Interactions on record — worth a quick check against your medications. Based on 8 of 10 ingredients. Check your meds →
Dietary supplement

5-Day Liquid Cleanse & Flush Ingredients & Drug Interactions

by Applied Nutrition

Liquid Category: Other Combinations
Most serious interaction: Moderate
The interaction bottom line Most serious interaction: Moderate

5-Day Liquid Cleanse & Flush is a dietary supplement by Applied Nutrition with 10 active ingredients. Its ingredients are commonly taken for replacing fluids and electrolytes, preventing dehydration during exercise or illness, treating low blood sodium (under medical care).Based on those ingredients, 1,251 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Pomegranate juice concentrate, Fennel extract, Cranberry (Vaccinium macrocarpon) juice concentrate. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

HelloPharmacist Scorecard of 5-Day Liquid Cleanse & Flush by Applied Nutrition

Our pharmacy team’s full take, with four database checks built into the cards below — a summary of what is known, not a grade of the product itself.

From our pharmacy team — supplement deep dive

What’s inside

Low disclosure
Ingredient Transparency · database check
Low

Most active ingredients don't disclose an individual amount — you can't tell how much of each you're getting.

Why this rating?
  • The label discloses an exact amount for 1 of its 9 active ingredients.
  • “Cleansing Blend” is a proprietary blend — the label gives one combined amount (70 mg) without saying how much of each component you get.
  • “Antioxidant & Replenishment Blend” is a proprietary blend — the label gives one combined amount (100 mg) without saying how much of each component you get.
  • “Soothing Extract” is listed as a grouped ingredient — the label gives one combined amount (30 mg) without saying how much of each component you get.

This 9-ingredient liquid cleanse contains sodium as an electrolyte, along with fruit juice concentrates (blueberry, cranberry, noni, pomegranate, and plum) in two named blends—a Cleansing Blend and an Antioxidant & Replenishment Blend. You'll also find fennel extract, burdock extract, and a Soothing Extract (listed as a blend).

Cascarosides (a natural laxative compound) round out the actives. The product is completed with inactive ingredients including water, fructose, citric acid, natural flavors, salt, sucralose, and Red 40 colorant.

Does it work?

Strong evidence
Evidence for Intended Use · database check
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

This product doesn't appear to be marketed for a specific use, so we graded its ingredients' overall clinical evidence instead.

Strong

Strong clinical evidence supports its ingredients for:

Why this rating?
  • We looked at the product name, claims, and label statements and couldn't find a stated purpose to grade.
  • Since the label doesn't commit to one use, we graded the ingredients' overall clinical evidence instead.
  • On file: Cystic fibrosis — rated "Likely Effective" (Sodium) (Natural Medicines).
  • On file: Constipation — rated "Possibly Effective" (Plum) (Natural Medicines).
  • On file: Hypertension — rated "Possibly Effective" (Pomegranate) (Natural Medicines).
  • On file: Urinary tract infections (UTIs) — rated "Possibly Effective" (Cranberry) (Natural Medicines).
  • On file: Dysmenorrhea — rated "Possibly Effective" (Fennel) (Natural Medicines).

The evidence for most ingredients in this cleanse is limited or absent from our data. Sodium is likely effective for cystic fibrosis and possibly effective for amphotericin B-related kidney damage—but those are medical uses, not cleansing.

Cranberry is possibly effective for urinary tract infections, and pomegranate is possibly effective for high blood pressure. Blueberry, noni, fennel, plum, and burdock either show insufficient evidence for their intended cleansing purposes or lack established effectiveness ratings in our data.

A 'cleanse' or 'flush' product isn't a standard medical category with proven benefit.

The evidence, ingredient by ingredient Sodium Burdock Blueberry Cranberry Noni Pomegranate Plum Fennel

How safe is it?

Well-documented data
Safety Information · database check
Well characterized

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 8 of the 8 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 8 of 8.
  • General safety write-ups exist for 8 of 8.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

Sodium is essential in small amounts, but excess intake is linked to high blood pressure and heart strain—avoid sodium supplements or very high intake without medical advice. Blueberry is generally well tolerated as food; freeze-dried versions may cause constipation, diarrhea, nausea, or vomiting; one trial showed 26% of participants dropped out in the first week due to gastrointestinal complaints.

Cranberry, noni, pomegranate, and plum are each generally well tolerated but may cause mild gastrointestinal effects like diarrhea, nausea, or abdominal discomfort, especially in larger doses. Noni carries a rare risk of liver injury; burdock's safety data are limited and it rarely causes allergic reactions.

Fennel is generally safe as food but concentrated amounts lack safety data.

Side effects, ingredient by ingredient Sodium Burdock Blueberry Cranberry Noni Pomegranate Plum Fennel

Meds to double-check

Moderate interaction found
Known Interaction Concern · database check
Moderate identified

The most serious documented interaction for these ingredients is Moderate. Check your medications for a personalized result.

Why this rating?
  • 8 of the 8 matched ingredients can interact with medications — Burdock, Fennel, Pomegranate, Noni, Cranberry, among others.
  • The most serious interaction on file is rated Moderate.
  • Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs; diabetes medications; lithium.
  • For scale: 1,252 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.

Moderate interactions exist with blood thinners (warfarin, anticoagulants, antiplatelets), blood pressure medications (antihypertensives, ACE inhibitors, ARBs), statins and other cholesterol drugs (CYP3A4 substrates), lithium, and antidiabetes drugs. Minor interactions affect buspirone, flurbiprofen, and drugs broken down by CYP2D6 and CYP2C9 enzymes.

Ask your pharmacist to run your medications through the interaction checker on this page.

Check your own medication Run your meds through the checker above

The bottom line

Scorecard at a glanceFormula with limited ingredient disclosure with strong clinical evidence behind its ingredients' uses. Moderate medication interactions have been identified, and safety information is well characterized.

If you take any medication—especially blood pressure drugs, blood thinners, statins, or antidiabetes medications—check this product against your specific prescriptions before starting. The high sodium content alone may interfere with blood pressure control.

Gastrointestinal side effects are common with multiple ingredients here. Talk to your pharmacist or doctor about whether a cleanse product is right for you and whether this one fits your health picture.

Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI

Assessment coverage: 8 of 9 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Sep 22, 2016.

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

At a glance

General information

Key facts about 5-Day Liquid Cleanse & Flush, straight from the product label.

Brand Applied Nutrition
Barcode (UPC) 710363573935
Net contents 10 Liquid Tube; 100 mL; 3.35 fl. Oz.
Market status On market
Date entered into DSLD Sep 22, 2016
DSLD ID 64568
Product type Other Combinations
Supplement form Liquid
Dietary claims / uses All Other, Structure/Function
Intended target group(s) Adult (18 - 50 Years)
From the label
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 5-Day Liquid Cleanse & Flush by Applied Nutrition, sourced from the NIH Dietary Supplement Label Database.

Supplement Facts

Daily Value (DV) Target Group(s):
Adults and children 4 or more years of age
Minimum serving Sizes:
10 mL
Maximum serving Sizes:
10 mL
Servings per container
10
UPC/BARCODE
710363573935
IngredientAmount% DV
Calories20 Calorie(s)--
Total Carbohydrates5 Gram(s)2%
Sugar4 Gram(s)--
Sodium95 mg4%
Cleansing Blend70 mg--
Antioxidant & Replenishment Blend100 mg--
Blueberry (Vaccinium angustifolium) juice concentrate0 NP--
Cranberry (Vaccinium macrocarpon) juice concentrate0 NP--
Noni extract0 NP--
Pomegranate juice concentrate0 NP--
Plum (Prune) juice concentrate0 NP--
Cascarosides0 NP--
Burdock (Artium lappa) extract0 NP--
Soothing Extract30 mg--
Fennel extract0 NP--

Other ingredients: filtered Water, Crystalline Fructose, Citric Acid, Natural flavors, Salt, Sucralose, Red 40

Tap any ingredient to jump to its full detail below.

