption, theoretically by chelating aluminum and keeping it in solution where it is available for absorption. In people with normal renal function, urinary excretion of aluminum will likely increase, making aluminum retention and toxicity unlikely. Patients with renal failure who take aluminum-containing compounds such as phosphate binders should avoid vitamin C supplements in doses above the recommended dietary allowances.

Likelihood Probable Evidence B
Antitumor Antibiotics

Theoretically, the antioxidant effects of vitamin C might reduce the effectiveness of antitumor antibiotics.
The use of antioxidants like vitamin C during chemotherapy is controversial. There is concern that antioxidants could reduce the activity of chemotherapy drugs which generate free radicals, such as doxorubicin. In contrast, some researchers theorize that antioxidants might make chemotherapy more effective by reducing oxidative stress that could interfere with apoptosis (cell death) of cancer cells. More evidence is needed to determine what effects, if any, antioxidants such as vitamin C have on chemotherapy.

Likelihood Possible Evidence D
Estrogens

Vitamin C might increase blood levels of estrogens.
Increases in plasma estrogen levels of up to 55% occur under some circumstances when vitamin C is taken concurrently with oral contraceptives or hormone replacement therapy, including topical products. It is suggested that vitamin C prevents oxidation of estrogen in the tissues, regenerates oxidized estrogen, and reduces sulfate conjugation of estrogen in the gut wall. When tissue levels of vitamin C are high, these processes are already maximized and supplemental vitamin C does not have any effect on estrogen levels. Increases in plasma estrogen levels may occur when patients who are deficient in vitamin C take supplements. Monitor these patients for estrogen-related side effects.

Likelihood Probable Evidence B
Fluphenazine (Prolixin)

Theoretically, vitamin C might decrease levels of fluphenazine.
In one patient there was a clinically significant decrease in fluphenazine levels when vitamin C (500 mg twice daily) was started. The mechanism is not known, and there is no further data to confirm this interaction.

Likelihood Possible Evidence D
Indinavir (Crixivan)

Vitamin C can modestly reduce indinavir levels.
One pharmacokinetic study shows that taking vitamin C 1 gram orally once daily along with indinavir 800 mg orally three times daily reduces the area under the concentration-time curve of indinavir by 14%. The mechanism of this interaction is unknown, but it is unlikely to be clinically significant in most patients. The effect of higher doses of vitamin C on indinavir levels is unknown.

Likelihood Probable Evidence B
Levothyroxine (Synthroid, Others)

Vitamin C can increase levothyroxine absorption.
Two clinical studies in adults with poorly controlled hypothyroidism show that swallowing levothyroxine with a glass of water containing vitamin C 500-1000 mg in solution reduces thyroid stimulating hormone (TSH) levels and increases thyroxine (T4) levels when compared with taking levothyroxine alone. This suggests that vitamin C increases the oral absorption of levothyroxine, possibly due to a reduction in pH.

Likelihood Probable Evidence B
Warfarin (Coumadin)

High-dose vitamin C might reduce the levels and effectiveness of warfarin.
Vitamin C in high doses may cause diarrhea and possibly reduce warfarin absorption. There are reports of two people who took up to 16 grams daily of vitamin C and had a reduction in prothrombin time. Lower doses of 5-10 grams daily can also reduce warfarin absorption. In many cases, this does not seem to be clinically significant. However, a case of warfarin resistance has been reported for a patient who took vitamin C 500 mg twice daily. Cessation of vitamin C supplementation resulted in a rapid increase in international normalized ratio (INR). Tell patients taking warfarin to avoid taking vitamin C in excessively high doses (greater than 10 grams daily). Lower doses may be safe, but the anticoagulation activity of warfarin should be monitored. Patients who are stabilized on warfarin while taking vitamin C should avoid adjusting vitamin C dosage to prevent the possibility of warfarin resistance.

Likelihood Possible Evidence D
Acetaminophen (Tylenol, Others)

High-dose vitamin C might slightly prolong the clearance of acetaminophen.
A small pharmacokinetic study in healthy volunteers shows that taking high-dose vitamin C (3 grams) 1.5 hours after taking acetaminophen 1 gram slightly increases the apparent half-life of acetaminophen from around 2.3 hours to 3.1 hours. Ascorbic acid competitively inhibits sulfate conjugation of acetaminophen. However, to compensate, elimination of acetaminophen glucuronide and unconjugated acetaminophen increases. This effect is not likely to be clinically significant.

Likelihood Probable Evidence B
Aspirin

Acidification of the urine by vitamin C might increase aspirin levels.
It has been suggested that acidification of the urine by vitamin C could increase reabsorption of salicylates by the renal tubules, and increase plasma salicylate levels. However, short-term use of up to 6 grams daily of vitamin C does not seem to affect urinary pH or salicylate excretion, suggesting this interaction is not clinically significant.

