Major interaction on record — check this product against your medications before combining. Based on 4 of 5 ingredients. Check your meds →
Dietary supplement

Backache Support Strawberry Flavor Ingredients & Drug Interactions

by TerraVita

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

First and foremost: checking Backache Support Strawberry Flavor against your medications. The heart of this page is the interaction checker and the full interaction report — how this product’s ingredients may interact with prescription and over-the-counter medicines you may be taking.

Around that, we add a pharmacist’s high-level view of the product as a whole — what’s inside, the evidence for its stated use, how transparent the label is, and what safety data exists — so you can see the full picture in one place. It’s educational information from our licensed clinical databases and the clinical staff at HelloPharmacist — not medical advice — and we don’t sell or endorse products. Our editorial policy

The interaction bottom line Most serious interaction: Major

Backache Support Strawberry Flavor is a dietary supplement by TerraVita with 5 active ingredients. Its ingredients are commonly taken for anxiety and stress, sleep and relaxation, digestive upset.Based on those ingredients, 1,322 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are St. John's Wort Glycerite Liquid Extract, Chamomile Flower Glycerite Liquid Extract, Devil's Claw Glycerite Liquid Extract. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

Jump to a section

Check Your Meds Against Backache Support Strawberry Flavor by TerraVita

Ask about any prescription or over-the-counter medication and we check it for interactions with Backache Support Strawberry Flavor by TerraVita — and tell you which ingredient is responsible.

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HelloPharmacist Scorecard of Backache Support Strawberry Flavor by TerraVita

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

From our pharmacy team — supplement deep dive

Generated from HelloPharmacist’s pharmacist-curated databases and editorial rules · Last generated Jul 11, 2026

What’s inside

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 5 active ingredients.
  • “Proprietary Blend” is a proprietary blend — the label gives one combined amount (0.13 mL) without saying how much of each component you get.

This product contains five ingredients, including a proprietary blend and four herbal glycerite liquid extracts: Chamomile Flower, White Willow, Devil's Claw, Horsetail, and St. John's Wort.

These herbs are traditionally used to address back discomfort and related aches. The inactive ingredients are glycerin and strawberry flavor.

The glycerite liquid extract form means each herb has been extracted into a sweet liquid base, which can make it easier to take by mouth compared to pills or powders.

Does it work?

Moderate evidence
Evidence for Intended Use · database check
By FDA rules, dietary supplements can’t claim to treat, cure, or prevent disease — so labels speak in careful marketing language. We discern each product’s intended use from its name, label claims, and label statements, then grade the clinical evidence for that use. How these ratings are computed
Moderate

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

Why this rating?
  • The label markets this product for: Support for back pain and joint discomfort.
  • We looked for evidence on: Back pain, Osteoarthritis, Myalgia, Lower back pain, Joint pain.
  • The strongest evidence on file: Devil's Claw is rated "Possibly Effective" for Back pain (Natural Medicines).
  • Also on file: Devil's Claw is rated "Possibly Effective" for Osteoarthritis.
  • Also on file: St. John's Wort is rated "Insufficient Reliable Evidence To Rate" for Fibromyalgia, Osteoarthritis.

The evidence for effectiveness varies by ingredient. Devil's Claw is rated possibly effective for back pain and osteoarthritis.

St. John's Wort is rated likely effective for depression and possibly effective for menopausal symptoms, though we note it is rated possibly ineffective for HIV/AIDS and irritable bowel syndrome.

Horsetail has insufficient evidence in our data for the conditions it's been studied for, including urinary incontinence, obesity, and hair loss. We hold no effectiveness rating for Chamomile Flower or White Willow in this database.

The evidence, ingredient by ingredient German Chamomile Devil's Claw Horsetail St. John's Wort

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 4 of the 4 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 4 of 4.
  • General safety write-ups exist for 4 of 4.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

Devil's Claw is generally well tolerated for short-term use in healthy adults but can cause digestive upset including allergic skin reactions, diarrhea, indigestion, and (rarely) gastrointestinal bleeding. Some people have reported headache, dizziness, or taste changes.

St. John's Wort is also generally well tolerated short-term but may cause diarrhea, dizziness, dry mouth, fatigue, headache, insomnia, or restlessness.

It can increase skin sensitivity to the sun with chronic use. Horsetail's safety profile is less established; it may cause bloating, increased bowel movements, or nausea.

Crude horsetail contains a compound that can cause thiamine deficiency with prolonged use. During pregnancy, Devil's Claw and Horsetail are not recommended — safety has not been established and they may affect the uterus or fetus.

