PUMP-HD Peaches N' Cream Ingredients & Drug Interactions
by BPI
What is this page for?
First and foremost: checking PUMP-HD Peaches N' Cream 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
PUMP-HD Peaches N' Cream is a dietary supplement by BPI with 21 active ingredients. Its ingredients are commonly taken for sleep quality and insomnia, relaxation, cognitive function.Based on those ingredients, 1,612 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are Pausinystalia yohimbe, Niacin, Caffeine. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against PUMP-HD Peaches N' Cream by BPI
Ask about any prescription or over-the-counter medication and we check it for interactions with PUMP-HD Peaches N' Cream by BPI — and tell you which ingredient is responsible.
AI summaries are generated from our interaction database for education only — always confirm with your pharmacist. How we use AI
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HelloPharmacist Scorecard of PUMP-HD Peaches N' Cream by BPI
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.
What’s inside
Partial disclosure
PUMP-HD Peaches N' Cream is a 21-ingredient powder designed for athletic performance and endurance. The active ingredients include amino acids (glycine, L-leucine, taurine, aspartic acid, L-ornithine, L-tyrosine, and acetyl-L-carnitine), the stimulant caffeine, minerals (manganese, calcium, potassium, and magnesium), the B vitamin niacin, creatine, beta-alanine (CarnoSyn), glycerol, and plant extracts (yohimbe, blueberry concentrate, and maritime pine bark concentrate).
It also contains several ingredients we cannot fully check for interactions: Psoralea corylifolia and red wine concentrate. The powder includes inactive ingredients such as natural and artificial flavors, citric acid, sucralose, silica, and FD&C Blue No.
1.
Does it work?
Strong evidence
Evidence for this product's active ingredients is mixed. Creatine is possibly effective for muscle strength and athletic performance; beta-alanine (CarnoSyn) is possibly effective for athletic and physical performance; and taurine is possibly effective for heart failure.
Niacin has strong evidence for treating pellagra and possibly effective ratings for metabolic syndrome and certain types of high cholesterol. Caffeine is likely effective for mental alertness and athletic performance.
Glycine, L-tyrosine, acetyl-L-carnitine, and blueberry show possibly effective ratings for specific cognitive or age-related conditions, though evidence is limited. For most of the blend's claimed endurance and recovery benefits, the data we hold either shows insufficient evidence or does not directly address those claims.
Talk with your doctor or pharmacist about whether the evidence supports its use for your fitness goals.
How safe is it?
Well-documented data
Most of these ingredients are generally well tolerated at typical doses in healthy adults, though several carry important caveats. Caffeine is safe in moderate amounts but can cause anxiety, insomnia, and jitteriness; pregnancy safety is possibly unsafe at high doses and lactation safety is possibly safe in moderation.
Beta-alanine commonly causes harmless tingling and flushing of the skin. Creatine may cause water retention, muscle cramps, and dehydration, and should be avoided in pregnancy and breastfeeding due to insufficient safety data.
Manganese at high doses can cause Parkinson-like neurological symptoms and liver damage—the safety notes advise against high-dose supplements. Niacin can cause flushing, liver problems, and gastrointestinal upset, especially at high doses.
Glycine, taurine, and yohimbe all carry pregnancy and breastfeeding safety concerns; yohimbe is considered unsafe in pregnancy and may affect blood pressure and heart rate. Acetyl-L-carnitine and L-tyrosine lack sufficient pregnancy and breastfeeding data and are best avoided unless your doctor advises.
Several ingredients (calcium, magnesium, potassium) are generally safe from food but carry risks if supplemented excessively, particularly in people with kidney disease.
Meds to double-check
Major interaction found
Check these medication types before taking this product: stimulants like ephedrine (Major risk); HIV medications including dolutegravir and elvitegravir, and the antibiotic ceftriaxone (Major risk); Parkinson's medication levodopa/carbidopa (Major risk); antipsychotics including clozapine; antihypertensive and heart medications; blood thinners and antiplatelet drugs; diabetes medications; antiseizure drugs; and quinolone and tetracycline antibiotics. If you take any of these, talk to your doctor or pharmacist before starting PUMP-HD.
The bottom line
Scorecard at a glancePartially disclosed formula with clinical evidence supporting its stated purpose. Major medication interactions have been identified, and safety information is well characterized.
PUMP-HD is designed for athletic performance and muscle endurance, with ingredients like creatine, beta-alanine, and caffeine supported by some evidence. However, this is a complex multi-ingredient product with significant medication interactions—especially concerning if you take blood pressure drugs, heart medications, diabetes drugs, antipsychotics, or blood thinners.
It's not appropriate for pregnant or breastfeeding individuals. Before starting, run your exact medications through the checker on this page and discuss the product with your own doctor or pharmacist to make sure it's safe for you.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 18 of 21 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Feb 26, 2014.
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
General information
Key facts about PUMP-HD Peaches N' Cream, straight from the product label.
| Brand | BPI |
|---|---|
| Barcode (UPC) | 851780005538 |
| Net contents | 11.64 oz.; 330 Gram(s) |
| Market status | On market |
| Date entered into DSLD | Feb 26, 2014 |
| DSLD ID | 30806 |
| Product type | Other Combinations |
| Supplement form | Powder |
| Dietary claims / uses | Nutrient, All Other, Structure/Function |
| Intended target group(s) | Adult (18 - 50 Years) |
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 PUMP-HD Peaches N' Cream by BPI, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Glycine | 1000 mg | -- |
| L-Leucine | 1000 mg | -- |
| Manganese | 2 mg | 100% |
| Taurine | 0 Not Present | -- |
| Niacin | 30 mg | 150% |
| CarnoSyn | 1000 mg | -- |
| Creatine | 2000 mg | -- |
| Psoralea corylifolia | 0 Not Present | -- |
| Glycerol | 1000 mg | -- |
| Caffeine | 0 Not Present | -- |
| Calcium | 30 mg | 3% |
| Aspartic Acid | 1000 mg | -- |
| Potassium | 99 mg | 3% |
| Magnesium | 12 mg | 3% |
| Pausinystalia yohimbe | 0 Not Present | -- |
| Acetyl-L-Carnitine | 0 Not Present | -- |
| L-Ornithine | 0 Not Present | -- |
| Electrolyte Matrix | 0 NP | -- |
| PROFESSIONAL ENDURANCE AND RECOVERY BLEND | 1230 mg | -- |
| L-Tyrosine | 0 Not Present | -- |
| PUMP-HD(TM) Matrix | 1000 mg | -- |
| Blueberry fruit {concentrate} | 0 NP | -- |
| Pine bark {concentrate} | 0 NP | -- |
| Red Wine concentrate | 0 NP | -- |
Other ingredients: Natural and Artificial flavors, Citric Acid, Sucralose, Silica, FD&C Blue No. 1
Tap any ingredient to jump to its full detail below.
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
+When combined with a proper exercise and nutrition regimen. Statements based on early-stage independent 3rd party in vivo and / or in vitro model scientific research data findings.
ENDURANCE*+ ~ POWER*+ ~ PRE-WORKOUT*+ ~ PERFORMANCE*+ ~ STRENGTH*+ ~ LEAN MUSCLE*+
PRE-WORKOUT
Powerful CNS STIMULANT Intensity/Energy*+
AMINOS Protein/Recovery*+
ELECTROLYTES Endurance Technology
TO BE USED IN CONJUNCTION WITH: ~STRENGTH / MUSCLE BUILDING PROGRAMS*+ ~POWER / ENDURANCE PROGRAMS*+
CarnoSyn(R) is shown to work as a lactic acid buffer, which can help to reduce fatigue and increase exercise capacity
Rev. 01-001-PHD011 01/13
ULTIMATE PRE-WORKOUT FORMULA*+
30 SERVINGS
Brand IP Statement(s)
CarnoSyn(R) Carnosine Synthesizer Licensed under one or more of U.S. Pat. Nos. 5,965,596, 6,426,361, 7,504,376 and 8,067,381, each of which is owned by Natural Alternatives International, Inc. (NAI). NAI is also the owner of the registered trademark CarnoSyn(R)
In short, CarnoSyn(R) may help you to train harder and longer. In fact, research shows that a clinical dose (3.2g daily) of CarnoSyn(R) literally builds on the dose before, and that performance can continue to increase with ongoing use.
PUMP-HD(TM) is our premier PRE-WORKOUT, formulated with researched, trialed and tested ingredients designed to feed your muscles and fuel exercise performance.
Suggested/Recommended/Usage/Directions
For maximum benefit from Beta-Alanine, supplement with additional CarnoSyn(R) to the clinical dose level of 3.2g daily.
Please read entire label before use.
Suggested Use: Take one (1) serving (1 scoop) approximately 15-30 minutes prior to training, blended into 8-10 ounces of cold water or beverage, or as suggested by a qualified healthcare practitioner.
Do not exceed recommended dose.
Combine this with an ultra strong PRE-WORKOUT ENERGY SYSTEM - the end result can be explosive workouts unlike anything you may have experienced.
Formula
PUMP-HD(TM) also includes the most researched form of CREATINE and the key branched chain amino acid LEUCINE. To complete this ADVANCED PRE-WORKOUT formula, we’ve added an ELECTROLYTE matrix to help rehydrate and refresh.*+
Caffeine warning: The recommended serving of this product contains approximately as much caffeine as three cups of coffee.
Natural and Artificial Flavors
PUMP-HD(TM) contains THE tested form of BETA-ALANINE, CarnoSyn(R), which has been shown in groundbreaking research to be the gold standard form of this compound.
Precautions
Warnings: Not intended for use by persons under age 18.
Get the consent of a licensed physician before using this product, especially if you are taking medication, have a medical condition, you are pregnant, nursing or thinking about becoming pregnant.
KEEP THIS PRODUCT AND ALL SUPPLEMENTS OUT OF THE REACH OF CHILDREN.
Do not consume caffeine, or combine with synephrine, including but not limited to coffee, tea, soda and other dietary supplements or medications containing phenylephrine or caffeine.
Too much caffeine may cause nervousness, irritability, sleeplessness, and occasionally rapid heartbeat. Discontinue use if you experience dizziness, severe headache, rapid heartbeat or shortness of breath.
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.
