Blood Pressure Support Ingredients & Drug Interactions
What is this page for?
First and foremost: checking Blood Pressure Support 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
Blood Pressure Support is a dietary supplement by Dr. Venessa's Formulas with 16 active ingredients. Its ingredients are commonly taken for morning sickness in pregnancy, premenstrual syndrome (pms), preventing or treating b6 deficiency.Based on those ingredients, 1,555 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are Green Tea extract, Vitamin E, Niacin. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against Blood Pressure Support by Dr. Venessa's Formulas
Ask about any prescription or over-the-counter medication and we check it for interactions with Blood Pressure Support by Dr. Venessa's Formulas — 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 Blood Pressure Support by Dr. Venessa's Formulas
Our pharmacy team’s full take, with four database checks built into the cards below — a summary of what is known, not a grade of the product itself.
What’s inside
Full disclosure
Blood Pressure Support contains 16 active ingredients aimed at cardiovascular health. The formula includes vitamins (B6 and E), minerals (potassium, magnesium, and selenium), amino acids (L-arginine and L-carnitine), niacin, coenzyme Q10, green tea extract, hawthorn extract, reishi mushroom powder, and dimethylglycine; folate and chloride are also listed.
The product's inactive ingredients are dicalcium phosphate, microcrystalline cellulose, stearic acid, magnesium stearate, croscarmellose sodium, and pharmaceutical glaze.
Does it work?
Moderate evidence
The evidence for effectiveness varies by ingredient and claimed benefit. Magnesium is effective for constipation and shows effectiveness for pre-eclampsia in pregnancy.
Potassium, L-arginine, and hawthorn extract have no effectiveness ratings in our data. Vitamin B6 is likely effective for high homocysteine levels (hyperhomocysteinemia) and possibly effective for pregnancy-related nausea.
Vitamin E is possibly effective for Alzheimer disease. Selenium is likely effective for selenium deficiency and possibly effective for pre-eclampsia.
Niacin is likely effective for pellagra and possibly effective for metabolic syndrome. Coenzyme Q10 is likely effective for CoQ10 deficiency and possibly effective for heart failure, migraines, and diabetic nerve damage.
Green tea extract is likely effective for HPV and possibly effective for high cholesterol. L-carnitine is possibly effective for heart failure and angina.
For other uses and ingredients, the evidence is either not established in our data or insufficient to rate.
How safe is it?
Well-documented data
Magnesium is generally well tolerated at recommended amounts. Vitamin B6 is safe at normal food and supplement doses, though high doses over time can damage nerves; it's often used at recommended levels for morning sickness under a doctor's guidance.
Vitamin E is generally safe from food and prenatal vitamins, but high-dose supplements may raise the risk of bleeding. Potassium from diet is fine; supplements require medical oversight, especially in pregnancy and those with kidney disease.
Selenium is safe in small recommended amounts, but excess is toxic. L-arginine is often well tolerated short-term but can lower blood pressure and may not be safe for everyone.
Niacin at normal dietary amounts is safe; high-dose supplements can cause flushing, liver problems, and elevated blood sugar. Coenzyme Q10 is generally well tolerated.
Green tea extract is generally safe as a beverage in moderate amounts, but concentrated extracts in high doses have been linked to rare liver injury. Hawthorn and reishi mushroom are generally well tolerated short-term, though long-term safety is not well studied for reishi.
None of these ingredients have established safety for pregnancy or breastfeeding (or have insufficient data to know either way) — discuss with your doctor or pharmacist for personalized advice on use during pregnancy or while nursing.
Meds to double-check
Major interaction found
Check with your pharmacist before taking this product if you use any of the following drug types, listed by severity of concern: nadolol (Corgard) or other beta-blockers; atorvastatin (Lipitor) or other statins; ephedrine; nitrates or phosphodiesterase-5 inhibitors like sildenafil (Viagra); ACE inhibitors or ARBs; blood thinners (anticoagulants or antiplatelets); seizure medications; levodopa/carbidopa (Sinemet); diabetes drugs; or digoxin (Lanoxin). Your pharmacist can run your exact medications through our interaction checker.
The bottom line
Scorecard at a glanceFully disclosed formula with some supporting evidence for its stated purpose. Major medication interactions have been identified, and safety information is well characterized.
This multi-ingredient blood pressure formula may appeal to someone looking for cardiovascular support, but the numerous documented interactions with common heart and blood pressure medications make it essential to check with your pharmacist before starting. Anyone taking beta-blockers, ACE inhibitors, ARBs, blood thinners, seizure drugs, or diabetes medications should especially be cautious.
People with kidney disease should avoid potassium supplements. Talk to your pharmacist or doctor before adding this product to your routine.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 12 of 16 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated May 22, 2015.
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 Blood Pressure Support, straight from the product label.
| Brand | Dr. Venessa's Formulas |
|---|---|
| Barcode (UPC) | 606851601207 |
| Net contents | 60 Tablet(s) |
| Market status | On market |
| Date entered into DSLD | May 22, 2015 |
| DSLD ID | 45216 |
| Product type | Other Combinations |
| Supplement form | Tablet Or Pill |
| Dietary claims / uses | All Other, Structure/Function |
| Intended target group(s) | Adult (18 - 50 Years) |
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.
Supplement Facts
The label details for Blood Pressure Support by Dr. Venessa's Formulas, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Vitamin B6 | 120 mg | 6000% |
| Potassium | 40 mg | 2% |
| Vitamin E | 200 IU | 667% |
| Folate | 800 mcg | 200% |
| Selenium | 200 mcg | 286% |
| Magnesium | 240 mg | 60% |
| Chloride | 38 mg | 2% |
| L-Arginine | 300 mg | -- |
| Niacin | 120 mg | 600% |
| Coenzyme Q10 | 60 mg | -- |
| L-Carnitine | 80 mg | -- |
| Dimethylglycine | 140 mg | -- |
| Green Tea extract | 180 mg | -- |
| Hawthorne extract | 240 mg | -- |
| Nattozime(TM) Proprietary Blend | 50 mg | -- |
| Reishi mushroom powder | 240 mg | -- |
Other ingredients: Dicalcium Phosphate, Microcrystalline Cellulose, Stearic Acid, Magnesium Stearate, Croscarmellose Sodium, Pharmaceutical Glaze
Tap any ingredient to jump to its full detail below.
These statements are the manufacturer’s wording, reproduced from the product label — the label is saying it, not HelloPharmacist. We don’t verify or endorse them.
General Statements
Dr. Venessa’s Blood Pressure Support is a clinically advanced formula designed to help maintain healthy blood pressure levels. Research shows that cardiovascular disorders are linked to hypertension and elevated homocysteine levels. Supporting a healthy blood pressure may extend your quality of life.
Specially formulated by Research Scientist Dr. Titus Venessa, Ph.D., Sc.D.
MAINTAINS HEALTHY BLOOD PRESSURE LEVELS*
Contains less than 2% of the Daily Value.
Suggested/Recommended/Usage/Directions
DIRECTIONS: Take 2 tablets twice daily with meals.
Precautions
If pregnant or nursing, please see your healthcare practitioner.
Keep out of reach of children.
Storage
Store in a cool, dry place.
FDA Disclaimer Statement
*This statement has not been evaluated by the FDA. This formula is not intended to diagnose, treat or cure any disease.
Seals/Symbols
SAFE THERAPEUTIC FORMULAS
FDA Statement of Identity
DIETARY SUPPLEMENT
Brand IP Statement(s)
Nattozime(TM) is a trademark of National Enzyme Company.
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Blood Pressure Support by Dr. Venessa's Formulas 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 Blood Pressure Support by Dr. Venessa's Formulas
These are the 16 active ingredients this product is made of. Select any to open its full monograph.
Serving size2 Tablet(s) Dosage formTablet Or Pill Servings per container15 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.
Vitamin B6
Interacts with210 drugs
Vitamin B6 (pyridoxine) is an essential water-soluble vitamin that your body needs for metabolism, brain function, and making red blood cells. It is b...
Vitamin B6 monograph & interactionsPotassium
Interacts with62 drugs
Potassium is an essential mineral your body needs for nerve signals, muscle function, and a steady heartbeat, and most people get enough from a balanc...
Potassium monograph & interactionsVitamin E
Interacts with764 drugs
Vitamin E is an essential fat-soluble vitamin and antioxidant that most people get in adequate amounts from a normal diet. Supplements can help correc...
Vitamin E monograph & interactionsFolate
Selenium
Interacts with321 drugs
Selenium is an essential trace mineral your body needs in small amounts for thyroid function, antioxidant defense, and immune health. Most people who...
Selenium monograph & interactionsMagnesium
Interacts with295 drugs
Magnesium is an essential mineral your body needs for muscles, nerves, blood pressure, and many other functions, and supplements are useful for preven...
Magnesium monograph & interactionsChloride
L-Arginine
Interacts with403 drugs
L-arginine is an amino acid that the body uses to make nitric oxide, a substance that helps blood vessels relax and widen. It is popularly used for bl...
L-Arginine 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 & interactionsCoenzyme Q10
Interacts with198 drugs
CoQ10 is a vitamin-like substance your body makes naturally that helps cells produce energy and acts as an antioxidant. It is generally well tolerated...
Coenzyme Q10 monograph & interactionsL-Carnitine
Interacts with19 drugs
L-carnitine is a compound your body makes naturally and also gets from foods like meat. It helps cells turn fat into energy, and supplements are most...
L-Carnitine monograph & interactionsDimethylglycine
Green Tea extract
Interacts with1,293 drugs
Green tea is a popular beverage rich in antioxidants called catechins, and drinking it in normal amounts is considered safe for most people. Concentra...
Green Tea extract monograph & interactionsHawthorne extract
Interacts with191 drugs
Hawthorn is a plant traditionally used for heart-related complaints, and some studies suggest it may modestly help symptoms of mild heart failure when...
Hawthorne extract monograph & interactionsNattozime(TM) Proprietary Blend
Reishi mushroom powder
Interacts with375 drugs
Reishi is a traditional Asian mushroom widely used to support the immune system and overall wellness. Human evidence for most of its claimed benefits...
Reishi mushroom powder monograph & interactionsOther (inactive) ingredients: Dicalcium Phosphate, Microcrystalline Cellulose, Stearic Acid, Magnesium Stearate, Croscarmellose Sodium, Pharmaceutical Glaze. These complete the product’s ingredient list but are not active constituents.
