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

Biothin Fermented Apple Cider Vinegar and Cayenne Ingredients & Drug Interactions

by Dr. Mercola

Biothin Fermented Apple Cider Vinegar and Cayenne label
See full label image
Tablet Or Pill Category: Botanical
Most serious interaction: Moderate
Clinical methodology reviewed by · Updated Sep 16, 2026 · Label data from the NIH DSLD
What is this page for?

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

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

The interaction bottom line Most serious interaction: Moderate

Biothin Fermented Apple Cider Vinegar and Cayenne is a dietary supplement by Dr. Mercola with 3 active ingredients. Its ingredients are commonly taken for constipation, diarrhea, high cholesterol.Based on those ingredients, 2,071 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Dietary Fiber, organic fermented Cayenne Pepper, organic fermented Apple Cider Vinegar. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

Jump to a section

Check Your Meds Against Biothin Fermented Apple Cider Vinegar and Cayenne by Dr. Mercola

Ask about any prescription or over-the-counter medication and we check it for interactions with Biothin Fermented Apple Cider Vinegar and Cayenne by Dr. Mercola — and tell you which ingredient is responsible.

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HelloPharmacist Scorecard of Biothin Fermented Apple Cider Vinegar and Cayenne by Dr. Mercola

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

From our pharmacy team — supplement deep dive

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

What’s inside

Full disclosure
Ingredient Transparency · database check
Full

Every active ingredient lists its own amount on the label.

Why this rating?
  • The label discloses an exact amount for 3 of its 3 active ingredients.
  • No proprietary blends here — you can verify the dose of every single component.

This product contains 2 active ingredients: organic fermented apple cider vinegar and organic fermented cayenne pepper. Apple cider vinegar is used in traditional and folk medicine for various purposes, though many claimed benefits lack strong evidence.

Cayenne pepper contains capsaicin, the compound responsible for its heat, and is used most commonly for nerve pain relief.

Does it work?

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

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

Why this rating?
  • The label markets this product for: digestive support and blood glucose support.
  • We looked for evidence on: Dyspepsia, Gastroparesis, Irritable bowel syndrome (IBS), Diabetes, Impaired glucose tolerance (prediabetes), Hyperlipidemia — and 4 related terms.
  • The closest evidence on file: Black Psyllium is rated "Insufficient Reliable Evidence To Rate" for Diabetes (Natural Medicines).
  • Also on file: Apple Cider Vinegar is rated "Insufficient Reliable Evidence To Rate" for Diabetes, Dyspepsia, Hyperlipidemia, Impaired glucose tolerance (prediabetes), and more.
  • Also on file: Capsicum is rated "Insufficient Reliable Evidence To Rate" for Diabetes.

For apple cider vinegar, the evidence we hold doesn't establish effectiveness for acne, athletic performance, cognitive function, dental plaque, depression, or atopic dermatitis (eczema) — the data is insufficient to rate any of these. For cayenne pepper, the evidence shows it's likely effective for postherpetic neuralgia (nerve pain after shingles) and diabetic neuropathy (nerve damage from diabetes).

It's possibly effective for cluster headache, back pain, and postoperative nausea and vomiting.

The evidence, ingredient by ingredient Black Psyllium Apple Cider Vinegar Capsicum

How safe is it?

Well-documented data
Safety Information · database check
Well characterized

Adverse-effect, pregnancy, and general safety data are on file for most of these ingredients.

Why this rating?
  • We hold adverse-effect (side-effect) data for 3 of the 3 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 3 of 3.
  • General safety write-ups exist for 3 of 3.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

Apple cider vinegar in food amounts is generally well tolerated, but undiluted or large medicinal doses can cause harm. Long-term use in larger amounts may be unsafe — a published case documented hypokalemia, elevated renin levels, and osteoporosis after someone ingested 250 mL daily for 6 years.

Applied to skin, apple cider vinegar may cause chemical burns and irritation. Cayenne pepper in food amounts is likely fine, but concentrated supplements and medicinal doses aren't well studied.

