4-Day Colon Cleanse Ingredients & Drug Interactions
by HCG Platinum
What is this page for?
First and foremost: checking 4-Day Colon Cleanse against your medications. The heart of this page is the interaction checker and the full interaction report — how this product’s ingredients may interact with prescription and over-the-counter medicines you may be taking.
Around that, we add a pharmacist’s high-level view of the product as a whole — what’s inside, the evidence for its stated use, how transparent the label is, and what safety data exists — so you can see the full picture in one place. It’s educational information from our licensed clinical databases and the clinical staff at HelloPharmacist — not medical advice — and we don’t sell or endorse products. Our editorial policy
4-Day Colon Cleanse is a dietary supplement by HCG Platinum with 5 active ingredients. Its ingredients are commonly taken for nausea and vomiting, motion sickness, morning sickness in pregnancy.Based on those ingredients, 1,375 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are Ginger, Rhubarb, Apple Fiber. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against 4-Day Colon Cleanse by HCG Platinum
Ask about any prescription or over-the-counter medication and we check it for interactions with 4-Day Colon Cleanse by HCG Platinum — and tell you which ingredient is responsible.
AI summaries are generated from our interaction database for education only — always confirm with your pharmacist. How we use AI
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HelloPharmacist Scorecard of 4-Day Colon Cleanse by HCG Platinum
Four independent checks of what is known — a summary of the available information, not a grade of the product itself.
By FDA rules, dietary supplements can’t claim to treat, cure, or prevent disease — so labels speak in careful marketing language. We discern each product’s intended use from its name, label claims, and label statements, then grade the clinical evidence for that use. How these ratings are computed
The stated purpose hasn't been mapped to our evidence data yet.
Why this rating?
- We haven't mapped this product's purpose to our evidence data yet — it'll be graded on the next content refresh.
Every active ingredient lists its own amount on the label.
Why this rating?
- The label discloses an exact amount for 5 of its 5 active ingredients.
- No proprietary blends here — you can verify the dose of every single component.
At least one ingredient has a documented Major-severity interaction. Check your medications for a personalized result.
Why this rating?
- 4 of the 4 matched ingredients can interact with medications — Rhubarb, Apple, Senna, Ginger.
- The most serious interaction on file is rated Major.
- Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs; immunosuppressants / transplant drugs; diabetes medications; heart-rhythm medications; lithium.
- For scale: 1,376 individual medications appear in the full list. A big number alone doesn't make a product dangerous — what matters is whether YOUR medication is on it, so run yours through the interaction checker on this page.
Adverse-effect, pregnancy, and general safety data are on file for most of these ingredients.
Why this rating?
- We hold adverse-effect (side-effect) data for 4 of the 4 matched ingredients.
- Pregnancy & breastfeeding safety ratings cover 4 of 4.
- General safety write-ups exist for 4 of 4.
- Remember: this measures how much safety information exists. Thin data is not the same as being safe.
HelloPharmacist summaryFully disclosed formula with no assessable stated purpose. Major medication interactions have been identified, and safety information is well characterized.
Assessment coverage: 4 of 5 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Nov 21, 2012.
This Scorecard evaluates available label information, ingredient evidence, and known medication-safety considerations. It does not independently verify product identity, purity, potency, contamination, or manufacturing quality. How these ratings are computed
General information
Key facts about 4-Day Colon Cleanse, straight from the product label.
| Brand | HCG Platinum |
|---|---|
| Barcode (UPC) | 721762312346 |
| Net contents | 32 Capsule(s) |
| Market status | Off market |
| Date entered into DSLD | Nov 21, 2012 |
| DSLD ID | 15792 |
| Product type | Botanical |
| Supplement form | Capsule |
| Dietary claims / uses | All Other |
| Intended target group(s) | Adult (18 - 50 Years) |
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.
Supplement Facts
The label details for 4-Day Colon Cleanse by HCG Platinum, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Psyllium | 2000 mg | -- |
| Ginger | 800 mg | -- |
| Rhubarb | 400 mg | -- |
| Senna | 400 mg | -- |
| Apple Fiber | 400 mg | -- |
Other ingredients: Gelatin
Tap any ingredient to jump to its full detail below.
These statements are the manufacturer’s wording, reproduced from the product label — the label is saying it, not HelloPharmacist. We don’t verify or endorse them.
Suggested/Recommended/Usage/Directions
DIRECTIONS: Take 4 capsules in the morning with a full glass of water and 4 capsules in the afternoon with a full glass of water. For best results, drink plenty of water throughout the day.
Precautions
WARNINGS Use only as directed.
Consult a health care professional before use if you are pregnant or nursing, have a serious medical condition, or prescription medications.
For adult use only.
FDA Statement of Identity
DIETARY SUPPLEMENT
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
4-Day Colon Cleanse by HCG Platinum label
The label scan from the NIH Dietary Supplement Label Database. Tap to enlarge.
Label images are published by the NIH Dietary Supplement Label Database for the version of this product on file. Always read your actual product label.
View the full label (PDF)The Ingredients in 4-Day Colon Cleanse by HCG Platinum
These are the 5 active ingredients this product is made of. Select any to open its full monograph.
Serving size4 Capsule(s) Dosage formCapsule Servings per container8 Amounts shown are per serving.
Most supplement products combine several ingredients, and a medication can interact with the product through any one of them. Each ingredient below shows whether it has known drug interactions.
Psyllium
Ginger
Interacts with1,007 drugs
Ginger is a widely used culinary spice with a long history in traditional medicine, and it has the strongest evidence for helping with nausea and vomi...
Ginger monograph & interactionsRhubarb
Interacts with658 drugs
Rhubarb root has a long history of use as a laxative and in traditional Chinese medicine, and its edible stalks are a common food. Most medicinal clai...
Rhubarb monograph & interactionsSenna
Interacts with140 drugs
Senna is a plant-based stimulant laxative that is widely used and generally effective for short-term relief of constipation. It is best used occasiona...
Senna monograph & interactionsApple Fiber
Interacts with300 drugs
Apples are a nutritious whole food that provides fiber, vitamins, and antioxidant plant compounds, and eating them regularly fits well into a healthy...
Apple Fiber monograph & interactionsOther (inactive) ingredients: Gelatin. These complete the product’s ingredient list but are not active constituents.
4-Day Colon Cleanse by HCG Platinum Drug Interactions
4-Day Colon Cleanse contains 5 ingredients, and 4 of them have known drug interactions. Altogether they interact with 1,375 medications. Here’s the picture, then you can look up your own drug.
Want to check YOUR meds against 4-Day Colon Cleanse?
Ask about interactions with your drugs in plain English — “Can I take it with lisinopril?” — and we find you the answer in seconds, ingredient by ingredient.
