Major interaction on record — check this product against your medications before combining. Based on 9 of 13 ingredients. Check your meds →
Dietary supplement

Aloe & Triphala Active-Cleanse and Probiotics Ingredients & Drug Interactions

by Irwin Naturals

Aloe & Triphala Active-Cleanse and Probiotics label
See full label image
Softgel Capsule Category: Other Combinations
Most serious interaction: Major
Clinical methodology reviewed by · Updated Sep 16, 2026 · Label data from the NIH DSLD
What is this page for?

First and foremost: checking Aloe & Triphala Active-Cleanse and Probiotics 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

The interaction bottom line Most serious interaction: Major

Aloe & Triphala Active-Cleanse and Probiotics is a dietary supplement by Irwin Naturals with 13 active ingredients. Its ingredients are commonly taken for heart health, high blood pressure, high cholesterol.Based on those ingredients, 1,500 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are BioPerine, Ginger Rhizome Extract, Fennel seed extract. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

Jump to a section

Check Your Meds Against Aloe & Triphala Active-Cleanse and Probiotics by Irwin Naturals

Ask about any prescription or over-the-counter medication and we check it for interactions with Aloe & Triphala Active-Cleanse and Probiotics by Irwin Naturals — and tell you which ingredient is responsible.

Pharmacist-reviewed data Checks every ingredient Answer in seconds
Prefer a human? Send your question to our licensed pharmacists — free, answered by email within 24 hours.

HelloPharmacist Scorecard of Aloe & Triphala Active-Cleanse and Probiotics by Irwin Naturals

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

Generated from HelloPharmacist’s pharmacist-curated databases and editorial rules · Last generated Jul 12, 2026

What’s inside

Partial disclosure
Ingredient Transparency · database check
Partial

Most active ingredients list an amount, but at least one is hidden in a blend or missing.

Why this rating?
  • The label discloses an exact amount for 7 of its 12 active ingredients.
  • “BioPerine Complex” is a proprietary blend — the label gives one combined amount (3 mg) without saying how much of each component you get.
  • “Triphala, Powder” is listed as a grouped ingredient — the label gives one combined amount (750 mg) without saying how much of each component you get.
  • “Chebulic Myrobalan Fruit Extract” is listed as a grouped ingredient — the label gives one combined amount (250 mg) without saying how much of each component you get.

This 12-ingredient product combines digestive botanicals with a probiotic strain. The active ingredients are ginger rhizome extract, fennel seed extract, amla (Indian gooseberry) powder, triphala powder (a traditional Ayurvedic blend), coriander seed extract, cumin seed extract, black pepper (BioPerine), and the probiotic bacillus coagulans.

Olive oil and the BioPerine Complex (a black pepper extract blend) round out the active list. The remaining ingredients are inactive excipients — fillers, binders, and capsule materials including gelatin, glycerin, and several thickening and coloring agents.

Does it work?

Moderate 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
Moderate

Some clinical evidence supports this product's ingredients for its stated purpose, but it isn't conclusive.

Why this rating?
  • The label markets this product for: digestive health and toxin elimination support.
  • We looked for evidence on: Constipation, Diarrhea, Dyspepsia, Flatulence, Colic, Clostridioides difficile infection — and 4 related terms.
  • The strongest evidence on file: Bacillus Coagulans is rated "Possibly Effective" for Constipation (Natural Medicines).
  • Also on file: Coriander is rated "Insufficient Reliable Evidence To Rate" for Constipation, Diarrhea, Dyspepsia, Flatulence.
  • Also on file: Olive is rated "Insufficient Reliable Evidence To Rate" for Dyspepsia.

The evidence for this product's ingredients is limited to modest claims. Ginger is possibly effective for pregnancy-related nausea, period pain, and joint pain, though research on muscle soreness from exercise suggests it may not help.

Fennel seed is possibly effective for period pain. Amla (Indian gooseberry) is possibly effective for heartburn and stomach acid reflux, and possibly for high cholesterol.

The bacillus coagulans probiotic is possibly effective for constipation and irritable bowel syndrome (IBS). For the other ingredients — coriander, cumin, black pepper, olive oil, and triphala — the evidence in our data is insufficient to establish effectiveness.

None of these ingredients has strong or definitive proof of benefit for the 'active-cleanse' claims on the label.

The evidence, ingredient by ingredient Olive Ginger Black Pepper Fennel Indian Gooseberry Bacillus Coagulans Aloe Coriander

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.

Most ingredients are generally well tolerated in typical amounts. Ginger is likely safe in pregnancy and lactation at moderate doses, though high doses (5+ grams daily) increase side effects like heartburn, burping, and diarrhea.

Fennel, however, carries a possibly unsafe rating in pregnancy and lactation due to limited safety data and hormone-like effects — avoid medicinal amounts if you are pregnant or nursing. Indian gooseberry has insufficient safety data in pregnancy and lactation, so talk to your pharmacist or doctor.

Coriander, cumin, and black pepper are generally safe in food amounts. The bacillus coagulans probiotic is well tolerated in healthy adults, though there's rare concern of infection in severely ill or immunocompromised patients with catheters.

Olive oil as a concentrated supplement is less studied than the food itself — use caution and check with your doctor.

Side effects, ingredient by ingredient Olive Ginger Black Pepper Fennel Indian Gooseberry Bacillus Coagulans Aloe Coriander

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?
  • 7 of the 8 matched ingredients can interact with medications — Coriander, Fennel, Cumin, Indian Gooseberry, Black Pepper, among others.
  • The most serious interaction on file is rated Moderate.
  • Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs; immunosuppressants / transplant drugs; diabetes medications; lithium.
  • For scale: 1,480 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.

Before taking this product, double-check these medication types with your exact prescriptions: blood thinners and antiplatelet drugs (warfarin, clopidogrel, aspirin) because of ginger and other ingredients; diabetes medications because ginger, coriander, and cumin may lower blood sugar; blood pressure and heart drugs (nifedipine, losartan, propranolol) because of ginger and black pepper; birth control and hormone therapy because of fennel; anti-seizure drugs like phenytoin because of black pepper; the antibiotic rifampin because of black pepper and cumin; and any antibiotic if you're taking the bacillus coagulans probiotic — separate them by a few hours. The ingredient black pepper is a strong booster of medication absorption and may increase blood levels of many drugs.

Check your own medication Run your meds through the checker above

The bottom line

Scorecard at a glancePartially disclosed formula with some supporting evidence for its stated purpose. Moderate medication interactions have been identified, and safety information is well characterized.

This product combines digestive and probiotic ingredients with modest evidence for nausea, period pain, and bowel regularity. If you take blood thinners, diabetes medications, birth control, heart drugs, anti-seizure medications, or antibiotics, check your exact medications with the tool on this page before starting — several ingredients interact with these drug types.

If you are pregnant or nursing, talk to your pharmacist or doctor first, especially regarding fennel. This is a decision for you and your healthcare provider.

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

Assessment coverage: 8 of 12 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Jul 18, 2023.

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 Aloe & Triphala Active-Cleanse and Probiotics, straight from the product label.

Brand Irwin Naturals
Barcode (UPC) 710363583071
Net contents 60 Liquid Softgel(s)
Market status On market
Date entered into DSLD Jul 18, 2023
DSLD ID 292062
Product type Other Combinations
Supplement form Softgel Capsule
Dietary claims / uses All Other, Structure/Function
Intended target group(s) Adult (18 - 50 Years), Women (not pregnant or lactating)
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 Aloe & Triphala Active-Cleanse and Probiotics by Irwin Naturals, 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:
3 Liquid Softgel(s)
Maximum serving Sizes:
3 Liquid Softgel(s)
Servings per container
20
UPC/BARCODE
710363583071
IngredientAmount% DV
Protein1 Gram(s)--
Total Fat2 Gram(s)2%
extra virgin Olive Oil1500 mg--
Calories30 Calories--
BioPerine Complex3 mg--
Tannins25 mg--
Total Carbohydrates2 Gram(s)1%
Ginger Rhizome Extract0 NP--
Fennel seed extract60 mg--
Triphala, Powder750 mg--
Amla, Powder0 NP--
Belleric Myrobalan, Powder0 NP--
Chebulic Myrobalan, Powder0 NP--
Unique IS-2 Bacillus coagulans300 mg--
Chebulic Myrobalan Fruit Extract250 mg--
Cape Aloe leaf extract120 mg--
Hydroxyanthracene Derivatives30 mg--
Coriander seed extract60 mg--
Cumin Seed Extract60 mg--
BioPerine0 NP--

Other ingredients: Gelatin, Water, Purified, Glycerin, Maltodextrin, Beeswax, Soy Lecithin, Dextrin, Titanium Dioxide, Sodium Copper Chlorophyllin, Silicon Dioxide, Turmeric

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.
Formulation

Aloe & Triphala Active-Cleanse and Probiotics is a gentle yet effective formula that works through the digestive tract to promote toxin elimination and probiotic replenishment. It can be used as part of a detox program or as a stand-alone product for deep internal cleansing.

