Major interaction on record — check this product against your medications before combining. Based on 9 of 12 ingredients. Check your meds →
Dietary supplement

Back & Neck Pain Ingredients & Drug Interactions

by BIOVEA Homeopathics

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

Back & Neck Pain is a dietary supplement by BIOVEA Homeopathics with 12 active ingredients. Its ingredients are commonly taken for pain and nerve pain, fever and cold or flu symptoms, anxiety and restlessness (homeopathic use).Based on those ingredients, 1,502 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are Hypericum, Cimicifuga, Mag phos. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

HelloPharmacist Scorecard of Back & Neck Pain by BIOVEA Homeopathics

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

From our pharmacy team — supplement deep dive

What’s inside

Low disclosure
Ingredient Transparency · database check
Low

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

Why this rating?
  • The label discloses an exact amount for 0 of its 12 active ingredients.

This liquid formula contains 12 ingredients, most in homeopathic or highly diluted form. The active ingredients are aconite, arnica, belladonna, black cohosh, gelsemium, magnesium, poison ivy (Rhus tox), and bulbous buttercup, along with Euphorbium, Gnaphalium poly, Hypericum, and Phytolacca.

The product also contains two inactive ingredients: organic alcohol and purified water.

Does it work?

Leans against
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
Leans against

The strongest graded evidence we hold for the stated purpose leans against a benefit.

Why this rating?
  • The label markets this product for: temporary relief of back pain and muscle spasms.
  • We looked for evidence on: Back pain, Muscle cramps, Exercise-induced muscle soreness, Pain (acute), Pain (chronic), Sciatica — and 2 related terms.
  • The closest evidence on file: Magnesium is rated "Possibly Ineffective" for Muscle cramps (Natural Medicines).
  • Also on file: Poison Ivy is rated "Insufficient Reliable Evidence To Rate" for Back pain, Pain (acute).
  • Also on file: Arnica is rated "Insufficient Reliable Evidence To Rate" for Exercise-induced muscle soreness.

The evidence is sparse. Magnesium (Mag phos) is rated Effective for constipation, indigestion, low magnesium levels, and preventing pre-eclampsia in pregnancy.

Black cohosh (Cimicifuga) is rated Possibly Effective for menopausal hot flashes. Arnica is rated Possibly Effective for osteoarthritis.

The other ingredients — aconite, belladonna, gelsemium, poison ivy, and bulbous buttercup — have no established evidence for any condition, or insufficient evidence for the conditions studied. Euphorbium, Gnaphalium poly, Hypericum, and Phytolacca lack effectiveness data in our files.

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 9 of the 9 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 9 of 9.
  • General safety write-ups exist for 9 of 9.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

This product carries serious safety concerns that overshadow its use for back and neck pain. Aconite is extremely toxic and can be fatal even in small doses, with risks of heart rhythm problems, low blood pressure, seizures, and organ damage.

Belladonna is poisonous and can cause vision problems, confusion, rapid heartbeat, and respiratory failure. Gelsemium and bulbous buttercup are toxic plants that can cause severe poisoning, nerve damage, and in extreme cases, death from respiratory muscle failure.

Poison ivy is a potent allergen that can cause severe skin reactions and, when inhaled from smoke, life-threatening throat swelling. Magnesium is generally well tolerated at normal doses but can cause diarrhea, nausea, and vomiting.

Arnica in homeopathic dilution is generally well tolerated, but black cohosh may cause breast tenderness, dizziness, headache, and rare liver problems.

Meds to double-check

Major interaction found
Known Interaction Concern · database check
Major identified

At least one ingredient has a documented Major-severity interaction. Check your medications for a personalized result.

Why this rating?
  • 6 of the 9 matched ingredients can interact with medications — St. John's Wort, Belladonna, Aconite, Arnica, Black Cohosh, among others.
  • The most serious interaction on file is rated Major.
  • Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs; immunosuppressants / transplant drugs; diabetes medications; heart-rhythm medications; Parkinson's medications.
  • For scale: 1,503 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.

If you take levodopa/carbidopa (Sinemet) for Parkinson's disease, do not use this product — magnesium will significantly reduce the medication's effectiveness. Avoid this formula if you take blood thinners like warfarin or aspirin, stimulant medications, anticholinergic drugs, serotonergic antidepressants, estrogen therapy, calcium channel blockers or other blood pressure drugs, skeletal muscle relaxants, diabetes drugs, quinolone antibiotics, or bisphosphonates.

The number of affected medications is too large to list fully here — use the interaction checker on this page with your specific prescriptions.

Check your own medication Run your meds through the checker above

The bottom line

Scorecard at a glanceFormula with limited ingredient disclosure with graded evidence leaning against its stated purpose. Major medication interactions have been identified, and safety information is well characterized.

We cannot recommend this product. Multiple ingredients are highly toxic plants with severe poisoning risks — aconite, belladonna, gelsemium, and poison ivy — that have no proven benefit for back or neck pain.

The formula interacts with over 1,000 individual medications, including critical Parkinson's drugs, blood thinners, and heart medications. If you're considering any homeopathic product for pain, talk to your pharmacist or doctor first.

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

Assessment coverage: 9 of 12 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Jun 23, 2021.

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 Back & Neck Pain, straight from the product label.

Brand BIOVEA Homeopathics
Barcode (UPC) 818423024851
Net contents 1 fl. Oz.; 30 mL
Market status On market
Date entered into DSLD Jun 23, 2021
DSLD ID 249265
Product type Other Combinations
Supplement form Liquid
Dietary claims / uses All Other, Structure/Function
Intended target group(s) Children 4 or More Years of Age, Adult (18 - 50 Years)
From the label
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.

Supplement Facts

The label details for Back & Neck Pain by BIOVEA Homeopathics, 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:
2 Spray(s)
Maximum serving Sizes:
2 Spray(s)
UPC/BARCODE
818423024851
IngredientAmount% DV
Aconitum nap0 NP--
Arnica0 NP--
Belladonna0 NP--
Cimicifuga0 NP--
Euphorbium0 NP--
Gelsemium0 NP--
Gnaphalium poly0 NP--
Hypericum0 NP--
Mag phos0 NP--
Phytolacca0 NP--
Ranunc bulb0 NP--
Rhus tox0 NP--

Other ingredients: organic Alcohol, 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.
Suggested/Recommended/Usage/Directions

Indications: Fast-acting homeopathic oral spray for the temporary relief of muscle cramps, stiffness & muscle spasms associated with back pain & sciatica.

Precautions

Directions: Adults & children over 12. Spray twice under the tongue 3 times per day. For severe symptoms, dosage may be taken up to six times the first day. Children 12 & under. Consult a doctor prior to use.

Children 12 & under. Consult a doctor prior to use.

Warnings: If symptoms persist, consult a doctor.

If pregnant or breast feeding, ask a doctor before use.

Keep out of reach of children.

In case of accidental overdose, get medical help or call a Poison Control Center right away. Do not use if tamper evident seal is broken or missing.

General Statements

NDC# 69607-0005-1

Natural relief

Formula

20% organic alcohol

Formulation

Homeopathic

FDA Disclaimer Statement

These statements are based upon traditional homeopathic practice. They have not been reviewed by the Food and Drug Administration.

