Maxi-Enzyme Ingredients & Drug Interactions
What is this page for?
First and foremost: checking Maxi-Enzyme 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
Maxi-Enzyme is a dietary supplement by Wonder Laboratories with 8 active ingredients. Its ingredients are commonly taken for bone health and osteoporosis prevention, dietary calcium deficiency, heartburn relief (calcium carbonate antacids).Based on those ingredients, 195 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are Calcium, Betaine Hydrochloride. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against Maxi-Enzyme by Wonder Laboratories
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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 Maxi-Enzyme by Wonder Laboratories
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
Full disclosure
Maxi-Enzyme contains 8 active ingredients: calcium, amylase, protease, lipase, betaine hydrochloride, pepsin, ammonium chloride, and pancreatin. Calcium supports bone and kidney health.
The enzyme ingredients—amylase, protease, lipase, pepsin, and pancreatin—are digestive enzymes meant to help break down food. Betaine hydrochloride is a source of stomach acid.
The product also contains inactive ingredients including calcium carbonate, cellulose, stearic acid, silica, and vanillin.
Does it work?
Strong evidence
Calcium in this product is rated Effective for kidney failure, dyspepsia (indigestion), low blood calcium (hypocalcemia), high blood potassium (hyperkalemia), and Likely Effective for osteoporosis. The enzyme ingredients—protease, lipase, and pepsin—have insufficient evidence to rate their effectiveness for dyspepsia and inflammatory bowel disease (IBD).
Betaine hydrochloride likewise shows insufficient evidence for dyspepsia, hypothyroidism, diarrhea, rheumatoid arthritis, food allergies, and hay fever. We hold no effectiveness data for amylase, ammonium chloride, or pancreatin.
How safe is it?
Well-documented data
Calcium is generally well tolerated at recommended doses, though high amounts can cause problems. Common side effects from oral calcium include belching, constipation, diarrhea, gas, and stomach upset.
Rarely, very high calcium intake (over 1,500 mg daily) has raised concerns about kidney stones, calciphylaxis (a rare condition affecting blood vessels), and possibly increased prostate cancer or heart disease risk—though research on these remains mixed. Betaine hydrochloride may irritate the stomach and isn't safe if you have ulcers or gastritis.
The proteolytic enzymes (protease and pepsin) are generally well tolerated but may cause digestive upset or, rarely, allergic reactions—occupational exposure to pepsin has triggered asthma and allergic rhinitis in some people. Lipase is generally well tolerated when used as a supplement, though safety in serious digestive conditions requires medical guidance.
Meds to double-check
Major interaction found
Check your medications before taking Maxi-Enzyme if you use HIV integrase inhibitors (dolutegravir, elvitegravir, raltegravir), the antibiotic ceftriaxone, levothyroxine for thyroid, sotalol for heart rhythm, calcipotriene for psoriasis, diltiazem for blood pressure or heart rate, or acid-reducing drugs (H2-blockers, antacids, proton pump inhibitors). The calcium in this product may reduce their effectiveness or cause dangerous interactions, depending on the drug and dose.
The bottom line
Scorecard at a glanceFully disclosed formula with strong clinical evidence behind its ingredients' uses. Major medication interactions have been identified, and safety information is well characterized.
Maxi-Enzyme may help with indigestion and calcium needs, but the calcium content creates serious interactions with several HIV and heart medications, antibiotics, and thyroid drugs. If you take any prescriptions—especially for HIV, heart rhythm, thyroid, or acid reduction—check them against the tool on this page before starting.
Talk with your doctor or pharmacist about whether this product fits your situation.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 5 of 8 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Jan 22, 2022.
This Scorecard evaluates available label information, ingredient evidence, and known medication-safety considerations. It does not independently verify product identity, purity, potency, contamination, or manufacturing quality. How these ratings are computed
General information
Key facts about Maxi-Enzyme, straight from the product label.
| Brand | Wonder Laboratories |
|---|---|
| Net contents | 180 Tablet(s) |
| Market status | On market |
| Date entered into DSLD | Jan 22, 2022 |
| DSLD ID | 263639 |
| Product type | Other Combinations |
| Supplement form | Tablet Or Pill |
| Dietary claims / uses | Nutrient, All Other, Structure/Function |
| Intended target group(s) | Adult (18 - 50 Years), Women (not pregnant or lactating) |
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 Maxi-Enzyme by Wonder Laboratories, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Calcium | 214 mg | 21% |
| Amylase | 50 mg | -- |
| Protease | 50 mg | -- |
| Lipase | 4 mg | -- |
| Betaine Hydrochloride | 356 mg | -- |
| Pepsin | 194 mg | -- |
| Ammonium Chloride | 20 mg | -- |
| Pancreatin | 194 mg | -- |
Other ingredients: Calcium Carbonate, Cellulose, Stearic Acid, Silica, Vanillin
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
Directions: Adults, take two (2) tablets daily, preferably with a meal. This product contains natural enzymes that sometimes have a distinctive odor.
Precautions
Tamper Evident: Do not use this product if imprinted foil seal under cap is broken or missing.
Keep out of reach of children.
Caution: If you are pregnant or nursing do not take this product.
Contains milk ingredients.
Formulation
Mfg. in our own state-of-the-art FDA Registered Facility (Registration #1023013) using Good Manufacturing Practices (GMPs) assuring correct potencies, freshness, quality and purity.
Conforms to USP <2091> for weight. Meets USP <2040> disintegration for maximum bioavailability.
Nutritionally supports digestive health
Made in USA
Storage
Keep tightly closed. Store at room temperature: 59 degrees-86 degrees (15 degrees to 30 degrees C).
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.
General Statements
Formula 894
Improved formula
FDA Statement of Identity
Dietary Supplement
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Maxi-Enzyme by Wonder Laboratories 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 Maxi-Enzyme by Wonder Laboratories
These are the 8 active ingredients this product is made of. Select any to open its full monograph.
