X7 - Care Ingredients & Drug Interactions
What is this page for?
First and foremost: checking X7 - Care 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
X7 - Care is a dietary supplement by OL Olympian Labs with 11 active ingredients. Its ingredients are commonly taken for memory and cognitive support, age-related mental decline, circulation problems.Based on those ingredients, 1,591 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are Ginkgo biloba, Boswellia serrata extract, Vitamin D3. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against X7 - Care by OL Olympian Labs
Ask about any prescription or over-the-counter medication and we check it for interactions with X7 - Care by OL Olympian Labs — 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 X7 - Care by OL Olympian Labs
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
X7 - Care contains 11 active ingredients formulated for joint and bone health. Ginkgo biloba is included for circulation and cognitive support, while Boswellia serrata extract and glucosamine HCl target joint function and comfort.
Coral Calcium, Vitamin D3, and Magnesium Oxide provide minerals and vitamins for bone mineralization and muscle function. Chondroitin Sulfate Sodium works alongside glucosamine for cartilage support, while Collagen Type II supplies structural protein for joints.
Vitamin A Palmitate supports tissue health. The product also contains Boron for bone metabolism and MSM, though detailed data on MSM's role in this formulation is not available to us.
Several inactive ingredients — microcrystalline cellulose, hydroxypropyl cellulose, croscarmellose sodium, stearic acid, silicon dioxide, magnesium stearate, and coating — provide structure and stability.
Does it work?
Strong evidence
Ginkgo biloba is possibly effective for hearing loss, stroke recovery, schizophrenia, premenstrual syndrome, dementia, and anxiety. Glucosamine is likely effective for osteoarthritis but has insufficient evidence for back pain, aging skin, cancer, and fatty liver disease.
Boswellia serrata extract is possibly effective for osteoarthritis but lacks reliable evidence for hay fever, Alzheimer's disease, asthma, and cluster headaches. Chondroitin sulfate is possibly effective for cataracts and osteoarthritis, with insufficient evidence for aging skin, osteoporosis, high cholesterol, and colorectal adenoma.
Calcium (coral calcium) is effective for bone health and hypocalcemia. Vitamin D3 is effective for rickets, osteomalacia, and renal bone disease.
Boron is likely effective for boron deficiency and possibly effective for yeast infections and radiation burns. Magnesium is effective for constipation and heartburn.
Vitamin A is effective for vitamin A deficiency and possibly effective for oral white patches, aging skin, measles, ulcerative colitis, and lung disease in premature infants. Evidence for several of these uses is limited or mixed, and quality varies between products.
How safe is it?
Well-documented data
Ginkgo biloba is generally well tolerated for up to 6 years when used orally, though it may increase bleeding risk — use with caution if you have a bleeding disorder or are at risk for one. The seed and crude plant contain toxic substances and should be avoided.
Rare but serious cardiac arrhythmias have been reported in some users. Boron is generally safe at low doses but can be toxic at high levels; doses above 20 mg daily should be avoided.
Calcium is well tolerated at recommended amounts; common mild side effects include constipation, gas, and bloating. Magnesium Oxide is generally safe but commonly causes diarrhea, nausea, and gastrointestinal upset.
Glucosamine and Chondroitin are generally well tolerated orally, though allergic reactions (rash, itching) and asthma exacerbation have been rarely reported. Vitamin A is safe at recommended doses but accumulates in the body and can be toxic at very high levels; symptoms of toxicity include headache, blurred vision, skin peeling, and hair loss.
Vitamin D3 is safe at recommended doses but can cause toxicity with excessive use, leading to high blood calcium levels and related problems. Boswellia serrata is generally well tolerated short-term but may cause diarrhea, nausea, heartburn, or headache.
Meds to double-check
Major interaction found
Before taking X7 - Care, double-check these medication types with the search tool: blood thinners (warfarin), HIV integrase inhibitors (dolutegravir, elvitegravir), Parkinson's medication (levodopa/carbidopa), beta-blockers (talinolol), cholesterol drugs (simvastatin, atorvastatin), anti-anxiety drugs (alprazolam), antidepressants (trazodone), HIV non-nucleoside inhibitors (efavirenz), diabetes drugs (rosiglitazone, sulfonylureas), immunosuppressants (tacrolimus), water pills (thiazide diuretics), heart rhythm medications (verapamil, diltiazem, digoxin), thyroid replacement (levothyroxine), muscle relaxants, quinolone antibiotics, and bisphosphonates. These represent the most significant documented interactions across the product's ingredients.
The bottom line
Scorecard at a glanceFully disclosed formula with strong clinical evidence behind its ingredients' uses. Major medication interactions have been identified, and safety information is well characterized.
X7 - Care targets joint and bone health with a multi-ingredient formula. If you take any blood thinners, HIV medications, heart rhythm drugs, thyroid replacement, Parkinson's medication, or diabetes drugs, you'll want to check this product against your specific medications using the tool below — several ingredients have meaningful interactions.
Talk with your pharmacist before starting, especially if you're on prescription medications, have a bleeding disorder, kidney disease, or are pregnant or breastfeeding.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 9 of 11 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Aug 31, 2018.
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 X7 - Care, straight from the product label.
| Brand | OL Olympian Labs |
|---|---|
| Barcode (UPC) | 710013911179 |
| Net contents | 60 Tablet(s) |
| Market status | On market |
| Date entered into DSLD | Aug 31, 2018 |
| DSLD ID | 176024 |
| Product type | Other Combinations |
| Supplement form | Tablet Or Pill |
| Dietary claims / uses | All Other, Structure/Function |
| Intended target group(s) | Adult (18 - 50 Years), Gluten Free |
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.
Supplement Facts
The label details for X7 - Care by OL Olympian Labs, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Ginkgo biloba | 50 mg | -- |
| Boron | 5 mg | 5% |
| Vitamin D3 | 400 IU | 67% |
| Coral Calcium | 50 mg | 5% |
| Vitamin A Palmitate | 2000 IU | 67% |
| Magnesium Oxide | 50 mg | 12% |
| MSM | 200 mg | -- |
| Glucosamine HCl | 1600 mg | -- |
| Boswellia serrata extract | 100 mg | -- |
| Collagen Type II | 400 mg | -- |
| Chondroitin Sulfate Sodium | 200 mg | -- |
Other ingredients: Microcrystalline Cellulose, Hydroxypropyl Cellulose, Croscarmellose Sodium, Stearic Acid, Silicon Dioxide, Magnesium Stearate, Coating
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.
General Statements
Olympian Labs, Inc. products are made with the highest quality ingredients and manufactured according to current Good Manufacturing Practices (cGMP).
We do not use ingredients that were produced using modern biotechnology.
Healthy joint support
Made in USA
Precautions
Caution: If you are pregnant or nursing, have a medical condition, or are taking medication, consult your healthcare professional before using this or any other nutritional supplement.
Discontinue use if allergic reaction occurs.
Keep out of reach of children.
Formulation
Gluten free Non-GMO
Storage
Store in a cool, dry place.
FDA Disclaimer Statement
These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.
General
REV 12-16-16
Formula
X7 - Care with Glucosamine Sulfate
Contains naturally occurring Chondroitin
FDA Statement of Identity
Dietary Supplement
Suggested/Recommended/Usage/Directions
Suggested Use: As a dietary supplement, take two (2) tablets one to three times a day with meals, or as directed by a healthcare professional.
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
X7 - Care by OL Olympian Labs 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 X7 - Care by OL Olympian Labs
These are the 11 active ingredients this product is made of. Select any to open its full monograph.
Serving size2 Tablet(s) Dosage formTablet Or Pill 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.
Ginkgo biloba
Interacts with1,266 drugs
Ginkgo is one of the world's most popular herbal supplements, mostly taken to support memory and circulation. The evidence for these uses is mixed and...
Ginkgo biloba monograph & interactionsBoron
No knowninteractions
Boron is a trace mineral found in many plant foods and sold as a supplement, mainly promoted for bone, joint, and hormone health. The human evidence f...
Boron monograph & interactionsVitamin D3
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 D3 monograph & interactionsCoral Calcium
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...
Coral Calcium monograph & interactionsVitamin A Palmitate
Interacts with387 drugs
Vitamin A is an essential nutrient important for vision, skin, immune function, and growth. Most people get enough from a balanced diet, and supplemen...
Vitamin A Palmitate monograph & interactionsMagnesium Oxide
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 Oxide monograph & interactionsMSM
Glucosamine HCl
Interacts with170 drugs
Glucosamine is a natural compound found in cartilage and joint fluid, and it is one of the most popular supplements for osteoarthritis, especially of...
Glucosamine HCl monograph & interactionsBoswellia serrata extract
Interacts with952 drugs
Boswellia serrata is a tree resin used in traditional medicine, mainly for joint pain and inflammation. Some studies suggest it may help with osteoart...
