Major interaction on record — check this product against your medications before combining. Based on 7 of 12 ingredients. Check your meds →
Dietary supplement

JXT5 Ingredients & Drug Interactions

by Metis Nutrition

JXT5 label
See full label image
Capsule Category: Other Combinations
Most serious interaction: Major
Clinical methodology reviewed by · Updated Sep 16, 2026 · Label data from the NIH DSLD
What is this page for?

First and foremost: checking JXT5 against your medications. The heart of this page is the interaction checker and the full interaction report — how this product’s ingredients may interact with prescription and over-the-counter medicines you may be taking.

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

The interaction bottom line Most serious interaction: Major

JXT5 is a dietary supplement by Metis Nutrition with 12 active ingredients. Its ingredients are commonly taken for morning sickness in pregnancy, premenstrual syndrome (pms), preventing or treating b6 deficiency.Based on those ingredients, 1,584 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are Joint Support Blend, BioPerine, Vitamin B6. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

Jump to a section

Check Your Meds Against JXT5 by Metis Nutrition

Ask about any prescription or over-the-counter medication and we check it for interactions with JXT5 by Metis Nutrition — and tell you which ingredient is responsible.

Pharmacist-reviewed data Checks every ingredient Answer in seconds
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HelloPharmacist Scorecard of JXT5 by Metis Nutrition

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

From our pharmacy team — supplement deep dive

Generated from HelloPharmacist’s pharmacist-curated databases and editorial rules · Last generated Aug 13, 2026

What’s inside

Low disclosure
Ingredient Transparency · database check
Low

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

Why this rating?
  • The label discloses an exact amount for 8 of its 29 active ingredients.
  • “Joint Support Blend” is a proprietary blend — the label doesn't break down how much of each component you get.
  • “Absorption Agent” is listed as a grouped ingredient — the label doesn't break down how much of each component you get.
  • “Surge-T Testosterone + LIBIDO Blend” is a proprietary blend — the label doesn't break down how much of each component you get.

JXT5 contains 29 ingredients total. The active components include vitamins B6 and B12 for energy metabolism and nervous system support; minerals like calcium and iron for bone health and oxygen transport; and herbal extracts including bromelain (a digestive enzyme from pineapple), tribulus, saw palmetto, turmeric, milk thistle, stinging nettle, Tongkat Ali, and pygeum — traditionally used for joint, prostate, and vitality support.

The product also contains chromium for blood sugar balance, BioPerine (black pepper extract) to enhance nutrient absorption, shilajit for energy, hydrolyzed collagen for joint and connective tissue, and several lesser-studied botanicals. Inactive ingredients include gelatin capsules, microcrystalline cellulose, silica, magnesium stearate, and titanium dioxide.

Does it work?

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

Clinical evidence supports at least one of this product's ingredients for its stated purpose.

Why this rating?
  • The label markets this product for: Support testosterone, joints, libido, prostate, vision.
  • We looked for evidence on: Age-related testosterone deficiency, Benign prostatic hyperplasia (BPH), Athletic performance, sexual function, urinary symptoms, eye health.
  • The strongest evidence on file: Pygeum is rated "Likely Effective" for Benign prostatic hyperplasia (BPH) (Natural Medicines).
  • Also on file: Tribulus is rated "Possibly Ineffective" for Athletic performance.
  • Also on file: Fenugreek is rated "Possibly Ineffective" for Benign prostatic hyperplasia (BPH).

Evidence for this product's ingredients is mixed. Vitamin B6 is effective for B6 deficiency and sideroblastic anemia, and possibly effective for pregnancy-related nausea.

Calcium is effective for bone health and osteoporosis prevention. Iron is effective for iron deficiency anemia.

Chromium shows only possibly effective evidence for blood sugar control. Bromelain, tribulus, and most herbal extracts in this blend have insufficient or limited evidence for their marketed uses — saw palmetto for prostate health is rated possibly ineffective, and athletic performance claims for several ingredients are not well established.

Turmeric shows possibly effective evidence for mood and digestion. Milk thistle is possibly effective for blood sugar.

The overall effectiveness for joint and sexual function claims remains largely unproven in the data we hold.

The evidence, ingredient by ingredient Vitamin B6 Calcium Iron Chromium Vitamin B12 Black Pepper Cannabis

How safe is it?

Well-documented data
Safety Information · database check
Well characterized

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

Why this rating?
  • We hold adverse-effect (side-effect) data for 21 of the 23 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 23 of 23.
  • General safety write-ups exist for 23 of 23.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

Most individual ingredients are generally well tolerated at normal supplement doses. However, several carry important cautions.

High-dose vitamin B6 over time can damage nerves (sensory neuropathy). Iron causes common digestive upset — constipation, nausea, and diarrhea — especially on an empty stomach.

Turmeric and milk thistle have rare reports of liver injury with prolonged use. Bromelain may cause allergic reactions in sensitive people.

Stinging nettle contains significant vitamin K and could interfere with blood thinners. Tribulus, saw palmetto, and Tongkat Ali carry theoretical hormonal effects.

For pregnancy, vitamin B6 and iron are rated likely safe when guided by a prenatal provider; calcium is also considered safe in recommended amounts. Bromelain, tribulus, saw palmetto, Tongkat Ali, stinging nettle, and shilajit are flagged as potentially unsafe or lacking safety data in pregnancy and should be avoided unless specifically approved by your OB.