Serving size2 Tablet(s) Dosage formTablet Or Pill Servings per container90 Amounts shown are per serving.
Most supplement products combine several ingredients, and a medication can interact with the product through any one of them. Each ingredient below shows whether it has known drug interactions.
Calcium
Interacts with168 drugs
Calcium is an essential mineral your body needs for strong bones, nerve signaling, and muscle function, and supplements can help fill gaps when diet f...
Calcium monograph & interactionsAmylase
Protease
No knowninteractions
Proteolytic enzymes are proteins that help break down other proteins, and common examples include bromelain (from pineapple), papain (from papaya), tr...
Protease monograph & interactionsLipase
No knowninteractions
Lipase is a digestive enzyme that helps your body break down dietary fats. It is well established as part of prescription pancreatic enzyme therapy fo...
Lipase monograph & interactionsBetaine Hydrochloride
Interacts with36 drugs
Betaine hydrochloride is a supplement used to temporarily increase stomach acid in people who may have low acid levels. Evidence for its benefits is l...
Betaine Hydrochloride monograph & interactionsPepsin
No knowninteractions
Proteolytic enzymes are proteins that help break down other proteins, and common examples include bromelain (from pineapple), papain (from papaya), tr...
Pepsin monograph & interactionsAmmonium Chloride
Pancreatin
Other (inactive) ingredients: Calcium Carbonate, Cellulose, Stearic Acid, Silica, Vanillin. These complete the product’s ingredient list but are not active constituents.
Maxi-Enzyme by Wonder Laboratories Drug Interactions
HelloPharmacist Interaction Report
Maxi-Enzyme by Wonder Laboratories contains ingredients that do interact with medications.
The most serious concern is calcium, which can significantly reduce levels of two HIV integrase inhibitors—dolutegravir (Tivicay) and elvitegravir (Vitekta)—both rated Major severity. Calcium also poses a Major risk with the antibiotic ceftriaxone (Rocephin) when given intravenously, as they can form a dangerous precipitate in the lungs and kidneys.
Read the full breakdown — every affected drug type, severity by severity
Calcium carries additional Moderate-severity interactions with raltegravir (another HIV medication), the thyroid hormone levothyroxine (Synthroid), the heart rhythm drug sotalol (Betapace), the psoriasis treatment calcipotriene (Dovonex), and the calcium-channel blocker diltiazem (Cardizem). Betaine hydrochloride, another active ingredient, has Minor interactions with acid-reducing medications—H2-blockers, antacids, and proton pump inhibitors (PPIs)—because it increases stomach acid and may blunt their effects.
We could not check amylase, ammonium chloride, or pancreatin, as we hold no interaction data for them. Protease, lipase, and pepsin have no interactions documented in our data.
Altogether, these interactions span 195 individual medications.
Use the medication checker on this page to confirm whether any of your prescriptions or over-the-counter drugs are affected before you start Maxi-Enzyme.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against Maxi-Enzyme?
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 Maxi-Enzyme interact with 195 drugs. Click any drug to see the details.
2 of the 8 ingredients in Maxi-Enzyme interact with drugs. Each result below shows which ingredient is responsible. Calcium Betaine Hydrochloride
DoxycyclineDoryx, Doxy, Doxy-D, Doxycin, Doxycycline Injection, Doxylin +6 more
How Doxycycline interacts with Maxi-Enzyme — through 1 ingredient. Tap an ingredient for the detail:
CalciumTetracycline Antibiotics Moderate
Interaction Summary
Calcium seems to reduce the absorption of tetracycline antibiotics.
Read the full Calcium + Doxycycline interactionDoxycycline HyclateActiclate, Acticlate Cap, Lymepak
How Doxycycline Hyclate interacts with Maxi-Enzyme — through 1 ingredient. Tap an ingredient for the detail:
CalciumTetracycline Antibiotics Moderate
Interaction Summary
Calcium seems to reduce the absorption of tetracycline antibiotics.
Read the full Calcium + Doxycycline Hyclate interactionDoxycycline MonohydrateErfacea
How Doxycycline Monohydrate interacts with Maxi-Enzyme — through 1 ingredient. Tap an ingredient for the detail:
CalciumTetracycline Antibiotics Moderate
Interaction Summary
Calcium seems to reduce the absorption of tetracycline antibiotics.
Read the full Calcium + Doxycycline Monohydrate interactionDoxycylineDoxychel
How Doxycyline interacts with Maxi-Enzyme — through 1 ingredient. Tap an ingredient for the detail:
CalciumTetracycline Antibiotics Moderate
Interaction Summary
Calcium seems to reduce the absorption of tetracycline antibiotics.
Read the full Calcium + Doxycyline interactionEmtricitabineEmtriva
How Emtricitabine interacts with Maxi-Enzyme — through 1 ingredient. Tap an ingredient for the detail:
CalciumBictegravir/emtricitabine/tenofovir Alafenamide (biktarvy) Moderate
Interaction Summary
Calcium might decrease levels of bictegravir/emtricitabine/tenofovir alafenamide by reducing its absorption when taken in a fasting state.
Read the full Calcium + Emtricitabine interactionEmtricitabine, Rilpivirine, TenofovirComplera
How Emtricitabine, Rilpivirine, Tenofovir interacts with Maxi-Enzyme — through 1 ingredient. Tap an ingredient for the detail:
CalciumBictegravir/emtricitabine/tenofovir Alafenamide (biktarvy) Moderate
Interaction Summary
Calcium might decrease levels of bictegravir/emtricitabine/tenofovir alafenamide by reducing its absorption when taken in a fasting state.