Likelihood Possible Evidence B
Choline Magnesium Trisalicylate (Trilisate)

Acidification of the urine by vitamin C might increase choline magnesium trisalicylate levels.
It has been suggested that acidification of the urine by vitamin C could increase reabsorption of salicylates by the renal tubules, and increase plasma salicylate levels. However, short-term use of up to 6 grams daily of vitamin C does not seem to affect urinary pH or salicylate excretion, suggesting this interaction probably is not clinically significant.

Likelihood Possible Evidence B
Niacin

Vitamin C might decrease the beneficial effects of niacin on high-density lipoprotein (HDL) cholesterol levels.
A combination of niacin and simvastatin (Zocor) effectively raises HDL cholesterol levels in patients with coronary disease and low HDL levels. Clinical research shows that taking a combination of antioxidants (vitamin C, vitamin E, beta-carotene, and selenium) along with niacin and simvastatin (Zocor) attenuates this rise in HDL, specifically the HDL-2 and apolipoprotein A1 fractions, by more than 50% in patients with coronary disease. It is not known whether this adverse effect is due to a single antioxidant such as vitamin C, or to the combination. It also is not known whether it will occur in other patient populations.

Likelihood Possible Evidence A
Salsalate (Disalcid)

Acidification of the urine by vitamin C might increase salsalate levels.
It has been suggested that acidification of the urine by vitamin C could increase reabsorption of salicylates by the renal tubules, and increase plasma salicylate levels. However, short-term use of up to 6 grams/day vitamin C does not seem to affect urinary pH or salicylate excretion, suggesting this interaction probably is not clinically significant.

Likelihood Possible Evidence B
Vitamin C full monograph & interactions

L-Taurine2 drug types · 173 drugs

Antihypertensive Drugs

Theoretically, taurine might increase the risk of hypotension when taken with antihypertensive drugs.
Some clinical evidence suggests that taurine can reduce both systolic and diastolic blood pressure.

Likelihood Probable Evidence D
Lithium

Theoretically, taurine might reduce excretion and increase plasma levels of lithium.
Taurine is thought to have diuretic properties, which might reduce the excretion of lithium.

Likelihood Probable Evidence D
L-Taurine full monograph & interactions

Chitosan2 drug types · 3 drugs

Acyclovir (Zovirax)

Chitosan can reduce the absorption of acyclovir, potentially increasing the risk for treatment failure.
Clinical research in humans shows that taking chitosan along with acyclovir 200 mg reduces acyclovir absorption. Concomitant administration of chitosan 400 mg or 1000 mg reduced the acyclovir area under the curve (AUC) and peak plasma concentration by about 30% and 40%, respectively, compared with control. Concomitant administration with chitosan 1000 mg also increased time to peak concentration from 1 hour to 2 hours. In vitro research suggests that the mechanism for reduced absorption is due to acyclovir entrapment in chitosan-mucus complexes, which reduces intestinal absorption.

Likelihood Possible Evidence B
Warfarin (Coumadin)

Theoretically, chitosan might increase the risk of bleeding when taken with warfarin.
In a case report, a patient taking warfarin had a significantly increased international normalized ratio (INR) after starting chitosan 1200 mg daily. The INR normalized after chitosan was discontinued and vitamin K was administered. The patient once again started taking chitosan and again had a significant increase in INR. The INR stabilized again once chitosan was discontinued. Researchers theorize that this interaction might occur because chitosan decreases absorption of fat-soluble vitamins, including vitamin K, which could increase the anticoagulant effect of warfarin.

Likelihood Possible Evidence D
Chitosan full monograph & interactions
The maker

Brand information

Manufacturer and brand details for Fibo-Trim, from the product label.

AdvoCare

Name
AdvoCare International, LLC
City
Richardson
State
TX
ZipCode
75082
Phone Number
800-542-4800
Web Address
advocare.com
Pharmacist Counseling Corner

