BBB Enhancement Formula Ingredients & Drug Interactions
by BBB Formula
What is this page for?
First and foremost: checking BBB Enhancement Formula 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
BBB Enhancement Formula is a dietary supplement by BBB Formula with 13 active ingredients. Its ingredients are commonly taken for bone health and osteoporosis prevention, dietary calcium deficiency, heartburn relief (calcium carbonate antacids).Based on those ingredients, 1,372 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are Citrus Bioflavonoids, Genistein, Dandelion. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against BBB Enhancement Formula by BBB Formula
Ask about any prescription or over-the-counter medication and we check it for interactions with BBB Enhancement Formula by BBB Formula — and tell you which ingredient is responsible.
AI summaries are generated from our interaction database for education only — always confirm with your pharmacist. How we use AI
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HelloPharmacist Scorecard of BBB Enhancement Formula by BBB Formula
Four independent checks of what is known — a summary of the available information, not a grade of the product itself.
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
The stated purpose hasn't been mapped to our evidence data yet.
Why this rating?
- We haven't mapped this product's purpose to our evidence data yet — it'll be graded on the next content refresh.
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 13 active ingredients.
- “BBB Proprietary Blend” is a proprietary blend — the label gives one combined amount (500 mg) without saying how much of each component you get.
At least one ingredient has a documented Major-severity interaction. Check your medications for a personalized result.
Why this rating?
- 11 of the 12 matched ingredients can interact with medications — Quercetin, Red Clover, Watercress, Dandelion, Fenugreek, among others.
- The most serious interaction on file is rated Major.
- Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs; immunosuppressants / transplant drugs; cancer treatments; diabetes medications; heart-rhythm medications; lithium; Parkinson's medications.
- For scale: 1,373 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.
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 12 of the 12 matched ingredients.
- Pregnancy & breastfeeding safety ratings cover 12 of 12.
- General safety write-ups exist for 12 of 12.
- Remember: this measures how much safety information exists. Thin data is not the same as being safe.
HelloPharmacist summaryFormula with limited ingredient disclosure with no assessable stated purpose. Major medication interactions have been identified, and safety information is well characterized.
Assessment coverage: 12 of 13 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Oct 26, 2011.
This Scorecard evaluates available label information, ingredient evidence, and known medication-safety considerations. It does not independently verify product identity, purity, potency, contamination, or manufacturing quality. How these ratings are computed
General information
Key facts about BBB Enhancement Formula, straight from the product label.
| Brand | BBB Formula |
|---|---|
| Barcode (UPC) | 736211148834 |
| Net contents | 30 Capsule(s); 500 mg |
| Market status | Off market |
| Date entered into DSLD | Oct 26, 2011 |
| DSLD ID | 1241 |
| Product type | Other Combinations |
| Supplement form | Capsule |
| Dietary claims / uses | All Other, Structure/Function |
| Intended target group(s) | Women (not pregnant or lactating) |
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 BBB Enhancement Formula by BBB Formula, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Calcium | 0 NP | -- |
| L-Tyrosine | 0 NP | -- |
| Citrus Bioflavonoids | 0 NP | -- |
| Dandelion | 0 NP | -- |
| Rose Hips | 0 NP | -- |
| Watercress | 0 NP | -- |
| Soy Isoflavones | 0 NP | -- |
| Maca | 0 NP | -- |
| BBB Proprietary Blend | 500 mg | -- |
| Dong Quai | 0 NP | -- |
| Saw Palmetto | 0 NP | -- |
| Fenugreek | 0 NP | -- |
| Mexican Wild Yam | 0 NP | -- |
| Genistein | 0 NP | -- |
Other ingredients: Gelatin, Magnesium Stearate, Silicon Dioxide
Tap any ingredient to jump to its full detail below.
These statements are the manufacturer’s wording, reproduced from the product label — the label is saying it, not HelloPharmacist. We don’t verify or endorse them.
FDA 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.
FDA Statement of Identity
Dietary Supplement
Precautions
Warning: If you are anorexic, clinically obese, pregnant or nursing, do note take. If you suffer from serious health problems and/or medical conditions please consult a physician. Keep out of reach of children and pets. Do not consume if seal is broken.
General Statements
Best if used by: 12-21-12
Seals/Symbols
All BBB Formula Ingredients are GRAS certified (Generally Recognized As Safe).
Suggested/Recommended/Usage/Directions
Directions: As a dietary supplement, take 1 a day before a meal. Store in a cool dry place.
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
BBB Enhancement Formula by BBB Formula label
The label scan from the NIH Dietary Supplement Label Database. Tap to enlarge.
Label images are published by the NIH Dietary Supplement Label Database for the version of this product on file. Always read your actual product label.
View the full label (PDF)The Ingredients in BBB Enhancement Formula by BBB Formula
These are the 13 active ingredients this product is made of. Select any to open its full monograph.
Serving size1 Capsule(s) Dosage formCapsule 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.
BBB Proprietary Blend
- › Calcium
- › L-Tyrosine
- › Citrus Bioflavonoids
- › Dandelion
- › Rose Hips
- › Watercress
- › Soy Isoflavones
- › Maca
- › Dong Quai
- › Saw Palmetto
- › Fenugreek
- › Mexican Wild Yam
- › Genistein
Other (inactive) ingredients: Gelatin, Magnesium Stearate, Silicon Dioxide. These complete the product’s ingredient list but are not active constituents.
BBB Enhancement Formula by BBB Formula Drug Interactions
BBB Enhancement Formula contains 13 ingredients, and 11 of them have known drug interactions. Altogether they interact with 1,372 medications. Here’s the picture, then you can look up your own drug.
Want to check YOUR meds against BBB Enhancement Formula?
Ask about interactions with your drugs in plain English — “Can I take it with lisinopril?” — and we find you the answer in seconds, ingredient by ingredient.
Go to the checkerIngredients driving the most interactions
Individual Drug Interactions
The ingredients in BBB Enhancement Formula interact with 1,372 drugs. Click any drug to see the details.
11 of the 13 ingredients in BBB Enhancement Formula interact with drugs. Each result below shows which ingredient is responsible. Citrus Bioflavonoids Genistein Dandelion Fenugreek Rose Hips Saw Palmetto Calcium Dong Quai Mexican Wild Yam L-Tyrosine Watercress
CeftriaxoneRocephin
How Ceftriaxone interacts with BBB Enhancement Formula — through 2 ingredients. Tap an ingredient for the detail:
CalciumCeftriaxone (rocephin) Major
Interaction Summary
Co-administration of intravenous calcium and ceftriaxone can result in precipitation of a ceftriaxone-calcium salt in the lungs and kidneys.
Read the full Calcium + Ceftriaxone interactionCitrus BioflavonoidsOrganic Anion Transporter 1 (oat1) Substrates, Organic Anion Transporter 3 (oat3) Substrates Moderate
Interaction Summary
Theoretically, concomitant use might increase the effects and adverse effects of OAT1 substrates.
Read the full Citrus Bioflavonoids + Ceftriaxone interactionCobicistat, Elvitegravir, Emtricitabine, Tenofovir Alafenamide FumarateGenvoya
How Cobicistat, Elvitegravir, Emtricitabine, Tenofovir Alafenamide Fumarate interacts with BBB Enhancement Formula — through 3 ingredients. Tap an ingredient for the detail:
CalciumElvitegravir (vitekta), Bictegravir/emtricitabine/tenofovir Alafenamide (biktarvy) Major
Interaction Summary
Calcium seems to reduce levels of elvitegravir.
Read the full Calcium + Cobicistat, Elvitegravir, Emtricitabine, Tenofovir Alafenamide Fumarate interactionCitrus BioflavonoidsP-glycoprotein Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, concomitant use might alter the effects and adverse effects of P-glycoprotein substrates.
Read the full Citrus Bioflavonoids + Cobicistat, Elvitegravir, Emtricitabine, Tenofovir Alafenamide Fumarate interactionGenisteinCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, red clover might increase levels of drugs metabolized by CYP3A4; however, a small clinical study found no effect.
Read the full Genistein + Cobicistat, Elvitegravir, Emtricitabine, Tenofovir Alafenamide Fumarate interactionDolutegravirTivicay
How Dolutegravir interacts with BBB Enhancement Formula — through 3 ingredients. Tap an ingredient for the detail:
CalciumDolutegravir (tivicay) Major
Interaction Summary
Calcium seems to reduce levels of dolutegravir.
Read the full Calcium + Dolutegravir interactionCitrus BioflavonoidsP-glycoprotein Substrates Moderate
Interaction Summary
Theoretically, concomitant use might alter the effects and adverse effects of P-glycoprotein substrates.
Read the full Citrus Bioflavonoids + Dolutegravir interactionDandelionGlucuronidated Drugs Moderate
Interaction Summary
Theoretically, dandelion might increase the clearance of drugs that are UDP-glucuronosyltransferase substrates.
Read the full Dandelion + Dolutegravir interactionDolutegravir, Emtricitabine, Tenofovir AlafenamideDolutegravir, Emtricitabine, Tenofovir Alafenamide
How Dolutegravir, Emtricitabine, Tenofovir Alafenamide interacts with BBB Enhancement Formula — through 3 ingredients. Tap an ingredient for the detail:
CalciumDolutegravir (tivicay), Bictegravir/emtricitabine/tenofovir Alafenamide (biktarvy) Major
Interaction Summary
Calcium seems to reduce levels of dolutegravir.