Read the full Calcium + Emtricitabine, Rilpivirine, Tenofovir interactionEmtricitabine, Rilpivirine, Tenofovir AlafenamideOdefsey
How Emtricitabine, Rilpivirine, Tenofovir Alafenamide interacts with Maxi-Enzyme — through 1 ingredient. Tap an ingredient for the detail:
CalciumBictegravir/emtricitabine/tenofovir Alafenamide (biktarvy) Moderate
Interaction Summary
Calcium might decrease levels of bictegravir/emtricitabine/tenofovir alafenamide by reducing its absorption when taken in a fasting state.
Read the full Calcium + Emtricitabine, Rilpivirine, Tenofovir Alafenamide interactionEmtricitabine, Tenofovir Alafenamide FumarateDescovy
How Emtricitabine, Tenofovir Alafenamide Fumarate interacts with Maxi-Enzyme — through 1 ingredient. Tap an ingredient for the detail:
CalciumBictegravir/emtricitabine/tenofovir Alafenamide (biktarvy) Moderate
Interaction Summary
Calcium might decrease levels of bictegravir/emtricitabine/tenofovir alafenamide by reducing its absorption when taken in a fasting state.
Read the full Calcium + Emtricitabine, Tenofovir Alafenamide Fumarate interactionEnalapril Maleate, HydrochlorothiazideVaseretic
How Enalapril Maleate, Hydrochlorothiazide interacts with Maxi-Enzyme — through 1 ingredient. Tap an ingredient for the detail:
CalciumThiazide Diuretics Moderate
Interaction Summary
Taking calcium along with thiazides might increase the risk of hypercalcemia and renal failure.
Read the full Calcium + Enalapril Maleate, Hydrochlorothiazide interactionEnoxacinPenetrex
How Enoxacin interacts with Maxi-Enzyme — through 1 ingredient. Tap an ingredient for the detail:
CalciumQuinolone Antibiotics Moderate
Interaction Summary
Calcium seems to reduce the absorption of quinolone antibiotics.
Read the full Calcium + Enoxacin interactionEravacyclineXerava
How Eravacycline interacts with Maxi-Enzyme — through 1 ingredient. Tap an ingredient for the detail:
CalciumTetracycline Antibiotics Moderate
Interaction Summary
Calcium seems to reduce the absorption of tetracycline antibiotics.
Read the full Calcium + Eravacycline interactionEtidronate DisodiumDidrocal, Didronel
How Etidronate Disodium interacts with Maxi-Enzyme — through 1 ingredient. Tap an ingredient for the detail:
CalciumBisphosphonates Moderate
Interaction Summary
Calcium reduces the absorption of bisphosphonates.
Read the full Calcium + Etidronate Disodium interactionFinafloxacinXtoro
How Finafloxacin interacts with Maxi-Enzyme — through 1 ingredient. Tap an ingredient for the detail:
CalciumQuinolone Antibiotics Moderate
Interaction Summary
Calcium seems to reduce the absorption of quinolone antibiotics.
Read the full Calcium + Finafloxacin interactionFish Oil TriglyceridesOmegaven
How Fish Oil Triglycerides interacts with Maxi-Enzyme — through 1 ingredient. Tap an ingredient for the detail:
CalciumAluminum Moderate
Interaction Summary
Calcium citrate might increase aluminum absorption and toxicity.
Read the full Calcium + Fish Oil Triglycerides interactionFosinopril, HydrochlorothiazideMonopril HCT
How Fosinopril, Hydrochlorothiazide interacts with Maxi-Enzyme — through 1 ingredient. Tap an ingredient for the detail:
CalciumThiazide Diuretics Moderate
Interaction Summary
Taking calcium along with thiazides might increase the risk of hypercalcemia and renal failure.
Read the full Calcium + Fosinopril, Hydrochlorothiazide interactionGatifloxacinTequin, Tequin Injection
How Gatifloxacin interacts with Maxi-Enzyme — through 1 ingredient. Tap an ingredient for the detail:
CalciumQuinolone Antibiotics Moderate
Interaction Summary
Calcium seems to reduce the absorption of quinolone antibiotics.
Read the full Calcium + Gatifloxacin interactionGemifloxacinFactive
How Gemifloxacin interacts with Maxi-Enzyme — through 1 ingredient. Tap an ingredient for the detail:
CalciumQuinolone Antibiotics Moderate
Interaction Summary
Calcium seems to reduce the absorption of quinolone antibiotics.
Read the full Calcium + Gemifloxacin interactionGrepafloxacinRaxar
How Grepafloxacin interacts with Maxi-Enzyme — through 1 ingredient. Tap an ingredient for the detail:
CalciumQuinolone Antibiotics Moderate
Interaction Summary
Calcium seems to reduce the absorption of quinolone antibiotics.
Read the full Calcium + Grepafloxacin interactionGuanethidine, HydrochlorothiazideEsimil
How Guanethidine, Hydrochlorothiazide interacts with Maxi-Enzyme — through 1 ingredient. Tap an ingredient for the detail:
CalciumThiazide Diuretics Moderate
Interaction Summary
Taking calcium along with thiazides might increase the risk of hypercalcemia and renal failure.
Read the full Calcium + Guanethidine, Hydrochlorothiazide interactionHydralazine, HydrochlorothiazideApresazide, Apresoline-Esidrix
How Hydralazine, Hydrochlorothiazide interacts with Maxi-Enzyme — through 1 ingredient. Tap an ingredient for the detail:
CalciumThiazide Diuretics Moderate
Interaction Summary
Taking calcium along with thiazides might increase the risk of hypercalcemia and renal failure.
Read the full Calcium + Hydralazine, Hydrochlorothiazide interactionHydralazine, Hydrochlorothiazide, ReserpineSer-Ap-Es, Unipres, Uniserp
How Hydralazine, Hydrochlorothiazide, Reserpine interacts with Maxi-Enzyme — through 1 ingredient. Tap an ingredient for the detail:
CalciumThiazide Diuretics Moderate
Interaction Summary
Taking calcium along with thiazides might increase the risk of hypercalcemia and renal failure.
