BioStrong Ingredients & Drug Interactions
What is this page for?
First and foremost: checking BioStrong 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
BioStrong is a dietary supplement by Health Concerns with 2 active ingredients. Its ingredients are commonly taken for bone health and osteoporosis, reducing fracture risk, tooth sensitivity (in some toothpastes).Based on those ingredients, 1,060 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are BioPerine Black Pepper fruit extract, Strontium. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against BioStrong by Health Concerns
Ask about any prescription or over-the-counter medication and we check it for interactions with BioStrong by Health Concerns — 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 BioStrong by Health Concerns
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
Full disclosure
BioStrong contains two active ingredients: strontium and BioPerine black pepper fruit extract. Strontium is a mineral that has been studied for bone health and pain relief.
BioPerine is a concentrated extract of black pepper that contains piperine, a compound believed to enhance the absorption of other nutrients. The product also contains inactive ingredients — hypromellose (a capsule material), rice bran, and magnesium stearate — which serve as fillers and binders.
Does it work?
Strong evidence
For strontium, the evidence shows it is effective for dental sensitivity and painful bone tumors, likely effective for osteoporosis, and possibly effective for osteoarthritis and prostate cancer. For BioPerine black pepper fruit extract, the evidence we hold does not establish effectiveness for any of the uses tested — allergic rhinitis, asthma, athletic performance, headache, depression, and diarrhea all lack sufficient reliable evidence to rate.
How safe is it?
Well-documented data
Strontium ranelate is generally well tolerated at doses up to 2 grams daily, with the most common side effects being skin reactions (atopic dermatitis), diarrhea, headache, and nausea. However, the facts carry a serious caution: strontium has been linked to heart attack and blood clots, especially in the ranelate form — clinical research shows increases in both venous thromboembolism and myocardial infarction.
Safety has not been established in pregnancy, so strontium should be avoided if you are pregnant. It should also be avoided while breastfeeding due to insufficient safety data.
Black pepper as a food spice is safe, but concentrated piperine supplements should be used cautiously — the most common side effects are burning aftertaste, indigestion, and reduced taste perception, with rare allergic reactions reported.
Meds to double-check
Moderate interaction found
Check before starting if you take estrogens or androgens (like testosterone) — strontium may raise strontium levels. Also double-check if you use antacids, quinolone antibiotics (like ciprofloxacin), or tetracycline antibiotics (like doxycycline) — take BioStrong at least 2 hours apart from these.
The black pepper extract may raise blood levels of propranolol, nevirapine, rifampin, phenytoin, cyclosporine, pentobarbital, atorvastatin, or theophylline; ask your pharmacist if any of these are in your medication list.
The bottom line
Scorecard at a glanceFully disclosed formula with clinical evidence supporting its stated purpose. Moderate medication interactions have been identified, and safety information is well characterized.
BioStrong is intended for bone health and may help with osteoporosis and osteoarthritis, but strontium carries real cardiovascular risks — heart attack and blood clots — that you need to discuss with your doctor before starting. Do not use it if you are pregnant or breastfeeding.
If you take estrogens, androgens, blood pressure or heart drugs, HIV or TB medications, seizure drugs, immunosuppressants, cholesterol drugs, or breathing medications, check with your pharmacist first.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 2 of 2 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Jan 22, 2022.
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 BioStrong, straight from the product label.
| Brand | Health Concerns |
|---|---|
| Barcode (UPC) | 810034440181 |
| Net contents | 90 Capsule(s) |
| Market status | On market |
| Date entered into DSLD | Jan 22, 2022 |
| DSLD ID | 259215 |
| Product type | Botanical With Nutrients |
| Supplement form | Capsule |
| Dietary claims / uses | All Other, Structure/Function |
| Intended target group(s) | Adult (18 - 50 Years) |
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 BioStrong by Health Concerns, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Strontium | 680 mg | -- |
| BioPerine Black Pepper fruit extract | 5 mg | -- |
Other ingredients: Hypromellose, Rice Bran, Magnesium Stearate
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.
General Statements
Energetic Formulas
Suggested/Recommended/Usage/Directions
Suggested Use: Two capsules per day between meals, or as recommended by your health care practitioner. For best results, take apart from calcium supplements.
Precautions
Notice: As with any dietary supplement, do not take without first consulting your health care practitioner, especially if you are pregnant, nursing, or are under medical supervision for any reason.
Notice: As with any dietary supplement, do not take without first consulting your health care practitioner, especially if you are pregnant, nursing, or are under medical supervision for any reason.
Keep out of reach of children.
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.
Formulation
Made in the U.S.A.
Formula
Strontium Piperine
FDA Statement of Identity
Dietary Supplement
Brand IP Statement(s)
Health Concerns Combining Modern Research and Ancient Wisdom
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
BioStrong by Health Concerns 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 BioStrong by Health Concerns
These are the 2 active ingredients this product is made of. Select any to open its full monograph.
