Multi-Enzyme Ingredients & Drug Interactions
What is this page for?
First and foremost: checking Multi-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
Multi-Enzyme is a dietary supplement by The Vitamin Shoppe with 14 active ingredients. Its ingredients are commonly taken for digestive support for protein digestion, wound cleaning (debridement of dead tissue), sore throat and inflammation.Based on those ingredients, 307 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are Calcium, Bromelain, Betaine HCl. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against Multi-Enzyme by The Vitamin Shoppe
Ask about any prescription or over-the-counter medication and we check it for interactions with Multi-Enzyme by The Vitamin Shoppe — and tell you which ingredient is responsible.
AI summaries are generated from our interaction database for education only — always confirm with your pharmacist. How we use AI
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HelloPharmacist Scorecard of Multi-Enzyme by The Vitamin Shoppe
Our pharmacy team’s full take, with four database checks built into the cards below — a summary of what is known, not a grade of the product itself.
What’s inside
Low disclosure
Multi-Enzyme by The Vitamin Shoppe contains 14 active ingredients—a blend of digestive enzymes and minerals designed to support digestion. The enzymes include amylase (breaks down carbohydrates), papain and bromelain (protein-digesting enzymes from papaya and pineapple), protease (another protein enzyme), lipase (breaks down fats), pepsin (stomach enzyme), and cellulase (breaks down plant fiber).
You'll also get calcium, phosphorus, betaine hydrochloride (an acidifying agent), and ox bile powder (aids fat digestion). The tablet or pill contains inactive ingredients like microcrystalline cellulose, magnesium stearate, and silicon dioxide—standard binders and flow agents.
Does it work?
Strong evidence
The evidence for most ingredients in this product isn't well established in the data we hold. Papain, bromelain, protease, lipase, and betaine HCl all show insufficient reliable evidence for the conditions they're commonly used for—including digestive complaints, muscle soreness, and various infections.
Calcium is an exception: it's rated effective for treating low blood calcium and likely effective for osteoporosis, though that's about bone health rather than digestion. Without solid evidence for how these enzymes work in supplement form for typical digestive support, it's hard to say whether this blend lives up to marketing claims.
How safe is it?
Well-documented data
The enzymes in this product are generally well tolerated at normal doses, but allergic reactions are possible—papain and bromelain can cause itching, hives, and in sensitive people, respiratory symptoms from exposure to airborne dust. Very high doses of papain carry rare risks of severe stomach inflammation or perforation.
Betaine HCl may irritate the stomach and isn't safe for anyone with ulcers or active gastritis. Calcium at recommended doses is safe in pregnancy and breastfeeding, but the safety data on supplemental papain, bromelain, protease, lipase, pepsin, and betaine HCl during pregnancy and breastfeeding is limited or insufficient—talk with your doctor or pharmacist before taking this product if you're pregnant or nursing.
No adverse effects have been reported in adults for lipase, though safety hasn't been thoroughly evaluated.
Meds to double-check
Major interaction found
Check before taking if you're on dolutegravir, elvitegravir, or intravenous ceftriaxone (Major interaction with calcium). Also flag any use of other HIV drugs, levothyroxine (thyroid), blood thinners including warfarin, heart medications like sotalol or diltiazem, tetracycline antibiotics, or acid-reducing drugs (H2-blockers, antacids, PPIs).
These Moderate and Minor interactions mean your medications or the supplement could be less effective—your doctor or pharmacist may need to adjust timing or doses.
The bottom line
Scorecard at a glanceFormula with limited ingredient disclosure with clinical evidence supporting its stated purpose. Major medication interactions have been identified, and safety information is well characterized.
This is a multi-enzyme supplement aimed at digestive support, but the evidence that these enzymes work as advertised isn't solid. More importantly, it contains calcium and betaine HCl, both of which can interfere with several common medications—including HIV drugs, thyroid meds, blood thinners, and acid-reducing medications.
If you take any prescription medications, run them through the tool on this page, or talk with your doctor or pharmacist before starting. If you're pregnant or nursing, check with your healthcare provider first.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 9 of 14 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Feb 25, 2019.
