Xanadrine Pure Ingredients & Drug Interactions
by MuscleTech
What is this page for?
First and foremost: checking Xanadrine Pure 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
Xanadrine Pure is a dietary supplement by MuscleTech with 6 active ingredients. Its ingredients are commonly taken for bone health and osteoporosis prevention, dietary calcium deficiency, heartburn relief (calcium carbonate antacids).Based on those ingredients, 1,349 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are Turmeric extract, BioPerine Black Pepper extract, Garcinia cambogia extract. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against Xanadrine Pure by MuscleTech
Ask about any prescription or over-the-counter medication and we check it for interactions with Xanadrine Pure by MuscleTech — 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 Xanadrine Pure by MuscleTech
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
Xanadrine Pure contains six active ingredients. Calcium supports bone health and is effective for low blood calcium and osteoporosis.
BioPerine black pepper extract is a standardized form of piperine, the active compound in black pepper, used mainly to enhance absorption of other ingredients. Alpha-lipoic acid (ALA) is a compound the body makes naturally; it's been studied for nerve damage from diabetes and cholesterol levels.
Apple cider vinegar and turmeric extract are traditional ingredients with modest evidence for inflammation and digestion. Garcinia cambogia extract is standardized to hydroxycitric acid and promoted for weight management, though evidence is insufficient.
The tablet also contains inactive ingredients—microcrystalline cellulose, hydroxypropylcellulose, dicalcium phosphate dihydrate, carboxymethylcellulose, stearic acid, magnesium stearate, and silicon dioxide—which serve as binders and fillers.
Does it work?
Not established
Calcium in this product is effective for supporting adequate calcium intake, preventing low blood calcium, and likely effective for osteoporosis. Black pepper extract, alpha-lipoic acid, apple cider vinegar, turmeric, and garcinia all show insufficient reliable evidence to rate them for the conditions marketed on supplement labels.
Alpha-lipoic acid is possibly effective for nerve damage caused by diabetes and possibly effective for cholesterol and weight management. Turmeric is possibly effective for depression, cholesterol, hay fever, and indigestion.
The evidence for black pepper as a solo ingredient and garcinia cambogia for weight loss and other uses is not established in the data we hold.
How safe is it?
Well-documented data
Calcium is generally well tolerated at recommended doses but can cause constipation, gas, stomach upset, or belching. High doses may raise concerns about kidney stones and possibly prostate cancer risk, though evidence is mixed.
Calcium is safe in pregnancy and lactation when used at recommended amounts. Black pepper is generally safe in food amounts; concentrated supplements carry more caution, and there's limited safety data on supplement-strength piperine in pregnancy and breastfeeding.
Alpha-lipoic acid is generally well tolerated but can lower blood sugar; it should be avoided in pregnancy and breastfeeding due to insufficient safety information. Apple cider vinegar is safe in food amounts but large or long-term doses can cause low potassium, bone loss, and chemical burns if applied to skin.
Turmeric is generally safe as a food but concentrated supplements may cause liver damage in rare cases—avoid medicinal doses in pregnancy and breastfeeding. Garcinia has rare reports of liver injury, heart inflammation, and mania; avoid it in pregnancy and breastfeeding.
Meds to double-check
Major interaction found
Check with your pharmacist or doctor before using Xanadrine Pure if you take HIV integrase inhibitors (dolutegravir, elvitegravir), blood thinners or antiplatelet drugs, heart medications (diltiazem, sotalol, propranolol), chemotherapy drugs, the antibiotic ceftriaxone, thyroid hormone, diabetes medications, diuretics, or digoxin. Calcium in this product must be separated from levothyroxine, ceftriaxone, and the integrase inhibitors by several hours to avoid reducing their effectiveness or causing serious harm.
The bottom line
Scorecard at a glanceFully disclosed formula with no established evidence rating for its marketed use. Major medication interactions have been identified, and safety information is well characterized.
Xanadrine Pure is primarily a calcium supplement with added ingredients used in weight-management and wellness formulas. It's reasonable for someone looking to meet calcium needs, but the product carries significant medication interactions—especially with HIV drugs, blood thinners, chemotherapy, and heart medications.
If you take any prescription drugs, check them against the interaction tool before starting. Talk to your pharmacist or doctor about whether this product fits your health situation.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 6 of 6 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Oct 22, 2021.
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 Xanadrine Pure, straight from the product label.
| Brand | MuscleTech |
|---|---|
| Barcode (UPC) | 631656609486 |
| Net contents | 100 Tablet(s) |
| Market status | On market |
| Date entered into DSLD | Oct 22, 2021 |
| DSLD ID | 255837 |
| Product type | Other Combinations |
| Supplement form | Tablet Or Pill |
| Dietary claims / uses | All Other, Structure/Function |
| Intended target group(s) | Adult (18 - 50 Years), Women (not pregnant or lactating) |
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 Xanadrine Pure by MuscleTech, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Calcium | 63 mg | 6% |
| BioPerine Black Pepper extract | 5.3 mg | -- |
| ALA | 400 mg | -- |
| Apple Cider Vinegar powder | 800 mg | -- |
| Apple Cider Vinegar | 400 mg | -- |
| Turmeric extract | 150 mg | -- |
| Garcinia cambogia extract | 100 mg | -- |
Other ingredients: Microcrystalline Cellulose, Hydroxypropylcellulose, Dicalcium Phosphate Dihydrate, Carboxymethylcellulose, Stearic Acid, Magnesium Stearate, Silicon Dioxide
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.
Formula
Pure ingredients Turmeric curcumin extract Standardized to 95% curcuminoids. Alpha lipoic acid (ALA) Helps metabolize carbohydrates, protein and fats. Apple cider vinegar Created by fermenting apples. Garcinia Cambogia Standardized to 60% Hydroxycitric Acid. Bioperine black pepper extract A patented extract from black pepper fruit.
Xenadrine Pure is a non-stimulant formula featuring a patented, scientifically backed ingredient combination of alpha lipoic acid (ALA) and turmeric (curcumin) to include in your healthy weight loss plan.
ALA+Curcumin combination
Alpha lipoic acid 400 mg Turmeric (curcumin) extract 150 mg Apple cider vinegar 400 mg Garcinia Cambogia 100 mg
Formulation
Made in the U.S.A. from international ingredients.
Healthy weight loss
Non-stimulant Healthy weight loss
Brand IP Statement(s)
2018.
Protected by United States Patents #9,040,576 and 9,770,434.
BioPerine is a Registered Trademark and Patented Product of Sabinsa Corporation.
General Statements
For lot no. and expiry date: see bottle.
Fast & effective backed by science Study #1: 16 weeks
12.56 lbs. lost Placebo 6.12 lbs. lost In two 16-week studies, subjects using the key ingredient combination (alpha lipoic acid and curcumin) lost an average of 12.56 lbs. vs. 6.12lbs for placebo and 4.84 lbs. vs. 0.87 lbs. for placebo, respectively. All subjects followed a calorie-reduced diet and walking program. Patented combination Xenadrine Pure holds 2 patents, #9,770,434 and #9,040,576, for weight loss. MuscleTech research & development
FDA Statement of Identity
Dietary Supplement
Suggested/Recommended/Usage/Directions
Directions: Take 1 serving (2 tablets) twice daily, 30 to 60 minutes before your 2 largest meals. A third serving may be added before your third meal. For best results, use for 60 days in combination with a calorie-reduced diet and exercise. Read the entire label before use and follow directions provided.
Precautions
Warning: Not intended for use by persons under 18.
Do not use if pregnant or nursing.
Discontinue use and consult a medical doctor if you experience unusual symptoms.
Consult a medical doctor before use if you have been treated for or diagnosed with, have a family history of any medical condition, you are using any prescription or over-the-counter drug, and before starting a diet or exercise program.
If you experience a skin rash or any other allergic reaction, discontinue use and consult a medical doctor.
Do not exceed recommended serving. Improper use of this will product will not improve results and is not advised. Use only as directed.
Keep out of reach of children.
Do not use if packaging has been tampered with.
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.
Storage
Store in a cool, dry place (60 degrees F to 80 degrees F).
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Xanadrine Pure by MuscleTech 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 Xanadrine Pure by MuscleTech
These are the 6 active ingredients this product is made of. Select any to open its full monograph.
Serving size2 Tablet(s) Dosage formTablet Or Pill Servings per container50 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.
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...
Calcium monograph & interactionsBioPerine Black Pepper extract
Interacts with1,019 drugs
Black pepper is a common kitchen spice that is generally safe in the amounts used in food. Its extract, piperine, is mostly added to supplements to he...
BioPerine Black Pepper extract monograph & interactionsALA
Interacts with263 drugs
Alpha-lipoic acid (ALA) is an antioxidant made naturally by the body and found in small amounts in foods. It is most studied for diabetic nerve pain,...
ALA monograph & interactionsApple Cider Vinegar powder
Interacts with162 drugs
Apple cider vinegar is a fermented apple product that many people use hoping to help with blood sugar, weight, or digestion. The evidence for most of...