Label statements
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.
General Statements

Mixed berry flavored concentrated drink mix.

Today's modern lifestyle can take a toll on your body. Stress, environmental toxins and a fast-food diet can slow down your digestive tract and leave you feeling bloated, gassy and sluggish.

Specially formulated for first-time cleansers and individuals seeking quick results, this product flushes away toxins and waste from your colon, while hydrating the body and delivering powerful Superfruit phytonutrients.

Superfruit Phytonutrients ORAC (Oxygen Radical Absorbance Capacity) is a test developed by the USDA to measure the antioxidant activity of foods. Superfruits have one of the highest ORAC values of any known food.

Easy All-Liquid Total Body Cleanse: Less bloating, flatter abdomen, feel energized & feel clean inside...in just 5 days! Fast-Acting mixed berry flavor Concentrated drink mix

Antioxidant & Replenishment Blend Our exclusive blend of Superfruits delivers a wide range of powerful phytonutrients and cell-protecting compounds. Cleansing Blend Cascara Sagrada promotes natural elimination and gently cleanses your digestive system. Soothing extract Fennel is traditionally used to calm and comfort the digestive system, as well as support overall health.

Suggested/Recommended/Usage/Directions

Just shake vial, twist to open, pour into water and shake or stir!

Directions: (Adult) Shake well then twist tab on top of Liquid-tube until it breaks off. Pour concentrated liquid into 16 oz. of water and shake or stir. Do not consume liquid directly from the Liquid-Tube. Drink-one (1) Liquid Cleanse & Flush drink in the morning with breakfast and another in the evening before dinner. If stools are loose, reduce to one (1) Liquid-Tube per day.

Taking a break of 30 or more days between use cycles will help maintain natural regularity. Not intended for long-term use.

Just break open the convenient twist tube, then add 5-Day liquid cleanse & flush to at least 16 ounces of water and enjoy the delicious mixed berry flavor while you flush away unwanted waste and toxins to help you look trimmer and feel better!

Mixed Berry flavored concentrated drink mix. Just shake vial, twist to open, pour into water and shake or stir!

Formula

Contains <1% fruit juice

Powerful Superfruit Phytonutrients from Concentrates of Pomegranate Prune Cranberry Blueberry Noni

Precautions

Usage Warning: Do not use if safety seal is broken.

Check with your doctor before using this product if you are using medication, including diuretics, heart medications and corticosteroids, or have any medical conditions.

Do not use if you have an intestinal obstruction, hemorrhoids or other intestinal disorder.

Do not use if you are taking any other product concurrently that has laxative effects. Do not use if you may become pregnant, are pregnant or nursing.

Do not exceed recommended daily intake.

Not intended for use by persons under 18. Keep out of reach of children.

Note: This product is not intended to be used without breaks. Cascara Sagrada belongs to a family of plants containing compounds with laxative effects. Can lead to dehydration and electrolyte loss. With long-term use without breaks, this ingredient may interfere with diagnostic imaging procedures of the colon.

Notice: This product contains Cascara Sagrada. Read and follow the directions carefully. Do not use if you have or develop diarrhea, loose stools, or abdominal pain because Cascara Sagrada may worsen these conditions and be harmful to your health.

Consult your physician if you have frequent diarrhea or if you are pregnant, nursing, taking medication, or have a medical condition.

Storage

Store in a cool, dry place.

FDA Disclaimer Statement

These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.

Brand IP Statement(s)

5-Day Liquid Cleanse & Flush gives you a quick and effective way to cleanse your digestive system.

5-Day Liquid Cleanse & Flush is designed to leave you feeling lighter, slimmer and more energetic in just 5 days.

Applied Nutrition is committed to developing science-based products that exceed the highest standards for quality and purity. As a leader in innovation, we continuously strive to bring forward new ideas and groundbreaking formulas that enhance health and well-being. To view our entire line of products, please visit us online at: www.AppliedNutrition.com

5-Day Liquid Cleanse & Flush

FDA Statement of Identity

Dietary Supplement

General

4187-BOX-08/14 ANO77393 Ver. 05

See for yourself

5-Day Liquid Cleanse & Flush by Applied Nutrition label

The label scan from the NIH Dietary Supplement Label Database. Tap to enlarge.

What’s inside

The Ingredients in 5-Day Liquid Cleanse & Flush by Applied Nutrition

These are the 10 active ingredients this product is made of. Select any to open its full monograph.

Serving size10 mL Dosage formLiquid Servings per container10 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.

Sugar

4 Gram(s) per serving

Sodium

Interacts with
205 drugs
95 mg per serving

Sodium is an essential mineral and electrolyte your body needs to balance fluids, support nerves, and help muscles work. Most people in modern diets g...

Sodium monograph & interactions

Cleansing Blend

70 mg per serving

Soothing Extract

30 mg per serving

Other (inactive) ingredients: Filtered Water, Crystalline Fructose, Citric Acid, Natural flavors, Salt, Sucralose, Red 40. These complete the product’s ingredient list but are not active constituents.

Interaction report

5-Day Liquid Cleanse & Flush by Applied Nutrition Drug Interactions

Want to check YOUR meds against 5-Day Liquid Cleanse & Flush?

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 checker
1,251Drugs
1,167 Moderate 84 Minor

Each ingredient & the kinds of drugs it affects

For each ingredient in 5-Day Liquid Cleanse & Flush 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.

Pomegranate juice concentrate9 drug types · 922 drugs

Ace Inhibitors (Aceis)

Theoretically, taking pomegranate with ACEIs might increase the risk of adverse effects.
Pomegranate juice is thought to have ACE inhibitor-like effects.

Likelihood Possible Evidence B
Antihypertensive Drugs

Theoretically, taking pomegranate with antihypertensive drugs might increase the risk of hypotension.
Consuming pomegranate juice can modestly lower blood pressure.

Likelihood Possible Evidence B
Cytochrome P450 2D6 (Cyp2D6) Substrates

Theoretically, pomegranate might increase levels of drugs metabolized by CYP2D6.
In vitro, pomegranate juice inhibits CYP2D6. However, the clinical significance of this potential interaction in humans is not known.

Likelihood Possible Evidence D
Rosuvastatin (Crestor)

Theoretically, taking pomegranate with rosuvastatin might increase the risk of adverse effects.
In one case, a patient taking rosuvastatin 5 mg every other day in combination with ezetimibe 10 mg daily developed rhabdomyolysis after drinking pomegranate juice 200 mL twice weekly for 3 weeks. This patient had a history of elevated creatine kinase levels while not receiving any statin treatment. This suggests a possible underlying myopathy and predisposition to rhabdomyolysis.

Likelihood Possible Evidence D
Warfarin (Coumadin)

Theoretically, pomegranate might increase warfarin levels and increase the risk of bleeding. Also, discontinuing regular consumption of pomegranate juice might decrease warfarin levels.
In one case report, a patient had a stable, therapeutic bleeding time, as measured by international normalized ratio (INR), while taking warfarin in combination with pomegranate juice 2-3 times per week. The patient became subtherapeutic within about 10 days after discontinuing pomegranate juice, which required a warfarin dose increase. In another case report, a patient with a stable INR for over one year presented with an INR of 14. The patient noted no changes to medications or diet but did report consuming around 3 liters of pomegranate juice over the previous week. The patient's INR stabilized upon moderation of pomegranate juice consumption. The mechanism of this potential interaction is unclear.