Oral cayenne commonly causes burning, gas, bloating, nausea, diarrhea, headache, and skin flushing. Serious adverse effects are rare but include cases of heart attack and high blood pressure.

The product's pregnancy and lactation safety hasn't been established in the data we hold — talk with your doctor or pharmacist before use if you're pregnant or breastfeeding.

Side effects, ingredient by ingredient Black Psyllium Apple Cider Vinegar Capsicum

Meds to double-check

Moderate interaction found
Known Interaction Concern · database check
Moderate identified

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

Why this rating?
  • 3 of the 3 matched ingredients can interact with medications — Black Psyllium, Apple Cider Vinegar, Capsicum.
  • The most serious interaction on file is rated Moderate.
  • Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs; diabetes medications; heart-rhythm medications; lithium.
  • For scale: 2,072 individual medications appear in the full list. A big number alone doesn't make a product dangerous — what matters is whether YOUR medication is on it, so run yours through the interaction checker on this page.

Double-check diuretic drugs and digoxin (a heart medication) — apple cider vinegar carries a Moderate risk of lowering potassium dangerously. Also verify any blood-sugar medications, blood thinners like warfarin, theophylline (a breathing medication), aspirin, and ciprofloxacin (an antibiotic) before taking this product.

Check your own medication Run your meds through the checker above

The bottom line

Scorecard at a glanceFully disclosed formula with no established evidence rating for its marketed use. Moderate medication interactions have been identified, and safety information is well characterized.

If you take diuretics, heart medications, insulin, blood thinners, or blood-sugar drugs, you'll want to check your exact medications with the tool on this page before starting. The evidence for apple cider vinegar's health claims is thin; cayenne has solid data for nerve pain but not much else.

Talk to your pharmacist before you start, especially if you're on prescription medications.

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

Assessment coverage: 3 of 3 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Jun 22, 2023.

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

At a glance

General information

Key facts about Biothin Fermented Apple Cider Vinegar and Cayenne, straight from the product label.

Brand Dr. Mercola
Barcode (UPC) 810487032353
Net contents 90 Tablet(s)
Market status On market
Date entered into DSLD Jun 22, 2023
DSLD ID 287321
Product type Botanical
Supplement form Tablet Or Pill
Dietary claims / uses All Other, Structure/Function
Intended target group(s) Adult (18 - 50 Years), Organic
From the label
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.

Supplement Facts

The label details for Biothin Fermented Apple Cider Vinegar and Cayenne by Dr. Mercola, sourced from the NIH Dietary Supplement Label Database.

Supplement Facts

Daily Value (DV) Target Group(s):
Adults and children 4 or more years of age
Minimum serving Sizes:
1 Tablet(s)
Maximum serving Sizes:
1 Tablet(s)
Servings per container
90
UPC/BARCODE
810487032353
IngredientAmount% DV
Calories5 Calorie(s)--
Total Carbohydrates1 Gram(s)1%
Dietary Fiber1 Gram(s)3%
organic fermented Apple Cider Vinegar500 mg--
organic fermented Cayenne Pepper100 mg--

Other ingredients: Gum Acacia, Rice Maltodextrin, Tapioca Dextrose, organic Jerusalem Artichoke Fiber, Carnauba Wax, Tapioca Maltodextrin, Sunflower Lecithin, Palm Oil, Guar Gum, Sunflower Lecithin

Tap any ingredient to jump to its full detail below.

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

Suggested Use: Adults, as a dietary supplement, take one (1) tablet daily with a meal.

Precautions

Keep out of reach of children.

Do not use if safety seal is broken.

If you are nursing, pregnant, taking medication or have a medical condition, consult your physician before taking this product.

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

Digestive support Blood glucose support Fermented nutrients

USDA Organic Certified organic by: QCS

Seals/Symbols

USDA Organic

FDA Statement of Identity

Dietary Supplement

General Statements

Providing quality products since 2001.

