Borage & Evening Primrose Ingredients & Drug Interactions
by SuperSmart
What is this page for?
First and foremost: checking Borage & Evening Primrose 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
Borage & Evening Primrose is a dietary supplement by SuperSmart with 4 active ingredients. Its ingredients are commonly taken for general antioxidant support, skin and hair care, heart health.Based on those ingredients, 879 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Vitamin E, Evening Primrose Oil, Borage Oil. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against Borage & Evening Primrose by SuperSmart
Ask about any prescription or over-the-counter medication and we check it for interactions with Borage & Evening Primrose by SuperSmart — 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 Borage & Evening Primrose by SuperSmart
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
This product has four ingredients. The three active ones are gamma-linolenic acid (from borage and evening primrose oils), vitamin E, and borage and evening primrose oils themselves—all believed to support joint and skin health.
Gamma-linolenic acid is an omega-6 fatty acid that your body can convert into compounds with anti-inflammatory potential. The inactive ingredients are tocopherols, ascorbyl palmitate, and propyl gallate, which are preservatives.
Does it work?
Not established
The evidence for these ingredients is mixed. Vitamin E is effective for vitamin E deficiency itself and a rare genetic disorder called AVED, and possibly effective for Alzheimer's disease, beta-thalassemia, and G6PD deficiency.
Borage oil is rated possibly ineffective for eczema and has insufficient evidence for conditions like ADHD and acute respiratory distress syndrome. Evening primrose oil is rated possibly ineffective for asthma and likely ineffective for breast pain (mastalgia), with insufficient evidence for acne, ADHD, and other uses.
The bottom line: vitamin E has the strongest evidence, while the oils lack strong clinical support for most claimed uses.
How safe is it?
Well-documented data
Vitamin E from food and standard doses is generally well tolerated, but high-dose long-term supplements may raise the risk of bleeding and, rarely, hemorrhagic stroke. There's also concern that high doses might increase cardiovascular complications.
Borage oil is generally well tolerated short-term, though it may cause belching, bloating, diarrhea, and soft stools; the serious concern is that some borage plant parts contain liver-toxic alkaloids, though seed oil itself contains little to none. Evening primrose oil is also generally well tolerated and causes mainly mild GI side effects (abdominal pain, diarrhea, nausea), though rare cases of dizziness and headache have been reported.
Pregnancy and breastfeeding data: borage oil is rated unsafe in pregnancy due to possible liver toxins and uterine risk; evening primrose oil evidence is unclear, so it's best avoided in pregnancy unless your doctor directs otherwise; vitamin E from food and prenatal vitamins is appropriate, but high-dose supplements should be discussed with your doctor during pregnancy and breastfeeding.
Meds to double-check
Moderate interaction found
Check your medications with your pharmacist if you take blood thinners or antiplatelet drugs (warfarin, aspirin, clopidogrel) — all three active ingredients can increase bleeding risk. If you're on cancer chemotherapy drugs, HIV medications (especially lopinavir/ritonavir), transplant rejection drugs (cyclosporine), antipsychotics (phenothiazines), lithium, or niacin, confirm it's safe with your pharmacist before starting.
The bottom line
Scorecard at a glanceFully disclosed formula with no established evidence rating for its marketed use. Moderate medication interactions have been identified, and safety information is well characterized.
This combination is worth considering if you're interested in omega fatty acids and antioxidant support, but anyone on blood thinners, cancer medications, anticonvulsants, or lithium needs to check with their pharmacist first. If you're pregnant or breastfeeding, talk to your doctor before starting, especially because of borage oil's safety profile.
Always run your exact medications through the tool on this page before you begin.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 3 of 4 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Jun 25, 2025.
