Interactions on record — worth a quick check against your medications. Based on 5 of 6 ingredients. Check your meds →
Dietary supplement

Ultimate Fiber Cleanse Digestion & Elimination Ingredients & Drug Interactions

by Nature's Secret

Ultimate Fiber Cleanse Digestion & Elimination label
See full label image
Powder Category: Other Combinations
Most serious interaction: Moderate
Clinical methodology reviewed by · Updated Oct 7, 2026 · Label data from the NIH DSLD
What is this page for?

First and foremost: checking Ultimate Fiber Cleanse Digestion & Elimination 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

The interaction bottom line Most serious interaction: Moderate

Ultimate Fiber Cleanse Digestion & Elimination is a dietary supplement by Nature's Secret with 6 active ingredients. Its ingredients are commonly taken for constipation, diarrhea, high cholesterol.Based on those ingredients, 2,101 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Marshmallow powder, Dietary Fiber, Slippery Elm powder. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

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Check Your Meds Against Ultimate Fiber Cleanse Digestion & Elimination by Nature's Secret

Ask about any prescription or over-the-counter medication and we check it for interactions with Ultimate Fiber Cleanse Digestion & Elimination by Nature's Secret — and tell you which ingredient is responsible.

Pharmacist-reviewed data Checks every ingredient Answer in seconds
Prefer a human? Send your question to our licensed pharmacists — free, answered by email within 24 hours.

HelloPharmacist Scorecard of Ultimate Fiber Cleanse Digestion & Elimination by Nature's Secret

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.

From our pharmacy team — supplement deep dive

Generated from HelloPharmacist’s pharmacist-curated databases and editorial rules · Last generated Sep 24, 2026

What’s inside

Low disclosure
Ingredient Transparency · database check
Low

Most active ingredients don't disclose an individual amount — you can't tell how much of each you're getting.

Why this rating?
  • The label discloses an exact amount for 1 of its 6 active ingredients.
  • “Proprietary Blend” is a proprietary blend — the label gives one combined amount (6.30 Gram(s)) without saying how much of each component you get.

This powder blend contains five active ingredients. Slippery elm powder is an herbal extract from the inner bark of the elm tree.

Psyllium powder is a soluble fiber. Fructooligosaccharides (FOS) is a prebiotic fiber that may support beneficial gut bacteria.

Lactobacillus acidophilus is a live probiotic organism. Marshmallow powder comes from the marshmallow plant root and leaf.

The product also contains inactive ingredients: rice dextrin, rice protein, mixed tocopherols (a form of vitamin E), and natural citrus flavor.

Does it work?

Strong evidence
Evidence for Intended Use · database check
By FDA rules, dietary supplements can’t claim to treat, cure, or prevent disease — so labels speak in careful marketing language. We discern each product’s intended use from its name, label claims, and label statements, then grade the clinical evidence for that use. How these ratings are computed
Strong

Clinical evidence supports at least one of this product's ingredients for its stated purpose.

Why this rating?
  • The label markets this product for: fiber supplementation for digestive health.
  • We looked for evidence on: Constipation, Diarrhea, Antibiotic-associated diarrhea, Irritable bowel syndrome (IBS), Inflammatory bowel disease (IBD), Lactose intolerance — and 4 related terms.
  • The strongest evidence on file: Black Psyllium is rated "Effective" for Constipation (Natural Medicines).
  • Also on file: Lactobacillus Acidophilus is rated "Possibly Effective" for Antibiotic-associated diarrhea, Irritable bowel syndrome (IBS).
  • Also on file: Black Psyllium is rated "Insufficient Reliable Evidence To Rate" for Diarrhea.

The evidence for most of these ingredients is incomplete. Lactobacillus acidophilus is possibly effective for irritable bowel syndrome (IBS), antibiotic-associated diarrhea, helicobacter pylori infection, and bacterial vaginosis.

For the other active ingredients—slippery elm, psyllium, fructooligosaccharides, and marshmallow—we don't have enough reliable evidence to rate their effectiveness for the conditions this product targets, including constipation and digestive support.

