Major interaction on record — check this product against your medications before combining. Based on 3 of 4 ingredients. Check your meds →
Dietary supplement

Osteo Bi-Flex Joint Health Triple Strength + MSM Formula Ingredients & Drug Interactions

by Osteo Bi-Flex

Osteo Bi-Flex Joint Health Triple Strength + MSM Formula label
See full label image
Tablet Or Pill 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 Osteo Bi-Flex Joint Health Triple Strength + MSM Formula against your medications. The heart of this page is the interaction checker and the full interaction report — how this product’s ingredients may interact with prescription and over-the-counter medicines you may be taking.

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

The interaction bottom line Most serious interaction: Major

Osteo Bi-Flex Joint Health Triple Strength + MSM Formula is a dietary supplement by Osteo Bi-Flex with 4 active ingredients. Its ingredients are commonly taken for replacing fluids and electrolytes, preventing dehydration during exercise or illness, treating low blood sodium (under medical care).Based on those ingredients, 1,159 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are Joint Shield 5-Loxin Advanced, Sodium, Glucosamine Hydrochloride. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

Jump to a section

Check Your Meds Against Osteo Bi-Flex Joint Health Triple Strength + MSM Formula by Osteo Bi-Flex

Ask about any prescription or over-the-counter medication and we check it for interactions with Osteo Bi-Flex Joint Health Triple Strength + MSM Formula by Osteo Bi-Flex — and tell you which ingredient is responsible.

Pharmacist-reviewed data Checks every ingredient Answer in seconds
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HelloPharmacist Scorecard of Osteo Bi-Flex Joint Health Triple Strength + MSM Formula by Osteo Bi-Flex

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 Sep 3, 2026

What’s inside

Full disclosure
Ingredient Transparency · database check
Full

Every active ingredient lists its own amount on the label.

Why this rating?
  • The label discloses an exact amount for 4 of its 4 active ingredients.
  • No proprietary blends here — you can verify the dose of every single component.

This product contains four active ingredients. Sodium is included as a mineral; glucosamine hydrochloride supports joint structure and function.

Joint Shield 5-Loxin Advanced is a branded extract of Boswellia serrata (also called frankincense), a plant resin traditionally used for joint health. Methylsulfonylmethane (MSM) is an organic sulfur compound.

The tablet also contains inactive ingredients — cellulose, silica, hydroxypropyl methylcellulose, croscarmellose, cellulose coating, titanium dioxide, and magnesium stearate — which serve as fillers, binders, and capsule materials.

Does it work?

Strong 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
Strong

Clinical evidence supports at least one of this product's ingredients for its stated purpose.

Why this rating?
  • The label markets this product for: joint comfort and range of motion.
  • We looked for evidence on: Joint pain, Knee pain, Osteoarthritis, Rheumatoid arthritis (RA), Back pain, Exercise-induced muscle soreness — and 4 related terms.
  • The strongest evidence on file: Glucosamine is rated "Likely Effective" for Osteoarthritis (Natural Medicines).
  • Also on file: Boswellia Serrata is rated "Possibly Effective" for Osteoarthritis.
  • Also on file: Boswellia Serrata is rated "Insufficient Reliable Evidence To Rate" for Exercise-induced muscle soreness, Rheumatoid arthritis (RA), Knee pain.

Glucosamine is likely effective for osteoarthritis, the main joint condition this product targets. Boswellia serrata is possibly effective for osteoarthritis as well.

We do not hold established evidence in our data for the other claimed uses — aging skin and back pain for glucosamine, and allergic rhinitis, Alzheimer disease, asthma, and cluster headache for Boswellia. Sodium's effectiveness ratings in our data reflect uses unrelated to joint health (cystic fibrosis, bipolar disorder, and heart failure), so they don't apply here.

The evidence, ingredient by ingredient Sodium Glucosamine Boswellia Serrata

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 3 of the 3 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 3 of 3.
  • General safety write-ups exist for 3 of 3.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

Glucosamine is generally well tolerated by most adults when taken orally, though the most common side effects include bloating, constipation, cramps, diarrhea, heartburn, and nausea. Rare serious effects have been reported.