Likelihood Possible Evidence D
Carbamazepine (Tegretol)

Theoretically, taking pomegranate with carbamazepine might increase the risk of adverse effects, although research suggests this interaction is unlikely to be clinically significant.
Animal research shows that pomegranate juice may inhibit cytochrome P450 3A4 (CYP3A4) metabolism of carbamazepine and increase levels of carbamazepine by 1.5 times without prolonging the elimination half-life. This suggests that pomegranate juice inhibits intestinal CYP3A4, but might not inhibit hepatic CYP3A4. However, some human research suggests that pomegranate does not significantly inhibit CYP3A4 drug metabolism in humans.

Likelihood Unlikely Evidence D
Cytochrome P450 2C9 (Cyp2C9) Substrates

Theoretically, pomegranate might increase levels of drugs metabolized by CYP2C9.
Some animal and in vitro research shows that pomegranate juice inhibits intestinal, but not hepatic, CYP2C9 isoenzyme activity. However, clinical research shows that neither pomegranate juice nor pomegranate extract have a significant effect on CYP2C9 activity in humans.

Likelihood Unlikely Evidence B
Cytochrome P450 3A4 (Cyp3A4) Substrates

Theoretically, pomegranate might increase levels of drugs metabolized by CYP3A4, but most research suggests this interaction is unlikely to be clinically significant.
Pomegranate contains several polyphenols that have individually been shown to inhibit CYP3A4. However, there is contradictory evidence about the effect of whole pomegranate juice on CYP3A4 activity. In vitro, pomegranate juice significantly inhibits the CYP3A4 enzyme, with comparable inhibition to grapefruit juice. In an animal model, pomegranate juice inhibits CYP3A4 metabolism of carbamazepine and increases levels of carbamazepine by 1.5 times; however, in human volunteers, drinking a single glass of pomegranate juice 240 mL or taking 200 mL daily for 2 weeks does not significantly affect levels of the CYP3A4 substrate midazolam after oral or intravenous administration. Another study in healthy volunteers shows that consuming pomegranate juice 300 mL three times daily for three days also does not significantly affect levels of simvastatin, a CYP3A4 substrate This suggests that pomegranate is unlikely to significantly affect levels of CYP3A4 substrates in humans.

Likelihood Unlikely Evidence B
Tolbutamide (Orinase)

Theoretically, pomegranate might increase levels of tolbutamide, although research suggests this interaction is unlikely to be clinically significant.
Animal research shows that pomegranate juice inhibits the cytochrome P450 2C9 (CYP2C9) metabolism of tolbutamide. Pomegranate juice increased tolbutamide levels by 1.2 times without prolonging the elimination half-life. This suggests that pomegranate juice inhibits intestinal CYP2C9, but might not inhibit hepatic CYP2C9. Despite this evidence, clinical research shows that neither pomegranate juice nor pomegranate extract have a significant effect on CYP2C9 activity in humans. This interaction does not appear to be clinically significant in humans.

Likelihood Unlikely Evidence D

Fennel extract6 drug types · 740 drugs

Anticoagulant/Antiplatelet Drugs

Theoretically, fennel might increase the risk of bleeding when used with antiplatelet or anticoagulant drugs.

Animal research suggests that fennel oil has antithrombotic and antiplatelet effects.

Likelihood Possible Evidence D
Ciprofloxacin (Cipro)

Theoretically, fennel might decrease the levels and clinical effects of ciprofloxacin.

Animal research shows that fennel reduces ciprofloxacin bioavailability by nearly 50%, possibly due to the metal cations such as calcium, iron, and magnesium contained in fennel. This study also found that fennel increased tissue distribution and slowed elimination of ciprofloxacin.

Likelihood Probable Evidence D
Contraceptive Drugs

Theoretically, taking large amounts of fennel might decrease the effects of contraceptive drugs due to competition for estrogen receptors.

Some constituents of fennel have estrogenic activity.

Likelihood Possible Evidence D
Cytochrome P450 3A4 (Cyp3A4) Substrates

Theoretically, fennel might increase levels of drugs metabolized by CYP3A4.

In vitro research suggests that fennel inhibits CYP3A4 enzyme activity. This effect has not been reported in humans.

Likelihood Possible Evidence D
Estrogens

Theoretically, taking large amounts of fennel might interfere with hormone replacement therapy due to competition for estrogen receptors.

Some constituents of fennel have estrogenic activity.

Likelihood Possible Evidence D
Tamoxifen (Nolvadex)

Theoretically, taking large amounts of fennel might decrease the antiestrogenic effect of tamoxifen.

Some constituents of fennel have estrogenic activity, which may interfere with the antiestrogenic activity of tamoxifen.

Likelihood Possible Evidence D

Cranberry (Vaccinium macrocarpon) juice concentrate6 drug types · 712 drugs

Atorvastatin (Lipitor)

Theoretically, cranberry might increase levels and adverse effects of atorvastatin.
In one case report, a patient taking atorvastatin experienced upper back pain, rhabdomyolysis, and abnormal liver function after drinking cranberry juice 16 ounces daily for 2 weeks. Theoretically, this may have been caused by inhibition of cytochrome P450 3A4 (CYP3A4) enzymes by cranberry juice, as atorvastatin is a CYP3A4 substrate. Creatinine kinase and liver enzymes normalized within 2 weeks of stopping cranberry juice. Patients taking atorvastatin should avoid large quantities of cranberry juice.

Likelihood Possible Evidence D
Cytochrome P450 3A4 (Cyp3A4) Substrates

Theoretically, cranberry might increase the levels and adverse effects of CYP3A4 substrates.
A case of upper back pain, rhabdomyolysis, and abnormal liver function has been reported for a patient taking atorvastatin, a CYP3A4 substrate, in combination with cranberry juice 16 ounces daily for 2 weeks. Creatinine kinase and liver enzymes normalized within 2 weeks of stopping cranberry juice. Also, animal research suggests that cranberry juice, administered intraduodenally 30 minutes prior to nifedipine, a CYP3A4 substrate, inhibits nifedipine metabolism and increases the area under the concentration-time curve by 1.6-fold compared to control.

Likelihood Possible Evidence D
Nifedipine (Procardia)

Theoretically, cranberry might increase the levels and adverse effects of nifedipine.
Animal research suggests that cranberry juice, administered intraduodenally 30 minutes prior to nifedipine treatment, inhibits nifedipine metabolism and increases the area under the concentration-time curve by 1.6-fold compared to control. This interaction has not been reported in humans.

Likelihood Possible Evidence D
Warfarin (Coumadin)

Theoretically, cranberry might increase the levels and adverse effects of warfarin. However, research is conflicting.
There is contradictory evidence about the effect of cranberry juice on warfarin. Case reports have linked cranberry juice consumption to increases in the international normalized ratio (INR) in patients taking warfarin, resulting in severe spontaneous bleeding and excessive postoperative bleeding. Daily consumption of cranberry sauce for one week has also been linked to an increase in INR in one case report. In a small study in healthy young males, taking a high dose of 3 grams of cranberry juice concentrate capsules, equivalent to 57 grams of fruit daily, for 2 weeks produced a 30% increase in the area under the INR-time curve after a single 25-mg dose of warfarin. However, 3 very small clinical studies in patients stabilized on warfarin reported that cranberry juice 250 mL once or twice daily for 7 days (27% cranberry juice or pure cranberry juice) or 240 mL once daily for 14 days does not significantly increase INR or affect plasma warfarin levels. The reasons for these discrepant findings are unclear. It is possible that the form and dose of cranberry may play a role, as cranberry extracts and juices contain different constituents. Additionally, an in vitro study evaluating 5 different cranberry juices found varying effects, with only a cranberry concentrate, and not diluted cranberry juices, inhibiting CYP2C9. However, this concentrate did not inhibit CYP2C9 activity in humans.

