RePlenish Ingredients & Drug Interactions
by Zemvelo
What is this page for?
First and foremost: checking RePlenish 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
RePlenish is a dietary supplement by Zemvelo 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 RePlenish by Zemvelo
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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 RePlenish by Zemvelo
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
RePlenish is a 5-ingredient electrolyte liquid. The three active electrolytes are sodium, potassium, and magnesium — the main minerals your body needs to balance fluid, nerve signals, and muscle work.
The product also contains chloride and trace minerals as active ingredients. Inactive ingredients are water, CHD-FA fulvic acid, and sorbic acid (a preservative).
Does it work?
Strong evidence
Sodium has established uses: it's rated likely effective for cystic fibrosis and possibly effective for amphotericin B kidney damage. The data on file doesn't have effectiveness ratings for potassium.
Magnesium is effective for dyspepsia (indigestion), constipation, magnesium deficiency (hypomagnesemia), and prevention of pre-eclampsia in pregnancy. We hold no effectiveness ratings for chloride or trace minerals.
How safe is it?
Well-documented data
Sodium is well tolerated in normal dietary amounts, but the safety notes warn against supplements or high intake without medical advice — too much is linked to high blood pressure and heart strain. Potassium from food is safe; supplements can cause dangerously high blood levels, especially in people with kidney disease.
Magnesium is generally safe for healthy adults at recommended amounts. In pregnancy, magnesium is rated possibly unsafe at high doses; the safety notes say to use supplements only under a doctor's guidance.
Common side effects of magnesium include diarrhea, nausea, and vomiting. Rare serious effects of sodium include worsening heart and kidney disease; rare serious potassium effects include heart rhythm problems and cardiac arrest.
Meds to double-check
Major interaction found
Check your medications against these types before taking this product: levodopa/carbidopa (Parkinson's) — the most serious; blood pressure drugs (antihypertensives, ACE inhibitors, ARBs, calcium channel blockers); potassium-sparing diuretics and other water pills; lithium; corticosteroids; skeletal muscle relaxants; quinolone and other antibiotics; bisphosphonates; sulfonylurea diabetes drugs; and antacids. Use the medication search tool on this page with your exact drug names.
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.
RePlenish is an electrolyte replacement for dehydration or mineral loss, especially useful if you have cystic fibrosis or are recovering from certain infections. If you take blood pressure drugs, lithium, Parkinson's medication, diuretics, or antibiotics, check your exact medications with the tool before starting — several of these can interact.
Talk to your pharmacist or doctor, especially if you have kidney disease, heart disease, or are pregnant.
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 Jul 24, 2025.
This Scorecard evaluates available label information, ingredient evidence, and known medication-safety considerations. It does not independently verify product identity, purity, potency, contamination, or manufacturing quality. How these ratings are computed
General information
Key facts about RePlenish, straight from the product label.
| Brand | Zemvelo |
|---|---|
| Barcode (UPC) | 891663002032 |
| Net contents | 4 Fluid Ounce(s); 120 mL |
| Market status | On market |
| Date entered into DSLD | Jul 24, 2025 |
| DSLD ID | 333502 |
| Product type | Mineral |
| Supplement form | Liquid |
| Dietary claims / uses | All Other, Structure/Function |
| Intended target group(s) | Children 4 or More Years of Age, Vegan, Vegetarian, Adult (18 - 50 Years), Gluten Free, Dairy 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 RePlenish by Zemvelo, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Sodium | 5 mg | 1% |
| Potassium | 120 mg | 3% |
| Magnesium | 30 mg | 7% |
| Chloride | 185 mg | 8% |
| Trace Minerals | 144 mg | -- |
Other ingredients: Water, CHD-FA Fulvic Acid, Sorbic Acid
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
Provides natural energy support Replenishes electrolytes Supports healthy muscles & endurance Helps maintain the body’s hydration
Vegan
Gluten-free Non GMO
3rd Party Tested cGMP
FDA Disclaimer Statement
These statements have not been evaluated by the FDA. This product is not intended to diagnose, treat, cure or prevent any disease.
Formula
RePlenish + CHD-Fulvic Acid for Enhanced Absorption
FDA Statement of Identity
Dietary Supplement
Suggested/Recommended/Usage/Directions
Directions: Adults: Place up to 1/2 tsp (2.5 ml) into 8–16 oz of water. Stir or shake well.
Precautions
Children under 4: Consult your physician.
Do not use if tamper evident seal is broken or missing.
Storage
For freshness, keep refrigerated after opening.
General Statements
"Love & gratitude"
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
RePlenish by Zemvelo 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 RePlenish by Zemvelo
These are the 5 active ingredients this product is made of. Select any to open its full monograph.
Serving size2.5 mL Dosage formLiquid Servings per container48 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 & interactionsMagnesium
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
Trace Minerals
Other (inactive) ingredients: Water, CHD-FA Fulvic Acid, Sorbic Acid. These complete the product’s ingredient list but are not active constituents.