See for yourself

Back & Neck Pain by BIOVEA Homeopathics label

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

What’s inside

The Ingredients in Back & Neck Pain by BIOVEA Homeopathics

These are the 12 active ingredients this product is made of. Select any to open its full monograph.

Serving size2 Spray(s) Dosage formLiquid 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.

Aconitum nap

Interacts with
278 drugs
0 NP per serving

Aconite is a highly poisonous plant, and even small amounts of the raw or improperly processed root can cause severe, life-threatening reactions. Ther...

Aconitum nap monograph & interactions

Arnica

Interacts with
122 drugs
0 NP per serving

Arnica is a daisy-family plant used mainly in topical and homeopathic products for bruising, muscle soreness, and pain. The evidence is mixed and most...

Arnica monograph & interactions

Belladonna

Interacts with
196 drugs
0 NP per serving

Belladonna is a highly toxic plant whose alkaloids (like atropine and scopolamine) are powerful medicines used only in carefully controlled, regulated...

Belladonna monograph & interactions

Cimicifuga

Interacts with
652 drugs
0 NP per serving

Black cohosh is a North American plant most often used to ease menopause symptoms like hot flashes, but the research is mixed and far from settled. It...

Cimicifuga monograph & interactions

Euphorbium

0 NP per serving

Gelsemium

No known
interactions
0 NP per serving

Gelsemium is a highly toxic flowering plant most often sold today in very dilute homeopathic forms for anxiety, headaches, and flu-like symptoms. Ther...

Gelsemium monograph & interactions

Gnaphalium poly

0 NP per serving

Hypericum

Interacts with
1,143 drugs
0 NP per serving

St. John's wort is a well-studied herb most often used for mild to moderate depression, and some research suggests it may help with this. However, it...

Hypericum monograph & interactions

Mag phos

Interacts with
295 drugs
0 NP per serving

Magnesium is an essential mineral your body needs for muscles, nerves, blood pressure, and many other functions, and supplements are useful for preven...

Mag phos monograph & interactions

Phytolacca

0 NP per serving

Ranunc bulb

No known
interactions
0 NP per serving

Bulbous buttercup is a wild flowering plant that is toxic and irritating when fresh, and it is used today mainly in heavily diluted homeopathic remedi...

Ranunc bulb monograph & interactions

Rhus tox

No known
interactions
0 NP per serving

Poison ivy is a toxic plant best known for causing an itchy, blistering allergic rash on contact. In supplement form it is sold almost exclusively as...

Rhus tox monograph & interactions

Other (inactive) ingredients: Organic Alcohol, Purified Water. These complete the product’s ingredient list but are not active constituents.

Interaction report

Back & Neck Pain by BIOVEA Homeopathics Drug Interactions

Want to check YOUR meds against Back & Neck Pain?

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
1,502Drugs
761 Major 737 Moderate 4 Minor

Ingredients driving the most interactions

Hypericum 1,143
Mag phos 295

Each ingredient & the kinds of drugs it affects

For each ingredient in Back & Neck Pain 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.

Hypericum47 drug types · 1,143 drugs

Alprazolam (Xanax)

St. John's wort increases the clearance of alprazolam and decreases its effects.
Alprazolam, which is used as a probe for cytochrome P450 3A4 (CYP3A4) activity, has a two-fold increase in clearance when given with St. John's wort. St. John's wort reduces the half-life of alprazolam from 12.4 hours to 6 hours.

Likelihood Likely Evidence B
Contraceptive Drugs

St. John's wort increases the clearance of contraceptive drugs and reduces their clinical effects.
Females taking St. John's wort and oral contraceptives concurrently should use an additional or alternative form of birth control. St. John's wort can decrease norethindrone and ethinyl estradiol levels by 13% to 15%, resulting in breakthrough bleeding, irregular menstrual bleeding, or unplanned pregnancy. Bleeding irregularities usually occur within a week of starting St. John's wort and regular cycles usually return when St. John's wort is discontinued. Unplanned pregnancy has occurred with concurrent use of oral contraceptives and St. John's wort extract. St. John's wort is thought to induce the cytochrome P450 1A2 (CYP1A2), 2C9 (CYP2C9), and 3A4 (CYP3A4) enzymes, which are responsible for metabolism of progestins and estrogens in contraceptives.

Likelihood Probable Evidence B
Cyclosporine (Neoral, Sandimmune)

St. John's wort reduces the levels and clinical effects of cyclosporine.
Concomitant use can decrease plasma cyclosporine levels by 30% to 70%. Using St. John's wort with cyclosporine in patients with heart, kidney, or liver transplants can cause subtherapeutic cyclosporine levels and acute transplant rejection. This interaction has occurred with a St. John's wort extract standardized to 0.3% hypericin and dosed at 300-600 mg per day. Withdrawal of St. John's wort can result in a 64% increase in cyclosporine levels. St. John's wort induces cytochrome P450 3A4 (CYP3A4) and the multi-drug transporter, P-glycoprotein/MDR-1, which increases cyclosporine clearance.

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

St. John's wort increases the metabolism and reduces the levels of CYP3A4 substrates.
St. John's wort induces CYP3A4 enzymes and increases metabolism of CYP3A4 substrates. Clinically significant interactions have been reported with St. John's wort products containing hyperforin 1 mg or more.

Likelihood Probable Evidence B
Digoxin (Lanoxin)

St. John's wort reduces the levels and clinical effects of digoxin.
St. John's wort can reduce the bioavailability, serum levels, and therapeutic effects of digoxin. Taking an extract of St. John's wort 900 mg, containing hyperforin 7.5 mg or more, daily for 10-14 days, can reduce serum digoxin levels by 25% in healthy people. St. John's wort is thought to affect the multidrug transporter, P-glycoprotein, which mediates the absorption and elimination of digoxin and other drugs. St. John's wort products providing less than 7.5 mg of hyperforin daily do not appear to affect digoxin levels.

Likelihood Likely Evidence B
Docetaxel (Taxotere)

St. John's wort reduces the levels and clinical effects of docetaxel.
Clinical research shows that taking a specific St. John's wort product (Hyperiplant, VSM) 300 mg three times daily for 14 days increases docetaxel clearance by about 14%, resulting in decreased plasma concentrations of docetaxel in cancer patients. This is most likely due to induction of cytochrome P450 3A4 (CYP3A4) by St. John's wort.

Likelihood Probable Evidence B
Imatinib (Gleevec)

St. John's wort reduces the levels and clinical effects of imatinib.
Taking St. John's wort 900 mg daily for 2 weeks reduces the bioavailability and half-life of a single dose of imatinib and decreases its serum levels by 30% in healthy volunteers. This is most likely due to induction of cytochrome P450 3A4 (CYP3A4) by St. John's wort, which increases clearance of imatinib.

Likelihood Likely Evidence A
Irinotecan (Camptosar)

St. John's wort reduces the levels and clinical effects of irinotecan.
St. John's wort 900 mg daily for 18 days decreases serum levels of irinotecan by at least 50%. Clearance of the active metabolite of irinotecan, SN-38, is also increased, resulting in a 42% decrease in the area under the concentration-time curve. This is thought to be due to induction of cytochrome P450 3A4 (CYP3A4) by St. John's wort.

