Black Snake Ingredients & Drug Interactions
by Vigor Labs
What is this page for?
First and foremost: checking Black Snake 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
Black Snake is a dietary supplement by Vigor Labs with 16 active ingredients. Its ingredients are commonly taken for zinc deficiency, immune support, cold symptoms.Based on those ingredients, 1,560 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Ginseng, Powder, Niacin, Black Cohosh Root, Stem Extract. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against Black Snake by Vigor Labs
Ask about any prescription or over-the-counter medication and we check it for interactions with Black Snake by Vigor Labs — 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 Black Snake by Vigor Labs
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
Black Snake contains 16 active ingredients spanning botanical extracts, amino acid chelates, and animal-derived materials. The formula includes zinc (for immune support and deficiency), niacin (B vitamin), oat straw and stinging nettle extracts (traditional herbal components), pumpkin powder, ginseng, astragalus, black cohosh root extract, and several others like longjack root, muira puama, catuaba bark, cnidium, xanthoparmelia, sarsaparilla, bovine orchic, and boron amino acid chelate.
The product is filled in gelatin capsules with silicon dioxide and magnesium stearate as inactive ingredients.
Does it work?
Moderate evidence
The evidence for this product's active ingredients is mixed. Zinc is effective for zinc deficiency and likely effective for Wilson disease, but only possibly effective for acne, age-related macular degeneration, and diabetes.
Niacin is likely effective for a condition called pellagra and possibly effective for certain cholesterol issues related to HIV. Oat straw extract is likely effective for heart health and cholesterol management.
Ginseng is possibly effective for erectile function and sexual arousal. Black cohosh may help with menopausal symptoms.
For boron, the data show it's likely effective for boron deficiency and possibly effective for vaginal yeast infections. For most of the other ingredients—including pumpkin, longjack, muira puama, catuaba bark, cnidium, xanthoparmelia, stinging nettle, sarsaparilla, and bovine orchic—either we hold no effectiveness data or the evidence is too limited to establish whether they work.
How safe is it?
Well-documented data
Zinc is generally well tolerated below 40 mg daily in adults, though doses above that can raise your risk of copper deficiency over time. Common side effects include nausea, metallic taste, and diarrhea.
Niacin commonly causes flushing and gastrointestinal upset, and high doses can affect liver function. Boron is generally safe below 20 mg daily but should be avoided in high doses in pregnancy.
Oat straw is well tolerated as food but may cause bloating or flatulence as you introduce fiber. Stinging nettle is generally well tolerated but rarely has been linked to liver injury.
Ginseng is well tolerated short-term but insomnia is common. Black cohosh is usually well tolerated in typical doses, though rare cases of liver concerns and elevated liver enzymes have been reported.
For xanthoparmelia, cnidium, muira puama, and catuaba bark, human safety data are very limited or absent. Bovine orchic products carry a contamination risk because they come from slaughterhouse tissue and may include material from sick animals.
Meds to double-check
Moderate interaction found
Before taking Black Snake, check your medications against these drug types: quinolone antibiotics (ciprofloxacin, levofloxacin), cephalosporins (like cephalexin), tetracycline antibiotics, blood thinners (warfarin, aspirin), diabetes medications and insulin, blood pressure drugs, statins, and liver-metabolized drugs including midazolam. If you take lithium, ginseng, stinging nettle, pumpkin, or sarsaparilla in this product may affect its levels.
Also check whether you're on any immunosuppressant drugs or antidepressants, as several ingredients interact with these.
The bottom line
Scorecard at a glanceFormula with limited ingredient disclosure with some supporting evidence for its stated purpose. Moderate medication interactions have been identified, and safety information is well characterized.
Black Snake is a multi-ingredient supplement with active components for various traditional uses, but its effectiveness for any single condition is not well established as a whole formula. If you take any prescription medications—especially blood pressure drugs, blood thinners, diabetes medications, antibiotics, or drugs that rely on liver metabolism—talk to your pharmacist before starting.
The product also raises pregnancy and breastfeeding safety concerns for several ingredients, so discuss it with your doctor if you're pregnant, planning to become pregnant, or nursing.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 16 of 16 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Sep 25, 2025.
This Scorecard evaluates available label information, ingredient evidence, and known medication-safety considerations. It does not independently verify product identity, purity, potency, contamination, or manufacturing quality. How these ratings are computed
General information
Key facts about Black Snake, straight from the product label.
| Brand | Vigor Labs |
|---|---|
| Barcode (UPC) | 713757297417 |
| Net contents | 30 Capsule(s) |
| Market status | On market |
| Date entered into DSLD | Sep 25, 2025 |
| DSLD ID | 334341 |
| Product type | Botanical With Nutrients |
| Supplement form | Capsule |
| Dietary claims / uses | All Other, Structure/Function |
| Intended target group(s) | Adult Male (18-50 Years), Seniors/Mature (>50 Years) - Men ONLY |
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 Black Snake by Vigor Labs, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Zinc | 29 mg | 264% |
| Niacin | 16 mg NE | 100% |
| Pumpkin, Powder | 0 NP | -- |
| Xanthoparmelia scabrosa extract | 0 NP | -- |
| Boron Amino Acid Chelate | 0 NP | -- |
| Cnidium monnieri fruit extract | 0 NP | -- |
| Oat Straw Extract | 0 NP | -- |
| Stinging Nettle, Powder | 0 NP | -- |
| Longjack Root Extract | 0 NP | -- |
| Muira Puama, Powder | 0 NP | -- |
| Ginseng, Powder | 0 NP | -- |
| Astragalus, Powder | 0 NP | -- |
| Catuaba Bark Extract | 0 NP | -- |
| Black Snake Gold Proprietary Blend | 500 mg | -- |
| Black Cohosh Root, Stem Extract | 0 NP | -- |
| Bovine Orchic, Raw | 0 NP | -- |
| Sarsaparilla, Powder | 0 NP | -- |
Other ingredients: Gelatin, Silicon Dioxide, 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.
Formulation
Harder Fuller Firmer Powerful formula Male enhancement
Suggested/Recommended/Usage/Directions
Once a day
Suggested use: As a dietary supplement, take one (1) Black Snake capsule daily.
FDA Statement of Identity
Dietary Supplement
Precautions
Caution: Seek advice from a health care practitioner to use this product if you have high blood pressure, heart or thyroid disease, diabetes, difficulty in urination due to an enlarged prostate, or if you are pregnant, nursing, or taking an MAO inhibitor or any prescription drug.
Reduce or discontinue use if nervousness, tremors, sleeplessness, loss of appetite or nausea occur. Do not exceed recommended serving size.
Not intended for use by persons under 18 years of age. Keep out of reach of children
Allergen warning: This product has been processed in a facility that handles gluten containing ingredients
Do not use this product if printed inner seal under cap is missing or broken.
Storage
Keep product at room temperature (59-86 F). Do not expose to excessive heat or moisture.
FDA Disclaimer Statement
These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.
Seals/Symbols
USA Made in the USA
General Statements
Follow us Instagram @VigorLabs Twitter @VigorLabs Facebook @VigorLabs
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Black Snake by Vigor Labs 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 Black Snake by Vigor Labs
These are the 16 active ingredients this product is made of. Select any to open its full monograph.
Serving size1 Capsule(s) Dosage formCapsule Servings per container30 Amounts shown are per serving.
Most supplement products combine several ingredients, and a medication can interact with the product through any one of them. Each ingredient below shows whether it has known drug interactions.
Zinc
Interacts with67 drugs
Zinc is an essential mineral that your body needs for immune function, wound healing, taste, and smell. Most people get enough from food, but suppleme...
Zinc monograph & interactionsNiacin
Interacts with727 drugs
Niacin (vitamin B3) is an essential nutrient your body needs for energy and metabolism, and deficiency is uncommon in most developed countries. Prescr...
Niacin monograph & interactionsBlack Snake Gold Proprietary Blend
- › Pumpkin, Powder
- › Xanthoparmelia scabrosa extract
- › Boron Amino Acid Chelate
- › Cnidium monnieri fruit extract
- › Oat Straw Extract
- › Stinging Nettle, Powder
- › Longjack Root Extract
- › Muira Puama, Powder
- › Ginseng, Powder
- › Astragalus, Powder
- › Catuaba Bark Extract
- › Black Cohosh Root, Stem Extract
- › Bovine Orchic, Raw
- › Sarsaparilla, Powder
Other (inactive) ingredients: Gelatin, Silicon Dioxide, Magnesium Stearate. These complete the product’s ingredient list but are not active constituents.
Black Snake by Vigor Labs Drug Interactions
HelloPharmacist Interaction Report
Black Snake by Vigor Labs contains 16 ingredients, several of which interact with medications.
The most serious documented interaction is with zinc and quinolone antibiotics (like ciprofloxacin or levofloxacin)—a Moderate severity issue where zinc forms complexes in your gut that block the antibiotic's absorption, reducing its effectiveness by a significant amount. You'll want to separate these by at least 2 hours before or 4–6 hours after taking zinc.
Read the full breakdown — every affected drug type, severity by severity
Zinc also interacts with other antibiotics (cephalosporins like cephalexin, and tetracyclines), as well as penicillamine, ritonavir, integrase inhibitors, and the chemotherapy drug cisplatin. Niacin in this product interacts with blood pressure medications, blood thinners, diabetes drugs, and statins.
Pumpkin powder may increase lithium levels. Oat straw extract and stinging nettle can lower blood sugar and may enhance the effect of diabetes medications or insulin.
Stinging nettle also contains vitamin K, which could interfere with warfarin. Ginseng affects liver metabolism of several drugs, including midazolam, and may interact with insulin, blood thinners, and certain antidepressants.
