Replace SR Ingredients & Drug Interactions
What is this page for?
First and foremost: checking Replace SR 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
Replace SR is a dietary supplement by Endurance Products Company with 5 active ingredients. Its ingredients are commonly taken for replacing fluids and electrolytes, preventing dehydration during exercise or illness, treating low blood sodium (under medical care).Based on those ingredients, 467 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are Magnesium, Sodium, Potassium. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against Replace SR by Endurance Products Company
Ask about any prescription or over-the-counter medication and we check it for interactions with Replace SR by Endurance Products Company — 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 Replace SR by Endurance Products Company
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
Full disclosure
Replace SR contains five active minerals: sodium, potassium, phosphorus, magnesium, and chloride. These are electrolytes — salts your body uses to maintain fluid balance, nerve and muscle function, and heart rhythm.
The product is designed as an electrolyte replacement, typically used by endurance athletes or people in hot climates who lose minerals through sweat. The tablet also contains inactive ingredients (fillers and binders) including monosodium phosphate, sodium chloride, vegetable wax, potassium chloride, magnesium citrate, stearic acid, silica, and magnesium stearate.
Note that some inactive ingredients — such as sodium chloride and potassium chloride — are also mineral salts, so the total sodium and potassium in each dose may be higher than the active ingredient amounts alone.
Does it work?
Strong evidence
Magnesium in this product is effective for dyspepsia (indigestion), constipation, low magnesium levels (hypomagnesemia), and preventing pre-eclampsia in pregnancy. Sodium and potassium are essential electrolytes, though the facts we hold don't provide effectiveness ratings for their roles in endurance or general athletic performance.
Phosphorus and chloride are also necessary minerals, but we have no effectiveness data on file for those. For use as an electrolyte-replacement drink or tablet during or after exercise, the evidence isn't established in the data we hold.
How safe is it?
Well-documented data
Magnesium is generally well tolerated at recommended doses and is likely safe in pregnancy and possibly safe while breastfeeding, though supplements should be used only under your doctor's guidance in both cases. The most common side effects from magnesium are diarrhea, nausea, vomiting, and gastrointestinal irritation.
Sodium is essential but too much raises blood pressure and strains your heart; normal dietary sodium is fine, but sodium supplements or very high intake should be avoided without medical advice. The facts note that high sodium intake is linked to gastric cancer risk in population studies.
Potassium from food is safe, but supplements can cause dangerously high blood levels, especially in people with kidney disease; it's likely safe in pregnancy and breastfeeding at dietary amounts. We don't have safety data on file for phosphorus or chloride.
Meds to double-check
Major interaction found
Check with your pharmacist before taking this product if you use levodopa/carbidopa (Sinemet) — magnesium is a major concern here. Also double-check if you take blood pressure drugs (especially ACE inhibitors or ARBs), potassium-sparing diuretics, lithium, corticosteroids, skeletal muscle relaxants, calcium channel blockers, sulfonylureas (diabetes drugs), quinolone or other antibiotics, or bisphosphonates.
These interactions carry moderate severity and spacing doses or dose adjustment may be needed.
The bottom line
Scorecard at a glanceFully disclosed formula with clinical evidence supporting its stated purpose. Major medication interactions have been identified, and safety information is well characterized.
Replace SR is designed for athletes and active people who need electrolyte replacement. If you take blood pressure drugs, lithium, Parkinson's medication, heart or diabetes drugs, or bisphosphonates, check your exact medications with the tool below first — several of them don't mix well with this product's minerals.
Talk with your pharmacist before starting if you have kidney disease, high blood pressure, or take any prescription medication.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 3 of 5 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Jun 25, 2018.