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

See for yourself

Biothin Fermented Apple Cider Vinegar and Cayenne by Dr. Mercola label

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

Biothin Fermented Apple Cider Vinegar and Cayenne label

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

View the full label (PDF)
What’s inside

The Ingredients in Biothin Fermented Apple Cider Vinegar and Cayenne by Dr. Mercola

These are the 3 active ingredients this product is made of. Select any to open its full monograph.

Serving size1 Tablet(s) Dosage formTablet Or Pill Servings per container90 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.

Dietary Fiber

Interacts with
2,025 drugs
1 Gram(s) per serving

Black psyllium is a soluble-fiber supplement made from the seeds of a Plantago plant, used mostly to ease constipation and support digestive health. I...

Dietary Fiber monograph & interactions

Organic fermented Apple Cider Vinegar

Interacts with
162 drugs
500 mg per serving

Apple cider vinegar is a fermented apple product that many people use hoping to help with blood sugar, weight, or digestion. The evidence for most of...

Organic fermented Apple Cider Vinegar monograph & interactions

Organic fermented Cayenne Pepper

Interacts with
239 drugs
100 mg per serving

Capsicum (chili pepper) contains capsaicin, which is best known and best studied as a topical treatment for certain types of pain. Topical capsaicin p...

Organic fermented Cayenne Pepper monograph & interactions

Other (inactive) ingredients: Gum Acacia, Rice Maltodextrin, Tapioca Dextrose, Organic Jerusalem Artichoke Fiber, Carnauba Wax, Tapioca Maltodextrin, Sunflower Lecithin, Palm Oil, Guar Gum, Sunflower Lecithin. These complete the product’s ingredient list but are not active constituents.

Interaction report

Biothin Fermented Apple Cider Vinegar and Cayenne by Dr. Mercola Drug Interactions

Want to check YOUR meds against Biothin Fermented Apple Cider Vinegar and Cayenne?

Ask about interactions with your drugs in plain English — “Can I take it with lisinopril?” — and we find you the answer in seconds, ingredient by ingredient.

 Go to the checker
2,071Drugs
294 Moderate 1,777 Minor

Ingredients driving the most interactions

Dietary Fiber 2,025
organic fermented Cayenne Pepper 239
organic fermented Apple Cider Vinegar 162

Individual Drug Interactions

The ingredients in Biothin Fermented Apple Cider Vinegar and Cayenne interact with 2,071 drugs. Click any drug to see the details.

3 of the 3 ingredients in Biothin Fermented Apple Cider Vinegar and Cayenne interact with drugs. Each result below shows which ingredient is responsible. Dietary Fiber organic fermented Cayenne Pepper organic fermented Apple Cider Vinegar

Each ingredient & the kinds of drugs it affects

For each ingredient in Biothin Fermented Apple Cider Vinegar and Cayenne 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.

Dietary Fiber7 drug types · 2,025 drugs

Carbamazepine (Tegretol)

Theoretically, black psyllium might reduce the effects of carbamazepine and increase the risk for convulsions.
Theoretically, black psyllium might reduce carbamazepine absorption. A preliminary study using blond psyllium reported decreased carbamazepine bioavailability due to binding of the drug to psyllium, as well as reduction of available fluid in the gut for dissolution of the drug. This interaction may also occur with black psyllium.

Likelihood Probable Evidence D
Lithium

Theoretically, taking black psyllium at the same time as lithium might reduce lithium absorption.
The fiber in black psyllium might reduce lithium absorption and plasma levels. Some case reports describe a reduction in plasma lithium levels with concomitant administration of blond psyllium. This was reversed when psyllium was stopped. This interaction may also occur with black psyllium.

Likelihood Probable Evidence D
Metformin (Glucophage)

Theoretically, black psyllium might increase the therapeutic and adverse effects of metformin.
Animal research shows that concurrent consumption of blond psyllium with metformin slows and increases the absorption of metformin. This interaction may also occur with black psyllium. To avoid changes in absorption, take psyllium 30-60 minutes after metformin.