Black cohosh may inhibit liver metabolism of some drugs and could raise liver enzymes when combined with certain statins.
We could not check interactions for xanthoparmelia, cnidium, muira puama, catuaba bark, or bovine orchic because we hold no monograph data for them.
Altogether, these interactions span 1,538 individual medications. Use the medication checker on this page to verify your exact drugs before starting.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against Black Snake?
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 Black Snake interact with 1,560 drugs. Click any drug to see the details.
11 of the 16 ingredients in Black Snake interact with drugs. Each result below shows which ingredient is responsible. Ginseng, Powder Niacin Black Cohosh Root, Stem Extract Cnidium monnieri fruit extract Longjack Root Extract Astragalus, Powder Stinging Nettle, Powder Oat Straw Extract Zinc Sarsaparilla, Powder Pumpkin, Powder
6-mercaptopurinePurinethol
How 6-mercaptopurine interacts with Black Snake — through 4 ingredients. Tap an ingredient for the detail:
Ginseng, PowderImmunosuppressants Moderate
Interaction Summary
Theoretically, Panax ginseng use might interfere with immunosuppressive therapy.
Read the full Ginseng, Powder + 6-mercaptopurine interactionNiacinHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + 6-mercaptopurine interactionBlack Cohosh Root, Stem ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
Read the full Black Cohosh Root, Stem Extract + 6-mercaptopurine interactionAstragalus, PowderImmunosuppressants Moderate
Interaction Summary
Theoretically, astragalus might interfere with immunosuppressive therapy.
Read the full Astragalus, Powder + 6-mercaptopurine interactionAdo-trastuzumab EmtansineKadcyla
How Ado-trastuzumab Emtansine interacts with Black Snake — through 1 ingredient. Tap an ingredient for the detail:
Ginseng, PowderCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, Panax ginseng might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full Ginseng, Powder + Ado-trastuzumab Emtansine interactionAbacavir Sulfate, Dolutegravir, LamivudineTriumeq
How Abacavir Sulfate, Dolutegravir, Lamivudine interacts with Black Snake — through 2 ingredients. Tap an ingredient for the detail:
Black Cohosh Root, Stem ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
Read the full Black Cohosh Root, Stem Extract + Abacavir Sulfate, Dolutegravir, Lamivudine interactionNiacinHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Abacavir Sulfate, Dolutegravir, Lamivudine interactionAbacavir, LamivudineEpzicom
How Abacavir, Lamivudine interacts with Black Snake — through 2 ingredients. Tap an ingredient for the detail:
NiacinHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Abacavir, Lamivudine interactionBlack Cohosh Root, Stem ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
Read the full Black Cohosh Root, Stem Extract + Abacavir, Lamivudine interactionAbciximabReoPro
How Abciximab interacts with Black Snake — through 3 ingredients. Tap an ingredient for the detail:
NiacinAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, niacin may have additive effects when used with anticoagulant or antiplatelet drugs.
Read the full Niacin + Abciximab interactionCnidium Monnieri Fruit ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Laboratory research shows that osthol, a constituent of cnidium, inhibits blood clotting and the activity of platelets.
Read the full Cnidium Monnieri Fruit Extract + Abciximab interactionGinseng, PowderAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Although Panax ginseng has shown antiplatelet effects in the laboratory, it is unlikely to increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Ginseng, Powder + Abciximab interactionAbemaciclibVerzenio
How Abemaciclib interacts with Black Snake — through 1 ingredient. Tap an ingredient for the detail:
Ginseng, PowderCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, Panax ginseng might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full Ginseng, Powder + Abemaciclib interactionAbiraterone
How Abiraterone interacts with Black Snake — through 3 ingredients. Tap an ingredient for the detail:
NiacinHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Abiraterone interactionBlack Cohosh Root, Stem ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
Read the full Black Cohosh Root, Stem Extract + Abiraterone interactionGinseng, PowderCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, Panax ginseng might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full Ginseng, Powder + Abiraterone interactionAbiraterone AcetateYonsa, Zytiga
How Abiraterone Acetate interacts with Black Snake — through 3 ingredients. Tap an ingredient for the detail:
NiacinHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Abiraterone Acetate interactionGinseng, PowderCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, Panax ginseng might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full Ginseng, Powder + Abiraterone Acetate interactionBlack Cohosh Root, Stem ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
Read the full Black Cohosh Root, Stem Extract + Abiraterone Acetate interactionAbrocitinibCibinqo
How Abrocitinib interacts with Black Snake — through 5 ingredients. Tap an ingredient for the detail:
Ginseng, PowderAnticoagulant/antiplatelet Drugs, Immunosuppressants Moderate
Interaction Summary
Although Panax ginseng has shown antiplatelet effects in the laboratory, it is unlikely to increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Ginseng, Powder + Abrocitinib interactionCnidium Monnieri Fruit ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Laboratory research shows that osthol, a constituent of cnidium, inhibits blood clotting and the activity of platelets.
Read the full Cnidium Monnieri Fruit Extract + Abrocitinib interactionAstragalus, PowderImmunosuppressants Moderate
Interaction Summary
Theoretically, astragalus might interfere with immunosuppressive therapy.
Read the full Astragalus, Powder + Abrocitinib interactionNiacinAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, niacin may have additive effects when used with anticoagulant or antiplatelet drugs.
Read the full Niacin + Abrocitinib interactionLongjack Root ExtractCytochrome P450 2c19 (cyp2c19) Substrates Minor
Interaction Summary
Theoretically, Eurycoma longifolia might increase levels of CYP2C19 substrates.
Read the full Longjack Root Extract + Abrocitinib interactionAcalabrutinibCalquence
How Acalabrutinib interacts with Black Snake — through 1 ingredient. Tap an ingredient for the detail:
Ginseng, PowderCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, Panax ginseng might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full Ginseng, Powder + Acalabrutinib interactionAcarboseGlucobay, Prandase, Precose
How Acarbose interacts with Black Snake — through 6 ingredients. Tap an ingredient for the detail:
NiacinAntidiabetes Drugs, Hepatotoxic Drugs Moderate
Interaction Summary
Niacin can increase blood glucose levels and may diminish the effects of antidiabetes drugs.
Read the full Niacin + Acarbose interactionAstragalus, PowderAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, taking astragalus with antidiabetes drugs might increase the risk of hypoglycemia.
Read the full Astragalus, Powder + Acarbose interactionBlack Cohosh Root, Stem ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
Read the full Black Cohosh Root, Stem Extract + Acarbose interactionStinging Nettle, PowderAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, stinging nettle might have additive effects with antidiabetes drugs.
Read the full Stinging Nettle, Powder + Acarbose interactionOat Straw ExtractAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, oats may have additive effects with antidiabetic agents and might increase the risk of hypoglycemia.
Read the full Oat Straw Extract + Acarbose interactionGinseng, PowderAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, taking Panax ginseng with antidiabetes drugs might increase the risk of hypoglycemia.
Read the full Ginseng, Powder + Acarbose interactionAcebutololRhotral, Sectral
How Acebutolol interacts with Black Snake — through 2 ingredients. Tap an ingredient for the detail:
NiacinHepatotoxic Drugs, Antihypertensive Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Acebutolol interactionBlack Cohosh Root, Stem ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
Read the full Black Cohosh Root, Stem Extract + Acebutolol interactionAcenocoumarolSintrom
How Acenocoumarol interacts with Black Snake — through 3 ingredients. Tap an ingredient for the detail:
NiacinAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, niacin may have additive effects when used with anticoagulant or antiplatelet drugs.
Read the full Niacin + Acenocoumarol interactionCnidium Monnieri Fruit ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Laboratory research shows that osthol, a constituent of cnidium, inhibits blood clotting and the activity of platelets.
Read the full Cnidium Monnieri Fruit Extract + Acenocoumarol interactionGinseng, PowderAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Although Panax ginseng has shown antiplatelet effects in the laboratory, it is unlikely to increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Ginseng, Powder + Acenocoumarol interactionAcepromazineAtravet
How Acepromazine interacts with Black Snake — through 1 ingredient. Tap an ingredient for the detail:
Cnidium Monnieri Fruit ExtractCns Depressants Moderate
Interaction Summary
In laboratory research, cnidium has been shown to have sedative and hypnotic effects, possibly related to constituent coumarins.
Read the full Cnidium Monnieri Fruit Extract + Acepromazine interactionAcetaminophenChildren's Tylenol, Children's Tylenol Meltaways, Tylenol, Tylenol Ex Strength
How Acetaminophen interacts with Black Snake — through 3 ingredients. Tap an ingredient for the detail:
Black Cohosh Root, Stem ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
Read the full Black Cohosh Root, Stem Extract + Acetaminophen interactionNiacinHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Acetaminophen interactionLongjack Root ExtractCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, Eurycoma longifolia might increase levels CYP1A2 substrates.
Read the full Longjack Root Extract + Acetaminophen interactionAcetaminophen, AspirinGemnisyn
How Acetaminophen, Aspirin interacts with Black Snake — through 5 ingredients. Tap an ingredient for the detail:
NiacinHepatotoxic Drugs, Anticoagulant/antiplatelet Drugs +1 Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Acetaminophen, Aspirin interactionBlack Cohosh Root, Stem ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
Read the full Black Cohosh Root, Stem Extract + Acetaminophen, Aspirin interactionCnidium Monnieri Fruit ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Laboratory research shows that osthol, a constituent of cnidium, inhibits blood clotting and the activity of platelets.
