ImmuPro Ingredients & Drug Interactions
by Young Living Essential Oils
What is this page for?
First and foremost: checking ImmuPro 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
ImmuPro is a dietary supplement by Young Living Essential Oils with 13 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, 1,570 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are Melatonin, Wolfberry, Selenium. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against ImmuPro by Young Living Essential Oils
Ask about any prescription or over-the-counter medication and we check it for interactions with ImmuPro by Young Living Essential Oils — 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 ImmuPro by Young Living Essential Oils
Our pharmacy team’s full take, with four database checks built into the cards below — a summary of what is known, not a grade of the product itself.
What’s inside
Low disclosure
ImmuPro contains 13 active ingredients designed to support immune function and general wellness. The formula includes minerals (calcium, copper, zinc, selenium), the hormone melatonin, a prebiotic fiber (larch arabinogalactan), botanicals (red raspberry fruit powder, strawberry powder, goji), medicinal mushrooms (maitake, and a proprietary ImmuPro Blend), and orange peel oil.
Three ingredients—reishi, mushroom powder, and orange peel oil—lack sufficient data for us to assess interactions.
Does it work?
Moderate evidence
For the ingredients we can assess, evidence varies. Calcium is effective for low blood calcium and osteoporosis, and likely effective for bone health.
Melatonin is likely effective for delayed sleep phase syndrome and non-24-hour sleep-wake disorder, and possibly effective for pre-procedural anxiety. Zinc is effective for zinc deficiency and likely effective for Wilson disease.
Selenium is likely effective for selenium deficiency. The other ingredients—including melatonin for hypertension, copper for Alzheimer disease, goji, strawberry, larch arabinogalactan, and maitake—either show insufficient evidence for their listed uses or lack established effectiveness in our data.
Raspberry leaf, strawberry, goji, and maitake all carry 'insufficient reliable evidence' ratings for the conditions listed on many supplement packages.
How safe is it?
Well-documented data
The minerals and melatonin are generally well tolerated at recommended doses, though some users report gastrointestinal side effects (calcium: constipation or diarrhea; zinc: nausea, metallic taste; selenium: gastric discomfort). High doses of calcium, zinc, and selenium carry more serious risks—including kidney stones, copper deficiency, and selenosis.
Melatonin may cause drowsiness, headache, or mood changes in a small number of users, and there is rare concern about increased seizure risk. The mushroom ingredients (maitake, reishi) are generally well tolerated as foods but have limited long-term safety data in concentrated supplement form.
Red raspberry and goji have insufficient data in pregnancy; strawberry and maitake should be avoided in pregnancy due to limited safety information. Breastfeeding safety is not established for melatonin, red raspberry, goji, or maitake—caution is advised.
Meds to double-check
Major interaction found
If you take any of the following, check with your pharmacist before using ImmuPro: blood thinners or anticoagulants (warfarin, aspirin, clopidogrel, and others—goji and other ingredients may increase bleeding risk); HIV medications, especially dolutegravir, elvitegravir, or integrase inhibitors (calcium and zinc can reduce their effectiveness); antibiotics, especially quinolones, tetracyclines, cephalexin, or ceftriaxone (zinc and calcium interfere with absorption); heart medications like diltiazem, nifedipine, or flecainide; diabetes or insulin treatments (goji, melatonin, and maitake may lower blood sugar); antihypertensive (blood pressure) drugs; immunosuppressants; anticonvulsants; or any drug metabolized by liver enzymes. Major interactions are documented with warfarin and dolutegravir.
The bottom line
Scorecard at a glanceFormula with limited ingredient disclosure with some supporting evidence for its stated purpose. Major medication interactions have been identified, and safety information is well characterized.
ImmuPro is a multi-ingredient supplement with mineral, vitamin, and botanical components. It's not recommended if you take blood thinners, HIV medications, certain antibiotics, heart drugs, diabetes medications, or immunosuppressants—talk to your pharmacist first.
Even if you don't take those medications, check your complete drug list with the tool on this page before you start, because the ingredient count is high and interactions are extensive.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 11 of 13 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Aug 23, 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
General information
Key facts about ImmuPro, straight from the product label.
| Brand | Young Living Essential Oils |
|---|---|
| Net contents | 30 Chewable Tablet(s) |
| Market status | On market |
| Date entered into DSLD | Aug 23, 2022 |
| DSLD ID | 273853 |
| Product type | Other Combinations |
| Supplement form | Tablet Or Pill |
| Dietary claims / uses | All Other, Structure/Function |
| Intended target group(s) | Adult (18 - 50 Years) |
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.
Supplement Facts
The label details for ImmuPro by Young Living Essential Oils, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Calories | 5 Calorie(s) | -- |
| Total Carbohydrates | 1 Gram(s) | 1% |
| Calcium | 84 mg | 6% |
| Added Sugars | 1 Gram(s) | 1% |
| Total Sugars | 1 Gram(s) | -- |
| Melatonin | 4.2 mg | -- |
| Copper | 0.16 mg | 18% |
| Zinc | 5 mg | 45% |
| Selenium | 68 mcg | 124% |
| Arabinogalactan | 0 NP | -- |
| Raspberry fruit powder | 0 NP | -- |
| ImmuPro Blend | 940 mg | -- |
| Strawberry, Powder | 0 NP | -- |
| Wolfberry | 0 NP | -- |
| Reishi, Powder | 0 NP | -- |
| Maitake Mushroom mycelia powder | 0 NP | -- |
| Mushroom, Powder | 0 NP | -- |
| Orange Peel Oil | 0 NP | -- |
Other ingredients: Dextrose, Hydroxypropyl Cellulose, Stevia leaf extract, Agave Inulin, Natural Flavors, Silicon Dioxide, Magnesium Stearate, Maltodextrin
Tap any ingredient to jump to its full detail below.
These statements are the manufacturer’s wording, reproduced from the product label — the label is saying it, not HelloPharmacist. We don’t verify or endorse them.
Formula
100% pure, therapeutic-grade essential oil
ImmuPro is a unique dietary supplement that combines a proprietary fruit and mushroom powder blend with pure orange essential oil to support the immune system.
Suggested/Recommended/Usage/Directions
Directions: Take 1 chewable tablet 1-2 times daily as needed. Do not exceed 2 tablets per day.
Precautions
Caution: Keep out of reach of children.
If you are pregnant, nursing, taking medication, or have a medical condition, consult a health care professional prior to use.
Consult a healthcare professional prior to use with children.
Do not drive or operate machinery when taking melatonin.
Storage
Storage: Keep in a cool, dark place.
General Statements
Formulated by D. Gary Young
This package may not be recyclable in your area
FDA Disclaimer Statement
These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.
FDA Statement of Identity
Herbal Supplement
Formulation
Supports the immune system
Seals/Symbols
Young Living Seed to Seal Quality Commitment EST. 1994
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
ImmuPro by Young Living Essential Oils 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 ImmuPro by Young Living Essential Oils
These are the 13 active ingredients this product is made of. Select any to open its full monograph.
Serving size1 Tablet(s) Dosage formTablet Or Pill 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 with168 drugs
Calcium is an essential mineral your body needs for strong bones, nerve signaling, and muscle function, and supplements can help fill gaps when diet f...
Calcium monograph & interactionsMelatonin
Interacts with1,461 drugs
Melatonin is a hormone your body makes naturally to help control your sleep-wake cycle, and the supplement form is widely used to help with sleep timi...
Melatonin monograph & interactionsCopper
Interacts with31 drugs
Copper is an essential trace mineral your body needs in small amounts for making red blood cells, supporting nerves and bones, and helping enzymes wor...
Copper monograph & interactionsZinc
Interacts with67 drugs
Zinc is an essential mineral that your body needs for immune function, wound healing, taste, and smell. Most people get enough from food, but suppleme...
Zinc monograph & interactionsSelenium
Interacts with321 drugs
Selenium is an essential trace mineral your body needs in small amounts for thyroid function, antioxidant defense, and immune health. Most people who...
Selenium monograph & interactionsImmuPro Blend
- › Arabinogalactan
- › Raspberry fruit powder
- › Strawberry, Powder
- › Wolfberry
- › Reishi, Powder
- › Maitake Mushroom mycelia powder
- › Mushroom, Powder
- › Orange Peel Oil
Other (inactive) ingredients: Dextrose, Hydroxypropyl Cellulose, Stevia leaf extract, Agave Inulin, Natural Flavors, Silicon Dioxide, Magnesium Stearate, Maltodextrin. These complete the product’s ingredient list but are not active constituents.
ImmuPro by Young Living Essential Oils Drug Interactions
HelloPharmacist Interaction Report
ImmuPro by Young Living Essential Oils has documented interactions with a substantial number of medications across its 13 ingredients.
The most serious concern is calcium's interaction with dolutegravir (Tivicay), an HIV medication—calcium can reduce dolutegravir levels by nearly 40%, requiring a 2-hour separation before or 6-hour separation after dosing. Calcium also has major interactions with elvitegravir (another HIV drug) and ceftriaxone (an antibiotic), both requiring careful timing or avoidance.
Read the full breakdown — every affected drug type, severity by severity
Melatonin in this product interacts moderately with blood thinners like warfarin, antidiabetes drugs, heart medications, anticonvulsants, and immunosuppressants. Goji (wolfberry) carries a major interaction with warfarin and moderate interactions with several drug-metabolizing enzymes (CYP2C9, CYP3A4, CYP2D6, CYP2C19), potentially raising levels of many common medications.
Zinc moderately interacts with antibiotics (quinolones, tetracyclines, cephalexin), HIV drugs (ritonavir, integrase inhibitors), and penicillamine. Selenium, copper, and other mushroom ingredients add moderate interactions with blood thinners, immunosuppressants, and various drug classes.
Altogether, these interactions span 1,547 individual medications. We could not check reishi, mushroom powder, or orange peel oil—no interaction data are held for them.
Before starting this product, use the medication checker on this page to verify your exact prescriptions, particularly if you take blood thinners, HIV drugs, antibiotics, heart or diabetes medications, or immunosuppressant drugs.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against ImmuPro?
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 ImmuPro interact with 1,570 drugs. Click any drug to see the details.
11 of the 13 ingredients in ImmuPro interact with drugs. Each result below shows which ingredient is responsible. Melatonin Wolfberry Selenium Strawberry, Powder Maitake Mushroom mycelia powder Orange Peel Oil Calcium Raspberry fruit powder Arabinogalactan Zinc Copper
AtorvastatinAtorvaliq
How Atorvastatin interacts with ImmuPro — through 3 ingredients. Tap an ingredient for the detail:
Orange Peel OilOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Consuming sweet orange juice can decrease oral absorption of OATP substrates.
Read the full Orange Peel Oil + Atorvastatin interactionWolfberryCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, goji berry might inhibit CYP3A4 and reduce metabolism of CYP3A4 substrates.