Some people may have allergic reactions; one review found that 72% of glucosamine adverse-event reports involved hypersensitivity reactions, ranging from mild (itching, hives) to severe (difficulty breathing, anaphylaxis in 1.5% of cases). Boswellia serrata is generally well tolerated short-term, with common side effects of abdominal pain, diarrhea, headache, heartburn, itching, and nausea.

Sodium is essential in small amounts, but too much is linked to high blood pressure and heart strain. Normal dietary sodium is fine, but avoid sodium supplements or very high intake without medical advice.

Pregnancy and lactation data: glucosamine safety is not established in pregnancy or while breastfeeding — the safety data advises against it. Boswellia serrata is rated likely safe in pregnancy, but safety while breastfeeding is unknown, so avoidance is advised.

We hold no pregnancy/lactation data for MSM.

Side effects, ingredient by ingredient Sodium Glucosamine Boswellia Serrata

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 3 matched ingredients can interact with medications — Boswellia Serrata, Glucosamine, Sodium.
  • The most serious interaction on file is rated Major.
  • Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs; immunosuppressants / transplant drugs; diabetes medications; lithium.
  • For scale: 1,160 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.

Check before taking if you use warfarin or other blood thinners — glucosamine may increase bleeding risk (Major severity). If you take blood pressure medications, lithium, corticosteroids, or diabetes drugs, confirm with your pharmacist, as sodium and glucosamine can affect how these work.

Also discuss with your doctor if you take acetaminophen regularly, any HIV medications like didanosine, or drugs your liver processes heavily (including many antidepressants, heart medications, and immunosuppressants), since Boswellia serrata may alter their levels.

Check your own medication Run your meds through the checker above

The bottom line

Scorecard at a glanceFully disclosed formula with clinical evidence supporting its stated purpose. Major medication interactions have been identified, and safety information is well characterized.

Osteo Bi-Flex may help with osteoarthritis, since both glucosamine and Boswellia serrata carry evidence for that condition. If you take warfarin or any blood thinner, blood pressure medication, lithium, diabetes drugs, acetaminophen regularly, or immunosuppressants, talk with your doctor or pharmacist before starting — the interactions warrant a one-on-one review of your specific medications and doses.

Avoid this product in pregnancy or while breastfeeding unless your own doctor advises otherwise.

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

Assessment coverage: 3 of 4 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Mar 22, 2024.

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 Osteo Bi-Flex Joint Health Triple Strength + MSM Formula, straight from the product label.

Brand Osteo Bi-Flex
Barcode (UPC) 030768541279
Net contents 80 Coated Tablet(s)
Market status On market
Date entered into DSLD Mar 22, 2024
DSLD ID 307938
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
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 Osteo Bi-Flex Joint Health Triple Strength + MSM Formula by Osteo Bi-Flex, 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:
2 Tablet(s)
Maximum serving Sizes:
2 Tablet(s)
Servings per container
40
UPC/BARCODE
030768541279
IngredientAmount% DV
Calories10 Calorie(s)--
Total Carbohydrates2 Gram(s)1%
Sodium20 mg1%
Methylsulfonylmethane1500 mg--
Glucosamine Hydrochloride1500 mg--
Joint Shield 5-Loxin Advanced100 mg--

Other ingredients: Cellulose, Silica, Hydroxypropyl Methylcellulose, Croscarmellose, Cellulose Coating, Titanium Dioxide, Magnesium Stearate

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.
Formulation

Range of Motion

During the day, you move your joints in so many different ways, getting up, sitting down, bending and flexing. Osteo Bi-Flex is America's #1 Joint Health Brand and supports joint comfort, so you can enjoy a range of motion for your day's activities. Source: IRI Total US - Multi Outlet: Latest 52 weeks ending April 25, 2021.

Osteo Bi-Flex is manufactured under the highest standards for product quality, purity and potency.

Made in the USA with select ingredients from around the world.