Blood Pressure Support by Dr. Venessa's Formulas Drug Interactions
HelloPharmacist Interaction Report
Blood Pressure Support by Dr.
Venessa's Formulas contains 16 ingredients, and several of them interact with medications. The most serious interaction we've documented is with green tea extract and nadolol (Corgard, a beta-blocker): green tea can reduce nadolol levels by roughly 85%, significantly weakening its blood pressure-lowering effect.
This is a Major severity interaction.
Read the full breakdown — every affected drug type, severity by severity
Additionally, green tea extract carries Major interactions with atorvastatin (Lipitor) — it reduces drug levels by about 24% — and with ephedrine, where the combination risks serious stimulant side effects like heart attack, stroke, or seizure. Hawthorn extract in this product has Major interactions with nitrates and phosphodiesterase-5 inhibitors (like sildenafil/Viagra), both carrying a risk of dangerous drops in blood pressure.
Moderate interactions are numerous. Magnesium can significantly reduce the absorption of levodopa/carbidopa (Sinemet) by 35–81%; vitamin B6 may reduce blood levels of seizure drugs (phenytoin, phenobarbital) and amplify photosensitivity from amiodarone; potassium raises the risk of dangerously high potassium levels (hyperkalemia) when combined with ACE inhibitors, ARBs, or potassium-sparing diuretics; and L-arginine may dangerously lower blood pressure alongside antihypertensive drugs, ACE inhibitors, or ARBs.
Vitamin E, selenium, niacin, coenzyme Q10, L-carnitine, and hawthorn carry additional moderate interactions with blood thinners, antidiabetes drugs, statins, and other common medications.
Additionally, folate, chloride, and Nattozyme proprietary blend could not be checked — we hold no interaction data for them. Altogether, these interactions span 1,532 individual medications.
Run your exact medications through the search tool below before starting this product.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against Blood Pressure Support?
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 Blood Pressure Support interact with 1,555 drugs. Click any drug to see the details.
12 of the 16 ingredients in Blood Pressure Support interact with drugs. Each result below shows which ingredient is responsible. Green Tea extract Vitamin E Niacin L-Arginine Reishi mushroom powder Selenium Magnesium Vitamin B6 Coenzyme Q10 Hawthorne extract Potassium L-Carnitine
Aminophylline, Amobarbital, EphedrineAmesec
How Aminophylline, Amobarbital, Ephedrine interacts with Blood Pressure Support — through 2 ingredients. Tap an ingredient for the detail:
Green Tea ExtractEphedrine, Stimulant Drugs Major
Interaction Summary
Theoretically, concomitant use might increase the risk for stimulant adverse effects.
Read the full Green Tea Extract + Aminophylline, Amobarbital, Ephedrine interactionSeleniumBarbiturates Moderate
Interaction Summary
Theoretically, selenium might prolong the sedating effects of barbiturates.
Read the full Selenium + Aminophylline, Amobarbital, Ephedrine interactionAtorvastatinAtorvaliq
How Atorvastatin interacts with Blood Pressure Support — through 3 ingredients. Tap an ingredient for the detail:
Green Tea ExtractAtorvastatin (lipitor), Cytochrome P450 3a4 (cyp3a4) Substrates +2 Major
Interaction Summary
Green tea extract seems to reduce the levels and clinical effects of atorvastatin.
Read the full Green Tea Extract + Atorvastatin interactionVitamin ECytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Vitamin E + Atorvastatin interactionNiacinHmg-coa Reductase Inhibitors ("statins"), Hepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and statins might increase the risk of myopathy and rhabdomyolysis in some patients.
Read the full Niacin + Atorvastatin interactionAtorvastatin CalciumLipitor
How Atorvastatin Calcium interacts with Blood Pressure Support — through 3 ingredients. Tap an ingredient for the detail:
Green Tea ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Organic Anion-transporting Polypeptide Substrates (oatp) +2 Major
Interaction Summary
Green tea is unlikely to produce clinically significant changes in the levels and clinical effects of CYP3A4 substrates.
Read the full Green Tea Extract + Atorvastatin Calcium interactionVitamin ECytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Vitamin E + Atorvastatin Calcium interactionNiacinHmg-coa Reductase Inhibitors ("statins"), Hepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and statins might increase the risk of myopathy and rhabdomyolysis in some patients.
Read the full Niacin + Atorvastatin Calcium interactionAvanafilStendra
How Avanafil interacts with Blood Pressure Support — through 3 ingredients. Tap an ingredient for the detail:
Hawthorne ExtractPhosphodiesterase-5 Inhibitors Major
Interaction Summary
Theoretically, concomitant use might result in additive vasodilation and hypotension.
Read the full Hawthorne Extract + Avanafil interactionVitamin ECytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Vitamin E + Avanafil interactionGreen Tea ExtractCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Green tea is unlikely to produce clinically significant changes in the levels and clinical effects of CYP3A4 substrates.
Read the full Green Tea Extract + Avanafil interactionBendroflumethiazide, NadololCorzide
How Bendroflumethiazide, Nadolol interacts with Blood Pressure Support — through 7 ingredients. Tap an ingredient for the detail:
Green Tea ExtractDiuretic Drugs, Nadolol (corgard) Major
Interaction Summary
Theoretically, using green tea with diuretic drugs might increase the risk of hypokalemia.
Read the full Green Tea Extract + Bendroflumethiazide, Nadolol interactionVitamin B6Antihypertensive Drugs Moderate
Interaction Summary
Theoretically, vitamin B6 may have additive effects when used with antihypertensive drugs.
Read the full Vitamin B6 + Bendroflumethiazide, Nadolol interactionL-arginineAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, concomitant use of L-arginine and antihypertensive drugs may increase the risk of hypotension.
Read the full L-arginine + Bendroflumethiazide, Nadolol interactionHawthorne ExtractBeta-blockers Moderate
Interaction Summary
Theoretically, concomitant use might cause additive effects on blood pressure and heart rate.
Read the full Hawthorne Extract + Bendroflumethiazide, Nadolol interactionReishi Mushroom PowderAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, concurrent use of reishi mushroom with antihypertensive drugs might increase the risk of hypotension.
Read the full Reishi Mushroom Powder + Bendroflumethiazide, Nadolol interactionNiacinAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, niacin may increase the risk of hypotension when used with antihypertensive drugs.
Read the full Niacin + Bendroflumethiazide, Nadolol interactionCoenzyme Q10Antihypertensive Drugs Minor
Interaction Summary
Theoretically, coenzyme Q10 might have additive effects with antihypertensive drugs.
Read the full Coenzyme Q10 + Bendroflumethiazide, Nadolol interactionBenserazide, LevodopaMadopar, Prolopa
How Benserazide, Levodopa interacts with Blood Pressure Support — through 2 ingredients. Tap an ingredient for the detail:
MagnesiumLevodopa/carbidopa (sinemet) Major
Interaction Summary
Magnesium can reduce the bioavailability of levodopa/carbidopa.
Read the full Magnesium + Benserazide, Levodopa interactionVitamin B6Levodopa Minor
Interaction Summary
Vitamin B6 may increase the metabolism of levodopa when taken alone, but not when taken in conjunction with carbidopa.
Read the full Vitamin B6 + Benserazide, Levodopa interactionCarbetapentane Tannate, Chlorpheniramine Tannate, Ephedrine Tannate, Phenylephrine TannateQuadratuss, Ry Tuss, Rynatuss, Tri Tannate Plus
How Carbetapentane Tannate, Chlorpheniramine Tannate, Ephedrine Tannate, Phenylephrine Tannate interacts with Blood Pressure Support — through 2 ingredients. Tap an ingredient for the detail:
Green Tea ExtractEphedrine, Stimulant Drugs +1 Major
Interaction Summary
Theoretically, concomitant use might increase the risk for stimulant adverse effects.
Read the full Green Tea Extract + Carbetapentane Tannate, Chlorpheniramine Tannate, Ephedrine Tannate, Phenylephrine Tannate interactionVitamin ECytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Vitamin E + Carbetapentane Tannate, Chlorpheniramine Tannate, Ephedrine Tannate, Phenylephrine Tannate interactionCarbidopaLodosyn
How Carbidopa interacts with Blood Pressure Support — through 1 ingredient. Tap an ingredient for the detail:
MagnesiumLevodopa/carbidopa (sinemet) Major
Interaction Summary
Magnesium can reduce the bioavailability of levodopa/carbidopa.
Read the full Magnesium + Carbidopa interactionCarbidopa, LevodopaDhivy, Rytary, Sinemet, Sinemet CR
How Carbidopa, Levodopa interacts with Blood Pressure Support — through 2 ingredients. Tap an ingredient for the detail:
MagnesiumLevodopa/carbidopa (sinemet) Major
Interaction Summary
Magnesium can reduce the bioavailability of levodopa/carbidopa.
Read the full Magnesium + Carbidopa, Levodopa interactionVitamin B6Levodopa Minor
Interaction Summary
Vitamin B6 may increase the metabolism of levodopa when taken alone, but not when taken in conjunction with carbidopa.
Read the full Vitamin B6 + Carbidopa, Levodopa interactionCarbidopa, Levodopa, EntacaponeStalevo
How Carbidopa, Levodopa, Entacapone interacts with Blood Pressure Support — through 2 ingredients. Tap an ingredient for the detail:
MagnesiumLevodopa/carbidopa (sinemet) Major
Interaction Summary
Magnesium can reduce the bioavailability of levodopa/carbidopa.
Read the full Magnesium + Carbidopa, Levodopa, Entacapone interactionVitamin B6Levodopa Minor
Interaction Summary
Vitamin B6 may increase the metabolism of levodopa when taken alone, but not when taken in conjunction with carbidopa.
Read the full Vitamin B6 + Carbidopa, Levodopa, Entacapone interactionDyphylline, Ephedrine, Guaifenesin, PhenobarbitalLufyllin-EPG
How Dyphylline, Ephedrine, Guaifenesin, Phenobarbital interacts with Blood Pressure Support — through 3 ingredients. Tap an ingredient for the detail:
Green Tea ExtractStimulant Drugs, Phenobarbital (luminal) +1 Major
Interaction Summary
Theoretically, concomitant use might increase stimulant adverse effects.