Likelihood Likely Evidence A
Mephenytoin (Mesantoin)

St. John's wort reduces the levels and clinical effects of mephenytoin.
Preliminary clinical research in healthy males shows that taking St. John's wort for 14 days induces cytochrome P450 2C19 (CYP2C19) and significantly increases metabolism of mephenytoin (Mesantoin). In people with wild-type 2C19, metabolism was almost 4-fold greater in subjects who received St. John's wort compared to placebo. In contrast, patients with 2C19*2/*2 and *2/*3 genotypes did not demonstrate a similar increase in metabolism.

Likelihood Likely Evidence B
Non-Nucleoside Reverse Transcriptase Inhibitors (Nnrtis)

St. John's wort decreases the levels and clinical effects of NNRTIs.
St. John's wort increases the oral clearance of nevirapine (Viramune) by 35%. Subtherapeutic concentrations are associated with therapeutic failure, development of viral resistance, and development of drug class resistance. St. John's wort induces intestinal and hepatic cytochrome P450 3A4 (CYP3A4) and intestinal P-glycoprotein/MDR-1, a drug transporter.

Likelihood Likely Evidence B
Omeprazole (Prilosec)

St. John's wort decreases the levels and clinical effects of omeprazole.
Taking St. John's wort, 300 mg orally three times daily for 14 days, reduces serum concentrations of omeprazole by inducing its metabolism via cytochrome P450 (CYP) 2C19 and 3A4. The reduction of omeprazole serum levels is dependent on CYP2C19 genotype, with reductions up to 50% in extensive metabolizers and 38% in poor metabolizers.

Likelihood Likely Evidence B
Oxycodone (Oxycontin)

St. John's wort decreases the levels and clinical effects of oxycodone.
St. John's wort can increase oxycodone metabolism by inducing cytochrome P450 3A4 (CYP3A4), reducing plasma levels and analgesic activity.

Likelihood Probable Evidence B
P-Glycoprotein Substrates

St. John's wort decreases the levels and clinical effects of P-glycoprotein substrates.
St. John's wort induces P-glycoprotein. P-glycoprotein is a carrier mechanism responsible for transporting drugs and other substances across cell membranes. When P-glycoprotein is induced in the gastrointestinal (GI) tract, it can prevent the absorption of some medications. In addition, induction of p-glycoprotein can decrease entry of drugs into the central nervous system (CNS) and decrease access to other sites of action.

Likelihood Probable Evidence B
Phenobarbital (Luminal)

St. John's wort decreases the levels and clinical effects of phenobarbital.
St. John's wort may increase the metabolism of phenobarbital. Plasma concentrations of phenobarbital should be monitored carefully. The dose of phenobarbital may need to be increased when St. John's wort is started and decreased when it is stopped.

Likelihood Likely Evidence B
Phenprocoumon (Marcoumar, Others)

St. John's wort decreases the levels and clinical effects of phenprocoumon.
St. John's wort appears to increase the metabolism of phenprocoumon (an anticoagulant that is not available in the US) by increasing the activity of the cytochrome P450 2C9 (CYP2C9) enzyme. This may result in decreases in the anticoagulant effect and international normalized ratio (INR).

Likelihood Likely Evidence B
Phenytoin (Dilantin)

St. John's wort decreases the levels and clinical effects of phenytoin.
St. John's wort may increase the metabolism of phenytoin. Plasma concentrations of phenytoin should be monitored closely. The dose of phenytoin may need to be increased when St. John's wort is started and decreased when it is stopped.

Likelihood Likely Evidence B
Protease Inhibitors (Pis)

St. John's wort reduces the levels and clinical effects of PIs.
In healthy volunteers, St. John's wort can reduce the plasma concentrations of indinavir (Crixivan) by inducing cytochrome P450 3A4 (CYP3A4). This might result in treatment failure and viral resistance. St. John's wort also induces P-glycoprotein, which can result in decreased intracellular protease inhibitor concentrations and increased elimination.

Likelihood Likely Evidence B
Rivaroxaban (Xarelto)

St. John's wort decreases the levels and clinical effects of rivaroxaban.
A small pharmacokinetic study in healthy volunteers shows that taking a single dose of rivaroxaban 20 mg after using a specific St. John's wort extract (Jarsin, Vifor SA) 450 mg orally twice daily for 14 days reduces the bioavailability of rivaroxaban by 24% and reduces rivaroxaban's therapeutic inhibition of factor Xa by 20%.

Likelihood Probable Evidence B
Tacrolimus (Prograf)

St. John's wort decreases the levels and clinical effects of tacrolimus.
Taking a St. John's wort extract (Jarsin) 600 mg daily significantly decreases tacrolimus serum levels. Dose increases of 60% may be required to maintain therapeutic tacrolimus levels in patients taking St. John's wort. St. John's wort is thought to lower tacrolimus levels by inducing cytochrome P450 3A4 (CYP3A4) enzymes. A small clinical study in healthy adults also shows that taking St. John's wort 300 mg three times daily for 10 days decreases the total systemic exposure to tacrolimus by 27% and 33% after taking a single 5 mg dose of immediate-release or prolonged-release tacrolimus, respectively.

Likelihood Likely Evidence B
Warfarin (Coumadin)

St. John's wort decreases the levels and clinical effects of warfarin.
Taking St. John's wort significantly increases clearance of warfarin, including both its R- and S-isomers. This is likely due to induction of cytochrome P450 (CYP) 1A2 and CYP3A4. St. John's wort can also significantly decrease International Normalized Ratio (INR) in people taking warfarin. In addition, taking warfarin at the same time as St. John's wort might reduce warfarin bioavailability. When a dried extract is mixed with warfarin in an aqueous medium, up to 30% of warfarin is bound to particles, reducing its absorption.

Likelihood Likely Evidence B
Aminolevulinic Acid

St. John's wort might have additive phototoxic effects with aminolevulinic acid.
Concomitant use with St. John's wort extract may cause synergistic phototoxicity. Delta-aminolevulinic acid can cause a burning erythematous rash and severe swelling of the face, neck, and hands when taken with St. John's wort.

Likelihood Possible Evidence D
Bupropion (Wellbutrin)

St. John's wort might reduce the levels and effects of bupropion.
Clinical research shows that taking St. John's wort 325 mg three times daily for 14 days along with bupropion reduces the area under the concentration-time curve by approximately 14% and increases the clearance of bupropion by approximately 20%. This effect is attributed to the induction of cytochrome P450 2B6 (CYP2B6) by St. John's wort.

Likelihood Probable Evidence B
Clopidogrel (Plavix)

St. John's wort might increase the levels and effects of clopidogrel.
Taking St. John's wort with clopidogrel seems to increase the activity of clopidogrel. In clopidogrel non-responders, taking St. John's wort seems to induce metabolism of clopidogrel to its active metabolite by cytochrome P450 enzymes 3A4 and 2C19. This leads to increased antiplatelet activity. Theoretically, this might lead to an increased risk of bleeding in clopidogrel responders.