Osteo Bi-Flex Joint Health Triple Strength + MSM Formula Refers to level of Glucosamine HCI per tablet compared to regular strength. Shows improved joint comfort within 7 days! Based on two human studies with 5-LOXIN ADVANCED where subjects rated their joint health over time, subjects' joint health improved within 7 days, and continued to improve throughout the duration of the studies.

Free of Gluten Non-GMO

Brand IP Statement(s)

Osteo Bi-Flex Made to Move

5-LOXIN ADVANCED is a registered trademark of PLT Health Solutions - Laila Nutraceuticals, LLC. U.S. Patent #8,551,496 and patents pending.

Formula

Osteo Bi-Flex Triple Strength + MSM contains glucosamine which helps to strengthen joints while helping maintain joint cartilage essential for comfortable movement. This formula also includes MSM which is vital in the support of connective tissue and healthy joints.

Glucosamine & MSM with joint shield

General Statements

To learn more about Osteo Bi-Flex visit www.OsteoBiFlex.com or call us toll free 1-888-VITAHELP (848-2435).

Individual results may vary. #1 pharmacist recommended brand Based on the results of the Pharmacy Time Survey of Pharmacists' OTC Recommendations who recommend a "joint health" deny supplement, 2021-2022.

Precautions

Keep out of reach of children. Not intended for use by persons under the age of 18.

Caution: If you are pregnant, nursing, taking any medications, including blood thinners, or have any medical condition, consult your doctor before use.

Discontinue use and consult your doctor if any adverse reactions occur.

Contains shellfish (crab, crayfish, lobster, shrimp) ingredients.

As a reminder, discuss the supplements and medications you take with your health care providers.

Storage

Store at room temperature and avoid excessive heat, tamper resistant: Do not use if seal under cap is broken or missing.

FDA Statement of Identity

Dietary Supplement

Suggested/Recommended/Usage/Directions

2 Per day Directions for adult use: Take two (2) tablets per day preferably with food. As a reminder, discuss the supplements and medications you take with your health care providers.

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.

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

See for yourself

Osteo Bi-Flex Joint Health Triple Strength + MSM Formula by Osteo Bi-Flex label

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

Osteo Bi-Flex Joint Health Triple Strength + MSM Formula 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 Osteo Bi-Flex Joint Health Triple Strength + MSM Formula by Osteo Bi-Flex

These are the 4 active ingredients this product is made of. Select any to open its full monograph.

Serving size2 Tablet(s) Dosage formTablet Or Pill Servings per container40 Amounts shown are per serving.

Most supplement products combine several ingredients, and a medication can interact with the product through any one of them. Each ingredient below shows whether it has known drug interactions.

Sodium

Interacts with
205 drugs
20 mg per serving

Sodium is an essential mineral and electrolyte your body needs to balance fluids, support nerves, and help muscles work. Most people in modern diets g...

Sodium monograph & interactions

Methylsulfonylmethane

1500 mg per serving

Glucosamine Hydrochloride

Interacts with
170 drugs
1500 mg per serving

Glucosamine is a natural compound found in cartilage and joint fluid, and it is one of the most popular supplements for osteoarthritis, especially of...

Glucosamine Hydrochloride monograph & interactions

Joint Shield 5-Loxin Advanced

Interacts with
952 drugs
100 mg per serving Form: Boswellia serrata Resin Extract

Boswellia serrata is a tree resin used in traditional medicine, mainly for joint pain and inflammation. Some studies suggest it may help with osteoart...

Joint Shield 5-Loxin Advanced monograph & interactions

Other (inactive) ingredients: Cellulose, Silica, Hydroxypropyl Methylcellulose, Croscarmellose, Cellulose Coating, Titanium Dioxide, Magnesium Stearate. These complete the product’s ingredient list but are not active constituents.

Interaction report

Osteo Bi-Flex Joint Health Triple Strength + MSM Formula by Osteo Bi-Flex Drug Interactions

Want to check YOUR meds against Osteo Bi-Flex Joint Health Triple Strength + MSM Formula?

