Interactions on record — worth a quick check against your medications. Check your meds →
Dietary supplement

Annatto Ingredients & Drug Interactions

by Hawaii Pharm

Annatto label
See full label image
Liquid Category: Botanical
Most serious interaction: Moderate
Clinical methodology reviewed by · Updated Sep 16, 2026 · Label data from the NIH DSLD
What is this page for?

First and foremost: checking Annatto 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: Moderate

Annatto is a dietary supplement by Hawaii Pharm with 1 active ingredient. Its ingredients are commonly taken for natural food and cosmetic coloring, source of antioxidants, antimicrobial/anti-infective (traditional use).Based on those ingredients, 86 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are certified organic Annatto 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 Annatto by Hawaii Pharm

Ask about any prescription or over-the-counter medication and we check it for interactions with Annatto by Hawaii Pharm — 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 Annatto by Hawaii Pharm

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 11, 2026

What’s inside

Full disclosure
Ingredient Transparency · database check
Full

Every active ingredient lists its own amount on the label.

Why this rating?
  • The label discloses an exact amount for 1 of its 1 active ingredient.
  • No proprietary blends here — you can verify the dose of every single component.

This product contains one active ingredient: certified organic annatto extract. Annatto is a plant-derived substance traditionally used in herbal medicine.

The liquid form also includes vegetable palm glycerin, pharmaceutical-grade alcohol, and purified water as inactive ingredients to deliver the extract.

Does it work?

Couldn't assess
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
Not assessable

This is a single-ingredient Annatto product and its label doesn't state a use — see Annatto's own graded uses on its monograph.

Why this rating?
  • We looked at the product name, claims, and label statements and couldn't find a stated purpose to grade.

The evidence on annatto for athletic performance, benign prostatic hyperplasia (enlarged prostate), exercise-induced muscle soreness, and halitosis (bad breath) is insufficient—we don't have reliable data supporting its use for any of these purposes. If you're considering annatto for one of these reasons, the science isn't yet established in the data we hold.

The evidence, ingredient by ingredient Annatto

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 1 of the 1 matched ingredient.
  • Pregnancy & breastfeeding safety ratings cover 1 of 1.
  • General safety write-ups exist for 1 of 1.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

Annatto is generally recognized as safe when used as a food coloring, though supplement use hasn't been well studied. The main cautions: concentrated supplement doses aren't well researched, so the safety data advises sticking to food amounts unless your doctor approves a higher dose.

Orally, annatto leaf is usually well tolerated, but rarely it can cause constipation. More significantly, annatto food coloring has triggered allergic reactions in some people—including hives, swelling of the face or throat (angioedema), severe low blood pressure, and in rare cases anaphylaxis.

One case report linked annatto coloring to worsening irritable bowel syndrome symptoms (diarrhea, bloating, belly pain); those symptoms improved when the person stopped consuming annatto products. If you've had allergic reactions to annatto before, this product isn't for you.

Side effects, ingredient by ingredient Annatto

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?
  • 1 of the 1 matched ingredient can interact with medications — Annatto.
  • The most serious interaction on file is rated Moderate.
  • Some involve high-stakes drug classes: diabetes medications.
  • For scale: 86 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.

Check your exact antidiabetes drugs (blood-sugar medications like metformin, insulin, or sulfonylureas) with the tool on this page before starting. Annatto may alter blood glucose in unpredictable ways when combined with these, creating a Moderate risk of either reduced medication effect or low blood sugar.

Your doctor or pharmacist should review your medication list.

Check your own medication Run your meds through the checker above

The bottom line

Scorecard at a glanceFully disclosed formula with no assessable stated purpose. Moderate medication interactions have been identified, and safety information is well characterized.

Hawaii Pharm Annatto may be worth exploring if you're interested in traditional herbal use, but the evidence for specific health claims isn't solid yet. The biggest concern is blood-sugar interaction if you take antidiabetes medication—check with your pharmacist first.

If you have a history of allergic reactions to annatto or foods colored with it, skip this product.

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

Assessment coverage: 1 of 1 active ingredient matched to our full ingredient reviews (monographs). Based on the product label dated Oct 23, 2020.

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 Annatto, straight from the product label.