Likelihood Possible Evidence D
Olanzapine (Zyprexa)

Theoretically, taking black psyllium at the same time as olanzapine might reduce olanzapine absorption.
The fiber in black psyllium might decrease the absorption of olanzapine. A single case report describes a reduction in the effectiveness of olanzapine when it was concomitantly administered with an unspecified type of psyllium 3 grams orally twice daily. This effect was reversed when psyllium was stopped.

Likelihood Possible Evidence D
Digoxin (Lanoxin)

Theoretically, taking black psyllium at the same time as digoxin might reduce digoxin absorption and decrease digoxin levels.
Psyllium might bind digoxin in the gut. However, some clinical evidence suggests that psyllium does not impact digoxin absorption.

Likelihood Unlikely Evidence B
Ethinyl Estradiol

Theoretically, taking black psyllium at the same time as ethinyl estradiol might alter levels of estradiol.
Concurrent use of blond psyllium with ethinyl estradiol results in a slight increase in the extent of ethinyl estradiol absorption and a slower rate of absorption. This is unlikely to be clinically significant.

Likelihood Unlikely Evidence D
Oral Drugs

Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Psyllium seems to have variable effects on drug absorption. To avoid changes in absorption, take psyllium 30-60 minutes after oral medications. Animal research shows that blond psyllium delays and increases the absorption of metformin and ethinyl estradiol. Case reports and animal research suggest that blond psyllium might reduce absorption of lithium, digoxin, olanzapine, and carbamazepine. Finally, some pharmacokinetic studies show that psyllium does not affect the absorption of levothyroxine or warfarin. Although many of these studies evaluated blond psyllium, the fiber content in black psyllium may have similar effects.

Likelihood Possible Evidence B
Dietary Fiber full monograph & interactions

organic fermented Cayenne Pepper6 drug types · 239 drugs

Anticoagulant/Antiplatelet Drugs

Theoretically, capsicum may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
In vitro research shows that capsicum might increase the effects of antiplatelet drugs. Also, population research shows that capsicum is associated with an increased risk of self-reported bleeding in patients taking warfarin. However, clinical research shows that taking a single dose of capsaicin (Asian Herbex Ltd.), the active ingredient in capsicum, 400-800 mcg orally in combination with aspirin 500 mg does not decrease platelet aggregation when compared with taking aspirin 500 mg alone. Also, there was no notable effect on measures of platelet aggregation with capsaicin. It is unclear whether capsaicin must be used in more than a single dose to affect platelet aggregation.

Likelihood Possible Evidence B
Antidiabetes Drugs

Theoretically, taking capsicum with antidiabetes drugs might increase the risk of hypoglycemia.
Preliminary clinical research shows that consuming capsicum 5 grams along with a glucose drink attenuates the rise in plasma glucose after 30 minutes by 21%, decreases the 2-hour postprandial area under the curve of plasma glucose by 11%, and increases the 2-hour postprandial area under the curve of plasma insulin by 58% in healthy individuals when compared with placebo. Other clinical research shows that taking capsicum 5 mg daily for 28 days significantly reduces postprandial blood glucose and insulin levels, but not fasting blood glucose and insulin levels, in patients with gestational diabetes.

Likelihood Possible Evidence B
Aspirin

Theoretically, taking capsicum with aspirin might reduce the bioavailability of aspirin.
Animal research shows that acute or chronic intake of capsicum pepper reduces oral aspirin bioavailability. This has not been shown in humans.

Likelihood Possible Evidence D
Theophylline

Theoretically, taking capsicum with theophylline might increase the levels and adverse effects of theophylline.
In animal research, oral administration of capsicum reduced excretion of theophylline. However, capsicum does not seem to affect the pharmacokinetics of theophylline when administered intravenously.

