Major interaction on record — check this product against your medications before combining. Based on 5 of 7 ingredients. Check your meds →
Dietary supplement

Bronchial Wellness Syrup Ingredients & Drug Interactions

by GaiaKids

Bronchial Wellness Syrup label
See full label image
Liquid Category: Botanical
Most serious interaction: Major
Clinical methodology reviewed by · Updated Sep 9, 2026 · Label data from the NIH DSLD
What is this page for?

First and foremost: checking Bronchial Wellness Syrup 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: Major

Bronchial Wellness Syrup is a dietary supplement by GaiaKids with 7 active ingredients. Its ingredients are commonly taken for vitamin c source, digestive support, flavoring and aromatherapy.Based on those ingredients, 957 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are Bitter Orange essential oil, Lemon peel essential oil. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

Jump to a section

Check Your Meds Against Bronchial Wellness Syrup by GaiaKids

Ask about any prescription or over-the-counter medication and we check it for interactions with Bronchial Wellness Syrup by GaiaKids — and tell you which ingredient is responsible.

Pharmacist-reviewed data Checks every ingredient Answer in seconds
Prefer a human? Send your question to our licensed pharmacists — free, answered by email within 24 hours.

HelloPharmacist Scorecard of Bronchial Wellness Syrup by GaiaKids

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 2 of its 7 active ingredients.
  • “Proprietary Blend” is a proprietary blend — the label gives one combined amount (20 mg) without saying how much of each component you get.

Bronchial Wellness Syrup is a liquid blend with 7 active ingredients. The main components are lemon peel essential oil and bitter orange essential oil—both traditional bronchial and respiratory support herbs—along with myrtle leaf essential oil, English plantain leaf extract in two forms (hydroalcoholic and freeze-dried), helichrysum flowering top extract, and grindelia flowering top extract.

The syrup base contains cane sugar, organic honey, water, and lemon as inactive ingredients.

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: Supports throat and lung health.
  • We looked for evidence on: Cough, Respiratory tract infections, Bronchitis, Sore throat, Respiratory congestion.
  • The closest evidence on file: Sandy Everlasting is rated "Insufficient Reliable Evidence To Rate" for Cough (Natural Medicines).
  • Also on file: Lemon is rated "Insufficient Reliable Evidence To Rate" for Respiratory tract infections.
  • Also on file: Myrtle is rated "Insufficient Reliable Evidence To Rate" for Respiratory tract infections.

The evidence we hold for these ingredients does not establish how well they work for bronchial or respiratory support. Lemon peel, myrtle leaf, helichrysum, and bitter orange all have insufficient evidence to rate their effectiveness for respiratory tract infections or related conditions.

Effectiveness data for the plantain extracts and grindelia are not on file. This product's ability to support respiratory health hasn't been established in the data we have.

The evidence, ingredient by ingredient Lemon Myrtle Sandy Everlasting Bitter Orange Buckhorn Plantain

How safe is it?

Well-documented data
Safety Information · database check
Well characterized

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

Why this rating?
  • We hold adverse-effect (side-effect) data for 3 of the 5 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 5 of 5.
  • General safety write-ups exist for 5 of 5.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

Lemon peel essential oil is well tolerated in food amounts, but concentrated essential oils warrant caution and doctor approval. Medicinal amounts of lemon have not been well studied; when taken orally in larger quantities, fresh lemon juice has caused gastrointestinal upset—heartburn and epigastralgia (upper stomach pain)—in a meaningful number of trial participants.

Bitter orange is unsafe when used in medicinal amounts; orally, it can raise blood pressure and heart rate, and serious adverse effects including heart attack, QT prolongation, seizure, and stroke have been reported in rare cases. Myrtle leaf oil carries the risk of rare but serious effects—respiratory failure at very high doses.

Myrtle, plantain extracts, and helichrysum are not recommended during pregnancy; safety while breastfeeding is unknown for myrtle and helichrysum. Grindelia interaction data we could not check; safety information is not on file.

Side effects, ingredient by ingredient Lemon Myrtle Sandy Everlasting Bitter Orange Buckhorn Plantain

Meds to double-check

Major interaction found
Known Interaction Concern · database check
Major identified

At least one ingredient has a documented Major-severity interaction. Check your medications for a personalized result.

