TOS Cal Hydroxy Ingredients & Drug Interactions
by Genestra Brands
What is this page for?
First and foremost: checking TOS Cal Hydroxy 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
TOS Cal Hydroxy is a dietary supplement by Genestra Brands with 7 active ingredients. Its ingredients are commonly taken for bone health and osteoporosis, correcting vitamin d deficiency, immune system support.Based on those ingredients, 1,029 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are Vitamin D, Magnesium, Vanadium. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against TOS Cal Hydroxy by Genestra Brands
Ask about any prescription or over-the-counter medication and we check it for interactions with TOS Cal Hydroxy by Genestra Brands — 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 TOS Cal Hydroxy by Genestra Brands
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
TOS Cal Hydroxy contains seven active ingredients: vitamin D, vanadium, magnesium, molybdenum, calcium, phosphorus, and horsetail (Equisetum arvense) aerial parts extract. These work together to support bone structure and mineral balance — vitamin D aids calcium absorption and bone metabolism, magnesium and calcium are structural minerals, and phosphorus partners with calcium in bone formation.
The product also includes inactive ingredients (hypromellose, cellulose, magnesium stearate, and silica) as capsule materials and binders.
Does it work?
Strong evidence
Vitamin D is effective for rickets, osteomalacia, renal bone disease, and hypoparathyroidism. Magnesium is effective for constipation, indigestion, and low blood magnesium.
Calcium is effective for low blood calcium, high potassium levels, and is likely effective for osteoporosis. Vanadium is likely effective for vanadium deficiency only.
For molybdenum, the evidence for deficiency is likely effective, but for other conditions listed — acne, anemia, asthma, osteoporosis, and cancer — the data we hold shows insufficient evidence to rate. Horsetail's effectiveness for urinary incontinence, weight management, and hair loss has insufficient evidence in our data.
How safe is it?
Well-documented data
Vitamin D is generally well tolerated at recommended doses but can cause toxicity with excessive use — symptoms include high blood calcium (hypercalcemia), kidney problems, and bone loss. Vanadium at dietary levels is fine, but supplement doses above 1.8 mg daily may cause stomach upset, diarrhea, or kidney damage with long-term high-dose use.
Magnesium is generally well tolerated and commonly causes mild diarrhea or stomach upset; rarely, very high doses can affect bones or cause bezoars (blockages). Molybdenum is generally well tolerated at recommended amounts.
Calcium is well tolerated at recommended doses; high doses carry theoretical concerns about kidney stones and cardiovascular risk, though evidence is mixed. Horsetail has limited safety data; common side effects include bloating and loose stools.
Crude horsetail contains thiaminase, which can deplete thiamine (vitamin B1) with long-term use, though Canadian products must be certified thiaminase-free.
Meds to double-check
Major interaction found
Check before taking this product if you use: levodopa/carbidopa (Parkinson's disease) — magnesium can significantly reduce its effectiveness. HIV integrase inhibitors like dolutegravir or elvitegravir — calcium reduces their blood levels dangerously.
Thiazide or potassium-sparing diuretics, verapamil, digoxin, diltiazem, or atorvastatin — vitamin D can interfere. Muscle relaxants, quinolone antibiotics, bisphosphonates, antacids, beta-blockers like sotalol, or levothyroxine — magnesium or calcium can reduce absorption.
Lithium, blood thinners, or diabetes medications — other ingredients may increase or decrease their effects. Use the medication checker on this page for your complete list.
The bottom line
Scorecard at a glanceFully disclosed formula with clinical evidence supporting its stated purpose. Major medication interactions have been identified, and safety information is well characterized.
TOS Cal Hydroxy is designed to support bone health and mineral balance through vitamin D, calcium, magnesium, and other minerals. If you take heart rhythm medications, blood thinners, HIV drugs, thyroid medication, diabetes medication, antibiotics, or bone drugs, check your exact prescriptions with the tool on this page before starting.
Talk with your pharmacist or doctor — this product has many interactions and isn't right for everyone.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 6 of 7 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Jan 25, 2016.
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 TOS Cal Hydroxy, straight from the product label.
| Brand | Genestra Brands |
|---|---|
| Barcode (UPC) | 88319612352 |
| Net contents | 60 Vegetable Capsule(s) |
| Market status | On market |
| Date entered into DSLD | Jan 25, 2016 |
| DSLD ID | 56094 |
| Product type | Botanical With Nutrients |
| Supplement form | Capsule |
| Dietary claims / uses | All Other |
| Intended target group(s) | Adult (18 - 50 Years) |
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.
Supplement Facts
The label details for TOS Cal Hydroxy by Genestra Brands, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Vitamin D | 100 IU | 25% |
| Vanadium | 25 mcg | -- |
| Magnesium | 25 mg | 6% |
| Molybdenum | 25 mcg | 33% |
| Calcium | 125 mg | 13% |
| Phosphorus | 62.5 mg | 6% |
| Horsetail (Equisetum arvense) aerial parts extract | 25 mg | -- |
Other ingredients: Hypromellose, Cellulose, Magnesium Stearate, Silica
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
Recommended Adult Dose: Take one capsule daily with a meal, a few hours before or after taking other medications, or as recommended by your healthcare practitioner.
