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Supplement–drug interactions: the full cited index

104 documented interactions34 supplements9 drug-class pages15 reference sources

Every interaction Magellan has curated between the supplements it covers and prescription or over-the-counter medication, published in full: 104 distinct entries (116 records before duplicate formulations of the same ingredient are merged) across 34 supplements and 36 medication classes. 12 are graded major, 57 moderate and 35 minor. Each one names the mechanism, the direction the risk runs, and the clinical reference it came from.

This is deliberately not a sales page. Several of the supplements with the most serious documented interactions are products Magellan links to and earns commission on — they are reported here exactly as the sources state them, in the same detail as everything else. Safety content that softens a risk to protect a sale is worthless to the reader and, eventually, to the site.

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Magellan’s Medication Safety Check runs entirely on your device — type the medicines you take and it flags every documented interaction in this dataset. Nothing you type is sent anywhere.

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How to read an interaction

Every entry on this hub has the same five parts, and reading them in order tells you almost everything you need before you pick up the phone.

The drug class. Interactions are documented against a class — anticoagulants, quinolone antibiotics — rather than against every brand. The class pages list the generic and brand names each class covers, because the name on your bottle is often the brand.
The severity. Major, moderate or minor, as the cited reference frames it. It describes the interaction, not you: a minor entry can matter more in someone with kidney disease on five other drugs than a major one in someone taking nothing else.
The direction. Interactions run in different directions and the difference is everything. A supplement can add to what a drug does (two things lowering blood sugar at once), oppose it (vitamin K against warfarin), block its absorption (minerals binding an antibiotic in the gut), or change its blood level by competing for the same liver enzyme. Only the third one is fixed by taking them a few hours apart.
The mechanism, in the source's own words. We quote the reference rather than paraphrase it, hedges included. Where the evidence is a single case report or an animal study, the entry says so.
What to do. Always the same shape: who to tell, what to monitor, and what not to change on your own. Nothing here ever asks you to adjust a prescription — that is the prescriber's decision, every time.

How to read a severity label

Major — the source describes a clinically significant risk — treat this as a combination to clear with a clinician before you start, not after.
Moderate — a real, documented interaction that usually calls for monitoring, separating the doses, or a prescriber-led dose change.
Minor — documented but usually low-impact, or based on mechanism and animal data rather than human events — still worth naming to your pharmacist.

Severity describes the interaction as the cited reference frames it, not how a specific person will react. A “minor” entry in someone with kidney disease, on five other drugs, can matter more than a “major” one in someone on nothing else.

By medication class

Start here if you know what you take.

Supplements and blood thinners: every documented interaction

22 documented interactions across 17 supplements · 7 major.

Supplements and blood pressure medications

15 documented interactions across 14 supplements.

Supplements and diabetes medications

9 documented interactions across 9 supplements · 1 major.

Supplements and statins

9 documented interactions across 9 supplements.

Supplements during chemotherapy and cancer treatment

9 documented interactions across 9 supplements · 1 major.

Supplements and antibiotics

7 documented interactions across 6 supplements.

Supplements and immunosuppressants

7 documented interactions across 7 supplements · 1 major.

Supplements and diuretics (water pills)

5 documented interactions across 4 supplements · 1 major.

Other medication classes with documented supplement interactions

43 documented interactions across 24 supplements · 1 major.

Supplements A–Z

Every supplement in this dataset with at least one documented interaction. Supplements with two or more have their own page; the rest are set out in full further down this page rather than given a page too thin to be worth reading.

