Joint Maxx Ingredients & Drug Interactions
by NRG-X Labs
What is this page for?
First and foremost: checking Joint Maxx 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
Joint Maxx is a dietary supplement by NRG-X Labs with 8 active ingredients. Its ingredients are commonly taken for morning sickness in pregnancy, premenstrual syndrome (pms), preventing or treating b6 deficiency.Based on those ingredients, 1,356 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are Joint MaXX(TM) Complex(TM), Vitamin B6, Vitamin C. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against Joint Maxx by NRG-X Labs
Ask about any prescription or over-the-counter medication and we check it for interactions with Joint Maxx by NRG-X Labs — 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 Joint Maxx by NRG-X Labs
Four independent checks of what is known — a summary of the available information, not a grade of the product itself.
By FDA rules, dietary supplements can’t claim to treat, cure, or prevent disease — so labels speak in careful marketing language. We discern each product’s intended use from its name, label claims, and label statements, then grade the clinical evidence for that use. How these ratings are computed
The stated purpose hasn't been mapped to our evidence data yet.
Why this rating?
- We haven't mapped this product's purpose to our evidence data yet — it'll be graded on the next content refresh.
Every active ingredient lists its own amount on the label.
Why this rating?
- The label discloses an exact amount for 8 of its 8 active ingredients.
- No proprietary blends here — you can verify the dose of every single component.
At least one ingredient has a documented Major-severity interaction. Check your medications for a personalized result.
Why this rating?
- 7 of the 7 matched ingredients can interact with medications — Manganese, Calcium, Copper, Vitamin B6, Cannabis, among others.
- The most serious interaction on file is rated Major.
- Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs; cancer treatments; heart-rhythm medications; lithium; Parkinson's medications.
- For scale: 1,357 individual medications appear in the full list. A big number alone doesn't make a product dangerous — what matters is whether YOUR medication is on it, so run yours through the interaction checker on this page.
Adverse-effect, pregnancy, and general safety data are on file for most of these ingredients.
Why this rating?
- We hold adverse-effect (side-effect) data for 7 of the 7 matched ingredients.
- Pregnancy & breastfeeding safety ratings cover 7 of 7.
- General safety write-ups exist for 7 of 7.
- Remember: this measures how much safety information exists. Thin data is not the same as being safe.
HelloPharmacist summaryFully disclosed formula with no assessable stated purpose. Major medication interactions have been identified, and safety information is well characterized.
Assessment coverage: 7 of 8 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Mar 25, 2013.
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 Joint Maxx, straight from the product label.
| Brand | NRG-X Labs |
|---|---|
| Barcode (UPC) | 853363908076 |
| Net contents | 140 Capsule(s) |
| Market status | Off market |
| Date entered into DSLD | Mar 25, 2013 |
| DSLD ID | 18982 |
| Product type | Other Combinations |
| Supplement form | Capsule |
| 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 Joint Maxx by NRG-X Labs, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Vitamin B6 | 5 mg | 250% |
| Calcium | 100 mg | 10% |
| Vitamin C | 150 mg | 250% |
| Zinc | 10 mg | 67% |
| Methylsulfonylmethane | 1000 mg | -- |
| Manganese | 2 mg | 25% |
| Copper | 200 mcg | 10% |
| Joint MaXX(TM) Complex(TM) | 2082 mg | -- |
Other ingredients: Magnesium Stearate, Rice Flour, Gelatin, Titanium Dioxide
Tap any ingredient to jump to its full detail below.
These statements are the manufacturer’s wording, reproduced from the product label — the label is saying it, not HelloPharmacist. We don’t verify or endorse them.
Precautions
If you are taking aspirin or blood thinning or other medication, consult your physician before using this product.
Discontinue use two weeks prior to surgery or if stomach upset occurs.
WARNING: Do not exceed the recommended dosage.
Not for use by individuals under the age of 18 years.
Do not use if pregnant, nursing or have a serious medical condition.
Consult a physician before using this product.
KEEP OUT OF REACH OF CHILDREN
WARNING: Do not use if you have a serious medical condition, are pregnant, nursing or are allergic or contraindicated to aspirin.
FDA Disclaimer Statement
These statements have not been evaluated by the FDA. This product is not intended to diagnose, treat, cure, or prevent any disease.
Seals/Symbols
QUALITY GUARANTEE 100% MONEY BACK
RATED X FOR XTREME NRG NSF CERTIFIED NRG GMP GOOD MANUFACTURING PROCCES CERTIFIED
General Statements
-QUICK JOINT PAIN RELIEF -LONG LASTING FORMULA -5 DAYS TO RELIEF GUARANTEE
MADE IN THE U.S.A.
We use time tested and clinically proven ingredients to produce maximum results in a VERY short amount of time.
FDA Statement of Identity
DIETARY SUPPLEMENT
Brand IP Statement(s)
We are so confident in Joint MaXX(TM) that we offer a "5 Days to Relief Guarantee" -if you take Joint MaXX(TM) as directed for 5 days and don't experience Joint Pain relief just send the bottle back for a FULL REFUND!!
Everyone from time to time suffers from joint pain but the good news is that you don't have to any longer; Joint MaXX(TM) from NRGX Labs is the answer to joint pain.
Suggested/Recommended/Usage/Directions
Suggested Use: Take one (1) serving of Joint MaXX(TM), twice daily for five (5) days for maximum joint pain relief, followed by one (1) serving daily as a maintenance dosage.
