Hawaiian Spirulina Natural Vanilla Protein Shake Ingredients & Drug Interactions
What is this page for?
First and foremost: checking Hawaiian Spirulina Natural Vanilla Protein Shake 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
Hawaiian Spirulina Natural Vanilla Protein Shake is a dietary supplement by Nutrex Hawaii with 13 active ingredients. Its ingredients are commonly taken for constipation, diarrhea, high cholesterol.Based on those ingredients, 2,285 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are Dietary Fiber, Rhodiola rosea (root extract), Panax ginseng (root extract). Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against Hawaiian Spirulina Natural Vanilla Protein Shake by Nutrex Hawaii
Ask about any prescription or over-the-counter medication and we check it for interactions with Hawaiian Spirulina Natural Vanilla Protein Shake by Nutrex Hawaii — 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 Hawaiian Spirulina Natural Vanilla Protein Shake by Nutrex Hawaii
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
Partial disclosure
This shake contains 11 active ingredients. The protein base blends three sources: pea protein, brown rice protein, and alfalfa protein, which together provide the amino acids for muscle support.
Complementing these are sodium, iron, and three vitamins—A, B12, and K—that play roles in energy, oxygen transport, blood clotting, and bone health. The product also includes two herbal extracts: rhodiola rosea root (traditionally used for energy and stress) and Panax ginseng root (used for vitality and stamina), plus spirulina, a nutrient-dense blue-green algae.
Inactive ingredients include coconut palm sugar, natural vanilla flavor, and stevia extract as sweetener.
Does it work?
Not established
Evidence for most of this product's ingredients is limited or hasn't been well established. Sodium is rated Effective for cystic fibrosis but has Insufficient or conflicting evidence for heart failure.
Iron is Effective for iron-deficiency anemia and anemia from chronic disease. Vitamin A is Effective for vitamin A deficiency and Possibly Effective for measles and some skin conditions.
Vitamin B12 is Effective for B12 deficiency. Vitamin K is Effective for blood-clotting disorders.
Pea protein, brown rice protein, and alfalfa have Insufficient evidence for their promoted uses—exercise recovery, muscle building, and metabolic health. Rhodiola and Panax ginseng each show Possibly Effective ratings for a few uses (cognitive function, sexual function, fatigue), but the overall evidence base is weak.
Spirulina carries Insufficient evidence for most claims, including energy and anemia support.
How safe is it?
Well-documented data
Most ingredients are generally well tolerated at recommended amounts. However, sodium in excess can raise blood pressure and strain the heart—the product should not be used as a sodium supplement without medical guidance.
Iron commonly causes mild digestive upset (nausea, constipation, diarrhea) and is generally safe in pregnancy and breastfeeding at appropriate doses, but high intakes are toxic. Vitamin A is safe at recommended levels but can cause serious birth defects in high doses during pregnancy; at normal amounts it is well tolerated.
Vitamin B12 is very safe and has no established upper limit. Vitamin K, pea protein, and brown rice protein are generally well tolerated; concentrated protein supplements have not been well studied in pregnancy or breastfeeding, so check with your provider.
Rhodiola is generally well tolerated short-term but lacks long-term safety data and should be avoided in pregnancy and breastfeeding. Spirulina quality varies widely and some products carry contamination risk with toxins or heavy metals; it is best avoided in pregnancy and breastfeeding.
Alfalfa protein has estrogen-like activity and is best avoided in supplement amounts during pregnancy. Panax ginseng is generally well tolerated for up to 6 months but should be avoided in pregnancy and breastfeeding due to insufficient safety data.
Meds to double-check
Major interaction found
Before taking this product, check with your doctor or pharmacist if you use warfarin or other blood thinners—vitamin K and alfalfa protein can reverse their effect. Blood pressure medications (ACE inhibitors, beta-blockers, and others), diabetes drugs, tetracycline or quinolone antibiotics, levothyroxine (thyroid hormone), or bisphosphonates (bone medications) all require dose timing adjustments around iron.
Corticosteroids, lithium, and certain HIV or heart failure drugs that contain sodium need careful sodium intake monitoring. Immunosuppressants, birth control pills, hormone therapy, and certain cancer or psychiatric medications may be affected by alfalfa, rhodiola, ginseng, or spirulina.
If you take retinoid acne medications, midazolam, selegiline, or raltegravir, these ingredients warrant a conversation with your provider before use.
The bottom line
Scorecard at a glancePartially disclosed formula with no established evidence rating for its marketed use. Major medication interactions have been identified, and safety information is well characterized.
This is a nutrient-dense protein shake designed for energy and muscle support, but it contains multiple ingredients that interact with common medications—especially blood thinners, blood pressure drugs, diabetes medications, and antibiotics. If you take any prescription or regular over-the-counter medications, check them against the interactions listed here before starting this product.
Talk with your doctor or pharmacist about whether this shake fits your health profile and current treatments.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 12 of 12 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Apr 22, 2016.
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 Hawaiian Spirulina Natural Vanilla Protein Shake, straight from the product label.
| Brand | Nutrex Hawaii |
|---|---|
| Barcode (UPC) | 732894400542 |
| Net contents | 12.8 oz.; 364 Gram(s) |
| Market status | On market |
| Date entered into DSLD | Apr 22, 2016 |
| DSLD ID | 58253 |
| Product type | Other Combinations |
| Supplement form | Powder |
| Dietary claims / uses | Nutrient, All Other, Structure/Function |
| Intended target group(s) | Vegan, Vegetarian, Adult (18 - 50 Years), Gluten Free, Dairy 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 Hawaiian Spirulina Natural Vanilla Protein Shake by Nutrex Hawaii, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Calories | 100 {Calories} | -- |
| Total Carbohydrates | 6 Gram(s) | 2% |
| Sugar | 3 Gram(s) | -- |
| Calories from Fat | 15 {Calories} | -- |
| Dietary Fiber | 1 Gram(s) | 4% |
| Protein | 16 Gram(s) | 32% |
| Sodium | 230 mg | 10% |
| Iron | 10 mg | 56% |
| Vitamin A | 500 IU | 10% |
| Vitamin B12 | 8 mcg | 133% |
| Total Fat | 2 Gram(s) | 3% |
| Brown Rice Protein | 0 NP | -- |
| Vitamin K | 70 mcg | 88% |
| Protein Blend (Amino Acid/Protein) | 19375 mg | -- |
| Pea Protein | 0 NP | -- |
| Rhodiola rosea (root extract) | 0 NP | -- |
| Spirulina | 3000 mg | -- |
| Alfalfa Protein | 0 NP | -- |
| Energy Blend: | 0 NP | -- |
| Panax ginseng (root extract) | 0 NP | -- |
Other ingredients: Coconut Palm Sugar, natural Vanilla flavor, Stevia extract
Tap any ingredient to jump to its full detail below.
These statements are the manufacturer’s wording, reproduced from the product label — the label is saying it, not HelloPharmacist. We don’t verify or endorse them.
Suggested/Recommended/Usage/Directions
Suggested Use: Mix one scoop with eight ounces or more of water, milk alternative (rice, coconut, almond, etc.) or add it to your favorite smoothie.
General Statements
Boosts Energy & Supports Recovery
+ Energy
Plant Protein Blend
Hawaiian Spirulina Plant Protein Shake is closely formulated to follow the World Health Organization's standard for ideal daily amino acid ratios, making it the superior choice for supplemental nutrition. The taste is unbeatable with a creamy vanilla flavor that is sure to please.
Made with Aloha
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.
Brand IP Statement(s)
2015 Nutrex Hawaii
Powered by Green Superfood Hawaiian Spirulina
Play hard and recover faster with Hawaiian Spirulina Plant Protein Shake!
Formula
16 G Protein
Including Pea, Rice & Alfalfa
This unique protein shake is powered by 3 grams of green superfood Hawaiian Spirulina, pea, brown rice and alfalfa protein, plus unique energy boosters rhodiola and ginseng to make this blend one of a kind.
Hawaiian Spirulina Protein Shake is an excellent source of Vitamin B12, Vitamin K, Iron, and supplies 32% recommended daily value of protein.
Contains: Coconut
+Spirulina
Formulation
100% Vegan Dietary Supplement
Hawaiian Spirulina plant protein shake is FREE of Gluten, Dairy, Lactose, and Soy. Non-GMO, Pesticide, Herbicide Free.
100% Vegan.
Seals/Symbols
Certified GF Gluten-Free
Precautions
Keep out of reach of children.
Do not use if seal is broken or torn.
WARNING: (California Proposition 65): This product contains a chemical known to the State of California to cause birth defects or other reproductive harm.
Contains: Coconut
Storage
Store in a cool, dry place.
Refrigerate after opening to maximize freshness.
General
1215 V1
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Hawaiian Spirulina Natural Vanilla Protein Shake by Nutrex Hawaii 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 Hawaiian Spirulina Natural Vanilla Protein Shake by Nutrex Hawaii
These are the 13 active ingredients this product is made of. Select any to open its full monograph.
Serving size26 Gram(s) Dosage formPowder Servings per container14 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 with2,025 drugs
Black psyllium is a soluble-fiber supplement made from the seeds of a Plantago plant, used mostly to ease constipation and support digestive health. I...
Dietary Fiber monograph & interactions- › Sugar
Protein
Sodium
Interacts with205 drugs
Sodium is an essential mineral and electrolyte your body needs to balance fluids, support nerves, and help muscles work. Most people in modern diets g...
Sodium monograph & interactionsIron
Interacts with80 drugs
Iron is an essential mineral your body needs to make hemoglobin and carry oxygen in the blood. Supplements are mainly useful for treating or preventin...
Iron monograph & interactionsVitamin A
Interacts with387 drugs
Vitamin A is an essential nutrient important for vision, skin, immune function, and growth. Most people get enough from a balanced diet, and supplemen...
Vitamin A monograph & interactionsVitamin B12
Interacts with20 drugs
Vitamin B12 (cobalamin) is an essential nutrient your body needs to make red blood cells, keep nerves healthy, and support DNA. Supplements are very h...
Vitamin B12 monograph & interactionsVitamin K
Interacts with2 drugs
Vitamin K is an essential nutrient your body needs for normal blood clotting and to support healthy bones. Most people get enough from food, but suppl...