This Scorecard evaluates available label information, ingredient evidence, and known medication-safety considerations. It does not independently verify product identity, purity, potency, contamination, or manufacturing quality. How these ratings are computed
General information
Key facts about Borage & Evening Primrose, straight from the product label.
| Brand | SuperSmart |
|---|---|
| Barcode (UPC) | 5453003828402 |
| Net contents | 120 Softgel(s) |
| Market status | On market |
| Date entered into DSLD | Jun 25, 2025 |
| DSLD ID | 332342 |
| Product type | Other Combinations |
| Supplement form | Softgel Capsule |
| Dietary claims / uses | Nutrient, All Other |
| 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 Borage & Evening Primrose by SuperSmart, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Gamma-Linolenic Acid | 300 mg | -- |
| Vitamin E | 26.8 mg | 223% |
| Borage Oil | 1000 mg | -- |
| Evening Primrose Oil | 1000 mg | -- |
Other ingredients: Tocopherols, Ascorbyl Palmitate, Propyl Gallate
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.
FDA Statement of Identity
Dietary Supplement
Suggested/Recommended/Usage/Directions
Directions: Adults. Take 4 softgels per day with meals.
Formula
Each softgel contains 250 mg of borage oil, 250 mg of evening primrose oil and 6.7 mg of vitamin E.
Precautions
Precautions: Do not exceed the recommended daily dose. This product is a nutritional supplement and should not be used to replace a varied, balanced diet or healthy lifestyle.
Keep out of young children's reach.
As with all nutritional supplements, consult a health professional before taking if you are pregnant, breastfeeding or suffer from a health problem.
Storage
Store away from light, heat and humidity.
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Borage & Evening Primrose by SuperSmart 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 Borage & Evening Primrose by SuperSmart
These are the 4 active ingredients this product is made of. Select any to open its full monograph.
Serving size4 Softgel(s) Dosage formSoftgel Capsule Servings per container30 Amounts shown are per serving.
Most supplement products combine several ingredients, and a medication can interact with the product through any one of them. Each ingredient below shows whether it has known drug interactions.
Gamma-Linolenic Acid
Vitamin 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 & interactionsBorage Oil
Interacts with226 drugs
Borage is a Mediterranean herb whose seed oil is rich in gamma-linolenic acid (GLA), an omega-6 fatty acid studied mostly for skin conditions and arth...
Borage Oil monograph & interactionsEvening Primrose Oil
Interacts with233 drugs
Evening primrose oil is a seed oil rich in gamma-linolenic acid (GLA), an omega-6 fatty acid, that is popularly used for skin conditions, PMS, and bre...
Evening Primrose Oil monograph & interactionsOther (inactive) ingredients: Tocopherols, Ascorbyl Palmitate, Propyl Gallate. These complete the product’s ingredient list but are not active constituents.
Borage & Evening Primrose by SuperSmart Drug Interactions
HelloPharmacist Interaction Report
Borage & Evening Primrose by SuperSmart contains four ingredients, three of which have documented interactions with medications.
Vitamin E is the source of the most serious concerns: it can increase bleeding risk when combined with blood thinners (anticoagulants) and antiplatelet drugs like aspirin or clopidogrel, especially at higher doses. Vitamin E may also reduce how your body breaks down certain cancer drugs (alkylating agents and antitumor antibiotics), potentially lowering their effectiveness, and can raise cyclosporine levels in transplant patients.
Read the full breakdown — every affected drug type, severity by severity
Borage oil and evening primrose oil both pose a moderate bleeding risk if you're on anticoagulants or antiplatelet medications. Evening primrose oil can theoretically reduce lithium levels in people taking it for mood disorders, and both borage and evening primrose carry a theoretical risk of lowering the seizure threshold if combined with antipsychotic medications (phenothiazines).
Borage oil may also increase toxic metabolite levels of certain alkaloids if you're on drugs that induce CYP3A4 metabolism.
Vitamin E may interfere with niacin's ability to raise good cholesterol (HDL), and borage oil can theoretically increase levels of the HIV medication lopinavir. Evening primrose oil may theoretically increase levels of certain medications metabolized by the CYP2C9 enzyme.
We could not check gamma-linolenic acid for interactions. Altogether, these interactions span 867 individual medications.
Use the medication checker on this page with your exact prescriptions before starting.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against Borage & Evening Primrose?
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 Borage & Evening Primrose interact with 879 drugs. Click any drug to see the details.
