Drug Interactions between calcium carbonate / melatonin / valerian / vitamin e and ozanimod

Calcium absorption may be increased by taking it with food. However, foods high in oxalic acid (spinach or rhubarb), or phytic acid (bran and whole grains) may decrease calcium absorption. Calcium may be taken with food to increase absorption. Consider spacing calcium administration for at least 2 hours before or after consuming foods high in oxalic acid or phytic acid. Talk to your doctor if you have any questions or concerns. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Both smoking and excessive caffeine consumption can alter the blood levels of melatonin, which may affect the dosing. Tobacco smoking reduces, while caffeine increases melatonin blood levels. If you start smoking or undergo smoking cessation, your doctor may need to adjust the dose of melatonin. In addition, alcohol may reduce the effect of melatonin on sleep. It is best to avoid alcohol consumption during melatonin therapy. Talk to a healthcare professional if you have any questions or concerns. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Alcohol can increase the nervous system side effects of valerian such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with valerian. Do not use more than the recommended dose of valerian, and avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medication affects you. Talk to your doctor or pharmacist if you have any questions or concerns.

Ozanimod may be taken with or without food. While there is no need to strictly avoid most foods and beverages that contain tyramine (usually aged, fermented, cured, smoked, or pickled foods such as air-dried and fermented meats or fish, aged cheeses, most soybean products, yeast extracts, red wine, beer, and sauerkraut) during treatment with ozanimod, certain foods such as some of the aged cheeses (for example, Boursault, Liederkrantz, Mycella, and Stilton) and pickled herring may contain very high amounts of tyramine and should generally be avoided if possible. Consumption of very high levels of tyramine (greater than 150 mg) while on ozanimod treatment may lead to dangerous increases in your blood pressure, a condition known as hypertensive crisis. Talk to your doctor or pharmacist if you are uncertain about what foods, if any, to avoid. You should seek immediate medical attention if you experience sudden and severe headache, blurred vision, confusion, seizures, chest pain, nausea or vomiting, sudden numbness or weakness (especially on one side of the body), speech difficulties, fever, sweating, lightheadedness, and/or fainting during treatment with ozanimod, as these may be signs and symptoms of a hypertensive crisis. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.