Read the full Green Tea Extract + Dyphylline, Ephedrine, Guaifenesin, Phenobarbital interactionSeleniumBarbiturates Moderate
Interaction Summary
Theoretically, selenium might prolong the sedating effects of barbiturates.
Read the full Selenium + Dyphylline, Ephedrine, Guaifenesin, Phenobarbital interactionVitamin B6Phenobarbital (luminal) Moderate
Interaction Summary
High doses of vitamin B6 may reduce the levels and clinical effects of phenobarbital.
Read the full Vitamin B6 + Dyphylline, Ephedrine, Guaifenesin, Phenobarbital interactionEphedrine, Guaifenesin (otc Drug)Ephedrine Formula 400, Ephedrine Plus Tabs
How Ephedrine, Guaifenesin (otc Drug) interacts with Blood Pressure Support — through 1 ingredient. Tap an ingredient for the detail:
Green Tea ExtractStimulant Drugs, Ephedrine Major
Interaction Summary
Theoretically, concomitant use might increase stimulant adverse effects.
Read the full Green Tea Extract + Ephedrine, Guaifenesin (otc Drug) interactionEphedrine, Guaifenesin, Phenobarbital, TheophyllineMudrane GG
How Ephedrine, Guaifenesin, Phenobarbital, Theophylline interacts with Blood Pressure Support — through 3 ingredients. Tap an ingredient for the detail:
Green Tea ExtractTheophylline, Phenobarbital (luminal) +2 Major
Interaction Summary
Theoretically, green tea might increase the levels and adverse effects of theophylline.
Read the full Green Tea Extract + Ephedrine, Guaifenesin, Phenobarbital, Theophylline interactionSeleniumBarbiturates Moderate
Interaction Summary
Theoretically, selenium might prolong the sedating effects of barbiturates.
Read the full Selenium + Ephedrine, Guaifenesin, Phenobarbital, Theophylline interactionVitamin B6Phenobarbital (luminal) Moderate
Interaction Summary
High doses of vitamin B6 may reduce the levels and clinical effects of phenobarbital.
Read the full Vitamin B6 + Ephedrine, Guaifenesin, Phenobarbital, Theophylline interactionEphedrine, Hydroxyzine, TheophyllineAmi Rax, Marax
How Ephedrine, Hydroxyzine, Theophylline interacts with Blood Pressure Support — through 1 ingredient. Tap an ingredient for the detail:
Green Tea ExtractStimulant Drugs, Theophylline +1 Major
Interaction Summary
Theoretically, concomitant use might increase stimulant adverse effects.
Read the full Green Tea Extract + Ephedrine, Hydroxyzine, Theophylline interactionEphedrine, Phenobarbital, Potassium Iodide, TheophyllineMudrane, Quadrinal
How Ephedrine, Phenobarbital, Potassium Iodide, Theophylline interacts with Blood Pressure Support — through 3 ingredients. Tap an ingredient for the detail:
Green Tea ExtractStimulant Drugs, Theophylline +2 Major
Interaction Summary
Theoretically, concomitant use might increase stimulant adverse effects.
Read the full Green Tea Extract + Ephedrine, Phenobarbital, Potassium Iodide, Theophylline interactionSeleniumBarbiturates Moderate
Interaction Summary
Theoretically, selenium might prolong the sedating effects of barbiturates.
Read the full Selenium + Ephedrine, Phenobarbital, Potassium Iodide, Theophylline interactionVitamin B6Phenobarbital (luminal) Moderate
Interaction Summary
High doses of vitamin B6 may reduce the levels and clinical effects of phenobarbital.
Read the full Vitamin B6 + Ephedrine, Phenobarbital, Potassium Iodide, Theophylline interactionEphedrine, Phenobarbital, TheophyllineTedral
How Ephedrine, Phenobarbital, Theophylline interacts with Blood Pressure Support — through 3 ingredients. Tap an ingredient for the detail:
Green Tea ExtractStimulant Drugs, Theophylline +2 Major
Interaction Summary
Theoretically, concomitant use might increase stimulant adverse effects.
Read the full Green Tea Extract + Ephedrine, Phenobarbital, Theophylline interactionVitamin B6Phenobarbital (luminal) Moderate
Interaction Summary
High doses of vitamin B6 may reduce the levels and clinical effects of phenobarbital.
Read the full Vitamin B6 + Ephedrine, Phenobarbital, Theophylline interactionSeleniumBarbiturates Moderate
Interaction Summary
Theoretically, selenium might prolong the sedating effects of barbiturates.
Read the full Selenium + Ephedrine, Phenobarbital, Theophylline interactionEzetimibe, AtorvastatinLiptruzet
How Ezetimibe, Atorvastatin interacts with Blood Pressure Support — through 3 ingredients. Tap an ingredient for the detail:
Green Tea ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Hepatotoxic Drugs +2 Major
Interaction Summary
Green tea is unlikely to produce clinically significant changes in the levels and clinical effects of CYP3A4 substrates.
Read the full Green Tea Extract + Ezetimibe, Atorvastatin interactionNiacinHepatotoxic Drugs, Hmg-coa Reductase Inhibitors ("statins") Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Ezetimibe, Atorvastatin interactionVitamin ECytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Vitamin E + Ezetimibe, Atorvastatin interactionFinasteride, TadalafilEntadfi
How Finasteride, Tadalafil interacts with Blood Pressure Support — through 3 ingredients. Tap an ingredient for the detail:
Hawthorne ExtractPhosphodiesterase-5 Inhibitors Major
Interaction Summary
Theoretically, concomitant use might result in additive vasodilation and hypotension.
Read the full Hawthorne Extract + Finasteride, Tadalafil interactionVitamin ECytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Vitamin E + Finasteride, Tadalafil interactionGreen Tea ExtractCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Green tea is unlikely to produce clinically significant changes in the levels and clinical effects of CYP3A4 substrates.
Read the full Green Tea Extract + Finasteride, Tadalafil interactionGlyceryl TrinitrateNitronal
How Glyceryl Trinitrate interacts with Blood Pressure Support — through 1 ingredient. Tap an ingredient for the detail:
Hawthorne ExtractNitrates Major
Interaction Summary
Theoretically, concomitant use might cause additive coronary vasodilatory effects.
Read the full Hawthorne Extract + Glyceryl Trinitrate interactionIsosorbide DinitrateAngitak, Cedocard Retard, Isoket, Isoket Retard, Isordil
How Isosorbide Dinitrate interacts with Blood Pressure Support — through 1 ingredient. Tap an ingredient for the detail:
Hawthorne ExtractNitrates Major
Interaction Summary
Theoretically, concomitant use might cause additive coronary vasodilatory effects.
Read the full Hawthorne Extract + Isosorbide Dinitrate interactionIsosorbide Dinitrate, HydralazineBiDil
How Isosorbide Dinitrate, Hydralazine interacts with Blood Pressure Support — through 6 ingredients. Tap an ingredient for the detail:
Hawthorne ExtractNitrates Major
Interaction Summary
Theoretically, concomitant use might cause additive coronary vasodilatory effects.
Read the full Hawthorne Extract + Isosorbide Dinitrate, Hydralazine interactionReishi Mushroom PowderAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, concurrent use of reishi mushroom with antihypertensive drugs might increase the risk of hypotension.
Read the full Reishi Mushroom Powder + Isosorbide Dinitrate, Hydralazine interactionNiacinAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, niacin may increase the risk of hypotension when used with antihypertensive drugs.
Read the full Niacin + Isosorbide Dinitrate, Hydralazine interactionL-arginineAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, concomitant use of L-arginine and antihypertensive drugs may increase the risk of hypotension.
Read the full L-arginine + Isosorbide Dinitrate, Hydralazine interactionVitamin B6Antihypertensive Drugs Moderate
Interaction Summary
Theoretically, vitamin B6 may have additive effects when used with antihypertensive drugs.
Read the full Vitamin B6 + Isosorbide Dinitrate, Hydralazine interactionCoenzyme Q10Antihypertensive Drugs Minor
Interaction Summary
Theoretically, coenzyme Q10 might have additive effects with antihypertensive drugs.
Read the full Coenzyme Q10 + Isosorbide Dinitrate, Hydralazine interactionIsosorbide MononitrateAngeze, Angeze SR, Chemydur 60XL, Dynamin, Elantan, Elantan LA +13 more
How Isosorbide Mononitrate interacts with Blood Pressure Support — through 1 ingredient. Tap an ingredient for the detail:
Hawthorne ExtractNitrates Major
Interaction Summary
Theoretically, concomitant use might cause additive coronary vasodilatory effects.
Read the full Hawthorne Extract + Isosorbide Mononitrate interactionLevodopaInbrija, Larodopa
How Levodopa interacts with Blood Pressure Support — through 2 ingredients. Tap an ingredient for the detail:
MagnesiumLevodopa/carbidopa (sinemet) Major
Interaction Summary
Magnesium can reduce the bioavailability of levodopa/carbidopa.
Read the full Magnesium + Levodopa interactionVitamin B6Levodopa Minor
Interaction Summary
Vitamin B6 may increase the metabolism of levodopa when taken alone, but not when taken in conjunction with carbidopa.
Read the full Vitamin B6 + Levodopa interactionLevodopa, CarbidopaDuodopa
How Levodopa, Carbidopa interacts with Blood Pressure Support — through 2 ingredients. Tap an ingredient for the detail:
MagnesiumLevodopa/carbidopa (sinemet) Major
Interaction Summary
Magnesium can reduce the bioavailability of levodopa/carbidopa.
Read the full Magnesium + Levodopa, Carbidopa interactionVitamin B6Levodopa Minor
Interaction Summary
Vitamin B6 may increase the metabolism of levodopa when taken alone, but not when taken in conjunction with carbidopa.
Read the full Vitamin B6 + Levodopa, Carbidopa interactionMacitentan, TadalafilOpsynvi
How Macitentan, Tadalafil interacts with Blood Pressure Support — through 8 ingredients. Tap an ingredient for the detail:
Hawthorne ExtractPhosphodiesterase-5 Inhibitors Major
Interaction Summary
Theoretically, concomitant use might result in additive vasodilation and hypotension.