Read the full Cnidium Monnieri Fruit Extract + Acetaminophen, Aspirin interactionGinseng, PowderAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Although Panax ginseng has shown antiplatelet effects in the laboratory, it is unlikely to increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Ginseng, Powder + Acetaminophen, Aspirin interactionLongjack Root ExtractCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, Eurycoma longifolia might increase levels CYP1A2 substrates.
Read the full Longjack Root Extract + Acetaminophen, Aspirin interactionAcetaminophen, Aspirin, CaffeineExcedrin, Excedrin Extra Strength, Excedrin Migraine
How Acetaminophen, Aspirin, Caffeine interacts with Black Snake — through 5 ingredients. Tap an ingredient for the detail:
NiacinAspirin, Anticoagulant/antiplatelet Drugs +1 Moderate
Interaction Summary
Large doses of aspirin might alter the clearance of niacin.
Read the full Niacin + Acetaminophen, Aspirin, Caffeine interactionGinseng, PowderCytochrome P450 3a4 (cyp3a4) Substrates, Anticoagulant/antiplatelet Drugs +2 Moderate
Interaction Summary
Theoretically, Panax ginseng might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full Ginseng, Powder + Acetaminophen, Aspirin, Caffeine interactionBlack Cohosh Root, Stem ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
Read the full Black Cohosh Root, Stem Extract + Acetaminophen, Aspirin, Caffeine interactionCnidium Monnieri Fruit ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Laboratory research shows that osthol, a constituent of cnidium, inhibits blood clotting and the activity of platelets.
Read the full Cnidium Monnieri Fruit Extract + Acetaminophen, Aspirin, Caffeine interactionLongjack Root ExtractCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, Eurycoma longifolia might increase levels CYP1A2 substrates.
Read the full Longjack Root Extract + Acetaminophen, Aspirin, Caffeine interactionAcetaminophen, Brompheniramine, PhenylpropanolamineDimetapp Cold and Flu
How Acetaminophen, Brompheniramine, Phenylpropanolamine interacts with Black Snake — through 4 ingredients. Tap an ingredient for the detail:
Ginseng, PowderStimulant Drugs Moderate
Interaction Summary
Theoretically, taking Panax ginseng with stimulant drugs might increase the risk of adverse stimulant effects.
Read the full Ginseng, Powder + Acetaminophen, Brompheniramine, Phenylpropanolamine interactionNiacinHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Acetaminophen, Brompheniramine, Phenylpropanolamine interactionBlack Cohosh Root, Stem ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
Read the full Black Cohosh Root, Stem Extract + Acetaminophen, Brompheniramine, Phenylpropanolamine interactionLongjack Root ExtractCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, Eurycoma longifolia might increase levels CYP1A2 substrates.
Read the full Longjack Root Extract + Acetaminophen, Brompheniramine, Phenylpropanolamine interactionAcetaminophen, ButalbitalAxocet, Bancap, Bucet, Butex Forte, Esgic CF, Orbivan CF +5 more
How Acetaminophen, Butalbital interacts with Black Snake — through 3 ingredients. Tap an ingredient for the detail:
Black Cohosh Root, Stem ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
Read the full Black Cohosh Root, Stem Extract + Acetaminophen, Butalbital interactionNiacinHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Acetaminophen, Butalbital interactionLongjack Root ExtractCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, Eurycoma longifolia might increase levels CYP1A2 substrates.
Read the full Longjack Root Extract + Acetaminophen, Butalbital interactionAcetaminophen, Butalbital, CaffeineEsgic, Esgic Plus, Fiogesic, Fioricet, Repan, Tecnal +1 more
How Acetaminophen, Butalbital, Caffeine interacts with Black Snake — through 4 ingredients. Tap an ingredient for the detail:
Ginseng, PowderStimulant Drugs, Caffeine +1 Moderate
Interaction Summary
Theoretically, taking Panax ginseng with stimulant drugs might increase the risk of adverse stimulant effects.
Read the full Ginseng, Powder + Acetaminophen, Butalbital, Caffeine interactionNiacinHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Acetaminophen, Butalbital, Caffeine interactionBlack Cohosh Root, Stem ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
Read the full Black Cohosh Root, Stem Extract + Acetaminophen, Butalbital, Caffeine interactionLongjack Root ExtractCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, Eurycoma longifolia might increase levels CYP1A2 substrates.
Read the full Longjack Root Extract + Acetaminophen, Butalbital, Caffeine interactionAcetaminophen, Butalbital, Caffeine, CodeineEsgic with Codeine, Fioricet w/ Codeine
How Acetaminophen, Butalbital, Caffeine, Codeine interacts with Black Snake — through 5 ingredients. Tap an ingredient for the detail:
Black Cohosh Root, Stem ExtractHepatotoxic Drugs, Cytochrome P450 2d6 (cyp2d6) Substrates Moderate
Interaction Summary
Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
Read the full Black Cohosh Root, Stem Extract + Acetaminophen, Butalbital, Caffeine, Codeine interactionNiacinHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Acetaminophen, Butalbital, Caffeine, Codeine interactionGinseng, PowderStimulant Drugs, Caffeine +2 Moderate
Interaction Summary
Theoretically, taking Panax ginseng with stimulant drugs might increase the risk of adverse stimulant effects.
Read the full Ginseng, Powder + Acetaminophen, Butalbital, Caffeine, Codeine interactionCnidium Monnieri Fruit ExtractCns Depressants Moderate
Interaction Summary
In laboratory research, cnidium has been shown to have sedative and hypnotic effects, possibly related to constituent coumarins.
Read the full Cnidium Monnieri Fruit Extract + Acetaminophen, Butalbital, Caffeine, Codeine interactionLongjack Root ExtractCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, Eurycoma longifolia might increase levels CYP1A2 substrates.
Read the full Longjack Root Extract + Acetaminophen, Butalbital, Caffeine, Codeine interactionAcetaminophen, Butalbital, CodeineBancap w/ Codeine
How Acetaminophen, Butalbital, Codeine interacts with Black Snake — through 5 ingredients. Tap an ingredient for the detail:
Ginseng, PowderCytochrome P450 2d6 (cyp2d6) Substrates Moderate
Interaction Summary
Theoretically, Panax ginseng might increase levels of drugs metabolized by CYP2D6.
Read the full Ginseng, Powder + Acetaminophen, Butalbital, Codeine interactionBlack Cohosh Root, Stem ExtractCytochrome P450 2d6 (cyp2d6) Substrates, Hepatotoxic Drugs Moderate
Interaction Summary
Some research suggests that black cohosh might inhibit CYP2D6, but there is conflicting evidence.
Read the full Black Cohosh Root, Stem Extract + Acetaminophen, Butalbital, Codeine interactionNiacinHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Acetaminophen, Butalbital, Codeine interactionCnidium Monnieri Fruit ExtractCns Depressants Moderate
Interaction Summary
In laboratory research, cnidium has been shown to have sedative and hypnotic effects, possibly related to constituent coumarins.
Read the full Cnidium Monnieri Fruit Extract + Acetaminophen, Butalbital, Codeine interactionLongjack Root ExtractCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, Eurycoma longifolia might increase levels CYP1A2 substrates.
Read the full Longjack Root Extract + Acetaminophen, Butalbital, Codeine interactionAcetaminophen, Butalbital, Codeine PhosphatePhrenilin #3
How Acetaminophen, Butalbital, Codeine Phosphate interacts with Black Snake — through 5 ingredients. Tap an ingredient for the detail:
Cnidium Monnieri Fruit ExtractCns Depressants Moderate
Interaction Summary
In laboratory research, cnidium has been shown to have sedative and hypnotic effects, possibly related to constituent coumarins.
Read the full Cnidium Monnieri Fruit Extract + Acetaminophen, Butalbital, Codeine Phosphate interactionGinseng, PowderCytochrome P450 2d6 (cyp2d6) Substrates Moderate
Interaction Summary
Theoretically, Panax ginseng might increase levels of drugs metabolized by CYP2D6.
Read the full Ginseng, Powder + Acetaminophen, Butalbital, Codeine Phosphate interactionBlack Cohosh Root, Stem ExtractHepatotoxic Drugs, Cytochrome P450 2d6 (cyp2d6) Substrates Moderate
Interaction Summary
Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
Read the full Black Cohosh Root, Stem Extract + Acetaminophen, Butalbital, Codeine Phosphate interactionNiacinHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Acetaminophen, Butalbital, Codeine Phosphate interactionLongjack Root ExtractCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, Eurycoma longifolia might increase levels CYP1A2 substrates.
Read the full Longjack Root Extract + Acetaminophen, Butalbital, Codeine Phosphate interactionAcetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, PhenylephrineHycomine Compound
How Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interacts with Black Snake — through 5 ingredients. Tap an ingredient for the detail:
Black Cohosh Root, Stem ExtractCytochrome P450 2d6 (cyp2d6) Substrates, Hepatotoxic Drugs Moderate
Interaction Summary
Some research suggests that black cohosh might inhibit CYP2D6, but there is conflicting evidence.
Read the full Black Cohosh Root, Stem Extract + Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interactionNiacinHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interactionCnidium Monnieri Fruit ExtractCns Depressants Moderate
Interaction Summary
In laboratory research, cnidium has been shown to have sedative and hypnotic effects, possibly related to constituent coumarins.
Read the full Cnidium Monnieri Fruit Extract + Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interactionGinseng, PowderCaffeine, Stimulant Drugs +2 Moderate
Interaction Summary
Theoretically, taking Panax ginseng with caffeine might increase the risk of adverse stimulant effects.
Read the full Ginseng, Powder + Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interactionLongjack Root ExtractCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, Eurycoma longifolia might increase levels CYP1A2 substrates.
