Bio-Candea Ingredients & Drug Interactions
by Bio-Kult
What is this page for?
First and foremost: checking Bio-Candea 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
Bio-Candea is a dietary supplement by Bio-Kult with 9 active ingredients. Its ingredients are commonly taken for high blood pressure, high cholesterol, heart health.Based on those ingredients, 1,358 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are Grapefruit extract, Garlic powder, Lactobacillus acidophilus PXN 35. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against Bio-Candea by Bio-Kult
Ask about any prescription or over-the-counter medication and we check it for interactions with Bio-Candea by Bio-Kult — 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 Bio-Candea by Bio-Kult
Our pharmacy team’s full take, with four database checks built into the cards below — a summary of what is known, not a grade of the product itself.
What’s inside
Low disclosure
Bio-Candea contains 9 ingredients, including three active ones: garlic powder, grapefruit extract, and a proprietary probiotic blend. The probiotic blend includes live organisms—Lactobacillus casei, Lactobacillus rhamnosus, Lactobacillus acidophilus, Lactobacillus delbrueckii, Streptococcus thermophilus, Bifidobacterium breve, and Bifidobacterium longum—intended to support your gut flora.
The inactive ingredients are cellulose and a vegetable capsule.
Does it work?
Moderate evidence
Garlic powder has shown possibly effective evidence for diabetes, hypertension, periodontitis, atherosclerosis, and nonalcoholic fatty liver disease. Grapefruit extract shows insufficient evidence for the conditions studied—acne, asthma, atherosclerosis, headache, upper respiratory infection, and depression.
For the individual probiotic strains: Lactobacillus acidophilus is possibly effective for irritable bowel syndrome, antibiotic-associated diarrhea, Helicobacter pylori, and bacterial vaginosis; the others lack sufficient evidence for their listed indications or show insufficient or ineffective ratings.
How safe is it?
Well-documented data
Garlic powder is generally well tolerated when used as food, though supplements may cause stomach upset, increase bleeding risk, and produce side effects like abdominal pain, body odor, flatulence, bad breath, and nausea in some people. Grapefruit is generally well tolerated as fruit, but concentrated supplements carry more risk.
Rare serious concerns include increased breast cancer risk with high consumption and arrhythmias in large amounts. The probiotic strains are generally well tolerated in healthy people, though they contain live organisms and carry rare theoretical risk of infection in severely ill or immunocompromised patients.
Probiotics may cause bloating, flatulence, and abdominal discomfort in some people.
Meds to double-check
Major interaction found
Before taking Bio-Candea, check your exact medications against these interactions: blood thinners and antiplatelet drugs like warfarin (Major risk from grapefruit, Moderate from garlic); heart rhythm drugs like amiodarone (Major from grapefruit); immunosuppressants like cyclosporine and tacrolimus (Major from grapefruit, Moderate from garlic); blood pressure drugs (Moderate from garlic); diabetes medications (Moderate from garlic); and antibiotics (Moderate from four probiotic strains). Use the medication checker on this page with your full medication list.
The bottom line
Scorecard at a glanceFormula with limited ingredient disclosure with some supporting evidence behind its ingredients' uses. Major medication interactions have been identified, and safety information is well characterized.
This product combines garlic, grapefruit, and probiotics—all with strong medication interactions, especially with blood thinners, diabetes drugs, heart medications, and antibiotics. If you take any prescription medications or have a bleeding disorder, check with your pharmacist before starting.
Healthy people taking no medications may tolerate it, but the data on probiotics is mixed.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 7 of 9 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Apr 25, 2017.
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 Bio-Candea, straight from the product label.
| Brand | Bio-Kult |
|---|---|
| Barcode (UPC) | 5027314502704 |
| Net contents | 60 Capsule(s) |
| Market status | On market |
| Date entered into DSLD | Apr 25, 2017 |
| DSLD ID | 72577 |
| Product type | Other Combinations |
| Supplement form | Capsule |
| Dietary claims / uses | All Other, Structure/Function |
| Intended target group(s) | Vegetarian, Adult (18 - 50 Years), Children (All), Gluten Free |
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 Bio-Candea by Bio-Kult, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Garlic powder | 120 mg | -- |
| Grapefruit extract | 260 mg | -- |
| Bio-Kult Candea | 83.2 mg | -- |
| Lactobacillus casei PXN 37 | 0 NP | -- |
| Lactobacillus rhamnosus PXN 54 | 0 NP | -- |
| Lactobacillus acidophilus PXN 35 | 0 NP | -- |
| Lactobacillus delbrueckii ssp. bulgaricus PXN 39 | 0 NP | -- |
| Streptococcus thermophilus PXN 66 | 0 NP | -- |
| Bifidobacterium breve PXN 25 | 0 NP | -- |
| Bifidobacterium longum PXN 30 | 0 NP | -- |
Other ingredients: Cellulose, Vegetable Capsule
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.
Seals/Symbols
Garlic & grapefruit
V Vegetarian Society Approved
Gluten free
Made in UK
Formulation
V Vegetarian Society Approved
Gluten free
Bio-Kult Candea is a non-GMO product.
No artificial colors, flavors or preservatives.
Suggested/Recommended/Usage/Directions
Bio-Kult Candea capsules can be pulled apart and the contents sprinkled onto food, mixed with a drink or swallowed whole.
Directions For Use: 2 capsules daily with the main meal Children Over 12: 1 capsule daily with the main meal. Children Under 12: As recommended by your doctor or healthcare practitioner.
Precautions
Dietary supplements should not be used as a substitute for a varied diet and a healthy lifestyle.
Keep out of reach of children.
Contains milk and soy.
Pregnancy: Bio-Kult Candea is suitable for use during pregnancy, but we would always suggest consulting your doctor or healthcare practitioner before taking any dietary supplement.
Caution: Grapefruit is contraindicated with the intake of statins: Please seek medical advice if you are taking statins, before taking Bio-Kult Candea. Do not exceed recommended daily intake.
Allergen advice: Bio-Kult Candea contains traces of milk and soy as these are used in the growth media of the strains.
Storage
Store in a cool dry place – out of direct sunlight.
General Statements
For best before end see base.
Advanced probiotic multi-strain formula
60 x 400 mg
Any questions? We are here to help.
What is a probiotic? Probiotics are live, beneficial microorganisms that can positively affect your digestive and immune systems by maintaining the balance of good bacteria throughout your digestive tract.
Strength: Probiotics 1 billion CFU/capsule (1 x 109 CFU/ capsule). Concentration of 1 billion probiotic microorganisms per capsule is guaranteed throughout the shelf life.
Bio-Kult, PXN and Protexin are registered trademarks of Probiotics International Limited (Protexin). All rights reserved.
Actual size of capsule
Bio-Kult Candea 60 capsules dietary supplement
Or as recommended by your doctor or healthcare practitioner.
Formula
Contains milk and soy.
Allergen advice: Bio-Kult Candea contains traces of milk and soy as these are used in the growth media of the strains.
Unique triple action formula - multi-strain probiotic, garlic and grapefruit extract. 7 protected probiotic strains - proven to survive the high acidity of stomach acid.
Why Bio-Kult Candéa? Bio-Kult Candea is a scientifically developed, naturally powerful, 7 strain probiotic with garlic and grapefruit extract, that works with your body to help maintain your natural balance of microorganisms. Bio-Kult Candea provides beneficial bacteria to help maintain a healthy microbial balance, as well as garlic and grapefruit extract for their well known naturally powerful properties.
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.
Brand IP Statement(s)
Protexin health care
General
P1 0230-03 219
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Bio-Candea by Bio-Kult 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 Bio-Candea by Bio-Kult
These are the 9 active ingredients this product is made of. Select any to open its full monograph.