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 Replace SR, straight from the product label.
| Brand | Endurance Products Company |
|---|---|
| Barcode (UPC) | 729135116904 |
| Net contents | 90 Tablet(s) |
| Market status | On market |
| Date entered into DSLD | Jun 25, 2018 |
| DSLD ID | 177697 |
| Product type | Mineral |
| Supplement form | Tablet Or Pill |
| Dietary claims / uses | All Other, Structure/Function |
| Intended target group(s) | Adult (18 - 50 Years), Sugar Free |
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 Replace SR by Endurance Products Company, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Sodium | 175 mg | 8% |
| Potassium | 65 mg | 1% |
| Phosphorus | 103 mg | 8% |
| Magnesium | 10 mg | 2% |
| Chloride | 211 mg | 38% |
Other ingredients: Monosodium Phosphate, Sodium Chloride, Vegetable Wax, Potassium Chloride, Magnesium Citrate, Stearic Acid, Silica, Magnesium Stearate
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.
Formulation
No sugar, starch, artificial flavors, colors, sweeteners or preservatives.
Precautions
Consult your healthcare professional prior to use if you have or suspect a medical condition, including high blood pressure, are taking any medications, are pregnant or nursing, or are sensitive to salt.
Keep out of reach of children.
Do not use if seal is broken or missing.
Do not exceed the recommend dosage without consulting your physician or team doctor.
Storage
Store in a cool, dry place.
General Statements
Formulated to release electrolytes over a 4–6 hour period.
Sustained release
Electrolyte
Buffered and balanced electrolyte replacement
FDA Disclaimer Statement
These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease
FDA Statement of Identity
Dietary Supplement
Suggested/Recommended/Usage/Directions
Suggested Use: As an electrolyte replacement, take 1–3 tablets with a large glass of water one-half hour prior to physical activity that results in fluid loss. Dose depends on duration of activity and volume to fluid loss. Replace SR can also be taken after fluid loss to help restore electrolyte and fluid balance. Drink plenty of water according to thirst. Do not exceed the recommend dosage without consulting your physician or team doctor.
General
11690
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Replace SR by Endurance Products Company 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 Replace SR by Endurance Products Company
These are the 5 active ingredients this product is made of. Select any to open its full monograph.
Serving size1 Tablet(s) Dosage formTablet Or Pill Amounts shown are per serving.
Most supplement products combine several ingredients, and a medication can interact with the product through any one of them. Each ingredient below shows whether it has known drug interactions.
Sodium
Interacts with205 drugs
Sodium is an essential mineral and electrolyte your body needs to balance fluids, support nerves, and help muscles work. Most people in modern diets g...
Sodium monograph & interactionsPotassium
Interacts with62 drugs
Potassium is an essential mineral your body needs for nerve signals, muscle function, and a steady heartbeat, and most people get enough from a balanc...
Potassium monograph & interactionsPhosphorus
Magnesium
Interacts with295 drugs
Magnesium is an essential mineral your body needs for muscles, nerves, blood pressure, and many other functions, and supplements are useful for preven...
Magnesium monograph & interactionsChloride
Other (inactive) ingredients: Monosodium Phosphate, Sodium Chloride, Vegetable Wax, Potassium Chloride, Magnesium Citrate, Stearic Acid, Silica, Magnesium Stearate. These complete the product’s ingredient list but are not active constituents.
Replace SR by Endurance Products Company Drug Interactions
HelloPharmacist Interaction Report
Replace SR by Endurance Products Company contains sodium, potassium, magnesium, phosphorus, and chloride — minerals meant to support endurance and electrolyte balance.
The product does interact with medications, and the most serious concern is magnesium's Major interaction with levodopa/carbidopa (Sinemet), a Parkinson's drug: magnesium can cut the drug's effectiveness by up to 35–81%, depending on which component you're measuring.
Read the full breakdown — every affected drug type, severity by severity
Sodium in this product can moderate-severity reduce how well blood pressure medications work, and it poses a moderate risk of high blood sodium (hypernatremia) if you're also taking corticosteroids, didanosine (Videx), sodium phosphate bowel-prep solutions, tolvaptan (Samsca), or other sodium-containing drugs. Sodium also interacts with lithium by potentially raising lithium levels to toxic ranges if you cut sodium intake, or lowering them if you raise it.
