Major interaction on record — check this product against your medications before combining. Based on 13 of 19 ingredients. Check your meds →
Dietary supplement

Pro-NH3 Ingredients & Drug Interactions

by Loomis Enzymes

Pro-NH3 label
See full label image
Capsule Category: Other Combinations
Most serious interaction: Major
Clinical methodology reviewed by · Updated Sep 9, 2026 · Label data from the NIH DSLD
What is this page for?

First and foremost: checking Pro-NH3 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

Pro-NH3 is a dietary supplement by Loomis Enzymes with 19 active ingredients. Its ingredients are commonly taken for hair growth and thinning hair, brittle nails, skin health.Based on those ingredients, 666 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are L-Arginine, Rose Hip, Vitamin C. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

Jump to a section

Check Your Meds Against Pro-NH3 by Loomis Enzymes

Ask about any prescription or over-the-counter medication and we check it for interactions with Pro-NH3 by Loomis Enzymes — and tell you which ingredient is responsible.

Pharmacist-reviewed data Checks every ingredient Answer in seconds
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HelloPharmacist Scorecard of Pro-NH3 by Loomis Enzymes

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 Jul 11, 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 7 of its 18 active ingredients.
  • “Pro-NH3 Amino Acid Blend” is a proprietary blend — the label gives one combined amount (500 mg) without saying how much of each component you get.

Pro-NH3 contains 18 active ingredients, primarily a blend of branched-chain and other amino acids: L-leucine, L-isoleucine, and L-valine (branched-chain amino acids), along with L-arginine, L-methionine, L-lysine, L-tyrosine, L-phenylalanine, L-histidine, L-threonine, and L-cysteine. It also includes biotin (a B vitamin), and plant-derived ingredients: rose hip, acerola fruit juice (a natural source of vitamin C), calcium, and vitamin C.

Egg white, methylsulfonylmethane (MSM), and phytase (an enzyme) round out the formula. The inactive ingredients are cellulose, water, and phytase.

Does it work?

Couldn't assess
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 assessable

We hold no graded evidence for this product's ingredients for its stated purpose.

Why this rating?
  • The label markets this product for: pH balancing system.
  • Our graded evidence for these ingredients doesn't cover that particular purpose.

The data we hold does not establish that Pro-NH3 as a whole product is effective for any specific condition. Individual amino acids in it have varying levels of evidence: biotin is likely effective for biotin deficiency but only possibly ineffective for multiple sclerosis and seborrheic dermatitis; L-tyrosine is effective for phenylketonuria (PKU) and possibly effective for cognitive function and memory; L-phenylalanine is possibly effective for vitiligo; L-lysine is possibly effective for cold sores; L-methionine is possibly effective for neural tube birth defects; L-arginine, L-histidine, L-threonine, and L-cysteine all carry insufficient evidence or show insufficient evidence for their proposed uses.

Rose hip is possibly effective for postoperative pain and osteoarthritis. Vitamin C is effective for vitamin C deficiency and possibly effective for several conditions including anemia of chronic disease and exercise-induced respiratory infections.

Calcium is effective for kidney failure, dyspepsia, and hypocalcemia, and likely effective for osteoporosis. Without a stated use for the product itself, we cannot rate its overall effectiveness.

The evidence, ingredient by ingredient Biotin Rose Hip L-arginine Methionine Lysine Tyrosine Phenylalanine Histidine

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 11 of the 13 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 13 of 13.
  • General safety write-ups exist for 13 of 13.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

L-arginine is often well tolerated short-term but can lower blood pressure and should only be used under medical supervision, as safety for self-treatment is not well established. Oral L-arginine may cause abdominal pain, bloating, nausea, diarrhea, headache, insomnia, and flushing.

L-phenylalanine is generally tolerated in food amounts but carries safety concerns in pregnancy (Unsafe for supplements) and breastfeeding (Avoid supplements); common side effects include anxiety, constipation, headache, heartburn, insomnia, and nausea. L-tyrosine and L-threonine lack adequate pregnancy and breastfeeding safety data and should be avoided in supplement form unless a doctor advises otherwise.

Biotin is generally safe and well tolerated, even at higher doses, though amounts above 300 mg daily have rarely caused mild diarrhea. Calcium is generally safe at recommended amounts, with common side effects of belching, constipation, diarrhea, and stomach upset; very high doses pose rare risks of kidney stones.

Vitamin C is well tolerated at normal doses but at high doses (above 2 grams daily) can cause osmotic diarrhea, nausea, heartburn, and kidney stones in susceptible individuals. L-cysteine, L-methionine, L-lysine, L-histidine, and rose hip are generally well tolerated at typical doses.

L-arginine has not been adequately studied and should be avoided unless medically supervised; safety data for L-tyrosine, L-threonine, L-cysteine, and lysine during pregnancy and lactation are insufficient or not established, and high-dose supplements are not recommended without medical guidance.

Side effects, ingredient by ingredient Biotin Rose Hip L-arginine Methionine Lysine Tyrosine Phenylalanine Histidine

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?
  • 10 of the 13 matched ingredients can interact with medications — Lysine, Acerola, Phenylalanine, Calcium, Rose Hip, among others.
  • The most serious interaction on file is rated Major.
  • Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs; cancer treatments; diabetes medications; heart-rhythm medications; lithium; Parkinson's medications.
  • For scale: 666 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 Pro-NH3, check with your pharmacist or doctor if you take any of these: levodopa or other Parkinson medications, blood pressure drugs (ACE inhibitors, ARBs, or other antihypertensives), diabetes medications, blood thinners or antiplatelet drugs, potassium-sparing diuretics, HIV integrase inhibitors (dolutegravir, elvitegravir) or other antiretrovirals, thyroid hormone, beta-blockers, lithium, estrogen-containing products, or chemotherapy drugs. Several ingredients we could not check — L-leucine, L-isoleucine, L-valine, egg white, and methylsulfonylmethane — so if your medications are not listed here, a complete check is still wise.

Check your own medication Run your meds through the checker above

The bottom line

Scorecard at a glanceFormula with limited ingredient disclosure with no assessable stated purpose. Major medication interactions have been identified, and safety information is well characterized.

This product's main use is not specified in the data we hold, so we cannot tell you whether it's right for your goals. What we can tell you: if you take blood pressure medications, diabetes drugs, blood thinners, HIV antiretrovirals, levodopa for Parkinson disease, thyroid hormone, or any drug metabolized by the liver, you need to discuss this product with your pharmacist or doctor before starting.

Do not use it if you have phenylketonuria (PKU) or are pregnant or breastfeeding without first checking with your provider about the amino acid content.

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

Assessment coverage: 13 of 18 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Feb 23, 2025.

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 Pro-NH3, straight from the product label.

Brand Loomis Enzymes
Barcode (UPC) 697706011005
Net contents 180 Capsule(s)
Market status On market
Date entered into DSLD Feb 23, 2025
DSLD ID 327546
Product type Other Combinations
Supplement form Capsule
Dietary claims / uses Nutrient, All Other, Structure/Function
Intended target group(s) Adult (18 - 50 Years)
From the label
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.

Supplement Facts

The label details for Pro-NH3 by Loomis Enzymes, 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:
3 Capsule(s)
Maximum serving Sizes:
3 Capsule(s)
Servings per container
60
UPC/BARCODE
697706011005
IngredientAmount% DV
L-Leucine0 NP--
L-Arginine0 NP--
Biotin38 mcg127%
L-Isoleucine0 NP--
L-Methionine0 NP--
L-Lysine Hydrochloride0 NP--
L-Tyrosine0 NP--
L-Phenylalanine0 NP--
L-Valine0 NP--
L-Histidine Hydrochloride0 NP--
L-Threonine0 NP--
L-Cysteine Hydrochloride0 NP--
Protein1 Gram(s)1%
Egg White735 mg--
Methylsulfonylmethane270 mg--
Rose Hip75 mg--
Pro-NH3 Amino Acid Blend500 mg--
Calcium120 mg9%
Vitamin C10 mg11%
Acerola Fruit Juice45 mg--

Other ingredients: Cellulose, Water, Phytase

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

pHBS pH Balancing System

FDA Disclaimer Statement

This statement has not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.

Precautions

Keep out of reach of children

Note: Consult your physician before using this product if you are pregnant, nursing, taking medication, or have a medical condition.

Do not use if inner or outer seal is broken, torn, or missing.

Contains egg

Storage

To ensure freshness and potency, keep bottle tightly closed and store in a cool, dry place.

FDA Statement of Identity

A Dietary Supplement

Suggested/Recommended/Usage/Directions

Directions for use: Take 3 capsules, 3 times daily at anytime or as directed.

Brand IP Statement(s)

ESC (Eggshell calcium) is a trademark of ESM Technologies, LLC and is registered in the United States and other countries.

Formula

ESC

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

See for yourself

Pro-NH3 by Loomis Enzymes label

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

Pro-NH3 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 Pro-NH3 by Loomis Enzymes

These are the 19 active ingredients this product is made of. Select any to open its full monograph.

Serving size3 Capsule(s) Dosage formCapsule Servings per container60 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.

Biotin

No known
interactions
38 mcg per serving

Biotin (vitamin B7) is a water-soluble vitamin your body needs to turn food into energy and to support healthy hair, skin, and nails. Most people get...

Biotin monograph & interactions

Protein

1 Gram(s) per serving

Egg White

735 mg per serving

Methylsulfonylmethane

270 mg per serving

Rose Hip

Interacts with
213 drugs
75 mg per serving Form: Rosa canina

Rose hip is the vitamin C–rich fruit of the wild rose, used traditionally for colds and joint pain. A standardized rose hip powder has some research s...

Rose Hip monograph & interactions

Pro-NH3 Amino Acid Blend

500 mg per serving

Calcium

Interacts with
168 drugs
120 mg per serving Form: Eggshell Calcium

Calcium is an essential mineral your body needs for strong bones, nerve signaling, and muscle function, and supplements can help fill gaps when diet f...

Calcium monograph & interactions

Vitamin C

Interacts with
207 drugs
10 mg per serving Form: Acerola Juice

Vitamin C (ascorbic acid) is an essential nutrient your body needs but cannot make, so you must get it from food or supplements. It's important for im...

Vitamin C monograph & interactions

Acerola Fruit Juice

Interacts with
128 drugs
45 mg per serving Form: Malpighia glabra Fruit Juice

Acerola is a small tropical fruit prized for its very high natural vitamin C content, and it is mostly used as a food-based source of vitamin C and an...

Acerola Fruit Juice monograph & interactions

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

Interaction report

Pro-NH3 by Loomis Enzymes Drug Interactions

Want to check YOUR meds against Pro-NH3?

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
666Drugs
15 Major 571 Moderate 80 Minor

Ingredients driving the most interactions

L-Arginine 403
Rose Hip 213
Vitamin C 207
Calcium 168
Acerola Fruit Juice 128

Individual Drug Interactions

The ingredients in Pro-NH3 interact with 666 drugs. Click any drug to see the details.

10 of the 19 ingredients in Pro-NH3 interact with drugs. Each result below shows which ingredient is responsible. L-Arginine Rose Hip Vitamin C Calcium Acerola Fruit Juice L-Cysteine Hydrochloride L-Tyrosine L-Phenylalanine L-Threonine L-Lysine Hydrochloride

Each ingredient & the kinds of drugs it affects

For each ingredient in Pro-NH3 with known interactions, here are the types of medications they can affect. Open any type for the detail — or search your exact drug in the checker above.

