Fizzy Mag Ingredients & Drug Interactions
What is this page for?
First and foremost: checking Fizzy Mag 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
Fizzy Mag is a dietary supplement by Highland Laboratories with 7 active ingredients. Its ingredients are commonly taken for preventing or treating low potassium (hypokalemia), supporting healthy blood pressure, muscle cramps.Based on those ingredients, 1,017 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are Vitamin D3, Magnesium, Vitamin C. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against Fizzy Mag by Highland Laboratories
Ask about any prescription or over-the-counter medication and we check it for interactions with Fizzy Mag by Highland Laboratories — 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 Fizzy Mag by Highland Laboratories
Our pharmacy team’s full take, with four database checks built into the cards below — a summary of what is known, not a grade of the product itself.
What’s inside
Full disclosure
Fizzy Mag contains 7 active ingredients. Potassium and magnesium are electrolytes that support nerve and muscle function.
Zinc supports immune health and wound healing. Vitamin C is an antioxidant needed for collagen and immune function.
Vitamin D3 (cholecalciferol) helps your body absorb calcium and supports bone and immune health. Glycine is an amino acid with limited evidence for a few conditions.
Boron is a trace mineral. The product also contains inactive ingredients—magnesium carbonate, citric acid, xylitol, natural berry flavoring, potassium carbonate, ascorbic acid, boron citrate, zinc citrate, and silicon dioxide—which are fillers, binders, and flavorings.
Does it work?
Strong evidence
Magnesium and vitamin C are effective for their established uses: magnesium for heartburn, constipation, and magnesium deficiency; vitamin C for vitamin C deficiency. Zinc is effective for zinc deficiency and likely effective for Wilson disease.
Vitamin D3 is effective for rickets, osteomalacia, renal bone disease, and hypoparathyroidism. Boron is likely effective for boron deficiency.
Glycine is possibly effective for schizophrenia, but evidence for other uses like ADHD and benign prostate enlargement is insufficient. For most people, the evidence we hold doesn't establish this as an all-in-one wellness formula.
How safe is it?
Well-documented data
Magnesium, potassium, zinc, and vitamin C are generally well tolerated at recommended doses. The most common side effects are gastrointestinal: nausea, diarrhea, vomiting, and abdominal cramps.
Potassium from food is safe, but supplements can cause dangerously high blood levels, especially in people with kidney disease. Zinc above 40 mg daily may increase copper deficiency risk over time.
Vitamin C at very high doses (above 2 grams daily) can cause kidney stones in people prone to them and osmotic diarrhea. Vitamin D3 toxicity from excessive long-term doses causes high blood calcium and bone loss.
Glycine safety data are limited; mild sedation, insomnia, and GI upset have been reported rarely. Boron at high doses is toxic; amounts in supplements are generally safe, but data in pregnancy and lactation are limited.
For pregnancy: magnesium and vitamin C are likely safe at recommended amounts; boron should be avoided. For breastfeeding: check with your doctor before using this product, as safety data for some ingredients are insufficient or limited.
Meds to double-check
Major interaction found
Before taking Fizzy Mag, double-check with your pharmacist if you take levodopa/carbidopa (Parkinson's disease), ACE inhibitors or ARBs (blood pressure), potassium-sparing diuretics, quinolone or tetracycline antibiotics, cephalexin, penicillamine, ritonavir or other HIV drugs, cisplatin or other chemotherapy, calcium channel blockers, skeletal muscle relaxants, sulfonylureas (diabetes), bisphosphonates (osteoporosis), warfarin or other blood thinners, thiazide diuretics, digoxin, verapamil, diltiazem, or levothyroxine. No interactions are documented for the boron in this product.
The bottom line
Scorecard at a glanceFully disclosed formula with clinical evidence supporting its stated purpose. Major medication interactions have been identified, and safety information is well characterized.
If you take blood-pressure meds, heart medications, diabetes drugs, blood thinners, antibiotics, or chemotherapy, talk with your pharmacist before starting Fizzy Mag—this product has multiple interactions. It's suitable for people wanting supplemental magnesium, potassium, zinc, vitamin C, or vitamin D3 for deficiency or general support, provided you have no kidney disease or relevant medications.
Always check your exact prescriptions against this product's ingredient list.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 7 of 7 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Nov 20, 2017.
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 Fizzy Mag, straight from the product label.
| Brand | Highland Laboratories |
|---|---|
| Barcode (UPC) | 768305757301 |
| Net contents | 300 Gram(s) |
| Market status | On market |
| Date entered into DSLD | Nov 20, 2017 |
| DSLD ID | 80018 |
| Product type | Other Combinations |
| Supplement form | Powder |
| Dietary claims / uses | Nutrient, All Other |
| Intended target group(s) | Adult (18 - 50 Years), Gluten Free, Sugar Free |
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.
Supplement Facts
The label details for Fizzy Mag by Highland Laboratories, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Potassium | 98 mg | 2% |
| Zinc | 15 mg | 100% |
| Glycine | 500 mg | -- |
| Magnesium | 400 mg | 100% |
| Vitamin C | 120 mg | 200% |
| Vitamin D3 | 1000 IU | 250% |
| Boron | 3 mg | -- |
Other ingredients: Magnesium Carbonate, Citric Acid, Xylitol, natural Berry, Potassium Carbonate, Ascorbic Acid, Boron Citrate, Zinc Citrate, Silicon Dioxide
Tap any ingredient to jump to its full detail below.
These statements are the manufacturer’s wording, reproduced from the product label — the label is saying it, not HelloPharmacist. We don’t verify or endorse them.
Formula
Magnesium plus Vitamin D3
FDA Statement of Identity
Dietary Supplement
Seals/Symbols
GMP Quality Assured Earth Friendly
General Statements
% Daily Value
The minerals are formed into citrate, glycinate, and ascorbate ionic forms naturally during the effervescent process.
Essential nutrients, like minerals, can be difficult to break down and absorb.
Formulation
No corn, soy, salt, yeast, gluten, egg products, sugar, starch, or preservatives.
Suggested/Recommended/Usage/Directions
One (1) rounded scoop (approximately 5 grams) in one half glass of water or juice for daily magnesium supplementation prior to retiring for sleep.
Brand IP Statement(s)
Fizzy Mag effervescent liquid can improve the absorbability of hard-to-digest minerals.
General
PR757
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Fizzy Mag by Highland Laboratories 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 Fizzy Mag by Highland Laboratories
These are the 7 active ingredients this product is made of. Select any to open its full monograph.
Serving size5 Gram(s) Dosage formPowder 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.
Potassium
Interacts with62 drugs
Potassium is an essential mineral your body needs for nerve signals, muscle function, and a steady heartbeat, and most people get enough from a balanc...
