Precautions:
Because supplements may have side effects or interact with medications, you should take them only under the supervision of a knowledgeable health care provider.
Psyllium supplements may reduce or delay the absorption of certain medications (See Possible Interactions). As a rule, you should not take psyllium supplements at the same time as other medications. Take psyllium at least 1 hour before or 2 - 4 hours after taking other medications.
You should always take psyllium with a full 8 oz. glass of water, and you should drink at least 6 - 8 full glasses of water throughout the day to avoid constipation. Taking psyllium supplements without adequate liquids may cause it to swell, and, in extreme cases, cause choking.
Do not take this product if you have bowel obstructions or spasms, or if you have difficulty swallowing. People with esophageal stricture (narrowing of the esophagus) or any other narrowing or obstruction of the gastrointestinal tract should not take psyllium.
A potential side effect from any fiber product is gas and bloating.
People with kidney disease should talk to their doctor before taking psyllium.
Possible Interactions:
If you are being treated with any of the following medications, you should not use psyllium supplements without first talking to your health care provider.
Antidepressant medications, Tricyclics -- Dietary fiber has been shown to lower the blood levels and effectiveness of tricyclic antidepressant medications in some patients. If you take tricyclic antidepressants, talk to your doctor before taking psyllium. Tricyclic antidepressants include:
Amitriptyline (Elavil)
Doxepin (Sinequan)
Imipramine (Tofranil)
Carbemazepine (Tegretol) -- Taking psyllium with carbamazepine, a medication used to treat seizures, may decrease the absorption and effectiveness of carbamazepine.
Cholesterol-lowering medications (bile acid sequestrants) -- Taking psyllium with cholesterol-lowering medications called bile acid sequestrants may help further lower cholesterol levels and may reduce side effects of colestipol. Talk to your doctor about whether this may be an option for you. Bile acid sequestrants include:
Cholestyramine (Questram)
Colestipol (Colestid)
Diabetes medications -- Fiber supplements may reduce levels of blood sugar, making the possibility of hypoglycemia (low blood sugar) more likely. Talk to your doctor before taking fiber supplements, as your dose of diabetes medications may need to be adjusted.
Digoxin -- Fiber supplements may reduce the absorption of digoxin, a medication used to regulate heart function. You should not take fiber supplements at the same time as digoxin.
Lithium -- Psyllium may lower lithium levels in the blood, reducing the effectiveness of this medication. If you are taking both psyllium and lithium, you should take them at least 1 - 2 hours apart, and your doctor should closely monitor your lithium levels.
Reviewed last on: 6/17/2011
Steven D. Ehrlich, NMD, Solutions Acupuncture, a private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed Healthcare Network.
