Major interaction on record — check this product against your medications before combining. Based on 5 of 7 ingredients. Check your meds →
Dietary supplement

NIOX Maximum Impact Ingredients & Drug Interactions

by Nutrex Research

NIOX Maximum Impact label
See full label image
Capsule Category: Other Combinations
Most serious interaction: Major
Clinical methodology reviewed by · Updated Sep 23, 2026 · Label data from the NIH DSLD
What is this page for?

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

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

The interaction bottom line Most serious interaction: Major

NIOX Maximum Impact is a dietary supplement by Nutrex Research with 7 active ingredients. Its ingredients are commonly taken for constipation (laxative), dry skin (moisturizer), dry, irritated eyes.Based on those ingredients, 538 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are L-Arginine Ethyl Ester Dichloride, R+Lipoic Acid, Dibasic Calcium Phosphate. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

Jump to a section

Check Your Meds Against NIOX Maximum Impact by Nutrex Research

Ask about any prescription or over-the-counter medication and we check it for interactions with NIOX Maximum Impact by Nutrex Research — and tell you which ingredient is responsible.

Pharmacist-reviewed data Checks every ingredient Answer in seconds
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HelloPharmacist Scorecard of NIOX Maximum Impact by Nutrex Research

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

From our pharmacy team — supplement deep dive

Generated from HelloPharmacist’s pharmacist-curated databases and editorial rules · Last generated Aug 27, 2026

What’s inside

Low disclosure
Ingredient Transparency · database check
Low

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

Why this rating?
  • The label discloses an exact amount for 0 of its 7 active ingredients.
  • “Liquid NIOX Muscle & Pump Formula” is a proprietary blend — the label gives one combined amount (4,000 mg) without saying how much of each component you get.

NIOX Maximum Impact contains 7 ingredients. The active components are Glycerol (an osmotic agent), CarnoSyn, a branded form of beta-alanine (an amino acid), L-Norvaline, Dibasic Calcium Phosphate (a source of calcium), L-Arginine Ethyl Ester Dichloride (an amino acid), Rutaecarpine, and R+Lipoic Acid (also called alpha-lipoic acid).

The product also contains inactive ingredients: vegetable cellulose, purified water, and polysorbate 80.

Does it work?

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

Some clinical evidence supports this product's ingredients for its stated purpose, but it isn't conclusive.

Why this rating?
  • The label markets this product for: muscle pump and athletic performance support.
  • We looked for evidence on: Athletic performance, Exercise-induced muscle damage, Exercise-induced muscle breakdown, Muscle strength, Blood flow, Endurance — and 1 related terms.
  • The strongest evidence on file: Glycerol is rated "Possibly Effective" for Athletic performance (Natural Medicines).
  • Also on file: Beta-alanine is rated "Possibly Effective" for Athletic performance.
  • Also on file: Alpha-lipoic Acid is rated "Insufficient Reliable Evidence To Rate" for Muscle strength.

The evidence for this product's ingredients varies. Glycerol is likely effective for constipation and possibly effective for athletic performance, though it's possibly ineffective for meningitis and stroke.

Beta-alanine (CarnoSyn) is possibly effective for athletic and physical performance but has insufficient evidence for cognitive function, COPD, or menopausal symptoms. Alpha-Lipoic Acid is possibly effective for diabetic nerve pain (neuropathy), high cholesterol, and obesity.

Calcium is effective for kidney failure, indigestion, low blood calcium, and high potassium levels, and is likely effective for osteoporosis. L-Arginine has no effectiveness ratings in our data.

We hold no effectiveness data for L-Norvaline or Rutaecarpine.

The evidence, ingredient by ingredient Glycerol Beta-alanine Calcium L-arginine Alpha-lipoic Acid

How safe is it?

