Interactions on record — worth a quick check against your medications. Based on 12 of 16 ingredients. Check your meds →
Dietary supplement

Breathe Activator Ingredients & Drug Interactions

by Nature's Sunshine

Breathe Activator label
See full label image
Capsule Category: Botanical
Most serious interaction: Moderate
Clinical methodology reviewed by · Updated Sep 16, 2026 · Label data from the NIH DSLD
What is this page for?

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

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

The interaction bottom line Most serious interaction: Moderate

Breathe Activator is a dietary supplement by Nature's Sunshine with 16 active ingredients. Its ingredients are commonly taken for fatigue and low energy, stress and adaptogen support, liver health.Based on those ingredients, 1,458 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Chinese Licorice Root Extract, Ginger Rhizome Extract, Schisandra extract. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

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Check Your Meds Against Breathe Activator by Nature's Sunshine

Ask about any prescription or over-the-counter medication and we check it for interactions with Breathe Activator by Nature's Sunshine — and tell you which ingredient is responsible.

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HelloPharmacist Scorecard of Breathe Activator by Nature's Sunshine

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

From our pharmacy team — supplement deep dive

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

What’s inside

Low disclosure
Ingredient Transparency · database check
Low

Most active ingredients don't disclose an individual amount — you can't tell how much of each you're getting.

Why this rating?
  • The label discloses an exact amount for 0 of its 16 active ingredients.
  • “Proprietary Blend” is a proprietary blend — the label gives one combined amount (475 mg) without saying how much of each component you get.

Breathe Activator contains 16 active ingredients in a proprietary blend, including schisandra extract (used traditionally for respiratory support), bupleurum root, ginger rhizome, licorice root, magnolia bark, and several others drawn from traditional herbal practice. Apricot seed, tangerine rind, perilla leaf, coltsfoot flower, white mulberry, and bamboo extracts round out the formula.

The product is delivered in a vegetable capsule with inactive ingredients including magnesium stearate and silicon dioxide.

Does it work?

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

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

Why this rating?
  • The label markets this product for: bronchial and lung support.
  • We looked for evidence on: Asthma, Cough, Common cold, Acute respiratory distress syndrome (ARDS), bronchitis, mucus clearance — and 2 related terms.
  • The closest evidence on file: Magnolia is rated "Insufficient Reliable Evidence To Rate" for Stress (Natural Medicines).
  • Also on file: Schisandra is rated "Insufficient Reliable Evidence To Rate" for Asthma, Cough, Stress.
  • Also on file: Perilla is rated "Insufficient Reliable Evidence To Rate" for Asthma, Common cold, Cough.

The evidence for most ingredients in this formula is not well established. Schisandra, bupleurum, ginger, and poria mushroom all show insufficient reliable evidence for asthma, cough, respiratory infections, and related respiratory conditions in our data.

Ginger does show possibly effective evidence for pregnancy-related nausea and dysmenorrhea (period pain), and licorice for canker sores and eczema-type skin conditions, but those are not respiratory uses. For the product's intended breathing support, the data we hold does not establish efficacy.

The evidence, ingredient by ingredient Schisandra Bupleurum Licorice Ginger Apricot Tangerine Poria Mushroom Magnolia

How safe is it?

Well-documented data
Safety Information · database check
Well characterized

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

Why this rating?
  • We hold adverse-effect (side-effect) data for 11 of the 12 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 12 of 12.
  • General safety write-ups exist for 12 of 12.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

Several ingredients in this product carry pregnancy or breastfeeding cautions. Schisandra, bupleurum, magnolia, and coltsfoot are rated unsafe or possibly unsafe during pregnancy — schisandra may stimulate the uterus, and coltsfoot carries liver-toxicity risk.

Licorice is rated unsafe in pregnancy due to potential harm linked to glycyrrhizin. Ginger is likely safe in pregnancy at food amounts and possibly safe at supplement doses, though you should check with your doctor first.

Perilla, white mulberry, platycodon, and bamboo all lack sufficient safety data in pregnancy and lactation; avoid medicinal amounts. Most ingredients are generally well tolerated in short-term use, though coltsfoot's main risk is liver and lung damage from pyrrolizidine alkaloids — use only certified PA-free products if at all.

Ginger at doses above 5 grams daily increases side-effect risk. Common mild side effects from these ingredients include heartburn, stomach upset, nausea, and decreased appetite.

Side effects, ingredient by ingredient Schisandra Bupleurum Licorice Ginger Apricot Tangerine Poria Mushroom Magnolia

Meds to double-check

Moderate interaction found
Known Interaction Concern · database check
Moderate identified

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

Why this rating?
  • 10 of the 12 matched ingredients can interact with medications — Magnolia, Poria Mushroom, Schisandra, Bamboo, Bupleurum, among others.
  • The most serious interaction on file is rated Moderate.
  • Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs; immunosuppressants / transplant drugs; diabetes medications; heart-rhythm medications.
  • For scale: 1,459 individual medications appear in the full list. A big number alone doesn't make a product dangerous — what matters is whether YOUR medication is on it, so run yours through the interaction checker on this page.

Before taking Breathe Activator, double-check with a pharmacist if you take tacrolimus, warfarin (or other blood thinners), heart medications metabolized by your liver's CYP3A4 enzymes, diabetes medications, digoxin, antifungals like voriconazole, sedatives, chemotherapy drugs, or metformin. These are the drug types most likely to be affected.

Check your own medication Run your meds through the checker above

The bottom line

Scorecard at a glanceFormula with limited ingredient disclosure with no established evidence rating for its marketed use. Moderate medication interactions have been identified, and safety information is well characterized.

Breathe Activator is a multi-ingredient herbal formula with limited evidence for respiratory benefit and significant interaction potential, especially with heart, blood-thinner, diabetes, and transplant medications. If you take any prescription drugs — particularly tacrolimus, warfarin, diabetes medications, digoxin, or sedatives — run your exact medications through the checker before adding this product.

Pregnant or breastfeeding? Talk to your pharmacist or doctor first.

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 Oct 24, 2022.

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

At a glance

General information

Key facts about Breathe Activator, straight from the product label.

Brand Nature's Sunshine
Barcode (UPC) 099904010369
Net contents 30 Capsule(s)
Market status On market
Date entered into DSLD Oct 24, 2022
DSLD ID 277993
Product type Botanical
Supplement form Capsule
Dietary claims / uses All Other, Structure/Function
Intended target group(s) Adult (18 - 50 Years)
From the label
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.

Supplement Facts

The label details for Breathe Activator by Nature's Sunshine, sourced from the NIH Dietary Supplement Label Database.

Supplement Facts

Daily Value (DV) Target Group(s):
Adults and children 4 or more years of age
Minimum serving Sizes:
1 Capsule(s)
Maximum serving Sizes:
1 Capsule(s)
Servings per container
30
UPC/BARCODE
099904010369
IngredientAmount% DV
Proprietary Blend475 mg--
Schisandra extract0 NP--
Bupleurum Root Extract0 NP--
Typhonium Rhizome Extract0 NP--
Chinese Licorice Root Extract0 NP--
Ginger Rhizome Extract0 NP--
Apricot Seed Extract0 NP--
Zhejiang fritillary bulb extract0 NP--
Tangerine Mature Fruit Rind Extract0 NP--
Platycodon Root Extract0 NP--
Hoelen Sclerotium Extract0 NP--
Magnolia Bark Extract0 NP--
Perilla Leaf Extract0 NP--
Coltsfoot flower bud extract0 NP--
Ophiopogon Root Tuber Extract0 NP--
White Mulberry extract0 NP--
Bamboo Extract, Dry Secretion0 NP--

Other ingredients: Capsule, Vegetable Magnesium Stearate, Silicon Dioxide

Tap any ingredient to jump to its full detail below.

Label statements
These statements are the manufacturer’s wording, reproduced from the product label — the label is saying it, not HelloPharmacist. We don’t verify or endorse them.
FDA Disclaimer Statement

These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.

General Statements

Bottle made from 100% post consumer recycled material. We are committed to you and our planet. Scan to learn more.

We source the world's purest ingredients, no matter where they are grown, to ensure the active nutrients are delivered just as nature intended.

Traditional Chinese medicine

New look! Same great product

Formulation

Contains herbs that have been traditionally used for bronchial and lung support.

Guaranteed pure

Concentrate Traditional respiratory system support

Xuan Fei (Metal Reducing)

Precautions

Pregnant or lactating women should consult their healthcare provider prior to taking this supplement.

