CitraMag 120c

Orthoplex

Orthoplex White Label CitraMag is a vegan friendly, ultra-low excipient and bioavailable magnesium citrate that delivers leading standards in magnesium purity.

Gluten Free
Egg Free
Dairy Free
Vegan
Vegetarian
    Product Details

    Pack Size
    120 Capsule

    Adult Dose
    Take 1 capsule per day, or as recommended by your registered healthcare practitioner.

    BIO

    Storage
    Store below 30°C in a cool, dry place, away from direct sunlight.

    Indications

      Contains magnesium which:

      • Helps to maintain normal healthy functioning of the nervous system
      • Is involved in energy production
      • Is necessary for proper muscle and nerve function
      • Supports normal healthy cardiovascular function

      Contraindications

      • No contraindications
      • Suitable for use in pregnancy and lactation

      Contraindications are taken from Natural Medicines database and are correct as of March 2019.

    Excipients
    Colloidal anhydrous silica, vegetable capsule (Vcaps®)

    Warning
    Vitamin and mineral supplements should not replace a balanced diet.

    Ingredients

    Each capsule contains

    Magnesium citrate 926.0mg
    equiv. Magnesium 150.0mg
    Drug Interactions
    Significance
    Ingredient
    Interaction Descriptions
    Major
    MAGNESIUM
    (Magnesium, Magnesium amino acid chelate, Magnesium aspartate, Magnesium citrate, Magnesium orotate dihydrate, Magnesium oxide, Heavy magnesium oxide, Magnesium chloride hexahydrate, Magnesium phosphate pentahydrate, Magnesium glycinate dihydrate, Magnesium orotate)
    Do not take this combination.
    View Interactions:
    Major

    LEVODOPA/CARBIDOPA (Sinemet)

    Do not take this combination.

    Major

    LEVODOPA/CARBIDOPA (Sinemet)

    Do not take this combination.

    Major

    LEVODOPA/CARBIDOPA (Sinemet)

    Do not take this combination.

    Severity: high
    Occurrence: probable
    Level of Evidence: B

    Magnesium can reduce the bioavailability of levodopa/carbidopa.<br> Clinical research in healthy volunteers shows that taking magnesium oxide 1000 mg with levodopa 100 mg/carbidopa 10 mg reduces the area under the curve (AUC) of levodopa by 35% and of carbidopa by 81%. In vitro and animal research shows that magnesium produces an alkaline environment in the digestive tract, which might lead to degradation and reduced bioavailability of levodopa/carbidopa (100265).

    References

    100265

    Kashihara Y, Terao Y, Yoda K, et al. Effects of magnesium oxide on pharmacokinetics of L-dopa/carbidopa and assessment of pharmacodynamic changes by a model-based simulation. Eur J Clin Pharmacol. 2019;75(3):351-361.

    Moderate

    AMINOGLYCOSIDE ANTIBIOTICS

    Be cautious with this combination.

    Moderate

    AMINOGLYCOSIDE ANTIBIOTICS

    Be cautious with this combination.

    Moderate

    AMINOGLYCOSIDE ANTIBIOTICS

    Be cautious with this combination.

    Severity: high
    Occurrence: possible
    Level of Evidence: D

    Concomitant use of aminoglycoside antibiotics and magnesium can increase the risk for neuromuscular weakness.<br> Both aminoglycosides and magnesium reduce presynaptic acetylcholine release, which can lead to neuromuscular blockade and possible paralysis. This is most likely to occur with high doses of magnesium given intravenously (13362).

    References

    13362

    L'Hommedieu CS, Nicholas D, Armes DA, et al. Potentiation of magnesium sulfate--induced neuromuscular weakness by gentamicin, tobramycin, and amikacin. J Pediatr 1983;102:629-31..

    Moderate

    CALCIUM CHANNEL BLOCKERS

    Be cautious with this combination.

    Moderate

    CALCIUM CHANNEL BLOCKERS

    Be cautious with this combination.

    Moderate

    CALCIUM CHANNEL BLOCKERS

    Be cautious with this combination.

    Severity: high
    Occurrence: possible
    Level of Evidence: D

    Magnesium can have additive effects with calcium channel blockers, although evidence is conflicting.<br> Magnesium inhibits calcium entry into smooth muscle cells and may therefore have additive effects with calcium channel blockers. Severe hypotension and neuromuscular blockades may occur when nifedipine is used with intravenous magnesium (3046,20264,20265,20266), although some contradictory evidence suggests that concurrent use of magnesium with nifedipine does not increase the risk of neuromuscular weakness (60831). High doses of magnesium could theoretically have additive effects with other calcium channel blockers.

