Apple 4:1 Extract Powder Ingredients & Drug Interactions
by TerraVita Premium Collection
What is this page for?
First and foremost: checking Apple 4:1 Extract Powder 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
Apple 4:1 Extract Powder is a dietary supplement by TerraVita Premium Collection with 1 active ingredient. Its ingredients are commonly taken for general nutrition and fiber intake, heart and cholesterol health, blood sugar and weight management.Based on those ingredients, 300 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are Apple Extract, Powder. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against Apple 4:1 Extract Powder by TerraVita Premium Collection
Ask about any prescription or over-the-counter medication and we check it for interactions with Apple 4:1 Extract Powder by TerraVita Premium Collection — and tell you which ingredient is responsible.
AI summaries are generated from our interaction database for education only — always confirm with your pharmacist. How we use AI
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HelloPharmacist Scorecard of Apple 4:1 Extract Powder by TerraVita Premium Collection
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.
What’s inside
Full disclosure
This product contains 1 active ingredient: apple extract powder in a 4:1 concentration, meaning the extract is made by processing 4 pounds of apples down to 1 pound of powder. There are no other inactive ingredients listed.
Does it work?
Couldn't assess
The evidence for apple extract isn't established in our data. We hold no reliable evidence that it works for Alzheimer disease, cancer, dental plaque, diabetes, or diarrhea.
That doesn't mean it won't help with something else or that research hasn't happened elsewhere — just that the information we have isn't strong enough to say one way or the other.
How safe is it?
Well-documented data
Apples as a food are generally well tolerated, with the most common side effects being bloating and flatulence in some people. Allergic reactions are rare but possible, especially if you're allergic to other fruits in the same family (apricot, almond, plum, peach, pear, strawberry) — in rare cases, apple allergy can trigger anaphylaxis.
Apple seeds contain small amounts of cyanide; while eating a few seeds is harmless, ingesting large amounts can cause serious poisoning. For pregnancy and breastfeeding, apples eaten as whole food are considered safe, but data on concentrated extracts like this powder is limited.
Talk with your doctor or pharmacist before using this product during pregnancy or while breastfeeding to get personalized advice.
Meds to double-check
Major interaction found
Check before starting if you take OATP substrates (a broad group that includes fexofenadine, atenolol, and aliskiren), antihypertensive drugs, antidiabetes drugs, or lithium. The apple extract can lower blood levels of these medications and reduce how well they work.
The bottom line
Scorecard at a glanceFully disclosed formula with no assessable stated purpose. Major medication interactions have been identified, and safety information is well characterized.
If you take medications — especially blood pressure drugs, allergy or asthma medications, antidiabetes drugs, or lithium — check with your pharmacist before trying this product. Even if you don't take prescription drugs, it's generally well tolerated, though bloating can happen in some people.
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 Mar 22, 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
General information
Key facts about Apple 4:1 Extract Powder, straight from the product label.
| Brand | TerraVita Premium Collection |
|---|---|
| Barcode (UPC) | 064435189662 |
| Net contents | 4 Ounce(s) |
| Market status | On market |
| Date entered into DSLD | Mar 22, 2023 |
| DSLD ID | 289341 |
| Product type | Botanical |
| Supplement form | Powder |
| Dietary claims / uses | All Other, Structure/Function |
| Intended target group(s) | Adult (18 - 50 Years) |
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.
Supplement Facts
The label details for Apple 4:1 Extract Powder by TerraVita Premium Collection, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Apple Extract, Powder | 1000 mg | -- |
Tap any ingredient to jump to its full detail below.
These statements are the manufacturer’s wording, reproduced from the product label — the label is saying it, not HelloPharmacist. We don’t verify or endorse them.
FDA Statement of Identity
A Dietary Supplement
Brand IP Statement(s)
Copyright 2017 TerraVita - Distributed by ZooScape LLC, All Rights Reserved.