Why this rating?
  • 2 of the 5 matched ingredients can interact with medications — Lemon, Bitter Orange.
  • The most serious interaction on file is rated Major.
  • Some involve high-stakes drug classes: diabetes medications; heart-rhythm medications.
  • For scale: 958 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.

Check your medications against this product if you take monoamine oxidase inhibitors (MAOIs), midazolam, QT interval-prolonging drugs, drugs metabolized by CYP3A4, diabetes medications, stimulant drugs, dextromethorphan, or caffeine—and especially if you combine stimulants with this syrup. Also flag itraconazole (an antifungal) with your pharmacist.

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. Major medication interactions have been identified, and safety information is well characterized.

This product is intended for respiratory support, but the evidence for how well it works isn't established in our data. If you take any prescription medication—especially antidepressants (MAOIs), sedatives like midazolam, antifungal drugs, heart rhythm medications, diabetes medications, stimulants, or a cough suppressant—talk with your pharmacist before starting.

Pregnant or breastfeeding? Check with your doctor or pharmacist first.

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

Assessment coverage: 6 of 7 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Jul 21, 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 Bronchial Wellness Syrup, straight from the product label.

Brand GaiaKids
Net contents 3 Fluid Ounce(s); 89 mL
Market status On market
Date entered into DSLD Jul 21, 2022
DSLD ID 272173
Product type Botanical
Supplement form Liquid
Dietary claims / uses All Other, Structure/Function
Intended target group(s) Children 4 or More Years of Age, Organic, Gluten Free, Dairy Free, Children more than 1 but less than 4
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 Bronchial Wellness Syrup by GaiaKids, 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:
5 mL
Maximum serving Sizes:
5 mL
Servings per container
18
IngredientAmount% DV
Calories20 Calorie(s)--
Total Carbohydrates5 Gram(s)3%, 2%
Proprietary Blend20 mg--
Added Sugars5 Gram(s)19%, 9%
Total Sugars5 Gram(s)--
Lemon peel essential oil0 NP--
Myrtle leaf essential oil0 NP--
English Plantain Leaf Extract, Hydroalcoholic61 mg--
English Plantain Leaf Extract, Freeze-Dried14 mg--
Grindelia Flowering Top Extract, Freeze-Dried0 NP--
Helichrysum Flowering Top Extract, Freeze-Dried0 NP--
Bitter Orange essential oil0 NP--

Other ingredients: Cane Sugar, organic Honey, Water, Lemon

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.
Formulation

New look Same formula

Immune support

USDA Organic

Supports overall throat & lung health for your little ones

Certified Organic by Oregon Tilth

Dairy-free Gluten-free

Certified Organic

Seals/Symbols

USDA Organic

EST 1987 USA Integrity Purity Potency Certified B Corporation

Formula

Supports overall throat & lung health for your little ones

Delicious herbal blend with Grindelia & organic honey

FDA Statement of Identity

Herbal Supplement

General Statements

Product of Italy

Meetyourherbs.com Gaia Herbs delivers unprecedented traceability by screening every product and sharing the results online. See for yourself, and learn more about your herbs, by entering the unique ID # below at meetyourherbs.com

Purity - Keep it clean All products are screened for pesticides, microbes & heavy metals. Integrity - Keep it real See the proof at meetyourherbs.com, the world's first herb traceability platform. Potency - Keep it strong Concentrated extracts provide a delicious & convenient way to get your daily dose of herbs. Discover our guiding truths at: Facebook Instagram @gaiaherbs

Black Elderberry Syrup is produced in Tuscany, Italy, by Aboca, the herbal supplement leader in Europe since 1978. Gaia Herbs' partnership with Aboca is born from a mutual belief in sustainable product development, dedication to quality, and a deep respect for science and nature working in harmony. Aboca

Suggested/Recommended/Usage/Directions

Suggested Use Ages 2-6: 1 teaspoon 2 times daily Ages 6-11: 1 teaspoon up to 4 times daily Shake well before use.

Storage

Refrigerate after opening.

Precautions

This product contains honey - not for use by children under 1 year old.

