Laxative Formula Ingredients & Drug Interactions
What is this page for?
First and foremost: checking Laxative Formula 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
Laxative Formula is a dietary supplement by Integrative Therapeutics with 9 active ingredients. Its ingredients are commonly taken for replacing fluids and electrolytes, preventing dehydration during exercise or illness, treating low blood sodium (under medical care).Based on those ingredients, 2,177 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are Marshmallow (Althaea officinalis) root extract, Slippery Elm, Ginger (Zingiber officinale) rhizome extract. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against Laxative Formula by Integrative Therapeutics
Ask about any prescription or over-the-counter medication and we check it for interactions with Laxative Formula by Integrative Therapeutics — 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 Laxative Formula by Integrative Therapeutics
Our pharmacy team’s full take, with four database checks built into the cards below — a summary of what is known, not a grade of the product itself.
What’s inside
Low disclosure
Laxative Formula contains 9 ingredients. The active components include sodium, fenugreek seed extract, magnesium hydroxide and magnesium, marshmallow root extract, fennel, slippery elm inner bark, ginger rhizome extract, and peppermint, along with two proprietary blends (Mucilage Blend and Soothing Blend) whose exact compositions aren't broken down here.
The inactive ingredients are cellulose, sodium carboxymethyl cellulose, stearic acid, hydroxypropyl methylcellulose, magnesium stearate, glycerin, and silicon dioxide.
Does it work?
Strong evidence
Evidence for this formula's active ingredients is mixed. Magnesium is rated Effective for constipation and dyspepsia (upset stomach).
Ginger is rated Possibly Effective for pregnancy-related nausea and dysmenorrhea (period pain), and Possibly Ineffective for exercise-related muscle soreness. Peppermint is rated Likely Effective for irritable bowel syndrome and Possibly Effective for indigestion and nausea.
Fenugreek is rated Possibly Effective for sexual function and diabetes. Fennel is rated Possibly Effective for period pain.
For marshmallow, slippery elm, sodium, and the proprietary blends, the evidence we hold does not establish effectiveness—we found insufficient evidence or no rating. Talk with your doctor about whether this formula matches your specific health goal.
How safe is it?
Well-documented data
Magnesium and ginger are generally well tolerated at typical doses; magnesium's most common side effects are diarrhea, nausea, and stomach irritation, while ginger may cause mild abdominal discomfort, heartburn, or burping. Fenugreek is generally well tolerated but can cause abdominal pain, bloating, or diarrhea in some people, and rare allergic reactions including breathing problems.
Peppermint is generally safe orally but may cause abdominal pain, heartburn, nausea, or anal irritation. Fennel is usually well tolerated but can trigger allergic reactions or, rarely, seizures.
Marshmallow and slippery elm have limited human safety data. Sodium, when consumed in high amounts regularly, is linked to high blood pressure, heart strain, and increased risk of gastric cancer; stick to normal dietary levels unless your doctor advises otherwise.
During pregnancy, magnesium and ginger are generally safe (ginger is rated Likely or Possibly Safe), but fenugreek is rated Likely Unsafe and fennel is Possibly Unsafe—talk with your doctor. For breastfeeding, fenugreek lactation safety is Possibly Safe, ginger and peppermint are rated Likely Safe, but fennel, marshmallow, and slippery elm are Possibly Unsafe or lack sufficient data—check with your provider before using medicinal amounts.
Meds to double-check
Major interaction found
Before taking Laxative Formula, double-check with your doctor or pharmacist if you're on levodopa/carbidopa for Parkinson's disease (Major interaction with magnesium), blood thinners like warfarin or clopidogrel, blood pressure medications, diabetes drugs, lithium, theophylline, phenytoin (Dilantin), sildenafil (Viagra), calcium channel blockers, skeletal muscle relaxants, quinolone antibiotics, bisphosphonates, liver enzyme substrates (CYP3A4, CYP2C19, CYP2C9, or P-glycoprotein), or acid reducers. Magnesium may also impair absorption of quinolone antibiotics—separate doses by at least 2 to 6 hours.
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.
This formula may help with constipation or digestive upset, thanks mainly to magnesium, ginger, and peppermint—though evidence for some ingredients is limited. However, it carries significant interactions with common medications, particularly blood pressure drugs, blood thinners, diabetes medications, Parkinson's drugs, and lithium.
If you take any regular prescriptions, check with your doctor or pharmacist before starting it. It's not right for pregnancy unless your provider approves, and some ingredients are not well studied while breastfeeding.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 9 of 9 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Jun 24, 2020.
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 Laxative Formula, straight from the product label.
| Brand | Integrative Therapeutics |
|---|---|
| Barcode (UPC) | 871791003262 |
| Net contents | 60 Tablet(s) |
| Market status | On market |
| Date entered into DSLD | Jun 24, 2020 |
| DSLD ID | 223032 |
| Product type | Other Combinations |
| Supplement form | Tablet Or Pill |
| Dietary claims / uses | All Other, Structure/Function |
| Intended target group(s) | Vegetarian, Adult (18 - 50 Years), Women (not pregnant or lactating), Dairy Free |
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.
Supplement Facts
The label details for Laxative Formula by Integrative Therapeutics, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Total Carbohydrates | 1 Gram(s) | 1% |
| Sodium | 5 mg | 1% |
| Fenugreek (Trigonella foenum-graecum) seed extract | 0 NP | -- |
| Magnesium Hydroxide | 1.7 Gram(s) | -- |
| Marshmallow (Althaea officinalis) root extract | 0 NP | -- |
| Magnesium | 722 mg | 172% |
| Fennel | 0 NP | -- |
| Slippery Elm | 0 NP | -- |
| Ginger (Zingiber officinale) rhizome extract | 0 NP | -- |
| Proprietary Mucilage Blend | 433 mg | -- |
| Proprietary Soothing Blend | 100 mg | -- |
| Peppermint | 0 NP | -- |
Other ingredients: Cellulose, Sodium Carboxymethyl Cellulose, Stearic Acid, Hydroxypropyl Methylcellulose, Magnesium Stearate, Glycerin, Silicon 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.
Suggested/Recommended/Usage/Directions
Recommendation: Take 2 tablets at bedtime with 8 oz of water. Reduce dosage if you experience abdominal discomfort or diarrhea. If discomfort persists, discontinue use. Do not take more than 2 tablets in a 24-hour period, or use the maximum dosage for more than 7 days, as frequent or prolonged use may result in dependence.
Precautions
Keep out of reach of children.
Safety sealed with printed inner seal. Do not use if seal is broken or missing.
Warning: Do not use this product if pregnant, attempting to become pregnant, or under the age of 12.
Warning: Do not use this product if pregnant, attempting to become pregnant, or under the age of 12.
Do not use when abdominal pain, nausea, or vomiting are present.
If you are nursing, have diabetes, a kidney disease, or if you are taking any medications, consult a healthcare professional before use.
If you notice a sudden change in bowel habits that persist over two weeks, consult your healthcare professional. Rectal bleeding or failure to move bowels after use may indicate a serious condition. If you experience any of these symptoms, discontinue use and consult your healthcare professional.
This product contains Slippery Elm.
Slippery Elm should not be taken together with any medication as it may interfere with their absorption.
Formulation
Contains no soy, dairy products, ingredients of animal origin, or artificial colors, flavors, or preservatives.
Brand IP Statement(s)
2019 Integrative Therapeutics, LLC
FDA Disclaimer Statement
This statement has not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.
FDA Statement of Identity
Dietary Supplement
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Laxative Formula by Integrative Therapeutics 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 Laxative Formula by Integrative Therapeutics
These are the 9 active ingredients this product is made of. Select any to open its full monograph.
Serving size2 Tablet(s) Dosage formTablet Or Pill Servings per container30 Amounts shown are per serving.
Most supplement products combine several ingredients, and a medication can interact with the product through any one of them. Each ingredient below shows whether it has known drug interactions.