St. John's Wort should also be avoided in pregnancy due to insufficient reliable safety data.

None of these ingredients should be used while breastfeeding.

Side effects, ingredient by ingredient German Chamomile Devil's Claw Horsetail St. John's Wort

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?
  • 4 of the 4 matched ingredients can interact with medications — St. John's Wort, Horsetail, German Chamomile, Devil's Claw.
  • 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; lithium.
  • For scale: 1,323 individual medications appear in the full list. A big number alone doesn't make a product dangerous — what matters is whether YOUR medication is on it, so run yours through the interaction checker on this page.

Before taking this product, check with your pharmacist if you take any of the following: heart medications like digoxin, seizure medications (phenytoin, phenobarbital, mephenytoin), cancer drugs (irinotecan, docetaxel), blood thinners (warfarin), HIV protease inhibitors or nucleoside reverse transcriptase inhibitors, transplant rejection medications (tacrolimus), blood sugar medications, diuretics, lithium, or acid-reflux medications (H2-blockers or PPIs). St.

John's Wort is the chief culprit for the Major-severity interactions with heart and cancer drugs.

Check your own medication Run your meds through the checker above

The bottom line

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

This product pairs traditional herbal remedies for back pain with a significant medication interaction risk, especially if you take heart, cancer, seizure, blood sugar, or blood-thinning medications. It's a reasonable consideration for occasional back discomfort in people not on chronic prescriptions, but if you take any regular medications, check with your pharmacist first.

Pregnant or nursing women should avoid it.

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

Assessment coverage: 4 of 5 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Feb 21, 2023.

This Scorecard evaluates available label information, ingredient evidence, and known medication-safety considerations. It does not independently verify product identity, purity, potency, contamination, or manufacturing quality. How these ratings are computed

At a glance

General information

Key facts about Backache Support Strawberry Flavor, straight from the product label.

Brand TerraVita
Barcode (UPC) 064435234775
Net contents 1 Fluid Ounce(s); 30 mL
Market status On market
Date entered into DSLD Feb 21, 2023
DSLD ID 283805
Product type Botanical
Supplement form Liquid
Dietary claims / uses All Other
Intended target group(s) Adult (18 - 50 Years)
From the label
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.

Supplement Facts

The label details for Backache Support Strawberry Flavor by TerraVita, 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:
25 Drop(s)
Maximum serving Sizes:
40 Drop(s)
Servings per container
227
UPC/BARCODE
064435234775
IngredientAmount% DV
Proprietary Blend0.13 mL--
Chamomile Flower Glycerite Liquid Extract0 NP--
White Willow Glycerite Liquid Extract0 NP--
Devil's Claw Glycerite Liquid Extract0 NP--
Horsetail Glycerite Liquid Extract0 NP--
St. John's Wort Glycerite Liquid Extract0 NP--

Other ingredients: Glycerin, Strawberry flavor

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.
Brand IP Statement(s)

Copyright 2018 TerraVita - Distributed by ZooScape LLC, All Rights Reserved.

Formula

Glycerite liquid extract (1:5)

Formulation

Alcohol free

Suggested/Recommended/Usage/Directions

Suggested Use: Take 25-40 drops of extract in a small amount of warm water 3-4 times daily. Shake well before using.

Precautions

Keep away from children.

Do not use if safety seal around cap is broken or missing.

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

See for yourself

Backache Support Strawberry Flavor by TerraVita label

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

Backache Support Strawberry Flavor label

Label images are published by the NIH Dietary Supplement Label Database for the version of this product on file. Always read your actual product label.

View the full label (PDF)
What’s inside

The Ingredients in Backache Support Strawberry Flavor by TerraVita

These are the 5 active ingredients this product is made of. Select any to open its full monograph.

Serving size25 Drop(s) Dosage formLiquid Servings per container227 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.

Other (inactive) ingredients: Glycerin, Strawberry flavor. These complete the product’s ingredient list but are not active constituents.

Interaction report

Backache Support Strawberry Flavor by TerraVita Drug Interactions

Want to check YOUR meds against Backache Support Strawberry Flavor?

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
1,322Drugs
755 Major 565 Moderate 2 Minor

Ingredients driving the most interactions

St. John's Wort Glycerite Liquid Extract 1,143
Chamomile Flower Glycerite Liquid Extract 960
Devil's Claw Glycerite Liquid Extract 804
Horsetail Glycerite Liquid Extract 188

Individual Drug Interactions

The ingredients in Backache Support Strawberry Flavor interact with 1,322 drugs. Click any drug to see the details.