Likelihood Possible Evidence B
Cytochrome P450 2C9 (Cyp2C9) Substrates

Theoretically, cranberry might increase the levels and adverse effects of CYP2C9 substrates. However, research is conflicting.
There is contradictory evidence about the effect of cranberry on CYP2C9 enzymes. In vitro evidence suggests that flavonoids in cranberry inhibit CYP2C9 enzymes. However, clinical research shows that cranberry juice does not significantly affect the levels, metabolism, or elimination of the CYP2C9 substrates flurbiprofen or diclofenac. Also, in patients stabilized on warfarin, drinking cranberry juice 250 mL daily for 7 days does not significantly increase the anticoagulant activity of warfarin, a CYP2C9 substrate. Additional pharmacokinetic research shows that cranberry juice does not increase peak plasma concentrations or area under the concentration-time curve of warfarin.

Likelihood Unlikely Evidence B
Diclofenac (Voltaren, Others)

Theoretically, cranberry might modestly increase the levels and adverse effects of diclofenac.
In vitro evidence suggests that cranberry juice inhibits diclofenac metabolism by human liver microsomes. However, drinking cranberry juice does not seem to affect diclofenac metabolism in humans.

Likelihood Unlikely Evidence B

Noni extract8 drug types · 542 drugs

Ace Inhibitors (Aceis)

Theoretically, combining noni and ACE inhibitors might increase the risk of hyperkalemia.
Noni juice contains significant amounts of potassium, about 6 mEq/100 mL juice. This may increase the risk for hyperkalemia when used in conjunction with ACE inhibitors, which can also increase potassium levels.

Likelihood Possible Evidence D
Angiotensin Receptor Blockers (Arbs)

Theoretically, combining noni and ARBs might increase the risk of hyperkalemia.
Noni juice contains significant amounts of potassium, about 6 mEq/100 mL juice. This may increase the risk for hyperkalemia when used in conjunction with ARBs, which can also increase potassium levels.

Likelihood Possible Evidence D
Antihypertensive Drugs

Theoretically, noni may increase the risk of hypotension when used in combination with antihypertensive drugs.
Preliminary clinical research suggests that drinking noni juice can reduce blood pressure in individuals with hypertension.

Likelihood Possible Evidence D
Hepatotoxic Drugs

Theoretically, taking noni with hepatotoxic drugs might increase the risk of liver damage.
There is concern that noni might cause hepatotoxicity in some patients. Advise patients against combining noni with potentially hepatotoxic drugs.

Likelihood Possible Evidence D
Phenytoin (Dilantin)

Theoretically, taking noni fruit juice concomitantly with phenytoin may lower phenytoin levels and increase the risk of seizures.
In one case report, an adult taking phenytoin for partial seizures experienced low serum phenytoin levels while taking noni juice 90-200 mL daily. Serum phenytoin levels increased after decreasing noni juice consumption; similarly, serum phenytoin levels decreased after increasing noni juice consumption. Some researchers believe noni juice may induce cytochrome P450 2C9 enzymes, which would decrease phenytoin levels, but this has not been well studied. Patients may need additional monitoring when starting or stopping noni juice supplementation.

Likelihood Possible Evidence D
Potassium-Sparing Diuretics

Theoretically, combing noni and a potassium-sparing diuretic might increase the risk of hyperkalemia.
Noni juice contains significant amounts of potassium, about 6 mEq/100 mL juice. This may increase the risk for hyperkalemia when used in conjunction with potassium-sparing diuretics, which can also increase potassium levels.

Likelihood Possible Evidence D
Warfarin (Coumadin)

Theoretically, taking noni juice concomitantly with warfarin might decrease the effectiveness of warfarin.
In one case, a 41-year-old patient stabilized on warfarin had a decreased international normalized ratio (INR) following consumption of a specific commercial noni juice product (Noni juice 4 Everything). While the patient was still taking noni juice, an increase in warfarin dose did not produce an increase in INR. However, it should be noted that this particular product contained extracts and derivatives from more than 115 components, many of which contained vitamin K. Furthermore, vitamin K was listed as a separate ingredient of the product, suggesting that the product was possibly fortified with vitamin K. It has not been verified that noni fruit alone contains a significant amount of vitamin K or interacts with warfarin.

Likelihood Possible Evidence D
Ranitidine (Zantac)

Taking noni fruit with ranitidine might increase the levels and clinical effects of ranitidine.
Clinical evidence shows that taking an aqueous extract of noni fruit 30 minutes prior to taking a single oral dose of ranitidine can increase the rate of absorption and plasma concentration of ranitidine.

Likelihood Possible Evidence B

Sodium7 drug types · 205 drugs

Antihypertensive Drugs

Theoretically, a high intake of dietary sodium might reduce the effectiveness of antihypertensive drugs.
High intake of dietary sodium can increase systolic and diastolic blood pressure. Also, high intake of sodium may necessitate increased use of antihypertensive medications to achieve blood pressure control in some patients, such as those with chronic kidney disease.

Likelihood Probable Evidence A
Corticosteroids

Concomitant use of mineralocorticoids and some glucocorticoids with sodium supplements might increase the risk of hypernatremia.
Mineralocorticoids and some glucocorticoids (corticosteroids) cause sodium retention. This effect is dose-related and depends on mineralocorticoid potency. It is most common with hydrocortisone, cortisone, and fludrocortisone, followed by prednisone and prednisolone.

Likelihood Possible Evidence D
Didanosine (Videx)

Concomitant use of didanosine with additional sodium from dietary or supplemental sources may increase the risk of hypernatremia.
Didanosine formulations contain a significant amount of sodium.

Likelihood Probable Evidence C
Lithium

Altering dietary intake of sodium might alter the levels and clinical effects of lithium.
High sodium intake can reduce plasma concentrations of lithium by increasing lithium excretion. Reducing sodium intake can significantly increase plasma concentrations of lithium and cause lithium toxicity in patients being treated with lithium carbonate. Stabilizing sodium intake is shown to reduce the percentage of patients with lithium level fluctuations above 0.8 mEq/L. Patients taking lithium should avoid significant alterations in their dietary intake of sodium.

Likelihood Probable Evidence B
Sodium Phosphates

Theoretically, concomitant use of sodium phosphate with sodium supplements might increase the risk of hypernatremia.
Use of high doses (> 45 mL in 24 hours) of sodium phosphate, such as those used for bowel cleansing before surgery, can lead to serious electrolyte disturbances, including hypernatremia. The risk of hypernatremia is highest in the elderly and people with other risk factors for electrolyte disturbances.

Likelihood Possible Evidence D
Sodium-Containing Drugs

Concomitant use of sodium-containing drugs with additional sodium from dietary or supplemental sources may increase the risk of hypernatremia and long-term sodium-related complications.
The Chronic Disease Risk Reduction (CDRR) intake level of 2.3 grams of sodium daily indicates the intake at which it is believed that chronic disease risk increases for the apparently healthy population. Some medications contain high quantities of sodium. When used in conjunction with sodium supplements or high-sodium diets, the CDRR may be exceeded. Additionally, concomitant use may increase the risk for hypernatremia; this risk is highest in the elderly and people with other risk factors for electrolyte disturbances.