Sodium
Interacts with205 drugs
Sodium is an essential mineral and electrolyte your body needs to balance fluids, support nerves, and help muscles work. Most people in modern diets g...
Sodium monograph & interactionsMagnesium Hydroxide
Interacts with295 drugs
Magnesium is an essential mineral your body needs for muscles, nerves, blood pressure, and many other functions, and supplements are useful for preven...
Magnesium Hydroxide monograph & interactionsMagnesium
Interacts with295 drugs
Magnesium is an essential mineral your body needs for muscles, nerves, blood pressure, and many other functions, and supplements are useful for preven...
Magnesium monograph & interactionsProprietary Mucilage Blend
Proprietary Soothing Blend
Other (inactive) ingredients: Cellulose, Sodium Carboxymethyl Cellulose, Stearic Acid, Hydroxypropyl Methylcellulose, Magnesium Stearate, Glycerin, Silicon Dioxide. These complete the product’s ingredient list but are not active constituents.
Laxative Formula by Integrative Therapeutics Drug Interactions
HelloPharmacist Interaction Report
Laxative Formula by Integrative Therapeutics contains several ingredients with documented interactions: sodium, fenugreek, magnesium (in two forms), marshmallow, fennel, slippery elm, ginger, and peppermint.
The most serious interaction is a Major-severity effect from magnesium with levodopa/carbidopa (Sinemet), a Parkinson's medication—magnesium can reduce levodopa levels by 35% and carbidopa levels by 81%, significantly weakening disease control.
Read the full breakdown — every affected drug type, severity by severity
Sodium carries Moderate interactions with blood pressure drugs (antihypertensives), corticosteroids, lithium, didanosine, sodium phosphate bowel-prep solutions, tolvaptan, and other sodium-containing medications. High sodium intake can reduce blood pressure drug effectiveness, increase the risk of high sodium levels in the blood (hypernatremia), or dangerously raise lithium levels.
Fenugreek poses Moderate interactions with blood thinners and antiplatelet drugs (warfarin, clopidogrel), diabetes medications, theophylline, metoprolol, phenytoin, and sildenafil—potentially reducing drug effectiveness or causing unwanted low blood sugar. Magnesium (listed twice in the formula) interacts Moderately with skeletal muscle relaxants, potassium-sparing diuretics, calcium channel blockers, acid reducers, sulfonylureas, quinolone antibiotics, and bisphosphonates.
Fennel, ginger, and peppermint each carry Moderate interactions with blood thinners, diabetes drugs, and various other medications metabolized by liver enzymes. Marshmallow has Minor interactions with lithium and oral drugs generally, and slippery elm may slow oral drug absorption.
Additionally, we could not check two proprietary blends (Proprietary Mucilage Blend and Proprietary Soothing Blend) because their component ingredients are listed separately. Altogether, these interactions span 2,178 individual medications.
Before starting this product, check your exact medications with your doctor or pharmacist—especially if you take Parkinson's drugs, blood thinners, diabetes medications, blood pressure drugs, or lithium.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against Laxative Formula?
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 Laxative Formula interact with 2,177 drugs. Click any drug to see the details.
8 of the 9 ingredients in Laxative Formula interact with drugs. Each result below shows which ingredient is responsible. Marshmallow (Althaea officinalis) root extract Slippery Elm Ginger (Zingiber officinale) rhizome extract Peppermint Fennel Fenugreek (Trigonella foenum-graecum) seed extract Magnesium Hydroxide Sodium
Benserazide, LevodopaMadopar, Prolopa
How Benserazide, Levodopa interacts with Laxative Formula — through 3 ingredients. Tap an ingredient for the detail:
MagnesiumLevodopa/carbidopa (sinemet) Major
Interaction Summary
Magnesium can reduce the bioavailability of levodopa/carbidopa.
Read the full Magnesium + Benserazide, Levodopa interactionSlippery ElmOral Drugs Moderate
Interaction Summary
Theoretically, slippery elm may slow the absorption and reduce serum levels of oral drugs.
Read the full Slippery Elm + Benserazide, Levodopa interactionMarshmallow (althaea Officinalis) Root ExtractOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow (althaea Officinalis) Root Extract + Benserazide, Levodopa interactionCarbidopaLodosyn
How Carbidopa interacts with Laxative Formula — through 3 ingredients. Tap an ingredient for the detail:
MagnesiumLevodopa/carbidopa (sinemet) Major
Interaction Summary
Magnesium can reduce the bioavailability of levodopa/carbidopa.
Read the full Magnesium + Carbidopa interactionSlippery ElmOral Drugs Moderate
Interaction Summary
Theoretically, slippery elm may slow the absorption and reduce serum levels of oral drugs.
Read the full Slippery Elm + Carbidopa interactionMarshmallow (althaea Officinalis) Root ExtractOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow (althaea Officinalis) Root Extract + Carbidopa interactionCarbidopa, LevodopaDhivy, Rytary, Sinemet, Sinemet CR
How Carbidopa, Levodopa interacts with Laxative Formula — through 3 ingredients. Tap an ingredient for the detail:
MagnesiumLevodopa/carbidopa (sinemet) Major
Interaction Summary
Magnesium can reduce the bioavailability of levodopa/carbidopa.
Read the full Magnesium + Carbidopa, Levodopa interactionSlippery ElmOral Drugs Moderate
Interaction Summary
Theoretically, slippery elm may slow the absorption and reduce serum levels of oral drugs.
Read the full Slippery Elm + Carbidopa, Levodopa interactionMarshmallow (althaea Officinalis) Root ExtractOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow (althaea Officinalis) Root Extract + Carbidopa, Levodopa interactionCarbidopa, Levodopa, EntacaponeStalevo
How Carbidopa, Levodopa, Entacapone interacts with Laxative Formula — through 3 ingredients. Tap an ingredient for the detail:
MagnesiumLevodopa/carbidopa (sinemet) Major
Interaction Summary
Magnesium can reduce the bioavailability of levodopa/carbidopa.
Read the full Magnesium + Carbidopa, Levodopa, Entacapone interactionSlippery ElmOral Drugs Moderate
Interaction Summary
Theoretically, slippery elm may slow the absorption and reduce serum levels of oral drugs.
Read the full Slippery Elm + Carbidopa, Levodopa, Entacapone interactionMarshmallow (althaea Officinalis) Root ExtractOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow (althaea Officinalis) Root Extract + Carbidopa, Levodopa, Entacapone interactionLevodopaInbrija, Larodopa
How Levodopa interacts with Laxative Formula — through 3 ingredients. Tap an ingredient for the detail:
MagnesiumLevodopa/carbidopa (sinemet) Major
Interaction Summary
Magnesium can reduce the bioavailability of levodopa/carbidopa.
Read the full Magnesium + Levodopa interactionSlippery ElmOral Drugs Moderate
Interaction Summary
Theoretically, slippery elm may slow the absorption and reduce serum levels of oral drugs.
Read the full Slippery Elm + Levodopa interactionMarshmallow (althaea Officinalis) Root ExtractOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow (althaea Officinalis) Root Extract + Levodopa interactionLevodopa, CarbidopaDuodopa
How Levodopa, Carbidopa interacts with Laxative Formula — through 1 ingredient. Tap an ingredient for the detail:
MagnesiumLevodopa/carbidopa (sinemet) Major
Interaction Summary
Magnesium can reduce the bioavailability of levodopa/carbidopa.
Read the full Magnesium + Levodopa, Carbidopa interaction"phentolamineOraVerse, Rogitine, Ryzumvi
How "phentolamine interacts with Laxative Formula — through 2 ingredients. Tap an ingredient for the detail:
Slippery ElmOral Drugs Moderate
Interaction Summary
Theoretically, slippery elm may slow the absorption and reduce serum levels of oral drugs.