L-Arginine9 drug types · 403 drugs

Ace Inhibitors (Aceis)

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

Likelihood Probable Evidence D
Angiotensin Receptor Blockers (Arbs)

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

Likelihood Probable Evidence D
Anticoagulant/Antiplatelet Drugs

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

Likelihood Possible Evidence D
Antidiabetes Drugs

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

Likelihood Possible Evidence D
Antihypertensive Drugs

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

Likelihood Probable Evidence D
Isoproterenol (Isuprel)

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

Likelihood Probable Evidence D
Potassium-Sparing Diuretics

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

Likelihood Possible Evidence D
Sildenafil (Viagra)

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

Likelihood Possible Evidence D
Testosterone

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

Likelihood Possible Evidence D
L-Arginine full monograph & interactions

Rose Hip8 drug types · 213 drugs

Alkylating Agents

Theoretically, the antioxidant effects of rose hip might reduce the effectiveness of alkylating agents but might also reduce the oxidative damage caused by certain alkylating agents.
Rose hip contains vitamin C. The use of antioxidants like vitamin C during chemotherapy is controversial. There is concern that antioxidants could reduce the activity of chemotherapy drugs that generate free radicals, such as cyclophosphamide, chlorambucil, carmustine, busulfan, and thiotepa. In contrast, some researchers theorize that antioxidants might make chemotherapy more effective by reducing oxidative stress that could interfere with apoptosis (cell death) of cancer cells. Further, some animal research suggests that the antioxidant effects of rose hip might attenuate cyclophosphamide-induced testicular toxicity. More evidence is needed to determine what effect, if any, antioxidants found in rose hip, such as vitamin C, have on the effectiveness and adverse effects of chemotherapy.

Likelihood Possible Evidence D
Aluminum

Theoretically, rose hip might increase the amount of aluminum absorbed from aluminum compounds.
Rose hip contains vitamin C. Theoretically, vitamin C increases the absorption of aluminum. Concomitant use might increase aluminum absorption, but the clinical significance of this is unknown. Administer rose hip two hours before or four hours after antacids.

Likelihood Probable Evidence D
Anticoagulant/Antiplatelet Drugs

Theoretically, rose hip might reduce the effectiveness of anticoagulant or antiplatelet drugs.
In vitro and animal research suggests that a constituent of rose hip, rugosin E, can induce platelet aggregation. This has not been shown in humans. Theoretically, concomitant use of rose hip might reduce the effectiveness of antiplatelet or anticoagulant drugs.

Likelihood Possible Evidence D
Antitumor Antibiotics

Theoretically, the antioxidant effects of rose hip might reduce the effectiveness of antitumor antibiotics.
Rose hip contains the antioxidant vitamin C. There is concern that antioxidants might reduce the activity of chemotherapy drugs that generate free radicals, such as antitumor antibiotics. In contrast, other researchers theorize that antioxidants might make antitumor antibiotic chemotherapy more effective by reducing oxidative stress that could interfere with apoptosis (cell death) of cancer cells. More evidence is needed to determine what effects, if any, antioxidants such as vitamin C have on antitumor antibiotic chemotherapy.

Likelihood Possible Evidence D
Estrogens

Theoretically, rose hip might increase blood levels of estrogens.
Rose hip contains vitamin C. Increases in plasma estrogen levels of up to 55% have occured under some circumstances when vitamin C is taken concurrently with oral contraceptives or hormone replacement therapy, including topical products. It is suggested that vitamin C prevents oxidation of estrogen in the tissues, regenerates oxidized estrogen, and reduces sulfate conjugation of estrogen in the gut wall. When tissue levels of vitamin C are high, these processes are already maximized and supplemental vitamin C does not have any effect on estrogen levels. However, increases in plasma estrogen levels may occur when women who are deficient in vitamin C take supplements.

Likelihood Possible Evidence D
Lithium

Theoretically, rose hip might increase blood levels of lithium.
Rose hip is thought to have diuretic properties. Theoretically, due to these potential diuretic effects, rose hip might reduce excretion and increase levels of lithium. The dose of lithium might need to be decreased.

Likelihood Probable Evidence D
Aspirin

Theoretically, rose hip might reduce the clearance of aspirin; however, its vitamin C content is likely too low to produce clinically significant effects.
Rose hip contains vitamin C. It has been suggested that acidification of the urine by vitamin C can decrease the urinary excretion of salicylates, increasing plasma salicylate levels. However, short-term use of up to 6 grams daily of vitamin C does not seem to affect urinary pH or salicylate excretion. The vitamin C content of rose hip is typically about 500 mg per 100 grams. Thus, a clinically significant interaction between rose hip and aspirin is unlikely.

Likelihood Unlikely Evidence B
Warfarin (Coumadin)

Theoretically, rose hip might reduce the effectiveness of warfarin; however, its vitamin C content is likely too low to produce clinically significant effects.
Rose hip contains vitamin C. High doses of vitamin C may reduce the response to warfarin, possibly by causing diarrhea and reducing warfarin absorption. This occurred in two people who took up to 16 grams daily of vitamin C, and resulted in decreased prothrombin time. Lower doses of 5-10 grams daily of vitamin C can also reduce warfarin absorption, but this does not seem to be clinically significant. The vitamin C content of rose hip is typically about 500 mg per 100 grams. Thus, a clinically significant interaction between rose hip and warfarin is unlikely.

Likelihood Unlikely Evidence D
Rose Hip full monograph & interactions

Vitamin C13 drug types · 207 drugs

Alkylating Agents

Theoretically, antioxidant effects of vitamin C might reduce the effectiveness of alkylating agents.
The use of antioxidants like vitamin C during chemotherapy is controversial. There is concern that antioxidants could reduce the activity of chemotherapy drugs that generate free radicals, such as cyclophosphamide, chlorambucil, carmustine, busulfan, and thiotepa. In contrast, some researchers theorize that antioxidants might make chemotherapy more effective by reducing oxidative stress that could interfere with apoptosis (cell death) of cancer cells. More evidence is needed to determine what effect, if any, antioxidants such as vitamin C have on chemotherapy.

Likelihood Possible Evidence D
Aluminum

Vitamin C can increase the amount of aluminum absorbed from aluminum compounds.
Research in animals and humans shows that vitamin C increases aluminum absorption, theoretically by chelating aluminum and keeping it in solution where it is available for absorption. In people with normal renal function, urinary excretion of aluminum will likely increase, making aluminum retention and toxicity unlikely. Patients with renal failure who take aluminum-containing compounds such as phosphate binders should avoid vitamin C supplements in doses above the recommended dietary allowances.

Likelihood Probable Evidence B
Antitumor Antibiotics

Theoretically, the antioxidant effects of vitamin C might reduce the effectiveness of antitumor antibiotics.
The use of antioxidants like vitamin C during chemotherapy is controversial. There is concern that antioxidants could reduce the activity of chemotherapy drugs which generate free radicals, such as doxorubicin. In contrast, some researchers theorize that antioxidants might make chemotherapy more effective by reducing oxidative stress that could interfere with apoptosis (cell death) of cancer cells. More evidence is needed to determine what effects, if any, antioxidants such as vitamin C have on chemotherapy.

Likelihood Possible Evidence D
Estrogens

Vitamin C might increase blood levels of estrogens.
Increases in plasma estrogen levels of up to 55% occur under some circumstances when vitamin C is taken concurrently with oral contraceptives or hormone replacement therapy, including topical products. It is suggested that vitamin C prevents oxidation of estrogen in the tissues, regenerates oxidized estrogen, and reduces sulfate conjugation of estrogen in the gut wall. When tissue levels of vitamin C are high, these processes are already maximized and supplemental vitamin C does not have any effect on estrogen levels. Increases in plasma estrogen levels may occur when patients who are deficient in vitamin C take supplements. Monitor these patients for estrogen-related side effects.

Likelihood Probable Evidence B
Fluphenazine (Prolixin)

Theoretically, vitamin C might decrease levels of fluphenazine.
In one patient there was a clinically significant decrease in fluphenazine levels when vitamin C (500 mg twice daily) was started. The mechanism is not known, and there is no further data to confirm this interaction.

Likelihood Possible Evidence D
Indinavir (Crixivan)

Vitamin C can modestly reduce indinavir levels.
One pharmacokinetic study shows that taking vitamin C 1 gram orally once daily along with indinavir 800 mg orally three times daily reduces the area under the concentration-time curve of indinavir by 14%. The mechanism of this interaction is unknown, but it is unlikely to be clinically significant in most patients. The effect of higher doses of vitamin C on indinavir levels is unknown.

Likelihood Probable Evidence B
Levothyroxine (Synthroid, Others)

Vitamin C can increase levothyroxine absorption.
Two clinical studies in adults with poorly controlled hypothyroidism show that swallowing levothyroxine with a glass of water containing vitamin C 500-1000 mg in solution reduces thyroid stimulating hormone (TSH) levels and increases thyroxine (T4) levels when compared with taking levothyroxine alone. This suggests that vitamin C increases the oral absorption of levothyroxine, possibly due to a reduction in pH.

Likelihood Probable Evidence B
Warfarin (Coumadin)

High-dose vitamin C might reduce the levels and effectiveness of warfarin.
Vitamin C in high doses may cause diarrhea and possibly reduce warfarin absorption. There are reports of two people who took up to 16 grams daily of vitamin C and had a reduction in prothrombin time. Lower doses of 5-10 grams daily can also reduce warfarin absorption. In many cases, this does not seem to be clinically significant. However, a case of warfarin resistance has been reported for a patient who took vitamin C 500 mg twice daily. Cessation of vitamin C supplementation resulted in a rapid increase in international normalized ratio (INR). Tell patients taking warfarin to avoid taking vitamin C in excessively high doses (greater than 10 grams daily). Lower doses may be safe, but the anticoagulation activity of warfarin should be monitored. Patients who are stabilized on warfarin while taking vitamin C should avoid adjusting vitamin C dosage to prevent the possibility of warfarin resistance.

Likelihood Possible Evidence D
Acetaminophen (Tylenol, Others)

High-dose vitamin C might slightly prolong the clearance of acetaminophen.
A small pharmacokinetic study in healthy volunteers shows that taking high-dose vitamin C (3 grams) 1.5 hours after taking acetaminophen 1 gram slightly increases the apparent half-life of acetaminophen from around 2.3 hours to 3.1 hours. Ascorbic acid competitively inhibits sulfate conjugation of acetaminophen. However, to compensate, elimination of acetaminophen glucuronide and unconjugated acetaminophen increases. This effect is not likely to be clinically significant.

Likelihood Probable Evidence B
Aspirin

Acidification of the urine by vitamin C might increase aspirin levels.
It has been suggested that acidification of the urine by vitamin C could increase reabsorption of salicylates by the renal tubules, and increase plasma salicylate levels. However, short-term use of up to 6 grams daily of vitamin C does not seem to affect urinary pH or salicylate excretion, suggesting this interaction is not clinically significant.

Likelihood Possible Evidence B
Choline Magnesium Trisalicylate (Trilisate)

Acidification of the urine by vitamin C might increase choline magnesium trisalicylate levels.
It has been suggested that acidification of the urine by vitamin C could increase reabsorption of salicylates by the renal tubules, and increase plasma salicylate levels. However, short-term use of up to 6 grams daily of vitamin C does not seem to affect urinary pH or salicylate excretion, suggesting this interaction probably is not clinically significant.

Likelihood Possible Evidence B
Niacin

Vitamin C might decrease the beneficial effects of niacin on high-density lipoprotein (HDL) cholesterol levels.
A combination of niacin and simvastatin (Zocor) effectively raises HDL cholesterol levels in patients with coronary disease and low HDL levels. Clinical research shows that taking a combination of antioxidants (vitamin C, vitamin E, beta-carotene, and selenium) along with niacin and simvastatin (Zocor) attenuates this rise in HDL, specifically the HDL-2 and apolipoprotein A1 fractions, by more than 50% in patients with coronary disease. It is not known whether this adverse effect is due to a single antioxidant such as vitamin C, or to the combination. It also is not known whether it will occur in other patient populations.

Likelihood Possible Evidence A
Salsalate (Disalcid)

Acidification of the urine by vitamin C might increase salsalate levels.
It has been suggested that acidification of the urine by vitamin C could increase reabsorption of salicylates by the renal tubules, and increase plasma salicylate levels. However, short-term use of up to 6 grams/day vitamin C does not seem to affect urinary pH or salicylate excretion, suggesting this interaction probably is not clinically significant.