Read the full Hawthorne Extract + Macitentan, Tadalafil interactionNiacinHepatotoxic Drugs, Antihypertensive Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Macitentan, Tadalafil interactionVitamin B6Antihypertensive Drugs Moderate
Interaction Summary
Theoretically, vitamin B6 may have additive effects when used with antihypertensive drugs.
Read the full Vitamin B6 + Macitentan, Tadalafil interactionVitamin ECytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Vitamin E + Macitentan, Tadalafil interactionGreen Tea ExtractHepatotoxic Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, concomitant use might have additive adverse hepatotoxic effects.
Read the full Green Tea Extract + Macitentan, Tadalafil interactionL-arginineAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, concomitant use of L-arginine and antihypertensive drugs may increase the risk of hypotension.
Read the full L-arginine + Macitentan, Tadalafil interactionReishi Mushroom PowderAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, concurrent use of reishi mushroom with antihypertensive drugs might increase the risk of hypotension.
Read the full Reishi Mushroom Powder + Macitentan, Tadalafil interactionCoenzyme Q10Antihypertensive Drugs Minor
Interaction Summary
Theoretically, coenzyme Q10 might have additive effects with antihypertensive drugs.
Read the full Coenzyme Q10 + Macitentan, Tadalafil interactionNadololCorgard, Nadolol
How Nadolol interacts with Blood Pressure Support — through 7 ingredients. Tap an ingredient for the detail:
Green Tea ExtractNadolol (corgard) Major
Interaction Summary
Green tea seems to reduce the levels and clinical effects of nadolol.
Read the full Green Tea Extract + Nadolol interactionVitamin B6Antihypertensive Drugs Moderate
Interaction Summary
Theoretically, vitamin B6 may have additive effects when used with antihypertensive drugs.
Read the full Vitamin B6 + Nadolol interactionNiacinAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, niacin may increase the risk of hypotension when used with antihypertensive drugs.
Read the full Niacin + Nadolol interactionL-arginineAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, concomitant use of L-arginine and antihypertensive drugs may increase the risk of hypotension.
Read the full L-arginine + Nadolol interactionReishi Mushroom PowderAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, concurrent use of reishi mushroom with antihypertensive drugs might increase the risk of hypotension.
Read the full Reishi Mushroom Powder + Nadolol interactionHawthorne ExtractBeta-blockers Moderate
Interaction Summary
Theoretically, concomitant use might cause additive effects on blood pressure and heart rate.
Read the full Hawthorne Extract + Nadolol interactionCoenzyme Q10Antihypertensive Drugs Minor
Interaction Summary
Theoretically, coenzyme Q10 might have additive effects with antihypertensive drugs.
Read the full Coenzyme Q10 + Nadolol interactionNicorandilAprior, Dancor, Ikorel, Sigmart, Zynicor
How Nicorandil interacts with Blood Pressure Support — through 1 ingredient. Tap an ingredient for the detail:
Hawthorne ExtractNitrates Major
Interaction Summary
Theoretically, concomitant use might cause additive coronary vasodilatory effects.
Read the full Hawthorne Extract + Nicorandil interactionNitroglycerinGonitro, Nitro Time, Nitro-Bid, Nitrocine Timecaps, Nitrogard, Nitrogard SR +7 more
How Nitroglycerin interacts with Blood Pressure Support — through 1 ingredient. Tap an ingredient for the detail:
Hawthorne ExtractNitrates Major
Interaction Summary
Theoretically, concomitant use might cause additive coronary vasodilatory effects.
Read the full Hawthorne Extract + Nitroglycerin interactionPentaerythritol TetranitratePeritrate, Peritrate SA
How Pentaerythritol Tetranitrate interacts with Blood Pressure Support — through 1 ingredient. Tap an ingredient for the detail:
Hawthorne ExtractNitrates Major
Interaction Summary
Theoretically, concomitant use might cause additive coronary vasodilatory effects.
Read the full Hawthorne Extract + Pentaerythritol Tetranitrate interactionSildenafilRevatio
How Sildenafil interacts with Blood Pressure Support — through 4 ingredients. Tap an ingredient for the detail:
Hawthorne ExtractPhosphodiesterase-5 Inhibitors Major
Interaction Summary
Theoretically, concomitant use might result in additive vasodilation and hypotension.
Read the full Hawthorne Extract + Sildenafil interactionVitamin ECytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Vitamin E + Sildenafil interactionL-arginineSildenafil (viagra) Moderate
Interaction Summary
Theoretically, concurrent use of sildenafil and L-arginine might increase the risk for hypotension.
Read the full L-arginine + Sildenafil interactionGreen Tea ExtractCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Green tea is unlikely to produce clinically significant changes in the levels and clinical effects of CYP3A4 substrates.
Read the full Green Tea Extract + Sildenafil interactionEach ingredient & the kinds of drugs it affects
For each ingredient in Blood Pressure Support 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.
Green Tea extract
Atorvastatin (Lipitor)
Green tea extract seems to reduce the levels and clinical effects of atorvastatin.
In healthy humans, taking green tea extract 300 mg or 600 mg along with atorvastatin reduces plasma levels of atorvastatin by approximately 24%. The elimination of atorvastatin is not affected. Atorvastatin is a substrate of organic anion-transporting polypeptides (OATPs). Research shows that two of the major catechins found in green tea, epicatechin gallate (ECG) and epigallocatechin gallate (EGCG), inhibit OATPs. Some OATPs are expressed in the small intestine and are responsible for the uptake of drugs and other compounds, which may have resulted in reduced plasma levels of atorvastatin. It is not clear if drinking green tea alters the absorption of atorvastatin.
Ephedrine
Theoretically, concomitant use might increase the risk for stimulant adverse effects.
Green tea contains caffeine. There is evidence that using ephedrine with caffeine might increase the risk of serious life-threatening or debilitating adverse effects such as hypertension, myocardial infarction, stroke, seizures, and death.
Nadolol (Corgard)
Green tea seems to reduce the levels and clinical effects of nadolol.
Preliminary clinical research shows that green tea consumption reduces plasma concentrations of nadolol. Compared to a control group, both peak levels and total drug exposure (AUC) of nadolol were reduced by approximately 85% in subjects who drank green tea daily for two weeks. Drinking green tea with nadolol also significantly reduced nadolol's systolic blood pressure lowering effect. Other clinical research shows that a single dose of green tea can affect plasma nadolol levels for at least one hour. Green tea catechins have been shown to inhibit organic anion transporting polypeptides (OATP), one of which, OATP1A2, is involved in the uptake of nadolol in the intestine The interaction is thought to be due primarily to the epigallocatechin gallate (EGCG) content of green tea.
5-Fluorouracil
Theoretically, high doses of green tea might increase the effects and side effects of 5-fluorouracil.
Animal research shows that taking green tea in amounts equivalent to about 6 cups daily in humans for 4 weeks prior to receiving a single injection of 5-fluorouracil increases the maximum plasma levels of 5-fluorouracil by about 2.5-fold and the area under the curve by 425%.
Adenosine (Adenocard)
Theoretically, green tea might decrease the vasodilatory effects of adenosine and interfere with its use prior to stress testing.
Green tea contains caffeine. Caffeine is a competitive inhibitor of adenosine at the cellular level. However, caffeine doesn't seem to affect supplemental adenosine because high interstitial levels of adenosine overcome the antagonistic effects of caffeine. It is recommended that methylxanthines and methylxanthine-containing products be stopped 24 hours prior to pharmacological stress tests. However, methylxanthines appear more likely to interfere with dipyridamole (Persantine) than adenosine-induced stress testing.
Anticoagulant/Antiplatelet Drugs
Theoretically, green tea may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Conflicting reports exist regarding the effect of green tea on bleeding risk when used with anticoagulant or antiplatelet drugs; however, most evidence suggests that drinking green tea in moderate amounts is unlikely to cause a significant interaction. Green tea contains small amounts of vitamin K, approximately 7 mcg per cup. Some case reports have associated the antagonism of warfarin with the vitamin K content of green tea. However, these reports are rare, and very large doses of green tea (about 8-16 cups daily) appear to be needed to cause these effects. Furthermore, the catechins and caffeine in green tea are reported to have antiplatelet activity.
Beta-Adrenergic Agonists
Green tea contains caffeine. Theoretically, concomitant use of large amounts of caffeine might increase cardiac inotropic effects of beta-agonists.
Bortezomib (Velcade)
Theoretically, green tea might interfere with the effects of bortezomib.
In vitro research shows that green tea polyphenols, such as epigallocatechin gallate (EGCG), interact with bortezomib and block its proteasome inhibitory action. This prevents the induction of cell death in multiple myeloma or glioblastoma cancer cell lines. Advise patients taking bortezomib, not to take green tea.
Carbamazepine (Tegretol)
Theoretically, green tea might reduce the effects of carbamazepine and increase the risk for convulsions.
Green tea contains caffeine. Animal research suggests that taking caffeine can lower the anticonvulsant effects of carbamazepine and can induce seizures when taken in doses above 400 mg/kg. Human research has shown that taking caffeine 300 mg in three divided doses along with carbamazepine 200 mg reduces the bioavailability of carbamazepine by 32% and prolongs the plasma half-life of carbamazepine 2-fold in healthy individuals.
Celiprolol (Celicard)
Theoretically, green tea might reduce the levels and clinical effects of celiprolol.
In a small human study, taking green tea daily for 4 days appears to decrease blood and urine levels of celiprolol by at least 98%. This interaction is possibly due to the inhibition of organic anion transporting polypeptide (OATP). Green tea catechins have been shown to inhibit organic anion transporting polypeptides (OATP), one of which, OATP1A2, is found in the intestine The interaction is thought to be due primarily to the epigallocatechin gallate (EGCG) content of green tea.
Cimetidine (Tagamet)
Theoretically, concomitant use might increase the effects and adverse effects of caffeine in green tea.
Green tea contains caffeine. Cimetidine can reduce caffeine clearance by 31% to 42%.
Clozapine (Clozaril)
Theoretically, green tea might increase the levels and adverse effects of clozapine and acutely exacerbate psychotic symptoms.