Read the full Slippery Elm + "phentolamine interactionMarshmallow (althaea Officinalis) Root ExtractOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow (althaea Officinalis) Root Extract + "phentolamine interaction6-mercaptopurinePurinethol
How 6-mercaptopurine interacts with Laxative Formula — through 2 ingredients. Tap an ingredient for the detail:
Slippery ElmOral Drugs Moderate
Interaction Summary
Theoretically, slippery elm may slow the absorption and reduce serum levels of oral drugs.
Read the full Slippery Elm + 6-mercaptopurine interactionMarshmallow (althaea Officinalis) Root ExtractOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow (althaea Officinalis) Root Extract + 6-mercaptopurine interactionAdo-trastuzumab EmtansineKadcyla
How Ado-trastuzumab Emtansine interacts with Laxative Formula — through 3 ingredients. Tap an ingredient for the detail:
FennelCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, fennel might increase levels of drugs metabolized by CYP3A4.
Read the full Fennel + Ado-trastuzumab Emtansine interactionPeppermintCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, peppermint might increase the levels of CYP3A4 substrates.
Read the full Peppermint + Ado-trastuzumab Emtansine interactionGinger (zingiber Officinale) Rhizome ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Ginger might increase or decrease the levels of CYP3A4 substrates.
Read the full Ginger (zingiber Officinale) Rhizome Extract + Ado-trastuzumab Emtansine interactionAbacavirZiagen
How Abacavir interacts with Laxative Formula — through 2 ingredients. Tap an ingredient for the detail:
Slippery ElmOral Drugs Moderate
Interaction Summary
Theoretically, slippery elm may slow the absorption and reduce serum levels of oral drugs.
Read the full Slippery Elm + Abacavir interactionMarshmallow (althaea Officinalis) Root ExtractOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow (althaea Officinalis) Root Extract + Abacavir interactionAbacavir Sulfate, Dolutegravir, LamivudineTriumeq
How Abacavir Sulfate, Dolutegravir, Lamivudine interacts with Laxative Formula — through 2 ingredients. Tap an ingredient for the detail:
Slippery ElmOral Drugs Moderate
Interaction Summary
Theoretically, slippery elm may slow the absorption and reduce serum levels of oral drugs.
Read the full Slippery Elm + Abacavir Sulfate, Dolutegravir, Lamivudine interactionMarshmallow (althaea Officinalis) Root ExtractOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow (althaea Officinalis) Root Extract + Abacavir Sulfate, Dolutegravir, Lamivudine interactionAbacavir, LamivudineEpzicom
How Abacavir, Lamivudine interacts with Laxative Formula — through 2 ingredients. Tap an ingredient for the detail:
Slippery ElmOral Drugs Moderate
Interaction Summary
Theoretically, slippery elm may slow the absorption and reduce serum levels of oral drugs.
Read the full Slippery Elm + Abacavir, Lamivudine interactionMarshmallow (althaea Officinalis) Root ExtractOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow (althaea Officinalis) Root Extract + Abacavir, Lamivudine interactionAbciximabReoPro
How Abciximab interacts with Laxative Formula — through 6 ingredients. Tap an ingredient for the detail:
Ginger (zingiber Officinale) Rhizome ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Ginger may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Ginger (zingiber Officinale) Rhizome Extract + Abciximab interactionFennelAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, fennel might increase the risk of bleeding when used with antiplatelet or anticoagulant drugs.
Read the full Fennel + Abciximab interactionFenugreek (trigonella Foenum-graecum) Seed ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, fenugreek might have additive effects when used with anticoagulant or antiplatelet drugs.
Read the full Fenugreek (trigonella Foenum-graecum) Seed Extract + Abciximab interactionSlippery ElmOral Drugs Moderate
Interaction Summary
Theoretically, slippery elm may slow the absorption and reduce serum levels of oral drugs.
Read the full Slippery Elm + Abciximab interactionMarshmallow (althaea Officinalis) Root ExtractOral Drugs, Anticoagulant/antiplatelet Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow (althaea Officinalis) Root Extract + Abciximab interactionMagnesiumAnticoagulant/antiplatelet Drugs Minor
Interaction Summary
Theoretically, magnesium may have antiplatelet effects, but the evidence is conflicting.
Read the full Magnesium + Abciximab interactionAbemaciclibVerzenio
How Abemaciclib interacts with Laxative Formula — through 5 ingredients. Tap an ingredient for the detail:
Slippery ElmOral Drugs Moderate
Interaction Summary
Theoretically, slippery elm may slow the absorption and reduce serum levels of oral drugs.
Read the full Slippery Elm + Abemaciclib interactionFennelCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, fennel might increase levels of drugs metabolized by CYP3A4.
Read the full Fennel + Abemaciclib interactionGinger (zingiber Officinale) Rhizome ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Ginger might increase or decrease the levels of CYP3A4 substrates.
Read the full Ginger (zingiber Officinale) Rhizome Extract + Abemaciclib interactionPeppermintCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, peppermint might increase the levels of CYP3A4 substrates.
Read the full Peppermint + Abemaciclib interactionMarshmallow (althaea Officinalis) Root ExtractOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow (althaea Officinalis) Root Extract + Abemaciclib interactionAbiraterone
How Abiraterone interacts with Laxative Formula — through 5 ingredients. Tap an ingredient for the detail:
PeppermintCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, peppermint might increase the levels of CYP3A4 substrates.
Read the full Peppermint + Abiraterone interactionGinger (zingiber Officinale) Rhizome ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Ginger might increase or decrease the levels of CYP3A4 substrates.
Read the full Ginger (zingiber Officinale) Rhizome Extract + Abiraterone interactionSlippery ElmOral Drugs Moderate
Interaction Summary
Theoretically, slippery elm may slow the absorption and reduce serum levels of oral drugs.
Read the full Slippery Elm + Abiraterone interactionFennelCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, fennel might increase levels of drugs metabolized by CYP3A4.
Read the full Fennel + Abiraterone interactionMarshmallow (althaea Officinalis) Root ExtractOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow (althaea Officinalis) Root Extract + Abiraterone interactionAbiraterone AcetateYonsa, Zytiga
How Abiraterone Acetate interacts with Laxative Formula — through 5 ingredients. Tap an ingredient for the detail:
Slippery ElmOral Drugs Moderate
Interaction Summary
Theoretically, slippery elm may slow the absorption and reduce serum levels of oral drugs.
Read the full Slippery Elm + Abiraterone Acetate interactionPeppermintCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, peppermint might increase the levels of CYP3A4 substrates.
Read the full Peppermint + Abiraterone Acetate interactionGinger (zingiber Officinale) Rhizome ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Ginger might increase or decrease the levels of CYP3A4 substrates.
Read the full Ginger (zingiber Officinale) Rhizome Extract + Abiraterone Acetate interactionFennelCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, fennel might increase levels of drugs metabolized by CYP3A4.
Read the full Fennel + Abiraterone Acetate interactionMarshmallow (althaea Officinalis) Root ExtractOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow (althaea Officinalis) Root Extract + Abiraterone Acetate interactionAbrocitinibCibinqo
How Abrocitinib interacts with Laxative Formula — through 7 ingredients. Tap an ingredient for the detail:
FennelAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, fennel might increase the risk of bleeding when used with antiplatelet or anticoagulant drugs.
Read the full Fennel + Abrocitinib interactionPeppermintCytochrome P450 2c19 (cyp2c19) Substrates, Cytochrome P450 2c9 (cyp2c9) Substrates Moderate
Interaction Summary
Theoretically, peppermint might increase the levels of CYP2C19 substrates.
Read the full Peppermint + Abrocitinib interactionFenugreek (trigonella Foenum-graecum) Seed ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, fenugreek might have additive effects when used with anticoagulant or antiplatelet drugs.
Read the full Fenugreek (trigonella Foenum-graecum) Seed Extract + Abrocitinib interactionGinger (zingiber Officinale) Rhizome ExtractAnticoagulant/antiplatelet Drugs, Cytochrome P450 2c9 (cyp2c9) Substrates Moderate
Interaction Summary
Ginger may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Ginger (zingiber Officinale) Rhizome Extract + Abrocitinib interactionSlippery ElmOral Drugs Moderate
Interaction Summary
Theoretically, slippery elm may slow the absorption and reduce serum levels of oral drugs.