Do not use if inner seal is missing or damaged.

FDA Statement of Identity

Dietary Supplement

Suggested/Recommended/Usage/Directions

Recommended Use: Take 1 capsule with a meal daily.

Brand IP Statement(s)

Natures Sunshine Herbal experts since 1972

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

See for yourself

Breathe Activator by Nature's Sunshine label

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

Breathe Activator label

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

View the full label (PDF)
What’s inside

The Ingredients in Breathe Activator by Nature's Sunshine

These are the 16 active ingredients this product is made of. Select any to open its full monograph.

Serving size1 Capsule(s) Dosage formCapsule Servings per container30 Amounts shown are per serving.

Most supplement products combine several ingredients, and a medication can interact with the product through any one of them. Each ingredient below shows whether it has known drug interactions.

Proprietary Blend

475 mg per serving

Other (inactive) ingredients: Capsule, Vegetable Magnesium Stearate, Silicon Dioxide. These complete the product’s ingredient list but are not active constituents.

Interaction report

Breathe Activator by Nature's Sunshine Drug Interactions

Want to check YOUR meds against Breathe Activator?

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

 Go to the checker
1,458Drugs
1,422 Moderate 36 Minor

Ingredients driving the most interactions

Chinese Licorice Root Extract 1,040
Ginger Rhizome Extract 1,007
Schisandra extract 803
Tangerine Mature Fruit Rind Extract 643
Hoelen Sclerotium Extract 417

Individual Drug Interactions

The ingredients in Breathe Activator interact with 1,458 drugs. Click any drug to see the details.

10 of the 16 ingredients in Breathe Activator interact with drugs. Each result below shows which ingredient is responsible. Chinese Licorice Root Extract Ginger Rhizome Extract Schisandra extract Tangerine Mature Fruit Rind Extract Hoelen Sclerotium Extract Coltsfoot flower bud extract Magnolia Bark Extract Bupleurum Root Extract White Mulberry extract Bamboo Extract, Dry Secretion

Each ingredient & the kinds of drugs it affects

For each ingredient in Breathe Activator 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.

Chinese Licorice Root Extract18 drug types · 1,040 drugs

Antihypertensive Drugs

Theoretically, licorice might reduce the effects of antihypertensive drugs.
In human research, licorice increases blood pressure in a dose-dependent manner.

Likelihood Possible Evidence B
Cisplatin (Platinol-Aq)

Theoretically, licorice might reduce the effects of cisplatin.
In animal research, licorice diminished the therapeutic efficacy of cisplatin.

Likelihood Possible Evidence D
Corticosteroids

Theoretically, concomitant use of licorice and corticosteroids might increase the side effects of corticosteroids.
Case reports suggest that concomitant use of licorice and oral corticosteroids, such as hydrocortisone, can potentiate the duration of activity and increase blood levels of corticosteroids. Additionally, in one case report, a patient with neurogenic orthostatic hypertension stabilized on fludrocortisone 0.1 mg twice daily developed pseudohyperaldosteronism after recent consumption of large amounts of black licorice.

Likelihood Possible Evidence D
Cytochrome P450 2B6 (Cyp2B6) Substrates

Theoretically, licorice might increase levels of drugs metabolized by CYP2B6.
In vitro research shows that licorice extract and glabridin, a licorice constituent, inhibit CYP2B6 isoenzymes. Licorice extract from the species G. uralensis seems to inhibit CYP2B6 isoenzymes to a greater degree than G. glabra extract in vitro. Theoretically, these species of licorice might increase levels of drugs metabolized by CYP2B6; however, these interactions have not yet been reported in humans.

Likelihood Possible Evidence D
Cytochrome P450 2C19 (Cyp2C19) Substrates

Theoretically, licorice might increase levels of drugs metabolized by CYP2C19.
In vitro, licorice extracts from the species G. glabra and G. uralensis inhibit CYP2C19 isoenzymes in vitro. Theoretically, these species of licorice might increase levels of drugs metabolized by CYP2C19; however, this interaction has not yet been reported in humans.

Likelihood Possible Evidence D
Cytochrome P450 2C8 (Cyp2C8) Substrates

Theoretically, licorice might increase levels of drugs metabolized by CYP2C8.
In vitro, licorice extract from the species G. glabra and G. uralensis inhibits CYP2C8 isoenzymes. Theoretically, these species of licorice might increase levels of drugs metabolized by CYP2C8; however, this interaction has not yet been reported in humans.

Likelihood Possible Evidence D
Cytochrome P450 2C9 (Cyp2C9) Substrates

Theoretically, licorice might increase or decrease levels of drugs metabolized by CYP2C9.
There is conflicting evidence about the effect of licorice on CYP2C9 enzyme activity. In vitro research shows that extracts from the licorice species G. glabra and G. uralensis moderately inhibit CYP2C9 isoenzymes. However, evidence from an animal model shows that licorice extract from the species G. uralensis can induce hepatic CYP2C9 activity. Until more is known, licorice should be used cautiously in people taking CYP2C9 substrates.

Likelihood Possible Evidence D
Cytochrome P450 3A4 (Cyp3A4) Substrates

Theoretically, licorice might increase or decrease levels of drugs metabolized by CYP3A4.
Pharmacokinetic research shows that the licorice constituent glycyrrhizin, taken in a dosage of 150 mg orally twice daily for 14 days, modestly decreases the area under the concentration-time curve of midazolam by about 20%. Midazolam is a substrate of CYP3A4, suggesting that glycyrrhizin modestly induces CYP3A4 activity. Animal research also shows that licorice extract from the species G. uralensis induces CYP3A4 activity. However, licorice extract from G. glabra species appear to inhibit CYP3A4-induced metabolism of testosterone in vitro. It is thought that the G. glabra inhibits CYP3A4 due to its constituent glabridin, which is a moderate CYP3A4 inhibitor in vitro and not present in other licorice species. Until more is known, licorice should be used cautiously in people taking CYP3A4 substrates.

Likelihood Possible Evidence B
Digoxin (Lanoxin)

Theoretically, concomitant use of licorice with digoxin might increase the risk of cardiac toxicity.
Overuse or misuse of licorice with cardiac glycoside therapy might increase the risk of cardiac toxicity due to potassium loss.

Likelihood Possible Evidence D
Diuretic Drugs

Theoretically, concomitant use of licorice with diuretic drugs might increase the risk of hypokalemia.
Overuse of licorice might compound diuretic-induced potassium loss. In one case report, a 72-year-old male with a past medical history of hypertension, type 2 diabetes, hyperlipidemia, arrhythmia, stroke, and hepatic dysfunction was hospitalized with severe hypokalemia and uncontrolled hypertension due to pseudohyperaldosteronism. This was thought to be provoked by concomitant daily consumption of a product containing 225 mg of glycyrrhizin, a constituent of licorice, and hydrochlorothiazide 12.5 mg for 1 month.

Likelihood Possible Evidence D
Estrogens

Theoretically, licorice might increase or decrease the effects of estrogen therapy.
Theoretically, licorice might interfere with estrogen therapy due to estrogenic and anti-estrogenic effects.

Likelihood Possible Evidence D
Loop Diuretics

Theoretically, loop diuretics might increase the mineralocorticoid effects of licorice.
Theoretically, loop diuretics might enhance the mineralocorticoid effects of licorice by inhibiting the enzyme that converts cortisol to cortisone; however, bumetanide (Bumex) does not appear to have this effect.

Likelihood Possible Evidence D
Midazolam (Versed)

Theoretically, licorice might decrease levels of midazolam.
In humans, the licorice constituent glycyrrhizin appears to moderately induce the metabolism of midazolam. This is likely due to induction of cytochrome P450 3A4 by licorice. Until more is known, licorice should be used cautiously in people taking midazolam.

Likelihood Possible Evidence B
P-Glycoprotein Substrates

Theoretically, licorice might decrease the absorption of P-glycoprotein substrates.
In vitro research shows that licorice can increase P-glycoprotein activity.

Likelihood Possible Evidence D
Paclitaxel (Abraxane, Onxol)

Theoretically, licorice might decrease plasma levels and clinical effects of paclitaxel.
Multiple doses of licorice taken concomitantly with paclitaxel might reduce the effectiveness of paclitaxel. Animal research shows that licorice 3 grams/kg given orally for 14 days before intravenous administration of paclitaxel decreases the exposure to paclitaxel and increases its clearance. Theoretically, this occurs because licorice induces cytochrome P450 3A4 enzymes, which metabolize paclitaxel. Notably, a single dose of licorice did not affect exposure or clearance of paclitaxel.