Likelihood Possible Evidence B
Vitamin C full monograph & interactions

Calcium18 drug types · 168 drugs

Ceftriaxone (Rocephin)

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

Likelihood Probable Evidence D
Dolutegravir (Tivicay)

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

Likelihood Probable Evidence B
Elvitegravir (Vitekta)

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

Likelihood Probable Evidence B
Aluminum

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

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

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

Likelihood Probable Evidence D
Bisphosphonates

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

Likelihood Probable Evidence C
Calcipotriene (Dovonex)

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

Likelihood Possible Evidence B
Digoxin (Lanoxin)

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

Likelihood Possible Evidence B
Diltiazem (Cardizem, Others)

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

Likelihood Probable Evidence D
Levothyroxine (Synthroid, Others)

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

Likelihood Probable Evidence B
Lithium

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

Likelihood Possible Evidence B
Quinolone Antibiotics

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

Likelihood Probable Evidence B
Raltegravir (Isentress)

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

Likelihood Possible Evidence B
Sotalol (Betapace)

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

Likelihood Possible Evidence B
Tetracycline Antibiotics

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

Likelihood Probable Evidence C
Thiazide Diuretics

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

Likelihood Probable Evidence C
Verapamil (Calan, Others)

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

Likelihood Probable Evidence D
Calcium Channel Blockers

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

Likelihood Unlikely Evidence D
Calcium full monograph & interactions

Acerola Fruit Juice6 drug types · 128 drugs

Alkylating Agents

Theoretically, the antioxidant effects of acerola might reduce the effectiveness of alkylating agents.
Acerola contains vitamin C, an antioxidant. There is concern that antioxidants might reduce the activity of chemotherapy drugs that generate free radicals, such as alkylating agents. In contrast, other researchers theorize that antioxidants might make alkylating chemotherapy more effective by reducing oxidative stress that could interfere with apoptosis (cell death) of cancer cells. More evidence is needed to determine what effect, if any, antioxidants such as vitamin C have on chemotherapy.

Likelihood Possible Evidence D
Antitumor Antibiotics

Theoretically, the antioxidant effects of acerola might reduce the effectiveness of antitumor antibiotics.
Acerola contains vitamin C, an antioxidant. There is concern that antioxidants might reduce the activity of chemotherapy drugs that generate free radicals, such as antitumor antibiotics. In contrast, other researchers theorize that antioxidants might make antitumor antibiotic chemotherapy more effective by reducing oxidative stress that could interfere with apoptosis (cell death) of cancer cells. More evidence is needed to determine what effects, if any, antioxidants such as vitamin C have on antitumor antibiotic chemotherapy.

Likelihood Possible Evidence D
Aluminum

Theoretically, concomitant use of acerola with aluminum salts might increase the amount of aluminum absorbed.
Acerola contains vitamin C. It is thought that vitamin C chelates aluminum, keeping it in solution and available for absorption. In people with normal renal function, urinary excretion of aluminum likely increases, making aluminum retention and toxicity unlikely. However, patients with renal failure who take aluminum-containing compounds, such as phosphate binders, should avoid acerola in doses that provide more vitamin C than the recommended dietary allowances.

Likelihood Possible Evidence D
Aspirin

Theoretically, acerola might reduce the clearance of aspirin; however, its vitamin C content is likely too low to produce clinically significant effects.
Acerola contains vitamin C. It has been suggested that acidification of the urine by vitamin C can decrease the urinary excretion of salicylates, increasing plasma salicylate levels. However, short-term use of up to 6 grams daily of vitamin C does not seem to affect urinary pH or salicylate excretion. The vitamin C content of acerola is typically about 2000 mg per 100 grams. Thus, a clinically significant interaction between acerola and aspirin is unlikely.

Likelihood Unlikely Evidence B
Estrogens

Theoretically, concomitant use of acerola with estrogens might increase estrogenic effects.
Acerola contains vitamin C. Increases in plasma estrogen levels of up to 55% have occurred under some circumstances when vitamin C is taken concurrently with oral contraceptives or hormone replacement therapy, including topical products. It is suggested that vitamin C prevents oxidation of estrogen in the tissues, regenerates oxidized estrogen, and reduces sulfate conjugation of estrogen in the gut wall. When tissue levels of vitamin C are high, these processes are already maximized and supplemental vitamin C does not have any effect on estrogen levels. However, increases in plasma estrogen levels may occur when women who are deficient in vitamin C take supplements.

Likelihood Possible Evidence D
Warfarin (Coumadin)

Theoretically, acerola might reduce the effectiveness of warfarin; however, its vitamin C content is likely too low to produce clinically significant effects.
Acerola contains vitamin C. High doses of vitamin C may reduce the response to warfarin, possibly by causing diarrhea and reducing warfarin absorption. This occurred in two people who took up to 16 grams daily of vitamin C, and resulted in decreased prothrombin time. Lower doses of 5-10 grams daily of vitamin C can also reduce warfarin absorption, but this does not seem to be clinically significant. The vitamin C content of acerola is typically about 2000 mg per 100 grams. Thus, a clinically significant interaction between acerola and warfarin is unlikely.

Likelihood Unlikely Evidence D
Acerola Fruit Juice full monograph & interactions

L-Cysteine Hydrochloride1 drug type · 86 drugs

Antidiabetes Drugs

Theoretically, taking L-cysteine supplements with antidiabetes drugs might increase the risk of hypoglycemia.
Animal research suggests that L-cysteine can have hypoglycemic effects.

Likelihood Possible Evidence D
L-Cysteine Hydrochloride full monograph & interactions

L-Tyrosine2 drug types · 21 drugs

Levodopa

Theoretically, tyrosine might decrease the effectiveness of levodopa.
Tyrosine and levodopa compete for absorption in the proximal duodenum by the large neutral amino acid (LNAA) transport system. Advise patients to separate doses of tyrosine and levodopa by at least 2 hours.

Likelihood Probable Evidence D
Thyroid Hormone

Theoretically, tyrosine might have additive effects with thyroid hormone medications.
Tyrosine is a precursor to thyroxine and might increase levels of thyroid hormones.

Likelihood Probable Evidence D
L-Tyrosine full monograph & interactions

L-Phenylalanine3 drug types · 16 drugs

Levodopa

Phenylalanine, especially in high doses, can reduce the effectiveness of levodopa.
Phenylalanine competes with levodopa for carrier-mediated transport into the brain. The resulting reduction in levels of levodopa in the brain can exacerbate tremor, rigidity, and the "on-off" phenomenon in patients with Parkinson disease.

Likelihood Probable Evidence B
Baclofen

Concomitant intake of phenylalanine may reduce the intestinal absorption of baclofen.
Phenylalanine and baclofen share the same intestinal carrier for absorption; phenylalanine competitively inhibits the absorption of baclofen, reducing its plasma levels.

Likelihood Possible Evidence D
Monoamine Oxidase Inhibitors (Maois)

Theoretically, concomitant use of L-phenylalanine and non-selective MAOIs might increase the risk of hypertensive crisis.
L-phenylalanine is metabolized to tyrosine. Some evidence suggests that L-phenylalanine, given with the non-selective MAOI pargyline, might prevent the elimination of tyramine, increasing the risk of hypertensive crisis. However, this was not reported in a small number of patients when using L-phenylalanine with the partially selective MAO-B inhibitor, selegiline.

Likelihood Possible Evidence D
L-Phenylalanine full monograph & interactions

L-Threonine1 drug type · 3 drugs

Nmda Antagonists

Theoretically, threonine might decrease the effects of NMDA antagonists.
Threonine increases central nervous system (CNS) glycine levels. Glycine seems to bind a site on NMDA receptors and enhance the activity of the receptors.

Likelihood Likely Evidence B
L-Threonine full monograph & interactions

L-Lysine Hydrochloride1 drug type · 1 drug

5-Ht4 Agonists

Theoretically, lysine may reduce the effects of 5-HT4 agonists.
Animal research suggests that L-lysine is a partial serotonin receptor 4 (5-HT4) antagonist and inhibits diarrhea induced by the 5-HT4 agonist, 5-hydroxytryptophane.

Likelihood Unlikely Evidence D
L-Lysine Hydrochloride full monograph & interactions
The maker

Brand information

Manufacturer and brand details for Pro-NH3, from the product label.

Loomis Enzymes

See all Loomis Enzymes products
Name
Loomis Enzymes, LLC
City
Fitchburg
State
Wisconsin
ZipCode
53719
Phone Number
1-800-614-4400
Web Address
www.loomisenzymes.com
Pharmacist Counseling Corner

Pro-NH3 by Loomis Enzymes: Common Questions

Does Pro-NH3 by Loomis Enzymes interact with any medications?
Yes. Based on its ingredients, Pro-NH3 has a known interaction with 666 medications, including 15 rated major. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Pro-NH3 contains 19 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?
Not without talking to your doctor first. L-phenylalanine is unsafe in supplement form during pregnancy and should be avoided while breastfeeding; biotin and calcium are likely safe at normal amounts, but L-tyrosine, L-threonine, L-cysteine, lysine, methionine, histidine, and arginine lack solid pregnancy and breastfeeding safety data. Call your provider before starting.
What are the most common side effects?
The amino acids — especially L-arginine — may cause abdominal pain, bloating, nausea, diarrhea, headache, and insomnia. Vitamin C at higher levels can trigger osmotic diarrhea and heartburn. Biotin and calcium are generally mild, though calcium may cause constipation or bloating.
Does this product contain any fillers or other ingredients besides the actives?
Yes. In addition to the 18 active ingredients, this product contains cellulose, water, and phytase as inactive ingredients — these are excipients used to make the capsule and preserve the formula.
Is biotin effective for hair loss or skin problems?
The data we hold shows biotin is likely effective only for actual biotin deficiency. For multiple sclerosis, seborrheic dermatitis, and alopecia areata, the evidence is insufficient or shows it to be possibly ineffective — so biotin alone is not established to help these conditions.
Can I take this with warfarin or other blood thinners?
Not without checking first. L-arginine and vitamin C (including acerola fruit juice in this product) theoretically can interfere with blood thinners — vitamin C at high doses may reduce warfarin's effect. Your pharmacist or doctor needs to evaluate your exact dose and medication.
Why does this product have so many amino acids?
The facts we hold don't specify the product's intended use, so we can't explain the reasoning behind the formula. Amino acids are building blocks for protein and may support various body functions, but the claims and evidence would depend on why the manufacturer included them — check the label or speak with a healthcare provider about its intended purpose.

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.

Pro-NH3 label
Go deeper

The Full Monographs Behind Pro-NH3’s Ingredients

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

Herb & supplement monograph

Biotin

Biotin (vitamin B7) is a water-soluble vitamin your body needs to turn food into energy and to support healthy hair, skin, and nails. Most people get plenty from a normal diet, and true defi...

Read the full Biotin monograph → Herb & supplement monograph

Rose Hip

Interacts with 213 drugs

Rose hip is the vitamin C–rich fruit of the wild rose, used traditionally for colds and joint pain. A standardized rose hip powder has some research support for easing osteoarthritis symptom...

Read the full Rose Hip monograph → Herb & supplement monograph

L-arginine

Interacts with 403 drugs

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

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

Methionine

Methionine is an essential amino acid that your body needs for protein building and many basic chemical reactions. Most people get enough from a normal diet, and supplements are generally no...

Read the full Methionine monograph → Herb & supplement monograph

Lysine

Interacts with 1 drug

Lysine is an essential amino acid your body cannot make on its own, so it must come from food or supplements. People most often take extra lysine to try to prevent or shorten cold sores, but...

Read the full Lysine monograph → Herb & supplement monograph

Tyrosine

Interacts with 21 drugs

L-tyrosine is an amino acid your body uses to make brain chemicals like dopamine and norepinephrine. Some studies suggest it may help mental performance during short-term stress, sleep loss,...

Read the full Tyrosine monograph → Herb & supplement monograph

Phenylalanine

Interacts with 16 drugs

Phenylalanine is an essential amino acid the body uses to make brain chemicals like dopamine and norepinephrine. Some people take it for mood, vitiligo, or pain, but the evidence is mostly l...

Read the full Phenylalanine monograph → Herb & supplement monograph

Histidine

Histidine is an essential amino acid your body needs to build proteins and to make compounds like histamine and carnosine. Most people get enough from a normal diet, and good-quality researc...

Read the full Histidine monograph → Herb & supplement monograph

Threonine

Interacts with 3 drugs

Threonine is an essential amino acid your body needs but cannot make, so you must get it from food or supplements. Most people get plenty from a normal diet, and high-quality evidence for ta...