Boswellia serrata extract monograph & interactionsCollagen Type II
Chondroitin Sulfate Sodium
Interacts with2 drugs
Chondroitin sulfate is a naturally occurring building block of cartilage that is widely taken, often with glucosamine, for osteoarthritis joint pain....
Chondroitin Sulfate Sodium monograph & interactionsOther (inactive) ingredients: Microcrystalline Cellulose, Hydroxypropyl Cellulose, Croscarmellose Sodium, Stearic Acid, Silicon Dioxide, Magnesium Stearate, Coating. These complete the product’s ingredient list but are not active constituents.
X7 - Care by OL Olympian Labs Drug Interactions
HelloPharmacist Interaction Report
X7 - Care by OL Olympian Labs contains several ingredients with documented interactions with medications.
The most serious concern is Ginkgo biloba with talinolol (a beta-blocker), which carries a Major severity rating — taking ginkgo can increase blood levels of talinolol by around 36% when used regularly, potentially raising the risk of side effects like low blood pressure or slow heart rate.
Read the full breakdown — every affected drug type, severity by severity
Ginkgo also has Moderate interactions with blood thinners like warfarin, which increases bleeding risk; with cholesterol drugs like simvastatin; with anti-anxiety medications like alprazolam; and with several other drug classes including antidepressants, HIV medications, diabetes drugs, and immunosuppressants. Coral Calcium (a form of calcium supplement) carries Major interactions with HIV integrase inhibitors (dolutegravir and elvitegravir) — calcium can reduce their blood levels by up to 40%, potentially compromising viral control — and with the antibiotic ceftriaxone when given intravenously.
Calcium also has Moderate interactions with thyroid hormone replacement, certain heart rhythm drugs, and blood pressure medications.
Vitamin D3 interacts with water pills (thiazide diuretics), heart medications like verapamil and diltiazem, and the cholesterol drug atorvastatin at Moderate severity. Magnesium Oxide has a Major interaction with Parkinson's medication (levodopa/carbidopa), reducing its absorption by about 35%, and Moderate interactions with muscle relaxants, certain diuretics, calcium channel blockers, quinolone antibiotics, and bisphosphonates.
Glucosamine carries a Major interaction with the blood thinner warfarin, increasing bleeding risk, and Moderate concerns with certain cancer chemotherapy drugs. Vitamin A Palmitate at high doses interacts with acne medications (retinoids), blood thinners, and tetracycline antibiotics.
Boswellia serrata theoretically affects multiple drug-metabolizing enzymes (CYP2D6, CYP2C19, CYP1A2, CYP2C9, CYP3A4) and immunosuppressants, all rated Moderate.
We could not check MSM and Collagen Type II as interaction data is not on file for these ingredients. Altogether, these interactions span 1,568 individual medications.
Use the medication checker below with your exact prescriptions before starting this product.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against X7 - Care?
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 X7 - Care interact with 1,591 drugs. Click any drug to see the details.
8 of the 11 ingredients in X7 - Care interact with drugs. Each result below shows which ingredient is responsible. Ginkgo biloba Boswellia serrata extract Vitamin D3 Vitamin A Palmitate Magnesium Oxide Glucosamine HCl Coral Calcium Chondroitin Sulfate Sodium
AcitretinSoriatane
How Acitretin interacts with X7 - Care — through 1 ingredient. Tap an ingredient for the detail:
Vitamin A PalmitateRetinoids Major
Interaction Summary
Concomitant use of retinoids with vitamin A supplements might produce supratherapeutic vitamin A levels.
Read the full Vitamin A Palmitate + Acitretin interactionAlitretinoinPanretin
How Alitretinoin interacts with X7 - Care — through 1 ingredient. Tap an ingredient for the detail:
Vitamin A PalmitateRetinoids Major
Interaction Summary
Concomitant use of retinoids with vitamin A supplements might produce supratherapeutic vitamin A levels.
Read the full Vitamin A Palmitate + Alitretinoin interactionBenserazide, LevodopaMadopar, Prolopa
How Benserazide, Levodopa interacts with X7 - Care — through 2 ingredients. Tap an ingredient for the detail:
Magnesium OxideLevodopa/carbidopa (sinemet) Major
Interaction Summary
Magnesium can reduce the bioavailability of levodopa/carbidopa.
Read the full Magnesium Oxide + Benserazide, Levodopa interactionGinkgo BilobaSeizure Threshold Lowering Drugs Moderate
Interaction Summary
Theoretically, taking ginkgo with drugs that lower the seizure threshold might increase the risk for convulsions.
Read the full Ginkgo Biloba + Benserazide, Levodopa interactionBexaroteneTargretin
How Bexarotene interacts with X7 - Care — through 4 ingredients. Tap an ingredient for the detail:
Vitamin A PalmitateRetinoids Major
Interaction Summary
Concomitant use of retinoids with vitamin A supplements might produce supratherapeutic vitamin A levels.
Read the full Vitamin A Palmitate + Bexarotene interactionBoswellia Serrata ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, Boswellia serrata might increase or decrease the levels and clinical effects of CYP3A4 substrates.
Read the full Boswellia Serrata Extract + Bexarotene interactionGinkgo BilobaCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, ginkgo might decrease levels of drugs metabolized by CYP3A4.
Read the full Ginkgo Biloba + Bexarotene interactionVitamin D3Cytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Vitamin D might induce CYP3A4 enzymes and reduce the bioavailability of CYP3A4 substrates.
Read the full Vitamin D3 + Bexarotene interactionCarbidopaLodosyn
How Carbidopa interacts with X7 - Care — through 1 ingredient. Tap an ingredient for the detail:
Magnesium OxideLevodopa/carbidopa (sinemet) Major
Interaction Summary
Magnesium can reduce the bioavailability of levodopa/carbidopa.
Read the full Magnesium Oxide + Carbidopa interactionCarbidopa, LevodopaDhivy, Rytary, Sinemet, Sinemet CR
How Carbidopa, Levodopa interacts with X7 - Care — through 2 ingredients. Tap an ingredient for the detail:
Magnesium OxideLevodopa/carbidopa (sinemet) Major
Interaction Summary
Magnesium can reduce the bioavailability of levodopa/carbidopa.
Read the full Magnesium Oxide + Carbidopa, Levodopa interactionGinkgo BilobaSeizure Threshold Lowering Drugs Moderate
Interaction Summary
Theoretically, taking ginkgo with drugs that lower the seizure threshold might increase the risk for convulsions.
Read the full Ginkgo Biloba + Carbidopa, Levodopa interactionCarbidopa, Levodopa, EntacaponeStalevo
How Carbidopa, Levodopa, Entacapone interacts with X7 - Care — through 2 ingredients. Tap an ingredient for the detail:
Magnesium OxideLevodopa/carbidopa (sinemet) Major
Interaction Summary
Magnesium can reduce the bioavailability of levodopa/carbidopa.
Read the full Magnesium Oxide + Carbidopa, Levodopa, Entacapone interactionGinkgo BilobaSeizure Threshold Lowering Drugs Moderate
Interaction Summary
Theoretically, taking ginkgo with drugs that lower the seizure threshold might increase the risk for convulsions.
Read the full Ginkgo Biloba + Carbidopa, Levodopa, Entacapone interactionCeftriaxoneRocephin
How Ceftriaxone interacts with X7 - Care — through 2 ingredients. Tap an ingredient for the detail:
Coral CalciumCeftriaxone (rocephin) Major
Interaction Summary
Co-administration of intravenous calcium and ceftriaxone can result in precipitation of a ceftriaxone-calcium salt in the lungs and kidneys.
Read the full Coral Calcium + Ceftriaxone interactionGinkgo BilobaSeizure Threshold Lowering Drugs Moderate
Interaction Summary
Theoretically, taking ginkgo with drugs that lower the seizure threshold might increase the risk for convulsions.
Read the full Ginkgo Biloba + Ceftriaxone interactionCobicistat, Elvitegravir, Emtricitabine, Tenofovir Alafenamide FumarateGenvoya
How Cobicistat, Elvitegravir, Emtricitabine, Tenofovir Alafenamide Fumarate interacts with X7 - Care — through 6 ingredients. Tap an ingredient for the detail:
Coral CalciumElvitegravir (vitekta), Bictegravir/emtricitabine/tenofovir Alafenamide (biktarvy) Major
Interaction Summary
Calcium seems to reduce levels of elvitegravir.
Read the full Coral Calcium + Cobicistat, Elvitegravir, Emtricitabine, Tenofovir Alafenamide Fumarate interactionGinkgo BilobaCytochrome P450 3a4 (cyp3a4) Substrates, P-glycoprotein Substrates Moderate
Interaction Summary
Theoretically, ginkgo might decrease levels of drugs metabolized by CYP3A4.