Brand Hawaii Pharm
Barcode (UPC) 650905473449
Net contents 4 Fluid Ounce(s); 120 mL
Market status On market
Date entered into DSLD Oct 23, 2020
DSLD ID 237865
Product type Botanical
Supplement form Liquid
Dietary claims / uses All Other, Structure/Function
Intended target group(s) Adult (18 - 50 Years), Organic, Gluten Free
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 Annatto by Hawaii Pharm, 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:
0.7 mL
Maximum serving Sizes:
1 mL
Servings per container
120
UPC/BARCODE
650905473449
IngredientAmount% DV
certified organic Annatto extract970 mg--

Other ingredients: Vegetable Palm Glycerin, pharmaceutical grade Alcohol, artesian Hawaiian purified Water

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

Hawaii Pharm Herbal Extract Highest quality since 2008

Made with Aloha!

Formulation

Contains no GMO, gluten, artificial colors, heavy metals, preservatives, pesticides, fertilizers.

Super concentrated liquid herbal extract. Dry herb/menstruum ratio: 1:3.

Manufactured in an FDA registered facility.

Non GMO Gluten free

Made in USA, Hawaii

Suggested/Recommended/Usage/Directions

Directions for use: Shake well before using. Take about 20-30 drops (0.7-1 ml, one full squeeze of the dropper bulb) to 2-4 oz of juice or water up to 4 times per day.

Precautions

Warning: Keep out of the reach of children.

May have contraindications. We recommend to seek expert medical advice before taking.

Do not use if you are allergic to any ingredients.

Consult a physician before using during pregnancy, if nursing or taking any medications.

Do not use if seal is broken or missing.

Storage

Store in a cool dry place.

Formula

(Bixa orellana)

FDA Statement of Identity

Herbal Dietary Supplement

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.

Seals/Symbols

FDA Registered Facility Made in United States of America USA

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

See for yourself

Annatto by Hawaii Pharm label

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

Annatto 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 Annatto by Hawaii Pharm

This is the 1 active ingredient this product is made of. Select it to open its full monograph.

Serving size0.7 mL Dosage formLiquid Servings per container120 Amounts shown are per serving.

Certified organic Annatto extract

Interacts with
86 drugs
970 mg per serving

Annatto is a plant-based coloring made from the seeds of the achiote tree and is widely used as a safe food dye. While it has a long history in tradit...

Certified organic Annatto extract monograph & interactions

Other (inactive) ingredients: Vegetable Palm Glycerin, Pharmaceutical grade Alcohol, Artesian Hawaiian purified Water. These complete the product’s ingredient list but are not active constituents.

Interaction report

Annatto by Hawaii Pharm Drug Interactions

Want to check YOUR meds against Annatto?

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
86Drugs
86 Moderate

Ingredients driving the most interactions

certified organic Annatto extract 86

Individual Drug Interactions

The ingredients in Annatto interact with 86 drugs. Click any drug to see the details.

1 of the 1 ingredient in Annatto interact with drugs. Each result below shows which ingredient is responsible. certified organic Annatto extract

Each ingredient & the kinds of drugs it affects

For each ingredient in Annatto with known interactions, here are the types of medications it can affect. Open any type for the detail — or search your exact drug in the checker above.

certified organic Annatto extract1 drug type · 86 drugs

Antidiabetes Drugs

Animal studies suggest that certain annatto extracts may have hypoglycemic or hyperglycemic effects. Theoretically, taking annatto with antidiabetes drugs could reduce the therapeutic effects of these drugs or increase the risk for additive hypoglycemia. Monitor blood glucose levels closely.

Likelihood Possible Evidence D
certified organic Annatto extract full monograph & interactions
The maker

Brand information

Manufacturer and brand details for Annatto, from the product label.

Hawaii Pharm

See all Hawaii Pharm products
Name
Hawaii Pharm LLC
City
Honolulu
State
HI
ZipCode
96815
Web Address
www.hawaiipharm.com
Pharmacist Counseling Corner

Annatto by Hawaii Pharm: Common Questions

Does Annatto by Hawaii Pharm interact with any medications?
Yes. Based on its ingredients, Annatto has a known interaction with 86 medications. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Annatto contains a single active ingredient, and that one ingredient can interact with many different medications on its own. We check it against each medication and show the mechanism 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 if I'm on diabetes medication?
Not without checking first. Annatto may interfere with how antidiabetes drugs work or add to their blood-sugar-lowering effect, both of which are risky. Use the medication checker on this page with your exact drugs, and talk to your pharmacist or doctor before starting.
Does this product actually work for any health condition?
The evidence we have doesn't support reliable benefit for athletic performance, prostate health, muscle soreness, or bad breath. The science just isn't established yet.
Is it safe to take annatto as a supplement?
The safety data is limited. Food amounts of annatto are considered safe, but concentrated supplement doses haven't been well studied. Your doctor should approve any supplement dose. Rare side effects include constipation and allergic reactions (hives, swelling, or anaphylaxis in very rare cases), especially if you've reacted to annatto before.
Can annatto make my IBS worse?
One case report described worsening IBS symptoms (diarrhea, bloating, belly pain) with annatto food coloring; symptoms improved when the person removed annatto products. If you have IBS, you may want to be cautious or skip this product.
What's actually in this liquid?
The active ingredient is organic annatto extract. It's mixed with vegetable palm glycerin, alcohol, and purified water to make it liquid.
I'm pregnant—is this safe?
The safety data for annatto in pregnancy and breastfeeding isn't on file. Talk with your doctor or pharmacist for personalized advice before taking any supplement during pregnancy or while nursing.