Potassium monograph & interactionsZinc
Interacts with67 drugs
Zinc is an essential mineral that your body needs for immune function, wound healing, taste, and smell. Most people get enough from food, but suppleme...
Zinc monograph & interactionsGlycine
Interacts with1 drug
Glycine is a non-essential amino acid your body makes on its own and that also appears in protein-rich foods. It is most studied for improving sleep q...
Glycine monograph & interactionsMagnesium
Interacts with295 drugs
Magnesium is an essential mineral your body needs for muscles, nerves, blood pressure, and many other functions, and supplements are useful for preven...
Magnesium monograph & interactionsVitamin C
Interacts with207 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 im...
Vitamin C monograph & interactionsVitamin D3
Interacts with715 drugs
Vitamin D is a fat-soluble vitamin that helps your body absorb calcium and is important for healthy bones, muscles, and immune function. Many people,...
Vitamin D3 monograph & interactionsBoron
No knowninteractions
Boron is a trace mineral found in many plant foods and sold as a supplement, mainly promoted for bone, joint, and hormone health. The human evidence f...
Boron monograph & interactionsOther (inactive) ingredients: Magnesium Carbonate, Citric Acid, Xylitol, Natural Berry, Potassium Carbonate, Ascorbic Acid, Boron Citrate, Zinc Citrate, Silicon Dioxide. These complete the product’s ingredient list but are not active constituents.
Fizzy Mag by Highland Laboratories Drug Interactions
HelloPharmacist Interaction Report
Fizzy Mag by Highland Laboratories contains seven active ingredients, and several of them interact with medications.
The most serious interaction is with levodopa/carbidopa (Sinemet), used for Parkinson's disease: magnesium can reduce levodopa levels by 35%, which may weaken symptom control. This is a Major-severity interaction.
Read the full breakdown — every affected drug type, severity by severity
Moderate-severity interactions affect multiple drug categories. Potassium in this product raises the risk of dangerously high blood potassium (hyperkalemia) when taken with ACE inhibitors, ARBs, or potassium-sparing diuretics—all blood-pressure or heart medications.
Zinc can reduce absorption of quinolone antibiotics, tetracyclines, cephalexin, and penicillamine by forming complexes in the stomach; it also modestly lowers levels of ritonavir and integrase inhibitors used in HIV treatment, and may interfere with cisplatin chemotherapy. Magnesium decreases absorption of quinolone antibiotics, bisphosphonates (osteoporosis drugs), and can alter effects of skeletal muscle relaxants and calcium channel blockers; it also increases absorption of sulfonylureas (diabetes drugs), raising low-blood-sugar risk.
Vitamin C at high doses can reduce warfarin (blood thinner) effectiveness and may interfere with certain chemotherapy drugs and antipsychotics. Vitamin D3 at high doses combined with thiazide diuretics raises calcium levels and can weaken verapamil or diltiazem (heart rhythm drugs) or digoxin (heart drug).
Glycine and boron were checked and have no interactions documented in our data.
Check your exact medications using the search tool below before starting this product.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against Fizzy Mag?
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 Fizzy Mag interact with 1,017 drugs. Click any drug to see the details.
6 of the 7 ingredients in Fizzy Mag interact with drugs. Each result below shows which ingredient is responsible. Vitamin D3 Magnesium Vitamin C Zinc Potassium Glycine
Amiloride, HydrochlorothiazideAmil-Co, Amilzide, Moduret 25, Moduretic
How Amiloride, Hydrochlorothiazide interacts with Fizzy Mag — through 4 ingredients. Tap an ingredient for the detail:
Vitamin D3Thiazide Diuretics Moderate
Interaction Summary
Theoretically, taking thiazide diuretics and high-dose vitamin D can increase the risk of hypercalcemia.
Read the full Vitamin D3 + Amiloride, Hydrochlorothiazide interactionMagnesiumPotassium-sparing Diuretics Moderate
Interaction Summary
Potassium-sparing diuretics decrease excretion of magnesium, possibly increasing magnesium levels.
Read the full Magnesium + Amiloride, Hydrochlorothiazide interactionPotassiumPotassium-sparing Diuretics Moderate
Interaction Summary
Concomitant use increases the risk of hyperkalemia.
Read the full Potassium + Amiloride, Hydrochlorothiazide interactionZincAmiloride (midamor) Minor
Interaction Summary
Amiloride can modestly reduce zinc excretion and increase zinc levels.
Read the full Zinc + Amiloride, Hydrochlorothiazide interactionAmlodipineNorliqva
How Amlodipine interacts with Fizzy Mag — through 2 ingredients. Tap an ingredient for the detail:
MagnesiumCalcium Channel Blockers Moderate
Interaction Summary
Magnesium can have additive effects with calcium channel blockers, although evidence is conflicting.
Read the full Magnesium + Amlodipine interactionVitamin D3Cytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Vitamin D might induce CYP3A4 enzymes and reduce the bioavailability of CYP3A4 substrates.
Read the full Vitamin D3 + Amlodipine interactionAmlodipine BenzoateKaterzia
How Amlodipine Benzoate interacts with Fizzy Mag — through 2 ingredients. Tap an ingredient for the detail:
MagnesiumCalcium Channel Blockers Moderate
Interaction Summary
Magnesium can have additive effects with calcium channel blockers, although evidence is conflicting.
Read the full Magnesium + Amlodipine Benzoate interactionVitamin D3Cytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Vitamin D might induce CYP3A4 enzymes and reduce the bioavailability of CYP3A4 substrates.
Read the full Vitamin D3 + Amlodipine Benzoate interactionAmlodipine BesilateIstin
How Amlodipine Besilate interacts with Fizzy Mag — through 2 ingredients. Tap an ingredient for the detail:
MagnesiumCalcium Channel Blockers Moderate
Interaction Summary
Magnesium can have additive effects with calcium channel blockers, although evidence is conflicting.
Read the full Magnesium + Amlodipine Besilate interactionVitamin D3Cytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Vitamin D might induce CYP3A4 enzymes and reduce the bioavailability of CYP3A4 substrates.
Read the full Vitamin D3 + Amlodipine Besilate interactionAmlodipine BesylateNorvasc
How Amlodipine Besylate interacts with Fizzy Mag — through 2 ingredients. Tap an ingredient for the detail:
MagnesiumCalcium Channel Blockers Moderate
Interaction Summary
Magnesium can have additive effects with calcium channel blockers, although evidence is conflicting.
Read the full Magnesium + Amlodipine Besylate interactionVitamin D3Cytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Vitamin D might induce CYP3A4 enzymes and reduce the bioavailability of CYP3A4 substrates.
