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

Balance Ingredients & Drug Interactions

by Eu Natural

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

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

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

The interaction bottom line Most serious interaction: Moderate

Balance is a dietary supplement by Eu Natural with 4 active ingredients. Its ingredients are commonly taken for flavoring and culinary use, digestive complaints like bloating and indigestion, boosting absorption of other supplements.Based on those ingredients, 1,121 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are BioPerine, Diindolylmethane, Evening Primrose Oil. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

Jump to a section

Check Your Meds Against Balance by Eu Natural

Ask about any prescription or over-the-counter medication and we check it for interactions with Balance by Eu Natural — and tell you which ingredient is responsible.

Pharmacist-reviewed data Checks every ingredient Answer in seconds
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HelloPharmacist Scorecard of Balance by Eu Natural

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 4 active ingredients.
  • “Balance Hormone Complex” is a proprietary blend — the label gives one combined amount (1.40 Gram(s)) without saying how much of each component you get.

Balance contains four active ingredients. BioPerine is a standardized black pepper extract used to enhance absorption of other compounds.

Diindolylmethane is a plant-derived compound from cruciferous vegetables. Evening primrose oil and black currant seed oil are both plant oils rich in gamma-linolenic acid (GLA).

The product also contains inactive ingredients — gelatin, glycerin, purified water, carob, yellow beeswax, and sunflower lecithin — which serve as the softgel capsule and binding materials.

Does it work?

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

The graded evidence we hold for these ingredients covers different conditions than the ones this product is marketed for, so there's no established rating for its stated use.

Why this rating?
  • The label markets this product for: hormonal health and menstrual cycle support.
  • We looked for evidence on: Dysmenorrhea, Mastalgia, Menopausal symptoms, Premenstrual syndrome (PMS), Polycystic ovary syndrome (PCOS), Endometriosis — and 3 related terms.
  • The closest evidence on file: Evening Primrose is rated "Likely Ineffective" for Mastalgia (Natural Medicines).
  • Also on file: Black Pepper is rated "Insufficient Reliable Evidence To Rate" for Dysmenorrhea.
  • Also on file: Evening Primrose is rated "Insufficient Reliable Evidence To Rate" for Menopausal symptoms, Polycystic ovary syndrome (PCOS), Premenstrual syndrome (PMS), Endometriosis.

The evidence we hold doesn't establish that any of these ingredients work for their stated purposes. BioPerine has insufficient evidence for hay fever, asthma, athletic performance, headache, depression, and diarrhea.

Diindolylmethane shows insufficient evidence for prostate health, breast cancer, colon cancer, cervical changes, and breast pain. Evening primrose oil is rated possibly ineffective for asthma and likely ineffective for breast pain, with insufficient evidence for acne, ADHD, and other conditions.

Black currant seed oil has insufficient evidence for Alzheimer's disease, liver disease, upper respiratory infections, cough, and eczema.

The evidence, ingredient by ingredient Black Pepper Diindolylmethane Evening Primrose Black Currant

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.

BioPerine is generally well tolerated at food-spice levels, though concentrated supplements warrant caution. Common side effects include a burning aftertaste, indigestion, and reduced taste perception.

Allergic reactions are rare but possible. Diindolylmethane is generally well tolerated short-term, with common side effects being diarrhea, gas, headache, nausea, rash, and vomiting; a rare serious reaction called DRESS (drug rash with eosinophilia and systemic symptoms) has been reported.

Evening primrose oil and black currant seed oil are generally well tolerated, with the most common side effects being abdominal pain, diarrhea, indigestion, gas, nausea, and vomiting. Pregnancy and lactation data are limited: diindolylmethane is rated likely safe in pregnancy and lactation, but evening primrose oil should be avoided in pregnancy unless your doctor directs otherwise, and black currant seed oil's safety in pregnancy and lactation is not well established — talk to your pharmacist before use if you're pregnant or breastfeeding.

Side effects, ingredient by ingredient Black Pepper Diindolylmethane Evening Primrose Black Currant

Meds to double-check

Moderate interaction found
Known Interaction Concern · database check
Moderate identified

The most serious documented interaction for these ingredients is Moderate. Check your medications for a personalized result.

