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Dietary supplement

Osteo Bi-Flex One Per Day Ingredients & Drug Interactions

by Osteo Bi-Flex

Osteo Bi-Flex One Per Day label
See full label image
Tablet Or Pill Category: Other Combinations
Most serious interaction: Major
Clinical methodology reviewed by · Updated Sep 16, 2026 · Label data from the NIH DSLD
What is this page for?

First and foremost: checking Osteo Bi-Flex One Per Day 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 One Per Day is a dietary supplement by Osteo Bi-Flex with 3 active ingredients. Its ingredients are commonly taken for bone health and osteoporosis, correcting vitamin d deficiency, immune system support.Based on those ingredients, 1,089 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are Joint Shield 5-Loxin Advanced Boswellia serrata extract, Vitamin D, Glucosamine HCl. 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 One Per Day by Osteo Bi-Flex

Ask about any prescription or over-the-counter medication and we check it for interactions with Osteo Bi-Flex One Per Day 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 One Per Day 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 3 of its 3 active ingredients.
  • No proprietary blends here — you can verify the dose of every single component.

Osteo Bi-Flex One Per Day contains three active ingredients: vitamin D, glucosamine HCl, and Joint Shield 5-Loxin Advanced Boswellia serrata extract. Vitamin D supports calcium absorption and bone health, particularly in conditions like rickets and osteomalacia.

Glucosamine is included to support joint structure and comfort, while Boswellia serrata extract is a plant resin traditionally used for joint flexibility. The tablet also contains inactive ingredients including cellulose and croscarmellose as binders and fillers.

Does it work?

Not established
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
Not established

The graded evidence we hold for these ingredients covers different conditions than the ones this product is marketed for, so there's no established rating for its stated use.

Why this rating?
  • The label markets this product for: joint comfort and cartilage health support.
  • We looked for evidence on: Joint pain, Knee pain, Back pain, Exercise-induced muscle soreness, cartilage support, joint mobility — and 1 related terms.
  • The closest evidence on file: Boswellia Serrata is rated "Insufficient Reliable Evidence To Rate" for Exercise-induced muscle soreness (Natural Medicines).
  • Also on file: Boswellia Serrata is rated "Insufficient Reliable Evidence To Rate" for Knee pain.
  • Also on file: Glucosamine is rated "Insufficient Reliable Evidence To Rate" for Back pain, Joint pain, Knee pain.

Vitamin D is effective for rickets, osteomalacia, renal bone disease, hypoparathyroidism, and familial hypophosphatemia — conditions where the body struggles to absorb or use calcium properly. Glucosamine is likely effective for osteoarthritis.

Boswellia serrata is possibly effective for osteoarthritis, but evidence for hay fever, Alzheimer disease, asthma, or headache isn't established in our data. The evidence for some claimed uses of glucosamine and Boswellia — such as aging skin, back pain, liver disease, or colorectal cancer — is insufficient to rate.

The evidence, ingredient by ingredient Vitamin D 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.

Vitamin D is generally well tolerated at recommended doses but can cause toxicity if taken in very high amounts over time; symptoms include weakness, nausea, and in severe cases, kidney problems and anemia. Glucosamine taken by mouth is well tolerated by most people, though some experience bloating, constipation, diarrhea, heartburn, or nausea.

Rarely, allergic reactions including itching, hives, swelling, difficulty breathing, or anaphylaxis have been reported; asthma flare-ups are also documented. Boswellia serrata is generally well tolerated short-term and may cause abdominal pain, diarrhea, headache, heartburn, nausea, or dizziness.

The safety data for this product during pregnancy is incomplete — vitamin D is often used at recommended doses in pregnancy but should be under your doctor's guidance; glucosamine is not recommended during pregnancy due to insufficient safety data, and Boswellia is also best avoided. None of these ingredients are recommended during breastfeeding.

Side effects, ingredient by ingredient Vitamin D 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, Vitamin D.
  • The most serious interaction on file is rated Major.
  • Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs; immunosuppressants / transplant drugs; diabetes medications; heart-rhythm medications.
  • For scale: 1,090 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.

Before taking Osteo Bi-Flex One Per Day, double-check with your doctor or pharmacist if you take warfarin or other blood thinners (Major interaction risk). Also flag heart rhythm medications (verapamil, diltiazem, digoxin), cholesterol drugs (atorvastatin), thiazide diuretics, calcipotriene, diabetes medications, acetaminophen, immunosuppressants, or any drug your liver processes through CYP3A4, CYP2D6, CYP2C19, CYP1A2, or CYP2C9 enzymes, since Moderate theoretical interactions or Minor concerns exist with one or more ingredients.