For breastfeeding, B6, B12, iron, and calcium are considered safe; bromelain, tribulus, saw palmetto, Tongkat Ali, and stinging nettle have insufficient safety data and are best avoided.

Side effects, ingredient by ingredient Vitamin B6 Calcium Iron Chromium Vitamin B12 Black Pepper Cannabis

Meds to double-check

Major interaction found
Known Interaction Concern · database check
Major identified

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

Why this rating?
  • 20 of the 23 matched ingredients can interact with medications — Tribulus, Milk Thistle, Bilberry, Calendula, Turmeric, among others.
  • The most serious interaction on file is rated Major.
  • Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs; immunosuppressants / transplant drugs; cancer treatments; diabetes medications; heart-rhythm medications; lithium; Parkinson's medications.
  • For scale: 1,510 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.

Before taking JXT5, double-check the following medication types with your pharmacist or doctor — especially if you take multiple drugs: HIV integrase inhibitors (dolutegravir, elvitegravir) or other antiretrovirals, blood thinners (warfarin) and antiplatelet drugs (aspirin, clopidogrel), thyroid hormone (levothyroxine), seizure medications (phenytoin, phenobarbital), diabetes drugs and insulin, antihypertensive and heart rhythm drugs (propranolol, amiodarone, diltiazem), antibiotics (quinolones, tetracyclines, ceftriaxone), and lithium. The ingredient BioPerine alone interacts with eight individual medications.

Altogether, these interactions span 1,510 individual medications.

Check your own medication Run your meds through the checker above

The bottom line

Scorecard at a glanceFormula with limited ingredient disclosure with clinical evidence supporting its stated purpose. Major medication interactions have been identified, and safety information is well characterized.

JXT5 is a multi-ingredient formula aimed at joint, sexual, and general vitality support, but it carries significant medication interactions — most critically with HIV drugs, blood thinners, thyroid hormones, diabetes medications, and several others. If you take any prescription medications, check each one against the product's ingredients using the interaction tool below before starting.

The formula's effectiveness for joint and sexual health is not strongly proven in current research. Talk with your doctor or pharmacist about whether this product is right for your specific health goals and medication list.

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

Assessment coverage: 25 of 29 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Nov 22, 2022.

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

At a glance

General information

Key facts about JXT5, straight from the product label.

Brand Metis Nutrition
Net contents 90 Capsule(s)
Market status On market
Date entered into DSLD Nov 22, 2022
DSLD ID 276561
Product type Other Combinations
Supplement form Capsule
Dietary claims / uses All Other, Structure/Function
Intended target group(s) Women (not pregnant or lactating), Adult Male (18-50 Years), Seniors/Mature (>50 Years) - Men ONLY
From the label
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.

Supplement Facts

The label details for JXT5 by Metis Nutrition, sourced from the NIH Dietary Supplement Label Database.

Supplement Facts

Daily Value (DV) Target Group(s):
Adults and children 4 or more years of age
Minimum serving Sizes:
3 Capsule(s)
Maximum serving Sizes:
3 Capsule(s)
Servings per container
30
IngredientAmount% DV
Vitamin B610 mg588%
Calcium16 mg1%
Iron0.15 mg1%
Chromium120 mcg343%
MSM0 NP--
Vitamin B1260 mcg2500%
Bromelain0 NP--
Tribulus terrestris Fruit Extract0 NP--
BioPerine0 NP--
Safed Musli Root Extract0 NP--
Saw Palmetto berry extract0 NP--
Diindolylmethane0 NP--
Calcium D-Glucarate0 NP--
Turmeric0 NP--
Milk Thistle seed extract0 NP--
Joint Support Blend0 NP--
Absorption Agent0 NP--
Nettle Leaf Extract0 NP--
FruiteX-B250 mg--
Tongkat Ali0 NP--
Cetyl Myristoleate0 NP--
PrimaVie200 mg--
Pygeum africanum bark extract0 NP--
hydrolyzed Chicken Collagen0 NP--
Surge-T Testosterone + LIBIDO Blend0 NP--
Trib-T Complex0 NP--
Prostate + Liver Support Blend0 NP--
Estrogen-Suppress Complex0 NP--
Ocular Health Blend0 NP--
JXT5 Proprietary Blend1990 mg--
Tribulus terrestris seed extract0 NP--
Chrysin0 NP--
Marigold oleoresin (flower) extract0 NP--
Bilberry (Vaccinium uliginosum L.) fruit extract0 NP--
Testosurge600 mg--
Blood Orange Fruit Extract0 NP--
Tomato Fruit Extract0 NP--

Other ingredients: Gelatin, Microcrystalline Cellulose, Silica, Magnesium Stearate, Titanium Dioxide

Tap any ingredient to jump to its full detail below.

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

Testosurge and Grecunin are trademarks of Indus Biotech. PrimaVie is an ingredient of Natreon, Inc patented under U.S. Patent No. 7,250,181; 6,869,612; 6,440,436; 6,558,712; 8,894,993 and other Pending Patents. FruiteX-B Calcium Fructoborate is a registered trademark of VDF FutureCeuticals, Inc. manufactured under US Patent #5,962,049. BioPerine Is a registered trademark and patented product of Sabinsa Corp.

Proven science Powerful results

JXT5 offers a dynamic, multifaceted 5N1 formulation created for today's man, now featuring patented PrimaVie purified shilajit.