4 of the 5 ingredients in Backache Support Strawberry Flavor interact with drugs. Each result below shows which ingredient is responsible. St. John's Wort Glycerite Liquid Extract Chamomile Flower Glycerite Liquid Extract Devil's Claw Glycerite Liquid Extract Horsetail Glycerite Liquid Extract

Each ingredient & the kinds of drugs it affects

For each ingredient in Backache Support Strawberry Flavor 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.

St. John's Wort Glycerite Liquid Extract47 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
St. John's Wort Glycerite Liquid Extract full monograph & all 47 interactions

Chamomile Flower Glycerite Liquid Extract9 drug types · 960 drugs

Cns Depressants

Theoretically, German chamomile might have additive effects when used with CNS depressants.
German chamomile has mild sedative effects. Theoretically, concomitant use with drugs with sedative properties can cause additive effects and side effects.

Likelihood Possible Evidence D
Contraceptive Drugs

Theoretically, large amounts of German chamomile might reduce the effectiveness of oral contraceptives.
In vitro, German chamomile has demonstrated antiestrogenic activity. Theoretically, concomitant use of large amounts of German chamomile might interfere with contraceptive drugs through competition for estrogen receptors.

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

Theoretically, German chamomile might inhibit CYP2C9 and increase levels of drugs metabolized by these enzymes.
In vitro evidence shows that German chamomile might inhibit CYP2C9. So far, this interaction has not been reported in humans. However, there might be an increase in the levels of drugs metabolized by CYP2C9 in patients taking German chamomile.

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

Theoretically, German chamomile might inhibit CYP2D6 and increase levels of drugs metabolized by these enzymes.
In vitro evidence shows that German chamomile might inhibit CYP2D6. So far, this interaction has not been reported in humans. However, there might be an increase in the levels of drugs metabolized by CYP2D6 in patients taking German chamomile.

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

Theoretically, German chamomile might inhibit CYP3A4 and increase levels of drugs metabolized by these enzymes.
In vitro evidence shows that German chamomile might inhibit CYP3A4. So far, this interaction has not been reported in humans. However, there might be an increase in the levels of drugs metabolized by CYP3A4 in patients taking German chamomile.

Likelihood Possible Evidence D
Estrogens

Theoretically, large amounts of German chamomile might reduce the effectiveness of estrogens.
In vitro, German chamomile has demonstrated antiestrogenic activity. Theoretically, large amounts of German chamomile might interfere with hormone replacement therapy through competition for estrogen receptors.

Likelihood Possible Evidence D
Tamoxifen (Nolvadex)

Theoretically, large amounts of German chamomile might interfere with the activity of tamoxifen.
In vitro, German chamomile has demonstrated antiestrogenic activity.

Likelihood Possible Evidence D
Warfarin (Coumadin)

German chamomile might increase the effects of warfarin and increase the risk of bleeding.
In one case, a 70-year-old female taking warfarin developed retroperitoneal hematoma and bilateral recti muscle bleeding along with an INR of 7.9 following ingestion of German chamomile tea 4-5 cups daily and use of a topical chamomile-based lotion applied 4-5 times daily.

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

Theoretically, German chamomile might inhibit CYP1A2 and increase levels of drugs metabolized by these enzymes.
In vitro and animal research shows that German chamomile might inhibit CYP1A2. So far, this interaction has not been reported in humans. However, there might be an increase in the levels of drugs metabolized by CYP1A2 in patients taking German chamomile.

Likelihood Possible Evidence D
Chamomile Flower Glycerite Liquid Extract full monograph & interactions

Devil's Claw Glycerite Liquid Extract7 drug types · 804 drugs

Cytochrome P450 2C19 (Cyp2C19) Substrates

Theoretically, devil's claw might increase levels of drugs metabolized by CYP2C19.
In vitro research shows that devil's claw might inhibit CYP2C19, although this has not been reported in humans.

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

Theoretically, devil's claw might increase levels of drugs metabolized by CYP2C9.
In vitro research shows that devil's claw might inhibit CYP2C9, although this has not been reported in humans.

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

Theoretically, devil's claw might increase levels of drugs metabolized by CYP3A4.
In vitro research shows that devil's claw might inhibit CYP3A4, although this has not been reported in humans.

Likelihood Possible Evidence D
Warfarin (Coumadin)

Theoretically, Devil's claw might increase the activity of warfarin.
In one case report, purpura occurred in a patient taking warfarin and devil's claw concurrently. This might indicate over-anticoagulation. It is unclear if this was due to Devil's claw or other contributing factors.