Likelihood Possible Evidence B
Clozapine (Clozaril)

St. John's wort might decrease the levels and clinical effects of clozapine.
A case report describes a female with schizophrenia controlled on clozapine who had a return of symptoms when she started taking St. John's wort. The plasma concentration of clozapine was reduced, likely because its clearance was increased due to induction of the cytochrome P450 enzymes 3A4, 1A2, 2C9, and 2C19 by St. John's wort.

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

St. John's wort may increase the metabolism and reduce the levels of CYP1A2 substrates.
Clinical and in vitro research shows that St. John's wort induces CYP1A2, but to a lesser extent than CYP3A4.

Likelihood Possible Evidence B

Cimicifuga7 drug types · 652 drugs

Atorvastatin (Lipitor)

Taking black cohosh with atorvastatin might increase the risk for elevated liver function tests.
In one case report, a patient taking atorvastatin (Lipitor) developed significantly elevated liver function enzymes after starting black cohosh 100 mg four times daily. Liver enzymes returned to normal when black cohosh was discontinued. It is unclear whether the elevated liver enzymes were due to black cohosh itself or an interaction between atorvastatin and black cohosh.

Likelihood Possible Evidence D
Cisplatin (Platinol-Aq)

Theoretically, black cohosh may reduce the clinical effects of cisplatin.
Animal research suggests that black cohosh might decrease the cytotoxic effect of cisplatin on breast cancer cells.

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

Some research suggests that black cohosh might inhibit CYP2D6, but there is conflicting evidence.
Some clinical research suggests that black cohosh might modestly inhibit CYP2D6 and increase levels of drugs metabolized by this enzyme. However, contradictory clinical research shows a specific black cohosh product (Remifemin, Enzymatic Therapy) 40 mg twice daily does not significantly inhibit metabolism of a CYP2D6 substrate in healthy study volunteers. Until more is known, use black cohosh cautiously in patients taking drugs metabolized by CYP2D6.

Likelihood Possible Evidence B
Estrogens

Theoretically, black cohosh may alter the effects of estrogen therapy.
Some research suggests that black cohosh has estrogenic effects. This may enhance or inhibit the effects of estrogen therapy.

Likelihood Possible Evidence D
Hepatotoxic Drugs

Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
There is concern that black cohosh might be linked to cases of liver failure and autoimmune hepatitis.

Likelihood Possible Evidence D
Serotonergic Drugs

Combining serotonergic drugs with black cohosh might cause additive serotonergic effects.
Black cohosh might increase the risk of serotonin syndrome when combined with other serotonergic drugs. Black cohosh acts as an agonist at several serotonin receptor subtypes and might interact with other serotonergic medications. In one case, a 55-year-old female who had been on stable treatment with sertraline 50 mg and duloxetine 60 mg daily developed serotonin syndrome after taking black cohosh extract 40 mg daily for 3 days.

Likelihood Possible Evidence D
Organic Anion-Transporting Polypeptide Substrates (Oatp)

Black cohosh may inhibit one form of OATP, OATP2B1, which could reduce the bioavailability and clinical effects of OATP2B1 substrates.
In vitro research shows that black cohosh modestly inhibits OATP2B1. OATPs are expressed in the small intestine and liver and are responsible for the uptake of drugs and other compounds into the body. Inhibition of OATP may reduce the bioavailability of oral drugs that are substrates of OATP.

Likelihood Possible Evidence D

Mag phos15 drug types · 295 drugs

Levodopa/Carbidopa (Sinemet)

Magnesium can reduce the bioavailability of levodopa/carbidopa.
Clinical research in healthy volunteers shows that taking magnesium oxide 1000 mg with levodopa 100 mg/carbidopa 10 mg reduces the area under the curve (AUC) of levodopa by 35% and of carbidopa by 81%. In vitro and animal research shows that magnesium produces an alkaline environment in the digestive tract, which might lead to degradation and reduced bioavailability of levodopa/carbidopa.

Likelihood Probable Evidence B
Aminoglycoside Antibiotics

Concomitant use of aminoglycoside antibiotics and magnesium can increase the risk for neuromuscular weakness.
Both aminoglycosides and magnesium reduce presynaptic acetylcholine release, which can lead to neuromuscular blockade and possible paralysis. This is most likely to occur with high doses of magnesium given intravenously.

Likelihood Possible Evidence D
Antacids

Use of acid reducers may reduce the laxative effect of magnesium oxide.
A retrospective analysis shows that, in the presence of H2 receptor antagonists (H2RAs) or proton pump inhibitors (PPIs), a higher dose of magnesium oxide is needed for a laxative effect. This may also occur with antacids. Under acidic conditions, magnesium oxide is converted to magnesium chloride and then to magnesium bicarbonate, which has an osmotic laxative effect. By reducing acidity, antacids may reduce the conversion of magnesium oxide to the active bicarbonate salt.

Likelihood Possible Evidence D
Bictegravir/Emtricitabine/Tenofovir Alafenamide (Biktarvy)

Magnesium might decrease levels of bictegravir/emtricitabine/tenofovir alafenamide by reducing its absorption.
Advise patients that bictegravir/emtricitabine/tenofovir alafenamide should be taken at least 2 hours before or 6 hours after magnesium containing products.

Likelihood Probable Evidence D
Bisphosphonates

Magnesium can decrease absorption of bisphosphonates.
Cations, including magnesium, can decrease bisphosphonate absorption. Advise patients to separate doses of magnesium and these drugs by at least 2 hours.

Likelihood Probable Evidence B
Calcium Channel Blockers

Magnesium can have additive effects with calcium channel blockers, although evidence is conflicting.
Magnesium inhibits calcium entry into smooth muscle cells and may therefore have additive effects with calcium channel blockers. Severe hypotension and neuromuscular blockades may occur when nifedipine is used with intravenous magnesium, although some contradictory evidence suggests that concurrent use of magnesium with nifedipine does not increase the risk of neuromuscular weakness. High doses of magnesium could theoretically have additive effects with other calcium channel blockers.

Likelihood Possible Evidence D
Digoxin

Magnesium salts may reduce absorption of digoxin.
Clinical evidence suggests that treatment with oral magnesium hydroxide or magnesium trisilicate reduces absorption of digoxin from the intestines. This may reduce the blood levels of digoxin and decrease its therapeutic effects.

Likelihood Possible Evidence B
Potassium-Sparing Diuretics

Potassium-sparing diuretics decrease excretion of magnesium, possibly increasing magnesium levels.
Potassium-sparing diuretics also have magnesium-sparing properties, which can counteract the magnesium losses associated with loop and thiazide diuretics. Theoretically, increased magnesium levels could result from concomitant use of potassium-sparing diuretics and magnesium supplements.

Likelihood Probable Evidence D
Quinolone Antibiotics

Magnesium decreases absorption of quinolones.
Magnesium can form insoluble complexes with quinolones and decrease their absorption. Advise patients to take these drugs at least 2 hours before, or 4 to 6 hours after, magnesium supplements.