Read the full Ginkgo Biloba + Cobicistat, Elvitegravir, Emtricitabine, Tenofovir Alafenamide Fumarate interactionBoswellia Serrata ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, Boswellia serrata might increase or decrease the levels and clinical effects of CYP3A4 substrates.
Read the full Boswellia Serrata Extract + Cobicistat, Elvitegravir, Emtricitabine, Tenofovir Alafenamide Fumarate interactionMagnesium OxideBictegravir/emtricitabine/tenofovir Alafenamide (biktarvy) Moderate
Interaction Summary
Magnesium might decrease levels of bictegravir/emtricitabine/tenofovir alafenamide by reducing its absorption.
Read the full Magnesium Oxide + Cobicistat, Elvitegravir, Emtricitabine, Tenofovir Alafenamide Fumarate interactionVitamin A PalmitateHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking high doses of vitamin A in combination with other potentially hepatotoxic drugs might increase the risk of liver disease.
Read the full Vitamin A Palmitate + Cobicistat, Elvitegravir, Emtricitabine, Tenofovir Alafenamide Fumarate interactionVitamin D3Cytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Vitamin D might induce CYP3A4 enzymes and reduce the bioavailability of CYP3A4 substrates.
Read the full Vitamin D3 + Cobicistat, Elvitegravir, Emtricitabine, Tenofovir Alafenamide Fumarate interactionDolutegravirTivicay
How Dolutegravir interacts with X7 - Care — through 2 ingredients. Tap an ingredient for the detail:
Coral CalciumDolutegravir (tivicay) Major
Interaction Summary
Calcium seems to reduce levels of dolutegravir.
Read the full Coral Calcium + Dolutegravir interactionGinkgo BilobaP-glycoprotein Substrates Moderate
Interaction Summary
Theoretically, taking ginkgo with P-glycoprotein substrates might increase the levels and adverse effects of these substrates.
Read the full Ginkgo Biloba + Dolutegravir interactionDolutegravir, Emtricitabine, Tenofovir AlafenamideDolutegravir, Emtricitabine, Tenofovir Alafenamide
How Dolutegravir, Emtricitabine, Tenofovir Alafenamide interacts with X7 - Care — through 4 ingredients. Tap an ingredient for the detail:
Coral CalciumDolutegravir (tivicay), Bictegravir/emtricitabine/tenofovir Alafenamide (biktarvy) Major
Interaction Summary
Calcium seems to reduce levels of dolutegravir.
Read the full Coral Calcium + Dolutegravir, Emtricitabine, Tenofovir Alafenamide interactionGinkgo BilobaP-glycoprotein Substrates Moderate
Interaction Summary
Theoretically, taking ginkgo with P-glycoprotein substrates might increase the levels and adverse effects of these substrates.
Read the full Ginkgo Biloba + Dolutegravir, Emtricitabine, Tenofovir Alafenamide interactionVitamin A PalmitateHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking high doses of vitamin A in combination with other potentially hepatotoxic drugs might increase the risk of liver disease.
Read the full Vitamin A Palmitate + Dolutegravir, Emtricitabine, Tenofovir Alafenamide interactionMagnesium OxideBictegravir/emtricitabine/tenofovir Alafenamide (biktarvy) Moderate
Interaction Summary
Magnesium might decrease levels of bictegravir/emtricitabine/tenofovir alafenamide by reducing its absorption.
Read the full Magnesium Oxide + Dolutegravir, Emtricitabine, Tenofovir Alafenamide interactionDolutegravir, RilpivirineJuluca
How Dolutegravir, Rilpivirine interacts with X7 - Care — through 4 ingredients. Tap an ingredient for the detail:
Coral CalciumDolutegravir (tivicay) Major
Interaction Summary
Calcium seems to reduce levels of dolutegravir.
Read the full Coral Calcium + Dolutegravir, Rilpivirine interactionGinkgo BilobaP-glycoprotein Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, taking ginkgo with P-glycoprotein substrates might increase the levels and adverse effects of these substrates.
Read the full Ginkgo Biloba + Dolutegravir, Rilpivirine interactionBoswellia Serrata ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, Boswellia serrata might increase or decrease the levels and clinical effects of CYP3A4 substrates.
Read the full Boswellia Serrata Extract + Dolutegravir, Rilpivirine interactionVitamin D3Cytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Vitamin D might induce CYP3A4 enzymes and reduce the bioavailability of CYP3A4 substrates.
Read the full Vitamin D3 + Dolutegravir, Rilpivirine interactionElvitegravirVitekta
How Elvitegravir interacts with X7 - Care — through 4 ingredients. Tap an ingredient for the detail:
Coral CalciumElvitegravir (vitekta) Major
Interaction Summary
Calcium seems to reduce levels of elvitegravir.
Read the full Coral Calcium + Elvitegravir interactionBoswellia Serrata ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, Boswellia serrata might increase or decrease the levels and clinical effects of CYP3A4 substrates.
Read the full Boswellia Serrata Extract + Elvitegravir interactionGinkgo BilobaCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, ginkgo might decrease levels of drugs metabolized by CYP3A4.
Read the full Ginkgo Biloba + Elvitegravir interactionVitamin D3Cytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Vitamin D might induce CYP3A4 enzymes and reduce the bioavailability of CYP3A4 substrates.
Read the full Vitamin D3 + Elvitegravir interactionElvitegravir, Cobicistat, Emtricitabine, Tenofovir Disoproxil FumarateStribild
How Elvitegravir, Cobicistat, Emtricitabine, Tenofovir Disoproxil Fumarate interacts with X7 - Care — through 6 ingredients. Tap an ingredient for the detail:
Coral CalciumElvitegravir (vitekta), Bictegravir/emtricitabine/tenofovir Alafenamide (biktarvy) Major
Interaction Summary
Calcium seems to reduce levels of elvitegravir.
Read the full Coral Calcium + Elvitegravir, Cobicistat, Emtricitabine, Tenofovir Disoproxil Fumarate interactionGinkgo BilobaCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, ginkgo might decrease levels of drugs metabolized by CYP3A4.
Read the full Ginkgo Biloba + Elvitegravir, Cobicistat, Emtricitabine, Tenofovir Disoproxil Fumarate interactionVitamin A PalmitateHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking high doses of vitamin A in combination with other potentially hepatotoxic drugs might increase the risk of liver disease.
Read the full Vitamin A Palmitate + Elvitegravir, Cobicistat, Emtricitabine, Tenofovir Disoproxil Fumarate interactionMagnesium OxideBictegravir/emtricitabine/tenofovir Alafenamide (biktarvy) Moderate
Interaction Summary
Magnesium might decrease levels of bictegravir/emtricitabine/tenofovir alafenamide by reducing its absorption.
Read the full Magnesium Oxide + Elvitegravir, Cobicistat, Emtricitabine, Tenofovir Disoproxil Fumarate interactionBoswellia Serrata ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, Boswellia serrata might increase or decrease the levels and clinical effects of CYP3A4 substrates.
Read the full Boswellia Serrata Extract + Elvitegravir, Cobicistat, Emtricitabine, Tenofovir Disoproxil Fumarate interactionVitamin D3Cytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Vitamin D might induce CYP3A4 enzymes and reduce the bioavailability of CYP3A4 substrates.
Read the full Vitamin D3 + Elvitegravir, Cobicistat, Emtricitabine, Tenofovir Disoproxil Fumarate interactionHalobetasol Propionate,tazaroteneDuobrii
How Halobetasol Propionate,tazarotene interacts with X7 - Care — through 1 ingredient. Tap an ingredient for the detail:
Vitamin A PalmitateRetinoids Major
Interaction Summary
Concomitant use of retinoids with vitamin A supplements might produce supratherapeutic vitamin A levels.
Read the full Vitamin A Palmitate + Halobetasol Propionate,tazarotene interactionIsotretinoinAbsorica, Accutane, Amnesteem, Claravis, Roaccutane, Sotret
How Isotretinoin interacts with X7 - Care — through 1 ingredient. Tap an ingredient for the detail:
Vitamin A PalmitateRetinoids Major
Interaction Summary
Concomitant use of retinoids with vitamin A supplements might produce supratherapeutic vitamin A levels.
Read the full Vitamin A Palmitate + Isotretinoin interactionLevodopaInbrija, Larodopa
How Levodopa interacts with X7 - Care — through 2 ingredients. Tap an ingredient for the detail:
Magnesium OxideLevodopa/carbidopa (sinemet) Major
Interaction Summary
Magnesium can reduce the bioavailability of levodopa/carbidopa.
Read the full Magnesium Oxide + Levodopa interactionGinkgo BilobaSeizure Threshold Lowering Drugs Moderate
Interaction Summary
Theoretically, taking ginkgo with drugs that lower the seizure threshold might increase the risk for convulsions.
