MSM 1000 mg Ingredients & Drug Interactions
by Thompson
What is this page for?
First and foremost: checking MSM 1000 mg 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
MSM 1000 mg is a dietary supplement by Thompson with 4 active ingredients. Its ingredients are commonly taken for preventing or treating low potassium (hypokalemia), supporting healthy blood pressure, muscle cramps.Based on those ingredients, 344 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Vitamin C, Manganese, Potassium. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against MSM 1000 mg by Thompson
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HelloPharmacist Scorecard of MSM 1000 mg by Thompson
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
Thompson's MSM 1000 mg contains four active ingredients: potassium, vitamin C, MSM, and manganese. Potassium is an electrolyte your body needs to regulate heart rhythm and muscle function.
Vitamin C is an antioxidant and immune supporter. MSM is a sulfur compound used in joint and connective-tissue supplements.
Manganese is a mineral involved in bone formation and metabolism. The product also contains inactive ingredients—cellulose, stearic acid, silica, and magnesium stearate—which serve as binders and flow agents in the tablet.
Does it work?
Not established
Vitamin C is effective for preventing vitamin C deficiency and possibly effective for anemia of chronic disease, atrial fibrillation, cataracts, and exercise-induced respiratory infections—though evidence for these conditions is limited. Manganese is effective for manganese deficiency but has insufficient reliable evidence for hay fever, osteoporosis, COPD, obesity, or osteoarthritis.
We hold no effectiveness data for potassium or MSM in this product.
How safe is it?
Well-documented data
Potassium is generally well-tolerated orally but can cause abdominal pain, nausea, diarrhea, and vomiting—and at high levels, dangerous heart rhythm problems and low blood pressure. It's especially risky for people with kidney disease.
The safety data advises against potassium supplements in pregnancy; use only under medical guidance. For breastfeeding, check with your doctor before taking a potassium supplement.
Vitamin C is generally safe at normal doses but at very high doses (above 2 grams daily) can cause kidney stones, abdominal cramps, heartburn, and diarrhea. The safety data advises against high-dose vitamin C supplements in pregnancy and during breastfeeding.
Manganese is well-tolerated at dietary amounts, but high doses carry a rare but serious risk of neurotoxicity and Parkinson-like symptoms; avoid high-dose supplements unless advised by your doctor. The safety data advises caution with high-dose manganese during breastfeeding.
Meds to double-check
Moderate interaction found
Before taking this product, check with your doctor or pharmacist if you're on potassium-sparing diuretics, ACE inhibitors, or ARBs (all moderate risk for high blood potassium). Also double-check if you take estrogens or birth control, warfarin or other blood thinners, thyroid medication, quinolone or tetracycline antibiotics, antipsychotic drugs, or any chemotherapy.
Vitamin C at high doses and manganese can both interfere with these medications' effectiveness or safety.
The bottom line
Scorecard at a glanceFully disclosed formula with no established evidence rating for its marketed use. Moderate medication interactions have been identified, and safety information is well characterized.
This product is a multi-ingredient supplement whose potassium, vitamin C, and manganese content can interact with common medications—especially blood pressure drugs, blood thinners, birth control, and antibiotics. If you take any prescription medication, check your exact drugs against the tool on this page before starting.
Talk it over with your own doctor or pharmacist, especially if you have kidney disease or are pregnant or breastfeeding.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 3 of 4 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Aug 26, 2014.
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 MSM 1000 mg, straight from the product label.
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.
Supplement Facts
The label details for MSM 1000 mg by Thompson, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Potassium | 40 mg | 1% |
| Vitamin C | 100 mg | 167% |
| MSM | 1000 mg | -- |
| Manganese | 5 mg | 250% |
Other ingredients: Cellulose, Stearic Acid, Silica, Magnesium Stearate
Tap any ingredient to jump to its full detail below.
These statements are the manufacturer’s wording, reproduced from the product label — the label is saying it, not HelloPharmacist. We don’t verify or endorse them.
Precautions
WARNING: Do not take if safety seal is broken or missing.
Keep out of reach of children.
General Statements
Keep your licensed health care practitioner informed when using this product.
DISCUSSION: MSM provides a rich source of organic sulfur that is essential to many structures and functions of the body. Shown to be particularly important to healthy joint function, MSM provides organic sulfur that is critical to the production of connective tissue and cartilage.
SINCE 1932
ORGANIC SULFATE
FRESH HEALTHY
ONCE DAILY
Suggested/Recommended/Usage/Directions
Directions: Use on only as directed. Take one to three tablets daily, preferably with a meal.
Storage
Store in a cool, dry place.
Brand IP Statement(s)
Our own laboratory analysis purity and freshness of all Thompson(R) products.
(C)2008
General
1306648 1107
FDA Statement of Identity
DIETARY SUPPLEMENT
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
MSM 1000 mg by Thompson 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 MSM 1000 mg by Thompson
These are the 4 active ingredients this product is made of. Select any to open its full monograph.
Serving size1 Tablet(s) Dosage formTablet Or Pill 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.
Potassium
Interacts with62 drugs
Potassium is an essential mineral your body needs for nerve signals, muscle function, and a steady heartbeat, and most people get enough from a balanc...
Potassium monograph & interactionsVitamin C
Interacts with207 drugs
Vitamin C (ascorbic acid) is an essential nutrient your body needs but cannot make, so you must get it from food or supplements. It's important for im...
Vitamin C monograph & interactionsMSM
Manganese
Interacts with83 drugs
Manganese is an essential trace mineral your body needs in small amounts for bone formation, metabolism, and antioxidant defense, and most people get...
Manganese monograph & interactionsOther (inactive) ingredients: Cellulose, Stearic Acid, Silica, Magnesium Stearate. These complete the product’s ingredient list but are not active constituents.