Likelihood Probable Evidence D
Skeletal Muscle Relaxants

Parenteral magnesium alters the pharmacokinetics of skeletal muscle relaxants, increasing their effects and accelerating the onset of effect.
Parenteral magnesium shortens the time to onset of skeletal muscle relaxants by about 1 minute and prolongs the duration of action by about 2 minutes. Magnesium potentiates the effects of skeletal muscle relaxants by decreasing calcium-mediated release of acetylcholine from presynaptic nerve terminals, reducing postsynaptic sensitivity to acetylcholine, and having a direct effect on the membrane potential of myocytes. Magnesium also has vasodilatory actions and increases cardiac output, allowing a greater amount of muscle relaxant to reach the motor end plate. A clinical study found that low-dose rocuronium (0.45 mg/kg), when given after administration of magnesium 30 mg/kg over 10 minutes, has an accelerated onset of effect, which matches the onset of effect seen with a full-dose rocuronium regimen (0.6 mg/kg). In another clinical study, onset times for rocuronium doses of 0.3, 0.6, and 1.2 mg/kg were 86, 76, and 50 seconds, respectively, when given alone, but were reduced to 66, 44, and 38 seconds, respectively, when the doses were given after a 15-minute infusion of magnesium sulfate 60 mg/kg. Giving intraoperative intravenous magnesium sulfate, 50 mg/kg loading dose followed by 15 mg/kg/hour, reduces the onset time of rocuronium, enhances its clinical effects, reduces the dose of intraoperative opiates, and prolongs the spontaneous recovery time. It does not affect the activity of subsequently administered neostigmine.

Likelihood Probable Evidence A
Sulfonylureas

Magnesium increases the systemic absorption of sulfonylureas, increasing their effects and side effects.
Clinical research shows that administration of magnesium hydroxide with glyburide increases glyburide absorption, increases maximal insulin response by 35-fold, and increases the risk of hypoglycemia, when compared with glyburide alone. A similar interaction occurs between magnesium hydroxide and glipizide. The mechanism of this effect appears to be related to the elevation of gastrointestinal pH by magnesium-based antacids, increasing solubility and enhancing absorption of sulfonylureas.

Likelihood Probable Evidence B
Tetracycline Antibiotics

Magnesium decreases absorption of tetracyclines.
Magnesium can form insoluble complexes with tetracyclines in the gut and decrease their absorption and antibacterial activity. Advise patients to take these drugs 1 hour before or 2 hours after magnesium supplements.

Likelihood Probable Evidence D
Anticoagulant/Antiplatelet Drugs

Theoretically, magnesium may have antiplatelet effects, but the evidence is conflicting.
In vitro evidence shows that magnesium sulfate inhibits platelet aggregation, even at low concentrations. Some preliminary clinical evidence shows that infusion of magnesium sulfate increases bleeding time by 48% and reduces platelet activity. However, other clinical research shows that magnesium does not affect platelet aggregation, although inhibition of platelet-dependent thrombosis can occur.

Likelihood Unlikely Evidence B
Gabapentin (Neurontin)

Gabapentin absorption can be decreased by magnesium.
Clinical research shows that giving magnesium oxide orally along with gabapentin decreases the maximum plasma concentration of gabapentin by 33%, time to maximum concentration by 36%, and area under the curve by 43%. Advise patients to take gabapentin at least 2 hours before, or 4 to 6 hours after, magnesium supplements.

Likelihood Unlikely Evidence B
Sevelamer (Renagel, Renvela)

Sevelamer may increase serum magnesium levels.
In patients on hemodialysis, sevelamer use was associated with a 0.28 mg/dL increase in serum magnesium. The mechanism of this interaction remains unclear.

Likelihood Possible Evidence B

Aconitum nap2 drug types · 278 drugs

Anticoagulant/Antiplatelet Drugs

Theoretically, combining aconite with other antiplatelet or anticoagulant drugs might increase the risk of bruising and bleeding.
Higenamine, a constituent of aconite, is thought to have antiplatelet and antithrombotic effects. In an animal model of thrombosis, higenamine inhibited platelet aggregation and reduced the size of thrombus formation.

Likelihood Possible Evidence D
Stimulant Drugs

Theoretically, combining aconite with other stimulant drugs might alter the effects of the stimulant drug or increase the risk of cardiovascular toxicity.
Aconite and its constituents have stimulant effects due to agonist activity at beta-2-adrenoreceptors. In cardiac muscle, aconite appears to have a positive inotropic effect and increases heart rate and blood pressure. However, some constituents of aconite can reduce heart rate and blood pressure.

Likelihood Possible Evidence D

Belladonna2 drug types · 196 drugs

Anticholinergic Drugs

Belladonna may increase the risk of adverse effects when used concomitantly with anticholinergic drugs.
Belladonna has anticholinergic activity and increases the activity of anticholinergic drugs.

Likelihood Probable Evidence D
Cisapride (Propulsid)

Theoretically, belladonna might reduce the effects of cisapride.
Belladonna contains atropine. In vivo evidence suggests that atropine can prevent cisapride from increasing motility in the gastrointestinal tract.

Likelihood Possible Evidence D

Arnica1 drug type · 122 drugs

Anticoagulant/Antiplatelet Drugs

Theoretically, arnica might have additive effects with anticoagulant and antiplatelet drugs. Homeopathic arnica preparations are unlikely to have this interaction.
In vitro evidence shows that sesquiterpene lactones in arnica flowers can decrease platelet aggregation. However, this effect has not been reported in humans.

Likelihood Unlikely Evidence D
The maker

Brand information

Manufacturer and brand details for Back & Neck Pain, from the product label.

BIOVEA Homeopathics

See all BIOVEA Homeopathics products
Name
BIOVEA
Street Address
7702 E. Doubletree Ranch Rd. Suite 300, #307
City
Scottsdale
State
AZ
ZipCode
85258
Phone Number
1-800-961-4750
Web Address
www.biovea.com
Pharmacist Counseling Corner

Back & Neck Pain by BIOVEA Homeopathics: Common Questions

Does Back & Neck Pain by BIOVEA Homeopathics interact with any medications?
Yes. Based on its ingredients, Back & Neck Pain has a known interaction with 1,502 medications, including 761 rated major. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Back & Neck Pain contains 12 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.
Is this product safe during pregnancy?
No. Multiple ingredients are rated unsafe or likely unsafe in pregnancy, including aconite, belladonna, gelsemium, bulbous buttercup, and poison ivy. Black cohosh is rated possibly unsafe. Do not use this product if you are pregnant or planning to become pregnant.
Is it safe while breastfeeding?
No. Aconite, gelsemium, poison ivy, and bulbous buttercup are rated unsafe while breastfeeding. Belladonna and black cohosh are rated likely unsafe or possibly unsafe. The toxic constituents can pass into breast milk and harm your baby. Avoid this product entirely.
Will this actually help my back pain?
The evidence doesn't support it. Poison ivy (Rhus tox) has insufficient evidence for back pain; arnica and black cohosh have not been studied for back pain specifically. None of the other 9 ingredients have established effectiveness for any condition.
What is aconite and why is it in here?
Aconite is a highly toxic plant used in homeopathic products in extremely diluted form. Even in small amounts of the crude plant, it can cause fatal heart rhythm problems, low blood pressure, and seizures. The homeopathic dilution is meant to reduce toxicity, but the plant itself is poisonous.
Can I take this with my blood pressure medication?
Do not assume so — aconite interacts with stimulant drugs and can raise heart toxicity risk, and magnesium interacts with calcium channel blockers and other blood pressure drugs. Check your exact medication with the interaction tool on this page before use.
What does the liquid form contain besides the active ingredients?
The inactive ingredients are organic alcohol and purified water. There are no other fillers or binders in the formula.