Read the full Slippery Elm + Abrocitinib interactionMarshmallow (althaea Officinalis) Root ExtractOral Drugs, Anticoagulant/antiplatelet Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow (althaea Officinalis) Root Extract + Abrocitinib interactionMagnesiumAnticoagulant/antiplatelet Drugs Minor
Interaction Summary
Theoretically, magnesium may have antiplatelet effects, but the evidence is conflicting.
Read the full Magnesium + Abrocitinib interactionAcalabrutinibCalquence
How Acalabrutinib interacts with Laxative Formula — through 5 ingredients. Tap an ingredient for the detail:
Ginger (zingiber Officinale) Rhizome ExtractP-glycoprotein Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Ginger might increase the absorption and blood levels of P-glycoprotein (P-gp) substrates.
Read the full Ginger (zingiber Officinale) Rhizome Extract + Acalabrutinib interactionFennelCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, fennel might increase levels of drugs metabolized by CYP3A4.
Read the full Fennel + Acalabrutinib interactionPeppermintCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, peppermint might increase the levels of CYP3A4 substrates.
Read the full Peppermint + Acalabrutinib interactionSlippery ElmOral Drugs Moderate
Interaction Summary
Theoretically, slippery elm may slow the absorption and reduce serum levels of oral drugs.
Read the full Slippery Elm + Acalabrutinib interactionMarshmallow (althaea Officinalis) Root ExtractOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow (althaea Officinalis) Root Extract + Acalabrutinib interactionAcamprosateCampral
How Acamprosate interacts with Laxative Formula — through 2 ingredients. Tap an ingredient for the detail:
Slippery ElmOral Drugs Moderate
Interaction Summary
Theoretically, slippery elm may slow the absorption and reduce serum levels of oral drugs.
Read the full Slippery Elm + Acamprosate interactionMarshmallow (althaea Officinalis) Root ExtractOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow (althaea Officinalis) Root Extract + Acamprosate interactionAcarboseGlucobay, Prandase, Precose
How Acarbose interacts with Laxative Formula — through 4 ingredients. Tap an ingredient for the detail:
Ginger (zingiber Officinale) Rhizome ExtractAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, taking ginger with antidiabetes drugs might increase the risk of hypoglycemia.
Read the full Ginger (zingiber Officinale) Rhizome Extract + Acarbose interactionSlippery ElmOral Drugs Moderate
Interaction Summary
Theoretically, slippery elm may slow the absorption and reduce serum levels of oral drugs.
Read the full Slippery Elm + Acarbose interactionFenugreek (trigonella Foenum-graecum) Seed ExtractAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, fenugreek seed might have additive hypoglycemic effects when used with antidiabetes drugs.
Read the full Fenugreek (trigonella Foenum-graecum) Seed Extract + Acarbose interactionMarshmallow (althaea Officinalis) Root ExtractOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow (althaea Officinalis) Root Extract + Acarbose interactionAcebutololRhotral, Sectral
How Acebutolol interacts with Laxative Formula — through 4 ingredients. Tap an ingredient for the detail:
SodiumAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, a high intake of dietary sodium might reduce the effectiveness of antihypertensive drugs.
Read the full Sodium + Acebutolol interactionSlippery ElmOral Drugs Moderate
Interaction Summary
Theoretically, slippery elm may slow the absorption and reduce serum levels of oral drugs.
Read the full Slippery Elm + Acebutolol interactionMarshmallow (althaea Officinalis) Root ExtractOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow (althaea Officinalis) Root Extract + Acebutolol interactionFenugreek (trigonella Foenum-graecum) Seed ExtractAntihypertensive Drugs Minor
Interaction Summary
Fenugreek may also have an additive effect on blood pressure-lowering medications.
Read the full Fenugreek (trigonella Foenum-graecum) Seed Extract + Acebutolol interactionAcenocoumarolSintrom
How Acenocoumarol interacts with Laxative Formula — through 6 ingredients. Tap an ingredient for the detail:
Fenugreek (trigonella Foenum-graecum) Seed ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, fenugreek might have additive effects when used with anticoagulant or antiplatelet drugs.
Read the full Fenugreek (trigonella Foenum-graecum) Seed Extract + Acenocoumarol interactionGinger (zingiber Officinale) Rhizome ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Ginger may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Ginger (zingiber Officinale) Rhizome Extract + Acenocoumarol interactionFennelAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, fennel might increase the risk of bleeding when used with antiplatelet or anticoagulant drugs.
Read the full Fennel + Acenocoumarol interactionSlippery ElmOral Drugs Moderate
Interaction Summary
Theoretically, slippery elm may slow the absorption and reduce serum levels of oral drugs.
Read the full Slippery Elm + Acenocoumarol interactionMarshmallow (althaea Officinalis) Root ExtractAnticoagulant/antiplatelet Drugs, Oral Drugs Minor
Interaction Summary
Theoretically, marshmallow flower might have antiplatelet effects.
Read the full Marshmallow (althaea Officinalis) Root Extract + Acenocoumarol interactionMagnesiumAnticoagulant/antiplatelet Drugs Minor
Interaction Summary
Theoretically, magnesium may have antiplatelet effects, but the evidence is conflicting.
Read the full Magnesium + Acenocoumarol interactionAcepromazineAtravet
How Acepromazine interacts with Laxative Formula — through 2 ingredients. Tap an ingredient for the detail:
Slippery ElmOral Drugs Moderate
Interaction Summary
Theoretically, slippery elm may slow the absorption and reduce serum levels of oral drugs.
Read the full Slippery Elm + Acepromazine interactionMarshmallow (althaea Officinalis) Root ExtractOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow (althaea Officinalis) Root Extract + Acepromazine interactionAcetaminophenChildren's Tylenol, Children's Tylenol Meltaways, Tylenol, Tylenol Ex Strength
How Acetaminophen interacts with Laxative Formula — through 4 ingredients. Tap an ingredient for the detail:
Slippery ElmOral Drugs Moderate
Interaction Summary
Theoretically, slippery elm may slow the absorption and reduce serum levels of oral drugs.
Read the full Slippery Elm + Acetaminophen interactionMarshmallow (althaea Officinalis) Root ExtractOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow (althaea Officinalis) Root Extract + Acetaminophen interactionGinger (zingiber Officinale) Rhizome ExtractCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, ginger might increase the levels of CYP1A2 substrates.
Read the full Ginger (zingiber Officinale) Rhizome Extract + Acetaminophen interactionPeppermintCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, peppermint might increase the levels of CYP1A2 substrates.
Read the full Peppermint + Acetaminophen interactionAcetaminophen, AspirinGemnisyn
How Acetaminophen, Aspirin interacts with Laxative Formula — through 7 ingredients. Tap an ingredient for the detail:
FennelAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, fennel might increase the risk of bleeding when used with antiplatelet or anticoagulant drugs.
Read the full Fennel + Acetaminophen, Aspirin interactionSlippery ElmOral Drugs Moderate
Interaction Summary
Theoretically, slippery elm may slow the absorption and reduce serum levels of oral drugs.
Read the full Slippery Elm + Acetaminophen, Aspirin interactionFenugreek (trigonella Foenum-graecum) Seed ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, fenugreek might have additive effects when used with anticoagulant or antiplatelet drugs.
Read the full Fenugreek (trigonella Foenum-graecum) Seed Extract + Acetaminophen, Aspirin interactionGinger (zingiber Officinale) Rhizome ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Anticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, ginger might increase the levels of CYP1A2 substrates.
Read the full Ginger (zingiber Officinale) Rhizome Extract + Acetaminophen, Aspirin interactionPeppermintCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, peppermint might increase the levels of CYP1A2 substrates.
