Meta Information
ID:multivitamin-men
Name:
Schema Version:2.4_uniform_evidence_2026_06_18
Created
2026-05-10T18:47:38.254096Z
Model
Gemini 3.1 Pro (High)
Interactions
Target id:
/class/anticoagulants-antiplatelets
Target name:
Anticoagulants and Antiplatelets
Severity:
major
Interaction type:
diminishing
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Vitamin K in multivitamins directly counteracts warfarin, increasing clotting risk. Vitamin E adds mild antiplatelet effect.
Actionable advice:
Vitamin K intake should be kept consistent daily.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Warfarin is thought to interfere with clotting factor synthesis by inhibition of the C1 subunit of vitamin K epoxide reductase (VKORC1) enzyme complex, thereby reducing the regeneration of vitamin K1 epoxide [see Clinical Pharmacology (12.5)].
Label source:
Action type:
informational_none
Target id:
/intervention/levothyroxine
Target name:
Levothyroxine
Severity:
major
Interaction type:
diminishing
Nature:
temporal
Temporal spacing:
Hours before target:
4
Hours after target:
4
Description:
Minerals like calcium and iron bind to levothyroxine, significantly reducing its absorption and effectiveness.
Actionable advice:
Doses should be separated by at least 4 hours.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
• Inform patients that agents such as iron and calcium supplements and antacids can decrease the absorption of levothyroxine.
Label source:
Action type:
separate
Target id:
/intervention/bisphosphonates
Target name:
Bisphosphonates
Severity:
major
Interaction type:
diminishing
Nature:
temporal
Temporal spacing:
Hours before target:
2
Hours after target:
2
Description:
Minerals like calcium and magnesium bind to this drug class, severely impairing its absorption.
Actionable advice:
Doses should be separated by at least 2 hours.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Co-administration of FOSAMAX and calcium, antacids, or oral medications containing multivalent cations will interfere with absorption of FOSAMAX.
Label source:
FDA label: Alendronate (Fosamax)
Action type:
separate
Target id:
/intervention/digoxin
Target name:
Digoxin
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Calcium in the multivitamin can increase the risk of heart rhythm problems from digoxin toxicity.
Actionable advice:
Requires close medical and lab monitoring.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
5.3 Misidentification of Digoxin Toxicity
Some signs and symptoms (anorexia, nausea, vomiting, and certain arrhythmias) can equally result from
digoxin toxicity as from congestive heart failure.
Label source:
Action type:
monitor
Target id:
/intervention/tretinoin
Target name:
Tretinoin
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Combining with the multivitamin's Vitamin A increases the risk of developing Vitamin A toxicity.
Actionable advice:
Skin and vision changes should be watched for closely.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
RETIN-A Gel contains tretinoin (retinoic acid, vitamin A acid) in either of two strengths, 0.025% or
0.01% by weight, in a gel vehicle of butyl alcohol, hydroxypropyl cellulose and alcohol (denatured with tert-
butylated hydroxytoluene, and brucine sulfate) 90% w/w.
Label source:
Action type:
monitor
Target id:
/intervention/levodopa
Target name:
Levodopa
Severity:
major
Interaction type:
diminishing
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Vitamin B6 can accelerate the breakdown of levodopa, reducing its effectiveness for Parkinson's symptoms.
Actionable advice:
High-dose vitamin B6 can blunt levodopa taken without carbidopa. If your levodopa includes carbidopa, no action is needed; otherwise keep B6 near the RDA or separate it from levodopa.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Carbidopa and levodopa and iron salts or multivitamins containing iron salts should be coadministered with caution. Iron salts can form chelates with levodopa and carbidopa and consequently reduce the bioavailability of carbidopa and levodopa.
Label source:
Carbidopa-levodopa (Sinemet IR) FDA label, Precautions - Drug Interactions.
Action type:
separate
Target id:
/class/ace-inhibitors
Target name:
ACE Inhibitors
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Combining with potassium in the multivitamin can lead to dangerously high blood potassium levels.
Actionable advice:
Potassium levels should be monitored via blood tests.
Validation status:
validated_via_class_inference
Evidence tier:
tier_c
Evidence basis:
class_inference_summary
Evidence anchors:
Source url:
Established mechanism / class pharmacology (no single primary source quoted)
Exact phrase from label:
Mechanistic inference: ACE inhibitors raise serum potassium, which matters only if the multivitamin/mineral supplies significant potassium; most men's multivitamins contain little/no potassium, so practical risk is low. Monitoring-level.
Label source:
Class inference
Action type:
monitor
Target id:
/class/arbs
Target name:
Angiotensin Receptor Blockers (ARBs)
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Combining with potassium in the multivitamin can lead to dangerously high blood potassium levels.
Actionable advice:
Potassium levels should be monitored via blood tests.
Validation status:
validated_via_class_inference
Evidence tier:
tier_c
Evidence basis:
class_inference_summary
Evidence anchors:
Source url:
Established mechanism / class pharmacology (no single primary source quoted)
Exact phrase from label:
Mechanistic inference: ARBs can raise serum potassium; relevant only if the product supplies significant potassium. Low practical risk for typical formulations. Monitoring-level.
Label source:
Class inference
Action type:
monitor
Target id:
/class/statins
Target name:
Statins
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Niacin (Vitamin B3) in some multivitamins can increase the risk of muscle damage (myopathy).