The evidence, ingredient by ingredient Black Psyllium Slippery Elm Fructo-oligosaccharides (fos) Lactobacillus Acidophilus Marshmallow

How safe is it?

Well-documented data
Safety Information · database check
Well characterized

Adverse-effect, pregnancy, and general safety data are on file for most of these ingredients.

Why this rating?
  • We hold adverse-effect (side-effect) data for 4 of the 5 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 5 of 5.
  • General safety write-ups exist for 5 of 5.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

Pregnancy and breastfeeding information is limited or incomplete for most ingredients. Slippery elm: some sources caution against use during pregnancy, and there is too little data on breastfeeding safety.

Fructooligosaccharides: supplement-level doses are not well studied; talk with your doctor for personalized guidance. Marshmallow: the safety data advise against use during pregnancy and breastfeeding.

Lactobacillus acidophilus is possibly safe during pregnancy. For the ingredients where data isn't on file, discuss the product with your doctor or pharmacist if you're pregnant or nursing.

Side effects, ingredient by ingredient Black Psyllium Slippery Elm Fructo-oligosaccharides (fos) Lactobacillus Acidophilus Marshmallow

Meds to double-check

Moderate interaction found
Known Interaction Concern · database check
Moderate identified

The most serious documented interaction for these ingredients is Moderate. Check your medications for a personalized result.

Why this rating?
  • 4 of the 5 matched ingredients can interact with medications — Black Psyllium, Marshmallow, Lactobacillus Acidophilus, Slippery Elm.
  • The most serious interaction on file is rated Moderate.
  • Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs; heart-rhythm medications; lithium.
  • For scale: 2,102 individual medications appear in the full list. A big number alone doesn't make a product dangerous — what matters is whether YOUR medication is on it, so run yours through the interaction checker on this page.

Before taking this product, double-check your medications with your doctor or pharmacist if you take lithium (a mood-disorder medication)—marshmallow may increase its levels. Also flag any antibiotic medications, since lactobacillus acidophilus may reduce their effectiveness if taken at the same time.

If you take blood thinners (anticoagulants) or any oral medications generally, ask your pharmacist, since slippery elm and marshmallow may slow drug absorption.

Check your own medication Run your meds through the checker above

The bottom line

Scorecard at a glanceFormula with limited ingredient disclosure with clinical evidence supporting its stated purpose. Moderate medication interactions have been identified, and safety information is well characterized.

This fiber and probiotic blend may help with irritable bowel syndrome and antibiotic-associated diarrhea, thanks mainly to its lactobacillus acidophilus content, though evidence for the other ingredients is limited. If you take lithium, any blood thinner, or antibiotics, or if you take oral medications generally, check your exact medications with your doctor or pharmacist before adding this product.

Pregnancy and breastfeeding safety data are sparse—talk it over with your healthcare provider for personalized advice.

Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI

Assessment coverage: 5 of 6 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated May 22, 2015.

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

At a glance

General information

Key facts about Ultimate Fiber Cleanse Digestion & Elimination, straight from the product label.

Brand Nature's Secret
Barcode (UPC) 732391500806
Net contents 7.9 oz.; 225 Gram(s)
Market status On market
Date entered into DSLD May 22, 2015
DSLD ID 45056
Product type Other Combinations
Supplement form Powder
Dietary claims / uses All Other, Structure/Function
Intended target group(s) Adult (18 - 50 Years)
From the label
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 Ultimate Fiber Cleanse Digestion & Elimination by Nature's Secret, sourced from the NIH Dietary Supplement Label Database.

Supplement Facts

Daily Value (DV) Target Group(s):
Adults and children 4 or more years of age
Minimum serving Sizes:
1 Tbsp
Maximum serving Sizes:
1 Tbsp
Servings per container
32
UPC/BARCODE
732391500806
IngredientAmount% DV
Calories25 NP--
Total Carbohydrates6 Gram(s)2%
Dietary Fiber4 Gram(s)16%
Proprietary Blend6.3 Gram(s)--
Slippery Elm powder0 NP--
Psyllium powder0 NP--
Fructooligosaccharides0 NP--
Lactobacillus acidophilus0 NP--
Marshmallow powder0 NP--

Other ingredients: Rice Dextrin, Rice Protein, Mixed Tocopherols, natural Citrus flavor

Tap any ingredient to jump to its full detail below.