Read the full Ginkgo Biloba + Levodopa interactionLevodopa, CarbidopaDuodopa
How Levodopa, Carbidopa interacts with X7 - Care — through 2 ingredients. Tap an ingredient for the detail:
Magnesium OxideLevodopa/carbidopa (sinemet) Major
Interaction Summary
Magnesium can reduce the bioavailability of levodopa/carbidopa.
Read the full Magnesium Oxide + Levodopa, Carbidopa interactionGinkgo BilobaSeizure Threshold Lowering Drugs Moderate
Interaction Summary
Theoretically, taking ginkgo with drugs that lower the seizure threshold might increase the risk for convulsions.
Read the full Ginkgo Biloba + Levodopa, Carbidopa interactionTalinololTalinolol
How Talinolol interacts with X7 - Care — through 1 ingredient. Tap an ingredient for the detail:
Ginkgo BilobaTalinolol Major
Interaction Summary
Taking ginkgo with talinolol seems to increase blood levels of talinolol.
Read the full Ginkgo Biloba + Talinolol interactionTazaroteneArazlo, Avage, Fabior, Tazorotene, Zorac
How Tazarotene interacts with X7 - Care — through 1 ingredient. Tap an ingredient for the detail:
Vitamin A PalmitateRetinoids Major
Interaction Summary
Concomitant use of retinoids with vitamin A supplements might produce supratherapeutic vitamin A levels.
Read the full Vitamin A Palmitate + Tazarotene interactionTretinoinAltreno, Renova, Retin-A, Vesanoid
How Tretinoin interacts with X7 - Care — through 1 ingredient. Tap an ingredient for the detail:
Vitamin A PalmitateRetinoids Major
Interaction Summary
Concomitant use of retinoids with vitamin A supplements might produce supratherapeutic vitamin A levels.
Read the full Vitamin A Palmitate + Tretinoin interactionTretinoin, Benzoyl PeroxideTwyneo
How Tretinoin, Benzoyl Peroxide interacts with X7 - Care — through 1 ingredient. Tap an ingredient for the detail:
Vitamin A PalmitateRetinoids Major
Interaction Summary
Concomitant use of retinoids with vitamin A supplements might produce supratherapeutic vitamin A levels.
Read the full Vitamin A Palmitate + Tretinoin, Benzoyl Peroxide interactionWarfarinWarfarin
How Warfarin interacts with X7 - Care — through 7 ingredients. Tap an ingredient for the detail:
Glucosamine HclWarfarin (coumadin) Major
Interaction Summary
Glucosamine might increase the anticoagulant effects of warfarin and increase the risk of bruising and bleeding.
Read the full Glucosamine Hcl + Warfarin interactionGinkgo BilobaCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 2c9 (cyp2c9) Substrates +4 Moderate
Interaction Summary
Theoretically, ginkgo might decrease levels of drugs metabolized by CYP3A4.
Read the full Ginkgo Biloba + Warfarin interactionBoswellia Serrata ExtractCytochrome P450 2c19 (cyp2c19) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates +2 Moderate
Interaction Summary
Theoretically, Boswellia serrata might increase the levels of CYP2C19 substrates.
Read the full Boswellia Serrata Extract + Warfarin interactionVitamin A PalmitateWarfarin (coumadin) Moderate
Interaction Summary
Theoretically, high doses of vitamin A could increase the risk of bleeding with warfarin.
Read the full Vitamin A Palmitate + Warfarin interactionChondroitin Sulfate SodiumWarfarin (coumadin) Moderate
Interaction Summary
Taking chondroitin in combination with glucosamine might increase the anticoagulant effects of warfarin.
Read the full Chondroitin Sulfate Sodium + Warfarin interactionMagnesium OxideAnticoagulant/antiplatelet Drugs Minor
Interaction Summary
Theoretically, magnesium may have antiplatelet effects, but the evidence is conflicting.
Read the full Magnesium Oxide + Warfarin interactionVitamin D3Cytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Vitamin D might induce CYP3A4 enzymes and reduce the bioavailability of CYP3A4 substrates.
Read the full Vitamin D3 + Warfarin interactionWarfarin SodiumCoumadin, Panwarfin, Sofarin
How Warfarin Sodium interacts with X7 - Care — through 7 ingredients. Tap an ingredient for the detail:
Glucosamine HclWarfarin (coumadin) Major
Interaction Summary
Glucosamine might increase the anticoagulant effects of warfarin and increase the risk of bruising and bleeding.
Read the full Glucosamine Hcl + Warfarin Sodium interactionVitamin A PalmitateWarfarin (coumadin) Moderate
Interaction Summary
Theoretically, high doses of vitamin A could increase the risk of bleeding with warfarin.
Read the full Vitamin A Palmitate + Warfarin Sodium interactionGinkgo BilobaWarfarin (coumadin), Cytochrome P450 1a2 (cyp1a2) Substrates +4 Moderate
Interaction Summary
Ginkgo has been shown to increase the risk of bleeding in some people when taken with warfarin.
Read the full Ginkgo Biloba + Warfarin Sodium interactionChondroitin Sulfate SodiumWarfarin (coumadin) Moderate
Interaction Summary
Taking chondroitin in combination with glucosamine might increase the anticoagulant effects of warfarin.
Read the full Chondroitin Sulfate Sodium + Warfarin Sodium interactionBoswellia Serrata ExtractCytochrome P450 2c9 (cyp2c9) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +2 Moderate
Interaction Summary
Theoretically, Boswellia serrata might increase the levels of CYP2C9 substrates.
Read the full Boswellia Serrata Extract + Warfarin Sodium interactionVitamin D3Cytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Vitamin D might induce CYP3A4 enzymes and reduce the bioavailability of CYP3A4 substrates.
Read the full Vitamin D3 + Warfarin Sodium interactionMagnesium OxideAnticoagulant/antiplatelet Drugs Minor
Interaction Summary
Theoretically, magnesium may have antiplatelet effects, but the evidence is conflicting.
Read the full Magnesium Oxide + Warfarin Sodium interactionEtretinateTegison
How Etretinate interacts with X7 - Care — through 1 ingredient. Tap an ingredient for the detail:
Vitamin A PalmitateRetinoids Major
Interaction Summary
Concomitant use of retinoids with vitamin A supplements might produce supratherapeutic vitamin A levels.
Read the full Vitamin A Palmitate + Etretinate interaction6-mercaptopurinePurinethol
How 6-mercaptopurine interacts with X7 - Care — through 2 ingredients. Tap an ingredient for the detail:
Vitamin A PalmitateHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking high doses of vitamin A in combination with other potentially hepatotoxic drugs might increase the risk of liver disease.
Read the full Vitamin A Palmitate + 6-mercaptopurine interactionBoswellia Serrata ExtractImmunosuppressants Moderate
Interaction Summary
Theoretically, Boswellia serrata might alter the effects of immunosuppressive drugs.
Read the full Boswellia Serrata Extract + 6-mercaptopurine interactionAdo-trastuzumab EmtansineKadcyla
How Ado-trastuzumab Emtansine interacts with X7 - Care — through 3 ingredients. Tap an ingredient for the detail:
Boswellia Serrata ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, Boswellia serrata might increase or decrease the levels and clinical effects of CYP3A4 substrates.
Read the full Boswellia Serrata Extract + Ado-trastuzumab Emtansine interactionGinkgo BilobaCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, ginkgo might decrease levels of drugs metabolized by CYP3A4.
Read the full Ginkgo Biloba + Ado-trastuzumab Emtansine interactionVitamin D3Cytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Vitamin D might induce CYP3A4 enzymes and reduce the bioavailability of CYP3A4 substrates.
Read the full Vitamin D3 + Ado-trastuzumab Emtansine interactionAbacavir Sulfate, Dolutegravir, LamivudineTriumeq
How Abacavir Sulfate, Dolutegravir, Lamivudine interacts with X7 - Care — through 1 ingredient. Tap an ingredient for the detail:
Vitamin A PalmitateHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking high doses of vitamin A in combination with other potentially hepatotoxic drugs might increase the risk of liver disease.
Read the full Vitamin A Palmitate + Abacavir Sulfate, Dolutegravir, Lamivudine interactionAbacavir, LamivudineEpzicom
How Abacavir, Lamivudine interacts with X7 - Care — through 1 ingredient. Tap an ingredient for the detail:
Vitamin A PalmitateHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking high doses of vitamin A in combination with other potentially hepatotoxic drugs might increase the risk of liver disease.
Read the full Vitamin A Palmitate + Abacavir, Lamivudine interactionAbciximabReoPro
How Abciximab interacts with X7 - Care — through 2 ingredients. Tap an ingredient for the detail:
Ginkgo BilobaAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Ginkgo has been shown to increase the risk of bleeding in some people when taken with warfarin.