Potassium carries moderate risk of dangerously high blood potassium (hyperkalemia) when combined with potassium-sparing diuretics, ACE inhibitors, or ARBs, especially at higher doses. Magnesium also has moderate interactions with skeletal muscle relaxants (prolonging their effect), some diuretics, calcium channel blockers, antacids, sulfonylureas (diabetes drugs — risk of low blood sugar), quinolone antibiotics, and bisphosphonates (bone drugs) — spacing doses 2–6 hours apart can help with some of these.
We could not check phosphorus and chloride because we hold no interaction data for them. Run your exact medications through the search tool on this page before you start.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against Replace SR?
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 Replace SR interact with 467 drugs. Click any drug to see the details.
3 of the 5 ingredients in Replace SR interact with drugs. Each result below shows which ingredient is responsible. Magnesium Sodium Potassium
Bendroflumethiazide, NadololCorzide
How Bendroflumethiazide, Nadolol interacts with Replace SR — through 1 ingredient. Tap an ingredient for the detail:
SodiumAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, a high intake of dietary sodium might reduce the effectiveness of antihypertensive drugs.
Read the full Sodium + Bendroflumethiazide, Nadolol interactionBendroflumethiazide, PotassiumCentyl K, Neo-NaClex-K
How Bendroflumethiazide, Potassium interacts with Replace SR — through 2 ingredients. Tap an ingredient for the detail:
PotassiumPotassium-sparing Diuretics Moderate
Interaction Summary
Concomitant use increases the risk of hyperkalemia.
Read the full Potassium + Bendroflumethiazide, Potassium interactionMagnesiumPotassium-sparing Diuretics Moderate
Interaction Summary
Potassium-sparing diuretics decrease excretion of magnesium, possibly increasing magnesium levels.
Read the full Magnesium + Bendroflumethiazide, Potassium interactionBendroflumethiazide, Rauwolfia SerpentinaRauzide
How Bendroflumethiazide, Rauwolfia Serpentina interacts with Replace SR — through 1 ingredient. Tap an ingredient for the detail:
SodiumAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, a high intake of dietary sodium might reduce the effectiveness of antihypertensive drugs.
Read the full Sodium + Bendroflumethiazide, Rauwolfia Serpentina interactionBenzthiazideExna
How Benzthiazide interacts with Replace SR — through 1 ingredient. Tap an ingredient for the detail:
SodiumAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, a high intake of dietary sodium might reduce the effectiveness of antihypertensive drugs.
Read the full Sodium + Benzthiazide interactionBepridilVascor
How Bepridil interacts with Replace SR — through 1 ingredient. Tap an ingredient for the detail:
MagnesiumCalcium Channel Blockers Moderate
Interaction Summary
Magnesium can have additive effects with calcium channel blockers, although evidence is conflicting.
Read the full Magnesium + Bepridil interactionBetamethasoneCelestone, Diprolene AF, Diprosone
How Betamethasone interacts with Replace SR — through 1 ingredient. Tap an ingredient for the detail:
SodiumCorticosteroids Moderate
Interaction Summary
Concomitant use of mineralocorticoids and some glucocorticoids with sodium supplements might increase the risk of hypernatremia.
Read the full Sodium + Betamethasone interactionBetamethasone DipropionateSernivo
How Betamethasone Dipropionate interacts with Replace SR — through 1 ingredient. Tap an ingredient for the detail:
SodiumCorticosteroids Moderate
Interaction Summary
Concomitant use of mineralocorticoids and some glucocorticoids with sodium supplements might increase the risk of hypernatremia.
Read the full Sodium + Betamethasone Dipropionate interactionBetamethasone Dipropionate, CalcipotrieneEnstilar, Wynzora
How Betamethasone Dipropionate, Calcipotriene interacts with Replace SR — through 1 ingredient. Tap an ingredient for the detail:
SodiumCorticosteroids Moderate
Interaction Summary
Concomitant use of mineralocorticoids and some glucocorticoids with sodium supplements might increase the risk of hypernatremia.