Likelihood Possible Evidence D
Ace Inhibitors (Aceis)

Theoretically, using topical capsaicin may increase the risk of ACE inhibitor-induced cough.
There is one case report of a topically applied capsaicin cream contributing to the cough reflex in a patient using an ACEI. However, it is unclear if this interaction is clinically significant.

Likelihood Unlikely Evidence D
Ciprofloxacin (Cipro)

Theoretically, taking capsicum with ciprofloxacin might increase levels and adverse effects of ciprofloxacin.
Animal research shows that concomitant use of capsaicin, the active constituent of capsicum, and ciprofloxacin increases the bioavailability of ciprofloxacin by up to 70%.

Likelihood Possible Evidence D
organic fermented Cayenne Pepper full monograph & interactions

organic fermented Apple Cider Vinegar4 drug types · 162 drugs

Digoxin (Lanoxin)

Theoretically, concomitant use of apple cider vinegar with digoxin might increase the risk of cardiac toxicity.
A case of hypokalemia related to chronic use of apple cider vinegar has been reported. Theoretically, overuse of apple cider vinegar could decrease potassium levels, increasing the risk of toxicity with digoxin.

Likelihood Possible Evidence D
Diuretic Drugs

Theoretically, concomitant use of apple cider vinegar with diuretic drugs might increase the risk of hypokalemia.
A case of hypokalemia related to chronic use of apple cider vinegar has been reported. There is some concern that people taking apple cider vinegar along with potassium depleting diuretics might have an increased risk for hypokalemia.

Likelihood Possible Evidence D
Insulin

Theoretically, concomitant use of apple cider vinegar with insulin might increase the risk of hypokalemia.
A case of hypokalemia related to chronic use of apple cider vinegar has been reported. Theoretically, overuse of apple cider vinegar concomitantly with insulin might increase the risk of hypokalemia.

Likelihood Possible Evidence D
Antidiabetes Drugs

Theoretically, taking apple cider vinegar with antidiabetes drugs might increase the risk of hypoglycemia.
Apple cider vinegar might reduce fasting and postprandial blood glucose levels and decrease gastric emptying in people with diabetes. However, not all research agrees. Theoretically, it might have additive effects on glucose levels when used with antidiabetes drugs.

Likelihood Possible Evidence B
organic fermented Apple Cider Vinegar full monograph & interactions
The maker

Brand information

Manufacturer and brand details for Biothin Fermented Apple Cider Vinegar and Cayenne, from the product label.

Dr. Mercola

See all Dr. Mercola products
Name
NHP
Street Address
125 SW 3rd Place
City
Cape Coral
State
FL
ZipCode
33991
Phone Number
(877) 985-2696
Pharmacist Counseling Corner

Biothin Fermented Apple Cider Vinegar and Cayenne by Dr. Mercola: Common Questions

Does Biothin Fermented Apple Cider Vinegar and Cayenne by Dr. Mercola interact with any medications?
Yes. Based on its ingredients, Biothin Fermented Apple Cider Vinegar and Cayenne has a known interaction with 2,071 medications. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Biothin Fermented Apple Cider Vinegar and Cayenne contains 3 active ingredients, and an interaction can come from any of them. We check every ingredient, combine the results into one list per medication, and show which ingredient and mechanism is responsible.
Where does this information come from?
The product label data comes from the NIH Dietary Supplement Label Database (DSLD); the interaction data is built on the Natural Medicines database and reviewed by HelloPharmacist pharmacists.
Does this actually work for weight loss or metabolism?
The evidence we hold doesn't show whether apple cider vinegar is effective for weight loss or metabolism — we just don't have enough reliable data. Cayenne pepper is proven helpful for nerve pain, but that's a different purpose entirely.
What's the difference between the apple cider vinegar in this and what I cook with?
This product contains fermented apple cider vinegar in concentrated supplement form, not the diluted food-grade version you'd use in recipes. The supplement delivers much higher doses, which is why the safety concerns are greater.
Will this bother my stomach?
Apple cider vinegar in food amounts is well tolerated, but the product contains concentrated forms. Cayenne commonly causes burning, gas, bloating, nausea, and diarrhea. If you have a sensitive stomach or take stomach medications, talk to your pharmacist first.
Is it safe during pregnancy or while breastfeeding?
We don't hold enough safety data on either ingredient during pregnancy or breastfeeding to say. Please talk with your doctor or pharmacist before taking this product if you're pregnant or nursing.
What does cayenne actually do in the body?
Cayenne contains capsaicin, which reduces pain signals in nerve cells. It's proven effective for postherpetic neuralgia (shingles nerve pain) and diabetic nerve damage, and possibly helpful for cluster headaches and back pain.
Is this product better taken with or without food?
The product facts don't specify dosing instructions or timing relative to meals — talk to your pharmacist about how best to take it.