Serving size2 Capsule(s) Dosage formCapsule Servings per container45 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.
Strontium
Interacts with101 drugs
Strontium is a mineral that has been studied mainly for bone health and osteoporosis. The prescription form (strontium ranelate) showed benefit for fr...
Strontium monograph & interactionsBioPerine Black Pepper fruit extract
Interacts with1,019 drugs
Black pepper is a common kitchen spice that is generally safe in the amounts used in food. Its extract, piperine, is mostly added to supplements to he...
BioPerine Black Pepper fruit extract monograph & interactionsOther (inactive) ingredients: Hypromellose, Rice Bran, Magnesium Stearate. These complete the product’s ingredient list but are not active constituents.
BioStrong by Health Concerns Drug Interactions
HelloPharmacist Interaction Report
BioStrong by Health Concerns contains strontium and BioPerine black pepper fruit extract, and it does interact with a number of medications.
Strontium's most serious documented concern involves heart and blood clotting risks — the facts note that strontium ranelate increases the relative risk of blood clots (venous thromboembolism and pulmonary embolism) by about 50% compared with placebo, and increases heart attack risk by about 1.6-fold in people with osteoporosis. This is a well-documented finding from clinical research.
Read the full breakdown — every affected drug type, severity by severity
Strontium also interacts moderately with estrogens and androgens (like testosterone), which may reduce how much strontium your body eliminates, potentially raising its levels and side effects. It also interacts with antacids — aluminum hydroxide, magnesium hydroxide, and especially calcium can reduce strontium absorption by 20% to 70%, so take strontium at least 2 hours away from any antacid.
Strontium may also decrease absorption of quinolone and tetracycline antibiotics; again, separate them by at least 2 hours.
BioPerine black pepper extract interacts moderately with several medications: propranolol (a blood pressure and heart drug), nevirapine (an HIV medication), rifampin (a tuberculosis antibiotic), phenytoin (a seizure medication), cyclosporine (an immunosuppressant), pentobarbital (a sedative), atorvastatin (a cholesterol drug), and theophylline (a breathing medication). In each case, black pepper may raise blood levels of the drug, which can amplify its effects and side effects.
Altogether, these interactions span 1,046 individual medications. Use the medication checker on this page to confirm whether any of your drugs are affected before you start BioStrong.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against BioStrong?
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 BioStrong interact with 1,060 drugs. Click any drug to see the details.
2 of the 2 ingredients in BioStrong interact with drugs. Each result below shows which ingredient is responsible. BioPerine Black Pepper fruit extract Strontium
Ado-trastuzumab EmtansineKadcyla
How Ado-trastuzumab Emtansine interacts with BioStrong — through 1 ingredient. Tap an ingredient for the detail:
Bioperine Black Pepper Fruit ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP3A4.
Read the full Bioperine Black Pepper Fruit Extract + Ado-trastuzumab Emtansine interactionAbciximabReoPro
How Abciximab interacts with BioStrong — through 1 ingredient. Tap an ingredient for the detail:
Bioperine Black Pepper Fruit ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, black pepper might increase the risk of bleeding when taken with antiplatelet or anticoagulant drugs.
Read the full Bioperine Black Pepper Fruit Extract + Abciximab interactionAbemaciclibVerzenio
How Abemaciclib interacts with BioStrong — through 1 ingredient. Tap an ingredient for the detail:
Bioperine Black Pepper Fruit ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP3A4.
Read the full Bioperine Black Pepper Fruit Extract + Abemaciclib interactionAbiraterone
How Abiraterone interacts with BioStrong — through 1 ingredient. Tap an ingredient for the detail:
Bioperine Black Pepper Fruit ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP3A4.
Read the full Bioperine Black Pepper Fruit Extract + Abiraterone interactionAbiraterone AcetateYonsa, Zytiga
How Abiraterone Acetate interacts with BioStrong — through 1 ingredient. Tap an ingredient for the detail:
Bioperine Black Pepper Fruit ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP3A4.
Read the full Bioperine Black Pepper Fruit Extract + Abiraterone Acetate interactionAbrocitinibCibinqo
How Abrocitinib interacts with BioStrong — through 1 ingredient. Tap an ingredient for the detail:
Bioperine Black Pepper Fruit ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, black pepper might increase the risk of bleeding when taken with antiplatelet or anticoagulant drugs.
Read the full Bioperine Black Pepper Fruit Extract + Abrocitinib interactionAcalabrutinibCalquence
How Acalabrutinib interacts with BioStrong — through 1 ingredient. Tap an ingredient for the detail:
Bioperine Black Pepper Fruit ExtractP-glycoprotein Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, black pepper might increase levels of P-glycoprotein substrates.