Label statements
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.
General Statements

It is recommended that every adult consume 20-30 grams of fiber per day. Yet the majority of Americans fall short of the daily fiber recommendations.

TAKE CONTROL of YOUR HEALTH

Experience the Sensation of Whole-Body Wellness... Detoxify ~ Cleanse ~ Rebuild

The conventional approach to health sees the body as a set of separate parts, each needing their own separate treatments. Take a look at the way our medical system is organized - from cardiologists to dermatologists, we have a doctor for nearly every body part. But nature has a well-kept secret… there is no separation between any of our systems. They are all intricately connected in a brilliant dance only nature could orchestrate.

We understand, for example, that sluggish digestion can lead to low energy levels and shouldn’t always be supported with caffeinated energy tablets. Our approach focuses on the origins of imbalance, not the signs of imbalance.

Daily Support for Regularity & Proper Elimination Probiotics to Renew & Replenish Your Digestive System

Questions: Call Consumer Affairs 1-800-297-3273 Weekdays 8:00 AM TO 5:00 PM (PST) [email protected]

To join our Wellness Club and receive tips on how to improve your health, please visit us at www.NaturesSecret.com/wellness1

Brand IP Statement(s)

Ultimate Fiber(R) is formulated with a proprietary blend of ingredients to help you meet your dietary needs.

Who is Nature's Secret(R)? At Nature’s Secret(R) we believe that total body wellness is the key to overall health.

At Nature’s Secret(R), we develop our products using this whole-body philosophy.

This is Nature’s Secret(R), total body wholeness and wellness.

ULTIMATE FIBER CLEANSE(R)

Formula

Each serving of this delicious formula provides 4 grams of dietary fiber per serving, making it easier to meet your daily requirements.

Psyllium is one of the most popular forms of fiber and has a long history of use. It is a bulk-forming fiber which helps speed bowel transit time. Marshmallow and Slippery Elm have been traditionally used to support the protective mucous lining of the intestines. Lactobacillus acidophilus helps promote the health of the digestive tract and supports a healthy balance of microflora or “friendly bacteria.” FOS (Fructooligosaccharides) helps promote “good” bacteria in the digestive tract.

Contains: Dairy

FDA Disclaimer Statement

These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.

FDA Statement of Identity

DIETARY SUPPLEMENT

Suggested/Recommended/Usage/Directions

DIRECTIONS: (Adult) Mix one (1) tablespoon (7g) in at least 8 ounces (a full glass) of water or juice once or twice daily. Taking this product without adequate liquid may cause choking. Drink 8 to 10 glasses of water daily.

Precautions

Contains: Dairy

USAGE WARNING: Do not use if safety seal is broken.

Taking this product without adequate water may cause product to swell and block your throat or esophagus, which may cause choking. Do not take if you are having difficulty swallowing. If you experience chest pain, vomiting, or difficulty in swallowing or breathing after taking this product, seek immediate medical attention.

Do not use if you may become pregnant, are pregnant or nursing.

Do not exceed recommended daily intake.

Not intended for use by persons under 18. KEEP OUT OF REACH OF CHILDREN.

WARNING: (State of California Prop 65) This product contains a chemical known to the State of California to cause birth defects or other reproductive harm.

Check with your doctor before using this product if you are using medication or have any medical conditions.

Storage

Product should be refrigerated after opening.

Store in a cool, dry place.

General

3149-LAB-05/14 NS030088 Ver. 13

Seals/Symbols

QUALITY TESTED

Is this label outdated? Report a formula or label change and our pharmacy team will review it.

See for yourself

Ultimate Fiber Cleanse Digestion & Elimination by Nature's Secret label

The label scan from the NIH Dietary Supplement Label Database. Tap to enlarge.

Ultimate Fiber Cleanse Digestion & Elimination label

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)
What’s inside

The Ingredients in Ultimate Fiber Cleanse Digestion & Elimination by Nature's Secret

These are the 6 active ingredients this product is made of. Select any to open its full monograph.