3 of the 4 ingredients in Borage & Evening Primrose interact with drugs. Each result below shows which ingredient is responsible. Vitamin E Evening Primrose Oil Borage Oil
Ado-trastuzumab EmtansineKadcyla
How Ado-trastuzumab Emtansine interacts with Borage & Evening Primrose — through 1 ingredient. Tap an ingredient for the detail:
Vitamin 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 + Ado-trastuzumab Emtansine interactionAbciximabReoPro
How Abciximab interacts with Borage & Evening Primrose — through 3 ingredients. Tap an ingredient for the detail:
Evening Primrose OilAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, evening primrose oil may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Evening Primrose Oil + Abciximab interactionBorage OilAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, borage seed oil may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Borage Oil + Abciximab interactionVitamin EAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Concomitant use of vitamin E and anticoagulant or antiplatelet agents might increase the risk of bleeding.
Read the full Vitamin E + Abciximab interactionAbemaciclibVerzenio
How Abemaciclib interacts with Borage & Evening Primrose — through 1 ingredient. Tap an ingredient for the detail:
Vitamin 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 + Abemaciclib interactionAbiraterone
How Abiraterone interacts with Borage & Evening Primrose — through 1 ingredient. Tap an ingredient for the detail:
Vitamin 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 + Abiraterone interactionAbiraterone AcetateYonsa, Zytiga
How Abiraterone Acetate interacts with Borage & Evening Primrose — through 1 ingredient. Tap an ingredient for the detail:
Vitamin 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 + Abiraterone Acetate interactionAbrocitinibCibinqo
How Abrocitinib interacts with Borage & Evening Primrose — through 3 ingredients. Tap an ingredient for the detail:
Vitamin EAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Concomitant use of vitamin E and anticoagulant or antiplatelet agents might increase the risk of bleeding.
Read the full Vitamin E + Abrocitinib interactionEvening Primrose OilCytochrome P450 2c9 (cyp2c9) Substrates, Anticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, evening primrose may increase the levels and clinical effects of CYP2C9 substrates.
Read the full Evening Primrose Oil + Abrocitinib interactionBorage OilAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, borage seed oil may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Borage Oil + Abrocitinib interactionAcalabrutinibCalquence
How Acalabrutinib interacts with Borage & Evening Primrose — through 1 ingredient. Tap an ingredient for the detail:
Vitamin 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 + Acalabrutinib interactionAcenocoumarolSintrom
How Acenocoumarol interacts with Borage & Evening Primrose — through 3 ingredients. Tap an ingredient for the detail:
Borage OilAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, borage seed oil may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Borage Oil + Acenocoumarol interactionVitamin EAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Concomitant use of vitamin E and anticoagulant or antiplatelet agents might increase the risk of bleeding.
Read the full Vitamin E + Acenocoumarol interactionEvening Primrose OilAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, evening primrose oil may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Evening Primrose Oil + Acenocoumarol interactionAcepromazineAtravet
How Acepromazine interacts with Borage & Evening Primrose — through 2 ingredients. Tap an ingredient for the detail:
Evening Primrose OilPhenothiazines Moderate
Interaction Summary
Theoretically, taking evening primrose oil with phenothiazines might increase the risk of convulsions.
Read the full Evening Primrose Oil + Acepromazine interactionBorage OilPhenothiazines Moderate
Interaction Summary
Theoretically, taking borage sed oil with phenothiazines might increase the risk of seizures.
Read the full Borage Oil + Acepromazine interactionAcetaminophen, AspirinGemnisyn
How Acetaminophen, Aspirin interacts with Borage & Evening Primrose — through 3 ingredients. Tap an ingredient for the detail:
Borage OilAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, borage seed oil may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Borage Oil + Acetaminophen, Aspirin interactionEvening Primrose OilAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, evening primrose oil may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Evening Primrose Oil + Acetaminophen, Aspirin interactionVitamin EAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Concomitant use of vitamin E and anticoagulant or antiplatelet agents might increase the risk of bleeding.
Read the full Vitamin E + Acetaminophen, Aspirin interactionAcetaminophen, Aspirin, CaffeineExcedrin, Excedrin Extra Strength, Excedrin Migraine
How Acetaminophen, Aspirin, Caffeine interacts with Borage & Evening Primrose — through 3 ingredients. Tap an ingredient for the detail:
Vitamin EAnticoagulant/antiplatelet Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Concomitant use of vitamin E and anticoagulant or antiplatelet agents might increase the risk of bleeding.