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

 Go to the checker
1,159Drugs
2 Major 1,088 Moderate 69 Minor

Ingredients driving the most interactions

Joint Shield 5-Loxin Advanced 952
Sodium 205
Glucosamine Hydrochloride 170

Individual Drug Interactions

The ingredients in Osteo Bi-Flex Joint Health Triple Strength + MSM Formula interact with 1,159 drugs. Click any drug to see the details.

3 of the 4 ingredients in Osteo Bi-Flex Joint Health Triple Strength + MSM Formula interact with drugs. Each result below shows which ingredient is responsible. Joint Shield 5-Loxin Advanced Sodium Glucosamine Hydrochloride

Each ingredient & the kinds of drugs it affects

For each ingredient in Osteo Bi-Flex Joint Health Triple Strength + MSM Formula with known interactions, here are the types of medications they can affect. Open any type for the detail — or search your exact drug in the checker above.

Joint Shield 5-Loxin Advanced6 drug types · 952 drugs

Cytochrome P450 1A2 (Cyp1A2) Substrates

Theoretically, Boswellia serrata might increase the levels of CYP1A2 substrates.
In vitro research shows that Boswellia serrata gum resin inhibits CYP1A2 enzymes.

Likelihood Possible Evidence D
Cytochrome P450 2C19 (Cyp2C19) Substrates

Theoretically, Boswellia serrata might increase the levels of CYP2C19 substrates.
In vitro research shows that Boswellia serrata gum resin inhibits CYP2C19 enzymes.

Likelihood Possible Evidence D
Cytochrome P450 2C9 (Cyp2C9) Substrates

Theoretically, Boswellia serrata might increase the levels of CYP2C9 substrates.
In vitro research shows that Boswellia serrata gum resin inhibits CYP2C9 enzymes.

Likelihood Possible Evidence D
Cytochrome P450 2D6 (Cyp2D6) Substrates

Theoretically, Boswellia serrata might increase the levels of CYP2D6 substrates.
In vitro research shows that Boswellia serrata gum resin inhibits CYP2D6 enzymes.

Likelihood Possible Evidence D
Cytochrome P450 3A4 (Cyp3A4) Substrates

Theoretically, Boswellia serrata might increase or decrease the levels and clinical effects of CYP3A4 substrates.
In vitro research shows that Boswellia serrata gum resin inhibits CYP3A4 enzymes. Other in vitro research shows that Boswellia serrata extract inhibits CYP3A4 enzymes at most concentrations, although it may modestly induce enzyme activity at low concentrations.

Likelihood Possible Evidence D
Immunosuppressants

Theoretically, Boswellia serrata might alter the effects of immunosuppressive drugs.
Some in vitro research suggests that Boswellia serrata extracts might inhibit mediators of autoimmune disorders such as leukotrienes and reduce production of antibodies and cell-mediated immunity. However, other in vitro research suggests that, when coupled with calcium ions, boswellic acids containing the keto group have immunostimulant properties within specific cell signaling pathways.

Likelihood Possible Evidence D
Joint Shield 5-Loxin Advanced full monograph & interactions

Sodium7 drug types · 205 drugs

Antihypertensive Drugs

Theoretically, a high intake of dietary sodium might reduce the effectiveness of antihypertensive drugs.
High intake of dietary sodium can increase systolic and diastolic blood pressure. Also, high intake of sodium may necessitate increased use of antihypertensive medications to achieve blood pressure control in some patients, such as those with chronic kidney disease.

Likelihood Probable Evidence A
Corticosteroids

Concomitant use of mineralocorticoids and some glucocorticoids with sodium supplements might increase the risk of hypernatremia.
Mineralocorticoids and some glucocorticoids (corticosteroids) cause sodium retention. This effect is dose-related and depends on mineralocorticoid potency. It is most common with hydrocortisone, cortisone, and fludrocortisone, followed by prednisone and prednisolone.

Likelihood Possible Evidence D
Didanosine (Videx)

Concomitant use of didanosine with additional sodium from dietary or supplemental sources may increase the risk of hypernatremia.
Didanosine formulations contain a significant amount of sodium.