Serving size2 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.
Garlic powder
Interacts with989 drugs
Garlic is a common food and supplement that may modestly help with blood pressure and cholesterol, though the evidence is mixed and effects are usuall...
Garlic powder monograph & interactionsGrapefruit extract
Interacts with990 drugs
Grapefruit is a nutritious citrus fruit rich in vitamin C and other nutrients, and it is generally safe to eat. However, grapefruit is famous for seri...
Grapefruit extract monograph & interactionsBio-Kult Candea
- › Lactobacillus casei PXN 37
- › Lactobacillus rhamnosus PXN 54
- › Lactobacillus acidophilus PXN 35
- › Lactobacillus delbrueckii ssp. bulgaricus PXN 39
- › Streptococcus thermophilus PXN 66
- › Bifidobacterium breve PXN 25
- › Bifidobacterium longum PXN 30
Other (inactive) ingredients: Cellulose, Vegetable Capsule. These complete the product’s ingredient list but are not active constituents.
Bio-Candea by Bio-Kult Drug Interactions
HelloPharmacist Interaction Report
Bio-Candea by Bio-Kult contains ingredients with documented interactions with medications.
The most serious concern is grapefruit extract, which carries Major-severity interactions with several drugs. Grapefruit can significantly raise blood levels of cyclosporine (Neoral, Sandimmune), scopolamine (Transderm Scop), amiodarone (Cordarone), buspirone (BuSpar), dextromethorphan (Robitussin DM), terfenadine (Seldane), and tacrolimus—potentially increasing their effects and side effects.
It can also lower levels of celiprolol (Celicard) and etoposide (VePesid), reducing how well they work.
Read the full breakdown — every affected drug type, severity by severity
Garlic powder has Moderate-severity interactions with anticoagulants and antiplatelet drugs (including warfarin), which raise bleeding risk; antidiabetes drugs, which may increase low blood sugar (hypoglycemia) risk; antihypertensive drugs, which may lower blood pressure too much; and several others metabolized by your liver (CYP3A4 and CYP2E1 substrates), as well as protease inhibitors and tacrolimus. Lactobacillus acidophilus, Lactobacillus delbrueckii, and Bifidobacterium breve and longum all interact with antibiotic drugs—taking antibiotics at the same time may kill the beneficial bacteria in these products, reducing their effectiveness.
We could not check three other ingredients: Lactobacillus casei PXN 37, Lactobacillus rhamnosus PXN 54, and Streptococcus thermophilus PXN 66 (though Streptococcus thermophilus has been checked with no interactions documented). Altogether, these interactions span 1,343 individual medications.
Use the medication checker below with your exact prescriptions before starting this product.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against Bio-Candea?
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 Bio-Candea interact with 1,358 drugs. Click any drug to see the details.
6 of the 9 ingredients in Bio-Candea interact with drugs. Each result below shows which ingredient is responsible. Grapefruit extract Garlic powder Lactobacillus acidophilus PXN 35 Lactobacillus delbrueckii ssp. bulgaricus PXN 39 Bifidobacterium breve PXN 25 Bifidobacterium longum PXN 30
Ado-trastuzumab EmtansineKadcyla
How Ado-trastuzumab Emtansine interacts with Bio-Candea — through 2 ingredients. Tap an ingredient for the detail:
Grapefruit ExtractCytochrome P450 3a4 (cyp3a4) Substrates Major
Interaction Summary
Grapefruit juice can increase levels of drugs metabolized by CYP3A4.
Read the full Grapefruit Extract + Ado-trastuzumab Emtansine interactionGarlic PowderCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, garlic products containing allicin might induce intestinal CYP3A4 and inhibit hepatic CYP3A4.
Read the full Garlic Powder + Ado-trastuzumab Emtansine interactionAbemaciclibVerzenio
How Abemaciclib interacts with Bio-Candea — through 2 ingredients. Tap an ingredient for the detail:
Grapefruit ExtractCytochrome P450 3a4 (cyp3a4) Substrates Major
Interaction Summary
Grapefruit juice can increase levels of drugs metabolized by CYP3A4.
Read the full Grapefruit Extract + Abemaciclib interactionGarlic PowderCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, garlic products containing allicin might induce intestinal CYP3A4 and inhibit hepatic CYP3A4.
Read the full Garlic Powder + Abemaciclib interactionAbiraterone
How Abiraterone interacts with Bio-Candea — through 2 ingredients. Tap an ingredient for the detail:
Grapefruit ExtractCytochrome P450 3a4 (cyp3a4) Substrates Major
Interaction Summary
Grapefruit juice can increase levels of drugs metabolized by CYP3A4.
Read the full Grapefruit Extract + Abiraterone interactionGarlic PowderCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, garlic products containing allicin might induce intestinal CYP3A4 and inhibit hepatic CYP3A4.
Read the full Garlic Powder + Abiraterone interactionAbiraterone AcetateYonsa, Zytiga
How Abiraterone Acetate interacts with Bio-Candea — through 2 ingredients. Tap an ingredient for the detail:
Grapefruit ExtractCytochrome P450 3a4 (cyp3a4) Substrates Major
Interaction Summary
Grapefruit juice can increase levels of drugs metabolized by CYP3A4.
Read the full Grapefruit Extract + Abiraterone Acetate interactionGarlic PowderCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, garlic products containing allicin might induce intestinal CYP3A4 and inhibit hepatic CYP3A4.
Read the full Garlic Powder + Abiraterone Acetate interactionAcalabrutinibCalquence
How Acalabrutinib interacts with Bio-Candea — through 2 ingredients. Tap an ingredient for the detail:
Grapefruit ExtractCytochrome P450 3a4 (cyp3a4) Substrates, P-glycoprotein Substrates Major
Interaction Summary
Grapefruit juice can increase levels of drugs metabolized by CYP3A4.
Read the full Grapefruit Extract + Acalabrutinib interactionGarlic PowderCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, garlic products containing allicin might induce intestinal CYP3A4 and inhibit hepatic CYP3A4.
Read the full Garlic Powder + Acalabrutinib interactionAcetaminophen, Aspirin, CaffeineExcedrin, Excedrin Extra Strength, Excedrin Migraine
How Acetaminophen, Aspirin, Caffeine interacts with Bio-Candea — through 2 ingredients. Tap an ingredient for the detail:
Grapefruit ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Major
Interaction Summary
Theoretically, grapefruit juice might increase levels of drugs metabolized by CYP1A2.
Read the full Grapefruit Extract + Acetaminophen, Aspirin, Caffeine interactionGarlic PowderCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 2e1 (cyp2e1) Substrates +1 Moderate
Interaction Summary
Theoretically, garlic products containing allicin might induce intestinal CYP3A4 and inhibit hepatic CYP3A4.
Read the full Garlic Powder + Acetaminophen, Aspirin, Caffeine interactionAcetaminophen, Butalbital, CaffeineEsgic, Esgic Plus, Fiogesic, Fioricet, Repan, Tecnal +1 more
How Acetaminophen, Butalbital, Caffeine interacts with Bio-Candea — through 2 ingredients. Tap an ingredient for the detail:
Grapefruit ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Caffeine +1 Major
Interaction Summary
Theoretically, grapefruit juice might increase levels of drugs metabolized by CYP1A2.
Read the full Grapefruit Extract + Acetaminophen, Butalbital, Caffeine interactionGarlic PowderCytochrome P450 2e1 (cyp2e1) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Garlic might increase levels of drugs metabolized by CYP2E1.
