Interactions on record — worth a quick check against your medications. Based on 1 of 5 ingredients. Check your meds →
Dietary supplement

PB-4 Select Ingredients & Drug Interactions

by Moss Nutrition

PB-4 Select label
See full label image
Capsule Category: Other Combinations
Most serious interaction: Moderate
Clinical methodology reviewed by · Updated Sep 16, 2026 · Label data from the NIH DSLD
What is this page for?

First and foremost: checking PB-4 Select 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: Moderate

PB-4 Select is a dietary supplement by Moss Nutrition with 5 active ingredients. Its ingredients are commonly taken for bone health and osteoporosis, correcting vitamin d deficiency, immune system support.Based on those ingredients, 715 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Vitamin D3. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

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Check Your Meds Against PB-4 Select by Moss Nutrition

Ask about any prescription or over-the-counter medication and we check it for interactions with PB-4 Select by Moss Nutrition — and tell you which ingredient is responsible.

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HelloPharmacist Scorecard of PB-4 Select by Moss Nutrition

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

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 1 of its 5 active ingredients.
  • “PB-4 Proprietary Probiotic Blend” is a proprietary blend — the label gives one combined amount (70 mg) without saying how much of each component you get.

PB-4 Select contains 5 active ingredients: vitamin D3 and four probiotic bacterial strains (L. plantarum KABP-022, L. plantarum KABP-023, L. plantarum KABP-033, and P. acidilactici KABP-21). Vitamin D3 supports bone health and calcium absorption; the probiotics are intended to support gut health.

The capsule also holds inactive ingredients — hydroxypropyl methylcellulose, maltodextrin, and vegetable stearate — which are fillers and binders.

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 — see Vitamin D's own graded uses on its monograph.

Why this rating?
  • The label markets this product for: Multi-strain probiotic blend with vitamin D3.
  • We looked for evidence on: Muscle strength.
  • The closest evidence on file: Vitamin D is rated "Insufficient Reliable Evidence To Rate" for Muscle strength (Natural Medicines).

Vitamin D3 is effective for several bone and mineral disorders: familial hypophosphatemia, osteomalacia (softening of the bones), renal osteodystrophy (bone disease from kidney disease), rickets, and hypoparathyroidism. The evidence for the probiotic strains in this product isn't on file in our data.

The evidence, ingredient by ingredient Vitamin D

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 1 of the 1 matched ingredient.
  • Pregnancy & breastfeeding safety ratings cover 1 of 1.
  • General safety write-ups exist for 1 of 1.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

Vitamin D3 is generally well tolerated at recommended doses, but very high doses over time can cause toxicity with symptoms like high blood calcium, bone loss in adults, and slowed growth in children. At recommended amounts, it's often used in pregnancy, though you should use it only under your doctor's guidance.

At those standard doses it's generally considered acceptable during breastfeeding as well; if you're considering higher amounts, check with your doctor first. The safety data for the four probiotic strains isn't on file for us.

Side effects, ingredient by ingredient Vitamin D

Meds to double-check

Moderate interaction found
Known Interaction Concern · database check
Moderate identified

The most serious documented interaction for these ingredients is Moderate. Check your medications for a personalized result.

Why this rating?
  • 1 of the 1 matched ingredient can interact with medications — Vitamin D.
  • The most serious interaction on file is rated Moderate.
  • Some involve high-stakes drug classes: heart-rhythm medications.
  • For scale: 716 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 you take this product, check with your doctor or pharmacist if you take digoxin or any heart-rhythm medication (verapamil, diltiazem), water pills (thiazide diuretics), atorvastatin or other cholesterol drugs, calcipotriene (a psoriasis cream), or any medication metabolized by your liver's CYP3A4 enzyme system. Moderate and minor interactions are documented.

Check your own medication Run your meds through the checker above

The bottom line

Scorecard at a glanceFormula with limited ingredient disclosure with no established evidence rating for its marketed use. Moderate medication interactions have been identified, and safety information is well characterized.

This product is most appropriate for people with specific bone and mineral disorders — rickets, hypoparathyroidism, or osteomalacia — when prescribed by their doctor. If you take a heart medication (like digoxin, verapamil, or diltiazem), a water pill, a cholesterol drug, or any other regular medication, check it against vitamin D's interactions on this page before you start.

Talk with your doctor or pharmacist about whether PB-4 Select is right for you.