Read the full Calcium + Dolutegravir, Emtricitabine, Tenofovir Alafenamide interactionDandelionGlucuronidated Drugs Moderate
Interaction Summary
Theoretically, dandelion might increase the clearance of drugs that are UDP-glucuronosyltransferase substrates.
Read the full Dandelion + Dolutegravir, Emtricitabine, Tenofovir Alafenamide interactionCitrus BioflavonoidsP-glycoprotein Substrates Moderate
Interaction Summary
Theoretically, concomitant use might alter the effects and adverse effects of P-glycoprotein substrates.
Read the full Citrus Bioflavonoids + Dolutegravir, Emtricitabine, Tenofovir Alafenamide interactionDolutegravir, RilpivirineJuluca
How Dolutegravir, Rilpivirine interacts with BBB Enhancement Formula — through 4 ingredients. Tap an ingredient for the detail:
CalciumDolutegravir (tivicay) Major
Interaction Summary
Calcium seems to reduce levels of dolutegravir.
Read the full Calcium + Dolutegravir, Rilpivirine interactionCitrus BioflavonoidsP-glycoprotein Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, concomitant use might alter the effects and adverse effects of P-glycoprotein substrates.
Read the full Citrus Bioflavonoids + Dolutegravir, Rilpivirine interactionDandelionGlucuronidated Drugs Moderate
Interaction Summary
Theoretically, dandelion might increase the clearance of drugs that are UDP-glucuronosyltransferase substrates.
Read the full Dandelion + Dolutegravir, Rilpivirine interactionGenisteinCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, red clover might increase levels of drugs metabolized by CYP3A4; however, a small clinical study found no effect.
Read the full Genistein + Dolutegravir, Rilpivirine interactionElvitegravirVitekta
How Elvitegravir interacts with BBB Enhancement Formula — through 3 ingredients. Tap an ingredient for the detail:
CalciumElvitegravir (vitekta) Major
Interaction Summary
Calcium seems to reduce levels of elvitegravir.
Read the full Calcium + Elvitegravir interactionCitrus BioflavonoidsCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, concomitant use might alter the effects and adverse effects of CYP3A4 substrates.
Read the full Citrus Bioflavonoids + Elvitegravir interactionGenisteinCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, red clover might increase levels of drugs metabolized by CYP3A4; however, a small clinical study found no effect.
Read the full Genistein + Elvitegravir interactionElvitegravir, Cobicistat, Emtricitabine, Tenofovir Disoproxil FumarateStribild
How Elvitegravir, Cobicistat, Emtricitabine, Tenofovir Disoproxil Fumarate interacts with BBB Enhancement Formula — through 3 ingredients. Tap an ingredient for the detail:
CalciumElvitegravir (vitekta), Bictegravir/emtricitabine/tenofovir Alafenamide (biktarvy) Major
Interaction Summary
Calcium seems to reduce levels of elvitegravir.
Read the full Calcium + Elvitegravir, Cobicistat, Emtricitabine, Tenofovir Disoproxil Fumarate interactionCitrus BioflavonoidsCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, concomitant use might alter the effects and adverse effects of CYP3A4 substrates.
Read the full Citrus Bioflavonoids + Elvitegravir, Cobicistat, Emtricitabine, Tenofovir Disoproxil Fumarate interactionGenisteinCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, red clover might increase levels of drugs metabolized by CYP3A4; however, a small clinical study found no effect.
Read the full Genistein + Elvitegravir, Cobicistat, Emtricitabine, Tenofovir Disoproxil Fumarate interactionWarfarinWarfarin
How Warfarin interacts with BBB Enhancement Formula — through 8 ingredients. Tap an ingredient for the detail:
Dong QuaiAnticoagulant/antiplatelet Drugs, Warfarin (coumadin) Major
Interaction Summary
Theoretically, dong quai may increase the risk of bleeding when used with anticoagulant or antiplatelet drugs; however, research is conflicting.
Read the full Dong Quai + Warfarin interactionCitrus BioflavonoidsCytochrome P450 2c8 (cyp2c8) Substrates, Warfarin (coumadin) +2 Moderate
Interaction Summary
Theoretically, concomitant use might increase the levels and adverse effects of CYP2C8 substrates.
Read the full Citrus Bioflavonoids + Warfarin interactionWatercressWarfarin (coumadin) Moderate
Saw PalmettoAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Saw palmetto might increase the risk of bleeding with anticoagulant or antiplatelet drugs.
Read the full Saw Palmetto + Warfarin interactionDandelionCytochrome P450 1a2 (cyp1a2) Substrates, Anticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, dandelion might increase levels of drugs metabolized by CYP1A2.
Read the full Dandelion + Warfarin interactionFenugreekAnticoagulant/antiplatelet Drugs, Warfarin (coumadin) Moderate
Interaction Summary
Theoretically, fenugreek might have additive effects when used with anticoagulant or antiplatelet drugs.
Read the full Fenugreek + Warfarin interactionRose HipsAnticoagulant/antiplatelet Drugs, Warfarin (coumadin) Moderate
Interaction Summary
Theoretically, rose hip might reduce the effectiveness of anticoagulant or antiplatelet drugs.
Read the full Rose Hips + Warfarin interactionGenisteinCytochrome P450 2c19 (cyp2c19) Substrates, Cytochrome P450 2c9 (cyp2c9) Substrates +3 Minor
Interaction Summary
Theoretically, red clover might increase the levels and clinical effects of drugs metabolized by CYP2C19.
Read the full Genistein + Warfarin interactionWarfarin SodiumCoumadin, Panwarfin, Sofarin
How Warfarin Sodium interacts with BBB Enhancement Formula — through 8 ingredients. Tap an ingredient for the detail:
Dong QuaiAnticoagulant/antiplatelet Drugs, Warfarin (coumadin) Major
Interaction Summary
Theoretically, dong quai may increase the risk of bleeding when used with anticoagulant or antiplatelet drugs; however, research is conflicting.
Read the full Dong Quai + Warfarin Sodium interactionFenugreekWarfarin (coumadin), Anticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, fenugreek might have additive effects with warfarin and increase the international normalized ratio (INR).
Read the full Fenugreek + Warfarin Sodium interactionDandelionAnticoagulant/antiplatelet Drugs, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, taking dandelion root along with anticoagulant or antiplatelet drugs might increase the risk of bruising and bleeding.
Read the full Dandelion + Warfarin Sodium interactionSaw PalmettoAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Saw palmetto might increase the risk of bleeding with anticoagulant or antiplatelet drugs.
Read the full Saw Palmetto + Warfarin Sodium interactionRose HipsAnticoagulant/antiplatelet Drugs, Warfarin (coumadin) Moderate
Interaction Summary
Theoretically, rose hip might reduce the effectiveness of anticoagulant or antiplatelet drugs.
Read the full Rose Hips + Warfarin Sodium interactionCitrus BioflavonoidsWarfarin (coumadin), Cytochrome P450 2c8 (cyp2c8) Substrates +2 Moderate
Interaction Summary
Theoretically, quercetin may increase the risk of bleeding if used with warfarin.
Read the full Citrus Bioflavonoids + Warfarin Sodium interactionWatercressWarfarin (coumadin) Moderate
Interaction Summary
Watercress contains vitamin K.
Read the full Watercress + Warfarin Sodium interactionGenisteinCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +3 Minor
Interaction Summary
Theoretically, red clover might increase levels of drugs metabolized by CYP1A2; however, a small clinical study found no effect.
Read the full Genistein + Warfarin Sodium interactionAdo-trastuzumab EmtansineKadcyla
How Ado-trastuzumab Emtansine interacts with BBB Enhancement Formula — through 2 ingredients. Tap an ingredient for the detail:
Citrus BioflavonoidsCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, concomitant use might alter the effects and adverse effects of CYP3A4 substrates.
Read the full Citrus Bioflavonoids + Ado-trastuzumab Emtansine interactionGenisteinCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, red clover might increase levels of drugs metabolized by CYP3A4; however, a small clinical study found no effect.
Read the full Genistein + Ado-trastuzumab Emtansine interactionAbciximabReoPro
How Abciximab interacts with BBB Enhancement Formula — through 6 ingredients. Tap an ingredient for the detail:
Saw PalmettoAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Saw palmetto might increase the risk of bleeding with anticoagulant or antiplatelet drugs.
Read the full Saw Palmetto + Abciximab interactionDong QuaiAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, dong quai may increase the risk of bleeding when used with anticoagulant or antiplatelet drugs; however, research is conflicting.
Read the full Dong Quai + Abciximab interactionRose HipsAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, rose hip might reduce the effectiveness of anticoagulant or antiplatelet drugs.
Read the full Rose Hips + Abciximab interactionDandelionAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, taking dandelion root along with anticoagulant or antiplatelet drugs might increase the risk of bruising and bleeding.
Read the full Dandelion + Abciximab interactionFenugreekAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, fenugreek might have additive effects when used with anticoagulant or antiplatelet drugs.
Read the full Fenugreek + Abciximab interactionGenisteinAnticoagulant/antiplatelet Drugs Minor
Interaction Summary
Although some laboratory research suggests that red clover may have anticoagulant and antiplatelet activity, clinical research has not shown this effect.
Read the full Genistein + Abciximab interactionAbemaciclibVerzenio
How Abemaciclib interacts with BBB Enhancement Formula — through 2 ingredients. Tap an ingredient for the detail:
Citrus BioflavonoidsCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, concomitant use might alter the effects and adverse effects of CYP3A4 substrates.
Read the full Citrus Bioflavonoids + Abemaciclib interactionGenisteinCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, red clover might increase levels of drugs metabolized by CYP3A4; however, a small clinical study found no effect.