Read the full Wolfberry + Atorvastatin interactionMelatoninCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, melatonin might increase levels of drugs metabolized by CYP3A4.
Read the full Melatonin + Atorvastatin interactionAtorvastatin CalciumLipitor
How Atorvastatin Calcium interacts with ImmuPro — through 3 ingredients. Tap an ingredient for the detail:
Orange Peel OilOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Consuming sweet orange juice can decrease oral absorption of OATP substrates.
Read the full Orange Peel Oil + Atorvastatin Calcium interactionWolfberryCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, goji berry might inhibit CYP3A4 and reduce metabolism of CYP3A4 substrates.
Read the full Wolfberry + Atorvastatin Calcium interactionMelatoninCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, melatonin might increase levels of drugs metabolized by CYP3A4.
Read the full Melatonin + Atorvastatin Calcium interactionBosentanTracleer
How Bosentan interacts with ImmuPro — through 4 ingredients. Tap an ingredient for the detail:
Orange Peel OilOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Consuming sweet orange juice can decrease oral absorption of OATP substrates.
Read the full Orange Peel Oil + Bosentan interactionMelatoninCytochrome P450 3a4 (cyp3a4) Substrates, Antihypertensive Drugs Moderate
Interaction Summary
Theoretically, melatonin might increase levels of drugs metabolized by CYP3A4.
Read the full Melatonin + Bosentan interactionWolfberryAntihypertensive Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Moderate
Interaction Summary
Theoretically, concomitant use of goji root bark, but not goji fruit, with antihypertensive drugs might have additive effects.
Read the full Wolfberry + Bosentan interactionMaitake Mushroom Mycelia PowderAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, combining maitake mushroom with antihypertensive drugs might increase the risk of hypotension.
Read the full Maitake Mushroom Mycelia Powder + Bosentan interactionBrincidofovirTembexa
How Brincidofovir interacts with ImmuPro — through 1 ingredient. Tap an ingredient for the detail:
Orange Peel OilOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Consuming sweet orange juice can decrease oral absorption of OATP substrates.
Read the full Orange Peel Oil + Brincidofovir interactionCeftriaxoneRocephin
How Ceftriaxone interacts with ImmuPro — through 2 ingredients. Tap an ingredient for the detail:
CalciumCeftriaxone (rocephin) Major
Interaction Summary
Co-administration of intravenous calcium and ceftriaxone can result in precipitation of a ceftriaxone-calcium salt in the lungs and kidneys.
Read the full Calcium + Ceftriaxone interactionMelatoninSeizure Threshold Lowering Drugs Moderate
Interaction Summary
Theoretically, taking melatonin with drugs that lower the seizure threshold might increase the risk of seizure activity.
Read the full Melatonin + Ceftriaxone interactionCeliprololCelicard
How Celiprolol interacts with ImmuPro — through 5 ingredients. Tap an ingredient for the detail:
Orange Peel OilOrganic Anion-transporting Polypeptide Substrates (oatp), Celiprolol (celicard) +1 Major
Interaction Summary
Consuming sweet orange juice can decrease oral absorption of OATP substrates.
Read the full Orange Peel Oil + Celiprolol interactionMaitake Mushroom Mycelia PowderAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, combining maitake mushroom with antihypertensive drugs might increase the risk of hypotension.
Read the full Maitake Mushroom Mycelia Powder + Celiprolol interactionStrawberry, PowderP-glycoprotein Substrates Moderate
Interaction Summary
In vitro research suggests that strawberry extract can inhibit p-glycoprotein efflux.
Read the full Strawberry, Powder + Celiprolol interactionWolfberryAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, concomitant use of goji root bark, but not goji fruit, with antihypertensive drugs might have additive effects.
Read the full Wolfberry + Celiprolol interactionMelatoninAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, taking melatonin with antihypertensive drugs might increase the risk of hypotension or hypertension.
Read the full Melatonin + Celiprolol interactionCerivastatin SodiumBaycol
How Cerivastatin Sodium interacts with ImmuPro — through 1 ingredient. Tap an ingredient for the detail:
Orange Peel OilOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Consuming sweet orange juice can decrease oral absorption of OATP substrates.
Read the full Orange Peel Oil + Cerivastatin Sodium interactionCinoxacinCinobac
How Cinoxacin interacts with ImmuPro — through 3 ingredients. Tap an ingredient for the detail:
Orange Peel OilOrganic Anion-transporting Polypeptide Substrates (oatp), Quinolone Antibiotics Major
Interaction Summary
Consuming sweet orange juice can decrease oral absorption of OATP substrates.
Read the full Orange Peel Oil + Cinoxacin interactionCalciumQuinolone Antibiotics Moderate
Interaction Summary
Calcium seems to reduce the absorption of quinolone antibiotics.
Read the full Calcium + Cinoxacin interactionZincQuinolone Antibiotics Moderate
Interaction Summary
Zinc can decrease the levels and clinical effects of quinolones antibiotics.
Read the full Zinc + Cinoxacin interactionCiprofloxacinCiloxan, Cipro, Cipro IV, Cipro XR, Ciprobay, Otiprio
How Ciprofloxacin interacts with ImmuPro — through 4 ingredients. Tap an ingredient for the detail:
Orange Peel OilOrganic Anion-transporting Polypeptide Substrates (oatp), Quinolone Antibiotics Major
Interaction Summary
Consuming sweet orange juice can decrease oral absorption of OATP substrates.
Read the full Orange Peel Oil + Ciprofloxacin interactionZincQuinolone Antibiotics Moderate
Interaction Summary
Zinc can decrease the levels and clinical effects of quinolones antibiotics.
Read the full Zinc + Ciprofloxacin interactionCalciumQuinolone Antibiotics Moderate
Interaction Summary
Calcium seems to reduce the absorption of quinolone antibiotics.
Read the full Calcium + Ciprofloxacin interactionMelatoninSeizure Threshold Lowering Drugs Moderate
Interaction Summary
Theoretically, taking melatonin with drugs that lower the seizure threshold might increase the risk of seizure activity.
Read the full Melatonin + Ciprofloxacin interactionCiprofloxacin, HydrocortisoneCipro HC Otic
How Ciprofloxacin, Hydrocortisone interacts with ImmuPro — through 1 ingredient. Tap an ingredient for the detail:
Orange Peel OilOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Consuming sweet orange juice can decrease oral absorption of OATP substrates.
Read the full Orange Peel Oil + Ciprofloxacin, Hydrocortisone interactionClinafloxacinClinafloxacin
How Clinafloxacin interacts with ImmuPro — through 4 ingredients. Tap an ingredient for the detail:
Orange Peel OilOrganic Anion-transporting Polypeptide Substrates (oatp), Quinolone Antibiotics Major
Interaction Summary
Consuming sweet orange juice can decrease oral absorption of OATP substrates.
Read the full Orange Peel Oil + Clinafloxacin interactionZincQuinolone Antibiotics Moderate
Interaction Summary
Zinc can decrease the levels and clinical effects of quinolones antibiotics.
Read the full Zinc + Clinafloxacin interactionMelatoninSeizure Threshold Lowering Drugs Moderate
Interaction Summary
Theoretically, taking melatonin with drugs that lower the seizure threshold might increase the risk of seizure activity.
Read the full Melatonin + Clinafloxacin interactionCalciumQuinolone Antibiotics Moderate
Interaction Summary
Calcium seems to reduce the absorption of quinolone antibiotics.
Read the full Calcium + Clinafloxacin interactionCobicistat, Elvitegravir, Emtricitabine, Tenofovir Alafenamide FumarateGenvoya
How Cobicistat, Elvitegravir, Emtricitabine, Tenofovir Alafenamide Fumarate interacts with ImmuPro — through 6 ingredients. Tap an ingredient for the detail:
CalciumElvitegravir (vitekta), Bictegravir/emtricitabine/tenofovir Alafenamide (biktarvy) Major
Interaction Summary
Calcium seems to reduce levels of elvitegravir.
Read the full Calcium + Cobicistat, Elvitegravir, Emtricitabine, Tenofovir Alafenamide Fumarate interactionZincBictegravir/emtricitabine/tenofovir Alafenamide (biktarvy) Moderate
Interaction Summary
Theoretically, zinc might decrease levels of bictegravir/emtricitabine/tenofovir alafenamide by reducing its absorption.
Read the full Zinc + Cobicistat, Elvitegravir, Emtricitabine, Tenofovir Alafenamide Fumarate interactionWolfberryCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, goji berry might inhibit CYP3A4 and reduce metabolism of CYP3A4 substrates.
Read the full Wolfberry + Cobicistat, Elvitegravir, Emtricitabine, Tenofovir Alafenamide Fumarate interactionStrawberry, PowderP-glycoprotein Substrates Moderate
Interaction Summary
In vitro research suggests that strawberry extract can inhibit p-glycoprotein efflux.
Read the full Strawberry, Powder + Cobicistat, Elvitegravir, Emtricitabine, Tenofovir Alafenamide Fumarate interactionOrange Peel OilP-glycoprotein Substrates Moderate
Interaction Summary
Sweet orange juice seems to modulate P-glycoprotein (P-gp), which might affect the blood levels of P-gp substrates.
Read the full Orange Peel Oil + Cobicistat, Elvitegravir, Emtricitabine, Tenofovir Alafenamide Fumarate interactionMelatoninCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, melatonin might increase levels of drugs metabolized by CYP3A4.
Read the full Melatonin + Cobicistat, Elvitegravir, Emtricitabine, Tenofovir Alafenamide Fumarate interactionDolutegravirTivicay
How Dolutegravir interacts with ImmuPro — through 3 ingredients. Tap an ingredient for the detail:
CalciumDolutegravir (tivicay) Major
Interaction Summary
Calcium seems to reduce levels of dolutegravir.
Read the full Calcium + Dolutegravir interactionOrange Peel OilP-glycoprotein Substrates Moderate
Interaction Summary
Sweet orange juice seems to modulate P-glycoprotein (P-gp), which might affect the blood levels of P-gp substrates.
Read the full Orange Peel Oil + Dolutegravir interactionStrawberry, PowderP-glycoprotein Substrates Moderate
Interaction Summary
In vitro research suggests that strawberry extract can inhibit p-glycoprotein efflux.
Read the full Strawberry, Powder + Dolutegravir interactionDolutegravir, Emtricitabine, Tenofovir AlafenamideDolutegravir, Emtricitabine, Tenofovir Alafenamide
How Dolutegravir, Emtricitabine, Tenofovir Alafenamide interacts with ImmuPro — through 4 ingredients. Tap an ingredient for the detail:
CalciumDolutegravir (tivicay), Bictegravir/emtricitabine/tenofovir Alafenamide (biktarvy) Major
Interaction Summary
Calcium seems to reduce levels of dolutegravir.
