Major interaction on record — check this product against your medications before combining. Based on 9 of 12 ingredients. Check your meds →
Dietary supplement

Hydrate Pineapple Coconut Ingredients & Drug Interactions

by Beeline Wellness

Hydrate Pineapple Coconut label
See full label image
Powder Category: Other Combinations
Most serious interaction: Major
Clinical methodology reviewed by · Updated Sep 16, 2026 · Label data from the NIH DSLD
What is this page for?

First and foremost: checking Hydrate Pineapple Coconut against your medications. The heart of this page is the interaction checker and the full interaction report — how this product’s ingredients may interact with prescription and over-the-counter medicines you may be taking.

Around that, we add a pharmacist’s high-level view of the product as a whole — what’s inside, the evidence for its stated use, how transparent the label is, and what safety data exists — so you can see the full picture in one place. It’s educational information from our licensed clinical databases and the clinical staff at HelloPharmacist — not medical advice — and we don’t sell or endorse products. Our editorial policy

The interaction bottom line Most serious interaction: Major

Hydrate Pineapple Coconut is a dietary supplement by Beeline Wellness with 12 active ingredients. Its ingredients are commonly taken for bone health and osteoporosis prevention, dietary calcium deficiency, heartburn relief (calcium carbonate antacids).Based on those ingredients, 2,097 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are Marshmallow, Slippery Elm, Aloe Vera. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

Jump to a section

Check Your Meds Against Hydrate Pineapple Coconut by Beeline Wellness

Ask about any prescription or over-the-counter medication and we check it for interactions with Hydrate Pineapple Coconut by Beeline Wellness — and tell you which ingredient is responsible.

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HelloPharmacist Scorecard of Hydrate Pineapple Coconut by Beeline Wellness

Our pharmacy team’s full take, with four database checks built into the cards below — a summary of what is known, not a grade of the product itself.

From our pharmacy team — supplement deep dive

Generated from HelloPharmacist’s pharmacist-curated databases and editorial rules · Last generated Aug 6, 2026

What’s inside

Low disclosure
Ingredient Transparency · database check
Low

Most active ingredients don't disclose an individual amount — you can't tell how much of each you're getting.

Why this rating?
  • The label discloses an exact amount for 4 of its 11 active ingredients.
  • “Keto-friendly Oil Complex” is a proprietary blend — the label gives one combined amount (2,850 mg) without saying how much of each component you get.
  • “Herbal Juice Concentrate” is listed as a grouped ingredient — the label gives one combined amount (150 mg) without saying how much of each component you get.
  • “Oral Care Flora Assist” is listed as a grouped ingredient — the label gives one combined amount (20 mg) without saying how much of each component you get.

Hydrate Pineapple Coconut is a powder with 11 active ingredients. The mineral base includes calcium, sodium, and potassium—electrolytes important for hydration and nerve function.

The oil component draws from sunflower, coconut, and avocado oils, which provide fat-soluble nutrients and support for cholesterol and heart health. Supporting ingredients are slippery elm and marshmallow (both traditional mucilage-rich herbs), plus aloe vera, known for digestive and skin applications.

The product also includes three blended ingredient groups—a Saliva Support Blend, Keto-friendly Oil Complex, and Herbal Juice Concentrate—along with BLIS K12, a specific strain of beneficial bacteria. Inactive ingredients (xylitol, natural flavors, silica, guar gum, stevia, and monk fruit extract) act as sweeteners, thickeners, and flow agents in the powder.

Does it work?

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

The graded evidence we hold for these ingredients covers different conditions than the ones this product is marketed for, so there's no established rating for its stated use.

Why this rating?
  • The label markets this product for: saliva production and oral health support.
  • We looked for evidence on: Burning mouth syndrome, Canker sores, Dental plaque, Dry mouth, Gingivitis, oral mucositis — and 3 related terms.
  • The closest evidence on file: Sunflower Oil is rated "Insufficient Reliable Evidence To Rate" for Dry mouth (Natural Medicines).
  • Also on file: Sunflower Oil is rated "Insufficient Reliable Evidence To Rate" for Gingivitis.
  • Also on file: Aloe is rated "Insufficient Reliable Evidence To Rate" for Dental plaque, Dry mouth, Gingivitis, Oral mucositis, and more.

Calcium in this product is effective for kidney failure, dyspepsia (indigestion), low calcium levels, high potassium, and osteoporosis (and likely effective for bone health). Sunflower oil and avocado oil show possibly effective evidence for high cholesterol and heart disease.

Aloe vera is possibly effective for acne, obesity, diabetes, psoriasis, burns, and constipation. The other active ingredients—slippery elm, marshmallow, coconut oil, sodium, and potassium—do not have established effectiveness in our data; slippery elm and marshmallow show insufficient evidence for the conditions they're traditionally used for, coconut oil shows insufficient evidence for diabetes and cholesterol, and we hold no effectiveness ratings for sodium or potassium as standalone supplement agents.

The herbal blends and BLIS K12 strain lack effectiveness data in our records.

The evidence, ingredient by ingredient Calcium Sodium Potassium Sunflower Oil Coconut Avocado Slippery Elm Marshmallow

How safe is it?

Well-documented data
Safety Information · database check
Well characterized

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

Why this rating?
  • We hold adverse-effect (side-effect) data for 8 of the 9 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 9 of 9.
  • General safety write-ups exist for 9 of 9.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

Calcium is generally well tolerated at recommended doses but can cause belching, constipation, diarrhea, and stomach upset; high doses carry rare concerns about kidney stones. Some evidence suggests very high calcium intake (over 1,500–2,000 mg/day) may be linked to increased prostate cancer risk and cardiovascular concerns, though research is mixed.

Calcium is likely safe in pregnancy and lactation when kept within recommended amounts. Sunflower oil is generally safe in normal food amounts; concentrated supplements warrant discussion with your doctor.

Slippery elm and marshmallow are generally well tolerated short-term but have limited safety data; neither has reliable pregnancy or breastfeeding data—marshmallow is best avoided in pregnancy and lactation. Coconut oil can trigger allergic reactions ranging from hives to anaphylaxis in sensitive individuals.

Avocado oil is widely used as food and generally well tolerated but carries rare risk of a severe food reaction (acute FPIES with vomiting and diarrhea) and cross-reactivity in those with latex allergy; its safety as a concentrated supplement in pregnancy and lactation is unknown. Aloe vera (especially the latex form) is generally well tolerated topically but carries significant risk with oral use—aloe latex can cause severe diarrhea, potassium loss, and long-term complications; it is possibly unsafe in pregnancy and lactation.

Sodium is essential but too much increases blood pressure and heart strain; the safety data show mixed pregnancy ratings. Potassium from food is safe, but supplements carry risk in those with kidney disease or on certain heart and blood pressure medications; it is likely safe in pregnancy and lactation at dietary levels.

Side effects, ingredient by ingredient Calcium Sodium Potassium Sunflower Oil Coconut Avocado Slippery Elm Marshmallow

Meds to double-check

Major interaction found
Known Interaction Concern · database check
Major identified

At least one ingredient has a documented Major-severity interaction. Check your medications for a personalized result.

