Interactions on record — worth a quick check against your medications. Based on 6 of 10 ingredients. Check your meds →
Dietary supplement

Psyllium Pre & Probiotic Fiber Orange Ingredients & Drug Interactions

by Organic India

Psyllium Pre & Probiotic Fiber Orange label
See full label image
Powder Category: Other Combinations
Most serious interaction: Moderate
Clinical methodology reviewed by · Updated Sep 16, 2026 · Label data from the NIH DSLD
What is this page for?

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

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

The interaction bottom line Most serious interaction: Moderate

Psyllium Pre & Probiotic Fiber Orange is a dietary supplement by Organic India with 10 active ingredients. Its ingredients are commonly taken for iron-deficiency anemia, low iron stores during pregnancy, fatigue from iron deficiency.Based on those ingredients, 2,199 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Dietary Fiber, Belleric Myrobalan, Garden Cress. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

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Check Your Meds Against Psyllium Pre & Probiotic Fiber Orange by Organic India

Ask about any prescription or over-the-counter medication and we check it for interactions with Psyllium Pre & Probiotic Fiber Orange by Organic India — and tell you which ingredient is responsible.

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HelloPharmacist Scorecard of Psyllium Pre & Probiotic Fiber Orange by Organic India

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 2 of its 10 active ingredients.
  • “Proprietary Blend” is a proprietary blend — the label gives one combined amount (4.90 Gram(s)) without saying how much of each component you get.
  • “organic Triphala Blend” is a proprietary blend — the label gives one combined amount (200 mg) without saying how much of each component you get.

This product contains 11 ingredients total, including several active components. Iron supports red blood cell production and oxygen transport.

Amla (Indian Gooseberry), Belleric Myrobalan, and Chebulic Myrobalan are traditional Ayurvedic fruits, with the latter two also known as part of the blend called Triphala. Bacillus coagulans is a probiotic organism that may support digestive health.

Psyllium, soluble fiber, and insoluble fiber work together to add bulk to stool. Garden Cress is included as another traditional botanical.

The product also contains rebaudioside A (a stevia-derived sweetener) and natural orange flavor. Beyond the actives, the product contains inactive ingredients listed as natural orange flavor.

Does it work?

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

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

Why this rating?
  • The label markets this product for: supports heart health and digestive function.
  • We looked for evidence on: Cardiovascular disease (CVD), Coronary heart disease (CHD), Dyslipidemia, Hypercholesterolemia, Hyperlipidemia, Constipation — and 4 related terms.
  • The strongest evidence on file: Black Psyllium is rated "Effective" for Constipation (Natural Medicines).
  • Also on file: Iron is rated "Effective" for Iron deficiency anemia.
  • Also on file: Black Psyllium is rated "Likely Effective" for Coronary heart disease (CHD).

Iron is effective for treating iron deficiency anemia and anemia from chronic disease, and is possibly effective for heart failure. Amla shows possibly effective evidence for gastroesophageal reflux disease (GERD) and dyslipidemia (abnormal blood fats), but has insufficient evidence for hypercholesterolemia or hair loss.

Bacillus coagulans is possibly effective for constipation and irritable bowel syndrome (IBS), but evidence is insufficient for antibiotic-associated diarrhea, athletic performance, cancer, or fatty liver disease. Belleric Myrobalan and Garden Cress lack sufficient reliable evidence for their claimed uses in obesity, high blood pressure, high cholesterol, chest pain, or other conditions listed.

The fiber components are not rated in our data.

The evidence, ingredient by ingredient Iron Bacillus Coagulans Garden Cress Black Psyllium Indian Gooseberry Terminalia

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 4 of the 6 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 6 of 6.
  • General safety write-ups exist for 6 of 6.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

Iron is generally well tolerated at recommended doses, though excess iron can be toxic—use it only when there's a real need. The most common side effects from iron are stomach upset, constipation, diarrhea, and nausea.

Iron is recommended in pregnancy but should be dosed by your prenatal care provider; it's also generally acceptable while breastfeeding at appropriate doses. Amla is generally well tolerated as a food, but supplement safety is less studied; there isn't enough safety data for supplement doses, so it's best to avoid, and there's too little reliable safety information during breastfeeding.

Belleric Myrobalan is generally well tolerated short-term in studies, but long-term safety and quality vary by product; there isn't enough safety information to use during pregnancy or breastfeeding. Bacillus coagulans is generally well tolerated in healthy adults, though evidence and product quality vary, and you should talk to your doctor before using, especially during pregnancy or breastfeeding.

Garden Cress is generally safe as a food, but concentrated seed amounts have limited safety data; medicinal amounts should be avoided in pregnancy because the seeds are traditionally believed to stimulate the uterus, though food amounts are likely fine. We hold no safety data for Chebulic Myrobalan, Soluble Fiber, Insoluble Fiber, Rebaudioside A, or Psyllium.

Side effects, ingredient by ingredient Iron Bacillus Coagulans Garden Cress Black Psyllium Indian Gooseberry Terminalia

Meds to double-check

Moderate interaction found
Known Interaction Concern · database check
Moderate identified

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

Why this rating?
  • 6 of the 6 matched ingredients can interact with medications — Black Psyllium, Garden Cress, Indian Gooseberry, Terminalia, Iron, among others.
  • The most serious interaction on file is rated Moderate.
  • Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs; diabetes medications; heart-rhythm medications; lithium; Parkinson's medications.
  • For scale: 2,200 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 this product, check with your pharmacist if you take any of these: blood thinners or antiplatelet drugs like warfarin, aspirin, or clopidogrel (risk of bleeding); diabetes medications (risk of low blood sugar); antibiotics, especially quinolones and tetracyclines (reduced antibiotic absorption); blood pressure medications, including amlodipine (risk of low blood pressure); thyroid medication (levothyroxine); osteoporosis drugs (bisphosphonates); muscle relaxants (chlorzoxazone); heartburn medication (omeprazole); levodopa for Parkinson's; methyldopa; penicillamine; mycophenolate mofetil; lithium; theophylline; or carbamazepine. Iron in this product requires spacing doses from several of these; other ingredients may affect how your liver processes many common drugs.

Check your own medication Run your meds through the checker above

The bottom line

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

This product combines iron, probiotics, and Ayurvedic botanicals with fiber. It may help if you're looking to support iron levels or digestive health, but the multiple ingredients mean several medication interactions you need to check first.

If you take any prescription drugs—especially for blood pressure, diabetes, antibiotics, blood thinning, thyroid, or osteoporosis—run them through the tool below before you start. Talk to your pharmacist about timing if interactions exist.

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

Assessment coverage: 6 of 10 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 Psyllium Pre & Probiotic Fiber Orange, straight from the product label.

Brand Organic India
Barcode (UPC) 801541517215
Net contents 10 Ounce(s); 283.5 Gram(s)
Market status On market
Date entered into DSLD Feb 23, 2025
DSLD ID 327604
Product type Other Combinations
Supplement form Powder
Dietary claims / uses Nutrient, All Other, Qualified Health, Structure/Function
Intended target group(s) Children 4 or More Years of Age, Vegan, Vegetarian, Adult (18 - 50 Years), Kosher, Organic
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 Psyllium Pre & Probiotic Fiber Orange by Organic India, 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:
5 Gram(s)
Maximum serving Sizes:
5 Gram(s)
Servings per container
56
UPC/BARCODE
801541517215
IngredientAmount% DV
Calories20 Calorie(s)--
Total Carbohydrates4 Gram(s)1%
Iron1 mg5%
Proprietary Blend4.9 Gram(s)--
Dietary Fiber3 Gram(s)11%
Chebulic Myrobalan0 NP--
Soluble Fiber2 Gram(s)--
Insoluble Fiber2 Gram(s)--
Amla0 NP--
Rebaudioside A0 NP--
Psyllium0 NP--
Belleric Myrobalan0 NP--
Bacillus coagulans0 NP--
Psyllium0 NP--
organic Triphala Blend200 mg--
Garden Cress0 NP--

Other ingredients: Orange Flavor, Natural

Tap any ingredient to jump to its full detail below.