Suggested/Recommended/Usage/Directions
Directions Stir 1/4 of a teaspoon into a glass of water and consume 3 times daily, with meals.
General Statements
TerraVita is an exclusive line of premium natural products that use the finest, purest and most potent ingredients in the world. TerraVita's hallmarks are the highest possible standards of purity, potency, stability and freshness. All products are prepared with the greatest quality control, from raw materials through the entire manufacturing process, right up to the moment your product is sealed for freshness and shipped to you.
Please recycle!
FDA Disclaimer Statement
Statements not evaluated by FDA. Product not intended to diagnose, treat, cure, or prevent any disease.
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Apple 4:1 Extract Powder by TerraVita Premium Collection label
The label scan from the NIH Dietary Supplement Label Database. Tap to enlarge.
Label images are published by the NIH Dietary Supplement Label Database for the version of this product on file. Always read your actual product label.
View the full label (PDF)The Ingredients in Apple 4:1 Extract Powder by TerraVita Premium Collection
This is the 1 active ingredient this product is made of. Select it to open its full monograph.
Serving size0.25 Teaspoon(s) Dosage formPowder Servings per container113 Amounts shown are per serving.
Apple Extract, Powder
Interacts with300 drugs
Apples are a nutritious whole food that provides fiber, vitamins, and antioxidant plant compounds, and eating them regularly fits well into a healthy...
Apple Extract, Powder monograph & interactionsApple 4:1 Extract Powder by TerraVita Premium Collection Drug Interactions
HelloPharmacist Interaction Report
Apple 4:1 Extract Powder by TerraVita Premium Collection interacts with medications, and the main concern involves a large group of drugs that rely on a specific transport system in your gut.
Read the full breakdown — every affected drug type, severity by severity
The most serious interaction is with OATP substrates (a Major severity interaction). Apple extract can significantly block the absorption of drugs that depend on this transporter, lowering their blood levels and reducing how well they work.
This includes fexofenadine (Allegra), atenolol (Tenormin), and aliskiren (Tekturna, Rasilez) — research shows apple can cut their absorption by 58% to 82% depending on the drug and dose. Altogether, these interactions span 297 individual medications.
Several other drug types are also affected. Antihypertensive drugs (blood pressure medications) may not work as well if you're consuming apple extract, and antidiabetes drugs could have their effect on blood sugar compromised.
There's also a concern with lithium — a mood-stabilizing medication — where apple juice has been shown to reduce its absorption to undetectable levels in at least one case report. Each of these is rated Moderate severity.
Before you start this product, use the medication checker below to search your exact prescriptions, especially if you take any of the drugs or drug types listed above.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against Apple 4:1 Extract Powder?
Ask about interactions with your drugs in plain English — “Can I take it with lisinopril?” — and we find you the answer in seconds, ingredient by ingredient.
Go to the checkerIngredients driving the most interactions
Individual Drug Interactions
The ingredients in Apple 4:1 Extract Powder interact with 300 drugs. Click any drug to see the details.
1 of the 1 ingredient in Apple 4:1 Extract Powder interact with drugs. Each result below shows which ingredient is responsible. Apple Extract, Powder
AtorvastatinAtorvaliq
How Atorvastatin interacts with Apple 4:1 Extract Powder — through 1 ingredient. Tap an ingredient for the detail:
Apple Extract, PowderOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple Extract, Powder + Atorvastatin interactionAtorvastatin CalciumLipitor
How Atorvastatin Calcium interacts with Apple 4:1 Extract Powder — through 1 ingredient. Tap an ingredient for the detail:
Apple Extract, PowderOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple Extract, Powder + Atorvastatin Calcium interactionBosentanTracleer
How Bosentan interacts with Apple 4:1 Extract Powder — through 1 ingredient. Tap an ingredient for the detail:
Apple Extract, PowderAntihypertensive Drugs, Organic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Consuming apple juice with antihypertensive drugs might interfere with blood pressure control.