Well-documented data
Safety Information · database check
Well characterized

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

Why this rating?
  • We hold adverse-effect (side-effect) data for 5 of the 5 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 5 of 5.
  • General safety write-ups exist for 5 of 5.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

Most ingredients are generally well tolerated at normal doses. Glycerol can cause bloating, diarrhea, nausea, vomiting, dizziness, and headache orally, and stomach upset and dehydration with large doses.

Beta-alanine commonly causes a harmless tingling sensation (paresthesia) and flushing, usually starting on the scalp within 20 minutes and lasting about an hour — this is dose-dependent and mild at lower doses. Calcium can cause belching, constipation, diarrhea, gas, and stomach upset; very high doses raise theoretical concerns about kidney stones and prostate cancer risk.

L-Arginine can lower blood pressure and may cause abdominal pain, bloating, nausea, diarrhea, headache, insomnia, and flushing; it's best used under medical supervision. Alpha-Lipoic Acid may lower blood sugar and commonly causes headache, heartburn, nausea, and vomiting.

Pregnancy and breastfeeding: beta-alanine and alpha-lipoic acid are best avoided due to insufficient safety data; calcium is likely safe in pregnancy and lactation at recommended amounts; glycerol and L-Arginine have limited or conflicting data — talk with your doctor or pharmacist.

Side effects, ingredient by ingredient Glycerol Beta-alanine Calcium L-arginine Alpha-lipoic Acid

Meds to double-check

Major interaction found
Known Interaction Concern · database check
Major identified

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

Why this rating?
  • 3 of the 5 matched ingredients can interact with medications — Alpha-lipoic Acid, Calcium, L-arginine.
  • The most serious interaction on file is rated Major.
  • Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs; cancer treatments; diabetes medications; heart-rhythm medications; lithium.
  • For scale: 538 individual medications appear in the full list. A big number alone doesn't make a product dangerous — what matters is whether YOUR medication is on it, so run yours through the interaction checker on this page.

If you take any of these, run your exact medication list through the interaction checker on this page first: HIV integrase inhibitors (dolutegravir, elvitegravir, raltegravir), thyroid hormone (levothyroxine), heart rhythm or blood pressure drugs (sotalol, diltiazem, antihypertensives, ACE inhibitors, angiotensin receptor blockers), blood thinners (anticoagulants and antiplatelet drugs), potassium-sparing diuretics, diabetes medications, chemotherapy (alkylating agents and antitumor antibiotics), sildenafil, or the antibiotic ceftriaxone. No interactions are documented for the ingredients we could check glycerol and beta-alanine, but that's not a guarantee none exist.

Check your own medication Run your meds through the checker above

The bottom line

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

NIOX Maximum Impact is designed for athletic performance and muscle support, with beta-alanine and glycerol as the primary active components. It's not appropriate if you take HIV integrase inhibitors, ceftriaxone, thyroid hormone, blood thinners, diabetes medications, blood pressure medications, or certain chemotherapy drugs without checking your exact medications first.

Before starting, talk with your doctor or pharmacist about whether this product fits your medications and health.

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

Assessment coverage: 5 of 7 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Mar 25, 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

At a glance

General information

Key facts about NIOX Maximum Impact, straight from the product label.

Brand Nutrex Research
Barcode (UPC) 853237000349
Net contents 180 Fast Absorbing Liqui-Cap(s)
Market status On market
Date entered into DSLD Mar 25, 2014
DSLD ID 30235
Product type Other Combinations
Supplement form Capsule
Dietary claims / uses All Other, Structure/Function
Intended target group(s) Adult (18 - 50 Years)
From the label
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.

Supplement Facts

The label details for NIOX Maximum Impact by Nutrex Research, sourced from the NIH Dietary Supplement Label Database.