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 Multi-Enzyme, straight from the product label.
| Brand | The Vitamin Shoppe |
|---|---|
| Barcode (UPC) | 766536021758 |
| Net contents | 600 Tablet(s) |
| Market status | On market |
| Date entered into DSLD | Feb 25, 2019 |
| DSLD ID | 184361 |
| Product type | Other Combinations |
| Supplement form | Tablet Or Pill |
| Dietary claims / uses | All Other, Structure/Function |
| Intended target group(s) | Adult (18 - 50 Years), Gluten Free |
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.
Supplement Facts
The label details for Multi-Enzyme by The Vitamin Shoppe, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Amylase | 0 NP | -- |
| Papain | 0 NP | -- |
| Bromelain | 0 NP | -- |
| Protease | 0 NP | -- |
| Lipase | 0 NP | -- |
| Calcium | 200 mg | 15% |
| Phosphorus | 156 mg | 12% |
| Betaine HCl | 400 mg | -- |
| Amylase | 0 NP | -- |
| Protease | 0 NP | -- |
| Lipase | 0 NP | -- |
| Pepsin | 100 mg | -- |
| Cellulase | 0 NP | -- |
| Ox Bile powder | 30 mg | -- |
| Pancreatin | 100 mg | -- |
Other ingredients: Microcrystalline Cellulose, Stearic Acid, Croscarmellose Sodium, Magnesium Stearate, Silicon Dioxide, Aqueous Coating, natural Peppermint flavor
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.
General Statements
Specialty
Protein Carbohydrate Fat digestion
Visit www.vitaminshoppe.com or call 1-800-223-1216 for more information and to reorder.
FDA Statement of Identity
Dietary Supplement
Formulation
Gluten free Soy free Nut free
Does not contain: Gluten, Artificial Colors or Flavors
Formula
Contains: Milk.
Precautions
Contains: Milk.
Do not take on an empty stomach.
Warning: Consult your healthcare provider prior to use if you are pregnant, nursing, taking any medication or have any medical conditions.
Keep out of reach of children.
Tamper evident Do not use if outer seal is broken or missing.
Suggested/Recommended/Usage/Directions
Directions: Take two (2) tablets after each meal. Do not take on an empty stomach.
FDA Disclaimer Statement
These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.
Storage
Store in a cool, dry place.
General
Item No. VS-2175 1307284 FS 37
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Multi-Enzyme by The Vitamin Shoppe 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 Multi-Enzyme by The Vitamin Shoppe
These are the 14 active ingredients this product is made of. Select any to open its full monograph.
Serving size2 Tablet(s) Dosage formTablet Or Pill Servings per container300 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.
Papain
Interacts with2 drugs
Papain is a protein-digesting enzyme from the papaya plant that is used in digestive supplements and some topical products. While it has clear food an...
Papain monograph & interactionsBromelain
Interacts with141 drugs
Bromelain is a group of protein-digesting enzymes from pineapple that people take mainly for inflammation, swelling, and sinus problems. Some early st...
Bromelain monograph & interactionsCalcium
Interacts with168 drugs
Calcium is an essential mineral your body needs for strong bones, nerve signaling, and muscle function, and supplements can help fill gaps when diet f...
Calcium monograph & interactionsPhosphorus
Betaine HCl
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 HCl 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 & 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 & interactionsCellulase
Ox Bile powder
Other (inactive) ingredients: Microcrystalline Cellulose, Stearic Acid, Croscarmellose Sodium, Magnesium Stearate, Silicon Dioxide, Aqueous Coating, Natural Peppermint flavor. These complete the product’s ingredient list but are not active constituents.
Multi-Enzyme by The Vitamin Shoppe Drug Interactions
HelloPharmacist Interaction Report
Multi-Enzyme by The Vitamin Shoppe interacts with medications through its calcium, papain, bromelain, and betaine HCl content.
The most serious interaction is calcium with HIV integrase inhibitors (dolutegravir and elvitegravir) and the antibiotic ceftriaxone — all rated Major severity. Calcium can reduce blood levels of these drugs by up to 40%, potentially lowering their effectiveness, or in ceftriaxone's case, cause dangerous precipitation in the lungs and kidneys if given intravenously.