Read the full Sodium + Betamethasone Dipropionate, Calcipotriene interactionBetamethasone ValerateLuxiq
How Betamethasone Valerate interacts with Replace SR — through 1 ingredient. Tap an ingredient for the detail:
SodiumCorticosteroids Moderate
Interaction Summary
Concomitant use of mineralocorticoids and some glucocorticoids with sodium supplements might increase the risk of hypernatremia.
Read the full Sodium + Betamethasone Valerate interactionBetaxololBetoptic, Kerlone
How Betaxolol interacts with Replace SR — through 1 ingredient. Tap an ingredient for the detail:
SodiumAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, a high intake of dietary sodium might reduce the effectiveness of antihypertensive drugs.
Read the full Sodium + Betaxolol interactionBictegravir, Emtricitabine, Tenofovir AlafenamideBiktarvy
How Bictegravir, Emtricitabine, Tenofovir Alafenamide interacts with Replace SR — through 1 ingredient. Tap an ingredient for the detail:
MagnesiumBictegravir/emtricitabine/tenofovir Alafenamide (biktarvy) Moderate
Interaction Summary
Magnesium might decrease levels of bictegravir/emtricitabine/tenofovir alafenamide by reducing its absorption.
Read the full Magnesium + Bictegravir, Emtricitabine, Tenofovir Alafenamide interactionBismuth Subcarbonate, Calcium Carbonate, OpiumDiabismul
How Bismuth Subcarbonate, Calcium Carbonate, Opium interacts with Replace SR — through 1 ingredient. Tap an ingredient for the detail:
MagnesiumAntacids Moderate
Interaction Summary
Use of acid reducers may reduce the laxative effect of magnesium oxide.
Read the full Magnesium + Bismuth Subcarbonate, Calcium Carbonate, Opium interactionBismuth Subsalicylate, Metronidazole, TetracyclineHelidac
How Bismuth Subsalicylate, Metronidazole, Tetracycline interacts with Replace SR — through 1 ingredient. Tap an ingredient for the detail:
MagnesiumTetracycline Antibiotics Moderate
Interaction Summary
Magnesium decreases absorption of tetracyclines.
Read the full Magnesium + Bismuth Subsalicylate, Metronidazole, Tetracycline interactionBisoprololZebeta
How Bisoprolol interacts with Replace SR — through 1 ingredient. Tap an ingredient for the detail:
SodiumAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, a high intake of dietary sodium might reduce the effectiveness of antihypertensive drugs.
Read the full Sodium + Bisoprolol interactionBisoprolol, HydrochlorothiazideZiac
How Bisoprolol, Hydrochlorothiazide interacts with Replace SR — through 1 ingredient. Tap an ingredient for the detail:
SodiumAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, a high intake of dietary sodium might reduce the effectiveness of antihypertensive drugs.
Read the full Sodium + Bisoprolol, Hydrochlorothiazide interactionBosentanTracleer
How Bosentan interacts with Replace SR — through 1 ingredient. Tap an ingredient for the detail:
SodiumAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, a high intake of dietary sodium might reduce the effectiveness of antihypertensive drugs.
Read the full Sodium + Bosentan interactionBudesonideEntocort EC, Eohilia, Pulmicort, Tarpeyo, Uceris
How Budesonide interacts with Replace SR — through 1 ingredient. Tap an ingredient for the detail:
SodiumCorticosteroids Moderate
Interaction Summary
Concomitant use of mineralocorticoids and some glucocorticoids with sodium supplements might increase the risk of hypernatremia.
Read the full Sodium + Budesonide interactionBumetanideBurinex
How Bumetanide interacts with Replace SR — through 1 ingredient. Tap an ingredient for the detail:
SodiumAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, a high intake of dietary sodium might reduce the effectiveness of antihypertensive drugs.
