Ribomax M Ingredients & Drug Interactions
What is this page for?
First and foremost: checking Ribomax M 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
Ribomax M is a dietary supplement by HoltraCeuticals with 2 active ingredients. Its ingredients are commonly taken for preventing or treating magnesium deficiency, constipation, muscle cramps.Based on those ingredients, 373 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are Magnesium, D-Ribose. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against Ribomax M by HoltraCeuticals
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HelloPharmacist Scorecard of Ribomax M by HoltraCeuticals
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
Ribomax M is a powder containing 2 active ingredients: magnesium and D-ribose. Magnesium is a mineral your body needs for muscle function, nerve signaling, and energy production.
D-ribose is a simple sugar (ribose) that your cells use to produce energy, particularly in muscle tissue. There are no other inactive ingredients listed.
Does it work?
Strong evidence
Magnesium is effective for heartburn (dyspepsia), constipation, low magnesium levels (hypomagnesemia), and pre-eclampsia in pregnancy. D-ribose's effectiveness is less clear: evidence is insufficient to rate it for restless legs syndrome, heart failure, muscle soreness, or recovery after bypass surgery.
For athletic performance, the evidence suggests it is likely ineffective.
How safe is it?
Well-documented data
Magnesium is generally well tolerated at recommended doses in healthy adults. The most common side effects when taken by mouth are diarrhea, gastrointestinal irritation, nausea, and vomiting.
Magnesium is needed during pregnancy, but supplements should be used only under your doctor's guidance. Normal dietary amounts are fine while breastfeeding, though you should check with your doctor before adding supplements.
D-ribose is generally well tolerated in the short term but can lower blood sugar; long-term safety has not been well studied. Common side effects include diarrhea, gastrointestinal discomfort, headache, nausea, and low blood sugar (hypoglycemia).
The safety data advises against D-ribose during pregnancy and breastfeeding.
Meds to double-check
Major interaction found
Before taking Ribomax M, double-check with your doctor or pharmacist if you take Parkinson's medication (levodopa/carbidopa) — this is a Major-severity interaction. Also important to review before starting: skeletal muscle relaxants, blood pressure drugs, potassium-sparing diuretics, diabetes medications, insulin, quinolone antibiotics, and bisphosphonates.
Additionally, mention any acid-reducing medications you're on, as they may affect how this product works.
The bottom line
Scorecard at a glanceFully disclosed formula with strong clinical evidence behind its ingredients' uses. Major medication interactions have been identified, and safety information is well characterized.
Ribomax M may be considered by people looking to address low magnesium, constipation, or heartburn, though its D-ribose component has uncertain benefits for most uses. If you take Parkinson's medication, blood pressure drugs, diabetes or insulin therapy, muscle relaxants, antibiotics, or osteoporosis drugs, you'll want to check with your doctor or pharmacist before starting this product.
Because D-ribose can lower blood sugar, discuss it with your healthcare provider if you manage diabetes or take related medications. Talk with your own doctor or pharmacist about whether this product is right for you and your current medications.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 2 of 2 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Sep 22, 2022.
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 Ribomax M, straight from the product label.
| Brand | HoltraCeuticals |
|---|---|
| Net contents | 361 Gram(s) |
| Market status | On market |
| Date entered into DSLD | Sep 22, 2022 |
| DSLD ID | 274444 |
| Product type | Fiber And Other Nutrients |
| Supplement form | Powder |
| Dietary claims / uses | All Other, Structure/Function |
| Intended target group(s) | Adult (18 - 50 Years), 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 Ribomax M by HoltraCeuticals, sourced from the NIH Dietary Supplement Label Database.
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.
Suggested/Recommended/Usage/Directions
Suggested use: Take 1 1/2 tsp daily or as recommended by your health care professional.
Storage
Store in a cool, dry place with the lid tightly closed.
Precautions
Keep out of reach of children.
Warning: Consult your physician prior to using this product if you are pregnant, nursing, taking medication or have a medical condition.
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.
General Statements
To reorder visit Holtraceuticals.com
Formulation
Made in a GMP compliant facility in USA
Clinically proven to improve cardiac function and restore energy to tired muscles
No artificial colors, artificial flavors, milk or milk derivatives, or sodium added.