General Statements

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Due to the unique restrictions of amateur and professional sports organizations (e.g., WADA, NCAA, NFL, MLB, UIL, etc.), it is recommended that you consult with the appropriate governing body before taking this or any other dietary supplement product.

Consumer notice: FitLife Brands can only confirm product purity when our brands are purchased from authorized retailers, on gnc.com, or on metisnutrition.com. For an approved list of retailers, go to metisnutrition.com.

1. Poole C, et al. (2009). Effects of TESTOSURGE Supplementation on strength, body composition and hormonal profiles during an 8-week resistance training program. JISSN. 6 (Suppl1):12. 2. Wilbon C, et al. (2010). Effects of a purported aromatase and 5-alpha reductase inhibitor on hormone profiles in college-age men. IJSNEM. 20(6):457-465. 3. Mokashi M, et al. (2014). Effects of glycosides based fenugreek seed extract on serum testosterone levels of healthy sedentary male subjects: an exploratory double-blind, placebo-controlled, crossover study. Asian J of Pharmaceutical and Clinical Research. 7(2):177-181. 4. Biswas TK, et al. (2009). Clinical evaluation of spermatogenic activity of processed Shilajit in oligospermia. Andrologia 42:48-56. 5. Pandit S. (2015). Clinical evaluation of purified Shilajit on testosterone levels in healthy volunteers. Andrologia 48:570-575. 6. Reyes-Izquierdo T, et al. (2011). Short-term intake of Calcium Fructoborate improves WOMAC and Mcgill scores and beneficially modulates biomarkers associated with knee osteoarthritis: A pilot clinical double-blind placebo-controlled study. American journal of Biomedical Science. ISSN:1937-9080. 7. Scorel R, et al. (2011). A double blind, placebo-controlled pilot study to evaluate the effect of Calcium Fructoborate on systemic inflammation and dyslipidemia markers for middle-aged people with primary osteoarthritis. Biol trace Elem Res. 144:253-263. 8. Reyes-Izquierdo T, et al. (2014). Short-term efficacy of a combination of Glucosamine and Chondroitin Sulfate compared to a combination of Glucosamine, Chondroitin Sulfate and Calcium Fructoborate (CFB) on improvement of knee discomfort conditions in healthy subjects. A comparative, double-blind, placebo controlled acute clinical study. Jour of Aging Research & Clinical Practice. 3(4):223-228. 9. Pletrzkowski Z, et al. (2014). Short-term efficacy of Calcium Fructoborate on subjects with knee discomfort: A comparative double-blind, placebo-controlled clinical study. Clinical Interventions in Aging. 9:895-899.

Formulation

Clinically studied ingredients

5N1 Support for Testosterone Joints Libido Prostate Vision

FDA Statement of Identity

Dietary Supplement

Formula

Now stronger with PrimaVie purified shilajit

JXT5 offers a dynamic, multifaceted 5N1 formulation created for today's man, now featuring patented PrimaVie purified shilajit. Containing the highest quality and purest ingredients available, JXT5 is designed to target five key areas of the body for health and vitality support. JXT5’s Premium formula includes 3 human clinically researched ingredients: Testosurge, newly added PrimaVie and FruitX-B (calcium fructoborate). Testosurge and PrimaVie purified shilajit work in concert to support healthy increases in testosterone levels, promote male sexual health and increase exercise endurance and performance, while FruiteX-B supports joint health and mobility. JXT5 Also includes a comprehensive blend of actives to support libido, prostate health and vision. JXT5 Isn't unrivaled men’s health formula that offers an exclusive edge for powerful results.

Testosurge and PrimaVie purified shilajit work in concert to support healthy increases in testosterone levels, promote male sexual health and increase exercise endurance and performance, while FruiteX-B supports joint health and mobility. JXT5 Also includes a comprehensive blend of actives to support libido, prostate health and vision. JXT5 Isn't unrivaled men’s health formula that offers an exclusive edge for powerful results.

Clinically studied TESTOSURGE TESTOSURGE is a proprietary extract of fenugreek (trigonella foenum-graecum) seeds, standardized to 80% Grecunin (glycosides). It has been clinically studied to determine its effects on strength, body composition and hormonal profiles. Research suggests that TESTOSURGE, combined with this structured resistance training program, can improve body composition and increase the anabolic hormonal status in resistance trained males over an 8 week period. It was concluded that 500 mg of daily TESTOSURGE supplementations impacted body fat percentage, total testosterone and bioavailable testosterone when compared to a placebo in a double-blind study. These changes were obtained without any clinical side effects.

Clinically studied PRIMAVIE PRIMAVIE is he patented form of purified shilajit from the Himalayas, standardized to greater than 50% fulvic acid and 40 unique minerals. Used for centuries in India as a traditional form of medicine, it has been clinically proven to support increases in healthy testosterone levels and vitality. Clinically proven to support healthy testosterone levels, specifically serum testosterone, in both younger and older men. PrimaVie Plays a direct role in the synthesis of adenosine triphosphate, or ATP, generating greater energy at the cellular level to support healthy aging. Through adaptogenic properties, PrimaVie helps provide protection from both physical and environmental stress.