Read the full Garlic Powder + Acetaminophen, Butalbital, Caffeine interactionAcetaminophen, Butalbital, Caffeine, CodeineEsgic with Codeine, Fioricet w/ Codeine
How Acetaminophen, Butalbital, Caffeine, Codeine interacts with Bio-Candea — through 2 ingredients. Tap an ingredient for the detail:
Grapefruit ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Caffeine +1 Major
Interaction Summary
Grapefruit juice can increase levels of drugs metabolized by CYP3A4.
Read the full Grapefruit Extract + Acetaminophen, Butalbital, Caffeine, Codeine interactionGarlic PowderCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 2e1 (cyp2e1) Substrates Moderate
Interaction Summary
Theoretically, garlic products containing allicin might induce intestinal CYP3A4 and inhibit hepatic CYP3A4.
Read the full Garlic Powder + Acetaminophen, Butalbital, Caffeine, Codeine interactionAcetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, PhenylephrineHycomine Compound
How Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interacts with Bio-Candea — through 2 ingredients. Tap an ingredient for the detail:
Grapefruit ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Caffeine +1 Major
Interaction Summary
Theoretically, grapefruit juice might increase levels of drugs metabolized by CYP1A2.
Read the full Grapefruit Extract + Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interactionGarlic PowderCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 2e1 (cyp2e1) Substrates Moderate
Interaction Summary
Theoretically, garlic products containing allicin might induce intestinal CYP3A4 and inhibit hepatic CYP3A4.
Read the full Garlic Powder + 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 Bio-Candea — through 2 ingredients. Tap an ingredient for the detail:
Grapefruit ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Caffeine +1 Major
Interaction Summary
Grapefruit juice can increase levels of drugs metabolized by CYP3A4.
Read the full Grapefruit Extract + Acetaminophen, Caffeine, Codeine interactionGarlic PowderCytochrome P450 2e1 (cyp2e1) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Garlic might increase levels of drugs metabolized by CYP2E1.
Read the full Garlic Powder + Acetaminophen, Caffeine, Codeine interactionAcetaminophen, Caffeine, Codeine, SalicylamideCodalan No.1, Codalan No.2, Codalan No.3
How Acetaminophen, Caffeine, Codeine, Salicylamide interacts with Bio-Candea — through 2 ingredients. Tap an ingredient for the detail:
Grapefruit ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Caffeine +1 Major
Interaction Summary
Theoretically, grapefruit juice might increase levels of drugs metabolized by CYP1A2.
Read the full Grapefruit Extract + Acetaminophen, Caffeine, Codeine, Salicylamide interactionGarlic PowderCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 2e1 (cyp2e1) Substrates Moderate
Interaction Summary
Theoretically, garlic products containing allicin might induce intestinal CYP3A4 and inhibit hepatic CYP3A4.
Read the full Garlic Powder + Acetaminophen, Caffeine, Codeine, Salicylamide interactionAcetaminophen, Caffeine, DihydrocodeineDHC Plus, Panlor DC, Panlor SS
How Acetaminophen, Caffeine, Dihydrocodeine interacts with Bio-Candea — through 2 ingredients. Tap an ingredient for the detail:
Grapefruit ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Caffeine +1 Major
Interaction Summary
Grapefruit juice can increase levels of drugs metabolized by CYP3A4.
Read the full Grapefruit Extract + Acetaminophen, Caffeine, Dihydrocodeine interactionGarlic PowderCytochrome P450 2e1 (cyp2e1) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Garlic might increase levels of drugs metabolized by CYP2E1.
Read the full Garlic Powder + Acetaminophen, Caffeine, Dihydrocodeine interactionAcetaminophen, Caffeine, IsomethepteneMigralam
How Acetaminophen, Caffeine, Isometheptene interacts with Bio-Candea — through 2 ingredients. Tap an ingredient for the detail:
Grapefruit ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Caffeine +1 Major
Interaction Summary
Theoretically, grapefruit juice might increase levels of drugs metabolized by CYP1A2.
Read the full Grapefruit Extract + Acetaminophen, Caffeine, Isometheptene interactionGarlic PowderCytochrome P450 2e1 (cyp2e1) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Garlic might increase levels of drugs metabolized by CYP2E1.
Read the full Garlic Powder + Acetaminophen, Caffeine, Isometheptene interactionAcetaminophen, Caffeine, PyrilamineMidol Max Strength Menstrual
How Acetaminophen, Caffeine, Pyrilamine interacts with Bio-Candea — through 2 ingredients. Tap an ingredient for the detail:
Grapefruit ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Caffeine +1 Major
Interaction Summary
Grapefruit juice can increase levels of drugs metabolized by CYP3A4.
Read the full Grapefruit Extract + Acetaminophen, Caffeine, Pyrilamine interactionGarlic PowderCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 2e1 (cyp2e1) Substrates Moderate
Interaction Summary
Theoretically, garlic products containing allicin might induce intestinal CYP3A4 and inhibit hepatic CYP3A4.
Read the full Garlic Powder + Acetaminophen, Caffeine, Pyrilamine interactionAcetaminophen, Chlorpheniramine Maleate, Dextromethorphan HbrVicks Formula 44M Cough, Cold & Flu Relief
How Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interacts with Bio-Candea — through 2 ingredients. Tap an ingredient for the detail:
Grapefruit ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Dextromethorphan (robitussin Dm, Others) +1 Major
Interaction Summary
Theoretically, grapefruit juice might increase levels of drugs metabolized by CYP1A2.
Read the full Grapefruit Extract + Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interactionGarlic PowderCytochrome P450 2e1 (cyp2e1) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Garlic might increase levels of drugs metabolized by CYP2E1.
Read the full Garlic Powder + Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interactionAcetaminophen, Chlorpheniramine, Codeine, PhenylephrineColrex
How Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interacts with Bio-Candea — through 2 ingredients. Tap an ingredient for the detail:
Grapefruit ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Major
Interaction Summary
Grapefruit juice can increase levels of drugs metabolized by CYP3A4.
Read the full Grapefruit Extract + Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interactionGarlic PowderCytochrome P450 2e1 (cyp2e1) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Garlic might increase levels of drugs metabolized by CYP2E1.
Read the full Garlic Powder + Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interactionAcetaminophen, Chlorpheniramine, DextromethorphanCoricidin II Extra Strength Cold and Flu
How Acetaminophen, Chlorpheniramine, Dextromethorphan interacts with Bio-Candea — through 2 ingredients. Tap an ingredient for the detail:
Grapefruit ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Major
Interaction Summary
Theoretically, grapefruit juice might increase levels of drugs metabolized by CYP1A2.
Read the full Grapefruit Extract + Acetaminophen, Chlorpheniramine, Dextromethorphan interactionGarlic PowderCytochrome P450 2e1 (cyp2e1) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Garlic might increase levels of drugs metabolized by CYP2E1.
Read the full Garlic Powder + Acetaminophen, Chlorpheniramine, Dextromethorphan interactionAcetaminophen, Chlorpheniramine, Dextromethorphan HydrobromideCoricidin HBP Maximum Strength Flu
How Acetaminophen, Chlorpheniramine, Dextromethorphan Hydrobromide interacts with Bio-Candea — through 2 ingredients. Tap an ingredient for the detail:
Grapefruit ExtractDextromethorphan (robitussin Dm, Others), Cytochrome P450 3a4 (cyp3a4) Substrates +1 Major
Interaction Summary
Grapefruit juice can increase blood levels of dextromethorphan, potentially increasing the effects and adverse effects of dextromethorphan.
Read the full Grapefruit Extract + Acetaminophen, Chlorpheniramine, Dextromethorphan Hydrobromide interactionGarlic PowderCytochrome P450 2e1 (cyp2e1) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Garlic might increase levels of drugs metabolized by CYP2E1.
