SP Complete Dairy Free Ingredients & Drug Interactions
What is this page for?
First and foremost: checking SP Complete Dairy Free 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
SP Complete Dairy Free is a dietary supplement by SP Standard Process with 20 active ingredients. Its ingredients are commonly taken for constipation, diarrhea, high cholesterol.Based on those ingredients, 2,259 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are Dietary Fiber, Grape (seed) extract, Red Wine extract. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against SP Complete Dairy Free by SP Standard Process
Ask about any prescription or over-the-counter medication and we check it for interactions with SP Complete Dairy Free by SP Standard Process — 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 SP Complete Dairy Free by SP Standard Process
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
Low disclosure
SP Complete Dairy Free contains 18 active ingredients designed to provide a nutrient-rich base. The main players are minerals—potassium, calcium (both citrate and as part of a proprietary blend), iron, and magnesium citrate—along with the amino acid inositol and choline (as bitartrate and free choline).
You also get rice protein as a plant-based protein source, plus a proprietary herbal blend that includes organic carrot, alfalfa juice powder, buckwheat, kale, and grape seed extract, along with sunflower lecithin powder. Red wine extract and organic flax meal round out the formula, though our data couldn't assess interactions for those two.
There are no inactive fillers, binders, or other excipients listed—what you see is what you get.
Does it work?
Strong evidence
Evidence for this product's ingredients is mixed. Calcium and magnesium are effective for bone health (osteoporosis) and for correcting deficiency states.
Iron is effective for iron-deficiency anemia and anemia of chronic disease. Potassium is effective for managing hyperkalemia (high blood potassium).
Inositol shows possibly effective evidence for polycystic ovary syndrome (PCOS), metabolic syndrome, and preterm labor, though it was rated possibly ineffective for anxiety and depression. Rice protein may help with food allergies, but evidence for muscle strength is insufficient.
Choline, grape seed extract, and the vegetable ingredients (carrot, alfalfa, buckwheat, kale) carry ratings of insufficient evidence or possibly ineffective for most conditions studied. Lecithin is rated likely ineffective for Alzheimer's disease.
Overall, the strongest evidence sits with the mineral content for deficiency correction and bone support.
How safe is it?
Well-documented data
Most ingredients are generally well tolerated at recommended doses. Potassium from food is safe, but supplements can cause dangerously high blood levels, especially in people with kidney disease—use only under medical guidance.
Calcium is safe at recommended amounts, though very high doses raise theoretical concerns about prostate cancer and heart disease risk. Iron is well tolerated when used appropriately but can cause abdominal pain, constipation, diarrhea, and nausea; excess iron is toxic.
Magnesium commonly causes diarrhea and gastrointestinal upset. Inositol is generally well tolerated with mild digestive side effects.
Choline can cause a fishy body odor at high doses and gastrointestinal upset above 9 grams daily. Alfalfa rarely causes a lupus-like syndrome with chronic use and may trigger allergic dermatitis in some people.
Grape seed extract is well tolerated but can rarely cause anaphylaxis in people allergic to grape skin. For pregnancy, potassium from food is fine but supplements need doctor guidance; calcium and magnesium are safe at recommended amounts; iron is often recommended but dosing should be guided by your prenatal provider; inositol lacks full safety data so medical supervision is needed; choline is likely safe; alfalfa is possibly unsafe due to estrogen-like activity; and grapes as food are safe but concentrated supplements lack safety data.
For breastfeeding, similar caution applies—check with your provider before using supplement doses of potassium, magnesium, choline, or concentrated grape or alfalfa products.
Meds to double-check
Major interaction found
Before you take this product, double-check if you're on any of these: HIV integrase inhibitors (dolutegravir, elvitegravir)—calcium will reduce their effectiveness. Blood pressure medications, especially ACE inhibitors, ARBs, or potassium-sparing diuretics—potassium may raise your blood level dangerously.
Levothyroxine or other thyroid medication—calcium and iron interfere with absorption. Blood thinners like warfarin—alfalfa's vitamin K content may counter the effect.
Antibiotics (quinolones, tetracyclines) and bisphosphonates—iron and magnesium reduce absorption. Diabetes drugs and levodopa—magnesium affects how your body handles these.
Use the search tool below with your exact medications.
The bottom line
Scorecard at a glanceFormula with limited ingredient disclosure with strong clinical evidence behind its ingredients' uses. Major medication interactions have been identified, and safety information is well characterized.
This is a nutrient-dense whole-food powder useful for people needing mineral and protein support, especially those avoiding dairy. If you take blood pressure medications (ACE inhibitors, ARBs, or potassium-sparing diuretics), HIV medications, thyroid medication, antibiotics, diabetes drugs, blood thinners, or Parkinson's medication, check your exact drugs with the tool on this page before starting.
Talk to your pharmacist or doctor to make sure the potassium and other minerals won't raise your blood levels dangerously if you have kidney disease or take certain heart or blood pressure drugs.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 17 of 19 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated May 19, 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 SP Complete Dairy Free, straight from the product label.
| Brand | SP Standard Process |
|---|---|
| Barcode (UPC) | 812122012539 |
| Net contents | 32 Ounce(s); 907 Gram(s) |
| Market status | On market |
| Date entered into DSLD | May 19, 2022 |
| DSLD ID | 265551 |
| Product type | Other Combinations |
| Supplement form | Powder |
| Dietary claims / uses | All Other |
| Intended target group(s) | 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 SP Complete Dairy Free by SP Standard Process, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Calories | 110 Calorie(s) | -- |
| Total Carbohydrates | 10 Gram(s) | 4% |
| Dietary Fiber | 4 Gram(s) | 14% |
| Potassium | 80 mg | 2% |
| Calcium | 200 mg | 15% |
| Iron | 0.5 mg | 3% |
| Total Fat | 2 Gram(s) | 3% |
| Inositol | 0 NP | -- |
| Proprietary Blend | 28 Gram(s) | -- |
| Protein | 13 Gram(s) | 26% |
| Total Sugars | 1 Gram(s) | -- |
| Choline Bitartrate | 0 NP | -- |
| Choline | 70 mg | 13% |
| Magnesium Citrate | 0 NP | -- |
| Calcium Citrate | 0 NP | -- |
| Rice Protein | 0 NP | -- |
| organic Carrot | 0 NP | -- |
| Red Wine extract | 0 NP | -- |
| Sunflower Lecithin powder | 0 NP | -- |
| organic Alfalfa (aerial parts) juice powder | 0 NP | -- |
| organic Buckwheat | 0 NP | -- |
| organic Flax Meal | 0 NP | -- |
| organic Brussels Sprouts | 0 NP | -- |
| organic Kale | 0 NP | -- |
| Grape (seed) extract | 0 NP | -- |
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.
FDA Statement of Identity
Dietary Supplement
Suggested/Recommended/Usage/Directions
Suggested Use: Two heaping tablespoons (scoops) per shake. One to three shakes per day, or as directed.
Storage
Store in a cool, dark place.
Formulation
Gluten free
Brand IP Statement(s)
Whole Food Supplements Since 1929
Precautions
Caution: This product is processed in a facility that manufactures other products containing soy, milk, egg, wheat, peanut, tree nuts, fish, and shellfish.