Likelihood Possible Evidence D
Warfarin (Coumadin)

Theoretically, licorice might decrease plasma levels and clinical effects of warfarin.
Licorice seems to increase metabolism and decrease levels of warfarin in animal models. This is likely due to induction of cytochrome P450 2C9 (CYP2C9) metabolism by licorice. Advise patients taking warfarin to avoid taking licorice.

Likelihood Possible Evidence D
Cytochrome P450 1A2 (Cyp1A2) Substrates

Theoretically, licorice might decrease the levels and clinical effects of CYP1A2 substrates.
In vitro research shows that licorice induces CYP1A2 enzymes.

Likelihood Possible Evidence D
Methotrexate (Trexall, Others)

Theoretically, licorice might increase levels of methotrexate.
Animal research suggests that intravenous administration of glycyrrhizin, a licorice constituent, and high-dose methotrexate may delay methotrexate excretion and increase systemic exposure, leading to transient elevations in liver enzymes and total bilirubin. This interaction has not yet been reported in humans.

Likelihood Unlikely Evidence D
Chinese Licorice Root Extract full monograph & interactions

Ginger Rhizome Extract14 drug types · 1,007 drugs

Anticoagulant/Antiplatelet Drugs

Ginger may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs. However, research is conflicting.
Laboratory research suggests that ginger inhibits thromboxane synthetase and decreases platelet aggregation. However, this has not been demonstrated unequivocally in humans, with mixed results from clinical trials. Theoretically, excessive amounts of ginger might increase the risk of bleeding when used with anticoagulant/antiplatelet drugs.

Likelihood Possible Evidence B
Antidiabetes Drugs

Theoretically, taking ginger with antidiabetes drugs might increase the risk of hypoglycemia.
Animal and human research suggests that ginger might increase insulin levels and/or decrease blood glucose levels.

Likelihood Possible Evidence D
Cytochrome P450 3A4 (Cyp3A4) Substrates

Ginger might increase or decrease the levels of CYP3A4 substrates.
In vitro research and some case reports suggest that ginger inhibits CYP3A4 activity. Three case reports from the World Health Organization (WHO) adverse drug reaction database describe increased toxicity in patients taking ginger and cancer medications that are CYP3A4 substrates (imatinib, dabrafenib, and crizotinib). However, the causality of this interaction is unclear due to the presence of multiple interacting drugs and routes of administration.
Conversely, other in vitro research suggests that ginger induces CYP3A4 activity, leading to reduced levels of CYP3A4 substrates. However, this interaction has not been reported in humans.

Likelihood Possible Evidence D
Losartan (Cozaar)

Theoretically, ginger might increase levels of losartan and the risk of hypotension.
In animal research, ginger increased the levels and hypotensive effects of a single dose of losartan. It is not clear if ginger alters the concentration or effects of losartan when taken continuously. Additionally, this interaction has not been shown in humans.

Likelihood Possible Evidence D
Nifedipine (Procardia)

Ginger may have antiplatelet effects and increase the risk of bleeding if used with nifedipine.
Clinical research shows that combined treatment with ginger 1 gram plus nifedipine 10 mg significantly inhibits platelet aggregation when compared to nifedipine or ginger alone.

Likelihood Possible Evidence B
P-Glycoprotein Substrates

Ginger might increase the absorption and blood levels of P-glycoprotein (P-gp) substrates.
In vitro research and case reports suggest that ginger inhibits drug efflux by P-gp, potentially increasing absorption and serum levels of P-gp substrates. Two case reports from the World Health Organization (WHO) adverse drug reaction database describe increased toxicity in patients taking ginger and cancer medications that are P-gp substrates (trametinib, crizotinib). However, the causality of this interaction is unclear due to the presence of multiple interacting drugs and routes of administration.

Likelihood Possible Evidence D
Phenprocoumon (Marcoumar, Others)

Ginger might increase the risk of bleeding with phenprocoumon.
Phenprocoumon, a warfarin-related anticoagulant, might increase the international normalized ratio (INR) when taken with ginger. There is one case report of a 76-year-old woman with a stable INR on phenprocoumon that increased to greater than 10 when she began consuming dried ginger and ginger tea.

Likelihood Possible Evidence D
Warfarin (Coumadin)

Ginger might increase the risk of bleeding with warfarin.
Laboratory research suggests that ginger might inhibit thromboxane synthetase and decrease platelet aggregation. In one case report, ginger increased the INR when taken with phenprocoumon, which has similar pharmacological effects as warfarin. In another case report, ginger increased the INR when taken with a combination of warfarin, hydrochlorothiazide, and acetaminophen. A longitudinal analysis suggests that taking ginger increases the risk of bleeding in patients taking warfarin for at least 4 months. However, research in healthy people suggests that ginger has no effect on INR, or the pharmacokinetics or pharmacodynamics of warfarin. Until more is known, monitor INRs closely in patients taking large amounts of ginger.

Likelihood Possible Evidence B
Calcium Channel Blockers

Theoretically, taking ginger with calcium channel blockers might increase the risk of hypotension.
Some animal and in vitro research suggests that ginger has hypotensive and calcium channel-blocking effects. Another animal study shows that concomitant administration of ginger and the calcium channel blocker amlodipine leads to greater reductions in blood pressure when compared with amlodipine alone.

Likelihood Unlikely Evidence D
Cyclosporine (Neoral, Sandimmune)

Theoretically, when taken prior to cyclosporine, ginger might decrease cyclosporine levels.
In an animal model, ginger juice taken 2 hours prior to cyclosporine administration reduced the maximum concentration and area under the curve of cyclosporine by 51% and 40%, respectively. This effect was not observed when ginger juice and cyclosporine were administered at the same time.

Likelihood Possible Evidence D
Cytochrome P450 1A2 (Cyp1A2) Substrates

Theoretically, ginger might increase the levels of CYP1A2 substrates.
In vitro research shows that ginger inhibits CYP1A2 activity. However, this interaction has not been reported in humans.

Likelihood Possible Evidence D
Cytochrome P450 2B6 (Cyp2B6) Substrates

Theoretically, ginger might increase the levels of CYP2B6 substrates.
In vitro research shows that ginger inhibits CYP2B6 activity. However, this interaction has not been reported in humans.

Likelihood Possible Evidence D
Cytochrome P450 2C9 (Cyp2C9) Substrates

Theoretically, ginger might increase the levels of CYP2C9 substrates.
In vitro research shows that ginger inhibits CYP2C9 activity. However, this interaction has not been reported in humans.

Likelihood Possible Evidence D
Metronidazole (Flagyl)

Theoretically, ginger might increase levels of metronidazole.
In an animal model, ginger increased the absorption and plasma half-life of metronidazole. In addition, the elimination rate and clearance of metronidazole was significantly reduced.

Likelihood Possible Evidence D
Ginger Rhizome Extract full monograph & interactions

Schisandra extract12 drug types · 803 drugs

Cyclophosphamide

Theoretically, schisandra might increase the levels and clinical effects of cyclophosphamide.
In vitro research shows that schisandra increases the concentration of cyclophosphamide, likely through inhibition of cytochrome P450 3A4. After multiple doses of the schisandra constituents schisandrin A and schisantherin A, the maximum concentration of cyclophosphamide was increased by 7% and 75%, respectively, while the overall exposure to cyclophosphamide was increased by 29% and 301%, respectively.

Likelihood Probable Evidence D
Cyclosporine (Neoral, Sandimmune)

Schisandra can increase the levels and clinical effects of cyclosporine.
A small observational study in children with aplastic anemia found that taking schisandra with cyclosporine increased cyclosporine trough levels by 93% without increasing the risk of adverse events. However, the dose of cyclosporine was reduced in 9% of children to maintain appropriate cyclosporine blood concentrations.

Likelihood Probable Evidence B
Cytochrome P450 2C19 (Cyp2C19) Substrates

Theoretically, schisandra might increase the levels and clinical effects of CYP2C19 substrates.
In vitro research shows that schisandra inhibits CYP2C19, and animal research shows that schisandra increases the concentration of voriconazole, a CYP2C19 substrate. Theoretically, schisandra may also inhibit the metabolism of other CYP2C19 substrates. This effect has not been reported in humans.