Serving size1 Tbsp Dosage formPowder Servings per container32 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 with
2,025 drugs
4 Gram(s) per serving

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 & interactions

Proprietary Blend

6.3 Gram(s) per serving

Other (inactive) ingredients: Rice Dextrin, Rice Protein, Mixed Tocopherols, Natural Citrus flavor. These complete the product’s ingredient list but are not active constituents.

Interaction report

Ultimate Fiber Cleanse Digestion & Elimination by Nature's Secret Drug Interactions

Want to check YOUR meds against Ultimate Fiber Cleanse Digestion & Elimination?

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 checker
2,101Drugs
2,080 Moderate 21 Minor

Ingredients driving the most interactions

Marshmallow powder 2,040
Dietary Fiber 2,025
Slippery Elm powder 2,022
Lactobacillus acidophilus 182

Individual Drug Interactions

The ingredients in Ultimate Fiber Cleanse Digestion & Elimination interact with 2,101 drugs. Click any drug to see the details.

4 of the 6 ingredients in Ultimate Fiber Cleanse Digestion & Elimination interact with drugs. Each result below shows which ingredient is responsible. Marshmallow powder Dietary Fiber Slippery Elm powder Lactobacillus acidophilus

Each ingredient & the kinds of drugs it affects

For each ingredient in Ultimate Fiber Cleanse Digestion & Elimination 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.

Marshmallow powder3 drug types · 2,040 drugs

Lithium

Theoretically, due to potential diuretic effects, marshmallow might reduce excretion and increase levels of lithium.
Marshmallow is thought to have diuretic properties. To avoid lithium toxicity, the dose of lithium might need to be decreased when used with marshmallow.

Likelihood Probable Evidence D
Anticoagulant/Antiplatelet Drugs

Theoretically, marshmallow flower might have antiplatelet effects.
Animal research suggests that marshmallow flower extract has antiplatelet effects. However, the root and leaf of marshmallow, not the flower, are the plant parts most commonly found in dietary supplements. Theoretically, use of marshmallow flower with anticoagulant/antiplatelet drugs can have additive effects, and might increase the risk for bleeding in some patients.

Likelihood Unlikely Evidence D
Oral Drugs

Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Marshmallow contains mucilage which can affect oral drug absorption. To avoid changes in absorption, take marshmallow 30-60 minutes after oral medications.

Likelihood Possible Evidence D
Marshmallow powder full monograph & interactions

Dietary Fiber7 drug types · 2,025 drugs

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.

Likelihood Probable Evidence D
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.

Likelihood Probable Evidence D
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.

Likelihood Possible Evidence D
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.

Likelihood Possible Evidence D
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.

Likelihood Unlikely Evidence B
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.

Likelihood Unlikely Evidence D
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.

Likelihood Possible Evidence B
Dietary Fiber full monograph & interactions

Slippery Elm powder1 drug type · 2,022 drugs

Oral Drugs

Theoretically, slippery elm may slow the absorption and reduce serum levels of oral drugs.
Slippery elm inner bark contains mucilage, which may interfere with the absorption of orally administered drugs.

Likelihood Possible Evidence D
Slippery Elm powder full monograph & interactions

Lactobacillus acidophilus1 drug type · 182 drugs

Antibiotic Drugs

Theoretically, taking Lactobacillus acidophilus with antibiotic drugs might decrease the effectiveness of L. acidophilus.
L. acidophilus preparations usually contain live and active organisms. Therefore, simultaneously taking antibiotics might kill a significant number of the organisms. Tell patients to separate administration of antibiotics and L. acidophilus preparations by at least two hours.

Likelihood Probable Evidence D
Lactobacillus acidophilus full monograph & interactions
The maker

Brand information

Manufacturer and brand details for Ultimate Fiber Cleanse Digestion & Elimination, from the product label.