Why this rating?
  • 9 of the 9 matched ingredients can interact with medications — Sunflower Oil, Aloe, Marshmallow, Calcium, Potassium, among others.
  • The most serious interaction on file is rated Major.
  • Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs; diabetes medications; heart-rhythm medications; lithium.
  • For scale: 2,098 individual medications appear in the full list. A big number alone doesn't make a product dangerous — what matters is whether YOUR medication is on it, so run yours through the interaction checker on this page.

Check the following medication types before taking this product. Major interactions: HIV integrase inhibitors (dolutegravir, elvitegravir), the antibiotic ceftriaxone (especially IV forms), and the heart medication digoxin.

Moderate interactions: blood pressure and heart drugs (diltiazem, sotalol, ACE inhibitors, ARBs, potassium-sparing diuretics), thyroid hormone (levothyroxine), HIV drugs (raltegravir), blood thinners (warfarin), diabetes medications, lithium, diuretics, laxatives, corticosteroids, and certain other HIV and heart medications. Minor interactions: oral drugs in general (due to slippery elm and marshmallow mucilage) and additional blood thinner and diabetes concerns.

Use the medication checker on this page to verify your prescriptions.

Check your own medication Run your meds through the checker above

The bottom line

Scorecard at a glanceFormula with limited ingredient disclosure with no established evidence rating for its marketed use. Major medication interactions have been identified, and safety information is well characterized.

Hydrate Pineapple Coconut is primarily a hydration and electrolyte powder with established benefit for calcium intake and some supportive evidence for oils in heart and cholesterol health. If you take any prescription medication—especially blood thinners, heart drugs, blood pressure or diabetes medications, HIV antiretrovirals, or thyroid hormones—you need to check your exact drugs against the interaction checker on this page before starting.

Talk with your doctor or pharmacist about whether this product is right for you, particularly if you have kidney disease, are pregnant or breastfeeding, or have a history of allergies to tree nuts or pollen.

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

Assessment coverage: 9 of 11 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Jan 22, 2022.

This Scorecard evaluates available label information, ingredient evidence, and known medication-safety considerations. It does not independently verify product identity, purity, potency, contamination, or manufacturing quality. How these ratings are computed

At a glance

General information

Key facts about Hydrate Pineapple Coconut, straight from the product label.

Brand Beeline Wellness
Net contents 4.33 Ounce(s); 123 Gram(s)
Market status On market
Date entered into DSLD Jan 22, 2022
DSLD ID 264234
Product type Other Combinations
Supplement form Powder
Dietary claims / uses Nutrient, Structure/Function
Intended target group(s) Adult (18 - 50 Years)
From the label
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.

Supplement Facts

The label details for Hydrate Pineapple Coconut by Beeline Wellness, sourced from the NIH Dietary Supplement Label Database.

Supplement Facts

Daily Value (DV) Target Group(s):
Adults and children 4 or more years of age
Minimum serving Sizes:
4.1 Gram(s)
Maximum serving Sizes:
4.1 Gram(s)
Servings per container
30
IngredientAmount% DV
Calories20 Calorie(s)--
Total Carbohydrates1 Gram(s)1%
Cholesterol0 mg--
Calcium25 mg2%
Total Sugars0 Gram(s)--
Total Fat2 Gram(s)3%
Saturated Fat2 Gram(s)10%
Sunflower Oil0 NP--
Slippery Elm0 NP--
Marshmallow0 NP--
added Sugars0 Gram(s)--
Coconut Oil0 NP--
Avocado Oil0 NP--
Calories from Saturated Fat15 Calorie(s)--
Aloe Vera0 NP--
Sodium150 mg6%
Potassium100 mg2%
Saliva Support Blend2.5 Gram(s)--
Keto-friendly Oil Complex2850 mg--
Herbal Juice Concentrate150 mg--
Oral Care Flora Assist20 mg--
BLIS K12 Streptococcus salivarius0 NP--

Other ingredients: Xylitol, Natural Flavors, Silica, Guar Gum, Stevia, Monk Fruit extract

Tap any ingredient to jump to its full detail below.

Label statements
These statements are the manufacturer’s wording, reproduced from the product label — the label is saying it, not HelloPharmacist. We don’t verify or endorse them.
Formulation

Saliva support and oral defense Supports saliva production to ease mouth sores Helps alleviate dry mouth and supports oral health

Made in USA using domestic & international ingredients.

FDA Statement of Identity

Dietary Supplement

Formula

Contains BLIS K12

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.

Precautions

Contains: Milk

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

See for yourself

Hydrate Pineapple Coconut by Beeline Wellness label

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

Hydrate Pineapple Coconut label

Label images are published by the NIH Dietary Supplement Label Database for the version of this product on file. Always read your actual product label.

View the full label (PDF)
What’s inside

The Ingredients in Hydrate Pineapple Coconut by Beeline Wellness

These are the 12 active ingredients this product is made of. Select any to open its full monograph.

Serving size4.1 Gram(s) Dosage formPowder Servings per container30 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.

Calcium

Interacts with
168 drugs
25 mg per serving Form: Calcium Citrate

Calcium is an essential mineral your body needs for strong bones, nerve signaling, and muscle function, and supplements can help fill gaps when diet f...

Calcium monograph & interactions

Calories from Saturated Fat

15 Calorie(s) per serving

Sodium

Interacts with
205 drugs
150 mg per serving Form: Himalayan Pink Salt, Sea Salt, Sodium Citrate

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 & interactions

Potassium

Interacts with
62 drugs
100 mg per serving Form: Dipotassium Phosphate, Potassium Chloride

Potassium is an essential mineral your body needs for nerve signals, muscle function, and a steady heartbeat, and most people get enough from a balanc...

Potassium monograph & interactions

Saliva Support Blend

2.5 Gram(s) per serving

Keto-friendly Oil Complex

2850 mg per serving

Herbal Juice Concentrate

150 mg per serving

Oral Care Flora Assist

20 mg per serving
  • › BLIS K12 Streptococcus salivarius

Other (inactive) ingredients: Xylitol, Natural Flavors, Silica, Guar Gum, Stevia, Monk Fruit extract. These complete the product’s ingredient list but are not active constituents.

Interaction report

Hydrate Pineapple Coconut by Beeline Wellness Drug Interactions

Want to check YOUR meds against Hydrate Pineapple Coconut?

Ask about interactions with your drugs in plain English — “Can I take it with lisinopril?” — and we find you the answer in seconds, ingredient by ingredient.

 Go to the checker
2,097Drugs
8 Major 2,082 Moderate 7 Minor

Ingredients driving the most interactions

Marshmallow 2,040
Slippery Elm 2,022
Aloe Vera 461
Sodium 205
Calcium 168

Individual Drug Interactions

The ingredients in Hydrate Pineapple Coconut interact with 2,097 drugs. Click any drug to see the details.