What makes us different: Liquid soft-gels - The nutrients in these easy-to-swallow Liquid Soft-Gels are released fast. Other forms of delivery can contain binders and fillers that may cause stomach upset and offer no nutritional value. Advanced Liquid Soft-Gels provide an optimum delivery system.

Quality assurance - Irwin Naturals is committed to providing the highest quality products for your health. We employ compliance testing to ensure purity and potency.

Patented BioPerine - BioPerine enhances the bioavailability, absorption and potency of many nutrients.

2-part colon care formula Flush: Cleans and Detox

No preservatives added.

Formula

Key ingredients include: Aloe: Prized for its many health benefits and for its unique ability to activate the body's natural detoxification processes. Aloe supports the elimination pathways and helps to clear toxins and waste from the intestinal tract. Triphala: A balanced blend of "three fruits" that are highly prized in the Ayurvedic tradition. Triphala has been traditionally used to assist natural internal cleansing, to support strong digestion, and to revitalize the body. Probiotics: To complement the eliminative action of Aloe and Triphala, this formula delivers 9 billion organisms of viable probiotic per day. Probiotics bring balance to the intestinal tract and can help to replenish, rebuild and nourish the digestive system overall. This product includes a clinically-tested probiotic called Unique IS-2 that is heat-resistant and acid-resistant.

Flora: Unique IS-2 probiotics

Storage

This pure-strain probiotic does not require refrigeration.

Store in a cool, dry place.

Seals/Symbols

Quality Tested Guaranteed Pass

FDA Disclaimer Statement

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

Precautions

Usage warnings: 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 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.

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

Warning: (State of California Prop 65) This product contains a chemical known to the State of California to cause birth defects or other reproductive harm. Notice: This product contains Cape Aloe. Read and follow the directions carefully. Do not use if you have or develop diarrhea, loose stools, or abdominal pain because Cape Aloe 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.

Contains: Soy

General Statements

Questions: Contact consumer affairs 1-800-297-3272 Weekdays 8:00 AM to 5:00 PM (PST) 100+ highly specialized products: www.IrwinNaturals.com

Full disclosure ingredient panel

FDA Statement of Identity

Dietary Supplement

Suggested/Recommended/Usage/Directions

Directions: (Adult) take (3) liquid soft-gels in the morning prior to breakfast and three (3) liquid soft-gels prior to bedtimes. Drink a full glass (8oz) of water with each serving. Do not exceed six (6) liquid soft-gels per day. If stools are loose, reduce intake from six (6) to four (4) per day.

Brand IP Statement(s)

BioPerine is a registered trademark of Sabinsa Corporation. Unique IS-2 is a trademark of Unique Biotech Limited.

Is this label outdated? Report a formula or label change and our pharmacy team will review it.

See for yourself

Aloe & Triphala Active-Cleanse and Probiotics by Irwin Naturals label

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

Aloe & Triphala Active-Cleanse and Probiotics label

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)
What’s inside

The Ingredients in Aloe & Triphala Active-Cleanse and Probiotics by Irwin Naturals

These are the 13 active ingredients this product is made of. Select any to open its full monograph.

Serving size3 Liquid Softgel(s) Dosage formSoftgel Capsule Servings per container20 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.

Protein

1 Gram(s) per serving

Extra virgin Olive Oil

No known
interactions
1500 mg per serving

Olive comes from the same tree that gives us olives and olive oil, and its leaf and fruit contain antioxidant compounds like oleuropein and hydroxytyr...

Extra virgin Olive Oil monograph & interactions

BioPerine Complex

3 mg per serving

Fennel seed extract

Interacts with
740 drugs
60 mg per serving

Fennel is a Mediterranean herb widely used as a food and spice, and traditionally taken for digestive complaints, colic, and menstrual cramps. Some sm...

Fennel seed extract monograph & interactions

Triphala, Powder

750 mg per serving
  • › Amla, Powder
  • › Belleric Myrobalan, Powder
  • › Chebulic Myrobalan, Powder

Unique IS-2 Bacillus coagulans

Interacts with
182 drugs
300 mg per serving

Bacillus coagulans is a spore-forming probiotic that survives stomach acid well and may help with some digestive problems such as IBS, constipation, a...

Unique IS-2 Bacillus coagulans monograph & interactions

Chebulic Myrobalan Fruit Extract

250 mg per serving
  • › Tannins

Cape Aloe leaf extract

Interacts with
461 drugs
120 mg per serving

Aloe vera gel is widely used on the skin for minor burns and irritation, and some research suggests it may help. Aloe latex (the yellow part) is a str...

Cape Aloe leaf extract monograph & interactions
  • › Hydroxyanthracene Derivatives

Coriander seed extract

Interacts with
717 drugs
60 mg per serving

Coriander (also called cilantro) is a common cooking herb and spice that has long been used in traditional medicine for digestive complaints. As a foo...

Coriander seed extract monograph & interactions

Cumin Seed Extract

Interacts with
211 drugs
60 mg per serving

Cumin is a common cooking spice that has a long history in traditional medicine for digestion and other complaints. Food amounts are generally safe fo...

Cumin Seed Extract monograph & interactions

Other (inactive) ingredients: Gelatin, Water, Purified, Glycerin, Maltodextrin, Beeswax, Soy Lecithin, Dextrin, Titanium Dioxide, Sodium Copper Chlorophyllin, Silicon Dioxide, Turmeric. These complete the product’s ingredient list but are not active constituents.

Interaction report

Aloe & Triphala Active-Cleanse and Probiotics by Irwin Naturals Drug Interactions

Want to check YOUR meds against Aloe & Triphala Active-Cleanse and Probiotics?

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
1,500Drugs
1 Major 1,462 Moderate 37 Minor

Ingredients driving the most interactions

BioPerine 1,019
Ginger Rhizome Extract 1,007
Fennel seed extract 740
Coriander seed extract 717
Cape Aloe leaf extract 461

Individual Drug Interactions

The ingredients in Aloe & Triphala Active-Cleanse and Probiotics interact with 1,500 drugs. Click any drug to see the details.

8 of the 13 ingredients in Aloe & Triphala Active-Cleanse and Probiotics interact with drugs. Each result below shows which ingredient is responsible. BioPerine Ginger Rhizome Extract Fennel seed extract Coriander seed extract Cape Aloe leaf extract Cumin Seed Extract Amla, Powder Unique IS-2 Bacillus coagulans

Each ingredient & the kinds of drugs it affects

For each ingredient in Aloe & Triphala Active-Cleanse and Probiotics 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.

BioPerine17 drug types · 1,019 drugs

Anticoagulant/Antiplatelet Drugs

Theoretically, black pepper might increase the risk of bleeding when taken with antiplatelet or anticoagulant drugs.
In vitro research shows that piperine, a constituent of black pepper, seems to inhibit platelet aggregation. This has not been reported in humans.

Likelihood Possible Evidence D
Antidiabetes Drugs

Theoretically, black pepper might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Animal research shows that piperine, a constituent of black pepper, can reduce blood glucose levels. Monitor blood glucose levels closely. Dose adjustments might be necessary.

Likelihood Possible Evidence D
Atorvastatin (Lipitor)

Theoretically, black pepper might increase blood levels of atorvastatin.
Animal research shows that taking piperine, a constituent of black pepper, 35 mg/kg can increase the maximum serum concentration of atorvastatin three-fold. This has not been reported in humans.

Likelihood Possible Evidence D
Cyclosporine (Neoral, Sandimmune)

Theoretically, black pepper might increase the effects and side effects of cyclosporine.
In vitro research shows that piperine, a constituent of black pepper, increases the bioavailability of cyclosporine. This has not been reported in humans.

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

Theoretically, black pepper might increase levels of drugs metabolized by CYP2D6.
In vitro research suggests that some constituents of black pepper inhibit CYP2D6. This has not been reported in humans.