Read the full Vitamin E + Acetaminophen, Aspirin, Caffeine interactionEvening Primrose OilAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, evening primrose oil may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Evening Primrose Oil + Acetaminophen, Aspirin, Caffeine interactionBorage OilAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, borage seed oil may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Borage Oil + Acetaminophen, Aspirin, Caffeine interactionAcetaminophen, Butalbital, CaffeineEsgic, Esgic Plus, Fiogesic, Fioricet, Repan, Tecnal +1 more
How Acetaminophen, Butalbital, Caffeine interacts with Borage & Evening Primrose — through 1 ingredient. Tap an ingredient for the detail:
Vitamin 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 + Acetaminophen, Butalbital, Caffeine interactionAcetaminophen, Butalbital, Caffeine, CodeineEsgic with Codeine, Fioricet w/ Codeine
How Acetaminophen, Butalbital, Caffeine, Codeine interacts with Borage & Evening Primrose — through 1 ingredient. Tap an ingredient for the detail:
Vitamin 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 + Acetaminophen, Butalbital, Caffeine, Codeine interactionAcetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, PhenylephrineHycomine Compound
How Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interacts with Borage & Evening Primrose — through 1 ingredient. Tap an ingredient for the detail:
Vitamin 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 + Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interactionAcetaminophen, Caffeine, CodeineGesic C15, Gesic C30, Gesic C8, Lenoltec 1, Lenoltec 2, Lenoltec 3 +1 more
How Acetaminophen, Caffeine, Codeine interacts with Borage & Evening Primrose — through 1 ingredient. Tap an ingredient for the detail:
Vitamin 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 + Acetaminophen, Caffeine, Codeine interactionAcetaminophen, Caffeine, Codeine, SalicylamideCodalan No.1, Codalan No.2, Codalan No.3
How Acetaminophen, Caffeine, Codeine, Salicylamide interacts with Borage & Evening Primrose — through 1 ingredient. Tap an ingredient for the detail:
Vitamin 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 + Acetaminophen, Caffeine, Codeine, Salicylamide interactionAcetaminophen, Caffeine, DihydrocodeineDHC Plus, Panlor DC, Panlor SS
How Acetaminophen, Caffeine, Dihydrocodeine interacts with Borage & Evening Primrose — through 1 ingredient. Tap an ingredient for the detail:
Vitamin 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 + Acetaminophen, Caffeine, Dihydrocodeine interactionAcetaminophen, Caffeine, IsomethepteneMigralam
How Acetaminophen, Caffeine, Isometheptene interacts with Borage & Evening Primrose — through 1 ingredient. Tap an ingredient for the detail:
Vitamin 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 + Acetaminophen, Caffeine, Isometheptene interactionAcetaminophen, Caffeine, PyrilamineMidol Max Strength Menstrual
How Acetaminophen, Caffeine, Pyrilamine interacts with Borage & Evening Primrose — through 1 ingredient. Tap an ingredient for the detail:
Vitamin 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 + Acetaminophen, Caffeine, Pyrilamine interactionAcetaminophen, Chlorpheniramine Maleate, Dextromethorphan HbrVicks Formula 44M Cough, Cold & Flu Relief
How Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interacts with Borage & Evening Primrose — through 1 ingredient. Tap an ingredient for the detail:
Vitamin 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 + Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interactionAcetaminophen, Chlorpheniramine, Codeine, PhenylephrineColrex
How Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interacts with Borage & Evening Primrose — through 1 ingredient. Tap an ingredient for the detail:
Vitamin 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 + Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interactionAcetaminophen, Chlorpheniramine, DextromethorphanCoricidin II Extra Strength Cold and Flu
How Acetaminophen, Chlorpheniramine, Dextromethorphan interacts with Borage & Evening Primrose — through 1 ingredient. Tap an ingredient for the detail:
Vitamin 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 + Acetaminophen, Chlorpheniramine, Dextromethorphan interactionAcetaminophen, Chlorpheniramine, Dextromethorphan HydrobromideCoricidin HBP Maximum Strength Flu