FDA Statement of Identity
Dietary Supplement
Brand IP Statement(s)
Holtorf Medical Group, Inc. Center for hormone imbalance, hypothyroidism and fatigue
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Ribomax M by HoltraCeuticals 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 Ribomax M by HoltraCeuticals
These are the 2 active ingredients this product is made of. Select any to open its full monograph.
Serving size1.5 Teaspoon(s) Dosage formPowder Servings per container56 Amounts shown are per serving.
Most supplement products combine several ingredients, and a medication can interact with the product through any one of them. Each ingredient below shows whether it has known drug interactions.
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 & interactionsD-Ribose
Interacts with86 drugs
Ribose (D-ribose) is a simple sugar your body makes naturally and uses to build energy molecules like ATP. Some people take it for fatigue, fibromyalg...
D-Ribose monograph & interactionsOther (inactive) ingredients: None. These complete the product’s ingredient list but are not active constituents.
Ribomax M by HoltraCeuticals Drug Interactions
HelloPharmacist Interaction Report
Ribomax M by HoltraCeuticals contains magnesium and D-ribose, both of which interact with medications.
The most serious interaction is magnesium with levodopa/carbidopa (Sinemet), a Major-severity interaction: magnesium can reduce how much levodopa your body absorbs by up to 35%, potentially making your Parkinson's medication less effective.
Read the full breakdown — every affected drug type, severity by severity
Magnesium also has Moderate interactions with skeletal muscle relaxants (it can strengthen their effect and speed up how fast they work), potassium-sparing diuretics (which may raise magnesium levels), calcium channel blockers (used for blood pressure and heart rhythm), sulfonylureas (diabetes drugs — magnesium can boost their effect and raise the risk of low blood sugar), quinolone antibiotics, and bisphosphonates (osteoporosis drugs). Magnesium may also reduce the laxative effect of acid-reducing medications like proton pump inhibitors.
D-ribose carries Moderate interactions with antidiabetes drugs and insulin; because ribose can lower blood sugar, combining it with these medications could theoretically increase the risk of low blood sugar (hypoglycemia).
Alongside these ingredients, there are inactive ingredients present. Altogether, these interactions span 373 individual medications.
Use the medication checker on this page to look up your exact prescriptions before starting this product.
Check your own medications below · Editorial policy · How we use AI
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Go to the checkerIngredients driving the most interactions
Individual Drug Interactions
The ingredients in Ribomax M interact with 373 drugs. Click any drug to see the details.
2 of the 2 ingredients in Ribomax M interact with drugs. Each result below shows which ingredient is responsible. Magnesium D-Ribose
Benserazide, LevodopaMadopar, Prolopa
How Benserazide, Levodopa interacts with Ribomax M — 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 Ribomax M — 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 Ribomax M — 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 Ribomax M — 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 Ribomax M — 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 Ribomax M — 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 interactionAcarboseGlucobay, Prandase, Precose
How Acarbose interacts with Ribomax M — through 1 ingredient. Tap an ingredient for the detail:
D-riboseAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, taking ribose in combination with antidiabetes drugs might increase the risk of hypoglycemia.
Read the full D-ribose + Acarbose interactionAcetaminophen, ChlorzoxazoneAcetazone Forte, Extra Strength Tylenol Aches & Strains, Parafon Forte
How Acetaminophen, Chlorzoxazone interacts with Ribomax M — 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 Ribomax M — 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 Ribomax M — 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 Ribomax M — 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 Ribomax M — 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 interactionAcetohexamideDymelor
How Acetohexamide interacts with Ribomax M — through 2 ingredients. Tap an ingredient for the detail:
D-riboseAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, taking ribose in combination with antidiabetes drugs might increase the risk of hypoglycemia.
Read the full D-ribose + Acetohexamide interactionMagnesiumSulfonylureas Moderate
Interaction Summary
Magnesium increases the systemic absorption of sulfonylureas, increasing their effects and side effects.