Likelihood Possible Evidence D
Tolvaptan (Samsca)

Theoretically, concomitant use of tolvaptan with sodium might increase the risk of hypernatremia.
Tolvaptan is a vasopressin receptor 2 antagonist that is used to increase sodium levels in patients with hyponatremia. Patients taking tolvaptan should use caution with the use of sodium salts such as sodium chloride.

Likelihood Probable Evidence C

Burdock (Artium lappa) extract1 drug type · 122 drugs

Anticoagulant/Antiplatelet Drugs

Theoretically, taking burdock with anticoagulant or antiplatelet drugs might increase the risk of bleeding.

In vitro research shows that lignans from burdock reduce rabbit platelet aggregation by inhibiting platelet activating factor. This interaction has not been reported in humans.

Likelihood Possible Evidence D

Plum (Prune) juice concentrate1 drug type · 122 drugs

Anticoagulant/Antiplatelet Drugs

Theoretically, plum juice might have antiplatelet effects.
Consuming plum juice while taking anticoagulant or antiplatelet drugs might increase the risk of bruising and bleeding. In healthy volunteers, drinking plum juice 200 mL daily for 28 days prolonged clotting time and inhibited platelet aggregation.

Likelihood Possible Evidence B

Blueberry (Vaccinium angustifolium) juice concentrate3 drug types · 88 drugs

Antidiabetes Drugs

Theoretically, blueberries or blueberry leaf extracts might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Animal and in vitro research suggests that blueberry and/or blueberry leaf extracts can lower blood glucose levels.

Likelihood Unlikely Evidence D
Buspirone (Buspar)

Theoretically, blueberry juice might increase blood levels of buspirone.
In vitro research shows that blueberry juice can inhibit the metabolism of buspirone, possibly by inhibiting cytochrome P450 3A (CYP3A) enzymes. However, pharmacokinetic research in humans shows that drinking 300 mL of blueberry juice 30 minutes before taking buspirone hydrochloride 10 mg does not significantly affect the concentration or clearance of buspirone.

Likelihood Unlikely Evidence B
Flurbiprofen (Ansaid, Others)

Theoretically, blueberry juice might increase blood levels of flurbiprofen.
In vitro research shows that blueberry juice can inhibit the metabolism of flurbiprofen, possibly by inhibiting cytochrome P450 2C9 (CYP2C9) enzymes. However, pharmacokinetic research in humans shows that drinking 300 mL of blueberry juice 30 minutes before taking flurbiprofen 100 mg does not significantly affect the concentration or clearance of flurbiprofen.

Likelihood Unlikely Evidence B
The maker

Brand information

Manufacturer and brand details for 5-Day Liquid Cleanse & Flush, from the product label.

Pharmacist Counseling Corner

5-Day Liquid Cleanse & Flush by Applied Nutrition: Common Questions

Does 5-Day Liquid Cleanse & Flush by Applied Nutrition interact with any medications?
Yes. Based on its ingredients, 5-Day Liquid Cleanse & Flush has a known interaction with 1,251 medications. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
5-Day Liquid Cleanse & Flush contains 10 active ingredients, and an interaction can come from any of them. We check every ingredient, combine the results into one list per medication, and show which ingredient and mechanism is responsible.
Where does this information come from?
The product label data comes from the NIH Dietary Supplement Label Database (DSLD); the interaction data is built on the Natural Medicines database and reviewed by HelloPharmacist pharmacists.
Can I use this if I take a blood thinner like warfarin?
No—not without checking with your pharmacist first. Cranberry juice concentrate, noni, pomegranate, plum, fennel, and burdock in this product all have documented interactions with warfarin and other blood thinners, and the effects can be serious. Your pharmacist needs to see your exact medication before you start.
Will this cause digestive side effects?
Yes, it's likely. Blueberry, cranberry, pomegranate, and plum can all trigger diarrhea, constipation, nausea, or abdominal discomfort, especially at supplement doses. One blueberry trial saw 26% of users drop out in week one due to stomach complaints.
Is the sodium content a problem?
If you have high blood pressure, take blood pressure medication, or have kidney or heart disease, yes—excess sodium can interfere with blood pressure control and increase sodium levels dangerously. Talk to your doctor before using this.
Can I take this while pregnant or breastfeeding?
No—noni, burdock, and fennel specifically advise against use during pregnancy and lactation. Blueberry and cranberry as foods are likely safe, but concentrated supplements in pregnancy haven't been well studied. Ask your doctor.
What does noni extract actually do?
The evidence in our data doesn't show it's effective for any specific condition; its uses are rated insufficient evidence. It's a traditional ingredient but carries a rare risk of liver injury.
Is a 'cleanse' or 'flush' proven to work?
No—cleansing isn't a standard medical category with proven benefit in our data. Most ingredients here either show no established effectiveness or insufficient evidence for detoxification claims.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

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Label information is sourced from the NIH Dietary Supplement Label Database and reflects the product version on file; always read your actual product label. This page is for education only and is not a substitute for professional medical advice. Confirm with your pharmacist or doctor before combining supplements and medications.

5-Day Liquid Cleanse & Flush label
Go deeper

The Full Monographs Behind 5-Day Liquid Cleanse & Flush’s Ingredients

Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.

Herb & supplement monograph

Sodium

Interacts with 205 drugs

Sodium is an essential mineral and electrolyte your body needs to balance fluids, support nerves, and help muscles work. Most people in modern diets get more than enough—often too much—from...

Read the full Sodium monograph →
Herb & supplement monograph

Burdock

Interacts with 122 drugs

Burdock is a traditional herb most often used for skin problems and as a so-called 'blood purifier,' but high-quality human studies are lacking and most claims are not well proven. It is wid...

Read the full Burdock monograph →
Herb & supplement monograph

Blueberry

Interacts with 88 drugs

Blueberries are a nutritious fruit rich in antioxidants called anthocyanins, and eating them as part of a balanced diet is healthy and safe for most people. Concentrated supplements are mark...

Read the full Blueberry monograph →
Herb & supplement monograph

Cranberry

Interacts with 712 drugs

Cranberry is best known for helping to prevent repeated urinary tract infections (UTIs) in some people, and the evidence here is moderate but mixed. It is not a reliable treatment for an act...

Read the full Cranberry monograph →
Herb & supplement monograph

Noni

Interacts with 542 drugs

Noni is a tropical fruit used widely in folk medicine and sold mostly as a juice or supplement, but solid human evidence for its many claimed benefits is limited. While moderate juice intake...

Read the full Noni monograph →
Herb & supplement monograph

Pomegranate

Interacts with 922 drugs

Pomegranate is a nutrient-rich fruit that is high in antioxidants and is widely enjoyed as food and juice. Early research suggests it may support heart health and blood pressure, but the evi...

Read the full Pomegranate monograph →
Herb & supplement monograph

Plum

Interacts with 122 drugs

Plums and their dried form (prunes) are common, nutritious foods that are best known for helping relieve constipation thanks to their fiber and sorbitol content. They are generally safe as f...

Read the full Plum monograph →
Herb & supplement monograph

Fennel

Interacts with 740 drugs

Fennel is a Mediterranean herb widely used as a food and spice, and traditionally taken for digestive complaints, colic, and menstrual cramps. Some small studies suggest possible benefit for...

Read the full Fennel monograph →
Sources

Sources & How We Checked

5-Day Liquid Cleanse & Flush'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.

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 159 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.