Precautions
Risk Information: If you are pregnant or breastfeeding; or if you have a heart or kidney disorder, consult your healthcare practitioner prior to use.
Quality Assurance: Safety-sealed for your protection and for product freshness. Do not use if outer seal is missing or broken.
Formulation
Guaranteed to contain no added wheat, yeast, gluten, soy, sodium, artificial coloring or flavoring or dairy products. The capsules are made from 100% pure vegetable sources, free of preservatives and additives.
Storage
Store in a cool, dry place.
General
V1.0 320
Seals/Symbols
Seroyal
FDA Statement of Identity
CALCIUM-MAGNESIUM SUPPLEMENT
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
TOS Cal Hydroxy by Genestra Brands 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 TOS Cal Hydroxy by Genestra Brands
These are the 7 active ingredients this product is made of. Select any to open its full monograph.
Serving size1 Capsule(s) Dosage formCapsule Servings per container60 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.
Vitamin D
Interacts with715 drugs
Vitamin D is a fat-soluble vitamin that helps your body absorb calcium and is important for healthy bones, muscles, and immune function. Many people,...
Vitamin D monograph & interactionsVanadium
Interacts with208 drugs
Vanadium is a trace mineral found in tiny amounts in food, and people get plenty from a normal diet. Supplement claims for diabetes, weight, and athle...
Vanadium monograph & interactionsMagnesium
Interacts with295 drugs
Magnesium is an essential mineral your body needs for muscles, nerves, blood pressure, and many other functions, and supplements are useful for preven...
Magnesium monograph & interactionsMolybdenum
No knowninteractions
Molybdenum is an essential trace mineral your body needs in tiny amounts to help certain enzymes work. Most people get enough from a normal diet, so s...
Molybdenum 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 & interactionsPhosphorus
Horsetail (Equisetum arvense) aerial parts extract
Interacts with188 drugs
Horsetail is a traditional herb most often used as a mild diuretic and for hair, nail, and bone support, but high-quality human evidence is limited. I...
Horsetail (Equisetum arvense) aerial parts extract monograph & interactionsOther (inactive) ingredients: Hypromellose, Cellulose, Magnesium Stearate, Silica. These complete the product’s ingredient list but are not active constituents.
TOS Cal Hydroxy by Genestra Brands Drug Interactions
HelloPharmacist Interaction Report
TOS Cal Hydroxy by Genestra Brands contains several active ingredients with documented interactions.
The most serious concern involves magnesium and levodopa/carbidopa (Sinemet) — a Major interaction where magnesium can reduce levodopa blood levels by up to 35%, potentially worsening Parkinson's disease control.
Read the full breakdown — every affected drug type, severity by severity
Vitamin D in this product has Moderate interactions with thiazide diuretics, verapamil, atorvastatin, diltiazem, digoxin, and calcipotriene, mainly through a mechanism of high-dose vitamin D raising blood calcium levels (hypercalcemia), which can interfere with heart rhythm drugs or increase toxicity risk. Calcium has Major interactions with two HIV integrase inhibitors (dolutegravir and elvitegravir) and intravenous ceftriaxone — calcium can significantly reduce their blood levels or cause dangerous precipitation.
Calcium also has Moderate interactions with thyroid hormone replacement, certain beta-blockers, and other drugs.
Magnesium carries Moderate interactions with muscle relaxants, potassium-sparing diuretics, calcium channel blockers, antacids, diabetes drugs, quinolone and fluoroquinolone antibiotics, and bisphosphonate bone drugs. Vanadium has Moderate interactions with blood thinners and diabetes medications.
Horsetail has Moderate interactions with diabetes drugs, diuretics, lithium, and HIV medications including efavirenz.
Altogether, these interactions span 1,016 individual medications. We could not check phosphorus — no interaction data is on file for it.
Use the medication checker below to verify your exact prescriptions before starting this product.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against TOS Cal Hydroxy?
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 TOS Cal Hydroxy interact with 1,029 drugs. Click any drug to see the details.
5 of the 7 ingredients in TOS Cal Hydroxy interact with drugs. Each result below shows which ingredient is responsible. Vitamin D Magnesium Vanadium Horsetail (Equisetum arvense) aerial parts extract Calcium
AcetohexamideDymelor
How Acetohexamide interacts with TOS Cal Hydroxy — through 3 ingredients. Tap an ingredient for the detail:
MagnesiumSulfonylureas Moderate
Interaction Summary
Magnesium increases the systemic absorption of sulfonylureas, increasing their effects and side effects.
Read the full Magnesium + Acetohexamide interactionVanadiumAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, vanadium might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Read the full Vanadium + Acetohexamide interactionHorsetail (equisetum Arvense) Aerial Parts ExtractAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, taking horsetail with antidiabetes drugs might increase the risk of hypoglycemia.
Read the full Horsetail (equisetum Arvense) Aerial Parts Extract + Acetohexamide interactionAcetylsalicylic AcidEntrophen
How Acetylsalicylic Acid interacts with TOS Cal Hydroxy — through 2 ingredients. Tap an ingredient for the detail:
VanadiumAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, vanadium might increase the risk of bleeding when taken with anticoagulant/antiplatelet drugs.