Read the full Garlic Powder + Acetaminophen, Chlorpheniramine, Dextromethorphan Hydrobromide interactionAcetaminophen, Chlorpheniramine, Dextromethorphan, PhenylpropanolamineMulti Symptom Cold Relief
How Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylpropanolamine interacts with Bio-Candea — through 2 ingredients. Tap an ingredient for the detail:
Grapefruit ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Dextromethorphan (robitussin Dm, Others) +1 Major
Interaction Summary
Theoretically, grapefruit juice might increase levels of drugs metabolized by CYP1A2.
Read the full Grapefruit Extract + Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylpropanolamine interactionGarlic PowderCytochrome P450 2e1 (cyp2e1) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Garlic might increase levels of drugs metabolized by CYP2E1.
Read the full Garlic Powder + Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylpropanolamine interactionAcetaminophen, Chlorpheniramine, Dextromethorphan, PseudoephedrineChildren's Tylenol Cold Plus Cough, Tylenol Cold Ex Strength
How Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine interacts with Bio-Candea — through 2 ingredients. Tap an ingredient for the detail:
Grapefruit ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Dextromethorphan (robitussin Dm, Others) +1 Major
Interaction Summary
Grapefruit juice can increase levels of drugs metabolized by CYP3A4.
Read the full Grapefruit Extract + Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine interactionGarlic PowderCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 2e1 (cyp2e1) Substrates Moderate
Interaction Summary
Theoretically, garlic products containing allicin might induce intestinal CYP3A4 and inhibit hepatic CYP3A4.
Read the full Garlic Powder + Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine interactionAcetaminophen, Chlorpheniramine, Guaifenesin, Phenylephrine, SalicylamideRhinogesic GG
How Acetaminophen, Chlorpheniramine, Guaifenesin, Phenylephrine, Salicylamide interacts with Bio-Candea — through 2 ingredients. Tap an ingredient for the detail:
Grapefruit ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Major
Interaction Summary
Theoretically, grapefruit juice might increase levels of drugs metabolized by CYP1A2.
Read the full Grapefruit Extract + Acetaminophen, Chlorpheniramine, Guaifenesin, Phenylephrine, Salicylamide interactionGarlic PowderCytochrome P450 2e1 (cyp2e1) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Garlic might increase levels of drugs metabolized by CYP2E1.
Read the full Garlic Powder + Acetaminophen, Chlorpheniramine, Guaifenesin, Phenylephrine, Salicylamide interactionAcetaminophen, Chlorpheniramine, PhenylephrineAlka-Seltzer PLUS, Histex SR, Protid
How Acetaminophen, Chlorpheniramine, Phenylephrine interacts with Bio-Candea — through 2 ingredients. Tap an ingredient for the detail:
Grapefruit ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Major
Interaction Summary
Grapefruit juice can increase levels of drugs metabolized by CYP3A4.
Read the full Grapefruit Extract + Acetaminophen, Chlorpheniramine, Phenylephrine interactionGarlic PowderCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 2e1 (cyp2e1) Substrates Moderate
Interaction Summary
Theoretically, garlic products containing allicin might induce intestinal CYP3A4 and inhibit hepatic CYP3A4.
Read the full Garlic Powder + Acetaminophen, Chlorpheniramine, Phenylephrine interactionAcetaminophen, Chlorpheniramine, Phenylephrine, SalicylamideRhinogesic, Rhinogesic JR
How Acetaminophen, Chlorpheniramine, Phenylephrine, Salicylamide interacts with Bio-Candea — through 2 ingredients. Tap an ingredient for the detail:
Grapefruit ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Major
Interaction Summary
Theoretically, grapefruit juice might increase levels of drugs metabolized by CYP1A2.
Read the full Grapefruit Extract + Acetaminophen, Chlorpheniramine, Phenylephrine, Salicylamide interactionGarlic PowderCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 2e1 (cyp2e1) Substrates Moderate
Interaction Summary
Theoretically, garlic products containing allicin might induce intestinal CYP3A4 and inhibit hepatic CYP3A4.
Read the full Garlic Powder + Acetaminophen, Chlorpheniramine, Phenylephrine, Salicylamide interactionAcetaminophen, Chlorpheniramine, PhenylpropanolamineAlumadrine, Conex, Sinadrin Max Strength, Sinulin
How Acetaminophen, Chlorpheniramine, Phenylpropanolamine interacts with Bio-Candea — through 2 ingredients. Tap an ingredient for the detail:
Grapefruit ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Major
Interaction Summary
Grapefruit juice can increase levels of drugs metabolized by CYP3A4.
Read the full Grapefruit Extract + Acetaminophen, Chlorpheniramine, Phenylpropanolamine interactionGarlic PowderCytochrome P450 2e1 (cyp2e1) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Garlic might increase levels of drugs metabolized by CYP2E1.
Read the full Garlic Powder + Acetaminophen, Chlorpheniramine, Phenylpropanolamine interactionAcetaminophen, Chlorpheniramine, Phenylpropanolamine, OpiumHista-Derfule
How Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium interacts with Bio-Candea — through 2 ingredients. Tap an ingredient for the detail:
Grapefruit ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Major
Interaction Summary
Theoretically, grapefruit juice might increase levels of drugs metabolized by CYP1A2.
Read the full Grapefruit Extract + Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium interactionGarlic PowderCytochrome P450 2e1 (cyp2e1) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Garlic might increase levels of drugs metabolized by CYP2E1.
Read the full Garlic Powder + Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium interactionAcetaminophen, Chlorpheniramine, Phenylpropanolamine, PhenyltoloxamineNorel Plus
How Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Phenyltoloxamine interacts with Bio-Candea — through 2 ingredients. Tap an ingredient for the detail:
Grapefruit ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Major
Interaction Summary
Grapefruit juice can increase levels of drugs metabolized by CYP3A4.
Read the full Grapefruit Extract + Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Phenyltoloxamine interactionGarlic PowderCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 2e1 (cyp2e1) Substrates Moderate
Interaction Summary
Theoretically, garlic products containing allicin might induce intestinal CYP3A4 and inhibit hepatic CYP3A4.
Read the full Garlic Powder + Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Phenyltoloxamine interactionAcetaminophen, Chlorpheniramine, PseudoephedrineAlka-Seltzer PLUS Liquid Gels, Children's Tylenol Cold, Codimal, Comtrex, Extra Strength Tylenol Allergy Sinus, Lorsin +3 more
How Acetaminophen, Chlorpheniramine, Pseudoephedrine interacts with Bio-Candea — through 2 ingredients. Tap an ingredient for the detail:
Grapefruit ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Major
Interaction Summary
Theoretically, grapefruit juice might increase levels of drugs metabolized by CYP1A2.
Read the full Grapefruit Extract + Acetaminophen, Chlorpheniramine, Pseudoephedrine interactionGarlic PowderCytochrome P450 2e1 (cyp2e1) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Garlic might increase levels of drugs metabolized by CYP2E1.
Read the full Garlic Powder + Acetaminophen, Chlorpheniramine, Pseudoephedrine interactionAcetaminophen, DextromethorphanTylenol Cough Ex Strength
How Acetaminophen, Dextromethorphan interacts with Bio-Candea — through 2 ingredients. Tap an ingredient for the detail:
Grapefruit ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Major
Interaction Summary
Theoretically, grapefruit juice might increase levels of drugs metabolized by CYP1A2.
Read the full Grapefruit Extract + Acetaminophen, Dextromethorphan interactionGarlic PowderCytochrome P450 2e1 (cyp2e1) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Garlic might increase levels of drugs metabolized by CYP2E1.