Read the full Longjack Root 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 Black Snake — through 5 ingredients. Tap an ingredient for the detail:
Ginseng, PowderCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 2d6 (cyp2d6) Substrates +2 Moderate
Interaction Summary
Theoretically, Panax ginseng might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full Ginseng, Powder + Acetaminophen, Caffeine, Codeine interactionBlack Cohosh Root, Stem ExtractHepatotoxic Drugs, Cytochrome P450 2d6 (cyp2d6) Substrates Moderate
Interaction Summary
Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
Read the full Black Cohosh Root, Stem Extract + Acetaminophen, Caffeine, Codeine interactionNiacinHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Acetaminophen, Caffeine, Codeine interactionCnidium Monnieri Fruit ExtractCns Depressants Moderate
Interaction Summary
In laboratory research, cnidium has been shown to have sedative and hypnotic effects, possibly related to constituent coumarins.
Read the full Cnidium Monnieri Fruit Extract + Acetaminophen, Caffeine, Codeine interactionLongjack Root ExtractCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, Eurycoma longifolia might increase levels CYP1A2 substrates.
Read the full Longjack Root Extract + Acetaminophen, Caffeine, Codeine interactionAcetaminophen, Caffeine, Codeine, SalicylamideCodalan No.1, Codalan No.2, Codalan No.3
How Acetaminophen, Caffeine, Codeine, Salicylamide interacts with Black Snake — through 5 ingredients. Tap an ingredient for the detail:
Ginseng, PowderStimulant Drugs, Caffeine +2 Moderate
Interaction Summary
Theoretically, taking Panax ginseng with stimulant drugs might increase the risk of adverse stimulant effects.
Read the full Ginseng, Powder + Acetaminophen, Caffeine, Codeine, Salicylamide interactionCnidium Monnieri Fruit ExtractCns Depressants Moderate
Interaction Summary
In laboratory research, cnidium has been shown to have sedative and hypnotic effects, possibly related to constituent coumarins.
Read the full Cnidium Monnieri Fruit Extract + Acetaminophen, Caffeine, Codeine, Salicylamide interactionBlack Cohosh Root, Stem ExtractCytochrome P450 2d6 (cyp2d6) Substrates, Hepatotoxic Drugs Moderate
Interaction Summary
Some research suggests that black cohosh might inhibit CYP2D6, but there is conflicting evidence.
Read the full Black Cohosh Root, Stem Extract + Acetaminophen, Caffeine, Codeine, Salicylamide interactionNiacinHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Acetaminophen, Caffeine, Codeine, Salicylamide interactionLongjack Root ExtractCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, Eurycoma longifolia might increase levels CYP1A2 substrates.
Read the full Longjack Root Extract + Acetaminophen, Caffeine, Codeine, Salicylamide interactionAcetaminophen, Caffeine, DihydrocodeineDHC Plus, Panlor DC, Panlor SS
How Acetaminophen, Caffeine, Dihydrocodeine interacts with Black Snake — through 5 ingredients. Tap an ingredient for the detail:
Black Cohosh Root, Stem ExtractCytochrome P450 2d6 (cyp2d6) Substrates, Hepatotoxic Drugs Moderate
Interaction Summary
Some research suggests that black cohosh might inhibit CYP2D6, but there is conflicting evidence.
Read the full Black Cohosh Root, Stem Extract + Acetaminophen, Caffeine, Dihydrocodeine interactionNiacinHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Acetaminophen, Caffeine, Dihydrocodeine interactionCnidium Monnieri Fruit ExtractCns Depressants Moderate
Interaction Summary
In laboratory research, cnidium has been shown to have sedative and hypnotic effects, possibly related to constituent coumarins.
Read the full Cnidium Monnieri Fruit Extract + Acetaminophen, Caffeine, Dihydrocodeine interactionGinseng, PowderStimulant Drugs, Caffeine +2 Moderate
Interaction Summary
Theoretically, taking Panax ginseng with stimulant drugs might increase the risk of adverse stimulant effects.
Read the full Ginseng, Powder + Acetaminophen, Caffeine, Dihydrocodeine interactionLongjack Root ExtractCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, Eurycoma longifolia might increase levels CYP1A2 substrates.
Read the full Longjack Root Extract + Acetaminophen, Caffeine, Dihydrocodeine interactionAcetaminophen, Caffeine, IsomethepteneMigralam
How Acetaminophen, Caffeine, Isometheptene interacts with Black Snake — through 4 ingredients. Tap an ingredient for the detail:
Ginseng, PowderCytochrome P450 3a4 (cyp3a4) Substrates, Stimulant Drugs +1 Moderate
Interaction Summary
Theoretically, Panax ginseng might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full Ginseng, Powder + Acetaminophen, Caffeine, Isometheptene interactionBlack Cohosh Root, Stem ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
Read the full Black Cohosh Root, Stem Extract + Acetaminophen, Caffeine, Isometheptene interactionNiacinHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Acetaminophen, Caffeine, Isometheptene interactionLongjack Root ExtractCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, Eurycoma longifolia might increase levels CYP1A2 substrates.
Read the full Longjack Root Extract + Acetaminophen, Caffeine, Isometheptene interactionAcetaminophen, Caffeine, PyrilamineMidol Max Strength Menstrual
How Acetaminophen, Caffeine, Pyrilamine interacts with Black Snake — through 5 ingredients. Tap an ingredient for the detail:
Ginseng, PowderStimulant Drugs, Caffeine +1 Moderate
Interaction Summary
Theoretically, taking Panax ginseng with stimulant drugs might increase the risk of adverse stimulant effects.
Read the full Ginseng, Powder + Acetaminophen, Caffeine, Pyrilamine interactionNiacinHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Acetaminophen, Caffeine, Pyrilamine interactionBlack Cohosh Root, Stem ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
Read the full Black Cohosh Root, Stem Extract + Acetaminophen, Caffeine, Pyrilamine interactionStinging Nettle, PowderDiuretic Drugs Moderate
Interaction Summary
Theoretically, combining stinging nettle with diuretic drugs may have additive effects.
Read the full Stinging Nettle, Powder + Acetaminophen, Caffeine, Pyrilamine interactionLongjack Root ExtractCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, Eurycoma longifolia might increase levels CYP1A2 substrates.
Read the full Longjack Root Extract + Acetaminophen, Caffeine, Pyrilamine interactionAcetaminophen, Chlorpheniramine Maleate, Dextromethorphan HbrVicks Formula 44M Cough, Cold & Flu Relief
How Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interacts with Black Snake — through 4 ingredients. Tap an ingredient for the detail:
Black Cohosh Root, Stem ExtractCytochrome P450 2d6 (cyp2d6) Substrates, Hepatotoxic Drugs +1 Moderate
Interaction Summary
Some research suggests that black cohosh might inhibit CYP2D6, but there is conflicting evidence.
Read the full Black Cohosh Root, Stem Extract + Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interactionNiacinHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interactionGinseng, PowderCytochrome P450 2d6 (cyp2d6) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, Panax ginseng might increase levels of drugs metabolized by CYP2D6.
Read the full Ginseng, Powder + Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interactionLongjack Root ExtractCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, Eurycoma longifolia might increase levels CYP1A2 substrates.
Read the full Longjack Root Extract + Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interactionEach ingredient & the kinds of drugs it affects
For each ingredient in Black Snake 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.
Ginseng, Powder
Anticoagulant/Antiplatelet Drugs
Although Panax ginseng has shown antiplatelet effects in the laboratory, it is unlikely to increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
In vitro evidence suggests that ginsenoside constituents in Panax ginseng might decrease platelet aggregation. However, research in humans suggests that ginseng does not affect platelet aggregation. Animal research indicates low oral bioavailability of Rb1 and rapid elimination of Rg1, which might explain the discrepancy between in vitro and human research. Until more is known, use with caution in patients concurrently taking anticoagulant or antiplatelet drugs.
Antidiabetes Drugs
Theoretically, taking Panax ginseng with antidiabetes drugs might increase the risk of hypoglycemia.
Clinical research suggests that Panax ginseng might decrease blood glucose levels. Monitor blood glucose levels closely.
Caffeine
Theoretically, taking Panax ginseng with caffeine might increase the risk of adverse stimulant effects.
Panax ginseng has been shown to have stimulant effects. Theoretically, caffeine might have an additive effect on the stimulant effects of Panax ginseng.
Cytochrome P450 2D6 (Cyp2D6) Substrates
Theoretically, Panax ginseng might increase levels of drugs metabolized by CYP2D6. However, research is conflicting.
There is some evidence that Panax ginseng can inhibit the CYP2D6 enzyme by approximately 6%. In addition, in animal research, Panax ginseng inhibits the metabolism of dextromethorphan, a drug metabolized by CYP2D6, by a small amount. However, contradictory research suggests Panax ginseng might not inhibit CYP2D6. Until more is known, use Panax ginseng cautiously in patients taking drugs metabolized by these enzymes.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, Panax ginseng might increase or decrease levels of drugs metabolized by CYP3A4.
Panax ginseng may affect the clearance of drugs metabolized by CYP3A4. One such drug is imatinib. Inhibition of CYP3A4 was believed to be responsible for a case of imatinib-induced hepatotoxicity. In contrast, Panax ginseng has been shown to increase the clearance of midazolam, another drug metabolized by CYP3A4. Clinical research shows that Panax ginseng can reduce midazolam area under the curve by 44%, maximum plasma concentration by 26%, and time to reach maximum plasma concentration by 29%. Midazolam metabolism was also increased in animals given Panax ginseng. Until more is known, use Panax ginseng cautiously in combination with CYP3A4 substrates.
Estrogens
Theoretically, concomitant use of large amounts of Panax ginseng might interfere with hormone replacement therapy.