Likelihood Probable Evidence D
Cytochrome P450 2C9 (Cyp2C9) Substrates

Theoretically, schisandra might decrease the levels and clinical effects of CYP2C9 substrates.
In vitro and animal research suggests that schisandra induces CYP2C9 enzymes. This effect has not been reported in humans.

Likelihood Possible Evidence D
Cytochrome P450 3A4 (Cyp3A4) Substrates

Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.
Most clinical and laboratory research shows that schisandra, administered either as a single dose or up to twice daily for 14 days, inhibits CYP3A4 and increases the concentration of CYP3A4 substrates such as cyclophosphamide, midazolam, tacrolimus, and talinolol. Although one in vitro and animal study shows that schisandra may induce CYP3A4 metabolism, this effect appears to be overpowered by schisandra's CYP3A4 inhibitory activity and has not been reported in humans.

Likelihood Probable Evidence D
Midazolam (Versed)

Schisandra can increase the levels and clinical effects of midazolam.
A small pharmacokinetic study in healthy adults shows that taking schisandra extract (Hezheng Pharmaceutical Co.) containing deoxyschizandrin 33.75 mg twice daily for 8 days and a single dose of midazolam 15 mg on day 8 increases the overall exposure to midazolam by about 119%, increases the peak plasma level of midazolam by 86%, and decreases midazolam clearance by about 52%. This effect has been attributed to inhibition of CYP3A4 by schisandra.

Likelihood Probable Evidence B
P-Glycoprotein Substrates

Schisandra might increase the levels and clinical effects of P-glycoprotein substrates.
In vitro research shows that schisandra extracts and constituents such as schisandrin B inhibit P-glycoprotein mediated efflux in intestinal cells and in P-glycoprotein over-expressing cell lines. Additionally, a small clinical study shows that schisandra increases the peak concentration and overall exposure to talinolol, a P-glycoprotein probe substrate. Theoretically, schisandra might inhibit the efflux of other P-glycoprotein substrates.

Likelihood Possible Evidence D
Sirolimus (Rapamune)

Schisandra can increase the levels and clinical effects of sirolimus.
A small pharmacokinetic study in healthy volunteers shows that taking 3 capsules of schisandra (Hezheng Pharmaceutical Company) containing a total of 33.75 mg deoxyschizandrin twice daily for 13 days and then taking a single dose of sirolimus 2 mg increases the overall exposure and peak level of sirolimus by two-fold. This effect is thought to be due to inhibition of cytochrome P450 3A4 by schisandra, as well as possible inhibition of the P-glycoprotein drug transporter.

Likelihood Probable Evidence B
Tacrolimus (Prograf)

Schisandra can increase the levels and clinical effects of tacrolimus.
Clinical research in healthy children and adults, transplant patients, and patients with nephrotic syndrome and various rheumatic immunologic disorders shows that taking schisandra with tacrolimus increases tacrolimus peak levels by 183% to 268%, prolongs or delays time to peak tacrolimus concentrations, increases overall exposure to tacrolimus by 126% to 343%, and decreases tacrolimus clearance by 19% to 73%. This effect is thought to be due to inhibition of P-glycoprotein drug transporter and CYP3A4 and CYP3A5 by schisandra. Some clinical and observational studies suggest that schisandra increases tacrolimus levels similarly in both expressors and non-expressors of CYP3A5, while other studies suggest it does so to a greater degree in CYP3A5 expressors than non-expressors. Animal research suggests that the greatest increase in tacrolimus levels occurs when schisandra is taken either concomitantly or up to 2 hours before tacrolimus, and clinical and observational research in humans suggests that schisandra may increase whole blood levels of tacrolimus and decrease clearance of tacrolimus in a dose-dependent manner.

Likelihood Probable Evidence B
Talinolol

Schisandra can increase the levels and clinical effects of talinolol.
A small pharmacokinetic study in healthy volunteers shows that taking schisandra extract 300 mg twice daily for 14 days with a single dose of talinolol 100 mg on day 14 increases the peak talinolol level by 51% and the overall exposure to talinolol by 47%. This effect is thought to be due to the possible inhibition of cytochrome P450 3A4 and P-glycoprotein by schisandra. tly.

Likelihood Probable Evidence B
Voriconazole (Vfend)

Theoretically, schisandra might increase the levels and clinical effects of voriconazole.
Animal research shows that oral schisandra given daily for 1 or 14 days increases levels of intravenously administered voriconazole, a cytochrome P450 (CYP) 2C19 substrate. This effect is thought to be due to inhibition of CYP2C19 by schisandra. However, this interaction has not been reported in humans.

Likelihood Possible Evidence D
Warfarin (Coumadin)

Theoretically, schisandra might decrease the levels and clinical effects of warfarin.
Animal research suggests that oral schisandra extract, given daily for 6 days, reduces levels of intravenously administered warfarin. This effect might be due to the induction of cytochrome P450 (CYP) 2C9 metabolism by schisandra. However, this interaction has not been reported in humans.

Likelihood Possible Evidence D
Schisandra extract full monograph & interactions

Tangerine Mature Fruit Rind Extract2 drug types · 643 drugs

Cytochrome P450 3A4 (Cyp3A4) Substrates

In vitro, tangeretin, a constituent of tangerine, induces a 52% increase in the metabolism of midazolam by cytochrome P450 3A4 (CYP3A4). This suggests that tangeretin may stimulate CYP3A4 activity. However, in humans, drinking tangerine juice 200 mL slightly delayed the absorption, but did not affect the metabolism, of midazolam, a CYP3A4 substrate. Theoretically, tangerine juice might increase CYP3A4 activity and decrease levels of drugs metabolized by this enzyme. However, this effect is unlikely.
Some drugs metabolized by CYP3A4 include amitriptyline (Elavil), amiodarone (Cordarone), citalopram (Celexa), felodipine (Plendil), lansoprazole (Prevacid), ondansetron (Zofran), prednisone (Deltasone, Orasone), sertraline (Zoloft), sibutramine (Meridia), and many others.

Likelihood Unlikely Evidence B
Midazolam (Versed)

In vitro, tangeretin, a constituent of tangerine, appears to increase the metabolism of midazolam in human liver microsomes by up to 52%. However, in humans, drinking tangerine juice 200 mL slightly delayed the absorption, but did not affect the metabolism, of midazolam. Theoretically, tangerine juice might increase the metabolism and reduce the effects of midazolam. However, this effect is unlikely.

Likelihood Unlikely Evidence B
Tangerine Mature Fruit Rind Extract full monograph & interactions

Hoelen Sclerotium Extract3 drug types · 417 drugs

Anticholinergic Drugs

Theoretically, poria mushroom might decrease the clinical effects of anticholinergic drugs.
In animal research, poria mushroom essential oil reduces acetylcholinesterase activity. This interaction has not been shown in humans.

Likelihood Possible Evidence D
Cholinergic Drugs

Theoretically, poria mushroom might have additive effects when used with cholinergic drugs.
In animal research, poria mushroom essential oil reduces acetylcholinesterase activity. This interaction has not been shown in humans.

Likelihood Possible Evidence D
Cns Depressants

Theoretically, taking poria mushroom extract may enhance the therapeutic and adverse effects of sedatives.
Animal research shows that poria mushroom extract has sedative properties. This interaction has not been shown in humans.

Likelihood Possible Evidence D
Hoelen Sclerotium Extract full monograph & interactions

Coltsfoot flower bud extract3 drug types · 374 drugs

Anticoagulant/Antiplatelet Drugs

Concomitant use might increase the risk of bleeding due to decreased platelet aggregation. Coltsfoot has been reported to inhibit platelet aggregation; avoid concomitant use. Some of these drugs include aspirin, clopidogrel (Plavix), dalteparin (Fragmin), enoxaparin (Lovenox), heparin, ticlopidine (Ticlid), warfarin (Coumadin), and others.

Likelihood Possible Evidence D
Antihypertensive Drugs

Theoretically, excessive doses of coltsfoot may interfere with antihypertensive or cardiovascular therapy.

Likelihood Possible Evidence D
Cytochrome P450 3A4 (Cyp3A4) Inducers

Hepatotoxic pyrrolizidine alkaloids (PA) are substrates of cytochrome P450 3A4 (CYP3A4). Theoretically, drugs that induce CYP3A4 might increase the conversion of PAs to toxic metabolites. Some drugs that induce CYP3A4 include carbamazepine (Tegretol), phenobarbital, phenytoin (Dilantin), rifampin, rifabutin (Mycobutin), and others.