Read the full Bioperine Black Pepper Fruit Extract + Acalabrutinib interactionAcarboseGlucobay, Prandase, Precose
How Acarbose interacts with BioStrong — through 1 ingredient. Tap an ingredient for the detail:
Bioperine Black Pepper Fruit ExtractAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, black pepper might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Read the full Bioperine Black Pepper Fruit Extract + Acarbose interactionAcenocoumarolSintrom
How Acenocoumarol interacts with BioStrong — through 1 ingredient. Tap an ingredient for the detail:
Bioperine Black Pepper Fruit ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, black pepper might increase the risk of bleeding when taken with antiplatelet or anticoagulant drugs.
Read the full Bioperine Black Pepper Fruit Extract + Acenocoumarol interactionAcetaminophen, AspirinGemnisyn
How Acetaminophen, Aspirin interacts with BioStrong — through 1 ingredient. Tap an ingredient for the detail:
Bioperine Black Pepper Fruit ExtractAnticoagulant/antiplatelet Drugs, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, black pepper might increase the risk of bleeding when taken with antiplatelet or anticoagulant drugs.
Read the full Bioperine Black Pepper Fruit Extract + Acetaminophen, Aspirin interactionAcetaminophen, Aspirin, CaffeineExcedrin, Excedrin Extra Strength, Excedrin Migraine
How Acetaminophen, Aspirin, Caffeine interacts with BioStrong — through 1 ingredient. Tap an ingredient for the detail:
Bioperine Black Pepper Fruit ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Anticoagulant/antiplatelet Drugs +1 Moderate
Interaction Summary
Theoretically, black pepper might decrease levels and clinical effects of drugs metabolized by CYP1A2.
Read the full Bioperine Black Pepper Fruit Extract + Acetaminophen, Aspirin, Caffeine interactionAcetaminophen, Butalbital, CaffeineEsgic, Esgic Plus, Fiogesic, Fioricet, Repan, Tecnal +1 more
How Acetaminophen, Butalbital, Caffeine interacts with BioStrong — through 1 ingredient. Tap an ingredient for the detail:
Bioperine Black Pepper Fruit ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, black pepper might decrease levels and clinical effects of drugs metabolized by CYP1A2.
Read the full Bioperine Black Pepper Fruit Extract + Acetaminophen, Butalbital, Caffeine interactionAcetaminophen, Butalbital, Caffeine, CodeineEsgic with Codeine, Fioricet w/ Codeine
How Acetaminophen, Butalbital, Caffeine, Codeine interacts with BioStrong — through 1 ingredient. Tap an ingredient for the detail:
Bioperine Black Pepper Fruit ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 2d6 (cyp2d6) Substrates +1 Moderate
Interaction Summary
Theoretically, black pepper might decrease levels and clinical effects of drugs metabolized by CYP1A2.
Read the full Bioperine Black Pepper Fruit Extract + Acetaminophen, Butalbital, Caffeine, Codeine interactionAcetaminophen, Butalbital, CodeineBancap w/ Codeine
How Acetaminophen, Butalbital, Codeine interacts with BioStrong — through 1 ingredient. Tap an ingredient for the detail:
Bioperine Black Pepper Fruit ExtractCytochrome P450 2d6 (cyp2d6) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP2D6.
Read the full Bioperine Black Pepper Fruit Extract + Acetaminophen, Butalbital, Codeine interactionAcetaminophen, Butalbital, Codeine PhosphatePhrenilin #3
How Acetaminophen, Butalbital, Codeine Phosphate interacts with BioStrong — through 1 ingredient. Tap an ingredient for the detail:
Bioperine Black Pepper Fruit ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 2d6 (cyp2d6) Substrates Moderate
Interaction Summary
Theoretically, black pepper might decrease levels and clinical effects of drugs metabolized by CYP1A2.
Read the full Bioperine Black Pepper Fruit Extract + Acetaminophen, Butalbital, Codeine Phosphate interactionAcetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, PhenylephrineHycomine Compound
How Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interacts with BioStrong — through 1 ingredient. Tap an ingredient for the detail:
Bioperine Black Pepper Fruit ExtractCytochrome P450 2d6 (cyp2d6) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP2D6.
Read the full Bioperine Black Pepper Fruit Extract + 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 BioStrong — through 1 ingredient. Tap an ingredient for the detail:
Bioperine Black Pepper Fruit ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP3A4.
Read the full Bioperine Black Pepper Fruit Extract + Acetaminophen, Caffeine, Codeine interactionAcetaminophen, Caffeine, Codeine, SalicylamideCodalan No.1, Codalan No.2, Codalan No.3
How Acetaminophen, Caffeine, Codeine, Salicylamide interacts with BioStrong — through 1 ingredient. Tap an ingredient for the detail:
Bioperine Black Pepper Fruit ExtractCytochrome P450 2d6 (cyp2d6) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP2D6.