Laboratory research and some case reports suggest that Panax ginseng can have estrogenic effects due to competition for estrogen receptors. The estrogenic activity is attributed to the ginsenoside constituents of Panax ginseng.
Furosemide (Lasix)
Theoretically, Panax ginseng might reduce the effects of furosemide.
There is some concern that Panax ginseng might contribute to furosemide resistance. There is one case of resistance to furosemide diuresis in a patient taking a germanium-containing ginseng product.
Imatinib (Gleevec)
Theoretically, Panax ginseng might increase the effects and adverse effects of imatinib.
A case of imatinib-induced hepatotoxicity has been reported for a 26-year-old male with chronic myelogenous leukemia stabilized on imatinib for 7 years. The patient took imatinib 400 mg along with a Panax ginseng-containing energy drink daily for 3 months. Since imatinib-associated hepatotoxicity typically occurs within 2 years of initiating therapy, it is believed that Panax ginseng affected imatinib toxicity though inhibition of cytochrome P450 3A4. CYP3A4 is the primary enzyme involved in imatinib metabolism.
Immunosuppressants
Theoretically, Panax ginseng use might interfere with immunosuppressive therapy.
Panax ginseng might have immune system stimulating properties.
Insulin
Theoretically, taking Panax ginseng with insulin might increase the risk of hypoglycemia.
Clinical research suggests that Panax ginseng might decrease blood glucose levels. Insulin dose adjustments might be necessary in patients taking Panax ginseng; use with caution.
Midazolam (Versed)
Theoretically, Panax ginseng may increase the clearance of midazolam.
Midazolam is metabolized by cytochrome P450 3A4 (CYP3A4). Clinical research suggests that Panax ginseng can reduce midazolam area under the curve by 44%, maximum plasma concentration by 26%, and time to reach maximum plasma concentration by 29%. Midazolam metabolism was also increased in animals given Panax ginseng.
Monoamine Oxidase Inhibitors (Maois)
Theoretically, Panax ginseng can interfere with MAOI therapy.
Concomitant use of Panax ginseng with phenelzine (Nardil) is associated with insomnia, headache, tremors, and hypomania.
Nifedipine (Procardia)
Theoretically, taking Panax ginseng with nifedipine might increase serum levels of nifedipine and the risk of hypotension.
Preliminary clinical research shows that concomitant use can increase serum levels of nifedipine in healthy volunteers. This might cause the blood pressure lowering effects of nifedipine to be increased when taken concomitantly with Panax ginseng.
Qt Interval-Prolonging Drugs
Theoretically, Panax ginseng has an additive effect with drugs that prolong the QT interval and potentially increase the risk of ventricular arrhythmias. However, research is conflicting.
Clinical research shows that short-term use of Panax ginseng can increase the QT interval. However, no changes in QT interval have been identified with prolonged use.
Raltegravir (Isentress)
Theoretically, taking Panax ginseng with raltegravir might increase the risk of liver toxicity.
A case report suggests that concomitant use of Panax ginseng with raltegravir can increase serum levels of raltegravir, resulting in elevated liver enzymes levels.
Selegiline (Eldepryl)
Theoretically, Panax ginseng might increase or decrease levels of selegiline, possibly altering the effects and side effects of selegiline.
Animal research shows that taking selegiline with a low dose of Panax ginseng extract (1 gram/kg) reduces selegiline bioavailability, while taking a high dose of Panax ginseng extract (3 grams/kg) increases selegiline bioavailability. More research is needed to confirm these effects.
Stimulant Drugs
Theoretically, taking Panax ginseng with stimulant drugs might increase the risk of adverse stimulant effects.
Panax ginseng has been shown to have stimulant effects.
Warfarin (Coumadin)
Panax ginseng might affect the clearance of warfarin. However, this interaction appears to be unlikely.
There has been a single case report of decreased effectiveness of warfarin in a patient who also took Panax ginseng. However, it is questionable whether Panax ginseng was the cause of this decrease in warfarin effectiveness. Some research in humans and animals suggests that Panax ginseng does not affect the pharmacokinetics of warfarin. However, other research in humans suggests that Panax ginseng might modestly increase the clearance of the S-warfarin isomer. More evidence is needed to determine whether Panax ginseng causes a significant interaction with warfarin.
Fexofenadine (Allegra)
Theoretically, Panax ginseng might decrease blood levels of oral or intravenous fexofenadine.
Animal research suggests that taking Panax ginseng in combination with oral or intravenous fexofenadine may reduce the bioavailability of fexofenadine. Some scientists have attributed this effect to the ability of Panax ginseng to increase the expression of P-glycoprotein.
Lopinavir/Ritonavir (Kaletra)
Although Panax ginseng has demonstrated variable effects on cytochrome P450 3A4 (CYP3A4), which metabolizes lopinavir, Panax ginseng is unlikely to alter levels of lopinavir/ritonavir.
Lopinavir is metabolized by CYP3A4 and is administered with the CYP3A4 inhibitor ritonavir to increase its plasma concentrations. Panax ginseng has shown variable effects on CYP3A4 activity in humans. However, taking Panax ginseng (Vitamer Laboratories) 500 mg twice daily for 14 days did not alter the pharmacokinetics of lopinavir/ritonavir in 12 healthy volunteers.
Niacin
Alcohol (Ethanol)
Concomitant use of alcohol and niacin might increase the risk of flushing and hepatotoxicity.
Alcohol can exacerbate the flushing and pruritus associated with niacin. Large doses of niacin might also exacerbate liver dysfunction associated with chronic alcohol use. A case report describes delirium and lactic acidosis in a patient taking niacin 3 grams daily who ingested 1 liter of wine. Advise patients to avoid large amounts of alcohol while taking niacin.
Allopurinol (Zyloprim)
Theoretically, niacin might antagonize the therapeutic effects of uricosurics such as allopurinol.
Large doses of niacin can reduce urinary excretion of uric acid, potentially resulting in hyperuricemia. Doses of uricosurics such as allopurinol might need to be increased to maintain control of gout in patients who start taking niacin. People who have frequent attacks of gout despite uricosuric therapy should avoid niacin.
Anticoagulant/Antiplatelet Drugs
Theoretically, niacin may have additive effects when used with anticoagulant or antiplatelet drugs.
Several cases of clotting factor synthesis deficiency and coagulopathy have been reported in patients taking sustained-release niacin. Also, thrombocytopenia has been reported in patients treated with niacin or niacin plus lovastatin.
Antidiabetes Drugs
Niacin can increase blood glucose levels and may diminish the effects of antidiabetes drugs.
Niacin impairs glucose tolerance in a dose-dependent manner, probably by causing or aggravating insulin resistance and increasing hepatic production of glucose. In diabetes patients, niacin 4.5 grams daily for 5 weeks can increase plasma glucose by an average of 16% and glycated hemoglobin (HbA1c) by 21%. However, lower doses of 1.5 grams daily or less appear to have minimal effects on blood glucose. In some patients, glucose levels increase when niacin is started, but then return to baseline when a stable dose is reached. Up to 35% of patients with diabetes may need adjustments in hypoglycemic therapy when niacin is added.
Antihypertensive Drugs
Theoretically, niacin may increase the risk of hypotension when used with antihypertensive drugs.
The vasodilating effects of niacin can cause hypotension. Furthermore, some clinical evidence suggests that a one-hour infusion of niacin can reduce systolic, diastolic, and mean blood pressure in hypertensive patients. This effect is not observed in normotensive patients.
Bile Acid Sequestrants
Bile acid sequestrants can bind niacin and decrease absorption. Separate administration by 4-6 hours to avoid an interaction.
In vitro studies show that colestipol (Colestid) binds about 98% of available niacin and cholestyramine (Questran) binds 10% to 30%.
Gemfibrozil (Lopid)
Theoretically, concomitant use of niacin and gemfibrozil might increase the risk of myopathy in some patients.
A case of myopathy from concomitant use of niacin and gemfibrozil has been reported. Niacin alone has also been associated with cases of myopathy. Using gemfibrozil with niacin might further increase the risk of developing myopathy.
Hepatotoxic Drugs
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Niacin has been associated with cases of liver toxicity, especially when used in pharmacologic doses. Sustained-release niacin preparations appear to be associated with a higher risk of hepatotoxicity than immediate-release niacin.
Hmg-Coa Reductase Inhibitors ("Statins")
Theoretically, concomitant use of niacin and statins might increase the risk of myopathy and rhabdomyolysis in some patients.
Some case reports have raised concerns that niacin might increase the risk of myopathy and rhabdomyolysis when combined with statins. However, a significantly increased risk of myopathy has not been demonstrated in clinical trials, including those using an FDA-approved combination of lovastatin and niacin (Advicor).
Probenecid (Benemid)
Theoretically, niacin might antagonize the therapeutic effects of uricosurics such as probenecid.
Large doses of niacin reduce urinary excretion of uric acid, potentially causing hyperuricemia. Doses of uricosurics such as probenecid might need to be increased to maintain control of gout in patients who start taking niacin. People who have frequent attacks of gout despite uricosuric therapy should avoid niacin.
Sulfinpyrazone (Anturane)
Theoretically, niacin might antagonize the therapeutic effects of uricosurics such as sulfinpyrazone.
Large doses of niacin reduce urinary excretion of uric acid, potentially causing hyperuricemia. Doses of uricosurics such as sulfinpyrazone might need to be increased to maintain control of gout in patients who start taking niacin. People who have frequent attacks of gout despite uricosuric therapy should avoid niacin.
Thyroid Hormone
Theoretically, niacin might antagonize the therapeutic effects of thyroid hormones.