9 of the 12 ingredients in Hydrate Pineapple Coconut interact with drugs. Each result below shows which ingredient is responsible. Marshmallow Slippery Elm Aloe Vera Sodium Calcium Sunflower Oil Coconut Oil Potassium Avocado Oil

Each ingredient & the kinds of drugs it affects

For each ingredient in Hydrate Pineapple Coconut 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.

Marshmallow3 drug types · 2,040 drugs

Lithium

Theoretically, due to potential diuretic effects, marshmallow might reduce excretion and increase levels of lithium.
Marshmallow is thought to have diuretic properties. To avoid lithium toxicity, the dose of lithium might need to be decreased when used with marshmallow.

Likelihood Probable Evidence D
Anticoagulant/Antiplatelet Drugs

Theoretically, marshmallow flower might have antiplatelet effects.
Animal research suggests that marshmallow flower extract has antiplatelet effects. However, the root and leaf of marshmallow, not the flower, are the plant parts most commonly found in dietary supplements. Theoretically, use of marshmallow flower with anticoagulant/antiplatelet drugs can have additive effects, and might increase the risk for bleeding in some patients.

Likelihood Unlikely Evidence D
Oral Drugs

Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Marshmallow contains mucilage which can affect oral drug absorption. To avoid changes in absorption, take marshmallow 30-60 minutes after oral medications.

Likelihood Possible Evidence D
Marshmallow full monograph & interactions

Slippery Elm1 drug type · 2,022 drugs

Oral Drugs

Theoretically, slippery elm may slow the absorption and reduce serum levels of oral drugs.
Slippery elm inner bark contains mucilage, which may interfere with the absorption of orally administered drugs.

Likelihood Possible Evidence D
Slippery Elm full monograph & interactions

Aloe Vera7 drug types · 461 drugs

Digoxin (Lanoxin)

Theoretically, aloe latex might increase the risk of adverse effects when taken with cardiac glycosides.
Overuse of aloe latex can increase the risk of adverse effects from cardiac glycoside drugs, such as digoxin, due to potassium depletion. Overuse of aloe, along with cardiac glycoside drugs, can increase the risk of toxicity.

Likelihood Probable Evidence D
Anticoagulant/Antiplatelet Drugs

Theoretically, aloe gel might increase the risk of bleeding when taken with anticoagulant or antiplatelet drugs.
In vitro research shows that aloe gel can inhibit platelet aggregation. This inhibition was greater than that seen with celecoxib, but less than that seen with aspirin.

Likelihood Possible Evidence D
Antidiabetes Drugs

Aloe might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Preliminary clinical research suggests aloe gel might lower blood glucose levels and have additive effects when used with antidiabetes drugs. Monitor blood glucose levels closely.

Likelihood Possible Evidence D
Diuretic Drugs

Theoretically, aloe latex might increase the risk of hypokalemia when taken with diuretic drugs.
Overuse of aloe latex might compound diuretic-induced potassium loss, increasing the risk of hypokalemia.

Likelihood Possible Evidence D
Stimulant Laxatives

Theoretically, aloe latex might increase the risk for fluid and electrolyte loss when taken with stimulant laxatives.
Due to cathartic laxative effects of aloe latex, concomitant use with other stimulant laxatives might compound fluid and electrolyte loss.

Likelihood Possible Evidence D
Warfarin (Coumadin)

Theoretically, aloe latex might increase the risk of bleeding when taken with warfarin.
Aloe latex has stimulant laxative effects. In some people aloe latex can cause diarrhea. Diarrhea can increase the effects of warfarin, increase international normalized ratio (INR), and increase the risk of bleeding. Advise patients who take warfarin not to take excessive amounts of aloe vera.

Likelihood Possible Evidence D
Cytochrome P450 1A2 (Cyp1A2) Substrates

Theoretically, aloe might decrease the levels and clinical effects of CYP1A2 substrates.
In vitro research shows that aloe extract induces CYP1A2 enzymes.

Likelihood Possible Evidence D
Aloe Vera full monograph & interactions

Sodium7 drug types · 205 drugs

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.

Likelihood Probable Evidence A
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.

Likelihood Possible Evidence D
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.

Likelihood Probable Evidence C
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.

Likelihood Probable Evidence B
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.

Likelihood Possible Evidence D
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.

Likelihood Possible Evidence D
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.

Likelihood Probable Evidence C
Sodium full monograph & interactions

Calcium18 drug types · 168 drugs

Ceftriaxone (Rocephin)

Co-administration of intravenous calcium and ceftriaxone can result in precipitation of a ceftriaxone-calcium salt in the lungs and kidneys.
Avoid administering intravenous calcium in any form, such as parenteral nutrition or Lactated Ringers, within 48 hours of intravenous ceftriaxone. Case reports in neonates show that administering intravenous ceftriaxone and calcium can result in precipitation of a ceftriaxone-calcium salt in the lungs and kidneys. In several cases, neonates have died as a result of this interaction. So far there are no reports in adults; however, there is still concern that this interaction might occur in adults.

Likelihood Probable Evidence D
Dolutegravir (Tivicay)

Calcium seems to reduce levels of dolutegravir.
Advise patients to take dolutegravir either 2 hours before or 6 hours after taking calcium supplements. Pharmacokinetic research suggests that taking calcium carbonate 1200 mg concomitantly with dolutegravir 50 mg reduces plasma levels of dolutegravir by almost 40%. Calcium appears to decrease levels of dolutegravir through chelation.

Likelihood Probable Evidence B
Elvitegravir (Vitekta)

Calcium seems to reduce levels of elvitegravir.
Advise patients to take elvitegravir either 2 hours before or 2 hours after taking calcium supplements. Pharmacokinetic research suggests that taking calcium along with elvitegravir can reduce blood levels of elvitegravir through chelation.

Likelihood Probable Evidence B
Aluminum

Calcium citrate might increase aluminum absorption and toxicity. Other types of calcium do not increase aluminum absorption.
Calcium citrate can increase the absorption of aluminum when taken with aluminum hydroxide. The increase in aluminum levels may become toxic, particularly in individuals with kidney disease. However, the effect of calcium citrate on aluminum absorption is due to the citrate anion rather than calcium cation. Calcium acetate does not appear to increase aluminum absorption.

Likelihood Possible Evidence B
Bictegravir/Emtricitabine/Tenofovir Alafenamide (Biktarvy)

Calcium might decrease levels of bictegravir/emtricitabine/tenofovir alafenamide by reducing its absorption when taken in a fasting state.
Advise patients that bictegravir/emtricitabine/tenofovir alafenamide and calcium can be taken together if taken with food. However, if taken on an empty stomach, bictegravir/emtricitabine/tenofovir alafenamide should not be taken with, or 2 hours after, calcium containing products.

Likelihood Probable Evidence D
Bisphosphonates

Calcium reduces the absorption of bisphosphonates.
Advise patients to take bisphosphonates at least 30 minutes before calcium, but preferably at a different time of day. Calcium supplements decrease absorption of bisphosphonates.