Vitamin K monograph & interactionsProtein Blend (Amino Acid/Protein)
Spirulina
Interacts with327 drugs
Blue-green algae are nutrient-rich aquatic microorganisms (such as spirulina and Klamath Lake algae) taken as a supplement for energy, nutrition, and...
Spirulina monograph & interactionsEnergy Blend:
Other (inactive) ingredients: Coconut Palm Sugar, Natural Vanilla flavor, Stevia extract. These complete the product’s ingredient list but are not active constituents.
Hawaiian Spirulina Natural Vanilla Protein Shake by Nutrex Hawaii Drug Interactions
HelloPharmacist Interaction Report
Hawaiian Spirulina Natural Vanilla Protein Shake by Nutrex Hawaii contains multiple ingredients with documented interactions.
Through its sodium, iron, vitamin A, vitamin K, rhodiola, spirulina, alfalfa protein, and Panax ginseng content, this product interacts with a wide range of medications. The most serious interaction is vitamin K's Major-severity antagonism of warfarin (Coumadin), which can reverse its blood-thinning effect.
Altogether, these interactions span 1,626 individual medications.
Read the full breakdown — every affected drug type, severity by severity
Sodium raises several Moderate-severity concerns: it may reduce effectiveness of blood pressure medications (antihypertensives), increase sodium levels dangerously when combined with corticosteroids or certain HIV or heart failure drugs, and critically alter lithium levels—either reducing its effectiveness or causing toxicity depending on your intake. Iron creates Moderate interactions by decreasing absorption of common antibiotics (quinolones and tetracyclines), the blood pressure drug methyldopa, the thyroid hormone levothyroxine, and bone-building medications (bisphosphonates)—all requiring dose separation of at least 2 hours.
Vitamin A carries a Major interaction with retinoid acne or psoriasis medications due to additive toxicity risk. It also poses Moderate concerns with blood thinners like warfarin (at high doses) and tetracycline antibiotics.
Alfalfa protein's high vitamin K content creates a Major interaction mirroring vitamin K's warfarin antagonism, plus Moderate interactions with birth control pills, hormone therapy, and immunosuppressants. Rhodiola and Panax ginseng each interact Moderately with blood pressure drugs, diabetes medications, and immunosuppressants; ginseng additionally affects how your body clears midazolam (Versed), selegiline, and raltegravir (an HIV drug).
Spiralina theoretically increases bleeding risk with anticoagulants or antiplatelet drugs, and both spirulina and alfalfa may increase low blood sugar risk with diabetes medications. Vitamin B12 shows only a Minor interaction with metformin.
Pea protein and brown rice protein had no interactions documented in our data. Check your exact medications with the tool on this page before starting.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against Hawaiian Spirulina Natural Vanilla Protein Shake?
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 Hawaiian Spirulina Natural Vanilla Protein Shake interact with 2,285 drugs. Click any drug to see the details.
11 of the 13 ingredients in Hawaiian Spirulina Natural Vanilla Protein Shake interact with drugs. Each result below shows which ingredient is responsible. Dietary Fiber Rhodiola rosea (root extract) Panax ginseng (root extract) Alfalfa Protein Vitamin A Spirulina Sodium Iron Brown Rice Protein Vitamin B12 Vitamin K
AcitretinSoriatane
How Acitretin interacts with Hawaiian Spirulina Natural Vanilla Protein Shake — through 3 ingredients. Tap an ingredient for the detail:
Vitamin ARetinoids Major
Interaction Summary
Concomitant use of retinoids with vitamin A supplements might produce supratherapeutic vitamin A levels.
Read the full Vitamin A + Acitretin interactionAlfalfa ProteinPhotosensitizing Drugs Moderate
Interaction Summary
Theoretically, concomitant use of alfalfa with photosensitizing drugs might have additive effects.
Read the full Alfalfa Protein + Acitretin interactionDietary FiberOral Drugs Minor
Interaction Summary
Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Read the full Dietary Fiber + Acitretin interactionAlitretinoinPanretin
How Alitretinoin interacts with Hawaiian Spirulina Natural Vanilla Protein Shake — through 3 ingredients. Tap an ingredient for the detail:
Vitamin ARetinoids Major
Interaction Summary
Concomitant use of retinoids with vitamin A supplements might produce supratherapeutic vitamin A levels.
Read the full Vitamin A + Alitretinoin interactionAlfalfa ProteinPhotosensitizing Drugs Moderate
Interaction Summary
Theoretically, concomitant use of alfalfa with photosensitizing drugs might have additive effects.
Read the full Alfalfa Protein + Alitretinoin interactionDietary FiberOral Drugs Minor
Interaction Summary
Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Read the full Dietary Fiber + Alitretinoin interactionBexaroteneTargretin
How Bexarotene interacts with Hawaiian Spirulina Natural Vanilla Protein Shake — through 4 ingredients. Tap an ingredient for the detail:
Vitamin ARetinoids Major
Interaction Summary
Concomitant use of retinoids with vitamin A supplements might produce supratherapeutic vitamin A levels.
Read the full Vitamin A + Bexarotene interactionPanax Ginseng (root Extract)Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, Panax ginseng might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full Panax Ginseng (root Extract) + Bexarotene interactionRhodiola Rosea (root Extract)Cytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, rhodiola might increase levels of drugs metabolized by CYP3A4.
Read the full Rhodiola Rosea (root Extract) + Bexarotene interactionDietary FiberOral Drugs Minor
Interaction Summary
Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Read the full Dietary Fiber + Bexarotene interactionHalobetasol Propionate,tazaroteneDuobrii
How Halobetasol Propionate,tazarotene interacts with Hawaiian Spirulina Natural Vanilla Protein Shake — through 2 ingredients. Tap an ingredient for the detail:
Vitamin ARetinoids Major
Interaction Summary
Concomitant use of retinoids with vitamin A supplements might produce supratherapeutic vitamin A levels.
Read the full Vitamin A + Halobetasol Propionate,tazarotene interactionAlfalfa ProteinPhotosensitizing Drugs Moderate
Interaction Summary
Theoretically, concomitant use of alfalfa with photosensitizing drugs might have additive effects.
Read the full Alfalfa Protein + Halobetasol Propionate,tazarotene interactionIsotretinoinAbsorica, Accutane, Amnesteem, Claravis, Roaccutane, Sotret
How Isotretinoin interacts with Hawaiian Spirulina Natural Vanilla Protein Shake — through 3 ingredients. Tap an ingredient for the detail:
Vitamin ARetinoids Major
Interaction Summary
Concomitant use of retinoids with vitamin A supplements might produce supratherapeutic vitamin A levels.
Read the full Vitamin A + Isotretinoin interactionAlfalfa ProteinPhotosensitizing Drugs Moderate
Interaction Summary
Theoretically, concomitant use of alfalfa with photosensitizing drugs might have additive effects.
Read the full Alfalfa Protein + Isotretinoin interactionDietary FiberOral Drugs Minor
Interaction Summary
Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Read the full Dietary Fiber + Isotretinoin interactionTazaroteneArazlo, Avage, Fabior, Tazorotene, Zorac
How Tazarotene interacts with Hawaiian Spirulina Natural Vanilla Protein Shake — through 2 ingredients. Tap an ingredient for the detail:
Vitamin ARetinoids Major
Interaction Summary
Concomitant use of retinoids with vitamin A supplements might produce supratherapeutic vitamin A levels.
Read the full Vitamin A + Tazarotene interactionAlfalfa ProteinPhotosensitizing Drugs Moderate
Interaction Summary
Theoretically, concomitant use of alfalfa with photosensitizing drugs might have additive effects.
Read the full Alfalfa Protein + Tazarotene interactionTretinoinAltreno, Renova, Retin-A, Vesanoid
How Tretinoin interacts with Hawaiian Spirulina Natural Vanilla Protein Shake — through 3 ingredients. Tap an ingredient for the detail:
Vitamin ARetinoids Major
Interaction Summary
Concomitant use of retinoids with vitamin A supplements might produce supratherapeutic vitamin A levels.
Read the full Vitamin A + Tretinoin interactionAlfalfa ProteinPhotosensitizing Drugs Moderate
Interaction Summary
Theoretically, concomitant use of alfalfa with photosensitizing drugs might have additive effects.
Read the full Alfalfa Protein + Tretinoin interactionDietary FiberOral Drugs Minor
Interaction Summary
Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Read the full Dietary Fiber + Tretinoin interactionTretinoin, Benzoyl PeroxideTwyneo
How Tretinoin, Benzoyl Peroxide interacts with Hawaiian Spirulina Natural Vanilla Protein Shake — through 2 ingredients. Tap an ingredient for the detail:
Vitamin ARetinoids Major
Interaction Summary
Concomitant use of retinoids with vitamin A supplements might produce supratherapeutic vitamin A levels.
Read the full Vitamin A + Tretinoin, Benzoyl Peroxide interactionAlfalfa ProteinPhotosensitizing Drugs Moderate
Interaction Summary
Theoretically, concomitant use of alfalfa with photosensitizing drugs might have additive effects.
Read the full Alfalfa Protein + Tretinoin, Benzoyl Peroxide interactionWarfarinWarfarin
How Warfarin interacts with Hawaiian Spirulina Natural Vanilla Protein Shake — through 7 ingredients. Tap an ingredient for the detail:
Vitamin KWarfarin (coumadin) Major
Interaction Summary
Vitamin K can antagonize and reverse the therapeutic effects of warfarin.
Read the full Vitamin K + Warfarin interactionAlfalfa ProteinWarfarin (coumadin) Major
Interaction Summary
Theoretically, alfalfa might reduce the anticoagulant activity of warfarin.
Read the full Alfalfa Protein + Warfarin interactionRhodiola Rosea (root Extract)Cytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Moderate
Interaction Summary
Theoretically, rhodiola might increase levels of drugs metabolized by CYP3A4.
Read the full Rhodiola Rosea (root Extract) + Warfarin interactionSpirulinaAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, spirulina blue-green algae might increase the risk of bleeding if used with other anticoagulant or antiplatelet drugs.