Read the full Bioperine Black Pepper Fruit Extract + Acetaminophen, Caffeine, Codeine, Salicylamide interactionAcetaminophen, Caffeine, DihydrocodeineDHC Plus, Panlor DC, Panlor SS
How Acetaminophen, Caffeine, Dihydrocodeine interacts with BioStrong — through 1 ingredient. Tap an ingredient for the detail:
Bioperine Black Pepper Fruit ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Moderate
Interaction Summary
Theoretically, black pepper might decrease levels and clinical effects of drugs metabolized by CYP1A2.
Read the full Bioperine Black Pepper Fruit Extract + Acetaminophen, Caffeine, Dihydrocodeine interactionAcetaminophen, Caffeine, IsomethepteneMigralam
How Acetaminophen, Caffeine, Isometheptene interacts with BioStrong — through 1 ingredient. Tap an ingredient for the detail:
Bioperine Black Pepper Fruit ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, black pepper might decrease levels and clinical effects of drugs metabolized by CYP1A2.
Read the full Bioperine Black Pepper Fruit Extract + Acetaminophen, Caffeine, Isometheptene interactionAcetaminophen, Caffeine, PyrilamineMidol Max Strength Menstrual
How Acetaminophen, Caffeine, Pyrilamine interacts with BioStrong — through 1 ingredient. Tap an ingredient for the detail:
Bioperine Black Pepper Fruit ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP3A4.
Read the full Bioperine Black Pepper Fruit Extract + Acetaminophen, Caffeine, Pyrilamine interactionAcetaminophen, Chlorpheniramine Maleate, Dextromethorphan HbrVicks Formula 44M Cough, Cold & Flu Relief
How Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interacts with BioStrong — through 1 ingredient. Tap an ingredient for the detail:
Bioperine Black Pepper Fruit ExtractCytochrome P450 2d6 (cyp2d6) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP2D6.
Read the full Bioperine Black Pepper Fruit Extract + Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interactionAcetaminophen, Chlorpheniramine, Codeine, PhenylephrineColrex
How Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interacts with BioStrong — through 1 ingredient. Tap an ingredient for the detail:
Bioperine Black Pepper Fruit ExtractCytochrome P450 2d6 (cyp2d6) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP2D6.
Read the full Bioperine Black Pepper Fruit Extract + Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interactionAcetaminophen, Chlorpheniramine, DextromethorphanCoricidin II Extra Strength Cold and Flu
How Acetaminophen, Chlorpheniramine, Dextromethorphan interacts with BioStrong — through 1 ingredient. Tap an ingredient for the detail:
Bioperine Black Pepper Fruit ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 2d6 (cyp2d6) Substrates +1 Moderate
Interaction Summary
Theoretically, black pepper might decrease levels and clinical effects of drugs metabolized by CYP1A2.
Read the full Bioperine Black Pepper Fruit Extract + Acetaminophen, Chlorpheniramine, Dextromethorphan interactionAcetaminophen, Chlorpheniramine, Dextromethorphan HydrobromideCoricidin HBP Maximum Strength Flu
How Acetaminophen, Chlorpheniramine, Dextromethorphan Hydrobromide interacts with BioStrong — through 1 ingredient. Tap an ingredient for the detail:
Bioperine Black Pepper Fruit ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP3A4.
Read the full Bioperine Black Pepper Fruit Extract + Acetaminophen, Chlorpheniramine, Dextromethorphan Hydrobromide interactionAcetaminophen, Chlorpheniramine, Dextromethorphan, PhenylpropanolamineMulti Symptom Cold Relief
How Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylpropanolamine interacts with BioStrong — through 1 ingredient. Tap an ingredient for the detail:
Bioperine Black Pepper Fruit ExtractCytochrome P450 2d6 (cyp2d6) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP2D6.
Read the full Bioperine Black Pepper Fruit Extract + Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylpropanolamine interactionAcetaminophen, Chlorpheniramine, Dextromethorphan, PseudoephedrineChildren's Tylenol Cold Plus Cough, Tylenol Cold Ex Strength
How Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine interacts with BioStrong — through 1 ingredient. Tap an ingredient for the detail:
Bioperine Black Pepper Fruit ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 2d6 (cyp2d6) Substrates +1 Moderate
Interaction Summary
Theoretically, black pepper might decrease levels and clinical effects of drugs metabolized by CYP1A2.
Read the full Bioperine Black Pepper Fruit Extract + Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine interactionAcetaminophen, Chlorpheniramine, Guaifenesin, Phenylephrine, SalicylamideRhinogesic GG
How Acetaminophen, Chlorpheniramine, Guaifenesin, Phenylephrine, Salicylamide interacts with BioStrong — through 1 ingredient. Tap an ingredient for the detail:
Bioperine Black Pepper Fruit ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP3A4.