Read the full Vitamin D3 + Amlodipine Besylate interactionAmlodipine Besylate, BenazeprilLotrel
How Amlodipine Besylate, Benazepril interacts with Fizzy Mag — through 3 ingredients. Tap an ingredient for the detail:
PotassiumAce Inhibitors (aceis) Moderate
Interaction Summary
Using ACEIs with high doses of potassium increases the risk of hyperkalemia.
Read the full Potassium + Amlodipine Besylate, Benazepril interactionMagnesiumCalcium Channel Blockers Moderate
Interaction Summary
Magnesium can have additive effects with calcium channel blockers, although evidence is conflicting.
Read the full Magnesium + Amlodipine Besylate, Benazepril interactionVitamin D3Cytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Vitamin D might induce CYP3A4 enzymes and reduce the bioavailability of CYP3A4 substrates.
Read the full Vitamin D3 + Amlodipine Besylate, Benazepril interactionAmlodipine, CelecoxibConsensi
How Amlodipine, Celecoxib interacts with Fizzy Mag — through 2 ingredients. Tap an ingredient for the detail:
MagnesiumCalcium Channel Blockers Moderate
Interaction Summary
Magnesium can have additive effects with calcium channel blockers, although evidence is conflicting.
Read the full Magnesium + Amlodipine, Celecoxib interactionVitamin D3Cytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Vitamin D might induce CYP3A4 enzymes and reduce the bioavailability of CYP3A4 substrates.
Read the full Vitamin D3 + Amlodipine, Celecoxib interactionAmphotericin, TetracyclineMysteclin-F
How Amphotericin, Tetracycline interacts with Fizzy Mag — through 2 ingredients. Tap an ingredient for the detail:
MagnesiumTetracycline Antibiotics Moderate
Interaction Summary
Magnesium decreases absorption of tetracyclines.
Read the full Magnesium + Amphotericin, Tetracycline interactionZincTetracycline Antibiotics Moderate
Interaction Summary
Zinc might reduce levels of tetracycline antibiotics.
Read the full Zinc + Amphotericin, Tetracycline interactionAspirin, Aluminum Hydroxide, Codeine Phosphate, Magnesium HydroxideAscriptin Codeine #3
How Aspirin, Aluminum Hydroxide, Codeine Phosphate, Magnesium Hydroxide interacts with Fizzy Mag — through 3 ingredients. Tap an ingredient for the detail:
Vitamin CAspirin, Aluminum Moderate
Interaction Summary
Acidification of the urine by vitamin C might increase aspirin levels.
Read the full Vitamin C + Aspirin, Aluminum Hydroxide, Codeine Phosphate, Magnesium Hydroxide interactionVitamin D3Aluminum Moderate
Interaction Summary
Vitamin D might increase aluminum absorption and toxicity, but this has only been reported in people with renal failure.
Read the full Vitamin D3 + Aspirin, Aluminum Hydroxide, Codeine Phosphate, Magnesium Hydroxide interactionMagnesiumAnticoagulant/antiplatelet Drugs, Antacids Moderate
Interaction Summary
Theoretically, magnesium may have antiplatelet effects, but the evidence is conflicting.
Read the full Magnesium + Aspirin, Aluminum Hydroxide, Codeine Phosphate, Magnesium Hydroxide interactionAspirin, Caffeine, OrphenadrineInvagesic, Invagesic Forte, Norgesic, Norgesic Forte, Orphengesic, Orphengesic Forte
How Aspirin, Caffeine, Orphenadrine interacts with Fizzy Mag — through 3 ingredients. Tap an ingredient for the detail:
MagnesiumAnticoagulant/antiplatelet Drugs, Skeletal Muscle Relaxants Moderate
Interaction Summary
Theoretically, magnesium may have antiplatelet effects, but the evidence is conflicting.
Read the full Magnesium + Aspirin, Caffeine, Orphenadrine interactionVitamin D3Cytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Vitamin D might induce CYP3A4 enzymes and reduce the bioavailability of CYP3A4 substrates.
Read the full Vitamin D3 + Aspirin, Caffeine, Orphenadrine interactionVitamin CAspirin Minor
Interaction Summary
Acidification of the urine by vitamin C might increase aspirin levels.
Read the full Vitamin C + Aspirin, Caffeine, Orphenadrine interactionAspirin, Calcium Carbonate, Magnesium Carbonate, Magnesium OxideBufferin
How Aspirin, Calcium Carbonate, Magnesium Carbonate, Magnesium Oxide interacts with Fizzy Mag — through 2 ingredients. Tap an ingredient for the detail:
MagnesiumAnticoagulant/antiplatelet Drugs, Antacids Moderate
Interaction Summary
Theoretically, magnesium may have antiplatelet effects, but the evidence is conflicting.
Read the full Magnesium + Aspirin, Calcium Carbonate, Magnesium Carbonate, Magnesium Oxide interactionVitamin CAspirin Minor
Interaction Summary
Acidification of the urine by vitamin C might increase aspirin levels.
Read the full Vitamin C + Aspirin, Calcium Carbonate, Magnesium Carbonate, Magnesium Oxide interactionAspirin, CarisoprodolSoma Compound
How Aspirin, Carisoprodol interacts with Fizzy Mag — through 2 ingredients. Tap an ingredient for the detail:
MagnesiumAnticoagulant/antiplatelet Drugs, Skeletal Muscle Relaxants Moderate
Interaction Summary
Theoretically, magnesium may have antiplatelet effects, but the evidence is conflicting.
Read the full Magnesium + Aspirin, Carisoprodol interactionVitamin CAspirin Minor
Interaction Summary
Acidification of the urine by vitamin C might increase aspirin levels.
Read the full Vitamin C + Aspirin, Carisoprodol interactionAspirin, Citric Acid, Sodium BicarbonateAlka-Seltzer Pain Reliever and Antacid
How Aspirin, Citric Acid, Sodium Bicarbonate interacts with Fizzy Mag — through 2 ingredients. Tap an ingredient for the detail:
MagnesiumAnticoagulant/antiplatelet Drugs, Antacids Moderate
Interaction Summary
Theoretically, magnesium may have antiplatelet effects, but the evidence is conflicting.
Read the full Magnesium + Aspirin, Citric Acid, Sodium Bicarbonate interactionVitamin CAspirin Minor
Interaction Summary
Acidification of the urine by vitamin C might increase aspirin levels.
Read the full Vitamin C + Aspirin, Citric Acid, Sodium Bicarbonate interactionAspirin, Codeine Phosphate, MethocarbamolRobaxisal C
How Aspirin, Codeine Phosphate, Methocarbamol interacts with Fizzy Mag — through 2 ingredients. Tap an ingredient for the detail:
MagnesiumAnticoagulant/antiplatelet Drugs, Skeletal Muscle Relaxants Moderate
Interaction Summary
Theoretically, magnesium may have antiplatelet effects, but the evidence is conflicting.