Check your own medication Run your meds through the checker above

The bottom line

Scorecard at a glanceFully disclosed formula with no established evidence rating for its marketed use. Major medication interactions have been identified, and safety information is well characterized.

Osteo Bi-Flex One Per Day is intended for people seeking joint support and bone health through glucosamine, vitamin D, and Boswellia. It's especially relevant if you have osteoarthritis or vitamin D deficiency.

Anyone taking warfarin, heart rhythm medications, diabetes drugs, cholesterol pills, or immunosuppressant drugs needs to check with their doctor or pharmacist before starting, because interactions are documented or theoretically possible. Pregnant or breastfeeding women should talk it over with their own healthcare provider before taking it.

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

Assessment coverage: 3 of 3 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Feb 23, 2016.

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 One Per Day, straight from the product label.

Brand Osteo Bi-Flex
Net contents 30 Coated Tablet(s)
Market status On market
Date entered into DSLD Feb 23, 2016
DSLD ID 56547
Product type Other Combinations
Supplement form Tablet Or Pill
Dietary claims / uses Nutrient, All Other, Structure/Function
Intended target group(s) Adult (18 - 50 Years), 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 One Per Day 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:
1 Tablet(s)
Maximum serving Sizes:
1 Tablet(s)
IngredientAmount% DV
Calories10 {Calories}--
Total Carbohydrates2 Gram(s)1%
Vitamin D400 IU100%
Glucosamine HCl1500 mg--
Joint Shield 5-Loxin Advanced Boswellia serrata extract100 mg--

Other ingredients: Cellulose, Croscarmellose, Contains <2% of

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.
General Statements

It's a lot easier to be active, not to mention go about your daily life and activities, when you've got joint comfort on your side.

When you're feeling great, nothing can stand in your way.

Individual results may vary.

New look

Joint Health

Helps strengthen your joints

Are you ready? Every minute of every day, the world asks the same question...Are you ready? Ready for your first step? Your next step? To walk? To run? To ride? To soar? Your joints? They're where motion begins.

To make sure they're always ready to perform. To give you the freedom to chase your joy. So that you can always be...Ready for action

Brand IP Statement(s)

With Osteo Bi-Flex, joint comfort is no longer a luxury - it's a way of life! Osteo Bi-Flex One Per Day is the most convenient way to comfort overworked joints and nourish your cartilage...which will give you the confidence you need to take on anything.

Osteo Bi-Flex keeps your joints healthy...so you can keep going!

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

5-Loxin ADVANCED is a trademark of PL Thomas - Laila Nutraceuticals, Inc and is used under license. International Patents: Pending. See bottom of box for more information about our Ambassador's Club

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

Osteo Bi-Flex was created to nurture and help defend those joints.

Joint Shield

Precautions

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

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

Keep out of reach of children.

Tamper resistant: Do not use if seal under cap is broken or missing.

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.

Not intended for use by persons under the age of 18.

Formula

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

Joint Shield plus glucosamine & Vitamin D

Formulation

Free of gluten

Storage

Store at room temperature and avoid excessive heat.

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.

Suggested/Recommended/Usage/Directions

1 per day

Directions for adult use: Take one (1) tablet per day preferably with food.

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

Osteo Bi-Flex One Per Day by Osteo Bi-Flex label

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

Osteo Bi-Flex One Per Day 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 One Per Day by Osteo Bi-Flex

These are the 3 active ingredients this product is made of. Select any to open its full monograph.

Serving size1 Tablet(s) Dosage formTablet Or Pill Amounts shown are per serving.

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

Vitamin D

Interacts with
715 drugs
400 IU per serving Form: Cholecalciferol, Vitamin D3

Vitamin D is a fat-soluble vitamin that helps your body absorb calcium and is important for healthy bones, muscles, and immune function. Many people,...

Vitamin D monograph & interactions

Glucosamine HCl

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 HCl monograph & interactions

Joint Shield 5-Loxin Advanced Boswellia serrata extract

Interacts with
952 drugs
100 mg per serving

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 Boswellia serrata extract monograph & interactions

Other (inactive) ingredients: Cellulose, Croscarmellose, Contains <2% of. These complete the product’s ingredient list but are not active constituents.

Interaction report

Osteo Bi-Flex One Per Day by Osteo Bi-Flex Drug Interactions

Want to check YOUR meds against Osteo Bi-Flex One Per Day?

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
1,089Drugs
2 Major 1,018 Moderate 69 Minor

Ingredients driving the most interactions

Joint Shield 5-Loxin Advanced Boswellia serrata extract 952
Vitamin D 715
Glucosamine HCl 170

Individual Drug Interactions

The ingredients in Osteo Bi-Flex One Per Day interact with 1,089 drugs. Click any drug to see the details.