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

Theoretically, black pepper might increase levels of drugs metabolized by CYP3A4.
In vitro research and pharmacokinetic simulation data suggest that piperine, a constituent of black pepper, as well as the pepper fruit seem to inhibit CYP3A4. This has not been reported in humans.

Likelihood Possible Evidence D
Lithium

Theoretically, black pepper might increase blood levels of lithium due to its diuretic effects. The dose of lithium might need to be reduced.
Black pepper is thought to have diuretic properties.

Likelihood Probable Evidence D
Nevirapine (Viramune)

Black pepper might increase blood levels of nevirapine.
Clinical research shows that piperine, a constituent of black pepper, increases the plasma concentration of nevirapine. However, no adverse effects were observed in this study.

Likelihood Probable Evidence D
P-Glycoprotein Substrates

Theoretically, black pepper might increase levels of P-glycoprotein substrates.
In vitro research shows that piperine, a constituent of black pepper, seems to inhibit P-glycoprotein.

Likelihood Possible Evidence D
Pentobarbital (Nembutal)

Theoretically, black pepper might increase the sedative effects of pentobarbital.
Animal research shows that piperine, a constituent of black pepper, increases pentobarbital-induced sleeping time.

Likelihood Possible Evidence D
Phenytoin (Dilantin)

Black pepper might increase blood levels of phenytoin.
Clinical research shows that piperine, a constituent of black pepper, seems to increase absorption, slow elimination, and increase levels of phenytoin. Taking a single dose of black pepper 1 gram along with phenytoin seems to double the serum concentration of phenytoin. Consuming a soup with black pepper providing piperine 44 mg/200 mL of soup along with phenytoin also seems to increase phenytoin levels when compared with consuming the same soup without black pepper.

Likelihood Possible Evidence B
Propranolol (Inderal)

Black pepper might increase blood levels of propranolol.
Clinical research shows that piperine, a constituent of black pepper, seems to increase absorption and slow elimination of propranolol.

Likelihood Possible Evidence B
Rifampin (Rifadin)

Black pepper might increase blood levels of rifampin.
Clinical research shows that piperine, a constituent of black pepper, seems to increase absorption and serum levels of rifampin.

Likelihood Possible Evidence B
Theophylline

Black pepper might increase blood levels of theophylline.
Clinical research shows that piperine, a constituent of black pepper, seems to increase absorption and slow elimination of theophylline.

Likelihood Possible Evidence D
Amoxicillin (Amoxil, Trimox)

Theoretically, black pepper might increase the effects and side effects of amoxicillin.
Animal research shows that taking piperine, a constituent of black pepper, with amoxicillin increases plasma levels of amoxicillin. This has not been reported in humans.

Likelihood Possible Evidence D
Carbamazepine (Tegretol)

Theoretically, black pepper might increase blood levels of carbamazepine, potentially increasing the effects and side effects of carbamazepine.
One clinical study in patients taking carbamazepine 300 mg or 500 mg twice daily shows that taking a single 20 mg dose of purified piperine, a constituent of black pepper, increases carbamazepine levels. Piperine may increase carbamazepine absorption by increasing blood flow to the GI tract, increasing the surface area of the small intestine, or inhibiting cytochrome P450 3A4 (CYP3A4) in the gut wall. Absorption was significantly increased by 7-10 mcg/mL/hour. The time to eliminate carbamazepine was also increased by 4-8 hours. Although carbamazepine levels were increased, this did not appear to increase side effects. In vitro research also shows that piperine can increase carbamazepine levels by 11% in a time-dependent manner.

Likelihood Possible Evidence B
Cytochrome P450 1A2 (Cyp1A2) Substrates

Theoretically, black pepper might decrease levels and clinical effects of drugs metabolized by CYP1A2.
In vitro research suggests that black pepper induces CYP1A2. This has not been reported in humans.

Likelihood Possible Evidence D
BioPerine full monograph & interactions

Ginger Rhizome Extract14 drug types · 1,007 drugs

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.

Likelihood Possible Evidence B
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.

Likelihood Possible Evidence D
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.

Likelihood Possible Evidence D
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.

Likelihood Possible Evidence D
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.

Likelihood Possible Evidence B
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.

Likelihood Possible Evidence D
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.

Likelihood Possible Evidence D
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.

Likelihood Possible Evidence B
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.

Likelihood Unlikely Evidence D
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.

Likelihood Possible Evidence D
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.

Likelihood Possible Evidence D
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.

Likelihood Possible Evidence D
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.

Likelihood Possible Evidence D
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.

Likelihood Possible Evidence D
Ginger Rhizome Extract full monograph & interactions

Fennel seed 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
Fennel seed extract full monograph & interactions

Coriander seed extract4 drug types · 717 drugs

Antidiabetes Drugs

Theoretically, coriander might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Evidence from animal research suggests that coriander fruit and coriander extract can reduce blood glucose levels. Monitor blood glucose levels closely. Dose adjustments might be necessary.

Likelihood Possible Evidence D
Antihypertensive Drugs

Theoretically, coriander might increase the risk of hypotension when taken with antihypertensive drugs.
Evidence from animal research suggests that coriander fruit can lower blood pressure.

Likelihood Possible Evidence D
Cns Depressants

Theoretically, coriander might cause additive sedative effects when taken with CNS depressants.
Evidence from animal research suggests that coriander fruit extract has sedative effects.

Likelihood Possible Evidence D
Photosensitizing Drugs

Theoretically, coriander might increase the risk of photosensitivity when taken with photosensitizing drugs.
Evidence from in vitro research suggests that coriandrin, a constituent of coriander, has photosensitizing effects.

Likelihood Possible Evidence D
Coriander seed extract full monograph & interactions

Cape Aloe leaf extract7 drug types · 461 drugs

Digoxin (Lanoxin)

Theoretically, aloe latex might increase the risk of adverse effects when taken with cardiac glycosides.
Overuse of aloe latex can increase the risk of adverse effects from cardiac glycoside drugs, such as digoxin, due to potassium depletion. Overuse of aloe, along with cardiac glycoside drugs, can increase the risk of toxicity.

Likelihood Probable Evidence D
Anticoagulant/Antiplatelet Drugs

Theoretically, aloe gel might increase the risk of bleeding when taken with anticoagulant or antiplatelet drugs.
In vitro research shows that aloe gel can inhibit platelet aggregation. This inhibition was greater than that seen with celecoxib, but less than that seen with aspirin.

Likelihood Possible Evidence D
Antidiabetes Drugs

Aloe might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Preliminary clinical research suggests aloe gel might lower blood glucose levels and have additive effects when used with antidiabetes drugs. Monitor blood glucose levels closely.

Likelihood Possible Evidence D
Diuretic Drugs

Theoretically, aloe latex might increase the risk of hypokalemia when taken with diuretic drugs.
Overuse of aloe latex might compound diuretic-induced potassium loss, increasing the risk of hypokalemia.

Likelihood Possible Evidence D
Stimulant Laxatives

Theoretically, aloe latex might increase the risk for fluid and electrolyte loss when taken with stimulant laxatives.
Due to cathartic laxative effects of aloe latex, concomitant use with other stimulant laxatives might compound fluid and electrolyte loss.

Likelihood Possible Evidence D
Warfarin (Coumadin)

Theoretically, aloe latex might increase the risk of bleeding when taken with warfarin.
Aloe latex has stimulant laxative effects. In some people aloe latex 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 aloe vera.

Likelihood Possible Evidence D
Cytochrome P450 1A2 (Cyp1A2) Substrates

Theoretically, aloe might decrease the levels and clinical effects of CYP1A2 substrates.
In vitro research shows that aloe extract induces CYP1A2 enzymes.

Likelihood Possible Evidence D
Cape Aloe leaf extract full monograph & interactions

Cumin Seed Extract3 drug types · 211 drugs

Anticoagulant/Antiplatelet Drugs

Theoretically, cumin might increase the risk of bleeding when used with antiplatelet or anticoagulant drugs.
In vitro evidence suggests that cumin can inhibit platelet aggregation. Theoretically, cumin might increase the risk of bleeding when used with antiplatelet or anticoagulant drugs.

Likelihood Possible Evidence D
Antidiabetes Drugs

Theoretically, cumin might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Animal research suggests that cumin can lower blood sugar in diabetic animals. However, research in humans with and without diabetes has found conflicting results.