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

At the heart of Organic India is our commitment to be a living embodiment of love and consciousness in action. All our products promote health and happiness and are made with loving care. Earth Seer Ethical, Authentic, Reliable, Trustworthy, Holistic, Socially, Environmentally, Economically Responsible

organicindiausa.com Instagram @organicindiausa Facebook #healthyconsiousliving Twitter Scan for recipes Pictured at the front is one of our beloved farmers

New look same great formula

Formula

Prebiotic Fiber Ayurvedic Herbs Probiotics Includes soothing Chandrashoor seeds Heat-stable B. coagulants great for baking

Keto Paleo

Psyllium Pre & Probiotic Fiber Orange With Triphala Psyllium Powder & Probiotics Probiotic Fiber Probiotics Ayurvedic Herbs

OU (Kosher)

Formulation

Supports heart health Soluble fiber from foods such as psyllium as a part of a diet low in saturated fat and cholesterol and high in fruits, vegetables, and grain products that contain fiber, may reduce the risk of heart disease. A serving of psyllium provides 3 grams of the 7 grams of soluble fiber from psyllium necessary per day to have this effect. Nourishes beneficial gut bacteria Improves digestion and nutrient assimilation Supports a healthy gut microbiome Supports immune health

Vegan Vegetarian

Gluten free

Supports digestive health Heart healthy Healthy conscious living

USDA Organic

Non GMO Project Verified nongmoproject.org

India Organic SGS Organic NPOP/NAB/009 Control Union Certified Certified Organic per NPOP by SGS INDIA PVT. LTD. Processed & produced as per NPOP standard of India Certified Organic by Control Union CU-801983

Product produced and processed according to USDA NOP standard Product of India for export to USA Mfg. Lic. No. A-2755

Suggested/Recommended/Usage/Directions

Suggested use: Persons 12 years and older: 1-2 servings daily before or between meals. Directions: Blend 1 tsp into a smoothie or mix 1 tsp with at least 10 oz of water or juice. Stir and drink immediately. Mixture will thicken - increase liquid to achieve desired consistency. For best results, drink an additional glass of water after taking to ensure hydration. Vegan egg replacement: For baking, mix 1 tsp per egg in with dry ingredients and omit eggs.

Consume within 2 months after opening.

Precautions

Please note: This product needs to be consumed with at least 10 oz. of liquid. Using this product without enough liquid may cause choking. Do not use this product if you have difficulty in swallowing. Warning: Reproductive Harm - www.P65Warnings.ca.gov.

FDA Disclaimer Statement

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

FDA Statement of Identity

Dietary Supplement

Seals/Symbols

USDA Organic Non GMO Project Verified nongmoproject.org Certified B Corporation

India Organic SGS Organic NPOP/NAB/009 Control Union Certified OU (Kosher)

Storage

Store in a cool, dry place away from sunlight.

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

See for yourself

Psyllium Pre & Probiotic Fiber Orange by Organic India label

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

Psyllium Pre & Probiotic Fiber Orange 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 Psyllium Pre & Probiotic Fiber Orange by Organic India

These are the 10 active ingredients this product is made of. Select any to open its full monograph.

Serving size5 Gram(s) Dosage formPowder Servings per container56 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.

Iron

Interacts with
80 drugs
1 mg per serving

Iron is an essential mineral your body needs to make hemoglobin and carry oxygen in the blood. Supplements are mainly useful for treating or preventin...

Iron monograph & interactions

Proprietary Blend

4.9 Gram(s) per serving

Dietary Fiber

Interacts with
2,025 drugs
3 Gram(s) per serving

Black psyllium is a soluble-fiber supplement made from the seeds of a Plantago plant, used mostly to ease constipation and support digestive health. I...

Dietary Fiber monograph & interactions
  • › Soluble Fiber
  • › Insoluble Fiber

Organic Triphala Blend

200 mg per serving

Other (inactive) ingredients: Orange Flavor, Natural. These complete the product’s ingredient list but are not active constituents.

Interaction report

Psyllium Pre & Probiotic Fiber Orange by Organic India Drug Interactions

Want to check YOUR meds against Psyllium Pre & Probiotic Fiber Orange?

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
2,199Drugs
1,254 Moderate 945 Minor

Ingredients driving the most interactions

Dietary Fiber 2,025
Belleric Myrobalan 933
Garden Cress 398
Amla 208
Bacillus coagulans 182

Individual Drug Interactions

The ingredients in Psyllium Pre & Probiotic Fiber Orange interact with 2,199 drugs. Click any drug to see the details.

6 of the 10 ingredients in Psyllium Pre & Probiotic Fiber Orange interact with drugs. Each result below shows which ingredient is responsible. Dietary Fiber Belleric Myrobalan Garden Cress Amla Bacillus coagulans Iron

Each ingredient & the kinds of drugs it affects

For each ingredient in Psyllium Pre & Probiotic Fiber Orange 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.

Dietary Fiber7 drug types · 2,025 drugs

Carbamazepine (Tegretol)

Theoretically, black psyllium might reduce the effects of carbamazepine and increase the risk for convulsions.
Theoretically, black psyllium might reduce carbamazepine absorption. A preliminary study using blond psyllium reported decreased carbamazepine bioavailability due to binding of the drug to psyllium, as well as reduction of available fluid in the gut for dissolution of the drug. This interaction may also occur with black psyllium.

Likelihood Probable Evidence D
Lithium

Theoretically, taking black psyllium at the same time as lithium might reduce lithium absorption.
The fiber in black psyllium might reduce lithium absorption and plasma levels. Some case reports describe a reduction in plasma lithium levels with concomitant administration of blond psyllium. This was reversed when psyllium was stopped. This interaction may also occur with black psyllium.

Likelihood Probable Evidence D
Metformin (Glucophage)

Theoretically, black psyllium might increase the therapeutic and adverse effects of metformin.
Animal research shows that concurrent consumption of blond psyllium with metformin slows and increases the absorption of metformin. This interaction may also occur with black psyllium. To avoid changes in absorption, take psyllium 30-60 minutes after metformin.

Likelihood Possible Evidence D
Olanzapine (Zyprexa)

Theoretically, taking black psyllium at the same time as olanzapine might reduce olanzapine absorption.
The fiber in black psyllium might decrease the absorption of olanzapine. A single case report describes a reduction in the effectiveness of olanzapine when it was concomitantly administered with an unspecified type of psyllium 3 grams orally twice daily. This effect was reversed when psyllium was stopped.

Likelihood Possible Evidence D
Digoxin (Lanoxin)

Theoretically, taking black psyllium at the same time as digoxin might reduce digoxin absorption and decrease digoxin levels.
Psyllium might bind digoxin in the gut. However, some clinical evidence suggests that psyllium does not impact digoxin absorption.

Likelihood Unlikely Evidence B
Ethinyl Estradiol

Theoretically, taking black psyllium at the same time as ethinyl estradiol might alter levels of estradiol.
Concurrent use of blond psyllium with ethinyl estradiol results in a slight increase in the extent of ethinyl estradiol absorption and a slower rate of absorption. This is unlikely to be clinically significant.