Supplement Facts

Daily Value (DV) Target Group(s):
Adults and children 4 or more years of age
Minimum serving Sizes:
4 Fast Absorbing Liqui-Cap(s)
Maximum serving Sizes:
4 Fast Absorbing Liqui-Cap(s)
Servings per container
45
UPC/BARCODE
853237000349
IngredientAmount% DV
Glycerol0 Not Present--
CarnoSyn0 Not Present--
L-Norvaline0 Not Present--
Dibasic Calcium Phosphate0 Not Present--
L-Arginine Ethyl Ester Dichloride0 Not Present--
Rutaecarpine 98%0 Not Present--
Liquid NIOX Muscle & Pump Formula4000 mg--
R+Lipoic Acid0 Not Present--

Other ingredients: Vegetable Cellulose, purified Water, Polysorbate 80

Tap any ingredient to jump to its full detail below.

Label statements
These statements are the manufacturer’s wording, reproduced from the product label — the label is saying it, not HelloPharmacist. We don’t verify or endorse them.
Seals/Symbols

Fast-Absorbing Liqui-Cap

General

LBL-NIOX-180CT-V2-US

General Statements

FAST-ABSORBING LIQUID CAPSULE TECHNOLOGY

~Swells Muscles with Super-Pump Effect ~Liquid Capsules for Powerful Results ~Superior Nitric Oxide Formula

As individuals vary so will results from using this product.

Superior Absorption: Getting results from Nitric Oxide products is a simple matter of how much of the formula your body can absorb and utilize. Tablets, regular capsules and powders are all known as slow and less effective. It takes your body a longer time to break down those preparations. Worse yet, part of the active ingredients may not be used at all. You get some results but nowhere near as good as they truly could be. Using our modern, fast-absorbing liquid capsule technology eliminates these roadblocks. Pre-dissolved and already liquefied Nitric Oxide boosting molecules rapidly enter your blood stream intact and and are ready for action.

Better & Faster Results: Through the above described process NIOX quickly shuttles several thousand milligrams of Nitric Oxide generating Arginine Ethyl Ester into your bloodstream. Fortified with a precise ratio of Nitric Oxide supporting compounds such as R+Lipoic Acid, real Beta Alanine, hight potency Rutaecarpine and L-Norvaline, results come rapidly. NIOX supports your drive for bigger, fuller and rounder muscles covered with road-map veins.

More Precise Timing: You take NIOX and within minutes it does what you want it to do. Your body starts absorbing it. This allows for more precise timing. Take NIOX before you start working out and its already liquefied Nitric Oxide boosting molecules will quickly go to work. More blood, nutrients and oxygen are being pushed into your muscles. Combined with high-intensity resistance training the ensuing muscle pump, blood engorged vascularity and muscle fullness will be dramatic.

FAST-ABSORBING NITRIC OXIDE MUSCLE & PUMP FORMULA

FAST-ABSORBING LIQUID CAPSULE TECHNOLOGY NIOX is a modern and fast-acting Nitric Oxide muscle and pump formula. by utilizing fast-absorbing liquid capsules NIOX delivers results rapidly.

Nitric Oxide Stimulator

Brand IP Statement(s)

Natural Alternatives International (NAI) is the owner or patents 5,965,596, 6,172,098, 6,426,361, 6,680,294 and registered trademark CarnoSyn(R).

Suggested/Recommended/Usage/Directions

RECOMMENDED USE: See "Suggested Dosing Protocol". For optimum results use NOIX every day. Stay well hydrated. Always take NIOX appro. 30 minutes before a meal or workout.

SUGGESTED DOSING PROTOCOL Up to 200lbs 4 Fast-Absorbing Liqui-Caps Per Day Take 4 Liqui-Caps with 10 oz. of water 30 minutes before a meal. On training days take your serving 30 minutes before working out. Over 200lbs. 8 Fast-Absorbing Liqui-Caps Per Day Take 4 Liqui-Caps with 10 oz. of water 30 minutes before breakfast and repeat 30 minutes before dinner. On training days take one of your daily servings 30 minutes before working out.

Precautions

WARNING: Do not use if you are pregnant or nursing.

KEEP OUT OF REACH OF CHILDREN.

FDA Disclaimer Statement

The statements on this label have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.