Read the full Bioperine Black Pepper Fruit Extract + Acetaminophen, Chlorpheniramine, Guaifenesin, Phenylephrine, Salicylamide interactionAcetaminophen, Chlorpheniramine, PhenylephrineAlka-Seltzer PLUS, Histex SR, Protid
How Acetaminophen, Chlorpheniramine, Phenylephrine interacts with BioStrong — through 1 ingredient. Tap an ingredient for the detail:
Bioperine Black Pepper Fruit ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, black pepper might decrease levels and clinical effects of drugs metabolized by CYP1A2.
Read the full Bioperine Black Pepper Fruit Extract + Acetaminophen, Chlorpheniramine, Phenylephrine interactionAcetaminophen, Chlorpheniramine, Phenylephrine, SalicylamideRhinogesic, Rhinogesic JR
How Acetaminophen, Chlorpheniramine, Phenylephrine, Salicylamide interacts with BioStrong — through 1 ingredient. Tap an ingredient for the detail:
Bioperine Black Pepper Fruit ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP3A4.
Read the full Bioperine Black Pepper Fruit Extract + Acetaminophen, Chlorpheniramine, Phenylephrine, Salicylamide interactionEach ingredient & the kinds of drugs it affects
For each ingredient in BioStrong 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.
BioPerine Black Pepper fruit extract
Anticoagulant/Antiplatelet Drugs
Theoretically, black pepper might increase the risk of bleeding when taken with antiplatelet or anticoagulant drugs.
In vitro research shows that piperine, a constituent of black pepper, seems to inhibit platelet aggregation. This has not been reported in humans.
Antidiabetes Drugs
Theoretically, black pepper might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Animal research shows that piperine, a constituent of black pepper, can reduce blood glucose levels. Monitor blood glucose levels closely. Dose adjustments might be necessary.
Atorvastatin (Lipitor)
Theoretically, black pepper might increase blood levels of atorvastatin.
Animal research shows that taking piperine, a constituent of black pepper, 35 mg/kg can increase the maximum serum concentration of atorvastatin three-fold. This has not been reported in humans.
Cyclosporine (Neoral, Sandimmune)
Theoretically, black pepper might increase the effects and side effects of cyclosporine.
In vitro research shows that piperine, a constituent of black pepper, increases the bioavailability of cyclosporine. This has not been reported in humans.
Cytochrome P450 2D6 (Cyp2D6) Substrates
Theoretically, black pepper might increase levels of drugs metabolized by CYP2D6.
In vitro research suggests that some constituents of black pepper inhibit CYP2D6. This has not been reported in humans.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, black pepper might increase levels of drugs metabolized by CYP3A4.
In vitro research and pharmacokinetic simulation data suggest that piperine, a constituent of black pepper, as well as the pepper fruit seem to inhibit CYP3A4. This has not been reported in humans.
Lithium
Theoretically, black pepper might increase blood levels of lithium due to its diuretic effects. The dose of lithium might need to be reduced.
Black pepper is thought to have diuretic properties.
Nevirapine (Viramune)
Black pepper might increase blood levels of nevirapine.
Clinical research shows that piperine, a constituent of black pepper, increases the plasma concentration of nevirapine. However, no adverse effects were observed in this study.
P-Glycoprotein Substrates
Theoretically, black pepper might increase levels of P-glycoprotein substrates.
In vitro research shows that piperine, a constituent of black pepper, seems to inhibit P-glycoprotein.
Pentobarbital (Nembutal)
Theoretically, black pepper might increase the sedative effects of pentobarbital.
Animal research shows that piperine, a constituent of black pepper, increases pentobarbital-induced sleeping time.
Phenytoin (Dilantin)
Black pepper might increase blood levels of phenytoin.
Clinical research shows that piperine, a constituent of black pepper, seems to increase absorption, slow elimination, and increase levels of phenytoin. Taking a single dose of black pepper 1 gram along with phenytoin seems to double the serum concentration of phenytoin. Consuming a soup with black pepper providing piperine 44 mg/200 mL of soup along with phenytoin also seems to increase phenytoin levels when compared with consuming the same soup without black pepper.
Propranolol (Inderal)
Black pepper might increase blood levels of propranolol.
Clinical research shows that piperine, a constituent of black pepper, seems to increase absorption and slow elimination of propranolol.
Rifampin (Rifadin)
Black pepper might increase blood levels of rifampin.
Clinical research shows that piperine, a constituent of black pepper, seems to increase absorption and serum levels of rifampin.
Theophylline
Black pepper might increase blood levels of theophylline.
Clinical research shows that piperine, a constituent of black pepper, seems to increase absorption and slow elimination of theophylline.
Amoxicillin (Amoxil, Trimox)
Theoretically, black pepper might increase the effects and side effects of amoxicillin.
Animal research shows that taking piperine, a constituent of black pepper, with amoxicillin increases plasma levels of amoxicillin. This has not been reported in humans.
Carbamazepine (Tegretol)
Theoretically, black pepper might increase blood levels of carbamazepine, potentially increasing the effects and side effects of carbamazepine.