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

Assessment coverage: 1 of 5 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Sep 22, 2022.

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 PB-4 Select, straight from the product label.

Brand Moss Nutrition
Barcode (UPC) M161
Net contents 30 Vegetarian Capsule(s)
Market status On market
Date entered into DSLD Sep 22, 2022
DSLD ID 274246
Product type Other Combinations
Supplement form Capsule
Dietary claims / uses Nutrient, All Other
Intended target group(s) Adult (18 - 50 Years), Gluten Free, Dairy 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 PB-4 Select by Moss Nutrition, 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 Capsule(s)
Maximum serving Sizes:
1 Capsule(s)
Servings per container
30
UPC/BARCODE
M161
IngredientAmount% DV
Vitamin D310 mcg50%
L. plantarum KABP-0220 NP--
L. plantarum KABP-0230 NP--
PB-4 Proprietary Probiotic Blend70 mg--
L. Plantarum KABP-0330 NP--
P. acidilactici KABP-210 NP--

Other ingredients: Hydroxypropyl Methylcellulose, Maltodextrin, Vegetable 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.
Brand IP Statement(s)

Moss Nutrition M Professional Supplements Est. 1991

KAPB is a trademark of Kaneka Corporation.

Formula

Multi-strain probiotic blend with vitamin D3

FDA Statement of Identity

Dietary Supplement

Suggested/Recommended/Usage/Directions

Suggested use: 1 capsule per day after a meal, or as directed by your healthcare professional.

Formulation

Does not contain gluten, dairy or GMOs.

Precautions

Warning: If you are taking medication, have a medical condition or an upcoming medical procedure, or are pregnant or nursing, consult a physician before using.

If adverse reactions occur, discontinue use and consult your healthcare practitioner.

Keep out of reach of children.

Storage

Store sealed in a cool, dry place.

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

See for yourself

PB-4 Select by Moss Nutrition label

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

PB-4 Select 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 PB-4 Select by Moss Nutrition

These are the 5 active ingredients this product is made of. Select any to open its full monograph.

Serving size1 Capsule(s) Dosage formCapsule Servings per container30 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 D3

Interacts with
715 drugs
10 mcg per serving Form: Cholecalciferol

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 D3 monograph & interactions

PB-4 Proprietary Probiotic Blend

70 mg per serving
  • › L. plantarum KABP-022
  • › L. plantarum KABP-023
  • › L. Plantarum KABP-033
  • › P. acidilactici KABP-21

Other (inactive) ingredients: Hydroxypropyl Methylcellulose, Maltodextrin, Vegetable Stearate. These complete the product’s ingredient list but are not active constituents.

Interaction report

PB-4 Select by Moss Nutrition Drug Interactions

Want to check YOUR meds against PB-4 Select?

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
715Drugs
80 Moderate 635 Minor

Ingredients driving the most interactions

Vitamin D3 715

Individual Drug Interactions

The ingredients in PB-4 Select interact with 715 drugs. Click any drug to see the details.

1 of the 5 ingredients in PB-4 Select interact with drugs. Each result below shows which ingredient is responsible. Vitamin D3

Each ingredient & the kinds of drugs it affects

For each ingredient in PB-4 Select with known interactions, here are the types of medications it can affect. Open any type for the detail — or search your exact drug in the checker above.

Vitamin D38 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 D3 full monograph & interactions
The maker

Brand information

Manufacturer and brand details for PB-4 Select, from the product label.

Moss Nutrition

See all Moss Nutrition products
Name
Moss Nutrition Products, Inc.
Street Address
380 Russell Street
City
Hadley
State
MA
ZipCode
01035
Phone Number
800-851-5444
Web Address
www.mossnutrition.com
Pharmacist Counseling Corner