Read the full Magnesium + Aspirin, Codeine Phosphate, Methocarbamol interactionVitamin CAspirin Minor
Interaction Summary
Acidification of the urine by vitamin C might increase aspirin levels.
Read the full Vitamin C + Aspirin, Codeine Phosphate, Methocarbamol interactionAspirin, MethocarbamolRobaxisal
How Aspirin, Methocarbamol interacts with Fizzy Mag — through 2 ingredients. Tap an ingredient for the detail:
MagnesiumAnticoagulant/antiplatelet Drugs, Skeletal Muscle Relaxants Moderate
Interaction Summary
Theoretically, magnesium may have antiplatelet effects, but the evidence is conflicting.
Read the full Magnesium + Aspirin, Methocarbamol interactionVitamin CAspirin Minor
Interaction Summary
Acidification of the urine by vitamin C might increase aspirin levels.
Read the full Vitamin C + Aspirin, Methocarbamol interactionAtenolol, ChlortalidoneAtenixCo, Tenoret 50, Totaretic
How Atenolol, Chlortalidone interacts with Fizzy Mag — through 1 ingredient. Tap an ingredient for the detail:
Vitamin D3Thiazide Diuretics Moderate
Interaction Summary
Theoretically, taking thiazide diuretics and high-dose vitamin D can increase the risk of hypercalcemia.
Read the full Vitamin D3 + Atenolol, Chlortalidone interactionAtenolol, ChlorthalidoneTenoretic
How Atenolol, Chlorthalidone interacts with Fizzy Mag — through 1 ingredient. Tap an ingredient for the detail:
Vitamin D3Thiazide Diuretics Moderate
Interaction Summary
Theoretically, taking thiazide diuretics and high-dose vitamin D can increase the risk of hypercalcemia.
Read the full Vitamin D3 + Atenolol, Chlorthalidone interactionAtorvastatinAtorvaliq
How Atorvastatin interacts with Fizzy Mag — through 1 ingredient. Tap an ingredient for the detail:
Vitamin D3Atorvastatin (lipitor), Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Vitamin D might reduce absorption of atorvastatin.
Read the full Vitamin D3 + Atorvastatin interactionAtorvastatin CalciumLipitor
How Atorvastatin Calcium interacts with Fizzy Mag — through 1 ingredient. Tap an ingredient for the detail:
Vitamin D3Cytochrome P450 3a4 (cyp3a4) Substrates, Atorvastatin (lipitor) Moderate
Interaction Summary
Vitamin D might induce CYP3A4 enzymes and reduce the bioavailability of CYP3A4 substrates.
Read the full Vitamin D3 + Atorvastatin Calcium interactionAtracuriumTracrium
How Atracurium interacts with Fizzy Mag — through 1 ingredient. Tap an ingredient for the detail:
MagnesiumSkeletal Muscle Relaxants Moderate
Interaction Summary
Parenteral magnesium alters the pharmacokinetics of skeletal muscle relaxants, increasing their effects and accelerating the onset of effect.
Read the full Magnesium + Atracurium interactionAzilsartanEdarbi
How Azilsartan interacts with Fizzy Mag — through 1 ingredient. Tap an ingredient for the detail:
PotassiumAngiotensin Receptor Blockers (arbs) Moderate
Interaction Summary
Using ARBs with high doses of potassium increases the risk of hyperkalemia.
Read the full Potassium + Azilsartan interactionAzilsartan, ChlorthalidoneEdarbyclor
How Azilsartan, Chlorthalidone interacts with Fizzy Mag — through 2 ingredients. Tap an ingredient for the detail:
PotassiumAngiotensin Receptor Blockers (arbs) Moderate
Interaction Summary
Using ARBs with high doses of potassium increases the risk of hyperkalemia.
Read the full Potassium + Azilsartan, Chlorthalidone interactionVitamin D3Thiazide Diuretics Moderate
Interaction Summary
Theoretically, taking thiazide diuretics and high-dose vitamin D can increase the risk of hypercalcemia.
Read the full Vitamin D3 + Azilsartan, Chlorthalidone interactionBaclofenFleqsuvy, Lioresal, Lyvispah, Ozobax
How Baclofen interacts with Fizzy Mag — through 1 ingredient. Tap an ingredient for the detail:
MagnesiumSkeletal Muscle Relaxants Moderate
Interaction Summary
Parenteral magnesium alters the pharmacokinetics of skeletal muscle relaxants, increasing their effects and accelerating the onset of effect.
Read the full Magnesium + Baclofen interactionBazedoxifene Acetate, Conjugated EstrogensDuavee
How Bazedoxifene Acetate, Conjugated Estrogens interacts with Fizzy Mag — through 2 ingredients. Tap an ingredient for the detail:
Vitamin CEstrogens Moderate
Interaction Summary
Vitamin C might increase blood levels of estrogens.
Read the full Vitamin C + Bazedoxifene Acetate, Conjugated Estrogens interactionVitamin D3Cytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Vitamin D might induce CYP3A4 enzymes and reduce the bioavailability of CYP3A4 substrates.
Read the full Vitamin D3 + Bazedoxifene Acetate, Conjugated Estrogens interactionBenazeprilLotensin
How Benazepril interacts with Fizzy Mag — through 1 ingredient. Tap an ingredient for the detail:
PotassiumAce Inhibitors (aceis) Moderate
Interaction Summary
Using ACEIs with high doses of potassium increases the risk of hyperkalemia.
Read the full Potassium + Benazepril interactionBenazepril, HydrochlorothiazideLotensin HCT
How Benazepril, Hydrochlorothiazide interacts with Fizzy Mag — through 2 ingredients. Tap an ingredient for the detail:
PotassiumAce Inhibitors (aceis) Moderate
Interaction Summary
Using ACEIs with high doses of potassium increases the risk of hyperkalemia.
Read the full Potassium + Benazepril, Hydrochlorothiazide interactionVitamin D3Thiazide Diuretics Moderate
Interaction Summary
Theoretically, taking thiazide diuretics and high-dose vitamin D can increase the risk of hypercalcemia.
Read the full Vitamin D3 + Benazepril, Hydrochlorothiazide interactionBendamustineBelrapzo, Treanda, Vivimusta
How Bendamustine interacts with Fizzy Mag — through 1 ingredient. Tap an ingredient for the detail:
Vitamin CAlkylating Agents Moderate
Interaction Summary
Theoretically, antioxidant effects of vitamin C might reduce the effectiveness of alkylating agents.