MSM 1000 mg by Thompson Drug Interactions
HelloPharmacist Interaction Report
Thompson's MSM 1000 mg contains potassium, vitamin C, and manganese—three ingredients with documented interactions.
The most serious concern is potassium's moderate-severity risk of dangerously high blood potassium levels (hyperkalemia) when combined with potassium-sparing diuretics, ACE inhibitors (blood pressure medications), or angiotensin receptor blockers (ARBs). This can affect heart rhythm and blood pressure.
Read the full breakdown — every affected drug type, severity by severity
Vitamin C at high doses interacts moderately with estrogens (including birth control and hormone therapy), blood thinners like warfarin, thyroid medication (levothyroxine), and chemotherapy drugs—both alkylating agents and antitumor antibiotics. It can also increase aluminum absorption and modestly lower levels of the HIV drug indinavir and the antipsychotic fluphenazine.
Manganese may theoretically reduce absorption of quinolone and tetracycline antibiotics (both commonly used), and may raise the risk of toxicity if you're on antipsychotic drugs. We could not check MSM for interactions—our data doesn't include it.
Altogether, these interactions span 344 individual medications. Use the search tool below to check your exact prescriptions before you start.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against MSM 1000 mg?
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 MSM 1000 mg interact with 344 drugs. Click any drug to see the details.
3 of the 4 ingredients in MSM 1000 mg interact with drugs. Each result below shows which ingredient is responsible. Vitamin C Manganese Potassium
AcepromazineAtravet
How Acepromazine interacts with MSM 1000 mg — through 1 ingredient. Tap an ingredient for the detail:
ManganeseAntipsychotic Drugs Moderate
Interaction Summary
Theoretically, the risk for manganese toxicity might increase when taken with antipsychotic drugs.
Read the full Manganese + Acepromazine interactionAcetophenazineTindal
How Acetophenazine interacts with MSM 1000 mg — through 1 ingredient. Tap an ingredient for the detail:
ManganeseAntipsychotic Drugs Moderate
Interaction Summary
Theoretically, the risk for manganese toxicity might increase when taken with antipsychotic drugs.
Read the full Manganese + Acetophenazine interactionAlginic Acid, Aluminum HydroxideRafton
How Alginic Acid, Aluminum Hydroxide interacts with MSM 1000 mg — through 1 ingredient. Tap an ingredient for the detail:
Vitamin CAluminum Moderate
Interaction Summary
Vitamin C can increase the amount of aluminum absorbed from aluminum compounds.
Read the full Vitamin C + Alginic Acid, Aluminum Hydroxide interactionAltretamineHexalen
How Altretamine interacts with MSM 1000 mg — through 1 ingredient. Tap an ingredient for the detail:
Vitamin CAlkylating Agents Moderate
Interaction Summary
Theoretically, antioxidant effects of vitamin C might reduce the effectiveness of alkylating agents.
Read the full Vitamin C + Altretamine interactionAluminum Acetate, Benzethonium ChlorideBuro-Sol Otic Solution
How Aluminum Acetate, Benzethonium Chloride interacts with MSM 1000 mg — through 1 ingredient. Tap an ingredient for the detail:
Vitamin CAluminum Moderate
Interaction Summary
Vitamin C can increase the amount of aluminum absorbed from aluminum compounds.
Read the full Vitamin C + Aluminum Acetate, Benzethonium Chloride interactionAluminum ChlorideAluminum Chloride, Anhydrol Forte, Driclor, Drysol
How Aluminum Chloride interacts with MSM 1000 mg — through 1 ingredient. Tap an ingredient for the detail:
Vitamin CAluminum Moderate
Interaction Summary
Vitamin C can increase the amount of aluminum absorbed from aluminum compounds.
Read the full Vitamin C + Aluminum Chloride interactionAluminum HydroxideAlu-Cap, Amphojel, Gaviscon
How Aluminum Hydroxide interacts with MSM 1000 mg — through 1 ingredient. Tap an ingredient for the detail:
Vitamin CAluminum Moderate
Interaction Summary
Vitamin C can increase the amount of aluminum absorbed from aluminum compounds.
Read the full Vitamin C + Aluminum Hydroxide interactionAluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium HydroxideAscriptin Codeine #2
How Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide interacts with MSM 1000 mg — through 1 ingredient. Tap an ingredient for the detail:
Vitamin CAspirin, Aluminum Moderate
Interaction Summary
Acidification of the urine by vitamin C might increase aspirin levels.
Read the full Vitamin C + Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide interactionAluminum Hydroxide, Aspirin, Magnesium HydroxideAscriptin
How Aluminum Hydroxide, Aspirin, Magnesium Hydroxide interacts with MSM 1000 mg — through 1 ingredient. Tap an ingredient for the detail:
Vitamin CAspirin, Aluminum Moderate
Interaction Summary
Acidification of the urine by vitamin C might increase aspirin levels.
Read the full Vitamin C + Aluminum Hydroxide, Aspirin, Magnesium Hydroxide interactionAluminum Hydroxide, Magnesium Hydroxide (otc Drug)Maalox, Mucogel
How Aluminum Hydroxide, Magnesium Hydroxide (otc Drug) interacts with MSM 1000 mg — through 1 ingredient. Tap an ingredient for the detail:
Vitamin CAluminum Moderate
Interaction Summary
Vitamin C can increase the amount of aluminum absorbed from aluminum compounds.
Read the full Vitamin C + Aluminum Hydroxide, Magnesium Hydroxide (otc Drug) interactionAluminum Hydroxide, Magnesium Hydroxide, Simethicone (otc Drug)Mylanta
How Aluminum Hydroxide, Magnesium Hydroxide, Simethicone (otc Drug) interacts with MSM 1000 mg — through 1 ingredient. Tap an ingredient for the detail:
Vitamin CAluminum Moderate
Interaction Summary
Vitamin C can increase the amount of aluminum absorbed from aluminum compounds.