FDA Statement of Identity

Dietary Supplement

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

See for yourself

NIOX Maximum Impact by Nutrex Research label

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

NIOX Maximum Impact label

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

View the full label (PDF)
What’s inside

The Ingredients in NIOX Maximum Impact by Nutrex Research

These are the 7 active ingredients this product is made of. Select any to open its full monograph.

Serving size4 Fast Absorbing Liqui-Cap(s) Dosage formCapsule Servings per container45 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.

Liquid NIOX Muscle & Pump Formula

4000 mg per serving

Other (inactive) ingredients: Vegetable Cellulose, Purified Water, Polysorbate 80. These complete the product’s ingredient list but are not active constituents.

Interaction report

NIOX Maximum Impact by Nutrex Research Drug Interactions

Want to check YOUR meds against NIOX Maximum Impact?

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

 Go to the checker
538Drugs
7 Major 522 Moderate 9 Minor

Ingredients driving the most interactions

L-Arginine Ethyl Ester Dichloride 403
R+Lipoic Acid 263
Dibasic Calcium Phosphate 168

Individual Drug Interactions

The ingredients in NIOX Maximum Impact interact with 538 drugs. Click any drug to see the details.

3 of the 7 ingredients in NIOX Maximum Impact interact with drugs. Each result below shows which ingredient is responsible. L-Arginine Ethyl Ester Dichloride R+Lipoic Acid Dibasic Calcium Phosphate

Each ingredient & the kinds of drugs it affects

For each ingredient in NIOX Maximum Impact 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.

L-Arginine Ethyl Ester Dichloride9 drug types · 403 drugs

Ace Inhibitors (Aceis)

Theoretically, concomitant use of L-arginine and ACE inhibitors may increase the risk for hypotension and hyperkalemia.
Combining L-arginine with some antihypertensive drugs, especially ACE inhibitors, seems to have additive vasodilating and blood pressure-lowering effects. Furthermore, ACE inhibitors can increase potassium levels. Use of L-arginine has been associated with hyperkalemia in some patients. Theoretically, concomitant use of ACE inhibitors with L-arginine may increases the risk of hyperkalemia.

Likelihood Probable Evidence D
Angiotensin Receptor Blockers (Arbs)

Theoretically, concomitant use of L-arginine and ARBs may increase the risk of hypotension and hyperkalemia.
L-arginine increases nitric oxide, which causes vasodilation. Combining L-arginine with ARBs seems to increase L-arginine-induced vasodilation. Furthermore, ARBs can increase potassium levels. Use of L-arginine has been associated with hyperkalemia in some patients. Theoretically, concomitant use of ARBs with L-arginine may increases the risk of hyperkalemia.

Likelihood Probable Evidence D
Anticoagulant/Antiplatelet Drugs

Theoretically, concomitant use of L-arginine with anticoagulant and antiplatelet drugs might have additive effects and increase the risk of bleeding.
Preliminary research suggests that L-arginine infusions reduce platelet aggregation in humans. The clinical significance of this effect is unclear.

Likelihood Possible Evidence D
Antidiabetes Drugs

Theoretically, concomitant use of L-arginine might have additive effects with antidiabetes drugs.
Preliminary clinical research shows that L-arginine decreases blood glucose levels in patients with type 2 diabetes.

Likelihood Possible Evidence D
Antihypertensive Drugs

Theoretically, concomitant use of L-arginine and antihypertensive drugs may increase the risk of hypotension.
L-arginine increases nitric oxide, which causes vasodilation. Clinical evidence shows that L-arginine can reduce blood pressure in some individuals with hypertension. Furthermore, combining L-arginine with some antihypertensive drugs seems to have additive vasodilating and blood pressure-lowering effects.

Likelihood Probable Evidence D
Isoproterenol (Isuprel)

Theoretically, concurrent use of isoproterenol and L-arginine might result in additive effects and hypotension.
Preliminary clinical evidence suggests that L-arginine enhances isoproterenol-induced vasodilation in patients with essential hypertension or a family history of essential hypertension.

