Interactions on record — worth a quick check against your medications. Based on 6 of 8 ingredients. Check your meds →
Dietary supplement

Whole Fiber Fusion Ingredients & Drug Interactions

by Vital Nutrients

Whole Fiber Fusion label
See full label image
Powder Category: Other Combinations
Most serious interaction: Moderate
Clinical methodology reviewed by · Updated Sep 16, 2026 · Label data from the NIH DSLD
What is this page for?

First and foremost: checking Whole Fiber Fusion 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

Whole Fiber Fusion is a dietary supplement by Vital Nutrients with 8 active ingredients. Its ingredients are commonly taken for digestive support for protein digestion, wound cleaning (debridement of dead tissue), sore throat and inflammation.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 root powder, Dietary Fiber, Slippery Elm, Powder. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

Jump to a section

Check Your Meds Against Whole Fiber Fusion by Vital Nutrients

Ask about any prescription or over-the-counter medication and we check it for interactions with Whole Fiber Fusion by Vital Nutrients — and tell you which ingredient is responsible.

Pharmacist-reviewed data Checks every ingredient Answer in seconds
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HelloPharmacist Scorecard of Whole Fiber Fusion by Vital Nutrients

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 Jul 11, 2026

What’s inside

Full disclosure
Ingredient Transparency · database check
Full

Every active ingredient lists its own amount on the label.

Why this rating?
  • The label discloses an exact amount for 8 of its 8 active ingredients.
  • No proprietary blends here — you can verify the dose of every single component.

Whole Fiber Fusion contains 7 ingredients, five of which are active. Papain is an enzyme from papaya that's included for digestive support, though evidence for its specific uses is not well established.

Lactobacillus sporogenes is a probiotic that may help with constipation and irritable bowel syndrome. Chia seed and flaxseed are both high-fiber plant seeds.

Marshmallow root and slippery elm are mucilage-rich botanicals traditionally used for digestive comfort. The product contains no inactive fillers or other ingredients—only the active components listed.

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: Digestive health and fiber support.
  • We looked for evidence on: Constipation, Diarrhea, Dyspepsia, Flatulence, Irritable bowel syndrome (IBS), Postoperative ileus — and 3 related terms.
  • The strongest evidence on file: Black Psyllium is rated "Effective" for Constipation (Natural Medicines).
  • Also on file: Bacillus Coagulans is rated "Possibly Effective" for Constipation, Irritable bowel syndrome (IBS).
  • Also on file: Black Psyllium is rated "Insufficient Reliable Evidence To Rate" for Diarrhea.

The evidence backing these ingredients is mixed and limited. Lactobacillus sporogenes is possibly effective for constipation and irritable bowel syndrome, making it one of the more established players here.

Chia seed, however, has not shown reliable benefit for lowering cholesterol or weight loss and appears possibly ineffective for those purposes. Papain, marshmallow root, and slippery elm all lack sufficient reliable evidence to rate their effectiveness for the conditions they're traditionally used for—meaning we don't have strong data showing they work.

Flaxseed and prune powder effectiveness ratings are not in our data.

The evidence, ingredient by ingredient Papain Black Psyllium Bacillus Coagulans Chia Marshmallow Slippery Elm

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 5 of the 6 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 6 of 6.
  • General safety write-ups exist for 6 of 6.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

Papain is generally tolerated as food but can irritate your digestive tract and trigger allergic reactions in sensitive people—including itchy eyes, sneezing, cramps, and diarrhea. High doses may be unsafe and rarely can cause severe inflammation or perforation of the esophagus.

Chia seed commonly causes mild gas and soft stools and very rarely can trigger anaphylaxis in those with seed allergies. Lactobacillus sporogenes is generally well tolerated in healthy adults, though serious infections have been reported in people with weakened immune systems or central lines.

Marshmallow root and slippery elm are reasonably well tolerated short-term, though slippery elm pollen can cause allergic reactions and contact dermatitis. Papain is best avoided in pregnancy due to safety concerns; concentrated papain and unripe papaya products are especially risky.

There isn't enough safety data to recommend papain while breastfeeding. Marshmallow and slippery elm should be avoided during pregnancy and breastfeeding due to insufficient safety information.

Chia, lactobacillus sporogenes, and flaxseed/prune powder have limited or no safety data on file for pregnancy and breastfeeding—talk with your doctor for personalized advice.

Side effects, ingredient by ingredient Papain Black Psyllium Bacillus Coagulans Chia Marshmallow Slippery Elm

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?
  • 5 of the 6 matched ingredients can interact with medications — Papain, Black Psyllium, Marshmallow, Slippery Elm, Bacillus Coagulans.
  • 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 Whole Fiber Fusion, check with your pharmacist if you're on warfarin (a blood thinner)—papain may raise your bleeding risk. If you take antibiotics, separate them from this product by several hours since the probiotic may lose effectiveness.