Read the full Genistein + Abemaciclib interactionAbiraterone
How Abiraterone interacts with BBB Enhancement Formula — through 2 ingredients. Tap an ingredient for the detail:
Citrus BioflavonoidsCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, concomitant use might alter the effects and adverse effects of CYP3A4 substrates.
Read the full Citrus Bioflavonoids + Abiraterone interactionGenisteinCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, red clover might increase levels of drugs metabolized by CYP3A4; however, a small clinical study found no effect.
Read the full Genistein + Abiraterone interactionAbiraterone AcetateYonsa, Zytiga
How Abiraterone Acetate interacts with BBB Enhancement Formula — through 2 ingredients. Tap an ingredient for the detail:
Citrus BioflavonoidsCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, concomitant use might alter the effects and adverse effects of CYP3A4 substrates.
Read the full Citrus Bioflavonoids + Abiraterone Acetate interactionGenisteinCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, red clover might increase levels of drugs metabolized by CYP3A4; however, a small clinical study found no effect.
Read the full Genistein + Abiraterone Acetate interactionAbrocitinibCibinqo
How Abrocitinib interacts with BBB Enhancement Formula — through 7 ingredients. Tap an ingredient for the detail:
Citrus BioflavonoidsCytochrome P450 2c9 (cyp2c9) Substrates Moderate
Interaction Summary
Theoretically, concomitant use might increase the levels and adverse effects of CYP2C9 substrates.
Read the full Citrus Bioflavonoids + Abrocitinib interactionFenugreekAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, fenugreek might have additive effects when used with anticoagulant or antiplatelet drugs.
Read the full Fenugreek + Abrocitinib interactionSaw PalmettoAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Saw palmetto might increase the risk of bleeding with anticoagulant or antiplatelet drugs.
Read the full Saw Palmetto + Abrocitinib interactionDandelionAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, taking dandelion root along with anticoagulant or antiplatelet drugs might increase the risk of bruising and bleeding.
Read the full Dandelion + Abrocitinib interactionDong QuaiAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, dong quai may increase the risk of bleeding when used with anticoagulant or antiplatelet drugs; however, research is conflicting.
Read the full Dong Quai + Abrocitinib interactionRose HipsAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, rose hip might reduce the effectiveness of anticoagulant or antiplatelet drugs.
Read the full Rose Hips + Abrocitinib interactionGenisteinCytochrome P450 2c19 (cyp2c19) Substrates, Cytochrome P450 2c9 (cyp2c9) Substrates +1 Minor
Interaction Summary
Theoretically, red clover might increase the levels and clinical effects of drugs metabolized by CYP2C19.
Read the full Genistein + Abrocitinib interactionAcalabrutinibCalquence
How Acalabrutinib interacts with BBB Enhancement Formula — through 2 ingredients. Tap an ingredient for the detail:
Citrus BioflavonoidsP-glycoprotein Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, concomitant use might alter the effects and adverse effects of P-glycoprotein substrates.
Read the full Citrus Bioflavonoids + Acalabrutinib interactionGenisteinCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, red clover might increase levels of drugs metabolized by CYP3A4; however, a small clinical study found no effect.
Read the full Genistein + Acalabrutinib interactionAcarboseGlucobay, Prandase, Precose
How Acarbose interacts with BBB Enhancement Formula — through 3 ingredients. Tap an ingredient for the detail:
Citrus BioflavonoidsAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, concomitant use of quercetin and antidiabetes drugs might increase the risk of hypoglycemia.
Read the full Citrus Bioflavonoids + Acarbose interactionFenugreekAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, fenugreek seed might have additive hypoglycemic effects when used with antidiabetes drugs.
Read the full Fenugreek + Acarbose interactionDandelionAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, dandelion might increase the risk for hypoglycemia when used with antidiabetes drugs.
Read the full Dandelion + Acarbose interactionAcebutololRhotral, Sectral
How Acebutolol interacts with BBB Enhancement Formula — through 2 ingredients. Tap an ingredient for the detail:
Citrus BioflavonoidsAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, taking quercetin with antihypertensive drugs might increase the risk of hypotension.
Read the full Citrus Bioflavonoids + Acebutolol interactionFenugreekAntihypertensive Drugs Minor
Interaction Summary
Fenugreek may also have an additive effect on blood pressure-lowering medications.
Read the full Fenugreek + Acebutolol interactionAcenocoumarolSintrom
How Acenocoumarol interacts with BBB Enhancement Formula — through 6 ingredients. Tap an ingredient for the detail:
Rose HipsAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, rose hip might reduce the effectiveness of anticoagulant or antiplatelet drugs.
Read the full Rose Hips + Acenocoumarol interactionSaw PalmettoAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Saw palmetto might increase the risk of bleeding with anticoagulant or antiplatelet drugs.
Read the full Saw Palmetto + Acenocoumarol interactionFenugreekAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, fenugreek might have additive effects when used with anticoagulant or antiplatelet drugs.
Read the full Fenugreek + Acenocoumarol interactionDandelionAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, taking dandelion root along with anticoagulant or antiplatelet drugs might increase the risk of bruising and bleeding.
Read the full Dandelion + Acenocoumarol interactionDong QuaiAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, dong quai may increase the risk of bleeding when used with anticoagulant or antiplatelet drugs; however, research is conflicting.
Read the full Dong Quai + Acenocoumarol interactionGenisteinAnticoagulant/antiplatelet Drugs Minor
Interaction Summary
Although some laboratory research suggests that red clover may have anticoagulant and antiplatelet activity, clinical research has not shown this effect.
Read the full Genistein + Acenocoumarol interactionAcetaminophenChildren's Tylenol, Children's Tylenol Meltaways, Tylenol, Tylenol Ex Strength
How Acetaminophen interacts with BBB Enhancement Formula — through 2 ingredients. Tap an ingredient for the detail:
DandelionGlucuronidated Drugs, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, dandelion might increase the clearance of drugs that are UDP-glucuronosyltransferase substrates.
Read the full Dandelion + Acetaminophen interactionGenisteinCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, red clover might increase levels of drugs metabolized by CYP1A2; however, a small clinical study found no effect.
Read the full Genistein + Acetaminophen interactionAcetaminophen, AspirinGemnisyn
How Acetaminophen, Aspirin interacts with BBB Enhancement Formula — through 7 ingredients. Tap an ingredient for the detail:
DandelionCytochrome P450 1a2 (cyp1a2) Substrates, Glucuronidated Drugs +1 Moderate
Interaction Summary
Theoretically, dandelion might increase levels of drugs metabolized by CYP1A2.
Read the full Dandelion + Acetaminophen, Aspirin interactionCitrus BioflavonoidsOrganic Anion Transporter 3 (oat3) Substrates, Organic Anion Transporter 1 (oat1) Substrates Moderate
Interaction Summary
Theoretically, concomitant use might increase the effects and adverse effects of OAT3 substrates.
Read the full Citrus Bioflavonoids + Acetaminophen, Aspirin interactionDong QuaiAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, dong quai may increase the risk of bleeding when used with anticoagulant or antiplatelet drugs; however, research is conflicting.
Read the full Dong Quai + Acetaminophen, Aspirin interactionRose HipsAnticoagulant/antiplatelet Drugs, Aspirin Moderate
Interaction Summary
Theoretically, rose hip might reduce the effectiveness of anticoagulant or antiplatelet drugs.
Read the full Rose Hips + Acetaminophen, Aspirin interactionSaw PalmettoAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Saw palmetto might increase the risk of bleeding with anticoagulant or antiplatelet drugs.
Read the full Saw Palmetto + Acetaminophen, Aspirin interactionFenugreekAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, fenugreek might have additive effects when used with anticoagulant or antiplatelet drugs.
Read the full Fenugreek + Acetaminophen, Aspirin interactionGenisteinCytochrome P450 1a2 (cyp1a2) Substrates, Anticoagulant/antiplatelet Drugs Minor
Interaction Summary
Theoretically, red clover might increase levels of drugs metabolized by CYP1A2; however, a small clinical study found no effect.
Read the full Genistein + Acetaminophen, Aspirin interactionAcetaminophen, Aspirin, CaffeineExcedrin, Excedrin Extra Strength, Excedrin Migraine
How Acetaminophen, Aspirin, Caffeine interacts with BBB Enhancement Formula — through 7 ingredients. Tap an ingredient for the detail:
FenugreekAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, fenugreek might have additive effects when used with anticoagulant or antiplatelet drugs.
Read the full Fenugreek + Acetaminophen, Aspirin, Caffeine interactionDong QuaiAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, dong quai may increase the risk of bleeding when used with anticoagulant or antiplatelet drugs; however, research is conflicting.
Read the full Dong Quai + Acetaminophen, Aspirin, Caffeine interactionDandelionGlucuronidated Drugs, Anticoagulant/antiplatelet Drugs +1 Moderate
Interaction Summary
Theoretically, dandelion might increase the clearance of drugs that are UDP-glucuronosyltransferase substrates.
Read the full Dandelion + Acetaminophen, Aspirin, Caffeine interactionRose HipsAnticoagulant/antiplatelet Drugs, Aspirin Moderate
Interaction Summary
Theoretically, rose hip might reduce the effectiveness of anticoagulant or antiplatelet drugs.
Read the full Rose Hips + Acetaminophen, Aspirin, Caffeine interactionSaw PalmettoAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Saw palmetto might increase the risk of bleeding with anticoagulant or antiplatelet drugs.