Read the full Peppermint + Acetaminophen, Aspirin interactionMarshmallow (althaea Officinalis) Root ExtractOral Drugs, Anticoagulant/antiplatelet Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow (althaea Officinalis) Root Extract + Acetaminophen, Aspirin interactionMagnesiumAnticoagulant/antiplatelet Drugs Minor
Interaction Summary
Theoretically, magnesium may have antiplatelet effects, but the evidence is conflicting.
Read the full Magnesium + Acetaminophen, Aspirin interactionAcetaminophen, Aspirin, CaffeineExcedrin, Excedrin Extra Strength, Excedrin Migraine
How Acetaminophen, Aspirin, Caffeine interacts with Laxative Formula — through 7 ingredients. Tap an ingredient for the detail:
Ginger (zingiber Officinale) Rhizome ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Anticoagulant/antiplatelet Drugs +1 Moderate
Interaction Summary
Theoretically, ginger might increase the levels of CYP1A2 substrates.
Read the full Ginger (zingiber Officinale) Rhizome Extract + Acetaminophen, Aspirin, Caffeine interactionFenugreek (trigonella Foenum-graecum) Seed ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, fenugreek might have additive effects when used with anticoagulant or antiplatelet drugs.
Read the full Fenugreek (trigonella Foenum-graecum) Seed Extract + Acetaminophen, Aspirin, Caffeine interactionFennelAnticoagulant/antiplatelet Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, fennel might increase the risk of bleeding when used with antiplatelet or anticoagulant drugs.
Read the full Fennel + Acetaminophen, Aspirin, Caffeine interactionPeppermintCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, peppermint might increase the levels of CYP3A4 substrates.
Read the full Peppermint + Acetaminophen, Aspirin, Caffeine interactionSlippery ElmOral Drugs Moderate
Interaction Summary
Theoretically, slippery elm may slow the absorption and reduce serum levels of oral drugs.
Read the full Slippery Elm + Acetaminophen, Aspirin, Caffeine interactionMarshmallow (althaea Officinalis) Root ExtractAnticoagulant/antiplatelet Drugs, Oral Drugs Minor
Interaction Summary
Theoretically, marshmallow flower might have antiplatelet effects.
Read the full Marshmallow (althaea Officinalis) Root Extract + Acetaminophen, Aspirin, Caffeine interactionMagnesiumAnticoagulant/antiplatelet Drugs Minor
Interaction Summary
Theoretically, magnesium may have antiplatelet effects, but the evidence is conflicting.
Read the full Magnesium + Acetaminophen, Aspirin, Caffeine interactionAcetaminophen, Brompheniramine, PhenylpropanolamineDimetapp Cold and Flu
How Acetaminophen, Brompheniramine, Phenylpropanolamine interacts with Laxative Formula — through 4 ingredients. Tap an ingredient for the detail:
Slippery ElmOral Drugs Moderate
Interaction Summary
Theoretically, slippery elm may slow the absorption and reduce serum levels of oral drugs.
Read the full Slippery Elm + Acetaminophen, Brompheniramine, Phenylpropanolamine interactionPeppermintCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, peppermint might increase the levels of CYP1A2 substrates.
Read the full Peppermint + Acetaminophen, Brompheniramine, Phenylpropanolamine interactionGinger (zingiber Officinale) Rhizome ExtractCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, ginger might increase the levels of CYP1A2 substrates.
Read the full Ginger (zingiber Officinale) Rhizome Extract + Acetaminophen, Brompheniramine, Phenylpropanolamine interactionMarshmallow (althaea Officinalis) Root ExtractOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow (althaea Officinalis) Root Extract + Acetaminophen, Brompheniramine, Phenylpropanolamine interactionAcetaminophen, ButalbitalAxocet, Bancap, Bucet, Butex Forte, Esgic CF, Orbivan CF +5 more
How Acetaminophen, Butalbital interacts with Laxative Formula — through 4 ingredients. Tap an ingredient for the detail:
Slippery ElmOral Drugs Moderate
Interaction Summary
Theoretically, slippery elm may slow the absorption and reduce serum levels of oral drugs.
Read the full Slippery Elm + Acetaminophen, Butalbital interactionGinger (zingiber Officinale) Rhizome ExtractCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, ginger might increase the levels of CYP1A2 substrates.
Read the full Ginger (zingiber Officinale) Rhizome Extract + Acetaminophen, Butalbital interactionPeppermintCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, peppermint might increase the levels of CYP1A2 substrates.
Read the full Peppermint + Acetaminophen, Butalbital interactionMarshmallow (althaea Officinalis) Root ExtractOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow (althaea Officinalis) Root Extract + Acetaminophen, Butalbital interactionAcetaminophen, Butalbital, CaffeineEsgic, Esgic Plus, Fiogesic, Fioricet, Repan, Tecnal +1 more
How Acetaminophen, Butalbital, Caffeine interacts with Laxative Formula — through 5 ingredients. Tap an ingredient for the detail:
Ginger (zingiber Officinale) Rhizome ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, ginger might increase the levels of CYP1A2 substrates.
Read the full Ginger (zingiber Officinale) Rhizome Extract + Acetaminophen, Butalbital, Caffeine interactionSlippery ElmOral Drugs Moderate
Interaction Summary
Theoretically, slippery elm may slow the absorption and reduce serum levels of oral drugs.
Read the full Slippery Elm + Acetaminophen, Butalbital, Caffeine interactionPeppermintCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, peppermint might increase the levels of CYP1A2 substrates.
Read the full Peppermint + Acetaminophen, Butalbital, Caffeine interactionFennelCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, fennel might increase levels of drugs metabolized by CYP3A4.
Read the full Fennel + Acetaminophen, Butalbital, Caffeine interactionMarshmallow (althaea Officinalis) Root ExtractOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow (althaea Officinalis) Root Extract + Acetaminophen, Butalbital, Caffeine interactionAcetaminophen, Butalbital, Caffeine, CodeineEsgic with Codeine, Fioricet w/ Codeine
How Acetaminophen, Butalbital, Caffeine, Codeine interacts with Laxative Formula — through 5 ingredients. Tap an ingredient for the detail:
PeppermintCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, peppermint might increase the levels of CYP3A4 substrates.
Read the full Peppermint + Acetaminophen, Butalbital, Caffeine, Codeine interactionFennelCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, fennel might increase levels of drugs metabolized by CYP3A4.
Read the full Fennel + Acetaminophen, Butalbital, Caffeine, Codeine interactionGinger (zingiber Officinale) Rhizome ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, ginger might increase the levels of CYP1A2 substrates.
Read the full Ginger (zingiber Officinale) Rhizome Extract + Acetaminophen, Butalbital, Caffeine, Codeine interactionSlippery ElmOral Drugs Moderate
Interaction Summary
Theoretically, slippery elm may slow the absorption and reduce serum levels of oral drugs.
Read the full Slippery Elm + Acetaminophen, Butalbital, Caffeine, Codeine interactionMarshmallow (althaea Officinalis) Root ExtractOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow (althaea Officinalis) Root Extract + Acetaminophen, Butalbital, Caffeine, Codeine interactionEach ingredient & the kinds of drugs it affects
For each ingredient in Laxative Formula 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.
Marshmallow (Althaea officinalis) root extract
Lithium
Theoretically, due to potential diuretic effects, marshmallow might reduce excretion and increase levels of lithium.
Marshmallow is thought to have diuretic properties. To avoid lithium toxicity, the dose of lithium might need to be decreased when used with marshmallow.
Anticoagulant/Antiplatelet Drugs
Theoretically, marshmallow flower might have antiplatelet effects.
Animal research suggests that marshmallow flower extract has antiplatelet effects. However, the root and leaf of marshmallow, not the flower, are the plant parts most commonly found in dietary supplements. Theoretically, use of marshmallow flower with anticoagulant/antiplatelet drugs can have additive effects, and might increase the risk for bleeding in some patients.
Oral Drugs
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Marshmallow contains mucilage which can affect oral drug absorption. To avoid changes in absorption, take marshmallow 30-60 minutes after oral medications.