Read the full Apple Extract, Powder + Bosentan interactionBrincidofovirTembexa
How Brincidofovir interacts with Apple 4:1 Extract Powder — through 1 ingredient. Tap an ingredient for the detail:
Apple Extract, PowderOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple Extract, Powder + Brincidofovir interactionCeliprololCelicard
How Celiprolol interacts with Apple 4:1 Extract Powder — through 1 ingredient. Tap an ingredient for the detail:
Apple Extract, PowderAntihypertensive Drugs, Organic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Consuming apple juice with antihypertensive drugs might interfere with blood pressure control.
Read the full Apple Extract, Powder + Celiprolol interactionCerivastatin SodiumBaycol
How Cerivastatin Sodium interacts with Apple 4:1 Extract Powder — through 1 ingredient. Tap an ingredient for the detail:
Apple Extract, PowderOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple Extract, Powder + Cerivastatin Sodium interactionCinoxacinCinobac
How Cinoxacin interacts with Apple 4:1 Extract Powder — through 1 ingredient. Tap an ingredient for the detail:
Apple Extract, PowderOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple Extract, Powder + Cinoxacin interactionCiprofloxacinCiloxan, Cipro, Cipro IV, Cipro XR, Ciprobay, Otiprio
How Ciprofloxacin interacts with Apple 4:1 Extract Powder — through 1 ingredient. Tap an ingredient for the detail:
Apple Extract, PowderOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple Extract, Powder + Ciprofloxacin interactionCiprofloxacin, HydrocortisoneCipro HC Otic
How Ciprofloxacin, Hydrocortisone interacts with Apple 4:1 Extract Powder — through 1 ingredient. Tap an ingredient for the detail:
Apple Extract, PowderOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple Extract, Powder + Ciprofloxacin, Hydrocortisone interactionClinafloxacinClinafloxacin
How Clinafloxacin interacts with Apple 4:1 Extract Powder — through 1 ingredient. Tap an ingredient for the detail:
Apple Extract, PowderOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple Extract, Powder + Clinafloxacin interactionEnoxacinPenetrex
How Enoxacin interacts with Apple 4:1 Extract Powder — through 1 ingredient. Tap an ingredient for the detail:
Apple Extract, PowderOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple Extract, Powder + Enoxacin interactionEtoposideEtopophos, VePesid, VP16
How Etoposide interacts with Apple 4:1 Extract Powder — through 1 ingredient. Tap an ingredient for the detail:
Apple Extract, PowderOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple Extract, Powder + Etoposide interactionEzetimibe, AtorvastatinLiptruzet
How Ezetimibe, Atorvastatin interacts with Apple 4:1 Extract Powder — through 1 ingredient. Tap an ingredient for the detail:
Apple Extract, PowderOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple Extract, Powder + Ezetimibe, Atorvastatin interactionFexofenadineAllegra
How Fexofenadine interacts with Apple 4:1 Extract Powder — through 1 ingredient. Tap an ingredient for the detail:
Apple Extract, PowderOrganic Anion-transporting Polypeptide Substrates (oatp), Fexofenadine (allegra) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple Extract, Powder + Fexofenadine interactionFexofenadine, PseudoephedrineAllegra D
How Fexofenadine, Pseudoephedrine interacts with Apple 4:1 Extract Powder — through 1 ingredient. Tap an ingredient for the detail:
Apple Extract, PowderFexofenadine (allegra), Organic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of fexofenadine.