Read the full Saw Palmetto + Acetaminophen, Aspirin, Caffeine interactionCitrus BioflavonoidsOrganic Anion Transporter 1 (oat1) Substrates, Organic Anion Transporter 3 (oat3) Substrates +1 Moderate
Interaction Summary
Theoretically, concomitant use might increase the effects and adverse effects of OAT1 substrates.
Read the full Citrus Bioflavonoids + Acetaminophen, Aspirin, Caffeine interactionGenisteinAnticoagulant/antiplatelet Drugs, Caffeine +2 Minor
Interaction Summary
Although some laboratory research suggests that red clover may have anticoagulant and antiplatelet activity, clinical research has not shown this effect.
Read the full Genistein + Acetaminophen, Aspirin, Caffeine interactionAcetaminophen, Brompheniramine, PhenylpropanolamineDimetapp Cold and Flu
How Acetaminophen, Brompheniramine, Phenylpropanolamine interacts with BBB Enhancement Formula — through 2 ingredients. Tap an ingredient for the detail:
DandelionGlucuronidated Drugs, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, dandelion might increase the clearance of drugs that are UDP-glucuronosyltransferase substrates.
Read the full Dandelion + Acetaminophen, Brompheniramine, Phenylpropanolamine interactionGenisteinCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, red clover might increase levels of drugs metabolized by CYP1A2; however, a small clinical study found no effect.
Read the full Genistein + Acetaminophen, Brompheniramine, Phenylpropanolamine interactionAcetaminophen, ButalbitalAxocet, Bancap, Bucet, Butex Forte, Esgic CF, Orbivan CF +5 more
How Acetaminophen, Butalbital interacts with BBB Enhancement Formula — through 2 ingredients. Tap an ingredient for the detail:
DandelionCytochrome P450 1a2 (cyp1a2) Substrates, Glucuronidated Drugs Moderate
Interaction Summary
Theoretically, dandelion might increase levels of drugs metabolized by CYP1A2.
Read the full Dandelion + Acetaminophen, Butalbital interactionGenisteinCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, red clover might increase levels of drugs metabolized by CYP1A2; however, a small clinical study found no effect.
Read the full Genistein + Acetaminophen, Butalbital interactionAcetaminophen, Butalbital, CaffeineEsgic, Esgic Plus, Fiogesic, Fioricet, Repan, Tecnal +1 more
How Acetaminophen, Butalbital, Caffeine interacts with BBB Enhancement Formula — through 3 ingredients. Tap an ingredient for the detail:
DandelionGlucuronidated Drugs, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, dandelion might increase the clearance of drugs that are UDP-glucuronosyltransferase substrates.
Read the full Dandelion + Acetaminophen, Butalbital, Caffeine interactionCitrus BioflavonoidsCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, concomitant use might alter the effects and adverse effects of CYP3A4 substrates.
Read the full Citrus Bioflavonoids + Acetaminophen, Butalbital, Caffeine interactionGenisteinCytochrome P450 1a2 (cyp1a2) Substrates, Caffeine +1 Minor
Interaction Summary
Theoretically, red clover might increase levels of drugs metabolized by CYP1A2; however, a small clinical study found no effect.
Read the full Genistein + Acetaminophen, Butalbital, Caffeine interactionAcetaminophen, Butalbital, Caffeine, CodeineEsgic with Codeine, Fioricet w/ Codeine
How Acetaminophen, Butalbital, Caffeine, Codeine interacts with BBB Enhancement Formula — through 3 ingredients. Tap an ingredient for the detail:
DandelionGlucuronidated Drugs, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, dandelion might increase the clearance of drugs that are UDP-glucuronosyltransferase substrates.
Read the full Dandelion + Acetaminophen, Butalbital, Caffeine, Codeine interactionCitrus BioflavonoidsCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 2d6 (cyp2d6) Substrates Moderate
Interaction Summary
Theoretically, concomitant use might alter the effects and adverse effects of CYP3A4 substrates.
Read the full Citrus Bioflavonoids + Acetaminophen, Butalbital, Caffeine, Codeine interactionGenisteinCytochrome P450 3a4 (cyp3a4) Substrates, Caffeine +1 Minor
Interaction Summary
Theoretically, red clover might increase levels of drugs metabolized by CYP3A4; however, a small clinical study found no effect.
Read the full Genistein + Acetaminophen, Butalbital, Caffeine, Codeine interactionAcetaminophen, Butalbital, CodeineBancap w/ Codeine
How Acetaminophen, Butalbital, Codeine interacts with BBB Enhancement Formula — through 3 ingredients. Tap an ingredient for the detail:
Citrus BioflavonoidsCytochrome P450 2d6 (cyp2d6) Substrates Moderate
Interaction Summary
Theoretically, concomitant use might increase the levels and adverse effects of CYP2D6 substrates.
Read the full Citrus Bioflavonoids + Acetaminophen, Butalbital, Codeine interactionDandelionCytochrome P450 1a2 (cyp1a2) Substrates, Glucuronidated Drugs Moderate
Interaction Summary
Theoretically, dandelion might increase levels of drugs metabolized by CYP1A2.
Read the full Dandelion + Acetaminophen, Butalbital, Codeine interactionGenisteinCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, red clover might increase levels of drugs metabolized by CYP1A2; however, a small clinical study found no effect.
Read the full Genistein + Acetaminophen, Butalbital, Codeine interactionAcetaminophen, Butalbital, Codeine PhosphatePhrenilin #3
How Acetaminophen, Butalbital, Codeine Phosphate interacts with BBB Enhancement Formula — through 3 ingredients. Tap an ingredient for the detail:
DandelionGlucuronidated Drugs, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, dandelion might increase the clearance of drugs that are UDP-glucuronosyltransferase substrates.
Read the full Dandelion + Acetaminophen, Butalbital, Codeine Phosphate interactionCitrus BioflavonoidsCytochrome P450 2d6 (cyp2d6) Substrates Moderate
Interaction Summary
Theoretically, concomitant use might increase the levels and adverse effects of CYP2D6 substrates.
Read the full Citrus Bioflavonoids + Acetaminophen, Butalbital, Codeine Phosphate interactionGenisteinCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, red clover might increase levels of drugs metabolized by CYP1A2; however, a small clinical study found no effect.
Read the full Genistein + Acetaminophen, Butalbital, Codeine Phosphate interactionAcetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, PhenylephrineHycomine Compound
How Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interacts with BBB Enhancement Formula — through 3 ingredients. Tap an ingredient for the detail:
DandelionCytochrome P450 1a2 (cyp1a2) Substrates, Glucuronidated Drugs Moderate
Interaction Summary
Theoretically, dandelion might increase levels of drugs metabolized by CYP1A2.
Read the full Dandelion + Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interactionCitrus BioflavonoidsCytochrome P450 2d6 (cyp2d6) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, concomitant use might increase the levels and adverse effects of CYP2D6 substrates.
Read the full Citrus Bioflavonoids + Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interactionGenisteinCytochrome P450 1a2 (cyp1a2) Substrates, Caffeine +1 Minor
Interaction Summary
Theoretically, red clover might increase levels of drugs metabolized by CYP1A2; however, a small clinical study found no effect.
Read the full Genistein + Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interactionAcetaminophen, Caffeine, CodeineGesic C15, Gesic C30, Gesic C8, Lenoltec 1, Lenoltec 2, Lenoltec 3 +1 more
How Acetaminophen, Caffeine, Codeine interacts with BBB Enhancement Formula — through 3 ingredients. Tap an ingredient for the detail:
Citrus BioflavonoidsCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 2d6 (cyp2d6) Substrates Moderate
Interaction Summary
Theoretically, concomitant use might alter the effects and adverse effects of CYP3A4 substrates.
Read the full Citrus Bioflavonoids + Acetaminophen, Caffeine, Codeine interactionDandelionCytochrome P450 1a2 (cyp1a2) Substrates, Glucuronidated Drugs Moderate
Interaction Summary
Theoretically, dandelion might increase levels of drugs metabolized by CYP1A2.
Read the full Dandelion + Acetaminophen, Caffeine, Codeine interactionGenisteinCytochrome P450 3a4 (cyp3a4) Substrates, Caffeine +1 Minor
Interaction Summary
Theoretically, red clover might increase levels of drugs metabolized by CYP3A4; however, a small clinical study found no effect.
Read the full Genistein + Acetaminophen, Caffeine, Codeine interactionEach ingredient & the kinds of drugs it affects
For each ingredient in BBB Enhancement Formula 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.
Citrus Bioflavonoids
Antidiabetes Drugs
Theoretically, concomitant use of quercetin and antidiabetes drugs might increase the risk of hypoglycemia.
Clinical research suggests that a combination of quercetin, myricetin, and chlorogenic acid reduce levels of fasting glucose in patients with type 2 diabetes, including those already taking antidiabetes agents. The effect of quercetin alone is unknown.
Antihypertensive Drugs
Theoretically, taking quercetin with antihypertensive drugs might increase the risk of hypotension.
Quercetin can modestly decrease blood pressure in people with mild hypertension. Theoretically, it might have additive blood pressure lowering effects when used with antihypertensive drugs.
Cyclosporine (Neoral, Sandimmune)
Theoretically, concomitant use might increase the levels and adverse effects of cyclosporine.
A small study in healthy volunteers shows that pretreatment with quercetin increases plasma levels and prolongs the half-life of a single dose of cyclosporine, possibly due to inhibition of p-glycoprotein or cytochrome P450 3A4 (CYP3A4), which metabolizes cyclosporin.
Cytochrome P450 2C8 (Cyp2C8) Substrates
Theoretically, concomitant use might increase the levels and adverse effects of CYP2C8 substrates.