Likelihood Probable Evidence C
Calcipotriene (Dovonex)

Taking calcipotriene with calcium might increase the risk for hypercalcemia.
Calcipotriene is a vitamin D analog used topically for psoriasis. It can be absorbed in sufficient amounts to cause systemic effects, including hypercalcemia. Theoretically, combining calcipotriene with calcium supplements might increase the risk of hypercalcemia.

Likelihood Possible Evidence B
Digoxin (Lanoxin)

Using intravenous calcium with digoxin might increase the risk of fatal cardiac arrhythmias.
Hypercalcemia increases the risk of fatal cardiac arrhythmias with digoxin. However, one retrospective analysis of clinical data suggests that intravenous calcium does not increase the risk of dysrhythmias or mortality in patients receiving digoxin.

Likelihood Possible Evidence B
Diltiazem (Cardizem, Others)

Theoretically, calcium may reduce the therapeutic effects of diltiazem.
Hypercalcemia can reduce the effectiveness of verapamil in atrial fibrillation. Theoretically, calcium might increase this risk of hypercalcemia and reduce the effectiveness of diltiazem.

Likelihood Probable Evidence D
Levothyroxine (Synthroid, Others)

Calcium seems to reduce the absorption and effectiveness of levothyroxine.
Advise patients to take levothyroxine and calcium supplements at least 4 hours apart. Calcium reduces levothyroxine absorption, probably by forming insoluble complexes. Calcium carbonate supplements reduce effectiveness of levothyroxine in patients with hypothyroidism.

Likelihood Probable Evidence B
Lithium

Theoretically, concomitant use of calcium and lithium may increase this risk of hypercalcemia.
Clinical research suggests that long-term use of lithium may cause hypercalcemia in 10% to 60% of patients. Theoretically, concomitant use of lithium and calcium supplements may further increase this risk.

Likelihood Possible Evidence B
Quinolone Antibiotics

Calcium seems to reduce the absorption of quinolone antibiotics.
Advise patients to take oral quinolones at least 2 hours before or 4-6 hours after calcium supplements or calcium-fortified foods. Taking calcium at the same time as oral quinolones can reduce quinolone absorption. Calcium binds to quinolones in the gut.

Likelihood Probable Evidence B
Raltegravir (Isentress)

Calcium may reduce levels of raltegravir.
Pharmacokinetic research shows that taking a single dose of calcium carbonate 3000 mg along with raltegravir 400 mg twice daily modestly decreases the mean area under the curve of raltegravir, but the decrease does not necessitate a dose adjustment of raltegravir. However, a case of elevated HIV-1 RNA levels and documented resistance to raltegravir has been reported for a patient taking calcium carbonate 1 gram three times daily plus vitamin D3 (cholecalciferol) 400 IU three times daily in combination with raltegravir 400 mg twice daily for 11 months. It is thought that calcium reduced raltegravir levels by chelation, leading to treatment failure.

Likelihood Possible Evidence B
Sotalol (Betapace)

Calcium seems to reduce the absorption of sotalol.
Advise patients to separate doses by at least 2 hours before or 4-6 hours after calcium. Calcium appears to reduce the absorption of sotalol, probably by forming insoluble complexes.

Likelihood Possible Evidence B
Tetracycline Antibiotics

Calcium seems to reduce the absorption of tetracycline antibiotics.
Advise patients to take oral tetracyclines at least 2 hours before, or 4-6 hours after calcium supplements. Taking calcium at the same time as oral tetracyclines can reduce tetracycline absorption. Calcium binds to tetracyclines in the gut.

Likelihood Probable Evidence C
Thiazide Diuretics

Taking calcium along with thiazides might increase the risk of hypercalcemia and renal failure.
Thiazides reduce calcium excretion by the kidneys. Using thiazides along with moderately large amounts of calcium carbonate increases the risk of milk-alkali syndrome (hypercalcemia, metabolic alkalosis, renal failure). Patients may need to have their serum calcium levels and/or parathyroid function monitored regularly.

Likelihood Probable Evidence C
Verapamil (Calan, Others)

Theoretically, calcium may reduce the therapeutic effects of verapamil.
Hypercalcemia can reduce the effectiveness of verapamil in atrial fibrillation. Theoretically, use of calcium supplements may increase this risk of hypercalcemia and reduce the effectiveness of verapamil.

Likelihood Probable Evidence D
Calcium Channel Blockers

Intravenous calcium may decrease the effects of calcium channel blockers; oral calcium is unlikely to have this effect.
Intravenous calcium is used to decrease the effects of calcium channel blockers in the management of overdose. Intravenous calcium gluconate has been used before intravenous verapamil (Isoptin) to prevent or reduce the hypotensive effects without affecting the antiarrhythmic effects. But there is no evidence that dietary or supplemental calcium when taken orally interacts with calcium channel blockers.

Likelihood Unlikely Evidence D
Calcium full monograph & interactions

Sunflower Oil1 drug type · 86 drugs

Antidiabetes Drugs

Theoretically, sunflower oil might decrease the effectiveness of antidiabetes medications.
A diet using sunflower oil as a fat source can cause increased fasting blood glucose levels in patients with type 2 diabetes. Dose adjustments to diabetes medications might be necessary.

Likelihood Possible Evidence B
Sunflower Oil full monograph & interactions

Coconut Oil1 drug type · 86 drugs

Antidiabetes Drugs

Theoretically, taking coconut with antidiabetes drugs might increase the risk of hypoglycemia.
Animal research suggests that coconut milk might increase insulin levels and/or decrease blood glucose levels.

Likelihood Unlikely Evidence D
Coconut Oil full monograph & interactions

Potassium3 drug types · 62 drugs

Ace Inhibitors (Aceis)

Using ACEIs with high doses of potassium increases the risk of hyperkalemia.
ACEIs block the actions of the renin-angiotensin-aldosterone system and reduce potassium excretion. Concomitant use of these drugs with potassium supplements increases the risk of hyperkalemia. However, concomitant use of these drugs with moderate dietary potassium intake (about 3775-5200 mg daily) does not increase serum potassium levels.

Likelihood Likely Evidence C
Angiotensin Receptor Blockers (Arbs)

Using ARBs with high doses of potassium increases the risk of hyperkalemia.
ARBs block the actions of the renin-angiotensin-aldosterone system and reduce potassium excretion. Concomitant use of these drugs with potassium supplements increases the risk of hyperkalemia. However, concomitant use of these drugs with moderate dietary potassium intake (about 3775-5200 mg daily) does not increase serum potassium levels.

Likelihood Likely Evidence C
Potassium-Sparing Diuretics

Concomitant use increases the risk of hyperkalemia.
Using potassium-sparing diuretics with potassium supplements increases the risk of hyperkalemia.

Likelihood Likely Evidence C
Potassium full monograph & interactions

Avocado Oil1 drug type · 2 drugs

Warfarin (Coumadin)

Avocado may antagonize the anticoagulant effects of warfarin.
Avocado may antagonize the anticoagulant effects of warfarin; however, there has been only one case report of this interaction.