Go to the checkerIngredients driving the most interactions
Individual Drug Interactions
The ingredients in 4-Day Colon Cleanse interact with 1,375 drugs. Click any drug to see the details.
4 of the 5 ingredients in 4-Day Colon Cleanse interact with drugs. Each result below shows which ingredient is responsible. Ginger Rhubarb Apple Fiber Senna
AtorvastatinAtorvaliq
How Atorvastatin interacts with 4-Day Colon Cleanse — through 3 ingredients. Tap an ingredient for the detail:
Apple FiberOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple Fiber + Atorvastatin interactionGingerCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Ginger might increase or decrease the levels of CYP3A4 substrates.
Read the full Ginger + Atorvastatin interactionRhubarbHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of rhubarb with potentially hepatotoxic drugs might increase the risk of developing liver damage.
Read the full Rhubarb + Atorvastatin interactionAtorvastatin CalciumLipitor
How Atorvastatin Calcium interacts with 4-Day Colon Cleanse — through 3 ingredients. Tap an ingredient for the detail:
Apple FiberOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple Fiber + Atorvastatin Calcium interactionRhubarbHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of rhubarb with potentially hepatotoxic drugs might increase the risk of developing liver damage.
Read the full Rhubarb + Atorvastatin Calcium interactionGingerCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Ginger might increase or decrease the levels of CYP3A4 substrates.
Read the full Ginger + Atorvastatin Calcium interactionBosentanTracleer
How Bosentan interacts with 4-Day Colon Cleanse — through 3 ingredients. Tap an ingredient for the detail:
Apple FiberAntihypertensive Drugs, Organic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Consuming apple juice with antihypertensive drugs might interfere with blood pressure control.
Read the full Apple Fiber + Bosentan interactionRhubarbHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of rhubarb with potentially hepatotoxic drugs might increase the risk of developing liver damage.
Read the full Rhubarb + Bosentan interactionGingerCytochrome P450 2c9 (cyp2c9) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, ginger might increase the levels of CYP2C9 substrates.
Read the full Ginger + Bosentan interactionBrincidofovirTembexa
How Brincidofovir interacts with 4-Day Colon Cleanse — through 1 ingredient. Tap an ingredient for the detail:
Apple FiberOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple Fiber + Brincidofovir interactionCeliprololCelicard
How Celiprolol interacts with 4-Day Colon Cleanse — through 2 ingredients. Tap an ingredient for the detail:
Apple FiberOrganic Anion-transporting Polypeptide Substrates (oatp), Antihypertensive Drugs Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple Fiber + Celiprolol interactionGingerP-glycoprotein Substrates Moderate
Interaction Summary
Ginger might increase the absorption and blood levels of P-glycoprotein (P-gp) substrates.
Read the full Ginger + Celiprolol interactionCerivastatin SodiumBaycol
How Cerivastatin Sodium interacts with 4-Day Colon Cleanse — through 2 ingredients. Tap an ingredient for the detail:
Apple FiberOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple Fiber + Cerivastatin Sodium interactionRhubarbHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of rhubarb with potentially hepatotoxic drugs might increase the risk of developing liver damage.
Read the full Rhubarb + Cerivastatin Sodium interactionCinoxacinCinobac
How Cinoxacin interacts with 4-Day Colon Cleanse — through 2 ingredients. Tap an ingredient for the detail:
Apple FiberOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple Fiber + Cinoxacin interactionRhubarbNephrotoxic Drugs, Hepatotoxic Drugs Moderate
Interaction Summary
Theoretically, long-term use of anthraquinones from rhubarb might increase the risk of nephrotoxicity when used with nephrotoxic drugs.
Read the full Rhubarb + Cinoxacin interactionCiprofloxacinCiloxan, Cipro, Cipro IV, Cipro XR, Ciprobay, Otiprio
How Ciprofloxacin interacts with 4-Day Colon Cleanse — through 2 ingredients. Tap an ingredient for the detail:
Apple FiberOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple Fiber + Ciprofloxacin interactionRhubarbHepatotoxic Drugs, Nephrotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of rhubarb with potentially hepatotoxic drugs might increase the risk of developing liver damage.
Read the full Rhubarb + Ciprofloxacin interactionCiprofloxacin, HydrocortisoneCipro HC Otic
How Ciprofloxacin, Hydrocortisone interacts with 4-Day Colon Cleanse — through 1 ingredient. Tap an ingredient for the detail:
Apple FiberOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple Fiber + Ciprofloxacin, Hydrocortisone interactionClinafloxacinClinafloxacin
How Clinafloxacin interacts with 4-Day Colon Cleanse — through 1 ingredient. Tap an ingredient for the detail:
Apple FiberOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple Fiber + Clinafloxacin interactionEnoxacinPenetrex
How Enoxacin interacts with 4-Day Colon Cleanse — through 1 ingredient. Tap an ingredient for the detail:
Apple FiberOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple Fiber + Enoxacin interactionEtoposideEtopophos, VePesid, VP16
How Etoposide interacts with 4-Day Colon Cleanse — through 2 ingredients. Tap an ingredient for the detail:
Apple FiberOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple Fiber + Etoposide interactionGingerP-glycoprotein Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Ginger might increase the absorption and blood levels of P-glycoprotein (P-gp) substrates.
Read the full Ginger + Etoposide interactionEzetimibe, AtorvastatinLiptruzet
How Ezetimibe, Atorvastatin interacts with 4-Day Colon Cleanse — through 3 ingredients. Tap an ingredient for the detail:
Apple FiberOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple Fiber + Ezetimibe, Atorvastatin interactionGingerCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Ginger might increase or decrease the levels of CYP3A4 substrates.
Read the full Ginger + Ezetimibe, Atorvastatin interactionRhubarbHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of rhubarb with potentially hepatotoxic drugs might increase the risk of developing liver damage.
Read the full Rhubarb + Ezetimibe, Atorvastatin interactionFexofenadineAllegra
How Fexofenadine interacts with 4-Day Colon Cleanse — through 2 ingredients. Tap an ingredient for the detail:
Apple FiberOrganic Anion-transporting Polypeptide Substrates (oatp), Fexofenadine (allegra) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple Fiber + Fexofenadine interactionGingerP-glycoprotein Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Ginger might increase the absorption and blood levels of P-glycoprotein (P-gp) substrates.
Read the full Ginger + Fexofenadine interactionFexofenadine, PseudoephedrineAllegra D
How Fexofenadine, Pseudoephedrine interacts with 4-Day Colon Cleanse — through 2 ingredients. Tap an ingredient for the detail:
Apple FiberOrganic Anion-transporting Polypeptide Substrates (oatp), Fexofenadine (allegra) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple Fiber + Fexofenadine, Pseudoephedrine interactionGingerCytochrome P450 3a4 (cyp3a4) Substrates, P-glycoprotein Substrates Moderate
Interaction Summary
Ginger might increase or decrease the levels of CYP3A4 substrates.