Lithium users should verify safety with their doctor; marshmallow may increase lithium levels. Anyone on other oral medications should allow 30–60 minutes between taking this product and their drugs, since both marshmallow and slippery elm can slow drug absorption.

Check your own medication Run your meds through the checker above

The bottom line

Scorecard at a glanceFully disclosed formula with clinical evidence supporting its stated purpose. Moderate medication interactions have been identified, and safety information is well characterized.

This product is a fiber and probiotic blend best suited for people without serious drug interactions or compromised immune systems. If you take warfarin, lithium, or antibiotics, or take other oral medications regularly, you need to check your specific prescriptions before starting.

Talk to your pharmacist—the timing and spacing of doses matters here.

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

Assessment coverage: 6 of 8 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Feb 22, 2024.

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 Whole Fiber Fusion, straight from the product label.

Brand Vital Nutrients
Barcode (UPC) 693465277119
Net contents 261 Gram(s); 9.2 Ounce(s)
Market status On market
Date entered into DSLD Feb 22, 2024
DSLD ID 305199
Product type Other Combinations
Supplement form Powder
Dietary claims / uses All Other
Intended target group(s) Adult (18 - 50 Years), Gluten Free, Dairy Free, Sugar Free
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 Whole Fiber Fusion by Vital Nutrients, 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:
8.5 Gram(s)
Maximum serving Sizes:
8.5 Gram(s)
Servings per container
30
UPC/BARCODE
693465277119
IngredientAmount% DV
Papain45 mg--
Dietary Fiber4.75 Gram(s)17%
Flaxseed, Powder3000 mg--
Lactobacillus sporogenes60 mg--
Chia Seed, Powder4500 mg--
Marshmallow root powder150 mg--
Prune, Dried, Powder450 mg--
Slippery Elm, Powder300 mg--

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.
Storage

Store sealed in a cool dry place

Precautions

Keep out of reach of children

Use only if safety seal is intact

Warning: If pregnant, consult your physician before taking.

Inner seal may lift off when cap is removed. Seal integrity is maintained until cap is removed.

Suggested/Recommended/Usage/Directions

Recommendations: 1 heaping tablespoon once daily mixed into water, juice, or soft food, or as directed by your healthcare professional.

Formulation

Excludes coatings, binders, gluten (wheat, rye, barley), milk/dairy (casein, whey), soy protein, egg protein, sugar. Verified by independent testing

General Statements

Raw materials and finished products are independently tested by U.S. Labs Learn more at vitalnutrients.net

FDA Statement of Identity

Dietary Supplement

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

See for yourself

Whole Fiber Fusion by Vital Nutrients label

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

Whole Fiber Fusion 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 Whole Fiber Fusion by Vital Nutrients

These are the 8 active ingredients this product is made of. Select any to open its full monograph.

Serving size8.5 Gram(s) Dosage formPowder Servings per container30 Amounts shown are per serving.

Most supplement products combine several ingredients, and a medication can interact with the product through any one of them. Each ingredient below shows whether it has known drug interactions.

Papain

Interacts with
2 drugs
45 mg per serving

Papain is a protein-digesting enzyme from the papaya plant that is used in digestive supplements and some topical products. While it has clear food an...

Papain monograph & interactions

Dietary Fiber

Interacts with
2,025 drugs
4.75 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

Flaxseed, Powder

3000 mg per serving

Lactobacillus sporogenes

Interacts with
182 drugs
60 mg per serving

Bacillus coagulans is a spore-forming probiotic that survives stomach acid well and may help with some digestive problems such as IBS, constipation, a...

Lactobacillus sporogenes monograph & interactions

Chia Seed, Powder

No known
interactions
4500 mg per serving

Chia seeds are a nutritious whole food rich in fiber, plant-based omega-3 fats (ALA), and protein. They are generally safe as part of a healthy diet,...

Chia Seed, Powder monograph & interactions

Marshmallow root powder

Interacts with
2,040 drugs
150 mg per serving

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,...

Marshmallow root powder monograph & interactions

Prune, Dried, Powder

450 mg per serving

Slippery Elm, Powder

Interacts with
2,022 drugs
300 mg per serving Form: Ulmus fulva, Powder

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 di...

Slippery Elm, Powder monograph & interactions
Interaction report

Whole Fiber Fusion by Vital Nutrients Drug Interactions

Want to check YOUR meds against Whole Fiber Fusion?

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 root powder 2,040
Dietary Fiber 2,025
Slippery Elm, Powder 2,022
Lactobacillus sporogenes 182
Papain 2

Individual Drug Interactions

The ingredients in Whole Fiber Fusion interact with 2,101 drugs. Click any drug to see the details.