Read the full Vitamin C + Aluminum Hydroxide, Magnesium Hydroxide, Simethicone (otc Drug) interactionAluminum, CalciumDomeboro
How Aluminum, Calcium interacts with MSM 1000 mg — through 1 ingredient. Tap an ingredient for the detail:
Vitamin CAluminum Moderate
Interaction Summary
Vitamin C can increase the amount of aluminum absorbed from aluminum compounds.
Read the full Vitamin C + Aluminum, Calcium interactionAluminum, Magnesium (otc Drug)Almagel
How Aluminum, Magnesium (otc Drug) interacts with MSM 1000 mg — through 1 ingredient. Tap an ingredient for the detail:
Vitamin CAluminum Moderate
Interaction Summary
Vitamin C can increase the amount of aluminum absorbed from aluminum compounds.
Read the full Vitamin C + Aluminum, Magnesium (otc Drug) interactionAluminum, Magnesium Hydroxide (otc Drug)Wingel
How Aluminum, Magnesium Hydroxide (otc Drug) interacts with MSM 1000 mg — through 1 ingredient. Tap an ingredient for the detail:
Vitamin CAluminum Moderate
Interaction Summary
Vitamin C can increase the amount of aluminum absorbed from aluminum compounds.
Read the full Vitamin C + Aluminum, Magnesium Hydroxide (otc Drug) interactionAmilorideAmilamont, Midamor
How Amiloride interacts with MSM 1000 mg — through 1 ingredient. Tap an ingredient for the detail:
PotassiumPotassium-sparing Diuretics Moderate
Interaction Summary
Concomitant use increases the risk of hyperkalemia.
Read the full Potassium + Amiloride interactionAmiloride, HydrochlorothiazideAmil-Co, Amilzide, Moduret 25, Moduretic
How Amiloride, Hydrochlorothiazide interacts with MSM 1000 mg — through 1 ingredient. Tap an ingredient for the detail:
PotassiumPotassium-sparing Diuretics Moderate
Interaction Summary
Concomitant use increases the risk of hyperkalemia.
Read the full Potassium + Amiloride, Hydrochlorothiazide interactionAmitriptyline, PerphenazineEtrafon, Etrafon-A, Etrafon-Forte, Triavil
How Amitriptyline, Perphenazine interacts with MSM 1000 mg — through 1 ingredient. Tap an ingredient for the detail:
ManganeseAntipsychotic Drugs Moderate
Interaction Summary
Theoretically, the risk for manganese toxicity might increase when taken with antipsychotic drugs.
Read the full Manganese + Amitriptyline, Perphenazine interactionAmlodipine Besylate, BenazeprilLotrel
How Amlodipine Besylate, Benazepril interacts with MSM 1000 mg — through 1 ingredient. Tap an ingredient for the detail:
PotassiumAce Inhibitors (aceis) Moderate
Interaction Summary
Using ACEIs with high doses of potassium increases the risk of hyperkalemia.
Read the full Potassium + Amlodipine Besylate, Benazepril interactionAmphotericin, TetracyclineMysteclin-F
How Amphotericin, Tetracycline interacts with MSM 1000 mg — through 1 ingredient. Tap an ingredient for the detail:
ManganeseTetracycline Antibiotics Moderate
Interaction Summary
Theoretically, manganese might reduce the absorption of tetracycline antibiotics.
Read the full Manganese + Amphotericin, Tetracycline interactionAripiprazoleAbilify, Abilify Maintena, Abilify Mycite
How Aripiprazole interacts with MSM 1000 mg — through 1 ingredient. Tap an ingredient for the detail:
ManganeseAntipsychotic Drugs Moderate
Interaction Summary
Theoretically, the risk for manganese toxicity might increase when taken with antipsychotic drugs.
Read the full Manganese + Aripiprazole interactionAripiprazole LauroxilAristada, Aristada Initio Kit
How Aripiprazole Lauroxil interacts with MSM 1000 mg — through 1 ingredient. Tap an ingredient for the detail:
ManganeseAntipsychotic Drugs Moderate
Interaction Summary
Theoretically, the risk for manganese toxicity might increase when taken with antipsychotic drugs.
Read the full Manganese + Aripiprazole Lauroxil interactionAsenapineSaphris, Secuado
How Asenapine interacts with MSM 1000 mg — through 1 ingredient. Tap an ingredient for the detail:
ManganeseAntipsychotic Drugs Moderate
Interaction Summary
Theoretically, the risk for manganese toxicity might increase when taken with antipsychotic drugs.
Read the full Manganese + Asenapine interactionAspirin, Aluminum Hydroxide, Codeine Phosphate, Magnesium HydroxideAscriptin Codeine #3
How Aspirin, Aluminum Hydroxide, Codeine Phosphate, Magnesium Hydroxide interacts with MSM 1000 mg — through 1 ingredient. Tap an ingredient for the detail:
Vitamin CAspirin, Aluminum Moderate
Interaction Summary
Acidification of the urine by vitamin C might increase aspirin levels.
Read the full Vitamin C + Aspirin, Aluminum Hydroxide, Codeine Phosphate, Magnesium Hydroxide interactionAzilsartanEdarbi
How Azilsartan interacts with MSM 1000 mg — through 1 ingredient. Tap an ingredient for the detail:
PotassiumAngiotensin Receptor Blockers (arbs) Moderate
Interaction Summary
Using ARBs with high doses of potassium increases the risk of hyperkalemia.
Read the full Potassium + Azilsartan interactionAzilsartan, ChlorthalidoneEdarbyclor
How Azilsartan, Chlorthalidone interacts with MSM 1000 mg — through 1 ingredient. Tap an ingredient for the detail:
PotassiumAngiotensin Receptor Blockers (arbs) Moderate
Interaction Summary
Using ARBs with high doses of potassium increases the risk of hyperkalemia.