Apple Cider Vinegar powder monograph & interactionsTurmeric extract
Interacts with1,133 drugs
Turmeric is a popular spice whose main active compounds, curcuminoids, are studied mostly for inflammation and joint pain. Some research is promising,...
Turmeric extract monograph & interactionsGarcinia cambogia extract
Interacts with704 drugs
Garcinia is a tropical fruit whose rind contains hydroxycitric acid (HCA), widely marketed for weight loss and appetite control. The scientific eviden...
Garcinia cambogia extract monograph & interactionsOther (inactive) ingredients: Microcrystalline Cellulose, Hydroxypropylcellulose, Dicalcium Phosphate Dihydrate, Carboxymethylcellulose, Stearic Acid, Magnesium Stearate, Silicon Dioxide. These complete the product’s ingredient list but are not active constituents.
Xanadrine Pure by MuscleTech Drug Interactions
HelloPharmacist Interaction Report
Xanadrine Pure by MuscleTech contains six active ingredients, and several of them interact with medications.
Calcium is responsible for the most serious interactions: it can reduce levels of two HIV integrase inhibitors, dolutegravir and elvitegravir, by chelation, potentially lowering their effectiveness. It can also cause a life-threatening reaction with the antibiotic ceftriaxone if both are given intravenously.
You'd need to separate doses by hours or avoid the IV combination entirely.
Read the full breakdown — every affected drug type, severity by severity
Calcium also interacts moderately with the heart drug diltiazem, the antibiotic-steroid calcipotriene, the heart rhythm drug sotalol, and the thyroid drug levothyroxine—in each case by reducing absorption or effectiveness. Black pepper extract can raise blood levels of several medications: the heart drug propranolol, the TB drug rifampin, the antiepileptic phenytoin, the antiviral nevirapine, and the immunosuppressant cyclosporine are all affected moderately.
It may also increase levels of the statin atorvastatin and the breathing drug theophylline, and could heighten the sedative effect of pentobarbital.
Alpha-lipoic acid (ALA) interacts moderately with blood thinners and chemotherapy drugs—the concern is its antioxidant effect may reduce how certain cancer treatments work. It could theoretically lower thyroid hormone effectiveness and raise the risk of low blood sugar with diabetes medications.
Apple cider vinegar can theoretically raise the risk of low potassium with diuretics and insulin, increase digoxin toxicity, or cause low blood sugar with diabetes drugs. Turmeric extract has moderate interactions with chemotherapy drugs, the immunosuppressant tacrolimus, the cancer drug tamoxifen, the antibiotic sulfasalazine, and methotrexate, and may affect tramadol levels.
Garcinia cambogia interacts with blood thinners, serotonergic antidepressants, liver-toxic drugs, and diabetes medications.
Altogether, these interactions span 1,328 individual medications. Use the medication checker on this page to search your exact drugs before starting.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against Xanadrine Pure?
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 Xanadrine Pure interact with 1,349 drugs. Click any drug to see the details.
6 of the 6 ingredients in Xanadrine Pure interact with drugs. Each result below shows which ingredient is responsible. Turmeric extract BioPerine Black Pepper extract Garcinia cambogia extract ALA Calcium Apple Cider Vinegar powder
6-mercaptopurinePurinethol
How 6-mercaptopurine interacts with Xanadrine Pure — through 2 ingredients. Tap an ingredient for the detail:
Garcinia Cambogia ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use with other potentially hepatotoxic drugs might increase the risk of developing liver damage.
Read the full Garcinia Cambogia Extract + 6-mercaptopurine interactionTurmeric ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, turmeric might increase the risk of liver damage when taken with hepatotoxic drugs.
Read the full Turmeric Extract + 6-mercaptopurine interactionAdo-trastuzumab EmtansineKadcyla
How Ado-trastuzumab Emtansine interacts with Xanadrine Pure — through 2 ingredients. Tap an ingredient for the detail:
Bioperine Black Pepper ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP3A4.
Read the full Bioperine Black Pepper Extract + Ado-trastuzumab Emtansine interactionTurmeric ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Turmeric might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full Turmeric Extract + Ado-trastuzumab Emtansine interactionAbacavir Sulfate, Dolutegravir, LamivudineTriumeq
How Abacavir Sulfate, Dolutegravir, Lamivudine interacts with Xanadrine Pure — through 2 ingredients. Tap an ingredient for the detail:
Turmeric ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, turmeric might increase the risk of liver damage when taken with hepatotoxic drugs.
Read the full Turmeric Extract + Abacavir Sulfate, Dolutegravir, Lamivudine interactionGarcinia Cambogia ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use with other potentially hepatotoxic drugs might increase the risk of developing liver damage.
Read the full Garcinia Cambogia Extract + Abacavir Sulfate, Dolutegravir, Lamivudine interactionAbacavir, LamivudineEpzicom
How Abacavir, Lamivudine interacts with Xanadrine Pure — through 2 ingredients. Tap an ingredient for the detail:
Garcinia Cambogia ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use with other potentially hepatotoxic drugs might increase the risk of developing liver damage.
Read the full Garcinia Cambogia Extract + Abacavir, Lamivudine interactionTurmeric ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, turmeric might increase the risk of liver damage when taken with hepatotoxic drugs.
Read the full Turmeric Extract + Abacavir, Lamivudine interactionAbciximabReoPro
How Abciximab interacts with Xanadrine Pure — through 4 ingredients. Tap an ingredient for the detail:
Turmeric ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Turmeric may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Turmeric Extract + Abciximab interactionAlaAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, alpha-lipoic acid may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Ala + Abciximab interactionBioperine Black Pepper ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, black pepper might increase the risk of bleeding when taken with antiplatelet or anticoagulant drugs.
Read the full Bioperine Black Pepper Extract + Abciximab interactionGarcinia Cambogia ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, hydroxycitric acid (HCA), the main active ingredient in garcinia, might increase the risk of bleeding when used with antiplatelet or anticoagulant drugs.
Read the full Garcinia Cambogia Extract + Abciximab interactionAbemaciclibVerzenio
How Abemaciclib interacts with Xanadrine Pure — through 2 ingredients. Tap an ingredient for the detail:
Turmeric ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Turmeric might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full Turmeric Extract + Abemaciclib interactionBioperine Black Pepper ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP3A4.
Read the full Bioperine Black Pepper Extract + Abemaciclib interactionAbiraterone
How Abiraterone interacts with Xanadrine Pure — through 3 ingredients. Tap an ingredient for the detail:
Garcinia Cambogia ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use with other potentially hepatotoxic drugs might increase the risk of developing liver damage.
Read the full Garcinia Cambogia Extract + Abiraterone interactionBioperine Black Pepper ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP3A4.
Read the full Bioperine Black Pepper Extract + Abiraterone interactionTurmeric ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Hepatotoxic Drugs Moderate
Interaction Summary
Turmeric might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full Turmeric Extract + Abiraterone interactionAbiraterone AcetateYonsa, Zytiga
How Abiraterone Acetate interacts with Xanadrine Pure — through 3 ingredients. Tap an ingredient for the detail:
Turmeric ExtractHepatotoxic Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, turmeric might increase the risk of liver damage when taken with hepatotoxic drugs.
Read the full Turmeric Extract + Abiraterone Acetate interactionBioperine Black Pepper ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP3A4.
Read the full Bioperine Black Pepper Extract + Abiraterone Acetate interactionGarcinia Cambogia ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use with other potentially hepatotoxic drugs might increase the risk of developing liver damage.
Read the full Garcinia Cambogia Extract + Abiraterone Acetate interactionAbrocitinibCibinqo
How Abrocitinib interacts with Xanadrine Pure — through 4 ingredients. Tap an ingredient for the detail:
Bioperine Black Pepper ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, black pepper might increase the risk of bleeding when taken with antiplatelet or anticoagulant drugs.
Read the full Bioperine Black Pepper Extract + Abrocitinib interactionGarcinia Cambogia ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, hydroxycitric acid (HCA), the main active ingredient in garcinia, might increase the risk of bleeding when used with antiplatelet or anticoagulant drugs.
Read the full Garcinia Cambogia Extract + Abrocitinib interactionTurmeric ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Turmeric may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Turmeric Extract + Abrocitinib interactionAlaAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, alpha-lipoic acid may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Ala + Abrocitinib interactionAcalabrutinibCalquence
How Acalabrutinib interacts with Xanadrine Pure — through 2 ingredients. Tap an ingredient for the detail:
Bioperine Black Pepper ExtractP-glycoprotein Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, black pepper might increase levels of P-glycoprotein substrates.
Read the full Bioperine Black Pepper Extract + Acalabrutinib interactionTurmeric ExtractP-glycoprotein Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, turmeric might increase the absorption of P-glycoprotein substrates.
Read the full Turmeric Extract + Acalabrutinib interactionAcarboseGlucobay, Prandase, Precose
How Acarbose interacts with Xanadrine Pure — through 5 ingredients. Tap an ingredient for the detail:
Turmeric ExtractAntidiabetes Drugs, Hepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking turmeric with antidiabetes drugs might increase the risk of hypoglycemia.