Clinical research and case reports suggests that taking niacin can reduce serum levels of thyroxine-binding globulin by up to 25% and moderately reduce levels of thyroxine (T4). Patients taking thyroid hormone for hypothyroidism might need dose adjustments when using niacin.
Transdermal Nicotine (Nicoderm)
Theoretically, concomitant use of niacin and transdermal nicotine might increase the risk of flushing and dizziness.
Niacin and nicotine can both cause flushing and dizziness.
Warfarin (Coumadin)
There is limited evidence that niacin may increase the anticoagulant effects of warfarin.
In a case report, a patient on warfarin developed an elevated international normalized ratio (INR) of 3.9 after taking niacin for two weeks. The patient's INR was previously stable, ranging between 2 and 3 in recent months, and no other medication changes were identified. The elevated INR returned to therapeutic range within 4 days following the discontinuation of niacin.
Aspirin
Large doses of aspirin might alter the clearance of niacin.
Aspirin is often used with niacin to reduce niacin-induced flushing. Doses of 80-975 mg aspirin have been used, but 325 mg appears to be optimal. Aspirin also seems to reduce the clearance of niacin by competing for glycine conjugation. Taking aspirin 1 gram seems to reduce niacin clearance by 45%. This is probably a dose-related effect and not clinically significant with the more common aspirin dose of 325 mg.
Black Cohosh Root, Stem Extract
Atorvastatin (Lipitor)
Taking black cohosh with atorvastatin might increase the risk for elevated liver function tests.
In one case report, a patient taking atorvastatin (Lipitor) developed significantly elevated liver function enzymes after starting black cohosh 100 mg four times daily. Liver enzymes returned to normal when black cohosh was discontinued. It is unclear whether the elevated liver enzymes were due to black cohosh itself or an interaction between atorvastatin and black cohosh.
Cisplatin (Platinol-Aq)
Theoretically, black cohosh may reduce the clinical effects of cisplatin.
Animal research suggests that black cohosh might decrease the cytotoxic effect of cisplatin on breast cancer cells.
Cytochrome P450 2D6 (Cyp2D6) Substrates
Some research suggests that black cohosh might inhibit CYP2D6, but there is conflicting evidence.
Some clinical research suggests that black cohosh might modestly inhibit CYP2D6 and increase levels of drugs metabolized by this enzyme. However, contradictory clinical research shows a specific black cohosh product (Remifemin, Enzymatic Therapy) 40 mg twice daily does not significantly inhibit metabolism of a CYP2D6 substrate in healthy study volunteers. Until more is known, use black cohosh cautiously in patients taking drugs metabolized by CYP2D6.
Estrogens
Theoretically, black cohosh may alter the effects of estrogen therapy.
Some research suggests that black cohosh has estrogenic effects. This may enhance or inhibit the effects of estrogen therapy.
Hepatotoxic Drugs
Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
There is concern that black cohosh might be linked to cases of liver failure and autoimmune hepatitis.
Serotonergic Drugs
Combining serotonergic drugs with black cohosh might cause additive serotonergic effects.
Black cohosh might increase the risk of serotonin syndrome when combined with other serotonergic drugs. Black cohosh acts as an agonist at several serotonin receptor subtypes and might interact with other serotonergic medications. In one case, a 55-year-old female who had been on stable treatment with sertraline 50 mg and duloxetine 60 mg daily developed serotonin syndrome after taking black cohosh extract 40 mg daily for 3 days.
Organic Anion-Transporting Polypeptide Substrates (Oatp)
Black cohosh may inhibit one form of OATP, OATP2B1, which could reduce the bioavailability and clinical effects of OATP2B1 substrates.
In vitro research shows that black cohosh modestly inhibits OATP2B1. OATPs are expressed in the small intestine and liver and are responsible for the uptake of drugs and other compounds into the body. Inhibition of OATP may reduce the bioavailability of oral drugs that are substrates of OATP.
Cnidium monnieri fruit extract
Anticoagulant/Antiplatelet Drugs
Laboratory research shows that osthol, a constituent of cnidium, inhibits blood clotting and the activity of platelets. Theoretically, cnidium might increase the risk of bleeding when used with antiplatelet or anticoagulant drugs.
Some anticoagulant or antiplatelet drugs include aspirin, clopidogrel (Plavix), dalteparin (Fragmin), enoxaparin (Lovenox), heparin, ticlopidine (Ticlid), warfarin (Coumadin), and others.
Cns Depressants
In laboratory research, cnidium has been shown to have sedative and hypnotic effects, possibly related to constituent coumarins. Theoretically, cnidium may potentiate the effects of barbiturates, other sedatives, and anxiolytics.
Longjack Root Extract
Propranolol (Inderal)
Eurycoma longifolia can reduce the levels and clinical effects of propranolol.
A small clinical study in healthy persons shows that taking a single dose of a water-based Eurycoma longifolia extract 200 mg, in combination with a single dose of propranolol 80 mg, reduces the propranolol area under the curve (AUC) by 29%, reduces the peak concentration by 42%, and increases time to peak concentration by 86% when compared with control. Since the elimination half-life of propranolol did not change, it seems that Eurycoma longifolia alters the kinetics of propranolol by decreasing its absorption in the gut, and not by altering its metabolism. It is not known if separating administration will prevent this interaction.
Cytochrome P450 1A2 (Cyp1A2) Substrates
Theoretically, Eurycoma longifolia might increase levels CYP1A2 substrates.
In vitro research suggests that methanolic Eurycoma longifolia root extract weakly inhibits CYP1A2 enzymes. This effect has not been reported in humans.
Cytochrome P450 2A6 (Cyp2A6) Substrates
Theoretically, Eurycoma longifolia might increase levels of CYP2A6 substrates.
In vitro research suggests that methanolic Eurycoma longifolia root extract weakly inhibits CYP2A6 enzymes. This effect has not been reported in humans.
Cytochrome P450 2C19 (Cyp2C19) Substrates
Theoretically, Eurycoma longifolia might increase levels of CYP2C19 substrates.
In vitro research suggests that methanolic Eurycoma longifolia root extract weakly inhibits CYP2C19 enzymes. This effect has not been reported in humans.
Testosterone
Theoretically, Eurycoma longifolia may further increase levels of testosterone.
A clinical study in aging males with testosterone levels below 300 ng/dL shows that taking a specific water extract of Eurycoma longifolia roots (Physta; Biotropics Malaysia) 100-200 mg daily with breakfast for 12 weeks increases total testosterone levels by 8% to 11% when compared with placebo. It is unclear whether this increase would occur in individuals with normal testosterone levels.
Astragalus, Powder
Antidiabetes Drugs
Theoretically, taking astragalus with antidiabetes drugs might increase the risk of hypoglycemia.
Clinical research in humans shows that astragalus might have hypoglycemic effects. Theoretically, taking astragalus, especially in combination with other hypoglycemic agents, might increase the risk of hypoglycemia.
Cyclophosphamide
Theoretically, astragalus might interfere with cyclophosphamide therapy.
Evidence regarding the effect of astragalus on immunosuppression caused by cyclophosphamide is conflicting. Some animal research suggests that astragalus reverses cyclophosphamide-induced immunosuppression. However, other animal research shows no effect.
Immunosuppressants
Theoretically, astragalus might interfere with immunosuppressive therapy.
Astragalus seems to stimulate immune function. Theoretically, taking astragalus might decrease the effects of immunosuppressive therapy.
Lithium
Theoretically, astragalus might increase levels and adverse effects of lithium.
Animal research suggests that astragalus has diuretic properties. Theoretically, due to this diuretic effect, astragalus might reduce excretion and increase levels of lithium.
Stinging Nettle, Powder
Antidiabetes Drugs
Theoretically, stinging nettle might have additive effects with antidiabetes drugs.
Clinical research shows that stinging nettle might decrease blood glucose levels in patients with diabetes.
Diuretic Drugs
Theoretically, combining stinging nettle with diuretic drugs may have additive effects.
Animal research suggests that the above ground parts and roots of stinging nettle may have a diuretic effect.
Lithium
Theoretically, stinging nettle might reduce excretion and increase levels of lithium.
Animal research suggests that stinging nettle has diuretic and natriuretic properties, which could alter the excretion of lithium. The dose of lithium might need to be decreased.
Warfarin (Coumadin)
There is some concern that stinging nettle might decrease the effects of anticoagulant drugs such as warfarin.
Stinging nettle contains a significant amount of vitamin K. When taken in large quantities, this might interfere with the activity of warfarin.
Oat Straw Extract
Antidiabetes Drugs
Theoretically, oats may have additive effects with antidiabetic agents and might increase the risk of hypoglycemia.
Consuming oats can decrease blood glucose in patients with diabetes. In those who require insulin, taking oats 100 grams daily for 2 days reduces the insulin dose required to achieve metabolic control.
Insulin
Concomitant use of oats and insulin might increase the risk of hypoglycemia.
In patients with insulin-dependent type 2 diabetes, taking oats 100 grams daily for 2 days reduces the insulin dose required to achieve metabolic control.
Zinc
Bictegravir/Emtricitabine/Tenofovir Alafenamide (Biktarvy)
Theoretically, zinc might decrease levels of bictegravir/emtricitabine/tenofovir alafenamide by reducing its absorption.
Advise patients that bictegravir/emtricitabine/tenofovir alafenamide should be taken at least 2 hours before or 6 hours after zinc containing products.
Cephalexin (Keflex)
Zinc might decrease cephalexin levels by chelating with cephalexin in the gut and preventing its absorption.