Read the full Calcium + Hydralazine, Hydrochlorothiazide, Reserpine interactionHydrochlorothiazideAquazide, Aquazide H, Esidrix, HCTZ, Hydro, Hydro-D +3 more
How Hydrochlorothiazide interacts with Maxi-Enzyme — through 1 ingredient. Tap an ingredient for the detail:
CalciumThiazide Diuretics Moderate
Interaction Summary
Taking calcium along with thiazides might increase the risk of hypercalcemia and renal failure.
Read the full Calcium + Hydrochlorothiazide interactionHydrochlorothiazide, IrbesartanAvalide
How Hydrochlorothiazide, Irbesartan interacts with Maxi-Enzyme — through 1 ingredient. Tap an ingredient for the detail:
CalciumThiazide Diuretics Moderate
Interaction Summary
Taking calcium along with thiazides might increase the risk of hypercalcemia and renal failure.
Read the full Calcium + Hydrochlorothiazide, Irbesartan interactionHydrochlorothiazide, LabetalolTrandate HCT
How Hydrochlorothiazide, Labetalol interacts with Maxi-Enzyme — through 1 ingredient. Tap an ingredient for the detail:
CalciumThiazide Diuretics Moderate
Interaction Summary
Taking calcium along with thiazides might increase the risk of hypercalcemia and renal failure.
Read the full Calcium + Hydrochlorothiazide, Labetalol interactionHydrochlorothiazide, LisinoprilPrinzide, Zestoretic
How Hydrochlorothiazide, Lisinopril interacts with Maxi-Enzyme — through 1 ingredient. Tap an ingredient for the detail:
CalciumThiazide Diuretics Moderate
Interaction Summary
Taking calcium along with thiazides might increase the risk of hypercalcemia and renal failure.
Read the full Calcium + Hydrochlorothiazide, Lisinopril interactionHydrochlorothiazide, Losartan PotassiumHyzaar
How Hydrochlorothiazide, Losartan Potassium interacts with Maxi-Enzyme — through 1 ingredient. Tap an ingredient for the detail:
CalciumThiazide Diuretics Moderate
Interaction Summary
Taking calcium along with thiazides might increase the risk of hypercalcemia and renal failure.
Read the full Calcium + Hydrochlorothiazide, Losartan Potassium interactionHydrochlorothiazide, MethyldopaAldoril 15, Aldoril 25, Aldoril D30, Methazide
How Hydrochlorothiazide, Methyldopa interacts with Maxi-Enzyme — through 1 ingredient. Tap an ingredient for the detail:
CalciumThiazide Diuretics Moderate
Interaction Summary
Taking calcium along with thiazides might increase the risk of hypercalcemia and renal failure.
Read the full Calcium + Hydrochlorothiazide, Methyldopa interactionHydrochlorothiazide, MetoprololLopressor HCT
How Hydrochlorothiazide, Metoprolol interacts with Maxi-Enzyme — through 1 ingredient. Tap an ingredient for the detail:
CalciumThiazide Diuretics Moderate
Interaction Summary
Taking calcium along with thiazides might increase the risk of hypercalcemia and renal failure.
Read the full Calcium + Hydrochlorothiazide, Metoprolol interactionHydrochlorothiazide, MoexiprilUniretic
How Hydrochlorothiazide, Moexipril interacts with Maxi-Enzyme — through 1 ingredient. Tap an ingredient for the detail:
CalciumThiazide Diuretics Moderate
Interaction Summary
Taking calcium along with thiazides might increase the risk of hypercalcemia and renal failure.
Read the full Calcium + Hydrochlorothiazide, Moexipril interactionHydrochlorothiazide, PindololViskazide
How Hydrochlorothiazide, Pindolol interacts with Maxi-Enzyme — through 1 ingredient. Tap an ingredient for the detail:
CalciumThiazide Diuretics Moderate
Interaction Summary
Taking calcium along with thiazides might increase the risk of hypercalcemia and renal failure.
Read the full Calcium + Hydrochlorothiazide, Pindolol interactionEach ingredient & the kinds of drugs it affects
For each ingredient in Maxi-Enzyme 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.
Calcium
Ceftriaxone (Rocephin)
Co-administration of intravenous calcium and ceftriaxone can result in precipitation of a ceftriaxone-calcium salt in the lungs and kidneys.
Avoid administering intravenous calcium in any form, such as parenteral nutrition or Lactated Ringers, within 48 hours of intravenous ceftriaxone. Case reports in neonates show that administering intravenous ceftriaxone and calcium can result in precipitation of a ceftriaxone-calcium salt in the lungs and kidneys. In several cases, neonates have died as a result of this interaction. So far there are no reports in adults; however, there is still concern that this interaction might occur in adults.
Dolutegravir (Tivicay)
Calcium seems to reduce levels of dolutegravir.
Advise patients to take dolutegravir either 2 hours before or 6 hours after taking calcium supplements. Pharmacokinetic research suggests that taking calcium carbonate 1200 mg concomitantly with dolutegravir 50 mg reduces plasma levels of dolutegravir by almost 40%. Calcium appears to decrease levels of dolutegravir through chelation.
Elvitegravir (Vitekta)
Calcium seems to reduce levels of elvitegravir.
Advise patients to take elvitegravir either 2 hours before or 2 hours after taking calcium supplements. Pharmacokinetic research suggests that taking calcium along with elvitegravir can reduce blood levels of elvitegravir through chelation.
Aluminum
Calcium citrate might increase aluminum absorption and toxicity. Other types of calcium do not increase aluminum absorption.