Likelihood Unlikely Evidence D
Avocado Oil full monograph & interactions
The maker

Brand information

Manufacturer and brand details for Hydrate Pineapple Coconut, from the product label.

Beeline Wellness

See all Beeline Wellness products
Name
Spring Hill Therapeutics LLC
Pharmacist Counseling Corner

Hydrate Pineapple Coconut by Beeline Wellness: Common Questions

Does Hydrate Pineapple Coconut by Beeline Wellness interact with any medications?
Yes. Based on its ingredients, Hydrate Pineapple Coconut has a known interaction with 2,097 medications, including 8 rated major. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Hydrate Pineapple Coconut contains 12 active ingredients, and an interaction can come from any of them. We check every ingredient, combine the results into one list per medication, and show which ingredient and mechanism is responsible.
Where does this information come from?
The product label data comes from the NIH Dietary Supplement Label Database (DSLD); the interaction data is built on the Natural Medicines database and reviewed by HelloPharmacist pharmacists.
Can I take this if I'm on levothyroxine for my thyroid?
Calcium in this product can reduce how much thyroid hormone your body absorbs, making it less effective. If you take levothyroxine, separate it from this product by at least 4 hours. Check with your doctor or pharmacist to confirm the timing works for your schedule.
Does this contain any common allergens?
Coconut oil in this product can cause allergic reactions—from hives to severe anaphylaxis—in people sensitive to coconut or pollen. Sunflower oil can trigger reactions in people allergic to ragweed and related plants in the Asteraceae family. If you have known plant or tree nut allergies, mention them to your doctor or pharmacist before using this product.
Will this help with my blood sugar if I'm diabetic?
Aloe vera and coconut oil are possibly effective for diabetes in our data, but sunflower oil may actually increase fasting blood glucose and reduce how well your diabetes medications work. Because this product contains ingredients that pull in opposite directions on blood sugar, talk with your doctor before starting—you may need dose adjustments to your medications.
Is this safe to use while I'm breastfeeding?
Calcium, sunflower oil, and potassium are likely safe at typical amounts. However, slippery elm and marshmallow have insufficient breastfeeding safety data, aloe vera is possibly unsafe while breastfeeding, and avocado oil's safety as a concentrated supplement during breastfeeding is unknown. Talk with your doctor or pharmacist about whether this product is right for you during breastfeeding.
What does the aloe vera in this do?
Aloe vera is possibly effective for acne, obesity, diabetes, psoriasis, burns, and constipation. However, oral aloe—especially the latex form—can cause serious side effects including abdominal pain, diarrhea, and potassium loss, particularly with long-term use. It also interacts with heart and blood-thinning medications.
Is potassium safe in this product if I take a blood pressure medication?
Potassium from food is generally safe, but this is a supplemental product. Many blood pressure and heart medications (ACE inhibitors, ARBs, potassium-sparing diuretics) already raise potassium levels in your body. Taking additional potassium can push levels too high and cause dangerous heart rhythms. Check with your doctor or pharmacist before using this product.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Not sure if Hydrate Pineapple Coconut is safe with your meds?

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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.

Hydrate Pineapple Coconut label
Go deeper

The Full Monographs Behind Hydrate Pineapple Coconut’s Ingredients

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

Herb & supplement monograph

Calcium

Interacts with 168 drugs

Calcium is an essential mineral your body needs for strong bones, nerve signaling, and muscle function, and supplements can help fill gaps when diet falls short. Most people do best getting...

Read the full Calcium monograph → Herb & supplement monograph

Sodium

Interacts with 205 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 get more than enough—often too much—from...

Read the full Sodium monograph → Herb & supplement monograph

Potassium

Interacts with 62 drugs

Potassium is an essential mineral your body needs for nerve signals, muscle function, and a steady heartbeat, and most people get enough from a balanced diet rich in fruits and vegetables. P...

Read the full Potassium monograph → Herb & supplement monograph

Sunflower Oil

Interacts with 86 drugs

Sunflower oil is a common edible vegetable oil rich in unsaturated fats and vitamin E that most people can use safely as part of a normal diet. As a food it is generally regarded as safe, an...

Read the full Sunflower Oil monograph → Herb & supplement monograph

Coconut

Interacts with 86 drugs

Coconut is a nutritious tropical food enjoyed as oil, water, milk, and flesh, and it is generally safe to eat in normal food amounts. While some uses (like skin moisturizing and hydration) h...

Read the full Coconut monograph → Herb & supplement monograph

Avocado

Interacts with 2 drugs

Avocado is a nutritious fruit rich in healthy monounsaturated fats, fiber, and potassium, and eating it as part of a balanced diet may support heart health. A specific extract called avocado...

Read the full Avocado monograph → Herb & supplement monograph

Slippery Elm

Interacts with 2,022 drugs

Slippery elm is a traditional herbal remedy made from the inner bark of a North American elm tree, used mainly to soothe sore throats and irritated digestive tracts. Its mucilage can coat an...

Read the full Slippery Elm monograph → Herb & supplement monograph

Marshmallow

Interacts with 2,040 drugs

Marshmallow root is a traditional herb rich in soothing, gel-like fibers called mucilage, which is why it has long been used for coughs, sore throats, and stomach irritation. Evidence for th...

Read the full Marshmallow monograph → Herb & supplement monograph

Aloe

Interacts with 461 drugs

Aloe vera gel is widely used on the skin for minor burns and irritation, and some research suggests it may help. Aloe latex (the yellow part) is a strong laxative that can cause cramping and...

Read the full Aloe monograph →
Sources

Sources & How We Checked

Hydrate Pineapple Coconut's label data comes from the NIH Dietary Supplement Label Database; the ingredient interaction data is from the Natural Medicines database, reviewed by our pharmacists.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

The 183 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.