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
SP Complete Dairy Free by SP Standard Process 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 SP Complete Dairy Free by SP Standard Process
These are the 20 active ingredients this product is made of. Select any to open its full monograph.
Serving size28 Gram(s) Dosage formPowder Servings per container30 Amounts shown are per serving.
Most supplement products combine several ingredients, and a medication can interact with the product through any one of them. Each ingredient below shows whether it has known drug interactions.
Dietary Fiber
Interacts with2,025 drugs
Black psyllium is a soluble-fiber supplement made from the seeds of a Plantago plant, used mostly to ease constipation and support digestive health. I...
Dietary Fiber 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 & interactionsCalcium
Interacts with168 drugs
Calcium is an essential mineral your body needs for strong bones, nerve signaling, and muscle function, and supplements can help fill gaps when diet f...
Calcium monograph & interactionsIron
Interacts with80 drugs
Iron is an essential mineral your body needs to make hemoglobin and carry oxygen in the blood. Supplements are mainly useful for treating or preventin...
Iron monograph & interactionsProprietary Blend
- › Inositol
- › Choline Bitartrate
- › Magnesium Citrate
- › Calcium Citrate
- › Rice Protein
- › Organic Carrot
- › Red Wine extract
- › Sunflower Lecithin powder
- › Organic Alfalfa (aerial parts) juice powder
- › Organic Buckwheat
- › Organic Flax Meal
- › Organic Brussels Sprouts
- › Organic Kale
- › Grape (seed) extract
Protein
Choline
Interacts with16 drugs
Choline is an essential nutrient your body needs for liver function, brain health, and nerve signaling, and many people get enough from foods like egg...
Choline monograph & interactionsSP Complete Dairy Free by SP Standard Process Drug Interactions
HelloPharmacist Interaction Report
SP Complete Dairy Free by Standard Process does interact with several medications.
The most serious interaction involves calcium—an ingredient in this product—with HIV integrase inhibitors. Calcium can reduce blood levels of dolutegravir (Tivicay) by almost 40% and elvitegravir (Vitekta) significantly, making these drugs less effective at controlling HIV.
You'd need to take these medications at least 2 hours before or 6 hours after (for dolutegravir) or 2 hours after (for elvitegravir) this supplement.
Read the full breakdown — every affected drug type, severity by severity
Potassium in this product poses a moderate risk with blood pressure medications. If you take ACE inhibitors, ARBs (angiotensin receptor blockers), or potassium-sparing diuretics, adding potassium can raise blood levels dangerously high—a condition called hyperkalemia—especially if your kidneys aren't working perfectly.
Iron, magnesium, and calcium all reduce how your body absorbs certain antibiotics and other drugs. Iron decreases absorption of quinolones, tetracyclines, and bisphosphonates; magnesium does the same with quinolones and bisphosphonates; and calcium interferes with levothyroxine (thyroid medication), bisphosphonates, and the heart drug sotalol.
Magnesium also has significant interactions with levodopa (Parkinson's medication), skeletal muscle relaxants, and diabetes drugs. Alfalfa in this product may interfere with warfarin (a blood thinner) because of its high vitamin K content, and it could also theoretically affect birth control pills and hormone therapy.
Grape seed extract may thin your blood further if you're already on anticoagulants or antiplatelet drugs, and it may alter how your body handles certain medications metabolized by your liver.
Although choline has only a minor documented interaction with atropine, several ingredients—red wine extract, flax meal, and Brussels sprouts—couldn't be checked against our data, so interactions with those are unknown. Altogether, these interactions span 1,356 individual medications.
Use the medication checker below with your exact prescriptions before starting this product.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against SP Complete Dairy Free?
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 SP Complete Dairy Free interact with 2,259 drugs. Click any drug to see the details.
11 of the 20 ingredients in SP Complete Dairy Free interact with drugs. Each result below shows which ingredient is responsible. Dietary Fiber Grape (seed) extract Red Wine extract organic Alfalfa (aerial parts) juice powder Magnesium Citrate Calcium Inositol Iron Potassium Rice Protein Choline Bitartrate
Benserazide, LevodopaMadopar, Prolopa
How Benserazide, Levodopa interacts with SP Complete Dairy Free — through 3 ingredients. Tap an ingredient for the detail:
Magnesium CitrateLevodopa/carbidopa (sinemet) Major
Interaction Summary
Magnesium can reduce the bioavailability of levodopa/carbidopa.
Read the full Magnesium Citrate + Benserazide, Levodopa interactionIronLevodopa Moderate
Interaction Summary
Iron might decrease levodopa levels by reducing its absorption.
Read the full Iron + Benserazide, Levodopa interactionDietary FiberOral Drugs Minor
Interaction Summary
Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Read the full Dietary Fiber + Benserazide, Levodopa interactionCarbidopaLodosyn
How Carbidopa interacts with SP Complete Dairy Free — through 2 ingredients. Tap an ingredient for the detail:
Magnesium CitrateLevodopa/carbidopa (sinemet) Major
Interaction Summary
Magnesium can reduce the bioavailability of levodopa/carbidopa.
Read the full Magnesium Citrate + Carbidopa interactionDietary FiberOral Drugs Minor
Interaction Summary
Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Read the full Dietary Fiber + Carbidopa interactionCarbidopa, LevodopaDhivy, Rytary, Sinemet, Sinemet CR
How Carbidopa, Levodopa interacts with SP Complete Dairy Free — through 3 ingredients. Tap an ingredient for the detail:
Magnesium CitrateLevodopa/carbidopa (sinemet) Major
Interaction Summary
Magnesium can reduce the bioavailability of levodopa/carbidopa.
Read the full Magnesium Citrate + Carbidopa, Levodopa interactionIronLevodopa Moderate
Interaction Summary
Iron might decrease levodopa levels by reducing its absorption.
Read the full Iron + Carbidopa, Levodopa interactionDietary FiberOral Drugs Minor
Interaction Summary
Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Read the full Dietary Fiber + Carbidopa, Levodopa interactionCarbidopa, Levodopa, EntacaponeStalevo
How Carbidopa, Levodopa, Entacapone interacts with SP Complete Dairy Free — through 3 ingredients. Tap an ingredient for the detail:
Magnesium CitrateLevodopa/carbidopa (sinemet) Major
Interaction Summary
Magnesium can reduce the bioavailability of levodopa/carbidopa.
Read the full Magnesium Citrate + Carbidopa, Levodopa, Entacapone interactionIronLevodopa Moderate
Interaction Summary
Iron might decrease levodopa levels by reducing its absorption.
Read the full Iron + Carbidopa, Levodopa, Entacapone interactionDietary FiberOral Drugs Minor
Interaction Summary
Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Read the full Dietary Fiber + Carbidopa, Levodopa, Entacapone interactionCeftriaxoneRocephin
How Ceftriaxone interacts with SP Complete Dairy Free — through 1 ingredient. Tap an ingredient for the detail:
Calcium CitrateCeftriaxone (rocephin) Major
Interaction Summary
Co-administration of intravenous calcium and ceftriaxone can result in precipitation of a ceftriaxone-calcium salt in the lungs and kidneys.