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Joint Maxx by NRG-X Labs 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 Joint Maxx by NRG-X Labs
These are the 8 active ingredients this product is made of. Select any to open its full monograph.
Serving size4 Capsule(s) Dosage formCapsule Servings per container35 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.
Vitamin B6
Interacts with210 drugs
Vitamin B6 (pyridoxine) is an essential water-soluble vitamin that your body needs for metabolism, brain function, and making red blood cells. It is b...
Vitamin B6 monograph & interactionsCalcium
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 & interactionsVitamin C
Interacts with207 drugs
Vitamin C (ascorbic acid) is an essential nutrient your body needs but cannot make, so you must get it from food or supplements. It's important for im...
Vitamin C monograph & 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 & interactionsMethylsulfonylmethane
Manganese
Interacts with83 drugs
Manganese is an essential trace mineral your body needs in small amounts for bone formation, metabolism, and antioxidant defense, and most people get...
Manganese 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 & interactionsJoint MaXX(TM) Complex(TM)
Interacts with1,136 drugs
Cannabis contains many active compounds, mainly THC (which causes a 'high') and CBD (which does not). Some uses, such as chemotherapy-related nausea,...
Joint MaXX(TM) Complex(TM) monograph & interactionsOther (inactive) ingredients: Magnesium Stearate, Rice Flour, Gelatin, Titanium Dioxide. These complete the product’s ingredient list but are not active constituents.
Joint Maxx by NRG-X Labs Drug Interactions
Joint Maxx contains 8 ingredients, and 7 of them have known drug interactions. Altogether they interact with 1,356 medications. Here’s the picture, then you can look up your own drug.
Want to check YOUR meds against Joint Maxx?
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 Joint Maxx interact with 1,356 drugs. Click any drug to see the details.
7 of the 8 ingredients in Joint Maxx interact with drugs. Each result below shows which ingredient is responsible. Joint MaXX(TM) Complex(TM) Vitamin B6 Vitamin C Calcium Manganese Zinc Copper
CeftriaxoneRocephin
How Ceftriaxone interacts with Joint Maxx — through 1 ingredient. 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 interactionCobicistat, Elvitegravir, Emtricitabine, Tenofovir Alafenamide FumarateGenvoya
How Cobicistat, Elvitegravir, Emtricitabine, Tenofovir Alafenamide Fumarate interacts with Joint Maxx — through 3 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 interactionJoint Maxx(tm) Complex(tm)Cytochrome P450 3a4 (cyp3a4) Inhibitors, P-glycoprotein Substrates +1 Moderate
Interaction Summary
Theoretically, CYP3A4 inhibitors might increase the levels and adverse effects of cannabis.
Read the full Joint Maxx(tm) Complex(tm) + 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 interactionDolutegravirTivicay
How Dolutegravir interacts with Joint Maxx — through 2 ingredients. Tap an ingredient for the detail:
CalciumDolutegravir (tivicay) Major
Interaction Summary
Calcium seems to reduce levels of dolutegravir.
Read the full Calcium + Dolutegravir interactionJoint Maxx(tm) Complex(tm)P-glycoprotein Substrates Moderate
Interaction Summary
Theoretically, cannabis might alter levels of drugs that are substrates of P-glycoprotein (P-gp).
Read the full Joint Maxx(tm) Complex(tm) + Dolutegravir interactionDolutegravir, Emtricitabine, Tenofovir AlafenamideDolutegravir, Emtricitabine, Tenofovir Alafenamide
How Dolutegravir, Emtricitabine, Tenofovir Alafenamide interacts with Joint Maxx — through 3 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 interactionJoint Maxx(tm) Complex(tm)P-glycoprotein Substrates Moderate
Interaction Summary
Theoretically, cannabis might alter levels of drugs that are substrates of P-glycoprotein (P-gp).
Read the full Joint Maxx(tm) Complex(tm) + 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 Joint Maxx — through 2 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 interactionJoint Maxx(tm) Complex(tm)P-glycoprotein Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, cannabis might alter levels of drugs that are substrates of P-glycoprotein (P-gp).
Read the full Joint Maxx(tm) Complex(tm) + Dolutegravir, Rilpivirine interactionElvitegravirVitekta
How Elvitegravir interacts with Joint Maxx — through 2 ingredients. Tap an ingredient for the detail:
CalciumElvitegravir (vitekta) Major
Interaction Summary
Calcium seems to reduce levels of elvitegravir.
Read the full Calcium + Elvitegravir interactionJoint Maxx(tm) Complex(tm)Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, cannabis may increase the levels and adverse effects of CYP3A4 substrates.
Read the full Joint Maxx(tm) Complex(tm) + Elvitegravir interactionElvitegravir, Cobicistat, Emtricitabine, Tenofovir Disoproxil FumarateStribild
How Elvitegravir, Cobicistat, Emtricitabine, Tenofovir Disoproxil Fumarate interacts with Joint Maxx — through 3 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 interactionJoint Maxx(tm) Complex(tm)Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, cannabis may increase the levels and adverse effects of CYP3A4 substrates.
Read the full Joint Maxx(tm) Complex(tm) + 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 interactionWarfarinWarfarin
How Warfarin interacts with Joint Maxx — through 2 ingredients. Tap an ingredient for the detail:
Joint Maxx(tm) Complex(tm)Cytochrome P450 2c9 (cyp2c9) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +3 Major
Interaction Summary
Theoretically, cannabis might increase the levels and adverse effects of CYP2C9 substrates.