Read the full Sodium + Bumetanide interactionBumetanide (iv)Bumex
How Bumetanide (iv) interacts with Replace SR — through 1 ingredient. Tap an ingredient for the detail:
SodiumAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, a high intake of dietary sodium might reduce the effectiveness of antihypertensive drugs.
Read the full Sodium + Bumetanide (iv) interactionBumetanide (oral)Bumex
How Bumetanide (oral) interacts with Replace SR — through 1 ingredient. Tap an ingredient for the detail:
SodiumAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, a high intake of dietary sodium might reduce the effectiveness of antihypertensive drugs.
Read the full Sodium + Bumetanide (oral) interactionBumetanide, PotassiumBurinex K
How Bumetanide, Potassium interacts with Replace SR — through 2 ingredients. Tap an ingredient for the detail:
PotassiumPotassium-sparing Diuretics Moderate
Interaction Summary
Concomitant use increases the risk of hyperkalemia.
Read the full Potassium + Bumetanide, Potassium interactionMagnesiumPotassium-sparing Diuretics Moderate
Interaction Summary
Potassium-sparing diuretics decrease excretion of magnesium, possibly increasing magnesium levels.
Read the full Magnesium + Bumetanide, Potassium interactionCalcium CarbonateAdcal, Adcal-D3, Calcichew, Os-Cal, Tums
How Calcium Carbonate interacts with Replace SR — through 1 ingredient. Tap an ingredient for the detail:
MagnesiumAntacids Moderate
Interaction Summary
Use of acid reducers may reduce the laxative effect of magnesium oxide.
Read the full Magnesium + Calcium Carbonate interactionCandesartan CilexetilAmias, Atacand
How Candesartan Cilexetil interacts with Replace SR — through 2 ingredients. Tap an ingredient for the detail:
SodiumAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, a high intake of dietary sodium might reduce the effectiveness of antihypertensive drugs.
Read the full Sodium + Candesartan Cilexetil interactionPotassiumAngiotensin Receptor Blockers (arbs) Moderate
Interaction Summary
Using ARBs with high doses of potassium increases the risk of hyperkalemia.
Read the full Potassium + Candesartan Cilexetil interactionCandesartan Cilexetil, HydrochlorothiazideAtacand HCT
How Candesartan Cilexetil, Hydrochlorothiazide interacts with Replace SR — through 2 ingredients. Tap an ingredient for the detail:
PotassiumAngiotensin Receptor Blockers (arbs) Moderate
Interaction Summary
Using ARBs with high doses of potassium increases the risk of hyperkalemia.
Read the full Potassium + Candesartan Cilexetil, Hydrochlorothiazide interactionSodiumAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, a high intake of dietary sodium might reduce the effectiveness of antihypertensive drugs.
Read the full Sodium + Candesartan Cilexetil, Hydrochlorothiazide interactionCaptoprilAcepril, Capoten
How Captopril interacts with Replace SR — through 2 ingredients. Tap an ingredient for the detail:
PotassiumAce Inhibitors (aceis) Moderate
Interaction Summary
Using ACEIs with high doses of potassium increases the risk of hyperkalemia.
Read the full Potassium + Captopril interactionSodiumAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, a high intake of dietary sodium might reduce the effectiveness of antihypertensive drugs.
Read the full Sodium + Captopril interactionCaptopril, HydrochlorothiazideAcezide, Capozide
How Captopril, Hydrochlorothiazide interacts with Replace SR — through 2 ingredients. Tap an ingredient for the detail:
SodiumAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, a high intake of dietary sodium might reduce the effectiveness of antihypertensive drugs.
Read the full Sodium + Captopril, Hydrochlorothiazide interactionPotassiumAce Inhibitors (aceis) Moderate
Interaction Summary
Using ACEIs with high doses of potassium increases the risk of hyperkalemia.