5 of the 8 ingredients in Whole Fiber Fusion interact with drugs. Each result below shows which ingredient is responsible. Marshmallow root powder Dietary Fiber Slippery Elm, Powder Lactobacillus sporogenes Papain

Each ingredient & the kinds of drugs it affects

For each ingredient in Whole Fiber Fusion 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 root 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 root 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 sporogenes1 drug type · 182 drugs

Antibiotic Drugs

Theoretically, taking antibiotics with Bacillus coagulans might decrease the effectiveness of B. coagulans.
B. coagulans 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 B. coagulans preparations by at least two hours.

Likelihood Probable Evidence D
Lactobacillus sporogenes full monograph & interactions

Papain1 drug type · 2 drugs

Warfarin (Coumadin)

Theoretically, papain might increase the effects and side effects of warfarin.
In one case report, a patient previously stable on warfarin was found to have an international normalization ratio (INR) of 7.4, which was attributed to ingestion of a supplement containing papain from papaya extract.

Likelihood Possible Evidence D
Papain full monograph & interactions
The maker

Brand information

Manufacturer and brand details for Whole Fiber Fusion, from the product label.

Vital Nutrients

See all Vital Nutrients products
Name
Vital Nutrients
Street Address
45 Kenneth Dooley Dr
City
Middletown
State
CT
ZipCode
06457
Web Address
vitalnutrients.net
Pharmacist Counseling Corner

Whole Fiber Fusion by Vital Nutrients: Common Questions

Does Whole Fiber Fusion by Vital Nutrients interact with any medications?
Yes. Based on its ingredients, Whole Fiber Fusion 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?
Whole Fiber Fusion contains 8 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.
Does this product have any fillers?
No. This powder contains only the seven active ingredients listed—papain, flaxseed, lactobacillus sporogenes, chia seed, marshmallow root, prune, and slippery elm. There are no inactive fillers, binders, or other additives.
Can I take this while I'm pregnant?
The safety data advises against papain during pregnancy, especially concentrated papain products. Marshmallow root and slippery elm should also be avoided in pregnancy due to insufficient safety information. Talk with your doctor before taking this product while pregnant—he or she can weigh the risks and benefits for your situation.
Will this actually help with constipation or diarrhea?
The probiotic lactobacillus sporogenes in here is possibly effective for constipation and irritable bowel syndrome, so that ingredient has some evidence. The other fiber and botanical ingredients—chia, flaxseed, marshmallow, and slippery elm—don't have enough reliable evidence to say whether they help. Papain and prune powder evidence is also not well established.
What are the most common side effects?
Chia seed commonly causes gas and soft stools in some people. Papain can cause allergic reactions like sneezing, runny nose, and diarrhea in sensitive individuals. Slippery elm pollen can trigger allergic reactions in some. Most people tolerate this product without trouble, but if you have a seed or enzyme allergy, be cautious.
Can I take this with my other medications?
It depends on what you're taking. Both marshmallow and slippery elm can slow how your other oral drugs are absorbed, so you may need to space doses 30–60 minutes apart. If you're on warfarin, lithium, or antibiotics, this product poses specific risks. Use the medication checker on this page with your exact prescriptions, and ask your pharmacist before starting.
Is this safe if I have a weakened immune system?
The probiotic in this product has rare but serious risks for people with severely weakened immune systems, indwelling catheters, or critical illness. If your immune system is compromised or you're hospitalized, talk to your doctor before using it.

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

Not sure if Whole Fiber Fusion is safe with your meds?

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Label information is sourced from the NIH Dietary Supplement Label Database and reflects the product version on file; always read your actual product label. This page is for education only and is not a substitute for professional medical advice. Confirm with your pharmacist or doctor before combining supplements and medications.

Whole Fiber Fusion label
Go deeper

The Full Monographs Behind Whole Fiber Fusion’s Ingredients

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

Herb & supplement monograph

Papain

Interacts with 2 drugs

Papain is a protein-digesting enzyme from the papaya plant that is used in digestive supplements and some topical products. While it has clear food and laboratory uses, strong human evidence...

Read the full Papain monograph → 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

Bacillus Coagulans

Interacts with 182 drugs

Bacillus coagulans is a spore-forming probiotic that survives stomach acid well and may help with some digestive problems such as IBS, constipation, and certain types of diarrhea. The eviden...

Read the full Bacillus Coagulans monograph → Herb & supplement monograph

Chia

Chia seeds are a nutritious whole food rich in fiber, plant-based omega-3 fats (ALA), and protein. They are generally safe as part of a healthy diet, and may modestly help with regularity an...