In vitro research shows that quercetin inhibits CYP2C8. Inhibition of paclitaxel (Taxol) metabolism via CYP2C8 has been reported in vitro. However, a small study in humans found no effect of quercetin on rosiglitazone (Avandia), which is also a CYP2C8 substrate.
Cytochrome P450 2C9 (Cyp2C9) Substrates
Theoretically, concomitant use might increase the levels and adverse effects of CYP2C9 substrates.
A small clinical study in healthy volunteers shows that taking quercetin 500 mg twice daily for 10 days prior to taking diclofenac, a CYP2C9 substrate, increases diclofenac plasma levels by 75% and prolongs the half-life by 32.5%. Animal research also shows that pretreatment with quercetin increases plasma levels and prolongs the half-life of losartan (Cozaar), a substrate of CYP2C9. Furthermore, laboratory research shows that quercetin inhibits CYP2C9.
Cytochrome P450 2D6 (Cyp2D6) Substrates
Theoretically, concomitant use might increase the levels and adverse effects of CYP2D6 substrates.
In vitro research show that quercetin inhibits CYP2D6. This effect has not been reported in humans.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, concomitant use might alter the effects and adverse effects of CYP3A4 substrates.
A small clinical study in healthy volunteers shows that pretreatment with quercetin increases plasma levels and prolongs the half-life of a single dose of cyclosporine (Neoral, Sandimmune), a substrate of CYP3A4. Animal research also shows that pretreatment with quercetin increases plasma levels and prolongs the half-life of losartan (Cozaar) and quetiapine (Seroquel), substrates of CYP3A4. Other laboratory research also shows that quercetin inhibits CYP3A4. However, one clinical study shows that quercetin can increase the metabolism of midazolam, a substrate of CYP3A4, and decrease serum concentrations of midazolam by about 24% in some healthy individuals, suggesting possible induction of CYP3A4.
Diclofenac (Voltaren, Others)
Theoretically, concomitant use might increase the levels and adverse effects of diclofenac.
A small clinical study in healthy volunteers shows that taking quercetin 500 mg twice daily for 10 days prior to taking diclofenac increases diclofenac plasma levels by 75% and prolongs the half-life by 32.5%. This is thought to be due to inhibition of CYP2C9 by quercetin.
Losartan (Cozaar)
Theoretically, concomitant use might increase the effects and adverse effects of losartan and decrease the effects of its active metabolite.
Animal research shows that pretreatment with quercetin increases plasma levels and prolongs the half-life of losartan (Cozaar) while decreasing plasma levels of losartan's active metabolite. This metabolite, which is around 10-fold more potent than losartan, is the result of cytochrome P450 (CYP) 2C9- and CYP3A4-mediated transformation of losartan. Additionally, in vitro research shows that quercetin may inhibit P-glycoprotein-mediated efflux of losartan from the intestines, resulting in increased absorption of losartan. These results suggest that concomitant use of quercetin and losartan might increase systemic exposure to losartan while also decreasing plasma concentrations of losartan's active and more potent metabolite.
Midazolam (Versed)
Theoretically, concomitant use might decrease the levels and effects of midazolam.
A small clinical study in healthy volunteers shows that quercetin can increase the metabolism of midazolam, with a decrease in AUC of about 24%.
Mitoxantrone
Theoretically, quercetin might increase the effects and adverse effects of mitoxantrone.
In vitro research shows that quercetin increases the intracellular accumulation and cytotoxicity of mitoxantrone, possibly through inhibition of breast cancer resistance protein (BCRP), of which mitoxantrone is a substrate. So far, this interaction has not been reported in humans.
Organic Anion Transporter 1 (Oat1) Substrates
Theoretically, concomitant use might increase the effects and adverse effects of OAT1 substrates.
In vitro research shows that quercetin is a strong non-competitive inhibitor of OAT1, with half-maximal inhibitory concentration (IC50) values less than 10 mcM. So far, this interaction has not been reported in humans.
Organic Anion Transporter 3 (Oat3) Substrates
Theoretically, concomitant use might increase the effects and adverse effects of OAT3 substrates.
In vitro research shows that quercetin is a strong non-competitive inhibitor of OAT3, with half-maximal inhibitory concentration (IC50) values as low as 0.75 mcM. So far, this interaction has not been reported in humans.
Organic Anion-Transporting Polypeptide Substrates (Oatp)
Theoretically, concomitant use might increase the effects and adverse effects of OATP substrates.
In vitro evidence shows that quercetin can inhibit organic anion-transporting peptide (OATP) 1B1-mediated uptake of estrone-3-sulfate and pravastatin. Furthermore, clinical research in healthy males shows that intake of quercetin along with pravastatin increases the AUC of pravastatin by 24%, prolongs its half-life by 14%, and decreases its apparent clearance by 18%, suggesting that quercetin modestly inhibits the uptake of pravastatin in hepatic cells.
P-Glycoprotein Substrates
Theoretically, concomitant use might alter the effects and adverse effects of P-glycoprotein substrates.
There is preliminary evidence that quercetin inhibits the gastrointestinal P-glycoprotein efflux pump, which might increase the bioavailability and serum levels of drugs transported by the pump. A small study in healthy volunteers reported that pretreatment with quercetin increased bioavailability and plasma levels after a single dose of cyclosporine (Neoral, Sandimmune). Also, two small studies have shown that quercetin might decrease the absorption of talinolol, a substrate transported by the gastrointestinal P-glycoprotein efflux pump. However, in another small study, several days of quercetin treatment did not significantly affect the pharmacokinetics of saquinavir (Invirase). The reason for these discrepancies is not entirely clear. Until more is known, use quercetin cautiously in combination with P-glycoprotein substrates.
Pravastatin (Pravachol)
Theoretically, concomitant use might increase the effects and adverse effects of pravastatin.
In vitro evidence shows that quercetin can inhibit OATP 1B1-mediated uptake of pravastatin. Also, preliminary clinical research in healthy males shows that intake of quercetin along with pravastatin increases the maximum concentration of pravastatin by 24%, prolongs its half-life by 14%, and decreases its apparent clearance by 18%, suggesting that quercetin modestly inhibits the uptake of pravastatin in hepatic cells.
Prazosin (Minipress)
Theoretically, quercetin might increase the effects and adverse effects of prazosin.
In vitro research shows that quercetin inhibits the transcellular efflux of prazosin, possibly through inhibition of breast cancer resistance protein (BCRP), of which prazosin is a substrate. BCRP is an ATP-binding cassette efflux transporter in the intestines, kidneys, and liver. So far, this interaction has not been reported in humans.
Quetiapine (Seroquel)
Theoretically, concomitant use might increase the effects and adverse effects of quetiapine.
Animal research shows that pretreatment with quercetin can increase plasma levels of quetiapine and prolong its clearance, possibly due to inhibition of cytochrome P450 3A4 (CYP3A4) by quercetin. Additionally, the brain-to-plasma ratio of quetiapine concentrations increased, possibly due to inhibition of P-glycoprotein at the blood-brain barrier. This interaction has not been reported in humans.
Quinolone Antibiotics
Theoretically, concomitant use might inhibit the effects of quinolone antibiotics.
In vitro, quercetin binds to the DNA gyrase site on bacteria, which may interfere with the activity of quinolone antibiotics.
Sulfasalazine (Azulfidine)
Theoretically, quercetin might increase the effects and adverse effects of sulfasalazine.
Animal research shows that quercetin increases the maximum serum concentration (Cmax) and area under the curve (AUC) of sulfasalazine, possibly through inhibition of breast cancer resistance protein (BCRP), of which sulfasalazine is a substrate. So far, this interaction has not been reported in humans.
Warfarin (Coumadin)
Theoretically, quercetin may increase the risk of bleeding if used with warfarin.
Animal and in vitro studies show that quercetin might increase serum levels of warfarin. Quercetin and warfarin have the same human serum albumin (HSA) binding site, and in vitro research shows that quercetin has stronger affinity for the HSA binding site and can theoretically displace warfarin, causing higher serum levels of warfarin. Animal research shows that taking quercetin for 2 weeks before initiating warfarin increases the maximum serum level of warfarin by 30%, the half-life by 10%, and the overall exposure by 63% when compared with control. Concomitant administration of quercetin and warfarin, without quercetin pre-treatment, also increased these measures, but to a lesser degree. Researchers theorize that inhibition of CYP3A4 by quercetin may explain these effects. So far, this interaction has not been reported in humans.
Genistein
Estrogens
Theoretically, concomitant use of large amounts of red clover might interfere with estrogen therapy.
Red clover contains phytoestrogens which might have estrogenic activity in some people. Theoretically, red clover might compete for estrogen receptors and interfere with estrogen-containing drug therapy.
Methotrexate (Trexall, Others)
Theoretically, red clover might increase the risk of methotrexate toxicity.
In a case report, a 52-year-old female receiving weekly methotrexate injections for psoriasis developed symptoms of methotrexate toxicity, including severe vomiting and epigastric pain, after three days of taking red clover 430 mg daily. Toxicity resolved after red clover was discontinued. However, no liver function tests or methotrexate levels were reported.
Tamoxifen (Nolvadex)
Theoretically, the phytoestrogens in red clover might interfere with tamoxifen.
In vitro and animal research suggests that genistein, a constituent of red clover, might antagonize the antitumor effects of tamoxifen. However, there is some evidence from an animal study that red clover does not reduce the efficacy of tamoxifen. Until more is known, tell patients taking tamoxifen to avoid red clover.