Likelihood Possible Evidence D
H2-Blockers

Theoretically, devil's claw might decrease the effectiveness of H2-blockers.
Devil's claw has been reported to increase stomach acid, which might interfere with the effects of H2-blockers.

Likelihood Possible Evidence D
P-Glycoprotein Substrates

Theoretically, devil's claw might increase levels of P-glycoprotein substrates.
In vitro research shows that devil's claw inhibits P-glycoprotein, which transports many drugs out of cells. This might increase intracellular levels of P-glycoprotein substrates, although it is unclear if this effect would be clinically important.

Likelihood Possible Evidence D
Proton Pump Inhibitors (Ppis)

Theoretically, devil's claw might decrease the effectiveness of PPIs.
Devil's claw has been reported to increase stomach acid, which might interfere with the effects of PPIs.

Likelihood Possible Evidence D
Devil's Claw Glycerite Liquid Extract full monograph & interactions

Horsetail Glycerite Liquid Extract5 drug types · 188 drugs

Antidiabetes Drugs

Theoretically, taking horsetail with antidiabetes drugs might increase the risk of hypoglycemia.
Equisetum myriochaetum has demonstrated hypoglycemic activity in clinical research. In an animal diabetic model, Equisetum giganteum had hypoglycemic effects. It is unclear whether other horsetail species have hypoglycemic effects.

Likelihood Possible Evidence D
Diuretic Drugs

Theoretically, taking horsetail with diuretic drugs might increase potassium loss and the risk of hypokalemia.
Laboratory research shows that various species of horsetail have diuretic properties. Due to its diuretic effects, there has been concern that taking horsetail along with potassium-depleting diuretics might increase the risk for hypokalemia. However, pharmacokinetic research in humans shows that taking horsetail 900 mg daily for 4 days does not affect urinary excretion of electrolytes, including potassium and sodium, despite having a diuretic effect similar to taking hydrochlorothiazide 25 mg daily. It is unclear if taking horsetail for a longer duration would affect electrolyte levels. Until more is known, use with caution.

Likelihood Possible Evidence D
Efavirenz (Sustiva)

Theoretically, horsetail might decrease the levels and clinical effects of efavirenz.
In two case reports, patients were found to have detectable viral loads when taking horsetail-containing supplements along with an antiretroviral regimen that included efavirenz. In one case, the antiretroviral regimen included zidovudine, lamivudine, and efavirenz; in the other case, the regimen consisted of emtricitabine, tenofovir disoproxil fumarate, and efavirenz. One month after discontinuing horsetail, the viral loads became undetectable in both cases. The exact mechanism of this interaction is unknown. It is also unclear if this interaction is specific to efavirenz or if it is related to various components of antiretroviral therapy.

Likelihood Possible Evidence D
Lithium

Theoretically, horsetail might increase the levels and adverse effects of lithium.
Animal research suggests that horsetail has diuretic properties. Theoretically, due to these potential diuretic effects, horsetail might reduce excretion and increase levels of lithium. The dose of lithium might need to be decreased.

Likelihood Possible Evidence D
Nucleoside Reverse Transcriptase Inhibitors (Nrtis)

Theoretically, horsetail might decrease the levels and clinical effects of NRTIs.
In two case reports, patients were found to have detectable viral loads when taking horsetail-containing supplements along with an antiretroviral therapy. In one case, the antiretroviral regimen included zidovudine, lamivudine, and efavirenz; in the other case, the regimen consisted of emtricitabine, tenofovir disoproxil fumarate, and efavirenz. One month after discontinuing the supplement, the viral loads became undetectable in both cases. The exact mechanism of these interactions is unknown. It is also unclear if these interactions are specific to NRTIs or if they are related to various components of antiretroviral therapy.

Likelihood Possible Evidence D
Horsetail Glycerite Liquid Extract full monograph & interactions
The maker

Brand information

Manufacturer and brand details for Backache Support Strawberry Flavor, from the product label.