How Acetaminophen, Chlorpheniramine, Dextromethorphan Hydrobromide interacts with Borage & Evening Primrose — through 1 ingredient. Tap an ingredient for the detail:
Vitamin 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 + Acetaminophen, Chlorpheniramine, Dextromethorphan Hydrobromide interactionAcetaminophen, Chlorpheniramine, Dextromethorphan, PhenylpropanolamineMulti Symptom Cold Relief
How Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylpropanolamine interacts with Borage & Evening Primrose — through 1 ingredient. Tap an ingredient for the detail:
Vitamin 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 + Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylpropanolamine interactionAcetaminophen, Chlorpheniramine, Dextromethorphan, PseudoephedrineChildren's Tylenol Cold Plus Cough, Tylenol Cold Ex Strength
How Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine interacts with Borage & Evening Primrose — through 1 ingredient. Tap an ingredient for the detail:
Vitamin 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 + Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine interactionAcetaminophen, Chlorpheniramine, Guaifenesin, Phenylephrine, SalicylamideRhinogesic GG
How Acetaminophen, Chlorpheniramine, Guaifenesin, Phenylephrine, Salicylamide interacts with Borage & Evening Primrose — through 1 ingredient. Tap an ingredient for the detail:
Vitamin 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 + Acetaminophen, Chlorpheniramine, Guaifenesin, Phenylephrine, Salicylamide interactionAcetaminophen, Chlorpheniramine, PhenylephrineAlka-Seltzer PLUS, Histex SR, Protid
How Acetaminophen, Chlorpheniramine, Phenylephrine interacts with Borage & Evening Primrose — through 1 ingredient. Tap an ingredient for the detail:
Vitamin 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 + Acetaminophen, Chlorpheniramine, Phenylephrine interactionAcetaminophen, Chlorpheniramine, Phenylephrine, SalicylamideRhinogesic, Rhinogesic JR
How Acetaminophen, Chlorpheniramine, Phenylephrine, Salicylamide interacts with Borage & Evening Primrose — through 1 ingredient. Tap an ingredient for the detail:
Vitamin 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 + Acetaminophen, Chlorpheniramine, Phenylephrine, Salicylamide interactionAcetaminophen, Chlorpheniramine, PhenylpropanolamineAlumadrine, Conex, Sinadrin Max Strength, Sinulin
How Acetaminophen, Chlorpheniramine, Phenylpropanolamine interacts with Borage & Evening Primrose — through 1 ingredient. Tap an ingredient for the detail:
Vitamin 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 + Acetaminophen, Chlorpheniramine, Phenylpropanolamine interactionAcetaminophen, Chlorpheniramine, Phenylpropanolamine, OpiumHista-Derfule
How Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium interacts with Borage & Evening Primrose — through 1 ingredient. Tap an ingredient for the detail:
Vitamin 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 + Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium interactionEach ingredient & the kinds of drugs it affects
For each ingredient in Borage & Evening Primrose 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.
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.
Evening Primrose Oil
Anticoagulant/Antiplatelet Drugs
Theoretically, evening primrose oil may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Evening primrose oil contains gamma linolenic acid (GLA). There is preliminary clinical evidence that GLA can reduce platelet aggregation and prolong bleeding time.
Lithium
Theoretically, concomitant use of lithium with evening primrose oil might decrease lithium levels and effects.
In a case report, a patient on a stable dose of lithium for 10 years experienced a reduction in lithium levels after taking evening primrose oil 500 mg daily. Baseline levels were 0.69 mmol/L, which decreased to 0.37 mmol/L after 2 months and 0.23 mmol/L after 3 months of use. Lithium levels increased within 6 weeks of discontinuing evening primrose oil, to 0.73 mmol/L; no clinical effects were noted.
Lopinavir/Ritonavir (Kaletra)
Theoretically, evening primrose oil might increase the levels and effects of lopinavir.