Read the full Garlic Powder + Acetaminophen, Dextromethorphan interactionAcetaminophen, Dextromethorphan, Doxylamine, PseudoephedrineVicks NyQuil
How Acetaminophen, Dextromethorphan, Doxylamine, Pseudoephedrine interacts with Bio-Candea — through 2 ingredients. Tap an ingredient for the detail:
Grapefruit ExtractDextromethorphan (robitussin Dm, Others), Cytochrome P450 3a4 (cyp3a4) Substrates +1 Major
Interaction Summary
Grapefruit juice can increase blood levels of dextromethorphan, potentially increasing the effects and adverse effects of dextromethorphan.
Read the full Grapefruit Extract + Acetaminophen, Dextromethorphan, Doxylamine, Pseudoephedrine interactionGarlic PowderCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 2e1 (cyp2e1) Substrates Moderate
Interaction Summary
Theoretically, garlic products containing allicin might induce intestinal CYP3A4 and inhibit hepatic CYP3A4.
Read the full Garlic Powder + Acetaminophen, Dextromethorphan, Doxylamine, Pseudoephedrine interactionAcetaminophen, Dextromethorphan, Guaifenesin, PhenylephrineConar-A
How Acetaminophen, Dextromethorphan, Guaifenesin, Phenylephrine interacts with Bio-Candea — through 2 ingredients. Tap an ingredient for the detail:
Grapefruit ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Major
Interaction Summary
Theoretically, grapefruit juice might increase levels of drugs metabolized by CYP1A2.
Read the full Grapefruit Extract + Acetaminophen, Dextromethorphan, Guaifenesin, Phenylephrine interactionGarlic PowderCytochrome P450 2e1 (cyp2e1) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Garlic might increase levels of drugs metabolized by CYP2E1.
Read the full Garlic Powder + Acetaminophen, Dextromethorphan, Guaifenesin, Phenylephrine interactionEach ingredient & the kinds of drugs it affects
For each ingredient in Bio-Candea 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.
Grapefruit extract
Amiodarone (Cordarone)
Grapefruit juice can increase blood levels of amiodarone, potentially increasing the effects and adverse effects of amiodarone.
Clinical research shows that grapefruit juice inhibits metabolism and increases absorption of amiodarone. Grapefruit juice increases amiodarone plasma levels by 50% and peak concentration by 84%.
Artemether (Artenam, Paluther)
Grapefruit juice can increase blood levels of oral artemether, potentially increasing the effects and adverse effects of artemether.
Clinical research shows that grapefruit juice increases the levels of oral artemether by 90% to 250% in healthy males.
Benzodiazepines
Grapefruit juice might increase blood levels of some oral benzodiazepines, potentially increasing the effects and adverse effects of these drugs.
Clinical research shows that grapefruit juice can increase plasma triazolam concentrations. Repeated consumption of grapefruit juice greatly increases triazolam concentrations and prolongs the half-life, probably due to inhibition of cytochrome P450 3A4 (CYP3A4). Some studies show that grapefruit juice, particularly when taken in large quantities, reduces the clearance and increases the maximum blood levels, area under the plasma concentration curve (AUC), and duration of effect of midazolam. However, there is no effect on intravenous midazolam. Grapefruit juice has also been shown to increase the maximum blood levels and duration of effect of diazepam, but the clinical significance of this is not known. This interaction does not appear to occur with alprazolam.
Buspirone (Buspar)
Grapefruit juice can increase blood levels of buspirone, potentially increasing the effects and adverse effects of buspirone.
Clinical research shows that grapefruit juice increases absorption and plasma concentrations of buspirone.
Calcium Channel Blockers
Grapefruit juice can increase blood levels of oral calcium channel blockers, potentially increasing the effects and adverse effects of these drugs.
Clinical research shows that grapefruit juice increases absorption and plasma concentrations of amlodipine, nifedipine, nisoldipine, verapamil, felodipine, nimodipine, nicardipine, diltiazem, pranidipine, nitrendipine, and manidipine,
This interaction is likely the result of the inhibition of intestinal metabolism of these drugs by CYP3A4, although some research suggests grapefruit may alter plasma drug levels by reducing the rate of gastric emptying. Consuming grapefruit juice 1 liter daily increases steady state concentrations of verapamil by as much as 50%. However, some references dispute the clinical relevance of the interactions with amlodipine, diltiazem, and verapamil. Other research in healthy individuals suggests plasma levels of felodipine and nifedipine are not affected when given intravenously. There is considerable interindividual variability in the effect of grapefruit juice on drug metabolism, which might account for inconsistent study results. In healthy older adults, the hemodynamic response to felodipine plus grapefruit juice might be influenced by altered autonomic regulation. In older healthy adults, a single dose of grapefruit juice and felodipine enhanced the blood pressure-lowering effects of felodipine. However, after a week of grapefruit juice and felodipine (steady state), the hypotensive activity was reduced, possibly due to compensatory tachycardia. Research indicates it is necessary to withhold grapefruit juice for as long as 3 days to avoid interactions with felodipine and nisoldipine.
Carbamazepine (Tegretol)
Grapefruit juice can increase blood levels of carbamazepine, potentially increasing the effects and adverse effects of carbamazepine.
Clinical research shows that grapefruit juice increases absorption and plasma concentrations of carbamazepine.
Carvedilol (Coreg)
Grapefruit juice can increase blood levels of carvedilol, potentially increasing the effects and adverse effects of carvedilol.
Clinical research shows that grapefruit juice increases the bioavailability of a single dose of carvedilol by 16%.
Celiprolol (Celicard)
Grapefruit juice can decrease blood levels of celiprolol, potentially decreasing the clinical effects of celiprolol.
In human research, taking grapefruit juice within two hours of celiprolol appears to decrease absorption and blood levels of celiprolol by approximately 85%. This interaction is due to grapefruit-induced inhibition of organic anion transporting polypeptide (OATP). Grapefruit juice is thought to affect OATP for only a short time. Therefore, separating drug administration and consumption of grapefruit by at least 4 hours is likely to prevent this interaction.
Cisapride (Propulsid)
Grapefruit juice can increase blood levels of cisapride, potentially increasing the effects and adverse effects of cisapride.
Clinical research shows that grapefruit juice increases the absorption and plasma concentrations of cisapride. According to the cisapride prescribing information, grapefruit juice is contraindicated in patients taking cisapride.
Clomipramine (Anafranil)
Theoretically, grapefruit juice might increase blood levels of clomipramine, potentially increasing the effects and adverse effects of clomipramine.
Case reports have shown that clomipramine trough levels increase significantly after the addition of grapefruit juice to the therapeutic regimen.
Clopidogrel (Plavix)
Grapefruit juice can decrease blood levels of the active metabolite of clopidogrel, thereby decreasing the antiplatelet effect of clopidogrel.
Clopidogrel is an antiplatelet prodrug that is metabolized primarily by cytochrome P450 2C19 (CYP2C19) to form the active metabolite. A small clinical study shows that taking grapefruit juice with clopidogrel decreases plasma levels of the active metabolite by more than 80% and impairs the antiplatelet effect of clopidogrel. This effect is possibly due to grapefruit-induced inhibition of CYP2C19.
Cyclosporine (Neoral, Sandimmune)
Grapefruit juice can increase blood levels of oral cyclosporine, potentially increasing the effects and adverse effects of cyclosporine.
Clinical research shows that grapefruit juice increases the absorption and plasma concentrations of cyclosporine. The mechanism of action is unclear. However, there is no effect on intravenous cyclosporine.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Grapefruit juice can increase levels of drugs metabolized by CYP3A4.