Why this rating?
  • 4 of the 4 matched ingredients can interact with medications — Black Pepper, Evening Primrose, Diindolylmethane, Black Currant.
  • The most serious interaction on file is rated Moderate.
  • Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs; immunosuppressants / transplant drugs; diabetes medications; lithium.
  • For scale: 1,122 individual medications appear in the full list. A big number alone doesn't make a product dangerous — what matters is whether YOUR medication is on it, so run yours through the interaction checker on this page.

Check your medications if you take blood thinners or antiplatelet drugs (evening primrose and black currant oil increase bleeding risk). Also flag heart rhythm medications like propranolol, seizure drugs like phenytoin, HIV medications like nevirapine or lopinavir/ritonavir, tuberculosis antibiotics like rifampin, lithium for mood disorders, phenothiazine antipsychotics, asthma medications like theophylline, immunosuppressants like cyclosporine, or cholesterol drugs like atorvastatin.

Use the medication checker below to search your exact prescriptions.

Check your own medication Run your meds through the checker above

The bottom line

Scorecard at a glanceFormula with limited ingredient disclosure with no established evidence rating for its marketed use. Moderate medication interactions have been identified, and safety information is well characterized.

Balance is designed for hormone support, but the evidence for its ingredients isn't established in our data. If you take blood thinners, heart rhythm meds, seizure drugs, HIV medications, mood stabilizers, or antipsychotics, you'll need to check your exact prescriptions with the tool on this page before starting — the interactions are real and documented.

Talk to your pharmacist before taking this if you're pregnant, breastfeeding, or on any regular medications.

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

Assessment coverage: 4 of 4 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Jan 23, 2025.

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 Balance, straight from the product label.

Brand Eu Natural
Barcode (UPC) 855244008394
Net contents 60 Softgel(s)
Market status On market
Date entered into DSLD Jan 23, 2025
DSLD ID 321852
Product type Other Combinations
Supplement form Softgel Capsule
Dietary claims / uses All Other, Structure/Function
Intended target group(s) Adult Female (18 - 50 Years), Gluten Free, Dairy Free
From the label
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.

Supplement Facts

The label details for Balance by Eu Natural, 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:
1 Softgel(s)
Maximum serving Sizes:
1 Softgel(s)
Servings per container
30
UPC/BARCODE
855244008394
IngredientAmount% DV
Calories15 Calorie(s)--
Total Fat1.5 Gram(s)2%
BioPerine0 NP--
Diindolylmethane0 NP--
Evening Primrose Oil0 NP--
Balance Hormone Complex1.4 Gram(s)--
Black Currant Seed Oil0 NP--

Other ingredients: Gelatin, Glycerin, Water, Purified, Carob, Yellow Beeswax, Sunflower Lecithin

Tap any ingredient to jump to its full detail below.

Label statements
These statements are the manufacturer’s wording, reproduced from the product label — the label is saying it, not HelloPharmacist. We don’t verify or endorse them.
General Statements

Plant-powered multi-blends for "Eu" (you)!

Share your story #EuNatural #BeYou

Suggested/Recommended/Usage/Directions

Suggested use 1 capsule with a meal and 8 oz. H2O Do not exceed two capsules per day.

Precautions

Do not exceed two capsules per day.

Caution: Keep out of reach of children.

If you are pregnant, nursing, or taking any prescription medicine, consult your physician before taking this product.

Formula

Taken to promote hormonal health, BALANCE provides natural herbal extracts to support your menstrual cycle.

Evening Primrose

Formulation

Zero gluten / wheat / dairy Artificial ingredients

Monthly hormone & menstrual support

Zero artificial ingredients Gluten, wheat & dairy free Cold-pressed & Hexane-free

Cold-pressed & Hexane-free

FDA Disclaimer Statement

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

Seals/Symbols

CGMP Certified Blended in the USA

FDA Statement of Identity

Dietary Supplement

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

See for yourself

Balance by Eu Natural label

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

Balance 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 Balance by Eu Natural

These are the 4 active ingredients this product is made of. Select any to open its full monograph.

Serving size1 Softgel(s) Dosage formSoftgel Capsule Servings per container30 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.

Balance Hormone Complex

1.4 Gram(s) per serving

Other (inactive) ingredients: Gelatin, Glycerin, Water, Purified, Carob, Yellow Beeswax, Sunflower Lecithin. These complete the product’s ingredient list but are not active constituents.