Nature's Secret

See all Nature's Secret products
Phone Number
1-800-297-3273
Pharmacist Counseling Corner

Ultimate Fiber Cleanse Digestion & Elimination by Nature's Secret: Common Questions

Does Ultimate Fiber Cleanse Digestion & Elimination by Nature's Secret interact with any medications?
Yes. Based on its ingredients, Ultimate Fiber Cleanse Digestion & Elimination has a known interaction with 2,101 medications. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Ultimate Fiber Cleanse Digestion & Elimination contains 6 active ingredients, and an interaction can come from any of them. We check every ingredient, combine the results into one list per medication, and show which ingredient and mechanism is responsible.
Where does this information come from?
The product label data comes from the NIH Dietary Supplement Label Database (DSLD); the interaction data is built on the Natural Medicines database and reviewed by HelloPharmacist pharmacists.
Can I take this if I'm on antibiotics?
Not at the same time. The lactobacillus acidophilus in this product contains live organisms that antibiotics can kill, which defeats the purpose of the probiotic. Ask your pharmacist about spacing them apart—usually antibiotics and probiotics are taken at different times of day.
Will this help my constipation?
Psyllium and slippery elm are used traditionally for constipation, but we don't have enough reliable evidence to say they work. Lactobacillus acidophilus is possibly effective for some digestive issues. If constipation is a concern, talk with your doctor about what might help.
What's lactobacillus acidophilus and why is it in here?
It's a live beneficial bacteria (a probiotic) that naturally lives in your gut. It's included because it's possibly effective for irritable bowel syndrome, antibiotic-associated diarrhea, and certain bacterial infections.
Can I take this while pregnant or breastfeeding?
The safety data for most ingredients are incomplete or advise caution. Marshmallow is best avoided during pregnancy and breastfeeding. Talk with your doctor or pharmacist before using this product if you're pregnant or nursing.
What are the most common side effects?
Gas, bloating, flatulence, and abdominal pain are the most likely, especially from the fructooligosaccharides (FOS) and fiber content—though these tend to be mild. Gastrointestinal discomfort from the probiotic is uncommon. Slippery elm can rarely cause an allergic reaction on skin contact.
Is this safe to take long-term?
Safety data for long-term use are limited for most ingredients, including slippery elm and marshmallow. Use this product with professional guidance and talk with your doctor about how long it's okay to take it.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Not sure if Ultimate Fiber Cleanse Digestion & Elimination is safe with your meds?

Our pharmacists answer your medication & supplement questions — free.

Ask a pharmacist

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.

Ultimate Fiber Cleanse Digestion & Elimination label
Go deeper

The Full Monographs Behind Ultimate Fiber Cleanse Digestion & Elimination’s Ingredients

Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.

Herb & supplement monograph

Black Psyllium

Interacts with 2,025 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. It is best known and most studied for rel...

Read the full Black Psyllium monograph → Herb & supplement monograph

Slippery Elm

Interacts with 2,022 drugs

Slippery elm is a traditional herbal remedy made from the inner bark of a North American elm tree, used mainly to soothe sore throats and irritated digestive tracts. Its mucilage can coat an...

Read the full Slippery Elm monograph → Herb & supplement monograph

Fructo-oligosaccharides (fos)

Fructo-oligosaccharides (FOS) are a type of soluble fiber that acts as a prebiotic, meaning they feed the helpful bacteria in your gut. They are generally considered safe for most people in...

Read the full Fructo-oligosaccharides (fos) monograph → Herb & supplement monograph

Lactobacillus Acidophilus

Interacts with 182 drugs

Lactobacillus acidophilus is a 'friendly' bacterium used as a probiotic to support gut and vaginal health. It is generally well tolerated in healthy people, and there is reasonable evidence...

Read the full Lactobacillus Acidophilus monograph → Herb & supplement monograph

Marshmallow

Interacts with 2,040 drugs

Marshmallow root is a traditional herb rich in soothing, gel-like fibers called mucilage, which is why it has long been used for coughs, sore throats, and stomach irritation. Evidence for th...

Read the full Marshmallow monograph →
Sources

Sources & How We Checked

Ultimate Fiber Cleanse Digestion & Elimination'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.