Read the full Spirulina + Warfarin interactionVitamin AWarfarin (coumadin) Moderate
Interaction Summary
Theoretically, high doses of vitamin A could increase the risk of bleeding with warfarin.
Read the full Vitamin A + Warfarin interactionPanax Ginseng (root Extract)Cytochrome P450 3a4 (cyp3a4) Substrates, Anticoagulant/antiplatelet Drugs +1 Moderate
Interaction Summary
Theoretically, Panax ginseng might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full Panax Ginseng (root Extract) + Warfarin interactionDietary FiberOral Drugs Minor
Interaction Summary
Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Read the full Dietary Fiber + Warfarin interactionWarfarin SodiumCoumadin, Panwarfin, Sofarin
How Warfarin Sodium interacts with Hawaiian Spirulina Natural Vanilla Protein Shake — through 7 ingredients. Tap an ingredient for the detail:
Vitamin KWarfarin (coumadin) Major
Interaction Summary
Vitamin K can antagonize and reverse the therapeutic effects of warfarin.
Read the full Vitamin K + Warfarin Sodium interactionAlfalfa ProteinWarfarin (coumadin) Major
Interaction Summary
Theoretically, alfalfa might reduce the anticoagulant activity of warfarin.
Read the full Alfalfa Protein + Warfarin Sodium interactionRhodiola Rosea (root Extract)Cytochrome P450 2c9 (cyp2c9) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Moderate
Interaction Summary
Theoretically, rhodiola might increase levels of drugs metabolized by CYP2C9.
Read the full Rhodiola Rosea (root Extract) + Warfarin Sodium interactionPanax Ginseng (root Extract)Warfarin (coumadin), Anticoagulant/antiplatelet Drugs +1 Moderate
Interaction Summary
Panax ginseng might affect the clearance of warfarin.
Read the full Panax Ginseng (root Extract) + Warfarin Sodium interactionSpirulinaAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, spirulina blue-green algae might increase the risk of bleeding if used with other anticoagulant or antiplatelet drugs.
Read the full Spirulina + Warfarin Sodium interactionVitamin AWarfarin (coumadin) Moderate
Interaction Summary
Theoretically, high doses of vitamin A could increase the risk of bleeding with warfarin.
Read the full Vitamin A + Warfarin Sodium interactionDietary FiberOral Drugs Minor
Interaction Summary
Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Read the full Dietary Fiber + Warfarin Sodium interactionEtretinateTegison
How Etretinate interacts with Hawaiian Spirulina Natural Vanilla Protein Shake — through 3 ingredients. Tap an ingredient for the detail:
Vitamin ARetinoids Major
Interaction Summary
Concomitant use of retinoids with vitamin A supplements might produce supratherapeutic vitamin A levels.
Read the full Vitamin A + Etretinate interactionAlfalfa ProteinPhotosensitizing Drugs Moderate
Interaction Summary
Theoretically, concomitant use of alfalfa with photosensitizing drugs might have additive effects.
Read the full Alfalfa Protein + Etretinate interactionDietary FiberOral Drugs Minor
Interaction Summary
Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Read the full Dietary Fiber + Etretinate interaction6-mercaptopurinePurinethol
How 6-mercaptopurine interacts with Hawaiian Spirulina Natural Vanilla Protein Shake — through 6 ingredients. Tap an ingredient for the detail:
Panax Ginseng (root Extract)Immunosuppressants Moderate
Interaction Summary
Theoretically, Panax ginseng use might interfere with immunosuppressive therapy.
Read the full Panax Ginseng (root Extract) + 6-mercaptopurine interactionAlfalfa ProteinImmunosuppressants Moderate
Interaction Summary
Theoretically, alfalfa might decrease the efficacy of immunosuppressive therapy.
Read the full Alfalfa Protein + 6-mercaptopurine interactionVitamin AHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking high doses of vitamin A in combination with other potentially hepatotoxic drugs might increase the risk of liver disease.
Read the full Vitamin A + 6-mercaptopurine interactionSpirulinaImmunosuppressants Moderate
Interaction Summary
Theoretically, concurrent use of blue-green algae might interfere with immunosuppressive therapy.
Read the full Spirulina + 6-mercaptopurine interactionRhodiola Rosea (root Extract)Immunosuppressants Moderate
Interaction Summary
Theoretically, rhodiola use might interfere with immunosuppressive therapy.
Read the full Rhodiola Rosea (root Extract) + 6-mercaptopurine interactionDietary FiberOral Drugs Minor
Interaction Summary
Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Read the full Dietary Fiber + 6-mercaptopurine interactionAdo-trastuzumab EmtansineKadcyla
How Ado-trastuzumab Emtansine interacts with Hawaiian Spirulina Natural Vanilla Protein Shake — through 2 ingredients. Tap an ingredient for the detail:
Panax Ginseng (root Extract)Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, Panax ginseng might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full Panax Ginseng (root Extract) + Ado-trastuzumab Emtansine interactionRhodiola Rosea (root Extract)Cytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, rhodiola might increase levels of drugs metabolized by CYP3A4.
Read the full Rhodiola Rosea (root Extract) + Ado-trastuzumab Emtansine interactionAbacavir Sulfate, Dolutegravir, LamivudineTriumeq
How Abacavir Sulfate, Dolutegravir, Lamivudine interacts with Hawaiian Spirulina Natural Vanilla Protein Shake — through 2 ingredients. Tap an ingredient for the detail:
Vitamin AHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking high doses of vitamin A in combination with other potentially hepatotoxic drugs might increase the risk of liver disease.
Read the full Vitamin A + Abacavir Sulfate, Dolutegravir, Lamivudine interactionDietary FiberOral Drugs Minor
Interaction Summary
Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Read the full Dietary Fiber + Abacavir Sulfate, Dolutegravir, Lamivudine interactionAbacavir, LamivudineEpzicom
How Abacavir, Lamivudine interacts with Hawaiian Spirulina Natural Vanilla Protein Shake — through 2 ingredients. Tap an ingredient for the detail:
Vitamin AHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking high doses of vitamin A in combination with other potentially hepatotoxic drugs might increase the risk of liver disease.
Read the full Vitamin A + Abacavir, Lamivudine interactionDietary FiberOral Drugs Minor
Interaction Summary
Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Read the full Dietary Fiber + Abacavir, Lamivudine interactionAbciximabReoPro
How Abciximab interacts with Hawaiian Spirulina Natural Vanilla Protein Shake — through 3 ingredients. Tap an ingredient for the detail:
Panax Ginseng (root Extract)Anticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Although Panax ginseng has shown antiplatelet effects in the laboratory, it is unlikely to increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Panax Ginseng (root Extract) + Abciximab interactionSpirulinaAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, spirulina blue-green algae might increase the risk of bleeding if used with other anticoagulant or antiplatelet drugs.
Read the full Spirulina + Abciximab interactionDietary FiberOral Drugs Minor
Interaction Summary
Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Read the full Dietary Fiber + Abciximab interactionAbemaciclibVerzenio
How Abemaciclib interacts with Hawaiian Spirulina Natural Vanilla Protein Shake — through 3 ingredients. Tap an ingredient for the detail:
Panax Ginseng (root Extract)Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, Panax ginseng might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full Panax Ginseng (root Extract) + Abemaciclib interactionDietary FiberOral Drugs Minor
Interaction Summary
Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Read the full Dietary Fiber + Abemaciclib interactionRhodiola Rosea (root Extract)Cytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, rhodiola might increase levels of drugs metabolized by CYP3A4.
Read the full Rhodiola Rosea (root Extract) + Abemaciclib interactionAbiraterone
How Abiraterone interacts with Hawaiian Spirulina Natural Vanilla Protein Shake — through 4 ingredients. Tap an ingredient for the detail:
Panax Ginseng (root Extract)Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, Panax ginseng might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full Panax Ginseng (root Extract) + Abiraterone interactionVitamin AHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking high doses of vitamin A in combination with other potentially hepatotoxic drugs might increase the risk of liver disease.
Read the full Vitamin A + Abiraterone interactionDietary FiberOral Drugs Minor
Interaction Summary
Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Read the full Dietary Fiber + Abiraterone interactionRhodiola Rosea (root Extract)Cytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, rhodiola might increase levels of drugs metabolized by CYP3A4.
Read the full Rhodiola Rosea (root Extract) + Abiraterone interactionAbiraterone AcetateYonsa, Zytiga
How Abiraterone Acetate interacts with Hawaiian Spirulina Natural Vanilla Protein Shake — through 4 ingredients. Tap an ingredient for the detail:
Vitamin AHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking high doses of vitamin A in combination with other potentially hepatotoxic drugs might increase the risk of liver disease.
Read the full Vitamin A + Abiraterone Acetate interactionPanax Ginseng (root Extract)Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, Panax ginseng might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full Panax Ginseng (root Extract) + Abiraterone Acetate interactionRhodiola Rosea (root Extract)Cytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, rhodiola might increase levels of drugs metabolized by CYP3A4.
Read the full Rhodiola Rosea (root Extract) + Abiraterone Acetate interactionDietary FiberOral Drugs Minor
Interaction Summary
Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Read the full Dietary Fiber + Abiraterone Acetate interactionAbrocitinibCibinqo
How Abrocitinib interacts with Hawaiian Spirulina Natural Vanilla Protein Shake — through 5 ingredients. Tap an ingredient for the detail:
Rhodiola Rosea (root Extract)Cytochrome P450 2c9 (cyp2c9) Substrates, Immunosuppressants Moderate
Interaction Summary
Theoretically, rhodiola might increase levels of drugs metabolized by CYP2C9.
Read the full Rhodiola Rosea (root Extract) + Abrocitinib interactionSpirulinaAnticoagulant/antiplatelet Drugs, Immunosuppressants Moderate
Interaction Summary
Theoretically, spirulina blue-green algae might increase the risk of bleeding if used with other anticoagulant or antiplatelet drugs.
Read the full Spirulina + Abrocitinib interactionPanax Ginseng (root Extract)Anticoagulant/antiplatelet Drugs, Immunosuppressants Moderate
Interaction Summary
Although Panax ginseng has shown antiplatelet effects in the laboratory, it is unlikely to increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Panax Ginseng (root Extract) + Abrocitinib interactionAlfalfa ProteinImmunosuppressants Moderate
Interaction Summary
Theoretically, alfalfa might decrease the efficacy of immunosuppressive therapy.