Read the full Turmeric Extract + Acarbose interactionGarcinia Cambogia ExtractAntidiabetes Drugs, Hepatotoxic Drugs Moderate
Interaction Summary
Theoretically, hydroxycitric acid (HCA), the main active ingredient in garcinia, might have additive effects with antidiabetes drugs and increase the risk of hypoglycemia.
Read the full Garcinia Cambogia Extract + Acarbose interactionBioperine Black Pepper ExtractAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, black pepper might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Read the full Bioperine Black Pepper Extract + Acarbose interactionApple Cider VinegarAntidiabetes Drugs Minor
Interaction Summary
Theoretically, taking apple cider vinegar with antidiabetes drugs might increase the risk of hypoglycemia.
Read the full Apple Cider Vinegar + Acarbose interactionAlaAntidiabetes Drugs Minor
Interaction Summary
Theoretically, taking alpha-lipoic acid with antidiabetes drugs might increase the risk of hypoglycemia.
Read the full Ala + Acarbose interactionAcebutololRhotral, Sectral
How Acebutolol interacts with Xanadrine Pure — through 2 ingredients. Tap an ingredient for the detail:
Turmeric ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, turmeric might increase the risk of liver damage when taken with hepatotoxic drugs.
Read the full Turmeric Extract + Acebutolol interactionGarcinia Cambogia ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use with other potentially hepatotoxic drugs might increase the risk of developing liver damage.
Read the full Garcinia Cambogia Extract + Acebutolol interactionAcenocoumarolSintrom
How Acenocoumarol interacts with Xanadrine Pure — through 4 ingredients. Tap an ingredient for the detail:
Bioperine Black Pepper ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, black pepper might increase the risk of bleeding when taken with antiplatelet or anticoagulant drugs.
Read the full Bioperine Black Pepper Extract + Acenocoumarol interactionGarcinia Cambogia ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, hydroxycitric acid (HCA), the main active ingredient in garcinia, might increase the risk of bleeding when used with antiplatelet or anticoagulant drugs.
Read the full Garcinia Cambogia Extract + Acenocoumarol interactionAlaAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, alpha-lipoic acid may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Ala + Acenocoumarol interactionTurmeric ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Turmeric may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Turmeric Extract + Acenocoumarol interactionAcetaminophenChildren's Tylenol, Children's Tylenol Meltaways, Tylenol, Tylenol Ex Strength
How Acetaminophen interacts with Xanadrine Pure — through 3 ingredients. Tap an ingredient for the detail:
Turmeric ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Hepatotoxic Drugs Moderate
Interaction Summary
Theoretically, turmeric might increase levels of drugs metabolized by CYP1A2.
Read the full Turmeric Extract + Acetaminophen interactionGarcinia Cambogia ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use with other potentially hepatotoxic drugs might increase the risk of developing liver damage.
Read the full Garcinia Cambogia Extract + Acetaminophen interactionBioperine Black Pepper ExtractCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, black pepper might decrease levels and clinical effects of drugs metabolized by CYP1A2.
Read the full Bioperine Black Pepper Extract + Acetaminophen interactionAcetaminophen, AspirinGemnisyn
How Acetaminophen, Aspirin interacts with Xanadrine Pure — through 4 ingredients. Tap an ingredient for the detail:
Bioperine Black Pepper ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Anticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, black pepper might decrease levels and clinical effects of drugs metabolized by CYP1A2.
Read the full Bioperine Black Pepper Extract + Acetaminophen, Aspirin interactionGarcinia Cambogia ExtractAnticoagulant/antiplatelet Drugs, Hepatotoxic Drugs Moderate
Interaction Summary
Theoretically, hydroxycitric acid (HCA), the main active ingredient in garcinia, might increase the risk of bleeding when used with antiplatelet or anticoagulant drugs.
Read the full Garcinia Cambogia Extract + Acetaminophen, Aspirin interactionTurmeric ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Anticoagulant/antiplatelet Drugs +1 Moderate
Interaction Summary
Theoretically, turmeric might increase levels of drugs metabolized by CYP1A2.
Read the full Turmeric Extract + Acetaminophen, Aspirin interactionAlaAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, alpha-lipoic acid may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Ala + Acetaminophen, Aspirin interactionAcetaminophen, Aspirin, CaffeineExcedrin, Excedrin Extra Strength, Excedrin Migraine
How Acetaminophen, Aspirin, Caffeine interacts with Xanadrine Pure — through 4 ingredients. Tap an ingredient for the detail:
AlaAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, alpha-lipoic acid may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Ala + Acetaminophen, Aspirin, Caffeine interactionBioperine Black Pepper ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Anticoagulant/antiplatelet Drugs +1 Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP3A4.
Read the full Bioperine Black Pepper Extract + Acetaminophen, Aspirin, Caffeine interactionGarcinia Cambogia ExtractHepatotoxic Drugs, Anticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, concomitant use with other potentially hepatotoxic drugs might increase the risk of developing liver damage.
Read the full Garcinia Cambogia Extract + Acetaminophen, Aspirin, Caffeine interactionTurmeric ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Hepatotoxic Drugs +2 Moderate
Interaction Summary
Theoretically, turmeric might increase levels of drugs metabolized by CYP1A2.
Read the full Turmeric Extract + Acetaminophen, Aspirin, Caffeine interactionAcetaminophen, Brompheniramine, PhenylpropanolamineDimetapp Cold and Flu
How Acetaminophen, Brompheniramine, Phenylpropanolamine interacts with Xanadrine Pure — through 3 ingredients. Tap an ingredient for the detail:
Turmeric ExtractHepatotoxic Drugs, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, turmeric might increase the risk of liver damage when taken with hepatotoxic drugs.
Read the full Turmeric Extract + Acetaminophen, Brompheniramine, Phenylpropanolamine interactionGarcinia Cambogia ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use with other potentially hepatotoxic drugs might increase the risk of developing liver damage.
Read the full Garcinia Cambogia Extract + Acetaminophen, Brompheniramine, Phenylpropanolamine interactionBioperine Black Pepper ExtractCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, black pepper might decrease levels and clinical effects of drugs metabolized by CYP1A2.
Read the full Bioperine Black Pepper Extract + Acetaminophen, Brompheniramine, Phenylpropanolamine interactionAcetaminophen, ButalbitalAxocet, Bancap, Bucet, Butex Forte, Esgic CF, Orbivan CF +5 more
How Acetaminophen, Butalbital interacts with Xanadrine Pure — through 3 ingredients. Tap an ingredient for the detail:
Garcinia Cambogia ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use with other potentially hepatotoxic drugs might increase the risk of developing liver damage.
Read the full Garcinia Cambogia Extract + Acetaminophen, Butalbital interactionTurmeric ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Hepatotoxic Drugs Moderate
Interaction Summary
Theoretically, turmeric might increase levels of drugs metabolized by CYP1A2.
Read the full Turmeric Extract + Acetaminophen, Butalbital interactionBioperine Black Pepper ExtractCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, black pepper might decrease levels and clinical effects of drugs metabolized by CYP1A2.
Read the full Bioperine Black Pepper Extract + Acetaminophen, Butalbital interactionAcetaminophen, Butalbital, CaffeineEsgic, Esgic Plus, Fiogesic, Fioricet, Repan, Tecnal +1 more
How Acetaminophen, Butalbital, Caffeine interacts with Xanadrine Pure — through 3 ingredients. Tap an ingredient for the detail:
Turmeric ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Moderate
Interaction Summary
Theoretically, turmeric might increase levels of drugs metabolized by CYP1A2.
Read the full Turmeric Extract + Acetaminophen, Butalbital, Caffeine interactionBioperine Black Pepper ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP3A4.
Read the full Bioperine Black Pepper Extract + Acetaminophen, Butalbital, Caffeine interactionGarcinia Cambogia ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use with other potentially hepatotoxic drugs might increase the risk of developing liver damage.
Read the full Garcinia Cambogia Extract + Acetaminophen, Butalbital, Caffeine interactionAcetaminophen, Butalbital, Caffeine, CodeineEsgic with Codeine, Fioricet w/ Codeine
How Acetaminophen, Butalbital, Caffeine, Codeine interacts with Xanadrine Pure — through 3 ingredients. Tap an ingredient for the detail:
Bioperine Black Pepper ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Moderate
Interaction Summary
Theoretically, black pepper might decrease levels and clinical effects of drugs metabolized by CYP1A2.
Read the full Bioperine Black Pepper Extract + Acetaminophen, Butalbital, Caffeine, Codeine interactionGarcinia Cambogia ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use with other potentially hepatotoxic drugs might increase the risk of developing liver damage.
Read the full Garcinia Cambogia Extract + Acetaminophen, Butalbital, Caffeine, Codeine interactionTurmeric ExtractHepatotoxic Drugs, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Moderate
Interaction Summary
Theoretically, turmeric might increase the risk of liver damage when taken with hepatotoxic drugs.