Read the full Chia 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 → 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 →
Sources

Sources & How We Checked

Whole Fiber Fusion'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 69 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.

Papain 11 references
  1. The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999.
  2. Shaw D, Leon C, Kolev S, Murray V. Traditional remedies and food supplements: a 5-year toxicological study (1991-1995). Drug Saf 1997;17:342-56.
  3. Shuttleworth D, Hill S, Marks R, Connelly DM. Relief of experimentally induced pruritus with a novel eutectic mixture of local anaesthetic agents. Br J Dermatol 1988;119:535-40.
  4. Mansfield LE, Ting S, Haverly RW, Yoo TJ. The incidence and clinical implications of hypersensitivity to papain in an allergic population, confirmed by blinded oral challenge. Ann Allergy 1985;55:541-3.
  5. Martin, T., Uhder, K., Kurek, R., Roeddiger, S., Schneider, L., Vogt, H. G., Heyd, R., and Zamboglou, N. Does prophylactic treatment with proteolytic enzymes reduce acute toxicity of adjuvant pelvic irradiation? Results of a double-blind randomized trial PubMed
  6. Walker-Renard, P. Update on the medicinal management of phytobezoars. Am J Gastroenterol. 1993;88(10):1663-1666.
  7. Tymoszuk D, Wiszniewska M, Walusiak-Skorupa J. Papain-induced occupational rhinoconjunctivitis and asthma - A case report. Med Pr 2016;67(1):109-12. PubMed
  8. Soto-Mera MT, López-Rico MR, Filgueira JF, et al. Occupational allergy to papain. Allergy 2000;55(10):983-4. PubMed
  9. Tarlo SM, Shaikh W, Bell B, et al. Papain-induced allergic reactions. Clin Allergy 1978;8(3):207-15. PubMed
  10. Baur X, König G, Bencze K, Fruhmann G. Clinical symptoms and results of skin test, RAST and bronchial provocation test in thirty-three papain workers: Evidence for strong immunogenic potency and clinically relevant proteolytic e?ects of airborne papain. C
  11. Novey HS, Keenan WJ, Fairshter RD, Wells ID, Wilson AF, Culver BD. Pulmonary disease in workers exposed to papain: clinico-physiological and immunological studies. Clin Allergy 1980;10(6):721-31. PubMed

See these in context on the Papain monograph →

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
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See these in context on the Black Psyllium monograph →

Bacillus Coagulans 20 references
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  10. Vahabnezhad E, Mochon AB, Wozniak LJ, Ziring DA. Lactobacillus bacteremia associated with probiotic use in a pediatric patient with ulcerative colitis. J Clin Gastroenterol. 2013;47(5):437-9. PubMed
  11. Pruccoli G, Silvestro E, Pace Napoleone C, Aidala E, Garazzino S, Scolfaro C. Are probiotics safe? Bifidobacterium bacteremia in a child with severe heart failure. Infez Med. 2019;27(2):175-178.
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  20. Kato K, Funabashi N, Takaoka H, et al. Lactobacillus paracasei endocarditis in a consumer of probiotics with advanced and severe bicuspid aortic valve stenosis complicated with diffuse left ventricular mid-layer fibrosis. Int J Cardiol. 2016;224:157-161. PubMed

See these in context on the Bacillus Coagulans monograph →

Chia 12 references
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  2. Ramon JM, Bou R, Romea S, et al. Dietary fat intake and prostate cancer risk: a case-control study in Spain. Cancer Causes Control 2000;11:679-85. PubMed
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  8. Chavarro JE, Stampfer MJ, Li H, et al. A prospective study of polyunsaturated fatty acid levels in blood and prostate cancer risk. Cancer Epidemiol Biomarkers Prev 2007;16:1364-70. PubMed
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  10. García Jiménez S, Pastor Vargas C, de las Heras M, Sanz Maroto A, Vivanco F, Sastre J. Allergen characterization of chia seeds (Salvia hispanica), a new allergenic food. J Investig Allergol Clin Immunol. 2015;25(1):55-6.
  11. Vuksan V, Jenkins AL, Brissette C, et al. Salba-chia (Salvia hispanica L.) in the treatment of overweight and obese patients with type 2 diabetes: a double-blind randomized controlled trial. Nutr Metab Cardiovasc Dis 2017;27(2):138-46. PubMed
  12. Zbinden-Foncea H, Ramos-Navarro C, Hevia-Larraín V, et al. Neither Chia Flour nor Whey Protein Supplementation Further Improves Body Composition or Strength Gains after a Resistance Training Program in Young Subjects with a Habitual High Daily Protein Int

See these in context on the Chia 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 →

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 →

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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.

© 2021 Therapeutic Research Center, LLC

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