Read the full Alfalfa Protein + Abrocitinib interactionDietary FiberOral Drugs Minor
Interaction Summary
Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Read the full Dietary Fiber + Abrocitinib interactionAcalabrutinibCalquence
How Acalabrutinib interacts with Hawaiian Spirulina Natural Vanilla Protein Shake — through 3 ingredients. Tap an ingredient for the detail:
Panax Ginseng (root Extract)Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, Panax ginseng might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full Panax Ginseng (root Extract) + Acalabrutinib interactionRhodiola Rosea (root Extract)Cytochrome P450 3a4 (cyp3a4) Substrates, P-glycoprotein Substrates Moderate
Interaction Summary
Theoretically, rhodiola might increase levels of drugs metabolized by CYP3A4.
Read the full Rhodiola Rosea (root Extract) + Acalabrutinib interactionDietary FiberOral Drugs Minor
Interaction Summary
Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Read the full Dietary Fiber + Acalabrutinib interactionAcarboseGlucobay, Prandase, Precose
How Acarbose interacts with Hawaiian Spirulina Natural Vanilla Protein Shake — through 6 ingredients. Tap an ingredient for the detail:
Rhodiola Rosea (root Extract)Antidiabetes Drugs Moderate
Interaction Summary
Theoretically, taking rhodiola with antidiabetes drugs might increase the risk of hypoglycemia.
Read the full Rhodiola Rosea (root Extract) + Acarbose interactionPanax Ginseng (root Extract)Antidiabetes Drugs Moderate
Interaction Summary
Theoretically, taking Panax ginseng with antidiabetes drugs might increase the risk of hypoglycemia.
Read the full Panax Ginseng (root Extract) + Acarbose interactionSpirulinaAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, taking blue-green algae with antidiabetes drugs might increase the risk of hypoglycemia.
Read the full Spirulina + Acarbose interactionVitamin AHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking high doses of vitamin A in combination with other potentially hepatotoxic drugs might increase the risk of liver disease.
Read the full Vitamin A + Acarbose interactionAlfalfa ProteinAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, alfalfa might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Read the full Alfalfa Protein + Acarbose interactionDietary FiberOral Drugs Minor
Interaction Summary
Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Read the full Dietary Fiber + Acarbose interactionAcebutololRhotral, Sectral
How Acebutolol interacts with Hawaiian Spirulina Natural Vanilla Protein Shake — through 4 ingredients. Tap an ingredient for the detail:
SodiumAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, a high intake of dietary sodium might reduce the effectiveness of antihypertensive drugs.
Read the full Sodium + Acebutolol interactionRhodiola Rosea (root Extract)Antihypertensive Drugs Moderate
Interaction Summary
Theoretically, taking rhodiola with antihypertensive drugs might increase the risk of hypotension.
Read the full Rhodiola Rosea (root Extract) + Acebutolol interactionVitamin AHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking high doses of vitamin A in combination with other potentially hepatotoxic drugs might increase the risk of liver disease.
Read the full Vitamin A + Acebutolol interactionDietary FiberOral Drugs Minor
Interaction Summary
Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Read the full Dietary Fiber + Acebutolol interactionAcenocoumarolSintrom
How Acenocoumarol interacts with Hawaiian Spirulina Natural Vanilla Protein Shake — through 3 ingredients. Tap an ingredient for the detail:
Panax Ginseng (root Extract)Anticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Although Panax ginseng has shown antiplatelet effects in the laboratory, it is unlikely to increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Panax Ginseng (root Extract) + Acenocoumarol interactionSpirulinaAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, spirulina blue-green algae might increase the risk of bleeding if used with other anticoagulant or antiplatelet drugs.
Read the full Spirulina + Acenocoumarol interactionDietary FiberOral Drugs Minor
Interaction Summary
Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Read the full Dietary Fiber + Acenocoumarol interactionAcepromazineAtravet
How Acepromazine interacts with Hawaiian Spirulina Natural Vanilla Protein Shake — through 3 ingredients. Tap an ingredient for the detail:
Alfalfa ProteinPhotosensitizing Drugs Moderate
Interaction Summary
Theoretically, concomitant use of alfalfa with photosensitizing drugs might have additive effects.
Read the full Alfalfa Protein + Acepromazine interactionDietary FiberOral Drugs Minor
Interaction Summary
Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Read the full Dietary Fiber + Acepromazine interactionRhodiola Rosea (root Extract)Cns Depressants Minor
Interaction Summary
Theoretically, rhodiola might increase the risk of adverse effects when taken with CNS depressants.
Read the full Rhodiola Rosea (root Extract) + Acepromazine interactionAcetaminophenChildren's Tylenol, Children's Tylenol Meltaways, Tylenol, Tylenol Ex Strength
How Acetaminophen interacts with Hawaiian Spirulina Natural Vanilla Protein Shake — through 3 ingredients. Tap an ingredient for the detail:
Vitamin AHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking high doses of vitamin A in combination with other potentially hepatotoxic drugs might increase the risk of liver disease.
Read the full Vitamin A + Acetaminophen interactionRhodiola Rosea (root Extract)Cytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, rhodiola might increase levels of drugs metabolized by CYP1A2.
Read the full Rhodiola Rosea (root Extract) + Acetaminophen interactionDietary FiberOral Drugs Minor
Interaction Summary
Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Read the full Dietary Fiber + Acetaminophen interactionAcetaminophen, AspirinGemnisyn
How Acetaminophen, Aspirin interacts with Hawaiian Spirulina Natural Vanilla Protein Shake — through 5 ingredients. Tap an ingredient for the detail:
Panax Ginseng (root Extract)Anticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Although Panax ginseng has shown antiplatelet effects in the laboratory, it is unlikely to increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Panax Ginseng (root Extract) + Acetaminophen, Aspirin interactionSpirulinaAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, spirulina blue-green algae might increase the risk of bleeding if used with other anticoagulant or antiplatelet drugs.
Read the full Spirulina + Acetaminophen, Aspirin interactionVitamin AHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking high doses of vitamin A in combination with other potentially hepatotoxic drugs might increase the risk of liver disease.
Read the full Vitamin A + Acetaminophen, Aspirin interactionDietary FiberOral Drugs Minor
Interaction Summary
Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Read the full Dietary Fiber + Acetaminophen, Aspirin interactionRhodiola Rosea (root Extract)Cytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, rhodiola might increase levels of drugs metabolized by CYP1A2.
Read the full Rhodiola Rosea (root Extract) + Acetaminophen, Aspirin interactionAcetaminophen, Aspirin, CaffeineExcedrin, Excedrin Extra Strength, Excedrin Migraine
How Acetaminophen, Aspirin, Caffeine interacts with Hawaiian Spirulina Natural Vanilla Protein Shake — through 5 ingredients. Tap an ingredient for the detail:
Panax Ginseng (root Extract)Cytochrome P450 3a4 (cyp3a4) Substrates, Anticoagulant/antiplatelet Drugs +2 Moderate
Interaction Summary
Theoretically, Panax ginseng might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full Panax Ginseng (root Extract) + Acetaminophen, Aspirin, Caffeine interactionVitamin AHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking high doses of vitamin A in combination with other potentially hepatotoxic drugs might increase the risk of liver disease.
Read the full Vitamin A + Acetaminophen, Aspirin, Caffeine interactionSpirulinaAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, spirulina blue-green algae might increase the risk of bleeding if used with other anticoagulant or antiplatelet drugs.
Read the full Spirulina + Acetaminophen, Aspirin, Caffeine interactionDietary FiberOral Drugs Minor
Interaction Summary
Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Read the full Dietary Fiber + Acetaminophen, Aspirin, Caffeine interactionRhodiola Rosea (root Extract)Cytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, rhodiola might increase levels of drugs metabolized by CYP1A2.
Read the full Rhodiola Rosea (root Extract) + Acetaminophen, Aspirin, Caffeine interactionAcetaminophen, Brompheniramine, PhenylpropanolamineDimetapp Cold and Flu
How Acetaminophen, Brompheniramine, Phenylpropanolamine interacts with Hawaiian Spirulina Natural Vanilla Protein Shake — through 5 ingredients. Tap an ingredient for the detail:
Alfalfa ProteinPhotosensitizing Drugs Moderate
Interaction Summary
Theoretically, concomitant use of alfalfa with photosensitizing drugs might have additive effects.
Read the full Alfalfa Protein + Acetaminophen, Brompheniramine, Phenylpropanolamine interactionVitamin AHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking high doses of vitamin A in combination with other potentially hepatotoxic drugs might increase the risk of liver disease.
Read the full Vitamin A + Acetaminophen, Brompheniramine, Phenylpropanolamine interactionPanax Ginseng (root Extract)Stimulant Drugs Moderate
Interaction Summary
Theoretically, taking Panax ginseng with stimulant drugs might increase the risk of adverse stimulant effects.
Read the full Panax Ginseng (root Extract) + Acetaminophen, Brompheniramine, Phenylpropanolamine interactionDietary FiberOral Drugs Minor
Interaction Summary
Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Read the full Dietary Fiber + Acetaminophen, Brompheniramine, Phenylpropanolamine interactionRhodiola Rosea (root Extract)Cytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, rhodiola might increase levels of drugs metabolized by CYP1A2.
Read the full Rhodiola Rosea (root Extract) + Acetaminophen, Brompheniramine, Phenylpropanolamine interactionAcetaminophen, ButalbitalAxocet, Bancap, Bucet, Butex Forte, Esgic CF, Orbivan CF +5 more
How Acetaminophen, Butalbital interacts with Hawaiian Spirulina Natural Vanilla Protein Shake — through 3 ingredients. Tap an ingredient for the detail:
Vitamin AHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking high doses of vitamin A in combination with other potentially hepatotoxic drugs might increase the risk of liver disease.
Read the full Vitamin A + Acetaminophen, Butalbital interactionRhodiola Rosea (root Extract)Cytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, rhodiola might increase levels of drugs metabolized by CYP1A2.