Clinical research shows that grapefruit juice can inhibit CYP3A4 metabolism of drugs, causing increased drug levels and potentially increasing the risk of adverse effects. When taken orally, effects of grapefruit juice on CYP3A4 levels appear to last at least 48 hours. Grapefruit's ability to inhibit CYP3A4 has even been harnessed to intentionally increase levels of venetoclax, which is metabolized by CYP3A4, in an elderly patient with acute myeloid leukemia who could not afford full dose venetoclax. The lower dose of venetoclax in combination with grapefruit juice resulted in serum levels of venetoclax in the therapeutic reference range of full dose venetoclax and positive treatment outcomes for the patient.
Professional consensus recommends the consideration of patient age, existing medical conditions, additional medications, and the potential for additive adverse effects when evaluating the risks of concomitant use of grapefruit juice with any medication metabolized by CYP3A4. While all patients are at risk for interactions with grapefruit juice consumption, patients older than 70 years of age and those taking multiple medications are at the greatest risk for a serious or fatal interaction with grapefruit juice.
Dextromethorphan (Robitussin Dm, Others)
Grapefruit juice can increase blood levels of dextromethorphan, potentially increasing the effects and adverse effects of dextromethorphan.
Clinical research shows that grapefruit juice can inhibit cytochrome P450 3A4 (CYP3A4) metabolism, causing increased dextromethorphan levels.
Estrogens
Grapefruit juice can increase blood levels of estrogens, potentially increasing the effects and adverse effects of estrogens.
Clinical research shows that grapefruit increases the levels of endogenous and exogenous estrogens by inhibiting cytochrome P450 3A4 (CYP3A4) enzymes. Grapefruit juice increases exogenously administered 17-beta-estradiol by about 20% in females without ovaries and ethinyl-estradiol in healthy females.
Etoposide (Vepesid)
Grapefruit juice can decrease blood levels of etoposide, potentially decreasing the clinical effects of etoposide.
Clinical research shows that grapefruit juice decreases the absorption and plasma concentrations of etoposide. There is some evidence that grapefruit juice co-administered with oral etoposide can reduce levels of etoposide by about 26%. Grapefruit juice seems to inhibit organic anion transporting polypeptide (OATP), which is a drug transporter in the gut, liver, and kidney. Grapefruit juice is thought to affect OATP for only a short time. Therefore, separating drug administration and consumption of grapefruit by at least 4 hours is likely to prevent this interaction.
Halofantrine
Grapefruit juice can increase blood levels of halofantrine, potentially increasing the effects and adverse effects of halofantrine.
Clinical research shows that grapefruit juice inhibits cytochrome P450 3A4 (CYP3A4) metabolism, which increases halofantrine levels and peak concentration, as well as a marker of ventricular tachyarrhythmia potential.
Hmg-Coa Reductase Inhibitors ("Statins")
Grapefruit juice can increase blood levels of statins that are metabolized by cytochrome P450 3A4 (CYP3A4), potentially increasing the effects and adverse effects of these statins. Additionally, grapefruit juice might interfere with the bioavailability of statins that are substrates of organic anion transporting polypeptides (OATP).
Clinical research shows that grapefruit juice inhibits metabolism and increases absorption and plasma concentrations of statins that are metabolized by CYP3A4. These include lovastatin, simvastatin, and atorvastatin. Keep in mind that there is considerable variability in the effect of grapefruit juice on drug metabolism, so individual patient response is difficult to predict.
Some statins, including pravastatin, fluvastatin, pitavastatin, and rosuvastatin, are not metabolized by CYP3A4. However, grapefruit juice might still affect the bioavailability of these statins. These statins are substrates of OATP. Grapefruit juice can inhibit OATP. Therefore, grapefruit juice may reduce the bioavailability or increase drug levels of these statins depending on the type of OATP. However, grapefruit juice affects OATP for only a short time. Therefore, separating drug administration by at least 4 hours is likely to avoid this interaction.
Methadone (Dolophine)
Grapefruit juice can increase blood levels of methadone, potentially increasing the effects and adverse effects of methadone.
Clinical research shows that grapefruit juice inhibits the metabolism of methadone, increasing methadone levels and peak concentrations. In one case, a 51-year-old male taking methadone 90 mg daily and no other medications was found unresponsive. The patient reported drinking grapefruit juice 500 mL daily for 3 days prior to the event. Methadone is a substrate of cytochrome P450 3A4 (CYP3A4), and grapefruit juice-induced inhibition of CYP3A4 is the likely cause of this interaction.
Methylprednisolone
Grapefruit juice can increase blood levels of methylprednisolone, potentially increasing the effects and adverse effects of methylprednisolone.
Clinical research shows that grapefruit juice can increase the plasma concentration of orally administered methylprednisolone. Grapefruit juice 200 mL three times daily given with methylprednisolone 16 mg increased methylprednisolone half-life by 35%, peak plasma concentration by 27%, and total area under the curve by 75%.
Organic Anion-Transporting Polypeptide Substrates (Oatp)
Grapefruit juice can decrease levels of drugs that are substrates of OATP.
In vitro and clinical research show that consuming grapefruit juice inhibits OATP, which reduces the bioavailability of oral drugs that are substrates of OATP. Various clinical studies have shown reduced absorption of OATP substrates when taken with grapefruit, including fexofenadine, acebutolol, aliskiren, celiprolol, levothyroxine, nadolol, and pitavastatin. Grapefruit juice is thought to affect OATP for only a short time. Therefore, separating drug administration and consumption of grapefruit by at least 4 hours is likely to prevent this interaction.
Praziquantel (Biltricide)
Grapefruit juice can increase blood levels of praziquantel, potentially increasing the effects and adverse effects of praziquantel.
Clinical research shows that grapefruit juice can inhibit cytochrome P450 3A4 (CYP3A4) metabolism of praziquantel. Plasma concentrations of praziquantel can increase by as much as 160% when administered with 250 mL of commercially available grapefruit juice.
Qt Interval-Prolonging Drugs
Grapefruit or grapefruit juice, especially if consumed in large amounts, can cause additive QT interval prolongation when taken with QT interval-prolonging drugs, potentially increasing the risk of ventricular arrhythmias.
Clinical research in healthy volunteers shows that drinking 6 liters of grapefruit juice over 6 hours prolonged the QTc by a peak amount of 14 milliseconds (ms). This prolongation was similar to the QT prolongation caused by the drug moxifloxacin. In individuals with long QT syndrome, a smaller dose of grapefruit juice, 1.5 liters, resulted in a greater peak QTc prolongation of about 30 ms. The effect of smaller quantities of grapefruit juice on the QT interval is unclear.
Quetiapine (Seroquel)
Grapefruit juice may increase blood levels of quetiapine, increasing the effects and adverse effects of quetiapine.
Quetiapine is metabolized by cytochrome P450 3A4 (CYP3A4). Grapefruit can inhibit CYP3A4. In one case report, a healthy 28-year-old female with bipolar disorder stabilized on quetiapine 800 mg daily presented with quetiapine toxicity considered to be related to consuming a gallon of grapefruit juice over the past 24 hours.
Quinidine
Grapefruit juice can alter blood levels of quinidine, potentially increasing or decreasing the clinical effects of quinidine.
Clinical research shows that grapefruit juice decreases quinidine absorption, clearance, and metabolism, and prolongs the half-life by about 20%.
Garlic powder
Anticoagulant/Antiplatelet Drugs
Garlic may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Raw garlic and a variety of garlic extracts have antiplatelet activity and can increase prothrombin time.