Read the full Potassium + Captopril, Hydrochlorothiazide interactionCarisoprodolRela, Soma
How Carisoprodol interacts with Replace SR — through 1 ingredient. Tap an ingredient for the detail:
MagnesiumSkeletal Muscle Relaxants Moderate
Interaction Summary
Parenteral magnesium alters the pharmacokinetics of skeletal muscle relaxants, increasing their effects and accelerating the onset of effect.
Read the full Magnesium + Carisoprodol interactionCarteololCartrol, Ocupress
How Carteolol interacts with Replace SR — through 1 ingredient. Tap an ingredient for the detail:
SodiumAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, a high intake of dietary sodium might reduce the effectiveness of antihypertensive drugs.
Read the full Sodium + Carteolol interactionCarvedilolCoreg, Coreg CR
How Carvedilol interacts with Replace SR — through 1 ingredient. Tap an ingredient for the detail:
SodiumAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, a high intake of dietary sodium might reduce the effectiveness of antihypertensive drugs.
Read the full Sodium + Carvedilol interactionCeliprololCelicard
How Celiprolol interacts with Replace SR — through 1 ingredient. Tap an ingredient for the detail:
SodiumAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, a high intake of dietary sodium might reduce the effectiveness of antihypertensive drugs.
Read the full Sodium + Celiprolol interactionEach ingredient & the kinds of drugs it affects
For each ingredient in Replace SR 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.
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.
Sodium
Antihypertensive Drugs
Theoretically, a high intake of dietary sodium might reduce the effectiveness of antihypertensive drugs.
High intake of dietary sodium can increase systolic and diastolic blood pressure. Also, high intake of sodium may necessitate increased use of antihypertensive medications to achieve blood pressure control in some patients, such as those with chronic kidney disease.
Corticosteroids
Concomitant use of mineralocorticoids and some glucocorticoids with sodium supplements might increase the risk of hypernatremia.
Mineralocorticoids and some glucocorticoids (corticosteroids) cause sodium retention. This effect is dose-related and depends on mineralocorticoid potency. It is most common with hydrocortisone, cortisone, and fludrocortisone, followed by prednisone and prednisolone.
Didanosine (Videx)
Concomitant use of didanosine with additional sodium from dietary or supplemental sources may increase the risk of hypernatremia.
Didanosine formulations contain a significant amount of sodium.
Lithium
Altering dietary intake of sodium might alter the levels and clinical effects of lithium.
High sodium intake can reduce plasma concentrations of lithium by increasing lithium excretion. Reducing sodium intake can significantly increase plasma concentrations of lithium and cause lithium toxicity in patients being treated with lithium carbonate. Stabilizing sodium intake is shown to reduce the percentage of patients with lithium level fluctuations above 0.8 mEq/L. Patients taking lithium should avoid significant alterations in their dietary intake of sodium.
Sodium Phosphates
Theoretically, concomitant use of sodium phosphate with sodium supplements might increase the risk of hypernatremia.
Use of high doses (> 45 mL in 24 hours) of sodium phosphate, such as those used for bowel cleansing before surgery, can lead to serious electrolyte disturbances, including hypernatremia. The risk of hypernatremia is highest in the elderly and people with other risk factors for electrolyte disturbances.
Sodium-Containing Drugs
Concomitant use of sodium-containing drugs with additional sodium from dietary or supplemental sources may increase the risk of hypernatremia and long-term sodium-related complications.
The Chronic Disease Risk Reduction (CDRR) intake level of 2.3 grams of sodium daily indicates the intake at which it is believed that chronic disease risk increases for the apparently healthy population. Some medications contain high quantities of sodium. When used in conjunction with sodium supplements or high-sodium diets, the CDRR may be exceeded. Additionally, concomitant use may increase the risk for hypernatremia; this risk is highest in the elderly and people with other risk factors for electrolyte disturbances.
Tolvaptan (Samsca)
Theoretically, concomitant use of tolvaptan with sodium might increase the risk of hypernatremia.