    References

    3046

    Hansten PD, Horn JR. Drug Interactions Analysis and Management. Vancouver, WA: Applied Therapeutics Inc., 1997 and updates.

    20264

    Koontz SL, Friedman SA, Schwartz ML. Symptomatic hypocalcemia after tocolytic therapy with magnesium sulfate and nifedipine. Am J Obstet Gynecol. 2004;190(6):1773-6.

    20265

    Snyder SW, Cardwell MS. Neuromuscular blockade with magnesium sulfate and nifedipine. Am J Obstet Gynecol. 1989;161(1):35-6.

    20266

    Waisman GD, Mayorga LM, Cámera MI, et al. Magnesium plus nifedipine: potentiation of hypotensive effect in preeclampsia? Am J Obstet Gynecol. 1988;159(2):308-9.

    60831

    Magee, L. A., Miremadi, S., Li, J., Cheng, C., Ensom, M. H., Carleton, B., Cote, A. M., and von Dadelszen, P. Therapy with both magnesium sulfate and nifedipine does not increase the risk of serious magnesium-related maternal side effects in women with preeclampsia. Am.J Obstet.Gynecol. 2005;193(1):153-163.

    Moderate

    BISPHOSPHONATES

    Be cautious with this combination.

    Moderate

    BISPHOSPHONATES

    Be cautious with this combination.

    Moderate

    BISPHOSPHONATES

    Be cautious with this combination.

    Severity: moderate
    Occurrence: probable
    Level of Evidence: B

    Magnesium can decrease absorption of bisphosphonates.<br> Cations, including magnesium, can decrease bisphosphonate absorption. Advise patients to separate doses of magnesium and these drugs by at least 2 hours (13363).

    References

    13363

    Dunn CJ, Goa KL. Risedronate: a review of its pharmacological properties and clinical use in resorptive bone disease. Drugs 2001;61:685-712..

    Moderate

    SULFONYLUREAS

    Be cautious with this combination.

    Moderate

    SULFONYLUREAS

    Be cautious with this combination.

    Moderate

    SULFONYLUREAS

    Be cautious with this combination.

    Severity: mild
    Occurrence: probable
    Level of Evidence: B

    Magnesium increases the systemic absorption of sulfonylureas, increasing their effects and side effects.<br> Clinical research shows that administration of magnesium hydroxide with glyburide increases glyburide absorption, increases maximal insulin response by 35-fold, and increases the risk of hypoglycemia, when compared with glyburide alone (20307). A similar interaction occurs between magnesium hydroxide and glipizide (20308). The mechanism of this effect appears to be related to the elevation of gastrointestinal pH by magnesium-based antacids, increasing solubility and enhancing absorption of sulfonylureas (22364).

    References

    20307

    Neuvonen PJ, Kivistö KT. The effects of magnesium hydroxide on the absorption and efficacy of two glibenclamide preparations. Br J Clin Pharmacol. 1991;32(2):215-20.

    20308

    Kivistö KT, Neuvonen PJ. Enhancement of absorption and effect of glipizide by magnesium hydroxide. Clin Pharmacol Ther. 1991;49(1):39-43.

    22364

    Neuvonen PJ, Kivistö KT. Enhancement of drug absorption by antacids. An unrecognised drug interaction. Clin Pharmacokinet. 1994;27(2):120-8.

    Moderate

    ANTACIDS

    Be cautious with this combination.

    Moderate

    ANTACIDS

    Be cautious with this combination.

    Moderate

    ANTACIDS

    Be cautious with this combination.

    Severity: moderate
    Occurrence: possible
    Level of Evidence: D

    Use of acid reducers may reduce the laxative effect of magnesium oxide.<br> A retrospective analysis shows that, in the presence of H2 receptor antagonists (H2RAs) or proton pump inhibitors (PPIs), a higher dose of magnesium oxide is needed for a laxative effect (90033). This may also occur with antacids. Under acidic conditions, magnesium oxide is converted to magnesium chloride and then to magnesium bicarbonate, which has an osmotic laxative effect. By reducing acidity, antacids may reduce the conversion of magnesium oxide to the active bicarbonate salt.