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

Not sure if Annatto 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.

Annatto label
Go deeper

The Full Monographs Behind Annatto’s Ingredients

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

Herb & supplement monograph

Annatto

Interacts with 86 drugs

Annatto is a plant-based coloring made from the seeds of the achiote tree and is widely used as a safe food dye. While it has a long history in traditional medicine and contains antioxidant...

Read the full Annatto monograph →
Sources

Sources & How We Checked

Annatto'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 15 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.

Annatto 15 references
  1. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
  2. Fernandes, A. C., Almeida, C. A., Albano, F., Laranja, G. A., Felzenszwalb, I., Lage, C. L., de Sa, C. C., Moura, A. S., and Kovary, K. Norbixin ingestion did not induce any detectable DNA breakage in liver and kidney but caused a considerable impairment
  3. Russell, K. R., Morrison, E. Y., and Ragoobirsingh, D. The effect of annatto on insulin binding properties in the dog. Phytother Res 2005;19(5):433-436. PubMed
  4. Morrison, E. Y., Thompson, H., Pascoe, K., West, M., and Fletcher, C. Extraction of an hyperglycaemic principle from the annatto (Bixa orellana), a medicinal plant in the West Indies. Trop.Geogr.Med 1991;43(1-2):184-188.
  5. Zegarra, L., Vaisberg, A., Loza, C., Aguirre, R. L., Campos, M., Fernandez, I., Talla, O., and Villegas, L. Double-blind randomized placebo-controlled study of Bixa orellana in patients with lower urinary tract symptoms associated to benign prostatic hyp
  6. Russell, K. R., Omoruyi, F. O., Pascoe, K. O., and Morrison, E. Y. Hypoglycaemic activity of Bixa orellana extract in the dog. Methods Find.Exp.Clin.Pharmacol. 2008;30(4):301-305.
  7. Ebo, D. G., Ingelbrecht, S., Bridts, C. H., and Stevens, W. J. Allergy for cheese: evidence for an IgE-mediated reaction from the natural dye annatto. Allergy 2009;64(10):1558-1560. PubMed
  8. Nish, W. A., Whisman, B. A., Goetz, D. W., and Ramirez, D. A. Anaphylaxis to annatto dye: a case report. Ann.Allergy 1991;66(2):129-131.
  9. Stein HL. Annatto and IBS. J Clin Gastroenterol 2009;43(10):1014-5.
  10. Raddatz-Mota D, Pérez-Flores LJ, Carrari F, et al. Achiote (Bixa orellana L.): a natural source of pigment and vitamin E. J Food Sci Technol 2017;54(6):1729-1741. PubMed
  11. Koc E, Arca E, Surucu B, Kurumlu Z. An open, randomized, controlled, comparative study of the combined effect of intralesional triamcinolone acetonide and onion extract gel and intralesional triamcinolone acetonide alone in the treatment of hypertrophic s
  12. Gonçalves MLL, da Mota ACC, Deana AM, et al. Antimicrobial photodynamic therapy with Bixa orellana extract and blue LED in the reduction of halitosis-A randomized, controlled clinical trial. Photodiagnosis Photodyn Ther. 2020 Jun;30:101751. PubMed
  13. Dominguez-Balmaseda D, Diez-Vega I, Larrosa M, et al. Effect of a blend of Zingiber officinale Roscoe and Bixa orellana L. herbal supplement on the recovery of delayed-onset muscle soreness induced by unaccustomed eccentric resistance training: A randomiz
  14. González-Gross M, Quesada-González C, Rueda J, et al. Analysis of effectiveness of a supplement combining Harpagophytum procumbens, Zingiber officinale and Bixa orellana in healthy recreational runners with self-reported knee pain: a pilot, randomized, tr
  15. Sadowska B, Sztormowska M, Chelminska M. Annatto hypersensitivity after oral ingestion confirmed by placebo-controlled oral challenge. Ann Allergy Asthma Immunol. 2021 Oct;127(4):510-511. PubMed

See these in context on the Annatto 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