Read the full Ginger + Fexofenadine, Pseudoephedrine interactionFluvastatinLescol, Lescol XL
How Fluvastatin interacts with 4-Day Colon Cleanse — through 3 ingredients. Tap an ingredient for the detail:
Apple FiberOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple Fiber + Fluvastatin interactionRhubarbHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of rhubarb with potentially hepatotoxic drugs might increase the risk of developing liver damage.
Read the full Rhubarb + Fluvastatin interactionGingerCytochrome P450 2c9 (cyp2c9) Substrates Minor
Interaction Summary
Theoretically, ginger might increase the levels of CYP2C9 substrates.
Read the full Ginger + Fluvastatin interactionGatifloxacinTequin, Tequin Injection
How Gatifloxacin interacts with 4-Day Colon Cleanse — through 2 ingredients. Tap an ingredient for the detail:
Apple FiberOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple Fiber + Gatifloxacin interactionRhubarbHepatotoxic Drugs, Nephrotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of rhubarb with potentially hepatotoxic drugs might increase the risk of developing liver damage.
Read the full Rhubarb + Gatifloxacin interactionGemifloxacinFactive
How Gemifloxacin interacts with 4-Day Colon Cleanse — through 1 ingredient. Tap an ingredient for the detail:
Apple FiberOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple Fiber + Gemifloxacin interactionGlyburideAlbert Glyburide, Diabeta, Glycron, Glynase, Glynase PresTab, Micronase +1 more
How Glyburide interacts with 4-Day Colon Cleanse — through 3 ingredients. Tap an ingredient for the detail:
Apple FiberAntidiabetes Drugs, Organic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Theoretically, consuming apple juice with antidiabetes drugs might interfere with blood glucose control.
Read the full Apple Fiber + Glyburide interactionGingerAntidiabetes Drugs, Cytochrome P450 2c9 (cyp2c9) Substrates Moderate
Interaction Summary
Theoretically, taking ginger with antidiabetes drugs might increase the risk of hypoglycemia.
Read the full Ginger + Glyburide interactionRhubarbHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of rhubarb with potentially hepatotoxic drugs might increase the risk of developing liver damage.
Read the full Rhubarb + Glyburide interactionGlyburide, MetforminGlucovance
How Glyburide, Metformin interacts with 4-Day Colon Cleanse — through 3 ingredients. Tap an ingredient for the detail:
Apple FiberAntidiabetes Drugs, Organic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Theoretically, consuming apple juice with antidiabetes drugs might interfere with blood glucose control.
Read the full Apple Fiber + Glyburide, Metformin interactionGingerCytochrome P450 2c9 (cyp2c9) Substrates, Antidiabetes Drugs Moderate
Interaction Summary
Theoretically, ginger might increase the levels of CYP2C9 substrates.
Read the full Ginger + Glyburide, Metformin interactionRhubarbHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of rhubarb with potentially hepatotoxic drugs might increase the risk of developing liver damage.
Read the full Rhubarb + Glyburide, Metformin interactionGrepafloxacinRaxar
How Grepafloxacin interacts with 4-Day Colon Cleanse — through 2 ingredients. Tap an ingredient for the detail:
Apple FiberOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple Fiber + Grepafloxacin interactionGingerCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, ginger might increase the levels of CYP1A2 substrates.
Read the full Ginger + Grepafloxacin interactionIrinotecanCamptosar, Onivyde
How Irinotecan interacts with 4-Day Colon Cleanse — through 2 ingredients. Tap an ingredient for the detail:
Apple FiberOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple Fiber + Irinotecan interactionGingerCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Ginger might increase or decrease the levels of CYP3A4 substrates.
Read the full Ginger + Irinotecan interactionIrinotecan Hydrochloride
How Irinotecan Hydrochloride interacts with 4-Day Colon Cleanse — through 2 ingredients. Tap an ingredient for the detail:
Apple FiberOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple Fiber + Irinotecan Hydrochloride interactionGingerCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Ginger might increase or decrease the levels of CYP3A4 substrates.
Read the full Ginger + Irinotecan Hydrochloride interactionIsoniazid, Pyrazinamide, RifampinRifater
How Isoniazid, Pyrazinamide, Rifampin interacts with 4-Day Colon Cleanse — through 2 ingredients. Tap an ingredient for the detail:
Apple FiberOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple Fiber + Isoniazid, Pyrazinamide, Rifampin interactionRhubarbHepatotoxic Drugs, Nephrotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of rhubarb with potentially hepatotoxic drugs might increase the risk of developing liver damage.
Read the full Rhubarb + Isoniazid, Pyrazinamide, Rifampin interactionIsoniazid, RifampinRifamate
How Isoniazid, Rifampin interacts with 4-Day Colon Cleanse — through 2 ingredients. Tap an ingredient for the detail:
Apple FiberOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple Fiber + Isoniazid, Rifampin interactionRhubarbNephrotoxic Drugs, Hepatotoxic Drugs Moderate
Interaction Summary
Theoretically, long-term use of anthraquinones from rhubarb might increase the risk of nephrotoxicity when used with nephrotoxic drugs.
Read the full Rhubarb + Isoniazid, Rifampin interactionLevofloxacinLeva-pak, Levaquin, Levaquin Injection
How Levofloxacin interacts with 4-Day Colon Cleanse — through 2 ingredients. Tap an ingredient for the detail:
Apple FiberOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple Fiber + Levofloxacin interactionRhubarbNephrotoxic Drugs, Hepatotoxic Drugs Moderate
Interaction Summary
Theoretically, long-term use of anthraquinones from rhubarb might increase the risk of nephrotoxicity when used with nephrotoxic drugs.
Read the full Rhubarb + Levofloxacin interactionLevofloxacin (ophthalmic)Levofloxacin
How Levofloxacin (ophthalmic) interacts with 4-Day Colon Cleanse — through 1 ingredient. Tap an ingredient for the detail:
Apple FiberOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple Fiber + Levofloxacin (ophthalmic) interactionLomefloxacinMaxaquin
How Lomefloxacin interacts with 4-Day Colon Cleanse — through 2 ingredients. Tap an ingredient for the detail:
Apple FiberOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple Fiber + Lomefloxacin interactionRhubarbNephrotoxic Drugs, Hepatotoxic Drugs Moderate
Interaction Summary
Theoretically, long-term use of anthraquinones from rhubarb might increase the risk of nephrotoxicity when used with nephrotoxic drugs.
Read the full Rhubarb + Lomefloxacin interactionLovastatinAltocor, Mevacor
How Lovastatin interacts with 4-Day Colon Cleanse — through 3 ingredients. Tap an ingredient for the detail:
Apple FiberOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple Fiber + Lovastatin interactionGingerCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Ginger might increase or decrease the levels of CYP3A4 substrates.