Slippery Elm
Oral Drugs
Theoretically, slippery elm may slow the absorption and reduce serum levels of oral drugs.
Slippery elm inner bark contains mucilage, which may interfere with the absorption of orally administered drugs.
Ginger (Zingiber officinale) rhizome extract
Anticoagulant/Antiplatelet Drugs
Ginger may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs. However, research is conflicting.
Laboratory research suggests that ginger inhibits thromboxane synthetase and decreases platelet aggregation. However, this has not been demonstrated unequivocally in humans, with mixed results from clinical trials. Theoretically, excessive amounts of ginger might increase the risk of bleeding when used with anticoagulant/antiplatelet drugs.
Antidiabetes Drugs
Theoretically, taking ginger with antidiabetes drugs might increase the risk of hypoglycemia.
Animal and human research suggests that ginger might increase insulin levels and/or decrease blood glucose levels.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Ginger might increase or decrease the levels of CYP3A4 substrates.
In vitro research and some case reports suggest that ginger inhibits CYP3A4 activity. Three case reports from the World Health Organization (WHO) adverse drug reaction database describe increased toxicity in patients taking ginger and cancer medications that are CYP3A4 substrates (imatinib, dabrafenib, and crizotinib). However, the causality of this interaction is unclear due to the presence of multiple interacting drugs and routes of administration.
Conversely, other in vitro research suggests that ginger induces CYP3A4 activity, leading to reduced levels of CYP3A4 substrates. However, this interaction has not been reported in humans.
Losartan (Cozaar)
Theoretically, ginger might increase levels of losartan and the risk of hypotension.
In animal research, ginger increased the levels and hypotensive effects of a single dose of losartan. It is not clear if ginger alters the concentration or effects of losartan when taken continuously. Additionally, this interaction has not been shown in humans.
Nifedipine (Procardia)
Ginger may have antiplatelet effects and increase the risk of bleeding if used with nifedipine.
Clinical research shows that combined treatment with ginger 1 gram plus nifedipine 10 mg significantly inhibits platelet aggregation when compared to nifedipine or ginger alone.
P-Glycoprotein Substrates
Ginger might increase the absorption and blood levels of P-glycoprotein (P-gp) substrates.
In vitro research and case reports suggest that ginger inhibits drug efflux by P-gp, potentially increasing absorption and serum levels of P-gp substrates. Two case reports from the World Health Organization (WHO) adverse drug reaction database describe increased toxicity in patients taking ginger and cancer medications that are P-gp substrates (trametinib, crizotinib). However, the causality of this interaction is unclear due to the presence of multiple interacting drugs and routes of administration.
Phenprocoumon (Marcoumar, Others)
Ginger might increase the risk of bleeding with phenprocoumon.
Phenprocoumon, a warfarin-related anticoagulant, might increase the international normalized ratio (INR) when taken with ginger. There is one case report of a 76-year-old woman with a stable INR on phenprocoumon that increased to greater than 10 when she began consuming dried ginger and ginger tea.
Warfarin (Coumadin)
Ginger might increase the risk of bleeding with warfarin.
Laboratory research suggests that ginger might inhibit thromboxane synthetase and decrease platelet aggregation. In one case report, ginger increased the INR when taken with phenprocoumon, which has similar pharmacological effects as warfarin. In another case report, ginger increased the INR when taken with a combination of warfarin, hydrochlorothiazide, and acetaminophen. A longitudinal analysis suggests that taking ginger increases the risk of bleeding in patients taking warfarin for at least 4 months. However, research in healthy people suggests that ginger has no effect on INR, or the pharmacokinetics or pharmacodynamics of warfarin. Until more is known, monitor INRs closely in patients taking large amounts of ginger.
Calcium Channel Blockers
Theoretically, taking ginger with calcium channel blockers might increase the risk of hypotension.
Some animal and in vitro research suggests that ginger has hypotensive and calcium channel-blocking effects. Another animal study shows that concomitant administration of ginger and the calcium channel blocker amlodipine leads to greater reductions in blood pressure when compared with amlodipine alone.
Cyclosporine (Neoral, Sandimmune)
Theoretically, when taken prior to cyclosporine, ginger might decrease cyclosporine levels.
In an animal model, ginger juice taken 2 hours prior to cyclosporine administration reduced the maximum concentration and area under the curve of cyclosporine by 51% and 40%, respectively. This effect was not observed when ginger juice and cyclosporine were administered at the same time.
Cytochrome P450 1A2 (Cyp1A2) Substrates
Theoretically, ginger might increase the levels of CYP1A2 substrates.
In vitro research shows that ginger inhibits CYP1A2 activity. However, this interaction has not been reported in humans.
Cytochrome P450 2B6 (Cyp2B6) Substrates
Theoretically, ginger might increase the levels of CYP2B6 substrates.
In vitro research shows that ginger inhibits CYP2B6 activity. However, this interaction has not been reported in humans.
Cytochrome P450 2C9 (Cyp2C9) Substrates
Theoretically, ginger might increase the levels of CYP2C9 substrates.
In vitro research shows that ginger inhibits CYP2C9 activity. However, this interaction has not been reported in humans.
Metronidazole (Flagyl)
Theoretically, ginger might increase levels of metronidazole.
In an animal model, ginger increased the absorption and plasma half-life of metronidazole. In addition, the elimination rate and clearance of metronidazole was significantly reduced.
Peppermint
Cyclosporine (Neoral, Sandimmune)
Theoretically, peppermint oil might increase the levels and adverse effects of cyclosporine.
In animal research, peppermint oil inhibits cyclosporine metabolism and increases cyclosporine levels. Inhibition of cytochrome P450 3A4 (CYP3A4) may be partially responsible for this interaction. An interaction between peppermint oil and cyclosporine has not been reported in humans.
Cytochrome P450 2C19 (Cyp2C19) Substrates
Theoretically, peppermint might increase the levels of CYP2C19 substrates.
In vitro research shows that peppermint oil inhibits CYP2C19. So far, this interaction has not been reported in humans.
Cytochrome P450 2C9 (Cyp2C9) Substrates
Theoretically, peppermint might increase the levels of CYP2C9 substrates.
In vitro research shows that peppermint oil inhibits CYP2C9. So far, this interaction has not been reported in humans.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, peppermint might increase the levels of CYP3A4 substrates.
Clinical research in healthy volunteers shows that a single dose of peppermint oil 600 mg inhibits CYP3A4 enzymes and increases the AUC of felodipine, a CYP3A4 substrate. However, in vitro research suggests that peppermint oil only inhibits CYP3A4 at very high concentrations.
Cytochrome P450 1A2 (Cyp1A2) Substrates
Theoretically, peppermint might increase the levels of CYP1A2 substrates.
In vitro and animal research shows that peppermint oil and peppermint leaf inhibit CYP1A2. However, in clinical research, peppermint tea did not significantly affect the metabolism of caffeine, a CYP1A2 substrate. It is possible that the 6-day duration of treatment may have been too short to identify a difference.
Fennel
Anticoagulant/Antiplatelet Drugs
Theoretically, fennel might increase the risk of bleeding when used with antiplatelet or anticoagulant drugs.
Animal research suggests that fennel oil has antithrombotic and antiplatelet effects.
Ciprofloxacin (Cipro)
Theoretically, fennel might decrease the levels and clinical effects of ciprofloxacin.
Animal research shows that fennel reduces ciprofloxacin bioavailability by nearly 50%, possibly due to the metal cations such as calcium, iron, and magnesium contained in fennel. This study also found that fennel increased tissue distribution and slowed elimination of ciprofloxacin.
Contraceptive Drugs
Theoretically, taking large amounts of fennel might decrease the effects of contraceptive drugs due to competition for estrogen receptors.
Some constituents of fennel have estrogenic activity.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, fennel might increase levels of drugs metabolized by CYP3A4.
In vitro research suggests that fennel inhibits CYP3A4 enzyme activity. This effect has not been reported in humans.