Calcium citrate can increase the absorption of aluminum when taken with aluminum hydroxide. The increase in aluminum levels may become toxic, particularly in individuals with kidney disease. However, the effect of calcium citrate on aluminum absorption is due to the citrate anion rather than calcium cation. Calcium acetate does not appear to increase aluminum absorption.
Bictegravir/Emtricitabine/Tenofovir Alafenamide (Biktarvy)
Calcium might decrease levels of bictegravir/emtricitabine/tenofovir alafenamide by reducing its absorption when taken in a fasting state.
Advise patients that bictegravir/emtricitabine/tenofovir alafenamide and calcium can be taken together if taken with food. However, if taken on an empty stomach, bictegravir/emtricitabine/tenofovir alafenamide should not be taken with, or 2 hours after, calcium containing products.
Bisphosphonates
Calcium reduces the absorption of bisphosphonates.
Advise patients to take bisphosphonates at least 30 minutes before calcium, but preferably at a different time of day. Calcium supplements decrease absorption of bisphosphonates.
Calcipotriene (Dovonex)
Taking calcipotriene with calcium might increase the risk for hypercalcemia.
Calcipotriene is a vitamin D analog used topically for psoriasis. It can be absorbed in sufficient amounts to cause systemic effects, including hypercalcemia. Theoretically, combining calcipotriene with calcium supplements might increase the risk of hypercalcemia.
Digoxin (Lanoxin)
Using intravenous calcium with digoxin might increase the risk of fatal cardiac arrhythmias.
Hypercalcemia increases the risk of fatal cardiac arrhythmias with digoxin. However, one retrospective analysis of clinical data suggests that intravenous calcium does not increase the risk of dysrhythmias or mortality in patients receiving digoxin.
Diltiazem (Cardizem, Others)
Theoretically, calcium may reduce the therapeutic effects of diltiazem.
Hypercalcemia can reduce the effectiveness of verapamil in atrial fibrillation. Theoretically, calcium might increase this risk of hypercalcemia and reduce the effectiveness of diltiazem.
Levothyroxine (Synthroid, Others)
Calcium seems to reduce the absorption and effectiveness of levothyroxine.
Advise patients to take levothyroxine and calcium supplements at least 4 hours apart. Calcium reduces levothyroxine absorption, probably by forming insoluble complexes. Calcium carbonate supplements reduce effectiveness of levothyroxine in patients with hypothyroidism.
Lithium
Theoretically, concomitant use of calcium and lithium may increase this risk of hypercalcemia.
Clinical research suggests that long-term use of lithium may cause hypercalcemia in 10% to 60% of patients. Theoretically, concomitant use of lithium and calcium supplements may further increase this risk.
Quinolone Antibiotics
Calcium seems to reduce the absorption of quinolone antibiotics.
Advise patients to take oral quinolones at least 2 hours before or 4-6 hours after calcium supplements or calcium-fortified foods. Taking calcium at the same time as oral quinolones can reduce quinolone absorption. Calcium binds to quinolones in the gut.
Raltegravir (Isentress)
Calcium may reduce levels of raltegravir.
Pharmacokinetic research shows that taking a single dose of calcium carbonate 3000 mg along with raltegravir 400 mg twice daily modestly decreases the mean area under the curve of raltegravir, but the decrease does not necessitate a dose adjustment of raltegravir. However, a case of elevated HIV-1 RNA levels and documented resistance to raltegravir has been reported for a patient taking calcium carbonate 1 gram three times daily plus vitamin D3 (cholecalciferol) 400 IU three times daily in combination with raltegravir 400 mg twice daily for 11 months. It is thought that calcium reduced raltegravir levels by chelation, leading to treatment failure.
Sotalol (Betapace)
Calcium seems to reduce the absorption of sotalol.
Advise patients to separate doses by at least 2 hours before or 4-6 hours after calcium. Calcium appears to reduce the absorption of sotalol, probably by forming insoluble complexes.
Tetracycline Antibiotics
Calcium seems to reduce the absorption of tetracycline antibiotics.
Advise patients to take oral tetracyclines at least 2 hours before, or 4-6 hours after calcium supplements. Taking calcium at the same time as oral tetracyclines can reduce tetracycline absorption. Calcium binds to tetracyclines in the gut.
Thiazide Diuretics
Taking calcium along with thiazides might increase the risk of hypercalcemia and renal failure.
Thiazides reduce calcium excretion by the kidneys. Using thiazides along with moderately large amounts of calcium carbonate increases the risk of milk-alkali syndrome (hypercalcemia, metabolic alkalosis, renal failure). Patients may need to have their serum calcium levels and/or parathyroid function monitored regularly.
Verapamil (Calan, Others)
Theoretically, calcium may reduce the therapeutic effects of verapamil.
Hypercalcemia can reduce the effectiveness of verapamil in atrial fibrillation. Theoretically, use of calcium supplements may increase this risk of hypercalcemia and reduce the effectiveness of verapamil.
Calcium Channel Blockers
Intravenous calcium may decrease the effects of calcium channel blockers; oral calcium is unlikely to have this effect.
Intravenous calcium is used to decrease the effects of calcium channel blockers in the management of overdose. Intravenous calcium gluconate has been used before intravenous verapamil (Isoptin) to prevent or reduce the hypotensive effects without affecting the antiarrhythmic effects. But there is no evidence that dietary or supplemental calcium when taken orally interacts with calcium channel blockers.
Betaine Hydrochloride
Antacids
Betaine hydrochloride increases stomach acidity and could decrease the effects of antacids.
In human research, betaine hydrochloride increases stomach acidity. Antacids are taken to decrease stomach acidity. Theoretically, taking betaine hydrochloride along with antacids might decrease the effects of the antacids.
H2-Blockers
Betaine hydrochloride increases stomach acidity and could decrease the effects of H2-blockers.