TerraVita

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Name
ZooScape LLC
Phone Number
844-449-0444
Web Address
www.ZooScape.com
Pharmacist Counseling Corner

Backache Support Strawberry Flavor by TerraVita: Common Questions

Does Backache Support Strawberry Flavor by TerraVita interact with any medications?
Yes. Based on its ingredients, Backache Support Strawberry Flavor has a known interaction with 1,322 medications, including 755 rated major. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Backache Support Strawberry Flavor contains 5 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.
Does this help with back pain?
Devil's Claw, one of the main ingredients, is rated possibly effective for back pain and osteoarthritis based on available evidence. The other herbal ingredients are traditionally used for the same purpose, though our data doesn't rate their effectiveness for this condition.
What side effects should I watch for?
The most common ones from Devil's Claw and St. John's Wort are digestive upset, diarrhea, headache, and dizziness. Devil's Claw may cause skin reactions or indigestion. St. John's Wort can make your skin more sensitive to sun. Gastrointestinal bleeding is rare but possible with Devil's Claw. Stop and contact your doctor if you notice unusual bleeding or severe stomach pain.
Can I take this while pregnant or breastfeeding?
No. Devil's Claw, Horsetail, and St. John's Wort should be avoided during pregnancy because safety hasn't been established and they may affect the developing baby. None of them should be used while breastfeeding because there isn't enough safety information for infants.
Is this a liquid, and how long does it last?
Yes, it's a liquid glycerite formula with strawberry flavor. The product facts don't specify the bottle size or how long a bottle lasts, so check the label or ask your pharmacist for dosing and duration details.
What are the ingredients I should know about?
The active herbal extracts are Chamomile Flower, White Willow, Devil's Claw, Horsetail, and St. John's Wort. The inactive ingredients are glycerin and strawberry flavor. The product contains a proprietary blend, which means the exact amounts of each herb aren't listed separately.
I take a blood thinner. Is this safe for me?
Devil's Claw may theoretically increase the activity of warfarin and other blood thinners, which could raise your bleeding risk. There's a case report of a bleeding complication in someone taking both together. Talk to your pharmacist or doctor before using this product if you take any blood-thinning medication.

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

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Backache Support Strawberry Flavor label
Go deeper

The Full Monographs Behind Backache Support Strawberry Flavor’s Ingredients

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

Herb & supplement monograph

German Chamomile

Interacts with 960 drugs

German chamomile is a widely used herbal remedy taken mainly as a tea for calming, sleep, and digestive complaints. Early research suggests possible benefits for mild anxiety and some skin o...

Read the full German Chamomile monograph → Herb & supplement monograph

Devil's Claw

Interacts with 804 drugs

Devil's claw is a southern African plant used mainly for arthritis and back pain, and some studies suggest it may help ease these types of discomfort. The evidence is moderate at best, and p...

Read the full Devil's Claw monograph → Herb & supplement monograph

Horsetail

Interacts with 188 drugs

Horsetail is a traditional herb most often used as a mild diuretic and for hair, nail, and bone support, but high-quality human evidence is limited. It can cause thiamine (vitamin B1) loss w...

Read the full Horsetail 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 →
Sources

Sources & How We Checked

Backache Support Strawberry Flavor'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 199 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.

German Chamomile 15 references
  1. Subiza J, Subiza JL, Hinojosa M, et al. Anaphylactic reaction after the ingestion of chamomile tea; a study of cross-reactivity with other composite pollens. J Allergy Clin Immunol 1989;84:353-8. PubMed
  2. Budzinski JW, Foster BC, Vandenhoek S, Arnason JT. An in vitro evaluation of human cytochrome P450 3A4 inhibition by selected commercial herbal extracts and tinctures. Phytomedicine 2000;7:273-82. PubMed
  3. Viola H, Wasowski C, Levi de Stein M, et al. Apigenin, a component of Matricaria recutita flowers, is a central benzodiazepine receptors-ligand with anxiolytic effects. Planta Med 1995;61:213-6.
  4. van Ketel WG. Allergy to Matricaria chamomilla. Contact Dermatitis 1982;8:143. PubMed
  5. van Ketel WG. Allergy to Matricaria chamomilla. Contact Dermatitis 1987;16:50-1. PubMed
  6. Hormann HP, Korting HC. Evidence for the efficacy and safety of topical herbal drugs in dermatology: part I: anti-inflammatory agents. Phytomedicine 1994;1:161-71. PubMed
  7. Avallone R, Zanoli P, Puia G, et al. Pharmacological profile of apigenin, a flavonoid isolated from Matricaria chamomilla. Biochem Pharmacol 2000;59:1387-94. PubMed
  8. Kassi E, Papoutsi Z, Fokialakis N, et al. Greek plant extracts exhibit selective estrogen receptor modulator (SERM)-like properties. J Agric Food Chem 2004;52:6956-61. PubMed
  9. Maliakal PP, Wanwimolruk S. Effect of herbal teas on hepatic drug metabolizing enzymes in rats. J Pharm Pharmacol 2001;53:1323-9. PubMed
  10. Segal R, Pilote L. Warfarin interaction with Matricaria chamomilla. CMAJ 2006;174:1281-2. PubMed
  11. Loggia RD, Traversa U, Scarcia V, et al. Depressive effects of Chamomilla recutita (L.) Rausch, tubular flowers, on central nervous system in mice. Pharmacol Res Commun 1982;14(2):153-162. PubMed
  12. Ganzera M, Schneider P, Stuppner H. Inhibitory effects of the essential oil of chamomile (Matricaria recutita L.) and its major constituents on human cytochrome P450 enzymes. Life Sci 2006;78(8):856-861. PubMed
  13. Benito P, Rodríguez-Perez R, García F, Juste S, Moneo I, Caballero ML. Occupational allergic rhinoconjunctivitis induced by Matricaria chamomilla with tolerance of chamomile tea. J Investig Allergol Clin Immunol. 2014;24(5):369-70. No abstract available.
  14. Braga FT, Santos AC, Bueno PC, et al. Use of Chamomilla recutita in the prevention and treatment of oral mucositis in patients undergoing hematopoietic stem cell transplantation: a randomized, controlled, phase II clinical trial. Cancer Nurs 2015;38(4):32 PubMed
  15. Sarris J, Ravindran A, Yatham LN, et al. Clinician guidelines for the treatment of psychiatric disorders with nutraceuticals and phytoceuticals: The World Federation of Societies of Biological Psychiatry (WFSBP) and Canadian Network for Mood and Anxiety T