RePlenish by Zemvelo Drug Interactions
HelloPharmacist Interaction Report
RePlenish by Zemvelo contains sodium, potassium, and magnesium — all electrolytes that interact with a number of medications.
The most serious is magnesium with levodopa/carbidopa (Sinemet), a Parkinson's drug: magnesium can cut the drug's effectiveness by about a third, which matters when you're managing tremor and stiffness.
Read the full breakdown — every affected drug type, severity by severity
Sodium poses Moderate-level risks with blood pressure medications (antihypertensives), heart and kidney drugs, lithium for bipolar disorder, corticosteroids, and HIV medication (didanosine). High sodium intake can blunt blood pressure control and, with lithium, tip levels toward toxicity.
Potassium carries Moderate risks with three major classes: potassium-sparing water pills, ACE inhibitors, and ARB blood pressure drugs — all can trap potassium in your body, raising it to dangerous levels. Magnesium additionally interacts with muscle relaxants, certain antibiotics (quinolones and bisphosphonates for bone), diabetes drugs (sulfonylureas), antacids, and calcium channel blockers for blood pressure.
We could not check Chloride or Trace Minerals — no interaction data is on file for them. Altogether, these interactions span 463 individual medications.
Before you start, search your exact medications in the tool on this page.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against RePlenish?
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 RePlenish interact with 467 drugs. Click any drug to see the details.
3 of the 5 ingredients in RePlenish interact with drugs. Each result below shows which ingredient is responsible. Magnesium Sodium Potassium
Benserazide, LevodopaMadopar, Prolopa
How Benserazide, Levodopa interacts with RePlenish — 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 + Benserazide, Levodopa interactionCarbidopaLodosyn
How Carbidopa interacts with RePlenish — 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 RePlenish — 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, Levodopa interactionCarbidopa, Levodopa, EntacaponeStalevo
How Carbidopa, Levodopa, Entacapone interacts with RePlenish — 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, Levodopa, Entacapone interactionLevodopaInbrija, Larodopa
How Levodopa interacts with RePlenish — 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 + Levodopa interactionLevodopa, CarbidopaDuodopa
How Levodopa, Carbidopa interacts with RePlenish — 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 + Levodopa, Carbidopa interactionAcebutololRhotral, Sectral
How Acebutolol interacts with RePlenish — 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 + Acebutolol interactionAcetaminophen, ChlorzoxazoneAcetazone Forte, Extra Strength Tylenol Aches & Strains, Parafon Forte
How Acetaminophen, Chlorzoxazone interacts with RePlenish — 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 + Acetaminophen, Chlorzoxazone interactionAcetaminophen, Chlorzoxazone, CodeineAcetazone Forte C8, Parafon Forte C8
How Acetaminophen, Chlorzoxazone, Codeine interacts with RePlenish — 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 + Acetaminophen, Chlorzoxazone, Codeine interactionAcetaminophen, Codeine, MethocarbamolAcetaminophen, Codeine, Methocarbamol, Robaxacet 8
How Acetaminophen, Codeine, Methocarbamol interacts with RePlenish — 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 + Acetaminophen, Codeine, Methocarbamol interactionAcetaminophen, MethocarbamolRobaxacet
How Acetaminophen, Methocarbamol interacts with RePlenish — 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 + Acetaminophen, Methocarbamol interactionAcetaminophen, OrphenadrineOrfenagesic
How Acetaminophen, Orphenadrine interacts with RePlenish — 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 + Acetaminophen, Orphenadrine interactionAcetazolamideAk-Zol, Diamox
How Acetazolamide interacts with RePlenish — 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 + Acetazolamide interactionAcetohexamideDymelor
How Acetohexamide interacts with RePlenish — through 1 ingredient. Tap an ingredient for the detail:
MagnesiumSulfonylureas Moderate
Interaction Summary
Magnesium increases the systemic absorption of sulfonylureas, increasing their effects and side effects.
Read the full Magnesium + Acetohexamide interactionAlcuroniumAlcuronium
How Alcuronium interacts with RePlenish — 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 + Alcuronium interactionAlendronateBinosto, Fosamax
How Alendronate interacts with RePlenish — through 1 ingredient. Tap an ingredient for the detail:
MagnesiumBisphosphonates Moderate
Interaction Summary
Magnesium can decrease absorption of bisphosphonates.
Read the full Magnesium + Alendronate interactionAlendronate Sodium
How Alendronate Sodium interacts with RePlenish — through 1 ingredient. Tap an ingredient for the detail:
MagnesiumBisphosphonates Moderate
Interaction Summary
Magnesium can decrease absorption of bisphosphonates.