If your child has a medical condition or takes medications, please consult with your doctor before use.

Do not use if cap seal is broken.

Store away from children.

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.

Brand IP Statement(s)

Gaia Herbs Connecting plants & people since 1987

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

See for yourself

Bronchial Wellness Syrup by GaiaKids label

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

Bronchial Wellness Syrup 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 Bronchial Wellness Syrup by GaiaKids

These are the 7 active ingredients this product is made of. Select any to open its full monograph.

Serving size5 mL Dosage formLiquid Servings per container18 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

20 mg per serving

English Plantain Leaf Extract, Hydroalcoholic

No known
interactions
61 mg per serving

Buckhorn plantain is a common weed-like herb used traditionally for coughs, sore throats, and minor skin wounds. Some lab and small studies suggest it...

English Plantain Leaf Extract, Hydroalcoholic monograph & interactions

English Plantain Leaf Extract, Freeze-Dried

No known
interactions
14 mg per serving

Buckhorn plantain is a common weed-like herb used traditionally for coughs, sore throats, and minor skin wounds. Some lab and small studies suggest it...

English Plantain Leaf Extract, Freeze-Dried monograph & interactions

Other (inactive) ingredients: Cane Sugar, Organic Honey, Water, Lemon. These complete the product’s ingredient list but are not active constituents.

Interaction report

Bronchial Wellness Syrup by GaiaKids Drug Interactions

Want to check YOUR meds against Bronchial Wellness Syrup?

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
957Drugs
10 Major 876 Moderate 71 Minor

Ingredients driving the most interactions

Bitter Orange essential oil 957
Lemon peel essential oil 1

Individual Drug Interactions

The ingredients in Bronchial Wellness Syrup interact with 957 drugs. Click any drug to see the details.

2 of the 7 ingredients in Bronchial Wellness Syrup interact with drugs. Each result below shows which ingredient is responsible. Bitter Orange essential oil Lemon peel essential oil

Each ingredient & the kinds of drugs it affects

For each ingredient in Bronchial Wellness Syrup 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.

Bitter Orange essential oil13 drug types · 957 drugs

Midazolam (Versed)

Bitter orange might increase blood levels of midazolam.
One small clinical study shows that bitter orange juice can increase midazolam levels, likely through inhibition of cytochrome P450 3A4 (CYP3A4). Theoretically, bitter orange might increase the risk of midazolam-related adverse effects.

Likelihood Probable Evidence B
Monoamine Oxidase Inhibitors (Maois)

Theoretically, taking MAOIs with synephrine-containing bitter orange preparations might increase the hypertensive effects of synephrine, potentially leading to hypertensive crisis.
Bitter orange contains tyramine, octopamine, and synephrine, which are MAO substrates.

Likelihood Probable Evidence D
Antidiabetes Drugs

Theoretically, bitter orange might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Some clinical research shows that drinking a tea containing bitter orange and Indian snakeroot reduces fasting and postprandial glucose levels in patients with type 2 diabetes who are using antidiabetes drugs. However, it is unclear if these effects are due to bitter orange, Indian snakeroot, or the combination. An animal study also shows that p-synephrine in combination with gliclazide , a sulfonylurea, causes an additional 20% to 44% decrease in glucose levels when compared with gliclazide alone.

Likelihood Possible Evidence B
Caffeine

Bitter orange might increase blood pressure and heart rate when taken with caffeine.
Small clinical studies show that taking bitter orange in combination with caffeine can increase blood pressure and heart rate in otherwise healthy normotensive adults. Theoretically, this might increase the risk of serious cardiovascular adverse effects.

Likelihood Possible Evidence B
Colchicine

Bitter orange might affect colchicine levels.
Colchicine is a substrate of P-glycoprotein and cytochrome P450 3A4 (CYP3A4). Bitter orange has been reported to inhibit CYP3A4 and increase levels of CYP3A4 substrates. However, one small clinical study in healthy adults shows that drinking bitter orange juice 240 mL twice daily for 4 days and taking a single dose of colchicine 0.6 mg on the 4th day decreases colchicine peak serum levels by 24%, time to peak serum level by 1 hour, and overall exposure to colchicine by 20%. The clinical significance of this finding is unclear.