Likelihood Probable Evidence C
Lithium

Altering dietary intake of sodium might alter the levels and clinical effects of lithium.
High sodium intake can reduce plasma concentrations of lithium by increasing lithium excretion. Reducing sodium intake can significantly increase plasma concentrations of lithium and cause lithium toxicity in patients being treated with lithium carbonate. Stabilizing sodium intake is shown to reduce the percentage of patients with lithium level fluctuations above 0.8 mEq/L. Patients taking lithium should avoid significant alterations in their dietary intake of sodium.

Likelihood Probable Evidence B
Sodium Phosphates

Theoretically, concomitant use of sodium phosphate with sodium supplements might increase the risk of hypernatremia.
Use of high doses (> 45 mL in 24 hours) of sodium phosphate, such as those used for bowel cleansing before surgery, can lead to serious electrolyte disturbances, including hypernatremia. The risk of hypernatremia is highest in the elderly and people with other risk factors for electrolyte disturbances.

Likelihood Possible Evidence D
Sodium-Containing Drugs

Concomitant use of sodium-containing drugs with additional sodium from dietary or supplemental sources may increase the risk of hypernatremia and long-term sodium-related complications.
The Chronic Disease Risk Reduction (CDRR) intake level of 2.3 grams of sodium daily indicates the intake at which it is believed that chronic disease risk increases for the apparently healthy population. Some medications contain high quantities of sodium. When used in conjunction with sodium supplements or high-sodium diets, the CDRR may be exceeded. Additionally, concomitant use may increase the risk for hypernatremia; this risk is highest in the elderly and people with other risk factors for electrolyte disturbances.

Likelihood Possible Evidence D
Tolvaptan (Samsca)

Theoretically, concomitant use of tolvaptan with sodium might increase the risk of hypernatremia.
Tolvaptan is a vasopressin receptor 2 antagonist that is used to increase sodium levels in patients with hyponatremia. Patients taking tolvaptan should use caution with the use of sodium salts such as sodium chloride.

Likelihood Probable Evidence C
Sodium full monograph & interactions

Glucosamine Hydrochloride4 drug types · 170 drugs

Warfarin (Coumadin)

Glucosamine might increase the anticoagulant effects of warfarin and increase the risk of bruising and bleeding.
In two individual case reports, glucosamine/chondroitin combinations were associated with a significant increase in international normalized ratio (INR) in patients previously stabilized on warfarin. In one case, the increase in INR occurred only after tripling the dose of a glucosamine/chondroitin supplement from 500 mg/400 mg daily to 1500/1200 mg daily. Additionally, 20 voluntary case reports to the U.S. Food & Drug Administration (FDA) have linked glucosamine plus chondroitin with increased INR, bruising, and bleeding in patients who were also taking warfarin. There have also been 20 additional case reports to the World Health Organization (WHO) that link glucosamine alone to increased INR in patients taking warfarin. The mechanism of this interaction is unclear. Glucosamine is a small component of heparin, but is not thought to have anticoagulant activity; however, animal research suggests that it might have antiplatelet activity.

Likelihood Probable Evidence D
Topoisomerase Ii Inhibitors

Theoretically glucosamine may induce resistance to topoisomerase II inhibitors.
In vitro research suggests that glucosamine might induce resistance to etoposide (VP16, VePesid) and doxorubicin (Adriamycin) by reducing inhibition of topoisomerase II, an enzyme required for DNA replication in tumor cells. This effect has not been reported in humans.

Likelihood Possible Evidence D
Acetaminophen (Tylenol, Others)

Acetaminophen might interfere with the activity of glucosamine sulfate by interacting with the sulfate portion.
Anecdotal reports suggest that adding glucosamine to an acetaminophen regimen might decrease pain control in patients with osteoarthritis. Some research suggests that the sulfate portion of glucosamine sulfate might contribute to its effect in osteoarthritis. Since acetaminophen metabolism requires sulfur and reduces serum sulfate concentrations, acetaminophen could theoretically interfere with the action of glucosamine sulfate. Conversely, the administration of sulfate could theoretically decrease the effectiveness of acetaminophen in sulfate-deficient people by increasing its clearance.