Read the full Magnesium + Alendronate Sodium interactionAlendronate Sodium, CholecalciferolFosamax Plus D
How Alendronate Sodium, Cholecalciferol interacts with RePlenish — through 1 ingredient. Tap an ingredient for the detail:
MagnesiumBisphosphonates Moderate
Interaction Summary
Magnesium can decrease absorption of bisphosphonates.
Read the full Magnesium + Alendronate Sodium, Cholecalciferol interactionAlginic Acid, Aluminum HydroxideRafton
How Alginic Acid, Aluminum Hydroxide interacts with RePlenish — 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 + Alginic Acid, Aluminum Hydroxide interactionAliskirenTekturna
How Aliskiren interacts with RePlenish — 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 + Aliskiren interactionAluminum HydroxideAlu-Cap, Amphojel, Gaviscon
How Aluminum Hydroxide interacts with RePlenish — 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 + Aluminum Hydroxide interactionAluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium HydroxideAscriptin Codeine #2
How Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide interacts with RePlenish — through 1 ingredient. Tap an ingredient for the detail:
MagnesiumAntacids, Anticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Use of acid reducers may reduce the laxative effect of magnesium oxide.
Read the full Magnesium + Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide interactionAluminum Hydroxide, Aspirin, Magnesium HydroxideAscriptin
How Aluminum Hydroxide, Aspirin, Magnesium Hydroxide interacts with RePlenish — through 1 ingredient. Tap an ingredient for the detail:
MagnesiumAnticoagulant/antiplatelet Drugs, Antacids Moderate
Interaction Summary
Theoretically, magnesium may have antiplatelet effects, but the evidence is conflicting.
Read the full Magnesium + Aluminum Hydroxide, Aspirin, Magnesium Hydroxide interactionAluminum Hydroxide, Magnesium Hydroxide (otc Drug)Maalox, Mucogel
How Aluminum Hydroxide, Magnesium Hydroxide (otc Drug) interacts with RePlenish — 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 + Aluminum Hydroxide, Magnesium Hydroxide (otc Drug) interactionAluminum Hydroxide, Magnesium Hydroxide, Simethicone (otc Drug)Mylanta
How Aluminum Hydroxide, Magnesium Hydroxide, Simethicone (otc Drug) interacts with RePlenish — 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 + Aluminum Hydroxide, Magnesium Hydroxide, Simethicone (otc Drug) interactionAluminum, Magnesium (otc Drug)Almagel
How Aluminum, Magnesium (otc Drug) interacts with RePlenish — 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 + Aluminum, Magnesium (otc Drug) interactionAmbrisentanLetairis, Volibris
How Ambrisentan interacts with RePlenish — 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 + Ambrisentan interactionAmikacinAmikin, Arikayce
How Amikacin interacts with RePlenish — through 1 ingredient. Tap an ingredient for the detail:
MagnesiumAminoglycoside Antibiotics Moderate
Interaction Summary
Concomitant use of aminoglycoside antibiotics and magnesium can increase the risk for neuromuscular weakness.
Read the full Magnesium + Amikacin interactionAmilorideAmilamont, Midamor
How Amiloride interacts with RePlenish — through 3 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 + Amiloride interactionPotassiumPotassium-sparing Diuretics Moderate
Interaction Summary
Concomitant use increases the risk of hyperkalemia.
Read the full Potassium + Amiloride interactionMagnesiumPotassium-sparing Diuretics Moderate
Interaction Summary
Potassium-sparing diuretics decrease excretion of magnesium, possibly increasing magnesium levels.
Read the full Magnesium + Amiloride interactionAmiloride, HydrochlorothiazideAmil-Co, Amilzide, Moduret 25, Moduretic
How Amiloride, Hydrochlorothiazide interacts with RePlenish — through 3 ingredients. Tap an ingredient for the detail:
PotassiumPotassium-sparing Diuretics Moderate
Interaction Summary
Concomitant use increases the risk of hyperkalemia.
Read the full Potassium + Amiloride, Hydrochlorothiazide interactionMagnesiumPotassium-sparing Diuretics Moderate
Interaction Summary
Potassium-sparing diuretics decrease excretion of magnesium, possibly increasing magnesium levels.
Read the full Magnesium + Amiloride, Hydrochlorothiazide interactionSodiumAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, a high intake of dietary sodium might reduce the effectiveness of antihypertensive drugs.
Read the full Sodium + Amiloride, Hydrochlorothiazide interactionEach ingredient & the kinds of drugs it affects
For each ingredient in RePlenish 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 RePlenish, from the product label.
Zemvelo
See all Zemvelo products- Name
- Zemvelo by MINERALIFE
- Street Address
- 1435 Woolsey Hts
- City
- Colorado Springs
- State
- CO
- ZipCode
- 80915
- Phone Number
- 8003031376
- Web Address
- zemvelo.com
RePlenish by Zemvelo: Common Questions
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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 RePlenish’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
RePlenish'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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- 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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- 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
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- 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
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- 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
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- 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.
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- 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
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- 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
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- 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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