Read the full Ginkgo Biloba + Abciximab interactionMagnesium OxideAnticoagulant/antiplatelet Drugs Minor
Interaction Summary
Theoretically, magnesium may have antiplatelet effects, but the evidence is conflicting.
Read the full Magnesium Oxide + Abciximab interactionEach ingredient & the kinds of drugs it affects
For each ingredient in X7 - Care 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.
Ginkgo biloba
Talinolol
Taking ginkgo with talinolol seems to increase blood levels of talinolol.
There is some evidence that using ginkgo leaf extract 120 mg orally three times daily for 14 days can increase levels of talinolol by 36% in healthy male individuals. However, single doses of ginkgo do not seem to affect talinolol pharmacokinetics.
Alprazolam (Xanax)
Theoretically, ginkgo might decrease the levels and clinical effects of alprazolam.
In clinical research, ginkgo extract (Ginkgold) 120 mg twice daily seems to decrease alprazolam levels by about 17%. However, ginkgo does not appear to decrease the elimination half-life of alprazolam. This suggests that ginkgo is more likely to decrease absorption of alprazolam rather than induce hepatic metabolism of alprazolam.
Anticoagulant/Antiplatelet Drugs
Ginkgo has been shown to increase the risk of bleeding in some people when taken with warfarin. Theoretically, ginkgo might increase the risk of bleeding if used with other anticoagulant or antiplatelet drugs.
Several pharmacodynamic studies suggest that ginkgo inhibits platelet aggregation. It is thought that the ginkgo constituent, ginkgolide B, displaces platelet-activating factor (PAF) from its binding sites, decreasing blood coagulation. Several case reports have documented serious bleeding events in patients taking ginkgo. However, population and clinical studies have produced mixed results. Some evidence shows that short-term use of ginkgo leaf does not significantly reduce platelet aggregation and blood clotting. A study in healthy males who took a specific ginkgo leaf extract (EGb 761) 160 mg twice daily for 7 days found no change in prothrombin time. An analysis of a large medical record database suggests that ginkgo increases the risk of a bleeding adverse event by 38% when taken concurrently with warfarin. It has been suggested that ginkgo has to be taken for at least 2-3 weeks to have a significant effect on platelet aggregation. However, a meta-analysis of 18 studies using standardized ginkgo extracts, 80-480 mg daily for up to 32 weeks, did not find a significant effect on platelet aggregation, fibrinogen concentration, or PT/aPTT. In addition, a single dose of ginkgo plus clopidogrel or ticlopidine does not seem to significantly increase bleeding time or platelet aggregation. Also, taking ginkgo leaf extract daily for 8 days in conjunction with rivaroxaban does not affect anti-factor Xa activity; however, this study did not evaluate bleeding time.
Anticonvulsants
Theoretically, ginkgo might reduce the effectiveness of anticonvulsants.
Ginkgo seeds contain ginkgotoxin. Large amounts of ginkgotoxin can cause neurotoxicity and seizure. Ginkgotoxin is present in much larger amounts in ginkgo seeds than leaves. Ginkgo leaf extract contains trace amounts of ginkgotoxin. The amount of ginkgotoxin in ginkgo leaf and leaf extract seems unlikely to cause toxicity. However, there are anecdotal reports of seizure occurring after use of ginkgo leaf both in patients without a history of seizure disorder and in those with previously well-controlled epilepsy.
Antidiabetes Drugs
Theoretically, taking ginkgo with antidiabetes drugs might alter the response to antidiabetes drugs.
Ginkgo leaf extract seems to alter insulin secretion and metabolism, and might affect blood glucose levels in people with type 2 diabetes. The effect of ginkgo seems to differ depending on the insulin and treatment status of the patient. In diet-controlled diabetes patients with hyperinsulinemia, taking ginkgo does not seem to significantly affect insulin or blood glucose levels. In patients with hyperinsulinemia who are treated with oral hypoglycemic agents, taking ginkgo seems to decrease insulin levels and increase blood glucose following an oral glucose tolerance test. Researchers speculate that this could be due to ginkgo-enhanced hepatic metabolism of insulin. In patients with pancreatic exhaustion, taking ginkgo seems to stimulate pancreatic beta-cells, resulting in increased insulin and C-peptide levels, but with no significant change in blood glucose levels in response to an oral glucose tolerance test.
Atorvastatin (Lipitor)
Theoretically, ginkgo might decrease the levels and clinical effects of atorvastatin.
In humans, intake of ginkgo extract appears to increase atorvastatin clearance, reducing the area under the curve of atorvastatin by 10% to 14% and the maximum concentration by 29%. However, this interaction does not appear to affect cholesterol synthesis and absorption. Further, a model in rats with hyperlipidemia suggests that administering ginkgo extract does not impact blood levels of atorvastatin and leads to lower total cholesterol, low-density lipoprotein cholesterol, and triglycerides when compared with rats given atorvastatin alone.
Cytochrome P450 1A2 (Cyp1A2) Substrates
Theoretically, ginkgo might increase levels of drugs metabolized by CYP1A2.
Laboratory research suggests that ginkgo leaf extract can mildly inhibit CYP1A2 enzymes. However, clinical research suggests ginkgo might not affect CYP1A2. Until more is known, use ginkgo cautiously in patients taking drugs metabolized by these enzymes.
Cytochrome P450 2C19 (Cyp2C19) Substrates
Theoretically, ginkgo might decrease levels of drugs metabolized by CYP2C19.
Some clinical research shows that a specific ginkgo leaf extract (Remembrance, Herbs Product LTD) 140 mg twice daily can induce CYP2C19 enzymes and potentially decrease levels of drugs metabolized by these enzymes. However, other clinical research shows that taking ginkgo 120 mg twice daily for 12 days has no effect on levels of drugs metabolized by CYP2C19.
Cytochrome P450 2C9 (Cyp2C9) Substrates
Theoretically, ginkgo might increase levels of drugs metabolized by CYP2C9.
In vitro, a specific standardized extract of ginkgo leaf (EGb 761) inhibits CYP2C9 activity . The terpenoid (ginkgolides) and flavonoid (quercetin, kaempferol, etc.) constituents seem to be responsible for this effect. Most ginkgo extracts contain some amount of these constituents. Therefore, other ginkgo leaf extracts might also inhibit the CYP2C9 enzyme. However, clinical research suggests that ginkgo might not have a significant effect on CYP2C9 in humans. Ginkgo does not seem to significantly affect the pharmacokinetics of CYP2C9 substrates diclofenac or tolbutamide.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, ginkgo might decrease levels of drugs metabolized by CYP3A4.
There is conflicting evidence about whether ginkgo induces or inhibits CYP3A4. Ginkgo does not appear to affect hepatic CYP3A4. However, it is not known if ginkgo affects intestinal CYP3A4. Preliminary clinical research suggests that taking ginkgo does not significantly affect levels of donepezil, lopinavir, or ritonavir, which are all CYP3A4 substrates. Other clinical research also suggests ginkgo does not significantly affect CYP3A4 activity. However, there are two case reports of decreased efavirenz concentrations and increased viral load in patients taking ginkgo. It is suspected that terpenoids from the ginkgo extract reduced drug levels by inducing cytochrome P450 3A4 (CYP3A4).
Efavirenz (Sustiva)
Theoretically, ginkgo might decrease the levels and clinical effects of efavirenz.
There are two case reports of decreased efavirenz concentrations and increased viral load in patients taking ginkgo. In one case, an HIV-positive male experienced over a 50% decrease in efavirenz levels over the course of 14 months while taking ginkgo extract. HIV-1 RNA copies also increased substantially, from less than 50 to more than 1500. It is suspected that terpenoids from the ginkgo extract reduced drug levels by inducing cytochrome P450 3A4 (CYP3A4). In another case report, a patient stable on antiviral therapy including efavirenz for 10 years, had an increase in viral load from <50 copies/mL to 1350 copies/mL after 2 months of taking a combination of supplements including ginkgo. After stopping ginkgo, the viral load was again controlled with the same antiviral therapy regimen.
Ibuprofen (Advil, Others)
Theoretically, ginkgo might increase the risk of bleeding when used with ibuprofen.
Ginkgo might have antiplatelet effects and has been associated with several case reports of spontaneous bleeding. In one case, a 71-year-old male had taken a specific ginkgo extract (Gingium, Biocur) 40 mg twice daily for 2.5 years. About 4 weeks after starting ibuprofen 600 mg daily he experienced a fatal intracerebral hemorrhage. However, the antiplatelet effects of ginkgo have been questioned. A meta-analysis and other studies have not found a significant antiplatelet effect with standardized ginkgo extracts, 80 mg to 480 mg taken daily for up to 32 weeks.