Read the full Calcium Citrate + Ceftriaxone interactionCobicistat, Elvitegravir, Emtricitabine, Tenofovir Alafenamide FumarateGenvoya
How Cobicistat, Elvitegravir, Emtricitabine, Tenofovir Alafenamide Fumarate interacts with SP Complete Dairy Free — through 6 ingredients. Tap an ingredient for the detail:
Calcium CitrateElvitegravir (vitekta), Bictegravir/emtricitabine/tenofovir Alafenamide (biktarvy) Major
Interaction Summary
Calcium seems to reduce levels of elvitegravir.
Read the full Calcium Citrate + Cobicistat, Elvitegravir, Emtricitabine, Tenofovir Alafenamide Fumarate interactionRed Wine ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, resveratrol might increase levels of drugs metabolized by CYP3A4.
Read the full Red Wine Extract + Cobicistat, Elvitegravir, Emtricitabine, Tenofovir Alafenamide Fumarate interactionIronBictegravir/emtricitabine/tenofovir Alafenamide (biktarvy) Moderate
Interaction Summary
Iron might decrease levels of bictegravir/emtricitabine/tenofovir alafenamide by reducing its absorption when taken in a fasting state.
Read the full Iron + Cobicistat, Elvitegravir, Emtricitabine, Tenofovir Alafenamide Fumarate interactionGrape (seed) ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
It is unclear if grape seed extract inhibits or induces CYP3A4; research is conflicting.
Read the full Grape (seed) Extract + Cobicistat, Elvitegravir, Emtricitabine, Tenofovir Alafenamide Fumarate interactionMagnesium CitrateBictegravir/emtricitabine/tenofovir Alafenamide (biktarvy) Moderate
Interaction Summary
Magnesium might decrease levels of bictegravir/emtricitabine/tenofovir alafenamide by reducing its absorption.
Read the full Magnesium Citrate + Cobicistat, Elvitegravir, Emtricitabine, Tenofovir Alafenamide Fumarate interactionDietary FiberOral Drugs Minor
Interaction Summary
Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Read the full Dietary Fiber + Cobicistat, Elvitegravir, Emtricitabine, Tenofovir Alafenamide Fumarate interactionDolutegravirTivicay
How Dolutegravir interacts with SP Complete Dairy Free — through 3 ingredients. Tap an ingredient for the detail:
Calcium CitrateDolutegravir (tivicay) Major
Interaction Summary
Calcium seems to reduce levels of dolutegravir.
Read the full Calcium Citrate + Dolutegravir interactionIronDolutegravir (tivicay) Moderate
Interaction Summary
Iron might decrease dolutegravir levels by reducing its absorption.
Read the full Iron + Dolutegravir interactionDietary FiberOral Drugs Minor
Interaction Summary
Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Read the full Dietary Fiber + Dolutegravir interactionDolutegravir, Emtricitabine, Tenofovir AlafenamideDolutegravir, Emtricitabine, Tenofovir Alafenamide
How Dolutegravir, Emtricitabine, Tenofovir Alafenamide interacts with SP Complete Dairy Free — through 4 ingredients. Tap an ingredient for the detail:
Calcium CitrateDolutegravir (tivicay), Bictegravir/emtricitabine/tenofovir Alafenamide (biktarvy) Major
Interaction Summary
Calcium seems to reduce levels of dolutegravir.
Read the full Calcium Citrate + Dolutegravir, Emtricitabine, Tenofovir Alafenamide interactionIronDolutegravir (tivicay), Bictegravir/emtricitabine/tenofovir Alafenamide (biktarvy) Moderate
Interaction Summary
Iron might decrease dolutegravir levels by reducing its absorption.
Read the full Iron + Dolutegravir, Emtricitabine, Tenofovir Alafenamide interactionMagnesium CitrateBictegravir/emtricitabine/tenofovir Alafenamide (biktarvy) Moderate
Interaction Summary
Magnesium might decrease levels of bictegravir/emtricitabine/tenofovir alafenamide by reducing its absorption.
Read the full Magnesium Citrate + Dolutegravir, Emtricitabine, Tenofovir Alafenamide interactionDietary FiberOral Drugs Minor
Interaction Summary
Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Read the full Dietary Fiber + Dolutegravir, Emtricitabine, Tenofovir Alafenamide interactionDolutegravir, RilpivirineJuluca
How Dolutegravir, Rilpivirine interacts with SP Complete Dairy Free — through 5 ingredients. Tap an ingredient for the detail:
Calcium CitrateDolutegravir (tivicay) Major
Interaction Summary
Calcium seems to reduce levels of dolutegravir.
Read the full Calcium Citrate + Dolutegravir, Rilpivirine interactionRed Wine ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, resveratrol might increase levels of drugs metabolized by CYP3A4.
Read the full Red Wine Extract + Dolutegravir, Rilpivirine interactionGrape (seed) ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
It is unclear if grape seed extract inhibits or induces CYP3A4; research is conflicting.
Read the full Grape (seed) Extract + Dolutegravir, Rilpivirine interactionIronDolutegravir (tivicay) Moderate
Interaction Summary
Iron might decrease dolutegravir levels by reducing its absorption.
Read the full Iron + Dolutegravir, Rilpivirine interactionDietary FiberOral Drugs Minor
Interaction Summary
Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Read the full Dietary Fiber + Dolutegravir, Rilpivirine interactionElvitegravirVitekta
How Elvitegravir interacts with SP Complete Dairy Free — through 4 ingredients. Tap an ingredient for the detail:
Calcium CitrateElvitegravir (vitekta) Major
Interaction Summary
Calcium seems to reduce levels of elvitegravir.
Read the full Calcium Citrate + Elvitegravir interactionGrape (seed) ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
It is unclear if grape seed extract inhibits or induces CYP3A4; research is conflicting.
Read the full Grape (seed) Extract + Elvitegravir interactionRed Wine ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, resveratrol might increase levels of drugs metabolized by CYP3A4.
Read the full Red Wine Extract + Elvitegravir interactionDietary FiberOral Drugs Minor
Interaction Summary
Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Read the full Dietary Fiber + Elvitegravir interactionElvitegravir, Cobicistat, Emtricitabine, Tenofovir Disoproxil FumarateStribild
How Elvitegravir, Cobicistat, Emtricitabine, Tenofovir Disoproxil Fumarate interacts with SP Complete Dairy Free — through 6 ingredients. Tap an ingredient for the detail:
Calcium CitrateElvitegravir (vitekta), Bictegravir/emtricitabine/tenofovir Alafenamide (biktarvy) Major
Interaction Summary
Calcium seems to reduce levels of elvitegravir.
Read the full Calcium Citrate + Elvitegravir, Cobicistat, Emtricitabine, Tenofovir Disoproxil Fumarate interactionRed Wine ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, resveratrol might increase levels of drugs metabolized by CYP3A4.
Read the full Red Wine Extract + Elvitegravir, Cobicistat, Emtricitabine, Tenofovir Disoproxil Fumarate interactionGrape (seed) ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
It is unclear if grape seed extract inhibits or induces CYP3A4; research is conflicting.