Read the full Vanadium + Acetylsalicylic Acid interactionMagnesiumAnticoagulant/antiplatelet Drugs Minor
Interaction Summary
Theoretically, magnesium may have antiplatelet effects, but the evidence is conflicting.
Read the full Magnesium + Acetylsalicylic Acid interactionAdefovirHepsera
How Adefovir interacts with TOS Cal Hydroxy — through 1 ingredient. Tap an ingredient for the detail:
Horsetail (equisetum Arvense) Aerial Parts ExtractNucleoside Reverse Transcriptase Inhibitors (nrtis) Moderate
Interaction Summary
Theoretically, horsetail might decrease the levels and clinical effects of NRTIs.
Read the full Horsetail (equisetum Arvense) Aerial Parts Extract + Adefovir interactionAlbiglutideTanzeum
How Albiglutide interacts with TOS Cal Hydroxy — through 2 ingredients. Tap an ingredient for the detail:
VanadiumAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, vanadium might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Read the full Vanadium + Albiglutide interactionHorsetail (equisetum Arvense) Aerial Parts ExtractAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, taking horsetail with antidiabetes drugs might increase the risk of hypoglycemia.
Read the full Horsetail (equisetum Arvense) Aerial Parts Extract + Albiglutide interactionAlcuroniumAlcuronium
How Alcuronium interacts with TOS Cal Hydroxy — 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 TOS Cal Hydroxy — through 2 ingredients. Tap an ingredient for the detail:
MagnesiumBisphosphonates Moderate
Interaction Summary
Magnesium can decrease absorption of bisphosphonates.
Read the full Magnesium + Alendronate interactionCalciumBisphosphonates Moderate
Interaction Summary
Calcium reduces the absorption of bisphosphonates.
Read the full Calcium + Alendronate interactionAlendronate Sodium
How Alendronate Sodium interacts with TOS Cal Hydroxy — through 2 ingredients. Tap an ingredient for the detail:
CalciumBisphosphonates Moderate
Interaction Summary
Calcium reduces the absorption of bisphosphonates.
Read the full Calcium + Alendronate Sodium interactionMagnesiumBisphosphonates 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 TOS Cal Hydroxy — through 2 ingredients. Tap an ingredient for the detail:
MagnesiumBisphosphonates Moderate
Interaction Summary
Magnesium can decrease absorption of bisphosphonates.
Read the full Magnesium + Alendronate Sodium, Cholecalciferol interactionCalciumBisphosphonates Moderate
Interaction Summary
Calcium reduces the absorption of bisphosphonates.
Read the full Calcium + Alendronate Sodium, Cholecalciferol interactionAlginic Acid, Aluminum HydroxideRafton
How Alginic Acid, Aluminum Hydroxide interacts with TOS Cal Hydroxy — through 3 ingredients. Tap an ingredient for the detail:
CalciumAluminum Moderate
Interaction Summary
Calcium citrate might increase aluminum absorption and toxicity.
Read the full Calcium + Alginic Acid, Aluminum Hydroxide interactionVitamin DAluminum Moderate
Interaction Summary
Vitamin D might increase aluminum absorption and toxicity, but this has only been reported in people with renal failure.
Read the full Vitamin D + Alginic Acid, Aluminum Hydroxide interactionMagnesiumAntacids 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 TOS Cal Hydroxy — through 3 ingredients. Tap an ingredient for the detail:
Horsetail (equisetum Arvense) Aerial Parts ExtractAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, taking horsetail with antidiabetes drugs might increase the risk of hypoglycemia.
Read the full Horsetail (equisetum Arvense) Aerial Parts Extract + Alogliptin interactionVanadiumAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, vanadium might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Read the full Vanadium + Alogliptin interactionVitamin DCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Vitamin D might induce CYP3A4 enzymes and reduce the bioavailability of CYP3A4 substrates.
Read the full Vitamin D + Alogliptin interactionAlogliptin, MetforminKazano
How Alogliptin, Metformin interacts with TOS Cal Hydroxy — through 2 ingredients. Tap an ingredient for the detail:
VanadiumAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, vanadium might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Read the full Vanadium + Alogliptin, Metformin interactionHorsetail (equisetum Arvense) Aerial Parts ExtractAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, taking horsetail with antidiabetes drugs might increase the risk of hypoglycemia.
Read the full Horsetail (equisetum Arvense) Aerial Parts Extract + Alogliptin, Metformin interactionAlogliptin, PioglitazoneOseni
How Alogliptin, Pioglitazone interacts with TOS Cal Hydroxy — through 3 ingredients. Tap an ingredient for the detail:
Horsetail (equisetum Arvense) Aerial Parts ExtractAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, taking horsetail with antidiabetes drugs might increase the risk of hypoglycemia.
Read the full Horsetail (equisetum Arvense) Aerial Parts Extract + Alogliptin, Pioglitazone interactionVanadiumAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, vanadium might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Read the full Vanadium + Alogliptin, Pioglitazone interactionVitamin DCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Vitamin D might induce CYP3A4 enzymes and reduce the bioavailability of CYP3A4 substrates.