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

Bitter orange might increase levels of drugs metabolized by CYP3A4.
Small clinical studies suggest that single or multiple doses of freshly squeezed bitter orange juice 200-240 mL can inhibit CYP3A4 metabolism of drugs, causing increased drug levels and potentially increasing the risk of adverse effects. However, the extent of the effect of bitter orange on CYP3A4-mediated drug interactions is unknown. Some evidence suggests that bitter orange selectively inhibits intestinal CYP3A4, but not hepatic CYP3A4. Its effect on P-glycoprotein, which strongly overlaps with CYP3A4 interactions, is unclear. One small clinical study shows that drinking 8 ounces of freshly squeezed bitter orange juice has no effect on cyclosporine, which seems to be more dependent on hepatic CYP3A4 and P-glycoprotein than intestinal CYP3A4.

Likelihood Possible Evidence B
Dextromethorphan (Robitussin Dm, Others)

Bitter orange might increase blood levels of dextromethorphan.
One small clinical study shows that bitter orange juice increases dextromethorphan levels, likely through cytochrome P450 3A4 (CYP3A4) inhibition. Theoretically, bitter orange might increase the risk for dextromethorphan-related adverse effects.

Likelihood Possible Evidence B
Felodipine (Plendil)

Bitter orange might increase blood levels of felodipine.
One small clinical study shows that bitter orange juice increases felodipine levels, likely through cytochrome P450 3A4 (CYP3A4) inhibition. Theoretically, bitter orange might increase the risk for felodipine-related adverse effects.

Likelihood Probable Evidence B
Indinavir (Crixivan)

Bitter orange might increase blood levels of indinavir.
One small clinical study shows that bitter orange juice slightly increases indinavir levels, but this effect is likely to be clinically insignificant. Bitter orange selectively inhibits intestinal cytochrome P450 3A4 (CYP3A4); however, the metabolism of indinavir seems to be more dependent on hepatic CYP3A4. The effect of bitter orange on other protease inhibitors has not been studied.

Likelihood Possible Evidence B
Qt Interval-Prolonging Drugs

Theoretically, bitter orange might have an additive effect when combined with drugs that prolong the QT interval, potentially increasing the risk of ventricular arrhythmias.
One case report suggests that taking bitter orange in combination with other stimulants such as caffeine might prolong the QT interval in some patients.

Likelihood Possible Evidence D
Sildenafil (Viagra)

Bitter orange juice might increase blood levels of sildenafil.
A small clinical study in healthy adult males shows that drinking freshly squeezed bitter orange juice 250 mL daily for 3 days and taking a single dose of sildenafil 50 mg on the 3rd day increases the peak plasma concentration of sildenafil by 18% and the overall exposure to sildenafil by 44%. Theoretically, this may be due to inhibition of cytochrome P450 3A4 by bitter orange.

Likelihood Probable Evidence B
Stimulant Drugs

Theoretically, bitter orange might increase the risk of hypertension and adverse cardiovascular effects when taken with stimulant drugs.
Bitter orange appears to have stimulant effects.

Likelihood Possible Evidence B
Cytochrome P450 2D6 (Cyp2D6) Substrates

Theoretically, bitter orange might increase levels of drug metabolized by CYP2D6.
In vitro research shows that octopamine, a constituent of bitter orange, weakly inhibits CYP2D6 enzymes. This effect has not been reported in humans.

Likelihood Possible Evidence D
Bitter Orange essential oil full monograph & interactions

Lemon peel essential oil1 drug type · 1 drug

Itraconazole (Sporanox)

Theoretically, taking itraconazole capsules or tablets with a beverage containing lemon might increase the levels and clinical effects of itraconazole.
In one case report, dissolving itraconazole tablets in a small amount of specific beverages containing lemon prior to administration increased the level of itraconazole in a lung transplant patient. In this case, the increased bioavailability was desirable and was likely due to improved tablet dissolution in the acidic beverage.

Likelihood Possible Evidence D
Lemon peel essential oil full monograph & interactions
The maker

Brand information

Manufacturer and brand details for Bronchial Wellness Syrup, from the product label.