Read the full Ginger + Lovastatin interactionRhubarbHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of rhubarb with potentially hepatotoxic drugs might increase the risk of developing liver damage.
Read the full Rhubarb + Lovastatin interactionMethotrexateOtrexup, Rasuvo, Reditrex, Rheumatrex
How Methotrexate interacts with 4-Day Colon Cleanse — through 2 ingredients. Tap an ingredient for the detail:
Apple FiberOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple Fiber + Methotrexate interactionRhubarbHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of rhubarb with potentially hepatotoxic drugs might increase the risk of developing liver damage.
Read the full Rhubarb + Methotrexate interactionEach ingredient & the kinds of drugs it affects
For each ingredient in 4-Day Colon Cleanse with known interactions, here are the types of medications they can affect. Open any type for the detail — or search your exact drug in the checker above.
Ginger
Anticoagulant/Antiplatelet Drugs
Ginger may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs. However, research is conflicting.
Laboratory research suggests that ginger inhibits thromboxane synthetase and decreases platelet aggregation. However, this has not been demonstrated unequivocally in humans, with mixed results from clinical trials. Theoretically, excessive amounts of ginger might increase the risk of bleeding when used with anticoagulant/antiplatelet drugs.
Antidiabetes Drugs
Theoretically, taking ginger with antidiabetes drugs might increase the risk of hypoglycemia.
Animal and human research suggests that ginger might increase insulin levels and/or decrease blood glucose levels.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Ginger might increase or decrease the levels of CYP3A4 substrates.
In vitro research and some case reports suggest that ginger inhibits CYP3A4 activity. Three case reports from the World Health Organization (WHO) adverse drug reaction database describe increased toxicity in patients taking ginger and cancer medications that are CYP3A4 substrates (imatinib, dabrafenib, and crizotinib). However, the causality of this interaction is unclear due to the presence of multiple interacting drugs and routes of administration.
Conversely, other in vitro research suggests that ginger induces CYP3A4 activity, leading to reduced levels of CYP3A4 substrates. However, this interaction has not been reported in humans.
Losartan (Cozaar)
Theoretically, ginger might increase levels of losartan and the risk of hypotension.
In animal research, ginger increased the levels and hypotensive effects of a single dose of losartan. It is not clear if ginger alters the concentration or effects of losartan when taken continuously. Additionally, this interaction has not been shown in humans.
Nifedipine (Procardia)
Ginger may have antiplatelet effects and increase the risk of bleeding if used with nifedipine.
Clinical research shows that combined treatment with ginger 1 gram plus nifedipine 10 mg significantly inhibits platelet aggregation when compared to nifedipine or ginger alone.
P-Glycoprotein Substrates
Ginger might increase the absorption and blood levels of P-glycoprotein (P-gp) substrates.
In vitro research and case reports suggest that ginger inhibits drug efflux by P-gp, potentially increasing absorption and serum levels of P-gp substrates. Two case reports from the World Health Organization (WHO) adverse drug reaction database describe increased toxicity in patients taking ginger and cancer medications that are P-gp substrates (trametinib, crizotinib). However, the causality of this interaction is unclear due to the presence of multiple interacting drugs and routes of administration.
Phenprocoumon (Marcoumar, Others)
Ginger might increase the risk of bleeding with phenprocoumon.
Phenprocoumon, a warfarin-related anticoagulant, might increase the international normalized ratio (INR) when taken with ginger. There is one case report of a 76-year-old woman with a stable INR on phenprocoumon that increased to greater than 10 when she began consuming dried ginger and ginger tea.
Warfarin (Coumadin)
Ginger might increase the risk of bleeding with warfarin.
Laboratory research suggests that ginger might inhibit thromboxane synthetase and decrease platelet aggregation. In one case report, ginger increased the INR when taken with phenprocoumon, which has similar pharmacological effects as warfarin. In another case report, ginger increased the INR when taken with a combination of warfarin, hydrochlorothiazide, and acetaminophen. A longitudinal analysis suggests that taking ginger increases the risk of bleeding in patients taking warfarin for at least 4 months. However, research in healthy people suggests that ginger has no effect on INR, or the pharmacokinetics or pharmacodynamics of warfarin. Until more is known, monitor INRs closely in patients taking large amounts of ginger.
Calcium Channel Blockers
Theoretically, taking ginger with calcium channel blockers might increase the risk of hypotension.
Some animal and in vitro research suggests that ginger has hypotensive and calcium channel-blocking effects. Another animal study shows that concomitant administration of ginger and the calcium channel blocker amlodipine leads to greater reductions in blood pressure when compared with amlodipine alone.
Cyclosporine (Neoral, Sandimmune)
Theoretically, when taken prior to cyclosporine, ginger might decrease cyclosporine levels.
In an animal model, ginger juice taken 2 hours prior to cyclosporine administration reduced the maximum concentration and area under the curve of cyclosporine by 51% and 40%, respectively. This effect was not observed when ginger juice and cyclosporine were administered at the same time.
Cytochrome P450 1A2 (Cyp1A2) Substrates
Theoretically, ginger might increase the levels of CYP1A2 substrates.
In vitro research shows that ginger inhibits CYP1A2 activity. However, this interaction has not been reported in humans.
Cytochrome P450 2B6 (Cyp2B6) Substrates
Theoretically, ginger might increase the levels of CYP2B6 substrates.
In vitro research shows that ginger inhibits CYP2B6 activity. However, this interaction has not been reported in humans.
Cytochrome P450 2C9 (Cyp2C9) Substrates
Theoretically, ginger might increase the levels of CYP2C9 substrates.
In vitro research shows that ginger inhibits CYP2C9 activity. However, this interaction has not been reported in humans.
Metronidazole (Flagyl)
Theoretically, ginger might increase levels of metronidazole.
In an animal model, ginger increased the absorption and plasma half-life of metronidazole. In addition, the elimination rate and clearance of metronidazole was significantly reduced.
Rhubarb
Corticosteroids
Theoretically, frequent and high doses of rhubarb might increase the risk of hypokalemia when taken with corticosteroids.
Rhubarb has stimulant laxative effects. Overuse of rhubarb might compound corticosteroid-induced potassium loss.
Cyclosporine (Neoral, Sandimmune)
Theoretically, taking rhubarb with cyclosporine might reduce cyclosporine levels.
Animal research shows that co-administration of rhubarb decoction 0.25 or 1 gram/kg with cyclosporine 2.5 mg/kg, decreases cyclosporine maximum plasma concentration and overall exposure levels when compared with taking cyclosporine alone. The authors theorize that rhubarb might reduce cyclosporine bioavailability by inducing of P-glycoprotein and/or cytochrome P450 3A4. However, since rhubarb was administered as a single oral dose and enzyme induction usually occurs after multiple doses, it is possible that cyclosporine absorption was actually reduced via rhubarb's stimulant laxative effects. Also, the composition of the rhubarb decoction was not described.