Sodium 38 references
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  2. Food and Drug Administration Science Background: Safety of Sodium Phosphates Oral Solution. September 17, 2001. Available at: http://www.fda.gov/cder/drug/safety/sodiumphospate.htm
  3. Coton T, Mallaret C, Coilliot C, Carre D, Guisset M. Severe acute ulcerated gastritis induced by salt. Presse Med 2009;38(3):499-500. PubMed
  4. Frings-Meuthen P, Buehlmeier J, Baecker N, et al. High sodium chloride intake exacerbates immobilization-induced bone resorption and protein losses. J Appl Physiol 2011;111(2):537-542. PubMed
  5. Frings-Meuthen P, Baecker N, Heer M. Low-grade metabolic acidosis may be the cause of sodium chloride-induced exaggerated bone resorption. J Bone Miner Res 2008;23(4):517-524. PubMed
  6. Alam S, Johnson AG. A meta-analysis of randomised controlled trials (RCT) among healthy normotensive and essential hypertensive elderly patients to determine the effect of high salt (NaCl) diet of blood pressure. J Hum Hypertens 1999;13(6):367-74.
  7. Boudville N, Ward S, Benaroia M, House AA. Increased sodium intake correlates with greater use of antihypertensive agents by subjects with chronic kidney disease. Am J Hypertens 2005;18(10):1300-5. PubMed
  8. Bennett WM. Drug interactions and consequences of sodium restriction. Am J Clin Nutr 1997;65(2 Suppl):678S-681S. PubMed
  9. Okusa MD, Crystal LJ. Clinical manifestations and management of acute lithium intoxication. Am J Med 1994;97(4):383-9. PubMed
  10. Food and Nutrition Board, Institute of Medicine. Dietary reference intakes for water, potassium, sodium, chloride, and sulfate. Washington, DC: National Academy Press, 2005. Available at: http://www.nap.edu/openbook.php?record_id=10925. DOI
  11. D'Elia L, Rossi G, Ippolito R, Cappuccio FP, Strazzullo P. Habitual salt intake and risk of gastric cancer: a meta-analysis of prospective studies. Clin Nutr 2012;31(4):489-98. PubMed
  12. Goldsmith SR. Hyponatremia in heart failure: time for a trial. J Card Fail 2013;19(6):398-400. PubMed
  13. Willocks L, Brettle R, Keen J, Valentine C, Pinching AJ. Formulations of didanosine (ddI) and salt overload. Lancet 1992;339(8786):190.
  14. Chen L, Zhang Z, Chen W, Whelton PK, Appel LJ. Lower Sodium Intake and Risk of Headaches: Results From the Trial of Nonpharmacologic Interventions in the Elderly. Am J Public Health. 2016;106(7):1270-5. PubMed
  15. Cook NR, Appel LJ, Whelton PK. Lower levels of sodium intake and reduced cardiovascular risk. Circulation. 2014;129(9):981-9. PubMed
  16. Cook NR, Appel LJ, Whelton PK. Sodium Intake and All-Cause Mortality Over 20 Years in the Trials of Hypertension Prevention. J Am Coll Cardiol. 2016;68(15):1609-1617. PubMed
  17. Mente A, O'Donnell M, Rangarajan S, et al. Associations of urinary sodium excretion with cardiovascular events in individuals with and without hypertension: a pooled analysis of data from four studies. Lancet. 2016;388(10043):465-75. PubMed
  18. Moosavian SP, Haghighatdoost F, Surkan PJ, Azadbakht L. Salt and obesity: a systematic review and meta-analysis of observational studies. Int J Food Sci Nutr. 2017;68(3):265-277. PubMed
  19. O'Donnell M, Mente A, Rangarajan S, et al. Urinary sodium and potassium excretion, mortality, and cardiovascular events. N Engl J Med. 2014;371(7):612-23. DOI
  20. Poggio R, Gutierrez L, Matta MG, Elorriaga N, Irazola V, Rubinstein A. Daily sodium consumption and CVD mortality in the general population: systematic review and meta-analysis of prospective studies. Public Health Nutr. 2015;18(4):695-704. PubMed
  21. Stallings VA, Harrison M, Oria M; Committee to Review the Dietary Reference Intakes for Sodium and Potassium, Food and Nutrition Board, Health and Medicine Division, National Academies of Sciences, Engineering, and Medicine. Washington (DC): National Acad
  22. Mahtani KR, Heneghan C, Onakpoya I, et al. Reduced Salt Intake for Heart Failure: A Systematic Review. JAMA Intern Med. 2018 Dec 1;178(12):1693-1700. PubMed
  23. Yancy CW. Sodium Restriction in Heart Failure: Too Much Uncertainty-Do the Trials. JAMA Intern Med. 2018 Dec 1;178(12):1700-1701. PubMed
  24. He FJ, Campbell NRC, Ma Y, MacGregor GA, Cogswell ME, Cook NR. Errors in estimating usual sodium intake by the Kawasaki formula alter its relationship with mortality: implications for public health. Int J Epidemiol. 2018;47(6):1784-1795. PubMed
  25. Murthy K, Ondrey GJ, Malkani N, et al. THE EFFECTS OF HYPONATREMIA ON BONE DENSITY AND FRACTURES: A SYSTEMATIC REVIEW AND META-ANALYSIS. Endocr Pract. 2019;25(4):366-378. PubMed
  26. Messerli FH, Hofstetter L, Syrogiannouli L, et al. Sodium intake, life expectancy, and all-cause mortality. Eur Heart J 2021;42(21):2103-2112. PubMed
  27. Graudal NA, Hubeck-Graudal T, Jurgens G. Effects of low sodium diet versus high sodium diet on blood pressure, renin, aldosterone, catecholamines, cholesterol, and triglyceride. Cochrane Database Syst Rev 2020;12(12):CD004022. PubMed
  28. Giatti S, Santos RB, Aielo AN, et al. Association of sodium with obstructive sleep apnea. The ELSA-Brasil study. Ann Am Thorac Soc 2021;18(3):502-510. PubMed
  29. Nan X, Lu H, Wu J, et al. The interactive association between sodium intake, alcohol consumption and hypertension among elderly in northern China: a cross-sectional study. BMC Geriatr 2021;21(1):135. PubMed
  30. Kyozuka H, Fukusda T, Murata T, et al. Impact of preconception sodium intake on hypertensive disorders of pregnancy: The Japan Environment and Children's study. Pregnancy Hypertens 2021;23:66-72. PubMed
  31. Zhao L, Ogden CL, Yang Q, et al. Association of usual sodium intake with obesity among US children and adolescents, NHANES 2009-2016. Obesity (Silver Spring) 2021;29(3):587-594. PubMed
  32. Ma Y, He FJ, Sun Q, et al. 24-Hour urinary sodium and potassium excretion and cardiovascular risk. N Engl J Med 2022;386(3):252-263. PubMed
  33. Liu J, Yang X, Zhang P, et al. Association of urinary sodium excretion and left ventricular hypertrophy in people with type 2 diabetes mellitus: A cross-sectional study. Front Endocrinol (Lausanne) 2021;12:728493. PubMed
  34. Filippini T, Malavolti M, Whelton PK, Vinceti M. Sodium intake and risk of hypertension: A systematic review and dose-response meta-analysis of observational cohort studies. Curr Hypertens Rep 2022;24(5):133-144. PubMed
  35. Wang DD, Li Y, Nguyen XT, et al. Dietary sodium and potassium intake and risk of non-fatal cardiovascular diseases: The million veteran program. Nutrients 2022;14(5):1121. PubMed
  36. Kwak JH, Park CH, Eun CS, et al. The associations of dietary intake of high sodium and low zinc with gastric cancer mortality: A prospective cohort study in Korea. Nutr Cancer 2022;74(10):3501-3508. PubMed
  37. George S, Maiti R, Mishra BR, Jena M, Mohapatra D. Effect of regulated add-on sodium chloride intake on stabilization of serum lithium concentration in bipolar disorder: A randomized controlled trial. Bipolar Disord 2023;25(1):66-75. PubMed
  38. Zhou TL, Schütten MTJ, Kroon AA, et al. Urinary Sodium Excretion and Salt Intake Are Not Associated With Blood Pressure Variability in a White General Population. J Am Heart Assoc 2023;12(1):e026578. PubMed