Likelihood Unlikely Evidence D
Oral Drugs

Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Psyllium seems to have variable effects on drug absorption. To avoid changes in absorption, take psyllium 30-60 minutes after oral medications. Animal research shows that blond psyllium delays and increases the absorption of metformin and ethinyl estradiol. Case reports and animal research suggest that blond psyllium might reduce absorption of lithium, digoxin, olanzapine, and carbamazepine. Finally, some pharmacokinetic studies show that psyllium does not affect the absorption of levothyroxine or warfarin. Although many of these studies evaluated blond psyllium, the fiber content in black psyllium may have similar effects.

Likelihood Possible Evidence B
Dietary Fiber full monograph & interactions

Belleric Myrobalan7 drug types · 933 drugs

Anticoagulant/Antiplatelet Drugs

Theoretically, concomitant use of Terminalia arjuna with anticoagulant or antiplatelet drugs may increase the risk of bleeding in some patients.
In vitro, Terminalia arjuna bark extract inhibits platelet aggregation, decreases platelet activation, and shows antithrombotic properties.

Likelihood Possible Evidence D
Antidiabetes Drugs

Theoretically, concomitant use of Terminalia bellirica or Terminalia chebula with antidiabetes drugs could affect blood sugar control and increase the risk of hypoglycemia.
Animal and in vitro research shows that Terminalia bellirica and Terminalia chebula fruit and seed extract have hypoglycemic effects.

Likelihood Possible Evidence D
Chlorzoxazone (Parafon Forte, Paraflex)

Theoretically, use of Terminalia chebula may increase the risk of adverse effects from chlorzoxazone.
Animal research shows that enteral administration of Terminalia chebula for 15 days prior to administration of chlorzoxazone increases blood levels of chlorzoxazone and decreases chlorzoxazone clearance. It is speculated that Terminalia chebula reduces the metabolism of chlorzoxazone by inhibiting cytochrome P450 2E1.

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

Theoretically, use of Terminalia arjuna may increase the levels and clinical effects of CYP2C9 substrates.
In vitro research shows that Terminalia arjuna extract inhibits CYP2C9 enzymes and reduces CYP2C9 substrate metabolism.

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

Theoretically, use of Terminalia arjuna may increase the levels and clinical effects of CYP2D6 substrates.
In vitro research shows that Terminalia arjuna extract inhibits CYP2D6 enzymes and reduces CYP2D6 substrate metabolism.

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

Theoretically, use of Terminalia arjuna may increase the levels and clinical effects of CYP3A4 substrates.
In vitro research shows that Terminalia arjuna extract inhibits CYP3A4 enzymes and reduces CYP3A4 substrate metabolism.

Likelihood Possible Evidence D
Omeprazole (Prilosec)

Theoretically, use of Terminalia chebula may increase the risk of adverse effects from omeprazole.
Animal research shows that enteral administration of Terminalia chebula for 15 days prior to administration of omeprazole increases blood levels of omeprazole and decreases omeprazole clearance. It is speculated that Terminalia chebula reduces the metabolism of omeprazole by inhibiting cytochrome P450 2C19.

Likelihood Possible Evidence D
Belleric Myrobalan full monograph & interactions

Garden Cress14 drug types · 398 drugs

Amlodipine (Norvasc)

Theoretically, taking garden cress seeds with amlodipine might increase the risk of hypotension.
Animal research indicates that giving garden cress seeds with amlodipine increases maximum concentrations of amlodipine by 83%. Blood pressure was also reduced when compared with amlodipine alone. However, the area under the curve was not significantly affected.

Likelihood Possible Evidence D
Anticoagulant/Antiplatelet Drugs

Theoretically, garden cress seed may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Animal research suggests that garden cress seed extract can increase bleeding time when used in combination with the antiplatelet agent clopidogrel. This has not been shown in humans and it is unclear if garden cress seed itself has anticoagulant or antiplatelet effects.

Likelihood Possible Evidence D
Antidiabetes Drugs

Theoretically, taking garden cress with antidiabetes drugs might increase the risk of hypoglycemia.
Evidence from animal research suggests that an extract of garden cress can reduce blood glucose levels. This has not been shown in humans.

Likelihood Possible Evidence D
Antihypertensive Drugs

Theoretically, taking garden cress with antihypertensive drugs might increase the risk of hypotension.
Garden cress has shown hypotensive effects in animal research and increases levels and effects of the antihypertensive medications amlodipine and losartan. This has not been shown in humans.

Likelihood Possible Evidence D
Carbamazepine (Tegretol)

Theoretically, garden cress might increase the absorption rate of carbamazepine and result in blood concentrations outside of the therapeutic window.
Animal research shows that taking garden cress seed daily for 8 days prior to a single dose of carbamazepine does not significantly affect maximum concentrations or area under the curve of carbamazepine. However, the absorption rate is increased, with a 50% reduction (2 hours) in time to peak concentration, resulting in increased plasma levels within 3 hours of dosing and then decreased plasma levels from 5-12 hours after dosing. This has not been shown in humans.

Likelihood Possible Evidence D
Clopidogrel (Plavix)

Theoretically, taking garden cress seed with clopidogrel might prolong bleeding.
Animal research shows that taking garden cress seed daily for 2 weeks prior to a single dose of clopidogrel does not affect the pharmacokinetics of clopidogrel. However, bleeding time was increased by 7%. This has not been shown in humans and the mechanism of action is unclear.

Likelihood Possible Evidence D
Diuretic Drugs

Theoretically, taking garden cress with diuretic drugs might increase the risk of hypokalemia.
Evidence from animal research suggests that garden cress has diuretic effects and can increase the urinary excretion of potassium. This has not been shown in humans. Initiation of potassium supplementation or an increase in potassium supplement dose may be necessary for some patients.

Likelihood Possible Evidence D
Gliclazide (Diamicron, Others)

Theoretically, taking garden cress seed with gliclazide might increase the risk of hypoglycemia.
Evidence from animal research suggests that garden cress seed increases the area under the curve of a single dose of gliclazide by approximately 70%. However, there was no statistically significant effect on maximum concentrations of gliclazide or on the effects of gliclazide on blood glucose. This has not been shown in humans.

Likelihood Possible Evidence D
Lithium

Theoretically, garden cress might reduce excretion and increase levels of lithium due to diuretic effects.
Animal research suggests that garden cress has diuretic properties.

Likelihood Probable Evidence D
Losartan (Cozaar)

Theoretically, garden cress seed might have additive hypotensive effects when used with losartan.
Animal research suggests that giving garden cress seed extract for two weeks before a single dose of losartan increases levels of plasma losartan by at least 2.4-fold and potentiates its blood pressure-lowering effects. Maximum concentrations of losartan were not significantly affected. So far, this interaction has not been reported in humans.

Likelihood Possible Evidence D
Metoprolol (Toprol)

Theoretically, garden cress seed might have additive hypotensive effects when used with metoprolol.
Animal research shows that garden cress seed for 2 weeks decreases systolic and diastolic blood pressure by 9% and 32%, respectively, when administered alone, and by 15% and 33%, respectively, when given with metoprolol 10 mg/kg. So far, this interaction has not been reported in humans.

Likelihood Possible Evidence D
Phenytoin (Dilantin)

Theoretically, garden cress might increase levels and side effects of phenytoin.
Animal research shows that garden cress seed for 1 week increases maximum concentrations and the area under the curve of a single dose of phenytoin by 16% and 49%, respectively. This seems to be related to decreased clearance. So far, this interaction has not been reported in humans.