One clinical study in patients taking carbamazepine 300 mg or 500 mg twice daily shows that taking a single 20 mg dose of purified piperine, a constituent of black pepper, increases carbamazepine levels. Piperine may increase carbamazepine absorption by increasing blood flow to the GI tract, increasing the surface area of the small intestine, or inhibiting cytochrome P450 3A4 (CYP3A4) in the gut wall. Absorption was significantly increased by 7-10 mcg/mL/hour. The time to eliminate carbamazepine was also increased by 4-8 hours. Although carbamazepine levels were increased, this did not appear to increase side effects. In vitro research also shows that piperine can increase carbamazepine levels by 11% in a time-dependent manner.
Cytochrome P450 1A2 (Cyp1A2) Substrates
Theoretically, black pepper might decrease levels and clinical effects of drugs metabolized by CYP1A2.
In vitro research suggests that black pepper induces CYP1A2. This has not been reported in humans.
Strontium
Androgens
Theoretically, androgens might reduce the excretion of strontium, potentially increasing its effects and adverse effects.
A small clinical study suggests that treatment with androgens such as testosterone, nandrolone, oxandrolone, and oxymetholone for 5-6 weeks might decrease urinary strontium excretion. The clinical significance of this interaction is unknown.
Antacids
Antacids can reduce the absorption of strontium, potentially decreasing its effectiveness.
Aluminum hydroxide and magnesium hydroxide can reduce absorption of strontium ranelate by 20% to 25%. Calcium can reduce its absorption to 60% to 70%. Avoid taking antacids within 2 hours of a dose of strontium ranelate. This interaction has also been reported with orally-administered radioactive strontium-85. It will likely also occur with other forms of strontium.
Estrogens
Theoretically, estrogens might reduce the excretion of strontium, potentially increasing its effects and adverse effects.
A small clinical study suggests that treatment with estrogens for 5-6 weeks might decrease urinary strontium excretion. The clinical significance of this interaction is unknown.
Quinolone Antibiotics
Theoretically, strontium might decrease the absorption of quinolone antibiotics.
Strontium is a divalent cation with similar properties to calcium. It is likely to form complexes with quinolones in the gastrointestinal (GI) tract, preventing absorption of the antibiotic. Recommend taking strontium supplements at least 2 hours before or after quinolones to avoid an interaction.
Tetracycline Antibiotics
Theoretically, strontium might decrease the absorption of tetracycline antibiotics.
Strontium is a divalent cation with similar properties to calcium. It is likely to form complexes with tetracyclines in the gastrointestinal (GI) tract, preventing absorption of the antibiotic. Recommend taking strontium supplements at least 2 hours before or after tetracyclines to avoid an interaction.
Brand information
Manufacturer and brand details for BioStrong, from the product label.
Health Concerns
See all Health Concerns products- Name
- Health Concerns
- City
- Springville
- State
- Utah
- Phone Number
- 1 (800) 233-9355
- Web Address
- www.healthconcerns.com/pro
BioStrong by Health Concerns: Common Questions
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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 BioStrong’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Strontium
Interacts with 101 drugsStrontium is a mineral that has been studied mainly for bone health and osteoporosis. The prescription form (strontium ranelate) showed benefit for fracture risk but carries serious heart-re...
Read the full Strontium monograph → Herb & supplement monographBlack Pepper
Interacts with 1,019 drugsBlack pepper is a common kitchen spice that is generally safe in the amounts used in food. Its extract, piperine, is mostly added to supplements to help the body absorb other ingredients (li...
Read the full Black Pepper monograph →Sources & How We Checked
BioStrong'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 51 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.
Strontium 22 references
- Martindale W. Martindale the Extra Pharmacopoeia. Pharmaceutical Press, 1999.
- Meunier PJ, Roux C, Seeman E, et al. The effects of strontium ranelate on the risk of vertebral fracture in women with postmenopausal osteoporosis. N Engl J Med 2004;350:459-68.. PubMed
- El-Hajj Fuleihan G. Strontium ranelate--a novel therapy for osteoporosis or a permutation of the same? N Engl J Med 2004;350:504-6. PubMed
- Verberckmoes SC, De Broe ME, D'Haese PC. Dose-dependent effects of strontium on osteoblast function and mineralization. Kidney Int 2003;64:534-43. . PubMed
- Meunier PJ, Slosman DO, Delmas PD, et al. Strontium ranelate: dose-dependent effects in established postmenopausal vertebral osteoporosis--a 2-year randomized placebo controlled trial. J Clin Endocrinol Metab 2002;87:2060-6.. DOI
- Brandi ML. New treatment strategies: ipriflavone, strontium, vitamin D metabolites and analogs. Am J Med 1993;95:69S-74S. . PubMed
- Eisenberg E. Effects of androgens, estrogens and corticoids on strontium kinetics in man. J Clin Endocrinol Metab 1966;26:566-72.