See these in context on the Sodium monograph →

Blueberry 7 references
  1. Cignarella A, Nastasi M, Cavalli E, Puglisi L. Novel lipid-lowering properties of Vaccinium myrtillus L. leaves, a traditional antidiabetic treatment, in several models of rat dyslipidaemia: a comparison with ciprofibrate. Thromb Res 1996;84:311-22. PubMed
  2. Wang SY, Lin HS. Antioxidant activity in fruits and leaves of blackberry, raspberry, and strawberry varies with cultivar and developmental stage. J Agric Food Chem 2000;48:140-6.. PubMed
  3. Martineau, L. C., Couture, A., Spoor, D., Benhaddou-Andaloussi, A., Harris, C., Meddah, B., Leduc, C., Burt, A., Vuong, T., Mai, Le P., Prentki, M., Bennett, S. A., Arnason, J. T., and Haddad, P. S. Anti-diabetic properties of the Canadian lowbush bluebe
  4. Vuong, T., Martineau, L. C., Ramassamy, C., Matar, C., and Haddad, P. S. Fermented Canadian lowbush blueberry juice stimulates glucose uptake and AMP-activated protein kinase in insulin-sensitive cultured muscle cells and adipocytes. Can J Physiol Pharma
  5. Hanley MJ, Masse G, Harmatz JS, Cancalon PF, Dolnikowski GG, Court MH, Greenblatt DJ. Effect of blueberry juice on clearance of buspirone and flurbiprofen in human volunteers. Br J Clin Pharmacol. 2013 Apr;75(4):1041-52. PubMed
  6. Basu A, Du M, Leyva MJ, et al. Blueberries decrease cardiovascular risk factors in obese men and women with metabolic syndrome. J Nutr 2010;140(9):1582-7. PubMed
  7. Basu A, Feng D, Planinic P, Ebersole JL, Lyons TJ, Alexander JM. Dietary blueberry and soluble fiber supplementation reduces risk of gestational diabetes in women with obesity in a randomized controlled trial. J Nutr 2021;151(5):1128-38. PubMed

See these in context on the Blueberry monograph →

Cranberry 33 references
  1. Anon. Possible interaction between warfarin and cranberry juice. Current Problems in Pharmacovigilance 2003;29:8. PubMed
  2. Greenblatt DJ, von Moltke LL, Perloff ES, et al. Interaction of flurbiprofen with cranberry juice, grape juice, tea, and fluconazole: in vitro and clinical studies. Clin Pharmacol Ther 2006;79:125-33. PubMed
  3. Hodek P, Trefil P, Stiborova M. Flavonoids-potent and versatile biologically active compounds interacting with cytochromes P450. Chem Biol Interact 2002;139:1-21.. PubMed
  4. Grant P. Warfarin and cranberry juice: An interaction? J Heart Valve Dis 2004;13:25-6.
  5. Suvarna R, Pirmohamed M, Henderson L. Possible interaction between warfarin and cranberry juice. BMJ 2003;327:1454. PubMed
  6. Li Z, Seeram NP, Carpenter CL, et al. Cranberry does not affect prothrombin time in male subjects on warfarin. J Am Diet Assoc 2006;106:2057-61. PubMed
  7. Lilja JJ, Backman JT, Neuvonen PJ. Effects of daily ingestion of cranberry juice on the pharmacokinetics of warfarin, tizanidine, and midazolam - probes of CYP2C9, CYP1A2 and CYP3A4. Clin Pharmacol The 2007:81:833-9. PubMed
  8. Wing DA, Rumney PJ, Preslicka CW, Chung JH. Daily cranberry juice for the prevention of asymptomatic bacteriuria in pregnancy: a randomized, controlled pilot study. J Urol 2008;180:1367-72. PubMed
  9. Mohammed Abdul MI, Jiang X, Williams KM, et al. Pharmacodynamic interaction of warfarin with cranberry but not with garlic in healthy subjects. Br J Pharmacol 2008;154:1691-700. PubMed
  10. McMurdo MET, Argo I, Phillips G, et al. Cranberry or trimethoprim for the prevention of recurrently urinary tract infections? A randomized controlled trial in older women. J Antimicrob Chemother 2009;63:389-95.
  11. Mergenhagen KA, Sherman O. Elevated International Normalized Ratio after concurrent ingestion of cranberry sauce and warfarin. Am J Health-Syst Pharm 2008;65:2113-6. PubMed
  12. Ansell J, McDonough M, Zhao Y, et al. The absence of an interaction between warfarin and cranberry juice: a randomized, double-blind trial. J Clin Pharmacol 2009;49:824-30. PubMed
  13. Haber SL, Cauthon KA, Raney EC. Cranberry and warfarin interaction: a case report and review of the literature. Consult Pharm 2012;27:58-65. PubMed
  14. Hamann GL, Campbell JD, George CM. Warfarin-cranberry juice interaction. Ann Pharmacother 2011;45:e17. PubMed
  15. Roberts D, Flanagan P. Case report: Cranberry juice and warfarin. Home Healthc Nurse 2011;29:92-7.
  16. Garcia-Calatayud, S., Larreina Cordoba, J. J., and Lozano De La Torre MJ. [Severe cranberry juice poisoning]. An.Esp.Pediatr. 2002;56(1):72-73.
  17. Patel, D. A., Gillespie, B., Sobel, J. D., Leaman, D., Nyirjesy, P., Weitz, M. V., and Foxman, B. Risk factors for recurrent vulvovaginal candidiasis in women receiving maintenance antifungal therapy: results of a prospective cohort study. Am J Obstet.Gy PubMed
  18. Isele, H. [Fatal bleeding under warfarin plus cranberry juice. Is it due to salicylic acid?]. MMW.Fortschr.Med 3-11-2004;146(11):13.
  19. Linsenmeyer, T. A., Harrison, B., Oakley, A., Kirshblum, S., Stock, J. A., and Millis, S. R. Evaluation of cranberry supplement for reduction of urinary tract infections in individuals with neurogenic bladders secondary to spinal cord injury. A prospecti
  20. McMurdo, M. E., Bissett, L. Y., Price, R. J., Phillips, G., and Crombie, I. K. Does ingestion of cranberry juice reduce symptomatic urinary tract infections in older people in hospital? A double-blind, placebo-controlled trial. Age Ageing 2005;34(3):256- PubMed
  21. Sylvan, L. and Justice, N. P. Possible interaction between warfarin and cranberry juice. Am Fam.Physician 9-15-2005;72(6):1000.
  22. Niklasson, A. and Andren, L. [Interaction between Waran and cranberry juice]. Lakartidningen 3-15-2006;103(11):853-854.
  23. Rindone, J. P. and Murphy, T. W. Warfarin-cranberry juice interaction resulting in profound hypoprothrombinemia and bleeding. Am J Ther 2006;13(3):283-284. PubMed
  24. Uesawa, Y. and Mohri, K. Effects of cranberry juice on nifedipine pharmacokinetics in rats. J Pharm Pharmacol 2006;58(8):1067-1072. PubMed
  25. Valentova, K., Stejskal, D., Bednar, P., Vostalova, J., Cihalik, C., Vecerova, R., Koukalova, D., Kolar, M., Reichenbach, R., Sknouril, L., Ulrichova, J., and Simanek, V. Biosafety, antioxidant status, and metabolites in urine after consumption of dried
  26. Royer, D. J., George, J. N., and Terrell, D. R. Thrombocytopenia as an adverse effect of complementary and alternative medicines, herbal remedies, nutritional supplements, foods, and beverages. Eur J Haematol 2010;84(5):421-429. PubMed
  27. Stapleton, A. E., Dziura, J., Hooton, T. M., Cox, M. E., Yarova-Yarovaya, Y., Chen, S., and Gupta, K. Recurrent urinary tract infection and urinary Escherichia coli in women ingesting cranberry juice daily: a randomized controlled trial. Mayo.Clin.Proc. PubMed
  28. Doad GJ, Kabange W. Cranberry juice, atorvastatin and back pain. J Med Assoc Ga 2014;103(1):14.
  29. Griffiths AP, Beddall A, Pegler S. Fatal haemopericardium and gastrointestinal haemorrhage due to possible interaction of cranberry juice with warfarin. J R Soc Promot Health 2008;128(6):324-6. PubMed
  30. Mellen CK, Ford M, Rindone JP. Effect of high-dose cranberry juice on the pharmacodynamics of warfarin in patients. Br J Clin Pharmacol 2010;70(1):139-42. PubMed
  31. Ushijima K, Tsuruoka S, Tsuda H, Hasegawa G, Obi Y, Kaneda T, Takahashi M, Maekawa T, Sasaki T, Koshimizu TA, Fujimura A. Cranberry juice suppressed the diclofenac metabolism by human liver microsomes, but not in healthy human subjects. Br J Clin Pharmaco PubMed
  32. Ngo N, Brantley SJ, Carrizosa DR, et al. The warfarin-cranberry juice interaction revisited: A systematic in vitro-in vivo evaluation. J Exp Pharmacol. 2010;2010(2):83-91.
  33. Williams G, Stothart CI, Hahn D, Stephens JH, Craig JC, Hodson EM. Cranberries for preventing urinary tract infections. Cochrane Database Syst Rev 2023;11(11):CD001321. PubMed