A pharmacokinetic study shows that zinc sulfate 250 mg taken concomitantly with cephalexin 500 mg decreases peak levels of cephalexin by 31% and reduces the exposure to cephalexin by 27%. Also, taking zinc sulfate 3 hours before cephalexin decreases peak levels of cephalexin by 11% and reduces the exposure to cephalexin by 18%. By decreasing cephalexin levels, zinc might increase the risk of treatment failure. This effect does not occur when zinc is taken 3 hours after the cephalexin dose. To avoid an interaction, advise patients take zinc sulfate 3 hours after taking cephalexin.
Cisplatin (Platinol-Aq)
Theoretically, zinc might interfere with the therapeutic effects of cisplatin.
Animal research suggests that zinc stimulates tumor cell production of the protein metallothionein, which binds and inactivates cisplatin. It is not known whether zinc supplements or high dietary zinc intake can cause clinically significant interference with cisplatin therapy. Cisplatin might also increase zinc excretion.
Integrase Inhibitors
Theoretically, taking zinc along with integrase inhibitors might decrease the levels and clinical effects of these drugs.
Zinc is a divalent cation. Pharmacokinetic studies have shown that other divalent cations such as calcium and iron can decrease blood levels of the integrase inhibitor dolutegravir through chelation.
Penicillamine (Cuprimine, Depen)
Zinc might reduce the levels and clinical effects of penicillamine.
By forming an insoluble complex with penicillamine, zinc interferes with penicillamine absorption and activity. Zinc supplements reduce the efficacy of low-dose penicillamine (0.5-1 gram/day), but do not seem to affect higher doses (1-2.75 gram/day), provided dosing times are separated. Advise patients to take zinc and penicillamine at least 2 hours apart.
Quinolone Antibiotics
Zinc can decrease the levels and clinical effects of quinolones antibiotics.
Quinolones form complexes with zinc in the gastrointestinal tract, reducing absorption of both the quinolone and zinc if taken at the same time. Advise patients to take these drugs at least 2 hours before, or 4-6 hours after, zinc supplements.
Ritonavir (Norvir)
Zinc modestly reduces levels of ritonavir.
Clinical research shows that zinc might reduce serum ritonavir levels by chelating with ritonavir in the gut and preventing its absorption. In patients with HIV, ritonavir is taken with atazanavir to prevent the metabolism and increase the effects of atazanavir. A pharmacokinetic study shows that, in patients being treated with atazanavir/ritonavir, co-administration of zinc sulfate (Solvazinc tablets) 125 mg as a single dose or as multiple daily doses for 2 weeks reduces plasma levels of ritonavir by about 16%. However, atazanavir levels still remains high enough to prevent HIV virus replication. Therefore, the decrease in ritonavir levels is not likely to be clinically significant.
Tetracycline Antibiotics
Zinc might reduce levels of tetracycline antibiotics.
Tetracyclines form complexes with zinc in the gastrointestinal tract, which can reduce absorption of both the tetracycline and zinc when taken at the same time. Taking zinc sulfate 200 mg with tetracycline reduces absorption of the antibiotic by 30% to 40%. Demeclocycline and minocycline cause a similar interaction. However, doxycycline does not seem to interact significantly with zinc. Advise patients to take tetracyclines at least 2 hours before, or 4-6 hours after, zinc supplements to avoid any interactions.
Amiloride (Midamor)
Amiloride can modestly reduce zinc excretion and increase zinc levels.
Clinical research shows that amiloride can reduce urinary zinc excretion, especially at doses of 10 mg per day or more. This zinc-sparing effect can help to counteract zinc losses caused by thiazide diuretics, but it is unlikely to cause zinc toxicity at usual amiloride doses. The other potassium-sparing diuretics, spironolactone (Aldactone) and triamterene (Dyrenium), do not seem to have a zinc-sparing effect.
Atazanavir (Reyataz)
Zinc modestly reduces levels of atazanavir, although this effect does not seem to be clinically significant.
Clinical research shows that zinc might decrease serum atazanavir levels by chelating with atazanavir in the gut and preventing its absorption. Although a single dose of zinc sulfate (Solvazinc tablets) 125 mg orally does not affect atazanavir concentrations in patients being treated with atazanavir/ritonavir, co-administration of zinc sulfate 125 mg daily for 2 weeks reduces plasma levels of atazanavir by about 22% in these patients. However, despite this decrease, atazanavir levels still remain at high enough concentrations for the prevention of HIV virus replication.
Sarsaparilla, Powder
Digoxin (Lanoxin)
Theoretically, concomitant use of sarsaparilla with digoxin might increase the risk of cardiac toxicity.
Sarsaparilla is thought to have diuretic properties, which could potentially cause potassium loss. Overuse or misuse of sarsaparilla with cardiac glycoside therapy might increase the risk of cardiac toxicity due to potassium loss.
Lithium
Theoretically, sarsaparilla might increase the effects and adverse effects of lithium.
Sarsaparilla is thought to have diuretic properties. Due to these effects, sarsaparilla might reduce excretion and increase levels of lithium. The dose of lithium might need to be decreased.
Pumpkin, Powder
Lithium
Pumpkin might reduce excretion and increase levels of lithium.
Pumpkin is thought to have diuretic properties. Theoretically, this might reduce excretion and increase levels of lithium. The dose of lithium might need to be decreased.
Brand information
Manufacturer and brand details for Black Snake, from the product label.
Vigor Labs
See all Vigor Labs products- Name
- Bioearth, LLC
- Street Address
- 1430 S. Dixie Hwy. Suite 105-1074
- City
- Coral Gables
- State
- FL
- ZipCode
- 33146
- Phone Number
- (888) 698-6603
- Web Address
- www.vigorlabs.com
Black Snake by Vigor Labs: 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 Black Snake’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Zinc
Interacts with 67 drugsZinc is an essential mineral that your body needs for immune function, wound healing, taste, and smell. Most people get enough from food, but supplements can help correct or prevent a defici...
Read the full Zinc monograph → Herb & supplement monographNiacin
Interacts with 727 drugsNiacin (vitamin B3) is an essential nutrient your body needs for energy and metabolism, and deficiency is uncommon in most developed countries. Prescription-strength niacin has been used to...
Read the full Niacin monograph → Herb & supplement monographPumpkin
Interacts with 1 drugPumpkin is a nutritious squash, and its seeds and seed oil are the parts most often used as supplements, mainly for urinary and prostate symptoms. The evidence for these uses is limited and...
Read the full Pumpkin monograph → Herb & supplement monographXanthoparmelia
Xanthoparmelia is a type of lichen marketed mainly in supplements promoted for erectile dysfunction and sexual performance, but there is very little reliable human research to support these...
Read the full Xanthoparmelia monograph → Herb & supplement monographBoron
Boron is a trace mineral found in many plant foods and sold as a supplement, mainly promoted for bone, joint, and hormone health. The human evidence for most of these uses is limited or prel...
Read the full Boron monograph → Herb & supplement monographCnidium
Interacts with 351 drugsCnidium is the dried fruit of an Asian plant long used in traditional Chinese medicine, mostly for skin problems and sexual health. Modern human evidence for these uses is very limited, with...
Read the full Cnidium monograph → Herb & supplement monographOats
Interacts with 86 drugsOats are a well-studied whole grain whose soluble fiber (beta-glucan) can help lower cholesterol and support heart health when eaten regularly. As a food, oats are safe for most people, and...
Read the full Oats monograph → Herb & supplement monographStinging Nettle
Interacts with 164 drugsStinging nettle is a common plant used as food and in traditional medicine, most often for prostate symptoms, allergies, and joint pain. The evidence is mixed and mostly preliminary, so it i...
Read the full Stinging Nettle monograph → Herb & supplement monographEurycoma Longifolia
Interacts with 248 drugsEurycoma longifolia (tongkat ali) is a Southeast Asian herb most popular for supporting testosterone, libido, and male fertility, with some small human studies suggesting possible benefits....
Read the full Eurycoma Longifolia monograph → Herb & supplement monographMuira Puama
Muira puama is a Brazilian plant traditionally used as an aphrodisiac and general tonic, often nicknamed 'potency wood.' Human research is very limited, so its benefits are not well proven,...
Read the full Muira Puama monograph → Herb & supplement monographPanax Ginseng
Interacts with 1,130 drugsPanax ginseng is a popular traditional herb used to boost energy, ease stress, and support overall wellness, though scientific evidence is mixed and mostly preliminary. It is generally well...
Read the full Panax Ginseng monograph → Herb & supplement monographAstragalus
Interacts with 208 drugsAstragalus is a root used for centuries in traditional Chinese medicine, mainly to support the immune system and help the body cope with stress. While early studies are interesting, strong h...
Read the full Astragalus monograph → Herb & supplement monographCatuaba
Catuaba is a Brazilian herbal bark long used as a traditional aphrodisiac and energy tonic, but there is very little reliable human research to show it works for any health condition. Qualit...
Read the full Catuaba monograph → Herb & supplement monographBlack Cohosh
Interacts with 652 drugsBlack cohosh is a North American plant most often used to ease menopause symptoms like hot flashes, but the research is mixed and far from settled. It is generally well tolerated for short-t...
Read the full Black Cohosh monograph → Herb & supplement monographOrchic Extract
Orchic extract is a glandular supplement made from the testicle tissue of animals, usually cattle. It is marketed for testosterone and male vitality, but there is essentially no reliable hum...
Read the full Orchic Extract monograph → Herb & supplement monographSarsaparilla
Interacts with 2 drugsSarsaparilla is a traditional root used in teas, tonics, and old-fashioned root beer flavoring. Modern evidence for its health claims is very limited and comes mostly from lab studies, so it...
Read the full Sarsaparilla monograph →Sources & How We Checked
Black Snake'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 361 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.