Antidiabetes Drugs
Theoretically, taking garlic with antidiabetes drugs might increase the risk of hypoglycemia.
Clinical research suggests that garlic and garlic extract lower blood glucose levels in healthy and diabetic individuals.
Antihypertensive Drugs
Theoretically, taking garlic with antihypertensive drugs might increase the risk of hypotension.
In human research, both garlic and garlic extracts have blood pressure-lowering effects.
Atazanavir (Reyataz)
Theoretically, garlic might decrease levels and effects of atazanavir.
In a case report, a patient consuming six stir-fried garlic cloves three times weekly developed suboptimal atazanavir levels and increases in HIV viral load. While the exact cause of this interaction is unclear, there is speculation that garlic might decrease the intestinal absorption of atazanavir or increase its metabolism by inducing cytochrome P450 3A4 (CYP3A4). Until more is known, advise patients not to consume large amounts of garlic while taking atazanavir.
Cytochrome P450 2E1 (Cyp2E1) Substrates
Garlic might increase levels of drugs metabolized by CYP2E1.
Clinical research suggests garlic oil can inhibit the activity of CYP2E1 by 39%. Use garlic oil cautiously in patients taking drugs metabolized by these enzymes.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, garlic products containing allicin might induce intestinal CYP3A4 and inhibit hepatic CYP3A4. This may increase or decrease levels of drugs metabolized by CYP3A4.
Some human research suggests that garlic may induce INTESTINAL CYP3A4, reducing levels of drugs metabolized by this enzyme. This is primarily based on a study showing that taking a specific allicin-containing garlic product (GarliPure Maximum Allicin Formula, Natrol Inc.) twice daily for 3 days reduces saquinavir levels by approximately 50%. It is speculated that the allicin constituent induced CYP3A4 in the gut mucosa. Another study shows that giving docetaxel intravenously, bypassing the CYP3A4 enzymes in the gut mucosa, along with the same specific garlic product for 12 consecutive days, does not affect docetaxel levels. Conversely, there is concern that garlic may inhibit HEPATIC CYP3A4. In a single case report, increased tacrolimus levels and liver injury occurred in a liver transplant patient after taking a specific garlic supplement (Garlicin Cardio, Nature's Way) at up to three times the manufacturer recommended dose for 7 days. Several other studies have evaluated the impact of other garlic formulations on CYP3A4 substrates and have found no effect. Most of the products in these studies provided little or no allicin.
Isoniazid
Theoretically, garlic might decrease levels of isoniazid.
Animal research suggests that an aqueous extract of garlic reduces isoniazid levels by about 65%. Garlic reduced the maximum concentration (Cmax) and area under the curve (AUC), but not the half-life, of isoniazid. This suggests that garlic extract might inhibit isoniazid absorption across the intestinal mucosa; however, the exact mechanism of this potential interaction is not known.
Protease Inhibitors (Pis)
Theoretically, garlic products containing allicin might decrease levels of PIs.
Protease inhibitors are metabolized by cytochrome P450 3A4 (CYP3A4) isoenzymes. There is concern that garlic products containing allicin might induce intestinal CYP3A4, reducing plasma levels of protease inhibitors. This is primarily based on a study showing that taking a specific garlic product (GarliPure Maximum Allicin Formula, Natrol Inc.) twice daily for 3 days reduces levels of saquinavir, a PI, by approximately 50%. It is speculated that the allicin constituent induce CYP3A4 in the gut mucosa. Several studies have evaluated the impact of other garlic formulations on CYP3A4 substrates and have found no effect. Most of the products in these studies provided little or no allicin.
Saquinavir (Fortovase, Invirase)
Theoretically, garlic containing allicin might decrease levels of saquinavir.
Saquinavir is a substrate of cytochrome P450 3A4 (CYP3A4) isoenzymes. There is concern that garlic products containing allicin might induce intestinal CYP3A4 and cause subtherapeutic levels of saquinavir. This is primarily based on a pharmacokinetic study showing that taking a specific garlic product (GarliPure Maximum Allicin Formula, Natrol Inc.) twice daily for 3 days reduces saquinavir levels by approximately 50%. It is speculated that the allicin constituent induces CYP3A4 in the gut mucosa. Several pharmacokinetic studies have evaluated the impact of other garlic formulations on CYP3A4 substrates and have found no effect. Most of the products in these studies provided little or no allicin. Until more is known about this potential interaction, use garlic containing allicin cautiously in patients taking saquinavir.
Sofosbuvir (Sovaldi)
Theoretically, taking garlic with sofosbuvir might decrease its effectiveness.
Animal research in rats shows that giving aged garlic extract 120 mg/kg orally daily for 14 days decreases the area under the concentration time curve (AUC) after a single sofosbuvir dose of 40 mg/kg by 36%, increases the clearance by 63%, and decreases the plasma concentrations at 1 and 8 hours by 35% and 58%, respectively. This interaction is hypothesized to be due to induction of intestinal P-glycoprotein expression by garlic.
Tacrolimus (Prograf)
Theoretically, garlic might increase levels of tacrolimus.
In one case report, a liver transplant patient taking tacrolimus experienced increased tacrolimus levels and liver injury after taking a specific garlic supplement (Garlicin Cardio, Nature's Way) at up to three times the manufacturer recommended dose for 7 days. It is speculated that garlic inhibited hepatic cytochrome P450 3A4 (CYP3A4), which increased plasma levels of tacrolimus.
Warfarin (Coumadin)
Theoretically, garlic might increase the risk of bleeding with warfarin.
Raw garlic and a variety of garlic extracts have antiplatelet activity and can increase prothrombin time. In addition, there is a report of two patients who experienced an increase in a previously stabilized international normalized ratio (INR) with concomitant garlic and warfarin use. However, this report has been subsequently debated due to limited clinical information. Other clinical studies have not identified an effect of garlic on INR, warfarin pharmacokinetics, or bleeding risk. More evidence is needed to determine the safety of using garlic with warfarin.
Lactobacillus acidophilus PXN 35
Antibiotic Drugs
Theoretically, taking Lactobacillus acidophilus with antibiotic drugs might decrease the effectiveness of L. acidophilus.
L. acidophilus preparations usually contain live and active organisms. Therefore, simultaneously taking antibiotics might kill a significant number of the organisms. Tell patients to separate administration of antibiotics and L. acidophilus preparations by at least two hours.
Lactobacillus delbrueckii ssp. bulgaricus PXN 39
Antibiotic Drugs
Theoretically, taking Lactobacillus delbrueckii with antibiotic drugs might decrease the effectiveness of L. delbrueckii.
Lactobacillus delbrueckii preparations usually contain live and active organisms. Therefore, simultaneously taking antibiotics might kill a significant number of the organisms. Tell patients to separate administration of antibiotics and L. delbrueckii preparations by at least two hours.
Bifidobacterium breve PXN 25
Antibiotic Drugs
Theoretically, taking Bifidobacterium breve with antibiotic drugs might decrease the effectiveness of B. breve.
Since B. breve preparations usually contain live and active organisms, simultaneously taking antibiotics might kill a significant number of the organisms. Tell patients to separate administration of antibiotics and B. breve preparations by at least 2 hours.
Bifidobacterium longum PXN 30
Antibiotic Drugs
Theoretically, taking Bifidobacterium longum with antibiotic drugs might decrease the effectiveness of B. longum.
Since B. longum preparations usually contain live and active organisms, simultaneously taking antibiotics might kill a significant number of the organisms. Tell patients to separate administration of antibiotics and B. longum preparations by at least 2 hours.
Brand information
Manufacturer and brand details for Bio-Candea, from the product label.