Likelihood Probable Evidence D
Potassium-Sparing Diuretics

Theoretically concomitant use of potassium-sparing diuretics with L-arginine may increases the risk of hyperkalemia.
Potassium-sparing diuretics can increase potassium levels. Use of L-arginine has been associated with hyperkalemia in some patients.

Likelihood Possible Evidence D
Sildenafil (Viagra)

Theoretically, concurrent use of sildenafil and L-arginine might increase the risk for hypotension.
In vivo, concurrent use of L-arginine and sildenafil has resulted in increased vasodilation. Theoretically, concurrent use might have additive vasodilatory and hypotensive effects. However, in studies evaluating the combined use of L-arginine and sildenafil for erectile dysfunction, hypotension was not reported.

Likelihood Possible Evidence D
Testosterone

Theoretically, concomitant use of L-arginine and testosterone might have additive effects.
In clinical research, L-arginine increases the level of testosterone in male patients with erectile dysfunction. The clinical significance of this finding is unclear.

Likelihood Possible Evidence D
L-Arginine Ethyl Ester Dichloride full monograph & interactions

R+Lipoic Acid5 drug types · 263 drugs

Alkylating Agents

Theoretically, the antioxidant effects of alpha-lipoic acid might alter the effectiveness of alkylating agents.
The use of antioxidants like alpha-lipoic acid during chemotherapy is controversial. There are concerns that antioxidants could reduce the activity of chemotherapy drugs that generate free radicals. However, some researchers theorize that antioxidants might make chemotherapy more effective by reducing oxidative stress that might interfere with apoptosis (cell death) of cancer cells. More evidence is needed to determine what effect, if any, antioxidants such as alpha-lipoic acid have on chemotherapy. Advise patients to consult their oncologist before using alpha-lipoic acid.

Likelihood Possible Evidence D
Anticoagulant/Antiplatelet Drugs

Theoretically, alpha-lipoic acid may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
In vitro, alpha-lipoic acid inhibits platelet aggregation.

Likelihood Possible Evidence D
Antitumor Antibiotics

Theoretically, the antioxidant effects of alpha-lipoic acid might alter the effectiveness of antitumor antibiotics.
The use of antioxidants like alpha-lipoic acid during chemotherapy is controversial. There are concerns that antioxidants could reduce the activity of antitumor antibiotic drugs, which work by generating free radicals. However, some researchers theorize that antioxidants might make chemotherapy more effective by reducing oxidative stress that might interfere with apoptosis (cell death) of cancer cells. More evidence is needed to determine what effect, if any, antioxidants such as alpha-lipoic acid have on chemotherapy involving antitumor antibiotics. Advise patients to consult their oncologist before using alpha-lipoic acid.

Likelihood Possible Evidence D
Thyroid Hormone

Theoretically, alpha-lipoic acid might decrease the effects of thyroid hormone drugs.
Animal research suggests that co-administration of thyroxine with alpha-lipoic acid reduces conversion into the active T3 form.

Likelihood Possible Evidence D
Antidiabetes Drugs

Theoretically, taking alpha-lipoic acid with antidiabetes drugs might increase the risk of hypoglycemia.
Although some small clinical studies have suggested that alpha-lipoic acid can lower blood glucose levels, larger clinical studies in patients with diabetes have shown no clinically meaningful effect. Additionally, co-administration of single doses of alpha-lipoic acid and glyburide or acarbose did not cause detectable drug interactions in healthy volunteers.