Read the full Grape (seed) Extract + Elvitegravir, Cobicistat, Emtricitabine, Tenofovir Disoproxil Fumarate interactionIronBictegravir/emtricitabine/tenofovir Alafenamide (biktarvy) Moderate
Interaction Summary
Iron might decrease levels of bictegravir/emtricitabine/tenofovir alafenamide by reducing its absorption when taken in a fasting state.
Read the full Iron + Elvitegravir, Cobicistat, Emtricitabine, Tenofovir Disoproxil Fumarate interactionMagnesium CitrateBictegravir/emtricitabine/tenofovir Alafenamide (biktarvy) Moderate
Interaction Summary
Magnesium might decrease levels of bictegravir/emtricitabine/tenofovir alafenamide by reducing its absorption.
Read the full Magnesium Citrate + Elvitegravir, Cobicistat, Emtricitabine, Tenofovir Disoproxil Fumarate interactionDietary FiberOral Drugs Minor
Interaction Summary
Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Read the full Dietary Fiber + Elvitegravir, Cobicistat, Emtricitabine, Tenofovir Disoproxil Fumarate interactionLevodopaInbrija, Larodopa
How Levodopa interacts with SP Complete Dairy Free — through 3 ingredients. Tap an ingredient for the detail:
Magnesium CitrateLevodopa/carbidopa (sinemet) Major
Interaction Summary
Magnesium can reduce the bioavailability of levodopa/carbidopa.
Read the full Magnesium Citrate + Levodopa interactionIronLevodopa Moderate
Interaction Summary
Iron might decrease levodopa levels by reducing its absorption.
Read the full Iron + Levodopa interactionDietary FiberOral Drugs Minor
Interaction Summary
Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Read the full Dietary Fiber + Levodopa interactionLevodopa, CarbidopaDuodopa
How Levodopa, Carbidopa interacts with SP Complete Dairy Free — through 2 ingredients. Tap an ingredient for the detail:
Magnesium CitrateLevodopa/carbidopa (sinemet) Major
Interaction Summary
Magnesium can reduce the bioavailability of levodopa/carbidopa.
Read the full Magnesium Citrate + Levodopa, Carbidopa interactionIronLevodopa Moderate
Interaction Summary
Iron might decrease levodopa levels by reducing its absorption.
Read the full Iron + Levodopa, Carbidopa interactionWarfarinWarfarin
How Warfarin interacts with SP Complete Dairy Free — through 5 ingredients. Tap an ingredient for the detail:
Organic Alfalfa (aerial Parts) Juice PowderWarfarin (coumadin) Major
Interaction Summary
Theoretically, alfalfa might reduce the anticoagulant activity of warfarin.
Read the full Organic Alfalfa (aerial Parts) Juice Powder + Warfarin interactionGrape (seed) ExtractAnticoagulant/antiplatelet Drugs, Cytochrome P450 1a2 (cyp1a2) Substrates +2 Moderate
Interaction Summary
Theoretically, grape extracts may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Grape (seed) Extract + Warfarin interactionRed Wine ExtractAnticoagulant/antiplatelet Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates +2 Moderate
Interaction Summary
Resveratrol may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Red Wine Extract + Warfarin interactionMagnesium CitrateAnticoagulant/antiplatelet Drugs Minor
Interaction Summary
Theoretically, magnesium may have antiplatelet effects, but the evidence is conflicting.
Read the full Magnesium Citrate + Warfarin interactionDietary FiberOral Drugs Minor
Interaction Summary
Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Read the full Dietary Fiber + Warfarin interactionWarfarin SodiumCoumadin, Panwarfin, Sofarin
How Warfarin Sodium interacts with SP Complete Dairy Free — through 5 ingredients. Tap an ingredient for the detail:
Organic Alfalfa (aerial Parts) Juice PowderWarfarin (coumadin) Major
Interaction Summary
Theoretically, alfalfa might reduce the anticoagulant activity of warfarin.
Read the full Organic Alfalfa (aerial Parts) Juice Powder + Warfarin Sodium interactionRed Wine ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 2c19 (cyp2c19) Substrates +2 Moderate
Interaction Summary
Theoretically, resveratrol might increase levels of drugs metabolized by CYP3A4.
Read the full Red Wine Extract + Warfarin Sodium interactionGrape (seed) ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 2c9 (cyp2c9) Substrates +2 Moderate
Interaction Summary
Theoretically, grape juice might reduce the levels of CYP1A2 substrates.
Read the full Grape (seed) Extract + Warfarin Sodium interactionMagnesium CitrateAnticoagulant/antiplatelet Drugs Minor
Interaction Summary
Theoretically, magnesium may have antiplatelet effects, but the evidence is conflicting.
Read the full Magnesium Citrate + Warfarin Sodium interactionDietary FiberOral Drugs Minor
Interaction Summary
Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Read the full Dietary Fiber + Warfarin Sodium interactionEach ingredient & the kinds of drugs it affects
For each ingredient in SP Complete Dairy Free with known interactions, here are the types of medications they can affect. Open any type for the detail — or search your exact drug in the checker above.
Dietary Fiber
Carbamazepine (Tegretol)
Theoretically, black psyllium might reduce the effects of carbamazepine and increase the risk for convulsions.
Theoretically, black psyllium might reduce carbamazepine absorption. A preliminary study using blond psyllium reported decreased carbamazepine bioavailability due to binding of the drug to psyllium, as well as reduction of available fluid in the gut for dissolution of the drug. This interaction may also occur with black psyllium.
Lithium
Theoretically, taking black psyllium at the same time as lithium might reduce lithium absorption.
The fiber in black psyllium might reduce lithium absorption and plasma levels. Some case reports describe a reduction in plasma lithium levels with concomitant administration of blond psyllium. This was reversed when psyllium was stopped. This interaction may also occur with black psyllium.
Metformin (Glucophage)
Theoretically, black psyllium might increase the therapeutic and adverse effects of metformin.
Animal research shows that concurrent consumption of blond psyllium with metformin slows and increases the absorption of metformin. This interaction may also occur with black psyllium. To avoid changes in absorption, take psyllium 30-60 minutes after metformin.
Olanzapine (Zyprexa)
Theoretically, taking black psyllium at the same time as olanzapine might reduce olanzapine absorption.
The fiber in black psyllium might decrease the absorption of olanzapine. A single case report describes a reduction in the effectiveness of olanzapine when it was concomitantly administered with an unspecified type of psyllium 3 grams orally twice daily. This effect was reversed when psyllium was stopped.
Digoxin (Lanoxin)
Theoretically, taking black psyllium at the same time as digoxin might reduce digoxin absorption and decrease digoxin levels.
Psyllium might bind digoxin in the gut. However, some clinical evidence suggests that psyllium does not impact digoxin absorption.
Ethinyl Estradiol
Theoretically, taking black psyllium at the same time as ethinyl estradiol might alter levels of estradiol.
Concurrent use of blond psyllium with ethinyl estradiol results in a slight increase in the extent of ethinyl estradiol absorption and a slower rate of absorption. This is unlikely to be clinically significant.