Seals/Symbols
CarnoSyn(R) Clinically Tested
FDA Statement of Identity
DIETARY SUPPLEMENT
Formulation
NO MALTODEXTRIN! NO FILLERS!
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
PUMP-HD Peaches N' Cream by BPI label
The label scan from the NIH Dietary Supplement Label Database. Tap to enlarge.
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)The Ingredients in PUMP-HD Peaches N' Cream by BPI
These are the 21 active ingredients this product is made of. Select any to open its full monograph.
Serving size11 Gram(s) Dosage formPowder Servings per container30 Amounts shown are per serving.
Most supplement products combine several ingredients, and a medication can interact with the product through any one of them. Each ingredient below shows whether it has known drug interactions.
Glycine
Interacts with1 drug
Glycine is a non-essential amino acid your body makes on its own and that also appears in protein-rich foods. It is most studied for improving sleep q...
Glycine monograph & interactionsL-Leucine
Niacin
Interacts with727 drugs
Niacin (vitamin B3) is an essential nutrient your body needs for energy and metabolism, and deficiency is uncommon in most developed countries. Prescr...
Niacin monograph & interactionsCarnoSyn
No knowninteractions
Beta-alanine is an amino acid taken mostly by athletes to raise muscle carnosine, which may help buffer acid and reduce fatigue during short, high-int...
CarnoSyn monograph & interactionsCreatine
No knowninteractions
Creatine is one of the most studied sports supplements, with solid evidence that it can boost strength and performance during short, high-intensity ac...
Creatine monograph & interactionsGlycerol
No knowninteractions
Glycerol (glycerin) is a sweet, syrupy compound made naturally in the body and widely used in foods, skin products, and medicines. It is well establis...
Glycerol monograph & interactionsAspartic Acid
No knowninteractions
Aspartic acid is a common amino acid your body makes on its own and gets from protein-rich foods, so a true deficiency is rare. D-aspartic acid is hea...
Aspartic Acid monograph & interactionsPROFESSIONAL ENDURANCE AND RECOVERY BLEND
- › Taurine
- › Psoralea corylifolia
- › Caffeine
- › Pausinystalia yohimbe
- › Acetyl-L-Carnitine
- › L-Ornithine
- › L-Tyrosine
PUMP-HD(TM) Matrix
- › Blueberry fruit {concentrate}
- › Pine bark {concentrate}
- › Red Wine concentrate
Other (inactive) ingredients: Natural and Artificial flavors, Citric Acid, Sucralose, Silica, FD&C Blue No. 1. These complete the product’s ingredient list but are not active constituents.
PUMP-HD Peaches N' Cream by BPI Drug Interactions
HelloPharmacist Interaction Report
PUMP-HD Peaches N' Cream by BPI contains several ingredients with documented interactions with medications.
The most serious concern is caffeine's Major-severity interaction with ephedrine, which can increase the risk of life-threatening stimulant side effects like heart attack and stroke. Additionally, calcium has Major interactions with three HIV medications (dolutegravir, elvitegravir, and the antibiotic ceftriaxone), and magnesium has a Major interaction with levodopa/carbidopa used for Parkinson's disease.
Read the full breakdown — every affected drug type, severity by severity
Through its glycine, manganese, taurine, niacin, and yohimbe content, this product carries Moderate interactions with antipsychotics (clozapine, haloperidol), blood pressure and heart medications, blood thinners, diabetes drugs, and antibiotics (quinolones and tetracyclines). Caffeine also interacts Moderately with antiseizure drugs, some heart medications, and psychiatric medications.
Calcium can reduce the absorption of thyroid hormone and several heart drugs. Magnesium may affect muscle relaxants, blood pressure control, and antibiotic absorption.
Blueberry and maritime pine bark extracts carry Minor interactions with blood sugar and anti-inflammatory drugs. We could not check L-leucine, Psoralea corylifolia, or red wine concentrate—no interaction data are on file for these ingredients.
Altogether, these interactions span 1,613 individual medications.
Use the medication checker on this page to look up any specific prescriptions you take before starting this product, and confirm the details with your own doctor or pharmacist.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against PUMP-HD Peaches N' Cream?
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 checkerIngredients driving the most interactions
Individual Drug Interactions
The ingredients in PUMP-HD Peaches N' Cream interact with 1,612 drugs. Click any drug to see the details.
13 of the 21 ingredients in PUMP-HD Peaches N' Cream interact with drugs. Each result below shows which ingredient is responsible. Pausinystalia yohimbe Niacin Caffeine Pine bark {concentrate} Magnesium Acetyl-L-Carnitine Taurine Calcium Blueberry fruit {concentrate} Manganese Potassium L-Tyrosine Glycine
Aminophylline, Amobarbital, EphedrineAmesec
How Aminophylline, Amobarbital, Ephedrine interacts with PUMP-HD Peaches N' Cream — through 2 ingredients. Tap an ingredient for the detail:
CaffeineEphedrine, Stimulant Drugs Major
Interaction Summary
Theoretically, concomitant use might increase the risk for stimulant adverse effects.
Read the full Caffeine + Aminophylline, Amobarbital, Ephedrine interactionPausinystalia YohimbeStimulant Drugs Moderate
Interaction Summary
Theoretically, taking yohimbe with stimulant drugs can have additive effects.
Read the full Pausinystalia Yohimbe + Aminophylline, Amobarbital, Ephedrine interactionAmphetamineAdensys XR-ODT, Adzenys ER, Dyanavel XR, Mydayis
How Amphetamine interacts with PUMP-HD Peaches N' Cream — through 2 ingredients. Tap an ingredient for the detail:
Pausinystalia YohimbeStimulant Drugs, Monoamine Oxidase Inhibitors (maois) +1 Major
Interaction Summary
Theoretically, taking yohimbe with stimulant drugs can have additive effects.
Read the full Pausinystalia Yohimbe + Amphetamine interactionCaffeineStimulant Drugs, Monoamine Oxidase Inhibitors (maois) Moderate
Interaction Summary
Theoretically, concomitant use might increase stimulant adverse effects.
Read the full Caffeine + Amphetamine interactionBenserazide, LevodopaMadopar, Prolopa
How Benserazide, Levodopa interacts with PUMP-HD Peaches N' Cream — through 2 ingredients. Tap an ingredient for the detail:
MagnesiumLevodopa/carbidopa (sinemet) Major
Interaction Summary
Magnesium can reduce the bioavailability of levodopa/carbidopa.
Read the full Magnesium + Benserazide, Levodopa interactionL-tyrosineLevodopa Moderate
Interaction Summary
Theoretically, tyrosine might decrease the effectiveness of levodopa.
Read the full L-tyrosine + Benserazide, Levodopa interactionCarbetapentane Tannate, Chlorpheniramine Tannate, Ephedrine Tannate, Phenylephrine TannateQuadratuss, Ry Tuss, Rynatuss, Tri Tannate Plus
How Carbetapentane Tannate, Chlorpheniramine Tannate, Ephedrine Tannate, Phenylephrine Tannate interacts with PUMP-HD Peaches N' Cream — through 3 ingredients. Tap an ingredient for the detail:
CaffeineEphedrine, Stimulant Drugs Major
Interaction Summary
Theoretically, concomitant use might increase the risk for stimulant adverse effects.
Read the full Caffeine + Carbetapentane Tannate, Chlorpheniramine Tannate, Ephedrine Tannate, Phenylephrine Tannate interactionPausinystalia YohimbeCytochrome P450 2d6 (cyp2d6) Inhibitors, Stimulant Drugs +1 Moderate
Interaction Summary
CYP2D6 inhibitors may increase the levels and adverse effects of yohimbine, a constituent of yohimbe.
Read the full Pausinystalia Yohimbe + Carbetapentane Tannate, Chlorpheniramine Tannate, Ephedrine Tannate, Phenylephrine Tannate interactionAcetyl-l-carnitineSerotonergic Drugs Moderate
Interaction Summary
Theoretically, acetyl-L-carnitine might increase the risk of serotonergic side effects, including serotonin syndrome and cerebral vasoconstrictive disorders, when taken with serotonergic drugs.
Read the full Acetyl-l-carnitine + Carbetapentane Tannate, Chlorpheniramine Tannate, Ephedrine Tannate, Phenylephrine Tannate interactionCarbidopaLodosyn
How Carbidopa interacts with PUMP-HD Peaches N' Cream — through 1 ingredient. Tap an ingredient for the detail:
MagnesiumLevodopa/carbidopa (sinemet) Major
Interaction Summary
Magnesium can reduce the bioavailability of levodopa/carbidopa.
Read the full Magnesium + Carbidopa interactionCarbidopa, LevodopaDhivy, Rytary, Sinemet, Sinemet CR
How Carbidopa, Levodopa interacts with PUMP-HD Peaches N' Cream — through 2 ingredients. Tap an ingredient for the detail:
MagnesiumLevodopa/carbidopa (sinemet) Major
Interaction Summary
Magnesium can reduce the bioavailability of levodopa/carbidopa.
Read the full Magnesium + Carbidopa, Levodopa interactionL-tyrosineLevodopa Moderate
Interaction Summary
Theoretically, tyrosine might decrease the effectiveness of levodopa.
Read the full L-tyrosine + Carbidopa, Levodopa interactionCarbidopa, Levodopa, EntacaponeStalevo
How Carbidopa, Levodopa, Entacapone interacts with PUMP-HD Peaches N' Cream — through 2 ingredients. Tap an ingredient for the detail:
MagnesiumLevodopa/carbidopa (sinemet) Major
Interaction Summary
Magnesium can reduce the bioavailability of levodopa/carbidopa.
Read the full Magnesium + Carbidopa, Levodopa, Entacapone interactionL-tyrosineLevodopa Moderate
Interaction Summary
Theoretically, tyrosine might decrease the effectiveness of levodopa.
Read the full L-tyrosine + Carbidopa, Levodopa, Entacapone interactionCeftriaxoneRocephin
How Ceftriaxone interacts with PUMP-HD Peaches N' Cream — through 1 ingredient. Tap an ingredient for the detail:
CalciumCeftriaxone (rocephin) Major
Interaction Summary
Co-administration of intravenous calcium and ceftriaxone can result in precipitation of a ceftriaxone-calcium salt in the lungs and kidneys.