Likelihood Probable Evidence D
Rifampin (Rifadin)

Theoretically, cumin might increase the effects and adverse effects of rifampin.
Animal research suggests that an aqueous extract of cumin containing a specific flavonoid glycoside can increase the bioavailability and plasma levels of rifampin.

Likelihood Possible Evidence D
Cumin Seed Extract full monograph & interactions

Amla, Powder4 drug types · 208 drugs

Anticoagulant/Antiplatelet Drugs

Theoretically, Indian gooseberry may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs; however, research is conflicting.
Clinical research shows that taking Indian gooseberry 500 mg as a single dose or twice daily for 10 days reduces platelet aggregation by about 24% to 36%, increases bleeding time by about 3.8-5.9 seconds, and increases clotting time by about 9.8-12.7 seconds when compared to baseline. However, taking Indian gooseberry 500 mg along with clopidogrel 75 mg or ecosprin 75 mg, as a single dose or for 10 days, does not significantly reduce platelet aggregation or increase bleeding time or clotting time when compared with clopidogrel 75 mg or ecosprin 75 mg alone. Until more is known, use caution when taking Indian gooseberry in combination with anticoagulant/antiplatelet drugs.

Likelihood Possible Evidence B
Antidiabetes Drugs

Taking Indian gooseberry with antidiabetes drugs might increase the risk of hypoglycemia.
Clinical research shows that taking Indian gooseberry fruit or fruit extract alone or in conjunction with antidiabetes medications can lower blood glucose levels. Dose adjustments to diabetes medications might be necessary.

Likelihood Possible Evidence B
Aspirin

Theoretically, Indian gooseberry may increase the risk of bleeding if used with aspirin; however, research is conflicting.
Clinical research shows that taking Indian gooseberry 500 mg as a single dose or twice daily for 10 days reduces platelet aggregation by about 24% to 36%, increases bleeding time by about 3.8-5.9 seconds, and increases clotting time by about 9.8-12.7 seconds when compared to baseline. However, taking a single dose of Indian gooseberry 500 mg along with ecosprin 75 mg, or taking a combination of Indian gooseberry 500 mg twice daily plus ecosprin 75 mg once daily for 10 days, does not significantly reduce platelet aggregation or increase bleeding time or clotting time when compared with ecosprin 75 mg alone.

Likelihood Possible Evidence B
Clopidogrel (Plavix)

Theoretically, Indian gooseberry may increase the risk of bleeding if used with clopidogrel; however, research is conflicting.
Clinical research shows that taking Indian gooseberry 500 mg as a single dose or twice daily for 10 days reduces platelet aggregation by about 24% to 36%, increases bleeding time by about 3.8-5.9 seconds, and increases clotting time by about 9.8-12.7 seconds when compared to baseline. However, taking a single dose of Indian gooseberry 500 mg along with clopidogrel 75 mg, or taking a combination of Indian gooseberry 500 mg twice daily plus clopidogrel 75 mg once daily for 10 days, does not significantly reduce platelet aggregation or increase bleeding time or clotting time when compared with clopidogrel 75 mg alone.

Likelihood Possible Evidence B
Amla, Powder full monograph & interactions

Unique IS-2 Bacillus coagulans1 drug type · 182 drugs

Antibiotic Drugs

Theoretically, taking antibiotics with Bacillus coagulans might decrease the effectiveness of B. coagulans.
B. coagulans preparations usually contain live and active organisms. Therefore, simultaneously taking antibiotics might kill a significant number of the organisms. Tell patients to separate administration of antibiotics and B. coagulans preparations by at least two hours.

Likelihood Probable Evidence D
Unique IS-2 Bacillus coagulans full monograph & interactions
The maker

Brand information

Manufacturer and brand details for Aloe & Triphala Active-Cleanse and Probiotics, from the product label.

Irwin Naturals

See all Irwin Naturals products
Name
Irwin Naturals
Street Address
5310 Beethoven Street
City
Los Angeles
State
CA
ZipCode
90066
Phone Number
1-800-297-3273
Web Address
www.IrwinNaturals.com
Pharmacist Counseling Corner

Aloe & Triphala Active-Cleanse and Probiotics by Irwin Naturals: Common Questions

Does Aloe & Triphala Active-Cleanse and Probiotics by Irwin Naturals interact with any medications?
Yes. Based on its ingredients, Aloe & Triphala Active-Cleanse and Probiotics has a known interaction with 1,500 medications, including 1 rated major. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Aloe & Triphala Active-Cleanse and Probiotics contains 13 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 take this while pregnant or breastfeeding?
Ginger and coriander are likely safe in pregnancy and lactation. Fennel, however, is rated possibly unsafe during pregnancy and possibly unsafe while breastfeeding due to hormone-like effects and limited safety data — avoid medicinal amounts. Indian gooseberry has insufficient safety data for pregnancy and lactation. Talk to your pharmacist or doctor to weigh the risks and benefits for your situation.
What side effects might I experience?
Ginger may cause heartburn, burping, diarrhea, or a pepper-like irritation in the mouth and throat — especially at higher doses. Fennel and coriander can occasionally trigger allergic reactions including rare cases of anaphylaxis in sensitive people. Cumin may cause gastrointestinal upset. The probiotic is well tolerated in healthy people. If you have a severe allergy to spices, use caution.
Does this product actually cleanse or detoxify?
The evidence in our data does not establish that these ingredients 'cleanse' or 'detoxify' the body in the way the label suggests. Ginger, fennel, and the bacillus coagulans probiotic do have some evidence for digestive benefits like nausea relief and bowel regularity, but that is different from a general cleanse.
If I take antibiotics, can I still use this?
The bacillus coagulans probiotic in this product may be killed by antibiotics if taken at the same time. Separate them by a few hours — take your antibiotic and wait, then take this product later (or vice versa). Also, check whether any of the other ingredients in this product interact with your specific antibiotic using the tool on this page.
Is the black pepper extract (BioPerine) safe?
Black pepper used as a food spice is generally safe. BioPerine, a concentrated extract, is well tolerated in normal doses, but it is a strong booster of how your body absorbs other medications — it can increase blood levels of many drugs. This is why it's important to check your exact medications before starting.
What is triphala, and does it work?
Triphala is a traditional Ayurvedic blend of three dried fruits. The individual fruits in it are listed separately on the label. We do not have enough evidence in our data to say whether triphala as a whole is effective, but the bacillus coagulans probiotic in this product is possibly effective for constipation and IBS.

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

Not sure if Aloe & Triphala Active-Cleanse and Probiotics is safe with your meds?

Our pharmacists answer your medication & supplement questions — free.

Ask a pharmacist

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.

Aloe & Triphala Active-Cleanse and Probiotics label
Go deeper

The Full Monographs Behind Aloe & Triphala Active-Cleanse and Probiotics’s Ingredients

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

Herb & supplement monograph

Olive

Olive comes from the same tree that gives us olives and olive oil, and its leaf and fruit contain antioxidant compounds like oleuropein and hydroxytyrosol. Olive oil as part of a Mediterrane...

Read the full Olive monograph → Herb & supplement monograph

Ginger

Interacts with 1,007 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 vomiting, including from motion sickness, pr...

Read the full Ginger monograph → Herb & supplement monograph

Black Pepper

Interacts with 1,019 drugs

Black pepper is a common kitchen spice that is generally safe in the amounts used in food. Its extract, piperine, is mostly added to supplements to help the body absorb other ingredients (li...

Read the full Black Pepper 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 → Herb & supplement monograph

Indian Gooseberry

Interacts with 208 drugs

Indian gooseberry (amla) is a vitamin C-rich fruit used in Ayurvedic medicine for many purposes, from antioxidant support to cholesterol and digestion. Early research is promising for some u...

Read the full Indian Gooseberry monograph → Herb & supplement monograph

Bacillus Coagulans

Interacts with 182 drugs

Bacillus coagulans is a spore-forming probiotic that survives stomach acid well and may help with some digestive problems such as IBS, constipation, and certain types of diarrhea. The eviden...

Read the full Bacillus Coagulans monograph → Herb & supplement monograph

Aloe

Interacts with 461 drugs

Aloe vera gel is widely used on the skin for minor burns and irritation, and some research suggests it may help. Aloe latex (the yellow part) is a strong laxative that can cause cramping and...

Read the full Aloe monograph → Herb & supplement monograph

Coriander

Interacts with 717 drugs

Coriander (also called cilantro) is a common cooking herb and spice that has long been used in traditional medicine for digestive complaints. As a food it is generally safe for most people,...