Likelihood Possible Evidence D
Sildenafil (Viagra)

Theoretically, concurrent use of sildenafil and L-arginine might reduce levels and therapeutic effects of sildenafil.
Animal research shows that garden cress seed for 1 week reduces maximum concentrations and the area under the curve of a single dose of sildenafil by 40% and 51%, respectively. So far, this interaction has not been reported in humans.

Likelihood Possible Evidence D
Theophylline

Theoretically, concurrent use of sildenafil and theophylline might increase levels and adverse effects of theophylline.
Animal research shows that garden cress can increase theophylline concentrations by approximately 37%. It is hypothesized that this increase is due to possible inhibition of cytochrome P450 (CYP) 1A2. So far, this interaction has not been reported in humans.

Likelihood Possible Evidence D
Garden Cress full monograph & interactions

Amla4 drug types · 208 drugs

Anticoagulant/Antiplatelet Drugs

Theoretically, Indian gooseberry may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs; however, research is conflicting.
Clinical research shows that taking Indian gooseberry 500 mg as a single dose or twice daily for 10 days reduces platelet aggregation by about 24% to 36%, increases bleeding time by about 3.8-5.9 seconds, and increases clotting time by about 9.8-12.7 seconds when compared to baseline. However, taking Indian gooseberry 500 mg along with clopidogrel 75 mg or ecosprin 75 mg, as a single dose or for 10 days, does not significantly reduce platelet aggregation or increase bleeding time or clotting time when compared with clopidogrel 75 mg or ecosprin 75 mg alone. Until more is known, use caution when taking Indian gooseberry in combination with anticoagulant/antiplatelet drugs.

Likelihood Possible Evidence B
Antidiabetes Drugs

Taking Indian gooseberry with antidiabetes drugs might increase the risk of hypoglycemia.
Clinical research shows that taking Indian gooseberry fruit or fruit extract alone or in conjunction with antidiabetes medications can lower blood glucose levels. Dose adjustments to diabetes medications might be necessary.

Likelihood Possible Evidence B
Aspirin

Theoretically, Indian gooseberry may increase the risk of bleeding if used with aspirin; however, research is conflicting.
Clinical research shows that taking Indian gooseberry 500 mg as a single dose or twice daily for 10 days reduces platelet aggregation by about 24% to 36%, increases bleeding time by about 3.8-5.9 seconds, and increases clotting time by about 9.8-12.7 seconds when compared to baseline. However, taking a single dose of Indian gooseberry 500 mg along with ecosprin 75 mg, or taking a combination of Indian gooseberry 500 mg twice daily plus ecosprin 75 mg once daily for 10 days, does not significantly reduce platelet aggregation or increase bleeding time or clotting time when compared with ecosprin 75 mg alone.

Likelihood Possible Evidence B
Clopidogrel (Plavix)

Theoretically, Indian gooseberry may increase the risk of bleeding if used with clopidogrel; however, research is conflicting.
Clinical research shows that taking Indian gooseberry 500 mg as a single dose or twice daily for 10 days reduces platelet aggregation by about 24% to 36%, increases bleeding time by about 3.8-5.9 seconds, and increases clotting time by about 9.8-12.7 seconds when compared to baseline. However, taking a single dose of Indian gooseberry 500 mg along with clopidogrel 75 mg, or taking a combination of Indian gooseberry 500 mg twice daily plus clopidogrel 75 mg once daily for 10 days, does not significantly reduce platelet aggregation or increase bleeding time or clotting time when compared with clopidogrel 75 mg alone.

Likelihood Possible Evidence B
Amla full monograph & interactions

Bacillus coagulans1 drug type · 182 drugs

Antibiotic Drugs

Theoretically, taking antibiotics with Bacillus coagulans might decrease the effectiveness of B. coagulans.
B. coagulans preparations usually contain live and active organisms. Therefore, simultaneously taking antibiotics might kill a significant number of the organisms. Tell patients to separate administration of antibiotics and B. coagulans preparations by at least two hours.

Likelihood Probable Evidence D
Bacillus coagulans full monograph & interactions

Iron13 drug types · 80 drugs

Bictegravir/Emtricitabine/Tenofovir Alafenamide (Biktarvy)

Iron 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 iron 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, iron containing products.

Likelihood Probable Evidence D
Bisphosphonates

Iron reduces the absorption of bisphosphonates.
Advise patients that doses of bisphosphonates should be separated by at least two hours from doses of all other medications, including supplements such as iron. Divalent cations, including iron, can decrease absorption of bisphosphonates by forming insoluble complexes in the gastrointestinal tract.

Likelihood Probable Evidence D
Denosumab (Prolia, Others)

Administration of intravenous iron within one month of denosumab administration might increase the risk of severe hypophosphatemia and hypocalcemia.
A case of severe hypocalcemia (albumin corrected calcium 6.88 mg/dL, ionized calcium 3.68 mg/dL) and hypophosphatemia (<0.5 mg/dL) with respiratory acidosis, QT interval prolongation, and nonsustained ventricular tachycardia was reported in a 76-year-old male who had received an iron polymaltose infusion within 2 weeks of a subcutaneous injection of denosumab. Serum parathyroid hormone was also elevated (348 pg/mL). Subsequent iron infusions with iron polymaltose and ferric carboxymaltose were followed by transient hypophosphatemia, but without hypocalcemia. Additionally, a literature review describes 6 additional cases of hypophosphatemia and hypocalcemia in patients 52-92 years of age who had been administered intravenous iron as either ferric carboxymaltose or iron polymaltose and subcutaneous denosumab within 1-4 weeks of each other.

Likelihood Possible Evidence D
Dolutegravir (Tivicay)

Iron might decrease dolutegravir levels by reducing its absorption.
Advise patients to take dolutegravir at least 2 hours before or 6 hours after taking iron. Pharmacokinetic research shows that iron can decrease the absorption of dolutegravir from the gastrointestinal tract through chelation. When taken under fasting conditions, a single dose of ferrous fumarate 324 mg orally along with dolutegravir 50 mg reduces overall exposure to dolutegravir by 54%.

Likelihood Probable Evidence B
Integrase Inhibitors

Theoretically, taking iron along with integrase inhibitors might decrease the levels and clinical effects of these drugs.
Iron is a divalent cation. There is concern that iron may decrease the absorption of integrase inhibitors from the gastrointestinal tract through chelation. One pharmacokinetic study shows that iron can decrease blood levels of the specific integrase inhibitor dolutegravir through chelation. Also, other pharmacokinetic research shows that other divalent cations such as calcium can decrease the absorption and levels of some integrase inhibitors through chelation.

Likelihood Possible Evidence D
Levodopa

Iron might decrease levodopa levels by reducing its absorption.
Advise patients to separate doses of levodopa and iron as much as possible. There is some evidence in healthy people that iron forms chelates with levodopa, reducing the amount of levodopa absorbed by around 50%. The clinical significance of this hasn't been determined.

Likelihood Probable Evidence B
Levothyroxine (Synthroid, Others)

Iron might decrease levothyroxine levels by reducing its absorption.
Advise patients to separate levothyroxine and iron doses by at least 2 hours. Iron can decrease the absorption and efficacy of levothyroxine by forming insoluble complexes in the gastrointestinal tract.

Likelihood Probable Evidence B
Methyldopa (Aldomet)

Iron might decrease methyldopa levels by reducing its absorption.
Advise patients to separate methyldopa and iron doses by at least 2 hours. Iron can decrease the absorption of methyldopa from the gastrointestinal tract through chelation, resulting in increases in blood pressure.

Likelihood Probable Evidence B
Mycophenolate Mofetil (Cellcept)

Theoretically, iron might decrease mycophenolate mofetil levels by reducing its absorption.
Advise patients to take iron 4-6 hours before, or 2 hours after, mycophenolate mofetil. It has been suggested that a decrease of absorption is possible, probably by forming nonabsorbable chelates. However, mycophenolate pharmacokinetics are not affected by iron supplementation in available clinical research.