Digoxin (Lanoxin)
Theoretically, overuse of rhubarb might increase the risk of adverse effects when taken with digoxin.
Rhubarb has stimulant laxative effects. Overuse of rhubarb might cause potassium depletion, increasing the risk of digoxin toxicity.
Diuretic Drugs
Theoretically, frequent and high doses of rhubarb might increase the risk of hypokalemia.
Rhubarb has stimulant laxative effects. Overuse of rhubarb might cause potassium depletion and compound diuretic-induced potassium loss.
Hepatotoxic Drugs
Theoretically, concomitant use of rhubarb with potentially hepatotoxic drugs might increase the risk of developing liver damage.
Some animal research suggests that anthraquinones in rhubarb might have hepatotoxic effects. Also, rhubarb use has been linked to at least 24 cases of liver injury, although details on the dose of rhubarb and duration of use in these cases is unclear.
Nephrotoxic Drugs
Theoretically, long-term use of anthraquinones from rhubarb might increase the risk of nephrotoxicity when used with nephrotoxic drugs.
The anthraquinone constituents of rhubarb have been shown to induce nephrotoxicity in animal research. Additionally, in a case report, a 23-year old female presented with kidney failure after taking 6 tablets of a proprietary slimming agent (found to contain the anthraquinones emodin and aloe-emodin from rhubarb) daily for 6 weeks and then adding diclofenac 25 mg 4 times daily for 2 days. The authors postulate that the anthraquinone constituents of rhubarb contributed to the renal dysfunction, and the addition of diclofenac, a nephrotoxic drug, led to renal failure. Until more is known, advise patients to avoid taking rhubarb if they are taking other potentially nephrotoxic drugs.
Stimulant Laxatives
Theoretically, rhubarb might increase the risk for fluid and electrolyte loss when taken with other stimulant laxatives.
Rhubarb has stimulant laxative effects. Concomitant use with stimulant laxatives might compound fluid and electrolyte loss.
Warfarin (Coumadin)
Theoretically, excessive use of rhubarb might increase the risk of bleeding when taken with warfarin.
Rhubarb has stimulant laxative effects and can cause diarrhea. Diarrhea can increase the effects of warfarin, increase international normalized ratio (INR), and increase the risk of bleeding. Advise patients who take warfarin not to take excessive amounts of rhubarb.
Apple Fiber
Organic Anion-Transporting Polypeptide Substrates (Oatp)
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Research shows that consuming apple juice inhibits OATP, which reduces bioavailability of oral drugs that are substrates of OATP. Fexofenadine, atenolol, and aliskiren are substrates of OATP. Clinical research shows that coadministration of apple juice decreases bioavailability of fexofenadine by up to 78%, aliskiren by 63%, and atenolol by up to 82%. These effects appear to increase with larger quantities of apple juice. It is thought that apple juice might affect OATP for only a short time. Therefore, separating drug administration and consumption of apple juice by at least 4 hours might avoid this interaction.
Aliskiren (Tekturna, Rasilez)
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of aliskiren.
Pharmacokinetic research shows that coadministration of apple juice 200 mL along with aliskiren 150 mg decreases the bioavailability of aliskiren by 63%. Apple juice seems to inhibit organic anion transporting polypeptide (OATP), which is involved in drug uptake in the gut, liver, and kidney. It is thought that apple juice might affect OATP for only a short time. Therefore, separating drug administration and consumption of apple juice by at least 4 hours might avoid this interaction.
Antidiabetes Drugs
Theoretically, consuming apple juice with antidiabetes drugs might interfere with blood glucose control.
Clinical research suggests that consuming apples or drinking apple juice can raise blood glucose levels, with the effects of drinking apple juice being more significant than consuming apples.
Antihypertensive Drugs
Consuming apple juice with antihypertensive drugs might interfere with blood pressure control.
Some clinical evidence suggests that consuming apple and cherry juice can increase blood pressure in elderly patients.
Atenolol (Tenormin)
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of atenolol.
Pharmacokinetic research shows that coadministration of apple juice 600-1200 mL decreases levels of atenolol by 58% to 82% in a dose-dependent manner. Apple juice seems to inhibit organic anion transporting polypeptide (OATP), which is involved in drug uptake in the gut, liver, and kidney. It is thought that apple juice might affect OATP for only a short time. Therefore, separating drug administration and consumption of apple juice by at least 4 hours might avoid this interaction.
Fexofenadine (Allegra)
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of fexofenadine.
Pharmacokinetic research shows that coadministration of apple juice 400-1200 mL along with fexofenadine 60-120 mg decreases bioavailability of fexofenadine by up to 78%. Coadministration with smaller quantities of apple juice (150 mL or less) does not appear to affect the bioavailability of fexofenadine. Apple juice seems to inhibit organic anion transporting polypeptide (OATP), which is involved in drug uptake in the gut, liver, and kidney. It is thought that apple juice might affect OATP for only a short time. Therefore, separating drug administration and consumption of apple juice by at least 4 hours might avoid this interaction.
Lithium
There is some concern that concomitant consumption of apple juice might decrease oral absorption and blood levels of lithium.
In one case report, a patient had an undetectable serum lithium level when lithium citrate was administered with apple juice. When lithium was administered with an alternative beverage, the lithium level became detectable and the patient demonstrated clinical improvement.
Senna
Digoxin (Lanoxin)
Theoretically, senna might increase the risk of adverse effects when taken with digoxin.
Overuse/abuse of senna increases the risk of adverse effects from cardiac glycosides, such as digoxin, due to potassium depletion.
Diuretic Drugs
Theoretically, senna might increase the risk of hypokalemia when taken with diuretic drugs.
Overuse of senna might compound diuretic-induced potassium loss and increase the risk for hypokalemia.
Estrogens
Theoretically, taking senna may interfere with the absorption of exogenous estrogens.
Some preliminary clinical evidence suggests that senna reduces the absorption of estradiol and decreases serum concentrations of estrone and estrone sulfate by decreasing intestinal transit time.
Stimulant Laxatives
Theoretically, senna might increase the risk for fluid and electrolyte loss when taken with other stimulant laxatives.
Senna is a stimulant laxative; concomitant use with other stimulant laxatives might compound fluid and electrolyte loss.
Warfarin (Coumadin)
Theoretically, excessive use of senna might increase the effects of warfarin.
Senna has stimulant laxative effects and can cause diarrhea. Diarrhea can increase the effects of warfarin, increase international normalized ratio (INR), and increase the risk of bleeding. In one case report, excessive use of senna for 3 weeks resulted in diarrhea, bloody stools, and an elevated INR of 11.9.