Read the full Threonine monograph → Herb & supplement monograph

L-cysteine

Interacts with 86 drugs

L-cysteine is a sulfur-containing amino acid your body uses to make proteins and the antioxidant glutathione. Most people get enough from food, and supplements are usually well tolerated, bu...

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

Calcium

Interacts with 168 drugs

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

Read the full Calcium monograph → Herb & supplement monograph

Vitamin C

Interacts with 207 drugs

Vitamin C (ascorbic acid) is an essential nutrient your body needs but cannot make, so you must get it from food or supplements. It's important for immune function, collagen, and acts as an...

Read the full Vitamin C monograph → Herb & supplement monograph

Acerola

Interacts with 128 drugs

Acerola is a small tropical fruit prized for its very high natural vitamin C content, and it is mostly used as a food-based source of vitamin C and antioxidants. While vitamin C itself has w...

Read the full Acerola monograph →
Sources

Sources & How We Checked

Pro-NH3'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 282 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.

L-arginine 66 references
  1. Sapienza MA, Kharitonov SA, Horvath I, et al. Effect of inhaled L-arginine on exhaled nitric oxide in normal and asthmatic subjects. Thorax 1998;53:172-5.
  2. Clarkson P, Adams MR, Powe AJ, et al. Oral L-arginine improves endothelium-dependent dilation in hypercholesterolemic young adults. J Clin Invest 1996;97:1989-94. PubMed
  3. Tenenbaum A, Fisman EZ, Motro M. L-arginine: Rediscovery in progress. Cardiology 1998;90:153-9.
  4. Brittenden J, Park KGM, Heys SD, et al. L-Arginine stimulates host defenses in patients with breast cancer. Surgery 1994;115:205-12.
  5. Korting GE, Smith SD, Wheeler MA, et al. A randomized double-blind trial of oral L-arginine for treatment of interstitial cystitis. J Urol 1999;161:558-65. DOI
  6. Rector TS, Bank AJ, Mullen KA, et al. Randomized, double-blind, placebo-controlled study of supplemental oral L-arginine in patients with heart failure. Circulation 1996;93:2135-41.
  7. Siani A, Pagano E, Iacone R, et al. Blood pressure and metabolic changes during dietary L-arginine supplementation in humans. Am J Hypertens 2000;13:547-51. PubMed
  8. Cheng JW, Balwin SN. L-arginine in the management of cardiovascular diseases. Ann Pharmacother 2001;35:755-64. PubMed
  9. Wallace AW, Tom WL. Interaction of L-arginine and phosphodiesterase inhibitors in vasodilation of the porcine internal mammary artery. Anesth Analg 2000;90:840-6. DOI
  10. Huynh NT, Tayek JA. Oral arginine reduces systemic blood pressure in type 2 diabetes: its potential role in nitric oxide generation. J Am Coll Nutr 2002;21:422-7.. PubMed
  11. Staff AC, Berge L, Haugen G, et al. Dietary supplementation with L-arginine or placebo in women with pre-eclampsia. Acta Obstet Gynecol Scand 2004;83:103-7.
  12. Resnick DJ, Softness B, Murphy AR, et al. Case report of an anaphylactoid reaction to arginine. Ann Allergy Asthma Immunol 2002;88:67-8. PubMed
  13. Anon. Arginine hydrochloride injection (marketed as R-Gene 10). FDA Drug Safety Newsletter 2009;2(2):16-18. Available at: www.fda.gov/Drugs/DrugSafety/DrugSafetyNewsletter/default.htm.
  14. Higashi Y, Oshima T, Sasaki S, et. al. Angiotensin-converting enzyme inhibition, but not calcium antagonism, improves a response of the renal vasculature to L-arginine in patients with essential hypertension. Hypertension. 1998 Jul;32(1):16-24.
  15. Facchinetti, F., Longo, M., Piccinini, F., Neri, I., and Volpe, A. L-arginine infusion reduces blood pressure in preeclamptic women through nitric oxide release. J Soc Gynecol.Investig. 1999;6(4):202-207. DOI
  16. de Gouw, H. W., Verbruggen, M. B., Twiss, I. M., and Sterk, P. J. Effect of oral L-arginine on airway hyperresponsiveness to histamine in asthma. Thorax 1999;54(11):1033-1035. PubMed
  17. Komers, R., Komersova, K., Kazdova, L., Ruzickova, J., and Pelikanova, T. Effect of ACE inhibition and angiotensin AT1 receptor blockade on renal and blood pressure response to L-arginine in humans. J Hypertens. 2000;18(1):51-59. PubMed
  18. Cartledge, J. J., Davies, A. M., and Eardley, I. A randomized double-blind placebo-controlled crossover trial of the efficacy of L-arginine in the treatment of interstitial cystitis. BJU.Int. 2000;85(4):421-426.
  19. Sozykin, A. V., Noeva, E. A., Balakhonova, T. V., Pogorelova, O. A., and Men'shikov, M. I. [Effect of L-arginine on platelet aggregation, endothelial function adn exercise tolerance in patients with stable angina pectoris]. Ter.Arkh. 2000;72(8):24-27.
  20. Nagaya, N., Uematsu, M., Oya, H., Sato, N., Sakamaki, F., Kyotani, S., Ueno, K., Nakanishi, N., Yamagishi, M., and Miyatake, K. Short-term oral administration of L-arginine improves hemodynamics and exercise capacity in patients with precapillary pulmona
  21. Stokes, G. S., Barin, E. S., Gilfillan, K. L., and Kaesemeyer, W. H. Interactions of L-arginine, isosorbide mononitrate, and angiotensin II inhibitors on arterial pulse wave. Am J Hypertens. 2003;16(9 Pt 1):719-724.
  22. Park, K. G., Heys, S. D., Blessing, K., Kelly, P., McNurlan, M. A., Eremin, O., and Garlick, P. J. Stimulation of human breast cancers by dietary L-arginine. Clin.Sci.(Lond) 1992;82(4):413-417.
  23. Palloshi, A., Fragasso, G., Piatti, P., Monti, L. D., Setola, E., Valsecchi, G., Galluccio, E., Chierchia, S. L., and Margonato, A. Effect of oral L-arginine on blood pressure and symptoms and endothelial function in patients with systemic hypertension,
  24. Schlaich, M. P., Ahlers, B. A., Parnell, M. M., and Kaye, D. M. beta-Adrenoceptor-mediated, nitric-oxide-dependent vasodilatation is abnormal in early hypertension: restoration by L-arginine. J Hypertens. 2004;22(10):1917-1925. PubMed
  25. Neri, I., Blasi, I., and Facchinetti, F. Effects of acute L-arginine infusion on non-stress test in hypertensive pregnant women. J Matern.Fetal Neonatal Med. 2004;16(1):23-26. PubMed
  26. Rytlewski, K., Olszanecki, R., Korbut, R., and Zdebski, Z. Effects of prolonged oral supplementation with l-arginine on blood pressure and nitric oxide synthesis in preeclampsia. Eur.J Clin.Invest 2005;35(1):32-37.
  27. Mansoor, J. K., Morrissey, B. M., Walby, W. F., Yoneda, K. Y., Juarez, M., Kajekar, R., Severinghaus, J. W., Eldridge, M. W., and Schelegle, E. S. L-arginine supplementation enhances exhaled NO, breath condensate VEGF, and headache at 4,342 m. High Alt.M
  28. Neri, I., Jasonni, V. M., Gori, G. F., Blasi, I., and Facchinetti, F. Effect of L-arginine on blood pressure in pregnancy-induced hypertension: a randomized placebo-controlled trial. J Matern.Fetal Neonatal Med. 2006;19(5):277-281.
  29. Lucotti, P., Setola, E., Monti, L. D., Galluccio, E., Costa, S., Sandoli, E. P., Fermo, I., Rabaiotti, G., Gatti, R., and Piatti, P. Beneficial effects of a long-term oral L-arginine treatment added to a hypocaloric diet and exercise training program in
  30. Savoye, G., Jemaa, Y., Mosni, G., Savoye-Collet, C., Morcamp, P., Dechelotte, P., Bouin, M., Denis, P., and Ducrotte, P. Effects of intragastric L-arginine administration on proximal stomach tone under basal conditions and after an intragastric diet. Dig PubMed
  31. Facchinetti, F., Saade, G. R., Neri, I., Pizzi, C., Longo, M., and Volpe, A. L-arginine supplementation in patients with gestational hypertension: a pilot study. Hypertens.Pregnancy. 2007;26(1):121-130. PubMed
  32. Jovanovic, A., Gerrard, J., and Taylor, R. The second-meal phenomenon in type 2 diabetes. Diabetes Care 2009;32(7):1199-1201. PubMed
  33. Fontanive P, Saponati G, Iurato A, et al. Effects of L-arginine on the Minnesota Living with Heart Failure Questionnaire quality-of-life score in patients with chronic systolic heart failure. Med.Sci.Monit. 2009;15:CR606-11.
  34. Doutreleau, S., Rouyer, O., Di, Marco P., Lonsdorfer, E., Richard, R., Piquard, F., and Geny, B. L-arginine supplementation improves exercise capacity after a heart transplant. Am J Clin.Nutr. 2010;91(5):1261-1267. PubMed
  35. Ast, J., Jablecka, A., Bogdanski, P., Smolarek, I., Krauss, H., and Chmara, E. Evaluation of the antihypertensive effect of L-arginine supplementation in patients with mild hypertension assessed with ambulatory blood pressure monitoring. Med.Sci.Monit. 2
  36. Saleh, A. I., Abdel Maksoud, S. M., El-Maraghy, S. A., and Gad, M. Z. Protective effect of L-arginine in experimentally induced myocardial ischemia: comparison with aspirin. J Cardiovasc.Pharmacol.Ther 2011;16(1):53-62. PubMed
  37. Dong, J. Y., Qin, L. Q., Zhang, Z., Zhao, Y., Wang, J., Arigoni, F., and Zhang, W. Effect of oral L-arginine supplementation on blood pressure: a meta-analysis of randomized, double-blind, placebo-controlled trials. Am.Heart J 2011;162(6):959-965. PubMed
  38. Hertz, P. and Richardson, J. A. Arginine-induced hyperkalemia in renal failure patients. Arch.Intern.Med. 1972;130(5):778-780. DOI
  39. Bushinsky, D. A. and Gennari, F. J. Life-threatening hyperkalemia induced by arginine. Ann.Intern.Med. 1978;89(5 Pt 1):632-634. PubMed
  40. Adams, M. R., Forsyth, C. J., Jessup, W., Robinson, J., and Celermajer, D. S. Oral L-arginine inhibits platelet aggregation but does not enhance endothelium-dependent dilation in healthy young men. J Am Coll.Cardiol 1995;26(4):1054-1061. PubMed
  41. Dell'Omo, G., Catapano, G., Ebel, M., Gazzano, A., Ducci, M., Del, Chicca M., Clerico, A., and Pedrinelli, R. [Pressor, renal and endocrine effects of systemic infusion of L-arginine in hypertensive patients]. Ann.Ital Med.Int. 1995;10(2):107-112.
  42. Higashi, Y., Oshima, T., Ozono, R., Watanabe, M., Matsuura, H., and Kajiyama, G. Effects of L-arginine infusion on renal hemodynamics in patients with mild essential hypertension. Hypertension 1995;25(4 Pt 2):898-902.
  43. Bode-Boger, S. M., Boger, R. H., Creutzig, A., Tsikas, D., Gutzki, F. M., Alexander, K., and Frolich, J. C. L-arginine infusion decreases peripheral arterial resistance and inhibits platelet aggregation in healthy subjects. Clin.Sci.(Lond) 1994;87(3):303
  44. Marfella, R., Acampora, R., Verrazzo, G., Ziccardi, P., De, Rosa N., Giunta, R., and Giugliano, D. Metformin improves hemodynamic and rheological responses to L-arginine in NIDDM patients. Diabetes Care 1996;19(9):934-939. PubMed
  45. Giugliano, D., Marfella, R., Verrazzo, G., Acampora, R., Coppola, L., Cozzolino, D., and D'Onofrio, F. The vascular effects of L-Arginine in humans. The role of endogenous insulin. J Clin.Invest 2-1-1997;99(3):433-438. PubMed
  46. Khan, F., Litchfield, S. J., McLaren, M., Veale, D. J., Littleford, R. C., and Belch, J. J. Oral L-arginine supplementation and cutaneous vascular responses in patients with primary Raynaud's phenomenon. Arthritis Rheum. 1997;40(2):352-357.
  47. Wolf, A., Zalpour, C., Theilmeier, G., Wang, B. Y., Ma, A., Anderson, B., Tsao, P. S., and Cooke, J. P. Dietary L-arginine supplementation normalizes platelet aggregation in hypercholesterolemic humans. J Am Coll.Cardiol 3-1-1997;29(3):479-485. PubMed
  48. Schellong, S. M., Boger, R. H., Burchert, W., Bode-Boger, S. M., Galland, A., Frolich, J. C., Hundeshagen, H., and Alexander, K. Dose-related effect of intravenous L-arginine on muscular blood flow of the calf in patients with peripheral vascular disease
  49. Marietta, M., Facchinetti, F., Neri, I., Piccinini, F., Volpe, A., and Torelli, G. L-arginine infusion decreases platelet aggregation through an intraplatelet nitric oxide release. Thromb.Res 10-15-1997;88(2):229-235. PubMed
  50. Bauer JD, Isenring E, Waterhouse M. The effectiveness of a specialised oral nutrition supplement on outcomes in patients with chronic wounds: a pragmatic randomised study. J Hum Nutr Diet. 2013 Oct;26(5):452-8. PubMed
  51. Vadillo-Ortega F, Perichart-Perera O, Espino S, et al. Effect of supplementation during pregnancy with L-arginine and antioxidant vitamins in medical food on pre-eclampsia in high risk population: randomised controlled trial. BMJ. 2011 May 19;342:d2901. PubMed
  52. Camarena Pulido EE, García Benavides L, Panduro Barón JG, et al. Efficacy of L-arginine for preventing preeclampsia in high-risk pregnancies: A double-blind, randomized, clinical trial. Hypertens Pregnancy. 2016;35(2):217-25. PubMed
  53. Yokota T, Hamauchi S, Yoshida Y, et al. A phase II study of HMB/Arg/Gln against oral mucositis induced by chemoradiotherapy for patients with head and neck cancer. Support Care Cancer. 2018;26(9):3241-3248. PubMed
  54. Binet Q, Dufour I, Agneessens E, et al. The second case of a young man with L-arginine-induced acute pancreatitis. Clin J Gastroenterol. 2018;11(5):424-427. PubMed
  55. El Taieb M, Hegazy E, Ibrahim A. Daily oral l-arginine plus tadalafil in diabetic patients with erectile dysfunction: A double-blinded, randomized, controlled clinical trial. J Sex Med. 2019;16(9):1390-1397.
  56. Gallo L, Pecoraro S, Sarnacchiaro P, Silvani M, Antonini G. The daily therapy with L-arginine 2,500 mg and tadalafil 5 mg in combination and in monotherapy for the treatment of erectile dysfunction: A prospective, randomized multicentre study. Sex Med. 20 PubMed
  57. de la Parra PR, González-Cruz MÁ, Ferreiro-Marin A, Casaubón-Garcín PR. L-arginine-induced esophagitis, report of six cases. Bol Med Hosp Infant Mex. 2020;77(1):38-41. PubMed
  58. El-Wakeel LM, Fouad FA, Saleem MD, Saber-Khalaf M. Efficacy and tolerability of sildenafil/l-arginine combination relative to sildenafil alone in patients with organic erectile dysfunction. Andrology. 2020;8(1):143-147.
  59. Abu El-Hamd M, Hegazy EM. Comparison of the clinical efficacy of daily use of L-arginine, tadalafil and combined L-arginine with tadalafil in the treatment of elderly patients with erectile dysfunction. Andrologia. 2020;52(7):e13640. PubMed
  60. Liao SY, Showalter MR, Linderholm AL, et al. l-Arginine supplementation in severe asthma. JCI Insight. 2020;5(13):e137777. PubMed
  61. Yousefi Rad E, Nazarian B, Saboori S, Falahi E, Hekmatdoost A. Effects of l-arginine supplementation on glycemic profile: Evidence from a systematic review and meta-analysis of clinical trials. J Integr Med. 2020;18(4):284-291. PubMed
  62. Xu Z, Liu C, Liu S, Zhou Z. Comparison of efficacy and safety of daily oral L-arginine and PDE5Is alone or combination in treating erectile dysfunction: A systematic review and meta-analysis of randomised controlled trials. Andrologia. 2021:e14007. PubMed
  63. Goto E. Effects of prenatal oral L-arginine on birth outcomes: a meta-analysis. Sci Rep 2021;11(1):22748. PubMed
  64. Monari F, Menichini D, Pignatti L, Basile L, Facchinetti F, Neri I. Effect of L-arginine supplementation in pregnant women with chronic hypertension and previous placenta vascular disorders receiving Aspirin prophylaxis: a randomized control trial. Minerv PubMed
  65. Li H, Liu Q, Zou Z, et al. L-arginine supplementation to mitigate cardiovascular effects of walking outside in the context of traffic-related air pollution in participants with elevated blood pressure: A randomized, double-blind, placebo-controlled trial. PubMed
  66. Shiraseb F, Asbaghi O, Bagheri R, Wong A, Figueroa A, Mirzaei K. The Effect of L-arginine Supplementation On Blood Pressure in Adults: A Systematic Review and Dose-response Meta-analysis of Randomized Clinical Trials. Adv Nutr 2021. PubMed