Clinically studied Fruitex-B (calcium fructoborate) is it clinically proven and patented plant based mineral conflicts studied for its ability to reduce joint discomfort and certain inflammatory markers. Multiple published human clinicals on its unique properties and potential health benefits. Fast-acting joint and mobility support; promoting joint comfort and improved function in as little as 7 days. Benefits for joints and flexibility when used alone, and with additional synergies when used in combination with glucosamine and chondroitin.

Suggested/Recommended/Usage/Directions

Suggested Use: Take 3 JXT5 capsules daily. For maximum results take JXT5 for at least 8 weeks. To be used as part of a healthy lifestyle with regular physical activity and a proper diet. Individual results may vary.

Precautions

Warning: Keep out of reach of children.

Consult with your physician before using this product.

Do not use this product if you are pregnant or lactating, have a medical condition, or are taking prescription medications.

Not intended for use by persons under the age of 40.

Consult a physician or licensed qualified healthcare professional before using this product if you have or have a family history of the following conditions, including but not limited to, prostate cancer, prostate enlargement, heart disease, low “good” cholesterol (HDL), or if you are using any other dietary supplement, prescription drug, or over-the-counter drug.

Do not exceed recommended serving. Exceeding recommended serving may cause serious adverse health effects. Possible side effects include acne, hair loss, hair growth on the face (in women), aggressiveness, irritability, and increased levels of estrogen.

Warning for California residents only: This product contains a chemical known in the state of California to cause birth defects or other reproductive harm.

Discontinue use and call physician or licensed qualified health care professional immediately if you experience rapid heartbeat, dizziness, blurred vision, or other similar symptoms. Discontinue use two weeks prior to surgery. Do not use if tamper resistant seal is broken.

Storage

Store in a cool, dry place. Avoid excessive heat.

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.

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

See for yourself

JXT5 by Metis Nutrition label

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

JXT5 label

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

View the full label (PDF)
What’s inside

The Ingredients in JXT5 by Metis Nutrition

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

Serving size3 Capsule(s) Dosage formCapsule 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.

Vitamin B6

Interacts with
210 drugs
10 mg per serving Form: Pyridoxine Hydrochloride

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 & interactions

Calcium

Interacts with
168 drugs
16 mg per serving

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

Calcium monograph & interactions

Iron

Interacts with
80 drugs
0.15 mg per serving

Iron is an essential mineral your body needs to make hemoglobin and carry oxygen in the blood. Supplements are mainly useful for treating or preventin...

Iron monograph & interactions

Chromium

Interacts with
178 drugs
120 mcg per serving Form: Chromium Polynicotinate

Chromium is an essential trace mineral involved in how the body handles sugar and fat. Some studies suggest it may modestly help blood sugar control i...

Chromium monograph & interactions

Vitamin B12

Interacts with
20 drugs
60 mcg per serving Form: Methylcobalamin

Vitamin B12 (cobalamin) is an essential nutrient your body needs to make red blood cells, keep nerves healthy, and support DNA. Supplements are very h...

Vitamin B12 monograph & interactions

Absorption Agent

0 NP per serving

JXT5 Proprietary Blend

1990 mg per serving
  • › Joint Support Blend
  • › Surge-T Testosterone + LIBIDO Blend
  • › Trib-T Complex
  • › Prostate + Liver Support Blend
  • › Estrogen-Suppress Complex
  • › Ocular Health Blend

Other (inactive) ingredients: Gelatin, Microcrystalline Cellulose, Silica, Magnesium Stearate, Titanium Dioxide. These complete the product’s ingredient list but are not active constituents.

Interaction report

JXT5 by Metis Nutrition Drug Interactions

Want to check YOUR meds against JXT5?

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

 Go to the checker
1,584Drugs
57 Major 1,483 Moderate 44 Minor

Ingredients driving the most interactions

Joint Support Blend 1,136
BioPerine 1,019
Vitamin B6 210
Chromium 178
Calcium 168

Individual Drug Interactions

The ingredients in JXT5 interact with 1,584 drugs. Click any drug to see the details.

7 of the 12 ingredients in JXT5 interact with drugs. Each result below shows which ingredient is responsible. Joint Support Blend BioPerine Vitamin B6 Chromium Calcium Iron Vitamin B12

Each ingredient & the kinds of drugs it affects

For each ingredient in JXT5 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 Support Blend18 drug types · 1,136 drugs

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.

Likelihood Probable Evidence D
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.

Likelihood Possible Evidence D
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.

Likelihood Possible Evidence B
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.

Likelihood Possible Evidence D
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.

Likelihood Possible Evidence D
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.

Likelihood Possible Evidence D
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.

Likelihood Possible Evidence D
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.

Likelihood Possible Evidence D
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.

Likelihood Possible Evidence D
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.

Likelihood Possible Evidence D
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.

Likelihood Possible Evidence D
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.

Likelihood Possible Evidence D
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.

Likelihood Possible Evidence D
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.

Likelihood Possible Evidence D
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.

Likelihood Possible Evidence D
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.

Likelihood Possible Evidence D
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.

Likelihood Possible Evidence D
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.

Likelihood Unlikely Evidence B
Joint Support Blend full monograph & interactions

BioPerine17 drug types · 1,019 drugs

Anticoagulant/Antiplatelet Drugs

Theoretically, black pepper might increase the risk of bleeding when taken with antiplatelet or anticoagulant drugs.
In vitro research shows that piperine, a constituent of black pepper, seems to inhibit platelet aggregation. This has not been reported in humans.