PB-4 Select by Moss Nutrition: Common Questions

Does PB-4 Select by Moss Nutrition interact with any medications?
Yes. Based on its ingredients, PB-4 Select has a known interaction with 715 medications. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
PB-4 Select contains 5 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.
Is vitamin D3 safe to take during pregnancy?
Vitamin D3 is rated likely safe at recommended doses and is often used in pregnancy, but use it only under your doctor's guidance. At higher doses the safety data is mixed, so talk with your doctor before taking more than the standard amount.
Can I take vitamin D3 if I'm breastfeeding?
Yes, vitamin D3 is considered likely safe during breastfeeding at recommended doses. If you're thinking about taking higher amounts, check with your doctor first.
What happens if I take too much vitamin D3?
Very high doses over time can cause vitamin D toxicity, with symptoms including high blood calcium levels, bone loss, weak growth in children, and in rare cases eye inflammation and light sensitivity. Stick to recommended doses unless your doctor tells you otherwise.
What are the probiotic strains in this product for?
The four Lactobacillus and Pediococcus strains are intended to support gut health, though the strength of evidence for these specific strains isn't on file for us.
Does this product have fillers?
Yes — it contains hydroxypropyl methylcellulose, maltodextrin, and vegetable stearate as inactive ingredients (binders and fillers).

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.

PB-4 Select label
Go deeper

The Full Monographs Behind PB-4 Select’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 →
Sources

Sources & How We Checked

PB-4 Select'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 26 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
  13. Dietary reference intakes for calcium and vitamin D. Institute of Medicine, November 30, 2010. Available at: http://www.iom.edu/~/media/Files/Report%20Files/2010/Dietary-Reference-Intakes-for-Calcium-and-Vitamin-D/Vitamin%20D%20and%20Calcium%202010%20Repo
  14. Cox KA, Dunn MA. Aluminum toxicity alters the regulation of calbindin-D28k protein and mRNA expression in chick intestine. J Nutr 2001;131:2007-13. PubMed
  15. Escribano, J., Balaguer, A., Pagone, F., Feliu, A., and Roque, I. Figuls. Pharmacological interventions for preventing complications in idiopathic hypercalciuria. Cochrane.Database.Syst.Rev. 2009;(1):CD004754. PubMed
  16. Carlton, S., Clopton, D., and Cappuzzo, K. A. Vitamin D deficiency: appropriate replenishment therapies and the effects of vitamin D toxicity. Consult Pharm 2010;25(3):171-177. PubMed
  17. Wang, H., Xia, N., Yang, Y., and Peng, D. Q. Influence of vitamin D supplementation on plasma lipid profiles: a meta-analysis of randomized controlled trials. Lipids Health Dis. 2012;11:42. PubMed
  18. Turner AN, Carr Reese P, Fields KS, Anderson J, Ervin M, Davis JA, Fichorova RN, Roberts MW, Klebanoff MA, Jackson RD. A blinded, randomized controlled trial of high-dose vitamin D supplementation to reduce recurrence of bacterial vaginosis. Am J Obstet G PubMed
  19. Weiner M, Epstein FH. Signs and symptoms of electrolyte disorders. Yale J Biol Med. 1970;43(2):76-109.
  20. Lappe J, Watson P, Travers-Gustafson D, Recker R, Garland C, Gorham E, Baggerly K, McDonnell SL. Effect of Vitamin D and Calcium Supplementation on Cancer Incidence in Older Women: A Randomized Clinical Trial. JAMA. 2017 Mar 28;317(12):1234-1243. PubMed
  21. Roth DE, Leung M, Mesfin E, Qamar H, Watterworth J, Papp E. Vitamin D supplementation during pregnancy: state of the evidence from a systematic review of randomised trials. BMJ. 2017;359:j5237. PubMed
  22. Murai IH, Fernandes AL, Sales LP, et al. Effect of a single high dose of vitamin D3 on hospital length of stay in patients with moderate to severe COVID-19: A randomized clinical trial. JAMA. 2021.
  23. Wang Z, Schuetz EG, Xu Y, Thummel KE. Interplay between vitamin D and the drug metabolizing enzyme CYP3A4. J Steroid Biochem Mol Biol 2013;136:54-8. PubMed
  24. Doyle D, Browne U, Brickley A, Murphy D. Vitamin D-induced hypercalcaemia and acute kidney injury in sarcoidosis. BMJ Case Rep 2023;16(1):e250580. PubMed
  25. Williamson A, Martineau AR, Sheikh A, Jolliffe D, Griffiths CJ. Vitamin D for the management of asthma. Cochrane Database Syst Rev 2023;2(2):CD011511. PubMed
  26. Kinesya E, Santoso D, Gde Arya N, et al. Vitamin D as adjuvant therapy for diabetic foot ulcers: Systematic review and meta-analysis approach. Clin Nutr ESPEN 2023;54:137-143. PubMed

See these in context on the Vitamin D monograph →

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

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