Read the full breakdown — every affected drug type, severity by severity
Calcium also has Moderate-severity interactions with other HIV drugs (raltegravir), thyroid medication (levothyroxine), heart drugs (sotalol and diltiazem), a psoriasis treatment (calcipotriene), and topical vitamin D products. Papain may increase the blood-thinning effects of warfarin.
Bromelain may raise bleeding risk if taken with blood thinners or antiplatelet drugs, and theoretically may increase levels of tetracycline antibiotics. Betaine HCl may reduce the effect of acid-reducing medications — H2-blockers, antacids, and proton pump inhibitors.
Protease, lipase, pepsin, amylase (appears twice), phosphorus, and ox bile powder either have no documented interactions or could not be checked against our data. Altogether, these interactions span 307 individual medications.
Check your exact medications with the search tool on this page before starting the product.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against Multi-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 Multi-Enzyme interact with 307 drugs. Click any drug to see the details.
4 of the 14 ingredients in Multi-Enzyme interact with drugs. Each result below shows which ingredient is responsible. Calcium Bromelain Betaine HCl Papain
AbciximabReoPro
How Abciximab interacts with Multi-Enzyme — through 1 ingredient. Tap an ingredient for the detail:
BromelainAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Bromelain may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Bromelain + Abciximab interactionAbrocitinibCibinqo
How Abrocitinib interacts with Multi-Enzyme — through 1 ingredient. Tap an ingredient for the detail:
BromelainAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Bromelain may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Bromelain + Abrocitinib interactionAcenocoumarolSintrom
How Acenocoumarol interacts with Multi-Enzyme — through 1 ingredient. Tap an ingredient for the detail:
BromelainAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Bromelain may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Bromelain + Acenocoumarol interactionAcetaminophen, AspirinGemnisyn
How Acetaminophen, Aspirin interacts with Multi-Enzyme — through 1 ingredient. Tap an ingredient for the detail:
BromelainAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Bromelain may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Bromelain + Acetaminophen, Aspirin interactionAcetaminophen, Aspirin, CaffeineExcedrin, Excedrin Extra Strength, Excedrin Migraine
How Acetaminophen, Aspirin, Caffeine interacts with Multi-Enzyme — through 1 ingredient. Tap an ingredient for the detail:
BromelainAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Bromelain may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Bromelain + Acetaminophen, Aspirin, Caffeine interactionAcetaminophen, IbuprofenCombogesic
How Acetaminophen, Ibuprofen interacts with Multi-Enzyme — through 1 ingredient. Tap an ingredient for the detail:
BromelainAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Bromelain may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Bromelain + Acetaminophen, Ibuprofen interactionAcetylsalicylic AcidEntrophen
How Acetylsalicylic Acid interacts with Multi-Enzyme — through 1 ingredient. Tap an ingredient for the detail:
BromelainAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Bromelain may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Bromelain + Acetylsalicylic Acid interactionAlendronateBinosto, Fosamax
How Alendronate interacts with Multi-Enzyme — through 1 ingredient. Tap an ingredient for the detail:
CalciumBisphosphonates Moderate
Interaction Summary
Calcium reduces the absorption of bisphosphonates.
Read the full Calcium + Alendronate interactionAlendronate Sodium
How Alendronate Sodium interacts with Multi-Enzyme — through 1 ingredient. Tap an ingredient for the detail:
CalciumBisphosphonates Moderate
Interaction Summary
Calcium reduces the absorption of bisphosphonates.
Read the full Calcium + Alendronate Sodium interactionAlendronate Sodium, CholecalciferolFosamax Plus D
How Alendronate Sodium, Cholecalciferol interacts with Multi-Enzyme — through 1 ingredient. Tap an ingredient for the detail:
CalciumBisphosphonates Moderate
Interaction Summary
Calcium reduces the absorption of bisphosphonates.
Read the full Calcium + Alendronate Sodium, Cholecalciferol interactionAlginic Acid, Aluminum HydroxideRafton
How Alginic Acid, Aluminum Hydroxide interacts with Multi-Enzyme — through 2 ingredients. Tap an ingredient for the detail:
CalciumAluminum Moderate
Interaction Summary
Calcium citrate might increase aluminum absorption and toxicity.