Read the full Turmeric Extract + Acetaminophen, Butalbital, Caffeine, Codeine interactionAcetaminophen, Butalbital, CodeineBancap w/ Codeine
How Acetaminophen, Butalbital, Codeine interacts with Xanadrine Pure — through 3 ingredients. Tap an ingredient for the detail:
Bioperine Black Pepper ExtractCytochrome P450 2d6 (cyp2d6) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP2D6.
Read the full Bioperine Black Pepper Extract + Acetaminophen, Butalbital, Codeine interactionGarcinia Cambogia ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use with other potentially hepatotoxic drugs might increase the risk of developing liver damage.
Read the full Garcinia Cambogia Extract + Acetaminophen, Butalbital, Codeine interactionTurmeric ExtractHepatotoxic Drugs, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, turmeric might increase the risk of liver damage when taken with hepatotoxic drugs.
Read the full Turmeric Extract + Acetaminophen, Butalbital, Codeine interactionAcetaminophen, Butalbital, Codeine PhosphatePhrenilin #3
How Acetaminophen, Butalbital, Codeine Phosphate interacts with Xanadrine Pure — through 3 ingredients. Tap an ingredient for the detail:
Turmeric ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Hepatotoxic Drugs Moderate
Interaction Summary
Theoretically, turmeric might increase levels of drugs metabolized by CYP1A2.
Read the full Turmeric Extract + Acetaminophen, Butalbital, Codeine Phosphate interactionBioperine Black Pepper ExtractCytochrome P450 2d6 (cyp2d6) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP2D6.
Read the full Bioperine Black Pepper Extract + Acetaminophen, Butalbital, Codeine Phosphate interactionGarcinia Cambogia ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use with other potentially hepatotoxic drugs might increase the risk of developing liver damage.
Read the full Garcinia Cambogia Extract + Acetaminophen, Butalbital, Codeine Phosphate interactionAcetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, PhenylephrineHycomine Compound
How Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interacts with Xanadrine Pure — through 3 ingredients. Tap an ingredient for the detail:
Garcinia Cambogia ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use with other potentially hepatotoxic drugs might increase the risk of developing liver damage.
Read the full Garcinia Cambogia Extract + Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interactionBioperine Black Pepper ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Moderate
Interaction Summary
Theoretically, black pepper might decrease levels and clinical effects of drugs metabolized by CYP1A2.
Read the full Bioperine Black Pepper Extract + Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interactionTurmeric ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Moderate
Interaction Summary
Turmeric might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full Turmeric Extract + Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interactionAcetaminophen, Caffeine, CodeineGesic C15, Gesic C30, Gesic C8, Lenoltec 1, Lenoltec 2, Lenoltec 3 +1 more
How Acetaminophen, Caffeine, Codeine interacts with Xanadrine Pure — through 3 ingredients. Tap an ingredient for the detail:
Bioperine Black Pepper ExtractCytochrome P450 2d6 (cyp2d6) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP2D6.
Read the full Bioperine Black Pepper Extract + Acetaminophen, Caffeine, Codeine interactionGarcinia Cambogia ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use with other potentially hepatotoxic drugs might increase the risk of developing liver damage.
Read the full Garcinia Cambogia Extract + Acetaminophen, Caffeine, Codeine interactionTurmeric ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Hepatotoxic Drugs +1 Moderate
Interaction Summary
Theoretically, turmeric might increase levels of drugs metabolized by CYP1A2.
Read the full Turmeric Extract + Acetaminophen, Caffeine, Codeine interactionAcetaminophen, Caffeine, Codeine, SalicylamideCodalan No.1, Codalan No.2, Codalan No.3
How Acetaminophen, Caffeine, Codeine, Salicylamide interacts with Xanadrine Pure — through 3 ingredients. Tap an ingredient for the detail:
Turmeric ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Hepatotoxic Drugs +1 Moderate
Interaction Summary
Turmeric might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full Turmeric Extract + Acetaminophen, Caffeine, Codeine, Salicylamide interactionBioperine Black Pepper ExtractCytochrome P450 2d6 (cyp2d6) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP2D6.
Read the full Bioperine Black Pepper Extract + Acetaminophen, Caffeine, Codeine, Salicylamide interactionGarcinia Cambogia ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use with other potentially hepatotoxic drugs might increase the risk of developing liver damage.
Read the full Garcinia Cambogia Extract + Acetaminophen, Caffeine, Codeine, Salicylamide interactionAcetaminophen, Caffeine, DihydrocodeineDHC Plus, Panlor DC, Panlor SS
How Acetaminophen, Caffeine, Dihydrocodeine interacts with Xanadrine Pure — through 3 ingredients. Tap an ingredient for the detail:
Bioperine Black Pepper ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Moderate
Interaction Summary
Theoretically, black pepper might decrease levels and clinical effects of drugs metabolized by CYP1A2.
Read the full Bioperine Black Pepper Extract + Acetaminophen, Caffeine, Dihydrocodeine interactionGarcinia Cambogia ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use with other potentially hepatotoxic drugs might increase the risk of developing liver damage.
Read the full Garcinia Cambogia Extract + Acetaminophen, Caffeine, Dihydrocodeine interactionTurmeric ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Moderate
Interaction Summary
Theoretically, turmeric might increase levels of drugs metabolized by CYP1A2.
Read the full Turmeric Extract + Acetaminophen, Caffeine, Dihydrocodeine interactionAcetaminophen, Caffeine, IsomethepteneMigralam
How Acetaminophen, Caffeine, Isometheptene interacts with Xanadrine Pure — through 3 ingredients. Tap an ingredient for the detail:
Bioperine Black Pepper ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP3A4.
Read the full Bioperine Black Pepper Extract + Acetaminophen, Caffeine, Isometheptene interactionGarcinia Cambogia ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use with other potentially hepatotoxic drugs might increase the risk of developing liver damage.
Read the full Garcinia Cambogia Extract + Acetaminophen, Caffeine, Isometheptene interactionTurmeric ExtractHepatotoxic Drugs, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Moderate
Interaction Summary
Theoretically, turmeric might increase the risk of liver damage when taken with hepatotoxic drugs.
Read the full Turmeric Extract + Acetaminophen, Caffeine, Isometheptene interactionAcetaminophen, Caffeine, PyrilamineMidol Max Strength Menstrual
How Acetaminophen, Caffeine, Pyrilamine interacts with Xanadrine Pure — through 4 ingredients. Tap an ingredient for the detail:
Turmeric ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Hepatotoxic Drugs +1 Moderate
Interaction Summary
Turmeric might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full Turmeric Extract + Acetaminophen, Caffeine, Pyrilamine interactionBioperine Black Pepper ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP3A4.
Read the full Bioperine Black Pepper Extract + Acetaminophen, Caffeine, Pyrilamine interactionApple Cider VinegarDiuretic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of apple cider vinegar with diuretic drugs might increase the risk of hypokalemia.
Read the full Apple Cider Vinegar + Acetaminophen, Caffeine, Pyrilamine interactionGarcinia Cambogia ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use with other potentially hepatotoxic drugs might increase the risk of developing liver damage.
Read the full Garcinia Cambogia Extract + Acetaminophen, Caffeine, Pyrilamine interactionAcetaminophen, Chlorpheniramine Maleate, Dextromethorphan HbrVicks Formula 44M Cough, Cold & Flu Relief
How Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interacts with Xanadrine Pure — through 3 ingredients. Tap an ingredient for the detail:
Garcinia Cambogia ExtractHepatotoxic Drugs, Serotonergic Drugs Moderate
Interaction Summary
Theoretically, concomitant use with other potentially hepatotoxic drugs might increase the risk of developing liver damage.
Read the full Garcinia Cambogia Extract + Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interactionBioperine Black Pepper ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Moderate
Interaction Summary
Theoretically, black pepper might decrease levels and clinical effects of drugs metabolized by CYP1A2.
Read the full Bioperine Black Pepper Extract + Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interactionTurmeric ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Moderate
Interaction Summary
Theoretically, turmeric might increase levels of drugs metabolized by CYP1A2.
Read the full Turmeric Extract + Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interactionAcetaminophen, Chlorpheniramine, Codeine, PhenylephrineColrex
How Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interacts with Xanadrine Pure — through 3 ingredients. Tap an ingredient for the detail:
Bioperine Black Pepper ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 2d6 (cyp2d6) Substrates +1 Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP3A4.
Read the full Bioperine Black Pepper Extract + Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interactionGarcinia Cambogia ExtractSerotonergic Drugs, Hepatotoxic Drugs Moderate
Interaction Summary
Theoretically, combining garcinia with other serotonergic drugs might increase the risk of serotonergic side effects, including serotonin syndrome.
Read the full Garcinia Cambogia Extract + Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interactionTurmeric ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Hepatotoxic Drugs +1 Moderate
Interaction Summary
Theoretically, turmeric might increase levels of drugs metabolized by CYP1A2.
Read the full Turmeric Extract + Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interactionEach ingredient & the kinds of drugs it affects
For each ingredient in Xanadrine Pure 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.
Turmeric extract
Alkylating Agents
Turmeric has antioxidant effects. Theoretically, this may reduce the activity of chemotherapy drugs that generate free radicals. However, research is conflicting.