Read the full Potassium + Azilsartan, Chlorthalidone interactionBazedoxifene Acetate, Conjugated EstrogensDuavee
How Bazedoxifene Acetate, Conjugated Estrogens interacts with MSM 1000 mg — through 1 ingredient. Tap an ingredient for the detail:
Vitamin CEstrogens Moderate
Interaction Summary
Vitamin C might increase blood levels of estrogens.
Read the full Vitamin C + Bazedoxifene Acetate, Conjugated Estrogens interactionBenazeprilLotensin
How Benazepril interacts with MSM 1000 mg — through 1 ingredient. Tap an ingredient for the detail:
PotassiumAce Inhibitors (aceis) Moderate
Interaction Summary
Using ACEIs with high doses of potassium increases the risk of hyperkalemia.
Read the full Potassium + Benazepril interactionBenazepril, HydrochlorothiazideLotensin HCT
How Benazepril, Hydrochlorothiazide interacts with MSM 1000 mg — through 1 ingredient. Tap an ingredient for the detail:
PotassiumAce Inhibitors (aceis) Moderate
Interaction Summary
Using ACEIs with high doses of potassium increases the risk of hyperkalemia.
Read the full Potassium + Benazepril, Hydrochlorothiazide interactionBendamustineBelrapzo, Treanda, Vivimusta
How Bendamustine interacts with MSM 1000 mg — through 1 ingredient. Tap an ingredient for the detail:
Vitamin CAlkylating Agents Moderate
Interaction Summary
Theoretically, antioxidant effects of vitamin C might reduce the effectiveness of alkylating agents.
Read the full Vitamin C + Bendamustine interactionBendamustine HydrochlorideBendeka
How Bendamustine Hydrochloride interacts with MSM 1000 mg — through 1 ingredient. Tap an ingredient for the detail:
Vitamin CAlkylating Agents Moderate
Interaction Summary
Theoretically, antioxidant effects of vitamin C might reduce the effectiveness of alkylating agents.
Read the full Vitamin C + Bendamustine Hydrochloride interactionEach ingredient & the kinds of drugs it affects
For each ingredient in MSM 1000 mg 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.
Vitamin C
Alkylating Agents
Theoretically, antioxidant effects of vitamin C might reduce the effectiveness of alkylating agents.
The use of antioxidants like vitamin C during chemotherapy is controversial. There is concern that antioxidants could reduce the activity of chemotherapy drugs that generate free radicals, such as cyclophosphamide, chlorambucil, carmustine, busulfan, and thiotepa. In contrast, some researchers theorize that antioxidants might make chemotherapy more effective by reducing oxidative stress that could interfere with apoptosis (cell death) of cancer cells. More evidence is needed to determine what effect, if any, antioxidants such as vitamin C have on chemotherapy.
Aluminum
Vitamin C can increase the amount of aluminum absorbed from aluminum compounds.
Research in animals and humans shows that vitamin C increases aluminum absorption, theoretically by chelating aluminum and keeping it in solution where it is available for absorption. In people with normal renal function, urinary excretion of aluminum will likely increase, making aluminum retention and toxicity unlikely. Patients with renal failure who take aluminum-containing compounds such as phosphate binders should avoid vitamin C supplements in doses above the recommended dietary allowances.
Antitumor Antibiotics
Theoretically, the antioxidant effects of vitamin C might reduce the effectiveness of antitumor antibiotics.
The use of antioxidants like vitamin C during chemotherapy is controversial. There is concern that antioxidants could reduce the activity of chemotherapy drugs which generate free radicals, such as doxorubicin. In contrast, some researchers theorize that antioxidants might make chemotherapy more effective by reducing oxidative stress that could interfere with apoptosis (cell death) of cancer cells. More evidence is needed to determine what effects, if any, antioxidants such as vitamin C have on chemotherapy.
Estrogens
Vitamin C might increase blood levels of estrogens.
Increases in plasma estrogen levels of up to 55% occur under some circumstances when vitamin C is taken concurrently with oral contraceptives or hormone replacement therapy, including topical products. It is suggested that vitamin C prevents oxidation of estrogen in the tissues, regenerates oxidized estrogen, and reduces sulfate conjugation of estrogen in the gut wall. When tissue levels of vitamin C are high, these processes are already maximized and supplemental vitamin C does not have any effect on estrogen levels. Increases in plasma estrogen levels may occur when patients who are deficient in vitamin C take supplements. Monitor these patients for estrogen-related side effects.
Fluphenazine (Prolixin)
Theoretically, vitamin C might decrease levels of fluphenazine.
In one patient there was a clinically significant decrease in fluphenazine levels when vitamin C (500 mg twice daily) was started. The mechanism is not known, and there is no further data to confirm this interaction.
Indinavir (Crixivan)
Vitamin C can modestly reduce indinavir levels.
One pharmacokinetic study shows that taking vitamin C 1 gram orally once daily along with indinavir 800 mg orally three times daily reduces the area under the concentration-time curve of indinavir by 14%. The mechanism of this interaction is unknown, but it is unlikely to be clinically significant in most patients. The effect of higher doses of vitamin C on indinavir levels is unknown.
Levothyroxine (Synthroid, Others)
Vitamin C can increase levothyroxine absorption.
Two clinical studies in adults with poorly controlled hypothyroidism show that swallowing levothyroxine with a glass of water containing vitamin C 500-1000 mg in solution reduces thyroid stimulating hormone (TSH) levels and increases thyroxine (T4) levels when compared with taking levothyroxine alone. This suggests that vitamin C increases the oral absorption of levothyroxine, possibly due to a reduction in pH.