Read the full Vitamin C + Bendamustine interactionBendamustine HydrochlorideBendeka
How Bendamustine Hydrochloride interacts with Fizzy Mag — through 1 ingredient. Tap an ingredient for the detail:
Vitamin CAlkylating Agents Moderate
Interaction Summary
Theoretically, antioxidant effects of vitamin C might reduce the effectiveness of alkylating agents.
Read the full Vitamin C + Bendamustine Hydrochloride interactionBendroflumethiazideAprinox, Naturetin, Neo-NaClex
How Bendroflumethiazide interacts with Fizzy Mag — through 1 ingredient. Tap an ingredient for the detail:
Vitamin D3Thiazide Diuretics Moderate
Interaction Summary
Theoretically, taking thiazide diuretics and high-dose vitamin D can increase the risk of hypercalcemia.
Read the full Vitamin D3 + Bendroflumethiazide interactionBendroflumethiazide, NadololCorzide
How Bendroflumethiazide, Nadolol interacts with Fizzy Mag — through 1 ingredient. Tap an ingredient for the detail:
Vitamin D3Thiazide Diuretics Moderate
Interaction Summary
Theoretically, taking thiazide diuretics and high-dose vitamin D can increase the risk of hypercalcemia.
Read the full Vitamin D3 + Bendroflumethiazide, Nadolol interactionEach ingredient & the kinds of drugs it affects
For each ingredient in Fizzy Mag 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.
Vitamin D3
Aluminum
Vitamin D might increase aluminum absorption and toxicity, but this has only been reported in people with renal failure.
The protein that transports calcium across the intestinal wall can also bind and transport aluminum. This protein is stimulated by vitamin D, which may therefore increase aluminum absorption. This mechanism may contribute to increased aluminum levels and toxicity in people with renal failure, when they take vitamin D and aluminum-containing phosphate binders chronically.
Atorvastatin (Lipitor)
Vitamin D might reduce absorption of atorvastatin.
A small, low-quality clinical study shows that taking vitamin D reduces levels of atorvastatin and its active metabolites by up to 55%. However, while atorvastatin levels decreased, total cholesterol, low-density lipoprotein (LDL) cholesterol, and high-density lipoprotein (HDL) cholesterol levels did not substantially change. Atorvastatin is metabolized in the gut by CYP3A4 enzymes, and researchers theorized that vitamin D might induce CYP3A4, causing reduced levels of atorvastatin. However, this proposed mechanism was not specifically studied.
Calcipotriene (Dovonex)
Taking calcipotriene with vitamin D increases 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 vitamin D supplements might increase the risk of hypercalcemia.
Digoxin (Lanoxin)
Theoretically, hypercalcemia induced by high-dose vitamin D can increase the risk of arrhythmia from digoxin.
High doses of vitamin D can cause hypercalcemia. Hypercalcemia increases the risk of fatal cardiac arrhythmias with digoxin. Avoid vitamin D doses above the tolerable upper intake level (4000 IU daily for adults) and monitor serum calcium levels in people taking vitamin D and digoxin concurrently.
Diltiazem (Cardizem, Others)
Theoretically, hypercalcemia induced by high-dose vitamin D can reduce the therapeutic effects of diltiazem for arrhythmia.
High doses of vitamin D can cause hypercalcemia. Hypercalcemia can reduce the effectiveness of verapamil in atrial fibrillation. Theoretically this could also occur with diltiazem. Avoid vitamin D doses above the tolerable upper intake level (4000 IU daily for adults) and monitor serum calcium levels in people taking vitamin D and diltiazem concurrently.
Thiazide Diuretics
Theoretically, taking thiazide diuretics and high-dose vitamin D can increase the risk of hypercalcemia.
Thiazide diuretics decrease urinary calcium excretion, which could lead to hypercalcemia if vitamin D supplements are taken concurrently. This has been reported in people being treated with vitamin D for hypoparathyroidism, and also in elderly people with normal parathyroid function who were taking a thiazide, vitamin D, and calcium-containing antacids daily.
Verapamil (Calan, Others)
Hypercalcemia induced by high-dose vitamin D can reduce the therapeutic effects of verapamil for arrhythmia.
Hypercalcemia due to high doses of vitamin D can reduce the effectiveness of verapamil in atrial fibrillation. Avoid vitamin D doses above the tolerable upper intake level (4000 IU daily for adults) and monitor serum calcium levels in people taking vitamin D and verapamil concurrently.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Vitamin D might induce CYP3A4 enzymes and reduce the bioavailability of CYP3A4 substrates.
There is some concern that vitamin D might induce CYP3A4. In vitro research suggests that vitamin D induces CYP3A4 transcription. Additionally, observational research has found that increased UV light exposure and serum vitamin D levels are associated with decreased serum levels of CYP3A4 substrates such as tacrolimus and sirolimus, while no association between UV light exposure or vitamin D levels and levels of mycophenolic acid, a non-CYP3A4 substrate, was found. A small, low-quality clinical study shows that taking vitamin D reduces levels of the CYP3A4 substrate atorvastatin and its active metabolites by up to 55%; however, the clinical effects of atorvastatin were not reduced. While researchers theorized that vitamin D might induce CYP3A4, this proposed mechanism was not specifically studied.
Magnesium
Levodopa/Carbidopa (Sinemet)
Magnesium can reduce the bioavailability of levodopa/carbidopa.
Clinical research in healthy volunteers shows that taking magnesium oxide 1000 mg with levodopa 100 mg/carbidopa 10 mg reduces the area under the curve (AUC) of levodopa by 35% and of carbidopa by 81%. In vitro and animal research shows that magnesium produces an alkaline environment in the digestive tract, which might lead to degradation and reduced bioavailability of levodopa/carbidopa.
Aminoglycoside Antibiotics
Concomitant use of aminoglycoside antibiotics and magnesium can increase the risk for neuromuscular weakness.
Both aminoglycosides and magnesium reduce presynaptic acetylcholine release, which can lead to neuromuscular blockade and possible paralysis. This is most likely to occur with high doses of magnesium given intravenously.
Antacids
Use of acid reducers may reduce the laxative effect of magnesium oxide.
A retrospective analysis shows that, in the presence of H2 receptor antagonists (H2RAs) or proton pump inhibitors (PPIs), a higher dose of magnesium oxide is needed for a laxative effect. This may also occur with antacids. Under acidic conditions, magnesium oxide is converted to magnesium chloride and then to magnesium bicarbonate, which has an osmotic laxative effect. By reducing acidity, antacids may reduce the conversion of magnesium oxide to the active bicarbonate salt.
Bictegravir/Emtricitabine/Tenofovir Alafenamide (Biktarvy)
Magnesium might decrease levels of bictegravir/emtricitabine/tenofovir alafenamide by reducing its absorption.
Advise patients that bictegravir/emtricitabine/tenofovir alafenamide should be taken at least 2 hours before or 6 hours after magnesium containing products.