Read the full Calcium + Ceftriaxone interactionCobicistat, Elvitegravir, Emtricitabine, Tenofovir Alafenamide FumarateGenvoya
How Cobicistat, Elvitegravir, Emtricitabine, Tenofovir Alafenamide Fumarate interacts with PUMP-HD Peaches N' Cream — through 4 ingredients. Tap an ingredient for the detail:
CalciumElvitegravir (vitekta), Bictegravir/emtricitabine/tenofovir Alafenamide (biktarvy) Major
Interaction Summary
Calcium seems to reduce levels of elvitegravir.
Read the full Calcium + Cobicistat, Elvitegravir, Emtricitabine, Tenofovir Alafenamide Fumarate interactionPausinystalia YohimbeCytochrome P450 3a4 (cyp3a4) Inhibitors, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, CYP3A4 inhibitors might increase the levels and adverse effects of yohimbine, a constituent of yohimbe bark.
Read the full Pausinystalia Yohimbe + Cobicistat, Elvitegravir, Emtricitabine, Tenofovir Alafenamide Fumarate interactionNiacinHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Cobicistat, Elvitegravir, Emtricitabine, Tenofovir Alafenamide Fumarate interactionMagnesiumBictegravir/emtricitabine/tenofovir Alafenamide (biktarvy) Moderate
Interaction Summary
Magnesium might decrease levels of bictegravir/emtricitabine/tenofovir alafenamide by reducing its absorption.
Read the full Magnesium + Cobicistat, Elvitegravir, Emtricitabine, Tenofovir Alafenamide Fumarate interactionDolutegravirTivicay
How Dolutegravir interacts with PUMP-HD Peaches N' Cream — through 1 ingredient. Tap an ingredient for the detail:
CalciumDolutegravir (tivicay) Major
Interaction Summary
Calcium seems to reduce levels of dolutegravir.
Read the full Calcium + Dolutegravir interactionDolutegravir, Emtricitabine, Tenofovir AlafenamideDolutegravir, Emtricitabine, Tenofovir Alafenamide
How Dolutegravir, Emtricitabine, Tenofovir Alafenamide interacts with PUMP-HD Peaches N' Cream — through 3 ingredients. Tap an ingredient for the detail:
CalciumDolutegravir (tivicay), Bictegravir/emtricitabine/tenofovir Alafenamide (biktarvy) Major
Interaction Summary
Calcium seems to reduce levels of dolutegravir.
Read the full Calcium + Dolutegravir, Emtricitabine, Tenofovir Alafenamide interactionNiacinHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Dolutegravir, Emtricitabine, Tenofovir Alafenamide interactionMagnesiumBictegravir/emtricitabine/tenofovir Alafenamide (biktarvy) Moderate
Interaction Summary
Magnesium might decrease levels of bictegravir/emtricitabine/tenofovir alafenamide by reducing its absorption.
Read the full Magnesium + Dolutegravir, Emtricitabine, Tenofovir Alafenamide interactionDolutegravir, RilpivirineJuluca
How Dolutegravir, Rilpivirine interacts with PUMP-HD Peaches N' Cream — through 2 ingredients. Tap an ingredient for the detail:
CalciumDolutegravir (tivicay) Major
Interaction Summary
Calcium seems to reduce levels of dolutegravir.
Read the full Calcium + Dolutegravir, Rilpivirine interactionPausinystalia YohimbeCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, yohimbe might decrease the levels and clinical effects of CYP3A4 substrates.
Read the full Pausinystalia Yohimbe + Dolutegravir, Rilpivirine interactionDyphylline, Ephedrine, Guaifenesin, PhenobarbitalLufyllin-EPG
How Dyphylline, Ephedrine, Guaifenesin, Phenobarbital interacts with PUMP-HD Peaches N' Cream — through 2 ingredients. Tap an ingredient for the detail:
CaffeineStimulant Drugs, Phenobarbital (luminal) +1 Major
Interaction Summary
Theoretically, concomitant use might increase stimulant adverse effects.
Read the full Caffeine + Dyphylline, Ephedrine, Guaifenesin, Phenobarbital interactionPausinystalia YohimbeStimulant Drugs Moderate
Interaction Summary
Theoretically, taking yohimbe with stimulant drugs can have additive effects.
Read the full Pausinystalia Yohimbe + Dyphylline, Ephedrine, Guaifenesin, Phenobarbital interactionElvitegravirVitekta
How Elvitegravir interacts with PUMP-HD Peaches N' Cream — through 2 ingredients. Tap an ingredient for the detail:
CalciumElvitegravir (vitekta) Major
Interaction Summary
Calcium seems to reduce levels of elvitegravir.
Read the full Calcium + Elvitegravir interactionPausinystalia YohimbeCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, yohimbe might decrease the levels and clinical effects of CYP3A4 substrates.
Read the full Pausinystalia Yohimbe + Elvitegravir interactionElvitegravir, Cobicistat, Emtricitabine, Tenofovir Disoproxil FumarateStribild
How Elvitegravir, Cobicistat, Emtricitabine, Tenofovir Disoproxil Fumarate interacts with PUMP-HD Peaches N' Cream — through 4 ingredients. Tap an ingredient for the detail:
CalciumElvitegravir (vitekta), Bictegravir/emtricitabine/tenofovir Alafenamide (biktarvy) Major
Interaction Summary
Calcium seems to reduce levels of elvitegravir.
Read the full Calcium + Elvitegravir, Cobicistat, Emtricitabine, Tenofovir Disoproxil Fumarate interactionNiacinHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Elvitegravir, Cobicistat, Emtricitabine, Tenofovir Disoproxil Fumarate interactionMagnesiumBictegravir/emtricitabine/tenofovir Alafenamide (biktarvy) Moderate
Interaction Summary
Magnesium might decrease levels of bictegravir/emtricitabine/tenofovir alafenamide by reducing its absorption.
Read the full Magnesium + Elvitegravir, Cobicistat, Emtricitabine, Tenofovir Disoproxil Fumarate interactionPausinystalia YohimbeCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, yohimbe might decrease the levels and clinical effects of CYP3A4 substrates.
Read the full Pausinystalia Yohimbe + Elvitegravir, Cobicistat, Emtricitabine, Tenofovir Disoproxil Fumarate interactionEphedrine, Guaifenesin (otc Drug)Ephedrine Formula 400, Ephedrine Plus Tabs
How Ephedrine, Guaifenesin (otc Drug) interacts with PUMP-HD Peaches N' Cream — through 2 ingredients. Tap an ingredient for the detail:
CaffeineStimulant Drugs, Ephedrine Major
Interaction Summary
Theoretically, concomitant use might increase stimulant adverse effects.
Read the full Caffeine + Ephedrine, Guaifenesin (otc Drug) interactionPausinystalia YohimbeStimulant Drugs Moderate
Interaction Summary
Theoretically, taking yohimbe with stimulant drugs can have additive effects.
Read the full Pausinystalia Yohimbe + Ephedrine, Guaifenesin (otc Drug) interactionEphedrine, Guaifenesin, Phenobarbital, TheophyllineMudrane GG
How Ephedrine, Guaifenesin, Phenobarbital, Theophylline interacts with PUMP-HD Peaches N' Cream — through 2 ingredients. Tap an ingredient for the detail:
CaffeinePhenobarbital (luminal), Ephedrine +2 Major
Interaction Summary
Theoretically, caffeine might reduce the effects of phenobarbital and increase the risk for convulsions.
Read the full Caffeine + Ephedrine, Guaifenesin, Phenobarbital, Theophylline interactionPausinystalia YohimbeCytochrome P450 1a2 (cyp1a2) Substrates, Stimulant Drugs Moderate
Interaction Summary
Theoretically, yohimbe might decrease the levels and clinical effects of CYP1A2 substrates.
Read the full Pausinystalia Yohimbe + Ephedrine, Guaifenesin, Phenobarbital, Theophylline interactionEphedrine, Hydroxyzine, TheophyllineAmi Rax, Marax
How Ephedrine, Hydroxyzine, Theophylline interacts with PUMP-HD Peaches N' Cream — through 2 ingredients. Tap an ingredient for the detail:
CaffeineStimulant Drugs, Theophylline +1 Major
Interaction Summary
Theoretically, concomitant use might increase stimulant adverse effects.
Read the full Caffeine + Ephedrine, Hydroxyzine, Theophylline interactionPausinystalia YohimbeCytochrome P450 1a2 (cyp1a2) Substrates, Stimulant Drugs Moderate
Interaction Summary
Theoretically, yohimbe might decrease the levels and clinical effects of CYP1A2 substrates.
Read the full Pausinystalia Yohimbe + Ephedrine, Hydroxyzine, Theophylline interactionEphedrine, Phenobarbital, Potassium Iodide, TheophyllineMudrane, Quadrinal
How Ephedrine, Phenobarbital, Potassium Iodide, Theophylline interacts with PUMP-HD Peaches N' Cream — through 2 ingredients. Tap an ingredient for the detail:
CaffeinePhenobarbital (luminal), Ephedrine +2 Major
Interaction Summary
Theoretically, caffeine might reduce the effects of phenobarbital and increase the risk for convulsions.
Read the full Caffeine + Ephedrine, Phenobarbital, Potassium Iodide, Theophylline interactionPausinystalia YohimbeStimulant Drugs Moderate
Interaction Summary
Theoretically, taking yohimbe with stimulant drugs can have additive effects.
Read the full Pausinystalia Yohimbe + Ephedrine, Phenobarbital, Potassium Iodide, Theophylline interactionEphedrine, Phenobarbital, TheophyllineTedral
How Ephedrine, Phenobarbital, Theophylline interacts with PUMP-HD Peaches N' Cream — through 2 ingredients. Tap an ingredient for the detail:
CaffeineStimulant Drugs, Theophylline +2 Major
Interaction Summary
Theoretically, concomitant use might increase stimulant adverse effects.
Read the full Caffeine + Ephedrine, Phenobarbital, Theophylline interactionPausinystalia YohimbeStimulant Drugs Moderate
Interaction Summary
Theoretically, taking yohimbe with stimulant drugs can have additive effects.