Interaction report

Balance by Eu Natural Drug Interactions

Want to check YOUR meds against Balance?

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
1,121Drugs
1,059 Moderate 62 Minor

Ingredients driving the most interactions

BioPerine 1,019
Diindolylmethane 269
Evening Primrose Oil 233
Black Currant Seed Oil 140

Individual Drug Interactions

The ingredients in Balance interact with 1,121 drugs. Click any drug to see the details.

4 of the 4 ingredients in Balance interact with drugs. Each result below shows which ingredient is responsible. BioPerine Diindolylmethane Evening Primrose Oil Black Currant Seed Oil

Each ingredient & the kinds of drugs it affects

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

BioPerine17 drug types · 1,019 drugs

Anticoagulant/Antiplatelet Drugs

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

Likelihood Possible Evidence D
Antidiabetes Drugs

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

Likelihood Possible Evidence D
Atorvastatin (Lipitor)

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

Likelihood Possible Evidence D
Cyclosporine (Neoral, Sandimmune)

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

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

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

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

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

Likelihood Possible Evidence D
Lithium

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

Likelihood Probable Evidence D
Nevirapine (Viramune)

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

Likelihood Probable Evidence D
P-Glycoprotein Substrates

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

Likelihood Possible Evidence D
Pentobarbital (Nembutal)

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

Likelihood Possible Evidence D
Phenytoin (Dilantin)

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

Likelihood Possible Evidence B
Propranolol (Inderal)

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

Likelihood Possible Evidence B
Rifampin (Rifadin)

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

Likelihood Possible Evidence B
Theophylline

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

Likelihood Possible Evidence D
Amoxicillin (Amoxil, Trimox)

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

Likelihood Possible Evidence D
Carbamazepine (Tegretol)

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

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

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

Likelihood Possible Evidence D
BioPerine full monograph & interactions

Diindolylmethane3 drug types · 269 drugs

Diuretic Drugs

Theoretically, diindolylmethane might increase the risk of hyponatremia if used with sodium-depleting diuretics.
Large doses of diindolylmethane (600 mg daily) have been associated with two cases of asymptomatic hyponatremia in clinical research.

Likelihood Possible Evidence B
Estrogens

Theoretically, diindolylmethane might increase or decrease the effects of estrogens.
Diindolylmethane might have mild estrogenic or antiestrogenic effects. Theoretically, large amounts of diindolylmethane might interfere with hormone replacement therapy.

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

Theoretically, diindolylmethane might lower serum levels of CYP1A2 substrates.
In vitro evidence suggests that diindolylmethane can induce CYP1A2. Theoretically, it might increase metabolism of CYP1A2 substrates and lower serum concentrations. This interaction has not been reported in humans.

Likelihood Unlikely Evidence D
Diindolylmethane full monograph & interactions

Evening Primrose Oil5 drug types · 233 drugs

Anticoagulant/Antiplatelet Drugs

Theoretically, evening primrose oil may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Evening primrose oil contains gamma linolenic acid (GLA). There is preliminary clinical evidence that GLA can reduce platelet aggregation and prolong bleeding time.

Likelihood Possible Evidence D
Lithium

Theoretically, concomitant use of lithium with evening primrose oil might decrease lithium levels and effects.
In a case report, a patient on a stable dose of lithium for 10 years experienced a reduction in lithium levels after taking evening primrose oil 500 mg daily. Baseline levels were 0.69 mmol/L, which decreased to 0.37 mmol/L after 2 months and 0.23 mmol/L after 3 months of use. Lithium levels increased within 6 weeks of discontinuing evening primrose oil, to 0.73 mmol/L; no clinical effects were noted.

Likelihood Possible Evidence D
Lopinavir/Ritonavir (Kaletra)

Theoretically, evening primrose oil might increase the levels and effects of lopinavir.
In a case report, an HIV patient who took evening primrose oil (Efamol) along with lopinavir/ritonavir experienced an increase in serum levels of lopinavir to 15.2 mg/L. Six weeks after discontinuing evening primrose oil, levels of lopinavir returned to the normal range of 5-10 mg/L. When re-challenged with evening primrose oil for a week, the patient's lopinavir levels increased from 6.69 to 8.11 mg/L. It is suspected that evening primrose oil increases levels of lopinavir by inhibiting cytochrome P450 3A4 (CYP3A4), which metabolizes lopinavir. However, this effect has not been reported in other research.