Read the full Joint Maxx(tm) Complex(tm) + Warfarin interactionVitamin CWarfarin (coumadin) Moderate
Interaction Summary
High-dose vitamin C might reduce the levels and effectiveness of warfarin.
Read the full Vitamin C + Warfarin interactionWarfarin SodiumCoumadin, Panwarfin, Sofarin
How Warfarin Sodium interacts with Joint Maxx — through 2 ingredients. Tap an ingredient for the detail:
Joint Maxx(tm) Complex(tm)Anticoagulant/antiplatelet Drugs, Cytochrome P450 2c9 (cyp2c9) Substrates +3 Major
Interaction Summary
Theoretically, cannabis might increase the risk of bleeding when used concomitantly with anticoagulant/antiplatelet drugs.
Read the full Joint Maxx(tm) Complex(tm) + Warfarin Sodium interactionVitamin CWarfarin (coumadin) Moderate
Interaction Summary
High-dose vitamin C might reduce the levels and effectiveness of warfarin.
Read the full Vitamin C + Warfarin Sodium interactionAdo-trastuzumab EmtansineKadcyla
How Ado-trastuzumab Emtansine interacts with Joint Maxx — through 1 ingredient. Tap an ingredient for the detail:
Joint Maxx(tm) Complex(tm)Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, cannabis may increase the levels and adverse effects of CYP3A4 substrates.
Read the full Joint Maxx(tm) Complex(tm) + Ado-trastuzumab Emtansine interactionAbametapirXeglyze
How Abametapir interacts with Joint Maxx — through 1 ingredient. Tap an ingredient for the detail:
Joint Maxx(tm) Complex(tm)Cytochrome P450 3a4 (cyp3a4) Inhibitors Moderate
Interaction Summary
Theoretically, CYP3A4 inhibitors might increase the levels and adverse effects of cannabis.
Read the full Joint Maxx(tm) Complex(tm) + Abametapir interactionAbciximabReoPro
How Abciximab interacts with Joint Maxx — through 1 ingredient. Tap an ingredient for the detail:
Joint Maxx(tm) Complex(tm)Anticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, cannabis might increase the risk of bleeding when used concomitantly with anticoagulant/antiplatelet drugs.
Read the full Joint Maxx(tm) Complex(tm) + Abciximab interactionAbemaciclibVerzenio
How Abemaciclib interacts with Joint Maxx — through 1 ingredient. Tap an ingredient for the detail:
Joint Maxx(tm) Complex(tm)Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, cannabis may increase the levels and adverse effects of CYP3A4 substrates.
Read the full Joint Maxx(tm) Complex(tm) + Abemaciclib interactionAbiraterone
How Abiraterone interacts with Joint Maxx — through 1 ingredient. Tap an ingredient for the detail:
Joint Maxx(tm) Complex(tm)Cytochrome P450 3a4 (cyp3a4) Inhibitors, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Moderate
Interaction Summary
Theoretically, CYP3A4 inhibitors might increase the levels and adverse effects of cannabis.
Read the full Joint Maxx(tm) Complex(tm) + Abiraterone interactionAbiraterone AcetateYonsa, Zytiga
How Abiraterone Acetate interacts with Joint Maxx — through 1 ingredient. Tap an ingredient for the detail:
Joint Maxx(tm) Complex(tm)Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, cannabis may increase the levels and adverse effects of CYP3A4 substrates.
Read the full Joint Maxx(tm) Complex(tm) + Abiraterone Acetate interactionAbrocitinibCibinqo
How Abrocitinib interacts with Joint Maxx — through 1 ingredient. Tap an ingredient for the detail:
Joint Maxx(tm) Complex(tm)Cytochrome P450 2c9 (cyp2c9) Substrates, Cytochrome P450 2c19 (cyp2c19) Substrates +1 Moderate
Interaction Summary
Theoretically, cannabis might increase the levels and adverse effects of CYP2C9 substrates.
Read the full Joint Maxx(tm) Complex(tm) + Abrocitinib interactionAcalabrutinibCalquence
How Acalabrutinib interacts with Joint Maxx — through 1 ingredient. Tap an ingredient for the detail:
Joint Maxx(tm) Complex(tm)Cytochrome P450 3a4 (cyp3a4) Substrates, P-glycoprotein Substrates Moderate
Interaction Summary
Theoretically, cannabis may increase the levels and adverse effects of CYP3A4 substrates.
Read the full Joint Maxx(tm) Complex(tm) + Acalabrutinib interactionAcebutololRhotral, Sectral
How Acebutolol interacts with Joint Maxx — through 1 ingredient. Tap an ingredient for the detail:
Vitamin B6Antihypertensive Drugs Moderate
Interaction Summary
Theoretically, vitamin B6 may have additive effects when used with antihypertensive drugs.
Read the full Vitamin B6 + Acebutolol interactionAcenocoumarolSintrom
How Acenocoumarol interacts with Joint Maxx — through 1 ingredient. Tap an ingredient for the detail:
Joint Maxx(tm) Complex(tm)Anticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, cannabis might increase the risk of bleeding when used concomitantly with anticoagulant/antiplatelet drugs.