Anticoagulant/Antiplatelet Drugs
Although some laboratory research suggests that red clover may have anticoagulant and antiplatelet activity, clinical research has not shown this effect.
In vitro research suggests that genistein in red clover has antiplatelet effects, and historically, red clover was thought to have anticoagulant effects due to its coumarin content. However, some experts state that this is unlikely as most natural coumarins have not been shown to have anticoagulant effects, and their content in red clover is low. Additionally, some clinical research in postmenopausal patients found no effect on coagulation or prothrombin time with the use of red clover flowering tops 378 mg daily for 12 months or red clover isoflavone (Rimostil) 50 mg daily for 2 years.
Caffeine
Theoretically, soy might reduce the clearance of caffeine; however, a small clinical study found no effect.
Red clover contains genistein. Taking genistein 1 gram daily for 14 days seems to inhibit caffeine clearance and metabolism in healthy females. However, this effect does not seem to occur with the lower amounts of genistein found in red clover. A clinical study in healthy postmenopausal individuals shows that taking red clover capsules standardized to contain 60 mg isoflavones twice daily for 14 days does not affect the pharmacokinetics of caffeine.
Cytochrome P450 1A2 (Cyp1A2) Substrates
Theoretically, red clover might increase levels of drugs metabolized by CYP1A2; however, a small clinical study found no effect.
In vitro evidence shows that red clover inhibits CYP1A2. However, a clinical study in healthy postmenopausal individuals shows that taking red clover capsules standardized to contain 60 mg isoflavones twice daily for 14 days does not affect the pharmacokinetics of caffeine, a CYP1A2 probe substrate.
Cytochrome P450 2C19 (Cyp2C19) Substrates
Theoretically, red clover might increase the levels and clinical effects of drugs metabolized by CYP2C19.
In vitro evidence suggests that red clover weakly inhibits CYP2C19. This interaction has not been reported in humans.
Cytochrome P450 2C9 (Cyp2C9) Substrates
Theoretically, red clover might increase levels of drugs metabolized by CYP2C9; however, a small clinical study found no effect.
In vitro evidence suggests that red clover might inhibit CYP2C9. However, a clinical study in healthy postmenopausal individuals shows that taking red clover capsules standardized to contain 60 mg isoflavones twice daily for 14 days does not affect the pharmacokinetics of tolbutamide, a CYP2C9 probe substrate.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, red clover might increase levels of drugs metabolized by CYP3A4; however, a small clinical study found no effect.
In vitro evidence shows that red clover might inhibit CYP3A4 isoenzymes. However, a clinical study in healthy postmenopausal individuals shows that taking red clover capsules standardized to contain 60 mg isoflavones twice daily for 14 days does not affect the pharmacokinetics of alprazolam, a CYP3A4 probe substrate.
Dandelion
Anticoagulant/Antiplatelet Drugs
Theoretically, taking dandelion root along with anticoagulant or antiplatelet drugs might increase the risk of bruising and bleeding.
In vitro research suggests that dandelion root inhibits platelet aggregation.
Antidiabetes Drugs
Theoretically, dandelion might increase the risk for hypoglycemia when used with antidiabetes drugs.
Laboratory research suggests that dandelion extract may have moderate alpha-glucosidase inhibitor activity and might also increase insulin secretion. Also, in a case report, a 58-year-old woman with type 2 diabetes who was being treated with insulin developed hypoglycemia 2 weeks after beginning to eat salads containing dandelion.
Cytochrome P450 1A2 (Cyp1A2) Substrates
Theoretically, dandelion might increase levels of drugs metabolized by CYP1A2.
Laboratory research suggests that dandelion might inhibit CYP1A2. So far, this interaction has not been reported in humans. However, until more is known, watch for an increase in the levels of drugs metabolized by CYP1A2 in patients taking dandelion.
Glucuronidated Drugs
Theoretically, dandelion might increase the clearance of drugs that are UDP-glucuronosyltransferase substrates.
There is some preliminary evidence that dandelion might induce UDP-glucuronosyltransferase, a phase II enzyme.
Lithium
Theoretically, through diuretic effects, dandelion might reduce excretion and increase levels of lithium.
Animal research suggests that dandelion has diuretic properties. As diuretics can increase serum lithium levels, the dose of lithium might need to be decreased when taken with dandelion.
Potassium-Sparing Diuretics
Theoretically, dandelion might increase the risk of hyperkalemia when taken with potassium-sparing diuretics.
Dandelion contains significant amounts of potassium.
Quinolone Antibiotics
Theoretically, dandelion might lower fluoroquinolone levels.
Animal research shows that dandelion reduces absorption of ciprofloxacin and can lower levels by 73%. However, this effect has not been reported in humans.
Fenugreek
Anticoagulant/Antiplatelet Drugs
Theoretically, fenugreek might have additive effects when used with anticoagulant or antiplatelet drugs.
Some of the constituents in fenugreek have antiplatelet effects in animal and in vitro research. However, common fenugreek products might not contain sufficient concentrations of these constituents for clinical effects. A clinical study in patients with coronary artery disease or diabetes shows that taking fenugreek seed powder 2.5 grams twice daily for 3 months does not affect platelet aggregation, fibrinolytic activity, or fibrinogen levels .
Antidiabetes Drugs
Theoretically, fenugreek seed might have additive hypoglycemic effects when used with antidiabetes drugs.
Clinical research shows that fenugreek seed can reduce fasting blood glucose and 2-hour postprandial glucose levels in adults with type 2 diabetes.
Clopidogrel (Plavix)
Theoretically, fenugreek seed might alter the clinical effects of clopidogrel by inhibiting its conversion to the active form.
Animal research shows that fenugreek seed 200 mg/kg daily for 14 days increases the maximum serum concentration of clopidogrel by 21%. It is unclear how this affects the pharmacokinetics of the active metabolite of clopidogrel; however, this study found that concomitant use of fenugreek seed and clopidogrel prolonged bleeding time by an additional 11%.
Metoprolol (Toprol)
Theoretically, fenugreek seed might have additive hypotensive effects when used with metoprolol.
Animal research shows that fenugreek seed 300 mg/kg daily for 2 weeks decreases systolic and diastolic blood pressure by 9% and 11%, respectively, when administered alone, and by 15% and 22%, respectively, when given with metoprolol 10 mg/kg.
Phenytoin (Dilantin)
Theoretically, fenugreek might decrease plasma levels of phenytoin.
Animal research shows that taking fenugreek seeds for 1 week decreases maximum concentrations and the area under the curve of a single dose of phenytoin by 44% and 72%, respectively. This seems to be related to increased clearance. So far, this interaction has not been reported in humans.
Sildenafil (Viagra)
Theoretically, concurrent use of sildenafil and fenugreek might reduce levels and therapeutic effects of sildenafil.
Animal research shows that taking fenugreek seeds for 1 week reduces maximum concentrations and the area under the curve of a single dose of sildenafil by 27% and 48%, respectively. So far, this interaction has not been reported in humans.
Theophylline
Theoretically, fenugreek may reduce the levels and clinical effects of theophylline.
Animal research shows that fenugreek 50 grams daily for 7 days reduces the maximum serum concentration (Cmax) of theophylline by 28% and the area under the plasma drug concentration-time curve (AUC) by 22%.
Warfarin (Coumadin)
Theoretically, fenugreek might have additive effects with warfarin and increase the international normalized ratio (INR).
Some fenugreek constituents have antiplatelet effects, although these might not be present in concentrations that are clinically significant. In one case report, a patient taking warfarin experienced an increased INR when starting to take fenugreek in combination with boldo.
Antihypertensive Drugs
Fenugreek may also have an additive effect on blood pressure-lowering medications. Studies on animals have shown that fenugreek seed can decrease both systolic and diastolic blood pressure by up to 22% when combined with metoprolol. Therefore, it is essential to monitor your blood pressure regularly if you are taking fenugreek and metoprolol together or any other antihypertensive drugs.
Rose Hips
Alkylating Agents
Theoretically, the antioxidant effects of rose hip might reduce the effectiveness of alkylating agents but might also reduce the oxidative damage caused by certain alkylating agents.
Rose hip contains vitamin C. The use of antioxidants like vitamin C during chemotherapy is controversial. There is concern that antioxidants could reduce the activity of chemotherapy drugs that generate free radicals, such as cyclophosphamide, chlorambucil, carmustine, busulfan, and thiotepa. In contrast, some researchers theorize that antioxidants might make chemotherapy more effective by reducing oxidative stress that could interfere with apoptosis (cell death) of cancer cells. Further, some animal research suggests that the antioxidant effects of rose hip might attenuate cyclophosphamide-induced testicular toxicity. More evidence is needed to determine what effect, if any, antioxidants found in rose hip, such as vitamin C, have on the effectiveness and adverse effects of chemotherapy.
Aluminum
Theoretically, rose hip might increase the amount of aluminum absorbed from aluminum compounds.
Rose hip contains vitamin C. Theoretically, vitamin C increases the absorption of aluminum. Concomitant use might increase aluminum absorption, but the clinical significance of this is unknown. Administer rose hip two hours before or four hours after antacids.
Anticoagulant/Antiplatelet Drugs
Theoretically, rose hip might reduce the effectiveness of anticoagulant or antiplatelet drugs.
In vitro and animal research suggests that a constituent of rose hip, rugosin E, can induce platelet aggregation. This has not been shown in humans. Theoretically, concomitant use of rose hip might reduce the effectiveness of antiplatelet or anticoagulant drugs.