Likelihood Unlikely Evidence B
R+Lipoic Acid full monograph & interactions

Dibasic Calcium Phosphate18 drug types · 168 drugs

Ceftriaxone (Rocephin)

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

Likelihood Probable Evidence D
Dolutegravir (Tivicay)

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

Likelihood Probable Evidence B
Elvitegravir (Vitekta)

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

Likelihood Probable Evidence B
Aluminum

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

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

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

Likelihood Probable Evidence D
Bisphosphonates

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

Likelihood Probable Evidence C
Calcipotriene (Dovonex)

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

Likelihood Possible Evidence B
Digoxin (Lanoxin)

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

Likelihood Possible Evidence B
Diltiazem (Cardizem, Others)

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

Likelihood Probable Evidence D
Levothyroxine (Synthroid, Others)

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

Likelihood Probable Evidence B
Lithium

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

Likelihood Possible Evidence B
Quinolone Antibiotics

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

Likelihood Probable Evidence B
Raltegravir (Isentress)

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

Likelihood Possible Evidence B
Sotalol (Betapace)

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

Likelihood Possible Evidence B
Tetracycline Antibiotics

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

Likelihood Probable Evidence C
Thiazide Diuretics

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

Likelihood Probable Evidence C
Verapamil (Calan, Others)

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

Likelihood Probable Evidence D
Calcium Channel Blockers

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

Likelihood Unlikely Evidence D
Dibasic Calcium Phosphate full monograph & interactions
The maker

Brand information

Manufacturer and brand details for NIOX Maximum Impact, from the product label.

Nutrex Research

See all Nutrex Research products
Name
Nutrex Research, Inc.
City
Oviedo
State
FL
ZipCode
32765
Phone Number
1-888-362-8739
Web Address
Nutrex.com
Pharmacist Counseling Corner

NIOX Maximum Impact by Nutrex Research: Common Questions

Does NIOX Maximum Impact by Nutrex Research interact with any medications?
Yes. Based on its ingredients, NIOX Maximum Impact has a known interaction with 538 medications, including 7 rated major. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
NIOX Maximum Impact contains 7 active ingredients, and an interaction can come from any of them. We check every ingredient, combine the results into one list per medication, and show which ingredient and mechanism is responsible.
Where does this information come from?
The product label data comes from the NIH Dietary Supplement Label Database (DSLD); the interaction data is built on the Natural Medicines database and reviewed by HelloPharmacist pharmacists.
What does beta-alanine do in this product?
Beta-alanine (branded as CarnoSyn here) is possibly effective for athletic and physical performance. It commonly causes a harmless tingling sensation (paresthesia) and skin flushing — usually mild at lower doses and starting on the scalp within 20 minutes, lasting about an hour.
Why is there so much calcium in a muscle supplement?
Calcium supports many functions beyond bone health; it's involved in muscle contraction and nerve signaling. At recommended amounts, it's generally safe, though very high doses can cause constipation, diarrhea, and other GI upset.
Can I take this while pregnant or breastfeeding?
Beta-alanine and alpha-lipoic acid should be avoided in pregnancy and lactation due to insufficient safety data. Calcium is likely safe at recommended amounts during both. For the other ingredients, data is limited — talk with your doctor or pharmacist to decide what's right for you.
Does this product work for building muscle?
Our data covers effectiveness for athletic and physical performance, where beta-alanine is possibly effective. We don't have effectiveness ratings for L-Arginine, L-Norvaline, or Rutaecarpine in muscle building.
What's the tingling I've read about with this product?
That's the paresthesia — a pins-and-needles sensation — from beta-alanine. It's harmless and dose-dependent; lower doses cause it in fewer people, and it typically lasts about an hour.
Does alpha-lipoic acid interact with diabetes drugs?
Yes, there's a Minor-severity interaction: theoretically, alpha-lipoic acid with diabetes medications might raise the risk of low blood sugar. Talk with your doctor or pharmacist if you take diabetes drugs before starting this.

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The Full Monographs Behind NIOX Maximum Impact’s Ingredients

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

Herb & supplement monograph

Glycerol

Glycerol (glycerin) is a sweet, syrupy compound made naturally in the body and widely used in foods, skin products, and medicines. It is well established as a laxative and a skin and eye moi...