Likelihood Possible Evidence D
Coltsfoot flower bud extract full monograph & interactions

Magnolia Bark Extract2 drug types · 351 drugs

Anticoagulant/Antiplatelet Drugs

Theoretically, magnolia might have additive effects and increase the risk of bleeding when used with anticoagulant or antiplatelet drugs.
In vitro research shows that the chemicals magnolol and honokiol, isolated from magnolia bark, inhibit platelet aggregation that is experimentally induced by collagen and arachidonic acid. However, they do not inhibit platelet aggregation that is induced by adenosine diphosphate, platelet-activating factor, or thrombin. This interaction has not been reported in humans.

Likelihood Possible Evidence D
Cns Depressants

Theoretically, concomitant use of large doses of magnolia bark and CNS depressants might have additive effects.
In vitro and animal research shows that constituents extracted from magnolia bark, especially honokiol and magnolol, have sedative effects. These effects may be due to the inhibition of catecholamine release and modulation of gamma-aminobutyric acid-A (GABA-A) receptors.

Likelihood Possible Evidence D
Magnolia Bark Extract full monograph & interactions

Bupleurum Root Extract3 drug types · 327 drugs

Anticoagulant/Antiplatelet Drugs

Theoretically, bupleurum might increase the risk of bleeding when taken with anticoagulant or antiplatelet drugs.
In vitro research suggests that saikosaponins, constituents of bupleurum, can inhibit platelet aggregation.

Likelihood Possible Evidence D
Antidiabetes Drugs

Theoretically, bupleurum might decrease the effects of antidiabetes drugs.
Animal research suggests that saikosaponins, constituents of bupleurum, can increase blood glucose.

Likelihood Possible Evidence D
Immunosuppressants

Theoretically, bupleurum might decrease the effects of immunosuppressants.
In vitro and animal research suggests that bupleurum might stimulate immune function.

Likelihood Possible Evidence D
Bupleurum Root Extract full monograph & interactions

White Mulberry extract2 drug types · 87 drugs

Antidiabetes Drugs

Theoretically, white mulberry leaf might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Clinical research shows that white mulberry leaf can lower blood glucose levels. Advise patients to monitor glucose levels closely.

Likelihood Possible Evidence D
Organic Cation Transporter 2 (Oct2) Substrates

Theoretically, white mulberry leaf might slow the elimination and increase the adverse effects of drugs which are OCT2 substrates.
Animal research shows that coadministration of white mulberry leaf extract with metformin, an OCT2 substrate, slows the renal elimination of metformin via inhibition of OCT2 activity. OCT2 is expressed in the kidneys and is responsible for transporting cationic drugs into tubular epithelial cells in order to be excreted in the urine.

Likelihood Possible Evidence D
White Mulberry extract full monograph & interactions

Bamboo Extract, Dry Secretion1 drug type · 5 drugs

Antithyroid Drugs

Theoretically, long-term bamboo use might increase the effects and adverse effects of antithyroid drugs, possibly leading to hypothyroidism.
Animal research suggests that long-term consumption of bamboo shoot can decrease thyroid peroxidase activity, as well as levels of thyroxine (T4) and triiodothyronine (T3). This effect has not yet been reported in humans.

Likelihood Possible Evidence D
Bamboo Extract, Dry Secretion full monograph & interactions
The maker

Brand information

Manufacturer and brand details for Breathe Activator, from the product label.

Nature's Sunshine

See all Nature's Sunshine products
Name
Nature's Sunshine Products, Inc
City
Spanish Fork
State
Utah
ZipCode
84660
Phone Number
1-800-223-8225
Web Address
www.naturessunshine.com
Pharmacist Counseling Corner

Breathe Activator by Nature's Sunshine: Common Questions

Does Breathe Activator by Nature's Sunshine interact with any medications?
Yes. Based on its ingredients, Breathe Activator has a known interaction with 1,458 medications. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Breathe Activator contains 16 active ingredients, and an interaction can come from any of them. We check every ingredient, combine the results into one list per medication, and show which ingredient and mechanism is responsible.
Where does this information come from?
The product label data comes from the NIH Dietary Supplement Label Database (DSLD); the interaction data is built on the Natural Medicines database and reviewed by HelloPharmacist pharmacists.
Is this safe to take while pregnant?
Several ingredients — schisandra, bupleurum, magnolia, and coltsfoot — are not recommended during pregnancy. Licorice is unsafe in pregnancy. Others like ginger are possibly safe at food amounts but need your doctor's okay at supplement strength. Do not take this product without checking with your doctor or pharmacist first if you're pregnant.
Can I take this if I'm breastfeeding?
Schisandra, bupleurum, magnolia, coltsfoot, and several others lack enough safety data while breastfeeding; most should be avoided. Ginger is likely safe at food amounts. Talk to your pharmacist before using this product if you're nursing.
Does this actually help with breathing or cough?
For asthma, cough, and respiratory infections, the evidence in our data is insufficient to rate whether these ingredients work. Ginger does have some evidence for nausea and period pain, but not for breathing support.
What are the most common side effects?
Heartburn, stomach upset, nausea, decreased appetite, and diarrhea are the most frequently reported side effects from the ginger, licorice, and schisandra in this blend. Mild gastrointestinal symptoms are most common.
Does coltsfoot in this product contain liver-toxic alkaloids?
Coltsfoot naturally contains pyrrolizidine alkaloids that can damage the liver and lungs with chronic use. If this product contains coltsfoot, only use it if the product is certified PA-free, and even then use cautiously and short-term only.
Why does this interact with so many medications?
Several ingredients — especially schisandra, ginger, and licorice — affect how your liver breaks down medications. When an herb slows or speeds up drug metabolism, it can raise or lower the amount of medication in your bloodstream, changing how well it works or increasing side effects.

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

Not sure if Breathe Activator is safe with your meds?

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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.

Breathe Activator label
Go deeper

The Full Monographs Behind Breathe Activator’s Ingredients

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

Herb & supplement monograph

Schisandra

Interacts with 803 drugs

Schisandra is a traditional Chinese medicine berry used as an adaptogen for stress, fatigue, and liver support. Human evidence is limited and most claims are not well proven, but it appears...

Read the full Schisandra monograph → Herb & supplement monograph

Bupleurum

Interacts with 327 drugs

Bupleurum (Chai Hu) is a root used in traditional Chinese medicine, usually as part of multi-herb formulas, for liver, digestive, and fever-related complaints. High-quality human evidence fo...

Read the full Bupleurum monograph → Herb & supplement monograph

Licorice

Interacts with 1,040 drugs

Licorice root is a traditional remedy used for sore throats, coughs, and digestive complaints, but solid human evidence is limited for most uses. Regular licorice contains glycyrrhizin, whic...

Read the full Licorice monograph → Herb & supplement monograph

Ginger

Interacts with 1,007 drugs

Ginger is a widely used culinary spice with a long history in traditional medicine, and it has the strongest evidence for helping with nausea and vomiting, including from motion sickness, pr...

Read the full Ginger monograph → Herb & supplement monograph

Apricot

Apricot is a nutritious fruit that provides fiber, potassium, and vitamins A and C, and it is safe and healthy to eat as part of a normal diet. There is little strong evidence that apricot f...

Read the full Apricot monograph → Herb & supplement monograph

Tangerine

Interacts with 643 drugs

Tangerine is a sweet citrus fruit that is a good source of vitamin C and other nutrients, and is widely enjoyed as food. While the peel and essential oil are used in traditional medicine and...

Read the full Tangerine monograph → Herb & supplement monograph

Poria Mushroom

Interacts with 417 drugs

Poria mushroom (Fu Ling) is a fungus long used in Traditional Chinese Medicine, mainly as a mild diuretic and digestive and calming aid. Modern scientific evidence in humans is very limited,...

Read the full Poria Mushroom monograph → Herb & supplement monograph

Magnolia

Interacts with 351 drugs

Magnolia bark and flower buds have a long history in traditional Chinese and Japanese medicine, often for stress, sleep, and digestion. Modern human research is still limited, so we can't be...

Read the full Magnolia monograph → Herb & supplement monograph

Perilla

Perilla is an Asian mint-family plant used in cooking and traditional medicine, mainly for allergy, breathing, and digestive complaints. Most human evidence is limited or preliminary, so it...