Animal research suggests that, although green tea extract does not affect the elimination of clozapine, it delays the time to reach peak concentration and reduces the peak plasma levels. Also, concomitant administration of green tea and clozapine might theoretically cause acute exacerbation of psychotic symptoms due to the caffeine in green tea. Caffeine can increase the effects and toxicity of clozapine. Caffeine doses of 400-1000 mg daily inhibit clozapine metabolism. Clozapine is metabolized by cytochrome P450 1A2 (CYP1A2). Researchers speculate that caffeine might inhibit CYP1A2. However, there is no reliable evidence that caffeine affects CYP1A2. There is also speculation that genetic factors might make some patients be more sensitive to the interaction between clozapine and caffeine.
Contraceptive Drugs
Theoretically, concomitant use might increase the effects and adverse effects of caffeine found in green tea.
Green tea contains caffeine. Oral contraceptives can decrease caffeine clearance by 40% to 65%.
Cytochrome P450 1A2 (Cyp1A2) Inhibitors
Theoretically, concomitant use might increase the levels and adverse effects of caffeine.
Green tea contains caffeine. Caffeine is metabolized by cytochrome P450 1A2 (CYP1A2),. Theoretically, drugs that inhibit CYP1A2 may decrease the clearance rate of caffeine from green tea and increase caffeine levels.
Dipyridamole (Persantine)
Theoretically, green tea might decrease the vasodilatory effects of dipyridamole and interfere with its use prior to stress testing.
Green tea contains caffeine. Caffeine might inhibit dipyridamole-induced vasodilation. It is recommended that methylxanthines and methylxanthine-containing products be stopped 24 hours prior to pharmacological stress tests. Methylxanthines appear more likely to interfere with dipyridamole (Persantine) than adenosine-induced stress testing.
Disulfiram (Antabuse)
Theoretically, disulfiram might increase the risk of adverse effects from caffeine.
In human research, disulfiram decreases the clearance and increases the half-life of caffeine.
Diuretic Drugs
Theoretically, using green tea with diuretic drugs might increase the risk of hypokalemia.
Green tea contains caffeine. In excessive amounts, caffeine can reduce potassium levels due to stimulation of the sodium-potassium pump. Diuretics can also cause lower potassium levels.
Estrogens
Theoretically, estrogens might increase the levels and adverse effects of caffeine.
Green tea contains caffeine. Estrogen inhibits caffeine metabolism.
Ethosuximide (Zarontin)
Theoretically, green tea might reduce the effects of ethosuximide and increase the risk for convulsions.
Green tea contains caffeine. Animal research suggests that caffeine 92.4 mg/kg can decrease the anticonvulsant activity of ethosuximide. However, this effect has not been reported in humans.
Felbamate (Felbatol)
Theoretically, green tea might reduce the effects of felbamate and increase the risk for convulsions.
Green tea contains caffeine. Animal research suggests that a high dose of caffeine 161.7 mg/kg can decreases the anticonvulsant activity of felbamate. However, this effect has not been reported in humans.
Fexofenadine (Allegra)
Green tea can decrease blood levels of fexofenadine.
Clinical research shows that green tea can significantly decrease blood levels and excretion of fexofenadine. Taking green tea extract with a dose of fexofenadine decreased bioavailability of fexofenadine by about 30%. In vitro, green tea inhibits the cellular accumulation of fexofenadine by inhibiting the organic anion transporting polypeptide (OATP) drug transporter. Research shows that two of the major catechins found in green tea, epicatechin gallate (ECG) and epigallocatechin gallate (EGCG), inhibit OATPs, specifically OATP1A2, OATP1B1, and OATP2B1. In addition, green tea has been shown to reduce the absorption of some drugs that are OATP substrates.
Flutamide (Eulexin)
Theoretically, green tea might increase the levels and adverse effects of flutamide.
Green tea contains caffeine. In vitro evidence suggests that caffeine can inhibit the metabolism of flutamide. Theoretically, concomitant use of caffeine and flutamide might increase serum concentrations of flutamide and increase the risk adverse effects.
Fluvoxamine (Luvox)
Theoretically, fluvoxamine might increase the levels and adverse effects of caffeine.
Green tea contains caffeine. Fluvoxamine reduces caffeine metabolism.
Hepatotoxic Drugs
Theoretically, concomitant use might have additive adverse hepatotoxic effects.
Green tea extract supplements have been linked to several cases of hepatotoxicity and might have additive hepatotoxic effects with other drugs..
Imatinib (Gleevec)
Theoretically, green tea might reduce the levels and clinical effects of imatinib.
In animal research, a single dose of green tea extract reduces the area under the curve (AUC) of imatinib by up to approximately 64% and its main metabolite N-desmethyl imatinib by up to approximately 81%. This interaction has not been shown in humans. The mechanism of action is unclear but may involve multiple pathways.
Vitamin E
Alkylating Agents
Theoretically, antioxidant effects of vitamin E might reduce the effectiveness of alkylating agents.
There's concern that antioxidants could reduce the activity of chemotherapy drugs which generate free radicals, such as cyclophosphamide, chlorambucil, carmustine, busulfan, and thiotepa. However, some researchers theorize that antioxidants might make chemotherapy more effective by reducing oxidative stress that might interfere with apoptosis (cell death) of cancer cells. More evidence is needed to determine what effect, if any, antioxidants such as vitamin E have on chemotherapy. Advise patients to consult their oncologist before using vitamin E supplements, especially in high doses.
Anticoagulant/Antiplatelet Drugs
Concomitant use of vitamin E and anticoagulant or antiplatelet agents might increase the risk of bleeding.
Vitamin E seems to inhibit of platelet aggregation and antagonize the effects of vitamin K-dependent clotting factors. These effects appear to be dose-dependent, and are probably only likely to be clinically significant with doses of at least 800 units daily. Mixed tocopherols, such as those found in food, might have a greater antiplatelet effect than alpha-tocopherol. RRR alpha-tocopherol (natural vitamin E) 1000 IU daily antagonizes vitamin K-dependent clotting factors. Advise patients to avoid high doses of vitamin E, especially in people with low vitamin K intake or other risk factors for bleeding.
Antitumor Antibiotics
Theoretically, antioxidant effects of vitamin E might reduce the effectiveness of antitumor antibiotics.
There's concern that antioxidants could reduce the activity of antitumor antibiotic drugs such as doxorubicin, which generate free radicals. However, some researchers theorize that antioxidants might make chemotherapy more effective by reducing oxidative stress that might interfere with apoptosis (cell death) of cancer cells. More evidence is needed to determine what effect, if any, antioxidants such as vitamin E have on chemotherapy involving antitumor antibiotics. Advise patients to consult their oncologist before using vitamin E supplements, especially in high doses.
Cyclosporine (Neoral, Sandimmune)
A specific form of vitamin E might increase absorption and levels of cyclosporine.
There is some evidence that one specific formulation of vitamin E (D-alpha-tocopheryl-polyethylene glycol-1000 succinate, TPGS, tocophersolan, Liqui-E) might increase absorption of cyclosporine. This vitamin E formulation forms micelles which seems to increase absorption of cyclosporine by 40% to 72% in some patients. However, this interaction is unlikely to occur with the usual forms of vitamin E.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Vitamin E appears to bind with the nuclear receptor, pregnane X receptor (PXR), which results in increased expression of CYP3A4. Although the clinical significance of this is not known, use caution when considering concomitant use of vitamin E and other drugs affected by these enzymes.
Selumetinib (Koselugo)
Taking selumetinib with vitamin E can result in a total daily dose of vitamin E that exceeds safe limits and therefore might increase the risk of bleeding.
Selumetinib contains 48-54 IU vitamin E per capsule. The increased risk of bleeding with vitamin E appears to be dose-dependent. Be cautious when using selumetinib in combination with supplemental vitamin E, especially in patients at higher risk of bleed, such as those with chronic conditions and those taking antiplatelet drugs.
Warfarin (Coumadin)
Using vitamin E with warfarin might increase the risk of bleeding.
Due to interference with production of vitamin K-dependent clotting factors, use of more than 400 IU of vitamin E daily with warfarin might increase prothrombin time (PT), INR, and the risk of bleeding,. At a dose of 1000 IU per day, vitamin E can antagonize vitamin K-dependent clotting factors even in people not taking warfarin. Limited clinical evidence suggests that doses up to 1200 IU daily may be used safely by patients taking warfarin, but this may not be applicable in all patient populations.
Niacin
Vitamin E might decrease the beneficial effects of niacin on high-density lipoprotein (HDL) cholesterol levels.
A combination of niacin and simvastatin (Zocor) effectively raises high-density lipoprotein (HDL) cholesterol levels in people with coronary disease and low HDL levels. Clinical research shows that taking a combination of antioxidants (vitamin C, vitamin E, beta-carotene, and selenium) along with niacin and simvastatin (Zocor) attenuates this rise in HDL, specifically the HDL-2 and apolipoprotein A1 fractions, by more than 50%. Vitamin E alone combined with a statin does not seem to decrease HDL levels. It is not known whether the adverse effect on HDL is due to one of the other antioxidants or to the combination. It also is not known whether it will occur in other patient populations.
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.
L-Arginine
Ace Inhibitors (Aceis)
Theoretically, concomitant use of L-arginine and ACE inhibitors may increase the risk for hypotension and hyperkalemia.
Combining L-arginine with some antihypertensive drugs, especially ACE inhibitors, seems to have additive vasodilating and blood pressure-lowering effects. Furthermore, ACE inhibitors can increase potassium levels. Use of L-arginine has been associated with hyperkalemia in some patients. Theoretically, concomitant use of ACE inhibitors with L-arginine may increases the risk of hyperkalemia.
Angiotensin Receptor Blockers (Arbs)
Theoretically, concomitant use of L-arginine and ARBs may increase the risk of hypotension and hyperkalemia.
L-arginine increases nitric oxide, which causes vasodilation. Combining L-arginine with ARBs seems to increase L-arginine-induced vasodilation. Furthermore, ARBs can increase potassium levels. Use of L-arginine has been associated with hyperkalemia in some patients. Theoretically, concomitant use of ARBs with L-arginine may increases the risk of hyperkalemia.
Anticoagulant/Antiplatelet Drugs
Theoretically, concomitant use of L-arginine with anticoagulant and antiplatelet drugs might have additive effects and increase the risk of bleeding.
Preliminary research suggests that L-arginine infusions reduce platelet aggregation in humans. The clinical significance of this effect is unclear.