Antitumor Antibiotics
Theoretically, the antioxidant effects of rose hip might reduce the effectiveness of antitumor antibiotics.
Rose hip contains the antioxidant vitamin C. There is concern that antioxidants might reduce the activity of chemotherapy drugs that generate free radicals, such as antitumor antibiotics. In contrast, other researchers theorize that antioxidants might make antitumor antibiotic chemotherapy more effective by reducing oxidative stress that could interfere with apoptosis (cell death) of cancer cells. More evidence is needed to determine what effects, if any, antioxidants such as vitamin C have on antitumor antibiotic chemotherapy.
Estrogens
Theoretically, rose hip might increase blood levels of estrogens.
Rose hip contains vitamin C. Increases in plasma estrogen levels of up to 55% have occured under some circumstances when vitamin C is taken concurrently with oral contraceptives or hormone replacement therapy, including topical products. It is suggested that vitamin C prevents oxidation of estrogen in the tissues, regenerates oxidized estrogen, and reduces sulfate conjugation of estrogen in the gut wall. When tissue levels of vitamin C are high, these processes are already maximized and supplemental vitamin C does not have any effect on estrogen levels. However, increases in plasma estrogen levels may occur when women who are deficient in vitamin C take supplements.
Lithium
Theoretically, rose hip might increase blood levels of lithium.
Rose hip is thought to have diuretic properties. Theoretically, due to these potential diuretic effects, rose hip might reduce excretion and increase levels of lithium. The dose of lithium might need to be decreased.
Aspirin
Theoretically, rose hip might reduce the clearance of aspirin; however, its vitamin C content is likely too low to produce clinically significant effects.
Rose hip contains vitamin C. It has been suggested that acidification of the urine by vitamin C can decrease the urinary excretion of salicylates, increasing plasma salicylate levels. However, short-term use of up to 6 grams daily of vitamin C does not seem to affect urinary pH or salicylate excretion. The vitamin C content of rose hip is typically about 500 mg per 100 grams. Thus, a clinically significant interaction between rose hip and aspirin is unlikely.
Warfarin (Coumadin)
Theoretically, rose hip might reduce the effectiveness of warfarin; however, its vitamin C content is likely too low to produce clinically significant effects.
Rose hip contains vitamin C. High doses of vitamin C may reduce the response to warfarin, possibly by causing diarrhea and reducing warfarin absorption. This occurred in two people who took up to 16 grams daily of vitamin C, and resulted in decreased prothrombin time. Lower doses of 5-10 grams daily of vitamin C can also reduce warfarin absorption, but this does not seem to be clinically significant. The vitamin C content of rose hip is typically about 500 mg per 100 grams. Thus, a clinically significant interaction between rose hip and warfarin is unlikely.
Saw Palmetto
Anticoagulant/Antiplatelet Drugs
Saw palmetto might increase the risk of bleeding with anticoagulant or antiplatelet drugs.
Saw palmetto is reported to prolong bleeding time. Theoretically, it might increase the risk of bleeding when used concomitantly with anticoagulant or antiplatelet drugs.
Contraceptive Drugs
Saw palmetto might reduce the effectiveness of contraceptive drugs.
Saw palmetto might have antiestrogenic effects. Theoretically, it might interfere with contraceptive drugs taken concomitantly.
Estrogens
Saw palmetto might reduce the effectiveness of estrogens.
Saw palmetto might have antiestrogenic effects. Theoretically, it might interfere with estrogens taken concomitantly.
Calcium
Ceftriaxone (Rocephin)
Co-administration of intravenous calcium and ceftriaxone can result in precipitation of a ceftriaxone-calcium salt in the lungs and kidneys.
Avoid administering intravenous calcium in any form, such as parenteral nutrition or Lactated Ringers, within 48 hours of intravenous ceftriaxone. Case reports in neonates show that administering intravenous ceftriaxone and calcium can result in precipitation of a ceftriaxone-calcium salt in the lungs and kidneys. In several cases, neonates have died as a result of this interaction. So far there are no reports in adults; however, there is still concern that this interaction might occur in adults.
Dolutegravir (Tivicay)
Calcium seems to reduce levels of dolutegravir.
Advise patients to take dolutegravir either 2 hours before or 6 hours after taking calcium supplements. Pharmacokinetic research suggests that taking calcium carbonate 1200 mg concomitantly with dolutegravir 50 mg reduces plasma levels of dolutegravir by almost 40%. Calcium appears to decrease levels of dolutegravir through chelation.
Elvitegravir (Vitekta)
Calcium seems to reduce levels of elvitegravir.
Advise patients to take elvitegravir either 2 hours before or 2 hours after taking calcium supplements. Pharmacokinetic research suggests that taking calcium along with elvitegravir can reduce blood levels of elvitegravir through chelation.
Aluminum
Calcium citrate might increase aluminum absorption and toxicity. Other types of calcium do not increase aluminum absorption.
Calcium citrate can increase the absorption of aluminum when taken with aluminum hydroxide. The increase in aluminum levels may become toxic, particularly in individuals with kidney disease. However, the effect of calcium citrate on aluminum absorption is due to the citrate anion rather than calcium cation. Calcium acetate does not appear to increase aluminum absorption.
Bictegravir/Emtricitabine/Tenofovir Alafenamide (Biktarvy)
Calcium might decrease levels of bictegravir/emtricitabine/tenofovir alafenamide by reducing its absorption when taken in a fasting state.
Advise patients that bictegravir/emtricitabine/tenofovir alafenamide and calcium can be taken together if taken with food. However, if taken on an empty stomach, bictegravir/emtricitabine/tenofovir alafenamide should not be taken with, or 2 hours after, calcium containing products.
Bisphosphonates
Calcium reduces the absorption of bisphosphonates.
Advise patients to take bisphosphonates at least 30 minutes before calcium, but preferably at a different time of day. Calcium supplements decrease absorption of bisphosphonates.
Calcipotriene (Dovonex)
Taking calcipotriene with calcium might increase the risk for hypercalcemia.
Calcipotriene is a vitamin D analog used topically for psoriasis. It can be absorbed in sufficient amounts to cause systemic effects, including hypercalcemia. Theoretically, combining calcipotriene with calcium supplements might increase the risk of hypercalcemia.
Digoxin (Lanoxin)
Using intravenous calcium with digoxin might increase the risk of fatal cardiac arrhythmias.
Hypercalcemia increases the risk of fatal cardiac arrhythmias with digoxin. However, one retrospective analysis of clinical data suggests that intravenous calcium does not increase the risk of dysrhythmias or mortality in patients receiving digoxin.
Diltiazem (Cardizem, Others)
Theoretically, calcium may reduce the therapeutic effects of diltiazem.
Hypercalcemia can reduce the effectiveness of verapamil in atrial fibrillation. Theoretically, calcium might increase this risk of hypercalcemia and reduce the effectiveness of diltiazem.
Levothyroxine (Synthroid, Others)
Calcium seems to reduce the absorption and effectiveness of levothyroxine.
Advise patients to take levothyroxine and calcium supplements at least 4 hours apart. Calcium reduces levothyroxine absorption, probably by forming insoluble complexes. Calcium carbonate supplements reduce effectiveness of levothyroxine in patients with hypothyroidism.
Lithium
Theoretically, concomitant use of calcium and lithium may increase this risk of hypercalcemia.
Clinical research suggests that long-term use of lithium may cause hypercalcemia in 10% to 60% of patients. Theoretically, concomitant use of lithium and calcium supplements may further increase this risk.
Quinolone Antibiotics
Calcium seems to reduce the absorption of quinolone antibiotics.
Advise patients to take oral quinolones at least 2 hours before or 4-6 hours after calcium supplements or calcium-fortified foods. Taking calcium at the same time as oral quinolones can reduce quinolone absorption. Calcium binds to quinolones in the gut.
Raltegravir (Isentress)
Calcium may reduce levels of raltegravir.
Pharmacokinetic research shows that taking a single dose of calcium carbonate 3000 mg along with raltegravir 400 mg twice daily modestly decreases the mean area under the curve of raltegravir, but the decrease does not necessitate a dose adjustment of raltegravir. However, a case of elevated HIV-1 RNA levels and documented resistance to raltegravir has been reported for a patient taking calcium carbonate 1 gram three times daily plus vitamin D3 (cholecalciferol) 400 IU three times daily in combination with raltegravir 400 mg twice daily for 11 months. It is thought that calcium reduced raltegravir levels by chelation, leading to treatment failure.
Sotalol (Betapace)
Calcium seems to reduce the absorption of sotalol.
Advise patients to separate doses by at least 2 hours before or 4-6 hours after calcium. Calcium appears to reduce the absorption of sotalol, probably by forming insoluble complexes.
Tetracycline Antibiotics
Calcium seems to reduce the absorption of tetracycline antibiotics.
Advise patients to take oral tetracyclines at least 2 hours before, or 4-6 hours after calcium supplements. Taking calcium at the same time as oral tetracyclines can reduce tetracycline absorption. Calcium binds to tetracyclines in the gut.
Thiazide Diuretics
Taking calcium along with thiazides might increase the risk of hypercalcemia and renal failure.
Thiazides reduce calcium excretion by the kidneys. Using thiazides along with moderately large amounts of calcium carbonate increases the risk of milk-alkali syndrome (hypercalcemia, metabolic alkalosis, renal failure). Patients may need to have their serum calcium levels and/or parathyroid function monitored regularly.
Verapamil (Calan, Others)
Theoretically, calcium may reduce the therapeutic effects of verapamil.