Tolvaptan is a vasopressin receptor 2 antagonist that is used to increase sodium levels in patients with hyponatremia. Patients taking tolvaptan should use caution with the use of sodium salts such as sodium chloride.
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.
Brand information
Manufacturer and brand details for Replace SR, from the product label.
Endurance Products Company
See all Endurance Products Company products- Name
- Endurance Products Company
- Street Address
- PO Box 3810
- City
- Tualatin
- State
- OR
- ZipCode
- 97062
- Phone Number
- 1-800-483-2532
- Web Address
- www.endur.com
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Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
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Label information is sourced from the NIH Dietary Supplement Label Database and reflects the product version on file; always read your actual product label. This page is for education only and is not a substitute for professional medical advice. Confirm with your pharmacist or doctor before combining supplements and medications.
The Full Monographs Behind Replace SR’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Sodium
Interacts with 205 drugsSodium is an essential mineral and electrolyte your body needs to balance fluids, support nerves, and help muscles work. Most people in modern diets get more than enough—often too much—from...
Read the full Sodium 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 →Sources & How We Checked
Replace SR'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 132 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.
Sodium 38 references
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- Goldsmith SR. Hyponatremia in heart failure: time for a trial. J Card Fail 2013;19(6):398-400. PubMed
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- Mente A, O'Donnell M, Rangarajan S, et al. Associations of urinary sodium excretion with cardiovascular events in individuals with and without hypertension: a pooled analysis of data from four studies. Lancet. 2016;388(10043):465-75. PubMed
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- Stallings VA, Harrison M, Oria M; Committee to Review the Dietary Reference Intakes for Sodium and Potassium, Food and Nutrition Board, Health and Medicine Division, National Academies of Sciences, Engineering, and Medicine. Washington (DC): National Acad
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- Yancy CW. Sodium Restriction in Heart Failure: Too Much Uncertainty-Do the Trials. JAMA Intern Med. 2018 Dec 1;178(12):1700-1701. PubMed
- He FJ, Campbell NRC, Ma Y, MacGregor GA, Cogswell ME, Cook NR. Errors in estimating usual sodium intake by the Kawasaki formula alter its relationship with mortality: implications for public health. Int J Epidemiol. 2018;47(6):1784-1795. PubMed
- Murthy K, Ondrey GJ, Malkani N, et al. THE EFFECTS OF HYPONATREMIA ON BONE DENSITY AND FRACTURES: A SYSTEMATIC REVIEW AND META-ANALYSIS. Endocr Pract. 2019;25(4):366-378. PubMed
- Messerli FH, Hofstetter L, Syrogiannouli L, et al. Sodium intake, life expectancy, and all-cause mortality. Eur Heart J 2021;42(21):2103-2112. PubMed
- Graudal NA, Hubeck-Graudal T, Jurgens G. Effects of low sodium diet versus high sodium diet on blood pressure, renin, aldosterone, catecholamines, cholesterol, and triglyceride. Cochrane Database Syst Rev 2020;12(12):CD004022. PubMed
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- Nan X, Lu H, Wu J, et al. The interactive association between sodium intake, alcohol consumption and hypertension among elderly in northern China: a cross-sectional study. BMC Geriatr 2021;21(1):135. PubMed
- Kyozuka H, Fukusda T, Murata T, et al. Impact of preconception sodium intake on hypertensive disorders of pregnancy: The Japan Environment and Children's study. Pregnancy Hypertens 2021;23:66-72. PubMed
- Zhao L, Ogden CL, Yang Q, et al. Association of usual sodium intake with obesity among US children and adolescents, NHANES 2009-2016. Obesity (Silver Spring) 2021;29(3):587-594. PubMed