Zinc 88 references
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- Smith DS, Helzner EC, Nuttall CE Jr, et al. Failure of zinc gluconate in treatment of acute upper respiratory tract infections. Antimicrob Agents Chemother 1989;33:646-8. PubMed
- Blondeau JM. Expanded activity and utility of the new fluoroquinolones: a review. Clin Ther 1999;21:3-40. PubMed
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- Kugelmas M. Preliminary observation: oral zinc sulfate replacement is effective in treating muscle cramps in cirrhotic patients. J Am Coll Nutr 2000;19:13-5. PubMed
- Hebel SK, ed. Drug Facts and Comparisons. 52nd ed. St. Louis: Facts and Comparisons, 1998.
- Chan S, Gerson B, Subramaniam S. The role of copper, molybdenum, selenium, and zinc in nutrition and health. Clin Lab Med 1998;18:673-85. DOI
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- Hansten PD, Horn JR. Drug Interactions Analysis and Management. Vancouver, WA: Applied Therapeutics Inc., 1997 and updates.
- Seelig MS. Auto-immune complications of D-penicillamine - A possible result of zinc and magnesium depletion and of pyridoxine inactivation. J Am Coll Nutr 1982;1:207-14. PubMed
- Neuvonen PJ. Interactions with the absorption of tetracyclines. Drugs 1976;11:45-54.. PubMed
- Hirt M, Nobel S, Barron E. Zinc nasal gel for the treatment of common cold symptoms: A double-blind, placebo-controlled trial. Ear Nose Throat J 2000;79:778-82.. DOI
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- Douglas RM, Miles HB, Moore BW, et al. Failure of effervescent zinc acetate lozenges to alter the course of upper respiratory tract infections in Australian adults. Antimicrob Agents Chemother 1987;31:1263-5. PubMed
- Lagiou P, Wuu J, Trichopoulou A, et al. Diet and benign prostatic hyperplasia: a study in Greece. Urology 1999;54:284-90. PubMed
- Ewing CI, Gibbs AC, Ashcroft C, David TJ. Failure of oral zinc supplementation in atopic eczema. Eur J Clin Nutr 1991;45:507-10.
- Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. Washington, DC: National Academy Press, 2002.
- Age-Related Eye Disease Study Research Group. A randomized, placebo-controlled, clinical trial of high-dose supplementation with vitamins C and E, beta carotene, and zinc for age-related macular degeneration and vision loss. AREDS report no. 8. Arch Oph
- Greenberg JE, Lynn M, Kirsner RS, et al. Mucocutaneous pigmented macule as a result of zinc deposition. J Cutan Pathol 2002;29:613-5. PubMed
- Godfrey HR, Godfrey NJ, Godfrey JC, Riley D. A randomized clinical trial on the treatment of oral herpes with topical zinc oxide/glycine. Altern Ther Health Med 2001;7:49-56.
- Turner RB. Ineffectiveness of intranasal zinc gluconate for prevention of experimental rhinovirus colds. Clin Infect Dis 2001;33:1865-70. PubMed
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- Mossad SB. Effect of zincum gluconicum nasal gel on the duration and symptom severity of the common cold in otherwise healthy adults. QJM 2003;96:35-43. DOI
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- Jafek BW, Linschoten M, Murrow BW. Zicam Induced Anosmia. American Rhinologic Society 49th Annual Fall Scientific Meeting abstract. Orlando, Florida. September 20, 2003. http://app.american-rhinologic.org/programs/2003ARSFallProgram071503.pdf (Accessed 24
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- Barrett S. Zicam Marketers Sued. United States District Court Western District of Michigan Southern Division, Filed October 14, 2003, Case No. 4:03CV0146.
- Bilici M, Yildirim F, Kandil S, et al. Double-blind, placebo-controlled study of zinc sulfate in the treatment of attention deficit hyperactivity disorder. Prog Neuropsychopharmacol Biol Psychiatry 2004;28:181-90.. PubMed
- Polk RE, Healy DP, Sahai J, et al. Effect of ferrous sulfate and multivitamins with zinc on absorption of ciprofloxacin in normal volunteers. Antimicrob Agents Chemother 1989;33:1841-4. PubMed
- Mery C, Delrieu F, Ghozlan R, et al. Controlled trial of D-penicillamine in rheumatoid arthritis. Dose effect and the role of zinc. Scand J Rheumatol 1976;5:241-7. PubMed
- Penttila O, Hurme H, Neuvonen PJ. Effect of zinc sulfate on the absorption of tetracycline and doxycycline in man. Eur J Clin Pharmacol 1975;9:131-4.
- Kondo Y, Yamagata K, Satoh M, et al. Optimal administration schedule of cisplatin for bladder tumor with minimal induction of metallothionein. J Urol 2003;170:2467-70. PubMed
- Doz F, Berens ME, Deschepper CF, et al. Experimental basis for increasing the therapeutic index of cis-diamminedicarboxylatocyclobutaneplatinum(II) in brain tumor therapy by a high-zinc diet. Cancer Chemother Pharmacol 1992;29:219-26.
- Wester PO. Urinary zinc excretion during treatment with different diuretics. Acta Med Scand 1980;208:209-12. PubMed
- Golik A, Modai D, Weissgarten J, et al. Hydrochlorothiazide-amiloride causes excessive urinary zinc excretion. Clin Pharmacol Ther 1987;42:42-4. PubMed
- Leary WP, Reyes AJ, Van der Byl K. Urinary magnesium and zinc excretion after two different single doses of amiloride in healthy adults. Curr Ther Res 1983;34:205-16.
- McBride K, Slotnick B, Margolis FL. Does intranasal application of zinc sulfate produce anosmia in the mouse? An olfactometric and anatomical study. Chem Senses 2003;28:659-70. PubMed
- Burd GD. Morphological study of the effects of intranasal zinc sulfate irrigation on the mouse olfactory epithelium and olfactory bulb. Microsc Res Tech 1993;24:195-213. PubMed
- Ducray A, Bondier JR, Michel G, et al. Recovery following peripheral destruction of olfactory neurons in young and adult mice. Eur J Neurosci 2002;15:1907-17. PubMed
- Mayer AD, Rosenblatt JS. Peripheral olfactory deafferentation of the primary olfactory system in rats using ZnSO4 nasal spray with special reference to maternal behavior. Physiol Behav 1993;53:587-92. PubMed
- DeCook CA, Hirsch AR. Anosmia due to inhalational zinc: a case report (abstract). Chem Senses 2000;25:659.
- Tisdall FF, Brown A, Defries RD. Persistent anosmia following zinc sulfate nasal spraying. JPed 1938;18:60-2. DOI
- Lawson KA, Wright ME, Subar A, et al. Multivitamin use and risk of prostate cancer in the National Institutes of Health-AARP Diet and Health Study. J Natl Cancer Inst 2007;99:754-64. PubMed
- Public Health Advisory. Loss of sense of smell with intranasal cold remedies containing zinc. U.S. Food and Drug Administration, June 16, 2009. Available at: http://www.fda.gov/Drugs/DrugSafety/PublicHealthAdvisories/ucm166059.htm (Accessed 16 June 2009)
- Dooren JC. FDA warns against use of Zicam. The Wall Street Journal, June 16, 2009. Available at: http://online.wsj.com/article/SB124516778692319231.html#mod=djemHL?mg=com-wsj (Accessed 16 June 2009).
- Alexander TH, Davidson TM. Intranasal zinc and anosmia: the zinc-induced anosmia syndrome. Laryngoscope 2006;116:217-20.
- Health Canada / GlaxoSmithKline Consumer Healthcare. Association of long-term, excessive use of zinc-containing Poli-Grip products with myeloneuropathy and blood dyscrasias. February 18, 2010. Available at: http://hc-sc.gc.ca/dhp-mps/alt_formats/pdf/medef
- GlaxoSmithKline Consumer Advisory. GlaxoSmithKline (GSK) warns about a potential health risk associated with long-term, excessive use of GSK's zinc-containing denture adhesives Super Polygrip Original, Ultra Fresh and Extra Care. February 18, 2010. Availa
- Science M, Johnstone J, Roth DE, et al. Zinc for the treatment of the common cold: a systematic review and meta-analysis of randomized controlled trials. CMAJ 2012;184:E551-61. PubMed
- Castilla-Higuero, L., Romero-Gomez, M., Suarez, E., and Castro, M. Acute hepatitis after starting zinc therapy in a patient with presymptomatic Wilson's disease. Hepatology 2000;32(4 Pt 1):877. PubMed
- Sharquie, K. E., Najim, R. A., Farjou, I. B., and Al Timimi, D. J. Oral zinc sulphate in the treatment of acute cutaneous leishmaniasis. Clin.Exp.Dermatol. 2001;26(1):21-26. PubMed
- Dreno, B., Moyse, D., Alirezai, M., Amblard, P., Auffret, N., Beylot, C., Bodokh, I., Chivot, M., Daniel, F., Humbert, P., Meynadier, J., and Poli, F. Multicenter randomized comparative double-blind controlled clinical trial of the safety and efficacy of
- Moore, R. Bleeding gastric erosion after oral zinc sulphate. Br.Med J 3-25-1978;1(6115):754. PubMed
- Jafek, B. W., Linschoten, M. R., and Murrow, B. W. Anosmia after intranasal zinc gluconate use. Am J Rhinol. 2004;18(3):137-141. DOI
- Simonart, T. and de, Maertelaer, V. Systemic treatments for cutaneous warts: a systematic review. J Dermatolog.Treat. 2012;23(1):72-77. PubMed
- Cochran, R. J., Tucker, S. B., and Flannigan, S. A. Topical zinc therapy for acne vulgaris. Int.J Dermatol. 1985;24(3):188-190. DOI
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