3 of the 3 ingredients in Osteo Bi-Flex One Per Day interact with drugs. Each result below shows which ingredient is responsible. Joint Shield 5-Loxin Advanced Boswellia serrata extract Vitamin D Glucosamine HCl

Each ingredient & the kinds of drugs it affects

For each ingredient in Osteo Bi-Flex One Per Day 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 Advanced Boswellia serrata extract6 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 Boswellia serrata extract full monograph & interactions

Vitamin D8 drug types · 715 drugs

Aluminum

Vitamin D might increase aluminum absorption and toxicity, but this has only been reported in people with renal failure.
The protein that transports calcium across the intestinal wall can also bind and transport aluminum. This protein is stimulated by vitamin D, which may therefore increase aluminum absorption. This mechanism may contribute to increased aluminum levels and toxicity in people with renal failure, when they take vitamin D and aluminum-containing phosphate binders chronically.

Likelihood Probable Evidence B
Atorvastatin (Lipitor)

Vitamin D might reduce absorption of atorvastatin.
A small, low-quality clinical study shows that taking vitamin D reduces levels of atorvastatin and its active metabolites by up to 55%. However, while atorvastatin levels decreased, total cholesterol, low-density lipoprotein (LDL) cholesterol, and high-density lipoprotein (HDL) cholesterol levels did not substantially change. Atorvastatin is metabolized in the gut by CYP3A4 enzymes, and researchers theorized that vitamin D might induce CYP3A4, causing reduced levels of atorvastatin. However, this proposed mechanism was not specifically studied.

Likelihood Probable Evidence B
Calcipotriene (Dovonex)

Taking calcipotriene with vitamin D increases 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 vitamin D supplements might increase the risk of hypercalcemia.

Likelihood Probable Evidence D
Digoxin (Lanoxin)

Theoretically, hypercalcemia induced by high-dose vitamin D can increase the risk of arrhythmia from digoxin.
High doses of vitamin D can cause hypercalcemia. Hypercalcemia increases the risk of fatal cardiac arrhythmias with digoxin. Avoid vitamin D doses above the tolerable upper intake level (4000 IU daily for adults) and monitor serum calcium levels in people taking vitamin D and digoxin concurrently.

Likelihood Possible Evidence D
Diltiazem (Cardizem, Others)

Theoretically, hypercalcemia induced by high-dose vitamin D can reduce the therapeutic effects of diltiazem for arrhythmia.
High doses of vitamin D can cause hypercalcemia. Hypercalcemia can reduce the effectiveness of verapamil in atrial fibrillation. Theoretically this could also occur with diltiazem. Avoid vitamin D doses above the tolerable upper intake level (4000 IU daily for adults) and monitor serum calcium levels in people taking vitamin D and diltiazem concurrently.

Likelihood Probable Evidence B
Thiazide Diuretics

Theoretically, taking thiazide diuretics and high-dose vitamin D can increase the risk of hypercalcemia.
Thiazide diuretics decrease urinary calcium excretion, which could lead to hypercalcemia if vitamin D supplements are taken concurrently. This has been reported in people being treated with vitamin D for hypoparathyroidism, and also in elderly people with normal parathyroid function who were taking a thiazide, vitamin D, and calcium-containing antacids daily.

Likelihood Probable Evidence D
Verapamil (Calan, Others)

Hypercalcemia induced by high-dose vitamin D can reduce the therapeutic effects of verapamil for arrhythmia.
Hypercalcemia due to high doses of vitamin D can reduce the effectiveness of verapamil in atrial fibrillation. Avoid vitamin D doses above the tolerable upper intake level (4000 IU daily for adults) and monitor serum calcium levels in people taking vitamin D and verapamil concurrently.

Likelihood Probable Evidence B
Cytochrome P450 3A4 (Cyp3A4) Substrates

Vitamin D might induce CYP3A4 enzymes and reduce the bioavailability of CYP3A4 substrates.
There is some concern that vitamin D might induce CYP3A4. In vitro research suggests that vitamin D induces CYP3A4 transcription. Additionally, observational research has found that increased UV light exposure and serum vitamin D levels are associated with decreased serum levels of CYP3A4 substrates such as tacrolimus and sirolimus, while no association between UV light exposure or vitamin D levels and levels of mycophenolic acid, a non-CYP3A4 substrate, was found. A small, low-quality clinical study shows that taking vitamin D reduces levels of the CYP3A4 substrate atorvastatin and its active metabolites by up to 55%; however, the clinical effects of atorvastatin were not reduced. While researchers theorized that vitamin D might induce CYP3A4, this proposed mechanism was not specifically studied.

