psyllium (generic name)

a laxative - treats Obesity, Diarrhea, Colonoscopy preparation, Anal fissures, Fat excretion in stool, Colon cancer, Irritable bowel syndrome, ...
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Interactions with Drugs

Psyllium-containing products may delay gastric emptying time and reduce the absorption of some drugs. It is advised that drugs be taken at separate administration times from psyllium to minimize potential interactions (for example, one hour before or a few hours after taking psyllium).

Although no effect on warfarin (Coumadin®) levels with co-administration of psyllium was reported in one study, administration of these agents should be separated until better research is available.

Due to potential reductions in blood sugar levels caused by psyllium, requirements for insulin or other diabetes drugs in diabetic patients may be reduced. Blood glucose levels should be closely monitored, and dosing adjustments may be necessary.

Other drugs may be affected by psyllium, including anticoagulants, antidepressants, anti-gout agents, anti-inflammatory agents, diuretics, salicylates, tetracyclines, nitrofurantoin, insulin, lithium (Lithobid®, Eskalith®), and digoxin (Lanoxin®). People should speak with their healthcare providers before taking psyllium. Dosing adjustments may be necessary.

Interactions with Herbs and Dietary Supplements

Psyllium-containing products may delay gastric emptying time and reduce the absorption of some herbs, supplements, vitamins, or minerals. Absorption of calcium, iron, zinc, and vitamin B12 may also be affected. Other agents should be taken one hour before or a few hours after psyllium to avoid potential interactions.

Psyllium should be used cautiously with other laxatives, such as senna, because effects may be increased.

Psyllium and chitosan together may increase fat excretion in the stool.

Theoretically, psyllium may reduce the absorption of anticoagulant herbs and supplements. However, no effect on warfarin levels by co-administered psyllium was found in one study.

Taking psyllium with herbs and supplements that alter blood sugar may increase the risk of hypoglycemia (lowered blood sugar). People using other herbs or supplements that may alter blood sugar levels, such as bitter melon (Momordica charantia), should be monitored closely by their healthcare provider while using psyllium. Dosing adjustments may be necessary.

Psyllium may interact with herbs and supplements with antidepressant, anti-gout, anti-inflammatory, and diuretic activities.


This information is based on a full professional monograph edited and peer-reviewed by contributors to the Natural Standard Research Collaboration ( Ethan Basch, MD (Memorial-Sloan-Kettering Cancer Center); Wendy Chao, PhD (Natural Standard Research Collaboration); Dawn Costa, BA, BS (Natural Standard Research Collaboration); Chi Dam, PharmD (Northeastern University); Nicole Giese, MS (Natural Standard Research Collaboration); Dana A. Hackman, BS (Northeastern University); Erica Seamon, PharmD (Nova Southeastern University); Scott W. Shurmur, MD (University of Nebraska Medical Center); Shaina Tanguay-Colucci, BS (Natural Standard Research Collaboration); Catherine Ulbricht, PharmD (Massachusetts General Hospital); Wendy Weissner, BA (Natural Standard Research Collaboration); Jen Woods, BS (Natural Standard Research Collaboration).

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