Brand information
Manufacturer and brand details for 4-Day Colon Cleanse, from the product label.
4-Day Colon Cleanse by HCG Platinum: Common Questions
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The Full Monographs Behind 4-Day Colon Cleanse’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Ginger
Interacts with 1,007 drugsGinger is a widely used culinary spice with a long history in traditional medicine, and it has the strongest evidence for helping with nausea and vomiting, including from motion sickness, pr...
Read the full Ginger monograph → Herb & supplement monographRhubarb
Interacts with 658 drugsRhubarb root has a long history of use as a laxative and in traditional Chinese medicine, and its edible stalks are a common food. Most medicinal claims are backed by limited or low-quality...
Read the full Rhubarb monograph → Herb & supplement monographSenna
Interacts with 140 drugsSenna is a plant-based stimulant laxative that is widely used and generally effective for short-term relief of constipation. It is best used occasionally and for only a few days at a time, s...
Read the full Senna monograph → Herb & supplement monographApple
Interacts with 300 drugsApples are a nutritious whole food that provides fiber, vitamins, and antioxidant plant compounds, and eating them regularly fits well into a healthy diet. While research suggests apples may...
Read the full Apple monograph →Sources & How We Checked
4-Day Colon Cleanse's label data comes from the NIH Dietary Supplement Label Database; the ingredient interaction data is from the Natural Medicines database, reviewed by our pharmacists.
- NIH Dietary Supplement Label Database (DSLD) — The official product label on file for this supplement.
- Natural Medicines (Therapeutic Research Center) — Evidence-graded clinical reference behind the ingredient interaction data.
Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.
The 142 references behind this product’s interaction data
Every citation that drives the interaction findings for this product’s ingredients, from the evidence-graded Natural Medicines (TRC Healthcare) database. Open an ingredient to browse its citations — links open the study on PubMed or the publisher’s site.
Ginger 64 references
- Fischer-Rasmussen W, Kjaer SK, Dahl C, Asping U. Ginger treatment of hyperemesis gravidarum. Eur J Obstet Gynecol Reprod Biol 1991;38:19-24. PubMed
- Jewell D, Young G. Interventions for nausea and vomiting in early pregnancy. Cochrane Database Syst Rev 2000;(2):CD000145. PubMed
- Vutyavanich T, Kraisarin T, Ruangsri R. Ginger for nausea and vomiting in pregnancy: randomized, double-masked, placebo-controlled trial. Obstet Gynecol 2001;97:577-82. DOI
- Backon J. Ginger in preventing nausea and vomiting of pregnancy; a caveat due to its thromboxane synthetase activity and effect on testosterone binding. Eur J Obstet Gynecol Reprod Biol 1991;42:163-4. PubMed
- Srivastava KC. Effect of onion and ginger consumption on platelet thromboxane production in humans. Prostaglandins Leukot Essent Fatty Acids 1989;35:183-5. PubMed
- Stewart JJ, Wood MJ, Wood CD, Mims ME. Effects of ginger on motion sickness susceptibility and gastric function. Pharmacology 1991;42:111-20. PubMed
- Smith C, Crowther C, Willson K, et al. A randomized controlled trial of ginger to treat nausea and vomiting in pregnancy. Obstet Gynecol 2004;103:639-45. PubMed
- Portnoi G, Chng LA, Karimi-Tabesh L, et al. Prospective comparative study of the safety and effectiveness of ginger for the treatment of nausea and vomiting in pregnancy. Am J Obstet Gynecol 2003;189:1374-7.. PubMed
- Wigler I, Grotto I, Caspi D, Yaron M. The effects of Zintona EC (a ginger extract) on symptomatic gonarthritis. Osteoarthritis Cartilage 2003;11:783-9. PubMed
- Ghayur MN, Gilani AH. Ginger lowers blood pressure through blockade of voltage-dependent calcium channels. J Cardiovasc Pharmacol 2005;45:74-80. PubMed
- Thomson M, Al-Qattan KK, Al-Sawan SM, et al. The use of ginger (Zingiber officinale Rosc.) as a potential anti-inflammatory and antithrombotic agent. Prostaglandins Leukot Essent Fatty Acids 2002;67:475-8. PubMed
- Kanerva L, Estlander T, Jolanki R. Occupational allergic contact dermatitis from spices. Contact Dermatitis 1996;35:157-62. PubMed
- Akhani SP, Vishwakarma SL, Goyal RK. Anti-diabetic activity of Zingiber officinale in streptozotocin-induced type I diabetic rats. J Pharm Pharmacol 2004;56:101-5.
- Kruth P, Brosi E, Fux R, et al. Ginger-associated overanticoagulation by phenprocoumon. Ann Pharmacother 2004;38:257-60. PubMed
- Jiang X, Williams KM, Liauw WS, et al. Effect of ginkgo and ginger on the pharmacokinetics and pharmacodynamics of warfarin in healthy subjects. Br J Clin Pharmacol 2005;59:425-32. PubMed
- Borrelli F, Capasso R, Aviello G, et al. Effectiveness and safety of ginger in the treatment of pregnancy-induced nausea and vomiting. Obstet Gynecol 2005;105:849-56. PubMed
- Smith C, Crowther C, Wilson K et al. A randomized controlled trial of ginger to treat nausea and vomiting in pregnancy. Obstet Gynecol 2004;103:639-45. PubMed
- Jiang X, Blair EY, McLachlan AJ. Investigation of the effects of herbal medicines on warfarin response in healthy subjects: a population pharmacokinetic-pharmacodynamic modeling approach. J Clin Pharmacol 2006;46:1370-8. PubMed
- Chittumma P, Kaewkiattikun K, Wiriyasiriwach B. Comparison of the effectiveness of ginger and vitamin B6 for treatment of nausea and vomiting in early pregnancy: a randomized double-blind controlled trial. J Med Assoc Thai 2007;90:15-20.
- Ozgoli G, Goli M, Moattar F. Comparison of effects of ginger, mefenamic acid, and ibuprofen on pain in women with primary dysmenorrhea. J Altern Complement Med 2009;15:129-32. PubMed
- Black CD, Herring MP, Hurley DJ, O'Connor PJ. Ginger (Zingiber officinale) reduces muscle pain caused by eccentric exercise. J Pain 2010;11:894-903. PubMed
- Heitmann K, Nordeng H, Holst L. Safety of ginger use in pregnancy: results from a large population-based cohort study. Eur J Clin Pharmacol 2012 Jun 17. PubMed
- Ryan JL, Heckler CE, Roscoe JA, et al. Ginger (Zingiber officinale) reduces acute chemotherapy-induced nausea: a URCC CCOP study of 576 patients. Support Care Cancer. 2012;20:1479-89. PubMed
- Backon J. Ginger as an antiemetic: possible side effects due to its thromboxane synthetase activity. Anaesthesia. 1991;46(8):705-6.. PubMed
- Abebe W. Herbal medication: potential for adverse interactions with analgesic drugs. J Clin Pharm Ther. 2002;27:391-401. PubMed
- Argento A, Tiraferri E, Marzaloni M. [Oral anticoagulants and medicinal plants. An emerging interaction]. Ann Ital Med Int. 2000;15:139-43.