See these in context on the Cranberry monograph →

Noni 16 references
  1. Mueller BA, Scott MK, Sowinski KM, Prag KA. Noni juice (Morinda citrifolia): hidden potential for hyperkalemia? Am J Kidney Dis 2000;35:310-2. PubMed
  2. Millonig G, Stadlmann S, Vogel W. Herbal hepatotoxicity: acute hepatitis caused by a Noni preparation (Morinda citrifolia). Eur J Gastroenterol Hepatol 2005;17:445-7. PubMed
  3. Stadlbauer V, Fickert P, Lackner C, et al. Hepatotoxicity of NONI juice: report of two cases. World J Gastroenterol 2005;11:4758-60. PubMed
  4. Carr ME, Klotz J, Bergeron M. Coumadin resistance and the vitamin supplement "Noni". Am J Hematol 2004;77:103. PubMed
  5. Jensen CJ, Westendorf J, Wang MY, Wadsworth DP. Noni juice protects the liver. Eur J Gastroenterol Hepatol 2006;18:575-7. PubMed
  6. Yuce B, Gulberg V, Diebold J, Gerbes AL. Hepatitis induced by noni juice from morinda citrifolia: a rare cause of hepatotoxicity or the tip of the iceberg? Digestion 2006;73:167-70.
  7. Koch E, Biber A. Treatment of rats with the Pelargonium sidoides extract EPs 7630 has no effect on blood coagulation parameters or on the pharmacokinetics of warfarin. Phytomedicine 2007;14 Suppl 6:40-5. PubMed
  8. Yu EL, Sivagnanam M, Ellis L, Huang JS. Acute hepatotoxicity after ingestion of Morinda citrifolia (noni berry) juice in a 14-year-old boy. J Pediatr Gastroenterol Nutr 2011;52:222-4.
  9. Stadlbauer V, Weiss S, Payer F, Stauber RE. Herbal does not at all mean innocuous: the sixth case of hepatotoxicity associated with morinda citrifolia (noni). Am J Gastroenterol 2008;103:2406-7. PubMed
  10. López-Cepero Andrada JM, Lerma Castilla S, Fernández Olvera MD, Amaya Vidal A. [Hepatotoxicity caused by a noni (Morinda citrifolia) preparation]. [Article in Spanish] Rev Esp Enferm Dig 2007;99:179-81.
  11. Nima S, Kasiwong S, Ridtitid W, et al. Gastrokinetic activity of Morinda citrifolia aqueous fruit extract and its possible mechanism of action in human and rat models. J Ethnopharmacol. 2012;142(2):354-61. PubMed
  12. Issell, B. F., Gotay, C. C., Pagano, I., and Franke, A. A. Using quality of life measures in a Phase I clinical trial of noni in patients with advanced cancer to select a Phase II dose. J.Diet.Suppl 2009;6(4):347-359. PubMed
  13. Palu AK, Santiago RA West B Kaluhiokalani N Jensen J. The Effects of Morillda citrifolia L. Noni on High Blood Pressure: A Mechanistic Investigation and Case Study. ACS SYMPOSIUM SERIES 993 2008;
  14. Jiménez-Encarnación E, Ríos G, Muñoz-Mirabal A, Vilá LM. Euforia-induced acute hepatitis in a patient with scleroderma. BMJ Case Rep 2012;2012. PubMed
  15. Bussmann RW, Hennig L, Giannis A, Ortwein J, Kutchan TM, Feng X. Anthraquinone Content in Noni (Morinda citrifolia L.). Evid Based Complement Alternat Med. 2013;2013:208378.
  16. Yu-Chan Kang, Ming-Hong Chen, Shung-Lon Lai. Potentially Unsafe Herb-drug Interactions Between a Commercial Product of Noni Juice and Phenytoin- A Case Report. Acta Neurol Taiwan. 2015 Jun;24(2):43-6.

See these in context on the Noni monograph →

Pomegranate 27 references
  1. Igea JM, Cuesta J, Cuevas M, et al. Adverse reaction to pomegranate ingestion. Allergy 1991;46:472-4. DOI
  2. Gaig P, Bartolome B, Lleonart R, et al. Allergy to pomegranate (Punica granatum). Allergy 1999;54:287-8.
  3. Aviram M, Dornfeld L. Pomegranate juice consumption inhibits serum angiotensin converting enzyme activity and reduces systolic blood pressure. Atherosclerosis 2001;158:195-8. PubMed
  4. Valsecchi R, Reseghetti A, Leghissa P, et al. Immediate contact hypersensitivity to pomegranate. Contact Dermatitis 1998;38:44-5. PubMed
  5. Esmaillzadeh A, Tahbaz F, Gaieni I, et al. Concentrated pomegranate juice improves lipid profiles in diabetic patients with hyperlipidemia. J Med Food 2004;7:305-8. PubMed
  6. Aviram M, Rosenblat M, Gaitini D, et al. Pomegranate juice consumption for 3 years by patients with carotid artery stenosis reduces common carotid intima-media thickness, blood pressure and LDL oxidation. Clin Nutr 2004;23:423-33. DOI
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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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