Read the full Apple Extract, Powder + Fexofenadine, Pseudoephedrine interactionFluvastatinLescol, Lescol XL
How Fluvastatin interacts with Apple 4:1 Extract Powder — through 1 ingredient. Tap an ingredient for the detail:
Apple Extract, PowderOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple Extract, Powder + Fluvastatin interactionGatifloxacinTequin, Tequin Injection
How Gatifloxacin interacts with Apple 4:1 Extract Powder — through 1 ingredient. Tap an ingredient for the detail:
Apple Extract, PowderOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple Extract, Powder + Gatifloxacin interactionGemifloxacinFactive
How Gemifloxacin interacts with Apple 4:1 Extract Powder — through 1 ingredient. Tap an ingredient for the detail:
Apple Extract, PowderOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple Extract, Powder + Gemifloxacin interactionGlyburideAlbert Glyburide, Diabeta, Glycron, Glynase, Glynase PresTab, Micronase +1 more
How Glyburide interacts with Apple 4:1 Extract Powder — through 1 ingredient. Tap an ingredient for the detail:
Apple Extract, PowderAntidiabetes Drugs, Organic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Theoretically, consuming apple juice with antidiabetes drugs might interfere with blood glucose control.
Read the full Apple Extract, Powder + Glyburide interactionGlyburide, MetforminGlucovance
How Glyburide, Metformin interacts with Apple 4:1 Extract Powder — through 1 ingredient. Tap an ingredient for the detail:
Apple Extract, PowderOrganic Anion-transporting Polypeptide Substrates (oatp), Antidiabetes Drugs Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple Extract, Powder + Glyburide, Metformin interactionGrepafloxacinRaxar
How Grepafloxacin interacts with Apple 4:1 Extract Powder — through 1 ingredient. Tap an ingredient for the detail:
Apple Extract, PowderOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple Extract, Powder + Grepafloxacin interactionIrinotecanCamptosar, Onivyde
How Irinotecan interacts with Apple 4:1 Extract Powder — through 1 ingredient. Tap an ingredient for the detail:
Apple Extract, PowderOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple Extract, Powder + Irinotecan interactionIrinotecan Hydrochloride
How Irinotecan Hydrochloride interacts with Apple 4:1 Extract Powder — through 1 ingredient. Tap an ingredient for the detail:
Apple Extract, PowderOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple Extract, Powder + Irinotecan Hydrochloride interactionIsoniazid, Pyrazinamide, RifampinRifater
How Isoniazid, Pyrazinamide, Rifampin interacts with Apple 4:1 Extract Powder — through 1 ingredient. Tap an ingredient for the detail:
Apple Extract, PowderOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple Extract, Powder + Isoniazid, Pyrazinamide, Rifampin interactionIsoniazid, RifampinRifamate
How Isoniazid, Rifampin interacts with Apple 4:1 Extract Powder — through 1 ingredient. Tap an ingredient for the detail:
Apple Extract, PowderOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple Extract, Powder + Isoniazid, Rifampin interactionLevofloxacinLeva-pak, Levaquin, Levaquin Injection
How Levofloxacin interacts with Apple 4:1 Extract Powder — through 1 ingredient. Tap an ingredient for the detail:
Apple Extract, PowderOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple Extract, Powder + Levofloxacin interactionLevofloxacin (ophthalmic)Levofloxacin
How Levofloxacin (ophthalmic) interacts with Apple 4:1 Extract Powder — through 1 ingredient. Tap an ingredient for the detail:
Apple Extract, PowderOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple Extract, Powder + Levofloxacin (ophthalmic) interactionLomefloxacinMaxaquin
How Lomefloxacin interacts with Apple 4:1 Extract Powder — through 1 ingredient. Tap an ingredient for the detail:
Apple Extract, PowderOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple Extract, Powder + Lomefloxacin interactionLovastatinAltocor, Mevacor
How Lovastatin interacts with Apple 4:1 Extract Powder — through 1 ingredient. Tap an ingredient for the detail:
Apple Extract, PowderOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple Extract, Powder + Lovastatin interactionMethotrexateOtrexup, Rasuvo, Reditrex, Rheumatrex
How Methotrexate interacts with Apple 4:1 Extract Powder — through 1 ingredient. Tap an ingredient for the detail:
Apple Extract, PowderOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple Extract, Powder + Methotrexate interactionEach ingredient & the kinds of drugs it affects
For each ingredient in Apple 4:1 Extract Powder 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.