Read the full Calcium + Alginic Acid, Aluminum Hydroxide interactionBetaine HclAntacids Minor
Interaction Summary
Betaine hydrochloride increases stomach acidity and could decrease the effects of antacids.
Read the full Betaine Hcl + Alginic Acid, Aluminum Hydroxide interactionAlteplase, TpaActilyse, Activase
How Alteplase, Tpa interacts with Multi-Enzyme — through 1 ingredient. Tap an ingredient for the detail:
BromelainAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Bromelain may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Bromelain + Alteplase, Tpa interactionAluminum Acetate, Benzethonium ChlorideBuro-Sol Otic Solution
How Aluminum Acetate, Benzethonium Chloride interacts with Multi-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 + Aluminum Acetate, Benzethonium Chloride interactionAluminum ChlorideAluminum Chloride, Anhydrol Forte, Driclor, Drysol
How Aluminum Chloride interacts with Multi-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 + Aluminum Chloride interactionAluminum HydroxideAlu-Cap, Amphojel, Gaviscon
How Aluminum Hydroxide interacts with Multi-Enzyme — through 2 ingredients. Tap an ingredient for the detail:
CalciumAluminum Moderate
Interaction Summary
Calcium citrate might increase aluminum absorption and toxicity.
Read the full Calcium + Aluminum Hydroxide interactionBetaine HclAntacids Minor
Interaction Summary
Betaine hydrochloride increases stomach acidity and could decrease the effects of antacids.
Read the full Betaine Hcl + Aluminum Hydroxide interactionAluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium HydroxideAscriptin Codeine #2
How Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide interacts with Multi-Enzyme — through 3 ingredients. Tap an ingredient for the detail:
CalciumAluminum Moderate
Interaction Summary
Calcium citrate might increase aluminum absorption and toxicity.
Read the full Calcium + Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide interactionBromelainAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Bromelain may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Bromelain + Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide interactionBetaine HclAntacids Minor
Interaction Summary
Betaine hydrochloride increases stomach acidity and could decrease the effects of antacids.
Read the full Betaine Hcl + Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide interactionAluminum Hydroxide, Aspirin, Magnesium HydroxideAscriptin
How Aluminum Hydroxide, Aspirin, Magnesium Hydroxide interacts with Multi-Enzyme — through 3 ingredients. Tap an ingredient for the detail:
BromelainAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Bromelain may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Bromelain + Aluminum Hydroxide, Aspirin, Magnesium Hydroxide interactionCalciumAluminum Moderate
Interaction Summary
Calcium citrate might increase aluminum absorption and toxicity.
Read the full Calcium + Aluminum Hydroxide, Aspirin, Magnesium Hydroxide interactionBetaine HclAntacids Minor
Interaction Summary
Betaine hydrochloride increases stomach acidity and could decrease the effects of antacids.
Read the full Betaine Hcl + Aluminum Hydroxide, Aspirin, Magnesium Hydroxide interactionAluminum Hydroxide, Magnesium Hydroxide (otc Drug)Maalox, Mucogel
How Aluminum Hydroxide, Magnesium Hydroxide (otc Drug) interacts with Multi-Enzyme — through 2 ingredients. Tap an ingredient for the detail:
CalciumAluminum Moderate
Interaction Summary
Calcium citrate might increase aluminum absorption and toxicity.
Read the full Calcium + Aluminum Hydroxide, Magnesium Hydroxide (otc Drug) interactionBetaine HclAntacids Minor
Interaction Summary
Betaine hydrochloride increases stomach acidity and could decrease the effects of antacids.
Read the full Betaine Hcl + Aluminum Hydroxide, Magnesium Hydroxide (otc Drug) interactionAluminum Hydroxide, Magnesium Hydroxide, Simethicone (otc Drug)Mylanta
How Aluminum Hydroxide, Magnesium Hydroxide, Simethicone (otc Drug) interacts with Multi-Enzyme — through 2 ingredients. Tap an ingredient for the detail:
CalciumAluminum Moderate
Interaction Summary
Calcium citrate might increase aluminum absorption and toxicity.