Read the full Calcium + Dolutegravir, Emtricitabine, Tenofovir Alafenamide interactionStrawberry, PowderP-glycoprotein Substrates Moderate
Interaction Summary
In vitro research suggests that strawberry extract can inhibit p-glycoprotein efflux.
Read the full Strawberry, Powder + Dolutegravir, Emtricitabine, Tenofovir Alafenamide interactionOrange Peel OilP-glycoprotein Substrates Moderate
Interaction Summary
Sweet orange juice seems to modulate P-glycoprotein (P-gp), which might affect the blood levels of P-gp substrates.
Read the full Orange Peel Oil + Dolutegravir, Emtricitabine, Tenofovir Alafenamide interactionZincBictegravir/emtricitabine/tenofovir Alafenamide (biktarvy) Moderate
Interaction Summary
Theoretically, zinc might decrease levels of bictegravir/emtricitabine/tenofovir alafenamide by reducing its absorption.
Read the full Zinc + Dolutegravir, Emtricitabine, Tenofovir Alafenamide interactionDolutegravir, RilpivirineJuluca
How Dolutegravir, Rilpivirine interacts with ImmuPro — through 5 ingredients. Tap an ingredient for the detail:
CalciumDolutegravir (tivicay) Major
Interaction Summary
Calcium seems to reduce levels of dolutegravir.
Read the full Calcium + Dolutegravir, Rilpivirine interactionWolfberryCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, goji berry might inhibit CYP3A4 and reduce metabolism of CYP3A4 substrates.
Read the full Wolfberry + Dolutegravir, Rilpivirine interactionOrange Peel OilP-glycoprotein Substrates Moderate
Interaction Summary
Sweet orange juice seems to modulate P-glycoprotein (P-gp), which might affect the blood levels of P-gp substrates.
Read the full Orange Peel Oil + Dolutegravir, Rilpivirine interactionStrawberry, PowderP-glycoprotein Substrates Moderate
Interaction Summary
In vitro research suggests that strawberry extract can inhibit p-glycoprotein efflux.
Read the full Strawberry, Powder + Dolutegravir, Rilpivirine interactionMelatoninCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, melatonin might increase levels of drugs metabolized by CYP3A4.
Read the full Melatonin + Dolutegravir, Rilpivirine interactionElvitegravirVitekta
How Elvitegravir interacts with ImmuPro — through 3 ingredients. Tap an ingredient for the detail:
CalciumElvitegravir (vitekta) Major
Interaction Summary
Calcium seems to reduce levels of elvitegravir.
Read the full Calcium + Elvitegravir interactionWolfberryCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, goji berry might inhibit CYP3A4 and reduce metabolism of CYP3A4 substrates.
Read the full Wolfberry + Elvitegravir interactionMelatoninCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, melatonin might increase levels of drugs metabolized by CYP3A4.
Read the full Melatonin + Elvitegravir interactionElvitegravir, Cobicistat, Emtricitabine, Tenofovir Disoproxil FumarateStribild
How Elvitegravir, Cobicistat, Emtricitabine, Tenofovir Disoproxil Fumarate interacts with ImmuPro — through 4 ingredients. Tap an ingredient for the detail:
CalciumElvitegravir (vitekta), Bictegravir/emtricitabine/tenofovir Alafenamide (biktarvy) Major
Interaction Summary
Calcium seems to reduce levels of elvitegravir.
Read the full Calcium + Elvitegravir, Cobicistat, Emtricitabine, Tenofovir Disoproxil Fumarate interactionWolfberryCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, goji berry might inhibit CYP3A4 and reduce metabolism of CYP3A4 substrates.
Read the full Wolfberry + Elvitegravir, Cobicistat, Emtricitabine, Tenofovir Disoproxil Fumarate interactionZincBictegravir/emtricitabine/tenofovir Alafenamide (biktarvy) Moderate
Interaction Summary
Theoretically, zinc might decrease levels of bictegravir/emtricitabine/tenofovir alafenamide by reducing its absorption.
Read the full Zinc + Elvitegravir, Cobicistat, Emtricitabine, Tenofovir Disoproxil Fumarate interactionMelatoninCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, melatonin might increase levels of drugs metabolized by CYP3A4.
Read the full Melatonin + Elvitegravir, Cobicistat, Emtricitabine, Tenofovir Disoproxil Fumarate interactionEnoxacinPenetrex
How Enoxacin interacts with ImmuPro — through 4 ingredients. Tap an ingredient for the detail:
Orange Peel OilOrganic Anion-transporting Polypeptide Substrates (oatp), Quinolone Antibiotics Major
Interaction Summary
Consuming sweet orange juice can decrease oral absorption of OATP substrates.
Read the full Orange Peel Oil + Enoxacin interactionZincQuinolone Antibiotics Moderate
Interaction Summary
Zinc can decrease the levels and clinical effects of quinolones antibiotics.
Read the full Zinc + Enoxacin interactionCalciumQuinolone Antibiotics Moderate
Interaction Summary
Calcium seems to reduce the absorption of quinolone antibiotics.
Read the full Calcium + Enoxacin interactionMelatoninSeizure Threshold Lowering Drugs Moderate
Interaction Summary
Theoretically, taking melatonin with drugs that lower the seizure threshold might increase the risk of seizure activity.
Read the full Melatonin + Enoxacin interactionEtoposideEtopophos, VePesid, VP16
How Etoposide interacts with ImmuPro — through 4 ingredients. Tap an ingredient for the detail:
Orange Peel OilOrganic Anion-transporting Polypeptide Substrates (oatp), P-glycoprotein Substrates Major
Interaction Summary
Consuming sweet orange juice can decrease oral absorption of OATP substrates.
Read the full Orange Peel Oil + Etoposide interactionWolfberryCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, goji berry might inhibit CYP3A4 and reduce metabolism of CYP3A4 substrates.
Read the full Wolfberry + Etoposide interactionStrawberry, PowderP-glycoprotein Substrates Moderate
Interaction Summary
In vitro research suggests that strawberry extract can inhibit p-glycoprotein efflux.
Read the full Strawberry, Powder + Etoposide interactionMelatoninCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, melatonin might increase levels of drugs metabolized by CYP3A4.
Read the full Melatonin + Etoposide interactionEzetimibe, AtorvastatinLiptruzet
How Ezetimibe, Atorvastatin interacts with ImmuPro — through 3 ingredients. Tap an ingredient for the detail:
Orange Peel OilOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Consuming sweet orange juice can decrease oral absorption of OATP substrates.
Read the full Orange Peel Oil + Ezetimibe, Atorvastatin interactionWolfberryCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, goji berry might inhibit CYP3A4 and reduce metabolism of CYP3A4 substrates.
Read the full Wolfberry + Ezetimibe, Atorvastatin interactionMelatoninCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, melatonin might increase levels of drugs metabolized by CYP3A4.
Read the full Melatonin + Ezetimibe, Atorvastatin interactionFexofenadineAllegra
How Fexofenadine interacts with ImmuPro — through 4 ingredients. Tap an ingredient for the detail:
Orange Peel OilP-glycoprotein Substrates, Organic Anion-transporting Polypeptide Substrates (oatp) +1 Major
Interaction Summary
Sweet orange juice seems to modulate P-glycoprotein (P-gp), which might affect the blood levels of P-gp substrates.
Read the full Orange Peel Oil + Fexofenadine interactionMelatoninSeizure Threshold Lowering Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, taking melatonin with drugs that lower the seizure threshold might increase the risk of seizure activity.
Read the full Melatonin + Fexofenadine interactionStrawberry, PowderP-glycoprotein Substrates Moderate
Interaction Summary
In vitro research suggests that strawberry extract can inhibit p-glycoprotein efflux.
Read the full Strawberry, Powder + Fexofenadine interactionWolfberryCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, goji berry might inhibit CYP3A4 and reduce metabolism of CYP3A4 substrates.
Read the full Wolfberry + Fexofenadine interactionFexofenadine, PseudoephedrineAllegra D
How Fexofenadine, Pseudoephedrine interacts with ImmuPro — through 4 ingredients. Tap an ingredient for the detail:
Orange Peel OilOrganic Anion-transporting Polypeptide Substrates (oatp), Fexofenadine (allegra) +1 Major
Interaction Summary
Consuming sweet orange juice can decrease oral absorption of OATP substrates.
Read the full Orange Peel Oil + Fexofenadine, Pseudoephedrine interactionWolfberryCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, goji berry might inhibit CYP3A4 and reduce metabolism of CYP3A4 substrates.
Read the full Wolfberry + Fexofenadine, Pseudoephedrine interactionMelatoninCytochrome P450 3a4 (cyp3a4) Substrates, Seizure Threshold Lowering Drugs Moderate
Interaction Summary
Theoretically, melatonin might increase levels of drugs metabolized by CYP3A4.
Read the full Melatonin + Fexofenadine, Pseudoephedrine interactionStrawberry, PowderP-glycoprotein Substrates Moderate
Interaction Summary
In vitro research suggests that strawberry extract can inhibit p-glycoprotein efflux.
Read the full Strawberry, Powder + Fexofenadine, Pseudoephedrine interactionFluvastatinLescol, Lescol XL
How Fluvastatin interacts with ImmuPro — through 2 ingredients. Tap an ingredient for the detail:
Orange Peel OilOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Consuming sweet orange juice can decrease oral absorption of OATP substrates.
Read the full Orange Peel Oil + Fluvastatin interactionWolfberryCytochrome P450 2c9 (cyp2c9) Substrates Moderate
Interaction Summary
Theoretically, goji berry might inhibit CYP2C9 and reduce metabolism of CYP2C9 substrates.
Read the full Wolfberry + Fluvastatin interactionGatifloxacinTequin, Tequin Injection
How Gatifloxacin interacts with ImmuPro — through 3 ingredients. Tap an ingredient for the detail:
Orange Peel OilOrganic Anion-transporting Polypeptide Substrates (oatp), Quinolone Antibiotics Major
Interaction Summary
Consuming sweet orange juice can decrease oral absorption of OATP substrates.
Read the full Orange Peel Oil + Gatifloxacin interactionZincQuinolone Antibiotics Moderate
Interaction Summary
Zinc can decrease the levels and clinical effects of quinolones antibiotics.
Read the full Zinc + Gatifloxacin interactionCalciumQuinolone Antibiotics Moderate
Interaction Summary
Calcium seems to reduce the absorption of quinolone antibiotics.
Read the full Calcium + Gatifloxacin interactionGemifloxacinFactive
How Gemifloxacin interacts with ImmuPro — through 3 ingredients. Tap an ingredient for the detail:
Orange Peel OilOrganic Anion-transporting Polypeptide Substrates (oatp), Quinolone Antibiotics Major
Interaction Summary
Consuming sweet orange juice can decrease oral absorption of OATP substrates.