In human research, betaine hydrochloride increases stomach acidity. H2-blockers are used to decrease stomach acidity. Theoretically, taking betaine hydrochloride along with H2-blockers might decrease the effects of H2-blockers.
Proton Pump Inhibitors (Ppis)
Betaine hydrochloride increases stomach acidity and could decrease the effects of PPIs.
In human research, betaine hydrochloride increases stomach acidity. PPIs are used to decrease stomach acidity. Theoretically, taking betaine hydrochloride along with PPIs might decrease the effects of PPIs
Brand information
Manufacturer and brand details for Maxi-Enzyme, from the product label.
Wonder Laboratories
See all Wonder Laboratories products- Name
- Wonder Laboratories
- Street Address
- 115 S.C.T. Ct.
- City
- White House
- State
- TN
- ZipCode
- 37188
Maxi-Enzyme by Wonder Laboratories: Common Questions
Does Maxi-Enzyme by Wonder Laboratories interact with any medications?
How can one product interact with so many drugs?
Where does this information come from?
Is calcium safe during pregnancy and breastfeeding?
What are the common side effects of taking this product?
Can I take this if I'm on thyroid medication?
What are the digestive enzymes in this product supposed to do?
Is it safe to take this with acid-reducing medications?
Is the calcium in this product from a natural source?
Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
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Label information is sourced from the NIH Dietary Supplement Label Database and reflects the product version on file; always read your actual product label. This page is for education only and is not a substitute for professional medical advice. Confirm with your pharmacist or doctor before combining supplements and medications.
The Full Monographs Behind Maxi-Enzyme’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Calcium
Interacts with 168 drugsCalcium is an essential mineral your body needs for strong bones, nerve signaling, and muscle function, and supplements can help fill gaps when diet falls short. Most people do best getting...
Read the full Calcium monograph → Herb & supplement monographProteolytic Enzymes (proteases)
Proteolytic enzymes are proteins that help break down other proteins, and common examples include bromelain (from pineapple), papain (from papaya), trypsin, chymotrypsin, and pancreatin. Peo...
Read the full Proteolytic Enzymes (proteases) monograph → Herb & supplement monographLipase
Lipase is a digestive enzyme that helps your body break down dietary fats. It is well established as part of prescription pancreatic enzyme therapy for people who cannot make enough of their...
Read the full Lipase monograph → Herb & supplement monographBetaine Hydrochloride
Interacts with 36 drugsBetaine hydrochloride is a supplement used to temporarily increase stomach acid in people who may have low acid levels. Evidence for its benefits is limited and mostly based on tradition rat...
Read the full Betaine Hydrochloride monograph →Sources & How We Checked
Maxi-Enzyme'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 68 references behind this product’s interaction data
Every citation that drives the interaction findings for this product’s ingredients, from the evidence-graded Natural Medicines (TRC Healthcare) database. Open an ingredient to browse its citations — links open the study on PubMed or the publisher’s site.
Calcium 62 references
- Shils M, Olson A, Shike M. Modern Nutrition in Health and Disease. 8th ed. Philadelphia, PA: Lea and Febiger, 1994.
- Hernandez-Avila M, Gonzalez-Cossio T, Hernandez-Avila JE, et al. Dietary calcium supplements to lower blood lead levels in lactating women: a randomized placebo-controlled trial. Epidemiology 2003;14:206-12.. PubMed
- Thys-Jacobs S, Ceccarelli S, Bierman A, et al. Calcium supplementation in premenstrual syndrome: a randomized crossover trial. J Gen Intern Med 1989;4:183-9. PubMed
- Maton PN, Burton ME. Antacids revisited: a review of their clinical pharmacology and recommended therapeutic use. Drugs 1999;57:855-70.
- Clemens JD, Feinstein AR. Calcium carbonate and constipation: a historical review of medical mythopoeia. Gastroenterology 1977;72:957-61. DOI
- Saunders D, Sillery J, Chapman R. Effect of calcium carbonate and aluminum hydroxide on human intestinal function. Dig Dis Sci 1988;33:409-13. PubMed
- Friedman PA, Bushinsky DA. Diuretic effects on calcium metabolism. Semin Nephrol 1999;19:551-6.
- Koo WK, Walters JC, Esterlitz J, et al. Maternal calcium supplementation and fetal bone mineralization. Obstet Gynecol 1999;94:577-82. DOI
- Raman L, Rajalakshmi K, Krishnamachari KAVR, et al. Effect of calcium supplementation to undernourished mothers during pregnancy on the bone density of the neonates. Am J Clin Nutr 1978; 31:466-9. DOI
- Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
- Chan JM, Giovannucci E, Andersson SO, et al. Dairy products, calcium, phosphorous, vitamin D, and risk of prostate cancer. Cancer Causes Control 1998;9:559-66.
- Butner LE, Fulco PP, Feldman G, et al. Calcium carbonate-induced hypothyroidism. Ann Intern Med 2000:132:595. PubMed
- Schneyer CR. Calcium carbonate and reduction of levothyroxine efficacy. JAMA 1998;279:750. PubMed
- Moser LR, Smythe MA, Tisdale JE. The use of calcium salts in the prevention and management of verapamil-induced hypotension. Ann Pharmacother 2000;34:622-9. PubMed
- Singh N, Singh PN, Hershman JM. Effect of calcium carbonate on the absorption of levothyroxine. JAMA 2000;283:2822-5. PubMed
- Kahela P, Anttila M, Tikkanen R, Sundquist H. Effect of food, food constituents and fluid volume on the bioavailability of sotalol. Acta Pharmacol Toxicol (Copenh) 1979;44:7-12.. PubMed
- Pletz MW, Petzold P, Allen A, et al. Effect of calcium carbonate on bioavailability of orally administered gemifloxacin. Antimicrob Agents Chemother 2003;47:2158-60.. PubMed
- Bar-Or D, Yoel G. Calcium and calciferol antagonize effect of verapamil in atrial fibrillation. Br Med J 1981;282:1585-6.