Likelihood Possible Evidence D
Antidiabetes Drugs

Theoretically, black pepper might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Animal research shows that piperine, a constituent of black pepper, can reduce blood glucose levels. Monitor blood glucose levels closely. Dose adjustments might be necessary.

Likelihood Possible Evidence D
Atorvastatin (Lipitor)

Theoretically, black pepper might increase blood levels of atorvastatin.
Animal research shows that taking piperine, a constituent of black pepper, 35 mg/kg can increase the maximum serum concentration of atorvastatin three-fold. This has not been reported in humans.

Likelihood Possible Evidence D
Cyclosporine (Neoral, Sandimmune)

Theoretically, black pepper might increase the effects and side effects of cyclosporine.
In vitro research shows that piperine, a constituent of black pepper, increases the bioavailability of cyclosporine. This has not been reported in humans.

Likelihood Possible Evidence D
Cytochrome P450 2D6 (Cyp2D6) Substrates

Theoretically, black pepper might increase levels of drugs metabolized by CYP2D6.
In vitro research suggests that some constituents of black pepper inhibit CYP2D6. This has not been reported in humans.

Likelihood Possible Evidence D
Cytochrome P450 3A4 (Cyp3A4) Substrates

Theoretically, black pepper might increase levels of drugs metabolized by CYP3A4.
In vitro research and pharmacokinetic simulation data suggest that piperine, a constituent of black pepper, as well as the pepper fruit seem to inhibit CYP3A4. This has not been reported in humans.

Likelihood Possible Evidence D
Lithium

Theoretically, black pepper might increase blood levels of lithium due to its diuretic effects. The dose of lithium might need to be reduced.
Black pepper is thought to have diuretic properties.

Likelihood Probable Evidence D
Nevirapine (Viramune)

Black pepper might increase blood levels of nevirapine.
Clinical research shows that piperine, a constituent of black pepper, increases the plasma concentration of nevirapine. However, no adverse effects were observed in this study.

Likelihood Probable Evidence D
P-Glycoprotein Substrates

Theoretically, black pepper might increase levels of P-glycoprotein substrates.
In vitro research shows that piperine, a constituent of black pepper, seems to inhibit P-glycoprotein.

Likelihood Possible Evidence D
Pentobarbital (Nembutal)

Theoretically, black pepper might increase the sedative effects of pentobarbital.
Animal research shows that piperine, a constituent of black pepper, increases pentobarbital-induced sleeping time.

Likelihood Possible Evidence D
Phenytoin (Dilantin)

Black pepper might increase blood levels of phenytoin.
Clinical research shows that piperine, a constituent of black pepper, seems to increase absorption, slow elimination, and increase levels of phenytoin. Taking a single dose of black pepper 1 gram along with phenytoin seems to double the serum concentration of phenytoin. Consuming a soup with black pepper providing piperine 44 mg/200 mL of soup along with phenytoin also seems to increase phenytoin levels when compared with consuming the same soup without black pepper.

Likelihood Possible Evidence B
Propranolol (Inderal)

Black pepper might increase blood levels of propranolol.
Clinical research shows that piperine, a constituent of black pepper, seems to increase absorption and slow elimination of propranolol.

Likelihood Possible Evidence B
Rifampin (Rifadin)

Black pepper might increase blood levels of rifampin.
Clinical research shows that piperine, a constituent of black pepper, seems to increase absorption and serum levels of rifampin.

Likelihood Possible Evidence B
Theophylline

Black pepper might increase blood levels of theophylline.
Clinical research shows that piperine, a constituent of black pepper, seems to increase absorption and slow elimination of theophylline.

Likelihood Possible Evidence D
Amoxicillin (Amoxil, Trimox)

Theoretically, black pepper might increase the effects and side effects of amoxicillin.
Animal research shows that taking piperine, a constituent of black pepper, with amoxicillin increases plasma levels of amoxicillin. This has not been reported in humans.

Likelihood Possible Evidence D
Carbamazepine (Tegretol)

Theoretically, black pepper might increase blood levels of carbamazepine, potentially increasing the effects and side effects of carbamazepine.
One clinical study in patients taking carbamazepine 300 mg or 500 mg twice daily shows that taking a single 20 mg dose of purified piperine, a constituent of black pepper, increases carbamazepine levels. Piperine may increase carbamazepine absorption by increasing blood flow to the GI tract, increasing the surface area of the small intestine, or inhibiting cytochrome P450 3A4 (CYP3A4) in the gut wall. Absorption was significantly increased by 7-10 mcg/mL/hour. The time to eliminate carbamazepine was also increased by 4-8 hours. Although carbamazepine levels were increased, this did not appear to increase side effects. In vitro research also shows that piperine can increase carbamazepine levels by 11% in a time-dependent manner.

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

Theoretically, black pepper might decrease levels and clinical effects of drugs metabolized by CYP1A2.
In vitro research suggests that black pepper induces CYP1A2. This has not been reported in humans.

Likelihood Possible Evidence D
BioPerine full monograph & interactions

Vitamin B65 drug types · 210 drugs

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.

Likelihood Possible Evidence B
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.

Likelihood Possible Evidence B
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.

Likelihood Possible Evidence D
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.

Likelihood Possible Evidence D
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.

Likelihood Unlikely Evidence D
Vitamin B6 full monograph & interactions

Chromium5 drug types · 178 drugs

Antidiabetes Drugs

Theoretically, chromium may have additive effects with antidiabetic agents and increase the risk of hypoglycemia.
Some research shows that taking chromium might lower blood glucose levels, especially in patients with poorly controlled type 2 diabetes.