- Young HY, Liao JC, Chang YS, et al. Synergistic effect of ginger and nifedipine on human platelet aggregation: a study in hypertensive patients and normal volunteers. Am J Chin Med. 2006;34:545-51. PubMed
- Greenway FL, Liu Z, Martin CK, et al. Safety and efficacy of NT, an herbal supplement, in treating human obesity. Int J Obes (Lond). 2006;30:1737-41. PubMed
- Shalansky S, Lynd L, Richardson K, et al. Risk of warfarin-related bleeding events and supratherapeutic international normalized ratios associated with complementary and alternative medicine: a longitudinal analysis. Pharmacotherapy. 2007;27:1237-47. PubMed
- Lesho EP, Saullo L, Udvari-Nagy S. A 76-year-old woman with erratic anticoagulation. Cleve Clin J Med. 2004;71:651-6. PubMed
- Okonta JM, Uboh M, Obonga WO. Herb-Drug Interaction: A Case Study of Effect of Ginger on the Pharmacokinetic of Metronidazole in Rabbit. Indian Journal of Pharmaceutical Sciences (India) 2008;70(230):232. PubMed
- Chiang HM, Chao PD, Hsiu SL, et al. Ginger significantly decreased the oral bioavailability of cyclosporine in rats. Am J Chin Med. 2006;34:845-55. PubMed
- Bhandari U, Kanojia R, Pillai KK. Effect of ethanolic extract of Zingiber officinale on dyslipidaemia in diabetic rats. J Ethnopharmacol. 2005;97:227-30. PubMed
- Ojewole JA. Analgesic, antiinflammatory and hypoglycaemic effects of ethanol extract of Zingiber officinale (Roscoe) rhizomes (Zingiberaceae) in mice and rats. Phytother Res. 2006;20:764-72.
- Al-Amin ZM, Thomson M, Al-Qattan KK, et al. Anti-diabetic and hypolipidaemic properties of ginger (Zingiber officinale) in streptozotocin-induced diabetic rats. Br J Nutr. 2006;96:660-6.
- Islam MS, Choi H. Comparative effects of dietary ginger (Zingiber officinale) and garlic (Allium sativum) investigated in a type 2 diabetes model of rats. J Med Food. 2008;11:152-9.
- Cady RK, Goldstein J, Nett R, et al. A double-blind placebo-controlled pilot study of sublingual feverfew and ginger (LipiGesic M) in the treatment of migraine. Headache 2011;51:1078-86.
- Futrell, J. M. and Rietschel, R. L. Spice allergy evaluated by results of patch tests. Cutis 1993;52(5):288-290.
- Sripramote, M. and Lekhyananda, N. A randomized comparison of ginger and vitamin B6 in the treatment of nausea and vomiting of pregnancy. J Med Assoc.Thai. 2003;86(9):846-853.
- Lohsiriwat, S., Rukkiat, M., Chaikomin, R., and Leelakusolvong, S. Effect of ginger on lower esophageal sphincter pressure. J.Med.Assoc.Thai. 2010;93(3):366-372.
- Liu, P. H. and Ho, H. L. Ginger and drug bezoar induced small bowel obstruction. J R.Coll.Surg.Edinb. 1983;28(6):397-398.
- Maghbooli M, Golipour F, Moghimi Esfandabadi A, Yousefi M. Comparison between the efficacy of ginger and sumatriptan in the ablative treatment of the common migraine. Phytother Res 2014;28(3):412-5. PubMed
- Mahluji S, Attari VE, Mobasseri M, Payahoo L, Ostadrahimi A, Golzari SE. Effects of ginger (Zingiber officinale) on plasma glucose level, HbA1c and insulin sensitivity in type 2 diabetic patients. Int J Food Sci Nutr 2013;64(6):682-6.
- Mozaffari-Khosravi H, Talaei B, Jalali BA, Najarzadeh A, Mozayan MR. The effect of ginger powder supplementation on insulin resistance and glycemic indices in patients with type 2 diabetes: a randomized, double-blind, placebo-controlled trial. Complement PubMed
- Paramdeep G. Efficacy and tolerability of ginger (Zingiber officinale) in patients of osteoarthritis of knee. Indian J Physiol Pharmacol 2013;57(2):177-83.
- Rahnama P, Montazeri A, Huseini HF, Kianbakht S, Naseri M. Effect of Zingiber officinale R. rhizomes (ginger) on pain relief in primary dysmenorrhea: a placebo randomized trial. BMC Complement Altern Med 2012;12:92. PubMed
- Viljoen E, Visser J, Koen N, Musekiwa A. A systematic review and meta-analysis of the effect and safety of ginger in the treatment of pregnancy-associated nausea and vomiting. Nutr J 2014;13:20. PubMed
- Bartels EM, Folmer VN, Bliddal H, et al. Efficacy and safety of ginger in osteoarthritis patients: a meta-analysis of randomized placebo-controlled trials. Osteoarthritis Cartilage. 2015;23(1):13-21. PubMed
- Choi JS, Han JY, Ahn HK, et al. Assessment of fetal and neonatal outcomes in the offspring of women who had been treated with dried ginger (Zingiberis rhizoma siccus) for a variety of illnesses during pregnancy. J Obstet Gynaecol. 2015;35(2):125-30.
- Marx W, McKavanagh D, McCarthy AL, Bird R, Ried K, Chan A, Isenring L. The effect of ginger (Zingiber officinale) on platelet aggregation: A systematic literature review. PLoS One. 2015;10(10):e0141119. PubMed
- Crichton M, Marshall S, Marx W, McCarthy AL, Isenring E. Efficacy of ginger (Zingiber officinale) in ameliorating chemotherapy-induced nausea and vomiting and chemotherapy-related outcomes: A systematic review update and meta-analysis. J Acad Nutr Diet. 2 PubMed
- Martins LB, Rodrigues AMDS, Monteze NM, et al. Double-blind placebo-controlled randomized clinical trial of ginger (Zingiber officinale Rosc.) in the prophylactic treatment of migraine. Cephalalgia. 2020;40(1):88-95.
- Martins LB, Rodrigues AMDS, Rodrigues DF, Dos Santos LC, Teixeira AL, Ferreira AVM. Double-blind placebo-controlled randomized clinical trial of ginger (Zingiber officinale Rosc.) addition in migraine acute treatment. Cephalalgia. 2019;39(1):68-76.