Read the full Coriander monograph → Herb & supplement monograph

Cumin

Interacts with 211 drugs

Cumin is a common cooking spice that has a long history in traditional medicine for digestion and other complaints. Food amounts are generally safe for most people, but the evidence for medi...

Read the full Cumin monograph →
Sources

Sources & How We Checked

Aloe & Triphala Active-Cleanse and Probiotics'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 201 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.

Olive 2 references
  1. Liccardi G, D'Amato M, D'Amato G. Oleaceae pollinosis: a review. Int Arch Allergy Immunol 1996;111:210-7. PubMed
  2. Somerville V, Moore R, Braakhuis A. The effect of olive leaf extract on upper respiratory illness in high school athletes: A randomised control trial. Nutrients. 2019;11(2). pii: E358. PubMed

See these in context on the Olive monograph →

Ginger 64 references
  1. 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
  2. Jewell D, Young G. Interventions for nausea and vomiting in early pregnancy. Cochrane Database Syst Rev 2000;(2):CD000145. PubMed
  3. 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
  4. 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
  5. Srivastava KC. Effect of onion and ginger consumption on platelet thromboxane production in humans. Prostaglandins Leukot Essent Fatty Acids 1989;35:183-5. PubMed
  6. Stewart JJ, Wood MJ, Wood CD, Mims ME. Effects of ginger on motion sickness susceptibility and gastric function. Pharmacology 1991;42:111-20. PubMed
  7. 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
  8. 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
  9. 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
  10. Ghayur MN, Gilani AH. Ginger lowers blood pressure through blockade of voltage-dependent calcium channels. J Cardiovasc Pharmacol 2005;45:74-80. PubMed
  11. 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
  12. Kanerva L, Estlander T, Jolanki R. Occupational allergic contact dermatitis from spices. Contact Dermatitis 1996;35:157-62. PubMed
  13. 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.
  14. Kruth P, Brosi E, Fux R, et al. Ginger-associated overanticoagulation by phenprocoumon. Ann Pharmacother 2004;38:257-60. PubMed
  15. 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
  16. 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
  17. 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
  18. 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
  19. 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.
  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
  21. 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
  22. 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
  23. 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
  24. Backon J. Ginger as an antiemetic: possible side effects due to its thromboxane synthetase activity. Anaesthesia. 1991;46(8):705-6.. PubMed
  25. Abebe W. Herbal medication: potential for adverse interactions with analgesic drugs. J Clin Pharm Ther. 2002;27:391-401. PubMed
  26. Argento A, Tiraferri E, Marzaloni M. [Oral anticoagulants and medicinal plants. An emerging interaction]. Ann Ital Med Int. 2000;15:139-43.
  27. 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
  28. 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
  29. 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
  30. Lesho EP, Saullo L, Udvari-Nagy S. A 76-year-old woman with erratic anticoagulation. Cleve Clin J Med. 2004;71:651-6. PubMed
  31. 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
  32. 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
  33. 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
  34. 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.
  35. 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.
  36. 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.
  37. 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.
  38. Futrell, J. M. and Rietschel, R. L. Spice allergy evaluated by results of patch tests. Cutis 1993;52(5):288-290.
  39. 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.
  40. 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.
  41. 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.
  42. 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
  43. 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.
  44. 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
  45. Paramdeep G. Efficacy and tolerability of ginger (Zingiber officinale) in patients of osteoarthritis of knee. Indian J Physiol Pharmacol 2013;57(2):177-83.
  46. 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
  47. 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
  48. 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
  49. 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.
  50. 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
  51. 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
  52. 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.
  53. 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.
  54. 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.
  55. Okuhira H, Nakatani Y, Furukawa F, Kanazawa N. Anaphylaxis to ginger induced by herbal medicine. Allergol Int. 2020;69(1):159-160. PubMed
  56. 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
  57. 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
  58. 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.
  59. 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
  60. 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
  61. 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
  62. 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.
  63. Committee on Practice Bulletins-Obstetrics. ACOG Practice Bulletin No. 189: Nausea And Vomiting Of Pregnancy. Obstet Gynecol. 2018;131(1):e15-e30. PubMed
  64. 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

See these in context on the Ginger monograph →

Fennel 17 references
  1. Leung AY, Foster S. Encyclopedia of Common Natural Ingredients Used in Food, Drugs and Cosmetics. 2nd ed. New York, NY: John Wiley & Sons, 1996.
  2. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
  3. Zhu M, Wong PY, Li RC. Effect of oral administration of fennel (Foeniculum vulgare) on ciprofloxacin absorption and disposition in the rat. J Pharm Pharmacol 1999;51:1391-6.
  4. Gral N, Beani JC, Bonnot D, et al. [Plasma levels of psoralens after celery ingestion]. Ann Dermatol Venereol 1993;120:599-603.
  5. Burkhard PR, Burkhardt K, Haenggeli CA, Landis T. Plant-induced seizures: reappearance of an old problem. J Neurol 1999;246:667-70. PubMed
  6. Rosti L, Nardini A, Bettinelli ME, Rosti D. Toxic effects of a herbal tea mixture in two newborns. Acta Paediatrica 1994;83:683. PubMed
  7. Cuzzolin L, Zaffani S, and Benoni G. Safety implications regarding use of phytomedicines. Eur.J Clin Pharmacol. 2006;62:37-42. PubMed
  8. Tognolini, M., Ballabeni, V., Bertoni, S., Bruni, R., Impicciatore, M., and Barocelli, E. Protective effect of Foeniculum vulgare essential oil and anethole in an experimental model of thrombosis. Pharmacol.Res 2007;56(3):254-260. PubMed
  9. Subehan, Usia, T., Iwata, H., Kadota, S., and Tezuka, Y. Mechanism-based inhibition of CYP3A4 and CYP2D6 by Indonesian medicinal plants. J Ethnopharmacol. 5-24-2006;105(3):449-455. PubMed
  10. Tognolini, M., Barocelli, E., Ballabeni, V., Bruni, R., Bianchi, A., Chiavarini, M., and Impicciatore, M. Comparative screening of plant essential oils: phenylpropanoid moiety as basic core for antiplatelet activity. Life Sci. 2-23-2006;78(13):1419-1432. PubMed
  11. Subehan, Zaidi, S. F., Kadota, S., and Tezuka, Y. Inhibition on human liver cytochrome P450 3A4 by constituents of fennel (Foeniculum vulgare): identification and characterization of a mechanism-based inactivator. J Agric.Food Chem. 12-12-2007;55(25):101 PubMed
  12. LEVY, S. B. Bronchial asthma due to ingestion of fennel and fennel seed. Ann.Allergy 1948;6(4):415.
  13. Ottolenghi, A., De Chiara, A., Arrigoni, S., Terracciano, L., and De Amici, M. [Diagnosis of food allergy caused by fruit and vegetables in children with atopic dermatitis]. Pediatr Med Chir 1995;17(6):525-530.
  14. Trabace L, Tucci P, Ciuffreda L, et al. "Natural" relief of pregnancy-related symptoms and neonatal outcomes: above all do no harm. J Ethnopharmacol. 2015;174:396-402. PubMed
  15. Denaxa D, Arkwright PD. Fennel as a cause of immediate hypersensitivity to toothpaste. Ann Allergy Asthma Immunol. 2020;125(1):99-100. PubMed
  16. Lee HW, Ang L, Lee MS, Alimoradi Z, Kim E. Fennel for reducing pain in primary dysmenorrhea: a systematic review and meta-analysis of randomized controlled trials. Nutrients 2020;12(11):3438. PubMed
  17. Mathew T, John SK, Javali M, Vasireddy M, Nadig R, Sarma GRK. Substance use related cluster headache: A case series. Headache 2022;62(7):908-910. PubMed