Likelihood Possible Evidence A
Insulin

Theoretically, concomitant use of chromium and insulin might increase the risk of hypoglycemia.
In clinical research, chromium has been shown to increase insulin sensitivity,

Likelihood Possible Evidence B
Levothyroxine (Synthroid, Others)

Chromium might bind levothyroxine in the intestinal tract and decrease levothyroxine absorption.
Clinical research in healthy volunteers shows that taking chromium picolinate 1000 mcg with levothyroxine 1 mg decreases serum levels of levothyroxine by 17% when compared to taking levothyroxine alone. Advise patients to take levothyroxine at least 30 minutes before or 3-4 hours after taking chromium.

Likelihood Probable Evidence B
Aspirin

Theoretically, aspirin might increase chromium absorption.
Animal research suggests that aspirin may increase chromium absorption and chromium levels in the blood.

Likelihood Possible Evidence D
Nonsteroidal Anti-Inflammatory Drugs (Nsaids)

NSAIDs might increase chromium levels in the body.
Drugs that are prostaglandin inhibitors, such as NSAIDs, seem to increase chromium absorption and retention.

Likelihood Possible Evidence D
Chromium full monograph & interactions

Calcium18 drug types · 168 drugs

Ceftriaxone (Rocephin)

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

Likelihood Probable Evidence D
Dolutegravir (Tivicay)

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

Likelihood Probable Evidence B
Elvitegravir (Vitekta)

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

Likelihood Probable Evidence B
Aluminum

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

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

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

Likelihood Probable Evidence D
Bisphosphonates

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

Likelihood Probable Evidence C
Calcipotriene (Dovonex)

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

Likelihood Possible Evidence B
Digoxin (Lanoxin)

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

Likelihood Possible Evidence B
Diltiazem (Cardizem, Others)

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

Likelihood Probable Evidence D
Levothyroxine (Synthroid, Others)

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

Likelihood Probable Evidence B
Lithium

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

Likelihood Possible Evidence B
Quinolone Antibiotics

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

Likelihood Probable Evidence B
Raltegravir (Isentress)

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

Likelihood Possible Evidence B
Sotalol (Betapace)

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

Likelihood Possible Evidence B
Tetracycline Antibiotics

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

Likelihood Probable Evidence C
Thiazide Diuretics

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

Likelihood Probable Evidence C
Verapamil (Calan, Others)

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

Likelihood Probable Evidence D
Calcium Channel Blockers

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

Likelihood Unlikely Evidence D
Calcium full monograph & interactions

Iron13 drug types · 80 drugs

Bictegravir/Emtricitabine/Tenofovir Alafenamide (Biktarvy)

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

Likelihood Probable Evidence D
Bisphosphonates

Iron reduces the absorption of bisphosphonates.
Advise patients that doses of bisphosphonates should be separated by at least two hours from doses of all other medications, including supplements such as iron. Divalent cations, including iron, can decrease absorption of bisphosphonates by forming insoluble complexes in the gastrointestinal tract.

Likelihood Probable Evidence D
Denosumab (Prolia, Others)

Administration of intravenous iron within one month of denosumab administration might increase the risk of severe hypophosphatemia and hypocalcemia.
A case of severe hypocalcemia (albumin corrected calcium 6.88 mg/dL, ionized calcium 3.68 mg/dL) and hypophosphatemia (<0.5 mg/dL) with respiratory acidosis, QT interval prolongation, and nonsustained ventricular tachycardia was reported in a 76-year-old male who had received an iron polymaltose infusion within 2 weeks of a subcutaneous injection of denosumab. Serum parathyroid hormone was also elevated (348 pg/mL). Subsequent iron infusions with iron polymaltose and ferric carboxymaltose were followed by transient hypophosphatemia, but without hypocalcemia. Additionally, a literature review describes 6 additional cases of hypophosphatemia and hypocalcemia in patients 52-92 years of age who had been administered intravenous iron as either ferric carboxymaltose or iron polymaltose and subcutaneous denosumab within 1-4 weeks of each other.

Likelihood Possible Evidence D
Dolutegravir (Tivicay)

Iron might decrease dolutegravir levels by reducing its absorption.
Advise patients to take dolutegravir at least 2 hours before or 6 hours after taking iron. Pharmacokinetic research shows that iron can decrease the absorption of dolutegravir from the gastrointestinal tract through chelation. When taken under fasting conditions, a single dose of ferrous fumarate 324 mg orally along with dolutegravir 50 mg reduces overall exposure to dolutegravir by 54%.

Likelihood Probable Evidence B
Integrase Inhibitors

Theoretically, taking iron along with integrase inhibitors might decrease the levels and clinical effects of these drugs.
Iron is a divalent cation. There is concern that iron may decrease the absorption of integrase inhibitors from the gastrointestinal tract through chelation. One pharmacokinetic study shows that iron can decrease blood levels of the specific integrase inhibitor dolutegravir through chelation. Also, other pharmacokinetic research shows that other divalent cations such as calcium can decrease the absorption and levels of some integrase inhibitors through chelation.