Warfarin (Coumadin)
High-dose vitamin C might reduce the levels and effectiveness of warfarin.
Vitamin C in high doses may cause diarrhea and possibly reduce warfarin absorption. There are reports of two people who took up to 16 grams daily of vitamin C and had a reduction in prothrombin time. Lower doses of 5-10 grams daily can also reduce warfarin absorption. In many cases, this does not seem to be clinically significant. However, a case of warfarin resistance has been reported for a patient who took vitamin C 500 mg twice daily. Cessation of vitamin C supplementation resulted in a rapid increase in international normalized ratio (INR). Tell patients taking warfarin to avoid taking vitamin C in excessively high doses (greater than 10 grams daily). Lower doses may be safe, but the anticoagulation activity of warfarin should be monitored. Patients who are stabilized on warfarin while taking vitamin C should avoid adjusting vitamin C dosage to prevent the possibility of warfarin resistance.
Acetaminophen (Tylenol, Others)
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
A small pharmacokinetic study in healthy volunteers shows that taking high-dose vitamin C (3 grams) 1.5 hours after taking acetaminophen 1 gram slightly increases the apparent half-life of acetaminophen from around 2.3 hours to 3.1 hours. Ascorbic acid competitively inhibits sulfate conjugation of acetaminophen. However, to compensate, elimination of acetaminophen glucuronide and unconjugated acetaminophen increases. This effect is not likely to be clinically significant.
Aspirin
Acidification of the urine by vitamin C might increase aspirin levels.
It has been suggested that acidification of the urine by vitamin C could increase reabsorption of salicylates by the renal tubules, and increase plasma salicylate levels. However, short-term use of up to 6 grams daily of vitamin C does not seem to affect urinary pH or salicylate excretion, suggesting this interaction is not clinically significant.
Choline Magnesium Trisalicylate (Trilisate)
Acidification of the urine by vitamin C might increase choline magnesium trisalicylate levels.
It has been suggested that acidification of the urine by vitamin C could increase reabsorption of salicylates by the renal tubules, and increase plasma salicylate levels. However, short-term use of up to 6 grams daily of vitamin C does not seem to affect urinary pH or salicylate excretion, suggesting this interaction probably is not clinically significant.
Niacin
Vitamin C might decrease the beneficial effects of niacin on high-density lipoprotein (HDL) cholesterol levels.
A combination of niacin and simvastatin (Zocor) effectively raises HDL cholesterol levels in patients with coronary disease and low HDL levels. Clinical research shows that taking a combination of antioxidants (vitamin C, vitamin E, beta-carotene, and selenium) along with niacin and simvastatin (Zocor) attenuates this rise in HDL, specifically the HDL-2 and apolipoprotein A1 fractions, by more than 50% in patients with coronary disease. It is not known whether this adverse effect is due to a single antioxidant such as vitamin C, or to the combination. It also is not known whether it will occur in other patient populations.
Salsalate (Disalcid)
Acidification of the urine by vitamin C might increase salsalate levels.
It has been suggested that acidification of the urine by vitamin C could increase reabsorption of salicylates by the renal tubules, and increase plasma salicylate levels. However, short-term use of up to 6 grams/day vitamin C does not seem to affect urinary pH or salicylate excretion, suggesting this interaction probably is not clinically significant.
Manganese
Antipsychotic Drugs
Theoretically, the risk for manganese toxicity might increase when taken with antipsychotic drugs.
Hallucinations and behavioral changes have been reported in a patient with liver disease who was taking haloperidol and manganese. Researchers speculate that taking manganese along with haloperidol, phenothiazine-derivatives, or other antipsychotic medications might increase the risk of manganese toxicity in some patients.
Quinolone Antibiotics
Theoretically, manganese might reduce the absorption of quinolone antibiotics.
Manganese is a multivalent cation. Interactions resulting in reduced quinolone absorption have been reported between quinolones and other multivalent cations, such as calcium and iron.
Tetracycline Antibiotics
Theoretically, manganese might reduce the absorption of tetracycline antibiotics.
Manganese is a multivalent cation. Interactions resulting in reduced tetracycline absorption have been reported between tetracyclines and other multivalent cations, such as calcium and iron.
Potassium
Ace Inhibitors (Aceis)
Using ACEIs with high doses of potassium increases the risk of hyperkalemia.
ACEIs block the actions of the renin-angiotensin-aldosterone system and reduce potassium excretion. Concomitant use of these drugs with potassium supplements increases the risk of hyperkalemia. However, concomitant use of these drugs with moderate dietary potassium intake (about 3775-5200 mg daily) does not increase serum potassium levels.
Angiotensin Receptor Blockers (Arbs)
Using ARBs with high doses of potassium increases the risk of hyperkalemia.
ARBs block the actions of the renin-angiotensin-aldosterone system and reduce potassium excretion. Concomitant use of these drugs with potassium supplements increases the risk of hyperkalemia. However, concomitant use of these drugs with moderate dietary potassium intake (about 3775-5200 mg daily) does not increase serum potassium levels.
Potassium-Sparing Diuretics
Concomitant use increases the risk of hyperkalemia.
Using potassium-sparing diuretics with potassium supplements increases the risk of hyperkalemia.
Brand information
Manufacturer and brand details for MSM 1000 mg, from the product label.
MSM 1000 mg by Thompson: Common Questions
Does MSM 1000 mg by Thompson interact with any medications?
How can one product interact with so many drugs?
Where does this information come from?
Is this product safe if I have kidney disease?
Can I take this while I'm pregnant?
What are the most common side effects?
Does this help with osteoarthritis?
Can I take this with my birth control?
What if I'm taking an antibiotic?
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 MSM 1000 mg’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Potassium
Interacts with 62 drugsPotassium is an essential mineral your body needs for nerve signals, muscle function, and a steady heartbeat, and most people get enough from a balanced diet rich in fruits and vegetables. P...