Oral Drugs
Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Psyllium seems to have variable effects on drug absorption. To avoid changes in absorption, take psyllium 30-60 minutes after oral medications. Animal research shows that blond psyllium delays and increases the absorption of metformin and ethinyl estradiol. Case reports and animal research suggest that blond psyllium might reduce absorption of lithium, digoxin, olanzapine, and carbamazepine. Finally, some pharmacokinetic studies show that psyllium does not affect the absorption of levothyroxine or warfarin. Although many of these studies evaluated blond psyllium, the fiber content in black psyllium may have similar effects.
Grape (seed) extract
Anticoagulant/Antiplatelet Drugs
Theoretically, grape extracts may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
In vitro evidence suggests that grape extracts might decrease platelet aggregation.
Cyclosporine (Neoral, Sandimmune)
Ingesting grape juice with cyclosporine can reduce cyclosporine absorption.
A small pharmacokinetic study in healthy young adults shows that intake of purple grape juice 200 mL along with cyclosporine can decrease the absorption of cyclosporine by up to 30% when compared with water. Separate doses of grape juice and cyclosporine by at least 2 hours to avoid this interaction.
Cytochrome P450 1A2 (Cyp1A2) Substrates
Theoretically, grape juice might reduce the levels of CYP1A2 substrates.
A small pharmacokinetic study in healthy adults shows that ingestion of 200 mL of grape juice decreases phenacetin plasma levels. This is thought to be due to induction of CYP1A2.
Cytochrome P450 2D6 (Cyp2D6) Substrates
Theoretically, grape seed extract may increase the levels of CYP2D6 substrates.
In vitro evidence suggests that grape seed extract might inhibit CYP2D6 enzymes. However, this interaction has not been reported in humans.
Cytochrome P450 2E1 (Cyp2E1) Substrates
Theoretically, grape seed extract might increase the levels of CYP2E1 substrates.
In vitro and animal research suggests that grape seed proanthocyanidin extract inhibits CYP2E1 enzymes. However, this interaction has not been reported in humans.
Cytochrome P450 3A4 (Cyp3A4) Substrates
It is unclear if grape seed extract inhibits or induces CYP3A4; research is conflicting.
In vitro evidence suggests that grape seed extract might inhibit CYP3A4 enzymes. However, evidence from animal research shows that grape seed extract may induce CYP3A4 in the liver. So far, these interactions have not been reported in humans.
Midazolam (Versed)
Theoretically, long-term intake of grape seed extract might decrease the effects of midazolam.
Animal research shows that subchronic ingestions of grape seed extract can increase the elimination of intravenous midazolam by increasing hepatic CYP3A4 activity. Single doses of grape seed extract do not appear to affect midazolam elimination.
Phenacetin
Grape juice might decrease phenacetin absorption.
A small pharmacokinetic study in healthy adults shows that ingestion of 200 mL of grape juice decreases phenacetin plasma levels. This is thought to be due to induction of cytochrome P450 1A2 (CYP1A2).
Cytochrome P450 2C9 (Cyp2C9) Substrates
It is unclear if grape juice or grape seed extract inhibits CYP2C9; research is conflicting.
In vitro evidence shows that grape seed extract or grape juice might inhibit CYP2C9 enzymes. However, a small pharmacokinetic study in healthy adults shows that drinking 8 ounces of grape juice once does not affect the clearance of flurbiprofen, a probe-drug for CYP2C9 metabolism. The effects of continued grape juice consumption are unclear.
Red Wine extract
Anticoagulant/Antiplatelet Drugs
Resveratrol may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Resveratrol seems to have antiplatelet effects.
Cytochrome P450 1A2 (Cyp1A2) Substrates
Theoretically, resveratrol might increase levels of drugs metabolized by CYP1A2.
In vitro research shows that resveratrol can inhibit CYP1A2 enzymes. However, this interaction has not been reported in humans.
Cytochrome P450 2C19 (Cyp2C19) Substrates
Theoretically, resveratrol might increase levels of drugs metabolized by CYP2C19.
In vitro research shows that resveratrol can inhibit CYP2C19 enzymes. However, this interaction has not been reported in humans.
Cytochrome P450 2E1 (Cyp2E1) Substrates
Resveratrol might increase levels of drugs metabolized by CYP2E1.
In vitro research suggests that resveratrol inhibits CYP2E1 isoenzyme. Also, a pharmacokinetic study shows that taking resveratrol 500 mg daily for 10 days prior to taking a single dose of chlorzoxazone 250 mg increases the maximum concentration of chlorzoxazone by about 54%, the area under the curve of chlorzoxazone by about 72%, and the half-life of chlorzoxazone by about 35%. Chlorzoxazone is used as a probe drug for CYP2E1.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, resveratrol might increase levels of drugs metabolized by CYP3A4.
In vitro research shows that resveratrol can inhibit the CYP3A4 enzyme. However, clinical research shows that taking resveratrol 3000 mg daily for 8 weeks does not necessitate dose adjustments to medications metabolized by CYP3A4.
organic Alfalfa (aerial parts) juice powder
Warfarin (Coumadin)
Theoretically, alfalfa might reduce the anticoagulant activity of warfarin.
Alfalfa contains a large amount of vitamin K. This could theoretically interfere with the activity of warfarin.
Antidiabetes Drugs
Theoretically, alfalfa might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Animal research suggests that alfalfa decreases blood sugar in diabetic mice. Also, in one case report, a diabetic patient experienced hypoglycemia after consuming alfalfa extract. Monitor blood glucose levels closely. Dose adjustments might be necessary.
Contraceptive Drugs
Theoretically, alfalfa might interfere with the activity of contraceptive drugs.
Alfalfa contains coumestrol, a phytoestrogen, and isoflavonoids, which have estrogenic effects.
Estrogens
Theoretically, alfalfa might interfere with hormone therapy.
Alfalfa contains coumestrol, a phytoestrogen, and isoflavonoids, which have estrogenic effects.
Immunosuppressants
Theoretically, alfalfa might decrease the efficacy of immunosuppressive therapy.
In vitro research and human case reports suggest that alfalfa may have immunostimulant effects.
Photosensitizing Drugs
Theoretically, concomitant use of alfalfa with photosensitizing drugs might have additive effects.
Animal research suggests that excessive doses of alfalfa may increase photosensitivity, possibly due to its chlorophyll content. It is unclear if this effect would be clinically relevant in humans.
Magnesium Citrate
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.
Calcium
Ceftriaxone (Rocephin)
Co-administration of intravenous calcium and ceftriaxone can result in precipitation of a ceftriaxone-calcium salt in the lungs and kidneys.
Avoid administering intravenous calcium in any form, such as parenteral nutrition or Lactated Ringers, within 48 hours of intravenous ceftriaxone. Case reports in neonates show that administering intravenous ceftriaxone and calcium can result in precipitation of a ceftriaxone-calcium salt in the lungs and kidneys. In several cases, neonates have died as a result of this interaction. So far there are no reports in adults; however, there is still concern that this interaction might occur in adults.
Dolutegravir (Tivicay)
Calcium seems to reduce levels of dolutegravir.
Advise patients to take dolutegravir either 2 hours before or 6 hours after taking calcium supplements. Pharmacokinetic research suggests that taking calcium carbonate 1200 mg concomitantly with dolutegravir 50 mg reduces plasma levels of dolutegravir by almost 40%. Calcium appears to decrease levels of dolutegravir through chelation.