Likelihood Possible Evidence B
Antidiabetes Drugs

Despite initial concerns, it is unlikely that glucosamine will interfere with the effects of antidiabetes drugs.
In vitro and animal research has suggested that glucosamine might increase insulin resistance or decrease insulin production. This has raised concerns that taking glucosamine might worsen diabetes and decrease the effectiveness of diabetes drugs. However, clinical research suggests that glucosamine does not have adverse effects on blood glucose or glycated hemoglobin (HbA1C) in healthy, obese, or type 2 diabetes patients.

Likelihood Unlikely Evidence B
Glucosamine Hydrochloride full monograph & interactions
The maker

Brand information

Manufacturer and brand details for Osteo Bi-Flex Joint Health Triple Strength + MSM Formula, from the product label.

Osteo Bi-Flex

See all Osteo Bi-Flex products
Name
Rexall Sundown, Inc.
City
Boca Raton
State
FL
ZipCode
33487
Phone Number
1-888-848-2435
Web Address
www.osteobiflex.com
Pharmacist Counseling Corner

Osteo Bi-Flex Joint Health Triple Strength + MSM Formula by Osteo Bi-Flex: Common Questions

Does Osteo Bi-Flex Joint Health Triple Strength + MSM Formula by Osteo Bi-Flex interact with any medications?
Yes. Based on its ingredients, Osteo Bi-Flex Joint Health Triple Strength + MSM Formula has a known interaction with 1,159 medications, including 2 rated major. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Osteo Bi-Flex Joint Health Triple Strength + MSM Formula contains 4 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.
Will this help my osteoarthritis?
Glucosamine in this formula is likely effective for osteoarthritis, and Boswellia serrata is possibly effective. That said, glucosamine quality and benefit vary between products, and results aren't universal. Talk with your doctor about whether it's right for you and what to expect.
Is it safe to take while I'm pregnant or breastfeeding?
The safety data advises against glucosamine in pregnancy and while breastfeeding — there isn't enough information to know it's safe. Boswellia serrata is rated likely safe in pregnancy, but its safety while breastfeeding is unknown. Talk with your doctor or pharmacist for personalized advice on whether you should take this product.
What side effects might I experience?
Most common ones are digestive: bloating, constipation, cramps, diarrhea, heartburn, and nausea. Headache is also possible. A small number of people report allergic reactions ranging from mild (itching, hives) to severe (difficulty breathing).
How much sodium does this product add to my diet?
The product facts don't specify the sodium dose per tablet, so you'd need to check the label or contact the manufacturer. If you have high blood pressure, heart disease, or kidney issues — or take medications affected by sodium — ask your pharmacist whether the amount in this product is safe for you.
What is MSM, and does it do anything for joints?
MSM (methylsulfonylmethane) is an organic sulfur compound included in this formula. We don't hold established evidence in our data for its effectiveness, so I can't tell you whether it works for joint health.
Can I take this if I'm on acetaminophen for pain?
There's a documented minor interaction — acetaminophen might interfere with glucosamine's activity. If you take acetaminophen regularly, check with your pharmacist before adding this product to be sure the combination won't reduce your pain control.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Not sure if Osteo Bi-Flex Joint Health Triple Strength + MSM Formula is safe with your meds?

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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.

Osteo Bi-Flex Joint Health Triple Strength + MSM Formula label
Go deeper

The Full Monographs Behind Osteo Bi-Flex Joint Health Triple Strength + MSM Formula’s Ingredients

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

Herb & supplement monograph

Sodium

Interacts with 205 drugs

Sodium is an essential mineral and electrolyte your body needs to balance fluids, support nerves, and help muscles work. Most people in modern diets get more than enough—often too much—from...