Antidiabetes Drugs
Theoretically, concomitant use of L-arginine might have additive effects with antidiabetes drugs.
Preliminary clinical research shows that L-arginine decreases blood glucose levels in patients with type 2 diabetes.
Antihypertensive Drugs
Theoretically, concomitant use of L-arginine and antihypertensive drugs may increase the risk of hypotension.
L-arginine increases nitric oxide, which causes vasodilation. Clinical evidence shows that L-arginine can reduce blood pressure in some individuals with hypertension. Furthermore, combining L-arginine with some antihypertensive drugs seems to have additive vasodilating and blood pressure-lowering effects.
Isoproterenol (Isuprel)
Theoretically, concurrent use of isoproterenol and L-arginine might result in additive effects and hypotension.
Preliminary clinical evidence suggests that L-arginine enhances isoproterenol-induced vasodilation in patients with essential hypertension or a family history of essential hypertension.
Potassium-Sparing Diuretics
Theoretically concomitant use of potassium-sparing diuretics with L-arginine may increases the risk of hyperkalemia.
Potassium-sparing diuretics can increase potassium levels. Use of L-arginine has been associated with hyperkalemia in some patients.
Sildenafil (Viagra)
Theoretically, concurrent use of sildenafil and L-arginine might increase the risk for hypotension.
In vivo, concurrent use of L-arginine and sildenafil has resulted in increased vasodilation. Theoretically, concurrent use might have additive vasodilatory and hypotensive effects. However, in studies evaluating the combined use of L-arginine and sildenafil for erectile dysfunction, hypotension was not reported.
Testosterone
Theoretically, concomitant use of L-arginine and testosterone might have additive effects.
In clinical research, L-arginine increases the level of testosterone in male patients with erectile dysfunction. The clinical significance of this finding is unclear.
Reishi mushroom powder
Anticoagulant/Antiplatelet Drugs
Theoretically, high doses of reishi mushroom might increase the risk of bleeding.
A dose of 1.5 grams daily of reishi mushroom does not seem to decrease platelet aggregation, but a higher dose of 3 grams daily does.
Antidiabetes Drugs
Theoretically, reishi mushroom might have additive effects with antidiabetes drugs.
Animal research suggests that reishi mushroom decreases blood sugar. However, in patients with type 2 diabetes, taking reishi mushroom does not reduce fasting glucose levels, and its effects on glycated hemoglobin are inconsistent.
Antihypertensive Drugs
Theoretically, concurrent use of reishi mushroom with antihypertensive drugs might increase the risk of hypotension.
Reishi mushroom has shown hypotensive activity in animal research. Clinical evidence suggests that reishi mushroom reduces blood pressure in some, but not all, patients with hypertension.
Selenium
Anticoagulant/Antiplatelet Drugs
Selenium may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Clinical research suggests that taking selenium 10 mcg/kg/day can increase bleeding times by increasing prostacyclin production, which inhibits platelet activity. Other clinical research suggests that taking selenium 75 mcg daily, in combination with ascorbic acid 600 mg, alpha-tocopherol 300 mg, and beta-carotene 27 mg, reduces platelet aggregation.
Barbiturates
Theoretically, selenium might prolong the sedating effects of barbiturates.
Laboratory research suggests that selenium can inhibit the hepatic metabolism of barbiturates. Selenium seems to prolong the sedative effect of pentobarbital in animal models.
Immunosuppressants
Theoretically, selenium supplementation may reduce the effectiveness of immunosuppressant therapy.
In vitro research and preliminary clinical evidence suggests that selenium may stimulate the immune system.
Warfarin (Coumadin)
Theoretically, selenium might interfere with warfarin activity.
Animal research suggests that selenium can increase warfarin activity. Selenium might interact with warfarin by displacing it from albumin binding sites, reducing its metabolism in the liver, or by decreasing production of vitamin K-dependent clotting factors. Selenium can also prolong bleeding times in humans by increasing prostacyclin production, which inhibits platelet activity.
Contraceptive Drugs
Contraceptive drugs might increase levels of selenium, although the clinical significance of this effect is unclear.
Some research suggests that oral contraceptives increase serum selenium levels in women taking oral contraceptives; however, other research shows no change in selenium levels. It is suggested that an increase could be due to increased carrier proteins, indicating a redistribution of selenium rather than a change in total body selenium.
Niacin
Selenium might reduce the beneficial effects of niacin on high-density lipoprotein (HDL) levels.
A combination of niacin and simvastatin (Zocor) effectively raises HDL cholesterol levels in patients with coronary disease and low HDL levels. Clinical research shows that taking a combination of antioxidants (vitamin C, vitamin E, beta-carotene, and selenium) along with niacin and simvastatin (Zocor) attenuates this rise in HDL, specifically the HDL-2 and apolipoprotein A1 fractions, by more than 50% in patients with coronary disease. It is not known whether this adverse effect is due to a single antioxidant such as selenium, or to the combination. It also is not known whether it will occur in other patient populations.
Magnesium
Levodopa/Carbidopa (Sinemet)
Magnesium can reduce the bioavailability of levodopa/carbidopa.
Clinical research in healthy volunteers shows that taking magnesium oxide 1000 mg with levodopa 100 mg/carbidopa 10 mg reduces the area under the curve (AUC) of levodopa by 35% and of carbidopa by 81%. In vitro and animal research shows that magnesium produces an alkaline environment in the digestive tract, which might lead to degradation and reduced bioavailability of levodopa/carbidopa.
Aminoglycoside Antibiotics
Concomitant use of aminoglycoside antibiotics and magnesium can increase the risk for neuromuscular weakness.
Both aminoglycosides and magnesium reduce presynaptic acetylcholine release, which can lead to neuromuscular blockade and possible paralysis. This is most likely to occur with high doses of magnesium given intravenously.
Antacids
Use of acid reducers may reduce the laxative effect of magnesium oxide.
A retrospective analysis shows that, in the presence of H2 receptor antagonists (H2RAs) or proton pump inhibitors (PPIs), a higher dose of magnesium oxide is needed for a laxative effect. This may also occur with antacids. Under acidic conditions, magnesium oxide is converted to magnesium chloride and then to magnesium bicarbonate, which has an osmotic laxative effect. By reducing acidity, antacids may reduce the conversion of magnesium oxide to the active bicarbonate salt.
Bictegravir/Emtricitabine/Tenofovir Alafenamide (Biktarvy)
Magnesium 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 magnesium containing products.
Bisphosphonates
Magnesium can decrease absorption of bisphosphonates.
Cations, including magnesium, can decrease bisphosphonate absorption. Advise patients to separate doses of magnesium and these drugs by at least 2 hours.
Calcium Channel Blockers
Magnesium can have additive effects with calcium channel blockers, although evidence is conflicting.
Magnesium inhibits calcium entry into smooth muscle cells and may therefore have additive effects with calcium channel blockers. Severe hypotension and neuromuscular blockades may occur when nifedipine is used with intravenous magnesium, although some contradictory evidence suggests that concurrent use of magnesium with nifedipine does not increase the risk of neuromuscular weakness. High doses of magnesium could theoretically have additive effects with other calcium channel blockers.
Digoxin
Magnesium salts may reduce absorption of digoxin.
Clinical evidence suggests that treatment with oral magnesium hydroxide or magnesium trisilicate reduces absorption of digoxin from the intestines. This may reduce the blood levels of digoxin and decrease its therapeutic effects.
Potassium-Sparing Diuretics
Potassium-sparing diuretics decrease excretion of magnesium, possibly increasing magnesium levels.
Potassium-sparing diuretics also have magnesium-sparing properties, which can counteract the magnesium losses associated with loop and thiazide diuretics. Theoretically, increased magnesium levels could result from concomitant use of potassium-sparing diuretics and magnesium supplements.
Quinolone Antibiotics
Magnesium decreases absorption of quinolones.
Magnesium can form insoluble complexes with quinolones and decrease their absorption. Advise patients to take these drugs at least 2 hours before, or 4 to 6 hours after, magnesium supplements.
Skeletal Muscle Relaxants
Parenteral magnesium alters the pharmacokinetics of skeletal muscle relaxants, increasing their effects and accelerating the onset of effect.
Parenteral magnesium shortens the time to onset of skeletal muscle relaxants by about 1 minute and prolongs the duration of action by about 2 minutes. Magnesium potentiates the effects of skeletal muscle relaxants by decreasing calcium-mediated release of acetylcholine from presynaptic nerve terminals, reducing postsynaptic sensitivity to acetylcholine, and having a direct effect on the membrane potential of myocytes. Magnesium also has vasodilatory actions and increases cardiac output, allowing a greater amount of muscle relaxant to reach the motor end plate. A clinical study found that low-dose rocuronium (0.45 mg/kg), when given after administration of magnesium 30 mg/kg over 10 minutes, has an accelerated onset of effect, which matches the onset of effect seen with a full-dose rocuronium regimen (0.6 mg/kg). In another clinical study, onset times for rocuronium doses of 0.3, 0.6, and 1.2 mg/kg were 86, 76, and 50 seconds, respectively, when given alone, but were reduced to 66, 44, and 38 seconds, respectively, when the doses were given after a 15-minute infusion of magnesium sulfate 60 mg/kg. Giving intraoperative intravenous magnesium sulfate, 50 mg/kg loading dose followed by 15 mg/kg/hour, reduces the onset time of rocuronium, enhances its clinical effects, reduces the dose of intraoperative opiates, and prolongs the spontaneous recovery time. It does not affect the activity of subsequently administered neostigmine.
Sulfonylureas
Magnesium increases the systemic absorption of sulfonylureas, increasing their effects and side effects.
Clinical research shows that administration of magnesium hydroxide with glyburide increases glyburide absorption, increases maximal insulin response by 35-fold, and increases the risk of hypoglycemia, when compared with glyburide alone. A similar interaction occurs between magnesium hydroxide and glipizide. The mechanism of this effect appears to be related to the elevation of gastrointestinal pH by magnesium-based antacids, increasing solubility and enhancing absorption of sulfonylureas.
Tetracycline Antibiotics
Magnesium decreases absorption of tetracyclines.
Magnesium can form insoluble complexes with tetracyclines in the gut and decrease their absorption and antibacterial activity. Advise patients to take these drugs 1 hour before or 2 hours after magnesium supplements.