Read the full Vitamin D + Alogliptin, Pioglitazone interactionAlteplase, TpaActilyse, Activase
How Alteplase, Tpa interacts with TOS Cal Hydroxy — through 2 ingredients. Tap an ingredient for the detail:
VanadiumAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, vanadium might increase the risk of bleeding when taken with anticoagulant/antiplatelet drugs.
Read the full Vanadium + Alteplase, Tpa interactionMagnesiumAnticoagulant/antiplatelet Drugs Minor
Interaction Summary
Theoretically, magnesium may have antiplatelet effects, but the evidence is conflicting.
Read the full Magnesium + Alteplase, Tpa interactionAluminum Acetate, Benzethonium ChlorideBuro-Sol Otic Solution
How Aluminum Acetate, Benzethonium Chloride interacts with TOS Cal Hydroxy — through 2 ingredients. Tap an ingredient for the detail:
Vitamin DAluminum Moderate
Interaction Summary
Vitamin D might increase aluminum absorption and toxicity, but this has only been reported in people with renal failure.
Read the full Vitamin D + Aluminum Acetate, Benzethonium Chloride interactionCalciumAluminum Moderate
Interaction Summary
Calcium citrate might increase aluminum absorption and toxicity.
Read the full Calcium + Aluminum Acetate, Benzethonium Chloride interactionAluminum ChlorideAluminum Chloride, Anhydrol Forte, Driclor, Drysol
How Aluminum Chloride interacts with TOS Cal Hydroxy — through 2 ingredients. Tap an ingredient for the detail:
CalciumAluminum Moderate
Interaction Summary
Calcium citrate might increase aluminum absorption and toxicity.
Read the full Calcium + Aluminum Chloride interactionVitamin DAluminum Moderate
Interaction Summary
Vitamin D might increase aluminum absorption and toxicity, but this has only been reported in people with renal failure.
Read the full Vitamin D + Aluminum Chloride interactionAluminum HydroxideAlu-Cap, Amphojel, Gaviscon
How Aluminum Hydroxide interacts with TOS Cal Hydroxy — through 3 ingredients. Tap an ingredient for the detail:
Vitamin DAluminum Moderate
Interaction Summary
Vitamin D might increase aluminum absorption and toxicity, but this has only been reported in people with renal failure.
Read the full Vitamin D + Aluminum Hydroxide interactionCalciumAluminum Moderate
Interaction Summary
Calcium citrate might increase aluminum absorption and toxicity.
Read the full Calcium + Aluminum Hydroxide interactionMagnesiumAntacids 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 TOS Cal Hydroxy — through 4 ingredients. 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, Codeine Phosphate, Magnesium Hydroxide interactionCalciumAluminum Moderate
Interaction Summary
Calcium citrate might increase aluminum absorption and toxicity.
Read the full Calcium + Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide interactionVitamin DAluminum Moderate
Interaction Summary
Vitamin D might increase aluminum absorption and toxicity, but this has only been reported in people with renal failure.
Read the full Vitamin D + Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide interactionVanadiumAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, vanadium might increase the risk of bleeding when taken with anticoagulant/antiplatelet drugs.
Read the full Vanadium + Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide interactionAluminum Hydroxide, Aspirin, Magnesium HydroxideAscriptin
How Aluminum Hydroxide, Aspirin, Magnesium Hydroxide interacts with TOS Cal Hydroxy — through 4 ingredients. Tap an ingredient for the detail:
VanadiumAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, vanadium might increase the risk of bleeding when taken with anticoagulant/antiplatelet drugs.
Read the full Vanadium + Aluminum Hydroxide, Aspirin, Magnesium Hydroxide interactionVitamin DAluminum Moderate
Interaction Summary
Vitamin D might increase aluminum absorption and toxicity, but this has only been reported in people with renal failure.
Read the full Vitamin D + Aluminum Hydroxide, Aspirin, Magnesium Hydroxide interactionMagnesiumAnticoagulant/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 interactionCalciumAluminum Moderate
Interaction Summary
Calcium citrate might increase aluminum absorption and toxicity.
Read the full Calcium + Aluminum Hydroxide, Aspirin, Magnesium Hydroxide interactionAluminum Hydroxide, Magnesium Hydroxide (otc Drug)Maalox, Mucogel
How Aluminum Hydroxide, Magnesium Hydroxide (otc Drug) interacts with TOS Cal Hydroxy — through 3 ingredients. Tap an ingredient for the detail:
CalciumAluminum Moderate
Interaction Summary
Calcium citrate might increase aluminum absorption and toxicity.
Read the full Calcium + Aluminum Hydroxide, Magnesium Hydroxide (otc Drug) interactionMagnesiumAntacids 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) interactionVitamin DAluminum Moderate
Interaction Summary
Vitamin D might increase aluminum absorption and toxicity, but this has only been reported in people with renal failure.
Read the full Vitamin D + Aluminum Hydroxide, Magnesium Hydroxide (otc Drug) interactionAluminum Hydroxide, Magnesium Hydroxide, Simethicone (otc Drug)Mylanta
How Aluminum Hydroxide, Magnesium Hydroxide, Simethicone (otc Drug) interacts with TOS Cal Hydroxy — through 3 ingredients. Tap an ingredient for the detail:
Vitamin DAluminum Moderate
Interaction Summary
Vitamin D might increase aluminum absorption and toxicity, but this has only been reported in people with renal failure.