Bisphosphonates
Magnesium can decrease absorption of bisphosphonates.
Cations, including magnesium, can decrease bisphosphonate absorption. Advise patients to separate doses of magnesium and these drugs by at least 2 hours.
Calcium Channel Blockers
Magnesium can have additive effects with calcium channel blockers, although evidence is conflicting.
Magnesium inhibits calcium entry into smooth muscle cells and may therefore have additive effects with calcium channel blockers. Severe hypotension and neuromuscular blockades may occur when nifedipine is used with intravenous magnesium, although some contradictory evidence suggests that concurrent use of magnesium with nifedipine does not increase the risk of neuromuscular weakness. High doses of magnesium could theoretically have additive effects with other calcium channel blockers.
Digoxin
Magnesium salts may reduce absorption of digoxin.
Clinical evidence suggests that treatment with oral magnesium hydroxide or magnesium trisilicate reduces absorption of digoxin from the intestines. This may reduce the blood levels of digoxin and decrease its therapeutic effects.
Potassium-Sparing Diuretics
Potassium-sparing diuretics decrease excretion of magnesium, possibly increasing magnesium levels.
Potassium-sparing diuretics also have magnesium-sparing properties, which can counteract the magnesium losses associated with loop and thiazide diuretics. Theoretically, increased magnesium levels could result from concomitant use of potassium-sparing diuretics and magnesium supplements.
Quinolone Antibiotics
Magnesium decreases absorption of quinolones.
Magnesium can form insoluble complexes with quinolones and decrease their absorption. Advise patients to take these drugs at least 2 hours before, or 4 to 6 hours after, magnesium supplements.
Skeletal Muscle Relaxants
Parenteral magnesium alters the pharmacokinetics of skeletal muscle relaxants, increasing their effects and accelerating the onset of effect.
Parenteral magnesium shortens the time to onset of skeletal muscle relaxants by about 1 minute and prolongs the duration of action by about 2 minutes. Magnesium potentiates the effects of skeletal muscle relaxants by decreasing calcium-mediated release of acetylcholine from presynaptic nerve terminals, reducing postsynaptic sensitivity to acetylcholine, and having a direct effect on the membrane potential of myocytes. Magnesium also has vasodilatory actions and increases cardiac output, allowing a greater amount of muscle relaxant to reach the motor end plate. A clinical study found that low-dose rocuronium (0.45 mg/kg), when given after administration of magnesium 30 mg/kg over 10 minutes, has an accelerated onset of effect, which matches the onset of effect seen with a full-dose rocuronium regimen (0.6 mg/kg). In another clinical study, onset times for rocuronium doses of 0.3, 0.6, and 1.2 mg/kg were 86, 76, and 50 seconds, respectively, when given alone, but were reduced to 66, 44, and 38 seconds, respectively, when the doses were given after a 15-minute infusion of magnesium sulfate 60 mg/kg. Giving intraoperative intravenous magnesium sulfate, 50 mg/kg loading dose followed by 15 mg/kg/hour, reduces the onset time of rocuronium, enhances its clinical effects, reduces the dose of intraoperative opiates, and prolongs the spontaneous recovery time. It does not affect the activity of subsequently administered neostigmine.
Sulfonylureas
Magnesium increases the systemic absorption of sulfonylureas, increasing their effects and side effects.
Clinical research shows that administration of magnesium hydroxide with glyburide increases glyburide absorption, increases maximal insulin response by 35-fold, and increases the risk of hypoglycemia, when compared with glyburide alone. A similar interaction occurs between magnesium hydroxide and glipizide. The mechanism of this effect appears to be related to the elevation of gastrointestinal pH by magnesium-based antacids, increasing solubility and enhancing absorption of sulfonylureas.
Tetracycline Antibiotics
Magnesium decreases absorption of tetracyclines.
Magnesium can form insoluble complexes with tetracyclines in the gut and decrease their absorption and antibacterial activity. Advise patients to take these drugs 1 hour before or 2 hours after magnesium supplements.
Anticoagulant/Antiplatelet Drugs
Theoretically, magnesium may have antiplatelet effects, but the evidence is conflicting.
In vitro evidence shows that magnesium sulfate inhibits platelet aggregation, even at low concentrations. Some preliminary clinical evidence shows that infusion of magnesium sulfate increases bleeding time by 48% and reduces platelet activity. However, other clinical research shows that magnesium does not affect platelet aggregation, although inhibition of platelet-dependent thrombosis can occur.
Gabapentin (Neurontin)
Gabapentin absorption can be decreased by magnesium.
Clinical research shows that giving magnesium oxide orally along with gabapentin decreases the maximum plasma concentration of gabapentin by 33%, time to maximum concentration by 36%, and area under the curve by 43%. Advise patients to take gabapentin at least 2 hours before, or 4 to 6 hours after, magnesium supplements.
Sevelamer (Renagel, Renvela)
Sevelamer may increase serum magnesium levels.
In patients on hemodialysis, sevelamer use was associated with a 0.28 mg/dL increase in serum magnesium. The mechanism of this interaction remains unclear.
Vitamin C
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
Zinc
Bictegravir/Emtricitabine/Tenofovir Alafenamide (Biktarvy)
Theoretically, zinc might decrease levels of bictegravir/emtricitabine/tenofovir alafenamide by reducing its absorption.
Advise patients that bictegravir/emtricitabine/tenofovir alafenamide should be taken at least 2 hours before or 6 hours after zinc containing products.
Cephalexin (Keflex)
Zinc might decrease cephalexin levels by chelating with cephalexin in the gut and preventing its absorption.
A pharmacokinetic study shows that zinc sulfate 250 mg taken concomitantly with cephalexin 500 mg decreases peak levels of cephalexin by 31% and reduces the exposure to cephalexin by 27%. Also, taking zinc sulfate 3 hours before cephalexin decreases peak levels of cephalexin by 11% and reduces the exposure to cephalexin by 18%. By decreasing cephalexin levels, zinc might increase the risk of treatment failure. This effect does not occur when zinc is taken 3 hours after the cephalexin dose. To avoid an interaction, advise patients take zinc sulfate 3 hours after taking cephalexin.
Cisplatin (Platinol-Aq)
Theoretically, zinc might interfere with the therapeutic effects of cisplatin.
Animal research suggests that zinc stimulates tumor cell production of the protein metallothionein, which binds and inactivates cisplatin. It is not known whether zinc supplements or high dietary zinc intake can cause clinically significant interference with cisplatin therapy. Cisplatin might also increase zinc excretion.
Integrase Inhibitors
Theoretically, taking zinc along with integrase inhibitors might decrease the levels and clinical effects of these drugs.