- Metastron prescribing information. Medi-Physics, Inc., Amersham Healthcare, Arlington Heights, IL, 1998. http://www.cancerpaintherapy.com/METATECHPAGE.htm. (Accessed 13 March 2004).
- Protelos European Summary of Product Characteristics. Les Laboratoires Servier, 2006. Available at: www.servier.com/pro/osteoporose/protelos/protelos_spc.asp. (Accessed 01 August 2006).
- US Department of Health and Human Services, Public Health Service. Agency for Toxic Substances and Disease Registry. Toxicological profile for strontium. April 2004. Available at: www.atsdr.cdc.gov/toxprofiles/tp159.pdf. (Accessed 8 August 2006).
- Apostolidis N, Paradellis T, Karydas A, et al. Calcium and strontium metabolic studies in patients on CAPD. Perit Dial Int 1998;18:410-4. DOI
- Ozgur S, Sumer H, Kocoglu G. Rickets and soil strontium. Arch Dis Child 1996;75:524-6. PubMed
- Schrooten I, Elseviers MM, Lamberts LV, et al. Increased serum strontium levels in dialysis patients: an epidemiological survey. Kidney Int 1999;56:1886-92. PubMed
- D'Haese PC, Couttenye MM, Lamberts LV, et al. Aluminum, iron, lead, cadmium, copper, zinc, chromium, magnesium, strontium, and calcium content in bone of end-stage renal failure patients. Clin Chem 1999;45:1548-56. DOI
- Pennington JA, Jones JW. Molybdenum, nickel, cobalt, vanadium, and strontium in total diets. J Am Diet Assoc 1987;87:1644-50. DOI
- O'Donnell S, Cranney A, Wells GA, et al. Strontium ranelate for preventing and treating postmenopausal osteoporosis. Cochrane Musculoskeletal Group. Cochrane Database Syst Rev 2006;(4):CD005326. PubMed
- Protelos European Public Assessment Report, Scientific Discussion. European Medicines Agency, 2005. Available at: www.emea.eu.int/humandocs/Humans/EPAR/protelos/protelos.htm. (Accessed 10 October 2006).
- Rousselet F, El Solh N, Maurat JP, et al. Strontium and calcium metabolism. Interaction of strontium and vitamin D. C R Seances Soc Biol Fil 1975;169:322-9.
- O'Donnell, S., Cranney, A., Wells, G. A., Adachi, J. D., and Reginster, J. Y. Strontium ranelate for preventing and treating postmenopausal osteoporosis. Cochrane.Database.Syst.Rev. 2006;3:CD005326. PubMed
- Rizzoli R, Chapurlat RD, Laroche JM, et al. Effects of strontium ranelate and alendronate on bone microstructure in women with osteoporosis. Results of a 2-year study. Osteoporosis Int. 2012. 23(1):305-315. doi: 10.1007/s00198-011-1758-z. PubMed
- Reginster JY, Kaufman JM, Goemaere S, et al. Maintenance of antifracture efficacy over 10 years with strontium ranelate in postmenopausal osteoporosis. Osteoporos Int. 2012;23(3):1115-1122. doi: 10.1007/s00198-011-1847-z. PubMed
- Protos [Product Information]. Available at: http://www.guildlink.com.au/gc/ws/servier/pi.cfm?product=sepproto. Accessed May 1, 2018.
Black Pepper 29 references
- Leung AY, Foster S. Encyclopedia of Common Natural Ingredients Used in Food, Drugs and Cosmetics. 2nd ed. New York, NY: John Wiley & Sons, 1996.
- Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
- Bano G, Amla V, Raina RK, et al. The effect of piperine on pharmacokinetics of phenytoin in healthy volunteers. Planta Med 1987;53:568-9. PubMed
- Bano G, et al. Effect of piperine on bioavailability and pharmacokinetics of propranolol and theophylline in healthy volunteers. Eur J Clin Pharmacol 1991;41;615-7. PubMed
- Cohle SD, Trestrail JD III, Graham MA, et al. Fatal pepper aspiration. Am J Dis Child 1988;142:633-6. PubMed
- Bhardwaj RK, Glaeser H, Becquemont L, et al. Piperine, a major constituent of black pepper, inhibits human P-glycoprotein and CYP3A4. J Pharmacol Exp Ther 2002;302:645-50. PubMed
- Velpandian T, Jasuja R, Bhardwaj RK, et al. Piperine in food: interference in the pharmacokinetics of phenytoin. Eur J Drug Metab Pharmacokinet 2001;26:241-7. PubMed
- Pattanaik S, Hota D, Prabhakar S, et al. Pharmacokinetic interaction of a single dose of piperine with steady-state carbamazepine in epilepsy patients. Phytother Res 2009;23:1281-6.