See these in context on the Fennel monograph →

Indian Gooseberry 6 references
  1. Sabu, M. C. and Kuttan, R. Anti-diabetic activity of medicinal plants and its relationship with their antioxidant property. J Ethnopharmacol. 2002;81(2):155-160. PubMed
  2. Fatima N, Pingali U, Muralidhar N. Study of pharmacodynamic interaction of Phyllanthus emblica extract with clopidogrel and ecosprin in patients with type II diabetes mellitus. Phytomedicine. 2014;21(5):579-85. PubMed
  3. Shanmugarajan D, Girish C, Harivenkatesh N, Chanaveerappa B, Prasanna Lakshmi NC. Antihypertensive and pleiotropic effects of Phyllanthus emblica extract as an add-on therapy in patients with essential hypertension-A randomized double-blind placebo-contro
  4. Akhtar MS, Ramzan A, Ali A, Ahmad M. Effect of amla fruit (Emblica officinalis Gaertn.) on blood glucose and lipid profile of normal subjects and type 2 diabetic patients. Int J Food Sci Nutr. 2011;62(6):609-16.
  5. Usharani P, Fatima N, Muralidhar N. Effects of Phyllanthus emblica extract on endothelial dysfunction and biomarkers of oxidative stress in patients with type 2 diabetes mellitus: a randomized, double-blind, controlled study. Diabetes Metab Syndr Obes. 20 PubMed
  6. Majeed M, Mundkur L, Paulose S, Nagabhushanam K. Novel Emblica officinalis extract containing ß-glucogallin vs. metformin: a randomized, open-label, comparative efficacy study in newly diagnosed type 2 diabetes mellitus patients with dyslipidemia. Food Fu

See these in context on the Indian Gooseberry monograph →

Bacillus Coagulans 20 references
  1. Saxelin M, Chuang NH, Chassy B, et al. Lactobacilli and bacteremia in southern Finland 1989-1992. Clin Infect Dis 1996;22:564-6. PubMed
  2. Tynkkynen S, Singh KV, Varmanen P. Vancomycin resistance factor of Lactobacillus rhamnosus GG in relation to enterococcal vancomycin resistance (van) genes. Int J Food Microbiol 1998;41:195-204. PubMed
  3. Klein G, Zill E, Schindler R, et al. Peritonitis associated with vancomycin-resistant Lactobacillus rhamnosus in a continuous ambulatory peritoneal dialysis patient; organism identification, antibiotic therapy, and case report. J Clin Microbiol 1998;36:
  4. Kalima P, Masterton RG, Roddie PH, et al. Lactobacillus rhamnosus infection in a child following bone marrow transplant. J Infect 1996;32:165-7. PubMed
  5. Goldin BR. Health Benefits of probiotics. Br J Nutr 1998;80:S203-7. DOI
  6. Rautio M, Jousimies-Somer H, Kauma H, et al. Liver abscess due to Lactobacillus rhamnosus strain indistinguishable from L. rhamnosus strain GG. Clin Infect Dis 1999;28:1159-60.
  7. MacGregor G, Smith AJ, Thakker B, Kinsella J. Yoghurt biotherapy: contraindicated in immunosuppressed patients? Postgrad Med J 2002;78:366-7. PubMed
  8. Land MH, Rouster-Stevens K, Woods CR, et al. Lactobacillus sepsis associated with probiotic therapy. Pediatrics 2005;115:178-81.
  9. De Groote MA, Frank DN, Dowell E, et al. Lactobacillus rhamnosus GG bacteremia associated with probiotic use in a child with short gut syndrome. Pediatr Infect Dis J 2005;24:278-80. PubMed
  10. Vahabnezhad E, Mochon AB, Wozniak LJ, Ziring DA. Lactobacillus bacteremia associated with probiotic use in a pediatric patient with ulcerative colitis. J Clin Gastroenterol. 2013;47(5):437-9. PubMed
  11. Pruccoli G, Silvestro E, Pace Napoleone C, Aidala E, Garazzino S, Scolfaro C. Are probiotics safe? Bifidobacterium bacteremia in a child with severe heart failure. Infez Med. 2019;27(2):175-178.
  12. Sendil S, Shrimanker I, Mansoora Q, Goldman J, Nookala VK. Lactobacillus rhamnosus bacteremia in an immunocompromised renal transplant patient. Cureus. 2020;12(2):e6887. PubMed
  13. Albarillo FS, Shah U, Joyce C, Slade D. Lactobacillus rhamnosus Infection: A single-center 4-year descriptive analysis. J Glob Infect Dis. 2020;12(3):119-123. PubMed
  14. Pasala S, Singer L, Arshad T, Roach K. Lactobacillus endocarditis in a healthy patient with probiotic use. IDCases. 2020;22:e00915. PubMed
  15. Agrawal S, Tuchman ES, Bruce MJ, Theodorou ME. Fatal Lactobacillus endocarditis in a patient with transcatheter aortic valve replacement. BMJ Case Rep. 2020;13(11):e236835.
  16. Antoun M, Hattab Y, Akhrass FA, Hamilton LD. Uncommon pathogen, Lactobacillus, causing infective endocarditis: Case report and review. Case Rep Infect Dis. 2020;2020:8833948. PubMed
  17. Rossi F, Amadoro C, Gasperi M, Colavita G. Lactobacilli infection case reports in the last three years and safety implications. Nutrients. 2022;14(6):1178. PubMed
  18. Franko B, Vaillant M, Recule C, Vautrin E, et al. Lactobacillus paracasei endocarditis in a consumer of probiotics. Med Mal Infect. 2013;43(4):171-3. PubMed
  19. Campbell RE, Miller A, Afroze A. Native valve endocarditis secondary to Lactobacillus paracasei bacteremia. Consultant. 2020;60(9):27-8. DOI
  20. Kato K, Funabashi N, Takaoka H, et al. Lactobacillus paracasei endocarditis in a consumer of probiotics with advanced and severe bicuspid aortic valve stenosis complicated with diffuse left ventricular mid-layer fibrosis. Int J Cardiol. 2016;224:157-161. PubMed