Read the full Sodium monograph → Herb & supplement monograph

Glucosamine

Interacts with 170 drugs

Glucosamine is a natural compound found in cartilage and joint fluid, and it is one of the most popular supplements for osteoarthritis, especially of the knee. The evidence is mixed, with so...

Read the full Glucosamine monograph → Herb & supplement monograph

Boswellia Serrata

Interacts with 952 drugs

Boswellia serrata is a tree resin used in traditional medicine, mainly for joint pain and inflammation. Some studies suggest it may help with osteoarthritis symptoms, but the overall evidenc...

Read the full Boswellia Serrata monograph →
Sources

Sources & How We Checked

Osteo Bi-Flex Joint Health Triple Strength + MSM Formula's label data comes from the NIH Dietary Supplement Label Database; the ingredient interaction data is from the Natural Medicines database, reviewed by our pharmacists.

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 112 references behind this product’s interaction data

Every citation that drives the interaction findings for this product’s ingredients, from the evidence-graded Natural Medicines (TRC Healthcare) database. Open an ingredient to browse its citations — links open the study on PubMed or the publisher’s site.

Sodium 38 references
  1. Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
  2. Food and Drug Administration Science Background: Safety of Sodium Phosphates Oral Solution. September 17, 2001. Available at: http://www.fda.gov/cder/drug/safety/sodiumphospate.htm
  3. Coton T, Mallaret C, Coilliot C, Carre D, Guisset M. Severe acute ulcerated gastritis induced by salt. Presse Med 2009;38(3):499-500. PubMed
  4. Frings-Meuthen P, Buehlmeier J, Baecker N, et al. High sodium chloride intake exacerbates immobilization-induced bone resorption and protein losses. J Appl Physiol 2011;111(2):537-542. PubMed
  5. Frings-Meuthen P, Baecker N, Heer M. Low-grade metabolic acidosis may be the cause of sodium chloride-induced exaggerated bone resorption. J Bone Miner Res 2008;23(4):517-524. PubMed
  6. Alam S, Johnson AG. A meta-analysis of randomised controlled trials (RCT) among healthy normotensive and essential hypertensive elderly patients to determine the effect of high salt (NaCl) diet of blood pressure. J Hum Hypertens 1999;13(6):367-74.
  7. Boudville N, Ward S, Benaroia M, House AA. Increased sodium intake correlates with greater use of antihypertensive agents by subjects with chronic kidney disease. Am J Hypertens 2005;18(10):1300-5. PubMed
  8. Bennett WM. Drug interactions and consequences of sodium restriction. Am J Clin Nutr 1997;65(2 Suppl):678S-681S. PubMed
  9. Okusa MD, Crystal LJ. Clinical manifestations and management of acute lithium intoxication. Am J Med 1994;97(4):383-9. PubMed
  10. Food and Nutrition Board, Institute of Medicine. Dietary reference intakes for water, potassium, sodium, chloride, and sulfate. Washington, DC: National Academy Press, 2005. Available at: http://www.nap.edu/openbook.php?record_id=10925. DOI
  11. D'Elia L, Rossi G, Ippolito R, Cappuccio FP, Strazzullo P. Habitual salt intake and risk of gastric cancer: a meta-analysis of prospective studies. Clin Nutr 2012;31(4):489-98. PubMed
  12. Goldsmith SR. Hyponatremia in heart failure: time for a trial. J Card Fail 2013;19(6):398-400. PubMed
  13. Willocks L, Brettle R, Keen J, Valentine C, Pinching AJ. Formulations of didanosine (ddI) and salt overload. Lancet 1992;339(8786):190.
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See these in context on the Sodium monograph →

Glucosamine 58 references
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See these in context on the Glucosamine monograph →

Boswellia Serrata 16 references
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  15. Haron MH, Dale O, Martin K, et al. Evaluation of the Herb-Drug Interaction Potential of Commonly Used Botanicals on the US Market with Regard to PXR- and AhR-Mediated Influences on CYP3A4 and CYP1A2. J Diet Suppl 2022. PubMed
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See these in context on the Boswellia Serrata monograph →

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