Elvitegravir (Vitekta)
Calcium seems to reduce levels of elvitegravir.
Advise patients to take elvitegravir either 2 hours before or 2 hours after taking calcium supplements. Pharmacokinetic research suggests that taking calcium along with elvitegravir can reduce blood levels of elvitegravir through chelation.
Aluminum
Calcium citrate might increase aluminum absorption and toxicity. Other types of calcium do not increase aluminum absorption.
Calcium citrate can increase the absorption of aluminum when taken with aluminum hydroxide. The increase in aluminum levels may become toxic, particularly in individuals with kidney disease. However, the effect of calcium citrate on aluminum absorption is due to the citrate anion rather than calcium cation. Calcium acetate does not appear to increase aluminum absorption.
Bictegravir/Emtricitabine/Tenofovir Alafenamide (Biktarvy)
Calcium might decrease levels of bictegravir/emtricitabine/tenofovir alafenamide by reducing its absorption when taken in a fasting state.
Advise patients that bictegravir/emtricitabine/tenofovir alafenamide and calcium can be taken together if taken with food. However, if taken on an empty stomach, bictegravir/emtricitabine/tenofovir alafenamide should not be taken with, or 2 hours after, calcium containing products.
Bisphosphonates
Calcium reduces the absorption of bisphosphonates.
Advise patients to take bisphosphonates at least 30 minutes before calcium, but preferably at a different time of day. Calcium supplements decrease absorption of bisphosphonates.
Calcipotriene (Dovonex)
Taking calcipotriene with calcium might increase the risk for hypercalcemia.
Calcipotriene is a vitamin D analog used topically for psoriasis. It can be absorbed in sufficient amounts to cause systemic effects, including hypercalcemia. Theoretically, combining calcipotriene with calcium supplements might increase the risk of hypercalcemia.
Digoxin (Lanoxin)
Using intravenous calcium with digoxin might increase the risk of fatal cardiac arrhythmias.
Hypercalcemia increases the risk of fatal cardiac arrhythmias with digoxin. However, one retrospective analysis of clinical data suggests that intravenous calcium does not increase the risk of dysrhythmias or mortality in patients receiving digoxin.
Diltiazem (Cardizem, Others)
Theoretically, calcium may reduce the therapeutic effects of diltiazem.
Hypercalcemia can reduce the effectiveness of verapamil in atrial fibrillation. Theoretically, calcium might increase this risk of hypercalcemia and reduce the effectiveness of diltiazem.
Levothyroxine (Synthroid, Others)
Calcium seems to reduce the absorption and effectiveness of levothyroxine.
Advise patients to take levothyroxine and calcium supplements at least 4 hours apart. Calcium reduces levothyroxine absorption, probably by forming insoluble complexes. Calcium carbonate supplements reduce effectiveness of levothyroxine in patients with hypothyroidism.
Lithium
Theoretically, concomitant use of calcium and lithium may increase this risk of hypercalcemia.
Clinical research suggests that long-term use of lithium may cause hypercalcemia in 10% to 60% of patients. Theoretically, concomitant use of lithium and calcium supplements may further increase this risk.
Quinolone Antibiotics
Calcium seems to reduce the absorption of quinolone antibiotics.
Advise patients to take oral quinolones at least 2 hours before or 4-6 hours after calcium supplements or calcium-fortified foods. Taking calcium at the same time as oral quinolones can reduce quinolone absorption. Calcium binds to quinolones in the gut.
Raltegravir (Isentress)
Calcium may reduce levels of raltegravir.
Pharmacokinetic research shows that taking a single dose of calcium carbonate 3000 mg along with raltegravir 400 mg twice daily modestly decreases the mean area under the curve of raltegravir, but the decrease does not necessitate a dose adjustment of raltegravir. However, a case of elevated HIV-1 RNA levels and documented resistance to raltegravir has been reported for a patient taking calcium carbonate 1 gram three times daily plus vitamin D3 (cholecalciferol) 400 IU three times daily in combination with raltegravir 400 mg twice daily for 11 months. It is thought that calcium reduced raltegravir levels by chelation, leading to treatment failure.
Sotalol (Betapace)
Calcium seems to reduce the absorption of sotalol.
Advise patients to separate doses by at least 2 hours before or 4-6 hours after calcium. Calcium appears to reduce the absorption of sotalol, probably by forming insoluble complexes.
Tetracycline Antibiotics
Calcium seems to reduce the absorption of tetracycline antibiotics.
Advise patients to take oral tetracyclines at least 2 hours before, or 4-6 hours after calcium supplements. Taking calcium at the same time as oral tetracyclines can reduce tetracycline absorption. Calcium binds to tetracyclines in the gut.
Thiazide Diuretics
Taking calcium along with thiazides might increase the risk of hypercalcemia and renal failure.
Thiazides reduce calcium excretion by the kidneys. Using thiazides along with moderately large amounts of calcium carbonate increases the risk of milk-alkali syndrome (hypercalcemia, metabolic alkalosis, renal failure). Patients may need to have their serum calcium levels and/or parathyroid function monitored regularly.
Verapamil (Calan, Others)
Theoretically, calcium may reduce the therapeutic effects of verapamil.
Hypercalcemia can reduce the effectiveness of verapamil in atrial fibrillation. Theoretically, use of calcium supplements may increase this risk of hypercalcemia and reduce the effectiveness of verapamil.
Calcium Channel Blockers
Intravenous calcium may decrease the effects of calcium channel blockers; oral calcium is unlikely to have this effect.
Intravenous calcium is used to decrease the effects of calcium channel blockers in the management of overdose. Intravenous calcium gluconate has been used before intravenous verapamil (Isoptin) to prevent or reduce the hypotensive effects without affecting the antiarrhythmic effects. But there is no evidence that dietary or supplemental calcium when taken orally interacts with calcium channel blockers.
Inositol
Antidiabetes Drugs
Theoretically, taking inositol with antidiabetes drugs might increase the risk of hypoglycemia.
Clinical research shows that inositol lowers blood glucose levels and glycated hemoglobin (HbA1c) levels in patients with diabetes.
Iron
Bictegravir/Emtricitabine/Tenofovir Alafenamide (Biktarvy)
Iron might decrease levels of bictegravir/emtricitabine/tenofovir alafenamide by reducing its absorption when taken in a fasting state.
Advise patients that bictegravir/emtricitabine/tenofovir alafenamide and iron can be taken together if taken with food. However, if taken on an empty stomach, bictegravir/emtricitabine/tenofovir alafenamide should not be taken with, or 2 hours after, iron containing products.
Bisphosphonates
Iron reduces the absorption of bisphosphonates.
Advise patients that doses of bisphosphonates should be separated by at least two hours from doses of all other medications, including supplements such as iron. Divalent cations, including iron, can decrease absorption of bisphosphonates by forming insoluble complexes in the gastrointestinal tract.
Denosumab (Prolia, Others)
Administration of intravenous iron within one month of denosumab administration might increase the risk of severe hypophosphatemia and hypocalcemia.