In vitro research suggests that curcumin, a constituent of turmeric, inhibits mechlorethamine-induced apoptosis of breast cancer cells by up to 70%. Also, animal research shows that curcumin inhibits cyclophosphamide-induced tumor regression. However, some in vitro research shows that curcumin does not affect the apoptosis capacity of etoposide. Also, other laboratory research suggests that curcumin might augment the cytotoxic effects of alkylating agents. Reasons for the discrepancies may relate to the dose of curcumin and the specific chemotherapeutic agent. Lower doses of curcumin might have antioxidant effects while higher doses might have pro-oxidant effects. More evidence is needed to determine what effect, if any, turmeric might have on alkylating agents.
Amlodipine (Norvasc)
Taking turmeric with amlodipine may increase levels of amlodipine.
Animal research shows that giving amlodipine 1 mg/kg as a single dose following the use of turmeric extract 200 mg/kg daily for 2 weeks increases the maximum concentration and area under the curve by 53% and 56%, respectively, when compared with amlodipine alone. Additional animal research shows that taking amlodipine 1 mg/kg with a curcumin 2 mg/kg pretreatment for 10 days increases the maximum concentration and area under the curve by about 2-fold when compared with amlodipine alone.
Anticoagulant/Antiplatelet Drugs
Turmeric may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs. However, research is conflicting.
Curcumin, a constituent of turmeric, has demonstrated antiplatelet effects in vitro. Furthermore, two case reports have found that taking turmeric along with warfarin or fluindione was associated with an increased international normalized ratio (INR). However, one clinical study in healthy volunteers shows that taking curcumin 500 mg daily for 3 weeks, alone or with aspirin 100 mg, does not increase antiplatelet effects or bleeding risk. It is possible that the dose of turmeric used in this study was too low to produce a notable effect.
Antidiabetes Drugs
Theoretically, taking turmeric with antidiabetes drugs might increase the risk of hypoglycemia.
Animal research and case reports suggest that curcumin, a turmeric constituent, can reduce blood glucose levels in patients with diabetes. Furthermore, clinical research in adults with type 2 diabetes shows that taking curcumin 475 mg daily for 10 days prior to taking glyburide 5 mg decreased postprandial glucose levels for up to 24 hours when compared with glyburide alone, despite the lack of a significant pharmacokinetic interaction. Other clinical studies in patients with diabetes show that taking curcumin daily can reduce blood glucose levels when compared with placebo.
Antitumor Antibiotics
Turmeric has antioxidant effects. Theoretically, this may reduce the activity of chemotherapy drugs that generate free radicals. However, research is conflicting.
In vitro and animal research shows that curcumin, a constituent of turmeric, inhibits doxorubicin-induced apoptosis of breast cancer cells by up to 65%. However, curcumin does not seem to affect the apoptosis capacity of daunorubicin. In fact, some research shows that curcumin might augment the cytotoxic effects of antitumor antibiotics, increasing their effectiveness. Reasons for the discrepancies may relate to the dose of curcumin and the chemotherapeutic agent. Lower doses of curcumin might have antioxidant effects while higher doses might have pro-oxidant effects. More evidence is needed to determine what effects, if any, antioxidants such as turmeric have on antitumor antibiotics.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Turmeric might increase or decrease levels of drugs metabolized by CYP3A4.
In vitro and animal research show that turmeric and its constituents curcumin and curcuminoids inhibit CYP3A4. Also, 8 case reports from the World Health Organization (WHO) adverse drug reaction database describe increased toxicity in patients taking turmeric and cancer medications that are CYP3A4 substrates, including everolimus, ruxolitinib, ibrutinib, and palbociclib, and bortezomib. In another case report, a transplant patient presented with acute nephrotoxicity and elevated tacrolimus levels after consuming turmeric powder at a dose of 15 or more spoonfuls daily for ten days prior. It was thought that turmeric increased levels of tacrolimus due to CYP3A4 inhibition.
Conversely, other in vitro research suggests that turmeric induces CYP3A4 activity, leading to reduced levels of CYP3A4 substrates. An animal model suggests that induction of CYP3A4 occurs after daily curcumin use for 1 week. However, the induction of CYP3A4 by turmeric has not been reported in humans.
Hepatotoxic Drugs
Theoretically, turmeric might increase the risk of liver damage when taken with hepatotoxic drugs.
There is concern that turmeric might cause hepatotoxicity, especially when highly bioavailable formulations are used in high doses.
Methotrexate (Trexall, Others)
Theoretically, turmeric might have additive effects when used with hepatotoxic drugs such as methotrexate.
In one case report, a 39-year-old female taking methotrexate, turmeric, and linseed oil developed hepatotoxicity.
Organic Anion-Transporting Polypeptide Substrates (Oatp)
Theoretically, turmeric might increase blood levels of OATP4C1 substrates.
In vitro research shows that the turmeric constituent curcumin competitively inhibits OATP4C1 transport. This transporter is expressed in the kidney and facilitates the renal excretion of certain drugs. Theoretically, taking turmeric might decrease renal excretion of OATP substrates.
Sulfasalazine (Azulfidine)
Turmeric might increase the effects and adverse effects of sulfasalazine.
Clinical research shows that taking the turmeric constituent, curcumin, can increase blood levels of sulfasalazine by 3.2-fold.
Tacrolimus (Prograf)
Turmeric might increase the effects and adverse effects of tacrolimus.
In one case report, a transplant patient presented with acute nephrotoxicity and elevated tacrolimus levels of 29 ng/mL. The patient previously had tacrolimus levels within the therapeutic range at 9.7 ng/mL. Ten days prior to presenting at the emergency room the patient started consumption of turmeric powder at a dose of 15 or more spoonfuls daily. It was thought that turmeric increased levels of tacrolimus due to cytochrome P450 3A4 (CYP3A4) inhibition. In vitro and animal research show that turmeric and its constituent curcumin inhibit CYP3A4.
Talinolol
Turmeric may reduce the absorption of talinolol in some situations.
Clinical research shows that taking curcumin for 6 days decreases the bioavailability of talinolol when taken together on the seventh day. The clinical significance of this effect is unclear.
Tamoxifen (Nolvadex)
Theoretically, turmeric might reduce the levels and clinical effects of tamoxifen.
In a small clinical trial in patients with breast cancer taking tamoxifen 20-30 mg daily, adding curcumin 1200 mg plus piperine 10 mg three times daily reduces the 24-hour area under the curve of tamoxifen and the active metabolite endoxifen by 12.8% and 12.4%, respectively, as well as the maximum concentrations of tamoxifen, when compared with tamoxifen alone. However, in the absence of piperine, the area under the curve for endoxifen and the maximum concentration of tamoxifen were not significantly reduced. Effects were most pronounced in patients who were extensive cytochrome P450 (CYP) 2D6 metabolizers.
Topoisomerase I Inhibitors
Turmeric has antioxidant effects. There is some concern that this may reduce the activity of chemotherapy drugs that generate free radicals. However, research is conflicting.
In vitro research shows that curcumin, a constituent of turmeric, inhibits camptothecin-induced apoptosis of breast cancer cells by up to 71%. However, other in vitro research shows that curcumin augments the cytotoxic effects of camptothecin. Reasons for the discrepancies may relate to the dose of curcumin and the chemotherapeutic agents. Lower doses of curcumin might have antioxidant effects while higher doses might have pro-oxidant effects. More evidence is needed to determine what effect, if any, turmeric might have.
Tramadol (Ultram)
Theoretically, turmeric might increase or decrease levels of tramadol.
Animal research suggests that a single dose of curcumin, a constituent of turmeric, may increase tramadol's maximum concentration (Cmax) by inhibiting metabolism, while continued daily use for 7 days may reduce the area under the curve (AUC) due to the induction of drug-metabolizing enzymes such as cytochrome P450 3A4 (CYP3A4). However, this interaction has not been reported in humans.
Warfarin (Coumadin)
Turmeric might increase the risk of bleeding with warfarin.
One case of increased international normalized ratio (INR) has been reported for a patient taking warfarin who began taking turmeric. Prior to taking turmeric, the patient had stable INR measurements. Within a few weeks of starting turmeric supplementation, the patient's INR increased to 10. Additionally, curcumin, the active constituent in turmeric, has demonstrated antiplatelet effects in vitro, which may produce additive effects when taken with warfarin.
Cytochrome P450 1A2 (Cyp1A2) Substrates
Theoretically, turmeric might increase levels of drugs metabolized by CYP1A2. However, research is conflicting.
In vitro and animal research show that the turmeric constituent, curcumin, inhibits CYP1A2. However, other in vitro research suggests that curcumin does not significantly affect CYP1A2.
Docetaxel (Taxotere)
Theoretically, turmeric might increase blood levels of oral docetaxel.
Animal research suggests that the turmeric constituent, curcumin, enhances the oral bioavailability of docetaxel. However, the significance of this interaction is unclear, as this drug is typically administered intravenously in clinical settings.
Estrogens
Theoretically, large amounts of turmeric might interfere with hormone replacement therapy through competition for estrogen receptors.