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

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

Back & Neck Pain label
Go deeper

The Full Monographs Behind Back & Neck Pain’s Ingredients

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

Herb & supplement monograph

Aconite

Interacts with 278 drugs

Aconite is a highly poisonous plant, and even small amounts of the raw or improperly processed root can cause severe, life-threatening reactions. There is no good scientific evidence that it...

Read the full Aconite monograph →
Herb & supplement monograph

Arnica

Interacts with 122 drugs

Arnica is a daisy-family plant used mainly in topical and homeopathic products for bruising, muscle soreness, and pain. The evidence is mixed and mostly weak, and undiluted arnica taken by m...

Read the full Arnica monograph →
Herb & supplement monograph

Belladonna

Interacts with 196 drugs

Belladonna is a highly toxic plant whose alkaloids (like atropine and scopolamine) are powerful medicines used only in carefully controlled, regulated forms. The raw plant and unregulated pr...

Read the full Belladonna monograph →
Herb & supplement monograph

Black Cohosh

Interacts with 652 drugs

Black cohosh is a North American plant most often used to ease menopause symptoms like hot flashes, but the research is mixed and far from settled. It is generally well tolerated for short-t...

Read the full Black Cohosh monograph →
Herb & supplement monograph

Gelsemium

Gelsemium is a highly toxic flowering plant most often sold today in very dilute homeopathic forms for anxiety, headaches, and flu-like symptoms. There is little reliable scientific evidence...

Read the full Gelsemium monograph →
Herb & supplement monograph

St. John's Wort

Interacts with 1,143 drugs

St. John's wort is a well-studied herb most often used for mild to moderate depression, and some research suggests it may help with this. However, it has many serious interactions with presc...

Read the full St. John's Wort monograph →
Herb & supplement monograph

Magnesium

Interacts with 295 drugs

Magnesium is an essential mineral your body needs for muscles, nerves, blood pressure, and many other functions, and supplements are useful for preventing or correcting deficiency. Some othe...

Read the full Magnesium monograph →
Herb & supplement monograph

Bulbous Buttercup

Bulbous buttercup is a wild flowering plant that is toxic and irritating when fresh, and it is used today mainly in heavily diluted homeopathic remedies. There is no solid scientific evidenc...

Read the full Bulbous Buttercup monograph →
Herb & supplement monograph

Poison Ivy

Poison ivy is a toxic plant best known for causing an itchy, blistering allergic rash on contact. In supplement form it is sold almost exclusively as an extremely dilute homeopathic remedy (...

Read the full Poison Ivy monograph →
Sources

Sources & How We Checked

Back & Neck Pain'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 389 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.

Aconite 33 references
  1. Tai YT. Adverse effects from traditional Chinese medicine. Lancet 1993;341:892.
  2. Tai YT, But PP, Young K, et al. Cardiotoxicity after accidental herb-induced aconite poisoning. Lancet 1992;340:1254-6. PubMed
  3. Fatovich DM. Aconite: a lethal Chinese herb. Ann Emerg Med 1992;21:309-11. PubMed
  4. Tomlinson B, Chan TY, Chan JC, Critchley JA. Herb-induced aconite poisoning. Lancet 1993;341:370-1. .
  5. Chan TY, Tomlinson B, Critchley JA. Aconitine poisoning following the ingestion of Chinese herbal medicines: a report of eight cases. Aust N Z J Med 1993;23:268-71. PubMed
  6. Yeih DF, Chiang FT, Huang SKS. Successful treatment of aconitine induced life threatening ventricular tachyarrhythmia with amiodarone. Heart 2000;84:E8. PubMed
  7. But PP, Tai YT, Young K. Three fatal cases of herbal aconite poisoning. Vet Hum Toxicol 1994;36:212-5.
  8. Feldkamp A, Koster B, Weber HP. [Fatal poisoning caused by aconite monk's hood]. Monatsschr Kinderheilkd 1991;139:366-7.
  9. Lin CC, Chan TY, Deng JF. Clinical features and management of herb-induced aconitine poisoning. Ann Emerg Med 2004;43:574-9. PubMed
  10. Poon WT, Lai CK, Ching CK, et al. Aconite poisoning in camouflage. Hong Kong Med J 2006;12:456-9.
  11. Guha, S., Dawn, B., Dutta, G., Chakraborty, T., and Pain, S. Bradycardia, reversible panconduction defect and syncope following self-medication with a homeopathic medicine. Cardiology 1999;91(4):268-271. PubMed
  12. Imazio, M., Belli, R., Pomari, F., Cecchi, E., Chinaglia, A., Gaschino, G., Ghisio, A., Trinchero, R., and Brusca, A. Malignant ventricular arrhythmias due to Aconitum napellus seeds. Circulation 12-5-2000;102(23):2907-2908.
  13. Telang, B. V. and Ng'ang'a, J. N. Involvement of Central adrenergic mechanisms in the induction of cardiac arrhythmias by aconitine nitrate administered intraventricularly. Indian J Physiol Pharmacol. 1975;19(1):1-10.
  14. Lin, C. C., Chou, H. L., and Lin, J. L. Acute aconitine poisoned patients with ventricular arrhythmias successfully reversed by charcoal hemoperfusion. Am J Emerg.Med 2002;20(1):66-67. PubMed
  15. Gaibazzi, N., Gelmini, G. P., Montresor, G., Canel, D., Comini, T., Fracalossi, C., Martinetti, C., Poeta, M. L., and Ziacchi, V. [Long QRS tachycardia secondary to Aconitum napellus alkaloid ingestion]. Ital.Heart J.Suppl 2002;3(8):874-877.
  16. Sorensen, B. [Poisoning with Aconitum napellus (monkshood)]. Ugeskr.Laeger 5-12-2003;165(20):2109-2110.
  17. Tai, Y. T., Lau, C. P., But, P. P., Fong, P. C., and Li, J. P. Bidirectional tachycardia induced by herbal aconite poisoning. Pacing Clin.Electrophysiol. 1992;15(5):831-839. PubMed
  18. Agarwal, B. L., Agarwal, R. K., and Misra, D. N. Malignant Arrhythmias Induced by Accidental Aconite Poisoning. Indian Heart J 1977;29(5):246-248.
  19. Dickens, P., Tai, Y. T., But, P. P., Tomlinson, B., Ng, H. K., and Yan, K. W. Fatal accidental aconitine poisoning following ingestion of Chinese herbal medicine: a report of two cases. Forensic Sci Int 6-28-1994;67(1):55-58. PubMed
  20. Chan, T. Y., Tomlinson, B., Critchley, J. A., and Cockram, C. S. Herb-induced aconitine poisoning presenting as tetraplegia. Vet.Hum.Toxicol. 1994;36(2):133-134. PubMed
  21. Chan, T. Y., Tomlinson, B., Chan, W. W., Yeung, V. T., and Tse, L. K. A case of acute aconitine poisoning caused by chuanwu and caowu. J Trop.Med Hyg. 1993;96(1):62-63.
  22. Yoshioka, N., Gonmori, K., Tagashira, A., Boonhooi, O., Hayashi, M., Saito, Y., and Mizugaki, M. A case of aconitine poisoning with analysis of aconitine alkaloids by GC/SIM. Forensic Sci.Int. 8-15-1996;81(2-3):117-123. PubMed
  23. Kimura, I., Takada, M., and Nojima, H. Aconitine induces bradycardia through a transmission pathway including the anterior hypothalamus in conscious mice. Biol.Pharm Bull. 1997;20(8):856-860. PubMed
  24. Chan TY. Aconite poisoning following the percutaneous absorption of Aconitum alkaloids. Forensic Sci Int. 2012 Nov 30;223(1-3):25-7. PubMed
  25. Chan TY. Aconitum Alkaloid Poisoning Because of Contamination of Herbs by Aconite Roots. Phytother Res. 2016 Jan;30(1):3-8.
  26. Li H, Liu L, Zhu S, Liu Q. Case reports of aconite poisoning in mainland China from 2004 to 2015: A retrospective analysis. J Forensic Leg Med. 2016 May 25;42:68-73. PubMed
  27. Zhao D, Wang J, Cui Y, Wu X. Pharmacological effects of Chinese herb aconite (fuzi) on cardiovascular system. J Tradit Chin Med. 2012 Sep;32(3):308-13. PubMed
  28. Wood C, Coulson J, Thompson J, Bonner S. An intentional aconite overdose: a case report. J Crit Care Med (Targu Mures) 2020;6(2):124-9. PubMed
  29. Bonanno G, Ippolito M, Moscarelli A, et al. Accidental poisoning with aconitum: case report and review of the literature. Clin Case Rep 2020;8(4):696-8. PubMed
  30. Blasco Mariño R, Pacheco Reyes A, Canel Micheloud C, Soteras Martínez I. Cardiac Arrest by Aconite Poisoning. Wilderness Environ Med 2021;32(3):415-417. PubMed
  31. Zhou C, Luo S, Tang J, Quick L, Liu H, Zhao Y. Poisoning Associated with Consumption of a Homemade Medicinal Liquor - Chongqing, China, 2018. MMWR Morb Mortal Wkly Rep 2022;71(16):569-573. PubMed
  32. Loo G, Yong TH, Yeo C. A case report of bidirectional ventricular tachycardia secondary to aconitum toxicity. J Arrhythm 2022;38(3):451-453. PubMed
  33. Majumder MI, Mahadi AR, Rahman OU, Roy BK, Shihab HM. Accidental poisoning with aconite overdose: A case report and resuscitative emergency management in a tertiary level hospital of Bangladesh. Clin Case Rep 2023;11(9):e7845. PubMed