Read the full Glycerol monograph → Herb & supplement monograph

Beta-alanine

Beta-alanine is an amino acid taken mostly by athletes to raise muscle carnosine, which may help buffer acid and reduce fatigue during short, high-intensity exercise. The evidence is moderat...

Read the full Beta-alanine monograph → Herb & supplement monograph

Calcium

Interacts with 168 drugs

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

Read the full Calcium monograph → Herb & supplement monograph

L-arginine

Interacts with 403 drugs

L-arginine is an amino acid that the body uses to make nitric oxide, a substance that helps blood vessels relax and widen. It is popularly used for blood pressure, erectile dysfunction, and...

Read the full L-arginine monograph → Herb & supplement monograph

Alpha-lipoic Acid

Interacts with 263 drugs

Alpha-lipoic acid (ALA) is an antioxidant made naturally by the body and found in small amounts in foods. It is most studied for diabetic nerve pain, where some evidence suggests it may help...

Read the full Alpha-lipoic Acid monograph →
Sources

Sources & How We Checked

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

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

The 197 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.

Glycerol 8 references
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  2. Wagner DR. Hyperhydrating with glycerol: implications for athletic performance. J Am Diet Assoc 1999;99:207-12. PubMed
  3. Yu YL, Kumana CR, Lauder IJ, et al. Treatment of acute cortical infarct with intravenous glycerol. A double-blind, placebo-controlled randomized trial. Stroke 1993;24:1119-24. PubMed
  4. Frei A, Cottier C, Wunderlich P, Ludin E. Glycerol and dextran combined in the therapy of acute stroke. A placebo-controlled, double-blind trial with a planned interim analysis. Stroke 1987;18:373-9. PubMed
  5. Balaskas E, Szepietowski JC, Bessis D, Ioannides D, Ponticelli C, Ghienne C, Taberly A, Dupuy P. Randomized, double-blind study with glycerol and paraffin in uremic xerosis. Clin J Am Soc Nephrol. 2011 Apr;6(4):748-52. PubMed
  6. Blanchet-Bardon C, Tadini G, Machado Matos M, Delarue A. Association of glycerol and paraffin in the treatment of ichthyosis in children: an international, multicentric, randomized, controlled, double-blind study. J Eur Acad Dermatol Venereol. 2012 Aug;26 PubMed
  7. Kajita N, Kanamori K, Yamamoto S, Yoshida K. Generalized Urticaria Caused by a Glycerin Enema in an Infant. J Investig Allergol Clin Immunol 2022;32(4):318-319. PubMed
  8. Suzuki R, Fukuyama K, Miyazaki Y, Namiki T. Contact urticaria syndrome and protein contact dermatitis caused by glycerin enema. JAAD Case Reports. 2016;2:108-10. PubMed