See these in context on the Bacillus Coagulans monograph →

Aloe 41 references
  1. Newall CA, Anderson LA, Philpson JD. Herbal Medicine: A Guide for Healthcare Professionals. London, UK: The Pharmaceutical Press, 1996.
  2. Wichtl MW. Herbal Drugs and Phytopharmaceuticals. Ed. N.M. Bisset. Stuttgart: Medpharm GmbH Scientific Publishers, 1994.
  3. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
  4. 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
  5. Luyckx VA, Ballantine R, Claeys M, et al. Herbal remedy-associated acute renal failure secondary to Cape aloes. Am J Kidney Dis 2002;39:E13. PubMed
  6. Rajasekaran S, Sivagnanam K, Ravi K, Subramanian S. Hypoglycemic effect of Aloe vera gel on streptozotocin-induced diabetes in experimental rats. J Med Food 2004;7:61-6.
  7. Williams MS, Burk M, Loprinzi CL, et al. Phase III double-blind evaluation of an aloe vera gel as a prophylactic agent for radiation-induced skin toxicity. Int J Radiat Oncol Biol Phys 1996;36:345-9. PubMed
  8. Vogler BK, Ernst E. Aloe vera: a systematic review of its clinical effectiveness. Br J Gen Pract 1999;49:823-8.
  9. Bottenberg MM, Wall GC, Harvey RL, Habib S. Oral aloe vera-induced hepatitis. Ann Pharmacother 2007;41:1740-3. PubMed
  10. Rabe C, Musch A, Schirmacher P, et al. Acute hepatitis induced by an Aloe vera preparation: a case report. World J Gastroenterol 2005;11:303-4. PubMed
  11. Kanat O, Ozet A, Ataergin S. Aloe vera-induced acute toxic hepatitis in a healthy young man. Eur J Int Med 2006;17:589. PubMed
  12. Mueller SO, Stopper H. Characterization of the genotoxicity of anthraquinones in mammalian cells. Biochim Biophys Acta 1999;1428:406-14. PubMed
  13. Schorkhuber M, Richter M, Dutter A, et al. Effect of anthraquinone laxatives on the proliferation and urokinase secretion of normal, premalignant and malignant colonic epithelial cells. Eur J Cancer 1998;34:1091-8. PubMed
  14. Yang HN, Kim DJ, Kim YM, et al. Aloe-induced toxic hepatitis. J Korean Med Sci 2010;25:492-5. PubMed
  15. Choonhakarn C, Busaracome P, Sripanidkulchai B, et al. A prospective, randomized clinical trial comparing topical aloe vera with 0.1% triamcinolone acetonide in mild to moderate plaque psoriasis. J.Eur.Acad.Dermatol.Venereol. 2010;24:168-72. PubMed
  16. Ishii Y, Tanizawa H, Takino Y. Studies of aloe. IV. Mechanism of cathartic effect. (3). Biol Pharm Bull. 1994;17:495-7. PubMed
  17. Ishii Y, Tanizawa H, Takino Y. Studies of aloe. V. Mechanism of cathartic effect. (4). Biol Pharm Bull. 1994;17:651-3. PubMed
  18. Nelemans FA. Clinical and toxicological aspects of anthraquinone laxatives. Pharmacology. 1976;14 Suppl 1:73-7. PubMed
  19. Paulsen E, Korsholm L, Brandrup F. A double-blind, placebo-controlled study of a commercial Aloe vera gel in the treatment of slight to moderate psoriasis vulgaris. J Eur Acad Dermatol Venereol. 2005;19:326-31.
  20. Huseini HF, Kianbakht S, Hajiaghaee R, et al. Anti-hyperglycemic and anti-hypercholesterolemic effects of Aloe vera leaf gel in hyperlipidemic type 2 diabetic patients: a randomized double-blind placebo-controlled clinical trial. Planta Med. 2012;78:311-6
  21. Ferreira, M., Teixeira, M., Silva, E., and Selores, M. Allergic contact dermatitis to Aloe vera. Contact Dermatitis 2007;57(4):278-279.
  22. Choonhakarn, C., Busaracome, P., Sripanidkulchai, B., and Sarakarn, P. The efficacy of aloe vera gel in the treatment of oral lichen planus: a randomized controlled trial. Br J Dermatol 2008;158(3):573-577. PubMed
  23. Baretta, Z., Ghiotto, C., Marino, D., and Jirillo, A. Aloe-induced hypokalemia in a patient with breast cancer during chemotherapy. Ann.Oncol. 2009;20(8):1445-1446. PubMed
  24. Hunter, D. and Frumkin, A. Adverse reactions to vitamin E and aloe vera preparations after dermabrasion and chemical peel. Cutis 1991;47(3):193-196.
  25. Alvarez-Perea, A., Garcia, A. P., Hernandez, A. L., de, Barrio M., and Baeza, M. L. Urticaria due to aloe vera: a new sensitizer? Ann.Allergy Asthma Immunol. 2010;105(5):404-405. PubMed
  26. Hogan, D. J. Widespread dermatitis after topical treatment of chronic leg ulcers and stasis dermatitis. CMAJ. 2-15-1988;138(4):336-338.
  27. Savchak VI. Acute bullous allergic dermatitis due to local application of aloe leaves. Vestnik Dermatologii i Venerologii 1977;12:44-45.
  28. Nakamura, T. and Kotajima, S. Contact dermatitis from aloe arborescens. Contact Dermatitis 1984;11(1):51. PubMed
  29. Shoji, A. Contact dermatitis to Aloe arborescens. Contact Dermatitis 1982;8(3):164-167. PubMed
  30. Morrow, D. M., Rapaport, M. J., and Strick, R. A. Hypersensitivity to aloe. Arch Dermatol. 1980;116(9):1064-1065. DOI
  31. Cosmetic Ingredient Review Expert Panel. Final report on the safety assessment of AloeAndongensis Extract, Aloe Andongensis Leaf Juice,aloe Arborescens Leaf Extract, Aloe Arborescens Leaf Juice, Aloe Arborescens Leaf Protoplasts, Aloe Barbadensis Flower E
  32. Bhalang K, Thunyakitpisal P, Rungsirisatean N. Acemannan, a polysaccharide extracted from Aloe vera, is effective in the treatment of oral aphthous ulceration. J Altern Complement Med 2013;19(5):429-34.
  33. Hajheydari Z, Saeedi M, Morteza-Semnani K, Soltani A. Effect of Aloe vera topical gel combined with tretinoin in treatment of mild and moderate acne vulgaris: a randomized, double-blind, prospective trial. J Dermatolog Treat 2014;25(2):123-9.
  34. 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
  35. Lee J, Lee MS, Nam KW. Acute toxic hepatitis caused by an aloe vera preparation in a young patient: a case report with a literature review. Korean J Gastroenterol 2014;64(1):54-8. PubMed
  36. Guo X, Mei N. Aloe Vera - A Review of Toxicity and Adverse Clinical Effects. J Environ Sci Health C Environ Carcinog Ecotoxicol Rev 2016;34(2):77-96.
  37. Hoogenboom TCH, Patel N, Cook NA, Williams R, Taylor-Robinson SD, Lim AKP. The effect of Aloe vera juice on liver enzymes and hepatic structure in a healthy population. Integr Med (Encinitas) 2020;19(3):30-4.
  38. Mushtaq S, Mushtaq Z, Sarfraz J, et al. Comparison of effect of aloe vera gel with aspirin and celecoxib on platelet aggregation. Professional Med J. 2020; 27(5):973-978. DOI
  39. 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
  40. Sabbaghzadegan S, Soltani MH, Kamalinejad M, Bahrami M, Kabir A, Dadmehr M. The effect of a standardized capsule of Aloe vera gel on the quality of life in patients with systolic heart failure: A randomized double-blind placebo-controlled clinical trial.
  41. Lewis ED, Crowley DC, Guthrie N, Evans M. Healthy adults supplemented with a nutraceutical formulation containing Aloe vera gel, rosemary and Poria cocos enhances the effect of influenza vaccination in a randomized, triple-blind, placebo-controlled trial. PubMed

See these in context on the Aloe monograph →

Coriander 12 references
  1. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
  2. Swanston-Flatt SK, Day C, Bailey CJ, Flatt PR. Traditional plant treatments for diabetes. Studies in normal and streptozotocin diabetic mice. Diabetologia 1990;33:462-4. PubMed
  3. Gray, A. M. and Flatt, P. R. Insulin-releasing and insulin-like activity of the traditional anti-diabetic plant Coriandrum sativum (coriander). Br.J Nutr. 1999;81(3):203-209.
  4. Kanerva, L. and Soini, M. Occupational protein contact dermatitis from coriander. Contact Dermatitis 2001;45(6):354-355. PubMed
  5. Emamghoreishi, M., Khasaki, M., and Aazam, M. F. Coriandrum sativum: evaluation of its anxiolytic effect in the elevated plus-maze. J Ethnopharmacol. 1-15-2005;96(3):365-370. PubMed
  6. Ebo, D. G., Bridts, C. H., Mertens, M. H., and Stevens, W. J. Coriander anaphylaxis in a spice grinder with undetected occupational allergy. Acta Clin Belg. 2006;61(3):152-156. PubMed
  7. Eidi, M., Eidi, A., Saeidi, A., Molanaei, S., Sadeghipour, A., Bahar, M., and Bahar, K. Effect of coriander seed (Coriandrum sativum L.) ethanol extract on insulin release from pancreatic beta cells in streptozotocin-induced diabetic rats. Phytother.Res
  8. Jabeen, Q., Bashir, S., Lyoussi, B., and Gilani, A. H. Coriander fruit exhibits gut modulatory, blood pressure lowering and diuretic activities. J Ethnopharmacol. 2-25-2009;122(1):123-130. PubMed
  9. van Toorenenbergen, A. W. and Dieges, P. H. Immunoglobulin E antibodies against coriander and other spices. J Allergy Clin Immunol. 1985;76(3):477-481. PubMed
  10. Ashwood-Smith, M. J., Warrington, P. J., Jenkins, M., Ceska, O., and Romaniuk, P. J. Photobiological properties of a novel, naturally occurring furoisocoumarin, coriandrin. Photochem.Photobiol. 1989;50(6):745-751. PubMed
  11. Sastre, J., Olmo, M., Novalvos, A., Ibanez, D., and Lahoz, C. Occupational asthma due to different spices. Allergy 1996;51(2):117-120. PubMed
  12. Beikert FC, Anastasiadou Z, Fritzen B, Frank U, Augustin M. Topical treatment of tinea pedis using 6% coriander oil in unguentum leniens: a randomized, controlled, comparative pilot study. Dermatology. 2013;226(1):47-51. PubMed