Read the full Joint Maxx(tm) Complex(tm) + Acenocoumarol interactionAcepromazineAtravet
How Acepromazine interacts with Joint Maxx — through 2 ingredients. Tap an ingredient for the detail:
Joint Maxx(tm) Complex(tm)Antipsychotic Drugs, Cns Depressants Moderate
Interaction Summary
Cannabis does not seem to affect blood levels or effects of some antipsychotic drugs.
Read the full Joint Maxx(tm) Complex(tm) + Acepromazine interactionManganeseAntipsychotic Drugs Moderate
Interaction Summary
Theoretically, the risk for manganese toxicity might increase when taken with antipsychotic drugs.
Read the full Manganese + Acepromazine interactionAcetaminophenChildren's Tylenol, Children's Tylenol Meltaways, Tylenol, Tylenol Ex Strength
How Acetaminophen interacts with Joint Maxx — through 2 ingredients. Tap an ingredient for the detail:
Joint Maxx(tm) Complex(tm)Cytochrome P450 2e1 (cyp2e1) Substrates Moderate
Interaction Summary
Theoretically, cannabis might decrease the levels and clinical effects of CYP2E1 substrates.
Read the full Joint Maxx(tm) Complex(tm) + Acetaminophen interactionVitamin CAcetaminophen (tylenol, Others) Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C + Acetaminophen interactionAcetaminophen, AspirinGemnisyn
How Acetaminophen, Aspirin interacts with Joint Maxx — through 2 ingredients. Tap an ingredient for the detail:
Joint Maxx(tm) Complex(tm)Anticoagulant/antiplatelet Drugs, Cytochrome P450 2e1 (cyp2e1) Substrates Moderate
Interaction Summary
Theoretically, cannabis might increase the risk of bleeding when used concomitantly with anticoagulant/antiplatelet drugs.
Read the full Joint Maxx(tm) Complex(tm) + Acetaminophen, Aspirin interactionVitamin CAcetaminophen (tylenol, Others), Aspirin Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C + Acetaminophen, Aspirin interactionAcetaminophen, Aspirin, CaffeineExcedrin, Excedrin Extra Strength, Excedrin Migraine
How Acetaminophen, Aspirin, Caffeine interacts with Joint Maxx — through 2 ingredients. Tap an ingredient for the detail:
Joint Maxx(tm) Complex(tm)Cytochrome P450 2e1 (cyp2e1) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Moderate
Interaction Summary
Theoretically, cannabis might decrease the levels and clinical effects of CYP2E1 substrates.
Read the full Joint Maxx(tm) Complex(tm) + Acetaminophen, Aspirin, Caffeine interactionVitamin CAcetaminophen (tylenol, Others), Aspirin Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C + Acetaminophen, Aspirin, Caffeine interactionAcetaminophen, Brompheniramine, PhenylpropanolamineDimetapp Cold and Flu
How Acetaminophen, Brompheniramine, Phenylpropanolamine interacts with Joint Maxx — through 2 ingredients. Tap an ingredient for the detail:
Joint Maxx(tm) Complex(tm)Cytochrome P450 2e1 (cyp2e1) Substrates Moderate
Interaction Summary
Theoretically, cannabis might decrease the levels and clinical effects of CYP2E1 substrates.
Read the full Joint Maxx(tm) Complex(tm) + Acetaminophen, Brompheniramine, Phenylpropanolamine interactionVitamin CAcetaminophen (tylenol, Others) Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C + Acetaminophen, Brompheniramine, Phenylpropanolamine interactionAcetaminophen, ButalbitalAxocet, Bancap, Bucet, Butex Forte, Esgic CF, Orbivan CF +5 more
How Acetaminophen, Butalbital interacts with Joint Maxx — through 2 ingredients. Tap an ingredient for the detail:
Joint Maxx(tm) Complex(tm)Cytochrome P450 2e1 (cyp2e1) Substrates, Barbiturates Moderate
Interaction Summary
Theoretically, cannabis might decrease the levels and clinical effects of CYP2E1 substrates.
Read the full Joint Maxx(tm) Complex(tm) + Acetaminophen, Butalbital interactionVitamin CAcetaminophen (tylenol, Others) Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C + Acetaminophen, Butalbital interactionAcetaminophen, Butalbital, CaffeineEsgic, Esgic Plus, Fiogesic, Fioricet, Repan, Tecnal +1 more
How Acetaminophen, Butalbital, Caffeine interacts with Joint Maxx — through 2 ingredients. Tap an ingredient for the detail:
Joint Maxx(tm) Complex(tm)Cytochrome P450 2e1 (cyp2e1) Substrates, Barbiturates +1 Moderate
Interaction Summary
Theoretically, cannabis might decrease the levels and clinical effects of CYP2E1 substrates.
Read the full Joint Maxx(tm) Complex(tm) + Acetaminophen, Butalbital, Caffeine interactionVitamin CAcetaminophen (tylenol, Others) Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C + Acetaminophen, Butalbital, Caffeine interactionAcetaminophen, Butalbital, Caffeine, CodeineEsgic with Codeine, Fioricet w/ Codeine
How Acetaminophen, Butalbital, Caffeine, Codeine interacts with Joint Maxx — through 2 ingredients. Tap an ingredient for the detail:
Joint Maxx(tm) Complex(tm)Cytochrome P450 3a4 (cyp3a4) Substrates, Cns Depressants +2 Moderate
Interaction Summary
Theoretically, cannabis may increase the levels and adverse effects of CYP3A4 substrates.