Read the full Rhodiola Rosea (root Extract) + Acetaminophen, Butalbital interactionDietary FiberOral Drugs Minor
Interaction Summary
Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Read the full Dietary Fiber + Acetaminophen, Butalbital interactionEach ingredient & the kinds of drugs it affects
For each ingredient in Hawaiian Spirulina Natural Vanilla Protein Shake with known interactions, here are the types of medications they can affect. Open any type for the detail — or search your exact drug in the checker above.
Dietary Fiber
Carbamazepine (Tegretol)
Theoretically, black psyllium might reduce the effects of carbamazepine and increase the risk for convulsions.
Theoretically, black psyllium might reduce carbamazepine absorption. A preliminary study using blond psyllium reported decreased carbamazepine bioavailability due to binding of the drug to psyllium, as well as reduction of available fluid in the gut for dissolution of the drug. This interaction may also occur with black psyllium.
Lithium
Theoretically, taking black psyllium at the same time as lithium might reduce lithium absorption.
The fiber in black psyllium might reduce lithium absorption and plasma levels. Some case reports describe a reduction in plasma lithium levels with concomitant administration of blond psyllium. This was reversed when psyllium was stopped. This interaction may also occur with black psyllium.
Metformin (Glucophage)
Theoretically, black psyllium might increase the therapeutic and adverse effects of metformin.
Animal research shows that concurrent consumption of blond psyllium with metformin slows and increases the absorption of metformin. This interaction may also occur with black psyllium. To avoid changes in absorption, take psyllium 30-60 minutes after metformin.
Olanzapine (Zyprexa)
Theoretically, taking black psyllium at the same time as olanzapine might reduce olanzapine absorption.
The fiber in black psyllium might decrease the absorption of olanzapine. A single case report describes a reduction in the effectiveness of olanzapine when it was concomitantly administered with an unspecified type of psyllium 3 grams orally twice daily. This effect was reversed when psyllium was stopped.
Digoxin (Lanoxin)
Theoretically, taking black psyllium at the same time as digoxin might reduce digoxin absorption and decrease digoxin levels.
Psyllium might bind digoxin in the gut. However, some clinical evidence suggests that psyllium does not impact digoxin absorption.
Ethinyl Estradiol
Theoretically, taking black psyllium at the same time as ethinyl estradiol might alter levels of estradiol.
Concurrent use of blond psyllium with ethinyl estradiol results in a slight increase in the extent of ethinyl estradiol absorption and a slower rate of absorption. This is unlikely to be clinically significant.
Oral Drugs
Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Psyllium seems to have variable effects on drug absorption. To avoid changes in absorption, take psyllium 30-60 minutes after oral medications. Animal research shows that blond psyllium delays and increases the absorption of metformin and ethinyl estradiol. Case reports and animal research suggest that blond psyllium might reduce absorption of lithium, digoxin, olanzapine, and carbamazepine. Finally, some pharmacokinetic studies show that psyllium does not affect the absorption of levothyroxine or warfarin. Although many of these studies evaluated blond psyllium, the fiber content in black psyllium may have similar effects.
Rhodiola rosea (root extract)
Antidiabetes Drugs
Theoretically, taking rhodiola with antidiabetes drugs might increase the risk of hypoglycemia.
In vitro and animal research shows that rhodiola extract can decrease blood glucose due to alpha-glucosidase activity.
Antihypertensive Drugs
Theoretically, taking rhodiola with antihypertensive drugs might increase the risk of hypotension.
In vitro and animal research shows that rhodiola extract inhibits angiotensin-converting enzyme (ACE) and might lower blood pressure.
Cytochrome P450 2C9 (Cyp2C9) Substrates
Theoretically, rhodiola might increase levels of drugs metabolized by CYP2C9.
In vitro research shows that rhodiola inhibits CYP2C9. This effect is highly variable and appears to be dependent on the rhodiola product studied. Also, a clinical study in healthy young males found that taking rhodiola extract 290 mg daily for 14 days reduces the metabolism of losartan, a CYP2C9 substrate, by 21% after 4 hours.
Immunosuppressants
Theoretically, rhodiola use might interfere with immunosuppressive therapy.
In vitro and animal research show that rhodiola has immunostimulatory effects.
Losartan (Cozaar)
Rhodiola might increase the levels and adverse effects of losartan.
A clinical study in healthy young males found that taking rhodiola extract 290 mg daily for 14 days reduces the metabolism of losartan, a CYP2C9 substrate, by 21% after 4 hours.
P-Glycoprotein Substrates
Theoretically, rhodiola might increase levels of P-glycoprotein substrates.
In vitro research shows that rhodiola inhibits P-glycoprotein. Theoretically, using rhodiola with P-glycoprotein substrates might increase drug levels and potentially increase the risk of adverse effects.
Antidepressant Drugs
Theoretically, rhodiola might increase the risk of adverse effects when taken with antidepressants.
A review of adverse event reports in Poland identified cases of tachyarrhythmias, myalgia, arthralgia, gum pain, restless leg syndrome, swallowing disorders, and changes in consciousness when rhodiola was taken in combination with paroxetine, escitalopram, fluoxetine, sertraline, trazodone, and/or duloxetine.
Cns Depressants
Theoretically, rhodiola might increase the risk of adverse effects when taken with CNS depressants.
A review of adverse event reports in Poland identified cases of excessive sedation, myoclonus, hypotension, and hallucinations when rhodiola was taken with haloperidol, diazepam, or alprazolam.
Cytochrome P450 1A2 (Cyp1A2) Substrates
Theoretically, rhodiola might increase levels of drugs metabolized by CYP1A2.
In vitro research shows that rhodiola inhibits CYP1A2. This effect is highly variable and appears to be dependent on the rhodiola product studied. However, a clinical study in healthy young males found that taking rhodiola extract 290 mg daily for 14 days does not inhibit the metabolism of caffeine, a CYP1A2 substrate.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, rhodiola might increase levels of drugs metabolized by CYP3A4.
In vitro research shows that rhodiola inhibits CYP3A4. This effect is highly variable and appears to be dependent on the rhodiola product studied. However, a clinical study in healthy young males found that taking rhodiola extract 290 mg daily for 14 days does not inhibit the metabolism of midazolam, a CYP3A4 substrate.
Panax ginseng (root extract)
Anticoagulant/Antiplatelet Drugs
Although Panax ginseng has shown antiplatelet effects in the laboratory, it is unlikely to increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
In vitro evidence suggests that ginsenoside constituents in Panax ginseng might decrease platelet aggregation. However, research in humans suggests that ginseng does not affect platelet aggregation. Animal research indicates low oral bioavailability of Rb1 and rapid elimination of Rg1, which might explain the discrepancy between in vitro and human research. Until more is known, use with caution in patients concurrently taking anticoagulant or antiplatelet drugs.
Antidiabetes Drugs
Theoretically, taking Panax ginseng with antidiabetes drugs might increase the risk of hypoglycemia.
Clinical research suggests that Panax ginseng might decrease blood glucose levels. Monitor blood glucose levels closely.
Caffeine
Theoretically, taking Panax ginseng with caffeine might increase the risk of adverse stimulant effects.
Panax ginseng has been shown to have stimulant effects. Theoretically, caffeine might have an additive effect on the stimulant effects of Panax ginseng.
Cytochrome P450 2D6 (Cyp2D6) Substrates
Theoretically, Panax ginseng might increase levels of drugs metabolized by CYP2D6. However, research is conflicting.
There is some evidence that Panax ginseng can inhibit the CYP2D6 enzyme by approximately 6%. In addition, in animal research, Panax ginseng inhibits the metabolism of dextromethorphan, a drug metabolized by CYP2D6, by a small amount. However, contradictory research suggests Panax ginseng might not inhibit CYP2D6. Until more is known, use Panax ginseng cautiously in patients taking drugs metabolized by these enzymes.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, Panax ginseng might increase or decrease levels of drugs metabolized by CYP3A4.
Panax ginseng may affect the clearance of drugs metabolized by CYP3A4. One such drug is imatinib. Inhibition of CYP3A4 was believed to be responsible for a case of imatinib-induced hepatotoxicity. In contrast, Panax ginseng has been shown to increase the clearance of midazolam, another drug metabolized by CYP3A4. Clinical research shows that Panax ginseng can reduce midazolam area under the curve by 44%, maximum plasma concentration by 26%, and time to reach maximum plasma concentration by 29%. Midazolam metabolism was also increased in animals given Panax ginseng. Until more is known, use Panax ginseng cautiously in combination with CYP3A4 substrates.
Estrogens
Theoretically, concomitant use of large amounts of Panax ginseng might interfere with hormone replacement therapy.
Laboratory research and some case reports suggest that Panax ginseng can have estrogenic effects due to competition for estrogen receptors. The estrogenic activity is attributed to the ginsenoside constituents of Panax ginseng.
Furosemide (Lasix)
Theoretically, Panax ginseng might reduce the effects of furosemide.
There is some concern that Panax ginseng might contribute to furosemide resistance. There is one case of resistance to furosemide diuresis in a patient taking a germanium-containing ginseng product.
Imatinib (Gleevec)
Theoretically, Panax ginseng might increase the effects and adverse effects of imatinib.
A case of imatinib-induced hepatotoxicity has been reported for a 26-year-old male with chronic myelogenous leukemia stabilized on imatinib for 7 years. The patient took imatinib 400 mg along with a Panax ginseng-containing energy drink daily for 3 months. Since imatinib-associated hepatotoxicity typically occurs within 2 years of initiating therapy, it is believed that Panax ginseng affected imatinib toxicity though inhibition of cytochrome P450 3A4. CYP3A4 is the primary enzyme involved in imatinib metabolism.
Immunosuppressants
Theoretically, Panax ginseng use might interfere with immunosuppressive therapy.
Panax ginseng might have immune system stimulating properties.
Insulin
Theoretically, taking Panax ginseng with insulin might increase the risk of hypoglycemia.
Clinical research suggests that Panax ginseng might decrease blood glucose levels. Insulin dose adjustments might be necessary in patients taking Panax ginseng; use with caution.
Midazolam (Versed)
Theoretically, Panax ginseng may increase the clearance of midazolam.