In vitro research shows that curcumin, a constituent of turmeric, displaces the binding of estrogen to its receptors.
Glyburide (Diabeta, Others)
Theoretically, taking turmeric and glyburide in combination might increase the risk of hypoglycemia.
Clinical research shows that taking curcumin 475 mg daily for 10 days prior to taking glyburide 5 mg increases blood levels of glyburide by 12% at 2 hours after the dose in patients with type 2 diabetes. While maximal blood concentrations of glyburide were not affected, turmeric modestly decreased postprandial glucose levels for up to 24 hours when compared to glyburide alone, possibly due to the hypoglycemic effect of turmeric demonstrated in animal research.
Losartan (Cozaar)
Theoretically, turmeric might increase the effects of losartan.
Research in hypertensive rats shows that taking turmeric can increase the hypotensive effects of losartan.
Norfloxacin (Noroxin)
Theoretically, turmeric might increase the effects and adverse effects of norfloxacin.
Animal research shows that taking curcumin, a turmeric constituent, can increase blood levels of orally administered norfloxacin.
P-Glycoprotein Substrates
Theoretically, turmeric might increase the absorption of P-glycoprotein substrates.
In vitro and animal research shows that curcuminoids and other constituents found in turmeric can inhibit P-glycoprotein expression and activity.
Paclitaxel (Abraxane, Onxol)
Theoretically, turmeric might alter blood levels of paclitaxel, although any effect may not be clinically relevant.
Clinical research in adults with breast cancer receiving intravenous paclitaxel suggests that taking turmeric may modestly alter paclitaxel pharmacokinetics. Patients received paclitaxel on day 1, followed by either no treatment or turmeric 2 grams daily from days 2-22. Pharmacokinetic modeling suggests that turmeric reduces the maximum concentration and area under the curve of paclitaxel by 12.1% and 7.7%, respectively. However, these changes are not likely to be considered clinically relevant. Conversely, animal research suggests that curcumin, a constituent of turmeric, enhances the oral bioavailability of paclitaxel. However, the significance of this interaction is unclear, as this drug is typically administered intravenously in clinical settings.
BioPerine Black Pepper extract
Anticoagulant/Antiplatelet Drugs
Theoretically, black pepper might increase the risk of bleeding when taken with antiplatelet or anticoagulant drugs.
In vitro research shows that piperine, a constituent of black pepper, seems to inhibit platelet aggregation. This has not been reported in humans.
Antidiabetes Drugs
Theoretically, black pepper might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Animal research shows that piperine, a constituent of black pepper, can reduce blood glucose levels. Monitor blood glucose levels closely. Dose adjustments might be necessary.
Atorvastatin (Lipitor)
Theoretically, black pepper might increase blood levels of atorvastatin.
Animal research shows that taking piperine, a constituent of black pepper, 35 mg/kg can increase the maximum serum concentration of atorvastatin three-fold. This has not been reported in humans.
Cyclosporine (Neoral, Sandimmune)
Theoretically, black pepper might increase the effects and side effects of cyclosporine.
In vitro research shows that piperine, a constituent of black pepper, increases the bioavailability of cyclosporine. This has not been reported in humans.
Cytochrome P450 2D6 (Cyp2D6) Substrates
Theoretically, black pepper might increase levels of drugs metabolized by CYP2D6.
In vitro research suggests that some constituents of black pepper inhibit CYP2D6. This has not been reported in humans.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, black pepper might increase levels of drugs metabolized by CYP3A4.
In vitro research and pharmacokinetic simulation data suggest that piperine, a constituent of black pepper, as well as the pepper fruit seem to inhibit CYP3A4. This has not been reported in humans.
Lithium
Theoretically, black pepper might increase blood levels of lithium due to its diuretic effects. The dose of lithium might need to be reduced.
Black pepper is thought to have diuretic properties.
Nevirapine (Viramune)
Black pepper might increase blood levels of nevirapine.
Clinical research shows that piperine, a constituent of black pepper, increases the plasma concentration of nevirapine. However, no adverse effects were observed in this study.
P-Glycoprotein Substrates
Theoretically, black pepper might increase levels of P-glycoprotein substrates.
In vitro research shows that piperine, a constituent of black pepper, seems to inhibit P-glycoprotein.
Pentobarbital (Nembutal)
Theoretically, black pepper might increase the sedative effects of pentobarbital.
Animal research shows that piperine, a constituent of black pepper, increases pentobarbital-induced sleeping time.
Phenytoin (Dilantin)
Black pepper might increase blood levels of phenytoin.
Clinical research shows that piperine, a constituent of black pepper, seems to increase absorption, slow elimination, and increase levels of phenytoin. Taking a single dose of black pepper 1 gram along with phenytoin seems to double the serum concentration of phenytoin. Consuming a soup with black pepper providing piperine 44 mg/200 mL of soup along with phenytoin also seems to increase phenytoin levels when compared with consuming the same soup without black pepper.
Propranolol (Inderal)
Black pepper might increase blood levels of propranolol.
Clinical research shows that piperine, a constituent of black pepper, seems to increase absorption and slow elimination of propranolol.
Rifampin (Rifadin)
Black pepper might increase blood levels of rifampin.
Clinical research shows that piperine, a constituent of black pepper, seems to increase absorption and serum levels of rifampin.
Theophylline
Black pepper might increase blood levels of theophylline.
Clinical research shows that piperine, a constituent of black pepper, seems to increase absorption and slow elimination of theophylline.
Amoxicillin (Amoxil, Trimox)
Theoretically, black pepper might increase the effects and side effects of amoxicillin.
Animal research shows that taking piperine, a constituent of black pepper, with amoxicillin increases plasma levels of amoxicillin. This has not been reported in humans.
Carbamazepine (Tegretol)
Theoretically, black pepper might increase blood levels of carbamazepine, potentially increasing the effects and side effects of carbamazepine.
One clinical study in patients taking carbamazepine 300 mg or 500 mg twice daily shows that taking a single 20 mg dose of purified piperine, a constituent of black pepper, increases carbamazepine levels. Piperine may increase carbamazepine absorption by increasing blood flow to the GI tract, increasing the surface area of the small intestine, or inhibiting cytochrome P450 3A4 (CYP3A4) in the gut wall. Absorption was significantly increased by 7-10 mcg/mL/hour. The time to eliminate carbamazepine was also increased by 4-8 hours. Although carbamazepine levels were increased, this did not appear to increase side effects. In vitro research also shows that piperine can increase carbamazepine levels by 11% in a time-dependent manner.
Cytochrome P450 1A2 (Cyp1A2) Substrates
Theoretically, black pepper might decrease levels and clinical effects of drugs metabolized by CYP1A2.
In vitro research suggests that black pepper induces CYP1A2. This has not been reported in humans.
Garcinia cambogia extract
Anticoagulant/Antiplatelet Drugs
Theoretically, hydroxycitric acid (HCA), the main active ingredient in garcinia, might increase the risk of bleeding when used with antiplatelet or anticoagulant drugs.
HCA inhibits platelet aggregation in vitro. The inhibitory effect seems to be greater in platelets extracted from diabetic subjects than non-diabetic subjects.
Antidiabetes Drugs
Theoretically, hydroxycitric acid (HCA), the main active ingredient in garcinia, might have additive effects with antidiabetes drugs and increase the risk of hypoglycemia.
HCA reduces fasting and postprandial blood glucose levels in animal models, theoretically by delaying glucose absorption. This effect has not been reported in humans.
Hepatotoxic Drugs
Theoretically, concomitant use with other potentially hepatotoxic drugs might increase the risk of developing liver damage.
There have been reports of acute hepatitis with elevated liver enzymes associated with garcinia, when taken alone or in combination with other ingredients. Case reports collected from the Drug Induced Liver Injury Network suggest this risk may be greater in people who carry the HLA B*35:01 allele.
Serotonergic Drugs
Theoretically, combining garcinia with other serotonergic drugs might increase the risk of serotonergic side effects, including serotonin syndrome.
In one report, a patient experienced serotonin syndrome after taking garcinia extract (60% hydroxycitric acid) 1000 mg daily in combination with escitalopram 20 mg, which had been taken for a year. The patient was switched to sertraline 50 mg daily and again experienced serotonin syndrome.
ALA
Alkylating Agents
Theoretically, the antioxidant effects of alpha-lipoic acid might alter the effectiveness of alkylating agents.
The use of antioxidants like alpha-lipoic acid during chemotherapy is controversial. There are concerns that antioxidants could reduce the activity of chemotherapy drugs that generate free radicals. However, some researchers theorize that antioxidants might make chemotherapy more effective by reducing oxidative stress that might interfere with apoptosis (cell death) of cancer cells. More evidence is needed to determine what effect, if any, antioxidants such as alpha-lipoic acid have on chemotherapy. Advise patients to consult their oncologist before using alpha-lipoic acid.
Anticoagulant/Antiplatelet Drugs
Theoretically, alpha-lipoic acid may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
In vitro, alpha-lipoic acid inhibits platelet aggregation.
Antitumor Antibiotics
Theoretically, the antioxidant effects of alpha-lipoic acid might alter the effectiveness of antitumor antibiotics.