Apple Extract, Powder
Organic Anion-Transporting Polypeptide Substrates (Oatp)
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Research shows that consuming apple juice inhibits OATP, which reduces bioavailability of oral drugs that are substrates of OATP. Fexofenadine, atenolol, and aliskiren are substrates of OATP. Clinical research shows that coadministration of apple juice decreases bioavailability of fexofenadine by up to 78%, aliskiren by 63%, and atenolol by up to 82%. These effects appear to increase with larger quantities of apple juice. It is thought that apple juice might affect OATP for only a short time. Therefore, separating drug administration and consumption of apple juice by at least 4 hours might avoid this interaction.
Aliskiren (Tekturna, Rasilez)
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of aliskiren.
Pharmacokinetic research shows that coadministration of apple juice 200 mL along with aliskiren 150 mg decreases the bioavailability of aliskiren by 63%. Apple juice seems to inhibit organic anion transporting polypeptide (OATP), which is involved in drug uptake in the gut, liver, and kidney. It is thought that apple juice might affect OATP for only a short time. Therefore, separating drug administration and consumption of apple juice by at least 4 hours might avoid this interaction.
Antidiabetes Drugs
Theoretically, consuming apple juice with antidiabetes drugs might interfere with blood glucose control.
Clinical research suggests that consuming apples or drinking apple juice can raise blood glucose levels, with the effects of drinking apple juice being more significant than consuming apples.
Antihypertensive Drugs
Consuming apple juice with antihypertensive drugs might interfere with blood pressure control.
Some clinical evidence suggests that consuming apple and cherry juice can increase blood pressure in elderly patients.
Atenolol (Tenormin)
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of atenolol.
Pharmacokinetic research shows that coadministration of apple juice 600-1200 mL decreases levels of atenolol by 58% to 82% in a dose-dependent manner. Apple juice seems to inhibit organic anion transporting polypeptide (OATP), which is involved in drug uptake in the gut, liver, and kidney. It is thought that apple juice might affect OATP for only a short time. Therefore, separating drug administration and consumption of apple juice by at least 4 hours might avoid this interaction.
Fexofenadine (Allegra)
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of fexofenadine.
Pharmacokinetic research shows that coadministration of apple juice 400-1200 mL along with fexofenadine 60-120 mg decreases bioavailability of fexofenadine by up to 78%. Coadministration with smaller quantities of apple juice (150 mL or less) does not appear to affect the bioavailability of fexofenadine. Apple juice seems to inhibit organic anion transporting polypeptide (OATP), which is involved in drug uptake in the gut, liver, and kidney. It is thought that apple juice might affect OATP for only a short time. Therefore, separating drug administration and consumption of apple juice by at least 4 hours might avoid this interaction.
Lithium
There is some concern that concomitant consumption of apple juice might decrease oral absorption and blood levels of lithium.
In one case report, a patient had an undetectable serum lithium level when lithium citrate was administered with apple juice. When lithium was administered with an alternative beverage, the lithium level became detectable and the patient demonstrated clinical improvement.
Brand information
Manufacturer and brand details for Apple 4:1 Extract Powder, from the product label.
TerraVita Premium Collection
See all TerraVita Premium Collection products- Name
- TerraVita Fine Whole Herbs
- City
- Brampton
- State
- Ontario
Apple 4:1 Extract Powder by TerraVita Premium Collection: Common Questions
Does Apple 4:1 Extract Powder by TerraVita Premium Collection interact with any medications?
How can one product interact with so many drugs?
Where does this information come from?
What are the most common side effects?
Is this safe to take while pregnant or breastfeeding?
What is a 4:1 extract?
Does this product actually work for the conditions listed?
Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
Not sure if Apple 4:1 Extract Powder is safe with your meds?