Midazolam is metabolized by cytochrome P450 3A4 (CYP3A4). Clinical research suggests that Panax ginseng can reduce midazolam area under the curve by 44%, maximum plasma concentration by 26%, and time to reach maximum plasma concentration by 29%. Midazolam metabolism was also increased in animals given Panax ginseng.
Monoamine Oxidase Inhibitors (Maois)
Theoretically, Panax ginseng can interfere with MAOI therapy.
Concomitant use of Panax ginseng with phenelzine (Nardil) is associated with insomnia, headache, tremors, and hypomania.
Nifedipine (Procardia)
Theoretically, taking Panax ginseng with nifedipine might increase serum levels of nifedipine and the risk of hypotension.
Preliminary clinical research shows that concomitant use can increase serum levels of nifedipine in healthy volunteers. This might cause the blood pressure lowering effects of nifedipine to be increased when taken concomitantly with Panax ginseng.
Qt Interval-Prolonging Drugs
Theoretically, Panax ginseng has an additive effect with drugs that prolong the QT interval and potentially increase the risk of ventricular arrhythmias. However, research is conflicting.
Clinical research shows that short-term use of Panax ginseng can increase the QT interval. However, no changes in QT interval have been identified with prolonged use.
Raltegravir (Isentress)
Theoretically, taking Panax ginseng with raltegravir might increase the risk of liver toxicity.
A case report suggests that concomitant use of Panax ginseng with raltegravir can increase serum levels of raltegravir, resulting in elevated liver enzymes levels.
Selegiline (Eldepryl)
Theoretically, Panax ginseng might increase or decrease levels of selegiline, possibly altering the effects and side effects of selegiline.
Animal research shows that taking selegiline with a low dose of Panax ginseng extract (1 gram/kg) reduces selegiline bioavailability, while taking a high dose of Panax ginseng extract (3 grams/kg) increases selegiline bioavailability. More research is needed to confirm these effects.
Stimulant Drugs
Theoretically, taking Panax ginseng with stimulant drugs might increase the risk of adverse stimulant effects.
Panax ginseng has been shown to have stimulant effects.
Warfarin (Coumadin)
Panax ginseng might affect the clearance of warfarin. However, this interaction appears to be unlikely.
There has been a single case report of decreased effectiveness of warfarin in a patient who also took Panax ginseng. However, it is questionable whether Panax ginseng was the cause of this decrease in warfarin effectiveness. Some research in humans and animals suggests that Panax ginseng does not affect the pharmacokinetics of warfarin. However, other research in humans suggests that Panax ginseng might modestly increase the clearance of the S-warfarin isomer. More evidence is needed to determine whether Panax ginseng causes a significant interaction with warfarin.
Fexofenadine (Allegra)
Theoretically, Panax ginseng might decrease blood levels of oral or intravenous fexofenadine.
Animal research suggests that taking Panax ginseng in combination with oral or intravenous fexofenadine may reduce the bioavailability of fexofenadine. Some scientists have attributed this effect to the ability of Panax ginseng to increase the expression of P-glycoprotein.
Lopinavir/Ritonavir (Kaletra)
Although Panax ginseng has demonstrated variable effects on cytochrome P450 3A4 (CYP3A4), which metabolizes lopinavir, Panax ginseng is unlikely to alter levels of lopinavir/ritonavir.
Lopinavir is metabolized by CYP3A4 and is administered with the CYP3A4 inhibitor ritonavir to increase its plasma concentrations. Panax ginseng has shown variable effects on CYP3A4 activity in humans. However, taking Panax ginseng (Vitamer Laboratories) 500 mg twice daily for 14 days did not alter the pharmacokinetics of lopinavir/ritonavir in 12 healthy volunteers.
Alfalfa Protein
Warfarin (Coumadin)
Theoretically, alfalfa might reduce the anticoagulant activity of warfarin.
Alfalfa contains a large amount of vitamin K. This could theoretically interfere with the activity of warfarin.
Antidiabetes Drugs
Theoretically, alfalfa might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Animal research suggests that alfalfa decreases blood sugar in diabetic mice. Also, in one case report, a diabetic patient experienced hypoglycemia after consuming alfalfa extract. Monitor blood glucose levels closely. Dose adjustments might be necessary.
Contraceptive Drugs
Theoretically, alfalfa might interfere with the activity of contraceptive drugs.
Alfalfa contains coumestrol, a phytoestrogen, and isoflavonoids, which have estrogenic effects.
Estrogens
Theoretically, alfalfa might interfere with hormone therapy.
Alfalfa contains coumestrol, a phytoestrogen, and isoflavonoids, which have estrogenic effects.
Immunosuppressants
Theoretically, alfalfa might decrease the efficacy of immunosuppressive therapy.
In vitro research and human case reports suggest that alfalfa may have immunostimulant effects.
Photosensitizing Drugs
Theoretically, concomitant use of alfalfa with photosensitizing drugs might have additive effects.
Animal research suggests that excessive doses of alfalfa may increase photosensitivity, possibly due to its chlorophyll content. It is unclear if this effect would be clinically relevant in humans.
Vitamin A
Retinoids
Concomitant use of retinoids with vitamin A supplements might produce supratherapeutic vitamin A levels.
Retinoids, which are vitamin A derivatives, could have additive toxic effects when taken with vitamin A supplements.
Hepatotoxic Drugs
Theoretically, taking high doses of vitamin A in combination with other potentially hepatotoxic drugs might increase the risk of liver disease.
The tolerable upper intake level (UL) is the highest level of intake that is likely to pose no risk of adverse effects. Doses of vitamin A above the UL can cause hepatotoxicity, ranging from elevated liver enzymes to liver failure.
Tetracycline Antibiotics
Theoretically, taking tetracycline antibiotics with high doses of vitamin A can increase the risk of pseudotumor cerebri.
Benign intracranial hypertension (pseudotumor cerebri) can occur with tetracyclines and with acute or chronic vitamin A toxicity. Case reports suggest that taking tetracyclines and vitamin A concurrently can increase the risk of this condition. Avoid high doses of vitamin A in people taking tetracyclines chronically.
Warfarin (Coumadin)
Theoretically, high doses of vitamin A could increase the risk of bleeding with warfarin.
Vitamin A toxicity is associated with hemorrhage and hypoprothrombinemia, possibly due to vitamin K antagonism. Advise patients taking warfarin to avoid doses of vitamin A above the tolerable upper intake level of 10,000 IU/day for adults.
Spirulina
Anticoagulant/Antiplatelet Drugs
Theoretically, spirulina blue-green algae might increase the risk of bleeding if used with other anticoagulant or antiplatelet drugs. However, this is unlikely.
Spirulina blue-green algae have shown antiplatelet and anticoagulant effects in vitro. However, one preliminary study in 24 patients receiving spirulina blue-green algae 2.3 grams daily for 2 weeks showed no effect on platelet activation or measures of clotting time.
Antidiabetes Drugs
Theoretically, taking blue-green algae with antidiabetes drugs might increase the risk of hypoglycemia.
Human research shows that spirulina blue-green algae can have hypoglycemic effects in patients with diabetes, at least some of whom were using antidiabetes drugs. However, blue-green algae does not seem to improve glycated hemoglobin (HbA1c) levels in patients with diabetes. A meta-analysis of animal studies also suggests that spirulina blue-green algae have hypoglycemic effects.
Immunosuppressants
Theoretically, concurrent use of blue-green algae might interfere with immunosuppressive therapy.
Blue-green algae have been shown to stimulate the immune system.
Sodium
Antihypertensive Drugs
Theoretically, a high intake of dietary sodium might reduce the effectiveness of antihypertensive drugs.
High intake of dietary sodium can increase systolic and diastolic blood pressure. Also, high intake of sodium may necessitate increased use of antihypertensive medications to achieve blood pressure control in some patients, such as those with chronic kidney disease.
Corticosteroids
Concomitant use of mineralocorticoids and some glucocorticoids with sodium supplements might increase the risk of hypernatremia.
Mineralocorticoids and some glucocorticoids (corticosteroids) cause sodium retention. This effect is dose-related and depends on mineralocorticoid potency. It is most common with hydrocortisone, cortisone, and fludrocortisone, followed by prednisone and prednisolone.
Didanosine (Videx)
Concomitant use of didanosine with additional sodium from dietary or supplemental sources may increase the risk of hypernatremia.
Didanosine formulations contain a significant amount of sodium.
Lithium
Altering dietary intake of sodium might alter the levels and clinical effects of lithium.
High sodium intake can reduce plasma concentrations of lithium by increasing lithium excretion. Reducing sodium intake can significantly increase plasma concentrations of lithium and cause lithium toxicity in patients being treated with lithium carbonate. Stabilizing sodium intake is shown to reduce the percentage of patients with lithium level fluctuations above 0.8 mEq/L. Patients taking lithium should avoid significant alterations in their dietary intake of sodium.
Sodium Phosphates
Theoretically, concomitant use of sodium phosphate with sodium supplements might increase the risk of hypernatremia.
Use of high doses (> 45 mL in 24 hours) of sodium phosphate, such as those used for bowel cleansing before surgery, can lead to serious electrolyte disturbances, including hypernatremia. The risk of hypernatremia is highest in the elderly and people with other risk factors for electrolyte disturbances.
Sodium-Containing Drugs
Concomitant use of sodium-containing drugs with additional sodium from dietary or supplemental sources may increase the risk of hypernatremia and long-term sodium-related complications.
The Chronic Disease Risk Reduction (CDRR) intake level of 2.3 grams of sodium daily indicates the intake at which it is believed that chronic disease risk increases for the apparently healthy population. Some medications contain high quantities of sodium. When used in conjunction with sodium supplements or high-sodium diets, the CDRR may be exceeded. Additionally, concomitant use may increase the risk for hypernatremia; this risk is highest in the elderly and people with other risk factors for electrolyte disturbances.
Tolvaptan (Samsca)
Theoretically, concomitant use of tolvaptan with sodium might increase the risk of hypernatremia.
Tolvaptan is a vasopressin receptor 2 antagonist that is used to increase sodium levels in patients with hyponatremia. Patients taking tolvaptan should use caution with the use of sodium salts such as sodium chloride.
Iron
Bictegravir/Emtricitabine/Tenofovir Alafenamide (Biktarvy)
Iron might decrease levels of bictegravir/emtricitabine/tenofovir alafenamide by reducing its absorption when taken in a fasting state.