Likelihood Possible Evidence D
Levodopa

Iron might decrease levodopa levels by reducing its absorption.
Advise patients to separate doses of levodopa and iron as much as possible. There is some evidence in healthy people that iron forms chelates with levodopa, reducing the amount of levodopa absorbed by around 50%. The clinical significance of this hasn't been determined.

Likelihood Probable Evidence B
Levothyroxine (Synthroid, Others)

Iron might decrease levothyroxine levels by reducing its absorption.
Advise patients to separate levothyroxine and iron doses by at least 2 hours. Iron can decrease the absorption and efficacy of levothyroxine by forming insoluble complexes in the gastrointestinal tract.

Likelihood Probable Evidence B
Methyldopa (Aldomet)

Iron might decrease methyldopa levels by reducing its absorption.
Advise patients to separate methyldopa and iron doses by at least 2 hours. Iron can decrease the absorption of methyldopa from the gastrointestinal tract through chelation, resulting in increases in blood pressure.

Likelihood Probable Evidence B
Mycophenolate Mofetil (Cellcept)

Theoretically, iron might decrease mycophenolate mofetil levels by reducing its absorption.
Advise patients to take iron 4-6 hours before, or 2 hours after, mycophenolate mofetil. It has been suggested that a decrease of absorption is possible, probably by forming nonabsorbable chelates. However, mycophenolate pharmacokinetics are not affected by iron supplementation in available clinical research.

Likelihood Unlikely Evidence D
Penicillamine (Cuprimine, Depen)

Iron might decrease penicillamine levels by reducing its absorption.
Advise patients to separate penicillamine and iron doses by at least 2 hours. Oral iron supplements can reduce absorption of penicillamine by 30% to 70%, probably due to chelate formation. In people with Wilson's disease, this interaction has led to reduced efficacy of penicillamine.

Likelihood Probable Evidence D
Quinolone Antibiotics

Iron might decrease levels of quinolone antibiotics by reducing their absorption.
Advise patients to separate quinolone antibiotics and iron doses by at least 2 hours. Iron decreases the absorption of quinolones due to formation of insoluble complexes in the gastrointestinal tract.

Likelihood Probable Evidence D
Tetracycline Antibiotics

Iron might decrease levels of tetracycline antibiotics by reducing their absorption.
Advise patients to take iron at least 2 hours before or 4 hours after tetracycline antibiotics. Concomitant use can decrease absorption of tetracycline antibiotics from the gastrointestinal tract by 50% to 90%.

Likelihood Probable Evidence D
Chloramphenicol

Theoretically, taking chloramphenicol with iron might reduce the response to iron therapy in iron deficiency anemia.
Chloramphenicol interferes with erythrocyte maturation. However, since chloramphenicol isn't usually taken for prolonged periods, this isn't likely to be clinically significant.

Likelihood Unlikely Evidence D
Iron full monograph & interactions

Vitamin B121 drug type · 20 drugs

Metformin (Glucophage)

Metformin, a common medication used to manage type 2 diabetes, has been associated with lower vitamin B12 levels in some individuals. Prolonged use of metformin can interfere with the absorption of B12 in the digestive system, potentially leading to a deficiency in this essential vitamin.

Likelihood Possible Evidence A
Vitamin B12 full monograph & interactions
The maker

Brand information

Manufacturer and brand details for JXT5, from the product label.

Metis Nutrition

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Name
Metis Nutrition
Pharmacist Counseling Corner

JXT5 by Metis Nutrition: Common Questions

Does JXT5 by Metis Nutrition interact with any medications?
Yes. Based on its ingredients, JXT5 has a known interaction with 1,584 medications, including 57 rated major. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
JXT5 contains 12 active ingredients, and an interaction can come from any of them. We check every ingredient, combine the results into one list per medication, and show which ingredient and mechanism is responsible.
Where does this information come from?
The product label data comes from the NIH Dietary Supplement Label Database (DSLD); the interaction data is built on the Natural Medicines database and reviewed by HelloPharmacist pharmacists.
Can I take JXT5 if I'm on birth control or hormone therapy?
Saw palmetto and diindolylmethane in this product may theoretically reduce how well estrogens and contraceptives work. If you're on hormonal birth control or hormone replacement therapy, check with your pharmacist before adding JXT5 — you may need to verify that the product won't interfere with your medication's effectiveness.
Is it safe to take JXT5 while pregnant?
Several ingredients — bromelain, tribulus, saw palmetto, Tongkat Ali, and stinging nettle — are flagged as potentially unsafe or untested in pregnancy. While vitamin B6, iron, and calcium are rated safe at recommended doses when guided by a prenatal provider, the herbal blend overall makes this product inadvisable in pregnancy unless your OB specifically approves it.
What should I do if I take levothyroxine (Synthroid)?
This product contains calcium, iron, and chromium — all of which can reduce levothyroxine absorption and effectiveness. If you're on thyroid hormone, separate your dose by at least 4 hours from this supplement, and ask your doctor or pharmacist to monitor your thyroid levels, as you may need a dose adjustment.
Will JXT5 help with joint pain?
The product contains collagen and several traditional joint-support herbs, but the evidence on file shows insufficient reliable evidence for most of these ingredients' effectiveness in joint health. Results vary widely, and clinical proof is limited.
Does this supplement have fillers?
Yes — in addition to the active ingredients, JXT5 contains inactive ingredients: gelatin capsules, microcrystalline cellulose (a binder), silica, magnesium stearate, and titanium dioxide. These are standard excipients used in most capsule supplements.
Can I take JXT5 with metformin?
Vitamin B12 (in this product) has a minor documented interaction with metformin — the diabetes drug can reduce B12 absorption over time. This isn't an absolute contraindication, but if you're on metformin long-term, ask your doctor to check your B12 levels periodically, and discuss whether this supplement is right for you.