- Ma Y, He FJ, Sun Q, et al. 24-Hour urinary sodium and potassium excretion and cardiovascular risk. N Engl J Med 2022;386(3):252-263. PubMed
- Liu J, Yang X, Zhang P, et al. Association of urinary sodium excretion and left ventricular hypertrophy in people with type 2 diabetes mellitus: A cross-sectional study. Front Endocrinol (Lausanne) 2021;12:728493. PubMed
- Filippini T, Malavolti M, Whelton PK, Vinceti M. Sodium intake and risk of hypertension: A systematic review and dose-response meta-analysis of observational cohort studies. Curr Hypertens Rep 2022;24(5):133-144. PubMed
- Wang DD, Li Y, Nguyen XT, et al. Dietary sodium and potassium intake and risk of non-fatal cardiovascular diseases: The million veteran program. Nutrients 2022;14(5):1121. PubMed
- Kwak JH, Park CH, Eun CS, et al. The associations of dietary intake of high sodium and low zinc with gastric cancer mortality: A prospective cohort study in Korea. Nutr Cancer 2022;74(10):3501-3508. PubMed
- George S, Maiti R, Mishra BR, Jena M, Mohapatra D. Effect of regulated add-on sodium chloride intake on stabilization of serum lithium concentration in bipolar disorder: A randomized controlled trial. Bipolar Disord 2023;25(1):66-75. PubMed
- Zhou TL, Schütten MTJ, Kroon AA, et al. Urinary Sodium Excretion and Salt Intake Are Not Associated With Blood Pressure Variability in a White General Population. J Am Heart Assoc 2023;12(1):e026578. PubMed
Potassium 12 references
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- Gennaro A. Remington: The Science and Practice of Pharmacy. 19th ed. Lippincott: Williams & Wilkins, 1996.
- Whelton PK, He J, Cutler JA, et al. Effects of oral potassium on blood pressure. Meta-analysis of randomized controlled clinical trials. JAMA 1997;277:1624-32. PubMed
- Phillips, C. O., Kashani, A., Ko, D. K., Francis, G., and Krumholz, H. M. Adverse effects of combination angiotensin II receptor blockers plus angiotensin-converting enzyme inhibitors for left ventricular dysfunction: a quantitative review of data from ra DOI
- Altieri, P. I., Herrero, C., Suero, R., and Ortiz, A. Bleeding duodenal ulcer in a patient taking slow-releasing potassium tablets. Bol.Asoc.Med P.R. 1977;69(8):276.
- Raf, L. E. Enteric-coated potassium chloride tablets and ulcer of the small intestine. Acta Chir Scand Suppl 1967;(374):1-87.
- Potassium chloride oral solution [package insert]. Allentown, PA: Lehigh Valley Technologies, Inc.; 2014.
- Potassium chloride injection [package insert]. Lake Forest, IL: Hospira Inc.; 2009.
- Patel RB, Tannenbaum S, Viana-Tejedor A, et al. Serum potassium levels, cardiac arrhythmias, and mortality following non-ST-elevation myocardial infarction or unstable angina: insights from MERLIN-TIMI 36. Eur Heart J Acute Cardiovasc Care 2017 Feb;6(1):1 PubMed
- Malta D, Arcand J, Ravindran A, Floras V, Allard JP, Newton GE. Adequate intake of potassium does not cause hyperkalemia in hypertensive individuals taking medications that antagonize the renin angiotensin aldosterone system. Am J Clin Nutr 2016 Oct;104(4 PubMed
- Keskin M, Kaya A, Tatlisu MA, et al. The effect of serum potassium level on in-hospital and long-term mortality in ST elevation myocardial infarction. Int J cardiol. 2016 Oct 15;221:505-10.
- Stallings VA, Harrison M, Oria M; Committee to Review the Dietary Reference Intakes for Sodium and Potassium, Food and Nutrition Board, Health and Medicine Division, National Academies of Sciences, Engineering, and Medicine. Washington (DC): National Acad
Magnesium 82 references
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- Covington TR, et al. Handbook of Nonprescription Drugs. 11th ed. Washington, DC: American Pharmaceutical Association, 1996.
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- Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride. Washington, DC: National Academy Press, 1999. Available at: http://books.nap.edu/books/0309063507/html/index.html.
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