Read the full Calcium + Aluminum Hydroxide, Magnesium Hydroxide, Simethicone (otc Drug) interactionBetaine HclAntacids Minor
Interaction Summary
Betaine hydrochloride increases stomach acidity and could decrease the effects of antacids.
Read the full Betaine Hcl + Aluminum Hydroxide, Magnesium Hydroxide, Simethicone (otc Drug) interactionAluminum, CalciumDomeboro
How Aluminum, Calcium interacts with Multi-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 + Aluminum, Calcium interactionAluminum, Magnesium (otc Drug)Almagel
How Aluminum, Magnesium (otc Drug) interacts with Multi-Enzyme — through 2 ingredients. Tap an ingredient for the detail:
CalciumAluminum Moderate
Interaction Summary
Calcium citrate might increase aluminum absorption and toxicity.
Read the full Calcium + Aluminum, Magnesium (otc Drug) interactionBetaine HclAntacids Minor
Interaction Summary
Betaine hydrochloride increases stomach acidity and could decrease the effects of antacids.
Read the full Betaine Hcl + Aluminum, Magnesium (otc Drug) interactionAluminum, Magnesium Hydroxide (otc Drug)Wingel
How Aluminum, Magnesium Hydroxide (otc Drug) interacts with Multi-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 + Aluminum, Magnesium Hydroxide (otc Drug) interactionAmiloride, HydrochlorothiazideAmil-Co, Amilzide, Moduret 25, Moduretic
How Amiloride, Hydrochlorothiazide interacts with Multi-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 + Amiloride, Hydrochlorothiazide interactionAmphotericin, TetracyclineMysteclin-F
How Amphotericin, Tetracycline interacts with Multi-Enzyme — through 2 ingredients. Tap an ingredient for the detail:
CalciumTetracycline Antibiotics Moderate
Interaction Summary
Calcium seems to reduce the absorption of tetracycline antibiotics.
Read the full Calcium + Amphotericin, Tetracycline interactionBromelainTetracycline Antibiotics Minor
Interaction Summary
Theoretically, bromelain might increase levels of tetracycline antibiotics.
Read the full Bromelain + Amphotericin, Tetracycline interactionAnacaulase-bcdbNexoBrid
How Anacaulase-bcdb interacts with Multi-Enzyme — through 1 ingredient. Tap an ingredient for the detail:
BromelainAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Bromelain may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Bromelain + Anacaulase-bcdb interactionAnagrelideAgrylin
How Anagrelide interacts with Multi-Enzyme — through 1 ingredient. Tap an ingredient for the detail:
BromelainAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Bromelain may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Bromelain + Anagrelide interactionAnisindioneMiradon
How Anisindione interacts with Multi-Enzyme — through 1 ingredient. Tap an ingredient for the detail:
BromelainAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Bromelain may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Bromelain + Anisindione interactionAntithrombin IiiThrombate III
How Antithrombin Iii interacts with Multi-Enzyme — through 1 ingredient. Tap an ingredient for the detail:
BromelainAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Bromelain may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Bromelain + Antithrombin Iii interactionApixabanEliquis
How Apixaban interacts with Multi-Enzyme — through 1 ingredient. Tap an ingredient for the detail:
BromelainAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Bromelain may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Bromelain + Apixaban interactionArgatrobanArgatroban
How Argatroban interacts with Multi-Enzyme — through 1 ingredient. Tap an ingredient for the detail:
BromelainAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Bromelain may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Bromelain + Argatroban interactionEach ingredient & the kinds of drugs it affects
For each ingredient in Multi-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.
Bromelain
Anticoagulant/Antiplatelet Drugs
Bromelain may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
There is one case report of a patient experiencing minor bruising while taking bromelain with naproxen. Bromelain is thought to have antiplatelet activity. Whether this interaction is of concern with topical bromelain is unclear. Interference with coagulation of burn wounds has been reported in a patient receiving bromelain-based enzymatic debridement. However, observational research has found that topical bromelain debridement is not associated with increases or decreases in laboratory markers of coagulation when compared with surgical debridement.