- Munakata, M., Kobayashi, K., Niisato-Nezu, J., Tanaka, S., Kakisaka, Y., Ebihara, T., Ebihara, S., Haginoya, K., Tsuchiya, S., and Onuma, A. Olfactory stimulation using black pepper oil facilitates oral feeding in pediatric patients receiving long-term en
- Myers, B. M., Smith, J. L., and Graham, D. Y. Effect of red pepper and black pepper on the stomach. Am J Gastroenterol 1987;82(3):211-214.
- Raghavendra, R. H. and Naidu, K. A. Spice active principles as the inhibitors of human platelet aggregation and thromboxane biosynthesis. Prostaglandins Leukot.Essent.Fatty Acids 2009;81(1):73-78. PubMed
- Subehan, Usia, T., Kadota, S., and Tezuka, Y. Mechanism-based inhibition of human liver microsomal cytochrome P450 2D6 (CYP2D6) by alkamides of Piper nigrum. Planta Med 2006;72(6):527-532.
- Kasibhatta, R. and Naidu, M. U. Influence of piperine on the pharmacokinetics of nevirapine under fasting conditions: a randomised, crossover, placebo-controlled study. Drugs R.D. 2007;8(6):383-391. PubMed
- Usia, T., Iwata, H., Hiratsuka, A., Watabe, T., Kadota, S., and Tezuka, Y. CYP3A4 and CYP2D6 inhibitory activities of Indonesian medicinal plants. Phytomedicine. 2006;13(1-2):67-73. PubMed
- Mujumdar, A. M., Dhuley, J. N., Deshmukh, V. K., Raman, P. H., Thorat, S. L., and Naik, S. R. Effect of piperine on pentobarbitone induced hypnosis in rats. Indian J Exp.Biol. 1990;28(5):486-487.
- Panda, S. and Kar, A. Piperine lowers the serum concentrations of thyroid hormones, glucose and hepatic 5'D activity in adult male mice. Horm.Metab Res. 2003;35(9):523-526. PubMed
- Lawless, H. and Stevens, D. A. Effects of oral chemical irritation on taste. Physiol Behav. 1984;32(6):995-998. PubMed
- Hiwale, A. R., Dhuley, J. N., and Naik, S. R. Effect of co-administration of piperine on pharmacokinetics of beta-lactam antibiotics in rats. Indian J Exp.Biol. 2002;40(3):277-281.
- Han, Y., Chin Tan, T. M., and Lim, L. Y. In vitro and in vivo evaluation of the effects of piperine on P-gp function and expression. Toxicol.Appl.Pharmacol. 8-1-2008;230(3):283-289. PubMed
- Sharma, P., Varma, M. V., Chawla, H. P., and Panchagnula, R. In situ and in vivo efficacy of peroral absorption enhancers in rats and correlation to in vitro mechanistic studies. Farmaco 2005;60(11-12):874-883. PubMed
- Aher, S., Biradar, S., Gopu, C. L., and Paradkar, A. Novel pepper extract for enhanced P-glycoprotein inhibition. J Pharm.Pharmacol. 2009;61(9):1179-1186. PubMed
- Zutshi, R. K., Singh, R., Zutshi, U., Johri, R. K., and Atal, C. K. Influence of piperine on rifampicin blood levels in patients of pulmonary tuberculosis. J Assoc.Physicians India 1985;33(3):223-224.
- Marotta, R. B. and Floch, M. H. Diet and nutrition in ulcer disease. Med Clin North Am 1991;75(4):967-979. PubMed
- Subehan, Usia, T., Iwata, H., Kadota, S., and Tezuka, Y. Mechanism-based inhibition of CYP3A4 and CYP2D6 by Indonesian medicinal plants. J Ethnopharmacol. 5-24-2006;105(3):449-455. PubMed
- Gimenez L, Zacharisen M. Severe pepper allergy in a young child. WMJ. 2011 Jun;110(3):138-9.
- Ren T, Yang M, Xiao M, Zhu J, Xie W, Zuo Z. Time-dependent inhibition of carbamazepine metabolism by piperine in anti-epileptic treatment. Life Sci. 2019;218:314-323. PubMed
- Thomas AB, Choudhary DC, Raje A, Nagrik SS. Pharmacokinetics and pharmacodynamic herb-drug interaction of piperine with atorvastatin in rats. J Chromatogr Sci 2021;59(4):371-80. PubMed
- Haron MH, Dale O, Martin K, et al. Evaluation of the Herb-Drug Interaction Potential of Commonly Used Botanicals on the US Market with Regard to PXR- and AhR-Mediated Influences on CYP3A4 and CYP1A2. J Diet Suppl 2022. PubMed
- Lin F, Hu Y, Zhang Y, Zhao L, Zhong D, Liu J. Predicting Food-Drug Interactions between Piperine and CYP3A4 Substrate Drugs Using PBPK Modeling. Int J Mol Sci 2024;25(20):10955. PubMed
Parts of this content are provided by the Therapeutic Research Center, LLC.
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.
© 2021 Therapeutic Research Center, LLC