Likelihood Unlikely Evidence D
Penicillamine (Cuprimine, Depen)

Iron might decrease penicillamine levels by reducing its absorption.
Advise patients to separate penicillamine and iron doses by at least 2 hours. Oral iron supplements can reduce absorption of penicillamine by 30% to 70%, probably due to chelate formation. In people with Wilson's disease, this interaction has led to reduced efficacy of penicillamine.

Likelihood Probable Evidence D
Quinolone Antibiotics

Iron might decrease levels of quinolone antibiotics by reducing their absorption.
Advise patients to separate quinolone antibiotics and iron doses by at least 2 hours. Iron decreases the absorption of quinolones due to formation of insoluble complexes in the gastrointestinal tract.

Likelihood Probable Evidence D
Tetracycline Antibiotics

Iron might decrease levels of tetracycline antibiotics by reducing their absorption.
Advise patients to take iron at least 2 hours before or 4 hours after tetracycline antibiotics. Concomitant use can decrease absorption of tetracycline antibiotics from the gastrointestinal tract by 50% to 90%.

Likelihood Probable Evidence D
Chloramphenicol

Theoretically, taking chloramphenicol with iron might reduce the response to iron therapy in iron deficiency anemia.
Chloramphenicol interferes with erythrocyte maturation. However, since chloramphenicol isn't usually taken for prolonged periods, this isn't likely to be clinically significant.

Likelihood Unlikely Evidence D
Iron full monograph & interactions
The maker

Brand information

Manufacturer and brand details for Psyllium Pre & Probiotic Fiber Orange, from the product label.

Organic India

See all Organic India products
Name
Organic India USA
City
Boulder
State
CO
ZipCode
80301
Phone Number
1-888-550-8332
Web Address
OrganicIndiaUSA.com
Pharmacist Counseling Corner

Psyllium Pre & Probiotic Fiber Orange by Organic India: Common Questions

Does Psyllium Pre & Probiotic Fiber Orange by Organic India interact with any medications?
Yes. Based on its ingredients, Psyllium Pre & Probiotic Fiber Orange has a known interaction with 2,199 medications. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Psyllium Pre & Probiotic Fiber Orange contains 10 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?
Iron is recommended in pregnancy—in fact, prenatal care providers often suggest it—but your doctor should guide the dose. However, there isn't enough safety data for the Amla or Belleric Myrobalan in this product during pregnancy, and Garden Cress seeds are traditionally believed to stimulate the uterus, so medicinal amounts should be avoided. Talk to your prenatal care provider about whether this specific product is right for you.
Is this safe while breastfeeding?
Iron at appropriate doses is generally considered acceptable while breastfeeding. However, Amla and Belleric Myrobalan don't have enough safety information for breastfeeding, and limited data exists for Garden Cress supplements. Check with your doctor or pharmacist before using this product while nursing.
Will iron in this product cause constipation?
Iron can cause constipation in some people, though it can also cause diarrhea or stomach upset. This product includes fiber, which may help offset constipation, but individual responses vary. If you experience digestive issues, mention it to your pharmacist.
What does the Bacillus coagulans probiotic do?
Bacillus coagulans is possibly effective for constipation and irritable bowel syndrome. It's a live organism, so if you're on antibiotics, you'll need to separate doses—antibiotics can kill the probiotic organisms and reduce its effectiveness.
Why does this product have so many ingredients?
The formula combines iron (for anemia support), fiber (for digestive health), a probiotic (for gut support), and traditional Ayurvedic botanicals like Amla and Triphala. The multiple ingredients do mean more potential interactions with medications, so checking with your pharmacist is important.
Does this work for weight loss?
The evidence doesn't support that. Belleric Myrobalan and the other botanicals have insufficient reliable evidence for weight loss or obesity, and we don't have effectiveness ratings for the fiber components in our data.

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.

Psyllium Pre & Probiotic Fiber Orange label
Go deeper

The Full Monographs Behind Psyllium Pre & Probiotic Fiber Orange’s Ingredients

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

Herb & supplement monograph

Iron

Interacts with 80 drugs

Iron is an essential mineral your body needs to make hemoglobin and carry oxygen in the blood. Supplements are mainly useful for treating or preventing iron deficiency and iron-deficiency an...

Read the full Iron monograph → Herb & supplement monograph

Bacillus Coagulans

Interacts with 182 drugs

Bacillus coagulans is a spore-forming probiotic that survives stomach acid well and may help with some digestive problems such as IBS, constipation, and certain types of diarrhea. The eviden...

Read the full Bacillus Coagulans monograph → Herb & supplement monograph

Garden Cress

Interacts with 398 drugs

Garden cress is a nutritious leafy herb and seed used widely in cooking and traditional medicine, providing vitamins, minerals, and fiber. While it has a long history of use for digestion, b...

Read the full Garden Cress monograph → Herb & supplement monograph

Black Psyllium

Interacts with 2,025 drugs

Black psyllium is a soluble-fiber supplement made from the seeds of a Plantago plant, used mostly to ease constipation and support digestive health. It is best known and most studied for rel...

Read the full Black Psyllium monograph → Herb & supplement monograph

Indian Gooseberry

Interacts with 208 drugs

Indian gooseberry (amla) is a vitamin C-rich fruit used in Ayurvedic medicine for many purposes, from antioxidant support to cholesterol and digestion. Early research is promising for some u...

Read the full Indian Gooseberry monograph → Herb & supplement monograph

Terminalia

Interacts with 933 drugs

Terminalia is a group of traditional Ayurvedic tree species (most notably Terminalia arjuna) used for heart, digestive, and general wellness purposes. Some small studies suggest possible ben...

Read the full Terminalia monograph →
Sources

Sources & How We Checked

Psyllium Pre & Probiotic Fiber Orange'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 137 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.