See these in context on the Coriander monograph →

Cumin 10 references
  1. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
  2. Anliker, M. D., Borelli, S., and Wuthrich, B. Occupational protein contact dermatitis from spices in a butcher: a new presentation of the mugwort-spice syndrome. Contact Dermatitis 2002;46(2):72-74. PubMed
  3. Dhandapani, S., Subramanian, V. R., Rajagopal, S., and Namasivayam, N. Hypolipidemic effect of Cuminum cyminum L. on alloxan-induced diabetic rats. Pharmacol.Res 2002;46(3):251-255. PubMed
  4. Sachin, B. S., Sharma, S. C., Sethi, S., Tasduq, S. A., Tikoo, M. K., Tikoo, A. K., Satti, N. K., Gupta, B. D., Suri, K. A., Johri, R. K., and Qazi, G. N. Herbal modulation of drug bioavailability: enhancement of rifampicin levels in plasma by herbal pro
  5. Jagtap, A. G. and Patil, P. B. Antihyperglycemic activity and inhibition of advanced glycation end product formation by Cuminum cyminum in streptozotocin induced diabetic rats. Food Chem.Toxicol. 5-6-2010; PubMed
  6. Srivastava, K. C. Extracts from two frequently consumed spices--cumin (Cuminum cyminum) and turmeric (Curcuma longa)--inhibit platelet aggregation and alter eicosanoid biosynthesis in human blood platelets. Prostaglandins Leukot.Essent.Fatty Acids 1989;3 PubMed
  7. Futrell, J. M. and Rietschel, R. L. Spice allergy evaluated by results of patch tests. Cutis 1993;52(5):288-290.
  8. Boxer, M., Roberts, M., and Grammer, L. Cumin anaphylaxis: a case report. J.Allergy Clin.Immunol. 1997;99(5):722-723. PubMed
  9. Karimian J, Farrokhzad A, Jalili C. The effect of cumin (Cuminum cyminum L.) supplementation on glycemic indices: A systematic review and meta-analysis of randomized controlled trials. Phytother Res 2021;35(8):4127-4135.
  10. Tavakoli-Rouzbehani OM, Faghfouri AH, Anbari M, et al. The effects of Cuminum cyminum on glycemic parameters: a systematic review and meta-analysis of controlled clinical trials. J Ethnopharmacol 2021;281:114510. PubMed

See these in context on the Cumin monograph →

Black Pepper 29 references
  1. Leung AY, Foster S. Encyclopedia of Common Natural Ingredients Used in Food, Drugs and Cosmetics. 2nd ed. New York, NY: John Wiley & Sons, 1996.
  2. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
  3. Bano G, Amla V, Raina RK, et al. The effect of piperine on pharmacokinetics of phenytoin in healthy volunteers. Planta Med 1987;53:568-9. PubMed
  4. Bano G, et al. Effect of piperine on bioavailability and pharmacokinetics of propranolol and theophylline in healthy volunteers. Eur J Clin Pharmacol 1991;41;615-7. PubMed
  5. Cohle SD, Trestrail JD III, Graham MA, et al. Fatal pepper aspiration. Am J Dis Child 1988;142:633-6. PubMed
  6. Bhardwaj RK, Glaeser H, Becquemont L, et al. Piperine, a major constituent of black pepper, inhibits human P-glycoprotein and CYP3A4. J Pharmacol Exp Ther 2002;302:645-50. PubMed
  7. Velpandian T, Jasuja R, Bhardwaj RK, et al. Piperine in food: interference in the pharmacokinetics of phenytoin. Eur J Drug Metab Pharmacokinet 2001;26:241-7. PubMed
  8. Pattanaik S, Hota D, Prabhakar S, et al. Pharmacokinetic interaction of a single dose of piperine with steady-state carbamazepine in epilepsy patients. Phytother Res 2009;23:1281-6.
  9. Munakata, M., Kobayashi, K., Niisato-Nezu, J., Tanaka, S., Kakisaka, Y., Ebihara, T., Ebihara, S., Haginoya, K., Tsuchiya, S., and Onuma, A. Olfactory stimulation using black pepper oil facilitates oral feeding in pediatric patients receiving long-term en
  10. Myers, B. M., Smith, J. L., and Graham, D. Y. Effect of red pepper and black pepper on the stomach. Am J Gastroenterol 1987;82(3):211-214.
  11. Raghavendra, R. H. and Naidu, K. A. Spice active principles as the inhibitors of human platelet aggregation and thromboxane biosynthesis. Prostaglandins Leukot.Essent.Fatty Acids 2009;81(1):73-78. PubMed
  12. Subehan, Usia, T., Kadota, S., and Tezuka, Y. Mechanism-based inhibition of human liver microsomal cytochrome P450 2D6 (CYP2D6) by alkamides of Piper nigrum. Planta Med 2006;72(6):527-532.
  13. Kasibhatta, R. and Naidu, M. U. Influence of piperine on the pharmacokinetics of nevirapine under fasting conditions: a randomised, crossover, placebo-controlled study. Drugs R.D. 2007;8(6):383-391. PubMed
  14. Usia, T., Iwata, H., Hiratsuka, A., Watabe, T., Kadota, S., and Tezuka, Y. CYP3A4 and CYP2D6 inhibitory activities of Indonesian medicinal plants. Phytomedicine. 2006;13(1-2):67-73. PubMed
  15. Mujumdar, A. M., Dhuley, J. N., Deshmukh, V. K., Raman, P. H., Thorat, S. L., and Naik, S. R. Effect of piperine on pentobarbitone induced hypnosis in rats. Indian J Exp.Biol. 1990;28(5):486-487.
  16. Panda, S. and Kar, A. Piperine lowers the serum concentrations of thyroid hormones, glucose and hepatic 5'D activity in adult male mice. Horm.Metab Res. 2003;35(9):523-526. PubMed
  17. Lawless, H. and Stevens, D. A. Effects of oral chemical irritation on taste. Physiol Behav. 1984;32(6):995-998. PubMed
  18. Hiwale, A. R., Dhuley, J. N., and Naik, S. R. Effect of co-administration of piperine on pharmacokinetics of beta-lactam antibiotics in rats. Indian J Exp.Biol. 2002;40(3):277-281.
  19. Han, Y., Chin Tan, T. M., and Lim, L. Y. In vitro and in vivo evaluation of the effects of piperine on P-gp function and expression. Toxicol.Appl.Pharmacol. 8-1-2008;230(3):283-289. PubMed
  20. Sharma, P., Varma, M. V., Chawla, H. P., and Panchagnula, R. In situ and in vivo efficacy of peroral absorption enhancers in rats and correlation to in vitro mechanistic studies. Farmaco 2005;60(11-12):874-883. PubMed
  21. Aher, S., Biradar, S., Gopu, C. L., and Paradkar, A. Novel pepper extract for enhanced P-glycoprotein inhibition. J Pharm.Pharmacol. 2009;61(9):1179-1186. PubMed
  22. Zutshi, R. K., Singh, R., Zutshi, U., Johri, R. K., and Atal, C. K. Influence of piperine on rifampicin blood levels in patients of pulmonary tuberculosis. J Assoc.Physicians India 1985;33(3):223-224.
  23. Marotta, R. B. and Floch, M. H. Diet and nutrition in ulcer disease. Med Clin North Am 1991;75(4):967-979. PubMed
  24. Subehan, Usia, T., Iwata, H., Kadota, S., and Tezuka, Y. Mechanism-based inhibition of CYP3A4 and CYP2D6 by Indonesian medicinal plants. J Ethnopharmacol. 5-24-2006;105(3):449-455. PubMed
  25. Gimenez L, Zacharisen M. Severe pepper allergy in a young child. WMJ. 2011 Jun;110(3):138-9.
  26. Ren T, Yang M, Xiao M, Zhu J, Xie W, Zuo Z. Time-dependent inhibition of carbamazepine metabolism by piperine in anti-epileptic treatment. Life Sci. 2019;218:314-323. PubMed
  27. Thomas AB, Choudhary DC, Raje A, Nagrik SS. Pharmacokinetics and pharmacodynamic herb-drug interaction of piperine with atorvastatin in rats. J Chromatogr Sci 2021;59(4):371-80. PubMed
  28. 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
  29. Lin F, Hu Y, Zhang Y, Zhao L, Zhong D, Liu J. Predicting Food-Drug Interactions between Piperine and CYP3A4 Substrate Drugs Using PBPK Modeling. Int J Mol Sci 2024;25(20):10955. PubMed

See these in context on the Black Pepper monograph →

Parts of this content are provided by the Therapeutic Research Center, LLC.

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.

© 2021 Therapeutic Research Center, LLC

Keep exploring
Supplement interaction checker › Check any supplement or product against your medications Drug–drug interactions › Check two or more of your medications against each other Browse medications A–Z › Every drug we've checked against herbs & supplements NDC & pricing lookup › Find a drug’s NDCs, packaging and costs Ask a pharmacist › Free, personal answer from our licensed team