Read the full Vitamin D + Aluminum Hydroxide, Magnesium Hydroxide, Simethicone (otc Drug) interactionMagnesiumAntacids 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) interactionCalciumAluminum Moderate
Interaction Summary
Calcium citrate might increase aluminum absorption and toxicity.
Read the full Calcium + Aluminum Hydroxide, Magnesium Hydroxide, Simethicone (otc Drug) interactionAluminum, CalciumDomeboro
How Aluminum, Calcium interacts with TOS Cal Hydroxy — through 2 ingredients. Tap an ingredient for the detail:
CalciumAluminum Moderate
Interaction Summary
Calcium citrate might increase aluminum absorption and toxicity.
Read the full Calcium + Aluminum, Calcium interactionVitamin DAluminum Moderate
Interaction Summary
Vitamin D might increase aluminum absorption and toxicity, but this has only been reported in people with renal failure.
Read the full Vitamin D + Aluminum, Calcium interactionAluminum, Magnesium (otc Drug)Almagel
How Aluminum, Magnesium (otc Drug) interacts with TOS Cal Hydroxy — through 3 ingredients. Tap an ingredient for the detail:
Vitamin DAluminum Moderate
Interaction Summary
Vitamin D might increase aluminum absorption and toxicity, but this has only been reported in people with renal failure.
Read the full Vitamin D + Aluminum, Magnesium (otc Drug) interactionCalciumAluminum Moderate
Interaction Summary
Calcium citrate might increase aluminum absorption and toxicity.
Read the full Calcium + Aluminum, Magnesium (otc Drug) interactionMagnesiumAntacids Moderate
Interaction Summary
Use of acid reducers may reduce the laxative effect of magnesium oxide.
Read the full Magnesium + Aluminum, Magnesium (otc Drug) interactionAluminum, Magnesium Hydroxide (otc Drug)Wingel
How Aluminum, Magnesium Hydroxide (otc Drug) interacts with TOS Cal Hydroxy — through 2 ingredients. Tap an ingredient for the detail:
CalciumAluminum Moderate
Interaction Summary
Calcium citrate might increase aluminum absorption and toxicity.
Read the full Calcium + Aluminum, Magnesium Hydroxide (otc Drug) interactionVitamin DAluminum Moderate
Interaction Summary
Vitamin D might increase aluminum absorption and toxicity, but this has only been reported in people with renal failure.
Read the full Vitamin D + Aluminum, Magnesium Hydroxide (otc Drug) interactionAmikacinAmikin, Arikayce
How Amikacin interacts with TOS Cal Hydroxy — 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 TOS Cal Hydroxy — 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 interactionAmiloride, HydrochlorothiazideAmil-Co, Amilzide, Moduret 25, Moduretic
How Amiloride, Hydrochlorothiazide interacts with TOS Cal Hydroxy — through 4 ingredients. Tap an ingredient for the detail:
Vitamin DThiazide Diuretics Moderate
Interaction Summary
Theoretically, taking thiazide diuretics and high-dose vitamin D can increase the risk of hypercalcemia.
Read the full Vitamin D + Amiloride, Hydrochlorothiazide interactionMagnesiumPotassium-sparing Diuretics Moderate
Interaction Summary
Potassium-sparing diuretics decrease excretion of magnesium, possibly increasing magnesium levels.
Read the full Magnesium + Amiloride, Hydrochlorothiazide interactionHorsetail (equisetum Arvense) Aerial Parts ExtractDiuretic Drugs Moderate
Interaction Summary
Theoretically, taking horsetail with diuretic drugs might increase potassium loss and the risk of hypokalemia.
Read the full Horsetail (equisetum Arvense) Aerial Parts Extract + Amiloride, Hydrochlorothiazide interactionCalciumThiazide Diuretics Moderate
Interaction Summary
Taking calcium along with thiazides might increase the risk of hypercalcemia and renal failure.
Read the full Calcium + Amiloride, Hydrochlorothiazide interactionAmlodipineNorliqva
How Amlodipine interacts with TOS Cal Hydroxy — through 3 ingredients. Tap an ingredient for the detail:
MagnesiumCalcium Channel Blockers Moderate
Interaction Summary
Magnesium can have additive effects with calcium channel blockers, although evidence is conflicting.
Read the full Magnesium + Amlodipine interactionVitamin DCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Vitamin D might induce CYP3A4 enzymes and reduce the bioavailability of CYP3A4 substrates.
Read the full Vitamin D + Amlodipine interactionCalciumCalcium Channel Blockers Minor
Interaction Summary
Intravenous calcium may decrease the effects of calcium channel blockers; oral calcium is unlikely to have this effect.
Read the full Calcium + Amlodipine interactionAmlodipine BenzoateKaterzia
How Amlodipine Benzoate interacts with TOS Cal Hydroxy — through 3 ingredients. Tap an ingredient for the detail:
MagnesiumCalcium Channel Blockers Moderate
Interaction Summary
Magnesium can have additive effects with calcium channel blockers, although evidence is conflicting.
Read the full Magnesium + Amlodipine Benzoate interactionVitamin DCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Vitamin D might induce CYP3A4 enzymes and reduce the bioavailability of CYP3A4 substrates.