Read the full Joint Maxx(tm) Complex(tm) + Acetaminophen, Butalbital, Caffeine, Codeine interactionVitamin CAcetaminophen (tylenol, Others) Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C + Acetaminophen, Butalbital, Caffeine, Codeine interactionAcetaminophen, Butalbital, CodeineBancap w/ Codeine
How Acetaminophen, Butalbital, Codeine interacts with Joint Maxx — through 2 ingredients. Tap an ingredient for the detail:
Joint Maxx(tm) Complex(tm)Cytochrome P450 2e1 (cyp2e1) Substrates, Cns Depressants Moderate
Interaction Summary
Theoretically, cannabis might decrease the levels and clinical effects of CYP2E1 substrates.
Read the full Joint Maxx(tm) Complex(tm) + Acetaminophen, Butalbital, Codeine interactionVitamin CAcetaminophen (tylenol, Others) Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C + Acetaminophen, Butalbital, Codeine interactionAcetaminophen, Butalbital, Codeine PhosphatePhrenilin #3
How Acetaminophen, Butalbital, Codeine Phosphate interacts with Joint Maxx — through 2 ingredients. Tap an ingredient for the detail:
Joint Maxx(tm) Complex(tm)Cns Depressants, Cytochrome P450 2e1 (cyp2e1) Substrates Moderate
Interaction Summary
Theoretically, cannabis might have additive effects if used with other CNS depressants.
Read the full Joint Maxx(tm) Complex(tm) + Acetaminophen, Butalbital, Codeine Phosphate interactionVitamin CAcetaminophen (tylenol, Others) Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C + Acetaminophen, Butalbital, Codeine Phosphate interactionAcetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, PhenylephrineHycomine Compound
How Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interacts with Joint Maxx — through 2 ingredients. Tap an ingredient for the detail:
Joint Maxx(tm) Complex(tm)Cns Depressants, Cytochrome P450 2e1 (cyp2e1) Substrates +1 Moderate
Interaction Summary
Theoretically, cannabis might have additive effects if used with other CNS depressants.
Read the full Joint Maxx(tm) Complex(tm) + Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interactionVitamin CAcetaminophen (tylenol, Others) Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C + Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interactionEach ingredient & the kinds of drugs it affects
For each ingredient in Joint Maxx 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.
Joint MaXX(TM) Complex(TM)
Warfarin (Coumadin)
Concomitant use with cannabis seems to increase the levels and clinical effects of warfarin.
In vitro research shows that the cannabis constituents delta-9-tetrahydrocannabinol (THC), cannabidiol (CBD), and cannabinol inhibit the cytochrome P450 2C9 (CYP2C9)-mediated 7-hydroxylation of S-warfarin in a concentration-dependent manner.
Additionally, there are multiple case reports of patients chronically taking warfarin that developed a spike in international normalized ratio (INR) after using cannabis in various forms, including smoking cannabis, taking medical cannabis orally, or drinking water infused with cannabis flower. One patient smoked 2-2.5 grams in one week and another patient had doubled the amount of THC consumed from 7.5 mg to 14.7 mg daily for one week.
Alcohol (Ethanol)
Theoretically, cannabis might have additive effects when used with alcohol.
Cannabis can have CNS depressant effects, similar to synthetic delta-9-tetrahydrocannabinol (THC). Theoretically, concomitant use of alcohol with cannabis can have additive effects including psychomotor impairment, sedation, and changes in mood and behavior.
Anesthesia
Cannabis use might alter the safety and clinical effects of various forms of anesthesia.
A small clinical study shows that higher doses of propofol may be needed to achieve relaxation and loss of consciousness in chronic cannabis users compared with nonusers. Another small clinical study shows that use of cannabis within 72 hours prior to undergoing surgery requiring atropine anesthesia may increase the risk of sustained postoperative tachycardia. The exact mechanisms of these interactions are unclear. Obtain a patient's history of cannabis use preoperatively and advise patients to discontinue cannabis use for at least 2 weeks prior to undergoing surgery.
Anticoagulant/Antiplatelet Drugs
Theoretically, cannabis might increase the risk of bleeding when used concomitantly with anticoagulant/antiplatelet drugs.
In vitro research shows that the cannabis constituents delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD) inhibit platelet aggregation.
Barbiturates
Theoretically, cannabis might increase the levels and adverse effects of barbiturates.
Some research shows that synthetic delta-9-tetrahydrocannabinol (THC) increases the elimination half-life of pentobarbital by 4 hours when dosed concomitantly.
Cns Depressants
Theoretically, cannabis might have additive effects if used with other CNS depressants.
Cannabis can have CNS depressant effects. Combining cannabis with other CNS depressants might result in additive or synergistic effects. A small clinical trial in healthy adults shows that inhaling a high-grade cannabis (Bedrocan International B.V., Veendam, The Netherlands) 100 mg, containing delta-9-tetrahydrocannabinol 21.8% and cannabinol 0.1%, modestly increases subjective feelings of sedation when compared with cannabis alone.
Cytochrome P450 2C19 (Cyp2C19) Substrates
Cannabis may increase levels of drugs metabolized by CYP2C19.