Read the full Perilla monograph → Herb & supplement monograph

Coltsfoot

Interacts with 374 drugs

Coltsfoot is a traditional herb long used to soothe coughs and clear mucus, but solid human evidence for these uses is lacking. More importantly, the raw plant can contain liver-toxic pyrrol...

Read the full Coltsfoot monograph → Herb & supplement monograph

White Mulberry

Interacts with 87 drugs

White mulberry leaf is most studied for helping blunt the rise in blood sugar after meals, but the human evidence is limited and not strong. It is generally well tolerated as a food and tea,...

Read the full White Mulberry monograph → Herb & supplement monograph

Bamboo

Interacts with 5 drugs

Bamboo is a giant grass whose shoots are eaten as food and whose leaves and silica-rich extracts are sold as supplements, often for hair, skin, nail, and bone support. Solid human evidence f...

Read the full Bamboo monograph →
Sources

Sources & How We Checked

Breathe Activator's label data comes from the NIH Dietary Supplement Label Database; the ingredient interaction data is from the Natural Medicines database, reviewed by our pharmacists.

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

The 237 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.

Schisandra 26 references
  1. Leung AY, Foster S. Encyclopedia of Common Natural Ingredients Used in Food, Drugs and Cosmetics. 2nd ed. New York, NY: John Wiley & Sons, 1996.
  2. Iwata H, Tezuka Y, Kadota S, et al. Identification and characterization of potent CYP3A4 inhibitors in Schisandra fruit extract. Drug Metab Dispos 2004;32:1351-8. PubMed
  3. Mu Y, Zhang J, Zhang S, et al. Traditional Chinese medicines Wu Wei Zi (Schisandra chinensis Baill) and Gan Cao (Glycyrrhiza uralensis Fisch) activate pregnane X receptor and increase warfarin clearance in rats. J Pharmacol Exp Ther 2006;316:1369-77. PubMed
  4. Xin HW, Wu XC, Li Q, et al. Effects of Schisandra sphenanthera extract on the pharmacokinetics of tacrolimus in healthy volunteers. Br J Clin Pharmacol 2007;64:469-75.
  5. Qin XL, Bi HC, Wang XD, et al. Mechanistic understanding of the different effects of Wuhzi Tablet (Schisandra sphenanthera extract) on the absorption and first-pass intestinal and hepatic metabolism of tacrolimus (FK506). Int J Pharm 2010;389:114-21.
  6. Makino, T., Mizuno, F., and Mizukami, H. Does a kampo medicine containing schisandra fruit affect pharmacokinetics of nifedipine like grapefruit juice? Biol.Pharm.Bull. 2006;29(10):2065-2069. PubMed
  7. Fan L, Mao XQ, Tao GY, Wang G, Jiang F, Chen Y, Li Q, Zhang W, Lei HP, Hu DL, Huang YF, Wang D, Zhou HH. Effect of Schisandra chinensis extract and Ginkgo biloba extract on the pharmacokinetics of talinolol in healthy volunteers. Xenobiotica. 2009 Mar;39(
  8. Jiang W, Wang X, Xu X, Kong L. Effect of Schisandra sphenanthera extract on the concentration of tacrolimus in the blood of liver transplant patients. Int J Clin Pharmacol Ther. 2010 Mar;48(3):224-9. PubMed
  9. Xin HW, Wu XC, Li Q, Yu AR, Xiong L. Effects of Schisandra sphenanthera extract on the pharmacokinetics of midazolam in healthy volunteers. Br J Clin Pharmacol. 2009 May;67(5):541-6.
  10. Li J, Chen S, Qin X, et at. Wuzhi Tablet (<i>Schisandra sphenanthera</i> Extract) is a Promising Tacrolimus-Sparing Agent for Renal Transplant Recipients Who are CYP3A5 Expressers: a Two-Phase Prospective Study. Drug Metab Dispos. 2017;45(11):1114-1119.
  11. Qin XL, Li JL, Wang SH, Chen X, Huang M, Bi HC. Co-administration of Wuzhi tablet (Schisandra sphenanthera extract) alters tacrolimus pharmacokinetics in a dose- and time-dependent manner in rats. J Ethnopharmacol. 2020;263:113233. PubMed
  12. Yuan F, Liang X, Chen X, Qin X, Tan C, Wang L. CYP2C19 is involved in the effect of Wuzhi tablet (Schisandra sphenanthera extract) and its constituents on the pharmacokinetics of intravenous voriconazole. Pharmazie. 2020;75(11):559-564. DOI
  13. Zhang Z, Lu X, Dong L, Ma J, Fan X. Clinical observation on the effect of Wuzhi soft capsule on FK506 concentration in membranous nephropathy patients. Medicine (Baltimore). 2019;98(48):e18150. PubMed
  14. Yoo HH, Lee M, Lee MW, Lim SY, Shin J, Kim DH. Effects of Schisandra lignans on P-glycoprotein-mediated drug efflux in human intestinal Caco-2. Planta Med. 2007;73(5):444-50.
  15. Qiangrong P, Wang T, Lu Q, Hu X. Schisandrin B--a novel inhibitor of P-glycoprotein. Biochem Biophys Res Commun. 2005;335(2):406-11. PubMed
  16. Chen L, Ji N, Zhang M, Chen W. The influence of Wuzhi capsule on the pharmacokinetics of cyclophosphamide. Recent Pat Anticancer Drug Discov 2021. PubMed
  17. Cheng X, Ma J, Xu X, Zhang L, Wang X, Wu R. Effect of Wuzhi capsules on cyclosporine A concentration in children with aplastic anemia immunotherapy: a single-center observational study. Expert Rev Clin Pharmacol 2022:1-5. PubMed
  18. Cheng F, Li Q, Wang J, Zeng F, Zhang Y. Effects and safety evaluation of Wuzhi capsules combined with tacrolimus for the treatment of kidney transplantation recipients. J Clin Pharm Ther 2021;46(6):1636-49. PubMed
  19. Teng F, Wang W, Zhang W, et al. Effect of hepar-protecting Wuzhi capsule on pharmacokinetics and dose-effect character of tacrolimus in healthy volunteers. Biopharm Drug Dispos 2022.
  20. Kou K, Sun X, Li M, et al. Beneficial effects of Wuzhi capsule on tacrolimus blood concentrations in liver transplant patients with different donor-recipient CYP3A5 genotypes. J Clin Pharm Ther 2022;47(2):200-10. PubMed
  21. Peng Y, Jiang F, Zhou R, et al. Clinical evaluation of the efficacy and safety of co-administration of Wuzhi capsule and tacrolimus in adult Chinese patients with myasthenia gravis. Neuropsychiatr Dis Treat 2021;17:2281-9. PubMed
  22. Chen P, Dai R, She Y, et al. Prediction of tacrolimus and Wuzhi tablet pharmacokinetic interaction magnitude in renal transplant recipients. Clin Transplant 2022;36(12):e14807. PubMed
  23. Qu J, Bian R, Liu B, et al. The pharmacokinetic study of tacrolimus and Wuzhi capsule in Chinese liver transplant patients. Front Pharmacol 2022;13:956166. PubMed
  24. Zhou Y, Huang X, Liu L, et al. Effect of Wuzhi preparations on tacrolimus in CYP3A5 expressers during the early period after transplantation: A real-life experience from heart transplant recipients. Transpl Immunol 2023;76:101748. PubMed
  25. Huang Q, Lin X, Wang Y, et al. Tacrolimus pharmacokinetics in pediatric nephrotic syndrome: A combination of population pharmacokinetic modelling and machine learning approaches to improve individual prediction. Front Pharmacol 2022;13:942129. PubMed
  26. Wang CB, Zhang YJ, Zhao MM, Zhao LM. Population pharmacokinetic analyses of tacrolimus in non-transplant patients: a systematic review. Eur J Clin Pharmacol 2023;79(7):897-913. PubMed