Calcium 62 references
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  3. Thys-Jacobs S, Ceccarelli S, Bierman A, et al. Calcium supplementation in premenstrual syndrome: a randomized crossover trial. J Gen Intern Med 1989;4:183-9. PubMed
  4. Maton PN, Burton ME. Antacids revisited: a review of their clinical pharmacology and recommended therapeutic use. Drugs 1999;57:855-70.
  5. Clemens JD, Feinstein AR. Calcium carbonate and constipation: a historical review of medical mythopoeia. Gastroenterology 1977;72:957-61. DOI
  6. Saunders D, Sillery J, Chapman R. Effect of calcium carbonate and aluminum hydroxide on human intestinal function. Dig Dis Sci 1988;33:409-13. PubMed
  7. Friedman PA, Bushinsky DA. Diuretic effects on calcium metabolism. Semin Nephrol 1999;19:551-6.
  8. Koo WK, Walters JC, Esterlitz J, et al. Maternal calcium supplementation and fetal bone mineralization. Obstet Gynecol 1999;94:577-82. DOI
  9. Raman L, Rajalakshmi K, Krishnamachari KAVR, et al. Effect of calcium supplementation to undernourished mothers during pregnancy on the bone density of the neonates. Am J Clin Nutr 1978; 31:466-9. DOI
  10. Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
  11. Chan JM, Giovannucci E, Andersson SO, et al. Dairy products, calcium, phosphorous, vitamin D, and risk of prostate cancer. Cancer Causes Control 1998;9:559-66.
  12. Butner LE, Fulco PP, Feldman G, et al. Calcium carbonate-induced hypothyroidism. Ann Intern Med 2000:132:595. PubMed
  13. Schneyer CR. Calcium carbonate and reduction of levothyroxine efficacy. JAMA 1998;279:750. PubMed
  14. Moser LR, Smythe MA, Tisdale JE. The use of calcium salts in the prevention and management of verapamil-induced hypotension. Ann Pharmacother 2000;34:622-9. PubMed
  15. Singh N, Singh PN, Hershman JM. Effect of calcium carbonate on the absorption of levothyroxine. JAMA 2000;283:2822-5. PubMed
  16. Kahela P, Anttila M, Tikkanen R, Sundquist H. Effect of food, food constituents and fluid volume on the bioavailability of sotalol. Acta Pharmacol Toxicol (Copenh) 1979;44:7-12.. PubMed
  17. Pletz MW, Petzold P, Allen A, et al. Effect of calcium carbonate on bioavailability of orally administered gemifloxacin. Antimicrob Agents Chemother 2003;47:2158-60.. PubMed
  18. Bar-Or D, Yoel G. Calcium and calciferol antagonize effect of verapamil in atrial fibrillation. Br Med J 1981;282:1585-6.
  19. Decktor DL, Robinson M, Maton PN, et al. Effects of aluminum/magnesium hydroxide and calcium carbonate on esophageal and gastric pH in subjects with heartburn. Am J Ther 1995;2:546-52. PubMed
  20. Simoneau G. Absence of rebound effect with calcium carbonate. Eur J Drug Metab Pharmacokinet 1996;21:351-7. PubMed
  21. Peters ML, Leonard M, Licata AA. Role of alendronate and risedronate in preventing and treating osteoporosis. Cleve Clin J Med 2001;68:945-51. PubMed
  22. Bourke JF, Mumford R, Whittaker P, et al. The effects of topical calcipotriol on systemic calcium homeostasis in patients with chronic plaque psoriasis. J Am Acad Dermatol 1997;37:929-34.
  23. Gueguen L, Pointillart A. The bioavailability of dietary calcium. J Am Coll Nutr 2000;19:119s-136s. PubMed
  24. Vella A, Gerber TC, Hayes DL, Reeder GS. Digoxin, hypercalcaemia, and cardiac conduction. Postgrad Med J 1999;75:554-6. PubMed
  25. Bania TC, Blaufeux B, Hughes S, et al. Calcium and digoxin vs. calcium alone for severe verapamil toxicity. Acad Emerg Med 2000;7:1089-96. PubMed
  26. Tseng M, Breslow RA, Graubard BI, Ziegler RG. Dairy, calcium, and vitamin D intakes and prostate cancer risk in the National Health and Nutrition Examination Epidemiologic Follow-up Study cohort. Am J Clin Nutr 2005;81:1147-54. PubMed
  27. Weingarten MA, Zalmanovici A, Yaphe J. Dietary calcium supplementation for preventing colorectal cancer and adenomatous polyps. Cochrane Database Syst Rev 2004;(1):CD003548. PubMed
  28. Tavani A, Bertuccio P, Bosetti C, et al. Dietary intake of calcium, vitamin D, phosphorus and the risk of prostate cancer. Eur Urol 2005;48:27-33. PubMed
  29. Giovannucci E, Liu Y, Stampfer MJ, Willett WC. A prospective study of calcium intake and incident and fatal prostate cancer. Cancer Epidemiol Biomarkers Prev 2006;15:203-10. PubMed
  30. Rocephin (ceftriaxone) and calcium interaction. Pharmacist's Letter / Prescriber's Letter 2007;23(10):231005.
  31. Bolland MJ, Barber PA, Doughty RN, et al. Vascular events in healthy older women receiving calcium supplementation: randomised control trial. BMJ 2008;336:262-6.
  32. Bolland MJ, Avenell A, Baron JA, et al. Effect of calcium supplements on risk of myocardial infarction and cardiovascular events: meta-analysis. BMJ 2010;341:c3691. PubMed
  33. Calcium supplementation and vascular events. Pharmacist's Letter / Prescriber's Letter 2008;24(3):240306.
  34. Dietary reference intakes for calcium and vitamin D. Institute of Medicine, November 30, 2010. Available at: http://www.iom.edu/~/media/Files/Report%20Files/2010/Dietary-Reference-Intakes-for-Calcium-and-Vitamin-D/Vitamin%20D%20and%20Calcium%202010%20Repo
  35. Coburn JW, Mischel MG, Goodman WG, et al. Calcium citrate markedly enhances aluminum absorption from aluminum hydroxide. Am J Kidney Dis. 1991;17(6):708-11. PubMed
  36. Bradley JS, Wassel RT, Lee L, et al. Intravenous ceftriaxone and calcium in the neonate: assessing the risk for cardiopulmonary adverse events. Pediatrics. 2009;123(4):e609-13. PubMed
  37. Kays MB, Overholser BR, Mueller BA, et al. Effects of sevelamer hydrochloride and calcium acetate on the oral bioavailability of ciprofloxacin. Am J Kidney Dis. 2003;42(6):1253-9. PubMed
  38. Neuhofel, A. L., Wilton, J. H., Victory, J. M., Hejmanowsk, L. G., and Amsden, G. W. Lack of bioequivalence of ciprofloxacin when administered with calcium-fortified orange juice: a new twist on an old interaction. J Clin Pharmacol. 2002;42(4):461-466. DOI
  39. Dickinson, H. O., Nicolson, D. J., Cook, J. V., Campbell, F., Beyer, F. R., Ford, G. A., and Mason, J. Calcium supplementation for the management of primary hypertension in adults. Cochrane.Database.Syst.Rev. 2006;(2):CD004639. PubMed
  40. Jones, B. J. and Twomey, P. J. Requesting patterns for serum calcium concentration in patients on long-term lithium therapy. Int J Clin Pract. 2009;63(1):170-172. PubMed
  41. Levine, M., Nikkanen, H., and Pallin, D. J. The effects of intravenous calcium in patients with digoxin toxicity. J Emerg.Med. 2011;40(1):41-46. PubMed
  42. Castelo-Branco, C., Ciria-Recasens, M., Cancelo-Hidalgo, M. J., Palacios, S., Haya-Palazuelos, J., Carbonell-Abello, J., Blanch-Rubio, J., Martinez-Zapata, M. J., Manasanch, J., and Perez-Edo, L. Efficacy of ossein-hydroxyapatite complex compared with ca
  43. Li K, Kaaks R, Linseisen J, Rohrmann S. Associations of dietary calcium intake and calcium supplementation with myocardial infarction and stroke risk and overall cardiovascular mortality in the Heidelberg cohort of the European Prospective Investigation i
  44. Chung M, Tang AM, Fu Z. Calcium Intake and Cardiovascular Disease Risk: An Updated Systematic Review and Meta-analysis. Ann Intern Med. 2016 Oct 25. PubMed
  45. Nolan CR, Califano JR, Butzin CA. Influence of calcium acetate or calcium citrate on intestinal aluminum absorption. Kidney Int. 1990;38(5):937-41. PubMed
  46. Lewis JR, Radavelli-Bagatini S, Rejnmark L, et al. The effects of calcium supplementation on verified coronary heart disease hospitalization and death in postmenopausal women: a collaborative meta-analysis of randomized controlled trials. J Bone Miner Res PubMed
  47. Jalloh MA, Gregory PJ, Hein D, et al. Dietary supplement interactions with antiretrovirals: a systematic review. Int J STD AIDS. 2017 Jan;28(1):4-15. PubMed
  48. Lappe J, Watson P, Travers-Gustafson D, Recker R, Garland C, Gorham E, Baggerly K, McDonnell SL. Effect of Vitamin D and Calcium Supplementation on Cancer Incidence in Older Women: A Randomized Clinical Trial. JAMA. 2017 Mar 28;317(12):1234-1243. PubMed
  49. Grove ML, Cook D. Calcium and heart attacks. Doesn't apply to most calcium prescriptions. BMJ. 2010;341:c5003. PubMed
  50. Insentress [package insert]. Whitehouse Station, NJ: Merck Sharp & Dohme Corp.; 2014.
  51. Roberts JL, Kiser JJ, Hindman JT, Meditz AL. Virologic failure with a raltegravir-containing antiretroviral regimen and concomitant calcium administration. Pharmacotherapy 2011;31(10):298e-302e. DOI
  52. Vitekta [package insert]. Foster City, CA: Gilead Sciences, Inc.; 2014.
  53. Storan ER, O'Gorman SM, Murphy A, Laing M. Case Report of Calciphylaxis Secondary to Calcium and Vitamin D<sub>3</sub> Supplementation. J Cutan Med Surg. 2017;21(2):162-163. DOI
  54. Jenkins DJA, Spence JD, Giovannucci EL, et al. Supplemental vitamins and minerals for CVD prevention and treatment. J Am Coll Cardiol 2018;71(22):2570-84. PubMed
  55. Borkenhagen JF, Connor EL, Stafstrom CE. Neonatal hypocalcemic seizures due to excessive maternal calcium ingestion. Pediatr Neurol 2013;48(6):469-71. PubMed
  56. WHO recommendations on antenatal care for a positive pregnancy experience. Geneva: World Health Organization; 2016 (http://www.who.int/reproductivehealth/publications/maternal_perinatal_health/ anc-positive-pregnancy-experience/en/).
  57. Aune D, Navarro Rosenblatt DA, Chan DS, et al. Dairy products, calcium, and prostate cancer risk: a systematic review and meta-analysis of cohort studies. Am J Clin Nutr. 2015;101(1):87-117. PubMed
  58. Lan T, Park Y, Colditz GA, et al. Adolescent dairy product and calcium intake in relation to later prostate cancer risk and mortality in the NIH-AARP Diet and Health Study. Cancer Causes Control. 2020;31(10):891-904. PubMed
  59. Zhang Y, Li Y, Liu J, et al. Association of Vitamin D or Calcium Supplementation with Cardiovascular Outcomes and Mortality: A Meta-Analysis with Trial Sequential Analysis. J Nutr Health Aging 2021;25(2):263-270. PubMed
  60. Myung SK, Kim HB, Lee YJ, Choi YJ, Oh SW. Calcium Supplements and Risk of Cardiovascular Disease: A Meta-Analysis of Clinical Trials. Nutrients 2021;13(2):368. PubMed
  61. Hetaimish B. Neonatal Calcinosis Cutis After Treatment of Hypocalcemia with Calcium Gluconate: A Report of 2 Cases. Am J Case Rep 2024;25:e943397. PubMed
  62. US Food and Drug Administration (FDA). Biktarvy Prescribing Information. October 2024. Available at: https://www.accessdata.fda.gov/drugsatfda_docs/label/2024/210251Orig1s020lbl.pdf. Accessed July 16, 2025.