Zinc is a divalent cation. Pharmacokinetic studies have shown that other divalent cations such as calcium and iron can decrease blood levels of the integrase inhibitor dolutegravir through chelation.
Penicillamine (Cuprimine, Depen)
Zinc might reduce the levels and clinical effects of penicillamine.
By forming an insoluble complex with penicillamine, zinc interferes with penicillamine absorption and activity. Zinc supplements reduce the efficacy of low-dose penicillamine (0.5-1 gram/day), but do not seem to affect higher doses (1-2.75 gram/day), provided dosing times are separated. Advise patients to take zinc and penicillamine at least 2 hours apart.
Quinolone Antibiotics
Zinc can decrease the levels and clinical effects of quinolones antibiotics.
Quinolones form complexes with zinc in the gastrointestinal tract, reducing absorption of both the quinolone and zinc if taken at the same time. Advise patients to take these drugs at least 2 hours before, or 4-6 hours after, zinc supplements.
Ritonavir (Norvir)
Zinc modestly reduces levels of ritonavir.
Clinical research shows that zinc might reduce serum ritonavir levels by chelating with ritonavir in the gut and preventing its absorption. In patients with HIV, ritonavir is taken with atazanavir to prevent the metabolism and increase the effects of atazanavir. A pharmacokinetic study shows that, in patients being treated with atazanavir/ritonavir, co-administration of zinc sulfate (Solvazinc tablets) 125 mg as a single dose or as multiple daily doses for 2 weeks reduces plasma levels of ritonavir by about 16%. However, atazanavir levels still remains high enough to prevent HIV virus replication. Therefore, the decrease in ritonavir levels is not likely to be clinically significant.
Tetracycline Antibiotics
Zinc might reduce levels of tetracycline antibiotics.
Tetracyclines form complexes with zinc in the gastrointestinal tract, which can reduce absorption of both the tetracycline and zinc when taken at the same time. Taking zinc sulfate 200 mg with tetracycline reduces absorption of the antibiotic by 30% to 40%. Demeclocycline and minocycline cause a similar interaction. However, doxycycline does not seem to interact significantly with zinc. Advise patients to take tetracyclines at least 2 hours before, or 4-6 hours after, zinc supplements to avoid any interactions.
Amiloride (Midamor)
Amiloride can modestly reduce zinc excretion and increase zinc levels.
Clinical research shows that amiloride can reduce urinary zinc excretion, especially at doses of 10 mg per day or more. This zinc-sparing effect can help to counteract zinc losses caused by thiazide diuretics, but it is unlikely to cause zinc toxicity at usual amiloride doses. The other potassium-sparing diuretics, spironolactone (Aldactone) and triamterene (Dyrenium), do not seem to have a zinc-sparing effect.
Atazanavir (Reyataz)
Zinc modestly reduces levels of atazanavir, although this effect does not seem to be clinically significant.
Clinical research shows that zinc might decrease serum atazanavir levels by chelating with atazanavir in the gut and preventing its absorption. Although a single dose of zinc sulfate (Solvazinc tablets) 125 mg orally does not affect atazanavir concentrations in patients being treated with atazanavir/ritonavir, co-administration of zinc sulfate 125 mg daily for 2 weeks reduces plasma levels of atazanavir by about 22% in these patients. However, despite this decrease, atazanavir levels still remain at high enough concentrations for the prevention of HIV virus replication.
Potassium
Ace Inhibitors (Aceis)
Using ACEIs with high doses of potassium increases the risk of hyperkalemia.
ACEIs block the actions of the renin-angiotensin-aldosterone system and reduce potassium excretion. Concomitant use of these drugs with potassium supplements increases the risk of hyperkalemia. However, concomitant use of these drugs with moderate dietary potassium intake (about 3775-5200 mg daily) does not increase serum potassium levels.
Angiotensin Receptor Blockers (Arbs)
Using ARBs with high doses of potassium increases the risk of hyperkalemia.
ARBs block the actions of the renin-angiotensin-aldosterone system and reduce potassium excretion. Concomitant use of these drugs with potassium supplements increases the risk of hyperkalemia. However, concomitant use of these drugs with moderate dietary potassium intake (about 3775-5200 mg daily) does not increase serum potassium levels.
Potassium-Sparing Diuretics
Concomitant use increases the risk of hyperkalemia.
Using potassium-sparing diuretics with potassium supplements increases the risk of hyperkalemia.
Glycine
Clozapine (Clozaril)
Theoretically, glycine might decrease the effectiveness of clozapine.
One small clinical study in patients with schizophrenia shows that adding glycine to clozapine therapy worsens symptoms of schizophrenia when compared with clozapine alone. The mechanism of this interaction is unclear.
Brand information
Manufacturer and brand details for Fizzy Mag, from the product label.
Fizzy Mag by Highland Laboratories: Common Questions
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Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
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The Full Monographs Behind Fizzy Mag’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Potassium
Interacts with 62 drugsPotassium is an essential mineral your body needs for nerve signals, muscle function, and a steady heartbeat, and most people get enough from a balanced diet rich in fruits and vegetables. P...
Read the full Potassium monograph → Herb & supplement monographZinc
Interacts with 67 drugsZinc is an essential mineral that your body needs for immune function, wound healing, taste, and smell. Most people get enough from food, but supplements can help correct or prevent a defici...
Read the full Zinc monograph → Herb & supplement monographGlycine
Interacts with 1 drugGlycine is a non-essential amino acid your body makes on its own and that also appears in protein-rich foods. It is most studied for improving sleep quality, where early research is promisin...
Read the full Glycine monograph → Herb & supplement monographMagnesium
Interacts with 295 drugsMagnesium is an essential mineral your body needs for muscles, nerves, blood pressure, and many other functions, and supplements are useful for preventing or correcting deficiency. Some othe...
Read the full Magnesium monograph → Herb & supplement monographVitamin C
Interacts with 207 drugsVitamin 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 monographVitamin D
Interacts with 715 drugsVitamin D is a fat-soluble vitamin that helps your body absorb calcium and is important for healthy bones, muscles, and immune function. Many people, especially those with low sun exposure,...
Read the full Vitamin D monograph → Herb & supplement monographBoron
Boron is a trace mineral found in many plant foods and sold as a supplement, mainly promoted for bone, joint, and hormone health. The human evidence for most of these uses is limited or prel...
Read the full Boron monograph →Sources & How We Checked
Fizzy Mag'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 270 references behind this product’s interaction data
Every citation that drives the interaction findings for this product’s ingredients, from the evidence-graded Natural Medicines (TRC Healthcare) database. Open an ingredient to browse its citations — links open the study on PubMed or the publisher’s site.
Potassium 12 references
- McEvoy GK, ed. AHFS Drug Information. Bethesda, MD: American Society of Health-System Pharmacists, 1998.