Read the full Pausinystalia Yohimbe + Ephedrine, Phenobarbital, Theophylline interactionIsocarboxazidMarplan
How Isocarboxazid interacts with PUMP-HD Peaches N' Cream — through 3 ingredients. Tap an ingredient for the detail:
Pausinystalia YohimbeMonoamine Oxidase Inhibitors (maois) Major
Interaction Summary
Concomitant use of MAOIs with yohimbe can result in additive effects.
Read the full Pausinystalia Yohimbe + Isocarboxazid interactionAcetyl-l-carnitineSerotonergic Drugs Moderate
Interaction Summary
Theoretically, acetyl-L-carnitine might increase the risk of serotonergic side effects, including serotonin syndrome and cerebral vasoconstrictive disorders, when taken with serotonergic drugs.
Read the full Acetyl-l-carnitine + Isocarboxazid interactionCaffeineMonoamine Oxidase Inhibitors (maois) Moderate
Interaction Summary
Theoretically, concomitant use might increase the risk of a hypertensive crisis.
Read the full Caffeine + Isocarboxazid interactionLevodopaInbrija, Larodopa
How Levodopa interacts with PUMP-HD Peaches N' Cream — through 2 ingredients. Tap an ingredient for the detail:
MagnesiumLevodopa/carbidopa (sinemet) Major
Interaction Summary
Magnesium can reduce the bioavailability of levodopa/carbidopa.
Read the full Magnesium + Levodopa interactionL-tyrosineLevodopa Moderate
Interaction Summary
Theoretically, tyrosine might decrease the effectiveness of levodopa.
Read the full L-tyrosine + Levodopa interactionLevodopa, CarbidopaDuodopa
How Levodopa, Carbidopa interacts with PUMP-HD Peaches N' Cream — through 2 ingredients. Tap an ingredient for the detail:
MagnesiumLevodopa/carbidopa (sinemet) Major
Interaction Summary
Magnesium can reduce the bioavailability of levodopa/carbidopa.
Read the full Magnesium + Levodopa, Carbidopa interactionL-tyrosineLevodopa Moderate
Interaction Summary
Theoretically, tyrosine might decrease the effectiveness of levodopa.
Read the full L-tyrosine + Levodopa, Carbidopa interactionMoclobemideManerix, Moclobemide
How Moclobemide interacts with PUMP-HD Peaches N' Cream — through 2 ingredients. Tap an ingredient for the detail:
Pausinystalia YohimbeCytochrome P450 2d6 (cyp2d6) Inhibitors, Monoamine Oxidase Inhibitors (maois) Major
Interaction Summary
CYP2D6 inhibitors may increase the levels and adverse effects of yohimbine, a constituent of yohimbe.
Read the full Pausinystalia Yohimbe + Moclobemide interactionCaffeineMonoamine Oxidase Inhibitors (maois) Moderate
Interaction Summary
Theoretically, concomitant use might increase the risk of a hypertensive crisis.
Read the full Caffeine + Moclobemide interactionOzanimod HydrochlorideZeposia
How Ozanimod Hydrochloride interacts with PUMP-HD Peaches N' Cream — through 4 ingredients. Tap an ingredient for the detail:
Pausinystalia YohimbeMonoamine Oxidase Inhibitors (maois) Major
Interaction Summary
Concomitant use of MAOIs with yohimbe can result in additive effects.
Read the full Pausinystalia Yohimbe + Ozanimod Hydrochloride interactionNiacinHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Ozanimod Hydrochloride interactionCaffeineMonoamine Oxidase Inhibitors (maois) Moderate
Interaction Summary
Theoretically, concomitant use might increase the risk of a hypertensive crisis.
Read the full Caffeine + Ozanimod Hydrochloride interactionPine Bark {concentrate}Immunosuppressants Moderate
Interaction Summary
Theoretically, maritime pine bark extract might decrease the effectiveness of immunosuppressant therapy.
Read the full Pine Bark {concentrate} + Ozanimod Hydrochloride interactionPhenelzine SulfateNardil
How Phenelzine Sulfate interacts with PUMP-HD Peaches N' Cream — through 3 ingredients. Tap an ingredient for the detail:
Pausinystalia YohimbeMonoamine Oxidase Inhibitors (maois) Major
Interaction Summary
Concomitant use of MAOIs with yohimbe can result in additive effects.
Read the full Pausinystalia Yohimbe + Phenelzine Sulfate interactionAcetyl-l-carnitineSerotonergic Drugs Moderate
Interaction Summary
Theoretically, acetyl-L-carnitine might increase the risk of serotonergic side effects, including serotonin syndrome and cerebral vasoconstrictive disorders, when taken with serotonergic drugs.
Read the full Acetyl-l-carnitine + Phenelzine Sulfate interactionCaffeineMonoamine Oxidase Inhibitors (maois) Moderate
Interaction Summary
Theoretically, concomitant use might increase the risk of a hypertensive crisis.
Read the full Caffeine + Phenelzine Sulfate interactionRasagilineAzilect
How Rasagiline interacts with PUMP-HD Peaches N' Cream — through 3 ingredients. Tap an ingredient for the detail:
Pausinystalia YohimbeMonoamine Oxidase Inhibitors (maois), Cytochrome P450 1a2 (cyp1a2) Substrates Major
Interaction Summary
Concomitant use of MAOIs with yohimbe can result in additive effects.
Read the full Pausinystalia Yohimbe + Rasagiline interactionCaffeineMonoamine Oxidase Inhibitors (maois) Moderate
Interaction Summary
Theoretically, concomitant use might increase the risk of a hypertensive crisis.
Read the full Caffeine + Rasagiline interactionAcetyl-l-carnitineSerotonergic Drugs Moderate
Interaction Summary
Theoretically, acetyl-L-carnitine might increase the risk of serotonergic side effects, including serotonin syndrome and cerebral vasoconstrictive disorders, when taken with serotonergic drugs.
Read the full Acetyl-l-carnitine + Rasagiline interactionSafinamide MesylateXadago
How Safinamide Mesylate interacts with PUMP-HD Peaches N' Cream — through 3 ingredients. Tap an ingredient for the detail:
Pausinystalia YohimbeMonoamine Oxidase Inhibitors (maois) Major
Interaction Summary
Concomitant use of MAOIs with yohimbe can result in additive effects.
Read the full Pausinystalia Yohimbe + Safinamide Mesylate interactionCaffeineMonoamine Oxidase Inhibitors (maois) Moderate
Interaction Summary
Theoretically, concomitant use might increase the risk of a hypertensive crisis.
Read the full Caffeine + Safinamide Mesylate interactionAcetyl-l-carnitineSerotonergic Drugs Moderate
Interaction Summary
Theoretically, acetyl-L-carnitine might increase the risk of serotonergic side effects, including serotonin syndrome and cerebral vasoconstrictive disorders, when taken with serotonergic drugs.
Read the full Acetyl-l-carnitine + Safinamide Mesylate interactionSelegilineCarbex, Eldepryl, Emsam, Zelapar
How Selegiline interacts with PUMP-HD Peaches N' Cream — through 3 ingredients. Tap an ingredient for the detail:
Pausinystalia YohimbeMonoamine Oxidase Inhibitors (maois) Major
Interaction Summary
Concomitant use of MAOIs with yohimbe can result in additive effects.
Read the full Pausinystalia Yohimbe + Selegiline interactionAcetyl-l-carnitineSerotonergic Drugs Moderate
Interaction Summary
Theoretically, acetyl-L-carnitine might increase the risk of serotonergic side effects, including serotonin syndrome and cerebral vasoconstrictive disorders, when taken with serotonergic drugs.
Read the full Acetyl-l-carnitine + Selegiline interactionCaffeineMonoamine Oxidase Inhibitors (maois) Moderate
Interaction Summary
Theoretically, concomitant use might increase the risk of a hypertensive crisis.
Read the full Caffeine + Selegiline interactionTranylcypromineParnate
How Tranylcypromine interacts with PUMP-HD Peaches N' Cream — through 3 ingredients. Tap an ingredient for the detail:
Pausinystalia YohimbeMonoamine Oxidase Inhibitors (maois) Major
Interaction Summary
Concomitant use of MAOIs with yohimbe can result in additive effects.
Read the full Pausinystalia Yohimbe + Tranylcypromine interactionCaffeineMonoamine Oxidase Inhibitors (maois) Moderate
Interaction Summary
Theoretically, concomitant use might increase the risk of a hypertensive crisis.
Read the full Caffeine + Tranylcypromine interactionAcetyl-l-carnitineSerotonergic Drugs Moderate
Interaction Summary
Theoretically, acetyl-L-carnitine might increase the risk of serotonergic side effects, including serotonin syndrome and cerebral vasoconstrictive disorders, when taken with serotonergic drugs.
Read the full Acetyl-l-carnitine + Tranylcypromine interactionEach ingredient & the kinds of drugs it affects
For each ingredient in PUMP-HD Peaches N' Cream 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.
Pausinystalia yohimbe
Monoamine Oxidase Inhibitors (Maois)
Concomitant use of MAOIs with yohimbe can result in additive effects.
Yohimbine, a constituent of yohimbe, has MAO inhibitory effects. At high doses, yohimbine is a non-selective inhibitor of MAO.
Antihypertensive Drugs
Theoretically, yohimbe might reduce the effects of antihypertensive drugs.
Yohimbine, a constituent of yohimbe, is an alpha-2 adrenoceptor antagonist and has been reported to increase blood pressure in clinical research. Theoretically, concomitant use of yohimbe and antihypertensive drugs can interfere with blood pressure control.
Clonidine (Catapres)
Theoretically, yohimbe might precipitate clonidine withdrawal.
Chronic clonidine use can downregulate alpha-2 adrenoreceptors. Animal research and one human case report suggest that concomitant administration of yohimbine, an alpha-2 adrenoceptor antagonist, may precipitate clonidine withdrawal and lead to sympathomimetic toxicity, including hypertensive crisis.
Cytochrome P450 2D6 (Cyp2D6) Inhibitors
CYP2D6 inhibitors may increase the levels and adverse effects of yohimbine, a constituent of yohimbe.
In vitro and clinical research shows that the yohimbe bark constituent, yohimbine, is metabolized by CYP2D6 isoenzymes. Paroxetine, a cytochrome P450 (CYP) 2D6 inhibitor, increases the maximum serum concentration of yohimbine and reduces the clearance of yohimbine compared to yohimbine alone in patients who are extensive CYP2D6 metabolizers..