P-Glycoprotein Substrates
Theoretically, taking ginkgo with P-glycoprotein substrates might increase the levels and adverse effects of these substrates.
A small clinical study in healthy volunteers shows that using ginkgo leaf extract 120 mg orally three times daily for 14 days can increase levels of the P-glycoprotein substrate, talinolol, by 36% in healthy male individuals. However, single doses of ginkgo do not have the same effect.
Risperidone (Risperdal)
Theoretically, taking ginkgo with risperidone might increase the levels and adverse effects of risperidone.
A single case of priapism has been reported for a 26-year-old male with schizophrenia who used risperidone 3 mg daily along with ginkgo extract 160 mg daily. Risperidone is metabolized by cytochrome P450 (CYP) 2D6 and CYP3A4. CYP3A4 activity might be affected by ginkgo. Theoretically, ginkgo may inhibit the metabolism of risperidone and increase the risk of adverse effects.
Rosiglitazone (Avandia)
Theoretically, ginkgo might decrease the levels and clinical effects of rosiglitazone.
Animal research shows that ginkgo leaf extract orally 100 or 200 mg/kg daily for 10 days alters the pharmacodynamics of rosiglitazone in a dose-dependent manner. The 100 mg/kg and 200 mg/kg doses reduce the area under the concentration time curve (AUC) of rosiglitazone by 39% and 52%, respectively, and the half-life by 28% and 39%, respectively. It is hypothesized that these changes may be due to induction of cytochrome P450 2C8 by ginkgo.
Seizure Threshold Lowering Drugs
Theoretically, taking ginkgo with drugs that lower the seizure threshold might increase the risk for convulsions.
Ginkgo seeds contain ginkgotoxin. Large amounts of ginkgotoxin can cause neurotoxicity and seizure. Ginkgotoxin is present in much larger amounts in ginkgo seeds than leaves. Ginkgo leaf extract contains trace amounts of ginkgotoxin. The amount of ginkgotoxin in ginkgo leaf and leaf extract seems unlikely to cause toxicity. However, there are anecdotal reports of seizure occurring after use of ginkgo leaf both in patients without a history of seizure disorder and in those with previously well-controlled epilepsy.
Simvastatin (Zocor)
Theoretically, ginkgo might decrease the levels and clinical effects of simvastatin.
Clinical research shows that taking ginkgo extract can reduce the area under the curve and maximum concentration of simvastatin by 32% to 39%. However, ginkgo extract does not seem to affect the cholesterol-lowering ability of simvastatin.
Sofosbuvir (Sovaldi)
Theoretically, ginkgo might increase the levels and clinical effects of sofosbuvir.
Animal research in rats shows that giving a ginkgo extract 25 mg/kg orally daily for 14 days increases the area under the concentration time curve (AUC) after a single sofosbuvir dose of 40 mg/kg by 11%, increases the half-life by 60%, and increases the plasma concentration at 4 hours by 38%. This interaction appears to be related to the inhibition of intestinal P-glycoprotein by ginkgo.
Tacrolimus (Prograf)
Theoretically, ginkgo might increase the blood levels of tacrolimus.
In vitro evidence suggests that certain biflavonoids in ginkgo leaves (i.e. amentoflavone, ginkgetin, bilobetin) may inhibit the metabolism of tacrolimus by up to 50%. This interaction appears to be time-dependent and due to inhibition of cytochrome P450 (CYP) 3A4 by these bioflavonoids. In rats given tacrolimus 1 mg/kg orally, amentoflavone was shown to increase the area under the concentration time curve (AUC) of tacrolimus by 3.8-fold.
Trazodone (Desyrel)
Theoretically, ginkgo might increase the levels and clinical effects of trazodone.
In a case report, an Alzheimer patient taking trazodone 20 mg twice daily and ginkgo leaf extract 80 mg twice daily for four doses became comatose. The coma was reversed by administration of flumazenil (Romazicon). Coma might have been induced by excessive GABA-ergic activity. Ginkgo flavonoids are thought to have GABA-ergic activity and act directly on benzodiazepine receptors. Ginkgo might also increase metabolism of trazodone to active GABA-ergic metabolites, possibly by inducing cytochrome P450 3A4 (CYP3A4) metabolism.
Warfarin (Coumadin)
Ginkgo has been shown to increase the risk of bleeding in some people when taken with warfarin.
Several pharmacodynamic studies suggest that ginkgo inhibits platelet aggregation. It is thought that the ginkgo constituent, ginkgolide B, displaces platelet-activating factor (PAF) from its binding sites, decreasing blood coagulation. Several case reports have documented serious bleeding events in patients taking ginkgo. Information from a medical database suggests that when taken concurrently with warfarin, ginkgo increases the risk of a bleeding adverse event by 38%. There is also some evidence that ginkgo leaf extract can inhibit cytochrome P450 2C9, an enzyme that metabolizes warfarin. This could result in increased warfarin levels. However, population and clinical research has produced mixed results. Clinical research in healthy people suggests that ginkgo has no effect on INR, or the pharmacokinetics or pharmacodynamics of warfarin. A meta-analysis of 18 studies using standardized ginkgo extracts, 80 mg to 480 mg daily for up to 32 weeks, did not find a significant effect on platelet aggregation, fibrinogen concentration, or PT/aPTT. There is also some preliminary clinical research that suggests ginkgo might not significantly increase the effects of warfarin in patients that have a stable INR.
Nifedipine (Procardia)
Theoretically, taking ginkgo with oral, but not intravenous, nifedipine might increase levels and adverse effects of nifedipine.
Animal research and some clinical evidence suggests that taking ginkgo leaf extract orally in combination with oral nifedipine might increase nifedipine levels and cause increased side effects, such as headaches, dizziness, and hot flushes. However, taking ginkgo orally does not seem to affect the pharmacokinetics of intravenous nifedipine.
Omeprazole (Prilosec)
Theoretically, taking ginkgo with omeprazole might decrease the levels and clinical effects of omeprazole.
Clinical research shows that a specific ginkgo leaf extract (Remembrance, Herbs Product LTD) 140 mg twice daily can induce cytochrome P450 (CYP) 2C19 enzymes and decrease levels of omeprazole by about 27% to 42%.
Boswellia serrata extract
Cytochrome P450 1A2 (Cyp1A2) Substrates
Theoretically, Boswellia serrata might increase the levels of CYP1A2 substrates.
In vitro research shows that Boswellia serrata gum resin inhibits CYP1A2 enzymes.
Cytochrome P450 2C19 (Cyp2C19) Substrates
Theoretically, Boswellia serrata might increase the levels of CYP2C19 substrates.
In vitro research shows that Boswellia serrata gum resin inhibits CYP2C19 enzymes.
Cytochrome P450 2C9 (Cyp2C9) Substrates
Theoretically, Boswellia serrata might increase the levels of CYP2C9 substrates.
In vitro research shows that Boswellia serrata gum resin inhibits CYP2C9 enzymes.
Cytochrome P450 2D6 (Cyp2D6) Substrates
Theoretically, Boswellia serrata might increase the levels of CYP2D6 substrates.
In vitro research shows that Boswellia serrata gum resin inhibits CYP2D6 enzymes.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, Boswellia serrata might increase or decrease the levels and clinical effects of CYP3A4 substrates.
In vitro research shows that Boswellia serrata gum resin inhibits CYP3A4 enzymes. Other in vitro research shows that Boswellia serrata extract inhibits CYP3A4 enzymes at most concentrations, although it may modestly induce enzyme activity at low concentrations.
Immunosuppressants
Theoretically, Boswellia serrata might alter the effects of immunosuppressive drugs.
Some in vitro research suggests that Boswellia serrata extracts might inhibit mediators of autoimmune disorders such as leukotrienes and reduce production of antibodies and cell-mediated immunity. However, other in vitro research suggests that, when coupled with calcium ions, boswellic acids containing the keto group have immunostimulant properties within specific cell signaling pathways.
Vitamin D3
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.
Vitamin A Palmitate
Retinoids
Concomitant use of retinoids with vitamin A supplements might produce supratherapeutic vitamin A levels.
Retinoids, which are vitamin A derivatives, could have additive toxic effects when taken with vitamin A supplements.
Hepatotoxic Drugs
Theoretically, taking high doses of vitamin A in combination with other potentially hepatotoxic drugs might increase the risk of liver disease.
The tolerable upper intake level (UL) is the highest level of intake that is likely to pose no risk of adverse effects. Doses of vitamin A above the UL can cause hepatotoxicity, ranging from elevated liver enzymes to liver failure.
Tetracycline Antibiotics
Theoretically, taking tetracycline antibiotics with high doses of vitamin A can increase the risk of pseudotumor cerebri.