Read the full Vitamin D + Amlodipine Benzoate interactionCalciumCalcium Channel Blockers Minor
Interaction Summary
Intravenous calcium may decrease the effects of calcium channel blockers; oral calcium is unlikely to have this effect.
Read the full Calcium + Amlodipine Benzoate interactionAmlodipine BesilateIstin
How Amlodipine Besilate interacts with TOS Cal Hydroxy — through 3 ingredients. Tap an ingredient for the detail:
MagnesiumCalcium Channel Blockers Moderate
Interaction Summary
Magnesium can have additive effects with calcium channel blockers, although evidence is conflicting.
Read the full Magnesium + Amlodipine Besilate interactionCalciumCalcium Channel Blockers Minor
Interaction Summary
Intravenous calcium may decrease the effects of calcium channel blockers; oral calcium is unlikely to have this effect.
Read the full Calcium + Amlodipine Besilate interactionVitamin DCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Vitamin D might induce CYP3A4 enzymes and reduce the bioavailability of CYP3A4 substrates.
Read the full Vitamin D + Amlodipine Besilate interactionAmlodipine BesylateNorvasc
How Amlodipine Besylate interacts with TOS Cal Hydroxy — through 3 ingredients. Tap an ingredient for the detail:
MagnesiumCalcium Channel Blockers Moderate
Interaction Summary
Magnesium can have additive effects with calcium channel blockers, although evidence is conflicting.
Read the full Magnesium + Amlodipine Besylate interactionCalciumCalcium Channel Blockers Minor
Interaction Summary
Intravenous calcium may decrease the effects of calcium channel blockers; oral calcium is unlikely to have this effect.
Read the full Calcium + Amlodipine Besylate interactionVitamin DCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Vitamin D might induce CYP3A4 enzymes and reduce the bioavailability of CYP3A4 substrates.
Read the full Vitamin D + Amlodipine Besylate interactionEach ingredient & the kinds of drugs it affects
For each ingredient in TOS Cal Hydroxy 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.
Vitamin D
Aluminum
Vitamin D might increase aluminum absorption and toxicity, but this has only been reported in people with renal failure.
The protein that transports calcium across the intestinal wall can also bind and transport aluminum. This protein is stimulated by vitamin D, which may therefore increase aluminum absorption. This mechanism may contribute to increased aluminum levels and toxicity in people with renal failure, when they take vitamin D and aluminum-containing phosphate binders chronically.
Atorvastatin (Lipitor)
Vitamin D might reduce absorption of atorvastatin.
A small, low-quality clinical study shows that taking vitamin D reduces levels of atorvastatin and its active metabolites by up to 55%. However, while atorvastatin levels decreased, total cholesterol, low-density lipoprotein (LDL) cholesterol, and high-density lipoprotein (HDL) cholesterol levels did not substantially change. Atorvastatin is metabolized in the gut by CYP3A4 enzymes, and researchers theorized that vitamin D might induce CYP3A4, causing reduced levels of atorvastatin. However, this proposed mechanism was not specifically studied.
Calcipotriene (Dovonex)
Taking calcipotriene with vitamin D increases 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 vitamin D supplements might increase the risk of hypercalcemia.
Digoxin (Lanoxin)
Theoretically, hypercalcemia induced by high-dose vitamin D can increase the risk of arrhythmia from digoxin.
High doses of vitamin D can cause hypercalcemia. Hypercalcemia increases the risk of fatal cardiac arrhythmias with digoxin. Avoid vitamin D doses above the tolerable upper intake level (4000 IU daily for adults) and monitor serum calcium levels in people taking vitamin D and digoxin concurrently.
Diltiazem (Cardizem, Others)
Theoretically, hypercalcemia induced by high-dose vitamin D can reduce the therapeutic effects of diltiazem for arrhythmia.
High doses of vitamin D can cause hypercalcemia. Hypercalcemia can reduce the effectiveness of verapamil in atrial fibrillation. Theoretically this could also occur with diltiazem. Avoid vitamin D doses above the tolerable upper intake level (4000 IU daily for adults) and monitor serum calcium levels in people taking vitamin D and diltiazem concurrently.
Thiazide Diuretics
Theoretically, taking thiazide diuretics and high-dose vitamin D can increase the risk of hypercalcemia.
Thiazide diuretics decrease urinary calcium excretion, which could lead to hypercalcemia if vitamin D supplements are taken concurrently. This has been reported in people being treated with vitamin D for hypoparathyroidism, and also in elderly people with normal parathyroid function who were taking a thiazide, vitamin D, and calcium-containing antacids daily.
Verapamil (Calan, Others)
Hypercalcemia induced by high-dose vitamin D can reduce the therapeutic effects of verapamil for arrhythmia.
Hypercalcemia due to high doses of vitamin D can reduce the effectiveness of verapamil in atrial fibrillation. Avoid vitamin D doses above the tolerable upper intake level (4000 IU daily for adults) and monitor serum calcium levels in people taking vitamin D and verapamil concurrently.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Vitamin D might induce CYP3A4 enzymes and reduce the bioavailability of CYP3A4 substrates.