See these in context on the German Chamomile monograph →

Devil's Claw 18 references
  1. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
  2. Shaw D, Leon C, Kolev S, Murray V. Traditional remedies and food supplements: a 5-year toxicological study (1991-1995). Drug Saf 1997;17:342-56.
  3. Chantre P, Cappelaere A, Leblan D, et al. Efficacy and tolerance or Harpagophytum procumbens versus diacerhein in treatment of osteoarthritis. Phytomedicine 2000;7:177-83.
  4. Chrubasik S, Thanner J, Kunzel O, et al. Comparison of outcome measures during treatment with the proprietary Harpagophytum extract doloteffin in patients with pain in the lower back, knee or hip. Phytomedicine 2002;9:181-94. PubMed
  5. Circosta C, Occhiuto F, Ragusa S, et al. A drug used in traditional medicine: Harpagophytum procumbens DC. II. Cardiovascular activity. J Ethnopharmacol 1984;11:259-74. PubMed
  6. Grahame R, Robinson BV. Devils's claw (Harpagophytum procumbens): pharmacological and clinical studies. Ann Rheum Dis 1981;40:632. PubMed
  7. Unger M, Frank A. Simultaneous determination of the inhibitory potency of herbal extracts on the activity of six major cytochrome P450 enzymes using liquid chromatography/mass spectrometry and automated online extraction. Rapid Commun Mass Spectrom 2004;1 PubMed
  8. Wegener T, Lupke NP. Treatment of patients with arthrosis of hip or knee with an aqueous extract of devil's claw (Harpagophytum procumbens DC). Phytother Res 2003;17:1165-72.
  9. Chrubasik S, Kunzel O, Thanner J, et al. A 1-year follow-up after a pilot study with Doloteffin for low back pain. Phytomedicine 2005;12:1-9. PubMed
  10. Romiti N, Tramonti G, Corti A, Chieli E. Effects of Devil's Claw (Harpagophytum procumbens) on the multidrug transporter ABCB1/P-glycoprotein. Phytomedicine 2009;16:1095-100. PubMed
  11. Chrubasik, S., Junck, H., Breitschwerdt, H., Conradt, C., and Zappe, H. Effectiveness of Harpagophytum extract WS 1531 in the treatment of exacerbation of low back pain: a randomized, placebo-controlled, double- blind study. Eur.J Anaesthesiol. 1999;16(2 DOI
  12. Laudahn, D. and Walper, A. Efficacy and tolerance of Harpagophytum extract LI 174 in patients with chronic non-radicular back pain. Phytother.Res. 2001;15(7):621-624.
  13. Belaiche P. Etude clinique de 630 cas d'artrose traites par le nebulisat aqueux d'Harpagophytum procumbens (Radix). Phytotherapy 1982;1:22-28.
  14. Chrubasik S, Model A, Black A, and et al. A randomized double-blind pilot study comparing Doloteffin® and Vioxx® in the treatment of low back pain. Rheumatology 2003;42:141-148.
  15. Cuspidi C, Sala C, Tadic M, et al. Systemic hypertension induced by Harpagophytum procumbens (devil's claw): a case report. J Clin Hypertens (Greenwich) 2015;17(11):908-10.
  16. Mahomed IM, Ojewole JAO. Oxytocin-like effect of Harpagophytum procumbens [Pedaliacae] secondary root aqueous extract on rat isolated uterus. Afr J Trad CAM 2006;3(1):82-89.
  17. Carvalho RR, Donadel CD, Cortez AF, Valviesse VR, Vianna PF, Correa BB. J Bras Nefrol. 2017 Mar;39(1):79-81.
  18. Anon. Devil's claw root: ulcers and gastrointestinal bleeding. Prescrire Int 2013;22(144):296.