The use of antioxidants like alpha-lipoic acid during chemotherapy is controversial. There are concerns that antioxidants could reduce the activity of antitumor antibiotic drugs, which work by generating free radicals. However, some researchers theorize that antioxidants might make chemotherapy more effective by reducing oxidative stress that might interfere with apoptosis (cell death) of cancer cells. More evidence is needed to determine what effect, if any, antioxidants such as alpha-lipoic acid have on chemotherapy involving antitumor antibiotics. Advise patients to consult their oncologist before using alpha-lipoic acid.
Thyroid Hormone
Theoretically, alpha-lipoic acid might decrease the effects of thyroid hormone drugs.
Animal research suggests that co-administration of thyroxine with alpha-lipoic acid reduces conversion into the active T3 form.
Antidiabetes Drugs
Theoretically, taking alpha-lipoic acid with antidiabetes drugs might increase the risk of hypoglycemia.
Although some small clinical studies have suggested that alpha-lipoic acid can lower blood glucose levels, larger clinical studies in patients with diabetes have shown no clinically meaningful effect. Additionally, co-administration of single doses of alpha-lipoic acid and glyburide or acarbose did not cause detectable drug interactions in healthy volunteers.
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.
Apple Cider Vinegar powder
Digoxin (Lanoxin)
Theoretically, concomitant use of apple cider vinegar with digoxin might increase the risk of cardiac toxicity.
A case of hypokalemia related to chronic use of apple cider vinegar has been reported. Theoretically, overuse of apple cider vinegar could decrease potassium levels, increasing the risk of toxicity with digoxin.
Diuretic Drugs
Theoretically, concomitant use of apple cider vinegar with diuretic drugs might increase the risk of hypokalemia.
A case of hypokalemia related to chronic use of apple cider vinegar has been reported. There is some concern that people taking apple cider vinegar along with potassium depleting diuretics might have an increased risk for hypokalemia.
Insulin
Theoretically, concomitant use of apple cider vinegar with insulin might increase the risk of hypokalemia.
A case of hypokalemia related to chronic use of apple cider vinegar has been reported. Theoretically, overuse of apple cider vinegar concomitantly with insulin might increase the risk of hypokalemia.
Antidiabetes Drugs
Theoretically, taking apple cider vinegar with antidiabetes drugs might increase the risk of hypoglycemia.
Apple cider vinegar might reduce fasting and postprandial blood glucose levels and decrease gastric emptying in people with diabetes. However, not all research agrees. Theoretically, it might have additive effects on glucose levels when used with antidiabetes drugs.
Brand information
Manufacturer and brand details for Xanadrine Pure, from the product label.
MuscleTech
See all MuscleTech products- Name
- Iovate Health Sciences U.S.A. Inc.
- Street Address
- 1105 North Market Street, Suite 1330
- City
- Wilmington
- State
- DE
- ZipCode
- 19801
- Web Address
- xenclear.com
Xanadrine Pure by MuscleTech: 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 Xanadrine Pure’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Calcium
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 monographBlack Pepper
Interacts with 1,019 drugsBlack pepper is a common kitchen spice that is generally safe in the amounts used in food. Its extract, piperine, is mostly added to supplements to help the body absorb other ingredients (li...
Read the full Black Pepper monograph → Herb & supplement monographAlpha-lipoic Acid
Interacts with 263 drugsAlpha-lipoic acid (ALA) is an antioxidant made naturally by the body and found in small amounts in foods. It is most studied for diabetic nerve pain, where some evidence suggests it may help...
Read the full Alpha-lipoic Acid monograph → Herb & supplement monographApple Cider Vinegar
Interacts with 162 drugsApple cider vinegar is a fermented apple product that many people use hoping to help with blood sugar, weight, or digestion. The evidence for most of these uses is limited and mixed, and the...
Read the full Apple Cider Vinegar monograph → Herb & supplement monographTurmeric
Interacts with 1,133 drugsTurmeric is a popular spice whose main active compounds, curcuminoids, are studied mostly for inflammation and joint pain. Some research is promising, but quality is mixed and curcumin is po...
Read the full Turmeric monograph → Herb & supplement monographGarcinia
Interacts with 704 drugsGarcinia is a tropical fruit whose rind contains hydroxycitric acid (HCA), widely marketed for weight loss and appetite control. The scientific evidence is weak and mixed, with most studies...
Read the full Garcinia monograph →Sources & How We Checked
Xanadrine Pure'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 296 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.
Calcium 62 references
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- Thys-Jacobs S, Ceccarelli S, Bierman A, et al. Calcium supplementation in premenstrual syndrome: a randomized crossover trial. J Gen Intern Med 1989;4:183-9. PubMed
- Maton PN, Burton ME. Antacids revisited: a review of their clinical pharmacology and recommended therapeutic use. Drugs 1999;57:855-70.
- Clemens JD, Feinstein AR. Calcium carbonate and constipation: a historical review of medical mythopoeia. Gastroenterology 1977;72:957-61. DOI
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- Friedman PA, Bushinsky DA. Diuretic effects on calcium metabolism. Semin Nephrol 1999;19:551-6.
- Koo WK, Walters JC, Esterlitz J, et al. Maternal calcium supplementation and fetal bone mineralization. Obstet Gynecol 1999;94:577-82. DOI
- Raman L, Rajalakshmi K, Krishnamachari KAVR, et al. Effect of calcium supplementation to undernourished mothers during pregnancy on the bone density of the neonates. Am J Clin Nutr 1978; 31:466-9. DOI
- Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
- Chan JM, Giovannucci E, Andersson SO, et al. Dairy products, calcium, phosphorous, vitamin D, and risk of prostate cancer. Cancer Causes Control 1998;9:559-66.
- Butner LE, Fulco PP, Feldman G, et al. Calcium carbonate-induced hypothyroidism. Ann Intern Med 2000:132:595. PubMed
- Schneyer CR. Calcium carbonate and reduction of levothyroxine efficacy. JAMA 1998;279:750. PubMed
- Moser LR, Smythe MA, Tisdale JE. The use of calcium salts in the prevention and management of verapamil-induced hypotension. Ann Pharmacother 2000;34:622-9. PubMed
- Singh N, Singh PN, Hershman JM. Effect of calcium carbonate on the absorption of levothyroxine. JAMA 2000;283:2822-5. PubMed
- Kahela P, Anttila M, Tikkanen R, Sundquist H. Effect of food, food constituents and fluid volume on the bioavailability of sotalol. Acta Pharmacol Toxicol (Copenh) 1979;44:7-12.. PubMed
- Pletz MW, Petzold P, Allen A, et al. Effect of calcium carbonate on bioavailability of orally administered gemifloxacin. Antimicrob Agents Chemother 2003;47:2158-60.. PubMed
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- Decktor DL, Robinson M, Maton PN, et al. Effects of aluminum/magnesium hydroxide and calcium carbonate on esophageal and gastric pH in subjects with heartburn. Am J Ther 1995;2:546-52. PubMed
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- Peters ML, Leonard M, Licata AA. Role of alendronate and risedronate in preventing and treating osteoporosis. Cleve Clin J Med 2001;68:945-51. PubMed
- Bourke JF, Mumford R, Whittaker P, et al. The effects of topical calcipotriol on systemic calcium homeostasis in patients with chronic plaque psoriasis. J Am Acad Dermatol 1997;37:929-34.
- Gueguen L, Pointillart A. The bioavailability of dietary calcium. J Am Coll Nutr 2000;19:119s-136s. PubMed
- Vella A, Gerber TC, Hayes DL, Reeder GS. Digoxin, hypercalcaemia, and cardiac conduction. Postgrad Med J 1999;75:554-6. PubMed
- Bania TC, Blaufeux B, Hughes S, et al. Calcium and digoxin vs. calcium alone for severe verapamil toxicity. Acad Emerg Med 2000;7:1089-96. PubMed
- Tseng M, Breslow RA, Graubard BI, Ziegler RG. Dairy, calcium, and vitamin D intakes and prostate cancer risk in the National Health and Nutrition Examination Epidemiologic Follow-up Study cohort. Am J Clin Nutr 2005;81:1147-54. PubMed
- Weingarten MA, Zalmanovici A, Yaphe J. Dietary calcium supplementation for preventing colorectal cancer and adenomatous polyps. Cochrane Database Syst Rev 2004;(1):CD003548. PubMed
- Tavani A, Bertuccio P, Bosetti C, et al. Dietary intake of calcium, vitamin D, phosphorus and the risk of prostate cancer. Eur Urol 2005;48:27-33. PubMed
- Giovannucci E, Liu Y, Stampfer MJ, Willett WC. A prospective study of calcium intake and incident and fatal prostate cancer. Cancer Epidemiol Biomarkers Prev 2006;15:203-10. PubMed
- Rocephin (ceftriaxone) and calcium interaction. Pharmacist's Letter / Prescriber's Letter 2007;23(10):231005.
- Bolland MJ, Barber PA, Doughty RN, et al. Vascular events in healthy older women receiving calcium supplementation: randomised control trial. BMJ 2008;336:262-6.