Read the full Potassium monograph → Herb & supplement monographVitamin C
Interacts with 207 drugsVitamin C (ascorbic acid) is an essential nutrient your body needs but cannot make, so you must get it from food or supplements. It's important for immune function, collagen, and acts as an...
Read the full Vitamin C monograph → Herb & supplement monographManganese
Interacts with 83 drugsManganese is an essential trace mineral your body needs in small amounts for bone formation, metabolism, and antioxidant defense, and most people get enough from a normal diet. Supplements m...
Read the full Manganese monograph →Sources & How We Checked
MSM 1000 mg'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 84 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.
Potassium 12 references
- McEvoy GK, ed. AHFS Drug Information. Bethesda, MD: American Society of Health-System Pharmacists, 1998.
- Gennaro A. Remington: The Science and Practice of Pharmacy. 19th ed. Lippincott: Williams & Wilkins, 1996.
- Whelton PK, He J, Cutler JA, et al. Effects of oral potassium on blood pressure. Meta-analysis of randomized controlled clinical trials. JAMA 1997;277:1624-32. PubMed
- Phillips, C. O., Kashani, A., Ko, D. K., Francis, G., and Krumholz, H. M. Adverse effects of combination angiotensin II receptor blockers plus angiotensin-converting enzyme inhibitors for left ventricular dysfunction: a quantitative review of data from ra DOI
- Altieri, P. I., Herrero, C., Suero, R., and Ortiz, A. Bleeding duodenal ulcer in a patient taking slow-releasing potassium tablets. Bol.Asoc.Med P.R. 1977;69(8):276.
- Raf, L. E. Enteric-coated potassium chloride tablets and ulcer of the small intestine. Acta Chir Scand Suppl 1967;(374):1-87.
- Potassium chloride oral solution [package insert]. Allentown, PA: Lehigh Valley Technologies, Inc.; 2014.
- Potassium chloride injection [package insert]. Lake Forest, IL: Hospira Inc.; 2009.
- Patel RB, Tannenbaum S, Viana-Tejedor A, et al. Serum potassium levels, cardiac arrhythmias, and mortality following non-ST-elevation myocardial infarction or unstable angina: insights from MERLIN-TIMI 36. Eur Heart J Acute Cardiovasc Care 2017 Feb;6(1):1 PubMed
- Malta D, Arcand J, Ravindran A, Floras V, Allard JP, Newton GE. Adequate intake of potassium does not cause hyperkalemia in hypertensive individuals taking medications that antagonize the renin angiotensin aldosterone system. Am J Clin Nutr 2016 Oct;104(4 PubMed
- Keskin M, Kaya A, Tatlisu MA, et al. The effect of serum potassium level on in-hospital and long-term mortality in ST elevation myocardial infarction. Int J cardiol. 2016 Oct 15;221:505-10.
- Stallings VA, Harrison M, Oria M; Committee to Review the Dietary Reference Intakes for Sodium and Potassium, Food and Nutrition Board, Health and Medicine Division, National Academies of Sciences, Engineering, and Medicine. Washington (DC): National Acad
Vitamin C 51 references
- McEvoy GK, ed. AHFS Drug Information. Bethesda, MD: American Society of Health-System Pharmacists, 1998.
- Back DJ, Breckenridge AM, MacIver M, et al. Interaction of ethinyloestradiol with ascorbic acid in man. Br Med J (Clin Res Ed) 1981;282:1516.
- Morris JC, Beeley L, Ballantine N. Interaction of ethinyloestradiol with ascorbic acid in man [letter]. Br Med J (Clin Res Ed) 1981;283:503.
- Labriola D, Livingston R. Possible interactions between dietary antioxidants and chemotherapy. Oncology 1999;13:1003-8.
- Dwyer JH, Merz NB, Shirocre AM, et al. Progression of early atherosclerosis and intake of vitamin C and vitamin E from supplements and food. The Los Angeles Atherosclerosis Study. 41st Annual Conference on Cardiovascular Disease Epidemiology and Prevent
- Levine M, Rumsey SC, Daruwala R, et al. Criteria and recommendations for vitamin C intake. JAMA 1999;281:1415-23. PubMed
- Hansten PD, Horn JR. Drug Interactions Analysis and Management. Vancouver, WA: Applied Therapeutics Inc., 1997 and updates.
- Segal S, Kaminski S. Drug-nutrient interactions. American Druggist 1996 Jul;42-8.
- Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes for Vitamin C, Vitamin E, Selenium, and Carotenoids. Washington, DC: National Academy Press, 2000. Available at: http://www.nap.edu/books/0309069351/html/.
- Houston JB, Levy G. Drug biotransformation interactions in man VI: Acetaminophen and ascorbic acid. J Pharm Sci 1976;65:1218-21. PubMed
- Brown BG, Zhao XQ, Chait A, et al. Simvastatin and niacin, antioxidant vitamins, or the combination for the prevention of coronary disease. N Engl J Med 2001;345:1583-93. DOI
- Rosenthal G. Interaction of ascorbic acid and warfarin. JAMA 1971;215:1671. DOI
- Hume R, Johnstone JM, Weyers E. Interaction of ascorbic acid and warfarin. JAMA 1972;219:1479. DOI
- Smith EC, Skalski RJ, Johnson GC, Rossi GV. Interaction of ascorbic acid and warfarin. JAMA 1972;221:1166. DOI
- Traxer O, Huet B, Poindexter J, et al. Effect of ascorbic acid consumption on urinary stone risk factors. J Urol 2003;170:397-401.. PubMed
- Domingo JL, Gomez M, Llobet JM, Richart C. Effect of ascorbic acid on gastrointestinal aluminum absorption (letter). Lancet 1991;338:1467.