Cytochrome P450 2D6 (Cyp2D6) Substrates
Theoretically, yohimbe might increase the levels and adverse effects of CYP2D6 substrates.
In vitro research suggests that yohimbine, a constituent of yohimbe bark, inhibits CYP2D6 enzyme activity.
Cytochrome P450 3A4 (Cyp3A4) Inhibitors
Theoretically, CYP3A4 inhibitors might increase the levels and adverse effects of yohimbine, a constituent of yohimbe bark.
In vitro and clinical research shows that the yohimbe bark constituent, yohimbine, is metabolized by CYP3A4 enzymes. Theoretically, drugs that inhibit CYP3A4 might increase the levels and adverse effects of yohimbine.
Paroxetine (Paxil)
Paroxetine decreases the clearance of yohimbine and may increase its effects.
Paroxetine, a cytochrome P450 (CYP) 2D6 inhibitor, increases the maximum serum concentration of yohimbine by about 350% and reduces the clearance of yohimbine by about 80% compared to yohimbine alone in patients who are extensive CYP2D6 metabolizers. No significant changes in pharmacokinetic parameters of yohimbine were observed with coadministration of paroxetine in patients who are poor CYP2D6 metabolizers.
Phenothiazines
Theoretically, using yohimbine with phenothiazines might have additive effects.
Yohimbine, a constituent of yohimbe, has alpha-2 adrenergic antagonist effects. Theoretically, combining it with phenothiazines can cause additive alpha-2 adrenergic antagonism.
Stimulant Drugs
Theoretically, taking yohimbe with stimulant drugs can have additive effects.
Yohimbine, a constituent of yohimbe, has sympathomimetic effects and increases blood pressure in a dose-dependent manner. Theoretically, taking yohimbe with stimulant drugs can have additive stimulant and hypertensive effects.
Tricyclic Antidepressants (Tcas)
Theoretically, taking yohimbe with TCAs can increase adverse effects.
A small clinical study in patients taking TCAs for at least 4 weeks shows that receiving doses of intravenous yohimbine 2.5-20 mg daily for up to 7 days precipitates severe anxiety, agitation, and tremor. The effects of yohimbe bark itself are unclear; oral yohimbe bark contains 0.6% to 1.38% yohimbine, but it is unclear how much is absorbed.
Anticoagulant/Antiplatelet Drugs
Theoretically, combining yohimbe bark with antiplatelet or anticoagulant drugs might have additive effects; however, this has not been reported in clinical research.
Research in healthy adults shows that taking yohimbine, a constituent of yohimbe bark, in doses of 8 mg or more, seems to inhibit platelet aggregation in vitro by binding to the alpha-2 adrenoceptor. The effects of yohimbe bark itself are unclear; yohimbe bark contains 0.6% to 1.38% yohimbine, but it is unclear how much is absorbed.
Cytochrome P450 1A2 (Cyp1A2) Substrates
Theoretically, yohimbe might decrease the levels and clinical effects of CYP1A2 substrates.
In vitro research shows that yohimbe extract induces CYP1A2 enzymes.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, yohimbe might decrease the levels and clinical effects of CYP3A4 substrates.
In vitro research shows that yohimbe extract induces CYP3A4 enzymes.
Niacin
Alcohol (Ethanol)
Concomitant use of alcohol and niacin might increase the risk of flushing and hepatotoxicity.
Alcohol can exacerbate the flushing and pruritus associated with niacin. Large doses of niacin might also exacerbate liver dysfunction associated with chronic alcohol use. A case report describes delirium and lactic acidosis in a patient taking niacin 3 grams daily who ingested 1 liter of wine. Advise patients to avoid large amounts of alcohol while taking niacin.
Allopurinol (Zyloprim)
Theoretically, niacin might antagonize the therapeutic effects of uricosurics such as allopurinol.
Large doses of niacin can reduce urinary excretion of uric acid, potentially resulting in hyperuricemia. Doses of uricosurics such as allopurinol might need to be increased to maintain control of gout in patients who start taking niacin. People who have frequent attacks of gout despite uricosuric therapy should avoid niacin.
Anticoagulant/Antiplatelet Drugs
Theoretically, niacin may have additive effects when used with anticoagulant or antiplatelet drugs.
Several cases of clotting factor synthesis deficiency and coagulopathy have been reported in patients taking sustained-release niacin. Also, thrombocytopenia has been reported in patients treated with niacin or niacin plus lovastatin.
Antidiabetes Drugs
Niacin can increase blood glucose levels and may diminish the effects of antidiabetes drugs.
Niacin impairs glucose tolerance in a dose-dependent manner, probably by causing or aggravating insulin resistance and increasing hepatic production of glucose. In diabetes patients, niacin 4.5 grams daily for 5 weeks can increase plasma glucose by an average of 16% and glycated hemoglobin (HbA1c) by 21%. However, lower doses of 1.5 grams daily or less appear to have minimal effects on blood glucose. In some patients, glucose levels increase when niacin is started, but then return to baseline when a stable dose is reached. Up to 35% of patients with diabetes may need adjustments in hypoglycemic therapy when niacin is added.
Antihypertensive Drugs
Theoretically, niacin may increase the risk of hypotension when used with antihypertensive drugs.
The vasodilating effects of niacin can cause hypotension. Furthermore, some clinical evidence suggests that a one-hour infusion of niacin can reduce systolic, diastolic, and mean blood pressure in hypertensive patients. This effect is not observed in normotensive patients.
Bile Acid Sequestrants
Bile acid sequestrants can bind niacin and decrease absorption. Separate administration by 4-6 hours to avoid an interaction.
In vitro studies show that colestipol (Colestid) binds about 98% of available niacin and cholestyramine (Questran) binds 10% to 30%.
Gemfibrozil (Lopid)
Theoretically, concomitant use of niacin and gemfibrozil might increase the risk of myopathy in some patients.
A case of myopathy from concomitant use of niacin and gemfibrozil has been reported. Niacin alone has also been associated with cases of myopathy. Using gemfibrozil with niacin might further increase the risk of developing myopathy.
Hepatotoxic Drugs
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Niacin has been associated with cases of liver toxicity, especially when used in pharmacologic doses. Sustained-release niacin preparations appear to be associated with a higher risk of hepatotoxicity than immediate-release niacin.
Hmg-Coa Reductase Inhibitors ("Statins")
Theoretically, concomitant use of niacin and statins might increase the risk of myopathy and rhabdomyolysis in some patients.
Some case reports have raised concerns that niacin might increase the risk of myopathy and rhabdomyolysis when combined with statins. However, a significantly increased risk of myopathy has not been demonstrated in clinical trials, including those using an FDA-approved combination of lovastatin and niacin (Advicor).
Probenecid (Benemid)
Theoretically, niacin might antagonize the therapeutic effects of uricosurics such as probenecid.
Large doses of niacin reduce urinary excretion of uric acid, potentially causing hyperuricemia. Doses of uricosurics such as probenecid might need to be increased to maintain control of gout in patients who start taking niacin. People who have frequent attacks of gout despite uricosuric therapy should avoid niacin.
Sulfinpyrazone (Anturane)
Theoretically, niacin might antagonize the therapeutic effects of uricosurics such as sulfinpyrazone.
Large doses of niacin reduce urinary excretion of uric acid, potentially causing hyperuricemia. Doses of uricosurics such as sulfinpyrazone might need to be increased to maintain control of gout in patients who start taking niacin. People who have frequent attacks of gout despite uricosuric therapy should avoid niacin.
Thyroid Hormone
Theoretically, niacin might antagonize the therapeutic effects of thyroid hormones.
Clinical research and case reports suggests that taking niacin can reduce serum levels of thyroxine-binding globulin by up to 25% and moderately reduce levels of thyroxine (T4). Patients taking thyroid hormone for hypothyroidism might need dose adjustments when using niacin.
Transdermal Nicotine (Nicoderm)
Theoretically, concomitant use of niacin and transdermal nicotine might increase the risk of flushing and dizziness.
Niacin and nicotine can both cause flushing and dizziness.
Warfarin (Coumadin)
There is limited evidence that niacin may increase the anticoagulant effects of warfarin.
In a case report, a patient on warfarin developed an elevated international normalized ratio (INR) of 3.9 after taking niacin for two weeks. The patient's INR was previously stable, ranging between 2 and 3 in recent months, and no other medication changes were identified. The elevated INR returned to therapeutic range within 4 days following the discontinuation of niacin.
Aspirin
Large doses of aspirin might alter the clearance of niacin.
Aspirin is often used with niacin to reduce niacin-induced flushing. Doses of 80-975 mg aspirin have been used, but 325 mg appears to be optimal. Aspirin also seems to reduce the clearance of niacin by competing for glycine conjugation. Taking aspirin 1 gram seems to reduce niacin clearance by 45%. This is probably a dose-related effect and not clinically significant with the more common aspirin dose of 325 mg.
Caffeine
Ephedrine
Theoretically, concomitant use might increase the risk for stimulant adverse effects.
Use of ephedrine with caffeine can increase the risk of stimulatory adverse effects. There is evidence that using ephedrine with caffeine might increase the risk of serious life-threatening or debilitating adverse effects such as hypertension, myocardial infarction, stroke, seizures, and death.
Adenosine (Adenocard)
Theoretically, caffeine might decrease the vasodilatory effects of adenosine and interfere with its use prior to stress testing.
Some evidence shows that caffeine is a competitive inhibitor of adenosine and can reduce the vasodilatory effects of adenosine in humans. However, other research shows that caffeine does not seem to affect supplemental adenosine because high interstitial levels of adenosine overcome the antagonistic effects of caffeine. It is recommended that methylxanthines and methylxanthine-containing products be stopped 24 hours prior to pharmacological stress tests. However, methylxanthines appear more likely to interfere with dipyridamole (Persantine) than adenosine-induced stress testing.
Anticoagulant/Antiplatelet Drugs
Theoretically, caffeine may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Caffeine is reported to have antiplatelet activity. Theoretically, it might increase the risk of bleeding when used concomitantly with these agents; however, this interaction has not been reported in humans.