Actionable advice:
Any unexplained muscle pain should be reported.
Validation status:
validated_via_class_inference
Evidence tier:
tier_c
Evidence basis:
class_inference_summary
Evidence anchors:
Source url:
Established mechanism / class pharmacology (no single primary source quoted)
Exact phrase from label:
Mechanistic inference: high-dose niacin combined with statins can increase myopathy risk, but standard multivitamin niacin doses are far below that threshold, so practical risk is low. Caution applies mainly to separate high-dose niacin.
Label source:
Class inference
Action type:
monitor
Target id:
/class/proton-pump-inhibitors
Target name:
Proton Pump Inhibitors
Severity:
moderate
Interaction type:
diminishing
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Long-term use impairs absorption of Vitamin B12 and magnesium from supplements and food.
Actionable advice:
Periodically monitor B12 and magnesium levels.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
5.7 Cyanocobalamin (Vitamin B-12) Deficiency Daily treatment with any acid-suppressing medications over a long period of time (e.
Label source:
FDA label: Omeprazole
Action type:
monitor
Target id:
/class/bile-acid-sequestrants
Target name:
Bile Acid Sequestrants
Severity:
moderate
Interaction type:
diminishing
Nature:
temporal
Temporal spacing:
Hours before target:
4
Hours after target:
4
Description:
This drug class can bind to fat-soluble vitamins (A, D, E, K), reducing their absorption.
Actionable advice:
Doses should be separated by at least 4 hours.
Validation status:
validated_via_class_inference
Evidence tier:
tier_c
Evidence basis:
class_inference_summary
Evidence anchors:
Source url:
Established mechanism / class pharmacology (no single primary source quoted)
Exact phrase from label:
Mechanistic inference: bile-acid sequestrants reduce absorption of fat-soluble vitamins (A, D, E, K) and some minerals; separate the multivitamin from the sequestrant by several hours. Established class effect.
Label source:
Class inference
Action type:
separate
Target id:
/intervention/iron-bisglycinate
Target name:
Iron Bisglycinate
Severity:
moderate
Interaction type:
diminishing
Nature:
temporal
Temporal spacing:
Hours before target:
2
Hours after target:
2
Description:
Calcium and zinc in the multivitamin compete with and reduce the absorption of supplemental iron.
Actionable advice:
Doses should be separated by at least 2 hours.
Validation status:
validated_via_pubmed
Evidence tier:
tier_b
Evidence basis:
pubmed_abstract_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Decreased iron absorption in the prenatal supplements was shown to be due to inhibition by calcium carbonate and magnesium oxide and, in some cases, to poor iron release.
Label source:
PubMed: Obstetrics and gynecology (1983)
Source url:
Exact phrase from label:
The absorption of iron from a low-iron-containing supplement was similar to that from a supplement with almost twice the amount of iron, due possibly to the exclusion of calcium in the LI product.
Label source:
PubMed: Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC (2004)
Action type:
separate
Target id:
/intervention/magnesium
Target name:
Magnesium
Severity:
moderate
Interaction type:
diminishing
Nature:
temporal
Temporal spacing:
Hours before target:
2
Hours after target:
2
Description:
Calcium in the multivitamin can compete with and reduce the absorption of supplemental magnesium.
Actionable advice:
Doses should be separated by at least 2 hours.
Validation status:
validated_via_primary_literature
Evidence tier:
tier_b
Evidence basis:
primary_literature_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Ten parameters, including iron, vitamin K1, zinc, C-reactive protein, hemoglobin, hematocrit, mean corpuscular volume, calcium, folic acid, and vitamin D, showed significant increases (p < 0.001). Conversely, magnesium, phosphate, and albumin levels significantly decreased (p < 0.001).
Label source:
PubMed: Assessment of Preoperative Multivitamin Use on the Impact on Micronutrient Deficiencies in Patients with Obesity Prior to Metabolic Bariatric Surgery. (PMID 40199822)
Action type:
separate
Target id:
/intervention/zinc
Target name:
Zinc
Severity:
moderate
Interaction type:
diminishing
Nature:
temporal
Temporal spacing:
Hours before target:
2
Hours after target:
2
Description:
Calcium and iron in the multivitamin can reduce the absorption of supplemental zinc.
Actionable advice:
Doses should be separated by at least 2 hours.
Validation status:
validated_via_pubmed
Evidence tier:
tier_b
Evidence basis:
pubmed_abstract_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
dietary phytates, casein and calcium can reduce zinc bioavailability.
Label source:
PubMed: Clinical and experimental medicine (2024)
Source url:
Exact phrase from label:
The present findings suggest that Ca and Zn interfere with iron metabolism. This interference is through an increase in ferroportin activity, which results in a diminished net iron absorption.
Label source:
PubMed: European journal of nutrition (2018)
Source url:
Exact phrase from label:
Addition of iron as ferrous sulfate to form ratios of Sn/Fe/Zn of 1:1:1 and 2:2:1 with the standard zinc solution and the appropriate doses of tin produced a reduction of zinc absorption not dissimilar from that seen previously with zinc and iron alone, and addition of picolinic acid did not influence the uptake of zinc from the solution with the 2:2:1 Sn/Fe/Zn ratio.
Label source:
PubMed: The American journal of clinical nutrition (1983)
Action type:
separate