Bio-Kult
See all Bio-Kult products- Name
- Protexin Inc.
- Street Address
- 1833 NW 79th Avenue
- City
- Doral, Miami
- State
- FL
- ZipCode
- 33126
- Phone Number
- 1.786.310.7233
- Web Address
- www.bio-kult.com
Bio-Candea by Bio-Kult: Common Questions
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Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
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The Full Monographs Behind Bio-Candea’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Garlic
Interacts with 989 drugsGarlic is a common food and supplement that may modestly help with blood pressure and cholesterol, though the evidence is mixed and effects are usually small. It is generally safe in food am...
Read the full Garlic monograph → Herb & supplement monographGrapefruit
Interacts with 990 drugsGrapefruit is a nutritious citrus fruit rich in vitamin C and other nutrients, and it is generally safe to eat. However, grapefruit is famous for serious interactions with many prescription...
Read the full Grapefruit monograph → Herb & supplement monographLactobacillus Acidophilus
Interacts with 182 drugsLactobacillus acidophilus is a 'friendly' bacterium used as a probiotic to support gut and vaginal health. It is generally well tolerated in healthy people, and there is reasonable evidence...
Read the full Lactobacillus Acidophilus monograph → Herb & supplement monographLactobacillus Delbrueckii
Interacts with 182 drugsLactobacillus delbrueckii is a 'friendly' bacterium used in food fermentation and sold as a probiotic, often as part of multi-strain products. It is generally considered safe for healthy peo...
Read the full Lactobacillus Delbrueckii monograph → Herb & supplement monographStreptococcus Thermophilus
Streptococcus thermophilus is a friendly bacterium used as a probiotic, often combined with other strains in yogurt and supplements. It is generally well tolerated in healthy people and may...
Read the full Streptococcus Thermophilus monograph → Herb & supplement monographBifidobacterium Breve
Interacts with 182 drugsBifidobacterium breve is a 'friendly' gut bacterium taken as a probiotic, most often to support digestion and balance the gut microbiome. Some studies suggest possible benefits for certain d...
Read the full Bifidobacterium Breve monograph → Herb & supplement monographBifidobacterium Longum
Interacts with 182 drugsBifidobacterium longum is a 'friendly' bacterium found naturally in the human gut and used as a probiotic. It is generally well tolerated and is most studied for digestive issues, though evi...
Read the full Bifidobacterium Longum monograph →Sources & How We Checked
Bio-Candea'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 386 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.
Garlic 154 references
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- McMahon FG, Vargas R. Can garlic lower blood pressure? A pilot study. Pharmacotherapy 1993;13:406-7. DOI
- Auer W, Eiber A, Hertkorn E, et al. Hypertension and hyperlipidaemia: garlic helps in mild cases. Br J Clin Pract Suppl 1990;69:3-6.
- Garty BZ. Garlic burns. Pediatrics 1993;91:658-9.
- Rose KD, Croissant PD, Parliament CF, Levin MB. Spontaneous spinal epidural hematoma with associated platelet dysfunction from excessive garlic ingestion: a case report. Neurosurg 1990;26:880-2. PubMed
- Burnham BE. Garlic as a possible risk for postoperative bleeding. Plast Reconstr Surg 1995;95:213.
- Sunter WH. Warfarin and garlic. Pharm J 1991;246:722.
- Berthold HK, Sudhop T, von Bergmann K. Effect of a garlic oil preparation on serum lipoproteins and cholesterol metabolism. JAMA 1998;279:1900-2.
- Steiner M, Khan AH, Holbert D, Lin RI. A double-blind crossover study in moderately hypercholesterolemic men that compared the effect of aged garlic extract and placebo administration on blood lipids. Am J Clin Nutr 1996;64:866-70. PubMed
- Steiner M, Lin RS. Changes in platelet function and susceptibility of lipoproteins to oxidation associated with administration of aged garlic extract. J Cardiovasc Pharmacol 1998;31:904-8. PubMed
- Gwilt PR, Lear CL, Tempero MA, et al. The effect of garlic extract on human metabolism of acetaminophen. Cancer Epidemiol Biomarkers Prev 1994;3:155-60.
- Rahman K, Billington D. Dietary supplementation with aged garlic extract inhibits ADP-induced platelet aggregation in humans. J Nutr 2000;130:2662-5. PubMed
- Bloch AS. Pushing the Envelope of Nutrition Support: Complementary Therapies. Nutrition 2000;16:236-9. PubMed
- Steiner M, Li W. Aged garlic extract, a modulator of cardiovascular risk factors: a dose-finding study on the effects of AGE on platelet functions. J Nutr 2001;131:980S-4S. PubMed
- Mader FH. Treatment of hyperlipidaemia with garlic-powder tablets. Evidence from the German Association of General Practitioners' multicentric placebo-controlled double-blind study. Arzneimittelforschung 1990;40:1111-6.
- Vorberg G, Schneider B. Therapy with garlic: results of a placebo-controlled, double-blind study. Br J Clin Pract Symp Suppl 1990;69:7-11.
- Simons LA, Balasubramaniam S, von Konigsmark M, et al. On the effect of garlic on plasma lipids and lipoproteins in mild hypercholesterolaemia. Atherosclerosis 1995;113:219-25. PubMed
- Neil HA, Silagy CA, Lancaster T, et al. Garlic powder in the treatment of moderate hyperlipidaemia: a controlled trial and meta-analysis. J R Coll Physicians Lond 1996;30:329-34. DOI
- Koscielny J, Klussendorf D, Latza R, et al. The antiatherosclerotic effect of Allium sativum. Atherosclerosis 1999;144:237-49. PubMed
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- Kiesewetter H, Jung F, Jung EM, et al. Effect of garlic on platelet aggregation in patients with increased risk of juvenile ischaemic attack. Eur J Clin Pharmacol 1993;45:333-6. PubMed
- Legnani C, Frascaro M, Guazzaloca G, et al. Effects of a dried garlic preparation on fibrinolysis and platelet aggregation in healthy subjects. Arzneimittelforschung 1993;43:119-22.
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- Dhamija P, Malhotra S, Pandhi P. Effect of oral administration of crude aqueous extract of garlic on pharmacokinetic parameters of isoniazid and rifampicin in rabbits. Pharmacology 2006;77:100-4. PubMed
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- Baruchin, A. M., Sagi, A., Yoffe, B., and Ronen, M. Garlic burns. Burns 2001;27(7):781-782.
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- McFadden, J. P., White, I. R., and Rycroft, R. J. Allergic contact dermatitis from garlic. Contact Dermatitis 1992;27(5):333-334. PubMed
- Tanamai, J., Veeramanomai, S., and Indrakosas, N. The efficacy of cholesterol-lowering action and side effects of garlic enteric coated tablets in man. J Med Assoc.Thai. 2004;87(10):1156-1161.
- Ashraf, R., Aamir, K., Shaikh, A. R., and Ahmed, T. Effects of garlic on dyslipidemia in patients with type 2 diabetes mellitus. J Ayub.Med Coll.Abbottabad. 2005;17(3):60-64.
- Laing, M. E., Barry, J., Buckley, A. M., and Murphy, G. M. Immediate and delayed hypersensitivity reactions to food and latex in a chef. Contact Dermatitis 2006;55(3):193-194. PubMed
- Friedman, T., Shalom, A., and Westreich, M. Self-inflicted garlic burns: our experience and literature review. Int.J Dermatol. 2006;45(10):1161-1163. PubMed
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- Ekeowa-Anderson, A. L., Shergill, B., and Goldsmith, P. Allergic contact cheilitis to garlic. Contact Dermatitis 2007;56(3):174-175. PubMed
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DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.
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