See these in context on the Aconite monograph →

Arnica 10 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. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
  3. Schroder H, Losche W, Strobach H, et al. Helenalin and 11 alpha, 13-dihydrohelenalin, two constituents from Arnica montana L., inhibit human platelet function via thiol-dependent pathways. Thromb Res 1990;57:839-45.
  4. Adkison JD, Bauer DW, Chang T. The effect of topical arnica on muscle pain. Ann Pharmacother 2010;44:1579-84. PubMed
  5. No authors listed. Final report on the safety assessment of Arnica montana extract and Arnica montana. Int.J.Toxicol. 2001;20:1-11. DOI
  6. Karow JH, Abt HP, Frohling M, and Ackermann H. Efficacy of Arnica montana D4 for healing of wounds after Hallux valgus surgery compared to diclofenac. J Altern Complement Med 2008;14:17-25.
  7. Venkatramani DV, Goel S, Ratra V, et al. Toxic optic neuropathy following ingestion of homeopathic medication Arnica-30. Cutan.Ocul.Toxicol. 2013;32:95-97. PubMed
  8. Moghadam BK, Gier R, and Thurlow T. Extensive oral mucosal ulcerations caused by misuse of a commercial mouthwash. Cutis 1999;64:131-134.
  9. Stevinson C, Devaraj VS, Fountain-Barber A, et al. Homeopathic arnica for prevention of pain and bruising: randomized placebo-controlled trial in hand surgery. J R Soc Med 2003;96:60-65. PubMed
  10. Canders CP, Stanford SR, Chiem AT. A dangerous cup of tea. Wilderness Environ Med. 2014 Mar;25(1):111-2. PubMed

See these in context on the Arnica monograph →

Belladonna 20 references
  1. Blumenthal M, ed. The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. Trans. S. Klein. Boston, MA: American Botanical Council, 1998.
  2. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
  3. McEvoy GK, ed. AHFS Drug Information. Bethesda, MD: American Society of Health-System Pharmacists, 1998.
  4. Jaspersen-Schib R, Theus L, Guirguis-Oeschger M, et al. [Serious plant poisonings in Switzerland 1966-1994. Case analysis from the Swiss Toxicology Information Center]. Schweiz Med Wochenschr 1996;126:1085-98.
  5. Corazziari, E., Bontempo, I., and Anzini, F. Effects of cisapride on distal esophageal motility in humans. Dig Dis Sci 1989;34(10):1600-1605. PubMed
  6. Heindl, S., Binder, C., Desel, H., Matthies, U., Lojewski, I., Bandelow, B., Kahl, G. F., and Chemnitius, J. M. [Etiology of initially unexplained confusion of excitability in deadly nightshade poisoning with suicidal intent. Symptoms, differential diagn
  7. Walach, H., Koster, H., Hennig, T., and Haag, G. The effects of homeopathic belladonna 30CH in healthy volunteers -- a randomized, double-blind experiment. J.Psychosom.Res. 2001;50(3):155-160. PubMed
  8. Davidov, M. I. [Factors predisposing to acute urine retention in patients with prostatic adenoma]. Urologiia. 2007;(2):25-31.
  9. Williams HC and du Vivier A. Belladonna plaster--not as bella as it seems. Contact Dermatitis 1990;23(2):119-120.
  10. Stieg, R. L. Double-blind study of belladonna-ergotamine-phenobarbital for interval treatment of recurrent throbbing headache. Headache 1977;17(3):120-124. PubMed
  11. Shader RI and Greenblatt DJ. Uses and toxicity of belladonna alkaloids and synthetic anticholinergics. Seminars in Psychiatry 1971;3(4):449-476.
  12. Gabel MC. Purposeful ingestion of belladonna for hallucinatory effects. J.Pediatr. 1968;72(6):864-866. PubMed
  13. Goldsmith SR, Frank I, and Ungerleider JT. Poisoning from ingestion of a stramonium-belladonna mixture: flower power gone sour. J.A.M.A 4-8-1968;204(2):169-170. DOI
  14. Schneider, F., Lutun, P., Kintz, P., Astruc, D., Flesch, F., and Tempe, J. D. Plasma and urine concentrations of atropine after the ingestion of cooked deadly nightshade berries. J Toxicol Clin Toxicol 1996;34(1):113-117. PubMed
  15. Ceha LJ, Presperin C, Young E, and et al. Anticholinergic toxicity from nightshade berry poisoning responsive to physostigmine. The Journal of Emergency Medicine 1997;15(1):65-69. PubMed
  16. Firth D and Bentley JR. Belladonna poisoning from eating rabbit. Lancet 1921;2:901. DOI
  17. Cummins BM, Obetz SW, Wilson MR, and et al. Belladonna poisoning as a facet of psychodelia. Jama 1968;204(11):153. DOI
  18. Hamilton M and Sclare AB. Belladonna poisoning. Br Med J 1947;611-612. PubMed
  19. Huff ML, Fikse D, Surmaitis RM, Greenberg MR. Acute angle closure glaucoma precipitated by homeopathic eyedrops containing Atropa belladonna. Am J Emerg Med. 2021 Nov 3:S0735-6757(21)00902-5. PubMed
  20. Chen L, Yeung JC, Anderson DR. Anisocoria secondary to anticholinergic mydriasis from homeopathic pink eye relief drops. Clin Med Res. 2017;15(3-4):93-5. PubMed