See these in context on the Glycerol monograph →

Beta-alanine 13 references
  1. Harris RC, Tallon MJ, Dunnett M, et al. The absorption of orally supplied beta-alanine and its effect on muscle carnosine synthesis in human vastus lateralis. Amino Acids 2006;30:279-89.
  2. Hill CA, Harris RC, Kim HJ, et al. Influence of beta-alanine supplementation on skeletal muscle carnosine concentrations and high intensity cycling capacity. Amino Acids 2007;32:225-33.
  3. Bellinger PM, Minahan CL. The effect of ß-alanine supplementation on cycling time trials of different length. Eur J Sport Sci 2016;16(7):829-36.
  4. Chung W, Shaw G, Anderson ME, et al. Effect of 10 week beta-alanine supplementation on competition and training performance in elite swimmers. Nutrients 2012;4(10):1441-53. PubMed
  5. Glenn JM, Gray M, Stewart R, et al. Incremental effects of 28 days of beta-alanine supplementation on high-intensity cycling performance and blood lactate in masters female cyclists. Amino Acids 2015;47(12):2593-600. PubMed
  6. Gross M, Bieri K, Hoppeler H, Norman B, Vogt M. Beta-alanine supplementation improves jumping power and affects severe-intensity performance in professional alpine skiers. Int J Sport Nutr Exerc Metab 2014;24(6):665-73. PubMed
  7. Howe ST, Bellinger PM, Driller MW, Shing CM, Fell JW. The effect of beta-alanine supplementation on isokinetic force and cycling performance in highly trained cyclists. Int J Sport Nutr Exerc Metab 2013;23(6):562-70. PubMed
  8. Sweeney KM, Wright GA, Glenn Brice A, Doberstein ST. The effect of beta-alanine supplementation on power performance during repeated sprint activity. J Strength Cond Res 2010;24(1):79-87.
  9. Décombaz J, Beaumont M, Vuichoud J, Bouisset F, Stellingwerff T. Effect of slow-release ß-alanine tablets on absorption kinetics and paresthesia. Amino Acids 2012;43(1):67-76. Erratum in: Amino Acids 2013;45(4):1015.
  10. Stellingwerff T, Anwander H, Egger A, et al. Effect of two ß-alanine dosing protocols on muscle carnosine synthesis and washout. Amino Acids 2012;42(6):2461-72. PubMed
  11. da Silva RP, de Oliveira LF, Saunders B, et al. Effects of ß-alanine and sodium bicarbonate supplementation on the estimated energy system contribution during high-intensity intermittent exercise. Amino Acids. 2019;51(1):83-96. PubMed
  12. Varanoske AN, Hoffman JR, Church DD, et al. Comparison of sustained-release and rapid-release ß-alanine formulations on changes in skeletal muscle carnosine and histidine content and isometric performance following a muscle-damaging protocol. Amino Acids. PubMed
  13. Perim P, Gobbi N, Duarte B, et al. Beta-alanine did not improve high-intensity performance throughout simulated road cycling. Eur J Sport Sci 2021. PubMed

See these in context on the Beta-alanine monograph →

Calcium 62 references
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  28. 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
  29. 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
  30. Rocephin (ceftriaxone) and calcium interaction. Pharmacist's Letter / Prescriber's Letter 2007;23(10):231005.
  31. 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.
  32. 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
  33. Calcium supplementation and vascular events. Pharmacist's Letter / Prescriber's Letter 2008;24(3):240306.
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  37. Kays MB, Overholser BR, Mueller BA, et al. Effects of sevelamer hydrochloride and calcium acetate on the oral bioavailability of ciprofloxacin. Am J Kidney Dis. 2003;42(6):1253-9. PubMed
  38. 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
  39. 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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See these in context on the Calcium monograph →

L-arginine 66 references
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  14. Higashi Y, Oshima T, Sasaki S, et. al. Angiotensin-converting enzyme inhibition, but not calcium antagonism, improves a response of the renal vasculature to L-arginine in patients with essential hypertension. Hypertension. 1998 Jul;32(1):16-24.
  15. Facchinetti, F., Longo, M., Piccinini, F., Neri, I., and Volpe, A. L-arginine infusion reduces blood pressure in preeclamptic women through nitric oxide release. J Soc Gynecol.Investig. 1999;6(4):202-207. DOI
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  23. Palloshi, A., Fragasso, G., Piatti, P., Monti, L. D., Setola, E., Valsecchi, G., Galluccio, E., Chierchia, S. L., and Margonato, A. Effect of oral L-arginine on blood pressure and symptoms and endothelial function in patients with systemic hypertension,
  24. Schlaich, M. P., Ahlers, B. A., Parnell, M. M., and Kaye, D. M. beta-Adrenoceptor-mediated, nitric-oxide-dependent vasodilatation is abnormal in early hypertension: restoration by L-arginine. J Hypertens. 2004;22(10):1917-1925. PubMed
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  38. Hertz, P. and Richardson, J. A. Arginine-induced hyperkalemia in renal failure patients. Arch.Intern.Med. 1972;130(5):778-780. DOI
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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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