GaiaKids

See all GaiaKids products
Name
Gaia Herbs, Inc.
Street Address
101 Gaia Herbs Dr.
City
Brevard
State
NC
ZipCode
28712
Web Address
GaiaHerbs.com
Pharmacist Counseling Corner

Bronchial Wellness Syrup by GaiaKids: Common Questions

Does Bronchial Wellness Syrup by GaiaKids interact with any medications?
Yes. Based on its ingredients, Bronchial Wellness Syrup has a known interaction with 957 medications, including 10 rated major. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Bronchial Wellness Syrup contains 7 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 during pregnancy?
No—myrtle leaf oil, plantain extracts, and helichrysum are not recommended during pregnancy based on available safety data. Talk with your doctor or pharmacist before using this product if you're pregnant.
Can I take this while breastfeeding?
Safety while breastfeeding is unknown for myrtle, plantain, and helichrysum. The safety data aren't there to say it's okay. Check with your doctor or pharmacist for personalized advice.
What side effects might I notice?
Lemon can cause heartburn and stomach discomfort when taken in larger amounts. Bitter orange may raise blood pressure and heart rate, especially if you also consume caffeine or take stimulant medications. Rare but serious cardiovascular effects (heart attack, abnormal rhythm, stroke) have been reported with bitter orange.
Does it actually work for cough and bronchial symptoms?
We don't have established evidence that these ingredients work for respiratory tract infections or bronchial support. The effectiveness ratings in our data show insufficient evidence for these uses.
Can I use this with my antifungal medication?
If you take itraconazole (Sporanox), the lemon in this syrup might raise itraconazole levels in your blood. Talk with your pharmacist before combining them.

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

Not sure if Bronchial Wellness Syrup is safe with your meds?

Our pharmacists answer your medication & supplement questions — free.

Ask a pharmacist

Label information is sourced from the NIH Dietary Supplement Label Database and reflects the product version on file; always read your actual product label. This page is for education only and is not a substitute for professional medical advice. Confirm with your pharmacist or doctor before combining supplements and medications.

Bronchial Wellness Syrup label
Go deeper

The Full Monographs Behind Bronchial Wellness Syrup’s Ingredients

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

Herb & supplement monograph

Lemon

Interacts with 1 drug

Lemon is a common citrus fruit that is a good source of vitamin C and citric acid, and it is widely used in food, drinks, and home remedies. While it can support hydration and a healthy diet...

Read the full Lemon monograph → Herb & supplement monograph

Myrtle

Myrtle (Myrtus communis) is a Mediterranean shrub used traditionally for respiratory, digestive, and skin complaints. Modern research is mostly limited to laboratory and small studies, so it...

Read the full Myrtle monograph → Herb & supplement monograph

Sandy Everlasting

Sandy Everlasting (Helichrysum arenarium) is a yellow-flowered plant used in traditional European herbal medicine, mainly for digestive and liver-related complaints. Human evidence for its b...

Read the full Sandy Everlasting monograph → Herb & supplement monograph

Bitter Orange

Interacts with 957 drugs

Bitter orange is a citrus fruit whose extracts contain synephrine, a mild stimulant often added to weight-loss and energy supplements. Evidence that it works for weight loss or performance i...

Read the full Bitter Orange monograph → Herb & supplement monograph

Buckhorn Plantain

Buckhorn plantain is a common weed-like herb used traditionally for coughs, sore throats, and minor skin wounds. Some lab and small studies suggest it has soothing and mild anti-inflammatory...

Read the full Buckhorn Plantain monograph →
Sources

Sources & How We Checked

Bronchial Wellness Syrup'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 56 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.