There is some concern that vitamin D might induce CYP3A4. In vitro research suggests that vitamin D induces CYP3A4 transcription. Additionally, observational research has found that increased UV light exposure and serum vitamin D levels are associated with decreased serum levels of CYP3A4 substrates such as tacrolimus and sirolimus, while no association between UV light exposure or vitamin D levels and levels of mycophenolic acid, a non-CYP3A4 substrate, was found. A small, low-quality clinical study shows that taking vitamin D reduces levels of the CYP3A4 substrate atorvastatin and its active metabolites by up to 55%; however, the clinical effects of atorvastatin were not reduced. While researchers theorized that vitamin D might induce CYP3A4, this proposed mechanism was not specifically studied.
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.
Vanadium
Anticoagulant/Antiplatelet Drugs
Theoretically, vanadium might increase the risk of bleeding when taken with anticoagulant/antiplatelet drugs.
In vitro research shows that the sodium orthovanadate form of vanadium prolongs clotting time, likely through inhibition of thrombin and factor Xa.
Antidiabetes Drugs
Theoretically, vanadium might increase the risk of hypoglycemia when taken with antidiabetes drugs.
A few very small clinical studies in patients with type 2 diabetes show that the vanadyl sulfate form of vanadium increases insulin sensitivity and might lower blood glucose levels.
Horsetail (Equisetum arvense) aerial parts extract
Antidiabetes Drugs
Theoretically, taking horsetail with antidiabetes drugs might increase the risk of hypoglycemia.
Equisetum myriochaetum has demonstrated hypoglycemic activity in clinical research. In an animal diabetic model, Equisetum giganteum had hypoglycemic effects. It is unclear whether other horsetail species have hypoglycemic effects.
Diuretic Drugs
Theoretically, taking horsetail with diuretic drugs might increase potassium loss and the risk of hypokalemia.
Laboratory research shows that various species of horsetail have diuretic properties. Due to its diuretic effects, there has been concern that taking horsetail along with potassium-depleting diuretics might increase the risk for hypokalemia. However, pharmacokinetic research in humans shows that taking horsetail 900 mg daily for 4 days does not affect urinary excretion of electrolytes, including potassium and sodium, despite having a diuretic effect similar to taking hydrochlorothiazide 25 mg daily. It is unclear if taking horsetail for a longer duration would affect electrolyte levels. Until more is known, use with caution.
Efavirenz (Sustiva)
Theoretically, horsetail might decrease the levels and clinical effects of efavirenz.
In two case reports, patients were found to have detectable viral loads when taking horsetail-containing supplements along with an antiretroviral regimen that included efavirenz. In one case, the antiretroviral regimen included zidovudine, lamivudine, and efavirenz; in the other case, the regimen consisted of emtricitabine, tenofovir disoproxil fumarate, and efavirenz. One month after discontinuing horsetail, the viral loads became undetectable in both cases. The exact mechanism of this interaction is unknown. It is also unclear if this interaction is specific to efavirenz or if it is related to various components of antiretroviral therapy.
Lithium
Theoretically, horsetail might increase the levels and adverse effects of lithium.
Animal research suggests that horsetail has diuretic properties. Theoretically, due to these potential diuretic effects, horsetail might reduce excretion and increase levels of lithium. The dose of lithium might need to be decreased.
Nucleoside Reverse Transcriptase Inhibitors (Nrtis)
Theoretically, horsetail might decrease the levels and clinical effects of NRTIs.
In two case reports, patients were found to have detectable viral loads when taking horsetail-containing supplements along with an antiretroviral therapy. In one case, the antiretroviral regimen included zidovudine, lamivudine, and efavirenz; in the other case, the regimen consisted of emtricitabine, tenofovir disoproxil fumarate, and efavirenz. One month after discontinuing the supplement, the viral loads became undetectable in both cases. The exact mechanism of these interactions is unknown. It is also unclear if these interactions are specific to NRTIs or if they are related to various components of antiretroviral therapy.
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.
Brand information
Manufacturer and brand details for TOS Cal Hydroxy, from the product label.
Genestra Brands
- Name
- Seroyal USA
- City
- Pittsburgh
- State
- PA
- ZipCode
- 15275
- Phone Number
- 1-888-737-6925
- Web Address
- seroyal.com
TOS Cal Hydroxy by Genestra Brands: Common Questions
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Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
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Label information is sourced from the NIH Dietary Supplement Label Database and reflects the product version on file; always read your actual product label. This page is for education only and is not a substitute for professional medical advice. Confirm with your pharmacist or doctor before combining supplements and medications.
The Full Monographs Behind TOS Cal Hydroxy’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Vitamin D
Interacts with 715 drugsVitamin D is a fat-soluble vitamin that helps your body absorb calcium and is important for healthy bones, muscles, and immune function. Many people, especially those with low sun exposure,...
Read the full Vitamin D monograph → Herb & supplement monographVanadium
Interacts with 208 drugsVanadium is a trace mineral found in tiny amounts in food, and people get plenty from a normal diet. Supplement claims for diabetes, weight, and athletic performance are not well proven, and...
Read the full Vanadium 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 monographMolybdenum
Molybdenum is an essential trace mineral your body needs in tiny amounts to help certain enzymes work. Most people get enough from a normal diet, so supplements are rarely needed unless a do...