See these in context on the L-arginine monograph →

Biotin 4 references
  1. Debourdeau PM, Djezzar S, Estival JL, et al. Life-threatening eosinophilic pleuropericardial effusion related to vitamins B5 and H. Ann Pharmacother 2001;35:424-6. DOI
  2. Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline (2000). Washington, DC: National Academy Press, 2000. Available at: http://b
  3. Mock DM, Quirk JG, Mock NI. Marginal biotin deficiency during normal pregnancy. Am J Clin Nutr 2002;75:295-9. PubMed
  4. Sedel F, Papeix C, Bellanger A, Touitou V, Lebrun-Frenay C, Galanaud D, et al. High doses of biotin in chronic progressive multiple sclerosis: a pilot study.Mult Scler Relat Disord. 2015;4(2):159-69. doi: 10.1016/j.msard.2015.01.005. PubMed

See these in context on the Biotin monograph →

Methionine 12 references
  1. La Vecchia C, Negri E, Franceschi S, Decarli A. Case-control study on influence of methionine, nitrite, and salt on gastric carcinogenesis in northern Italy. Nutr Cancer 1997;27:65-8. PubMed
  2. Btaiche IF, Khalidi N. Parenteral nutrition-associated liver complications in children. Pharmacotherapy 2002;22:188-211.. PubMed
  3. Cottington EM, LaMantia C, Stabler SP, et al. Adverse event associated with methionine loading test: a case report. Arterioscler Thromb Vasc Biol 2002;22:1046-50.. PubMed
  4. Anon. Should methionine be added to paracetamol formulations? Drug Ther Perspect 1997;10:11-3. DOI
  5. Smulders, Y. M., Rakic, M., Slaats, E. H., Treskes, M., Sijbrands, E. J., Odekerken, D. A., Stehouwer, C. D., and Silberbusch, J. Fasting and post-methionine homocysteine levels in NIDDM. Determinants and correlations with retinopathy, albuminuria, and c
  6. McAuley, D. F., Hanratty, C. G., McGurk, C., Nugent, A. G., and Johnston, G. D. Effect of methionine supplementation on endothelial function, plasma homocysteine, and lipid peroxidation. J.Toxicol.Clin.Toxicol. 1999;37(4):435-440. PubMed
  7. Hanratty, C. G., McGrath, L. T., McAuley, D. F., Young, I. S., and Johnston, G. D. The effects of oral methionine and homocysteine on endothelial function. Heart 2001;85(3):326-330. PubMed
  8. Ward, M., McNulty, H., McPartlin, J., Strain, J. J., Weir, D. G., and Scott, J. M. Effect of supplemental methionine on plasma homocysteine concentrations in healthy men: a preliminary study. Int.J.Vitam.Nutr.Res. 2001;71(1):82-86. PubMed
  9. Yaghmai, R., Kashani, A. H., Geraghty, M. T., Okoh, J., Pomper, M., Tangerman, A., Wagner, C., Stabler, S. P., Allen, R. H., Mudd, S. H., and Braverman, N. Progressive cerebral edema associated with high methionine levels and betaine therapy in a patient
  10. Talukdar R, Murthy HV, Reddy DN. Role of methionine containing antioxidant combination in the management of pain in chronic pancreatitis: a systematic review and meta-analysis. Pancreatology 2015;15(2):136-44. PubMed
  11. Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids. Washington, DC: The National Academies Press, 2005. Available at: https://doi.org/10.17226 DOI
  12. Khairan P, Sobue T, Eshak ES, et al. Association of B Vitamins and Methionine Intake with the Risk of Gastric Cancer: The Japan Public Health Center-based Prospective Study. Cancer Prev Res (Phila) 2022;15(2):101-110. PubMed

See these in context on the Methionine monograph →

Lysine 7 references
  1. Thein DJ, Hurt WC. Lysine as a prophylactic agent in the treatment of recurrent herpes simplex labialis. Oral Surg Oral Med Oral Pathol 1984;58:659-66. PubMed
  2. McCune MA, Perry HO, Muller SA, O'Fallon WM. Treatment of recurrent herpes simplex infections with L-lysine monohydrochloride. Cutis 1984;34:366-73.
  3. DiGiovanna JJ, Blank H. Failure of lysine in frequently recurrent herpes simplex infection. Treatment and prophylaxis. Arch Dermatol 1984;120:48-51. DOI
  4. Milman N, Scheibel J, Jessen O. Lysine prophylaxis in recurrent herpes simplex labialis: a double-blind, controlled crossover study. Acta Derm Venereol 1980;60:85-7.
  5. Griffith RS, Walsh DE, Myrmel KH, et al. Success of L-lysine therapy in frequently recurrent herpes simplex infection. Treatment and prophylaxis. Dermatologica 1987;175:183-90. DOI
  6. Lo JC, Chertow GM, Rennke H, Seifter JL. Fanconi's syndrome and tubulointerstitial nephritis in association with L-lysine ingestion. Am J Kidney Dis 1996;28:614-7. PubMed
  7. Smriga M, Torii K. L-Lysine acts like a partial serotonin receptor 4 antagonist and inhibits serotonin-mediated intestinal pathologies and anxiety in rats. Proc Natl Acad Sci U S A. 2003 Dec 23;100(26):15370-5.