Anticoagulant/Antiplatelet Drugs
Theoretically, magnesium may have antiplatelet effects, but the evidence is conflicting.
In vitro evidence shows that magnesium sulfate inhibits platelet aggregation, even at low concentrations. Some preliminary clinical evidence shows that infusion of magnesium sulfate increases bleeding time by 48% and reduces platelet activity. However, other clinical research shows that magnesium does not affect platelet aggregation, although inhibition of platelet-dependent thrombosis can occur.
Gabapentin (Neurontin)
Gabapentin absorption can be decreased by magnesium.
Clinical research shows that giving magnesium oxide orally along with gabapentin decreases the maximum plasma concentration of gabapentin by 33%, time to maximum concentration by 36%, and area under the curve by 43%. Advise patients to take gabapentin at least 2 hours before, or 4 to 6 hours after, magnesium supplements.
Sevelamer (Renagel, Renvela)
Sevelamer may increase serum magnesium levels.
In patients on hemodialysis, sevelamer use was associated with a 0.28 mg/dL increase in serum magnesium. The mechanism of this interaction remains unclear.
Vitamin B6
Amiodarone (Cordarone)
Theoretically, vitamin B6 might increase the photosensitivity caused by amiodarone.
Despite initial case reports suggesting that pyridoxine may have a protective effect against amiodarone-induced photosensitivity, preliminary clinical research suggests that pyridoxine may actually exacerbate this adverse effect.
Antihypertensive Drugs
Theoretically, vitamin B6 may have additive effects when used with antihypertensive drugs.
Research in hypertensive rats shows that vitamin B6 can decrease systolic blood pressure. Similarly, clinical research in patients with hypertension shows that taking high doses of vitamin B6 may reduce systolic and diastolic blood pressure, possibly by reducing plasma levels of epinephrine and norepinephrine.
Phenobarbital (Luminal)
High doses of vitamin B6 may reduce the levels and clinical effects of phenobarbital.
Preliminary clinical evidence suggests that vitamin B6 200 mg daily can reduce plasma levels of phenobarbital, possibly by increasing metabolism. It is not known whether lower doses have any effect. Advise people taking phenobarbital to avoid high doses of vitamin B6.
Phenytoin (Dilantin)
High doses of vitamin B6 may reduce the levels and clinical effects of phenytoin.
Preliminary clinical evidence suggests that vitamin B6 200 mg daily can reduce plasma levels of phenytoin, possibly by increasing metabolism. It is not known whether lower doses have any effect. Advise people taking phenytoin to avoid high doses of vitamin B6.
Levodopa
Vitamin B6 may increase the metabolism of levodopa when taken alone, but not when taken in conjunction with carbidopa.
Vitamin B6 (pyridoxine) enhances the metabolism of levodopa, reducing its clinical effects. However, this interaction does not occur when carbidopa is used concurrently with levodopa (Sinemet). Therefore, it is not likely to be a problem in most people.
Coenzyme Q10
Alkylating Agents
Coenzyme Q10 has antioxidant effects. Theoretically, this may reduce the activity of chemotherapy drugs that generate free radicals.
Theoretically, antioxidants such as coenzyme Q10 might protect tumor cells from chemotherapeutic agents that work by inducing oxidative stress, such as alkylating agents (e.g., cyclophosphamide) and radiation therapy. The clinical importance of this interaction is unknown.
Warfarin (Coumadin)
Coenzyme Q10 is chemically similar to menaquinone and might have vitamin K-like procoagulant effects, which could decrease the effects of warfarin.
Concomitant use of coenzyme Q10 and warfarin might reduce the anticoagulant effects of warfarin. Four cases of decreased warfarin efficacy thought to be due to coenzyme Q10 have been reported. However, there is some preliminary clinical research that suggests coenzyme Q10 might not significantly decrease the effects of warfarin in patients who have a stable INR.
Antihypertensive Drugs
Theoretically, coenzyme Q10 might have additive effects with antihypertensive drugs.
Some clinical research shows that coenzyme Q10 can significantly lower blood pressure, although other studies have shown conflicting results.
Hawthorne extract
Nitrates
Theoretically, concomitant use might cause additive coronary vasodilatory effects.
Some evidence shows that hawthorn might lower blood pressure due to vasodilatory effects.
Phosphodiesterase-5 Inhibitors
Theoretically, concomitant use might result in additive vasodilation and hypotension.
Hawthorn might inhibit PDE-5 and cause vasodilation.
Anticoagulant/Antiplatelet Drugs
Theoretically, hawthorn may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
In vitro and animal research shows that hawthorn can inhibit platelet aggregation. However, its effect in humans is unclear. One observational study shows that patients taking hawthorn shortly before undergoing coronary artery bypass graft (CABG) surgery or valve replacement surgery have a 10% incidence of postoperative bleeding, compared with 1% in those who never consumed hawthorn extract. However, clinical research shows that taking a specific preparation of dried hawthorn leaves and flowers (Crataesor, Soria Natural Lab) 800 mg three times daily for 15 days does not affect platelet aggregation or levels of thromboxane B2, the metabolite of thromboxane A2, in healthy humans.
Beta-Blockers
Theoretically, concomitant use might cause additive effects on blood pressure and heart rate.
Some evidence shows that hawthorn might lower blood pressure and heart rate.
Calcium Channel Blockers
Theoretically, concomitant use might cause additive coronary vasodilation and hypotensive effects.
Some evidence shows that hawthorn might lower blood pressure due to vasodilatory effects.
Digoxin (Lanoxin)
Theoretically, hawthorn might potentiate the effects and adverse effects of digoxin.
Hawthorn appears to improve cardiac output; however, hawthorn does not appear to affect digoxin pharmacokinetics. Case reports suggest that at least one species of hawthorn root extract (Crataegus mexicana) may produce adverse effects similar to digoxin and can cross-react with digoxin assays, leading to falsely elevated plasma digoxin levels.
Potassium
Ace Inhibitors (Aceis)
Using ACEIs with high doses of potassium increases the risk of hyperkalemia.
ACEIs block the actions of the renin-angiotensin-aldosterone system and reduce potassium excretion. Concomitant use of these drugs with potassium supplements increases the risk of hyperkalemia. However, concomitant use of these drugs with moderate dietary potassium intake (about 3775-5200 mg daily) does not increase serum potassium levels.
Angiotensin Receptor Blockers (Arbs)
Using ARBs with high doses of potassium increases the risk of hyperkalemia.
ARBs block the actions of the renin-angiotensin-aldosterone system and reduce potassium excretion. Concomitant use of these drugs with potassium supplements increases the risk of hyperkalemia. However, concomitant use of these drugs with moderate dietary potassium intake (about 3775-5200 mg daily) does not increase serum potassium levels.
Potassium-Sparing Diuretics
Concomitant use increases the risk of hyperkalemia.
Using potassium-sparing diuretics with potassium supplements increases the risk of hyperkalemia.
L-Carnitine
Acenocoumarol (Sintrom)
Theoretically, L-carnitine might increase the anticoagulant effects of acenocoumarol.
L-carnitine might enhance the anticoagulant effects of acenocoumarol, an oral anticoagulant similar to warfarin, but shorter-acting. There are at least two case reports of INR elevation with concomitant use. In one case, a 33-year-old male with a previously stable INR had an elevated INR of 4.65 after L-carnitine was started and continued for 10 weeks. INR normalized after discontinuation of the L-carnitine-containing product.
Thyroid Hormone
Theoretically, L-carnitine might decrease the effectiveness of thyroid hormone replacement.
L-carnitine appears to act as a peripheral thyroid hormone antagonist by inhibiting entry of thyroid hormone into the nucleus of cells. Taking L-carnitine also seems to diminish some of the symptoms of hyperthyroidism.
Warfarin (Coumadin)
Theoretically, L-carnitine might increase the anticoagulant effects of warfarin.
L-carnitine might increase the anticoagulant effects of acenocoumarol, a shorter-acting oral anticoagulant similar to warfarin. There is not enough information to know whether this interaction occurs with L-carnitine and warfarin.
Brand information
Manufacturer and brand details for Blood Pressure Support, from the product label.
Dr. Venessa's Formulas
See all Dr. Venessa's Formulas products- Name
- Dr. Venessa’s Formulas(TM)
- City
- Orlando
- State
- FL
- ZipCode
- 32822
Blood Pressure Support by Dr. Venessa's Formulas: Common Questions
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Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
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The Full Monographs Behind Blood Pressure Support’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Vitamin B6
Interacts with 210 drugsVitamin B6 (pyridoxine) is an essential water-soluble vitamin that your body needs for metabolism, brain function, and making red blood cells. It is best known for helping with pregnancy-rel...
Read the full Vitamin B6 monograph → Herb & supplement monographPotassium
Interacts with 62 drugsPotassium is an essential mineral your body needs for nerve signals, muscle function, and a steady heartbeat, and most people get enough from a balanced diet rich in fruits and vegetables. P...
Read the full Potassium monograph → Herb & supplement monographVitamin E
Interacts with 764 drugsVitamin E is an essential fat-soluble vitamin and antioxidant that most people get in adequate amounts from a normal diet. Supplements can help correct a true deficiency, but high-dose vitam...
Read the full Vitamin E monograph → Herb & supplement monographSelenium
Interacts with 321 drugsSelenium is an essential trace mineral your body needs in small amounts for thyroid function, antioxidant defense, and immune health. Most people who eat a varied diet get enough, and supple...
Read the full Selenium monograph → Herb & supplement monographMagnesium
Interacts with 295 drugsMagnesium is an essential mineral your body needs for muscles, nerves, blood pressure, and many other functions, and supplements are useful for preventing or correcting deficiency. Some othe...
Read the full Magnesium monograph → Herb & supplement monographL-arginine
Interacts with 403 drugsL-arginine is an amino acid that the body uses to make nitric oxide, a substance that helps blood vessels relax and widen. It is popularly used for blood pressure, erectile dysfunction, and...
Read the full L-arginine 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 monographCoenzyme Q10
Interacts with 198 drugsCoQ10 is a vitamin-like substance your body makes naturally that helps cells produce energy and acts as an antioxidant. It is generally well tolerated and is most studied for heart condition...
Read the full Coenzyme Q10 monograph → Herb & supplement monographL-carnitine
Interacts with 19 drugsL-carnitine is a compound your body makes naturally and also gets from foods like meat. It helps cells turn fat into energy, and supplements are most clearly useful for people with a true ca...