Iron 72 references
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  3. Ullen H, Augustsson K, Gustavsson C, Steineck G. Supplementary iron intake and risk of cancer: reversed causality? Cancer Lett 1997;114:215-6.
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  5. Lund EK, Wharf SG, Fairweather-Tait SJ, Johnson IT. Oral ferrous sulfate supplements increase the free radical-generating capacity of feces from healthy volunteers. Am J Clin Nutr 1999;69:250-5.
  6. Rehman A, Collis CS, Yang M, et al. The effects of iron and vitamin C co-supplementation on oxidative damage to DNA in healthy volunteers. Biochem Biophys Res Comm 1998;246:293-8. PubMed
  7. Klipstein-Grobusch K, Grobbee DE, den Breeijen JH, et al. Dietary iron and risk of myocardial infarction in the Rotterdam Study. Am J Epidemiol 1999;149:421-8. PubMed
  8. Hansten PD, Horn JR. Drug Interactions Analysis and Management. Vancouver, WA: Applied Therapeutics Inc., 1997 and updates.
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  10. Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. Washington, DC: National Academy Press, 2002.
  11. Campbell N, Paddock V, Sundaram R. Alteration of methyldopa absorption, metabolism, and blood pressure control by ferrous sulfate and ferrous gluconate. Clin Pharmacol Ther 1988;43:381-6..
  12. Schumann K, Borch-Iohnsen B, Hentze MW, Marx JJ. Tolerable upper intakes for dietary iron set by the US Food and Nutrition Board (commentary). Am J Clin Nutr 2002;76:499-500. PubMed
  13. Tuomainen TP, Punnonen K, Nyyssonen K, Salonen JT. Association between body iron stores and the risk of acute myocardial infarction in men. Circulation 1998;97:1461-6.. PubMed
  14. Salonen JT, Nyyssonen K, Korpela H, et al. High stored iron levels are associated with excess risk of myocardial infarction in Eastern Finnish men. Circulation 1992;86:803-11.. PubMed
  15. Campbell NRC, Hasinoff B. Ferrous sulfate reduces levodopa bioavailability: Chelation as a possible mechanism. Clin Pharmacol Ther 1989;45:220-5.. PubMed
  16. Campbell NRC, Hasinoff BB, Stalts H, et al. Ferrous sulfate reduces thyroxine efficacy in patients with hypothyroidism. Ann Int Med 1992;117:1010-3.. PubMed
  17. Kiechl S, Willeit J, Egger G, et al. Body iron stores and the risk of carotid atherosclerosis: prospective results from the Bruneck study. Circulation 1997;96:3300-07. PubMed
  18. Comparison of oral iron supplements. Pharmacist's Letter / Prescriber's Letter 2008;24(8):240811.
  19. Tran T., Wax J. R., Philput C., Steinfeld J. D., Ingardia C. J. Intentional iron overdose in pregnancy--management and outcome. J Emerg Med 2000;18(2):225-228. PubMed
  20. Toblli J. E., Brignoli, R. Iron(III)-hydroxide polymaltose complex in iron deficiency anemia / review and meta-analysis. Arzneimittelforschung 2007;57(6A):431-438. PubMed
  21. Köpcke W., Sauerland M. C. Meta-analysis of efficacy and tolerability data on iron proteinsuccinylate in patients with iron deficiency anemia of different severity. Arzneimittelforschung 1995;45(11):1211-1216.
  22. Campbell N. R., Campbell R. R., Hasinoff B. B. Ferrous sulfate reduces methyldopa absorption: methyldopa: iron complex formation as a likely mechanism. Clin Invest Med 1990;13(6):329-332.
  23. Morii M., Ueno K., Ogawa A., Kato R., Yoshimura H., Wada K., Hashimoto H., Takada M., Tanaka K., Nakatani T., Shibakawa M. Impairment of mycophenolate mofetil absorption by iron ion. Clin Pharmacol Ther 2000;68(6):613-616. PubMed
  24. Gelone D. K., Park J. M., Lake K. D. Lack of an effect of oral iron administration on mycophenolic acid pharmacokinetics in stable renal transplant recipients. Pharmacotherapy 2007;27(9):1272-1278. PubMed
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  26. Lorenz M., Wolzt M., Weigel G., Puttinger H., Hörl W. H., Födinger M., Speiser W., Sunder-Plassmann G. Ferrous sulfate does not affect mycophenolic acid pharmacokinetics in kidney transplant patients. Am J Kidney Dis 2004;43(6):1098-1103. PubMed
  27. Osman M. A., Patel R. B., Schuna A., Sundstrom W. R., Welling P. G. Reduction in oral penicillamine absorption by food, antacid, and ferrous sulfate. Clin Pharmacol Ther 1983;33(4):465-470. PubMed
  28. Michael, B., Coyne, D. W., Fishbane, S., Folkert, V., Lynn, R., Nissenson, A. R., Agarwal, R., Eschbach, J. W., Fadem, S. Z., Trout, J. R., Strobos, J., and Warnock, D. G. Sodium ferric gluconate complex in hemodialysis patients: adverse reactions compar
  29. Zhang, X., Ouyang, J., Wieczorek, R., and DeSoto, F. Iron medication-induced gastric mucosal injury. Pathol.Res Pract 2009;205(8):579-581. PubMed
  30. Barbieri, P. G. [To-day exposure to occupational carcinogens and their effects. The experience of the rubber industry, iron metallurgy, asphalt work and aviculture]. Epidemiol.Prev 2009;33(4-5 Suppl 2):94-105.
  31. Macedo, A. and Cardoso, S. [Routine iron supplementation in pregnancy]. Acta Med Port. 2010;23(5):785-792.
  32. Bastide, N. M., Pierre, F. H., and Corpet, D. E. Heme iron from meat and risk of colorectal cancer: a meta-analysis and a review of the mechanisms involved. Cancer Prev Res (Phila) 2011;4(2):177-184. PubMed
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  34. van den, Hombergh J., Dalderop, E., and Smit, Y. Does iron therapy benefit children with severe malaria-associated anaemia? A clinical trial with 12 weeks supplementation of oral iron in young children from the Turiani Division, Tanzania. J.Trop.Pediatr. PubMed
  35. Liabeuf S, Gras V, Moragny J, et al. Ulceration of the oral mucosa following direct contact with ferrous sulfate in elderly patients: a case report and a review of the French National Pharmacovigilance Database. Clin Interv Aging. 2014 Apr 25;9:737-40. PubMed
  36. Qiao L, Feng Y. Intakes of heme iron and zinc and colorectal cancer incidence: a meta-analysis of prospective studies. Cancer Causes Control. 2013 Jun;24(6):1175-83. PubMed
  37. 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
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  40. Esan MO, Boele van Hensbroek M, Nkhoma E, et al. Iron supplementation in HIV infected Malawian children with anemia: a double-blind, randomized, controlled trial. Clin Inf Dis 2013;57(11):1626-34.doi:10.1093/cid/cit528. PubMed
  41. Zlotkin S, Newton S, Aimone AM, et al. Effect of iron fortification on malaria incidence in infants and young children in Ghana: a randomized trial. JAMA 2013;310(9):938-47. PubMed
  42. Khambalia AZ, Aimone A, Nagubandi P, et al. High maternal iron status, dietary iron intake and iron supplement use in pregnancy and risk of gestational diabetes mellitus: a prospective study and systematic review. Diabet Med. 2016;33(9):1211-21. PubMed
  43. Kinnunen TI, Luoto R, Helin A, Hemminki E. Supplemental iron intake and the risk of glucose intolerance in pregnancy: re-analysis of a randomised controlled trial in Finland. Matern Child Nutr. 2016;12(1):74-84.
  44. Low MS, Speedy J, Styles CE, De-Regil LM, Pasricha SR. Daily iron supplementation for improving anaemia, iron status and health in menstruating women. Cochrane Database Syst Rev. 2016;4:CD009747. PubMed
  45. Melit LE, Marginean CO, Mocanu S, Marginean MO. A rare case of iron-pill induced gastritis in a female teenager: A case report and a review of the literature. Medicine (Baltimore). 2017;96(30):e7550. PubMed
  46. Neuberger A, Okebe J, Yahav D, Paul M. Oral iron supplements for children in malaria-endemic areas. Cochrane Database Syst Rev. 2016;2:CD006589. PubMed
  47. Peña-Rosas JP, De-Regil LM, Gomez Malave H, Flores-Urrutia MC, Dowswell T. Intermittent oral iron supplementation during pregnancy. Cochrane Database Syst Rev. 2015;(10):CD009997. PubMed
  48. Brabin B, Gies S, Roberts SA, et al. Excess risk of preterm birth with periconceptional iron supplementation in a malaria endemic area: analysis of secondary data on birth outcomes in a double blind randomized controlled safety trial in Burkina Faso. Mala PubMed
  49. Kaundal R, Bhatia P, Jain A, et al. Randomized controlled trial of twice-daily versus alternate-day oral iron therapy in the treatment of iron-deficiency anemia. Ann Hematol 2020;99(1):57-63. PubMed
  50. Li N, Zhao G, Wu W, et al. The efficacy and safety of vitamin C for iron supplementation in adult patients with iron deficiency anemia: A randomized clinical trial. JAMA Netw Open. 2020;3(11):e2023644.<br> PubMed
  51. Houston BL, Hurrie D, Graham J, et al. Efficacy of iron supplementation on fatigue and physical capacity in non-anaemic iron-deficient adults: a systematic review of randomised controlled trials. BMJ Open. 2018;8(4):e019240. PubMed
  52. Koch RM, Tchernodrinski S, Principe DR. Case report: Rapid onset, ischemic-type gastritis after initiating oral iron supplementation. Front Med (Lausanne) 2022;9:1010897. PubMed
  53. Milman NT. Iron supplementation in pregnant Danish women revisited: Effects on prepartum and postpartum iron deficiency, anemia, serum erythropoietin; including iron status, erythropoietin and anthropometrics in newborns. A randomized, placebo-controlled
  54. Rogozinska E, Daru J, Nicolaides M, et al. Iron preparations for women of reproductive age with iron deficiency anaemia in pregnancy (FRIDA): a systematic review and network meta-analysis. Lancet Haematol 2021;8(7):e503-e512. PubMed
  55. Shah AA, Donovan K, Seeley C, et al. Risk of infection associated with administration of intravenous iron: A systematic review and meta-analysis. JAMA Netw Open 2021;4(11):e2133935. PubMed
  56. Gamad N, Saha PK, Sharma P, Suri V, Chakrabarti A, Saha L. A randomized controlled trial comparing the efficacy, tolerability, and cost of oral iron preparations in iron-deficiency anemia in pregnancy. J Obstet Gynaecol Res 2021;47(11):3828-3841. PubMed
  57. El-Hawy MA, Abd Al-Salam SA, Bahbah WA. Comparing oral iron bisglycinate chelate, lactoferrin, lactoferrin with iron and iron polymaltose complex in the treatment of children with iron deficiency anemia. Clin Nutr ESPEN 2021;46:367-371. PubMed
  58. Adams A, Scheckel B, Habsaoui A, et al. Intravenous iron versus oral iron versus no iron with or without erythropoiesis- stimulating agents (ESA) for cancer patients with anaemia: a systematic review and network meta-analysis. Cochrane Database Syst Rev 2 PubMed
  59. Kancherla K, Constantin H, Kanawati A, Graham E. Iron-induced Hypophosphatemic Osteomalacia-An Atypical Case of Bilateral Femoral Stress Fractures. J Am Acad Orthop Surg Glob Res Rev 2023;7(5):e22. PubMed
  60. Shi R, Marin JG, Beaulieu M. Skin staining following intravenous iron extravasation in a patient with chronic kidney disease: A case report. Can J Kidney Health Dis 2023;10:20543581231165705. PubMed
  61. Varandas C, Vieira J, Correia CJ, et al. Hypersensitivity reactions to iron products: 10-year experience in a Portuguese tertiary Centre. Eur Ann Allergy Clin Immunol 2023.
  62. Jara Vidal M, López García MC, Quílez Toboso RP. Kounis syndrome after intravenous iron administration. Med Clin (Barc) 2023. DOI
  63. Jara Vidal M, Ruiz de Assín Valverde A, Aznar Rodríguez S. Severe hypophospathemia secondary to intravenous iron. Med Clin (Barc) 2023. DOI
  64. Samões B, Silva B, Martins A, et al. Hypophosphatemic osteomalacia induced by intravenous iron therapy: a case report. Joint Bone Spine 2023;90(5):105586. PubMed
  65. Seng NW, Barco JB, Wong MH, et al. Hypophosphatemia related to intravenous iron therapy with ferric carboxymaltose: A case series. Transfus Med 2023. PubMed
  66. Fernandez-Flores A, Fernandez-Parrado M, Alzoghby-Abi Chaker J, Angulo AG. Axillary cutaneous hemosiderosis in a patient with hyperhidrosis, after intravenous iron infusion. Am J Dermatopathol 2023;45(7):463-465. PubMed
  67. Ye S, Grill V, Luo J, Nguyen HH. Concurrent Denosumab and Parenteral Iron Therapy Precipitating Severe Hypocalcemia and Hypophosphatemia. JCEM Case Rep 2024;2(2):luae005. PubMed
  68. Yerigeri K. Hemochromatosis in an Adult Female With Previous Iron Deficiency Anemia on Iron Supplementation. Cureus 2023;15(12):e50166. PubMed
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  70. Short V, Allen R, Earley CJ, et al. A randomized double-blind pilot study to evaluate the efficacy, safety, and tolerability of intravenous iron versus oral iron for the treatment of restless legs syndrome in patients with iron deficiency anemia. Am J Hem PubMed
  71. Bellos I, Frountzas M, Pergialiotis V. Comparative Risk of Hypophosphatemia Following the Administration of Intravenous Iron Formulations: A Network Meta-Analysis. Transfus Med Rev 2020;34(3):188-194. PubMed
  72. 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 Iron monograph →