See these in context on the Lysine monograph →

Tyrosine 4 references
  1. Meyer JS, Welch KM, Deshmukh VD, et al. Neurotransmitter precursor amino acids in the treatment of multi-infarct dementia and Alzheimer's disease. J Amer Geriat Soc 1977;25:289-98.
  2. DiPiro JT, Talbert RL, Yee GC, et al; eds. Pharmacotherapy: A pathophysiologic approach. 4th ed. Stamford, CT: Appleton & Lange, 1999.
  3. Wood DR, Reimherr FW, Wender PH. Amino acid precursors for the treatment of attention deficit disorder, residual type. Psychopharmacol Bull 1985;21:146-9.
  4. van Spronsen FJ, van Rijn M, Bekhof J. Phenylketonuria: tyrosine supplementation in phenylalanine-restricted diets. Am J Clin Nutr 2001;73:153-7. PubMed

See these in context on the Tyrosine monograph →

Phenylalanine 23 references
  1. Rouse B, Azen C, Koch R, et al. Maternal phenylketonuria collaborative Study (MPKUCS) offspring: facial anomalies, malformations, and early neurological sequelae. Am J Med Genet 1997;69:89-95. DOI
  2. Sturtevant FM. Use of aspartame in pregnancy. Int J Fertil 1985;30:85-7.
  3. Silkaitis RP, Mosnaim AD. Pathways linking L-phenylalanine and 2-phenylethylamine with p-tyramine in rabbit brain. Brain Res 1976;114:105-15.
  4. Lehmann WD, Theobald N, Fischer R, Heinrich HC. Stereospecificity of phenylalanine plasma kinetics and hydroxylation in man following oral application of a stable isotope-labelled pseudo-racemic mixture of L- and D-phenylalanine. Clin Chim Acta 1983;128 PubMed
  5. Mosnik DM, Spring B, Rogers K, Baruah S. Tardive dyskinesia exacerbated after ingestion of phenylalanine by schizophrenic patients. Neuropsychopharmacology 1997;16:136-46. PubMed
  6. Siddiqui AH, Stolk LM, Bhaggoe R, et al. L-phenylalanine and UVA irradiation in the treatment of vitiligo. Dermatology 1994;88:215-8. PubMed
  7. Birkmayer W, Riederer P, Linauer W, Knoll J. L-deprenyl plus L-phenylalanine in the treatment of depression. J Neural Transm 1984;59:81-7. PubMed
  8. Nutt JG, Woodward WR, Hammerstad JP, et al. The "on-off" phenomenon in Parkinson's disease. Relation to levodopa absorption and transport. N Engl J Med 1984;310:483-8. PubMed
  9. Baruzzi A, Contin M, Riva R, et al. Influence of meal ingestion time on pharmacokinetics of orally administered levodopa in parkinsonian patients. Clin Neuropharmacol 1987;10:527-37. PubMed
  10. Juncos JL, Fabbrini G, Mouradian MM, et al. Dietary influences on the antiparkinsonian response to levodopa. Arch Neurol 1987;44:1003-5. PubMed
  11. Eriksson T, Granerus AK, Linde A, et al. "On-off" phenomenon in Parkinson's disease: relationship between dopa and other large neutral amino acids in plasma. Neurology 1988;38:1245-8. PubMed
  12. Baker GB, Bornstein RA, Rouget AC, et al. Phenylethylaminergic mechanisms in attention-deficit disorder. Biol Psychiatry 1991;29:15-22.. PubMed
  13. Wood DR, Reimherr FW, Wender PH. Treatment of attention deficit disorder with DL-phenylalanine. Psychiatry Res 1985;16:21-6.. PubMed
  14. Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids (Macronutrients). Washington, DC: National Academy Press, 2002. Available at: http://www.n
  15. Cederbaum S. Phenylketonuria: an update. Curr Opin Pediatr 2002;14:702-6. PubMed
  16. Cejudo-Ferragud, E., Nacher, A., Polache, A., Cercos-Fortea, T., Merino, M., and Casabo, V. G. Evidence of competitive inhibition for the intestinal absorption of baclofen by phenylalanine. Int J of Pharm (Amsterdam) 1996;132:63-69. DOI
  17. Fischer, E., Heller, B., Nachon, M., and Spatz, H. Therapy of depression by phenylalanine. Preliminary note. Arzneimittelforschung. 1975;25(1):132.
  18. Beckmann, H., Strauss, M. A., and Ludolph, E. Dl-phenylalanine in depressed patients: an open study. J.Neural Transm. 1977;41(2-3):123-134. PubMed
  19. Sabelli, H. C., Fawcett, J., Gusovsky, F., Javaid, J. I., Wynn, P., Edwards, J., Jeffriess, H., and Kravitz, H. Clinical studies on the phenylethylamine hypothesis of affective disorder: urine and blood phenylacetic acid and phenylalanine dietary supplem
  20. Cotzias, G. C., Van Woert, M. H., and Schiffer, L. M. Aromatic amino acids and modification of parkinsonism. N Engl.J Med 2-16-1967;276(7):374-379. PubMed
  21. Kravitz, H. M., Sabelli, H. C., and Fawcett, J. Dietary supplements of phenylalanine and other amino acid precursors of brain neuroamines in the treatment of depressive disorders. J Am Osteopath.Assoc 1984;84(1 Suppl):119-123. DOI
  22. Mann, J., Peselow, E. D., Snyderman, S., and Gershon, S. D-phenylalanine in endogenous depression. Am.J.Psychiatry 1980;137(12):1611-1612. PubMed
  23. Katoulis AC, Alevizou A, Bozi E, et al. A randomized, double-blind, vehicle-controlled study of a preparation containing undecylenoyl phenylalanine 2% in the treatment of solar lentigines. Clin Exp Dermatol 2010;35(5):473-6. PubMed

See these in context on the Phenylalanine monograph →

Histidine 3 references
  1. Histidine — MedlinePlus (U.S. National Library of Medicine) Source
  2. Amino Acids — MedlinePlus (U.S. National Library of Medicine) Source
  3. Dietary Supplements: What You Need to Know — NIH Office of Dietary Supplements Source

See these in context on the Histidine monograph →

Threonine 4 references
  1. Tandan R, Bromberg MB, Forshew D, et al. A controlled trial of amino acid therapy in amyotrophic lateral sclerosis: I. Clinical, functional, and maximum isometric torque data. Neurology 1996;47:1220-6. PubMed
  2. Lee A, Patterson V. A double blind study of L-threonine in patients with spinal spasticity. Acta Neurol Scand 1993;88:334-8. PubMed
  3. Blin O, Pouget J, Aubrespy G, et al. A double-blind placebo controlled trial of L-threonine in amyotrophic lateral sclerosis. J Neurol 1992;239:79-81.
  4. Roufs JB. L-threonine as a symptomatic treatment for amyotrophic lateral sclerosis (ALS). Med Hypotheses 1991;34:20-3. PubMed

See these in context on the Threonine monograph →

L-cysteine 2 references
  1. Dowlati Y, Maheux M, Meyer JH. The effect of oral L-cysteine on breast milk and plasma cysteine concentrations. Neuropsychiatr Dis Treat 2020;16:3163-3172.
  2. Lee S, Han KH, Nakamura Y, et al. Dietary L-cysteine improves the antioxidative potential and lipid metabolism in rats fed a normal diet. Biosci Biotechnol Biochem 2013;77(7):1430-4.

See these in context on the L-cysteine monograph →

Rose Hip 24 references
  1. Foster S, Tyler VE. Tyler's Honest Herbal: A Sensible Guide to the Use of Herbs and Related Remedies. 3rd ed., Binghamton, NY: Haworth Herbal Press, 1993.
  2. McEvoy GK, ed. AHFS Drug Information. Bethesda, MD: American Society of Health-System Pharmacists, 1998.
  3. Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.
  4. Back DJ, Breckenridge AM, MacIver M, et al. Interaction of ethinyloestradiol with ascorbic acid in man. Br Med J (Clin Res Ed) 1981;282:1516.
  5. Morris JC, Beeley L, Ballantine N. Interaction of ethinyloestradiol with ascorbic acid in man [letter]. Br Med J (Clin Res Ed) 1981;283:503.
  6. Labriola D, Livingston R. Possible interactions between dietary antioxidants and chemotherapy. Oncology 1999;13:1003-8.
  7. Hansten PD, Horn JR. Drug Interactions Analysis and Management. Vancouver, WA: Applied Therapeutics Inc., 1997 and updates.
  8. Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes for Vitamin C, Vitamin E, Selenium, and Carotenoids. Washington, DC: National Academy Press, 2000. Available at: http://www.nap.edu/books/0309069351/html/.
  9. Rosenthal G. Interaction of ascorbic acid and warfarin. JAMA 1971;215:1671. DOI
  10. Hume R, Johnstone JM, Weyers E. Interaction of ascorbic acid and warfarin. JAMA 1972;219:1479. DOI
  11. Smith EC, Skalski RJ, Johnson GC, Rossi GV. Interaction of ascorbic acid and warfarin. JAMA 1972;221:1166. DOI
  12. Mc Leod DC, Nahata MC. Inefficacy of ascorbic acid as a urinary acidifier (letter). N Engl J Med 1977;296:1413. DOI
  13. Hansten PD, Hayton WL. Effect of antacid and ascorbic acid on serum salicylate concentration. J Clin Pharmacol 1980;20:326-31. PubMed
  14. Vihtamaki T, Parantainen J, Koivisto AM, et al. Oral ascorbic acid increases plasma oestradiol during postmenopausal hormone replacement therapy. Maturitas 2002;42:129-35. PubMed
  15. Feetam CL, Leach RH, Meynell MJ. Lack of a clinically important interaction between warfarin and ascorbic acid. Toxicol Appl Pharmacol 1975;31:544-7. PubMed
  16. Weintraub M, Griner PF. Warfarin and ascorbic acid: lack of evidence for a drug interaction. Toxicol Appl Pharmacol 1974;28:53-6. PubMed
  17. Prasad KN. Rationale for using high-dose multiple dietary antioxidants as an adjunct to radiation therapy and chemotherapy. J Nutr 2004;134:3182S-3S. PubMed
  18. Conklin KA. Cancer chemotherapy and antioxidants. J Nutr 2004;134:3201S-3204S. PubMed
  19. Andersson U, Berger K, Hogberg A, et al. Effects of rose hip intake on risk markers of type 2 diabetes and cardiovascular disease: a randomized, double-blind, cross-over investigation in obese persons. Eur J Clin Nutr 2012;66:585-90. PubMed
  20. Rein, E., Kharazmi, A., and Winther, K. A herbal remedy, Hyben Vital (stand. powder of a subspecies of Rosa canina fruits), reduces pain and improves general wellbeing in patients with osteoarthritis--a double-blind, placebo-controlled, randomised trial. PubMed
  21. Winther, K., Apel, K., and Thamsborg, G. A powder made from seeds and shells of a rose-hip subspecies (Rosa canina) reduces symptoms of knee and hip osteoarthritis: a randomized, double-blind, placebo-controlled clinical trial. Scand J Rheumatol. 2005;34
  22. Teng, C. M., Kang, Y. F., Chang, Y. L., Ko, F. N., Yang, S. C., and Hsu, F. L. ADP-mimicking platelet aggregation caused by rugosin E, an ellagitannin isolated from Rosa rugosa Thunb. Thromb.Haemost. 1997;77(3):555-561. DOI
  23. Seifi M, Abbasalizadeh S, Mohammad-Alizadeh-Charandabi S, Khodaie L, Mirghafourvand M. The effect of Rosa (L. Rosa canina) on the incidence of urinary tract infection in the puerperium: a randomized placebo-controlled trial. Phytother Res 2018;32(1):76-83
  24. Parandin R, Ghowsi M, Dadbod A. Protective effects of hydroalcoholic extract of Rosa canina L. fruit on cyclophosphamide-induced testicular toxicity in mice. Avicenna J Phytomed 2023;13(1):7-17.