Likelihood Possible Evidence D
Phenothiazines

Theoretically, taking evening primrose oil with phenothiazines might increase the risk of convulsions.
Evening primrose oil contains gamma-linolenic acid (GLA). There is some concern that taking supplements containing GLA might cause seizures, or lower the seizure threshold, when taken with phenothiazines. In one report, three patients with schizophrenia who had received phenothiazines developed EEG changes suggestive of temporal lobe epilepsy after starting treatment with GLA, although none experienced an actual seizure. In another report, two patients with schizophrenia who were stabilized on phenothiazines developed seizures when evening primrose oil 4 grams daily was added. One of these patients had a prior history of seizures. It is unclear whether evening primrose oil had any additive epileptogenic effects with the phenothiazines; there is no evidence that taking evening primrose oil alone causes seizures.

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

Theoretically, evening primrose may increase the levels and clinical effects of CYP2C9 substrates.
In vitro research shows that linoleic acid, a constituent of evening primrose oil, inhibits CYP2C9.

Likelihood Possible Evidence D
Evening Primrose Oil full monograph & interactions

Black Currant Seed Oil2 drug types · 140 drugs

Anticoagulant/Antiplatelet Drugs

Theoretically, black currant seed oil might increase the risk of bleeding if used in combination with anticoagulant or antiplatelet drugs.
Gamma-linolenic acid (GLA), a constituent of black currant seed oil, appears to have antiplatelet effects.

Likelihood Possible Evidence D
Phenothiazines

Theoretically, black currant seed oil might increase the risk of seizure in patients receiving phenothiazines.
Black currant seed oil contains gamma-linolenic acid (GLA). There is some concern that taking supplements containing GLA might cause seizures, or lower the seizure threshold, when taken with phenothiazines, although there is no evidence that black currant seed oil causes seizures. In one report, three patients with schizophrenia who had received phenothiazines developed EEG changes suggestive of temporal lobe epilepsy after starting treatment with GLA, although none experienced an actual seizure. In another report, two patients with schizophrenia who were stabilized on phenothiazines developed seizures when evening primrose 4 grams daily, which contains GLA, was added. One of these patients had a prior history of seizures.

Likelihood Possible Evidence D
Black Currant Seed Oil full monograph & interactions
The maker

Brand information

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

Eu Natural

See all Eu Natural products
Name
Eu Natural Inc
City
Henderson
State
NV
ZipCode
89052
Phone Number
408-256-1387
Web Address
EuNatural.com
Pharmacist Counseling Corner

Balance by Eu Natural: Common Questions

Does Balance by Eu Natural interact with any medications?
Yes. Based on its ingredients, Balance has a known interaction with 1,121 medications. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Balance contains 4 active ingredients, and an interaction can come from any of them. We check every ingredient, combine the results into one list per medication, and show which ingredient and mechanism is responsible.
Where does this information come from?
The product label data comes from the NIH Dietary Supplement Label Database (DSLD); the interaction data is built on the Natural Medicines database and reviewed by HelloPharmacist pharmacists.
Can I take this if I'm pregnant?
Diindolylmethane is rated likely safe in pregnancy, but evening primrose oil should be avoided in pregnancy unless your doctor says otherwise. Black currant seed oil and BioPerine don't have pregnancy safety data on file. Talk with your pharmacist or doctor before starting — it's an individual decision based on your health.
Can I take this while breastfeeding?
Diindolylmethane is rated likely safe while breastfeeding, but there isn't enough reliable safety information for black currant seed oil, and no data is on file for evening primrose oil or BioPerine. Check with your pharmacist or doctor before use.
What are the most common side effects?
The most common side effects across the ingredients are digestive — diarrhea, gas, indigestion, nausea, and vomiting. BioPerine may also cause a burning aftertaste or reduced taste perception. Most people tolerate these ingredients well, especially at the amounts found in food.
Does this actually work for hormone balance?
The evidence we hold doesn't establish that these ingredients work for the conditions they're marketed for. BioPerine, diindolylmethane, evening primrose oil, and black currant seed oil all show insufficient evidence or no reliable evidence for their stated purposes.
Why does this product interact with so many medications?
BioPerine is a black pepper extract designed to increase absorption of other compounds — it does this by speeding up how your body processes certain drugs, which can raise their blood levels or change their effects. Evening primrose and black currant oils contain compounds that may affect blood clotting and liver enzymes. These are real, documented mechanisms, which is why checking your specific prescriptions is important.
Is this safe to use long-term?
Long-term safety data are limited for all of these ingredients. Diindolylmethane has not been well studied long-term, and black currant and evening primrose oil lack quality long-term safety evidence. Use caution and talk to your pharmacist if you're considering this as a daily supplement.