Read the full Orange Peel Oil + Gemifloxacin interactionCalciumQuinolone Antibiotics Moderate
Interaction Summary
Calcium seems to reduce the absorption of quinolone antibiotics.
Read the full Calcium + Gemifloxacin interactionZincQuinolone Antibiotics Moderate
Interaction Summary
Zinc can decrease the levels and clinical effects of quinolones antibiotics.
Read the full Zinc + Gemifloxacin interactionGlyburideAlbert Glyburide, Diabeta, Glycron, Glynase, Glynase PresTab, Micronase +1 more
How Glyburide interacts with ImmuPro — through 4 ingredients. Tap an ingredient for the detail:
Orange Peel OilOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Consuming sweet orange juice can decrease oral absorption of OATP substrates.
Read the full Orange Peel Oil + Glyburide interactionMaitake Mushroom Mycelia PowderAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, combining maitake mushroom with antidiabetes drugs might increase the risk of hypoglycemia.
Read the full Maitake Mushroom Mycelia Powder + Glyburide interactionWolfberryAntidiabetes Drugs, Cytochrome P450 2c9 (cyp2c9) Substrates Moderate
Interaction Summary
Theoretically, concomitant use of goji fruit polysaccharides or goji root bark with antidiabetes drugs might have additive effects.
Read the full Wolfberry + Glyburide interactionMelatoninAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, taking melatonin with antidiabetes drugs might increase the risk of hypoglycemia.
Read the full Melatonin + Glyburide interactionGlyburide, MetforminGlucovance
How Glyburide, Metformin interacts with ImmuPro — through 4 ingredients. Tap an ingredient for the detail:
Orange Peel OilOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Consuming sweet orange juice can decrease oral absorption of OATP substrates.
Read the full Orange Peel Oil + Glyburide, Metformin interactionMelatoninAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, taking melatonin with antidiabetes drugs might increase the risk of hypoglycemia.
Read the full Melatonin + Glyburide, Metformin interactionWolfberryAntidiabetes Drugs, Cytochrome P450 2c9 (cyp2c9) Substrates Moderate
Interaction Summary
Theoretically, concomitant use of goji fruit polysaccharides or goji root bark with antidiabetes drugs might have additive effects.
Read the full Wolfberry + Glyburide, Metformin interactionMaitake Mushroom Mycelia PowderAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, combining maitake mushroom with antidiabetes drugs might increase the risk of hypoglycemia.
Read the full Maitake Mushroom Mycelia Powder + Glyburide, Metformin interactionGrepafloxacinRaxar
How Grepafloxacin interacts with ImmuPro — through 4 ingredients. Tap an ingredient for the detail:
Orange Peel OilOrganic Anion-transporting Polypeptide Substrates (oatp), Quinolone Antibiotics Major
Interaction Summary
Consuming sweet orange juice can decrease oral absorption of OATP substrates.
Read the full Orange Peel Oil + Grepafloxacin interactionZincQuinolone Antibiotics Moderate
Interaction Summary
Zinc can decrease the levels and clinical effects of quinolones antibiotics.
Read the full Zinc + Grepafloxacin interactionCalciumQuinolone Antibiotics Moderate
Interaction Summary
Calcium seems to reduce the absorption of quinolone antibiotics.
Read the full Calcium + Grepafloxacin interactionMelatoninCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, melatonin might increase levels of drugs metabolized by CYP1A2.
Read the full Melatonin + Grepafloxacin interactionIrinotecanCamptosar, Onivyde
How Irinotecan interacts with ImmuPro — through 3 ingredients. Tap an ingredient for the detail:
Orange Peel OilOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Consuming sweet orange juice can decrease oral absorption of OATP substrates.
Read the full Orange Peel Oil + Irinotecan interactionWolfberryCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, goji berry might inhibit CYP3A4 and reduce metabolism of CYP3A4 substrates.
Read the full Wolfberry + Irinotecan interactionMelatoninCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, melatonin might increase levels of drugs metabolized by CYP3A4.
Read the full Melatonin + Irinotecan interactionIrinotecan Hydrochloride
How Irinotecan Hydrochloride interacts with ImmuPro — through 3 ingredients. Tap an ingredient for the detail:
Orange Peel OilOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Consuming sweet orange juice can decrease oral absorption of OATP substrates.
Read the full Orange Peel Oil + Irinotecan Hydrochloride interactionWolfberryCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, goji berry might inhibit CYP3A4 and reduce metabolism of CYP3A4 substrates.
Read the full Wolfberry + Irinotecan Hydrochloride interactionMelatoninCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, melatonin might increase levels of drugs metabolized by CYP3A4.
Read the full Melatonin + Irinotecan Hydrochloride interactionEach ingredient & the kinds of drugs it affects
For each ingredient in ImmuPro 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.
Melatonin
Anticoagulant/Antiplatelet Drugs
Theoretically, melatonin may have anticoagulant effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
There are isolated case reports of minor bleeding and decreased prothrombin activity in people taking melatonin with warfarin (Coumadin). The mechanism, if any, of this interaction is unknown. Taking melatonin orally seems to decrease coagulation activity within one hour of dosing in healthy men.
Anticonvulsants
Theoretically, melatonin may reduce the effects of anticonvulsants. Some clinical research suggests that melatonin may increase the frequency of seizures in certain patients, particularly children with neurological impairment.
Antidiabetes Drugs
Theoretically, taking melatonin with antidiabetes drugs might increase the risk of hypoglycemia.
Some clinical research shows that melatonin reduces levels of fasting blood glucose and improves glycemic control. However, other research suggests that melatonin might impair glucose utilization and increase insulin resistance, while other research has found no effect on glucose levels. Until more is known, use melatonin cautiously in combination with antidiabetes drugs.
Antihypertensive Drugs
Theoretically, taking melatonin with antihypertensive drugs might increase the risk of hypotension or hypertension.
Some clinical research suggests that taking melatonin decreases blood pressure in healthy adults. Also, melatonin seems to lower systolic and diastolic blood pressure in individuals with high blood pressure at nighttime or untreated essential hypertension. However, melatonin seems to worsen blood pressure in patients who are taking antihypertensive medications. Immediate-release melatonin 5 mg at night in combination with nifedipine GITS (Procardia XL) increases systolic blood pressure an average of 6.5 mmHg, diastolic blood pressure by an average of 4.9 mmHg, and heart rate by 3.9 bpm. Also, results from animal research suggest that melatonin reduces the effectiveness of certain antihypertensive drugs, including methoxamine and clonidine.
Caffeine
Theoretically, taking caffeine with melatonin might increase levels of melatonin.
Some evidence suggests that caffeine consumption can decrease endogenous melatonin levels, while other evidence suggests that caffeine increases endogenous melatonin levels. When administered in combination with melatonin supplements, caffeine seems to increase melatonin effects and levels. The reason for this discrepancy is not completely clear. Part of the discrepancy may result from the fact that caffeine can inhibit melatonin synthesis as well as inhibit melatonin metabolism. By functioning as an adenosine receptor antagonist, caffeine may indirectly inhibit the synthesis of melatonin. Conversely, because melatonin and caffeine are both metabolized by cytochrome P450 1A2 (CYP1A2) enzyme, concomitant use of melatonin and caffeine may reduce the metabolism of melatonin, resulting in higher serum levels.
Cns Depressants
Theoretically, taking melatonin might increase the sedative effects of CNS depressants.
Melatonin has sedative effects. Theoretically, concomitant use of melatonin with alcohol, benzodiazepines, or other sedative drugs might cause additive sedation.
Contraceptive Drugs
Theoretically, taking contraceptive drugs with melatonin might increase the effects and adverse effects of melatonin.
Contraceptive drugs can increase the levels of endogenous melatonin. Theoretically, these drugs may increase the effects and adverse effects of oral melatonin.
Cytochrome P450 1A2 (Cyp1A2) Substrates
Theoretically, melatonin might increase levels of drugs metabolized by CYP1A2. Also, other CYP1A2 substrates might decrease the metabolism of melatonin, increasing melatonin levels.
Melatonin is metabolized in the liver primarily by the CYP2C19 and CYP1A2 enzymes. Theoretically, combined administration of melatonin with drugs metabolized by the CYP1A2 enzyme might reduce the metabolism of these drugs, resulting in increased serum levels. Conversely, some drugs metabolized by CYP1A2 may inhibit the metabolism of melatonin, resulting in increased serum levels of melatonin. Until more is known, use melatonin cautiously in patients taking drugs metabolized by these enzymes.
Cytochrome P450 2C19 (Cyp2C19) Substrates
Theoretically, melatonin might increase levels of drugs metabolized by CYP2C19. Also, other CYP2C19 substrates might decrease the metabolism of melatonin, increasing melatonin levels.
Melatonin is metabolized in the liver primarily by the CYP2C19 and CYP1A2 enzymes. Theoretically, combined administration of melatonin with certain drugs metabolized by the CYP2C19 enzyme may reduce the metabolism of these drugs, resulting in increased serum levels. Conversely, some drugs metabolized by CYP2C19 may inhibit the metabolism of melatonin, resulting in increased serum levels of melatonin. Until more is known, use melatonin cautiously in patients taking drugs metabolized by these enzymes.
Fluvoxamine (Luvox)
Theoretically, taking fluvoxamine with melatonin might increase levels of melatonin.
Fluvoxamine can significantly increase melatonin levels. In some cases, fluvoxamine might increase bioavailability of exogenously administered melatonin by up to 20 times. Some researchers think this might be a beneficial interaction and be potentially useful for cases of refractory insomnia. However, this interaction might also cause unwanted excessive drowsiness and possibly other adverse effects. Fluvoxamine is known to increase endogenous melatonin secretion. It seems to increase serum levels of exogenously administered melatonin possibly by decreasing melatonin metabolism by inhibiting cytochrome P450 (CYP450) 1A2 and 2C19 or by inhibiting melatonin elimination. This effect has been found in healthy people taking fluvoxamine 50-75 mg and melatonin 5 mg.
Immunosuppressants
Theoretically, melatonin might interfere with immunosuppressive therapy.
Melatonin can stimulate immune function. Theoretically, melatonin might interfere with immunosuppressive therapy.
Methamphetamine (Desoxyn)
Theoretically, taking melatonin with methamphetamine may increase the adverse effects of methamphetamine.
Animal research suggests that melatonin exacerbates the adverse effects of methamphetamine, resulting in greater depression of tryptophan hydroxylase (TPH) and tyrosine hydroxylase (TH) activity, as well as a significant reduction in dopamine levels. This has not been shown in humans.
Nifedipine Gits (Procardia Xl)
Theoretically, taking melatonin with extended release nifedipine reduces the effects of nifedipine.