Benign intracranial hypertension (pseudotumor cerebri) can occur with tetracyclines and with acute or chronic vitamin A toxicity. Case reports suggest that taking tetracyclines and vitamin A concurrently can increase the risk of this condition. Avoid high doses of vitamin A in people taking tetracyclines chronically.
Warfarin (Coumadin)
Theoretically, high doses of vitamin A could increase the risk of bleeding with warfarin.
Vitamin A toxicity is associated with hemorrhage and hypoprothrombinemia, possibly due to vitamin K antagonism. Advise patients taking warfarin to avoid doses of vitamin A above the tolerable upper intake level of 10,000 IU/day for adults.
Magnesium Oxide
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.
Glucosamine HCl
Warfarin (Coumadin)
Glucosamine might increase the anticoagulant effects of warfarin and increase the risk of bruising and bleeding.
In two individual case reports, glucosamine/chondroitin combinations were associated with a significant increase in international normalized ratio (INR) in patients previously stabilized on warfarin. In one case, the increase in INR occurred only after tripling the dose of a glucosamine/chondroitin supplement from 500 mg/400 mg daily to 1500/1200 mg daily. Additionally, 20 voluntary case reports to the U.S. Food & Drug Administration (FDA) have linked glucosamine plus chondroitin with increased INR, bruising, and bleeding in patients who were also taking warfarin. There have also been 20 additional case reports to the World Health Organization (WHO) that link glucosamine alone to increased INR in patients taking warfarin. The mechanism of this interaction is unclear. Glucosamine is a small component of heparin, but is not thought to have anticoagulant activity; however, animal research suggests that it might have antiplatelet activity.
Topoisomerase Ii Inhibitors
Theoretically glucosamine may induce resistance to topoisomerase II inhibitors.
In vitro research suggests that glucosamine might induce resistance to etoposide (VP16, VePesid) and doxorubicin (Adriamycin) by reducing inhibition of topoisomerase II, an enzyme required for DNA replication in tumor cells. This effect has not been reported in humans.
Acetaminophen (Tylenol, Others)
Acetaminophen might interfere with the activity of glucosamine sulfate by interacting with the sulfate portion.
Anecdotal reports suggest that adding glucosamine to an acetaminophen regimen might decrease pain control in patients with osteoarthritis. Some research suggests that the sulfate portion of glucosamine sulfate might contribute to its effect in osteoarthritis. Since acetaminophen metabolism requires sulfur and reduces serum sulfate concentrations, acetaminophen could theoretically interfere with the action of glucosamine sulfate. Conversely, the administration of sulfate could theoretically decrease the effectiveness of acetaminophen in sulfate-deficient people by increasing its clearance.
Antidiabetes Drugs
Despite initial concerns, it is unlikely that glucosamine will interfere with the effects of antidiabetes drugs.
In vitro and animal research has suggested that glucosamine might increase insulin resistance or decrease insulin production. This has raised concerns that taking glucosamine might worsen diabetes and decrease the effectiveness of diabetes drugs. However, clinical research suggests that glucosamine does not have adverse effects on blood glucose or glycated hemoglobin (HbA1C) in healthy, obese, or type 2 diabetes patients.
Coral 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.
Chondroitin Sulfate Sodium
Warfarin (Coumadin)
Taking chondroitin in combination with glucosamine might increase the anticoagulant effects of warfarin. However, the effect of chondroitin alone is unclear.
There have been multiple reports of increased international normalized ratio (INR) in patients taking warfarin with glucosamine, with or without chondroitin. The lack of reports with chondroitin alone seem to suggest that the interactions occurring in these reports may have been due to glucosamine. In two individual case reports, glucosamine/chondroitin combinations were associated with a significant increase in INR in patients previously stabilized on warfarin. Additionally, 20 voluntary case reports to the US Food & Drug Administration (FDA) have linked glucosamine plus chondroitin with increased INR, bruising, and bleeding in patients who were also taking warfarin. There have also been 20 additional case reports to the World Health Organization (WHO) that link glucosamine alone, without chondroitin, to increased INR in patients taking warfarin.
Brand information
Manufacturer and brand details for X7 - Care, from the product label.
OL Olympian Labs
See all OL Olympian Labs products- Name
- Olympian Labs, Inc.
- City
- Phoenix
- State
- AZ
- ZipCode
- 85027
- Phone Number
- 1.800.473.5883
- Web Address
- www.olympianlabs.com
X7 - Care by OL Olympian Labs: 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 X7 - Care’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Ginkgo
Interacts with 1,266 drugsGinkgo is one of the world's most popular herbal supplements, mostly taken to support memory and circulation. The evidence for these uses is mixed and generally weak, and it is not proven to...
Read the full Ginkgo monograph → Herb & supplement monographBoron
Boron is a trace mineral found in many plant foods and sold as a supplement, mainly promoted for bone, joint, and hormone health. The human evidence for most of these uses is limited or prel...
Read the full Boron monograph → Herb & supplement monographVitamin 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 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 monographVitamin A
Interacts with 387 drugsVitamin A is an essential nutrient important for vision, skin, immune function, and growth. Most people get enough from a balanced diet, and supplements are mainly useful for correcting a tr...
Read the full Vitamin A 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 monographGlucosamine
Interacts with 170 drugsGlucosamine is a natural compound found in cartilage and joint fluid, and it is one of the most popular supplements for osteoarthritis, especially of the knee. The evidence is mixed, with so...
Read the full Glucosamine monograph → Herb & supplement monographBoswellia Serrata
Interacts with 952 drugsBoswellia serrata is a tree resin used in traditional medicine, mainly for joint pain and inflammation. Some studies suggest it may help with osteoarthritis symptoms, but the overall evidenc...
Read the full Boswellia Serrata monograph → Herb & supplement monographChondroitin Sulfate
Interacts with 2 drugsChondroitin sulfate is a naturally occurring building block of cartilage that is widely taken, often with glucosamine, for osteoarthritis joint pain. The evidence is mixed—some people report...
Read the full Chondroitin Sulfate monograph →Sources & How We Checked
X7 - Care'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 400 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.
Ginkgo 97 references
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- Matthews, MK. Association of Ginkgo biloba with intracerebral hemorrhage. Neurology 1998;50:1934.
- Rowin J, Lewis SL. Spontaneous bilateral subdural hemotomas with chronic Ginkgo biloba ingestion. Neurology 1996;46:1775-6.
- Rosenblatt M, Mindel T. Spontaneous hyphema associated with ingestion of Ginkgo biloba extract. N Engl J Med 1997;336:1108.
- Fessenden JM, Wittenborn W, Clarke L. Gingko biloba: a case report of herbal medicine and bleeding postoperatively from a laparoscopic cholecystectomy. Am Surg 2001;67:33-5. DOI
- Gurley BJ, Gardner SF, Hubbard MA. Clinical assessment of potential cytochrome P450-mediated herb-drug interactions. AAPS Ann Mtg & Expo Indianapolis, IN: 2000; Oct 29 - Nov 2:presentation #3460.
- Cohen AJ, Bartlik B. Ginkgo biloba for antidepressant-induced sexual dysfunction. J Sex Marital Ther 1998;24:139-43. PubMed
- Kudolo GB. The effect of 3-month ingestion of Ginkgo biloba extract on pancreatic beta-cell function in response to glucose loading in normal glucose tolerant individuals. J Clin Pharmacol 2000;40:647-54.
- Heck AM, DeWitt BA, Lukes AL. Potential interactions between alternative therapies and warfarin. Am J Health Syst Pharm 2000;57:1221-7. DOI
- Cesarani A, Meloni F, Alpini D, et al. Ginkgo biloba (EGb 761) in the treatment of equilibrium disorders. Adv Ther 1998;15:291-304.
- Galluzzi S, Zanetti O, Binetti G, et al. Coma in a patient with Alzheimer's disease taking low dose trazodone and Ginkgo biloba. J Neurol Neurosurg Psychiatry 2000;68:679-80. DOI
- Budzinski JW, Foster BC, Vandenhoek S, Arnason JT. An in vitro evaluation of human cytochrome P450 3A4 inhibition by selected commercial herbal extracts and tinctures. Phytomedicine 2000;7:273-82. PubMed
- Gregory PJ. Seizure associated with Ginkgo biloba? Ann Intern Med 2001;134:344.
- Granger AS. Ginkgo biloba precipitating epileptic seizures. Age Ageing 2001;30:523-5. PubMed
- Kajiyama Y, Fujii K, Takeuchi H, Manabe Y. Ginkgo seed poisoning. Pediatrics 2002;109:325-7. PubMed
- Miwa H, Iijima M, Tanaka S, Mizuno Y. Generalized convulsions after consuming a large amount of gingko nuts. Epilepsia 2001;42:280-1. DOI
- Burschka MA, Hassan HA, Reineke T, et al. Effect of treatment with Ginkgo biloba extract EGb 761 (oral) on unilateral idiopathic sudden hearing loss in a prospective randomized double-blind study of 106 outpatients. Eur Arch Otorhinolaryngol 2001;258:213- PubMed
- Miller LG, Freeman B. Possible subdural hematoma associated with Ginkgo biloba. J Herb Pharmacother 2002;2:57-63.