    References

    90033

    Yamasaki M, Funakoshi S, Matsuda S, Imazu T, Takeda Y, Murakami T, Maeda Y. Interaction of magnesium oxide with gastric acid secretion inhibitors in clinical pharmacotherapy. Eur J Clin Pharmacol 2014;70(8):921-4.

    Moderate

    TETRACYCLINE ANTIBIOTICS

    Be cautious with this combination.

    Moderate

    TETRACYCLINE ANTIBIOTICS

    Be cautious with this combination.

    Moderate

    TETRACYCLINE ANTIBIOTICS

    Be cautious with this combination.

    Severity: moderate
    Occurrence: probable
    Level of Evidence: D

    Magnesium decreases absorption of tetracyclines.<br> Magnesium can form insoluble complexes with tetracyclines in the gut and decrease their absorption and antibacterial activity (12586). Advise patients to take these drugs 1 hour before or 2 hours after magnesium supplements.

    References

    12586

    Sompolinsky D, Samra Z. Influence of magnesium and manganese on some biological and physical properties of tetracycline. J Bacteriol 1972;110:468-76..

    Moderate

    QUINOLONE ANTIBIOTICS

    Be cautious with this combination.

    Moderate

    QUINOLONE ANTIBIOTICS

    Be cautious with this combination.

    Moderate

    QUINOLONE ANTIBIOTICS

    Be cautious with this combination.

    Severity: moderate
    Occurrence: probable
    Level of Evidence: D

    Magnesium decreases absorption of quinolones.<br> Magnesium can form insoluble complexes with quinolones and decrease their absorption (3046). Advise patients to take these drugs at least 2 hours before, or 4 to 6 hours after, magnesium supplements.

    References

    3046

    Hansten PD, Horn JR. Drug Interactions Analysis and Management. Vancouver, WA: Applied Therapeutics Inc., 1997 and updates.

    Moderate

    SKELETAL MUSCLE RELAXANTS

    Be cautious with this combination.

    Moderate

    SKELETAL MUSCLE RELAXANTS

    Be cautious with this combination.

    Moderate

    SKELETAL MUSCLE RELAXANTS

    Be cautious with this combination.

    Severity: moderate
    Occurrence: probable
    Level of Evidence: A

    Parenteral magnesium alters the pharmacokinetics of skeletal muscle relaxants, increasing their effects.<br> Parenteral magnesium shortens the time to onset of skeletal muscle relaxants by about 1 minute and prolongs the duration of action by about 2 minutes. Magnesium potentiates the effects of skeletal muscle relaxants by decreasing acetylcholine release from motor nerve terminals (3046,97492). A clinical study found that low-dose rocuronium (0.45 mg/kg), when given after administration of magnesium 30 mg/kg over 10 minutes, undergoes an accelerated onset of effect, which matches the onset of effect seen with a full-dose rocuronium regimen (0.6 mg/kg) (96485).

    References

    3046

    Hansten PD, Horn JR. Drug Interactions Analysis and Management. Vancouver, WA: Applied Therapeutics Inc., 1997 and updates.

    96485

    Choi ES, Jeong WJ, Ahn SH, Oh AY, Jeon YT, Do SH. Magnesium sulfate accelerates the onset of low-dose rocuronium in patients undergoing laryngeal microsurgery. J Clin Anesth. 2017 Feb;36:102-106.

    97492

    Rodríguez-Rubio L, Solis Garcia Del Pozo J, Nava E, Jordán J. Interaction between magnesium sulfate and neuromuscular blockers during the perioperative period. A systematic review and meta-analysis. J Clin Anesth. 2016;34:524-34.

    Moderate

    DIGOXIN

    Be cautious with this combination.

    Moderate

    DIGOXIN

    Be cautious with this combination.

    Moderate

    DIGOXIN

    Be cautious with this combination.

    Severity: moderate
    Occurrence: possible
    Level of Evidence: B

    Magnesium salts may reduce absorption of digoxin.<br> Clinical evidence suggests that treatment with oral magnesium hydroxide or magnesium trisilicate reduces absorption of digoxin from the intestines (198,20268,20270). This may reduce the blood levels of digoxin and decrease its therapeutic effects.

    References

    198

    Rodin SM, Johnson BF. Pharmacokinetic interactions with digoxin. Clin Pharmacokinet 1988;15:227-44.