Melatonin can decrease the effectiveness of extended release nifedipine (GITS). Immediate-release melatonin 5 mg at night in combination with nifedipine GITS 30-60 mg daily increases systolic and blood pressure by an average of 6.5 mmHg and 4.9 mmHg, respectively. Concomitant use with melatonin also increases heart rate by 3.9 bpm. The mechanism of this interaction is not known.
Seizure Threshold Lowering Drugs
Theoretically, taking melatonin with drugs that lower the seizure threshold might increase the risk of seizure activity.
Some clinical evidence suggests that melatonin may increase the frequency of seizures in certain patients, particularly children with neurological disabilities.
Warfarin (Coumadin)
Theoretically, melatonin may have antiplatelet effects and may increase the risk of bleeding with warfarin.
Three cases of increased prothrombin time have been reported for patients aged 48-72 years who took melatonin orally in combination with warfarin. However, three cases of decreased prothrombin time have also been reported for patients aged 51-84 years who took melatonin orally in combination with warfarin. Until more is known, use melatonin cautiously in patients taking warfarin.
Cytochrome P450 2D6 (Cyp2D6) Substrates
Theoretically, melatonin might increase levels of drugs metabolized by CYP2D6.
Laboratory research suggests that certain lots of melatonin inhibit CYP2D6. Theoretically, combined administration of melatonin with certain drugs metabolized by the CYP2D6 enzyme may reduce the metabolism of these drugs, resulting in increased serum levels. Until more is known, use melatonin cautiously in patients taking drugs metabolized by these enzymes.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, melatonin might increase levels of drugs metabolized by CYP3A4.
Laboratory research shows that certain lots of melatonin inhibit CYP3A4. Theoretically, combined administration of melatonin with certain drugs metabolized by CYP3A4 may reduce the metabolism of these drugs, resulting in increased serum levels. Until more is known, use melatonin cautiously in patients taking drugs metabolized by these enzymes.
Flumazenil (Romazicon)
Theoretically, taking flumazenil with melatonin might reduce the effects of melatonin.
Animal research shows that flumazenil may inhibit the effect of melatonin.
Wolfberry
Warfarin (Coumadin)
Goji can increase the effects of warfarin and possibly increase the risk of bleeding.
There are at least 5 case reports of increased international normalized ratio (INR) in patients stabilized on warfarin who began drinking goji juice, concentrated goji tea, or goji wine. Goji may inhibit the metabolism of warfarin by cytochrome P450 2C9 (CYP2C9).
Antihypertensive Drugs
Theoretically, concomitant use of goji root bark, but not goji fruit, with antihypertensive drugs might have additive effects.
Animal and in vitro research suggest that goji root bark has hypotensive effects. However, goji fruit juice does not appear to reduce systolic or diastolic blood pressure in humans.
Cytochrome P450 2C19 (Cyp2C19) Substrates
Theoretically, goji berry might inhibit CYP2C19 and reduce metabolism of CYP2C19 substrates.
In vitro research shows that goji berry tincture and juice inhibit CYP2C19 enzymes. Concomitant use with goji may decrease metabolism and increase levels of CYP2C19 substrates. However, this has not been reported in humans.
Cytochrome P450 2C9 (Cyp2C9) Substrates
Theoretically, goji berry might inhibit CYP2C9 and reduce metabolism of CYP2C9 substrates.
In vitro research shows that goji berry tincture and juice inhibit CYP2C9 enzymes. Additionally, multiple case reports suggest that goji berry concentrated tea and juice inhibit the metabolism of warfarin, a CYP2C9 substrate. Concomitant use with goji may decrease metabolism and increase levels of CYP2C9 substrates.
Cytochrome P450 2D6 (Cyp2D6) Substrates
Theoretically, goji berry might inhibit CYP2D6 and reduce metabolism of CYP2D6 substrates.
In vitro research shows that goji berry juice inhibits CYP2D6 enzymes. Concomitant use with goji may decrease metabolism and increase levels of CYP2D6 substrates. However, this has not been reported in humans.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, goji berry might inhibit CYP3A4 and reduce metabolism of CYP3A4 substrates.
In vitro research shows that goji berry juice inhibits CYP3A4 enzymes. Concomitant use with goji may decrease metabolism and increase levels of CYP3A4 substrates. However, this has not been reported in humans.
Flecainide (Tambocor)
Theoretically, goji berry might increase the levels and clinical effects of flecainide.
In one case report, a 75-year-old patient stable on flecainide and warfarin presented to the emergency room with fainting and pleomorphic arrhythmia caused by flecainide toxicity. Flecainide toxicity was attributed to drinking 1-2 glasses of concentrated goji tea daily for 2 weeks. Theoretically, goji may have inhibited the cytochrome P450 2D6 (CYP2D6) metabolism of flecainide.
Antidiabetes Drugs
Theoretically, concomitant use of goji fruit polysaccharides or goji root bark with antidiabetes drugs might have additive effects.
Animal and in vitro research show that goji root bark and fruit polysaccharides might have hypoglycemic effects. However, clinical research has only shown that taking goji fruit polysaccharides with or without antidiabetes drugs modestly reduces postprandial glucose when compared with control, with no reports of hypoglycemia.
Selenium
Anticoagulant/Antiplatelet Drugs
Selenium may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Clinical research suggests that taking selenium 10 mcg/kg/day can increase bleeding times by increasing prostacyclin production, which inhibits platelet activity. Other clinical research suggests that taking selenium 75 mcg daily, in combination with ascorbic acid 600 mg, alpha-tocopherol 300 mg, and beta-carotene 27 mg, reduces platelet aggregation.
Barbiturates
Theoretically, selenium might prolong the sedating effects of barbiturates.
Laboratory research suggests that selenium can inhibit the hepatic metabolism of barbiturates. Selenium seems to prolong the sedative effect of pentobarbital in animal models.
Immunosuppressants
Theoretically, selenium supplementation may reduce the effectiveness of immunosuppressant therapy.
In vitro research and preliminary clinical evidence suggests that selenium may stimulate the immune system.
Warfarin (Coumadin)
Theoretically, selenium might interfere with warfarin activity.
Animal research suggests that selenium can increase warfarin activity. Selenium might interact with warfarin by displacing it from albumin binding sites, reducing its metabolism in the liver, or by decreasing production of vitamin K-dependent clotting factors. Selenium can also prolong bleeding times in humans by increasing prostacyclin production, which inhibits platelet activity.
Contraceptive Drugs
Contraceptive drugs might increase levels of selenium, although the clinical significance of this effect is unclear.
Some research suggests that oral contraceptives increase serum selenium levels in women taking oral contraceptives; however, other research shows no change in selenium levels. It is suggested that an increase could be due to increased carrier proteins, indicating a redistribution of selenium rather than a change in total body selenium.
Niacin
Selenium might reduce the beneficial effects of niacin on high-density lipoprotein (HDL) levels.
A combination of niacin and simvastatin (Zocor) effectively raises HDL cholesterol levels in patients with coronary disease and low HDL levels. Clinical research shows that taking a combination of antioxidants (vitamin C, vitamin E, beta-carotene, and selenium) along with niacin and simvastatin (Zocor) attenuates this rise in HDL, specifically the HDL-2 and apolipoprotein A1 fractions, by more than 50% in patients with coronary disease. It is not known whether this adverse effect is due to a single antioxidant such as selenium, or to the combination. It also is not known whether it will occur in other patient populations.
Strawberry, Powder
Anticoagulant/Antiplatelet Drugs
In vitro and animal research suggests that strawberry extract can inhibit platelet aggregation due to its phenolic content. Theoretically, strawberry might increase the risk of bleeding when used with antiplatelet or anticoagulant drugs.
Some anticoagulant or antiplatelet drugs include aspirin, clopidogrel (Plavix), dalteparin (Fragmin), enoxaparin (Lovenox), heparin, ticlopidine (Ticlid), warfarin (Coumadin), and others.
P-Glycoprotein Substrates
In vitro research suggests that strawberry extract can inhibit p-glycoprotein efflux. Theoretically, strawberry might inhibit p-glycoprotein mediated drug efflux and potentially increase levels of drugs that are substrates of p-glycoprotein. Until more is known, strawberry should be used cautiously in people taking p-glycoprotein substrates.
Drugs that might be affected include some chemotherapeutic agents (etoposide, paclitaxel, vinblastine, vincristine, vindesine), antifungals (ketoconazole, itraconazole), protease inhibitors (amprenavir, indinavir, nelfinavir, saquinavir), H2 antagonists (cimetidine, ranitidine), some calcium channel blockers (diltiazem, verapamil), corticosteroids, erythromycin, cisapride (Propulsid), fexofenadine (Allegra), cyclosporine, loperamide (Imodium), quinidine, and others.
Maitake Mushroom mycelia powder
Antidiabetes Drugs
Theoretically, combining maitake mushroom with antidiabetes drugs might increase the risk of hypoglycemia.
Clinical research shows that taking maitake mushroom polysaccharide (MMP) can lower blood glucose levels in patients with types 2 diabetes.
Antihypertensive Drugs
Theoretically, combining maitake mushroom with antihypertensive drugs might increase the risk of hypotension.
Animal research shows that maitake mushroom can lower blood pressure.
Warfarin (Coumadin)
There is limited evidence that maitake mushroom may increase the anticoagulant effects of warfarin.
In a case report, a patient previously stabilized on warfarin developed an elevated international normalized ratio (INR) of 5.1 after taking maitake mushroom (Grifron-Pro Maitake D-Fraction) 1 drop/kg daily in three divided doses for one week. The elevated INR resolved after holding warfarin for two days, then reducing the dose by 11%. It is thought that the beta-glucan constituent of maitake mushroom might cause warfarin dissociation from proteins, resulting in increased free warfarin levels and increased warfarin effects.
Orange Peel Oil
Celiprolol (Celicard)
Consuming sweet orange with celiprolol can decrease oral absorption of celiprolol.
A pharmacokinetic study in healthy volunteers shows that celiprolol levels, after a single dose of 100 mg, are decreased by up to 90% in people who drink sweet orange juice 200 mL three times daily. It's not known if lower consumption of sweet orange juice will have the same effect. Theoretically, this occurs due to short-term inhibition of organic anion transporting polypeptide (OATP). Recommend separating drug administration and consumption of sweet orange by at least 4 hours.
Ivermectin (Stromectol, Others)
Consuming sweet orange juice with ivermectin can decrease the oral absorption of ivermectin.
A pharmacokinetic study in healthy volunteers shows that taking ivermectin orally with sweet orange juice 750 mL over 4 hours reduces the bioavailability of ivermectin. This effect does not seem to be related to effects on P-glycoprotein. The effect on ivermectin is more pronounced in males compared to females.
Organic Anion-Transporting Polypeptide Substrates (Oatp)
Consuming sweet orange juice can decrease oral absorption of OATP substrates. Separate administration by at least 4 hours.