See these in context on the Belladonna monograph →

Black Cohosh 68 references
  1. McFarlin BL, Gibson MH, O'Rear J, Harman P. A national survey of herbal preparation use by nurse-midwives for labor stimulation. Review of the literature and recommendations for practice. J Nurse Midwifery 1999;44:205-16. PubMed
  2. Whiting PW, Clouston A, Kerlin P. Black cohosh and other herbal remedies associated with acute hepatitis. Med J Aust 2002;177:440-3. PubMed
  3. Pepping J. Black cohosh: Cimicifuga racemosa. Am J Health Syst Pharm 1999;56:1400-2. PubMed
  4. Liske E. Therapeutic efficacy and safety of Cimicifuga racemosa for gynecologic disorders. Adv Ther 1998;15:45-53.
  5. Kruse SO, Lohning A, Pauli GF, et al. Fukiic and piscidic acid esters from the rhizome of Cimicifuga racemosa and the in vitro estrogenic activity of fukinolic acid. Planta Med 1999;65:763-4.
  6. Jacobson JS, Troxel AB, Evans J, et al. Randomized trial of black cohosh for the treatment of hot flashes among women with a history of breast cancer. J Clin Oncol 2001;19:2739-45. PubMed
  7. Gunn TR, Wright IM. The use of black and blue cohosh in labour. N Z Med J 1996;109:410-1.
  8. Baillie N, Rasmussen P. Black and blue cohosh in labour. N Z Med J 1997;110:20-1.
  9. Lontos S, Jones RM, Angus PW, Gow PJ. Acute liver failure associated with the use of herbal preparations containing black cohosh. Med J Aust 2003;179:390-1.. DOI
  10. Wuttke W, Seidlova-Wuttke D, Gorkow C. The Cimicifuga preparation BNO 1055 vs. conjugated estrogens in a double-blind placebo-controlled study: effects on menopause symptoms and bone markers. Maturitas 2003;44:S67-77. PubMed
  11. Huntley A, Ernst E. A systematic review of the safety of black cohosh. Menopause 2003;10:58-64.. DOI
  12. Cohen SM, O'Connor AM, Hart J, et al. Autoimmune hepatitis associated with the use of black cohosh: a case study. Menopause 2004;11:575-7. PubMed
  13. Vitetta L, Thomsen M, Sali A. Black cohosh and other herbal remedies associated with acute hepatitis. Med J Aust 2003;178:411-2.. PubMed
  14. Thomsen M, Vitetta L, Schmidt M, Sali A. Acute liver failure associated with the use of herbal preparations containing black cohosh. Med J Aust 2004;180:598-600.. DOI
  15. Cohen B, Schardt D. Center for Science in the Public Interest. Letter to Food and Drug Administration. Commissioner Mark McClellan, MD, PhD. March 4, 2004.
  16. Seidlova-Wuttke D, Hesse O, Jarry H, et al. Evidence for selective estrogen receptor modulator activity in a black cohosh (Cimicifuga racemosa) extract: comparison with estradiol-17beta. Eur J Endocrinol 2003;149:351-62. PubMed
  17. Rockwell S, Liu Y, Higgins SA. Alteration of the effects of cancer therapy agents on breast cancer cells by the herbal medicine black cohosh. Breast Cancer Res Treat 2005;90:233-9. PubMed
  18. Levitsky J, Alli TA, Wisecarver J, Sorrell MF. Fulminant liver failure associated with the use of black cohosh. Dig Dis Sci 2005;50:538-9. PubMed
  19. Cheong JL, Bucknall R. Retinal vein thrombosis associated with a herbal phytoestrogen preparation in a susceptible patient. Postgrad Med J 2005;81:266-7.. PubMed
  20. Nappi RE, Malavasi B, Brundu B, Facchinetti F. Efficacy of Cimicifuga racemosa on climacteric complaints: a randomized study versus low-dose transdermal estradiol. Gynecol Endocrinol 2005;20:30-5.
  21. Gurley BJ, Gardner SF, Hubbard MA, et al. In vivo effects of goldenseal, kava kava, black cohosh, and valerian on human cytochrome P450 1A2, 2D6, 2E1, and 3A4/5 phenotypes. Clin Pharmacol Ther 2005;77:415-26. PubMed
  22. Minciullo PL, Saija A, Patafi M, et al. Muscle damage induced by black cohosh (Cimicifuga racemosa). Phytomedicine 2006;13:115-8. PubMed
  23. Wuttke W, Gorkow C, Seidlova-Wuttke D. Effects of black cohosh (Cimicifuga racemosa) on bone turnover, vaginal mucosa, and various blood parameters in postmenopausal women: a double-blind, placebo-controlled, and conjugated estrogens-controlled study. Men PubMed
  24. MHRA. Black cohosh (Cimicifuga racemosa) - risk of liver problems. Herbal Safety News July 2006. Available at: http://www.mhra.gov.uk/home/idcplg?IdcService=SS_GET_PAGE&useSecondary= true&ssDocName=CON2024131&ssTargetNodeId=663.
  25. Dugoua JJ, Seely D, Perri D, et al. Safety and efficacy of black cohosh (cimicifuga racemosa) during pregnancy and lactation. Can J Clin Pharmacol 2006;13:e257-61.
  26. Raus K, Brucker C, Gorkow C, Wuttke W. First-time proof of endometrial safety of the special black cohosh extract (Actaea or Cimicifuga racemosa extract) CR BNO 1055. Menopause 2006;13:678-91. PubMed
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See these in context on the Black Cohosh monograph →

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See these in context on the Gelsemium monograph →

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See these in context on the St. John's Wort monograph →

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Bulbous Buttercup 1 reference
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Poison Ivy 21 references
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See these in context on the Poison Ivy monograph →

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DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

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