- Kudolo GB, Dorsey S, Blodgett J. Effect of the ingestion of Ginkgo biloba extract on platelet aggregation and urinary prostanoid excretion in healthy and Type 2 diabetic subjects. Thromb Res 2002;108:151-60.. PubMed
- Fong KC, Kinnear PE. Retrobulbar haemorrhage associated with chronic Ginkgo biloba ingestion. Postgrad Med J 2003;79:531-2..
- Gurley BJ, Gardner SF, Hubbard MA, et al. Cytochrome P450 phenotypic ratios for predicting herb-drug interactions in humans. Clin Pharmacol Ther 2002;72:276-87.. PubMed
- Kang BJ, Lee SJ, Kim MD, Cho MJ. A placebo-controlled, double-blind trial of Ginkgo biloba for antidepressant-induced sexual dysfunction. Hum Psychopharmacol 2002;17:279-84.
- Yale SH, Glurich I. Analysis of the inhibitory potential of Ginkgo biloba, Echinacea purpurea, and Serenoa repens on the metabolic activity of cytochrome P450 3A4, 2D6, and 2C9. J Altern Complement Med 2005;11:433-9.
- Yasui-Furukori N, Furukori H, Kaneda A, et al. The effects of Ginkgo biloba extracts on the pharmacokinetics and pharmacodynamics of donepezil. J Clin Pharmacol 2004;44:538-42.
- Markowitz JS, Donovan JL, Lindsay DeVane C, et al. Multiple-dose administration of Ginkgo biloba did not affect cytochrome P-450 2D6 or 3A4 activity in normal volunteers. J Clin Psychopharmacol 2003;23:576-81. PubMed
- Arenz A, Kelin M, Flehe K, et al. Occurrence of neurotoxic 4'-O-methylpyridoxine in ginkgo biloba leaves, ginkgo medications and Japanese ginkgo food. Planta Med 1996;62:548-51.
- Engelsen J, Nielsen JD, Winther K. Effect of coenzyme Q10 and Ginkgo biloba on warfarin dosage in stable, long-term warfarin treated outpatients. A randomised, double blind, placebo-crossover trial. Thromb Haemost 2002;87:1075-6. DOI
- Gaudineau C, Beckerman R, Welbourn S, Auclair K. Inhibition of human P450 enzymes by multiple constituents of the Ginkgo biloba extract. Biochem Biophys Res Comm 2004;318:1072–8. PubMed
- Kohler S, Funk P, Kieser M. Influence of a 7-day treatment with Ginkgo biloba special extract EGb 761 on bleeding time and coagulation: a randomized, placebo-controlled, double-blind study in healthy volunteers. Blood Coagul Fibrinolysis 2004;15:303–9. PubMed
- Jiang X, Williams KM, Liauw WS, et al. Effect of ginkgo and ginger on the pharmacokinetics and pharmacodynamics of warfarin in healthy subjects. Br J Clin Pharmacol 2005;59:425-32. PubMed
- Destro MW, Speranzini MB, Cavalheiro Filho C, et al. Bilateral haematoma after rhytidoplasty and blepharoplasty following chronic use of Ginkgo biloba. Br J Plast Surg 2005;58:100-1. PubMed
- Yin OQ, Tomlinson B, Waye MM, et al. Pharmacogenetics and herb-drug interactions: experience with Ginkgo biloba and omeprazole. Pharmacogenetics 2004;14:841-50. PubMed
- Bent S, Goldberg H, Padula A, Avins AL. Spontaneous bleeding associated with Ginkgo biloba: a case report and systematic review of the literature. J Gen Intern Med 2005;20;657-61. DOI
- Meisel C, Johne A, Roots I. Fatal intracerebral mass bleeding associated with Ginkgo biloba and ibuprofen. Atherosclerosis 2003;167:367. PubMed
- Bebbington A, Kulkarni R, Roberts P. Ginkgo biloba: Persistent bleeding after total hip arthroplasty caused by herbal self-medication. J Arthroplasty 2005;20:125-6. .
- Kupiec T, Raj V. Fatal seizures due to potential herb-drug interactions with Ginkgo biloba. J Anal Toxicol 2005:755-8. PubMed
- Hauser D, Gayowski T, Singh N. Bleeding complications precipitated by unrecognized Gingko biloba use after liver transplantation. Transpl Int 2002;15:377-9. DOI
- Mohutsky MA, Anderson GD, Miller JW, Elmer GW. Ginkgo biloba: evaluation of CYP2C9 drug interactions in vitro and in vivo. Am J Ther 2006;13:24-31. PubMed
- Kudolo GB. The effect of 3-month ingestion of Ginkgo biloba extract (EGb 761) on pancreatic beta-cell function in response to glucose loading in individuals with non-insulin-dependent diabetes mellitus. J Clin Pharmacol 2001;41:600-11.
- Pennisi RS. Acute generalised exanthematous pustulosis induced by the herbal remedy Ginkgo biloba. Med J Aust 2006;184:583-4. PubMed
- Yagmur E, Piatkowski A, Groger A, et al. Bleeding complication under Gingko biloba medication. Am J Hematol 2005;79:343-4. PubMed
- Vale S. Subarachnoid haemorrhage associated with Ginkgo biloba. Lancet 1998;352:36. PubMed
- Aruna D, Naidu MU. Pharmacodynamic interaction studies of Ginkgo biloba with cilostazol and clopidogrel in healthy human subjects. Br J Clin Pharmacol 2007;63:333-8.
- Dugoua JJ, Mills E, Perri D, Koren G. Safety and efficacy of ginkgo (Ginkgo biloba) during pregnancy and lactation. Can J Clin Pharmacol 2006;13:e277-84.
- Jiang X, Blair EY, McLachlan AJ. Investigation of the effects of herbal medicines on warfarin response in healthy subjects: a population pharmacokinetic-pharmacodynamic modeling approach. J Clin Pharmacol 2006;46:1370-8. PubMed
- Woelk H, Arnoldt KH, Kieser M, Hoerr R. Ginkgo biloba special extract EGb 761 in generalized anxiety disorder and adjustment disorder with anxious mood: a randomized, double-blind, placebo-controlled trial. J Psychiatr Res 2007;41:472-80. PubMed
- DeKosky ST, Williamson JD, Fitzpatrick AL, et al. Ginkgo biloba for prevention of dementia. JAMA 2008;300:2253-62.
- Dodge HH, Zitzelberger T, Oken BS, et al. A randomized placebo-controlled trial of ginkgo biloba for the prevention of cognitive decline. Neurology 2008;70(19 Pt 2):1809-17. PubMed
- Wiegman DJ, Brinkman K, Franssen EJ. Interaction of Ginkgo biloba with efavirenz. AIDS 2009;23:1184-5. PubMed
- Kim BH, Kim KP, Lim KS, et al. Influence of Ginkgo biloba extract on the pharmacodynamic effects and pharmacokinetic properties of ticlopidine: An open-label, randomized, two-period, two-treatment, two-sequence, single-dose crossover study in healthy Kor
- Salehi B, Imani R, Mohammadi MR, et al. Ginkgo biloba for attention-deficit/hyperactivity disorder in children and adolescents: a double blind, randomized controlled trial. Prog Neuropsychopharmacol Biol Psychiatry 2010;34:76-80. PubMed
- Kellermann AJ, Kloft C. Is there a risk of bleeding associated with standardized ginkgo biloba extract therapy? A systematic review and meta-analysis. Pharmacotherapy 2011;31:490-502.
- Kuller LH, Ives DG, Fitzpatrick AL, et al. Does Ginkgo biloba reduce the risk of cardiovascular events? Circ Cardiovasc Qual Outcomes 2010;3:41-7.
- Naccarato M, Yoong D, Gough K. A potential drug-herbal interaction between Ginkgo biloba and efavirenz. J Int Assoc Physicians AIDS Care (Chic). 2012;11(2):98-100. doi: 10.1177/1545109711435364. Epub 2012 Feb 9.
- Engelsen, J., Nielsen, J. D., and Hansen, K. F. [Effect of Coenzyme Q10 and Ginkgo biloba on warfarin dosage in patients on long-term warfarin treatment. A randomized, double-blind, placebo-controlled cross-over trial]. Ugeskr.Laeger 4-28-2003;165(18):18
- Parsad, D., Pandhi, R., and Juneja, A. Effectiveness of oral Ginkgo biloba in treating limited, slowly spreading vitiligo. Clin Exp.Dermatol. 2003;28(3):285-287.
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