Estrogens
Theoretically, taking large amounts of fennel might interfere with hormone replacement therapy due to competition for estrogen receptors.
Some constituents of fennel have estrogenic activity.
Tamoxifen (Nolvadex)
Theoretically, taking large amounts of fennel might decrease the antiestrogenic effect of tamoxifen.
Some constituents of fennel have estrogenic activity, which may interfere with the antiestrogenic activity of tamoxifen.
Fenugreek (Trigonella foenum-graecum) seed extract
Anticoagulant/Antiplatelet Drugs
Theoretically, fenugreek might have additive effects when used with anticoagulant or antiplatelet drugs.
Some of the constituents in fenugreek have antiplatelet effects in animal and in vitro research. However, common fenugreek products might not contain sufficient concentrations of these constituents for clinical effects. A clinical study in patients with coronary artery disease or diabetes shows that taking fenugreek seed powder 2.5 grams twice daily for 3 months does not affect platelet aggregation, fibrinolytic activity, or fibrinogen levels .
Antidiabetes Drugs
Theoretically, fenugreek seed might have additive hypoglycemic effects when used with antidiabetes drugs.
Clinical research shows that fenugreek seed can reduce fasting blood glucose and 2-hour postprandial glucose levels in adults with type 2 diabetes.
Clopidogrel (Plavix)
Theoretically, fenugreek seed might alter the clinical effects of clopidogrel by inhibiting its conversion to the active form.
Animal research shows that fenugreek seed 200 mg/kg daily for 14 days increases the maximum serum concentration of clopidogrel by 21%. It is unclear how this affects the pharmacokinetics of the active metabolite of clopidogrel; however, this study found that concomitant use of fenugreek seed and clopidogrel prolonged bleeding time by an additional 11%.
Metoprolol (Toprol)
Theoretically, fenugreek seed might have additive hypotensive effects when used with metoprolol.
Animal research shows that fenugreek seed 300 mg/kg daily for 2 weeks decreases systolic and diastolic blood pressure by 9% and 11%, respectively, when administered alone, and by 15% and 22%, respectively, when given with metoprolol 10 mg/kg.
Phenytoin (Dilantin)
Theoretically, fenugreek might decrease plasma levels of phenytoin.
Animal research shows that taking fenugreek seeds for 1 week decreases maximum concentrations and the area under the curve of a single dose of phenytoin by 44% and 72%, respectively. This seems to be related to increased clearance. So far, this interaction has not been reported in humans.
Sildenafil (Viagra)
Theoretically, concurrent use of sildenafil and fenugreek might reduce levels and therapeutic effects of sildenafil.
Animal research shows that taking fenugreek seeds for 1 week reduces maximum concentrations and the area under the curve of a single dose of sildenafil by 27% and 48%, respectively. So far, this interaction has not been reported in humans.
Theophylline
Theoretically, fenugreek may reduce the levels and clinical effects of theophylline.
Animal research shows that fenugreek 50 grams daily for 7 days reduces the maximum serum concentration (Cmax) of theophylline by 28% and the area under the plasma drug concentration-time curve (AUC) by 22%.
Warfarin (Coumadin)
Theoretically, fenugreek might have additive effects with warfarin and increase the international normalized ratio (INR).
Some fenugreek constituents have antiplatelet effects, although these might not be present in concentrations that are clinically significant. In one case report, a patient taking warfarin experienced an increased INR when starting to take fenugreek in combination with boldo.
Antihypertensive Drugs
Fenugreek may also have an additive effect on blood pressure-lowering medications. Studies on animals have shown that fenugreek seed can decrease both systolic and diastolic blood pressure by up to 22% when combined with metoprolol. Therefore, it is essential to monitor your blood pressure regularly if you are taking fenugreek and metoprolol together or any other antihypertensive drugs.
Magnesium Hydroxide
Levodopa/Carbidopa (Sinemet)
Magnesium can reduce the bioavailability of levodopa/carbidopa.
Clinical research in healthy volunteers shows that taking magnesium oxide 1000 mg with levodopa 100 mg/carbidopa 10 mg reduces the area under the curve (AUC) of levodopa by 35% and of carbidopa by 81%. In vitro and animal research shows that magnesium produces an alkaline environment in the digestive tract, which might lead to degradation and reduced bioavailability of levodopa/carbidopa.
Aminoglycoside Antibiotics
Concomitant use of aminoglycoside antibiotics and magnesium can increase the risk for neuromuscular weakness.
Both aminoglycosides and magnesium reduce presynaptic acetylcholine release, which can lead to neuromuscular blockade and possible paralysis. This is most likely to occur with high doses of magnesium given intravenously.
Antacids
Use of acid reducers may reduce the laxative effect of magnesium oxide.
A retrospective analysis shows that, in the presence of H2 receptor antagonists (H2RAs) or proton pump inhibitors (PPIs), a higher dose of magnesium oxide is needed for a laxative effect. This may also occur with antacids. Under acidic conditions, magnesium oxide is converted to magnesium chloride and then to magnesium bicarbonate, which has an osmotic laxative effect. By reducing acidity, antacids may reduce the conversion of magnesium oxide to the active bicarbonate salt.
Bictegravir/Emtricitabine/Tenofovir Alafenamide (Biktarvy)
Magnesium 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 magnesium containing products.
Bisphosphonates
Magnesium can decrease absorption of bisphosphonates.
Cations, including magnesium, can decrease bisphosphonate absorption. Advise patients to separate doses of magnesium and these drugs by at least 2 hours.
Calcium Channel Blockers
Magnesium can have additive effects with calcium channel blockers, although evidence is conflicting.
Magnesium inhibits calcium entry into smooth muscle cells and may therefore have additive effects with calcium channel blockers. Severe hypotension and neuromuscular blockades may occur when nifedipine is used with intravenous magnesium, although some contradictory evidence suggests that concurrent use of magnesium with nifedipine does not increase the risk of neuromuscular weakness. High doses of magnesium could theoretically have additive effects with other calcium channel blockers.
Digoxin
Magnesium salts may reduce absorption of digoxin.
Clinical evidence suggests that treatment with oral magnesium hydroxide or magnesium trisilicate reduces absorption of digoxin from the intestines. This may reduce the blood levels of digoxin and decrease its therapeutic effects.
Potassium-Sparing Diuretics
Potassium-sparing diuretics decrease excretion of magnesium, possibly increasing magnesium levels.
Potassium-sparing diuretics also have magnesium-sparing properties, which can counteract the magnesium losses associated with loop and thiazide diuretics. Theoretically, increased magnesium levels could result from concomitant use of potassium-sparing diuretics and magnesium supplements.
Quinolone Antibiotics
Magnesium decreases absorption of quinolones.
Magnesium can form insoluble complexes with quinolones and decrease their absorption. Advise patients to take these drugs at least 2 hours before, or 4 to 6 hours after, magnesium supplements.
Skeletal Muscle Relaxants
Parenteral magnesium alters the pharmacokinetics of skeletal muscle relaxants, increasing their effects and accelerating the onset of effect.
Parenteral magnesium shortens the time to onset of skeletal muscle relaxants by about 1 minute and prolongs the duration of action by about 2 minutes. Magnesium potentiates the effects of skeletal muscle relaxants by decreasing calcium-mediated release of acetylcholine from presynaptic nerve terminals, reducing postsynaptic sensitivity to acetylcholine, and having a direct effect on the membrane potential of myocytes. Magnesium also has vasodilatory actions and increases cardiac output, allowing a greater amount of muscle relaxant to reach the motor end plate. A clinical study found that low-dose rocuronium (0.45 mg/kg), when given after administration of magnesium 30 mg/kg over 10 minutes, has an accelerated onset of effect, which matches the onset of effect seen with a full-dose rocuronium regimen (0.6 mg/kg). In another clinical study, onset times for rocuronium doses of 0.3, 0.6, and 1.2 mg/kg were 86, 76, and 50 seconds, respectively, when given alone, but were reduced to 66, 44, and 38 seconds, respectively, when the doses were given after a 15-minute infusion of magnesium sulfate 60 mg/kg. Giving intraoperative intravenous magnesium sulfate, 50 mg/kg loading dose followed by 15 mg/kg/hour, reduces the onset time of rocuronium, enhances its clinical effects, reduces the dose of intraoperative opiates, and prolongs the spontaneous recovery time. It does not affect the activity of subsequently administered neostigmine.