Research shows that cannabidiol (CBD), a constituent of cannabis, inhibits CYP2C19. In clinical studies and case reports, cannabidiol use resulted in significant increases in the serum levels of topiramate, methadone, citalopram, omeprazole, and N-desmethylclobazam, the primary active metabolite of clobazam. These chemicals are metabolized by CYP2C19. Concomitant use of cannabis with CYP2C19 substrates may increase the risk for adverse effects from these substrates.
Cytochrome P450 2C9 (Cyp2C9) Inducers
Theoretically, drugs that are CYP2C9 inducers might decrease the effects of cannabis.
Delta-9-tetrahydrocannabinol (THC), an active constituent of cannabis, is a substrate of CYP2C9 enzymes.
Cytochrome P450 2C9 (Cyp2C9) Inhibitors
Theoretically, drugs that are CYP2C9 inhibitors might increase the adverse effects of cannabis.
Delta-9-tetrahydrocannabinol (THC), an active constituent of cannabis, is a substrate of CYP2C9 enzymes.
Cytochrome P450 2C9 (Cyp2C9) Substrates
Theoretically, cannabis might increase the levels and adverse effects of CYP2C9 substrates.
In vitro research shows that the cannabis constituents delta-9-tetrahydrocannabinol (THC), cannabidiol (CBD), and cannabinol moderately inhibit the CYP2C9-mediated 7-hydroxylation of S-warfarin in a concentration-dependent manner. In vitro research also shows that cannabis extracts modestly inhibit the CYP2C9 metabolism of tolbutamide; extracts providing the specific cannabinoids CBD and cannabigerol (CBG) had stronger inhibitory effects than extracts containing THC and CBD.
Cytochrome P450 2E1 (Cyp2E1) Substrates
Theoretically, cannabis might decrease the levels and clinical effects of CYP2E1 substrates.
In vitro research shows that cannabis can induce the activity of CYP2E1, which might increase the metabolism of CYP2E1 substrates.
Cytochrome P450 3A4 (Cyp3A4) Inducers
Theoretically, CYP3A4 inducers might reduce the levels and clinical effects of cannabis.
Delta-9-tetrahydrocannabinol (THC), an active constituent of cannabis, is a substrate of CYP3A4 enzymes.
Cytochrome P450 3A4 (Cyp3A4) Inhibitors
Theoretically, CYP3A4 inhibitors might increase the levels and adverse effects of cannabis.
Delta-9-tetrahydrocannabinol (THC), an active constituent of cannabis, is a substrate of CYP3A4 enzymes.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, cannabis may increase the levels and adverse effects of CYP3A4 substrates.
In vitro research shows that cannabis can inhibit the activity of CYP3A4 enzymes, which might decrease the metabolism of CYP3A4 substrates. In vitro research also shows that cannabis extracts modestly inhibit the CYP3A4 metabolism of testosterone; extracts providing the specific cannabinoids CBD and cannabigerol (CBG) had stronger inhibitory effects than extracts containing THC and CBD.
P-Glycoprotein Substrates
Theoretically, cannabis might alter levels of drugs that are substrates of P-glycoprotein (P-gp).
Most in vitro research suggests that constituents of cannabis, including cannabidiol (CBD) and delta-9-tetrahydrocannabinol (THC), can inhibit P-gp and increase the accumulation of probe compounds by reducing P-gp mediated drug efflux. In vitro studies in kidney cell lines show that a 1-hour exposure to CBD and THC inhibits P-gp. Cannabis may also alter the expression of P-gp, although this effect appears to vary based on duration of exposure. Some in vitro research in lymphoblastoid leukemia cell lines indicates that a 1-hour exposure to cannabinoids does not affect P-gp expression, while a prolonged 72-hour exposure decreases P-gp expression. Other in vitro research in these cell lines shows that a 4-hour exposure to THC and CBD induces P-gp gene expression, while exposure for longer than 4 hours and up to 48 hours does not induce P-gp gene expression.
Theophylline
Smoking cannabis while taking theophylline might reduce the levels and clinical effects of theophylline.
Similar to smoking tobacco, smoking cannabis seems to increase the metabolism of theophylline.
Thrombolytic Drugs
Cannabis might augment the effects of thrombolytic drugs and increase the risk of severe bleeding.
A case of cerebral hemorrhage has been reported for a 51-year-old female and chronic cannabis user who had consumed a large amount of cannabis prior to receiving recombinant tissue plasminogen activator (rtPA) for ischemic stroke. Hemorrhage had been ruled out prior to providing the rtPA. The exact mechanism of this interaction is unclear.
Antipsychotic Drugs
Cannabis does not seem to affect blood levels or effects of some antipsychotic drugs.
Human research shows that cannabis use does not affect blood levels or clinical effects of amisulpride, aripiprazole, or olanzapine in patients with schizophrenia and related disorders.
Vitamin B6
Amiodarone (Cordarone)
Theoretically, vitamin B6 might increase the photosensitivity caused by amiodarone.
Despite initial case reports suggesting that pyridoxine may have a protective effect against amiodarone-induced photosensitivity, preliminary clinical research suggests that pyridoxine may actually exacerbate this adverse effect.
Antihypertensive Drugs
Theoretically, vitamin B6 may have additive effects when used with antihypertensive drugs.
Research in hypertensive rats shows that vitamin B6 can decrease systolic blood pressure. Similarly, clinical research in patients with hypertension shows that taking high doses of vitamin B6 may reduce systolic and diastolic blood pressure, possibly by reducing plasma levels of epinephrine and norepinephrine.