Beta-Adrenergic Agonists
Theoretically, large amounts of caffeine might increase the cardiac inotropic effects of beta-agonists.
Carbamazepine (Tegretol)
Theoretically, caffeine might reduce the effects of carbamazepine and increase the risk for convulsions.
Animal research suggests that taking caffeine can lower the anticonvulsant effects of carbamazepine and can induce seizures when taken in doses above 400 mg/kg. Human research has shown that taking caffeine 300 mg in three divided doses along with carbamazepine 200 mg reduces the bioavailability of carbamazepine by 32% and prolongs the plasma half-life of carbamazepine 2-fold in healthy individuals.
Cimetidine (Tagamet)
Theoretically, cimetidine might increase the levels and adverse effects of caffeine.
Cimetidine decreases the rate of caffeine clearance by 31% to 42%.
Clozapine (Clozaril)
Caffeine might increase the levels and adverse effects of clozapine and acutely exacerbate psychotic symptoms.
Caffeine might increase the effects and toxicity of clozapine. Caffeine doses of 400-1000 mg per day inhibit clozapine metabolism. Clozapine is metabolized by cytochrome P450 1A2 (CYP1A2). Although researchers speculate that caffeine might inhibit CYP1A2, there is no reliable evidence that caffeine affects CYP1A2. There is also speculation that genetic factors might make some patients more sensitive to an interaction between clozapine and caffeine. In one case report, severe, life-threatening clozapine toxicity and multiorgan system failure occurred in a patient with schizophrenia stabilized on clozapine who consumed caffeine 600 mg daily.
Dipyridamole (Persantine)
Theoretically, caffeine might decrease the vasodilatory effects of dipyridamole and interfere with its use prior to stress testing.
Caffeine inhibits dipyridamole-induced vasodilation. It is recommended that methylxanthines and methylxanthine-containing products be stopped 24 hours prior to pharmacological stress tests. Methylxanthines appear more likely to interfere with dipyridamole (Persantine) than adenosine-induced stress testing.
Disulfiram (Antabuse)
Theoretically, disulfiram use might increase the levels and adverse effects of caffeine.
Disulfiram decreases the rate of caffeine clearance.
Diuretic Drugs
Theoretically, using caffeine with diuretic drugs might increase the risk of hypokalemia.
Caffeine, especially in excessive amounts, can reduce potassium levels due to stimulation of the sodium-potassium pump. Diuretics can also cause lower potassium levels.
Estrogens
Theoretically, estrogens might increase the levels and adverse effects of caffeine.
Estrogen inhibits caffeine metabolism.
Ethosuximide (Zarontin)
Theoretically, caffeine might reduce the effects of ethosuximide and increase the risk for convulsions.
Animal research suggests that caffeine 92.4 mg/kg can decrease the anticonvulsant activity of ethosuximide. However, this effect has not been reported in humans.
Felbamate (Felbatol)
Theoretically, caffeine might reduce the effects of felbamate and increase the risk for convulsions.
Animal research suggests that a high dose of caffeine 161.7 mg/kg can decreases the anticonvulsant activity of felbamate. However, this effect has not been reported in humans.
Flutamide (Eulexin)
Theoretically, caffeine might increase the levels and adverse effects of flutamide.
In vitro evidence suggests that caffeine can inhibit the metabolism of flutamide. However, this effect has not been reported in humans.
Fluvoxamine (Luvox)
Theoretically, fluvoxamine might increase the levels and adverse effects of caffeine.
Fluvoxamine reduces caffeine metabolism.
Lithium
Abrupt caffeine withdrawal might increase the levels and adverse effects of lithium.
Caffeine has diuretic activity. When abruptly discontinued, caffeine may alter the clearance of lithium. There are two case reports of lithium tremor that worsened upon abrupt coffee withdrawal and 6 case reports of elevated serum lithium levels after reducing or eliminating caffeine intake. In one case, a male with schizoaffective disorder stabilized on lithium had an elevated lithium level after reducing his caffeine intake by 87%. At a later date, he increased his caffeine intake by 6-fold, resulting in a subtherapeutic lithium level and a recurrence of psychiatric symptoms.
Monoamine Oxidase Inhibitors (Maois)
Theoretically, concomitant use might increase the risk of a hypertensive crisis.
Caffeine has been shown to inhibit monoamine oxidase (MAO) A and B in laboratory studies. Concomitant intake of large amounts of caffeine with MAOIs might precipitate a hypertensive crisis. In a case report, a patient that consumed 10-12 cups of caffeinated coffee and took the MAOI tranylcypromine presented with severe hypertension. Hypertension was resolved after the patient switched to drinking decaffeinated coffee.
Nicotine
Theoretically, concomitant use might increase the risk of hypertension.
Concomitant use of caffeine and nicotine has been shown to have additive cardiovascular effects, including increased heart rate and blood pressure. Blood pressure was increased by 10.8/12.4 mmHg when the agents were used concomitantly.
Pentobarbital (Nembutal)
Theoretically, caffeine might decrease the effects of pentobarbital.
Caffeine might negate the hypnotic effects of pentobarbital.
Phenobarbital (Luminal)
Theoretically, caffeine might reduce the effects of phenobarbital and increase the risk for convulsions.
Animal research suggests that caffeine can decrease the anticonvulsant activity of phenobarbital. However, the exact mechanism of this interaction is unclear.
Phenylpropanolamine
Theoretically, phenylpropanolamine might increase the risk of hypertension, as well as the levels and adverse effects of caffeine.
Concomitant use of phenylpropanolamine and caffeine might cause an additive increase in blood pressure. Phenylpropanolamine also seems to increase caffeine serum levels.
Phenytoin (Dilantin)
Theoretically, caffeine might reduce the effects of phenytoin and increase the risk for convulsions.
Animal research suggests that caffeine can decrease the anticonvulsant activity of phenytoin. The effect does not seem to be related to the seizure threshold-lowering effects of caffeine. However, the exact mechanism of this interaction is unclear.
Pioglitazone (Actos)
Theoretically, caffeine might increase the levels and clinical effects of pioglitazone.
Animal research suggests that caffeine can modestly increase the maximum concentration, area under the curve, and half-life of pioglitazone, and also reduce its clearance. This increased the antidiabetic effects of pioglitazone. However, the exact mechanism of this interaction is unclear.
Quinolone Antibiotics
Theoretically, quinolone antibiotics might increase the levels and adverse effects of caffeine.
Quinolones (also called fluoroquinolones) can decrease caffeine clearance by inhibiting cytochrome P450 1A2 (CYP1A2) enzyme.
Riluzole (Rilutek)
Theoretically, concomitant use might increase the levels and adverse effects of both caffeine and riluzole.
Caffeine and riluzole are both metabolized by cytochrome P450 1A2 (CYP1A2), and concomitant use might reduce the metabolism of one or both agents.
Pine bark {concentrate}
Anticoagulant/Antiplatelet Drugs
Theoretically, maritime pine bark extract might increase the risk of bleeding when used with antiplatelet or anticoagulant drugs.
Clinical research suggests that maritime pine bark extract inhibits platelet aggregation. However, the clinical significance of this effect is unclear.
Antidiabetes Drugs
Theoretically, maritime pine bark extract might increase the risk of hypoglycemia when used with antidiabetes drugs.
One clinical study shows that maritime pine bark extract decreases blood sugar in patients with diabetes being treated with antidiabetes agents. Monitor blood glucose levels closely. Dose adjustments might be necessary.
Immunosuppressants
Theoretically, maritime pine bark extract might decrease the effectiveness of immunosuppressant therapy.
In vitro and animal research suggests that maritime pine bark extract has immunostimulant activity. This effect has not been reported in humans.
Magnesium
Levodopa/Carbidopa (Sinemet)
Magnesium can reduce the bioavailability of levodopa/carbidopa.
Clinical research in healthy volunteers shows that taking magnesium oxide 1000 mg with levodopa 100 mg/carbidopa 10 mg reduces the area under the curve (AUC) of levodopa by 35% and of carbidopa by 81%. In vitro and animal research shows that magnesium produces an alkaline environment in the digestive tract, which might lead to degradation and reduced bioavailability of levodopa/carbidopa.
Aminoglycoside Antibiotics
Concomitant use of aminoglycoside antibiotics and magnesium can increase the risk for neuromuscular weakness.
Both aminoglycosides and magnesium reduce presynaptic acetylcholine release, which can lead to neuromuscular blockade and possible paralysis. This is most likely to occur with high doses of magnesium given intravenously.
Antacids
Use of acid reducers may reduce the laxative effect of magnesium oxide.
A retrospective analysis shows that, in the presence of H2 receptor antagonists (H2RAs) or proton pump inhibitors (PPIs), a higher dose of magnesium oxide is needed for a laxative effect. This may also occur with antacids. Under acidic conditions, magnesium oxide is converted to magnesium chloride and then to magnesium bicarbonate, which has an osmotic laxative effect. By reducing acidity, antacids may reduce the conversion of magnesium oxide to the active bicarbonate salt.
Bictegravir/Emtricitabine/Tenofovir Alafenamide (Biktarvy)
Magnesium might decrease levels of bictegravir/emtricitabine/tenofovir alafenamide by reducing its absorption.
Advise patients that bictegravir/emtricitabine/tenofovir alafenamide should be taken at least 2 hours before or 6 hours after magnesium containing products.
Bisphosphonates
Magnesium can decrease absorption of bisphosphonates.
Cations, including magnesium, can decrease bisphosphonate absorption. Advise patients to separate doses of magnesium and these drugs by at least 2 hours.
Calcium Channel Blockers
Magnesium can have additive effects with calcium channel blockers, although evidence is conflicting.
Magnesium inhibits calcium entry into smooth muscle cells and may therefore have additive effects with calcium channel blockers. Severe hypotension and neuromuscular blockades may occur when nifedipine is used with intravenous magnesium, although some contradictory evidence suggests that concurrent use of magnesium with nifedipine does not increase the risk of neuromuscular weakness. High doses of magnesium could theoretically have additive effects with other calcium channel blockers.
Digoxin
Magnesium salts may reduce absorption of digoxin.
Clinical evidence suggests that treatment with oral magnesium hydroxide or magnesium trisilicate reduces absorption of digoxin from the intestines. This may reduce the blood levels of digoxin and decrease its therapeutic effects.