    20268

    Brown DD, Juhl RP. Decreased bioavailability of digoxin due to antacids and kaolin-pectin. N Engl J Med. 1976;295(19):1034-7.

    20270

    Allen MD, Greenblatt DJ, Harmatz JS, et al. Effect of magnesium--aluminum hydroxide and kaolin--pectin on absorption of digoxin from tablets and capsules. J Clin Pharmacol. 1981;21(1):26-30.

    Moderate

    POTASSIUM-SPARING DIURETICS

    Be cautious with this combination.

    Moderate

    POTASSIUM-SPARING DIURETICS

    Be cautious with this combination.

    Moderate

    POTASSIUM-SPARING DIURETICS

    Be cautious with this combination.

    Severity: moderate
    Occurrence: probable
    Level of Evidence: D

    Potassium-sparing diuretics decrease excretion of magnesium, possibly increasing magnesium levels.<br> Potassium-sparing diuretics also have magnesium-sparing properties, which can counteract the magnesium losses associated with loop and thiazide diuretics (9613,9614,9622). Theoretically, increased magnesium levels could result from concomitant use of potassium-sparing diuretics and magnesium supplements.

    References

    9613

    Ryan MP. Diuretics and potassium/magnesium depletion. Directions for treatment. Am J Med 1987;82:38-47..

    9614

    Hollifield JW. Magnesium depletion, diuretics, and arrhythmias. Am J Med 1987;82:30-7..

    9622

    Heidenreich O. Mode of action of conventional and potassium-sparing diuretics--aspects with relevance to Mg-sparing effects. Magnesium 1984;3:248-56..

    Minor

    GABAPENTIN (Neurontin)

    Be watchful with this combination.

    Minor

    GABAPENTIN (Neurontin)

    Be watchful with this combination.

    Minor

    GABAPENTIN (Neurontin)

    Be watchful with this combination.

    Severity: mild
    Occurrence: unlikely
    Level of Evidence: B

    Gabapentin absorption can be decreased by magnesium.<br> Clinical research shows that giving magnesium oxide orally along with gabapentin decreases the maximum plasma concentration of gabapentin by 33%, time to maximum concentration by 36%, and area under the curve by 43% (90032). Advise patients to take gabapentin at least 2 hours before, or 4 to 6 hours after, magnesium supplements.

    References

    90032

    Yagi T, Naito T, Mino Y, Umemura K, Kawakami J. Impact of concomitant antacid administration on gabapentin plasma exposure and oral bioavailability in healthy adult subjects. Drug Metab Pharmacokinet 2012;27(2):248-54.

    Minor

    ANTICOAGULANT/ANTIPLATELET DRUGS

    Be watchful with this combination.

    Minor

    ANTICOAGULANT/ANTIPLATELET DRUGS

    Be watchful with this combination.

    Minor

    ANTICOAGULANT/ANTIPLATELET DRUGS

    Be watchful with this combination.

    Severity: moderate
    Occurrence: unlikely
    Level of Evidence: B

    Theoretically, magnesium may have antiplatelet effects, but the evidence is conflicting.<br> In vitro evidence shows that magnesium sulfate inhibits platelet aggregation, even at low concentrations (20304,20305). Some preliminary clinical evidence shows that infusion of magnesium sulfate increases bleeding time by 48% and reduces platelet activity (20306). However, other clinical research shows that magnesium does not affect platelet aggregation, although inhibition of platelet-dependent thrombosis can occur (60759).

    References

    20304

    Ravn HB, Vissinger H, Kristensen SD, et al. Magnesium inhibits platelet activity--an in vitro study. Thromb Haemost. 1996;76(1):88-93.

    20305

    Ravn HB, Kristensen SD, Vissinger H, et al. Magnesium inhibits human platelets. Blood Coagul Fibrinolysis. 1996;7(2):241-4.

    20306

    Ravn HB, Vissinger H, Kristensen SD, et al. Magnesium inhibits platelet activity--an infusion study in healthy volunteers. Thromb Haemost. 1996;75(6):939-44.

    60759

    Shechter, M., Merz, C. N., Paul-Labrador, M., Meisel, S. R., Rude, R. K., Molloy, M. D., Dwyer, J. H., Shah, P. K., and Kaul, S. Beneficial antithrombotic effects of the association of pharmacological oral magnesium therapy with aspirin in coronary heart disease patients. Magnes.Res. 2000;13(4):275-284.

    Minor

    SEVELAMER (Renagel, Renvela)

    Be watchful with this combination.