A case of severe hypocalcemia (albumin corrected calcium 6.88 mg/dL, ionized calcium 3.68 mg/dL) and hypophosphatemia (<0.5 mg/dL) with respiratory acidosis, QT interval prolongation, and nonsustained ventricular tachycardia was reported in a 76-year-old male who had received an iron polymaltose infusion within 2 weeks of a subcutaneous injection of denosumab. Serum parathyroid hormone was also elevated (348 pg/mL). Subsequent iron infusions with iron polymaltose and ferric carboxymaltose were followed by transient hypophosphatemia, but without hypocalcemia. Additionally, a literature review describes 6 additional cases of hypophosphatemia and hypocalcemia in patients 52-92 years of age who had been administered intravenous iron as either ferric carboxymaltose or iron polymaltose and subcutaneous denosumab within 1-4 weeks of each other.
Dolutegravir (Tivicay)
Iron might decrease dolutegravir levels by reducing its absorption.
Advise patients to take dolutegravir at least 2 hours before or 6 hours after taking iron. Pharmacokinetic research shows that iron can decrease the absorption of dolutegravir from the gastrointestinal tract through chelation. When taken under fasting conditions, a single dose of ferrous fumarate 324 mg orally along with dolutegravir 50 mg reduces overall exposure to dolutegravir by 54%.
Integrase Inhibitors
Theoretically, taking iron along with integrase inhibitors might decrease the levels and clinical effects of these drugs.
Iron is a divalent cation. There is concern that iron may decrease the absorption of integrase inhibitors from the gastrointestinal tract through chelation. One pharmacokinetic study shows that iron can decrease blood levels of the specific integrase inhibitor dolutegravir through chelation. Also, other pharmacokinetic research shows that other divalent cations such as calcium can decrease the absorption and levels of some integrase inhibitors through chelation.
Levodopa
Iron might decrease levodopa levels by reducing its absorption.
Advise patients to separate doses of levodopa and iron as much as possible. There is some evidence in healthy people that iron forms chelates with levodopa, reducing the amount of levodopa absorbed by around 50%. The clinical significance of this hasn't been determined.
Levothyroxine (Synthroid, Others)
Iron might decrease levothyroxine levels by reducing its absorption.
Advise patients to separate levothyroxine and iron doses by at least 2 hours. Iron can decrease the absorption and efficacy of levothyroxine by forming insoluble complexes in the gastrointestinal tract.
Methyldopa (Aldomet)
Iron might decrease methyldopa levels by reducing its absorption.
Advise patients to separate methyldopa and iron doses by at least 2 hours. Iron can decrease the absorption of methyldopa from the gastrointestinal tract through chelation, resulting in increases in blood pressure.
Mycophenolate Mofetil (Cellcept)
Theoretically, iron might decrease mycophenolate mofetil levels by reducing its absorption.
Advise patients to take iron 4-6 hours before, or 2 hours after, mycophenolate mofetil. It has been suggested that a decrease of absorption is possible, probably by forming nonabsorbable chelates. However, mycophenolate pharmacokinetics are not affected by iron supplementation in available clinical research.
Penicillamine (Cuprimine, Depen)
Iron might decrease penicillamine levels by reducing its absorption.
Advise patients to separate penicillamine and iron doses by at least 2 hours. Oral iron supplements can reduce absorption of penicillamine by 30% to 70%, probably due to chelate formation. In people with Wilson's disease, this interaction has led to reduced efficacy of penicillamine.
Quinolone Antibiotics
Iron might decrease levels of quinolone antibiotics by reducing their absorption.
Advise patients to separate quinolone antibiotics and iron doses by at least 2 hours. Iron decreases the absorption of quinolones due to formation of insoluble complexes in the gastrointestinal tract.
Tetracycline Antibiotics
Iron might decrease levels of tetracycline antibiotics by reducing their absorption.
Advise patients to take iron at least 2 hours before or 4 hours after tetracycline antibiotics. Concomitant use can decrease absorption of tetracycline antibiotics from the gastrointestinal tract by 50% to 90%.
Chloramphenicol
Theoretically, taking chloramphenicol with iron might reduce the response to iron therapy in iron deficiency anemia.
Chloramphenicol interferes with erythrocyte maturation. However, since chloramphenicol isn't usually taken for prolonged periods, this isn't likely to be clinically significant.
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.
Rice Protein
Ace Inhibitors (Aceis)
In laboratory research, hydrolyzed rice protein inhibits angiotensin-converting enzyme (ACE). In animal research, the inhibition of ACE is correlated with a reduction in systolic blood pressure. So far, this effect has not been shown in humans. Theoretically, concomitant use of rice protein and ACE inhibitors may increase the risk of blood pressure becoming too low. Use with caution. ACE inhibitors include benazepril (Lotensin), captopril (Capoten), enalapril (Vasotec), fosinopril (Monopril), lisinopril (Prinivil, Zestril), moexipril (Univasc), perindopril (Aceon), quinapril (Accupril), ramipril (Altace), and trandolapril (Mavik).
Choline Bitartrate
Atropine
Theoretically, choline might decrease the effects of atropine in the brain.
Animal research shows that administering choline one hour before administering atropine can attenuate atropine-induced decreases in brain levels of acetylcholine. Theoretically, concomitant use of choline and atropine may decrease the effects of atropine.
Brand information
Manufacturer and brand details for SP Complete Dairy Free, from the product label.
SP Standard Process
See all SP Standard Process products- Name
- Standard Process Inc.
- Street Address
- 1200 West Royal Lee Drive
- City
- Palmyra
- State
- WI
- ZipCode
- 53156
SP Complete Dairy Free by SP Standard Process: Common Questions
Does SP Complete Dairy Free by SP Standard Process interact with any medications?
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What is inositol, and does it actually work?
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Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
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The Full Monographs Behind SP Complete Dairy Free’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Black Psyllium
Interacts with 2,025 drugsBlack psyllium is a soluble-fiber supplement made from the seeds of a Plantago plant, used mostly to ease constipation and support digestive health. It is best known and most studied for rel...
Read the full Black Psyllium monograph → Herb & supplement 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 monographCalcium
Interacts with 168 drugsCalcium is an essential mineral your body needs for strong bones, nerve signaling, and muscle function, and supplements can help fill gaps when diet falls short. Most people do best getting...
Read the full Calcium monograph → Herb & supplement monographIron
Interacts with 80 drugsIron is an essential mineral your body needs to make hemoglobin and carry oxygen in the blood. Supplements are mainly useful for treating or preventing iron deficiency and iron-deficiency an...
Read the full Iron monograph → Herb & supplement monographInositol
Interacts with 86 drugsInositol is a sugar alcohol made naturally in the body and found in many foods, and it is sold as a supplement (often myo-inositol) mainly for PCOS, mood, and metabolic concerns. The stronge...
Read the full Inositol monograph → Herb & supplement monographCholine
Interacts with 16 drugsCholine is an essential nutrient your body needs for liver function, brain health, and nerve signaling, and many people get enough from foods like eggs, meat, and fish. Supplements may help...
Read the full Choline monograph → Herb & supplement monographMagnesium
Interacts with 295 drugsMagnesium is an essential mineral your body needs for muscles, nerves, blood pressure, and many other functions, and supplements are useful for preventing or correcting deficiency. Some othe...