- Gennaro A. Remington: The Science and Practice of Pharmacy. 19th ed. Lippincott: Williams & Wilkins, 1996.
- Whelton PK, He J, Cutler JA, et al. Effects of oral potassium on blood pressure. Meta-analysis of randomized controlled clinical trials. JAMA 1997;277:1624-32. PubMed
- Phillips, C. O., Kashani, A., Ko, D. K., Francis, G., and Krumholz, H. M. Adverse effects of combination angiotensin II receptor blockers plus angiotensin-converting enzyme inhibitors for left ventricular dysfunction: a quantitative review of data from ra DOI
- Altieri, P. I., Herrero, C., Suero, R., and Ortiz, A. Bleeding duodenal ulcer in a patient taking slow-releasing potassium tablets. Bol.Asoc.Med P.R. 1977;69(8):276.
- Raf, L. E. Enteric-coated potassium chloride tablets and ulcer of the small intestine. Acta Chir Scand Suppl 1967;(374):1-87.
- Potassium chloride oral solution [package insert]. Allentown, PA: Lehigh Valley Technologies, Inc.; 2014.
- Potassium chloride injection [package insert]. Lake Forest, IL: Hospira Inc.; 2009.
- Patel RB, Tannenbaum S, Viana-Tejedor A, et al. Serum potassium levels, cardiac arrhythmias, and mortality following non-ST-elevation myocardial infarction or unstable angina: insights from MERLIN-TIMI 36. Eur Heart J Acute Cardiovasc Care 2017 Feb;6(1):1 PubMed
- Malta D, Arcand J, Ravindran A, Floras V, Allard JP, Newton GE. Adequate intake of potassium does not cause hyperkalemia in hypertensive individuals taking medications that antagonize the renin angiotensin aldosterone system. Am J Clin Nutr 2016 Oct;104(4 PubMed
- Keskin M, Kaya A, Tatlisu MA, et al. The effect of serum potassium level on in-hospital and long-term mortality in ST elevation myocardial infarction. Int J cardiol. 2016 Oct 15;221:505-10.
- Stallings VA, Harrison M, Oria M; Committee to Review the Dietary Reference Intakes for Sodium and Potassium, Food and Nutrition Board, Health and Medicine Division, National Academies of Sciences, Engineering, and Medicine. Washington (DC): National Acad
Zinc 88 references
- Barceloux DG. Zinc. J Toxicol Clin Toxicol 1999;37:279-92.
- Eby GA, Davis DR, Halcomb WW. Reduction in duration of common colds by zinc gluconate lozenges in a double-blind study. Antimicrob Agents Chemother 1984;25:20-4. DOI
- Smith DS, Helzner EC, Nuttall CE Jr, et al. Failure of zinc gluconate in treatment of acute upper respiratory tract infections. Antimicrob Agents Chemother 1989;33:646-8. PubMed
- Blondeau JM. Expanded activity and utility of the new fluoroquinolones: a review. Clin Ther 1999;21:3-40. PubMed
- Reyes AJ, Olhaberry JV, Leary WP, et al. Urinary zinc excretion, diuretics, zinc deficiency and some side-effects of diuretics. S Afr Med J 1983;64:936-41.
- Kugelmas M. Preliminary observation: oral zinc sulfate replacement is effective in treating muscle cramps in cirrhotic patients. J Am Coll Nutr 2000;19:13-5. PubMed
- Hebel SK, ed. Drug Facts and Comparisons. 52nd ed. St. Louis: Facts and Comparisons, 1998.
- Chan S, Gerson B, Subramaniam S. The role of copper, molybdenum, selenium, and zinc in nutrition and health. Clin Lab Med 1998;18:673-85. DOI
- Brewer GJ, Yuzbasiyan-Gurkan V, Johnson V, et al. Treatment of Wilson's disease with zinc: XI. Interaction with other anticopper agents. J Am Coll Nutr 1993;12:26-30. PubMed
- Fosmire GJ. Zinc toxicity. Am J Clin Nutr 1990;51:225-7.
- Lomaestro BM, Bailie GR. Absorption interactions with fluoroquinolones. 1995 update. Drug Saf 1995;12:314-33. PubMed
- Hansten PD, Horn JR. Drug Interactions Analysis and Management. Vancouver, WA: Applied Therapeutics Inc., 1997 and updates.
- Seelig MS. Auto-immune complications of D-penicillamine - A possible result of zinc and magnesium depletion and of pyridoxine inactivation. J Am Coll Nutr 1982;1:207-14. PubMed
- Neuvonen PJ. Interactions with the absorption of tetracyclines. Drugs 1976;11:45-54.. PubMed
- Hirt M, Nobel S, Barron E. Zinc nasal gel for the treatment of common cold symptoms: A double-blind, placebo-controlled trial. Ear Nose Throat J 2000;79:778-82.. DOI
- Simkin PA. Oral zinc sulphate in rheumatoid arthritis. Lancet 1976;2:539-42. PubMed
- Wray D. A double-blind trial of systemic zinc sulfate in recurrent aphthous stomatitis. Oral Surg Oral Med Oral Pathol 1982;53:469-72. PubMed
- Douglas RM, Miles HB, Moore BW, et al. Failure of effervescent zinc acetate lozenges to alter the course of upper respiratory tract infections in Australian adults. Antimicrob Agents Chemother 1987;31:1263-5. PubMed
- Lagiou P, Wuu J, Trichopoulou A, et al. Diet and benign prostatic hyperplasia: a study in Greece. Urology 1999;54:284-90. PubMed
- Ewing CI, Gibbs AC, Ashcroft C, David TJ. Failure of oral zinc supplementation in atopic eczema. Eur J Clin Nutr 1991;45:507-10.
- Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. Washington, DC: National Academy Press, 2002.
- Age-Related Eye Disease Study Research Group. A randomized, placebo-controlled, clinical trial of high-dose supplementation with vitamins C and E, beta carotene, and zinc for age-related macular degeneration and vision loss. AREDS report no. 8. Arch Oph
- Greenberg JE, Lynn M, Kirsner RS, et al. Mucocutaneous pigmented macule as a result of zinc deposition. J Cutan Pathol 2002;29:613-5. PubMed
- Godfrey HR, Godfrey NJ, Godfrey JC, Riley D. A randomized clinical trial on the treatment of oral herpes with topical zinc oxide/glycine. Altern Ther Health Med 2001;7:49-56.
- Turner RB. Ineffectiveness of intranasal zinc gluconate for prevention of experimental rhinovirus colds. Clin Infect Dis 2001;33:1865-70. PubMed
- Belongia EA, Berg R, Liu K. A randomized trial of zinc nasal spray for the treatment of upper respiratory illness in adults. Am J Med 2001;111:103-8. PubMed
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