Likelihood Possible Evidence D
Vitamin D full monograph & interactions

Glucosamine HCl4 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 HCl full monograph & interactions
The maker

Brand information

Manufacturer and brand details for Osteo Bi-Flex One Per Day, 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 One Per Day by Osteo Bi-Flex: Common Questions

Does Osteo Bi-Flex One Per Day by Osteo Bi-Flex interact with any medications?
Yes. Based on its ingredients, Osteo Bi-Flex One Per Day has a known interaction with 1,089 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 One Per Day contains 3 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.
Can I take this if I'm pregnant or breastfeeding?
There isn't enough safety data for glucosamine or Boswellia serrata during pregnancy or breastfeeding — these ingredients are best avoided unless your doctor advises otherwise. Vitamin D may be used at recommended doses during pregnancy under your doctor's guidance, but the full picture for this product in pregnancy is incomplete. Talk with your doctor or pharmacist for personalized advice.
What's glucosamine HCl, and what does it do in this product?
Glucosamine HCl is a compound found naturally in cartilage. It's included in this product to support joint structure and comfort, particularly for people with osteoarthritis. It's likely effective for that use, though the evidence for other joint conditions is not yet established.
Will this interact with my blood thinner?
Yes — glucosamine may increase the blood-thinning effect of warfarin (Coumadin), raising your risk of bruising and bleeding. Two case reports documented this in people taking glucosamine/chondroitin combinations with warfarin. Do not start this product without checking with your doctor or pharmacist first.
What are the most common side effects?
Glucosamine can cause bloating, constipation, diarrhea, heartburn, or nausea. Boswellia serrata may cause abdominal pain, diarrhea, headache, heartburn, or nausea. Vitamin D is well tolerated at recommended doses. Rarely, glucosamine has caused allergic reactions including hives, swelling, or difficulty breathing.
Is vitamin D toxic?
Vitamin D is generally safe at recommended doses, but very high doses over time can cause toxicity with symptoms like weakness, nausea, and in severe cases, kidney problems and anemia. This product is formulated as a one-per-day supplement, so staying at the recommended dose is important.
Does Boswellia serrata work for osteoarthritis?
Boswellia serrata is possibly effective for osteoarthritis based on available evidence. However, evidence for other uses like hay fever, Alzheimer disease, asthma, or cluster headaches isn't established in our data, so talk with your doctor about whether it's right for your specific joint concerns.

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.

Osteo Bi-Flex One Per Day label
Go deeper

The Full Monographs Behind Osteo Bi-Flex One Per Day’s Ingredients

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

Herb & supplement monograph

Vitamin D

Interacts with 715 drugs

Vitamin D is a fat-soluble vitamin that helps your body absorb calcium and is important for healthy bones, muscles, and immune function. Many people, especially those with low sun exposure,...

Read the full Vitamin D 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 One Per Day'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 100 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.

Vitamin D 26 references
  1. McEvoy GK, ed. AHFS Drug Information. Bethesda, MD: American Society of Health-System Pharmacists, 1998.
  2. Tatro DS, ed. Drug Interactions Facts. Facts and Comparisons Inc., St. Louis, MO. 1999.
  3. Koutkia P, Chen TC, Holick MF. Vitamin D intoxication associated with an over-the-counter supplement. N Engl J Med 2001;345:66-7. PubMed
  4. Bar-Or D, Yoel G. Calcium and calciferol antagonize effect of verapamil in atrial fibrillation. Br Med J 1981;282:1585-6.
  5. Demontis R, Leflon A, Fournier A, et al. 1 alpha(OH) vitamin D3 increases plasma aluminum in hemodialyzed patients taking AI(OH)3. Clin Nephrol 1986;26:146-9.
  6. Crowe M, Wollner L, Griffiths RA. Hypercalcemia following vitamin D and thiazide therapy in the elderly. Practitioner 1984;228:312-3.
  7. Parfitt AM. Thiazide-induced hypercalcemia in vitamin D-treated hypoparathyroidism. Ann Intern Med 1972;77:557-63. PubMed
  8. Thiazide diuretics and the risk of osteoporosis. Pharmacist's Letter/Prescriber's Letter 2003;19(11):191105.
  9. Moon J. The role of vitamin D in toxic metal absorption. J Am Coll Nutr 1994;13:559-64.
  10. Demontis R, Reissi D, Noel C, et al. Indirect clinical evidence that 1alphaOH vitamin D<SUB>3</SUB> increases the intestinal absorption of aluminum. Clin Nephrol 1989;31:123-7.
  11. Adler AJ, Berlyne GM. Duodenal aluminum absorption in the rat: effect of vitamin D. Am J Physiol 1985;249:G209-13. PubMed
  12. Schwartz JB. Effects of vitamin D supplementation in atorvastatin-treated patients: A new drug interaction with an unexpected consequence. Clin Pharmacol Ther 2009;85:198-203. PubMed
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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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