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.

Balance label
Go deeper

The Full Monographs Behind Balance’s Ingredients

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

Herb & supplement monograph

Black Pepper

Interacts with 1,019 drugs

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

Read the full Black Pepper monograph → Herb & supplement monograph

Diindolylmethane

Interacts with 269 drugs

Diindolylmethane (DIM) is a compound made when your body digests cruciferous vegetables, and it is sold as a supplement mainly for hormone balance and cancer prevention. Although early lab s...

Read the full Diindolylmethane monograph → Herb & supplement monograph

Evening Primrose

Interacts with 233 drugs

Evening primrose oil is a seed oil rich in gamma-linolenic acid (GLA), an omega-6 fatty acid, that is popularly used for skin conditions, PMS, and breast pain. The evidence behind most of th...

Read the full Evening Primrose monograph → Herb & supplement monograph

Black Currant

Interacts with 140 drugs

Black currant is a nutritious berry that is rich in vitamin C and antioxidants, and its seed oil contains the omega-6 fatty acid GLA. While it is enjoyed safely as a food and is popular as a...

Read the full Black Currant monograph →
Sources

Sources & How We Checked

Balance'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 82 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.

Black Pepper 29 references
  1. Leung AY, Foster S. Encyclopedia of Common Natural Ingredients Used in Food, Drugs and Cosmetics. 2nd ed. New York, NY: John Wiley & Sons, 1996.
  2. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
  3. Bano G, Amla V, Raina RK, et al. The effect of piperine on pharmacokinetics of phenytoin in healthy volunteers. Planta Med 1987;53:568-9. PubMed
  4. Bano G, et al. Effect of piperine on bioavailability and pharmacokinetics of propranolol and theophylline in healthy volunteers. Eur J Clin Pharmacol 1991;41;615-7. PubMed
  5. Cohle SD, Trestrail JD III, Graham MA, et al. Fatal pepper aspiration. Am J Dis Child 1988;142:633-6. PubMed
  6. Bhardwaj RK, Glaeser H, Becquemont L, et al. Piperine, a major constituent of black pepper, inhibits human P-glycoprotein and CYP3A4. J Pharmacol Exp Ther 2002;302:645-50. PubMed
  7. Velpandian T, Jasuja R, Bhardwaj RK, et al. Piperine in food: interference in the pharmacokinetics of phenytoin. Eur J Drug Metab Pharmacokinet 2001;26:241-7. PubMed
  8. Pattanaik S, Hota D, Prabhakar S, et al. Pharmacokinetic interaction of a single dose of piperine with steady-state carbamazepine in epilepsy patients. Phytother Res 2009;23:1281-6.
  9. Munakata, M., Kobayashi, K., Niisato-Nezu, J., Tanaka, S., Kakisaka, Y., Ebihara, T., Ebihara, S., Haginoya, K., Tsuchiya, S., and Onuma, A. Olfactory stimulation using black pepper oil facilitates oral feeding in pediatric patients receiving long-term en
  10. Myers, B. M., Smith, J. L., and Graham, D. Y. Effect of red pepper and black pepper on the stomach. Am J Gastroenterol 1987;82(3):211-214.
  11. Raghavendra, R. H. and Naidu, K. A. Spice active principles as the inhibitors of human platelet aggregation and thromboxane biosynthesis. Prostaglandins Leukot.Essent.Fatty Acids 2009;81(1):73-78. PubMed
  12. Subehan, Usia, T., Kadota, S., and Tezuka, Y. Mechanism-based inhibition of human liver microsomal cytochrome P450 2D6 (CYP2D6) by alkamides of Piper nigrum. Planta Med 2006;72(6):527-532.
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Black Currant 6 references
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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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