See these in context on the Rose Hip monograph →

Calcium 62 references
  1. Shils M, Olson A, Shike M. Modern Nutrition in Health and Disease. 8th ed. Philadelphia, PA: Lea and Febiger, 1994.
  2. Hernandez-Avila M, Gonzalez-Cossio T, Hernandez-Avila JE, et al. Dietary calcium supplements to lower blood lead levels in lactating women: a randomized placebo-controlled trial. Epidemiology 2003;14:206-12.. PubMed
  3. Thys-Jacobs S, Ceccarelli S, Bierman A, et al. Calcium supplementation in premenstrual syndrome: a randomized crossover trial. J Gen Intern Med 1989;4:183-9. PubMed
  4. Maton PN, Burton ME. Antacids revisited: a review of their clinical pharmacology and recommended therapeutic use. Drugs 1999;57:855-70.
  5. Clemens JD, Feinstein AR. Calcium carbonate and constipation: a historical review of medical mythopoeia. Gastroenterology 1977;72:957-61. DOI
  6. Saunders D, Sillery J, Chapman R. Effect of calcium carbonate and aluminum hydroxide on human intestinal function. Dig Dis Sci 1988;33:409-13. PubMed
  7. Friedman PA, Bushinsky DA. Diuretic effects on calcium metabolism. Semin Nephrol 1999;19:551-6.
  8. Koo WK, Walters JC, Esterlitz J, et al. Maternal calcium supplementation and fetal bone mineralization. Obstet Gynecol 1999;94:577-82. DOI
  9. Raman L, Rajalakshmi K, Krishnamachari KAVR, et al. Effect of calcium supplementation to undernourished mothers during pregnancy on the bone density of the neonates. Am J Clin Nutr 1978; 31:466-9. DOI
  10. Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
  11. Chan JM, Giovannucci E, Andersson SO, et al. Dairy products, calcium, phosphorous, vitamin D, and risk of prostate cancer. Cancer Causes Control 1998;9:559-66.
  12. Butner LE, Fulco PP, Feldman G, et al. Calcium carbonate-induced hypothyroidism. Ann Intern Med 2000:132:595. PubMed
  13. Schneyer CR. Calcium carbonate and reduction of levothyroxine efficacy. JAMA 1998;279:750. PubMed
  14. Moser LR, Smythe MA, Tisdale JE. The use of calcium salts in the prevention and management of verapamil-induced hypotension. Ann Pharmacother 2000;34:622-9. PubMed
  15. Singh N, Singh PN, Hershman JM. Effect of calcium carbonate on the absorption of levothyroxine. JAMA 2000;283:2822-5. PubMed
  16. Kahela P, Anttila M, Tikkanen R, Sundquist H. Effect of food, food constituents and fluid volume on the bioavailability of sotalol. Acta Pharmacol Toxicol (Copenh) 1979;44:7-12.. PubMed
  17. Pletz MW, Petzold P, Allen A, et al. Effect of calcium carbonate on bioavailability of orally administered gemifloxacin. Antimicrob Agents Chemother 2003;47:2158-60.. PubMed
  18. Bar-Or D, Yoel G. Calcium and calciferol antagonize effect of verapamil in atrial fibrillation. Br Med J 1981;282:1585-6.
  19. Decktor DL, Robinson M, Maton PN, et al. Effects of aluminum/magnesium hydroxide and calcium carbonate on esophageal and gastric pH in subjects with heartburn. Am J Ther 1995;2:546-52. PubMed
  20. Simoneau G. Absence of rebound effect with calcium carbonate. Eur J Drug Metab Pharmacokinet 1996;21:351-7. PubMed
  21. Peters ML, Leonard M, Licata AA. Role of alendronate and risedronate in preventing and treating osteoporosis. Cleve Clin J Med 2001;68:945-51. PubMed
  22. Bourke JF, Mumford R, Whittaker P, et al. The effects of topical calcipotriol on systemic calcium homeostasis in patients with chronic plaque psoriasis. J Am Acad Dermatol 1997;37:929-34.
  23. Gueguen L, Pointillart A. The bioavailability of dietary calcium. J Am Coll Nutr 2000;19:119s-136s. PubMed
  24. Vella A, Gerber TC, Hayes DL, Reeder GS. Digoxin, hypercalcaemia, and cardiac conduction. Postgrad Med J 1999;75:554-6. PubMed
  25. Bania TC, Blaufeux B, Hughes S, et al. Calcium and digoxin vs. calcium alone for severe verapamil toxicity. Acad Emerg Med 2000;7:1089-96. PubMed
  26. Tseng M, Breslow RA, Graubard BI, Ziegler RG. Dairy, calcium, and vitamin D intakes and prostate cancer risk in the National Health and Nutrition Examination Epidemiologic Follow-up Study cohort. Am J Clin Nutr 2005;81:1147-54. PubMed
  27. Weingarten MA, Zalmanovici A, Yaphe J. Dietary calcium supplementation for preventing colorectal cancer and adenomatous polyps. Cochrane Database Syst Rev 2004;(1):CD003548. PubMed
  28. Tavani A, Bertuccio P, Bosetti C, et al. Dietary intake of calcium, vitamin D, phosphorus and the risk of prostate cancer. Eur Urol 2005;48:27-33. PubMed
  29. Giovannucci E, Liu Y, Stampfer MJ, Willett WC. A prospective study of calcium intake and incident and fatal prostate cancer. Cancer Epidemiol Biomarkers Prev 2006;15:203-10. PubMed
  30. Rocephin (ceftriaxone) and calcium interaction. Pharmacist's Letter / Prescriber's Letter 2007;23(10):231005.
  31. Bolland MJ, Barber PA, Doughty RN, et al. Vascular events in healthy older women receiving calcium supplementation: randomised control trial. BMJ 2008;336:262-6.
  32. Bolland MJ, Avenell A, Baron JA, et al. Effect of calcium supplements on risk of myocardial infarction and cardiovascular events: meta-analysis. BMJ 2010;341:c3691. PubMed
  33. Calcium supplementation and vascular events. Pharmacist's Letter / Prescriber's Letter 2008;24(3):240306.
  34. 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
  35. Coburn JW, Mischel MG, Goodman WG, et al. Calcium citrate markedly enhances aluminum absorption from aluminum hydroxide. Am J Kidney Dis. 1991;17(6):708-11. PubMed
  36. Bradley JS, Wassel RT, Lee L, et al. Intravenous ceftriaxone and calcium in the neonate: assessing the risk for cardiopulmonary adverse events. Pediatrics. 2009;123(4):e609-13. PubMed
  37. Kays MB, Overholser BR, Mueller BA, et al. Effects of sevelamer hydrochloride and calcium acetate on the oral bioavailability of ciprofloxacin. Am J Kidney Dis. 2003;42(6):1253-9. PubMed
  38. Neuhofel, A. L., Wilton, J. H., Victory, J. M., Hejmanowsk, L. G., and Amsden, G. W. Lack of bioequivalence of ciprofloxacin when administered with calcium-fortified orange juice: a new twist on an old interaction. J Clin Pharmacol. 2002;42(4):461-466. DOI
  39. Dickinson, H. O., Nicolson, D. J., Cook, J. V., Campbell, F., Beyer, F. R., Ford, G. A., and Mason, J. Calcium supplementation for the management of primary hypertension in adults. Cochrane.Database.Syst.Rev. 2006;(2):CD004639. PubMed
  40. Jones, B. J. and Twomey, P. J. Requesting patterns for serum calcium concentration in patients on long-term lithium therapy. Int J Clin Pract. 2009;63(1):170-172. PubMed
  41. Levine, M., Nikkanen, H., and Pallin, D. J. The effects of intravenous calcium in patients with digoxin toxicity. J Emerg.Med. 2011;40(1):41-46. PubMed
  42. Castelo-Branco, C., Ciria-Recasens, M., Cancelo-Hidalgo, M. J., Palacios, S., Haya-Palazuelos, J., Carbonell-Abello, J., Blanch-Rubio, J., Martinez-Zapata, M. J., Manasanch, J., and Perez-Edo, L. Efficacy of ossein-hydroxyapatite complex compared with ca
  43. Li K, Kaaks R, Linseisen J, Rohrmann S. Associations of dietary calcium intake and calcium supplementation with myocardial infarction and stroke risk and overall cardiovascular mortality in the Heidelberg cohort of the European Prospective Investigation i
  44. Chung M, Tang AM, Fu Z. Calcium Intake and Cardiovascular Disease Risk: An Updated Systematic Review and Meta-analysis. Ann Intern Med. 2016 Oct 25. PubMed
  45. Nolan CR, Califano JR, Butzin CA. Influence of calcium acetate or calcium citrate on intestinal aluminum absorption. Kidney Int. 1990;38(5):937-41. PubMed
  46. Lewis JR, Radavelli-Bagatini S, Rejnmark L, et al. The effects of calcium supplementation on verified coronary heart disease hospitalization and death in postmenopausal women: a collaborative meta-analysis of randomized controlled trials. J Bone Miner Res PubMed
  47. Jalloh MA, Gregory PJ, Hein D, et al. Dietary supplement interactions with antiretrovirals: a systematic review. Int J STD AIDS. 2017 Jan;28(1):4-15. PubMed
  48. 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
  49. Grove ML, Cook D. Calcium and heart attacks. Doesn't apply to most calcium prescriptions. BMJ. 2010;341:c5003. PubMed
  50. Insentress [package insert]. Whitehouse Station, NJ: Merck Sharp & Dohme Corp.; 2014.
  51. Roberts JL, Kiser JJ, Hindman JT, Meditz AL. Virologic failure with a raltegravir-containing antiretroviral regimen and concomitant calcium administration. Pharmacotherapy 2011;31(10):298e-302e. DOI
  52. Vitekta [package insert]. Foster City, CA: Gilead Sciences, Inc.; 2014.
  53. Storan ER, O'Gorman SM, Murphy A, Laing M. Case Report of Calciphylaxis Secondary to Calcium and Vitamin D<sub>3</sub> Supplementation. J Cutan Med Surg. 2017;21(2):162-163. DOI
  54. Jenkins DJA, Spence JD, Giovannucci EL, et al. Supplemental vitamins and minerals for CVD prevention and treatment. J Am Coll Cardiol 2018;71(22):2570-84. PubMed
  55. Borkenhagen JF, Connor EL, Stafstrom CE. Neonatal hypocalcemic seizures due to excessive maternal calcium ingestion. Pediatr Neurol 2013;48(6):469-71. PubMed
  56. WHO recommendations on antenatal care for a positive pregnancy experience. Geneva: World Health Organization; 2016 (http://www.who.int/reproductivehealth/publications/maternal_perinatal_health/ anc-positive-pregnancy-experience/en/).
  57. Aune D, Navarro Rosenblatt DA, Chan DS, et al. Dairy products, calcium, and prostate cancer risk: a systematic review and meta-analysis of cohort studies. Am J Clin Nutr. 2015;101(1):87-117. PubMed
  58. Lan T, Park Y, Colditz GA, et al. Adolescent dairy product and calcium intake in relation to later prostate cancer risk and mortality in the NIH-AARP Diet and Health Study. Cancer Causes Control. 2020;31(10):891-904. PubMed
  59. Zhang Y, Li Y, Liu J, et al. Association of Vitamin D or Calcium Supplementation with Cardiovascular Outcomes and Mortality: A Meta-Analysis with Trial Sequential Analysis. J Nutr Health Aging 2021;25(2):263-270. PubMed
  60. Myung SK, Kim HB, Lee YJ, Choi YJ, Oh SW. Calcium Supplements and Risk of Cardiovascular Disease: A Meta-Analysis of Clinical Trials. Nutrients 2021;13(2):368. PubMed
  61. Hetaimish B. Neonatal Calcinosis Cutis After Treatment of Hypocalcemia with Calcium Gluconate: A Report of 2 Cases. Am J Case Rep 2024;25:e943397. PubMed
  62. US Food and Drug Administration (FDA). Biktarvy Prescribing Information. October 2024. Available at: https://www.accessdata.fda.gov/drugsatfda_docs/label/2024/210251Orig1s020lbl.pdf. Accessed July 16, 2025.