Read the full Magnesium monograph → Herb & supplement monographRice Protein
Interacts with 23 drugsRice protein is a plant-based protein powder made from rice that offers an easy way to add protein to your diet, especially if you avoid dairy or animal products. It is generally considered...
Read the full Rice Protein monograph → Herb & supplement monographCarrot
Carrot is a common food vegetable that is a rich source of beta-carotene (which the body turns into vitamin A) and other nutrients. Eating carrots is safe and nutritious for most people, but...
Read the full Carrot monograph → Herb & supplement monographResveratrol
Interacts with 822 drugsResveratrol is a plant compound found in red grapes, berries, and peanuts that is popular for heart health, anti-aging, and antioxidant support. While lab and animal studies are promising, s...
Read the full Resveratrol monograph → Herb & supplement monographLecithin
Lecithin is a natural fatty substance found in foods and made by the body that is widely used as a supplement and food emulsifier. Evidence supporting most of its health claims is limited, t...
Read the full Lecithin monograph → Herb & supplement monographAlfalfa
Interacts with 583 drugsAlfalfa is a nutrient-rich legume that people use for high cholesterol, menopause symptoms, and general wellness, but solid human evidence for most of these uses is limited. It is best avoid...
Read the full Alfalfa monograph → Herb & supplement monographBuckwheat
Buckwheat is a nutritious, naturally gluten-free seed that is high in fiber, protein, and antioxidants like rutin. As a food it can be part of a heart-healthy diet, but evidence that buckwhe...
Read the full Buckwheat monograph → Herb & supplement monographKale
Kale is a nutrient-dense leafy green vegetable that is rich in vitamins, minerals, fiber, and antioxidants. Eaten as a normal food it is very healthy for most people, but it is a whole food...
Read the full Kale monograph → Herb & supplement monographGrape
Interacts with 910 drugsGrapes and grape products like grape seed extract contain antioxidant compounds such as resveratrol and proanthocyanidins that may support heart and blood vessel health. While the food is he...
Read the full Grape monograph →Sources & How We Checked
SP Complete Dairy Free'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 407 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.
Black Psyllium 18 references
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- Covington TR, et al. Handbook of Nonprescription Drugs. 11th ed. Washington, DC: American Pharmaceutical Association, 1996.
- Etman M. Effect of a bulk forming laxative on the bioavailablility of carbamazepine in man. Drug Dev Ind Pharm 1995;21:1901-6.
- Perlman BB. Interaction between lithium salts and ispaghula husk. Lancet 1990;335:416.
- Vaswani SK, Hamilton RG, Valentine MD, Adkinson NF. Psyllium laxative-induced anaphylaxis, asthma, and rhinitis. Allergy 1996;51:266-8. PubMed
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- Nordstrom M, Melander A, Robertsson E, Steen B. Influence of wheat bran and of a bulk-forming ispaghula cathartic on the bioavailability of digoxin in geriatric in-patients. Drug Nutr Interact 1987;5:67-9..
- Robinson DS, Benjamin DM, McCormack JJ. Interaction of warfarin and nonsystemic gastrointestinal drugs. Clin Pharmacol Ther 1971;12:491-5. PubMed
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- Fernandez N, Lopez C, Díez R, et al. Drug interactions with the dietary fiber Plantago ovata husk. Expert Opin Drug Metab Toxicol 2012;8(11):1377-86.
- Semen plantaginis in: WHO Monographs on Selected Medicinal Plants, volume 1. World Health Organization, Geneva, 1999. Available at http://apps.who.int/medicinedocs/en/d/Js2200e/. Accessed November 26, 1026.
- Code of Federal Regulations, Title 21 (21CFR 101.17). Food labeling warning, notice, and safe handling statements. Available at www.ecfr.gov/cgi-bin/text-idx?SID=20f647d3b74161501f46564b915b4048&mc=true&node=se21.2.101_117&rgn=div8. Accessed December 3, 2
- Code of Federal Regulations, Title 21 (21CFR 201.319). Specific labeling requirements - water-soluble gums, hydrophilic gums, and hydrophilic mucilloids. Available at www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?fr=201.319. Accessed Dece
- Diez R, Garcia JJ, Diez MJ, Sierra M, Sahagun AM, Fernandez N. Influence of Plantago ovata husk (dietary fiber) on the bioavailability and other pharmacokinetic parameters of metformin in diabetic rabbits. BMC Complement Altern Med. 2017 Jun 7;17(1):298. PubMed
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Potassium 12 references
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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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- 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
Calcium 62 references
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- Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
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- Gueguen L, Pointillart A. The bioavailability of dietary calcium. J Am Coll Nutr 2000;19:119s-136s. PubMed
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- Bania TC, Blaufeux B, Hughes S, et al. Calcium and digoxin vs. calcium alone for severe verapamil toxicity. Acad Emerg Med 2000;7:1089-96. PubMed
- Tseng M, Breslow RA, Graubard BI, Ziegler RG. Dairy, calcium, and vitamin D intakes and prostate cancer risk in the National Health and Nutrition Examination Epidemiologic Follow-up Study cohort. Am J Clin Nutr 2005;81:1147-54. PubMed
- Weingarten MA, Zalmanovici A, Yaphe J. Dietary calcium supplementation for preventing colorectal cancer and adenomatous polyps. Cochrane Database Syst Rev 2004;(1):CD003548. PubMed
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- Giovannucci E, Liu Y, Stampfer MJ, Willett WC. A prospective study of calcium intake and incident and fatal prostate cancer. Cancer Epidemiol Biomarkers Prev 2006;15:203-10. PubMed
- Rocephin (ceftriaxone) and calcium interaction. Pharmacist's Letter / Prescriber's Letter 2007;23(10):231005.
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- Dietary reference intakes for calcium and vitamin D. Institute of Medicine, November 30, 2010. Available at: http://www.iom.edu/~/media/Files/Report%20Files/2010/Dietary-Reference-Intakes-for-Calcium-and-Vitamin-D/Vitamin%20D%20and%20Calcium%202010%20Repo
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- Li K, Kaaks R, Linseisen J, Rohrmann S. Associations of dietary calcium intake and calcium supplementation with myocardial infarction and stroke risk and overall cardiovascular mortality in the Heidelberg cohort of the European Prospective Investigation i
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- Lappe J, Watson P, Travers-Gustafson D, Recker R, Garland C, Gorham E, Baggerly K, McDonnell SL. Effect of Vitamin D and Calcium Supplementation on Cancer Incidence in Older Women: A Randomized Clinical Trial. JAMA. 2017 Mar 28;317(12):1234-1243. PubMed
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- Insentress [package insert]. Whitehouse Station, NJ: Merck Sharp & Dohme Corp.; 2014.
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- Vitekta [package insert]. Foster City, CA: Gilead Sciences, Inc.; 2014.
- Storan ER, O'Gorman SM, Murphy A, Laing M. Case Report of Calciphylaxis Secondary to Calcium and Vitamin D<sub>3</sub> Supplementation. J Cutan Med Surg. 2017;21(2):162-163. DOI
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- Borkenhagen JF, Connor EL, Stafstrom CE. Neonatal hypocalcemic seizures due to excessive maternal calcium ingestion. Pediatr Neurol 2013;48(6):469-71. PubMed
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Iron 72 references
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