Phenobarbital (Luminal)
High doses of vitamin B6 may reduce the levels and clinical effects of phenobarbital.
Preliminary clinical evidence suggests that vitamin B6 200 mg daily can reduce plasma levels of phenobarbital, possibly by increasing metabolism. It is not known whether lower doses have any effect. Advise people taking phenobarbital to avoid high doses of vitamin B6.
Phenytoin (Dilantin)
High doses of vitamin B6 may reduce the levels and clinical effects of phenytoin.
Preliminary clinical evidence suggests that vitamin B6 200 mg daily can reduce plasma levels of phenytoin, possibly by increasing metabolism. It is not known whether lower doses have any effect. Advise people taking phenytoin to avoid high doses of vitamin B6.
Levodopa
Vitamin B6 may increase the metabolism of levodopa when taken alone, but not when taken in conjunction with carbidopa.
Vitamin B6 (pyridoxine) enhances the metabolism of levodopa, reducing its clinical effects. However, this interaction does not occur when carbidopa is used concurrently with levodopa (Sinemet). Therefore, it is not likely to be a problem in most people.
Vitamin C
Alkylating Agents
Theoretically, antioxidant effects of vitamin C might reduce the effectiveness of alkylating agents.
The use of antioxidants like vitamin C during chemotherapy is controversial. There is concern that antioxidants could reduce the activity of chemotherapy drugs that generate free radicals, such as cyclophosphamide, chlorambucil, carmustine, busulfan, and thiotepa. In contrast, some researchers theorize that antioxidants might make chemotherapy more effective by reducing oxidative stress that could interfere with apoptosis (cell death) of cancer cells. More evidence is needed to determine what effect, if any, antioxidants such as vitamin C have on chemotherapy.
Aluminum
Vitamin C can increase the amount of aluminum absorbed from aluminum compounds.
Research in animals and humans shows that vitamin C increases aluminum absorption, theoretically by chelating aluminum and keeping it in solution where it is available for absorption. In people with normal renal function, urinary excretion of aluminum will likely increase, making aluminum retention and toxicity unlikely. Patients with renal failure who take aluminum-containing compounds such as phosphate binders should avoid vitamin C supplements in doses above the recommended dietary allowances.
Antitumor Antibiotics
Theoretically, the antioxidant effects of vitamin C might reduce the effectiveness of antitumor antibiotics.
The use of antioxidants like vitamin C during chemotherapy is controversial. There is concern that antioxidants could reduce the activity of chemotherapy drugs which generate free radicals, such as doxorubicin. In contrast, some researchers theorize that antioxidants might make chemotherapy more effective by reducing oxidative stress that could interfere with apoptosis (cell death) of cancer cells. More evidence is needed to determine what effects, if any, antioxidants such as vitamin C have on chemotherapy.
Estrogens
Vitamin C might increase blood levels of estrogens.
Increases in plasma estrogen levels of up to 55% occur under some circumstances when vitamin C is taken concurrently with oral contraceptives or hormone replacement therapy, including topical products. It is suggested that vitamin C prevents oxidation of estrogen in the tissues, regenerates oxidized estrogen, and reduces sulfate conjugation of estrogen in the gut wall. When tissue levels of vitamin C are high, these processes are already maximized and supplemental vitamin C does not have any effect on estrogen levels. Increases in plasma estrogen levels may occur when patients who are deficient in vitamin C take supplements. Monitor these patients for estrogen-related side effects.
Fluphenazine (Prolixin)
Theoretically, vitamin C might decrease levels of fluphenazine.
In one patient there was a clinically significant decrease in fluphenazine levels when vitamin C (500 mg twice daily) was started. The mechanism is not known, and there is no further data to confirm this interaction.
Indinavir (Crixivan)
Vitamin C can modestly reduce indinavir levels.
One pharmacokinetic study shows that taking vitamin C 1 gram orally once daily along with indinavir 800 mg orally three times daily reduces the area under the concentration-time curve of indinavir by 14%. The mechanism of this interaction is unknown, but it is unlikely to be clinically significant in most patients. The effect of higher doses of vitamin C on indinavir levels is unknown.
Levothyroxine (Synthroid, Others)
Vitamin C can increase levothyroxine absorption.
Two clinical studies in adults with poorly controlled hypothyroidism show that swallowing levothyroxine with a glass of water containing vitamin C 500-1000 mg in solution reduces thyroid stimulating hormone (TSH) levels and increases thyroxine (T4) levels when compared with taking levothyroxine alone. This suggests that vitamin C increases the oral absorption of levothyroxine, possibly due to a reduction in pH.
Warfarin (Coumadin)
High-dose vitamin C might reduce the levels and effectiveness of warfarin.
Vitamin C in high doses may cause diarrhea and possibly reduce warfarin absorption. There are reports of two people who took up to 16 grams daily of vitamin C and had a reduction in prothrombin time. Lower doses of 5-10 grams daily can also reduce warfarin absorption. In many cases, this does not seem to be clinically significant. However, a case of warfarin resistance has been reported for a patient who took vitamin C 500 mg twice daily. Cessation of vitamin C supplementation resulted in a rapid increase in international normalized ratio (INR). Tell patients taking warfarin to avoid taking vitamin C in excessively high doses (greater than 10 grams daily). Lower doses may be safe, but the anticoagulation activity of warfarin should be monitored. Patients who are stabilized on warfarin while taking vitamin C should avoid adjusting vitamin C dosage to prevent the possibility of warfarin resistance.