Read the full Molybdenum 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 monographHorsetail
Interacts with 188 drugsHorsetail is a traditional herb most often used as a mild diuretic and for hair, nail, and bone support, but high-quality human evidence is limited. It can cause thiamine (vitamin B1) loss w...
Read the full Horsetail monograph →Sources & How We Checked
TOS Cal Hydroxy'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 207 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.
Vitamin D 26 references
- McEvoy GK, ed. AHFS Drug Information. Bethesda, MD: American Society of Health-System Pharmacists, 1998.
- Tatro DS, ed. Drug Interactions Facts. Facts and Comparisons Inc., St. Louis, MO. 1999.
- Koutkia P, Chen TC, Holick MF. Vitamin D intoxication associated with an over-the-counter supplement. N Engl J Med 2001;345:66-7. PubMed
- Bar-Or D, Yoel G. Calcium and calciferol antagonize effect of verapamil in atrial fibrillation. Br Med J 1981;282:1585-6.
- Demontis R, Leflon A, Fournier A, et al. 1 alpha(OH) vitamin D3 increases plasma aluminum in hemodialyzed patients taking AI(OH)3. Clin Nephrol 1986;26:146-9.
- Crowe M, Wollner L, Griffiths RA. Hypercalcemia following vitamin D and thiazide therapy in the elderly. Practitioner 1984;228:312-3.
- Parfitt AM. Thiazide-induced hypercalcemia in vitamin D-treated hypoparathyroidism. Ann Intern Med 1972;77:557-63. PubMed
- Thiazide diuretics and the risk of osteoporosis. Pharmacist's Letter/Prescriber's Letter 2003;19(11):191105.
- Moon J. The role of vitamin D in toxic metal absorption. J Am Coll Nutr 1994;13:559-64.
- Demontis R, Reissi D, Noel C, et al. Indirect clinical evidence that 1alphaOH vitamin D<SUB>3</SUB> increases the intestinal absorption of aluminum. Clin Nephrol 1989;31:123-7.
- Adler AJ, Berlyne GM. Duodenal aluminum absorption in the rat: effect of vitamin D. Am J Physiol 1985;249:G209-13. PubMed
- Schwartz JB. Effects of vitamin D supplementation in atorvastatin-treated patients: A new drug interaction with an unexpected consequence. Clin Pharmacol Ther 2009;85:198-203. PubMed
- 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
- Cox KA, Dunn MA. Aluminum toxicity alters the regulation of calbindin-D28k protein and mRNA expression in chick intestine. J Nutr 2001;131:2007-13. PubMed
- Escribano, J., Balaguer, A., Pagone, F., Feliu, A., and Roque, I. Figuls. Pharmacological interventions for preventing complications in idiopathic hypercalciuria. Cochrane.Database.Syst.Rev. 2009;(1):CD004754. PubMed
- Carlton, S., Clopton, D., and Cappuzzo, K. A. Vitamin D deficiency: appropriate replenishment therapies and the effects of vitamin D toxicity. Consult Pharm 2010;25(3):171-177. PubMed
- Wang, H., Xia, N., Yang, Y., and Peng, D. Q. Influence of vitamin D supplementation on plasma lipid profiles: a meta-analysis of randomized controlled trials. Lipids Health Dis. 2012;11:42. PubMed
- Turner AN, Carr Reese P, Fields KS, Anderson J, Ervin M, Davis JA, Fichorova RN, Roberts MW, Klebanoff MA, Jackson RD. A blinded, randomized controlled trial of high-dose vitamin D supplementation to reduce recurrence of bacterial vaginosis. Am J Obstet G PubMed
- Weiner M, Epstein FH. Signs and symptoms of electrolyte disorders. Yale J Biol Med. 1970;43(2):76-109.
- 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
- Roth DE, Leung M, Mesfin E, Qamar H, Watterworth J, Papp E. Vitamin D supplementation during pregnancy: state of the evidence from a systematic review of randomised trials. BMJ. 2017;359:j5237. PubMed
- Murai IH, Fernandes AL, Sales LP, et al. Effect of a single high dose of vitamin D3 on hospital length of stay in patients with moderate to severe COVID-19: A randomized clinical trial. JAMA. 2021.
- Wang Z, Schuetz EG, Xu Y, Thummel KE. Interplay between vitamin D and the drug metabolizing enzyme CYP3A4. J Steroid Biochem Mol Biol 2013;136:54-8. PubMed
- Doyle D, Browne U, Brickley A, Murphy D. Vitamin D-induced hypercalcaemia and acute kidney injury in sarcoidosis. BMJ Case Rep 2023;16(1):e250580. PubMed
- Williamson A, Martineau AR, Sheikh A, Jolliffe D, Griffiths CJ. Vitamin D for the management of asthma. Cochrane Database Syst Rev 2023;2(2):CD011511. PubMed
- Kinesya E, Santoso D, Gde Arya N, et al. Vitamin D as adjuvant therapy for diabetic foot ulcers: Systematic review and meta-analysis approach. Clin Nutr ESPEN 2023;54:137-143. PubMed
Vanadium 15 references
- Harland BF, Harden-Williams BA. Is vanadium of human nutritional importance yet? J Am Diet Assoc 1994;94:891-4. PubMed
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DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.
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