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.

JXT5 label
Go deeper

The Full Monographs Behind JXT5’s Ingredients

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

Herb & supplement monograph

Vitamin B6

Interacts with 210 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 best known for helping with pregnancy-rel...

Read the full Vitamin B6 monograph → Herb & supplement monograph

Calcium

Interacts with 168 drugs

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

Read the full Calcium monograph → Herb & supplement monograph

Iron

Interacts with 80 drugs

Iron is an essential mineral your body needs to make hemoglobin and carry oxygen in the blood. Supplements are mainly useful for treating or preventing iron deficiency and iron-deficiency an...

Read the full Iron monograph → Herb & supplement monograph

Chromium

Interacts with 178 drugs

Chromium is an essential trace mineral involved in how the body handles sugar and fat. Some studies suggest it may modestly help blood sugar control in certain people with type 2 diabetes, b...

Read the full Chromium monograph → Herb & supplement monograph

Vitamin B12

Interacts with 20 drugs

Vitamin B12 (cobalamin) is an essential nutrient your body needs to make red blood cells, keep nerves healthy, and support DNA. Supplements are very helpful for people who are deficient — su...

Read the full Vitamin B12 monograph → Herb & supplement monograph

Black Pepper

Interacts with 1,019 drugs

Black pepper is a common kitchen spice that is generally safe in the amounts used in food. Its extract, piperine, is mostly added to supplements to help the body absorb other ingredients (li...

Read the full Black Pepper monograph → Herb & supplement monograph

Cannabis

Interacts with 1,136 drugs

Cannabis contains many active compounds, mainly THC (which causes a 'high') and CBD (which does not). Some uses, such as chemotherapy-related nausea, certain seizure disorders, and muscle sp...

Read the full Cannabis monograph →
Sources

Sources & How We Checked

JXT5's label data comes from the NIH Dietary Supplement Label Database; the ingredient interaction data is from the Natural Medicines database, reviewed by our pharmacists.

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

The 910 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
  1. Hansten PD, Horn JR. Drug Interactions Analysis and Management. Vancouver, WA: Applied Therapeutics Inc., 1997 and updates.
  2. Yates AA, Schlicker SA, Suitor CW. Dietary reference intakes: The new basis for recommendations for calcium and related nutrients, B vitamins, and choline. J Am Diet Assoc 1998;98:699-706. PubMed
  3. Geerling BJ, Dagnelie PC, Badart-Smook A, et al. Diet as a risk factor for the development of ulcerative colitis. Am J Gastroenterol 2000;95:1008-13. PubMed
  4. South M. Neonatal seizures after pyridoxine use -- reply. Lancet 1999;354:2083. PubMed
  5. Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline (2000). Washington, DC: National Academy Press, 2000. Available at: http://b
  6. Baxter P, Aicardi J. Neonatal seizures after pyridoxine use. Lancet 1999;354:2082-3. PubMed
  7. Bendich A, Cohen M. Vitamin B6 safety issues. Ann N Y Acad Sci 1990;585:321-30.
  8. Schaumburg H, Kaplan J, Windebank A. Sensory neuropathy from pyridoxine abuse. A new megavitamin syndrome. N Engl J Med 1983;309:445-8. PubMed
  9. Gordon N. Pyridoxine dependency: an update. Dev Med Child Neurol 1997;39:63-5. PubMed
  10. Lewis PJ. Pain in the hand and wrist. Pyridoxine supplements may help patients with carpal tunnel syndrome. BMJ 1995;310:1534. PubMed
  11. Kaufman G. Pyridoxine against amiodarone-induced photosensitivity (letter). Lancet 1984;1:51-2. PubMed
  12. Mulrow JP, Mulrow CD, McKenna WJ. Pyridoxine and amiodarone-induced photosensitivity. Ann Intern Med 1985;103:68-9. PubMed
  13. Kawada A, Kashima A, Shiraishi H, et al. Pyridoxine-induced photosensitivity and hypophosphatasia. Dermatology 2000;201:356-60.. PubMed
  14. Vasile A, Goldberg R, Kornberg B. Pyridoxine toxicity: report of a case. J Am Osteopath Assoc 1984;83:790-1. DOI
  15. Hansson O, Sillanpaa M. Pyridoxine and serum concentration of phenytoin and phenobarbitone. Lancet 1976;1:256. DOI
  16. Jansen T, Romiti R, Kreuter A, Altmeyer P. Rosacea fulminans triggered by high-dose vitamins B6 and B12. J Eur Acad Dermatol Venereol 2001;15:484-5..
  17. Chittumma P, Kaewkiattikun K, Wiriyasiriwach B. Comparison of the effectiveness of ginger and vitamin B6 for treatment of nausea and vomiting in early pregnancy: a randomized double-blind controlled trial. J Med Assoc Thai 2007;90:15-20.
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Pygeum 3 references
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Chrysin 23 references
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Calendula 9 references
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Bilberry 14 references
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Fenugreek 30 references
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Sweet Orange 17 references
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Tomato 3 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.

© 2021 Therapeutic Research Center, LLC

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