Supplement	Documented	Most serious
Alpha-lipoic acid (ALA)	2	Moderate
Beetroot and dietary nitrate	3	Major
Berberine	5	Major
Boswellia serrata	1	Moderate
Carnitine (L-carnitine and acetyl-L-carnitine)	7	Moderate
Carnosine	1	Minor
CoQ10 / ubiquinol also searched as coenzyme Q10	4	Major
Creatine monohydrate	1	Minor
DaVinci Labs Phyto Benefits	3	Moderate
Glucosamine and chondroitin	5	Major
Grape seed extract	2	Moderate
Green tea EGCG extract	4	Moderate
Hesperidin (citrus flavonoid)	3	Moderate
Inulin prebiotic fibre	2	Moderate
L-methylfolate (5-MTHF)	4	Moderate
Low-dose lithium (lithium orotate)	4	Moderate
Magnesium also searched as magnesium glycinate, magnesium L-threonate	5	Moderate
Milk thistle (silymarin)	1	Minor
MSM (methylsulfonylmethane)	2	Minor
NAC and GlyNAC also searched as N-acetylcysteine	3	Moderate
NOVOS Core (multi-ingredient formula)	8	Major
NOVOS Vital Organ Support	4	Major
Olive leaf extract (oleuropein)	2	Minor
Omega-3 (EPA/DHA fish oil)	3	Moderate
Pomegranate ellagitannins	4	Moderate
Probiotics	2	Major
Pycnogenol (pine bark extract)	1	Moderate
Quercetin	2	Moderate
Resveratrol	2	Moderate
Saffron extract	4	Moderate
Taurine	1	Minor
Vitamin D3	4	Major
Vitamin K2 (MK-7)	2	Major
Zinc	3	Moderate

Supplements with a single documented interaction

These 6 supplements each have exactly one interaction on record. One entry cannot carry a page worth reading, so they are published here in full rather than spun into thin pages — same detail, same citation, same routing.

Creatine monohydrate (evidence guide)

Minor Caffeine (high intake)

Mayo Clinic notes taking caffeine together with creatine might reduce how well creatine works, though more research is needed; a study in Parkinson's disease patients also flagged faster disease progression in those combining high-dose caffeine with creatine, but this needs further investigation.

Source: Creatine - Mayo Clinic (Drugs & Supplements) ↗ · More on this class: other drug classes

What to do: Track your real caffeine total — coffee, tea, energy drinks, and pre-workout together — and raise it with your clinician if you notice palpitations, tremor, or poor sleep.

Product page: Creatine Monohydrate · Molecule: creatine

Taurine

Minor Drugs metabolized via cytochrome P450 pathways (antidepressants, antiseizure drugs, blood thinners, statins)

Direction of the risk: Drug levels — the source describes a change in how much of the medicine ends up in the blood.

Taurine may interfere with cytochrome P450 enzymes used to metabolize these drug classes at supplemental (not typical energy-drink) doses, though this is a general mechanism-based caution rather than itemized per-drug clinical data.

Medicines in this group include: Atorvastatin (Lipitor), Simvastatin (Zocor), Rosuvastatin (Crestor), Lovastatin (Mevacor, Altoprev), Pravastatin (Pravachol), Pitavastatin (Livalo), Fluvastatin (Lescol), Sertraline (Zoloft) and 25 more.

Source: Taurine Benefits and Side Effects ↗ · More on this class: statins, other drug classes, blood thinners

What to do: Tell your prescriber or pharmacist, and mention which statin you take — some are cleared by the CYP3A4 pathway and some are not. Ask whether your usual lipid or liver testing should be repeated after you start.

Product page: Taurine

Carnosine

Minor Antihypertensive medications (e.g., calcium channel blockers, other blood pressure drugs)

Direction of the risk: Additive — pushes in the same direction as the medicine, so the combined effect can overshoot.

Carnosine may itself lower blood pressure; combining it with blood pressure-lowering medication could cause blood pressure to drop excessively.

Medicines in this group include: Amlodipine (Norvasc), Diltiazem (Cardizem, Tiazac), Verapamil (Calan, Verelan), Nifedipine (Procardia, Adalat), Hydrochlorothiazide (Hctz, Microzide), Chlorthalidone (Thalitone), Indapamide (Lozol), Furosemide (Lasix) and 6 more.

Source: Carnosine: Health Benefits, Side Effects, Uses, Dose & Precautions ↗ · More on this class: blood pressure medications

What to do: Tell your prescriber and check your blood pressure at home for the first couple of weeks, ideally at the same time of day. Report light-headedness on standing, which can be a sign that the combined effect is too strong.