Clinical research shows that consuming sweet orange juice inhibits OATP, which reduces bioavailability of oral drugs that are substrates of OATP. For example, sweet orange juice decreases bioavailability of fexofenadine, a substrate of OATP, by about 72% and of celiprolol, another OATP substrate, by up to 90%. Since sweet orange juice seems to affect OATP for a short time, recommend separating drug administration and consumption of sweet orange juice by at least 4 hours.
Pravastatin (Pravachol)
Consuming sweet orange juice with pravastatin can increase the absorption of pravastatin.
A small pharmacokinetic study in healthy volunteers shows that consuming sweet orange juice 800 mL over 3 hours, including before, during, and after taking pravastatin 10 mg, increases pravastatin levels by about 149%, without affecting pravastatin elimination. Theoretically this effect might be due to modulation of organic anion transporting polypeptides (OATPs) by sweet orange juice. Sweet orange juice does not seem to affect simvastatin levels, but it is not known if sweet orange affects any of the other statins.
Fexofenadine (Allegra)
Consuming sweet orange juice with fexofenadine can decrease oral absorption of fexofenadine.
Clinical research shows that coadministration of sweet orange juice 1200 mL decreases bioavailability of fexofenadine by about 72%. In an animal model, sweet orange juice decreased bioavailability of fexofenadine by 31%. Fexofenadine manufacturer data indicates that concomitant administration of sweet orange juice and fexofenadine results in larger wheal and flare sizes in research models. This suggests that sweet orange reduces the clinical response to fexofenadine. Theoretically, this occurs due to short-term inhibition of organic anion transporting polypeptide (OATP). Recommend separating drug administration and consumption of sweet orange by at least 4 hours.
P-Glycoprotein Substrates
Sweet orange juice seems to modulate P-glycoprotein (P-gp), which might affect the blood levels of P-gp substrates.
Animal and in vitro research suggest that orange juice extract inhibits drug efflux by P-gp, increasing absorption and levels of P-gp substrates. In contrast, pharmacokinetic research in humans shows that drinking large amounts of sweet orange juice decreases absorption and levels of the P-gp substrate celiprolol. This suggests that orange juice actually induces drug efflux by P-gp or affects drug levels by another mechanism such as inhibiting the gut drug transporter called organic anion transporting polypeptide (OATP). Until more is known, sweet orange juice should be used cautiously in people taking P-gp substrates.
Quinolone Antibiotics
Calcium-fortified sweet orange juice might reduce quinolone absorption.
Calcium binds to quinolones in the gut. Theoretically, the calcium in certain fortified orange juices can also bind to quinolone antibiotics and reduce their absorption and levels.
Calcium
Ceftriaxone (Rocephin)
Co-administration of intravenous calcium and ceftriaxone can result in precipitation of a ceftriaxone-calcium salt in the lungs and kidneys.
Avoid administering intravenous calcium in any form, such as parenteral nutrition or Lactated Ringers, within 48 hours of intravenous ceftriaxone. Case reports in neonates show that administering intravenous ceftriaxone and calcium can result in precipitation of a ceftriaxone-calcium salt in the lungs and kidneys. In several cases, neonates have died as a result of this interaction. So far there are no reports in adults; however, there is still concern that this interaction might occur in adults.
Dolutegravir (Tivicay)
Calcium seems to reduce levels of dolutegravir.
Advise patients to take dolutegravir either 2 hours before or 6 hours after taking calcium supplements. Pharmacokinetic research suggests that taking calcium carbonate 1200 mg concomitantly with dolutegravir 50 mg reduces plasma levels of dolutegravir by almost 40%. Calcium appears to decrease levels of dolutegravir through chelation.
Elvitegravir (Vitekta)
Calcium seems to reduce levels of elvitegravir.
Advise patients to take elvitegravir either 2 hours before or 2 hours after taking calcium supplements. Pharmacokinetic research suggests that taking calcium along with elvitegravir can reduce blood levels of elvitegravir through chelation.
Aluminum
Calcium citrate might increase aluminum absorption and toxicity. Other types of calcium do not increase aluminum absorption.
Calcium citrate can increase the absorption of aluminum when taken with aluminum hydroxide. The increase in aluminum levels may become toxic, particularly in individuals with kidney disease. However, the effect of calcium citrate on aluminum absorption is due to the citrate anion rather than calcium cation. Calcium acetate does not appear to increase aluminum absorption.
Bictegravir/Emtricitabine/Tenofovir Alafenamide (Biktarvy)
Calcium might decrease levels of bictegravir/emtricitabine/tenofovir alafenamide by reducing its absorption when taken in a fasting state.
Advise patients that bictegravir/emtricitabine/tenofovir alafenamide and calcium can be taken together if taken with food. However, if taken on an empty stomach, bictegravir/emtricitabine/tenofovir alafenamide should not be taken with, or 2 hours after, calcium containing products.
Bisphosphonates
Calcium reduces the absorption of bisphosphonates.
Advise patients to take bisphosphonates at least 30 minutes before calcium, but preferably at a different time of day. Calcium supplements decrease absorption of bisphosphonates.
Calcipotriene (Dovonex)
Taking calcipotriene with calcium might increase the risk for hypercalcemia.
Calcipotriene is a vitamin D analog used topically for psoriasis. It can be absorbed in sufficient amounts to cause systemic effects, including hypercalcemia. Theoretically, combining calcipotriene with calcium supplements might increase the risk of hypercalcemia.
Digoxin (Lanoxin)
Using intravenous calcium with digoxin might increase the risk of fatal cardiac arrhythmias.
Hypercalcemia increases the risk of fatal cardiac arrhythmias with digoxin. However, one retrospective analysis of clinical data suggests that intravenous calcium does not increase the risk of dysrhythmias or mortality in patients receiving digoxin.
Diltiazem (Cardizem, Others)
Theoretically, calcium may reduce the therapeutic effects of diltiazem.
Hypercalcemia can reduce the effectiveness of verapamil in atrial fibrillation. Theoretically, calcium might increase this risk of hypercalcemia and reduce the effectiveness of diltiazem.
Levothyroxine (Synthroid, Others)
Calcium seems to reduce the absorption and effectiveness of levothyroxine.
Advise patients to take levothyroxine and calcium supplements at least 4 hours apart. Calcium reduces levothyroxine absorption, probably by forming insoluble complexes. Calcium carbonate supplements reduce effectiveness of levothyroxine in patients with hypothyroidism.
Lithium
Theoretically, concomitant use of calcium and lithium may increase this risk of hypercalcemia.
Clinical research suggests that long-term use of lithium may cause hypercalcemia in 10% to 60% of patients. Theoretically, concomitant use of lithium and calcium supplements may further increase this risk.
Quinolone Antibiotics
Calcium seems to reduce the absorption of quinolone antibiotics.
Advise patients to take oral quinolones at least 2 hours before or 4-6 hours after calcium supplements or calcium-fortified foods. Taking calcium at the same time as oral quinolones can reduce quinolone absorption. Calcium binds to quinolones in the gut.
Raltegravir (Isentress)
Calcium may reduce levels of raltegravir.
Pharmacokinetic research shows that taking a single dose of calcium carbonate 3000 mg along with raltegravir 400 mg twice daily modestly decreases the mean area under the curve of raltegravir, but the decrease does not necessitate a dose adjustment of raltegravir. However, a case of elevated HIV-1 RNA levels and documented resistance to raltegravir has been reported for a patient taking calcium carbonate 1 gram three times daily plus vitamin D3 (cholecalciferol) 400 IU three times daily in combination with raltegravir 400 mg twice daily for 11 months. It is thought that calcium reduced raltegravir levels by chelation, leading to treatment failure.
Sotalol (Betapace)
Calcium seems to reduce the absorption of sotalol.
Advise patients to separate doses by at least 2 hours before or 4-6 hours after calcium. Calcium appears to reduce the absorption of sotalol, probably by forming insoluble complexes.
Tetracycline Antibiotics
Calcium seems to reduce the absorption of tetracycline antibiotics.
Advise patients to take oral tetracyclines at least 2 hours before, or 4-6 hours after calcium supplements. Taking calcium at the same time as oral tetracyclines can reduce tetracycline absorption. Calcium binds to tetracyclines in the gut.
Thiazide Diuretics
Taking calcium along with thiazides might increase the risk of hypercalcemia and renal failure.
Thiazides reduce calcium excretion by the kidneys. Using thiazides along with moderately large amounts of calcium carbonate increases the risk of milk-alkali syndrome (hypercalcemia, metabolic alkalosis, renal failure). Patients may need to have their serum calcium levels and/or parathyroid function monitored regularly.
Verapamil (Calan, Others)
Theoretically, calcium may reduce the therapeutic effects of verapamil.
Hypercalcemia can reduce the effectiveness of verapamil in atrial fibrillation. Theoretically, use of calcium supplements may increase this risk of hypercalcemia and reduce the effectiveness of verapamil.
Calcium Channel Blockers
Intravenous calcium may decrease the effects of calcium channel blockers; oral calcium is unlikely to have this effect.
Intravenous calcium is used to decrease the effects of calcium channel blockers in the management of overdose. Intravenous calcium gluconate has been used before intravenous verapamil (Isoptin) to prevent or reduce the hypotensive effects without affecting the antiarrhythmic effects. But there is no evidence that dietary or supplemental calcium when taken orally interacts with calcium channel blockers.
Raspberry fruit powder
Anticoagulant/Antiplatelet Drugs
Theoretically, taking red raspberry leaf with anticoagulant/antiplatelet drugs might increase the risk of bleeding.
In vitro research suggests that red raspberry leaf extract has antiplatelet activity and enhances the in vitro effects of the antiplatelet medication cangrelor. This interaction has not been reported in humans.
Insulin
Red raspberry leaf might reduce glucose levels in patients being treated with insulin.
In one case report, a 38-year-old patient with gestational diabetes, whose blood glucose was being controlled with medical nutrition therapy and insulin, developed hypoglycemia after consuming two servings of raspberry leaf tea daily for 3 days beginning at 32 weeks' gestation. The patient required an insulin dose reduction. The hypoglycemia was considered to be probably related to use of red raspberry leaf tea.
Arabinogalactan
Immunosuppressants
Theoretically, larch arabinogalactan might interfere with immunosuppression therapy due to immunostimulant effects. Immunosuppressant drugs include azathioprine (Imuran), basiliximab (Simulect), cyclosporine (Neoral, Sandimmune), daclizumab (Zenapax), muromonab-CD3 (OKT3, Orthoclone OKT3), mycophenolate (CellCept), tacrolimus (FK506, Prograf), sirolimus (Rapamune), prednisone (Deltasone, Orasone), corticosteroids (glucocorticoids), and other drugs.