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 47 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
  1. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
  2. Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.
  3. Covington TR, et al. Handbook of Nonprescription Drugs. 11th ed. Washington, DC: American Pharmaceutical Association, 1996.
  4. Etman M. Effect of a bulk forming laxative on the bioavailablility of carbamazepine in man. Drug Dev Ind Pharm 1995;21:1901-6.
  5. Perlman BB. Interaction between lithium salts and ispaghula husk. Lancet 1990;335:416.
  6. Vaswani SK, Hamilton RG, Valentine MD, Adkinson NF. Psyllium laxative-induced anaphylaxis, asthma, and rhinitis. Allergy 1996;51:266-8. PubMed
  7. Lantner RR, Espiritu BR, Zumerchik P, Tobin MC. Anaphylaxis following ingestion of a psyllium-containing cereal. JAMA 1990;264:2534-6. DOI
  8. Kaplan MJ. Anaphylactic reaction to "Heartwise." N Engl J Med 1990;323:1072-3. DOI
  9. 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..
  10. Robinson DS, Benjamin DM, McCormack JJ. Interaction of warfarin and nonsystemic gastrointestinal drugs. Clin Pharmacol Ther 1971;12:491-5. PubMed
  11. Garcia JJ, Fernandez N, Diez MJ, et al. Influence of two dietary fibers in the oral bioavailability and other pharmacokinetic parameters of ethinyloestradiol. Contraception 2000;62:253-7. PubMed
  12. 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.
  13. 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.
  14. 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
  15. 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
  16. 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
  17. Chiu AC, Sherman SI. Effects of pharmacological fiber supplements on levothyroxine absorption. Thyroid. 1998;8(8):667-71. PubMed
  18. Merrick C, Madden CA, Capurso NA. A Case of Blunted Orally Disintegrating Olanzapine Effect Due to Coadministered Psyllium. J Clin Psychiatry 2021;82(2):20cr13633. PubMed

See these in context on the Black Psyllium monograph →

Slippery Elm 3 references
  1. The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999.
  2. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
  3. Czarnecki D, Nixon R, Bekhor P, and et al. Delayed prolonged contact urticaria from the elm tree. Contact Dermatitis 1993;28:196-197. PubMed

See these in context on the Slippery Elm monograph →

Fructo-oligosaccharides (fos) 6 references
  1. Briet F, et al. Symptomatic response to varying levels of fructo-oligosaccharides consumed occasionally or regularly. Eur J Clin Nutr 1995;49:501-7.
  2. Bouhnik Y, Vahedi K, Achour L, et al. Short-chain fructo-oligosaccharide administration dose-dependently increases fecal bifidobacteria in healthy humans. J Nutr 1999;129:113-6. PubMed
  3. Cummings JH, Macfarlane GT, Englyst HN. Prebiotic digestion and fermentation. Am J Clin Nutr 2001;73:415S-420S. PubMed
  4. Souza DDS, Tahan S, Weber TK, Araujo-Filho HB, de Morais MB. Randomized, double-blind, placebo-controlled parallel clinical trial assessing the effect of fructooligosaccharides in infants with constipation. Nutrients. 2018;10(11). pii: E1602. PubMed
  5. Andermann TM, Fouladi F, Tamburini FB, et al. A Fructo-Oligosaccharide Prebiotic Is Well Tolerated in Adults Undergoing Allogeneic Hematopoietic Stem Cell Transplantation: A Phase I Dose-Escalation Trial. Transplant Cell Ther 2021;27(11):932. PubMed
  6. Dou Y, Yu X, Luo Y, Chen B, Ma D, Zhu J. Effect of Fructooligosaccharides Supplementation on the Gut Microbiota in Human: A Systematic Review and Meta-Analysis. Nutrients 2022;14(16):3298. PubMed