Hypercalcemia can reduce the effectiveness of verapamil in atrial fibrillation. Theoretically, use of calcium supplements may increase this risk of hypercalcemia and reduce the effectiveness of verapamil.
Calcium Channel Blockers
Intravenous calcium may decrease the effects of calcium channel blockers; oral calcium is unlikely to have this effect.
Intravenous calcium is used to decrease the effects of calcium channel blockers in the management of overdose. Intravenous calcium gluconate has been used before intravenous verapamil (Isoptin) to prevent or reduce the hypotensive effects without affecting the antiarrhythmic effects. But there is no evidence that dietary or supplemental calcium when taken orally interacts with calcium channel blockers.
Dong Quai
Warfarin (Coumadin)
Dong quai may increase the risk of bleeding when used with warfarin.
Case reports suggest that concomitant use of dong quai with warfarin can increase the anticoagulant effects of warfarin and increase the risk of bleeding. In one case, after 4 weeks of taking dong quai 565 mg once or twice daily, the international normalized ratio (INR) increased to 4.9. The INR normalized 4 weeks after discontinuation of dong quai.
Anticoagulant/Antiplatelet Drugs
Theoretically, dong quai may increase the risk of bleeding when used with anticoagulant or antiplatelet drugs; however, research is conflicting.
Animal studies suggest that dong quai has antithrombin activity and inhibits platelet aggregation due to its coumarin components. Additionally, some case reports in humans suggest that dong quai can increase the anticoagulant effects of warfarin. However, clinical research in healthy adults shows that taking 1 gram of dong quai root daily for 3 weeks does not significantly inhibit platelet aggregation or cause bleeding. Until more is known, use dong quai with caution in patients taking antiplatelet/anticoagulant drugs.
Estrogens
Theoretically, dong quai may reduce the effects of estrogens.
Dong quai has estrogenic effects. Theoretically, concomitant use of large amounts of dong quai might interfere with hormone replacement therapy due to competition for estrogen receptors.
Mexican Wild Yam
Estrogens
Theoretically, wild yam might increase or decrease the effects of estrogen.
Wild yam root shows estrogenic and anti-estrogenic effects in vitro. Theoretically, wild yam might interfere with hormone therapy.
L-Tyrosine
Levodopa
Theoretically, tyrosine might decrease the effectiveness of levodopa.
Tyrosine and levodopa compete for absorption in the proximal duodenum by the large neutral amino acid (LNAA) transport system. Advise patients to separate doses of tyrosine and levodopa by at least 2 hours.
Thyroid Hormone
Theoretically, tyrosine might have additive effects with thyroid hormone medications.
Tyrosine is a precursor to thyroxine and might increase levels of thyroid hormones.
Watercress
Chlorzoxazone (Parafon Forte, Paraflex)
Watercress might reduce the metabolism of chlorzoxazone and increase its effects and side effects. Clinical research in healthy volunteers shows that a single ingestion of watercress 50 grams increases the chlorzoxazone plasma concentration-time curve by about 56% and increases its half-life by about 53%.
Lithium
Watercress is thought to have diuretic properties. Theoretically, due to these potential diuretic effects, watercress might reduce excretion and increase levels of lithium.
Warfarin (Coumadin)
Watercress contains vitamin K. Consuming large amounts of watercress might antagonize the anticoagulant effects of warfarin.
Brand information
Manufacturer and brand details for BBB Enhancement Formula, from the product label.
BBB Formula
See all BBB Formula products- Name
- BBB Formula
- Street Address
- P.O. Box 262389
- City
- Houston
- State
- TX
- ZipCode
- 77207
BBB Enhancement Formula by BBB Formula: Common Questions
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Where does this information come from?
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.
The Full Monographs Behind BBB Enhancement Formula’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Calcium
Interacts with 168 drugsCalcium is an essential mineral your body needs for strong bones, nerve signaling, and muscle function, and supplements can help fill gaps when diet falls short. Most people do best getting...
Read the full Calcium monograph → Herb & supplement monographTyrosine
Interacts with 21 drugsL-tyrosine is an amino acid your body uses to make brain chemicals like dopamine and norepinephrine. Some studies suggest it may help mental performance during short-term stress, sleep loss,...
Read the full Tyrosine monograph → Herb & supplement monographQuercetin
Interacts with 1,169 drugsQuercetin is a plant flavonoid with antioxidant and anti-inflammatory properties found in many common foods and sold as a supplement. While early research is interesting for allergies, blood...
Read the full Quercetin monograph → Herb & supplement monographDandelion
Interacts with 457 drugsDandelion is a common plant used in food and traditional medicine, often promoted as a natural 'water pill' and digestive aid. Human evidence for these uses is very limited, so its benefits...
Read the full Dandelion monograph → Herb & supplement monographRose Hip
Interacts with 213 drugsRose hip is the vitamin C–rich fruit of the wild rose, used traditionally for colds and joint pain. A standardized rose hip powder has some research support for easing osteoarthritis symptom...
Read the full Rose Hip monograph → Herb & supplement monographWatercress
Interacts with 6 drugsWatercress is a nutrient-rich leafy green that provides vitamins A, C, and K plus minerals and antioxidant plant compounds. Eaten as a food it is generally safe and healthy for most people,...
Read the full Watercress monograph → Herb & supplement monographMaca
Maca is a nutrient-rich Andean root often used for energy, libido, and menopause symptoms. Early studies suggest it may modestly help sexual desire and some menopause symptoms, but the evide...
Read the full Maca monograph → Herb & supplement monographDong Quai
Interacts with 163 drugsDong Quai is a traditional Chinese herb often called "female ginseng" and is mostly used for menstrual and menopausal complaints. High-quality scientific evidence that it works for these use...
Read the full Dong Quai monograph → Herb & supplement monographSaw Palmetto
Interacts with 174 drugsSaw palmetto is a plant extract most often used for urinary symptoms linked to an enlarged prostate (BPH). The best research suggests it works no better than a placebo for most men, though i...
Read the full Saw Palmetto monograph → Herb & supplement monographFenugreek
Interacts with 389 drugsFenugreek is a common kitchen spice that is also taken as a supplement, mainly for blood sugar, cholesterol, and to support breast milk production. Some early research is encouraging for blo...
Read the full Fenugreek monograph → Herb & supplement monographWild Yam
Interacts with 41 drugsWild yam is a root traditionally used for menopausal symptoms, cramps, and as a so-called 'natural' hormone supplement, but solid human evidence for these uses is lacking. Despite popular cl...
Read the full Wild Yam monograph → Herb & supplement monographRed Clover
Interacts with 867 drugsRed clover is a plant rich in isoflavones (plant compounds with weak estrogen-like activity) that is most often used for menopause symptoms like hot flashes. The evidence is mixed and genera...
Read the full Red Clover monograph →Sources & How We Checked
BBB Enhancement Formula's label data comes from the NIH Dietary Supplement Label Database; the ingredient interaction data is from the Natural Medicines database, reviewed by our pharmacists.
- NIH Dietary Supplement Label Database (DSLD) — The official product label on file for this supplement.
- Natural Medicines (Therapeutic Research Center) — Evidence-graded clinical reference behind the ingredient interaction data.
Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.
The 280 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.
Calcium 62 references
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- Thys-Jacobs S, Ceccarelli S, Bierman A, et al. Calcium supplementation in premenstrual syndrome: a randomized crossover trial. J Gen Intern Med 1989;4:183-9. PubMed
- Maton PN, Burton ME. Antacids revisited: a review of their clinical pharmacology and recommended therapeutic use. Drugs 1999;57:855-70.
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- Dietary reference intakes for calcium and vitamin D. Institute of Medicine, November 30, 2010. Available at: http://www.iom.edu/~/media/Files/Report%20Files/2010/Dietary-Reference-Intakes-for-Calcium-and-Vitamin-D/Vitamin%20D%20and%20Calcium%202010%20Repo
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- Dickinson, H. O., Nicolson, D. J., Cook, J. V., Campbell, F., Beyer, F. R., Ford, G. A., and Mason, J. Calcium supplementation for the management of primary hypertension in adults. Cochrane.Database.Syst.Rev. 2006;(2):CD004639. PubMed
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- Li K, Kaaks R, Linseisen J, Rohrmann S. Associations of dietary calcium intake and calcium supplementation with myocardial infarction and stroke risk and overall cardiovascular mortality in the Heidelberg cohort of the European Prospective Investigation i
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- Roberts JL, Kiser JJ, Hindman JT, Meditz AL. Virologic failure with a raltegravir-containing antiretroviral regimen and concomitant calcium administration. Pharmacotherapy 2011;31(10):298e-302e. DOI
- Vitekta [package insert]. Foster City, CA: Gilead Sciences, Inc.; 2014.
- Storan ER, O'Gorman SM, Murphy A, Laing M. Case Report of Calciphylaxis Secondary to Calcium and Vitamin D<sub>3</sub> Supplementation. J Cutan Med Surg. 2017;21(2):162-163. DOI
- Jenkins DJA, Spence JD, Giovannucci EL, et al. Supplemental vitamins and minerals for CVD prevention and treatment. J Am Coll Cardiol 2018;71(22):2570-84. PubMed
- Borkenhagen JF, Connor EL, Stafstrom CE. Neonatal hypocalcemic seizures due to excessive maternal calcium ingestion. Pediatr Neurol 2013;48(6):469-71. PubMed
- WHO recommendations on antenatal care for a positive pregnancy experience. Geneva: World Health Organization; 2016 (http://www.who.int/reproductivehealth/publications/maternal_perinatal_health/ anc-positive-pregnancy-experience/en/).
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