In a case report, an HIV patient who took evening primrose oil (Efamol) along with lopinavir/ritonavir experienced an increase in serum levels of lopinavir to 15.2 mg/L. Six weeks after discontinuing evening primrose oil, levels of lopinavir returned to the normal range of 5-10 mg/L. When re-challenged with evening primrose oil for a week, the patient's lopinavir levels increased from 6.69 to 8.11 mg/L. It is suspected that evening primrose oil increases levels of lopinavir by inhibiting cytochrome P450 3A4 (CYP3A4), which metabolizes lopinavir. However, this effect has not been reported in other research.
Phenothiazines
Theoretically, taking evening primrose oil with phenothiazines might increase the risk of convulsions.
Evening primrose oil contains gamma-linolenic acid (GLA). There is some concern that taking supplements containing GLA might cause seizures, or lower the seizure threshold, when taken with phenothiazines. In one report, three patients with schizophrenia who had received phenothiazines developed EEG changes suggestive of temporal lobe epilepsy after starting treatment with GLA, although none experienced an actual seizure. In another report, two patients with schizophrenia who were stabilized on phenothiazines developed seizures when evening primrose oil 4 grams daily was added. One of these patients had a prior history of seizures. It is unclear whether evening primrose oil had any additive epileptogenic effects with the phenothiazines; there is no evidence that taking evening primrose oil alone causes seizures.
Cytochrome P450 2C9 (Cyp2C9) Substrates
Theoretically, evening primrose may increase the levels and clinical effects of CYP2C9 substrates.
In vitro research shows that linoleic acid, a constituent of evening primrose oil, inhibits CYP2C9.
Borage Oil
Anticoagulant/Antiplatelet Drugs
Theoretically, borage seed oil may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
In healthy individuals, borage seed oil supplementation does not seem to affect platelet aggregation. However, gamma-linolenic acid, a constituent of borage seed oil, seems to decrease platelet aggregation by 45% and increase the risk of bleeding by 40% in animal and clinical research.
Cytochrome P450 3A4 (Cyp3A4) Inducers
Theoretically, taking borage with drugs that induce CYP3A4 might increase levels of pyrrolizidine alkaloid (PA) toxic metabolites.
Although borage seed oil contains little to no PAs, some borage plant parts, such as the leaf, flower, and seed, can contain hepatotoxic PAs. Hepatotoxic PAs are substrates of CYP3A4, which converts these chemicals into toxic metabolites. Tell patients to avoid borage preparations that are not certified and labeled as hepatotoxic PA-free.
Phenothiazines
Theoretically, taking borage sed oil with phenothiazines might increase the risk of seizures.
Borage seed oil contains gamma-linolenic acid (GLA). There is concern that taking supplements containing GLA might cause seizures, or lower the seizure threshold, when taken with phenothiazines. This is based on limited data from two reports published in the 1980s. In one report, three patients with schizophrenia who had received phenothiazines developed EEG changes suggestive of temporal lobe epilepsy after starting treatment with evening primrose, another source of GLA. However, none experienced an actual seizure. In the other report, two patients with schizophrenia who were stabilized on phenothiazines developed seizures when evening primrose 4 grams daily was added. One of these patients had a prior history of seizures. It is unclear whether evening primrose had any additive epileptogenic effects with the phenothiazines, but there is no evidence that taking GLA-containing supplements alone can cause seizures.
Brand information
Manufacturer and brand details for Borage & Evening Primrose, from the product label.
SuperSmart
See all SuperSmart products- Name
- SN Worldwide Unipessoal, LDA
- Street Address
- Avenida Do Infante 66 Edificio Quinta Avenida 1 C
- City
- Funchal
- ZipCode
- 9000-015
Borage & Evening Primrose by SuperSmart: Common Questions
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Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
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Label information is sourced from the NIH Dietary Supplement Label Database and reflects the product version on file; always read your actual product label. This page is for education only and is not a substitute for professional medical advice. Confirm with your pharmacist or doctor before combining supplements and medications.
The Full Monographs Behind Borage & Evening Primrose’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Vitamin 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 monographBorage
Interacts with 226 drugsBorage is a Mediterranean herb whose seed oil is rich in gamma-linolenic acid (GLA), an omega-6 fatty acid studied mostly for skin conditions and arthritis with mixed results. The plant's le...