Black Psyllium 18 references
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  2. Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.
  3. Covington TR, et al. Handbook of Nonprescription Drugs. 11th ed. Washington, DC: American Pharmaceutical Association, 1996.
  4. Etman M. Effect of a bulk forming laxative on the bioavailablility of carbamazepine in man. Drug Dev Ind Pharm 1995;21:1901-6.
  5. Perlman BB. Interaction between lithium salts and ispaghula husk. Lancet 1990;335:416.
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  7. Lantner RR, Espiritu BR, Zumerchik P, Tobin MC. Anaphylaxis following ingestion of a psyllium-containing cereal. JAMA 1990;264:2534-6. DOI
  8. Kaplan MJ. Anaphylactic reaction to "Heartwise." N Engl J Med 1990;323:1072-3. DOI
  9. Nordstrom M, Melander A, Robertsson E, Steen B. Influence of wheat bran and of a bulk-forming ispaghula cathartic on the bioavailability of digoxin in geriatric in-patients. Drug Nutr Interact 1987;5:67-9..
  10. Robinson DS, Benjamin DM, McCormack JJ. Interaction of warfarin and nonsystemic gastrointestinal drugs. Clin Pharmacol Ther 1971;12:491-5. PubMed
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  12. Fernandez N, Lopez C, Díez R, et al. Drug interactions with the dietary fiber Plantago ovata husk. Expert Opin Drug Metab Toxicol 2012;8(11):1377-86.
  13. Semen plantaginis in: WHO Monographs on Selected Medicinal Plants, volume 1. World Health Organization, Geneva, 1999. Available at http://apps.who.int/medicinedocs/en/d/Js2200e/. Accessed November 26, 1026.
  14. Code of Federal Regulations, Title 21 (21CFR 101.17). Food labeling warning, notice, and safe handling statements. Available at www.ecfr.gov/cgi-bin/text-idx?SID=20f647d3b74161501f46564b915b4048&mc=true&node=se21.2.101_117&rgn=div8. Accessed December 3, 2
  15. Code of Federal Regulations, Title 21 (21CFR 201.319). Specific labeling requirements - water-soluble gums, hydrophilic gums, and hydrophilic mucilloids. Available at www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?fr=201.319. Accessed Dece
  16. Diez R, Garcia JJ, Diez MJ, Sierra M, Sahagun AM, Fernandez N. Influence of Plantago ovata husk (dietary fiber) on the bioavailability and other pharmacokinetic parameters of metformin in diabetic rabbits. BMC Complement Altern Med. 2017 Jun 7;17(1):298. PubMed
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  18. Merrick C, Madden CA, Capurso NA. A Case of Blunted Orally Disintegrating Olanzapine Effect Due to Coadministered Psyllium. J Clin Psychiatry 2021;82(2):20cr13633. PubMed