Acetaminophen (Tylenol, Others)
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
A small pharmacokinetic study in healthy volunteers shows that taking high-dose vitamin C (3 grams) 1.5 hours after taking acetaminophen 1 gram slightly increases the apparent half-life of acetaminophen from around 2.3 hours to 3.1 hours. Ascorbic acid competitively inhibits sulfate conjugation of acetaminophen. However, to compensate, elimination of acetaminophen glucuronide and unconjugated acetaminophen increases. This effect is not likely to be clinically significant.
Aspirin
Acidification of the urine by vitamin C might increase aspirin levels.
It has been suggested that acidification of the urine by vitamin C could increase reabsorption of salicylates by the renal tubules, and increase plasma salicylate levels. However, short-term use of up to 6 grams daily of vitamin C does not seem to affect urinary pH or salicylate excretion, suggesting this interaction is not clinically significant.
Choline Magnesium Trisalicylate (Trilisate)
Acidification of the urine by vitamin C might increase choline magnesium trisalicylate levels.
It has been suggested that acidification of the urine by vitamin C could increase reabsorption of salicylates by the renal tubules, and increase plasma salicylate levels. However, short-term use of up to 6 grams daily of vitamin C does not seem to affect urinary pH or salicylate excretion, suggesting this interaction probably is not clinically significant.
Niacin
Vitamin C might decrease the beneficial effects of niacin on high-density lipoprotein (HDL) cholesterol levels.
A combination of niacin and simvastatin (Zocor) effectively raises HDL cholesterol levels in patients with coronary disease and low HDL levels. Clinical research shows that taking a combination of antioxidants (vitamin C, vitamin E, beta-carotene, and selenium) along with niacin and simvastatin (Zocor) attenuates this rise in HDL, specifically the HDL-2 and apolipoprotein A1 fractions, by more than 50% in patients with coronary disease. It is not known whether this adverse effect is due to a single antioxidant such as vitamin C, or to the combination. It also is not known whether it will occur in other patient populations.
Salsalate (Disalcid)
Acidification of the urine by vitamin C might increase salsalate levels.
It has been suggested that acidification of the urine by vitamin C could increase reabsorption of salicylates by the renal tubules, and increase plasma salicylate levels. However, short-term use of up to 6 grams/day vitamin C does not seem to affect urinary pH or salicylate excretion, suggesting this interaction probably is not clinically significant.
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.
Manganese
Antipsychotic Drugs
Theoretically, the risk for manganese toxicity might increase when taken with antipsychotic drugs.
Hallucinations and behavioral changes have been reported in a patient with liver disease who was taking haloperidol and manganese. Researchers speculate that taking manganese along with haloperidol, phenothiazine-derivatives, or other antipsychotic medications might increase the risk of manganese toxicity in some patients.
Quinolone Antibiotics
Theoretically, manganese might reduce the absorption of quinolone antibiotics.
Manganese is a multivalent cation. Interactions resulting in reduced quinolone absorption have been reported between quinolones and other multivalent cations, such as calcium and iron.
Tetracycline Antibiotics
Theoretically, manganese might reduce the absorption of tetracycline antibiotics.
Manganese is a multivalent cation. Interactions resulting in reduced tetracycline absorption have been reported between tetracyclines and other multivalent cations, such as calcium and iron.
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 Joint Maxx, from the product label.
NRG-X Labs
See all NRG-X Labs products- Name
- NRGX LABS
- Street Address
- 2945 W. Chestnut Expwy Ste. C
- City
- Springfield
- State
- MO
- ZipCode
- 65802
- Web Address
- WWW.NRGXLABS.COM
Joint Maxx by NRG-X Labs: Common Questions
Does Joint Maxx by NRG-X Labs interact with any medications?
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Where does this information come from?
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 Joint Maxx’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Vitamin B6
Interacts with 210 drugsVitamin B6 (pyridoxine) is an essential water-soluble vitamin that your body needs for metabolism, brain function, and making red blood cells. It is best known for helping with pregnancy-rel...
Read the full Vitamin B6 monograph → Herb & supplement monographCalcium
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 monographVitamin C
Interacts with 207 drugsVitamin C (ascorbic acid) is an essential nutrient your body needs but cannot make, so you must get it from food or supplements. It's important for immune function, collagen, and acts as an...
Read the full Vitamin C monograph → Herb & supplement 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 monographManganese
Interacts with 83 drugsManganese is an essential trace mineral your body needs in small amounts for bone formation, metabolism, and antioxidant defense, and most people get enough from a normal diet. Supplements m...
Read the full Manganese 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 monographCannabis
Interacts with 1,136 drugsCannabis contains many active compounds, mainly THC (which causes a 'high') and CBD (which does not). Some uses, such as chemotherapy-related nausea, certain seizure disorders, and muscle sp...
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Joint Maxx'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 526 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.
Vitamin B6 32 references
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- Mahmoud A, Tabassum S, Al Enazi S, et al. Amelioration of levetiracetam-induced behavioral side effects by pyridoxine. A randomized double blind controlled study. Pediatr Neurol 2021;119:15-21. PubMed
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Calcium 62 references
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- 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
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- 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
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Vitamin C 51 references
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Zinc 88 references
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