Zinc
Bictegravir/Emtricitabine/Tenofovir Alafenamide (Biktarvy)
Theoretically, zinc might decrease levels of bictegravir/emtricitabine/tenofovir alafenamide by reducing its absorption.
Advise patients that bictegravir/emtricitabine/tenofovir alafenamide should be taken at least 2 hours before or 6 hours after zinc containing products.
Cephalexin (Keflex)
Zinc might decrease cephalexin levels by chelating with cephalexin in the gut and preventing its absorption.
A pharmacokinetic study shows that zinc sulfate 250 mg taken concomitantly with cephalexin 500 mg decreases peak levels of cephalexin by 31% and reduces the exposure to cephalexin by 27%. Also, taking zinc sulfate 3 hours before cephalexin decreases peak levels of cephalexin by 11% and reduces the exposure to cephalexin by 18%. By decreasing cephalexin levels, zinc might increase the risk of treatment failure. This effect does not occur when zinc is taken 3 hours after the cephalexin dose. To avoid an interaction, advise patients take zinc sulfate 3 hours after taking cephalexin.
Cisplatin (Platinol-Aq)
Theoretically, zinc might interfere with the therapeutic effects of cisplatin.
Animal research suggests that zinc stimulates tumor cell production of the protein metallothionein, which binds and inactivates cisplatin. It is not known whether zinc supplements or high dietary zinc intake can cause clinically significant interference with cisplatin therapy. Cisplatin might also increase zinc excretion.
Integrase Inhibitors
Theoretically, taking zinc along with integrase inhibitors might decrease the levels and clinical effects of these drugs.
Zinc is a divalent cation. Pharmacokinetic studies have shown that other divalent cations such as calcium and iron can decrease blood levels of the integrase inhibitor dolutegravir through chelation.
Penicillamine (Cuprimine, Depen)
Zinc might reduce the levels and clinical effects of penicillamine.
By forming an insoluble complex with penicillamine, zinc interferes with penicillamine absorption and activity. Zinc supplements reduce the efficacy of low-dose penicillamine (0.5-1 gram/day), but do not seem to affect higher doses (1-2.75 gram/day), provided dosing times are separated. Advise patients to take zinc and penicillamine at least 2 hours apart.
Quinolone Antibiotics
Zinc can decrease the levels and clinical effects of quinolones antibiotics.
Quinolones form complexes with zinc in the gastrointestinal tract, reducing absorption of both the quinolone and zinc if taken at the same time. Advise patients to take these drugs at least 2 hours before, or 4-6 hours after, zinc supplements.
Ritonavir (Norvir)
Zinc modestly reduces levels of ritonavir.
Clinical research shows that zinc might reduce serum ritonavir levels by chelating with ritonavir in the gut and preventing its absorption. In patients with HIV, ritonavir is taken with atazanavir to prevent the metabolism and increase the effects of atazanavir. A pharmacokinetic study shows that, in patients being treated with atazanavir/ritonavir, co-administration of zinc sulfate (Solvazinc tablets) 125 mg as a single dose or as multiple daily doses for 2 weeks reduces plasma levels of ritonavir by about 16%. However, atazanavir levels still remains high enough to prevent HIV virus replication. Therefore, the decrease in ritonavir levels is not likely to be clinically significant.
Tetracycline Antibiotics
Zinc might reduce levels of tetracycline antibiotics.
Tetracyclines form complexes with zinc in the gastrointestinal tract, which can reduce absorption of both the tetracycline and zinc when taken at the same time. Taking zinc sulfate 200 mg with tetracycline reduces absorption of the antibiotic by 30% to 40%. Demeclocycline and minocycline cause a similar interaction. However, doxycycline does not seem to interact significantly with zinc. Advise patients to take tetracyclines at least 2 hours before, or 4-6 hours after, zinc supplements to avoid any interactions.
Amiloride (Midamor)
Amiloride can modestly reduce zinc excretion and increase zinc levels.
Clinical research shows that amiloride can reduce urinary zinc excretion, especially at doses of 10 mg per day or more. This zinc-sparing effect can help to counteract zinc losses caused by thiazide diuretics, but it is unlikely to cause zinc toxicity at usual amiloride doses. The other potassium-sparing diuretics, spironolactone (Aldactone) and triamterene (Dyrenium), do not seem to have a zinc-sparing effect.
Atazanavir (Reyataz)
Zinc modestly reduces levels of atazanavir, although this effect does not seem to be clinically significant.
Clinical research shows that zinc might decrease serum atazanavir levels by chelating with atazanavir in the gut and preventing its absorption. Although a single dose of zinc sulfate (Solvazinc tablets) 125 mg orally does not affect atazanavir concentrations in patients being treated with atazanavir/ritonavir, co-administration of zinc sulfate 125 mg daily for 2 weeks reduces plasma levels of atazanavir by about 22% in these patients. However, despite this decrease, atazanavir levels still remain at high enough concentrations for the prevention of HIV virus replication.
Copper
Penicillamine (Cuprimine, Depen)
Theoretically, taking copper with penicillamine might decrease the absorption of penicillamine; separate dosing by at least 2 hours.
Copper chelates penicillamine, which decreases its absorption and may reduce its clinical effects.
Contraceptive Drugs
Theoretically, taking copper with contraceptive drugs might increase the levels and toxic effects of copper.
A meta-analysis of clinical studies suggests that chronic use of oral contraceptives increases serum copper levels by a mean of 57 mcg/dL. In most people, this resulted in levels above the normal reference range for copper.
Brand information
Manufacturer and brand details for ImmuPro, from the product label.
Young Living Essential Oils
See all Young Living Essential Oils products- Name
- Young Living Essential Oils, LC
- City
- Lehi
- State
- Utah
- ZipCode
- 84043
- Phone Number
- 1-800-371-3515
- Web Address
- YoungLiving.com
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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 ImmuPro’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Calcium
Interacts with 168 drugsCalcium is an essential mineral your body needs for strong bones, nerve signaling, and muscle function, and supplements can help fill gaps when diet falls short. Most people do best getting...
Read the full Calcium monograph → Herb & supplement monographMelatonin
Interacts with 1,461 drugsMelatonin is a hormone your body makes naturally to help control your sleep-wake cycle, and the supplement form is widely used to help with sleep timing problems and jet lag. The evidence is...
Read the full Melatonin monograph → Herb & supplement monographCopper
Interacts with 31 drugsCopper is an essential trace mineral your body needs in small amounts for making red blood cells, supporting nerves and bones, and helping enzymes work. Most people get enough copper from fo...
Read the full Copper monograph → Herb & supplement monographZinc
Interacts with 67 drugsZinc is an essential mineral that your body needs for immune function, wound healing, taste, and smell. Most people get enough from food, but supplements can help correct or prevent a defici...
Read the full Zinc monograph → Herb & supplement monographSelenium
Interacts with 321 drugsSelenium is an essential trace mineral your body needs in small amounts for thyroid function, antioxidant defense, and immune health. Most people who eat a varied diet get enough, and supple...
Read the full Selenium monograph → Herb & supplement monographLarch Arabinogalactan
Interacts with 121 drugsLarch arabinogalactan is a soluble fiber from larch trees that is mainly used as a prebiotic and for immune support. Early research is interesting but limited, and most claims are not yet fi...
Read the full Larch Arabinogalactan monograph → Herb & supplement monographRed Raspberry
Interacts with 135 drugsRed raspberry leaf is a traditional herbal remedy most often used as a tea in late pregnancy and for menstrual discomfort, but solid scientific evidence for these uses is limited. It is gene...
Read the full Red Raspberry monograph → Herb & supplement monographStrawberry
Interacts with 316 drugsStrawberry is a popular, nutrient-rich fruit that supplies vitamin C, fiber, and antioxidant plant compounds. Eating strawberries as part of a balanced diet is healthy for most people, but c...
Read the full Strawberry monograph → Herb & supplement monographGoji
Interacts with 1,000 drugsGoji berries are a nutritious fruit rich in antioxidants, vitamins, and plant polysaccharides, and they are safe for most people as a food. While they are popular for eye health, immune supp...
Read the full Goji monograph → Herb & supplement monographMaitake Mushroom
Interacts with 260 drugsMaitake is an edible mushroom long used as food and in traditional Japanese medicine, and it is being studied for possible immune, blood sugar, and blood pressure effects. The human evidence...
Read the full Maitake Mushroom monograph → Herb & supplement monographSweet Orange
Interacts with 246 drugsSweet orange is a common citrus fruit that is a good source of vitamin C, fiber, and antioxidants, and is enjoyed as a food worldwide. Its peel and essential oil are used in aromatherapy and...
Read the full Sweet Orange monograph →Sources & How We Checked
ImmuPro'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 388 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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- Thys-Jacobs S, Ceccarelli S, Bierman A, et al. Calcium supplementation in premenstrual syndrome: a randomized crossover trial. J Gen Intern Med 1989;4:183-9. PubMed
- Maton PN, Burton ME. Antacids revisited: a review of their clinical pharmacology and recommended therapeutic use. Drugs 1999;57:855-70.
- Clemens JD, Feinstein AR. Calcium carbonate and constipation: a historical review of medical mythopoeia. Gastroenterology 1977;72:957-61. DOI
- Saunders D, Sillery J, Chapman R. Effect of calcium carbonate and aluminum hydroxide on human intestinal function. Dig Dis Sci 1988;33:409-13. PubMed
- Friedman PA, Bushinsky DA. Diuretic effects on calcium metabolism. Semin Nephrol 1999;19:551-6.
- Koo WK, Walters JC, Esterlitz J, et al. Maternal calcium supplementation and fetal bone mineralization. Obstet Gynecol 1999;94:577-82. DOI
- Raman L, Rajalakshmi K, Krishnamachari KAVR, et al. Effect of calcium supplementation to undernourished mothers during pregnancy on the bone density of the neonates. Am J Clin Nutr 1978; 31:466-9. DOI
- Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
- Chan JM, Giovannucci E, Andersson SO, et al. Dairy products, calcium, phosphorous, vitamin D, and risk of prostate cancer. Cancer Causes Control 1998;9:559-66.
- Butner LE, Fulco PP, Feldman G, et al. Calcium carbonate-induced hypothyroidism. Ann Intern Med 2000:132:595. PubMed
- Schneyer CR. Calcium carbonate and reduction of levothyroxine efficacy. JAMA 1998;279:750. PubMed
- Moser LR, Smythe MA, Tisdale JE. The use of calcium salts in the prevention and management of verapamil-induced hypotension. Ann Pharmacother 2000;34:622-9. PubMed
- Singh N, Singh PN, Hershman JM. Effect of calcium carbonate on the absorption of levothyroxine. JAMA 2000;283:2822-5. PubMed
- Kahela P, Anttila M, Tikkanen R, Sundquist H. Effect of food, food constituents and fluid volume on the bioavailability of sotalol. Acta Pharmacol Toxicol (Copenh) 1979;44:7-12.. PubMed
- Pletz MW, Petzold P, Allen A, et al. Effect of calcium carbonate on bioavailability of orally administered gemifloxacin. Antimicrob Agents Chemother 2003;47:2158-60.. PubMed
- Bar-Or D, Yoel G. Calcium and calciferol antagonize effect of verapamil in atrial fibrillation. Br Med J 1981;282:1585-6.