See these in context on the Schisandra monograph →

Bupleurum 17 references
  1. Kobashi Y, Nakajima M, Niki Y, Matsushima T. [A case of acute eosinophilic pneumonia due to Sho-saiko-to]. Nippon Kyobu Shikkan Gakkai Zasshi 1997;35:1372-7.
  2. Wada Y, Kubo M. [Acute lymphoblastic leukemia complicated by type C hepatitis during treatment and further by acute interstitial pneumonia due to sho-saiko-to in 7-year-old]. Arerugi 1997;46:1148-55.
  3. Sato A, Toyoshima M, Kondo A, et al. [Pneumonitis induced by the herbal medicine Sho-saiko-to in Japan]. Nippon Kyobu Shikkan Gakkai Zasshi 1997;35:391-5.
  4. Daibo A, Yoshida Y, Kitazawa S, et al. [A case of pneumonitis and hepatic injury caused by a herbal drug (sho-saiko-to)]. Nippon Kyobu Shikkan Gakkai Zasshi 1992;30:1583-8.
  5. Sugiyama H, Nagai M, Kotajima F, et al. [A case of interstitial pneumonia with chronic hepatitis C following interferon-alfa and sho-saiko-to therapy]. Arerugi 1995;44:711-4.
  6. Ishizaki T, Sasaki F, Ameshima S, et al. Pneumonitis during interferon and/or herbal drug therapy in patients with chronic active hepatitis. Eur Respir J 1996;9:2691-6. PubMed
  7. Nakagawa A, Yamaguchi T, Takao T, Amano H. [Five cases of drug induced pneumonitis due to Sho-saiko-to or interferon-alpha or both]. Nippon Kyobu Shikkan Gakkai Zasshi 1995;33:1361-6.
  8. Miyazaki E, Ando M, Ih K, et al. [Pulmonary edema associated with the Chinese medicine shosaikoto]. Nihon Kokyuki Gakkai Zasshi 1998;36:776-80.
  9. Matsumoto T, Yamada H. Regulation of immune complexes binding of macrophages by pectic polysaccharide from Bupleurum falcatum L.: pharmacological evidence for the requirement of intracellular calcium/calmodulin on Fc receptor up-regulation by bupleuran 2
  10. Hattori T, Ito M, Suzuki Y. [Studies on antinephritic effects of plant components in rats (1). Effects of saikosaponins original-type anti-GBM nephritis in rats and its mechanisms]. Nippon Yakurigaku Zasshi 1991;97:13-21. PubMed
  11. Chang WC, Hsu FL. Inhibition of platelet activation and endothelial cell injury by flavan-3-ol and saikosaponin compounds. Prostaglandins Leukot Essent Fatty Acids 1991;44:51-6. PubMed
  12. Kato M, Pu MY, Isobe K, et al. Characterization of the immunoregulatory action of saikosaponin-d. Cell Immunol 1994;159:15-25. PubMed
  13. Ushio Y, Oda Y, Abe H. Effect of saikosaponin on the immune responses in mice. Int J Immunopharmacol 1991;13:501-8. PubMed
  14. Hirayama, C., Okumura, M., Tanikawa, K., and et al. A multicenter randomized controlled clinical trial of Shosaiko-to in chronic active hepatitis. Gastroenterol Jpn 1989;24(6):715-719. PubMed
  15. Hiai S, Yokoyama H, Nagasawa T, and et al. Stimulation of the pituitary-adrenocortical axis by saikosaponin of Bupleuri radix. Chemical and Pharmaceutical Bulletin (Tokyo) 1981;29(2):495-499. PubMed
  16. Yokoyama H, Hiai S, and Oura H. Chemical structures and corticosterone secretion-inducing activities of saikosaponins. Chem Pharm Bull (Tokyo) 1981;29(2):500-504. PubMed
  17. Sugiyama H, Nagai M, Kotajima F, and et al. [A case of interstitial pneumonia with chronic hepatitis C following interferon-alfa and sho-saiko-to therapy]. Arerugi 1995;44(7):711-714.

See these in context on the Bupleurum monograph →

Licorice 92 references
  1. Farese RV Jr, Biglieri EG, Shackleton CH, et al. Licorice-induced hypermineralocorticoidism. N Engl J Med 1991;325:1223-7. PubMed
  2. Sigurjonsdottir HA, Ragnarsson J, Franzson L, Sigurdsson G. Is blood pressure commonly raised by moderate consumption of liquorice? J Hum Hypertens 1995;9:345-8.
  3. Armanini D, Lewicka S, Pratesi C, et al. Further studies on the mechanism of the mineralocorticoid action of licorice in humans. J Endocrinol Invest 1996;19:624-9. PubMed
  4. Zhang YD, Lorenzo B, Reidenberg MM. Inhibition of 11 beta hydroxysteroid dehydrogenase obtained from guinea pig kidney by furosemide, naringenin and some other compounds. J Steroid Biochem Mol Biol 1994;49:81-5.
  5. Strandberg TE, Jarvenpaa AL, Vanhanen H, McKeigue PM. Birth outcome in relation to licorice consumption during pregnancy. Am J Epidemiol 2001;153:1085-8. PubMed
  6. Sigurjonsdottir HA, Franzson L, Manhem K, et al. Liquorice-induced rise in blood pressure: a linear dose-response relationship. J Hum Hypertens 2001;15:549-52. PubMed
  7. Amato P, Christophe S, Mellon PL. Estrogenic activity of herbs commonly used as remedies for menopausal symptoms. Menopause 2002;9:145-50. PubMed
  8. Kent UM, Aviram M, Rosenblat M, Hollenberg PF. The licorice root derived isoflavan glabridin inhibits the activities of human cytochrome P450S 3A4, 2B6, and 2C9. Drug Metab Dispos 2002;30:709-15.. PubMed
  9. Yoshida S, Takayama Y. Licorice-induced hypokalemia as a treatable cause of dropped head syndrome. Clin Neurol Neurosurg 2003;105:286-7.. PubMed
  10. Strandberg TE, Andersson S, Jarvenpaa AL, et al. Preterm birth and licorice consumption during pregnancy. Am J Epidemiol 2002;156:803-5.. PubMed
  11. Hussain RM. The sweet cake that reaches parts other cakes can't! Postgrad Med J 2003;79:115-6.. PubMed
  12. Morris DJ, Davis E, Latif SA. Licorice, tobacco chewing, and hypertension. N Engl J Med 1990;322:849-50. PubMed
  13. Quinkler M, Stewart PM. Hypertension and the cortisol-cortisone shuttle. J Clin Endocrinol Metab 2003;88:2384-92. PubMed
  14. Westman EC, Guthrie GP. Licorice, tobacco chewing, and hypertension. N Engl J Med 1990;322:850. PubMed
  15. Mu Y, Zhang J, Zhang S, et al. Traditional Chinese medicines Wu Wei Zi (Schisandra chinensis Baill) and Gan Cao (Glycyrrhiza uralensis Fisch) activate pregnane X receptor and increase warfarin clearance in rats. J Pharmacol Exp Ther 2006;316:1369-77. PubMed
  16. Yasue H, Itoh T, Mizuno Y, Harada E. Severe hypokalemia, rhabdomyolysis, muscle paralysis, and respiratory impairment in a hypertensive patient taking herbal medicines containing licorice. Intern Med 2007;46:575-8. PubMed
  17. Brayley J, Jones J. Life-threatening hypokalemia associated with excessive licorice ingestion (letter). Am J Psychiatry 1994;151:617-8. PubMed
  18. de Klerk GJ, Nieuwenhuis G, Beutler JJ. Hypokalaemia and hypertension associated with use of liquorice flavoured chewing gum. BMJ 1997;314:731-2.
  19. Dellow EL, Unwin RJ, Honour JW. Pontefract cakes can be bad for you: refractory hypertension and liquorice excess. Nephol Dial Transplant 1999;14:218-20. PubMed
  20. Elinav E, Chajek-Shaul T. Licorice consumption causing severe hypokalemic paralysis. Mayo Clin Proc 2003;78:767-8. PubMed
  21. Eriksson JW, Carlberg B, Hillom V. Life-threatening ventricular tachycardia due to liquorice-induced hypokalemia. J Intern Med 1999;245:307-10.
  22. Janse A, van Iersel M, Hoefnagels WH, Olde Rikker MG. The old lady who liked liquorice: hypertension due to chronic intoxication in a memory-impaired patient. Neth J Med 2005;63:149-50.
  23. Lin SH, Yang SS, Chau T, Halperin ML. An unusual cause of hypokalemic paralysis: chronic licorice ingestion. Am J Med Sci 2003;325:153-6. PubMed
  24. van den Bosch AE, van der Klooster JM, Zuidgeest DM, et al. Severe hypokalemic paralysis and rhabdomyolysis due to ingestion of liquorice. Neth J Med 2005;63:146-8.
  25. van Uum SH. Liquorice and hypertension. Neth J Med 2005;63:119-20.
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Ginger 64 references
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Apricot 1 reference
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Tangerine 3 references
  1. Yuan, J. M., Wang, X. L., Xiang, Y. B., Gao, Y. T., Ross, R. K., and Yu, M. C. Preserved foods in relation to risk of nasopharyngeal carcinoma in Shanghai, China. Int J Cancer 2000;85(3):358-363. DOI
  2. Backman, J. T., Maenpaa, J., Belle, D. J., Wrighton, S. A., Kivisto, K. T., and Neuvonen, P. J. Lack of correlation between in vitro and in vivo studies on the effects of tangeretin and tangerine juice on midazolam hydroxylation. Clin Pharmacol Ther 2000; PubMed
  3. Vilaplana, J. and Romaguera, C. Contact dermatitis from the essential oil of tangerine in fragrance. Contact Dermatitis 2002;46(2):108. PubMed