Sulfonylureas
Magnesium increases the systemic absorption of sulfonylureas, increasing their effects and side effects.
Clinical research shows that administration of magnesium hydroxide with glyburide increases glyburide absorption, increases maximal insulin response by 35-fold, and increases the risk of hypoglycemia, when compared with glyburide alone. A similar interaction occurs between magnesium hydroxide and glipizide. The mechanism of this effect appears to be related to the elevation of gastrointestinal pH by magnesium-based antacids, increasing solubility and enhancing absorption of sulfonylureas.
Tetracycline Antibiotics
Magnesium decreases absorption of tetracyclines.
Magnesium can form insoluble complexes with tetracyclines in the gut and decrease their absorption and antibacterial activity. Advise patients to take these drugs 1 hour before or 2 hours after magnesium supplements.
Anticoagulant/Antiplatelet Drugs
Theoretically, magnesium may have antiplatelet effects, but the evidence is conflicting.
In vitro evidence shows that magnesium sulfate inhibits platelet aggregation, even at low concentrations. Some preliminary clinical evidence shows that infusion of magnesium sulfate increases bleeding time by 48% and reduces platelet activity. However, other clinical research shows that magnesium does not affect platelet aggregation, although inhibition of platelet-dependent thrombosis can occur.
Gabapentin (Neurontin)
Gabapentin absorption can be decreased by magnesium.
Clinical research shows that giving magnesium oxide orally along with gabapentin decreases the maximum plasma concentration of gabapentin by 33%, time to maximum concentration by 36%, and area under the curve by 43%. Advise patients to take gabapentin at least 2 hours before, or 4 to 6 hours after, magnesium supplements.
Sevelamer (Renagel, Renvela)
Sevelamer may increase serum magnesium levels.
In patients on hemodialysis, sevelamer use was associated with a 0.28 mg/dL increase in serum magnesium. The mechanism of this interaction remains unclear.
Sodium
Antihypertensive Drugs
Theoretically, a high intake of dietary sodium might reduce the effectiveness of antihypertensive drugs.
High intake of dietary sodium can increase systolic and diastolic blood pressure. Also, high intake of sodium may necessitate increased use of antihypertensive medications to achieve blood pressure control in some patients, such as those with chronic kidney disease.
Corticosteroids
Concomitant use of mineralocorticoids and some glucocorticoids with sodium supplements might increase the risk of hypernatremia.
Mineralocorticoids and some glucocorticoids (corticosteroids) cause sodium retention. This effect is dose-related and depends on mineralocorticoid potency. It is most common with hydrocortisone, cortisone, and fludrocortisone, followed by prednisone and prednisolone.
Didanosine (Videx)
Concomitant use of didanosine with additional sodium from dietary or supplemental sources may increase the risk of hypernatremia.
Didanosine formulations contain a significant amount of sodium.
Lithium
Altering dietary intake of sodium might alter the levels and clinical effects of lithium.
High sodium intake can reduce plasma concentrations of lithium by increasing lithium excretion. Reducing sodium intake can significantly increase plasma concentrations of lithium and cause lithium toxicity in patients being treated with lithium carbonate. Stabilizing sodium intake is shown to reduce the percentage of patients with lithium level fluctuations above 0.8 mEq/L. Patients taking lithium should avoid significant alterations in their dietary intake of sodium.
Sodium Phosphates
Theoretically, concomitant use of sodium phosphate with sodium supplements might increase the risk of hypernatremia.
Use of high doses (> 45 mL in 24 hours) of sodium phosphate, such as those used for bowel cleansing before surgery, can lead to serious electrolyte disturbances, including hypernatremia. The risk of hypernatremia is highest in the elderly and people with other risk factors for electrolyte disturbances.
Sodium-Containing Drugs
Concomitant use of sodium-containing drugs with additional sodium from dietary or supplemental sources may increase the risk of hypernatremia and long-term sodium-related complications.
The Chronic Disease Risk Reduction (CDRR) intake level of 2.3 grams of sodium daily indicates the intake at which it is believed that chronic disease risk increases for the apparently healthy population. Some medications contain high quantities of sodium. When used in conjunction with sodium supplements or high-sodium diets, the CDRR may be exceeded. Additionally, concomitant use may increase the risk for hypernatremia; this risk is highest in the elderly and people with other risk factors for electrolyte disturbances.
Tolvaptan (Samsca)
Theoretically, concomitant use of tolvaptan with sodium might increase the risk of hypernatremia.
Tolvaptan is a vasopressin receptor 2 antagonist that is used to increase sodium levels in patients with hyponatremia. Patients taking tolvaptan should use caution with the use of sodium salts such as sodium chloride.
Brand information
Manufacturer and brand details for Laxative Formula, from the product label.
Integrative Therapeutics
See all Integrative Therapeutics products- Name
- Integrative Therapeutics, LLC
- City
- Green Bay
- State
- WI
- ZipCode
- 54311
- Phone Number
- 800.931.1709
- Web Address
- integrativepro.com
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Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
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The Full Monographs Behind Laxative Formula’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Sodium
Interacts with 205 drugsSodium is an essential mineral and electrolyte your body needs to balance fluids, support nerves, and help muscles work. Most people in modern diets get more than enough—often too much—from...
Read the full Sodium monograph → Herb & supplement monographMagnesium
Interacts with 295 drugsMagnesium is an essential mineral your body needs for muscles, nerves, blood pressure, and many other functions, and supplements are useful for preventing or correcting deficiency. Some othe...
Read the full Magnesium monograph → Herb & supplement monographFenugreek
Interacts with 389 drugsFenugreek is a common kitchen spice that is also taken as a supplement, mainly for blood sugar, cholesterol, and to support breast milk production. Some early research is encouraging for blo...
Read the full Fenugreek monograph → Herb & supplement monographMarshmallow
Interacts with 2,040 drugsMarshmallow root is a traditional herb rich in soothing, gel-like fibers called mucilage, which is why it has long been used for coughs, sore throats, and stomach irritation. Evidence for th...
Read the full Marshmallow monograph → Herb & supplement monographSlippery Elm
Interacts with 2,022 drugsSlippery elm is a traditional herbal remedy made from the inner bark of a North American elm tree, used mainly to soothe sore throats and irritated digestive tracts. Its mucilage can coat an...
Read the full Slippery Elm monograph → Herb & supplement monographFennel
Interacts with 740 drugsFennel is a Mediterranean herb widely used as a food and spice, and traditionally taken for digestive complaints, colic, and menstrual cramps. Some small studies suggest possible benefit for...
Read the full Fennel monograph → Herb & supplement monographGinger
Interacts with 1,007 drugsGinger is a widely used culinary spice with a long history in traditional medicine, and it has the strongest evidence for helping with nausea and vomiting, including from motion sickness, pr...
Read the full Ginger monograph → Herb & supplement monographPeppermint
Interacts with 796 drugsPeppermint is a popular herb with the best evidence supporting enteric-coated peppermint oil for easing IBS symptoms. It is generally well tolerated for most adults, but it can cause heartbu...
Read the full Peppermint monograph →Sources & How We Checked
Laxative Formula'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 280 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.
Sodium 38 references
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Fenugreek 30 references
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- Turkyilmaz C, Onal E, Hirfanoglu IM, et al. The effect of galactagogue herbal tea on breast milk production and short-term catch-up of birth weight in the first week of life. J Altern Complement Med 2011;17(2):139-42. PubMed
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Magnesium 82 references
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DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.
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