See these in context on the Calcium monograph →

Vitamin C 51 references
  1. McEvoy GK, ed. AHFS Drug Information. Bethesda, MD: American Society of Health-System Pharmacists, 1998.
  2. Back DJ, Breckenridge AM, MacIver M, et al. Interaction of ethinyloestradiol with ascorbic acid in man. Br Med J (Clin Res Ed) 1981;282:1516.
  3. Morris JC, Beeley L, Ballantine N. Interaction of ethinyloestradiol with ascorbic acid in man [letter]. Br Med J (Clin Res Ed) 1981;283:503.
  4. Labriola D, Livingston R. Possible interactions between dietary antioxidants and chemotherapy. Oncology 1999;13:1003-8.
  5. Dwyer JH, Merz NB, Shirocre AM, et al. Progression of early atherosclerosis and intake of vitamin C and vitamin E from supplements and food. The Los Angeles Atherosclerosis Study. 41st Annual Conference on Cardiovascular Disease Epidemiology and Prevent
  6. Levine M, Rumsey SC, Daruwala R, et al. Criteria and recommendations for vitamin C intake. JAMA 1999;281:1415-23. PubMed
  7. Hansten PD, Horn JR. Drug Interactions Analysis and Management. Vancouver, WA: Applied Therapeutics Inc., 1997 and updates.
  8. Segal S, Kaminski S. Drug-nutrient interactions. American Druggist 1996 Jul;42-8.
  9. Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes for Vitamin C, Vitamin E, Selenium, and Carotenoids. Washington, DC: National Academy Press, 2000. Available at: http://www.nap.edu/books/0309069351/html/.
  10. Houston JB, Levy G. Drug biotransformation interactions in man VI: Acetaminophen and ascorbic acid. J Pharm Sci 1976;65:1218-21. PubMed
  11. Brown BG, Zhao XQ, Chait A, et al. Simvastatin and niacin, antioxidant vitamins, or the combination for the prevention of coronary disease. N Engl J Med 2001;345:1583-93. DOI
  12. Rosenthal G. Interaction of ascorbic acid and warfarin. JAMA 1971;215:1671. DOI
  13. Hume R, Johnstone JM, Weyers E. Interaction of ascorbic acid and warfarin. JAMA 1972;219:1479. DOI
  14. Smith EC, Skalski RJ, Johnson GC, Rossi GV. Interaction of ascorbic acid and warfarin. JAMA 1972;221:1166. DOI
  15. Traxer O, Huet B, Poindexter J, et al. Effect of ascorbic acid consumption on urinary stone risk factors. J Urol 2003;170:397-401.. PubMed
  16. Domingo JL, Gomez M, Llobet JM, Richart C. Effect of ascorbic acid on gastrointestinal aluminum absorption (letter). Lancet 1991;338:1467.
  17. Domingo JL, Gomez M, Llobet JM, Corbella J. Influence of some dietary constituents on aluminum absorption and retention in rats. Kidney Int 1991;39:598-601. PubMed
  18. Partridge NA, Regnier FE, White JL, Hem SL. Influence of dietary constituents on intestinal absorption of aluminum. Kidney Int 1989;35:1413-7. PubMed
  19. Mc Leod DC, Nahata MC. Inefficacy of ascorbic acid as a urinary acidifier (letter). N Engl J Med 1977;296:1413. DOI
  20. Hansten PD, Hayton WL. Effect of antacid and ascorbic acid on serum salicylate concentration. J Clin Pharmacol 1980;20:326-31. PubMed
  21. Dysken MW, Cumming RJ, Channon RA, Davis JM. Drug interaction between ascorbic acid and fluphenazine. JAMA 1979;241:2008. DOI
  22. Vihtamaki T, Parantainen J, Koivisto AM, et al. Oral ascorbic acid increases plasma oestradiol during postmenopausal hormone replacement therapy. Maturitas 2002;42:129-35. PubMed
  23. Slain D, Amsden JR, Khakoo RA, et al. Effect of high-dose vitamin C on the steady-state pharmacokinetics of the protease inhibitor indinavir in healthy volunteers. Pharmacotherapy 2005;25:165-70. PubMed
  24. Cheung MC, Zhao XQ, Chait A, et al. Antioxidant supplements block the response of HDL to simvastatin-niacin therapy in patients with coronary artery disease and low HDL. Arterioscler Thromb Vasc Biol 2001;21:1320-6. PubMed
  25. Feetam CL, Leach RH, Meynell MJ. Lack of a clinically important interaction between warfarin and ascorbic acid. Toxicol Appl Pharmacol 1975;31:544-7. PubMed
  26. Weintraub M, Griner PF. Warfarin and ascorbic acid: lack of evidence for a drug interaction. Toxicol Appl Pharmacol 1974;28:53-6. PubMed
  27. Lee DH, Folsom AR, Harnack L, et al. Does supplemental vitamin C increase cardiovascular disease risk in women with diabetes? Am J Clin Nutr 2004;80:1194-200. PubMed
  28. Taylor EN, Stampfer MJ, Curhan GC. Dietary factors and the risk of incident kidney stones in men: new insights after 14 years of follow-up. J Am Soc Nephrol 2004;15:3225-32. PubMed
  29. Ward NC, Hodgson JM, Croft KD, et al. The combination of vitamin C and grape-seed polyphenols increases blood pressure: a randomized, double-blind, placebo-controlled trial. J Hypertens 2005;23:427-34.. PubMed
  30. Prasad KN. Rationale for using high-dose multiple dietary antioxidants as an adjunct to radiation therapy and chemotherapy. J Nutr 2004;134:3182S-3S. PubMed
  31. Conklin KA. Cancer chemotherapy and antioxidants. J Nutr 2004;134:3201S-3204S. PubMed
  32. Fairweather-Tait S, Hickson K, McGaw B, et al. Orange juice enhances aluminium absorption from antacid preparation. Eur J Clin Nutr. 1994;48(1):71-3.
  33. Gruenwald, J., Graubaum, H. J., Busch, R., and Bentley, C. Safety and tolerance of ester-C compared with regular ascorbic acid. Adv.Ther. 2006;23(1):171-178.
  34. Rahimi, R., Nikfar, S., Rezaie, A., and Abdollahi, M. A meta-analysis on the efficacy and safety of combined vitamin C and E supplementation in preeclamptic women. Hypertens.Pregnancy. 2009;28(4):417-434. PubMed
  35. Einerson, B., Nathorn, C., Kitiyakara, C., Sirada, M., and Thamlikitkul, V. The efficacy of ascorbic acid in suboptimal responsive anemic hemodialysis patients receiving erythropoietin: a meta-analysis. J Med.Assoc.Thai. 2011;94 Suppl 1:S134-S146.
  36. Li, G., Li, L., Yu, C., and Chen, L. Effect of vitamins C and E supplementation on Helicobacter pylori eradication: a meta-analysis. Br.J Nutr 2011;106(11):1632-1637.
  37. Chen X, Shen L, Gu X, et al. High-dose supplementation with vitamin C--induced pediatric urolithiasis: the first case report in a child and literature review. Urology. 2014;84(4):922-4. PubMed
  38. Sattar A, Willman JE, Kolluri R. Possible warfarin resistance due to interaction with ascorbic acid: case report and literature review. Am J Health Syst Pharm. 2013;70(9):782-6. PubMed
  39. Yaich S, Chaabouni Y, Charfeddine K, et al. Secondary oxalosis due to excess vitamin C intake: a cause of graft loss in a renal transplant recipient. Saudi J Kidney Dis Transpl. 2014;25(1):113-6. PubMed
  40. Jalloh MA, Gregory PJ, Hein D, et al. Dietary supplement interactions with antiretrovirals: a systematic review. Int J STD AIDS. 2017 Jan;28(1):4-15. PubMed
  41. Rumbold A, Ota E, Nagata C, Shahrook S, Crowther CA. Vitamin C supplementation in pregnancy. Cochrane Database Syst Rev. 2015;(9):CD004072. PubMed
  42. Seo MS, Kim JK, Shim JY. High-dose vitamin C promotes regression of multiple pulmonary metastases originating from hepatocellular carcinoma. Yonsei Med J. 2015;56(5):1449-52. PubMed
  43. Skelin M, Lucijanic T, Amidzic Klaric D, et al. Factors Affecting Gastrointestinal Absorption of Levothyroxine: A Review. Clin Ther. 2017 Feb;39(2):378-403. PubMed
  44. Jiang K, Tang K, Liu H, Xu H, Ye Z, Chen Z. Ascorbic acid supplements and kidney stones incidence among men and women: a systematic review and meta-analysis. Urol J. 2019;16(2):115-120.
  45. Thomas S, Patel D, Bittel B, et al. Effect of High-Dose Zinc and Ascorbic Acid Supplementation vs Usual Care on Symptom Length and Reduction Among Ambulatory Patients With SARS-CoV-2 Infection: The COVID A to Z Randomized Clinical Trial. JAMA Netw Open. 2 PubMed
  46. Giffen MA, McLemore JL. Hyperoxalosis Secondary to Intravenous Vitamin C Administration as a Non-Allopathic Treatment for Cancer. Acad Forensic Pathol 2019;9(1-2):118-126. PubMed
  47. Maike A, Sturgill D, Gallan A. Oxalate Nephropathy in a Renal Transplant Recipient After Receiving High Dose Ascorbic Acid. Am J Med Sci 2021. PubMed
  48. Shen ZY, Chen YR, Wang MC, Chang SS. High-dose vitamin C-induced acute oxalate nephropathy in a renal transplant recipient: a case report and literature review. Asian J Surg 2022. PubMed
  49. Yanase F, Spano S, Maeda A, et al. Mega-dose sodium ascorbate: a pilot, single-dose, physiological effect, double-blind, randomized, controlled trial. Crit Care 2023;27(1):371. PubMed
  50. Sharma Y, Sumanadasa S, Shahi R, et al. Efficacy and safety of vitamin C supplementation in the treatment of community-acquired pneumonia: a systematic review and meta-analysis with trial sequential analysis. Sci Rep 2024;14(1):11846. PubMed
  51. Pejcic AV, Petrovic NZ, Djordjic MD, Milosavljevic MN. Vitamin C Levels in Pregnant Women and the Efficacy of Vitamin C Supplements in Preventing Premature Rupture of Membranes: A Systematic Review and Meta-Analysis. Balkan Med J 2024;41(4):248-260. PubMed

See these in context on the Vitamin C monograph →

Acerola 20 references
  1. Back DJ, Breckenridge AM, MacIver M, et al. Interaction of ethinyloestradiol with ascorbic acid in man. Br Med J (Clin Res Ed) 1981;282:1516.
  2. Morris JC, Beeley L, Ballantine N. Interaction of ethinyloestradiol with ascorbic acid in man [letter]. Br Med J (Clin Res Ed) 1981;283:503.
  3. Labriola D, Livingston R. Possible interactions between dietary antioxidants and chemotherapy. Oncology 1999;13:1003-8.
  4. Hansten PD, Horn JR. Drug Interactions Analysis and Management. Vancouver, WA: Applied Therapeutics Inc., 1997 and updates.
  5. Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes for Vitamin C, Vitamin E, Selenium, and Carotenoids. Washington, DC: National Academy Press, 2000. Available at: http://www.nap.edu/books/0309069351/html/.
  6. Rosenthal G. Interaction of ascorbic acid and warfarin. JAMA 1971;215:1671. DOI
  7. Hume R, Johnstone JM, Weyers E. Interaction of ascorbic acid and warfarin. JAMA 1972;219:1479. DOI
  8. Smith EC, Skalski RJ, Johnson GC, Rossi GV. Interaction of ascorbic acid and warfarin. JAMA 1972;221:1166. DOI
  9. Domingo JL, Gomez M, Llobet JM, Richart C. Effect of ascorbic acid on gastrointestinal aluminum absorption (letter). Lancet 1991;338:1467.
  10. Domingo JL, Gomez M, Llobet JM, Corbella J. Influence of some dietary constituents on aluminum absorption and retention in rats. Kidney Int 1991;39:598-601. PubMed
  11. Partridge NA, Regnier FE, White JL, Hem SL. Influence of dietary constituents on intestinal absorption of aluminum. Kidney Int 1989;35:1413-7. PubMed
  12. Mc Leod DC, Nahata MC. Inefficacy of ascorbic acid as a urinary acidifier (letter). N Engl J Med 1977;296:1413. DOI
  13. Hansten PD, Hayton WL. Effect of antacid and ascorbic acid on serum salicylate concentration. J Clin Pharmacol 1980;20:326-31. PubMed
  14. Vihtamaki T, Parantainen J, Koivisto AM, et al. Oral ascorbic acid increases plasma oestradiol during postmenopausal hormone replacement therapy. Maturitas 2002;42:129-35. PubMed
  15. Feetam CL, Leach RH, Meynell MJ. Lack of a clinically important interaction between warfarin and ascorbic acid. Toxicol Appl Pharmacol 1975;31:544-7. PubMed
  16. Weintraub M, Griner PF. Warfarin and ascorbic acid: lack of evidence for a drug interaction. Toxicol Appl Pharmacol 1974;28:53-6. PubMed
  17. Prasad KN. Rationale for using high-dose multiple dietary antioxidants as an adjunct to radiation therapy and chemotherapy. J Nutr 2004;134:3182S-3S. PubMed
  18. Conklin KA. Cancer chemotherapy and antioxidants. J Nutr 2004;134:3201S-3204S. PubMed
  19. Denadai R, Souza FM, Valle MR. Fecal impaction by rectal acerola bezoar. Indian J Pediatr 2013;80(5):432-3. PubMed
  20. Raulf-Heimsoth M, Stark R, Sander I, et al. Anaphylactic reaction to apple juice containing acerola: cross-reactivity to latex due to prohevein. J Allergy Clin Immunol 2002;109(4):715-6. PubMed

See these in context on the Acerola 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.

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