Tetracycline Antibiotics
Theoretically, bromelain might increase levels of tetracycline antibiotics.
Laboratory research suggests that bromelain might increase the absorption of tetracycline antibiotics. However, a study in healthy adults reported no difference in tetracycline plasma levels when a 500 mg dose was taken with or without bromelain 80 mg.
Betaine HCl
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
Papain
Warfarin (Coumadin)
Theoretically, papain might increase the effects and side effects of warfarin.
In one case report, a patient previously stable on warfarin was found to have an international normalization ratio (INR) of 7.4, which was attributed to ingestion of a supplement containing papain from papaya extract.
Brand information
Manufacturer and brand details for Multi-Enzyme, from the product label.
The Vitamin Shoppe
See all The Vitamin Shoppe products- Name
- Vitamin Shoppe, Inc.
- City
- Secaucus
- State
- NJ
- ZipCode
- 07094
- Phone Number
- 1-800-223-1216
- Web Address
- www.vitaminshoppe.com
Multi-Enzyme by The Vitamin Shoppe: Common Questions
Does Multi-Enzyme by The Vitamin Shoppe interact with any medications?
How can one product interact with so many drugs?
Where does this information come from?
Can I take this if I'm on levothyroxine for my thyroid?
Is this safe if I'm pregnant?
Does this product actually help with digestion?
Can I take this with my acid reflux medication?
What's papain, and why is it in here?
I'm allergic to pineapple—should I avoid this?
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 Multi-Enzyme’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Papain
Interacts with 2 drugsPapain is a protein-digesting enzyme from the papaya plant that is used in digestive supplements and some topical products. While it has clear food and laboratory uses, strong human evidence...
Read the full Papain monograph → Herb & supplement monographBromelain
Interacts with 141 drugsBromelain is a group of protein-digesting enzymes from pineapple that people take mainly for inflammation, swelling, and sinus problems. Some early studies are promising, but the overall evi...
Read the full Bromelain monograph → Herb & supplement monographCalcium
Interacts with 168 drugsCalcium is an essential mineral your body needs for strong bones, nerve signaling, and muscle function, and supplements can help fill gaps when diet falls short. Most people do best getting...
Read the full Calcium monograph → Herb & supplement 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 → 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 →Sources & How We Checked
Multi-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 98 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.
Papain 11 references
- The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999.
- Shaw D, Leon C, Kolev S, Murray V. Traditional remedies and food supplements: a 5-year toxicological study (1991-1995). Drug Saf 1997;17:342-56.
- Shuttleworth D, Hill S, Marks R, Connelly DM. Relief of experimentally induced pruritus with a novel eutectic mixture of local anaesthetic agents. Br J Dermatol 1988;119:535-40.
- Mansfield LE, Ting S, Haverly RW, Yoo TJ. The incidence and clinical implications of hypersensitivity to papain in an allergic population, confirmed by blinded oral challenge. Ann Allergy 1985;55:541-3.
- Martin, T., Uhder, K., Kurek, R., Roeddiger, S., Schneider, L., Vogt, H. G., Heyd, R., and Zamboglou, N. Does prophylactic treatment with proteolytic enzymes reduce acute toxicity of adjuvant pelvic irradiation? Results of a double-blind randomized trial PubMed
- Walker-Renard, P. Update on the medicinal management of phytobezoars. Am J Gastroenterol. 1993;88(10):1663-1666.