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

Not sure if Biothin Fermented Apple Cider Vinegar and Cayenne is safe with your meds?

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Ask a pharmacist

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.

Biothin Fermented Apple Cider Vinegar and Cayenne label
Go deeper

The Full Monographs Behind Biothin Fermented Apple Cider Vinegar and Cayenne’s Ingredients

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

Herb & supplement monograph

Black Psyllium

Interacts with 2,025 drugs

Black psyllium is a soluble-fiber supplement made from the seeds of a Plantago plant, used mostly to ease constipation and support digestive health. It is best known and most studied for rel...

Read the full Black Psyllium monograph → Herb & supplement monograph

Apple Cider Vinegar

Interacts with 162 drugs

Apple cider vinegar is a fermented apple product that many people use hoping to help with blood sugar, weight, or digestion. The evidence for most of these uses is limited and mixed, and the...

Read the full Apple Cider Vinegar monograph → Herb & supplement monograph

Capsicum

Interacts with 239 drugs

Capsicum (chili pepper) contains capsaicin, which is best known and best studied as a topical treatment for certain types of pain. Topical capsaicin products are supported by reasonable evid...

Read the full Capsicum monograph →
Sources

Sources & How We Checked

Biothin Fermented Apple Cider Vinegar and Cayenne's label data comes from the NIH Dietary Supplement Label Database; the ingredient interaction data is from the Natural Medicines database, reviewed by our pharmacists.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

The 118 references behind this product’s interaction data

Every citation that drives the interaction findings for this product’s ingredients, from the evidence-graded Natural Medicines (TRC Healthcare) database. Open an ingredient to browse its citations — links open the study on PubMed or the publisher’s site.