Potassium-Sparing Diuretics
Potassium-sparing diuretics decrease excretion of magnesium, possibly increasing magnesium levels.
Potassium-sparing diuretics also have magnesium-sparing properties, which can counteract the magnesium losses associated with loop and thiazide diuretics. Theoretically, increased magnesium levels could result from concomitant use of potassium-sparing diuretics and magnesium supplements.
Quinolone Antibiotics
Magnesium decreases absorption of quinolones.
Magnesium can form insoluble complexes with quinolones and decrease their absorption. Advise patients to take these drugs at least 2 hours before, or 4 to 6 hours after, magnesium supplements.
Skeletal Muscle Relaxants
Parenteral magnesium alters the pharmacokinetics of skeletal muscle relaxants, increasing their effects and accelerating the onset of effect.
Parenteral magnesium shortens the time to onset of skeletal muscle relaxants by about 1 minute and prolongs the duration of action by about 2 minutes. Magnesium potentiates the effects of skeletal muscle relaxants by decreasing calcium-mediated release of acetylcholine from presynaptic nerve terminals, reducing postsynaptic sensitivity to acetylcholine, and having a direct effect on the membrane potential of myocytes. Magnesium also has vasodilatory actions and increases cardiac output, allowing a greater amount of muscle relaxant to reach the motor end plate. A clinical study found that low-dose rocuronium (0.45 mg/kg), when given after administration of magnesium 30 mg/kg over 10 minutes, has an accelerated onset of effect, which matches the onset of effect seen with a full-dose rocuronium regimen (0.6 mg/kg). In another clinical study, onset times for rocuronium doses of 0.3, 0.6, and 1.2 mg/kg were 86, 76, and 50 seconds, respectively, when given alone, but were reduced to 66, 44, and 38 seconds, respectively, when the doses were given after a 15-minute infusion of magnesium sulfate 60 mg/kg. Giving intraoperative intravenous magnesium sulfate, 50 mg/kg loading dose followed by 15 mg/kg/hour, reduces the onset time of rocuronium, enhances its clinical effects, reduces the dose of intraoperative opiates, and prolongs the spontaneous recovery time. It does not affect the activity of subsequently administered neostigmine.
Sulfonylureas
Magnesium increases the systemic absorption of sulfonylureas, increasing their effects and side effects.
Clinical research shows that administration of magnesium hydroxide with glyburide increases glyburide absorption, increases maximal insulin response by 35-fold, and increases the risk of hypoglycemia, when compared with glyburide alone. A similar interaction occurs between magnesium hydroxide and glipizide. The mechanism of this effect appears to be related to the elevation of gastrointestinal pH by magnesium-based antacids, increasing solubility and enhancing absorption of sulfonylureas.
Tetracycline Antibiotics
Magnesium decreases absorption of tetracyclines.
Magnesium can form insoluble complexes with tetracyclines in the gut and decrease their absorption and antibacterial activity. Advise patients to take these drugs 1 hour before or 2 hours after magnesium supplements.
Anticoagulant/Antiplatelet Drugs
Theoretically, magnesium may have antiplatelet effects, but the evidence is conflicting.
In vitro evidence shows that magnesium sulfate inhibits platelet aggregation, even at low concentrations. Some preliminary clinical evidence shows that infusion of magnesium sulfate increases bleeding time by 48% and reduces platelet activity. However, other clinical research shows that magnesium does not affect platelet aggregation, although inhibition of platelet-dependent thrombosis can occur.
Gabapentin (Neurontin)
Gabapentin absorption can be decreased by magnesium.
Clinical research shows that giving magnesium oxide orally along with gabapentin decreases the maximum plasma concentration of gabapentin by 33%, time to maximum concentration by 36%, and area under the curve by 43%. Advise patients to take gabapentin at least 2 hours before, or 4 to 6 hours after, magnesium supplements.
Sevelamer (Renagel, Renvela)
Sevelamer may increase serum magnesium levels.
In patients on hemodialysis, sevelamer use was associated with a 0.28 mg/dL increase in serum magnesium. The mechanism of this interaction remains unclear.
Acetyl-L-Carnitine
Acenocoumarol (Sintrom)
Theoretically, acetyl-L-carnitine might increase the anticoagulant effects of acenocoumarol.
L-carnitine, the parent compound of acetyl-L-carnitine, might enhance the anticoagulant effects of acenocoumarol, an oral anticoagulant that is similar to warfarin, but shorter-acting. There are at least two case reports of INR elevation when L-carnitine was taken with acenocoumarol. In one case, a 33-year-old male with a previously stable INR had an elevated INR of 4.65 after L-carnitine was started and continued for 10 weeks. INR normalized after discontinuation of the L-carnitine-containing product. It is unclear if such an interaction would also occur with acetyl-L-carnitine.
Serotonergic Drugs
Theoretically, acetyl-L-carnitine might increase the risk of serotonergic side effects, including serotonin syndrome and cerebral vasoconstrictive disorders, when taken with serotonergic drugs.
Animal research shows that acetyl-L-carnitine can increase levels of serotonin in the brain.
Thyroid Hormone
Theoretically, acetyl-L-carnitine might decrease the effectiveness of thyroid hormone replacement.
L-carnitine appears to act as a peripheral thyroid hormone antagonist by inhibiting entry of thyroid hormone into the nucleus of cells. Taking L-carnitine also seems to diminish some of the symptoms of hyperthyroidism. It is unclear if such an interaction would occur with acetyl-L-carnitine.
Warfarin (Coumadin)
Theoretically, acetyl-L-carnitine might increase the anticoagulant effects of warfarin.
L-carnitine, the parent compound of acetyl-L-carnitine, might increase the anticoagulant effects of acenocoumarol, a shorter-acting oral anticoagulant similar to warfarin. There is not enough information to know whether this interaction occurs with acetyl-L-carnitine and warfarin.
Taurine
Antihypertensive Drugs
Theoretically, taurine might increase the risk of hypotension when taken with antihypertensive drugs.
Some clinical evidence suggests that taurine can reduce both systolic and diastolic blood pressure.
Lithium
Theoretically, taurine might reduce excretion and increase plasma levels of lithium.
Taurine is thought to have diuretic properties, which might reduce the excretion of lithium.
Calcium
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
Blueberry fruit {concentrate}
Antidiabetes Drugs
Theoretically, blueberries or blueberry leaf extracts might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Animal and in vitro research suggests that blueberry and/or blueberry leaf extracts can lower blood glucose levels.
Buspirone (Buspar)
Theoretically, blueberry juice might increase blood levels of buspirone.
In vitro research shows that blueberry juice can inhibit the metabolism of buspirone, possibly by inhibiting cytochrome P450 3A (CYP3A) enzymes. However, pharmacokinetic research in humans shows that drinking 300 mL of blueberry juice 30 minutes before taking buspirone hydrochloride 10 mg does not significantly affect the concentration or clearance of buspirone.
Flurbiprofen (Ansaid, Others)
Theoretically, blueberry juice might increase blood levels of flurbiprofen.
In vitro research shows that blueberry juice can inhibit the metabolism of flurbiprofen, possibly by inhibiting cytochrome P450 2C9 (CYP2C9) enzymes. However, pharmacokinetic research in humans shows that drinking 300 mL of blueberry juice 30 minutes before taking flurbiprofen 100 mg does not significantly affect the concentration or clearance of flurbiprofen.
Manganese
Antipsychotic Drugs
Theoretically, the risk for manganese toxicity might increase when taken with antipsychotic drugs.
Hallucinations and behavioral changes have been reported in a patient with liver disease who was taking haloperidol and manganese. Researchers speculate that taking manganese along with haloperidol, phenothiazine-derivatives, or other antipsychotic medications might increase the risk of manganese toxicity in some patients.
Quinolone Antibiotics
Theoretically, manganese might reduce the absorption of quinolone antibiotics.
Manganese is a multivalent cation. Interactions resulting in reduced quinolone absorption have been reported between quinolones and other multivalent cations, such as calcium and iron.
Tetracycline Antibiotics
Theoretically, manganese might reduce the absorption of tetracycline antibiotics.
Manganese is a multivalent cation. Interactions resulting in reduced tetracycline absorption have been reported between tetracyclines and other multivalent cations, such as calcium and iron.
Potassium
Ace Inhibitors (Aceis)
Using ACEIs with high doses of potassium increases the risk of hyperkalemia.
ACEIs block the actions of the renin-angiotensin-aldosterone system and reduce potassium excretion. Concomitant use of these drugs with potassium supplements increases the risk of hyperkalemia. However, concomitant use of these drugs with moderate dietary potassium intake (about 3775-5200 mg daily) does not increase serum potassium levels.
Angiotensin Receptor Blockers (Arbs)
Using ARBs with high doses of potassium increases the risk of hyperkalemia.
ARBs block the actions of the renin-angiotensin-aldosterone system and reduce potassium excretion. Concomitant use of these drugs with potassium supplements increases the risk of hyperkalemia. However, concomitant use of these drugs with moderate dietary potassium intake (about 3775-5200 mg daily) does not increase serum potassium levels.
Potassium-Sparing Diuretics
Concomitant use increases the risk of hyperkalemia.
Using potassium-sparing diuretics with potassium supplements increases the risk of hyperkalemia.
L-Tyrosine
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.
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.
Glycine
Clozapine (Clozaril)
Theoretically, glycine might decrease the effectiveness of clozapine.
One small clinical study in patients with schizophrenia shows that adding glycine to clozapine therapy worsens symptoms of schizophrenia when compared with clozapine alone. The mechanism of this interaction is unclear.
Brand information
Manufacturer and brand details for PUMP-HD Peaches N' Cream, from the product label.
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The Full Monographs Behind PUMP-HD Peaches N' Cream’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Glycine
Interacts with 1 drugGlycine is a non-essential amino acid your body makes on its own and that also appears in protein-rich foods. It is most studied for improving sleep quality, where early research is promisin...
Read the full Glycine monograph → Herb & supplement monographNiacin
Interacts with 727 drugsNiacin (vitamin B3) is an essential nutrient your body needs for energy and metabolism, and deficiency is uncommon in most developed countries. Prescription-strength niacin has been used to...