    Minor

    SEVELAMER (Renagel, Renvela)

    Be watchful with this combination.

    Minor

    SEVELAMER (Renagel, Renvela)

    Be watchful with this combination.

    Severity: mild
    Occurrence: possible
    Level of Evidence: B

    Sevelamer may increase serum magnesium levels. <br> In patients on hemodialysis, sevelamer use was associated with a 0.28 mg/dL increase in serum magnesium. The mechanism of this interaction remains unclear (96486).

    References

    96486

    Ikee R, Toyoyama T, Endo T, Tsunoda M, Hashimoto N. Impact of sevelamer hydrochloride on serum magnesium concentrations in hemodialysis patients. Magnes Res. 2016 Apr 1;29(4):184-90.


    Full Reference List

    9613
    Ryan MP. Diuretics and potassium/magnesium depletion. Directions for treatment. Am J Med 1987;82:38-47..
    9614
    Hollifield JW. Magnesium depletion, diuretics, and arrhythmias. Am J Med 1987;82:30-7..
    9622
    Heidenreich O. Mode of action of conventional and potassium-sparing diuretics--aspects with relevance to Mg-sparing effects. Magnesium 1984;3:248-56..
    198
    Rodin SM, Johnson BF. Pharmacokinetic interactions with digoxin. Clin Pharmacokinet 1988;15:227-44.
    20268
    Brown DD, Juhl RP. Decreased bioavailability of digoxin due to antacids and kaolin-pectin. N Engl J Med. 1976;295(19):1034-7.
    20270
    Allen MD, Greenblatt DJ, Harmatz JS, et al. Effect of magnesium--aluminum hydroxide and kaolin--pectin on absorption of digoxin from tablets and capsules. J Clin Pharmacol. 1981;21(1):26-30.
    3046
    Hansten PD, Horn JR. Drug Interactions Analysis and Management. Vancouver, WA: Applied Therapeutics Inc., 1997 and updates.
    96485
    Choi ES, Jeong WJ, Ahn SH, Oh AY, Jeon YT, Do SH. Magnesium sulfate accelerates the onset of low-dose rocuronium in patients undergoing laryngeal microsurgery. J Clin Anesth. 2017 Feb;36:102-106.
    97492
    Rodríguez-Rubio L, Solis Garcia Del Pozo J, Nava E, Jordán J. Interaction between magnesium sulfate and neuromuscular blockers during the perioperative period. A systematic review and meta-analysis. J Clin Anesth. 2016;34:524-34.
    96486
    Ikee R, Toyoyama T, Endo T, Tsunoda M, Hashimoto N. Impact of sevelamer hydrochloride on serum magnesium concentrations in hemodialysis patients. Magnes Res. 2016 Apr 1;29(4):184-90.
    12586
    Sompolinsky D, Samra Z. Influence of magnesium and manganese on some biological and physical properties of tetracycline. J Bacteriol 1972;110:468-76..
    90033
    Yamasaki M, Funakoshi S, Matsuda S, Imazu T, Takeda Y, Murakami T, Maeda Y. Interaction of magnesium oxide with gastric acid secretion inhibitors in clinical pharmacotherapy. Eur J Clin Pharmacol 2014;70(8):921-4.
    20304
    Ravn HB, Vissinger H, Kristensen SD, et al. Magnesium inhibits platelet activity--an in vitro study. Thromb Haemost. 1996;76(1):88-93.
    20305
    Ravn HB, Kristensen SD, Vissinger H, et al. Magnesium inhibits human platelets. Blood Coagul Fibrinolysis. 1996;7(2):241-4.
    20306
    Ravn HB, Vissinger H, Kristensen SD, et al. Magnesium inhibits platelet activity--an infusion study in healthy volunteers. Thromb Haemost. 1996;75(6):939-44.
    60759
    Shechter, M., Merz, C. N., Paul-Labrador, M., Meisel, S. R., Rude, R. K., Molloy, M. D., Dwyer, J. H., Shah, P. K., and Kaul, S. Beneficial antithrombotic effects of the association of pharmacological oral magnesium therapy with aspirin in coronary heart disease patients. Magnes.Res. 2000;13(4):275-284.
    90032
    Yagi T, Naito T, Mino Y, Umemura K, Kawakami J. Impact of concomitant antacid administration on gabapentin plasma exposure and oral bioavailability in healthy adult subjects. Drug Metab Pharmacokinet 2012;27(2):248-54.
    20307
    Neuvonen PJ, Kivistö KT. The effects of magnesium hydroxide on the absorption and efficacy of two glibenclamide preparations. Br J Clin Pharmacol. 1991;32(2):215-20.
    20308
    Kivistö KT, Neuvonen PJ. Enhancement of absorption and effect of glipizide by magnesium hydroxide. Clin Pharmacol Ther. 1991;49(1):39-43.
    22364
    Neuvonen PJ, Kivistö KT. Enhancement of drug absorption by antacids. An unrecognised drug interaction. Clin Pharmacokinet. 1994;27(2):120-8.
    100265
    Kashihara Y, Terao Y, Yoda K, et al. Effects of magnesium oxide on pharmacokinetics of L-dopa/carbidopa and assessment of pharmacodynamic changes by a model-based simulation. Eur J Clin Pharmacol. 2019;75(3):351-361.
    13363
    Dunn CJ, Goa KL. Risedronate: a review of its pharmacological properties and clinical use in resorptive bone disease. Drugs 2001;61:685-712..
    20264
    Koontz SL, Friedman SA, Schwartz ML. Symptomatic hypocalcemia after tocolytic therapy with magnesium sulfate and nifedipine. Am J Obstet Gynecol. 2004;190(6):1773-6.
    20265
    Snyder SW, Cardwell MS. Neuromuscular blockade with magnesium sulfate and nifedipine. Am J Obstet Gynecol. 1989;161(1):35-6.
    20266
    Waisman GD, Mayorga LM, Cámera MI, et al. Magnesium plus nifedipine: potentiation of hypotensive effect in preeclampsia? Am J Obstet Gynecol. 1988;159(2):308-9.
    60831
    Magee, L. A., Miremadi, S., Li, J., Cheng, C., Ensom, M. H., Carleton, B., Cote, A. M., and von Dadelszen, P. Therapy with both magnesium sulfate and nifedipine does not increase the risk of serious magnesium-related maternal side effects in women with preeclampsia. Am.J Obstet.Gynecol. 2005;193(1):153-163.
    13362
    L'Hommedieu CS, Nicholas D, Armes DA, et al. Potentiation of magnesium sulfate--induced neuromuscular weakness by gentamicin, tobramycin, and amikacin. J Pediatr 1983;102:629-31..