Black Psyllium 18 references
  1. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
  2. Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.
  3. Covington TR, et al. Handbook of Nonprescription Drugs. 11th ed. Washington, DC: American Pharmaceutical Association, 1996.
  4. Etman M. Effect of a bulk forming laxative on the bioavailablility of carbamazepine in man. Drug Dev Ind Pharm 1995;21:1901-6.
  5. Perlman BB. Interaction between lithium salts and ispaghula husk. Lancet 1990;335:416.
  6. Vaswani SK, Hamilton RG, Valentine MD, Adkinson NF. Psyllium laxative-induced anaphylaxis, asthma, and rhinitis. Allergy 1996;51:266-8. PubMed
  7. Lantner RR, Espiritu BR, Zumerchik P, Tobin MC. Anaphylaxis following ingestion of a psyllium-containing cereal. JAMA 1990;264:2534-6. DOI
  8. Kaplan MJ. Anaphylactic reaction to "Heartwise." N Engl J Med 1990;323:1072-3. DOI
  9. Nordstrom M, Melander A, Robertsson E, Steen B. Influence of wheat bran and of a bulk-forming ispaghula cathartic on the bioavailability of digoxin in geriatric in-patients. Drug Nutr Interact 1987;5:67-9..
  10. Robinson DS, Benjamin DM, McCormack JJ. Interaction of warfarin and nonsystemic gastrointestinal drugs. Clin Pharmacol Ther 1971;12:491-5. PubMed
  11. Garcia JJ, Fernandez N, Diez MJ, et al. Influence of two dietary fibers in the oral bioavailability and other pharmacokinetic parameters of ethinyloestradiol. Contraception 2000;62:253-7. PubMed
  12. Fernandez N, Lopez C, Díez R, et al. Drug interactions with the dietary fiber Plantago ovata husk. Expert Opin Drug Metab Toxicol 2012;8(11):1377-86.
  13. Semen plantaginis in: WHO Monographs on Selected Medicinal Plants, volume 1. World Health Organization, Geneva, 1999. Available at http://apps.who.int/medicinedocs/en/d/Js2200e/. Accessed November 26, 1026.
  14. Code of Federal Regulations, Title 21 (21CFR 101.17). Food labeling warning, notice, and safe handling statements. Available at www.ecfr.gov/cgi-bin/text-idx?SID=20f647d3b74161501f46564b915b4048&mc=true&node=se21.2.101_117&rgn=div8. Accessed December 3, 2
  15. Code of Federal Regulations, Title 21 (21CFR 201.319). Specific labeling requirements - water-soluble gums, hydrophilic gums, and hydrophilic mucilloids. Available at www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?fr=201.319. Accessed Dece
  16. Diez R, Garcia JJ, Diez MJ, Sierra M, Sahagun AM, Fernandez N. Influence of Plantago ovata husk (dietary fiber) on the bioavailability and other pharmacokinetic parameters of metformin in diabetic rabbits. BMC Complement Altern Med. 2017 Jun 7;17(1):298. PubMed
  17. Chiu AC, Sherman SI. Effects of pharmacological fiber supplements on levothyroxine absorption. Thyroid. 1998;8(8):667-71. PubMed
  18. Merrick C, Madden CA, Capurso NA. A Case of Blunted Orally Disintegrating Olanzapine Effect Due to Coadministered Psyllium. J Clin Psychiatry 2021;82(2):20cr13633. PubMed

See these in context on the Black Psyllium monograph →

Apple Cider Vinegar 11 references
  1. Lhotta K, Hofle G, Gasser R, Finkenstedt G. Hypokalemia, hyperreninemia, and osteoporosis in a patient ingesting large amounts of cider vinegar. Nephron 1998;80:242-3. PubMed
  2. Hill LL, Woodruff LH, Foote JC, Barreto-Alcoba M. Esophageal injury by apple cider vinegar tablets and subsequent evaluation of products. J Am Diet Assoc 2005;105:1141-4. PubMed
  3. Hlebowicz J, Darwiche G, Björgell O, Almér LO. Effect of apple cider vinegar on delayed gastric emptying in patients with type 1 diabetes mellitus: a pilot study. BMC Gastroenterol 2007;7:46. PubMed
  4. Johnston CS, Kim CM, Buller AJ. Vinegar improves insulin sensitivity to a high-carbohydrate meal in subjects with insulin resistance or type 2 diabetes. Diabetes Care 2004;27:281-2. PubMed
  5. Lhotta, K., Hofle, G., Gasser, R., and Finkenstedt, G. Hypokalemia, hyperreninemia and osteoporosis in a patient ingesting large amounts of cider vinegar. Nephron 1998;80(2):242-243. PubMed
  6. Bunick CG, Lott JP, Warren CB, et al. Chemical burn from topical apple cider vinegar. J Am Acad Dermatol 2012;67(4):e143-4. PubMed
  7. Feldstein S, Afshar M, Krakowski AC. Chemical Burn from Vinegar Following an Internet-based Protocol for Self-removal of Nevi. J Clin Aesthet Dermatol. 2015 Jun;8(6):50.
  8. Luu LA, Flowers RH, Kellams AL, et al. Apple cider vinegar soaks [0.5%] as a treatment for atopic dermatitis do not improve skin barrier integrity. Pediatr Dermatol. 2019;36(5):634-639. 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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