See these in context on the Fructo-oligosaccharides (fos) monograph →

Lactobacillus Acidophilus 15 references
  1. Pierce A. The American Pharmaceutical Association Practical Guide to Natural Medicines. New York: The Stonesong Press, 1999:19.
  2. Begtrup LM, de Muckadell OB, Kjeldsen J, Christensen RD, Jarbøl DE. Long-term treatment with probiotics in primary care patients with irritable bowel syndrome--a randomised, double-blind, placebo controlled trial. Scand J Gastroenterol 2013;48(10):1127-35 PubMed
  3. Chatterjee S, Kar P, Das T, Ray S, Gangulyt S, Rajendiran C, Mitra M. Randomised placebo-controlled double blind multicentric trial on efficacy and safety of Lactobacillus acidophilus LA-5 and Bifidobacterium BB-12 for prevention of antibiotic-associated
  4. Shavakhi A, Tabesh E, Yaghoutkar A, Hashemi H, Tabesh F, Khodadoostan M,Minakari M, Shavakhi S, Gholamrezaei A. The effects of multistrain probiotic compound on bismuth-containing quadruple therapy for Helicobacter pylori infection: a randomized placebo-c
  5. Karamali M, Dadkhah F, Sadrkhanlou M, et al. Effects of probiotic supplementation on glycaemic control and lipid profiles in gestational diabetes: a randomized, double-blind, placebo-controlled trial. Diabetes Metab 2016;42(4):234-41. PubMed
  6. Badehnoosh B, Karamali M, Zarrati M, et al. The effects of probiotic supplementation on biomarkers of inflammation, oxidative stress and pregnancy outcomes in gestational diabetes. J Matern Fetal Neonatal Med. 2018 May;31(9):1128-1136.
  7. Kumar S, Kumar R, Rohilla L, Jacob N, Yadav J, Sachdeva N. A high potency multi-strain probiotic improves glycemic control in children with new-onset type 1 diabetes mellitus: A randomized, double-blind, and placebo-controlled pilot study. Pediatr Diabete
  8. Shahriari A, Karimi E, Shahriari M, Aslani N, Khooshideh M, Arab A. The effect of probiotic supplementation on the risk of gestational diabetes mellitus among high-risk pregnant women: A parallel double-blind, randomized, placebo-controlled clinical trial PubMed
  9. Xiao SD, Zhang DZ, Lu H, et al. Multicenter, randomized, controlled trial of heat-killed Lactobacillus acidophilus LB in patients with chronic diarrhea. Adv Ther. 2003;20(5):253-60.
  10. Rossi F, Amadoro C, Gasperi M, Colavita G. Lactobacilli infection case reports in the last three years and safety implications. Nutrients. 2022;14(6):1178. PubMed
  11. Ozer M, Goksu SY, Shahverdiani A, Mustafa M. Lactobacillus acidophilus-induced endocarditis and associated splenic abscess. Case Rep Infect Dis 2020;2020:1382709.
  12. Sadrin S, Sennoune S, Gout B, et al. A 2-strain mixture of Lactobacillus acidophilus in the treatment of irritable bowel syndrome: A placebo-controlled randomized clinical trial. Dig Liver Dis 2020;52(5):534-540. PubMed
  13. Stoffer JN, Slingsby TJ, Giuliari GP. Lactobacillus acidophilus endophthalmitis after intravitreal bevacizumab injection requiring intraocular lens explantation. Can J Ophthalmol 2022;57(1):e21-e22. PubMed
  14. Cukovic-Cavka S, Likic R, Francetic I, Rustemovic N, Opacic M, Vucelic B. Lactobacillus acidophilus as a cause of liver abscess in a NOD2/CARD15-positive patient with Crohn's disease. Digestion 2006;73(2-3):107-10.
  15. Hui J, Ren Y, Wang Y, Han Q. Lactobacillus acidophilus endophthalmitis postcataract operation: A case report with a literature review. Ocul Immunol Inflamm 2023.

See these in context on the Lactobacillus Acidophilus monograph →

Marshmallow 5 references
  1. Monographs on the medicinal uses of plant drugs. Exeter, UK: European Scientific Co-op Phytother, 1997.
  2. Leung AY, Foster S. Encyclopedia of Common Natural Ingredients Used in Food, Drugs and Cosmetics. 2nd ed. New York, NY: John Wiley & Sons, 1996.
  3. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
  4. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
  5. Hage-Sleiman R, Mroueh M, Daher CF. Pharmacological evaluation of aqueous extract of Althaea officinalis flower grown in Lebanon. Pharm Biol 2011;49(3):327-33.

See these in context on the Marshmallow monograph →

Parts of this content are provided by the Therapeutic Research Center, LLC.

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.

© 2021 Therapeutic Research Center, LLC

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