    Rating System Description

    Level of Significance: Stop‑Light Rating System Occurrence/Severity
    Major

    Do not use combination; contraindicated; strongly discourage patients from using this combination; a serious adverse outcome could occur.

    Moderate

    Use cautiously or avoid combination; warn patients that a significant interaticon or adverse outcome could occur.

    Minor

    Be aware that there is a chance of an interaction; advise patients to watch for warning signs of a potential interaction.

    Likelihood of Occurrence

    Likely: Well‑controlled human studies have demonstrated existence of this interaction.

    Probable: Interaction has not been documented in well‑controlled studies, however interaction has been demonstrated in human studies or in controlled animal studies plus multiple case reports.

    Possible: Interaction has been documented in animal or in vitro research, or interaction has been documented in humans but is limited to case reports or conflicting clinical research.

    Unlikely: Interaction has been demonstrated in animal or in vitro research but has been shown not to occur in humans.

    Severity

    High: Life threatening or requires medical intervention to prevent a serious adverse event.

    Moderate: Worsened clinical status and/or requires medication adjustment.

    Mild: May cause minor clinical side effects. Unlikely to require medication adjustment.

    Insignificant: Drug or supplement levels may be affected but will not cause clinical effects.

    Level of Evidence

    A: High-quality randomized controlled trial(RCT).

    A: High-quality meta-analysis (quantitative systematic review)

    B: Nonrandomized clinical trial

    B: Nonquantitative systematic review

    B: Lower quality RCT

    B: Clinical cohort study

    B: Case-control study

    B: Historical control

    B: Epidemoilogic study

    C: Consensus

    C: Expert opinion

    D: Acecdotal evidence

    D: In vitro or animal study

    D: Theoretical based on pharmacology


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    Disclaimer: This information on interactions is licensed from the TRC Natural Medicines Database. Neither Bio Concepts nor TRC are providing medical, clinical or other advice and nothing should be interpreted as constituting such advice. Currently this does not check for drug-drug or supplementsupplement 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 judgement is necessary.