Advise patients that bictegravir/emtricitabine/tenofovir alafenamide and iron can be taken together if taken with food. However, if taken on an empty stomach, bictegravir/emtricitabine/tenofovir alafenamide should not be taken with, or 2 hours after, iron containing products.
Bisphosphonates
Iron reduces the absorption of bisphosphonates.
Advise patients that doses of bisphosphonates should be separated by at least two hours from doses of all other medications, including supplements such as iron. Divalent cations, including iron, can decrease absorption of bisphosphonates by forming insoluble complexes in the gastrointestinal tract.
Denosumab (Prolia, Others)
Administration of intravenous iron within one month of denosumab administration might increase the risk of severe hypophosphatemia and hypocalcemia.
A case of severe hypocalcemia (albumin corrected calcium 6.88 mg/dL, ionized calcium 3.68 mg/dL) and hypophosphatemia (<0.5 mg/dL) with respiratory acidosis, QT interval prolongation, and nonsustained ventricular tachycardia was reported in a 76-year-old male who had received an iron polymaltose infusion within 2 weeks of a subcutaneous injection of denosumab. Serum parathyroid hormone was also elevated (348 pg/mL). Subsequent iron infusions with iron polymaltose and ferric carboxymaltose were followed by transient hypophosphatemia, but without hypocalcemia. Additionally, a literature review describes 6 additional cases of hypophosphatemia and hypocalcemia in patients 52-92 years of age who had been administered intravenous iron as either ferric carboxymaltose or iron polymaltose and subcutaneous denosumab within 1-4 weeks of each other.
Dolutegravir (Tivicay)
Iron might decrease dolutegravir levels by reducing its absorption.
Advise patients to take dolutegravir at least 2 hours before or 6 hours after taking iron. Pharmacokinetic research shows that iron can decrease the absorption of dolutegravir from the gastrointestinal tract through chelation. When taken under fasting conditions, a single dose of ferrous fumarate 324 mg orally along with dolutegravir 50 mg reduces overall exposure to dolutegravir by 54%.
Integrase Inhibitors
Theoretically, taking iron along with integrase inhibitors might decrease the levels and clinical effects of these drugs.
Iron is a divalent cation. There is concern that iron may decrease the absorption of integrase inhibitors from the gastrointestinal tract through chelation. One pharmacokinetic study shows that iron can decrease blood levels of the specific integrase inhibitor dolutegravir through chelation. Also, other pharmacokinetic research shows that other divalent cations such as calcium can decrease the absorption and levels of some integrase inhibitors through chelation.
Levodopa
Iron might decrease levodopa levels by reducing its absorption.
Advise patients to separate doses of levodopa and iron as much as possible. There is some evidence in healthy people that iron forms chelates with levodopa, reducing the amount of levodopa absorbed by around 50%. The clinical significance of this hasn't been determined.
Levothyroxine (Synthroid, Others)
Iron might decrease levothyroxine levels by reducing its absorption.
Advise patients to separate levothyroxine and iron doses by at least 2 hours. Iron can decrease the absorption and efficacy of levothyroxine by forming insoluble complexes in the gastrointestinal tract.
Methyldopa (Aldomet)
Iron might decrease methyldopa levels by reducing its absorption.
Advise patients to separate methyldopa and iron doses by at least 2 hours. Iron can decrease the absorption of methyldopa from the gastrointestinal tract through chelation, resulting in increases in blood pressure.
Mycophenolate Mofetil (Cellcept)
Theoretically, iron might decrease mycophenolate mofetil levels by reducing its absorption.
Advise patients to take iron 4-6 hours before, or 2 hours after, mycophenolate mofetil. It has been suggested that a decrease of absorption is possible, probably by forming nonabsorbable chelates. However, mycophenolate pharmacokinetics are not affected by iron supplementation in available clinical research.
Penicillamine (Cuprimine, Depen)
Iron might decrease penicillamine levels by reducing its absorption.
Advise patients to separate penicillamine and iron doses by at least 2 hours. Oral iron supplements can reduce absorption of penicillamine by 30% to 70%, probably due to chelate formation. In people with Wilson's disease, this interaction has led to reduced efficacy of penicillamine.
Quinolone Antibiotics
Iron might decrease levels of quinolone antibiotics by reducing their absorption.
Advise patients to separate quinolone antibiotics and iron doses by at least 2 hours. Iron decreases the absorption of quinolones due to formation of insoluble complexes in the gastrointestinal tract.
Tetracycline Antibiotics
Iron might decrease levels of tetracycline antibiotics by reducing their absorption.
Advise patients to take iron at least 2 hours before or 4 hours after tetracycline antibiotics. Concomitant use can decrease absorption of tetracycline antibiotics from the gastrointestinal tract by 50% to 90%.
Chloramphenicol
Theoretically, taking chloramphenicol with iron might reduce the response to iron therapy in iron deficiency anemia.
Chloramphenicol interferes with erythrocyte maturation. However, since chloramphenicol isn't usually taken for prolonged periods, this isn't likely to be clinically significant.
Brown Rice Protein
Ace Inhibitors (Aceis)
In laboratory research, hydrolyzed rice protein inhibits angiotensin-converting enzyme (ACE). In animal research, the inhibition of ACE is correlated with a reduction in systolic blood pressure. So far, this effect has not been shown in humans. Theoretically, concomitant use of rice protein and ACE inhibitors may increase the risk of blood pressure becoming too low. Use with caution. ACE inhibitors include benazepril (Lotensin), captopril (Capoten), enalapril (Vasotec), fosinopril (Monopril), lisinopril (Prinivil, Zestril), moexipril (Univasc), perindopril (Aceon), quinapril (Accupril), ramipril (Altace), and trandolapril (Mavik).
Vitamin B12
Metformin (Glucophage)
Metformin, a common medication used to manage type 2 diabetes, has been associated with lower vitamin B12 levels in some individuals. Prolonged use of metformin can interfere with the absorption of B12 in the digestive system, potentially leading to a deficiency in this essential vitamin.
Vitamin K
Warfarin (Coumadin)
Vitamin K can antagonize and reverse the therapeutic effects of warfarin.
Vitamin K antagonizes the effects of warfarin. Excessive vitamin K intake, either from supplements or from changes in the diet, can reduce the anticoagulant effect of warfarin.
Brand information
Manufacturer and brand details for Hawaiian Spirulina Natural Vanilla Protein Shake, from the product label.
Nutrex Hawaii
See all Nutrex Hawaii products- Name
- Nutrex Hawaii Inc.
- City
- Kailuna-Kona
- State
- HI
- ZipCode
- 96740
- Phone Number
- (800) 453-1187
- Web Address
- www.nutrex-hawaii.com
Hawaiian Spirulina Natural Vanilla Protein Shake by Nutrex Hawaii: Common Questions
Does Hawaiian Spirulina Natural Vanilla Protein Shake by Nutrex Hawaii interact with any medications?
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Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
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Label information is sourced from the NIH Dietary Supplement Label Database and reflects the product version on file; always read your actual product label. This page is for education only and is not a substitute for professional medical advice. Confirm with your pharmacist or doctor before combining supplements and medications.
The Full Monographs Behind Hawaiian Spirulina Natural Vanilla Protein Shake’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Black Psyllium
Interacts with 2,025 drugsBlack psyllium is a soluble-fiber supplement made from the seeds of a Plantago plant, used mostly to ease constipation and support digestive health. It is best known and most studied for rel...
Read the full Black Psyllium monograph → Herb & supplement monographSodium
Interacts with 205 drugsSodium is an essential mineral and electrolyte your body needs to balance fluids, support nerves, and help muscles work. Most people in modern diets get more than enough—often too much—from...
Read the full Sodium monograph → Herb & supplement monographIron
Interacts with 80 drugsIron is an essential mineral your body needs to make hemoglobin and carry oxygen in the blood. Supplements are mainly useful for treating or preventing iron deficiency and iron-deficiency an...
Read the full Iron monograph → Herb & supplement monographVitamin A
Interacts with 387 drugsVitamin A is an essential nutrient important for vision, skin, immune function, and growth. Most people get enough from a balanced diet, and supplements are mainly useful for correcting a tr...
Read the full Vitamin A monograph → Herb & supplement monographVitamin B12
Interacts with 20 drugsVitamin B12 (cobalamin) is an essential nutrient your body needs to make red blood cells, keep nerves healthy, and support DNA. Supplements are very helpful for people who are deficient — su...
Read the full Vitamin B12 monograph → Herb & supplement monographVitamin K
Interacts with 2 drugsVitamin K is an essential nutrient your body needs for normal blood clotting and to support healthy bones. Most people get enough from food, but supplements are sometimes used for deficiency...
Read the full Vitamin K monograph → Herb & supplement monographRice Protein
Interacts with 23 drugsRice protein is a plant-based protein powder made from rice that offers an easy way to add protein to your diet, especially if you avoid dairy or animal products. It is generally considered...
Read the full Rice Protein monograph → Herb & supplement monographPea Protein
Pea protein is a plant-based protein powder made from yellow split peas, commonly used by people who want a dairy-free or vegan source of protein to support muscle and overall protein intake...
Read the full Pea Protein monograph → Herb & supplement monographAlfalfa
Interacts with 583 drugsAlfalfa is a nutrient-rich legume that people use for high cholesterol, menopause symptoms, and general wellness, but solid human evidence for most of these uses is limited. It is best avoid...
Read the full Alfalfa monograph → Herb & supplement monographBlue-green Algae
Interacts with 327 drugsBlue-green algae are nutrient-rich aquatic microorganisms (such as spirulina and Klamath Lake algae) taken as a supplement for energy, nutrition, and general wellness. Evidence for most heal...
Read the full Blue-green Algae monograph → Herb & supplement monographRhodiola
Interacts with 1,271 drugsRhodiola is an herb traditionally used to fight fatigue and help the body cope with stress. Some small studies suggest it may modestly reduce fatigue and improve mood, but the evidence is li...
Read the full Rhodiola monograph → Herb & supplement monographPanax Ginseng
Interacts with 1,130 drugsPanax ginseng is a popular traditional herb used to boost energy, ease stress, and support overall wellness, though scientific evidence is mixed and mostly preliminary. It is generally well...