Fibo-Trim by AdvoCare: Common Questions

Does Fibo-Trim by AdvoCare interact with any medications?
Yes. Based on its ingredients, Fibo-Trim has a known interaction with 2,185 medications. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Fibo-Trim contains 11 active ingredients, and an interaction can come from any of them. We check every ingredient, combine the results into one list per medication, and show which ingredient and mechanism is responsible.
Where does this information come from?
The product label data comes from the NIH Dietary Supplement Label Database (DSLD); the interaction data is built on the Natural Medicines database and reviewed by HelloPharmacist pharmacists.
Can I take Fibo-Trim if I'm pregnant or breastfeeding?
It depends on the ingredient. Niacin, vitamin C, L-taurine, and garlic (in food amounts) are likely safe during pregnancy and breastfeeding. Vitamin E is possibly safe in pregnancy and likely safe when breastfeeding. However, guar gum, beta-sitosterol, and chitosan don't have enough safety data — the facts advise avoiding them or using caution. Talk with your doctor or pharmacist for personalized advice on whether this product is right for your situation.
What are the most common side effects I might experience?
Digestive upset is most common: xanthan gum and guar gum may cause bloating, gas, and loose stools; chitosan and garlic commonly cause constipation or diarrhea and nausea; vitamin C can trigger heartburn or diarrhea at higher doses. Niacin often causes flushing (facial warmth and redness). If you start with a small dose and take it with food, many of these effects decrease over time.
Why do xanthan gum and guar gum need to be taken 30–60 minutes apart from my medications?
Both are soluble fibers that slow how quickly food (and drugs) move through your stomach and intestines. This can reduce how much of a medication your body absorbs, which may make the drug less effective. Spacing them out gives your medications time to be absorbed before the fiber slows things down.
Is Fibo-Trim safe to use long-term?
Short-term safety is established for most ingredients, but long-term safety data is limited for some — particularly L-taurine and chitosan. Beta-sitosterol and garlic are intended for longer use, but vitamin E at high doses carries a rare bleeding risk with long-term use. Check with your doctor about how long you should take this product.
Does Fibo-Trim contain any ingredients I'm allergic to?
Chitosan is derived from shellfish, so if you have a shellfish allergy, this product is not for you. Garlic can trigger allergic reactions in sensitive individuals. The product also contains gelatin (from animal sources) and other inactive ingredients — review the full ingredient list if you have multiple allergies.
What is psyllium husk powder, and does it interact with medications?
Psyllium husk powder is a soluble fiber similar to xanthan and guar gum, used to support digestive and cholesterol health. We could not check interaction data for it — no monograph is on file — so we can't tell you whether it interacts with specific drugs. Ask your pharmacist if you're concerned about this ingredient and your medications.

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.

Fibo-Trim label
Go deeper

The Full Monographs Behind Fibo-Trim’s Ingredients

Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.

Herb & supplement monograph

Black Psyllium

Interacts with 2,025 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. It is best known and most studied for rel...

Read the full Black Psyllium monograph → Herb & supplement monograph

Xanthan Gum

Interacts with 2,022 drugs

Xanthan gum is a fermentation-made fiber widely used to thicken and stabilize foods and to thicken liquids for people with swallowing difficulties. It is generally recognized as safe in the...

Read the full Xanthan Gum monograph → Herb & supplement monograph

Guar Gum

Interacts with 2,025 drugs

Guar gum is a soluble, gel-forming fiber from the guar bean that may modestly help with cholesterol, blood sugar, and bowel regularity. It is generally safe in food amounts, but concentrated...

Read the full Guar Gum monograph → Herb & supplement monograph

Vitamin E

Interacts with 764 drugs

Vitamin E is an essential fat-soluble vitamin and antioxidant that most people get in adequate amounts from a normal diet. Supplements can help correct a true deficiency, but high-dose vitam...

Read the full Vitamin E monograph → Herb & supplement monograph

Taurine

Interacts with 173 drugs

Taurine is an amino acid your body makes naturally and that you also get from animal foods. It is widely used in energy drinks and sports supplements, and short-term use appears generally sa...

Read the full Taurine monograph → Herb & supplement monograph

Niacin

Interacts with 727 drugs

Niacin (vitamin B3) is an essential nutrient your body needs for energy and metabolism, and deficiency is uncommon in most developed countries. Prescription-strength niacin has been used to...

Read the full Niacin monograph → Herb & supplement monograph

Beta-sitosterol

Beta-sitosterol is a plant sterol that may modestly lower LDL ('bad') cholesterol and may help ease urinary symptoms from an enlarged prostate. Evidence is moderate for these uses and weaker...

Read the full Beta-sitosterol monograph → Herb & supplement monograph

Chitosan

Interacts with 3 drugs

Chitosan is a fiber-like substance made from the shells of shrimp, crabs, and other shellfish, often marketed for weight loss and cholesterol. The evidence for these benefits is weak, and an...

Read the full Chitosan monograph → Herb & supplement monograph

Vitamin C

Interacts with 207 drugs

Vitamin C (ascorbic acid) is an essential nutrient your body needs but cannot make, so you must get it from food or supplements. It's important for immune function, collagen, and acts as an...

Read the full Vitamin C monograph → Herb & supplement monograph

Garlic

Interacts with 989 drugs

Garlic is a common food and supplement that may modestly help with blood pressure and cholesterol, though the evidence is mixed and effects are usually small. It is generally safe in food am...

Read the full Garlic monograph →
Sources

Sources & How We Checked

Fibo-Trim'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.