- Domingo JL, Gomez M, Llobet JM, Corbella J. Influence of some dietary constituents on aluminum absorption and retention in rats. Kidney Int 1991;39:598-601. PubMed
- Partridge NA, Regnier FE, White JL, Hem SL. Influence of dietary constituents on intestinal absorption of aluminum. Kidney Int 1989;35:1413-7. PubMed
- Mc Leod DC, Nahata MC. Inefficacy of ascorbic acid as a urinary acidifier (letter). N Engl J Med 1977;296:1413. DOI
- Hansten PD, Hayton WL. Effect of antacid and ascorbic acid on serum salicylate concentration. J Clin Pharmacol 1980;20:326-31. PubMed
- Dysken MW, Cumming RJ, Channon RA, Davis JM. Drug interaction between ascorbic acid and fluphenazine. JAMA 1979;241:2008. DOI
- Vihtamaki T, Parantainen J, Koivisto AM, et al. Oral ascorbic acid increases plasma oestradiol during postmenopausal hormone replacement therapy. Maturitas 2002;42:129-35. PubMed
- Slain D, Amsden JR, Khakoo RA, et al. Effect of high-dose vitamin C on the steady-state pharmacokinetics of the protease inhibitor indinavir in healthy volunteers. Pharmacotherapy 2005;25:165-70. PubMed
- Cheung MC, Zhao XQ, Chait A, et al. Antioxidant supplements block the response of HDL to simvastatin-niacin therapy in patients with coronary artery disease and low HDL. Arterioscler Thromb Vasc Biol 2001;21:1320-6. PubMed
- Feetam CL, Leach RH, Meynell MJ. Lack of a clinically important interaction between warfarin and ascorbic acid. Toxicol Appl Pharmacol 1975;31:544-7. PubMed
- Weintraub M, Griner PF. Warfarin and ascorbic acid: lack of evidence for a drug interaction. Toxicol Appl Pharmacol 1974;28:53-6. PubMed
- Lee DH, Folsom AR, Harnack L, et al. Does supplemental vitamin C increase cardiovascular disease risk in women with diabetes? Am J Clin Nutr 2004;80:1194-200. PubMed
- Taylor EN, Stampfer MJ, Curhan GC. Dietary factors and the risk of incident kidney stones in men: new insights after 14 years of follow-up. J Am Soc Nephrol 2004;15:3225-32. PubMed
- Ward NC, Hodgson JM, Croft KD, et al. The combination of vitamin C and grape-seed polyphenols increases blood pressure: a randomized, double-blind, placebo-controlled trial. J Hypertens 2005;23:427-34.. PubMed
- Prasad KN. Rationale for using high-dose multiple dietary antioxidants as an adjunct to radiation therapy and chemotherapy. J Nutr 2004;134:3182S-3S. PubMed
- Conklin KA. Cancer chemotherapy and antioxidants. J Nutr 2004;134:3201S-3204S. PubMed
- Fairweather-Tait S, Hickson K, McGaw B, et al. Orange juice enhances aluminium absorption from antacid preparation. Eur J Clin Nutr. 1994;48(1):71-3.
- Gruenwald, J., Graubaum, H. J., Busch, R., and Bentley, C. Safety and tolerance of ester-C compared with regular ascorbic acid. Adv.Ther. 2006;23(1):171-178.
- Rahimi, R., Nikfar, S., Rezaie, A., and Abdollahi, M. A meta-analysis on the efficacy and safety of combined vitamin C and E supplementation in preeclamptic women. Hypertens.Pregnancy. 2009;28(4):417-434. PubMed
- Einerson, B., Nathorn, C., Kitiyakara, C., Sirada, M., and Thamlikitkul, V. The efficacy of ascorbic acid in suboptimal responsive anemic hemodialysis patients receiving erythropoietin: a meta-analysis. J Med.Assoc.Thai. 2011;94 Suppl 1:S134-S146.
- Li, G., Li, L., Yu, C., and Chen, L. Effect of vitamins C and E supplementation on Helicobacter pylori eradication: a meta-analysis. Br.J Nutr 2011;106(11):1632-1637.
- Chen X, Shen L, Gu X, et al. High-dose supplementation with vitamin C--induced pediatric urolithiasis: the first case report in a child and literature review. Urology. 2014;84(4):922-4. PubMed
- Sattar A, Willman JE, Kolluri R. Possible warfarin resistance due to interaction with ascorbic acid: case report and literature review. Am J Health Syst Pharm. 2013;70(9):782-6. PubMed
- Yaich S, Chaabouni Y, Charfeddine K, et al. Secondary oxalosis due to excess vitamin C intake: a cause of graft loss in a renal transplant recipient. Saudi J Kidney Dis Transpl. 2014;25(1):113-6. 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
- Rumbold A, Ota E, Nagata C, Shahrook S, Crowther CA. Vitamin C supplementation in pregnancy. Cochrane Database Syst Rev. 2015;(9):CD004072. PubMed
- Seo MS, Kim JK, Shim JY. High-dose vitamin C promotes regression of multiple pulmonary metastases originating from hepatocellular carcinoma. Yonsei Med J. 2015;56(5):1449-52. PubMed
- Skelin M, Lucijanic T, Amidzic Klaric D, et al. Factors Affecting Gastrointestinal Absorption of Levothyroxine: A Review. Clin Ther. 2017 Feb;39(2):378-403. PubMed
- Jiang K, Tang K, Liu H, Xu H, Ye Z, Chen Z. Ascorbic acid supplements and kidney stones incidence among men and women: a systematic review and meta-analysis. Urol J. 2019;16(2):115-120.