Read the full Panax Ginseng monograph →Sources & How We Checked
Hawaiian Spirulina Natural Vanilla Protein Shake'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 340 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
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- Covington TR, et al. Handbook of Nonprescription Drugs. 11th ed. Washington, DC: American Pharmaceutical Association, 1996.
- Etman M. Effect of a bulk forming laxative on the bioavailablility of carbamazepine in man. Drug Dev Ind Pharm 1995;21:1901-6.
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- Lantner RR, Espiritu BR, Zumerchik P, Tobin MC. Anaphylaxis following ingestion of a psyllium-containing cereal. JAMA 1990;264:2534-6. DOI
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- Robinson DS, Benjamin DM, McCormack JJ. Interaction of warfarin and nonsystemic gastrointestinal drugs. Clin Pharmacol Ther 1971;12:491-5. PubMed
- Garcia JJ, Fernandez N, Diez MJ, et al. Influence of two dietary fibers in the oral bioavailability and other pharmacokinetic parameters of ethinyloestradiol. Contraception 2000;62:253-7. PubMed
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- Code of Federal Regulations, Title 21 (21CFR 101.17). Food labeling warning, notice, and safe handling statements. Available at www.ecfr.gov/cgi-bin/text-idx?SID=20f647d3b74161501f46564b915b4048&mc=true&node=se21.2.101_117&rgn=div8. Accessed December 3, 2
- Code of Federal Regulations, Title 21 (21CFR 201.319). Specific labeling requirements - water-soluble gums, hydrophilic gums, and hydrophilic mucilloids. Available at www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?fr=201.319. Accessed Dece
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- 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
Sodium 38 references
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- Food and Drug Administration Science Background: Safety of Sodium Phosphates Oral Solution. September 17, 2001. Available at: http://www.fda.gov/cder/drug/safety/sodiumphospate.htm
- Coton T, Mallaret C, Coilliot C, Carre D, Guisset M. Severe acute ulcerated gastritis induced by salt. Presse Med 2009;38(3):499-500. PubMed
- Frings-Meuthen P, Buehlmeier J, Baecker N, et al. High sodium chloride intake exacerbates immobilization-induced bone resorption and protein losses. J Appl Physiol 2011;111(2):537-542. PubMed
- Frings-Meuthen P, Baecker N, Heer M. Low-grade metabolic acidosis may be the cause of sodium chloride-induced exaggerated bone resorption. J Bone Miner Res 2008;23(4):517-524. PubMed
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- Food and Nutrition Board, Institute of Medicine. Dietary reference intakes for water, potassium, sodium, chloride, and sulfate. Washington, DC: National Academy Press, 2005. Available at: http://www.nap.edu/openbook.php?record_id=10925. DOI
- D'Elia L, Rossi G, Ippolito R, Cappuccio FP, Strazzullo P. Habitual salt intake and risk of gastric cancer: a meta-analysis of prospective studies. Clin Nutr 2012;31(4):489-98. PubMed
- Goldsmith SR. Hyponatremia in heart failure: time for a trial. J Card Fail 2013;19(6):398-400. PubMed
- Willocks L, Brettle R, Keen J, Valentine C, Pinching AJ. Formulations of didanosine (ddI) and salt overload. Lancet 1992;339(8786):190.
- Chen L, Zhang Z, Chen W, Whelton PK, Appel LJ. Lower Sodium Intake and Risk of Headaches: Results From the Trial of Nonpharmacologic Interventions in the Elderly. Am J Public Health. 2016;106(7):1270-5. PubMed
- Cook NR, Appel LJ, Whelton PK. Lower levels of sodium intake and reduced cardiovascular risk. Circulation. 2014;129(9):981-9. PubMed
- Cook NR, Appel LJ, Whelton PK. Sodium Intake and All-Cause Mortality Over 20 Years in the Trials of Hypertension Prevention. J Am Coll Cardiol. 2016;68(15):1609-1617. PubMed
- Mente A, O'Donnell M, Rangarajan S, et al. Associations of urinary sodium excretion with cardiovascular events in individuals with and without hypertension: a pooled analysis of data from four studies. Lancet. 2016;388(10043):465-75. PubMed
- Moosavian SP, Haghighatdoost F, Surkan PJ, Azadbakht L. Salt and obesity: a systematic review and meta-analysis of observational studies. Int J Food Sci Nutr. 2017;68(3):265-277. PubMed
- O'Donnell M, Mente A, Rangarajan S, et al. Urinary sodium and potassium excretion, mortality, and cardiovascular events. N Engl J Med. 2014;371(7):612-23. DOI
- Poggio R, Gutierrez L, Matta MG, Elorriaga N, Irazola V, Rubinstein A. Daily sodium consumption and CVD mortality in the general population: systematic review and meta-analysis of prospective studies. Public Health Nutr. 2015;18(4):695-704. PubMed
- 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
- Mahtani KR, Heneghan C, Onakpoya I, et al. Reduced Salt Intake for Heart Failure: A Systematic Review. JAMA Intern Med. 2018 Dec 1;178(12):1693-1700. PubMed
- Yancy CW. Sodium Restriction in Heart Failure: Too Much Uncertainty-Do the Trials. JAMA Intern Med. 2018 Dec 1;178(12):1700-1701. PubMed
- He FJ, Campbell NRC, Ma Y, MacGregor GA, Cogswell ME, Cook NR. Errors in estimating usual sodium intake by the Kawasaki formula alter its relationship with mortality: implications for public health. Int J Epidemiol. 2018;47(6):1784-1795. PubMed
- Murthy K, Ondrey GJ, Malkani N, et al. THE EFFECTS OF HYPONATREMIA ON BONE DENSITY AND FRACTURES: A SYSTEMATIC REVIEW AND META-ANALYSIS. Endocr Pract. 2019;25(4):366-378. PubMed
- Messerli FH, Hofstetter L, Syrogiannouli L, et al. Sodium intake, life expectancy, and all-cause mortality. Eur Heart J 2021;42(21):2103-2112. PubMed
- Graudal NA, Hubeck-Graudal T, Jurgens G. Effects of low sodium diet versus high sodium diet on blood pressure, renin, aldosterone, catecholamines, cholesterol, and triglyceride. Cochrane Database Syst Rev 2020;12(12):CD004022. PubMed
- Giatti S, Santos RB, Aielo AN, et al. Association of sodium with obstructive sleep apnea. The ELSA-Brasil study. Ann Am Thorac Soc 2021;18(3):502-510. PubMed
- Nan X, Lu H, Wu J, et al. The interactive association between sodium intake, alcohol consumption and hypertension among elderly in northern China: a cross-sectional study. BMC Geriatr 2021;21(1):135. PubMed
- Kyozuka H, Fukusda T, Murata T, et al. Impact of preconception sodium intake on hypertensive disorders of pregnancy: The Japan Environment and Children's study. Pregnancy Hypertens 2021;23:66-72. PubMed
- Zhao L, Ogden CL, Yang Q, et al. Association of usual sodium intake with obesity among US children and adolescents, NHANES 2009-2016. Obesity (Silver Spring) 2021;29(3):587-594. PubMed
- Ma Y, He FJ, Sun Q, et al. 24-Hour urinary sodium and potassium excretion and cardiovascular risk. N Engl J Med 2022;386(3):252-263. PubMed
- Liu J, Yang X, Zhang P, et al. Association of urinary sodium excretion and left ventricular hypertrophy in people with type 2 diabetes mellitus: A cross-sectional study. Front Endocrinol (Lausanne) 2021;12:728493. PubMed
- Filippini T, Malavolti M, Whelton PK, Vinceti M. Sodium intake and risk of hypertension: A systematic review and dose-response meta-analysis of observational cohort studies. Curr Hypertens Rep 2022;24(5):133-144. PubMed
- Wang DD, Li Y, Nguyen XT, et al. Dietary sodium and potassium intake and risk of non-fatal cardiovascular diseases: The million veteran program. Nutrients 2022;14(5):1121. PubMed
- Kwak JH, Park CH, Eun CS, et al. The associations of dietary intake of high sodium and low zinc with gastric cancer mortality: A prospective cohort study in Korea. Nutr Cancer 2022;74(10):3501-3508. PubMed
- George S, Maiti R, Mishra BR, Jena M, Mohapatra D. Effect of regulated add-on sodium chloride intake on stabilization of serum lithium concentration in bipolar disorder: A randomized controlled trial. Bipolar Disord 2023;25(1):66-75. PubMed
- Zhou TL, Schütten MTJ, Kroon AA, et al. Urinary Sodium Excretion and Salt Intake Are Not Associated With Blood Pressure Variability in a White General Population. J Am Heart Assoc 2023;12(1):e026578. PubMed
Iron 72 references
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- Bruner AB, Joffe A, Duggan AK, et al. Randomized study of cognitive effects of iron supplementation in non- anaemic iron-deficient adolescent girls. Lancet 1996;348:992-6.
- Ullen H, Augustsson K, Gustavsson C, Steineck G. Supplementary iron intake and risk of cancer: reversed causality? Cancer Lett 1997;114:215-6.
- Reunanen A, Takkunen H, Knekt P, et al. Body iron stores, dietary iron intake and coronary heart disease mortality. J Intern Med 1995;238:223-30. PubMed
- Lund EK, Wharf SG, Fairweather-Tait SJ, Johnson IT. Oral ferrous sulfate supplements increase the free radical-generating capacity of feces from healthy volunteers. Am J Clin Nutr 1999;69:250-5.
- Rehman A, Collis CS, Yang M, et al. The effects of iron and vitamin C co-supplementation on oxidative damage to DNA in healthy volunteers. Biochem Biophys Res Comm 1998;246:293-8. PubMed
- Klipstein-Grobusch K, Grobbee DE, den Breeijen JH, et al. Dietary iron and risk of myocardial infarction in the Rotterdam Study. Am J Epidemiol 1999;149:421-8. PubMed
- Hansten PD, Horn JR. Drug Interactions Analysis and Management. Vancouver, WA: Applied Therapeutics Inc., 1997 and updates.
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DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.
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