- Decktor DL, Robinson M, Maton PN, et al. Effects of aluminum/magnesium hydroxide and calcium carbonate on esophageal and gastric pH in subjects with heartburn. Am J Ther 1995;2:546-52. PubMed
- Simoneau G. Absence of rebound effect with calcium carbonate. Eur J Drug Metab Pharmacokinet 1996;21:351-7. PubMed
- Peters ML, Leonard M, Licata AA. Role of alendronate and risedronate in preventing and treating osteoporosis. Cleve Clin J Med 2001;68:945-51. PubMed
- Bourke JF, Mumford R, Whittaker P, et al. The effects of topical calcipotriol on systemic calcium homeostasis in patients with chronic plaque psoriasis. J Am Acad Dermatol 1997;37:929-34.
- Gueguen L, Pointillart A. The bioavailability of dietary calcium. J Am Coll Nutr 2000;19:119s-136s. PubMed
- Vella A, Gerber TC, Hayes DL, Reeder GS. Digoxin, hypercalcaemia, and cardiac conduction. Postgrad Med J 1999;75:554-6. PubMed
- Bania TC, Blaufeux B, Hughes S, et al. Calcium and digoxin vs. calcium alone for severe verapamil toxicity. Acad Emerg Med 2000;7:1089-96. PubMed
- Tseng M, Breslow RA, Graubard BI, Ziegler RG. Dairy, calcium, and vitamin D intakes and prostate cancer risk in the National Health and Nutrition Examination Epidemiologic Follow-up Study cohort. Am J Clin Nutr 2005;81:1147-54. PubMed
- Weingarten MA, Zalmanovici A, Yaphe J. Dietary calcium supplementation for preventing colorectal cancer and adenomatous polyps. Cochrane Database Syst Rev 2004;(1):CD003548. PubMed
- Tavani A, Bertuccio P, Bosetti C, et al. Dietary intake of calcium, vitamin D, phosphorus and the risk of prostate cancer. Eur Urol 2005;48:27-33. PubMed
- Giovannucci E, Liu Y, Stampfer MJ, Willett WC. A prospective study of calcium intake and incident and fatal prostate cancer. Cancer Epidemiol Biomarkers Prev 2006;15:203-10. PubMed
- Rocephin (ceftriaxone) and calcium interaction. Pharmacist's Letter / Prescriber's Letter 2007;23(10):231005.
- Bolland MJ, Barber PA, Doughty RN, et al. Vascular events in healthy older women receiving calcium supplementation: randomised control trial. BMJ 2008;336:262-6.
- Bolland MJ, Avenell A, Baron JA, et al. Effect of calcium supplements on risk of myocardial infarction and cardiovascular events: meta-analysis. BMJ 2010;341:c3691. PubMed
- Calcium supplementation and vascular events. Pharmacist's Letter / Prescriber's Letter 2008;24(3):240306.
- Dietary reference intakes for calcium and vitamin D. Institute of Medicine, November 30, 2010. Available at: http://www.iom.edu/~/media/Files/Report%20Files/2010/Dietary-Reference-Intakes-for-Calcium-and-Vitamin-D/Vitamin%20D%20and%20Calcium%202010%20Repo
- Coburn JW, Mischel MG, Goodman WG, et al. Calcium citrate markedly enhances aluminum absorption from aluminum hydroxide. Am J Kidney Dis. 1991;17(6):708-11. PubMed
- Bradley JS, Wassel RT, Lee L, et al. Intravenous ceftriaxone and calcium in the neonate: assessing the risk for cardiopulmonary adverse events. Pediatrics. 2009;123(4):e609-13. PubMed
- Kays MB, Overholser BR, Mueller BA, et al. Effects of sevelamer hydrochloride and calcium acetate on the oral bioavailability of ciprofloxacin. Am J Kidney Dis. 2003;42(6):1253-9. PubMed
- Neuhofel, A. L., Wilton, J. H., Victory, J. M., Hejmanowsk, L. G., and Amsden, G. W. Lack of bioequivalence of ciprofloxacin when administered with calcium-fortified orange juice: a new twist on an old interaction. J Clin Pharmacol. 2002;42(4):461-466. DOI
- Dickinson, H. O., Nicolson, D. J., Cook, J. V., Campbell, F., Beyer, F. R., Ford, G. A., and Mason, J. Calcium supplementation for the management of primary hypertension in adults. Cochrane.Database.Syst.Rev. 2006;(2):CD004639. PubMed
- Jones, B. J. and Twomey, P. J. Requesting patterns for serum calcium concentration in patients on long-term lithium therapy. Int J Clin Pract. 2009;63(1):170-172. PubMed
- Levine, M., Nikkanen, H., and Pallin, D. J. The effects of intravenous calcium in patients with digoxin toxicity. J Emerg.Med. 2011;40(1):41-46. PubMed
- Castelo-Branco, C., Ciria-Recasens, M., Cancelo-Hidalgo, M. J., Palacios, S., Haya-Palazuelos, J., Carbonell-Abello, J., Blanch-Rubio, J., Martinez-Zapata, M. J., Manasanch, J., and Perez-Edo, L. Efficacy of ossein-hydroxyapatite complex compared with ca
- Li K, Kaaks R, Linseisen J, Rohrmann S. Associations of dietary calcium intake and calcium supplementation with myocardial infarction and stroke risk and overall cardiovascular mortality in the Heidelberg cohort of the European Prospective Investigation i
- Chung M, Tang AM, Fu Z. Calcium Intake and Cardiovascular Disease Risk: An Updated Systematic Review and Meta-analysis. Ann Intern Med. 2016 Oct 25. PubMed
- Nolan CR, Califano JR, Butzin CA. Influence of calcium acetate or calcium citrate on intestinal aluminum absorption. Kidney Int. 1990;38(5):937-41. PubMed
- Lewis JR, Radavelli-Bagatini S, Rejnmark L, et al. The effects of calcium supplementation on verified coronary heart disease hospitalization and death in postmenopausal women: a collaborative meta-analysis of randomized controlled trials. J Bone Miner Res PubMed
- Jalloh MA, Gregory PJ, Hein D, et al. Dietary supplement interactions with antiretrovirals: a systematic review. Int J STD AIDS. 2017 Jan;28(1):4-15. PubMed
- Lappe J, Watson P, Travers-Gustafson D, Recker R, Garland C, Gorham E, Baggerly K, McDonnell SL. Effect of Vitamin D and Calcium Supplementation on Cancer Incidence in Older Women: A Randomized Clinical Trial. JAMA. 2017 Mar 28;317(12):1234-1243. PubMed
- Grove ML, Cook D. Calcium and heart attacks. Doesn't apply to most calcium prescriptions. BMJ. 2010;341:c5003. PubMed
- Insentress [package insert]. Whitehouse Station, NJ: Merck Sharp & Dohme Corp.; 2014.