Our pharmacists answer your medication & supplement questions — free.
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.
The Full Monographs Behind Apple 4:1 Extract Powder’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Sources & How We Checked
Apple 4:1 Extract Powder's label data comes from the NIH Dietary Supplement Label Database; the ingredient interaction data is from the Natural Medicines database, reviewed by our pharmacists.
- NIH Dietary Supplement Label Database (DSLD) — The official product label on file for this supplement.
- Natural Medicines (Therapeutic Research Center) — Evidence-graded clinical reference behind the ingredient interaction data.
Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.
The 16 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.
Apple 16 references
- The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999.
- Bailey DG, Dresser GK, Munoz C, et al. Reduction of fexofenadine bioavailability by fruit juices. Clin Pharmacol Ther 2001;69:P21.
- Rodriguez J, Crespo JF, Lopez-Rubio A, et al. Clinical cross-reactivity among foods of the Rosaceae family. J Allergy Clin Immunol 2000;106:183-189. PubMed
- Greenblatt DJ. Analysis of drug interactions involving fruit beverages and organic anion-transporting polypeptides. J Clin Pharmacol 2009;49:1403-7. PubMed
- Bailey DG. Fruit juice inhibition of uptake transport: a new type of food-drug interaction. Br J Clin Pharmacol 2010;70:645-55. PubMed
- Kamath AV, Yao M, Zhang Y, Chong S. Effect of fruit juices on the oral bioavailability of fexofenadine in rats. J Pharm Sci 2005;94:233-9. PubMed
- Tapaninen T, Neuvonen PJ, Niemi M. Orange and apple juice greatly reduce the plasma concentrations of the OATP2B1 substrate aliskiren. Br J Clin Pharmacol 2011;71:718-26. PubMed
- Jeon H, Jang IJ, Lee S, et al. Apple juice greatly reduces systemic exposure to atenolol. Br J Clin Pharmacol 2012 May 11. doi: 10.1111/j.1365-2125.2012.04324.x. [Epub ahead of print]. PubMed
- Visvanathan, R., Chen, R., Horowitz, M., and Chapman, I. Blood pressure responses in healthy older people to 50 g carbohydrate drinks with differing glycaemic effects. Br J Nutr 2004;92(2):335-340. PubMed
- Asp, N. G., Agardh, C. D., Ahren, B., Dencker, I., Johansson, C. G., Lundquist, I., Nyman, M., Sartor, G., and Schersten, B. Dietary fibre in type II diabetes. Acta Med Scand Suppl 1981;656:47-50. PubMed
- Akamine Y, Miura M, Komori H, et al. Effects of one-time apple juice ingestion on the pharmacokinetics of fexofenadine enantiomers. Eur J Clin Pharmacol. 2014 Sep;70(9):1087-95. PubMed
- Luo J, Imai H, Ohyama T, et al. The Pharmacokinetic Exposure to Fexofenadine is Volume-Dependently Reduced in Healthy Subjects Following Oral Administration With Apple Juice. Clin Transl Sci. 2016 Aug;9(4):201-6. PubMed
- Tsiougkos N, Vovolis V. Repeated anaphylactic episodes to orange and apple. Eur Ann Allergy Clin Immunol. 2013 May;45(3):113-5.
- Rubido S, García-Caballero L, Abeleira MT, Limeres J, García M, Diz P. Effect of chewing an apple on dental plaque removal and on salivary bacterial viability. PLoS One. 2018;13(7):e0199812. PubMed
- Krishnasamy S, Lomer MCE, Marciani L, et al. Processing apples to puree or juice speeds gastric emptying and reduces postprandial intestinal volumes and satiety in healthy adults. J Nutr 2020;150(11):2890-9. PubMed
- Awan S, Abelleira A, Khehra L, Hieber R. Undetectable serum lithium concentrations after coadministration of liquid lithium citrate and apple juice: A case report. Ment Health Clin. 2021;11(1):27-30. PubMed
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