- Thomas S, Patel D, Bittel B, et al. Effect of High-Dose Zinc and Ascorbic Acid Supplementation vs Usual Care on Symptom Length and Reduction Among Ambulatory Patients With SARS-CoV-2 Infection: The COVID A to Z Randomized Clinical Trial. JAMA Netw Open. 2 PubMed
- Giffen MA, McLemore JL. Hyperoxalosis Secondary to Intravenous Vitamin C Administration as a Non-Allopathic Treatment for Cancer. Acad Forensic Pathol 2019;9(1-2):118-126. PubMed
- Maike A, Sturgill D, Gallan A. Oxalate Nephropathy in a Renal Transplant Recipient After Receiving High Dose Ascorbic Acid. Am J Med Sci 2021. PubMed
- Shen ZY, Chen YR, Wang MC, Chang SS. High-dose vitamin C-induced acute oxalate nephropathy in a renal transplant recipient: a case report and literature review. Asian J Surg 2022. PubMed
- Yanase F, Spano S, Maeda A, et al. Mega-dose sodium ascorbate: a pilot, single-dose, physiological effect, double-blind, randomized, controlled trial. Crit Care 2023;27(1):371. PubMed
- Sharma Y, Sumanadasa S, Shahi R, et al. Efficacy and safety of vitamin C supplementation in the treatment of community-acquired pneumonia: a systematic review and meta-analysis with trial sequential analysis. Sci Rep 2024;14(1):11846. PubMed
- Pejcic AV, Petrovic NZ, Djordjic MD, Milosavljevic MN. Vitamin C Levels in Pregnant Women and the Efficacy of Vitamin C Supplements in Preventing Premature Rupture of Membranes: A Systematic Review and Meta-Analysis. Balkan Med J 2024;41(4):248-260. PubMed
Manganese 21 references
- Hansten PD, Horn JR. Hansten and Horn's Drug Interactions Analysis and Management. Vancouver, CAN:Appl Therapeut, 1999.
- Barrington WW, Angle CR, Willcockson NK, et al. Autonomic function in manganese alloy workers. Environ Res 1998;78:50-8. PubMed
- Hauser RA, Zesiewicz TA, Martinez C, et al. Blood manganese correlates with brain magnetic resonance imaging changes in patients with liver disease. Can J Neurol Sci 1996;23:95-8. PubMed
- Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. Washington, DC: National Academy Press, 2002.
- Lee JW. Manganese intoxication. Arch Neurol 2000;57:597-9.. PubMed
- Powers KM, Smith-Weller T, Franklin GM, et al. Parkinson's disease risks associated with dietary iron, manganese, and other nutrient intakes. Neurology 2003;60:1761-6.. PubMed
- McMillan, D. E. A brief history of the neurobehavioral toxicity of manganese: some unanswered questions. Neurotoxicology 1999;20(2-3):499-507.
- Gerber, G. B., Leonard, A., and Hantson, P. Carcinogenicity, mutagenicity and teratogenicity of manganese compounds. Crit Rev Oncol Hematol. 2002;42(1):25-34. PubMed
- Jiang, Y. and Zheng, W. Cardiovascular toxicities upon manganese exposure. Cardiovasc.Toxicol 2005;5(4):345-354. PubMed
- Mehta, R. and Reilly, J. J. Manganese levels in a jaundiced long-term total parenteral nutrition patient: potentiation of haloperidol toxicity? Case report and literature review. JPEN J Parenter.Enteral Nutr 1990;14(4):428-430. PubMed
- Nemery, B. Metal toxicity and the respiratory tract. Eur Respir.J 1990;3(2):202-219. DOI
- Vanek VW, Borum P, Buchman A, et al. A.S.P.E.N. position paper: recommendations for changes in commercially available parenteral multivitamin and multi-trace element products. Nutr Clin Pract. 2012;27:440-491.doi: 10.1177/0884533612446706 PubMed
- Schuh MJ. Possible Parkinson's disease induced by chronic manganese supplement ingestion. Consult Pharm. 2016;31(12):698-703. doi: 10.4140/TCP.n.2016.698. PubMed
- Baker B, Ali A, Isenring L. Recommendations for manganese supplementation to adult patients receiving long-term home parenteral nutrition: an analysis of the supporting evidence. Nutr Clin Pract 2016;31(2):180-5. doi: 10.1177/0884533615591600. PubMed
- Ho CSH, Ho RCM, Quek AML. Chronic manganese toxicity associated with voltage-gated potassium channel complex antibodies in a relapsing neuropsychiatric disorder. Int J Environ Res Public Health 2018;15(4). pii: E783. doi: 10.3390/ijerph15040783. PubMed
- Yamamoto M, Sakurai K, Eguchi A, et al.; Japan Environment and Children's Study Group: Association between blood manganese level during pregnancy and birth size: the Japan environment and children's study (JECS). Environ Res 2019;172:117-26. PubMed
- Li D, Ge X, Liu Z, et al. Association between long-term occupational manganese exposure and bone quality among retired workers. Environ Sci Pollut Res Int 2020;27(1):482-9. PubMed
- Martin KV, Sucharew H, Dietrich KN, et al. Co-exposure to manganese and lead and pediatric neurocognition in East Liverpool, Ohio. Environ Res 2021;202:111644. PubMed
- Racette BA, Nelson G, Dlamini WW, et al. Depression and anxiety in a manganese-exposed community. Neurotoxicology 2021;85:222-33. PubMed
- Ruiz-Azcona L, Fernández-Olmo I, Expósito A, et al. Impact of environmental airborne manganese exposure on cognitive and motor functions in adults: a systematic review and meta-analysis. Int J Environ Res Public Health 2021;18(8):4075. PubMed
- Uyar E, Gurkas E, Aksu AU, et al. Can therapeutic plasma exchange be life-saving in life-threatening manganese intoxication?. Transfus Apher Sci 2022;61(4):103417. PubMed
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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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