Product page: Carnosine

Boswellia serrata

Moderate Anticoagulants and antiplatelet drugs (e.g., warfarin, aspirin, clopidogrel)

Direction of the risk: Bleeding risk — stacked on top of a drug that already reduces the blood's ability to clot.

Boswellic acid compounds can inhibit platelet aggregation, which may add to the bleeding risk of blood-thinning medications.

Medicines in this group include: Warfarin (Coumadin, Jantoven), Apixaban (Eliquis), Rivaroxaban (Xarelto), Dabigatran (Pradaxa), Edoxaban (Savaysa), Heparin (Lovenox, Enoxaparin), Acenocoumarol (Sintrom), Aspirin (Asa, Bayer aspirin) and 4 more.

Source: Boswellia ↗ · More on this class: blood thinners

What to do: Do not start, stop, or change the dose on your own. Tell the clinician or anticoagulation clinic that manages your blood thinner, and ask whether an INR check is warranted a week or two after any change if you take warfarin. If you do take it, keep the amount steady day to day rather than on-and-off — swings are harder to manage than a stable intake.

Product page: Boswellia Serrata Extract

Pycnogenol (pine bark extract)

Moderate Anticoagulants and antiplatelet drugs (e.g., warfarin/Coumadin)

Direction of the risk: Bleeding risk — stacked on top of a drug that already reduces the blood's ability to clot.

Pine bark extract may inhibit platelet aggregation, which could add to the bleeding risk of blood-thinning medications.

Source: Pine Bark Extract | Memorial Sloan Kettering Cancer Center ↗ · More on this class: blood thinners

Product page: Pycnogenol Pine Bark Extract

Milk thistle (silymarin)

Minor General - all prescription medications

NCCIH does not name a specific well-established drug pairing on its consumer safety page, but explicitly cautions that milk thistle can interact with medicines in harmful ways and advises anyone on any medication to talk with their health care provider before use; it also flags that some milk thistle products are inconsistent in silymarin content or contaminated with pesticides/mycotoxins.

Source: Milk Thistle: Usefulness and Safety | NCCIH ↗ · More on this class: other drug classes

What to do: Bring the actual bottle to your pharmacist and ask them to run your full list. That review is free at almost every pharmacy and it is the single highest-yield thing you can do.

Product page: Silymarin (Milk Thistle)

When to seek care urgently

These are the warning signs that go with the medication classes on this page. They are general safety-netting, not a prediction that any supplement will cause them.

Bleeding that will not stop, black or tarry stools, blood in urine, vomit that looks like coffee grounds, coughing up blood, a sudden severe headache, or any head injury while you are on a blood thinner — these need emergency assessment, not a next-available appointment.
Shakiness, sweating, confusion, slurred speech, or fainting can signal low blood sugar. Treat immediately with fast-acting sugar and get help; repeated lows mean the medication plan needs review, not a supplement adjustment.
Fainting, chest pain, or severe dizziness after combining anything that widens blood vessels needs emergency assessment. Nitrate medicines and PDE5 inhibitors (sildenafil, tadalafil) must never be taken together.
Lithium toxicity is a medical emergency: a coarse tremor, vomiting or diarrhoea, unsteady walking, slurred speech, or new confusion. Stop and seek care the same day, and mention every supplement you have started.
Agitation, fever, heavy sweating, muscle twitching or rigidity and a racing heart after adding something to a serotonergic medicine can indicate serotonin syndrome — that is an emergency.
If you are immunosuppressed, have a central line, or are between chemotherapy cycles, a fever or new chills is a same-day medical problem regardless of how well you feel otherwise.
Excessive thirst and urination, nausea, constipation, or new confusion can reflect a high calcium level and should be evaluated promptly rather than waited out.
Unexplained muscle pain or weakness, especially with dark urine, should be checked promptly by whoever prescribes your statin.