Lemon 2 references
  1. Ruggenenti P, Caruso MR, Cortinovis M, et al. Fresh lemon juice supplementation for the prevention of recurrent stones in calcium oxalate nephrolithiasis: A pragmatic, prospective, randomised, open, blinded endpoint (PROBE) trial. EClinicalMedicine 2021;4 PubMed
  2. Umemura K, Katada Y, Nakagawa S, et al. Improved absorption of itraconazole tablet by co-administration with lemon beverages in a lung transplant recipient: A case report. J Infect Chemother 2022;28(8):1203-1207. PubMed

See these in context on the Lemon monograph →

Myrtle 3 references
  1. Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.
  2. Salmanian M, Shirbeigi L, Hashem-Dabaghian F, et al. The Effects of Myrtle (Myrtus communis) and Clindamycin Topical Solution in the Treatment of Mild to Moderate Acne Vulgaris: A Comparative Split-Face Study. J Pharmacopuncture 2020;23(4):220-229.
  3. Paknejad MS, Eftekhari K, Rahimi R, Vigeh M, Naghizadeh A, Karimi M. Myrtle (Myrtus communis L.) fruit syrup for gastroesophageal reflux disease in children: A double-blind randomized clinical trial. Phytother Res 2021;35(11):6369-6376.

See these in context on the Myrtle monograph →

Buckhorn Plantain 1 reference
  1. Shipochliev T. Uterotonic action of extracts from a group of medicinal plants. Vet Med Nauki 1981;18:94-8.

See these in context on the Buckhorn Plantain monograph →

Sandy Everlasting 3 references
  1. Herbs at a Glance — NIH NCCIH Source
  2. Herbs and Supplements — MedlinePlus Source
  3. About Herbs, Botanicals & Other Products — Memorial Sloan Kettering Cancer Center Source