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 435 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
  1. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
  2. Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.
  3. Covington TR, et al. Handbook of Nonprescription Drugs. 11th ed. Washington, DC: American Pharmaceutical Association, 1996.
  4. Etman M. Effect of a bulk forming laxative on the bioavailablility of carbamazepine in man. Drug Dev Ind Pharm 1995;21:1901-6.
  5. Perlman BB. Interaction between lithium salts and ispaghula husk. Lancet 1990;335:416.
  6. Vaswani SK, Hamilton RG, Valentine MD, Adkinson NF. Psyllium laxative-induced anaphylaxis, asthma, and rhinitis. Allergy 1996;51:266-8. PubMed
  7. Lantner RR, Espiritu BR, Zumerchik P, Tobin MC. Anaphylaxis following ingestion of a psyllium-containing cereal. JAMA 1990;264:2534-6. DOI
  8. Kaplan MJ. Anaphylactic reaction to "Heartwise." N Engl J Med 1990;323:1072-3. DOI
  9. 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..
  10. Robinson DS, Benjamin DM, McCormack JJ. Interaction of warfarin and nonsystemic gastrointestinal drugs. Clin Pharmacol Ther 1971;12:491-5. PubMed
  11. 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
  12. 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.
  13. 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.
  14. 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
  15. 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
  16. 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
  17. Chiu AC, Sherman SI. Effects of pharmacological fiber supplements on levothyroxine absorption. Thyroid. 1998;8(8):667-71. PubMed
  18. 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

See these in context on the Black Psyllium monograph →

Xanthan Gum 11 references
  1. Sargent EV, Adolph J, Clemmons MK, et al. Evaluation of flu-like symptoms in workers handling xanthan gum powder. Occup Med 1990;32:625-30. PubMed
  2. van der Reijden WA, van der Kwaak, Vissink A, et al. Treatment of xerostomia with polymer-based saliva substitutes in patients with Sjogren's syndrome. Arthritis Rheum 1996;39:57-63.
  3. Osilesi O, Trout DL, Glover EE, et al. Use of xanthan gum in dietary management of diabetes mellitus. Am J Clin Nutr 1985;42: 597-603. PubMed
  4. Eastwood MA, Brydon WG, Anderson DM. The dietary effects of xanthan gum in man. Food Addit Contam 1987;4:17-26. PubMed
  5. Daly J, Tomlin J, Read NW. The effect of feeding xanthan gum on colonic function in man: correlation with in vitro determinants of bacterial breakdown. Br J Nutr 1993;69: 897-902.
  6. Llamas-Moreno JF, Baiza-Durán LM, Saucedo-Rodríguez LR, Alaníz-De la O JF. Efficacy and safety of chondroitin sulfate/xanthan gum versus polyethylene glycol/propylene glycol/hydroxypropyl guar in patients with dry eye. Clin Ophthalmol 2013;7:995-9. PubMed
  7. Pérez-Balbuena AL, Ochoa-Tabares JC, Belalcazar-Rey S, et al. Efficacy of a fixed combination of 0.09 % xanthan gum/0.1 % chondroitin sulfate preservative free vs polyethylene glycol/propylene glycol in subjects with dry eye disease: a multicenter randomi
  8. Vilardell N, Rofes L, Arreola V, Speyer R, Clavé P. A comparative study between modified starch and xanthan gum thickeners in post-stroke oropharyngeal dysphagia. Dysphagia 2016;31(2):169-79. doi: 10.1007/s00455-015-9672-8. PubMed
  9. Rofes L, Arreola V, Mukherjee R, Swanson J, Clav é P. The effects of a xanthan gum-based thickener on the swallowing function of patients with dysphagia. Aliment Pharmacol Ther 2014;39(10):1169-79. doi: 10.1111/apt.12696. PubMed
  10. Aerts O, Clinck B, Schramme M, Lambert J. Contact allergy caused by Tinosorb M: let us not forget about xanthan gum. Contact Dermatitis 2015;72(2):121-3. doi: 10.1111/cod.12324.
  11. Beneke CE, Viljoen AM, Hamman JH. Polymeric plant-derived excipients in drug delivery. Molecules. 2009;14(7):2602-20. PubMed

See these in context on the Xanthan Gum monograph →

Guar Gum 26 references
  1. Gin H, Orgerie MB, Aubertin J. The influence of Guar gum on absorption of metformin from the gut in healthy volunteers. Horm Metab Res 1989;21:81-3.
  2. Huupponen R, Seppala P, Iisalo E. Effect of guar gum, a fibre preparation, on digoxin and penicillin absorption in man. Eur J Clin Pharmacol 1984;26:279-81. PubMed
  3. Malo JL, Cartier A, L'Archeveque J, et al. Prevalence of occupational asthma and immunologic sensitization to guar gum among employees at a carpet-manufacturing plant. J Allergy Clin Immunol 1990;86:562-9. PubMed
  4. Lagier F, Cartier A, Somer J, et al. Occupational asthma caused by guar gum. J Allergy Clin Immunol 1990;85:785-90.
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