If something feels seriously wrong, do not wait for an appointment. Call 911 (US) or your local emergency number.

Where this data comes from

Curated from NIH ODS, NCCIH, MedlinePlus, Mayo Clinic, Memorial Sloan Kettering 'About Herbs', and similar clinical references. Not a substitute for medical advice.

Entries by source domain: mskcc.org (24), ods.od.nih.gov (22), mayoclinic.org (12), nccih.nih.gov (11), rxlist.com (9), webmd.com (8), health.clevelandclinic.org (5), goodrx.com (5), drugs.com (2), sciencedirect.com (1), mdpi.com (1), nature.com (1), dhpp.hpfb-dgpsa.ca (1), pubmed.ncbi.nlm.nih.gov (1), hellopharmacist.com (1). Every entry links out to the specific page it was drawn from, so you can read the original rather than take our word for it.

What this page does not tell you

This is a curated set of interactions with citations — not an exhaustive pharmacology database. An interaction that is absent here has not been ruled out; it may simply not be documented in the references Magellan curates from. Supplements are also not batch-tested for identity or contamination the way prescription drugs are, so what is on the label is a claim rather than a guarantee. And most of these entries come from case reports and mechanistic work rather than randomized trials, which is exactly why the sensible response is a pharmacist review rather than either alarm or dismissal.

Keep going

The evidence-graded supplement guide · The research map · NMN · Senolytics · Omega-3 · Berberine · Creatine · How Magellan grades evidence

Questions people actually ask

How do I check whether my supplement interacts with my medication?

Find your supplement in the A–Z below and read the entries, or find your drug class. For a check against your whole list at once, use Magellan's Medication Safety Check — it runs on your device, accepts brand or generic names, and flags every documented interaction in this dataset. Then take the result to your pharmacist; a full-list review is free at almost every pharmacy and it catches things no database can.

What does it mean if my supplement is not listed here?

It means no interaction is documented for it in the clinical references Magellan curates from — not that it has been tested and cleared. Of the supplements in this dataset, 34 have at least one documented interaction and the rest have none on record. Absence of evidence is not evidence of safety, which is why we do not publish a page saying any supplement is safe.

What is the difference between major, moderate and minor here?

Major means the cited reference describes a clinically significant risk — clear it with a clinician before starting. Moderate means a real documented interaction that usually calls for monitoring, dose separation, or a prescriber-led dose change. Minor means documented but usually low-impact, or based on mechanism and animal data rather than human events. There are 12 major, 57 moderate and 35 minor entries in this dataset.

Where does this interaction data come from?

Curated from NIH ODS, NCCIH, MedlinePlus, Mayo Clinic, Memorial Sloan Kettering 'About Herbs', and similar clinical references. Not a substitute for medical advice. The most-cited sources here are mskcc.org (24 entries), ods.od.nih.gov (22 entries), mayoclinic.org (12 entries), nccih.nih.gov (11 entries). Every entry on every page links out to the reference it came from.

Do affiliate commissions change what you publish about risk?

No. Magellan earns commission on some of the products named on these pages, and several of the supplements with major documented interactions are products we link to. The interaction, its severity and its citation are reported exactly as the source states them. A supplement's evidence grade and its safety entries are produced independently of any commercial relationship.

Who compiles this. Magellan Longevity is written and edited by Gabriel Radu, DO — a physiatrist (New York license 275110, NPI 1376861765). Interaction entries are curated from clinical references — the NIH Office of Dietary Supplements, NCCIH, MedlinePlus, Mayo Clinic and Memorial Sloan Kettering’s About Herbs among them — and every entry links to the reference it came from so you can check it yourself. Magellan earns affiliate commission on some products; nothing on a safety page is softened, delayed, or omitted because of it. Where a supplement we sell carries a major documented interaction, that is the first thing on the page.

Educational information, not medical advice. This hub cannot see your doses, your kidney function, or the rest of your medication list — a pharmacist can, in about five minutes, for free. Supplements are not intended to diagnose, treat, cure, or prevent any disease.