Read the full Niacin monograph → Herb & supplement monographBeta-alanine
Beta-alanine is an amino acid taken mostly by athletes to raise muscle carnosine, which may help buffer acid and reduce fatigue during short, high-intensity exercise. The evidence is moderat...
Read the full Beta-alanine monograph → Herb & supplement monographCreatine
Creatine is one of the most studied sports supplements, with solid evidence that it can boost strength and performance during short, high-intensity activities like weightlifting and sprintin...
Read the full Creatine monograph → Herb & supplement monographGlycerol
Glycerol (glycerin) is a sweet, syrupy compound made naturally in the body and widely used in foods, skin products, and medicines. It is well established as a laxative and a skin and eye moi...
Read the full Glycerol monograph → Herb & supplement monographAspartic Acid
Aspartic acid is a common amino acid your body makes on its own and gets from protein-rich foods, so a true deficiency is rare. D-aspartic acid is heavily marketed for boosting testosterone...
Read the full Aspartic Acid monograph → Herb & supplement monographManganese
Interacts with 83 drugsManganese is an essential trace mineral your body needs in small amounts for bone formation, metabolism, and antioxidant defense, and most people get enough from a normal diet. Supplements m...
Read the full Manganese monograph → Herb & supplement monographCalcium
Interacts with 168 drugsCalcium 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 monographPotassium
Interacts with 62 drugsPotassium is an essential mineral your body needs for nerve signals, muscle function, and a steady heartbeat, and most people get enough from a balanced diet rich in fruits and vegetables. P...
Read the full Potassium monograph → Herb & supplement monographMagnesium
Interacts with 295 drugsMagnesium is an essential mineral your body needs for muscles, nerves, blood pressure, and many other functions, and supplements are useful for preventing or correcting deficiency. Some othe...
Read the full Magnesium monograph → Herb & supplement monographTaurine
Interacts with 173 drugsTaurine is an amino acid your body makes naturally and that you also get from animal foods. It is widely used in energy drinks and sports supplements, and short-term use appears generally sa...
Read the full Taurine monograph → Herb & supplement monographCaffeine
Interacts with 655 drugsCaffeine is a natural stimulant found in coffee, tea, and many other plants and products. In moderate amounts it can boost alertness and reduce tiredness for most healthy adults, but too muc...
Read the full Caffeine monograph → Herb & supplement monographYohimbe
Interacts with 1,125 drugsYohimbe is a West African tree bark that contains yohimbine, a compound mainly promoted for erectile dysfunction and as an aphrodisiac. A prescription form of yohimbine has some evidence for...
Read the full Yohimbe monograph → Herb & supplement monographAcetyl-l-carnitine
Interacts with 203 drugsAcetyl-L-carnitine is a form of the amino acid carnitine that the body uses to help produce energy in cells. It is most studied for nerve pain and memory-related conditions, though the evide...
Read the full Acetyl-l-carnitine monograph → Herb & supplement monographOrnithine
Ornithine is a non-essential amino acid your body makes naturally as part of the urea cycle, which helps remove ammonia. It is sold as a supplement for fatigue, exercise recovery, and sleep,...
Read the full Ornithine monograph → Herb & supplement monographTyrosine
Interacts with 21 drugsL-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 monographBlueberry
Interacts with 88 drugsBlueberries are a nutritious fruit rich in antioxidants called anthocyanins, and eating them as part of a balanced diet is healthy and safe for most people. Concentrated supplements are mark...
Read the full Blueberry monograph → Herb & supplement monographMaritime Pine
Interacts with 327 drugsMaritime pine bark extract (often sold as Pycnogenol) is a plant-based antioxidant most studied for circulation, vein, and skin health. Some research is promising, but many studies are small...
Read the full Maritime Pine monograph →Sources & How We Checked
PUMP-HD Peaches N' Cream'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.
- NIH Dietary Supplement Label Database (DSLD) — The official product label on file for this supplement.
- Natural Medicines (Therapeutic Research Center) — Evidence-graded clinical reference behind the ingredient interaction data.
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 727 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.
Glycine 5 references
- Heresco-Levy U, Javitt DC, Ermilov M, et al. Efficacy of high-dose glycine in the treatment of enduring negative symptoms of schizophrenia. Arch Gen Psychiatry 1999;56:29-36.. PubMed
- Potkin SG, Jin Y, Bunney BG, Costa J, Gulasekaram B. Effect of clozapine and adjunctive high-dose glycine in treatment-resistant schizophrenia. Am J Psychiatry 1999;156:145-7.. PubMed
- Gusev EI, Skvortsova VI, Dambinova SA, et al. Neuroprotective effects of glycine for therapy of acute ischaemic stroke. Cerebrovasc Dis 2000;10:49-60. PubMed
- Inagawa K, Kawai N, Ono K, Sukegawa E, Tsubuku S, Takahashi M. Assessment of acute adverse effects of glycine ingestion at a high dose in human volunteers. Seikatsu Eisei. 2006; 50:27-32.
- Woods SW, Walsh BC, Hawkins KA, Miller TJ, Saksa JR, D'Souza DC, Pearlson GD, Javitt DC, McGlashan TH, Krystal JH. Glycine treatment of the risk syndrome for psychosis: report of two pilot studies. Eur Neuropsychopharmacol. 2013 Aug;23(8):931-40. PubMed
Manganese 21 references
- Hansten PD, Horn JR. Hansten and Horn's Drug Interactions Analysis and Management. Vancouver, CAN:Appl Therapeut, 1999.
- Barrington WW, Angle CR, Willcockson NK, et al. Autonomic function in manganese alloy workers. Environ Res 1998;78:50-8. PubMed
- Hauser RA, Zesiewicz TA, Martinez C, et al. Blood manganese correlates with brain magnetic resonance imaging changes in patients with liver disease. Can J Neurol Sci 1996;23:95-8. PubMed
- 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.
- Lee JW. Manganese intoxication. Arch Neurol 2000;57:597-9.. PubMed
- Powers KM, Smith-Weller T, Franklin GM, et al. Parkinson's disease risks associated with dietary iron, manganese, and other nutrient intakes. Neurology 2003;60:1761-6.. PubMed
- McMillan, D. E. A brief history of the neurobehavioral toxicity of manganese: some unanswered questions. Neurotoxicology 1999;20(2-3):499-507.
- Gerber, G. B., Leonard, A., and Hantson, P. Carcinogenicity, mutagenicity and teratogenicity of manganese compounds. Crit Rev Oncol Hematol. 2002;42(1):25-34. PubMed
- Jiang, Y. and Zheng, W. Cardiovascular toxicities upon manganese exposure. Cardiovasc.Toxicol 2005;5(4):345-354. PubMed
- Mehta, R. and Reilly, J. J. Manganese levels in a jaundiced long-term total parenteral nutrition patient: potentiation of haloperidol toxicity? Case report and literature review. JPEN J Parenter.Enteral Nutr 1990;14(4):428-430. PubMed
- Nemery, B. Metal toxicity and the respiratory tract. Eur Respir.J 1990;3(2):202-219. DOI
- Vanek VW, Borum P, Buchman A, et al. A.S.P.E.N. position paper: recommendations for changes in commercially available parenteral multivitamin and multi-trace element products. Nutr Clin Pract. 2012;27:440-491.doi: 10.1177/0884533612446706 PubMed
- Schuh MJ. Possible Parkinson's disease induced by chronic manganese supplement ingestion. Consult Pharm. 2016;31(12):698-703. doi: 10.4140/TCP.n.2016.698. PubMed
- Baker B, Ali A, Isenring L. Recommendations for manganese supplementation to adult patients receiving long-term home parenteral nutrition: an analysis of the supporting evidence. Nutr Clin Pract 2016;31(2):180-5. doi: 10.1177/0884533615591600. PubMed
- Ho CSH, Ho RCM, Quek AML. Chronic manganese toxicity associated with voltage-gated potassium channel complex antibodies in a relapsing neuropsychiatric disorder. Int J Environ Res Public Health 2018;15(4). pii: E783. doi: 10.3390/ijerph15040783. PubMed
- Yamamoto M, Sakurai K, Eguchi A, et al.; Japan Environment and Children's Study Group: Association between blood manganese level during pregnancy and birth size: the Japan environment and children's study (JECS). Environ Res 2019;172:117-26. PubMed
- Li D, Ge X, Liu Z, et al. Association between long-term occupational manganese exposure and bone quality among retired workers. Environ Sci Pollut Res Int 2020;27(1):482-9. PubMed
- Martin KV, Sucharew H, Dietrich KN, et al. Co-exposure to manganese and lead and pediatric neurocognition in East Liverpool, Ohio. Environ Res 2021;202:111644. PubMed
- Racette BA, Nelson G, Dlamini WW, et al. Depression and anxiety in a manganese-exposed community. Neurotoxicology 2021;85:222-33. PubMed
- Ruiz-Azcona L, Fernández-Olmo I, Expósito A, et al. Impact of environmental airborne manganese exposure on cognitive and motor functions in adults: a systematic review and meta-analysis. Int J Environ Res Public Health 2021;18(8):4075. PubMed
- Uyar E, Gurkas E, Aksu AU, et al. Can therapeutic plasma exchange be life-saving in life-threatening manganese intoxication?. Transfus Apher Sci 2022;61(4):103417. PubMed
Taurine 21 references
- Ahmad S, Robertson HT, Golper TA, et al. Multicenter trial of L-carnitine in maintenance hemodialysis patients. II. Clinical and biochemical effects. Kidney Int 1990;38:912-8. PubMed
- Machado-Vieira R, Viale CI, Kapczinski F. Mania associated with an energy drink: the possible role of caffeine, taurine, and inositol. Can J Psychiatry 2001;46:454-5. PubMed
- Obermann M, Schorn CF, Mummel P, et al. Taurine induced toxic encephalopathy? Clin Neurol Neurosurg 2006;108:812-3. PubMed
- Bichler, A., Swenson, A., and Harris, M. A. A combination of caffeine and taurine has no effect on short term memory but induces changes in heart rate and mean arterial blood pressure. Amino Acids 2006;31(4):471-476. PubMed
- Iyadurai, S. J. and Chung, S. S. New-onset seizures in adults: possible association with consumption of popular energy drinks. Epilepsy Behav 2007;10(3):504-508. PubMed
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