Read the full Magnesium + Acetohexamide interactionAlbiglutideTanzeum
How Albiglutide interacts with Ribomax M — through 1 ingredient. Tap an ingredient for the detail:
D-riboseAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, taking ribose in combination with antidiabetes drugs might increase the risk of hypoglycemia.
Read the full D-ribose + Albiglutide interactionAlcuroniumAlcuronium
How Alcuronium interacts with Ribomax M — 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 Ribomax M — 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 Ribomax M — 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 Ribomax M — 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 Ribomax M — 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 interactionAlogliptinNesina
How Alogliptin interacts with Ribomax M — through 1 ingredient. Tap an ingredient for the detail:
D-riboseAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, taking ribose in combination with antidiabetes drugs might increase the risk of hypoglycemia.
Read the full D-ribose + Alogliptin interactionAlogliptin, MetforminKazano
How Alogliptin, Metformin interacts with Ribomax M — through 1 ingredient. Tap an ingredient for the detail:
D-riboseAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, taking ribose in combination with antidiabetes drugs might increase the risk of hypoglycemia.
Read the full D-ribose + Alogliptin, Metformin interactionAlogliptin, PioglitazoneOseni
How Alogliptin, Pioglitazone interacts with Ribomax M — through 1 ingredient. Tap an ingredient for the detail:
D-riboseAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, taking ribose in combination with antidiabetes drugs might increase the risk of hypoglycemia.
Read the full D-ribose + Alogliptin, Pioglitazone interactionAluminum HydroxideAlu-Cap, Amphojel, Gaviscon
How Aluminum Hydroxide interacts with Ribomax M — 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 Ribomax M — 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 Ribomax M — 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 Ribomax M — 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 Ribomax M — 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 Ribomax M — 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) interactionAmikacinAmikin, Arikayce
How Amikacin interacts with Ribomax M — 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 Ribomax M — through 1 ingredient. Tap an ingredient for the detail:
MagnesiumPotassium-sparing Diuretics Moderate
Interaction Summary
Potassium-sparing diuretics decrease excretion of magnesium, possibly increasing magnesium levels.
Read the full Magnesium + Amiloride interactionEach ingredient & the kinds of drugs it affects
For each ingredient in Ribomax M 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.
D-Ribose
Antidiabetes Drugs
Theoretically, taking ribose in combination with antidiabetes drugs might increase the risk of hypoglycemia.
In clinical research, ribose decreases serum glucose levels in a dose-dependent manner.
Insulin
Theoretically, taking ribose with insulin could increase the hypoglycemic effect of insulin.
In clinical pharmacokinetic studies, oral administration of ribose modestly increased serum insulin levels.
Brand information
Manufacturer and brand details for Ribomax M, from the product label.
HoltraCeuticals
See all HoltraCeuticals products- Name
- Kent Holtorf, M.D. and the Holtorf Medical Group
- City
- El Segundo
- State
- CA
- Phone Number
- 310-375-2705
- Web Address
- HoltraCeuticals.com
Ribomax M by HoltraCeuticals: Common Questions
Does Ribomax M by HoltraCeuticals interact with any medications?
How can one product interact with so many drugs?
Where does this information come from?
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Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
Not sure if Ribomax M is safe with your meds?
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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 Ribomax M’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Magnesium
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 monographRibose
Interacts with 86 drugsRibose (D-ribose) is a simple sugar your body makes naturally and uses to build energy molecules like ATP. Some people take it for fatigue, fibromyalgia, exercise recovery, or heart conditio...
Read the full Ribose monograph →Sources & How We Checked
Ribomax M'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 90 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.
Magnesium 82 references
- Rodin SM, Johnson BF. Pharmacokinetic interactions with digoxin. Clin Pharmacokinet 1988;15:227-44.
- Covington TR, et al. Handbook of Nonprescription Drugs. 11th ed. Washington, DC: American Pharmaceutical Association, 1996.
- Dahle LO, Berg G, Hammar M, et al. The effect of oral magnesium substitution on pregnancy-induced leg cramps. Am J Obstet Gynecol 1995;173:175-80. PubMed
- Hansten PD, Horn JR. Drug Interactions Analysis and Management. Vancouver, WA: Applied Therapeutics Inc., 1997 and updates.
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