See these in context on the Devil's Claw monograph →

Horsetail 14 references
  1. Sudan BJ. Seborrhoeic dermatitis induced by nicotine of horsetails (Equisetum arvense L.). Contact Dermatitis 1985;13:201-2.
  2. Perez Gutierrez RM, Laguna GY, Walkowski A. Diuretic activity of Mexican equisetum. J Ethnopharmacol 1985;14:269-72. PubMed
  3. Lemus I, Garcia R, Erazo S, et al. Diuretic activity of an Equisetum bogotense tea (Platero herb): evaluation in healthy volunteers. J Ethnopharmacol 1996;54:55-8. PubMed
  4. Revilla MC, Andrade-Cetto A, Islas S, Wiedenfeld H. Hypoglycemic effect of Equisetum myriochaetum aerial parts on type 2 diabetic patients. J Ethnopharmacol 2002;81:117-20. PubMed
  5. Tiktinskii, O. L. and Bablumian, I. A. [Therapeutic action of Java tea and field horsetail in uric acid diathesis]. Urol.Nefrol.(Mosk) 1983;3(1):47-50.
  6. Henderson JA, Evans EV, and McIntosh RA. The antithiamine action of Equisetum. J Amer Vet Med Assoc 1952;120:375-378.
  7. Carneiro DM, Freire RC, Honório TC, Zoghaib I, Cardoso FF, Tresvenzol LM, de Paula JR, Sousa AL, Jardim PC, da Cunha LC. Randomized, Double-Blind Clinical Trial to Assess the Acute Diuretic Effect of Equisetum arvense (Field Horsetail) in Healthy Voluntee
  8. Klnçalp S, Ekiz F, Basar Ö, Coban S, Yüksel O. Equisetum arvense (Field Horsetail)-induced liver injury. Eur J Gastroenterol Hepatol. 2012 Feb;24(2):213-4. PubMed
  9. Ortega García JA, Angulo MG, Sobrino-Najul EJ, Soldin OP, Mira AP, Martínez-Salcedo E, Claudio L. Prenatal exposure of a girl with autism spectrum disorder to 'horsetail' (Equisetum arvense) herbal remedy and alcohol: a case report. J Med Case Rep. 2011 M PubMed
  10. Cordova E, Morganti L, Rodriguez C. Possible Drug-Herb Interaction between Herbal Supplement Containing Horsetail (Equisetum arvense) and Antiretroviral Drugs. J Int Assoc Provid AIDS Care. 2017;16(1):11-13.
  11. García Gavilán MD, Moreno García AM, Rosales Zabal JM, Navarro Jarabo JM, Sánchez Cantos A. Case of drug-induced acute pancreatitis produced by horsetail infusions. Rev Esp Enferm Dig. 2017 Apr;109(4):301-304. PubMed
  12. Vieira GT, de Oliveira TT, Carneiro MAA, et al. Antidiabetic effect of Equisetum giganteum L. extract on alloxan-diabetic rabbit. J Ethnopharmacol. 2020;260:112898. PubMed
  13. Health Canada. Organism-Equisetum arvense. Available at: http://webprod.hc-sc.gc.ca/nhpid-bdipsn/ingredReq.do?id=6117&lang=eng. Accessed 21-July 2021.
  14. Bates D, Duong TB, Kheyson S, Moore K. Hyponatremia Secondary to Decreased Oral Intake and SIADH and Possibly Exacerbated by Horsetail (Equisetum arvense). Can J Hosp Pharm 2021;74(4):386-389. PubMed