See these in context on the Calcium monograph →

Sunflower Oil 2 references
  1. Madigan C, Ryan M, Owens D, et al. Dietary unsaturated fatty acids in type 2 diabetes: higher levels of postprandial lipoprotein on a linoleic acid-rich sunflower oil diet compared with an oleic acid-rich olive oil diet. Diabetes Care 2000;23:1472-7. PubMed
  2. An J. Anaphylaxis to sunflower seed with tolerance to sunflower oil: A case report. Medicina (Kaunas) 2021;57(7):661. PubMed

See these in context on the Sunflower Oil monograph →

Slippery Elm 3 references
  1. The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999.
  2. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
  3. Czarnecki D, Nixon R, Bekhor P, and et al. Delayed prolonged contact urticaria from the elm tree. Contact Dermatitis 1993;28:196-197. PubMed

See these in context on the Slippery Elm monograph →

Marshmallow 5 references
  1. Monographs on the medicinal uses of plant drugs. Exeter, UK: European Scientific Co-op Phytother, 1997.
  2. Leung AY, Foster S. Encyclopedia of Common Natural Ingredients Used in Food, Drugs and Cosmetics. 2nd ed. New York, NY: John Wiley & Sons, 1996.
  3. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
  4. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
  5. Hage-Sleiman R, Mroueh M, Daher CF. Pharmacological evaluation of aqueous extract of Althaea officinalis flower grown in Lebanon. Pharm Biol 2011;49(3):327-33.

See these in context on the Marshmallow monograph →

Coconut 10 references
  1. Teuber SS, Peterson WR. Systemic allergic reaction to coconut (Cocos nucifera) in 2 subjects with hypersensitivity to tree nut and demonstration of cross-reactivity to legumin-like seed storage proteins: new coconut and walnut food allergens. J Allergy Cl PubMed
  2. Rosado A, Fernandez-Rivas M, Gonzalez-Mancebo E, et al. Anaphylaxis to coconut. Allergy 2002;57(2):182-3. PubMed
  3. Karmakar PR, Das A, Chatterjee BP. Placebo-controlled immunotherapy with Cocos nucifera pollen extract. Int Arch Allergy Immunol 1994;103(2):194-201. PubMed
  4. Anagnostou K. Coconut Allergy Revisited. Children (Basel). 2017;4(10). pii: E85. PubMed
  5. Cifuentes L, Mistrello G, Amato S, et al. Identification of cross-reactivity between buckwheat and coconut. Ann Allergy Asthma Immunol. 2015;115(6):530-2. PubMed
  6. Michavila Gomez A, Amat Bou M, Gonzalez Cortés MV, Segura Navas L, Moreno Palanques MA, Bartolomé B. Coconut anaphylaxis: Case report and review. Allergol Immunopathol (Madr). 2015;43(2):219-20. PubMed
  7. 21CFR170.3. U.S. Food and Drug Administration Department of Health and Human Services. Updated April 1, 2017. https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?fr=170.3
  8. Alatawi KA, Alshubaily FA. Coconut products alleviate hyperglycaemic, hyperlipidimic and nephropathy indices in streptozotocin-induced diabetic wistar rats. Saudi J Biol Sci. 2021;28(8):4224-4231. PubMed
  9. Kruse L, Lor J, Yousif R, Pongracic JA, Fishbein AB. Coconut allergy: Characteristics of reactions and diagnostic predictors in a pediatric tertiary care center. Ann Allergy Asthma Immunol 2021;126(5):562-568.
  10. Pathmanandavel K, Kaur N, Joshi P, Ford LS. Anaphylaxis and allergy to coconut: An Australian pediatric case series. J Allergy Clin Immunol Pract 2020;8(10):3657-3659. PubMed