See these in context on the Tangerine monograph →

Poria Mushroom 3 references
  1. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
  2. Kim H, Park I, Park K, Park S, Kim YI, Park BG. The positive effects of Poria cocos extract on quality of sleep in insomnia rat models. Int J Environ Res Public Health 2022;19(11):6629. PubMed
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See these in context on the Poria Mushroom monograph →

Magnolia 9 references
  1. Kuribara H, Kishi E, Hattori N, et al. The anxiolytic effect of two oriental herbal drugs in Japan attributed to honokiol from magnolia bark. J Pharm Pharmacol 2000;52:1425-9. PubMed
  2. Tachikawa E, Takahashi M, Kashimoto T. Effects of extract and ingredients isolated from Magnolia obovata thunberg on catecholamine secretion from bovine adrenal chromaffin cells. Biochem Pharmacol 2000;60:433-40. PubMed
  3. Jung KY, Kim DS, Oh SR, et al. Magnone A and B, novel anti-PAF tetrahydrofuran lignans from the flower buds of Magnolia fargesii. J Nat Prod 1998;61:808-11.
  4. Garrison R, Chambliss WG. Effect of a proprietary Magnolia and Phellodendron extract on weight management: a pilot, double-blind, placebo-controlled clinical trial. Altern Ther Health Med 2006;12:50-4.
  5. Teng CM, Chen CC, Ko FN, et al. Two antiplatelet agents from Magnolia officinalis. Thromb Res 1988;50:757-65. PubMed
  6. Ghys K, De Palma A, Vandevenne A, Werbrouck J, Goossens A. Magnolia officinalis bark extract, a recently identified contact allergen in 'anti-ageing' cosmetics. Contact Dermatitis. 2015 Aug;73(2):130-2.
  7. Raison-Peyron N, Césaire A, Du-Thanh A, Dereure O. Allergic contact dermatitis caused by Magnolia officinalis bark extract in a facial anti-ageing cream. Contact Dermatitis. 2015 Jun;72(6):416-7.
  8. Nilausen TD, Johansen JD, Thyssen JP. Allergic contact dermatitis of the face caused by Magnolia officinalis bark extract. Contact Dermatitis. 2016;75(6):385-87.
  9. Amat-Samaranch V, López-Sánchez C, Tubau C, Puig L, Serra-Baldrich E. Vulvar allergic contact dermatitis caused by Magnolia officinalis bark extract. Contact Dermatitis 2022;87(1):96-97.

See these in context on the Magnolia monograph →

Perilla 4 references
  1. The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999.
  2. Kanzaki, T. and Kimura, S. Occupational allergic contact dermatitis from Perilla frutescens (shiso). Contact Dermatitis 1992;26(1):55-56.
  3. Yu H, Qiu JF, Ma LJ, Hu YJ, Li P, Wan JB. Phytochemical and phytopharmacological review of Perilla frutescens L. (Labiatae), a traditional edible-medicinal herb in China. Food Chem Toxicol 2017;108(Pt B):375-91. PubMed
  4. Jeong K, Lee SY, Jeon SA, et al. Clinical and immunological characterization of perilla seed allergy in children. J Investig Allergol Clin Immunol 2021. PubMed

See these in context on the Perilla monograph →

Coltsfoot 8 references
  1. Roulet M, Laurini R, Rivier L, Calame A. Hepatic veno-occlusive disease in newborn infant of a woman drinking herbal tea. J Pediatr 1988;112:433-6. PubMed
  2. WHO working group. Pyrrolizidine alkaloids. Environmental Health Criteria, 80. WHO: Geneva, 1988.
  3. Chojkier M. Hepatic sinusoidal-obstruction syndrome: toxicity of pyrrolizidine alkaloids. J Hepatol 2003;39:437-46. PubMed
  4. Roeder E. Medicinal plants in Europe containing pyrrolizidine alkaloids. Pharmazie 1995;50:83-98.
  5. Wilson BE, Hobbs WN. Case report: pseudoephedrine-associated thyroid storm: thyroid hormone-catecholamine interactions. Am J Med Sci 1993;306:317-9. PubMed
  6. Wang YP, Yan J, Fu PP, Chou MW. Human liver microsomal reduction of pyrrolizidine alkaloid N-oxides to form the corresponding carcinogenic parent alkaloid. Toxicol Lett 2005;155:411-20. PubMed
  7. Hwang SB, Chang MN, Garcia ML, et al. L-652,469--a dual receptor antagonist of platelet activating factor and dihydropyridines from Tussilago farfara L. Eur J Pharmacol 1987;141:269-81. PubMed
  8. Freshour JE, Odle B, Rikhye S, Stewart DW. Coltsfoot as a potential cause of deep vein thrombosis and pulmonary embolism in a patient also consuming kava and blue vervain. J Diet Suppl 2012;9:149-54. PubMed

See these in context on the Coltsfoot monograph →

White Mulberry 6 references
  1. Andallu B, Suryakantham V, Lakshmi Srikanthi B, Reddy GK. Effect of mulberry (Morus indica L.) therapy on plasma and erythrocyte membrane lipids in patients with type 2 diabetes. Clin Chim Acta 2001;314:47-53. PubMed
  2. Mudra M, Ercan-Fang N, Zhong L, et al. Influence of mulberry leaf extract on the blood glucose and breath hydrogen response to ingestion of 75 g sucrose by type 2 diabetic and control subjects. Diabetes Care 2007;30:1272-4. PubMed
  3. Kimura T, Nakagawa K, Kubota H, et al. Food-grade mulberry powder enriched with 1-deoxynojirimycin suppresses the elevation of postprandial blood glucose in humans. J Agric Food Chem 2007;55:5869-74. PubMed
  4. Huh HW, Na YG, Bang KH, et al. Extended intake of mulberry leaf extract delayed metformin elimination via inhibiting the organic cation transporter 2. Pharmaceutics. 2020;12(1):49. PubMed
  5. Thaipitakwong T, Supasyndh O, Rasmi Y, Aramwit P. A randomized controlled study of dose-finding, efficacy, and safety of mulberry leaves on glycemic profiles in obese persons with borderline diabetes. Complement Ther Med. 2020;49:102292. PubMed
  6. Thondre PS, Lightowler H, Ahlstrom L, Gallagher A. Mulberry leaf extract improves glycaemic response and insulaemic response to sucrose in healthy subjects: results of a randomized, double blind, placebo-controlled study. Nutr Metab (Lond) 2021;18(1):41. PubMed

See these in context on the White Mulberry monograph →

Bamboo 4 references
  1. Chandra AK, Ghosh D, Mukhopadhyay S, et al. Effect of bamboo shoot, Bambusa arundinacea (Retz.) Willd. on thyroid status under conditions of varying iodine intake in rats. Indian J Exp Biol 2004;42(8):781-786.
  2. Kitajima T. Contact allergy caused by bamboo shoots. Contact Dermatitis 1986;15(2):100-102. PubMed
  3. Sang-A-Gad P, Guharat S, Wananukul W. A mass cyanide poisoning from pickling bamboo shoots. Clin Toxicol (Phila). 2011 Nov;49(9):834-9. PubMed
  4. Satya S, Bal LM, Singhal P, Naik SN. Bamboo shoot processing: food quality and safety aspect (a review). Trends in Food Sci. Technol. 2010;21(4):181-9. DOI

See these in context on the Bamboo monograph →

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DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

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