See these in context on the Horsetail monograph →

St. John's Wort 152 references
  1. Miller LG. Herbal Medicinals: Selected clinical considerations focusing on known or potential drug-herb interactions. Arch Intern Med 1998;158:2200-11.
  2. Gulick RM, McAuliffe V, Holden-Wiltse J, et al. Phase I studies of hypericin, the active compound in St. John's Wort, as an antiretroviral agent in HIV-infected adults. AIDS Clinical Trials Group Protocols 150 and 258. Ann Intern Med 1999;130:510-4. PubMed
  3. O'Breasail AM, Argouarch S. Hypomania and St John's wort. Can J Psychiatry 1998;43:746-7.
  4. Johne A, Brockmoller J, Bauer S, et al. Pharmacokinetic interaction of digoxin with an herbal extract from St John's wort (Hypericum perforatum). Clin Pharmacol Ther 1999;66:338-45.
  5. Gordon JB. SSRIs and St. John's Wort: possible toxicity? Am Fam Physician 1998;57:950, 953.
  6. Golsch S, Vocks E, Rakoski J, et al. [Reversible increase in photosensitivity to UV-B caused by St. John's wort extract]. Hautarzt 1997;48:249-52.
  7. Bove GM. Acute neuropathy after exposure to sun in a patient treated with St. John's Wort. Lancet 1998;352:1121-2. PubMed
  8. Brockmoller J, Reum T, Bauer S, et al. Hypericin and pseudohypericin: pharmacokinetics and effects on photosensitivity in humans. Pharmacopsychiatry 1997;30:94-101. PubMed
  9. Upton R, ed. St. John's wort, Hypericum perforatum: Quality control, analytical and therapeutic monograph. Santa Cruz, CA: American Herbal Pharmacopoeia 1997;1-32.
  10. Muller WE, Singer A, Wonnemann M, et al. Hyperforin represents the neurotransmitter reuptake inhibiting constituent of hypericum extract. Pharmacopsychiatry 1998;31:16-21.
  11. Abul-Ezz SR, Barone GW, Gurley BJ, et al. Effect of herbal supplements on cyclosporine blood levels and associated acute rejection. Am Soc of Nephrol Ann Mtg, Toronto, CAN 2000;Oct. 11-16:abstract A3754.
  12. Piscitelli SC, Burstein AH, Chaitt D, et al. Indinavir concentrations and St John's wort. Lancet 2000;355:547-8. PubMed
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  14. Ruschitzka F, Meier PJ, Turina M, et al. Acute heart transplant rejection due to Saint John's wort. Lancet 2000;355:548-9. PubMed
  15. Roberts JE, Wang RH, Tan IP, et al. Hypericin (active ingredient in St. John's wort) photo-oxidation of lens proteins. Photochem Photobiol 1999;69:42S.
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  27. Schempp CM, Ludtke R, Winghofer B, Simon JC. Effect of topical application of hypericum perforatum extract on skin sensitivity to solar simulated radiation. Photodermatol Photoimmunol Photomed 2000;16:125-8.
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  30. Karliova M, Treichel U, Malago M, et al. Interaction of Hypericum perforatum (SJW) with cyclosporin A metabolism in a patient after liver transplantation. J Hepatol 2000;33:853-5.
  31. Mandelbaum A, Pertzborn F, Martin-Facklam M, Wiesel M. Unexplained decrease of cyclosporin trough levels in a compliant renal transplant patient. Nephrol Dial Transplant 2000;15:1473-4. PubMed
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  48. Hennessy M, Kelleher D, Spiers JP, et al. St Johns wort increases expression of P-glycoprotein: implications for drug interactions. Br J Clin Pharmacol 2002;53:75-82.
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  52. Holme SA, Roberts DL. Erythroderma associated with St John's wort. Br J Dermatol 2000;143:1127-8. PubMed
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  55. Henderson L, Yue QY, Bergquist C, et al. St John's wort (Hypericum perforatum): drug interactions and clinical outcomes. Br J Clin Pharmacol 2002;54:349-56..
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  57. Ladner DP, Klein SD, Steiner RA, Walt H. Synergistic toxicity of delta-aminolaevulinic acid-induced protoporphyrin IX used for photodiagnosis and hypericum extract, a herbal antidepressant. Br J Dermatol 2001;144:916-8. PubMed
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  62. Logan JL, Ahmed J. Critical hypokalemic renal tubular acidosis due to Sjogren's syndrome: association with the purported immune stimulant echinacea. Clin Rheumatol 2003;22:158-9.
  63. Mai I, Stormer E, Bauer S, et al. Impact of St John's wort treatment on the pharmacokinetics of tacrolimus and mycophenolic acid in renal transplant patients. Nephrol Dial Transplant 2003;18:819-22.. PubMed
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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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