- Roberts JL, Kiser JJ, Hindman JT, Meditz AL. Virologic failure with a raltegravir-containing antiretroviral regimen and concomitant calcium administration. Pharmacotherapy 2011;31(10):298e-302e. DOI
- Vitekta [package insert]. Foster City, CA: Gilead Sciences, Inc.; 2014.
- Storan ER, O'Gorman SM, Murphy A, Laing M. Case Report of Calciphylaxis Secondary to Calcium and Vitamin D<sub>3</sub> Supplementation. J Cutan Med Surg. 2017;21(2):162-163. DOI
- Jenkins DJA, Spence JD, Giovannucci EL, et al. Supplemental vitamins and minerals for CVD prevention and treatment. J Am Coll Cardiol 2018;71(22):2570-84. PubMed
- Borkenhagen JF, Connor EL, Stafstrom CE. Neonatal hypocalcemic seizures due to excessive maternal calcium ingestion. Pediatr Neurol 2013;48(6):469-71. PubMed
- WHO recommendations on antenatal care for a positive pregnancy experience. Geneva: World Health Organization; 2016 (http://www.who.int/reproductivehealth/publications/maternal_perinatal_health/ anc-positive-pregnancy-experience/en/).
- Aune D, Navarro Rosenblatt DA, Chan DS, et al. Dairy products, calcium, and prostate cancer risk: a systematic review and meta-analysis of cohort studies. Am J Clin Nutr. 2015;101(1):87-117. PubMed
- Lan T, Park Y, Colditz GA, et al. Adolescent dairy product and calcium intake in relation to later prostate cancer risk and mortality in the NIH-AARP Diet and Health Study. Cancer Causes Control. 2020;31(10):891-904. PubMed
- Zhang Y, Li Y, Liu J, et al. Association of Vitamin D or Calcium Supplementation with Cardiovascular Outcomes and Mortality: A Meta-Analysis with Trial Sequential Analysis. J Nutr Health Aging 2021;25(2):263-270. PubMed
- Myung SK, Kim HB, Lee YJ, Choi YJ, Oh SW. Calcium Supplements and Risk of Cardiovascular Disease: A Meta-Analysis of Clinical Trials. Nutrients 2021;13(2):368. PubMed
- Hetaimish B. Neonatal Calcinosis Cutis After Treatment of Hypocalcemia with Calcium Gluconate: A Report of 2 Cases. Am J Case Rep 2024;25:e943397. PubMed
- US Food and Drug Administration (FDA). Biktarvy Prescribing Information. October 2024. Available at: https://www.accessdata.fda.gov/drugsatfda_docs/label/2024/210251Orig1s020lbl.pdf. Accessed July 16, 2025.
Proteolytic Enzymes (proteases) 3 references
- Weeks JA, Harper RA, Simon RA, Burdick JD. Assessment of sensitization risk of a laundry pre-spotter containing protease. Cutan Ocul Toxicol. 2011;30(4):272-9. PubMed
- Marquès LI, Lara S, Abós T, Bartolomé B. Occupational rhinitis due to pepsin. J Investig Allergol Clin Immunol. 2006;16(2):136-7. DOI
- Cartier A, Malo JL, Pineau L, Dolovich J. Occupational asthma due to pepsin. J Allergy Clin Immunol. 1984;73(5 Pt 1):574-7. PubMed
See these in context on the Proteolytic Enzymes (proteases) monograph →
Lipase 1 reference
- Casper C, Hascoet JM, Ertl T, et al. Recombinant bile salt-stimulated lipase in preterm infant feeding: A randomized phase 3 study. PLoS One. 2016;11(5):e0156071. PubMed
Betaine Hydrochloride 2 references
- Yago MR, Frymoyer A, Benet LZ, Smelick GS, Frassetto LA, Ding X, Dean B, Salphati L, Budha N, Jin JY, Dresser MJ, Ware JA. The use of betaine HCl to enhance dasatinib absorption in healthy volunteers with rabeprazole-induced hypochlorhydria. AAPS J. 2014 PubMed
- Yago MR, Frymoyer AR, Smelick GS, Frassetto LA, Budha NR, Dresser MJ, Ware JA, Benet LZ. Gastric reacidification with betaine HCl in healthy volunteers with rabeprazole-induced hypochlorhydria. Mol Pharm. 2013 Nov 4;10(11):4032-7. PubMed
See these in context on the Betaine Hydrochloride monograph →
Parts of this content are provided by the Therapeutic Research Center, LLC.
DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.
© 2021 Therapeutic Research Center, LLC