Read the full L-carnitine monograph → Herb & supplement monographGreen Tea
Interacts with 1,293 drugsGreen tea is a popular beverage rich in antioxidants called catechins, and drinking it in normal amounts is considered safe for most people. Concentrated green tea extracts are a different s...
Read the full Green Tea monograph → Herb & supplement monographHawthorn
Interacts with 191 drugsHawthorn is a plant traditionally used for heart-related complaints, and some studies suggest it may modestly help symptoms of mild heart failure when added to standard care. However, the ev...
Read the full Hawthorn monograph → Herb & supplement monographReishi Mushroom
Interacts with 375 drugsReishi is a traditional Asian mushroom widely used to support the immune system and overall wellness. Human evidence for most of its claimed benefits is limited or low-quality, so it should...
Read the full Reishi Mushroom monograph →Sources & How We Checked
Blood Pressure Support'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 700 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.
Vitamin B6 32 references
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- Yates AA, Schlicker SA, Suitor CW. Dietary reference intakes: The new basis for recommendations for calcium and related nutrients, B vitamins, and choline. J Am Diet Assoc 1998;98:699-706. PubMed
- Geerling BJ, Dagnelie PC, Badart-Smook A, et al. Diet as a risk factor for the development of ulcerative colitis. Am J Gastroenterol 2000;95:1008-13. PubMed
- South M. Neonatal seizures after pyridoxine use -- reply. Lancet 1999;354:2083. PubMed
- Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline (2000). Washington, DC: National Academy Press, 2000. Available at: http://b
- Baxter P, Aicardi J. Neonatal seizures after pyridoxine use. Lancet 1999;354:2082-3. PubMed
- Bendich A, Cohen M. Vitamin B6 safety issues. Ann N Y Acad Sci 1990;585:321-30.
- Schaumburg H, Kaplan J, Windebank A. Sensory neuropathy from pyridoxine abuse. A new megavitamin syndrome. N Engl J Med 1983;309:445-8. PubMed
- Gordon N. Pyridoxine dependency: an update. Dev Med Child Neurol 1997;39:63-5. PubMed
- Lewis PJ. Pain in the hand and wrist. Pyridoxine supplements may help patients with carpal tunnel syndrome. BMJ 1995;310:1534. PubMed
- Kaufman G. Pyridoxine against amiodarone-induced photosensitivity (letter). Lancet 1984;1:51-2. PubMed
- Mulrow JP, Mulrow CD, McKenna WJ. Pyridoxine and amiodarone-induced photosensitivity. Ann Intern Med 1985;103:68-9. PubMed
- Kawada A, Kashima A, Shiraishi H, et al. Pyridoxine-induced photosensitivity and hypophosphatasia. Dermatology 2000;201:356-60.. PubMed
- Vasile A, Goldberg R, Kornberg B. Pyridoxine toxicity: report of a case. J Am Osteopath Assoc 1984;83:790-1. DOI
- Hansson O, Sillanpaa M. Pyridoxine and serum concentration of phenytoin and phenobarbitone. Lancet 1976;1:256. DOI
- Jansen T, Romiti R, Kreuter A, Altmeyer P. Rosacea fulminans triggered by high-dose vitamins B6 and B12. J Eur Acad Dermatol Venereol 2001;15:484-5..
- Chittumma P, Kaewkiattikun K, Wiriyasiriwach B. Comparison of the effectiveness of ginger and vitamin B6 for treatment of nausea and vomiting in early pregnancy: a randomized double-blind controlled trial. J Med Assoc Thai 2007;90:15-20.
- Hatzitolios, A., Iliadis, F., Katsiki, N., and Baltatzi, M. Is the anti-hypertensive effect of dietary supplements via aldehydes reduction evidence based? A systematic review. Clin Exp.Hypertens. 2008;30(7):628-639. PubMed
- Vasdev, S., Ford, C. A., Parai, S., Longerich, L., and Gadag, V. Dietary vitamin B6 supplementation attenuates hypertension in spontaneously hypertensive rats. Mol.Cell Biochem. 1999;200(1-2):155-162.
- de, Vogel S., Dindore, V., van, Engeland M., Goldbohm, R. A., van den Brandt, P. A., and Weijenberg, M. P. Dietary folate, methionine, riboflavin, and vitamin B-6 and risk of sporadic colorectal cancer. J Nutr 2008;138(12):2372-2378. PubMed
- Hagen, I., Nesheim, B. I., and Tuntland, T. No effect of vitamin B-6 against premenstrual tension. A controlled clinical study. Acta Obstet.Gynecol.Scand. 1985;64(8):667-670. PubMed
- Aybak, M., Sermet, A., Ayyildiz, M. O., and Karakilcik, A. Z. Effect of oral pyridoxine hydrochloride supplementation on arterial blood pressure in patients with essential hypertension. Arzneimittelforschung. 1995;45(12):1271-1273.
- Lal, K. J., Dakshinamurti, K., and Thliveris, J. The effect of vitamin B6 on the systolic blood pressure of rats in various animal models of hypertension. J Hypertens. 1996;14(3):355-363. PubMed
- Lauritzen CH, Reuter HD, Repges R, Bohnert K, and Schmidt U. Treatment of premenstrual tension syndrome with Vitex agnus castus. Controlled, double-blind study versus pyridoxine. Phytomed 1997;4(3):183-189. PubMed
- Fonseca VA, Lavery LA, Thethi TK, et al. Metanx in type 2 diabetes with peripheral neuropathy: A randomized trial. Am J Med 2013;126(2):141-9. PubMed
- Hankey GJ, Eikelboom JW, Yi Q, et al. Treatment with B vitamins and incidence of cancer in patients with previous stroke or transient ischemic attack: Results of a randomized placebo-controlled trial. Stroke 2012;43(6):1572-7. PubMed
- Hoyer-Kuhn H, Kohbrok S, Volland R, Franklin J, Hero B, Beck BB, Hoppe B. Vitamin B6 in primary hyperoxaluria I: first prospective trial after 40 years of practice. Clin J Am Soc Nephrol. 2014 Mar;9(3):468-77. PubMed
- Mahmoud A, Tabassum S, Al Enazi S, et al. Amelioration of levetiracetam-induced behavioral side effects by pyridoxine. A randomized double blind controlled study. Pediatr Neurol 2021;119:15-21. PubMed
- Gupta M, Gallante B, Bamberger JN, et al. Prospective randomized evaluation of idiopathic hyperoxaluria treatments. J Endourol 2021;35(12):1844-1851. PubMed
- Li H, Chen M, Liang S, et al. Excessive vitamin B6 during treatment is related to poor prognosis of patients with nasopharyngeal carcinoma: A U-shaped distribution suggests low dose supplement. Clin Nutr 2021;40(4):2293-2300. PubMed
- Tanigawa J, Nabatame S, Tominaga K, et al. High-dose pyridoxine treatment for inherited glycosylphosphatidylinositol deficiency. Brain Dev 2021;43(6):680-687. PubMed
- Committee on Practice Bulletins-Obstetrics. ACOG Practice Bulletin No. 189: Nausea And Vomiting Of Pregnancy. Obstet Gynecol. 2018;131(1):e15-e30. PubMed
Potassium 12 references
- McEvoy GK, ed. AHFS Drug Information. Bethesda, MD: American Society of Health-System Pharmacists, 1998.
- Gennaro A. Remington: The Science and Practice of Pharmacy. 19th ed. Lippincott: Williams & Wilkins, 1996.
- Whelton PK, He J, Cutler JA, et al. Effects of oral potassium on blood pressure. Meta-analysis of randomized controlled clinical trials. JAMA 1997;277:1624-32. PubMed
- Phillips, C. O., Kashani, A., Ko, D. K., Francis, G., and Krumholz, H. M. Adverse effects of combination angiotensin II receptor blockers plus angiotensin-converting enzyme inhibitors for left ventricular dysfunction: a quantitative review of data from ra DOI
- Altieri, P. I., Herrero, C., Suero, R., and Ortiz, A. Bleeding duodenal ulcer in a patient taking slow-releasing potassium tablets. Bol.Asoc.Med P.R. 1977;69(8):276.
- Raf, L. E. Enteric-coated potassium chloride tablets and ulcer of the small intestine. Acta Chir Scand Suppl 1967;(374):1-87.
- Potassium chloride oral solution [package insert]. Allentown, PA: Lehigh Valley Technologies, Inc.; 2014.
- Potassium chloride injection [package insert]. Lake Forest, IL: Hospira Inc.; 2009.
- Patel RB, Tannenbaum S, Viana-Tejedor A, et al. Serum potassium levels, cardiac arrhythmias, and mortality following non-ST-elevation myocardial infarction or unstable angina: insights from MERLIN-TIMI 36. Eur Heart J Acute Cardiovasc Care 2017 Feb;6(1):1 PubMed
- Malta D, Arcand J, Ravindran A, Floras V, Allard JP, Newton GE. Adequate intake of potassium does not cause hyperkalemia in hypertensive individuals taking medications that antagonize the renin angiotensin aldosterone system. Am J Clin Nutr 2016 Oct;104(4 PubMed
- Keskin M, Kaya A, Tatlisu MA, et al. The effect of serum potassium level on in-hospital and long-term mortality in ST elevation myocardial infarction. Int J cardiol. 2016 Oct 15;221:505-10.
- Stallings VA, Harrison M, Oria M; Committee to Review the Dietary Reference Intakes for Sodium and Potassium, Food and Nutrition Board, Health and Medicine Division, National Academies of Sciences, Engineering, and Medicine. Washington (DC): National Acad
Vitamin E 64 references
- Kim JM, White RH. Effect of vitamin E on the anticoagulant response to warfarin. Am J Cardiol 1996;77:545-6. PubMed
- Corrigan JJ Jr. The effect of vitamin E on warfarin-induced vitamin K deficiency. Ann N Y Acad Sci 1982;393:361-8. PubMed
- Corrigan JJ Jr. Coagulation problems relating to vitamin E. Am J Pediatr Hematol Oncol 1979;1:169-73.
- Corrigan JJ Jr, Marcus FI. Coagulopathy associated with vitamin E ingestion. JAMA 1974;230:1300-1. DOI
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