- Bolland MJ, Avenell A, Baron JA, et al. Effect of calcium supplements on risk of myocardial infarction and cardiovascular events: meta-analysis. BMJ 2010;341:c3691. PubMed
- Calcium supplementation and vascular events. Pharmacist's Letter / Prescriber's Letter 2008;24(3):240306.
- Dietary reference intakes for calcium and vitamin D. Institute of Medicine, November 30, 2010. Available at: http://www.iom.edu/~/media/Files/Report%20Files/2010/Dietary-Reference-Intakes-for-Calcium-and-Vitamin-D/Vitamin%20D%20and%20Calcium%202010%20Repo
- Coburn JW, Mischel MG, Goodman WG, et al. Calcium citrate markedly enhances aluminum absorption from aluminum hydroxide. Am J Kidney Dis. 1991;17(6):708-11. PubMed
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- Kays MB, Overholser BR, Mueller BA, et al. Effects of sevelamer hydrochloride and calcium acetate on the oral bioavailability of ciprofloxacin. Am J Kidney Dis. 2003;42(6):1253-9. PubMed
- Neuhofel, A. L., Wilton, J. H., Victory, J. M., Hejmanowsk, L. G., and Amsden, G. W. Lack of bioequivalence of ciprofloxacin when administered with calcium-fortified orange juice: a new twist on an old interaction. J Clin Pharmacol. 2002;42(4):461-466. DOI
- Dickinson, H. O., Nicolson, D. J., Cook, J. V., Campbell, F., Beyer, F. R., Ford, G. A., and Mason, J. Calcium supplementation for the management of primary hypertension in adults. Cochrane.Database.Syst.Rev. 2006;(2):CD004639. PubMed
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- Levine, M., Nikkanen, H., and Pallin, D. J. The effects of intravenous calcium in patients with digoxin toxicity. J Emerg.Med. 2011;40(1):41-46. PubMed
- Castelo-Branco, C., Ciria-Recasens, M., Cancelo-Hidalgo, M. J., Palacios, S., Haya-Palazuelos, J., Carbonell-Abello, J., Blanch-Rubio, J., Martinez-Zapata, M. J., Manasanch, J., and Perez-Edo, L. Efficacy of ossein-hydroxyapatite complex compared with ca
- Li K, Kaaks R, Linseisen J, Rohrmann S. Associations of dietary calcium intake and calcium supplementation with myocardial infarction and stroke risk and overall cardiovascular mortality in the Heidelberg cohort of the European Prospective Investigation i
- Chung M, Tang AM, Fu Z. Calcium Intake and Cardiovascular Disease Risk: An Updated Systematic Review and Meta-analysis. Ann Intern Med. 2016 Oct 25. PubMed
- Nolan CR, Califano JR, Butzin CA. Influence of calcium acetate or calcium citrate on intestinal aluminum absorption. Kidney Int. 1990;38(5):937-41. PubMed
- Lewis JR, Radavelli-Bagatini S, Rejnmark L, et al. The effects of calcium supplementation on verified coronary heart disease hospitalization and death in postmenopausal women: a collaborative meta-analysis of randomized controlled trials. J Bone Miner Res PubMed
- Jalloh MA, Gregory PJ, Hein D, et al. Dietary supplement interactions with antiretrovirals: a systematic review. Int J STD AIDS. 2017 Jan;28(1):4-15. PubMed
- Lappe J, Watson P, Travers-Gustafson D, Recker R, Garland C, Gorham E, Baggerly K, McDonnell SL. Effect of Vitamin D and Calcium Supplementation on Cancer Incidence in Older Women: A Randomized Clinical Trial. JAMA. 2017 Mar 28;317(12):1234-1243. PubMed
- Grove ML, Cook D. Calcium and heart attacks. Doesn't apply to most calcium prescriptions. BMJ. 2010;341:c5003. PubMed
- Insentress [package insert]. Whitehouse Station, NJ: Merck Sharp & Dohme Corp.; 2014.
- Roberts JL, Kiser JJ, Hindman JT, Meditz AL. Virologic failure with a raltegravir-containing antiretroviral regimen and concomitant calcium administration. Pharmacotherapy 2011;31(10):298e-302e. DOI
- Vitekta [package insert]. Foster City, CA: Gilead Sciences, Inc.; 2014.
- Storan ER, O'Gorman SM, Murphy A, Laing M. Case Report of Calciphylaxis Secondary to Calcium and Vitamin D<sub>3</sub> Supplementation. J Cutan Med Surg. 2017;21(2):162-163. DOI
- Jenkins DJA, Spence JD, Giovannucci EL, et al. Supplemental vitamins and minerals for CVD prevention and treatment. J Am Coll Cardiol 2018;71(22):2570-84. PubMed
- Borkenhagen JF, Connor EL, Stafstrom CE. Neonatal hypocalcemic seizures due to excessive maternal calcium ingestion. Pediatr Neurol 2013;48(6):469-71. PubMed
- WHO recommendations on antenatal care for a positive pregnancy experience. Geneva: World Health Organization; 2016 (http://www.who.int/reproductivehealth/publications/maternal_perinatal_health/ anc-positive-pregnancy-experience/en/).
- Aune D, Navarro Rosenblatt DA, Chan DS, et al. Dairy products, calcium, and prostate cancer risk: a systematic review and meta-analysis of cohort studies. Am J Clin Nutr. 2015;101(1):87-117. PubMed
- Lan T, Park Y, Colditz GA, et al. Adolescent dairy product and calcium intake in relation to later prostate cancer risk and mortality in the NIH-AARP Diet and Health Study. Cancer Causes Control. 2020;31(10):891-904. PubMed
- Zhang Y, Li Y, Liu J, et al. Association of Vitamin D or Calcium Supplementation with Cardiovascular Outcomes and Mortality: A Meta-Analysis with Trial Sequential Analysis. J Nutr Health Aging 2021;25(2):263-270. PubMed
- Myung SK, Kim HB, Lee YJ, Choi YJ, Oh SW. Calcium Supplements and Risk of Cardiovascular Disease: A Meta-Analysis of Clinical Trials. Nutrients 2021;13(2):368. PubMed
- Hetaimish B. Neonatal Calcinosis Cutis After Treatment of Hypocalcemia with Calcium Gluconate: A Report of 2 Cases. Am J Case Rep 2024;25:e943397. PubMed
- US Food and Drug Administration (FDA). Biktarvy Prescribing Information. October 2024. Available at: https://www.accessdata.fda.gov/drugsatfda_docs/label/2024/210251Orig1s020lbl.pdf. Accessed July 16, 2025.
Black Pepper 29 references
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- Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
- Bano G, Amla V, Raina RK, et al. The effect of piperine on pharmacokinetics of phenytoin in healthy volunteers. Planta Med 1987;53:568-9. PubMed
- Bano G, et al. Effect of piperine on bioavailability and pharmacokinetics of propranolol and theophylline in healthy volunteers. Eur J Clin Pharmacol 1991;41;615-7. PubMed
- Cohle SD, Trestrail JD III, Graham MA, et al. Fatal pepper aspiration. Am J Dis Child 1988;142:633-6. PubMed
- Bhardwaj RK, Glaeser H, Becquemont L, et al. Piperine, a major constituent of black pepper, inhibits human P-glycoprotein and CYP3A4. J Pharmacol Exp Ther 2002;302:645-50. PubMed
- Velpandian T, Jasuja R, Bhardwaj RK, et al. Piperine in food: interference in the pharmacokinetics of phenytoin. Eur J Drug Metab Pharmacokinet 2001;26:241-7. PubMed
- Pattanaik S, Hota D, Prabhakar S, et al. Pharmacokinetic interaction of a single dose of piperine with steady-state carbamazepine in epilepsy patients. Phytother Res 2009;23:1281-6.
- Munakata, M., Kobayashi, K., Niisato-Nezu, J., Tanaka, S., Kakisaka, Y., Ebihara, T., Ebihara, S., Haginoya, K., Tsuchiya, S., and Onuma, A. Olfactory stimulation using black pepper oil facilitates oral feeding in pediatric patients receiving long-term en
- Myers, B. M., Smith, J. L., and Graham, D. Y. Effect of red pepper and black pepper on the stomach. Am J Gastroenterol 1987;82(3):211-214.
- Raghavendra, R. H. and Naidu, K. A. Spice active principles as the inhibitors of human platelet aggregation and thromboxane biosynthesis. Prostaglandins Leukot.Essent.Fatty Acids 2009;81(1):73-78. PubMed
- Subehan, Usia, T., Kadota, S., and Tezuka, Y. Mechanism-based inhibition of human liver microsomal cytochrome P450 2D6 (CYP2D6) by alkamides of Piper nigrum. Planta Med 2006;72(6):527-532.
- Kasibhatta, R. and Naidu, M. U. Influence of piperine on the pharmacokinetics of nevirapine under fasting conditions: a randomised, crossover, placebo-controlled study. Drugs R.D. 2007;8(6):383-391. PubMed
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DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.
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