See these in context on the Sandy Everlasting monograph →

Bitter Orange 47 references
  1. Penzak SR, Jann MW, Cold JA, et al. Seville (sour) orange juice: synephrine content and cardiovascular effects in normotensive adults. J Clin Pharmacol 2001;41:1059-63. PubMed
  2. Electronic Code of Federal Regulations. Title 21. Part 182 -- Substances Generally Recognized As Safe. Available at: https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?CFRPart=182
  3. Calapai G, Firenzuoli F, Saitta A, et al. Antiobesity and cardiovascular toxic effects of Citrus aurantium extracts in the rat: A preliminary report. Fitoterapia 1999;70:586-92. DOI
  4. Keogh AM, Baron DW. Sympathomimetic abuse and coronary artery spasm. Br Med J 1985;291:940.
  5. Malhotra S, Bailey DG, Paine MF, Watkins PB. Seville orange juice-felodipine interaction: comparison with dilute grapefruit juice and involvement of furocoumarins. Clin Pharmacol Ther 2001;69:14-23. PubMed
  6. Pellati F, Benvenuti S, Melegari M, Firenzuoli F. Determination of adrenergic agonists from extracts and herbal products of Citrus aurantium L. var. amara by LC. J Pharm Biomed Anal 2002;29:1113-9. . PubMed
  7. Colker CM, Kalman DS, Torina GC, et al. Effects of Citrus aurantium extract, caffeine, and St. John's wort on body fat loss, lipid levels, and mood states in overweight healthy adults. Curr Ther Res 1999;60:145-153. DOI
  8. Penzak SR, Acosta EP, Turner M, et al. Effect of Seville orange juice and grapefruit juice on indinavir pharmacokinetics. J Clin Pharmacol 2002;42:1165-70. PubMed
  9. Edwards DJ, Fitzsimmons ME, Schuetz EG, et al. 6',7'-Dihydroxybergamottin in grapefruit juice and Seville orange juice: effects on cyclosporine disposition, enterocyte CYP3A4, and P-glycoprotein. Clin Pharmacol Ther 1999;65:237-44. PubMed
  10. Di Marco MP, Edwards DJ, Wainer IW, Ducharme MP. The effect of grapefruit juice and seville orange juice on the pharmacokinetics of dextromethorphan: the role of gut CYP3A and P-glycoprotein. Life Sci 2002;71:1149-60. PubMed
  11. Visentin V, Morin N, Fontana E, et al. Dual action of octopamine on glucose transport into adipocytes: inhibition via beta3-adrenoceptor activation and stimulation via oxidation by amine oxidases. J Pharmacol Exp Ther 2001;299:96-104.
  12. Nykamp DL, Fackih MN, Compton AL. Possible association of acute lateral-wall myocardial infarction and bitter orange supplement. Ann Pharmacother 2004;38:812-6. PubMed
  13. Fugh-Berman A, Myers A. Citrus aurantium, an ingredient of dietary supplements marketed for weight loss: Current status of clinical and basic Research. Exp Biol Med 2004;229:698-704.
  14. Suzuki O, Matsumoto T, Oya M, Katsumata Y. Oxidation of synephrine by type A and type B monoamine oxidase. Experientia 1979;35:1283-4. PubMed
  15. Nasir JM, Durning SJ, Ferguson M, et al. Exercise-induced syncope associated with QT prolongation and ephedra-free Xenadrine. Mayo Clin Proc 2004;79:1059-62.. PubMed
  16. Firenzuoli F, Gori L, Galapai C. Adverse reaction to an adrenergic herbal extract (Citrus aurantium). Phytomedicine 2005;12:247-8. PubMed
  17. Bouchard NC, Howland MA, Greller HA, et al. Ischemic stroke associated with use of an ephedra-free dietary supplement containing synephrine. Mayo Clin Proc 2005;80:541-5. PubMed
  18. Haller CA, Benowitz NL, Jacob P 3rd. Hemodynamic effects of ephedra-free weight-loss supplements in humans. Am J Med 2005;118:998-1003.. PubMed
  19. Bui LT, Nguyen DT, Ambrose PJ. Blood pressure and heart rate effects following a single dose of bitter orange. Ann Pharmacother 2006;40:53-7. PubMed
  20. Min B, Cios D, Kluger J, White CM. Absence of QTc-interval-prolonging or hemodynamic effects of a single dose of bitter-orange extract in healthy subjects. Pharmacotherapy 2005;25:1719-24. PubMed
  21. Gange CA, Madias C, Felix-Getzik EM, et al. Variant angina associated with bitter orange in a dietary supplement. Mayo Clin Proc 2006;81:545-8. PubMed
  22. Jordan S, Murty M, Pilon K. Products containing bitter orange or synephrine: suspected cardiovascular adverse reactions. Canadian Adverse Reaction Newsletter 2004;14:3-4.
  23. Burke J, Seda G, Allen D, Knee TS. A case of severe exercise-induced rhabdomyolysis associated with a weight loss dietary supplement. Mil Med 2007;172:656-8. PubMed
  24. Gray, S. and Woolf, A. D. Citrus aurantium used for weight loss by an adolescent with anorexia nervosa. J Adolesc.Health 2005;37(5):414-415. PubMed
  25. Haller, C. A., Duan, M., Jacob, P., III, and Benowitz, N. Human pharmacology of a performance-enhancing dietary supplement under resting and exercise conditions. Br J Clin Pharmacol 2008;65(6):833-840. PubMed
  26. Thomas, J. E., Munir, J. A., McIntyre, P. Z., and Ferguson, M. A. STEMI in a 24-year-old man after use of a synephrine-containing dietary supplement: a case report and review of the literature. Tex.Heart Inst.J 2009;36(6):586-590.