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- Peters ML, Leonard M, Licata AA. Role of alendronate and risedronate in preventing and treating osteoporosis. Cleve Clin J Med 2001;68:945-51. PubMed
- Bourke JF, Mumford R, Whittaker P, et al. The effects of topical calcipotriol on systemic calcium homeostasis in patients with chronic plaque psoriasis. J Am Acad Dermatol 1997;37:929-34.
- Gueguen L, Pointillart A. The bioavailability of dietary calcium. J Am Coll Nutr 2000;19:119s-136s. PubMed
- Vella A, Gerber TC, Hayes DL, Reeder GS. Digoxin, hypercalcaemia, and cardiac conduction. Postgrad Med J 1999;75:554-6. PubMed
- Bania TC, Blaufeux B, Hughes S, et al. Calcium and digoxin vs. calcium alone for severe verapamil toxicity. Acad Emerg Med 2000;7:1089-96. PubMed
- Tseng M, Breslow RA, Graubard BI, Ziegler RG. Dairy, calcium, and vitamin D intakes and prostate cancer risk in the National Health and Nutrition Examination Epidemiologic Follow-up Study cohort. Am J Clin Nutr 2005;81:1147-54. PubMed
- Weingarten MA, Zalmanovici A, Yaphe J. Dietary calcium supplementation for preventing colorectal cancer and adenomatous polyps. Cochrane Database Syst Rev 2004;(1):CD003548. PubMed
- Tavani A, Bertuccio P, Bosetti C, et al. Dietary intake of calcium, vitamin D, phosphorus and the risk of prostate cancer. Eur Urol 2005;48:27-33. PubMed
- Giovannucci E, Liu Y, Stampfer MJ, Willett WC. A prospective study of calcium intake and incident and fatal prostate cancer. Cancer Epidemiol Biomarkers Prev 2006;15:203-10. PubMed
- Rocephin (ceftriaxone) and calcium interaction. Pharmacist's Letter / Prescriber's Letter 2007;23(10):231005.
- Bolland MJ, Barber PA, Doughty RN, et al. Vascular events in healthy older women receiving calcium supplementation: randomised control trial. BMJ 2008;336:262-6.
- Bolland MJ, Avenell A, Baron JA, et al. Effect of calcium supplements on risk of myocardial infarction and cardiovascular events: meta-analysis. BMJ 2010;341:c3691. PubMed
- Calcium supplementation and vascular events. Pharmacist's Letter / Prescriber's Letter 2008;24(3):240306.
- Dietary reference intakes for calcium and vitamin D. Institute of Medicine, November 30, 2010. Available at: http://www.iom.edu/~/media/Files/Report%20Files/2010/Dietary-Reference-Intakes-for-Calcium-and-Vitamin-D/Vitamin%20D%20and%20Calcium%202010%20Repo
- Coburn JW, Mischel MG, Goodman WG, et al. Calcium citrate markedly enhances aluminum absorption from aluminum hydroxide. Am J Kidney Dis. 1991;17(6):708-11. PubMed
- Bradley JS, Wassel RT, Lee L, et al. Intravenous ceftriaxone and calcium in the neonate: assessing the risk for cardiopulmonary adverse events. Pediatrics. 2009;123(4):e609-13. PubMed
- Kays MB, Overholser BR, Mueller BA, et al. Effects of sevelamer hydrochloride and calcium acetate on the oral bioavailability of ciprofloxacin. Am J Kidney Dis. 2003;42(6):1253-9. PubMed
- Neuhofel, A. L., Wilton, J. H., Victory, J. M., Hejmanowsk, L. G., and Amsden, G. W. Lack of bioequivalence of ciprofloxacin when administered with calcium-fortified orange juice: a new twist on an old interaction. J Clin Pharmacol. 2002;42(4):461-466. DOI
- Dickinson, H. O., Nicolson, D. J., Cook, J. V., Campbell, F., Beyer, F. R., Ford, G. A., and Mason, J. Calcium supplementation for the management of primary hypertension in adults. Cochrane.Database.Syst.Rev. 2006;(2):CD004639. PubMed
- Jones, B. J. and Twomey, P. J. Requesting patterns for serum calcium concentration in patients on long-term lithium therapy. Int J Clin Pract. 2009;63(1):170-172. PubMed
- Levine, M., Nikkanen, H., and Pallin, D. J. The effects of intravenous calcium in patients with digoxin toxicity. J Emerg.Med. 2011;40(1):41-46. PubMed
- Castelo-Branco, C., Ciria-Recasens, M., Cancelo-Hidalgo, M. J., Palacios, S., Haya-Palazuelos, J., Carbonell-Abello, J., Blanch-Rubio, J., Martinez-Zapata, M. J., Manasanch, J., and Perez-Edo, L. Efficacy of ossein-hydroxyapatite complex compared with ca
- Li K, Kaaks R, Linseisen J, Rohrmann S. Associations of dietary calcium intake and calcium supplementation with myocardial infarction and stroke risk and overall cardiovascular mortality in the Heidelberg cohort of the European Prospective Investigation i
- Chung M, Tang AM, Fu Z. Calcium Intake and Cardiovascular Disease Risk: An Updated Systematic Review and Meta-analysis. Ann Intern Med. 2016 Oct 25. PubMed
- Nolan CR, Califano JR, Butzin CA. Influence of calcium acetate or calcium citrate on intestinal aluminum absorption. Kidney Int. 1990;38(5):937-41. PubMed
- Lewis JR, Radavelli-Bagatini S, Rejnmark L, et al. The effects of calcium supplementation on verified coronary heart disease hospitalization and death in postmenopausal women: a collaborative meta-analysis of randomized controlled trials. J Bone Miner Res PubMed
- Jalloh MA, Gregory PJ, Hein D, et al. Dietary supplement interactions with antiretrovirals: a systematic review. Int J STD AIDS. 2017 Jan;28(1):4-15. PubMed
- Lappe J, Watson P, Travers-Gustafson D, Recker R, Garland C, Gorham E, Baggerly K, McDonnell SL. Effect of Vitamin D and Calcium Supplementation on Cancer Incidence in Older Women: A Randomized Clinical Trial. JAMA. 2017 Mar 28;317(12):1234-1243. PubMed
- Grove ML, Cook D. Calcium and heart attacks. Doesn't apply to most calcium prescriptions. BMJ. 2010;341:c5003. PubMed
- Insentress [package insert]. Whitehouse Station, NJ: Merck Sharp & Dohme Corp.; 2014.
- Roberts JL, Kiser JJ, Hindman JT, Meditz AL. Virologic failure with a raltegravir-containing antiretroviral regimen and concomitant calcium administration. Pharmacotherapy 2011;31(10):298e-302e. DOI
- Vitekta [package insert]. Foster City, CA: Gilead Sciences, Inc.; 2014.
- Storan ER, O'Gorman SM, Murphy A, Laing M. Case Report of Calciphylaxis Secondary to Calcium and Vitamin D<sub>3</sub> Supplementation. J Cutan Med Surg. 2017;21(2):162-163. DOI
- Jenkins DJA, Spence JD, Giovannucci EL, et al. Supplemental vitamins and minerals for CVD prevention and treatment. J Am Coll Cardiol 2018;71(22):2570-84. PubMed
- Borkenhagen JF, Connor EL, Stafstrom CE. Neonatal hypocalcemic seizures due to excessive maternal calcium ingestion. Pediatr Neurol 2013;48(6):469-71. PubMed
- WHO recommendations on antenatal care for a positive pregnancy experience. Geneva: World Health Organization; 2016 (http://www.who.int/reproductivehealth/publications/maternal_perinatal_health/ anc-positive-pregnancy-experience/en/).
- Aune D, Navarro Rosenblatt DA, Chan DS, et al. Dairy products, calcium, and prostate cancer risk: a systematic review and meta-analysis of cohort studies. Am J Clin Nutr. 2015;101(1):87-117. PubMed
- Lan T, Park Y, Colditz GA, et al. Adolescent dairy product and calcium intake in relation to later prostate cancer risk and mortality in the NIH-AARP Diet and Health Study. Cancer Causes Control. 2020;31(10):891-904. PubMed
- Zhang Y, Li Y, Liu J, et al. Association of Vitamin D or Calcium Supplementation with Cardiovascular Outcomes and Mortality: A Meta-Analysis with Trial Sequential Analysis. J Nutr Health Aging 2021;25(2):263-270. PubMed
- Myung SK, Kim HB, Lee YJ, Choi YJ, Oh SW. Calcium Supplements and Risk of Cardiovascular Disease: A Meta-Analysis of Clinical Trials. Nutrients 2021;13(2):368. PubMed
- Hetaimish B. Neonatal Calcinosis Cutis After Treatment of Hypocalcemia with Calcium Gluconate: A Report of 2 Cases. Am J Case Rep 2024;25:e943397. PubMed
- US Food and Drug Administration (FDA). Biktarvy Prescribing Information. October 2024. Available at: https://www.accessdata.fda.gov/drugsatfda_docs/label/2024/210251Orig1s020lbl.pdf. Accessed July 16, 2025.
Melatonin 118 references
- Voordouw BC, Euser R, Verdonk RE, et al. Melatonin and melatonin-progestin combinations alter pituitary-ovarian function in women and can inhibit ovulation. J Clin Endocrinol Metab 1992;74:108-17. DOI
- Ellis CM, Lemmens G, Parkes JD. Melatonin and insomnia. J Sleep Res 1996;5:61-5. PubMed
- Petrie K, Dawson AG, Thompson L, Brook R. A double-blind trial of melatonin as a treatment for jet lag in international cabin crew. Biol Psychiatr 1993;33:526-30. PubMed
- Claustrat B, Brun J, David M, et al. Melatonin and jet lag: confirmatory result using a simplified protocol. Biol Psychiatr 1992;32:705-11.
- Fauteck J, Schmidt H, Lerchl A, et al. Melatonin in epilepsy: first results of replacement therapy and first clinical results. Biol Signals Recept 1999;8:105-10. PubMed
- Arangino S, Cagnacci A, Angiolucci M, et al. Effects of melatonin on vascular reactivity, catecholamine levels, and blood pressure in healthy men. Am J Cardiol 1999;83:1417-9. PubMed
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See these in context on the Larch Arabinogalactan monograph →
Red Raspberry 8 references
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Strawberry 18 references
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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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