See these in context on the Black Psyllium monograph →

Indian Gooseberry 6 references
  1. Sabu, M. C. and Kuttan, R. Anti-diabetic activity of medicinal plants and its relationship with their antioxidant property. J Ethnopharmacol. 2002;81(2):155-160. PubMed
  2. Fatima N, Pingali U, Muralidhar N. Study of pharmacodynamic interaction of Phyllanthus emblica extract with clopidogrel and ecosprin in patients with type II diabetes mellitus. Phytomedicine. 2014;21(5):579-85. PubMed
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  4. Akhtar MS, Ramzan A, Ali A, Ahmad M. Effect of amla fruit (Emblica officinalis Gaertn.) on blood glucose and lipid profile of normal subjects and type 2 diabetic patients. Int J Food Sci Nutr. 2011;62(6):609-16.
  5. Usharani P, Fatima N, Muralidhar N. Effects of Phyllanthus emblica extract on endothelial dysfunction and biomarkers of oxidative stress in patients with type 2 diabetes mellitus: a randomized, double-blind, controlled study. Diabetes Metab Syndr Obes. 20 PubMed
  6. Majeed M, Mundkur L, Paulose S, Nagabhushanam K. Novel Emblica officinalis extract containing ß-glucogallin vs. metformin: a randomized, open-label, comparative efficacy study in newly diagnosed type 2 diabetes mellitus patients with dyslipidemia. Food Fu

See these in context on the Indian Gooseberry monograph →

Terminalia 9 references
  1. Sabu, M. C. and Kuttan, R. Anti-diabetic activity of medicinal plants and its relationship with their antioxidant property. J Ethnopharmacol. 2002;81(2):155-160. PubMed
  2. Rao, N. K. and Nammi, S. Antidiabetic and renoprotective effects of the chloroform extract of Terminalia chebula Retz. seeds in streptozotocin-induced diabetic rats. BMC.Complement Altern.Med 2006;6:17. PubMed
  3. Murali, Y. K., Anand, P., Tandon, V., Singh, R., Chandra, R., and Murthy, P. S. Long-term effects of Terminalia chebula Retz. on hyperglycemia and associated hyperlipidemia, tissue glycogen content and in vitro release of insulin in streptozotocin induced
  4. Senthilkumar, G. P. and Subramanian, S. Evaluation of antioxidant potential of Terminalia chebula fruits studies in streptozotocin-induced diabetic rats. Pharmaceutical Biology (Netherlands) 2007;45:511-518.
  5. Malik N, Dhawan V, Bahl A, Kaul D. Inihbitory effects of Terminalia arjuna on platelet activation in vitro in healthy subjects and patients with coronary artery disease. Platelets. 2009;20(3):183-1190.
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  7. Wu G, Dong Z, Dong J, et al. Effects of mongolian medicine Terminalia chebula Retz. on 6 CYP450 enzymes in rats. Int J Clin Exp Pathol 2020;13(12):3128-3138.
  8. Das A, Naveen J, Sreerama YN, Gnanesh Kumar BS, Baskaran V. Low-glycemic foods with wheat, barley and herbs (Terminalia chebula, Terminalia bellerica and Emblica officinalis) inhibit a-amylase, a-glucosidase and DPP-IV activity in high fat and low dose st
  9. Eltimamy M, Elshamarka M, Aboelsaad M, Sayed M, Moawad H. Effects of alcoholic extract of Terminalia Chebula dried fruit on blood biochemical profile in diabetic rats. J Diabetes Metab Disord 2022;21(1):159-170. PubMed

See these in context on the Terminalia monograph →

Bacillus Coagulans 20 references
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  4. Kalima P, Masterton RG, Roddie PH, et al. Lactobacillus rhamnosus infection in a child following bone marrow transplant. J Infect 1996;32:165-7. PubMed
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  20. Kato K, Funabashi N, Takaoka H, et al. Lactobacillus paracasei endocarditis in a consumer of probiotics with advanced and severe bicuspid aortic valve stenosis complicated with diffuse left ventricular mid-layer fibrosis. Int J Cardiol. 2016;224:157-161. PubMed

See these in context on the Bacillus Coagulans monograph →

Garden Cress 12 references
  1. Eddouks, M. and Maghrani, M. Effect of Lepidium sativum L. on renal glucose reabsorption and urinary TGF-beta 1 levels in diabetic rats. Phytother.Res 2008;22(1):1-5.
  2. Maghrani, M, Zeggwagh, NA, Michel, JB, and Eddouks, M. Antihypertensive effect of <it>Lepidium sativum</it> L. in spontaneously hypertensive rats. Journal of Ethnopharmacology (Ireland) 2005;100:193-197.
  3. Al-Jenoobi FI, Ahad A, Mahrous GM, Al-Mohizea AM, AlKharfy KM, Al-Suwayeh SA. Effects of fenugreek, garden cress, and black seed on theophylline pharmacokinetics in beagle dogs. Pharm Biol 2015;53(2):296-300. PubMed
  4. Alkharfy KM, Al-Jenoobi FI, Alam MA, et al. Lepidium sativum but not Nigella sativa affects carbamazepine disposition in an animal model. Drug Metab Lett 2013;7:47-51. PubMed
  5. Chen X, Yuan H, Shi F, Zhu Y. Effect of garden cress in reducing blood glucose, improving blood lipids, and reducing oxidative stress in a mouse model of diabetes induced by a high-fat diet and streptozotocin. J Sci Food Agric 2020;100(5):2074-2081. PubMed
  6. Alkharfy K, Jan B, Alotaibi K, et al. Clopidogrel-herb Interactions: A Pharmacokinetic and Pharmacodynamic Assessment in a Rat Model. Curr Drug Metab 2021;22(12):969-977. PubMed
  7. Bin Jardan YA, Ahad A, Raish M, Alam MA, Al-Mohizea AM, Al-Jenoobi FI. Effects of garden cress, fenugreek and black seed on the pharmacodynamics of metoprolol: an herb-drug interaction study in rats with hypertension. Pharm Biol 2021;59(1):1088-1097. PubMed
  8. Ramadan S, Hegab AM, Al-Awthan YS, Al-Duais MA, Tayel AA, Al-Saman MA. Comparison of the efficiency of Lepidium sativum, Ficus carica, and Punica granatum methanolic extracts in relieving hyperglycemia and hyperlipidemia of streptozotocin-induced diabetic
  9. I Al-Suwaydani A, Alam MA, Raish M, A Bin Jardan Y, Ahad A, I Al-Jenoobi F. Effect of C. cyminum and L. sativum on pharmacokinetics and pharmacodynamics of antidiabetic drug gliclazide. Curr Drug Metab 2022;23(10):842-849.
  10. Alam MA, Bin Jardan YA, Raish M, Al-Mohizea AM, Ahad A, Al-Jenoobi FI. Herb-drug interaction: pharmacokinetics and pharmacodynamics of anti-hypertensive drug amlodipine besylate in presence of Lepidium sativum and Curcuma longa. Xenobiotica 2022;52(2):177
  11. Ahad A, Raish M, Abdelrahman IA, et al. Changes in pharmacokinetics and pharmacodynamics of losartan in experimental diseased rats treated with Curcuma longa and Lepidium sativum. Pharmaceuticals (Basel) 2022;16(1):33. PubMed
  12. Doghmane A, Aouacheri O, Laouaichia R, Saka S. The investigation of the efficacy ratio of cress seeds supplementation to moderate hyperglycemia and hepatotoxicity in streptozotocin-induced diabetic rats. J Diabetes Metab Disord 2021;20(1):447-459. PubMed

See these in context on the Garden Cress monograph →

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

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

© 2021 Therapeutic Research Center, LLC

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