Read the full Borage monograph → Herb & supplement monographEvening Primrose
Interacts with 233 drugsEvening primrose oil is a seed oil rich in gamma-linolenic acid (GLA), an omega-6 fatty acid, that is popularly used for skin conditions, PMS, and breast pain. The evidence behind most of th...
Read the full Evening Primrose monograph →Sources & How We Checked
Borage & Evening Primrose'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 108 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 E 64 references
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- Smedts HP, de Vries JH, Rakhshandehroo M, et al. High maternal vitamin E intake by diet or supplements is associated with congenital heart defects in the offspring. BJOG 2009;116:416-23. PubMed
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- Papaioannou, D., Cooper, K. L., Carroll, C., Hind, D., Squires, H., Tappenden, P., and Logan, R. F. Antioxidants in the chemoprevention of colorectal cancer and colorectal adenomas in the general population: a systematic review and meta-analysis. Colorec PubMed
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- Mathew, M. C., Ervin, A. M., Tao, J., and Davis, R. M. Antioxidant vitamin supplementation for preventing and slowing the progression of age-related cataract. Cochrane.Database.Syst.Rev. 2012;6:CD004567. PubMed
- Rahimi, R., Nikfar, S., Rezaie, A., and Abdollahi, M. A meta-analysis on the efficacy and safety of combined vitamin C and E supplementation in preeclamptic women. Hypertens.Pregnancy. 2009;28(4):417-434. PubMed
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- Barak, Y., Swartz, M., Shamir, E., Stein, D., and Weizman, A. Vitamin E (alpha-tocopherol) in the treatment of tardive dyskinesia: a statistical meta-analysis. Ann.Clin.Psychiatry 1998;10(3):101-105.
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- Prescribing information: KOSELUGO (selumetinib) capsules. U.S. Food and Drug Administration. Available at: https://www.accessdata.fda.gov/drugsatfda_docs/label/2020/213756s000lbl.pdf.
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Borage 11 references
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- WHO working group. Pyrrolizidine alkaloids. Environmental Health Criteria, 80. WHO: Geneva, 1988.
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- Puri BK. The safety of evening primrose oil in epilepsy. Prostaglandins Leukotrienes Essential Fatty Acids 2007;77:101-3. PubMed
Evening Primrose 33 references
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- Vaddadi KS. The use of gamma-linolenic acid and linoleic acid to differentiate between temporal lobe epilepsy and schizophrenia. Prostaglandins Med 1981;6(4):375-379. PubMed
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- Yoon, S., Lee, J., and Lee, S. The therapeutic effect of evening primrose oil in atopic dermatitis patients with dry scaly skin lesions is associated with the normalization of serum gamma-interferon levels. Skin Pharmacol Appl.Skin Physiol 2002;15(1):20- PubMed
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- Parveen, S. Sarwar G. Ali M. Channa G. A. Danazol versus oil of evening primrose in the treatment of mastalgia. Pakistan Journal of Surgery. 2007;23(1):10-13.
- Belch JJF, Shaw B, O'Dowd A, et al. Evening primrose oil (Efamol) as a treatment for cold-induced vasospasm (Raynaud's phenomenon). Prog Lipid Res 1986;25:335-40.
- Johnson, M., Ostlund, S., Fransson, G., Kadesjo, B., and Gillberg, C. Omega-3/omega-6 fatty acids for attention deficit hyperactivity disorder: a randomized placebo-controlled trial in children and adolescents. J.Atten.Disord. 2009;12(5):394-401. PubMed
- Farzaneh F, Fatehi S, Sohrabi MR, Alizadeh K. The effect of oral evening primrose oil on menopausal hot flashes: a randomized clinical trial. Arch Gynecol Obstet 2013;288(5):1075-9. PubMed
- Puri BK. The safety of evening primrose oil in epilepsy. Prostaglandins Leukotrienes Essential Fatty Acids 2007;77:101-3. PubMed
- Jalloh MA, Gregory PJ, Hein D, et al. Dietary supplement interactions with antiretrovirals: a systematic review. Int J STD AIDS. 2017 Jan;28(1):4-15. PubMed
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