  27. Campbell-Tofte, J. I., Molgaard, P., Josefsen, K., Abdallah, Z., Hansen, S. H., Cornett, C., Mu, H., Richter, E. A., Petersen, H. W., Norregaard, J. C., and Winther, K. Randomized and double-blinded pilot clinical study of the safety and anti-diabetic ef
  28. Seifert, J. G., Nelson, A., Devonish, J., Burke, E. R., and Stohs, S. J. Effect of acute administration of an herbal preparation on blood pressure and heart rate in humans. Int J Med Sci 2011;8(3):192-197. PubMed
  29. Stohs, S. J., Preuss, H. G., Keith, S. C., Keith, P. L., Miller, H., and Kaats, G. R. Effects of p-synephrine alone and in combination with selected bioflavonoids on resting metabolism, blood pressure, heart rate and self-reported mood changes. Int J Med
  30. Wason, S., DiGiacinto, J. L., and Davis, M. W. Effects of grapefruit and Seville orange juices on the pharmacokinetic properties of colchicine in healthy subjects. Clin Ther 2012;34(10):2161-2173. PubMed
  31. Kaats, G. R., Miller, H., Preuss, H. G., and Stohs, S. J. A 60day double-blind, placebo-controlled safety study involving Citrus aurantium (bitter orange) extract. Food Chem Toxicol. 2013;55:358-362.
  32. Calapai, G., Firenzuoli, F., Saitta, A., Squadrito, F. R., Arlotta, M., Costantino, G., and Inferrera, G. Antiobesity and cardiovascular toxic effects of Citrus aurantium extracts in the rat: a preliminary report. Fitoterapia 12-1-1999;70(6):586-592. DOI
  33. Colker, C., Kalman, D., and Torina, G. Effects of Citrus aurantium extract, caffeine, and St. John's Wort on body fat loss, lipid levels, and mood states in overweight healthy adults. Curr Ther Res 1999;60:145-153. DOI
  34. Shara M, Stohs SJ. Safety evaluation of Bitter orange extract (p-synephrine) in healthy volunteers. J.Amer.Coll.Nutr. 2011;30:358.
  35. Lynch B. Review of the safety of p-synephrine and caffeine. Intertek-Cantox Report, 2013;1-20.
  36. Smith TB, Staub BA, Natarajan GM, et al. Acute myocardial infarction associated with dietary supplements containing 1,3-dimethylamylamine and Citrus aurantium. Tex Heart Inst J 2014;41(1):70-2. PubMed
  37. Shara M, Stohs SJ, Mukattash TL. Cardiovascular safety of oral p-synephrine (bitter orange) in healthy subjects: a randomized placebo-controlled cross-over clinical trial. Phytother Res. 2016;30(5):842-7.
  38. Liu Y, Santillo MF. Cytochrome P450 2D6 and 3A4 enzyme inhibition by amine stimulants in dietary supplements. Drug Test Anal. 2016;8(3-4):307-10. PubMed
  39. Abdelkawy KS, Donia AM, Turner RB, Elbarbry F. Effects of Lemon and Seville Orange Juices on the Pharmacokinetic Properties of Sildenafil in Healthy Subjects. Drugs R D. 2016 Sep;16(3):271-278. PubMed
  40. Gutiérrez-Hellín J, Salinero JJ, Abían-Vicen J, Areces F, Lara B, Gallo C, et al. Acute consumption of p-synephrine does not enhance performance in sprint athletes.J. Appl Physiol Nutr Metab. 2016;41(1):63-9. doi: 10.1139/apnm-2015-0299.
  41. Jung YP, Earnest CP, Koozehchian M, et al. Effects of ingesting a pre-workout dietary supplement with and without synephrine for 8 weeks on training adaptations in resistance-trained males. J Int Soc Sports Nutr. 2017;3;14:1. doi: 10.1186/s12970-016-0158- PubMed
  42. Jung YP, Earnest CP, Koozehchian M, et al. Effects of acute ingestion of a pre-workout dietary supplement with and without synephrine on resting energy expenditure, cognitive function and exercise performance. J Int Soc Sports Nutr. 2017;14:3. doi: 10.118
  43. Vatsavai LK, Kilari EK. Interaction of p-synephrine on the pharmacodynamic and pharmacokinetics of gliclazide in animal models. J Ayurveda Integr Med 2017; S0975-9476(16)30487-9. doi: 10.1016/j.jaim.2017.04.010.
  44. Ratamess NA, Bush JA, Stohs SJ, et al. Acute cardiovascular effects of bitter orange extract (p-synephrine) consumed alone and in combination with caffeine in human subjects: A placebo-controlled, double-blind study. Phytother Res. 2018;32(1):94-102.
  45. Gutiérrez-Hellín J, Ruiz-Moreno C, Del Coso J. Acute p-synephrine ingestion increases whole-body fat oxidation during 1-h of cycling at Fatmax. Eur J Nutr. 2019 Nov 5. PubMed
  46. Karimzadeh Z, Azizzadeh Forouzi M, Tajadini H, Ahmadinejad M, Roy C, Dehghan M. Effects of lavender and Citrus aurantium on pain of conscious intensive care unit patients: a parallel randomized placebo-controlled trial. J Integr Med 2021:S2095-4964(21)000 PubMed
  47. Koncz D, Tóth B, Bahar MA, Roza O, Csupor D. The Safety and Efficacy of Citrus aurantium (Bitter Orange) Extracts and p-Synephrine: A Systematic Review and Meta-Analysis. Nutrients 2022;14(19):4019. PubMed

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

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