See these in context on the Coconut monograph →

Avocado 10 references
  1. Blickstein D, Shaklai M, Inbal A. Warfarin antagonism by avocado. Lancet 1991;337:914-5. PubMed
  2. Blanco C, Diaz-Perales A, Collada C, et al. Class I chitinases as potential panallergens involved in the latex-fruit syndrome. J Allergy Clin Immunol 1999;103(3 Pt 1):507-13. PubMed
  3. Diaz-Perales A, Collada C, Blanco C, et al. Cross-reactions in the latex-fruit syndrome: A relevant role of chitinases but not of complex asparagine-linked glycans. J Allergy Clin Immunol 1999;104:681-7. PubMed
  4. Stucker M, Memmel U, Hoffmann M, et al. Vitamin B(12) cream containing avocado oil in the therapy of plaque psoriasis. Dermatology 2001;203:141-7.
  5. Ahlroth, M., Alenius, H., Turjanmaa, K., Makinen-Kiljunen, S., Reunala, T., and Palosuo, T. Cross-reacting allergens in natural rubber latex and avocado. J.Allergy Clin.Immunol. 1995;96(2):167-173. PubMed
  6. de Groot, A. C., van der Meeren, H. L., and Weyland, J. W. Contact allergy to avocado oil in a sunscreen. Contact Dermatitis 1987;16(2):108-109. PubMed
  7. Blanco, C., Carrillo, T., Castillo, R., Quiralte, J., and Cuevas, M. Avocado hypersensitivity. Allergy 1994;49(6):454-459. PubMed
  8. Crisi, G. and Belsito, D. V. Contact urticaria from latex in a patient with immediate hypersensitivity to banana, avocado and peach. Contact Dermatitis 1993;28(4):247-248.
  9. Cherian S, Neupert K, Varshney P. Avocado as an emerging trigger for food protein-induced enterocolitis syndrome. Ann Allergy Asthma Immunol. 2018;121(3):369-71. PubMed
  10. Lichtenstein AH, Kris-Etherton PM, Petersen KS, et al. Effect of Incorporating 1 Avocado Per Day Versus Habitual Diet on Visceral Adiposity: A Randomized Trial. J Am Heart Assoc 2022;11(14):e025657.

See these in context on the Avocado monograph →

Aloe 41 references
  1. Newall CA, Anderson LA, Philpson JD. Herbal Medicine: A Guide for Healthcare Professionals. London, UK: The Pharmaceutical Press, 1996.
  2. Wichtl MW. Herbal Drugs and Phytopharmaceuticals. Ed. N.M. Bisset. Stuttgart: Medpharm GmbH Scientific Publishers, 1994.
  3. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
  4. Nusko G, Schneider B, Schneider I, et al. Anthranoid laxative use is not a risk factor for colorectal neoplasia: results of a prospective case control study. Gut 2000;46:651-5. PubMed
  5. Luyckx VA, Ballantine R, Claeys M, et al. Herbal remedy-associated acute renal failure secondary to Cape aloes. Am J Kidney Dis 2002;39:E13. PubMed
  6. Rajasekaran S, Sivagnanam K, Ravi K, Subramanian S. Hypoglycemic effect of Aloe vera gel on streptozotocin-induced diabetes in experimental rats. J Med Food 2004;7:61-6.
  7. Williams MS, Burk M, Loprinzi CL, et al. Phase III double-blind evaluation of an aloe vera gel as a prophylactic agent for radiation-induced skin toxicity. Int J Radiat Oncol Biol Phys 1996;36:345-9. PubMed
  8. Vogler BK, Ernst E. Aloe vera: a systematic review of its clinical effectiveness. Br J Gen Pract 1999;49:823-8.
  9. Bottenberg MM, Wall GC, Harvey RL, Habib S. Oral aloe vera-induced hepatitis. Ann Pharmacother 2007;41:1740-3. PubMed
  10. Rabe C, Musch A, Schirmacher P, et al. Acute hepatitis induced by an Aloe vera preparation: a case report. World J Gastroenterol 2005;11:303-4. PubMed
  11. Kanat O, Ozet A, Ataergin S. Aloe vera-induced acute toxic hepatitis in a healthy young man. Eur J Int Med 2006;17:589. PubMed
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  13. Schorkhuber M, Richter M, Dutter A, et al. Effect of anthraquinone laxatives on the proliferation and urokinase secretion of normal, premalignant and malignant colonic epithelial cells. Eur J Cancer 1998;34:1091-8. PubMed
  14. Yang HN, Kim DJ, Kim YM, et al. Aloe-induced toxic hepatitis. J Korean Med Sci 2010;25:492-5. PubMed
  15. Choonhakarn C, Busaracome P, Sripanidkulchai B, et al. A prospective, randomized clinical trial comparing topical aloe vera with 0.1% triamcinolone acetonide in mild to moderate plaque psoriasis. J.Eur.Acad.Dermatol.Venereol. 2010;24:168-72. PubMed
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  19. Paulsen E, Korsholm L, Brandrup F. A double-blind, placebo-controlled study of a commercial Aloe vera gel in the treatment of slight to moderate psoriasis vulgaris. J Eur Acad Dermatol Venereol. 2005;19:326-31.
  20. Huseini HF, Kianbakht S, Hajiaghaee R, et al. Anti-hyperglycemic and anti-hypercholesterolemic effects of Aloe vera leaf gel in hyperlipidemic type 2 diabetic patients: a randomized double-blind placebo-controlled clinical trial. Planta Med. 2012;78:311-6
  21. Ferreira, M., Teixeira, M., Silva, E., and Selores, M. Allergic contact dermatitis to Aloe vera. Contact Dermatitis 2007;57(4):278-279.
  22. Choonhakarn, C., Busaracome, P., Sripanidkulchai, B., and Sarakarn, P. The efficacy of aloe vera gel in the treatment of oral lichen planus: a randomized controlled trial. Br J Dermatol 2008;158(3):573-577. PubMed
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See these in context on the Sodium monograph →

Potassium 12 references
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See these in context on the Potassium monograph →

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

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