- Ahad A, Raish M, Bin Jardan YA, Alam MA, Al-Mohizea AM, Al-Jenoobi FI. Effect of Hibiscus sabdariffa and Zingiber officinale on the antihypertensive activity and pharmacokinetic of losartan in hypertensive rats. Xenobiotica. 2020:1-11.
- Okuhira H, Nakatani Y, Furukawa F, Kanazawa N. Anaphylaxis to ginger induced by herbal medicine. Allergol Int. 2020;69(1):159-160. PubMed
- Yamprasert R, Chanvimalueng W, Mukkasombut N, Itharat A. Ginger extract versus Loratadine in the treatment of allergic rhinitis: a randomized controlled trial. BMC Complement Med Ther. 2020;20(1):116. PubMed
- Ebrahimzadeh A, Ebrahimzadeh A, Mirghazanfari SM, Hazrati E, Hadi S, Milajerdi A. The effect of ginger supplementation on metabolic profiles in patients with type 2 diabetes mellitus: a systematic review and meta-analysis of randomized controlled trials. PubMed
- Alam MA, Bin Jardan YA, Alzenaidy B, et al. Effect of Hibiscus sabdariffa and Zingiber officinale on pharmacokinetics and pharmacodynamics of amlodipine. J Pharm Pharmacol 2021;73(9):1151-60.
- Akbarzadeh E, Heydari M, Atarzadeh F, Jaladat AM. Chronic dysuria following ginger (Zingiber officinale) use: a case report. Galen Med J 2018;7:e1086. DOI
- Haron MH, Dale O, Martin K, et al. Evaluation of the Herb-Drug Interaction Potential of Commonly Used Botanicals on the US Market with Regard to PXR- and AhR-Mediated Influences on CYP3A4 and CYP1A2. J Diet Suppl 2022. PubMed
- Rostamkhani H, Veisi P, Niknafs B, Jafarabadi MA, Ghoreishi Z. The effect of zingiber officinale on prooxidant-antioxidant balance and glycemic control in diabetic patients with ESRD undergoing hemodialysis: a double-blind randomized control trial. BMC Co PubMed
- Husain I, Dale OR, Idrisi M, et al. Evaluation of the Herb-Drug Interaction (HDI) Potential of Zingiber officinale and Its Major Phytoconstituents. J Agric Food Chem. 2023;71(19):7521-7534.
- Committee on Practice Bulletins-Obstetrics. ACOG Practice Bulletin No. 189: Nausea And Vomiting Of Pregnancy. Obstet Gynecol. 2018;131(1):e15-e30. PubMed
- Pochet S, Lechon AS, Lescrainier C, et al. Herb-anticancer drug interactions in real life based on VigiBase, the WHO global database. Sci Rep 2022;12(1):14178. PubMed
Rhubarb 20 references
- Blumenthal M, ed. The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. Trans. S. Klein. Boston, MA: American Botanical Council, 1998.
- McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
- Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.
- Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
- Nusko G, Schneider B, Schneider I, et al. Anthranoid laxative use is not a risk factor for colorectal neoplasia: results of a prospective case control study. Gut 2000;46:651-5. PubMed
- Kwan TH, Tong MK, Leung KT, et al. Acute renal failure associated with prolonged intake of slimming pills containing anthraquinones. Hong Kong Med J 2006;12:394-7.
- Fairbairn JW. The anthraquinone laxatives. Biological assay and its relation to chemical structure. Pharmacology 1976;14:48-61. PubMed
- Siegers, C. P., Hertzberg-Lottin, E., Otte, M., and Schneider, B. Anthranoid laxative abuse--a risk for colorectal cancer? Gut 1993;34(8):1099-1101. PubMed
- Fan, J. G. Evaluating the efficacy and safety of Danning Pian in the short-term treatment of patients with non-alcoholic fatty liver disease: a multicenter clinical trial. Hepatobiliary.Pancreat.Dis.Int 2004;3(3):375-380.
- Yan, M., Zhang, L. Y., Sun, L. X., Jiang, Z. Z., and Xiao, X. H. Nephrotoxicity study of total rhubarb anthraquinones on Sprague Dawley rats using DNA microarrays. J Ethnopharmacol. 4-15-2006; PubMed
- Zhang, J. H., Li, L. S., and Zhang, M. Clinical effects of rheum and captopril on preventing progression of chronic renal failure. Chin Med J (Engl.) 1990;103(10):788-793.
- Mitsuma, T., Yokozawa, T., Oura, H., and Terasawa, K. [Rhubarb therapy in patients with chronic renal failure (Part 2)]. Nippon Jinzo Gakkai Shi 1987;29(2):195-207.
- Wu, C. X. [A preliminary study on the effect of a single Rheum officinale in heavy doses in the treatment of acute icteric hepatitis]. Zhong.Xi.Yi.Jie.He.Za Zhi.(Chinese Journal of Modern Developments in Traditional Medicine) 1984;4(2):88-89.
- Jiao, D. H. [Clinical research on the hemostatic effect of rhubarb on peptic ulcer with acute bleeding]. Zhong.Xi.Yi.Jie.He.Za Zhi.(Chinese Journal of Modern Developments in Traditional Medicine) 1984;4(10):597-600, 579.
- Jiao, D. H., Ma, Y. H., Chen, S. J., Liu, C. T., Shu, H. N., and Chu, C. M. Resume of 400 cases of acute upper digestive tract bleeding treated by rhubarb alone. Pharmacology 1980;20 Suppl 1:128-130.
- Zhang, JH, Yao, XD, Song, Y, and et al. [Long-term treating effects of rhubarb and captopril in delaying the progression of renal failure]. Chinese Kidney Disease Journal 1993;9(4):197-201.
- Rehman H, Begum W, Anjum F, Tabasum H, Zahid S. Effect of rhubarb (Rheum emodi) in primary dysmenorrhoea: a single-blind randomized controlled trial. J Complement Integr Med. 2015 Mar;12(1):61-9.
- Yu CP, Lin HJ, Lin SP, Shia CS, Chang PH, Hou YC, Hsieh YW. Rhubarb decreased the systemic exposure of cyclosporine, a probe substrate of P-glycoprotein and CYP 3A. Xenobiotica. 2016 Aug;46(8):677-82. PubMed
- Byeon JH, Kil JH, Ahn YC, Son CG. Systematic review of published data on herb induced liver injury. J Ethnopharmacol 2019;233:190-6. PubMed
- Zhao D, Feng SX, Zhang HJ, et al. Pharmacokinetics, tissue distribution and excretion of five rhubarb anthraquinones in rats after oral administration of effective fraction of anthraquinones from rheum officinale. Xenobiotica. 2021;51(8):916-925. PubMed
Senna 42 references
- McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
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DISCLAIMER: Currently this does not check for drug-drug 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 judgment is necessary.
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