- Tymoszuk D, Wiszniewska M, Walusiak-Skorupa J. Papain-induced occupational rhinoconjunctivitis and asthma - A case report. Med Pr 2016;67(1):109-12. PubMed
- Soto-Mera MT, López-Rico MR, Filgueira JF, et al. Occupational allergy to papain. Allergy 2000;55(10):983-4. PubMed
- Tarlo SM, Shaikh W, Bell B, et al. Papain-induced allergic reactions. Clin Allergy 1978;8(3):207-15. PubMed
- Baur X, König G, Bencze K, Fruhmann G. Clinical symptoms and results of skin test, RAST and bronchial provocation test in thirty-three papain workers: Evidence for strong immunogenic potency and clinically relevant proteolytic e?ects of airborne papain. C
- Novey HS, Keenan WJ, Fairshter RD, Wells ID, Wilson AF, Culver BD. Pulmonary disease in workers exposed to papain: clinico-physiological and immunological studies. Clin Allergy 1980;10(6):721-31. PubMed
Bromelain 19 references
- Nettis E, Napoli G, Ferrannini A, Tursi A. IgE-mediated allergy to bromelain. Allergy 2001;56:257-8. PubMed
- Taussig SJ, Batkin S. Bromelain, the enzyme complex of pineapple (Ananas comosus) and its clinical application. An update. J Ethnopharmacol 1988;22:191-203.. PubMed
- Bradbrook ID, Morrison PJ, Rogers HJ. The effect of bromelain on the absorption of orally administered tetracycline. Br J Clin Pharmacol 1978;6:552-4. PubMed
- Bush TM, Rayburn KS, Holloway SW, et al. Adverse interactions between herbal and dietary substances and prescription medications: a clinical survey. Altern Ther Health Med 2007;13:30-5.
- Brien S, Lewith G, Walker AF, et al. Bromelain as an adjunctive treatment for moderate-to-severe osteoarthritis of the knee: a randomized placebo-controlled pilot study. QJM 2006;99:841-50. PubMed
- Mori S, Ojima Y, Hirose T, et al. The clinical effect of proteolytic enzyme containing bromelain and trypsin on urinary tract infection evaluated by double blind method. Acta Obstet Gynaecol Jpn 1972;19:147-53.
- Glaser D, Hilberg T. The influence of bromelain on platelet count and platelet activity in vitro. Platelets 2006;17:37-41. PubMed
- Heinicke R M, van der Wal L, Yokoyama M. Effect of bromelain (Ananase) on human platelet aggregation. Experientia 1972;28:844-5. PubMed
- Gailhofer, G., Wilders-Truschnig, M., Smolle, J., and Ludvan, M. Asthma caused by bromelain: an occupational allergy. Clin Allergy 1988;18(5):445-450. PubMed
- Mattei, O., Fabri, G., and Farina, G. [Occupational health experience regarding four cases of asthma due to bromelain (author's transl)]. Medicina del Lavoro 1979;70(5):404-409.
- Galleguillos, F. and Rodriguez, J. C. Asthma caused by bromelin inhalation. Clin Allergy 1978;8(1):21-24. PubMed
- Perez-Camo I, Quirce S, Duran MA, and et al. Latex allergy: evidence of cross-reactivity with papain and bromelain [abstract]. Allergy 1996;51(suppl 31):48.
- Martin GJ, Ehrenreich J, and Asbell N. Bromelain: pineapple proteases with anti-edema activity. Exp Med Surg 1962;20:227-247.
- Kasemsuk T, Saengpetch N, Sibmooh N, Unchern S. Improved WOMAC score following 16-week treatment with bromelain for knee osteoarthritis. Clin Rheumatol. 2016 Oct;35(10):2531-40. PubMed
- Kutlu Ö, DemirbaS A, Elmas ÖF, Güvenç U, Metin A. Fixed drug eruption: a new side effect of bromelain. Contact Dermatitis 2020. Online ahead of print. PubMed
- Shoham Y, Shapira E, Haik J, et al. Bromelain-based enzymatic debridement of chronic wounds: Results of a multicentre randomized controlled trial. Wound Repair Regen 2021;29(6):899-907. PubMed
- Pfister P, Garcia Wendel PD, Kim BS, et al. Coagulation side effects of enzymatic debridement in burned patients. Burns 2022. PubMed
- Hasham S, Riyat H, Fletcher A, O'Boyle CP, Alexander S. To bleed or not to bleed? Case series and discussion of haemorrhage risk with enzymatic debridement in burn injuries. Scars Burn Heal 2023;9:20595131231168333. PubMed
- Leelakanok N, Petchsomrit A, Janurai T, Saechan C, Sunsandee N. Efficacy and safety of bromelain: A systematic review and meta-analysis. Nutr Health 2023. PubMed
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
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
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- 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
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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