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Dietary supplement

Calm Bladder Ingredients & Drug Interactions

by Herb Pharm

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

First and foremost: checking Calm Bladder 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

Calm Bladder is a dietary supplement by Herb Pharm with 4 active ingredients. Its ingredients are commonly taken for urinary tract and bladder problems, mild fluid retention (diuretic), kidney and prostate concerns.Based on those ingredients, 2,160 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are Plantain Leaf Extract, Fresh, Undried, St. John's Wort Flowering Top Extract, Fresh, Undried, Corn Silk Extract, Fresh, Undried. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

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Check Your Meds Against Calm Bladder by Herb Pharm

Ask about any prescription or over-the-counter medication and we check it for interactions with Calm Bladder by Herb Pharm — and tell you which ingredient is responsible.

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HelloPharmacist Scorecard of Calm Bladder by Herb Pharm

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 12, 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 4 active ingredients.
  • “Proprietary Extract Blend” is a proprietary blend — the label gives one combined amount (652 mg) without saying how much of each component you get.

Calm Bladder contains four active ingredients in a liquid extract form. The Proprietary Extract Blend combines Corn Silk (fresh, undried), St.

John's Wort Flowering Top (fresh, undried), Plantain Leaf (fresh, undried), and Goldenrod Flowering Top (fresh, undried). The product also contains inactive ingredients: cane alcohol, distilled water, and glycerin, which serve as the liquid base and preservative.

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: urinary and bladder system restoration.
  • We looked for evidence on: Urinary tract infections (UTIs), Nocturnal enuresis, Benign prostatic hyperplasia (BPH), Prostatitis, Kidney stones (nephrolithiasis), Bladder support — and 2 related terms.
  • The closest evidence on file: Goldenrod is rated "Insufficient Reliable Evidence To Rate" for Benign prostatic hyperplasia (BPH) (Natural Medicines).
  • Also on file: Goldenrod is rated "Insufficient Reliable Evidence To Rate" for Kidney stones (nephrolithiasis), Urinary tract infections (UTIs).
  • Also on file: Corn Silk is rated "Insufficient Reliable Evidence To Rate" for Kidney stones (nephrolithiasis), Prostatitis, Urinary tract infections (UTIs), Nocturnal enuresis.

The evidence for this product's ingredients is mixed. St.

John's Wort is likely effective for depression. Corn Silk, Plantain Leaf, and Goldenrod all have insufficient reliable evidence to rate their effectiveness for the conditions this product is marketed toward.

In other words, we hold data showing they *may* help with certain uses, but the research isn't solid enough to confirm it. If you're considering this for a specific bladder or urinary concern, talk to your pharmacist about what the actual evidence supports.

The evidence, ingredient by ingredient Corn Silk St. John's Wort Black Psyllium Goldenrod

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 4 of the 4 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 4 of 4.
  • General safety write-ups exist for 4 of 4.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

Corn Silk is generally well tolerated for short-term use, but human safety data are limited. The most common adverse effects are low potassium and low sodium, especially with longer use.

St. John's Wort is generally well tolerated short-term but can cause diarrhea, dizziness, dry mouth, headache, insomnia, and fatigue — and it increases your skin's sensitivity to sunlight, so you'll sunburn more easily.

Rare serious effects include suicidal thoughts and psychosis. Plantain Leaf (psyllium) is generally well tolerated when you drink plenty of water with it; without enough fluid, it can cause choking or bowel blockage.

Bloating and gas are common but usually go away as your body adjusts. Goldenrod is often well tolerated short-term, but human safety data are limited and allergic reactions are possible.

During pregnancy, Corn Silk and St. John's Wort should be avoided — there isn't enough reliable safety data.

Plantain Leaf is likely safe in pregnancy and lactation. For St.

John's Wort and Goldenrod, safety while breastfeeding is not known — play it safe and avoid them unless a doctor approves. Corn Silk lactation is possibly safe.

Side effects, ingredient by ingredient Corn Silk St. John's Wort Black Psyllium Goldenrod

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?
  • 4 of the 4 matched ingredients can interact with medications — Goldenrod, Black Psyllium, Corn Silk, St. John's Wort.
  • The most serious interaction on file is rated Major.
  • Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs; immunosuppressants / transplant drugs; diabetes medications; heart-rhythm medications; lithium.
  • For scale: 2,161 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 you take Calm Bladder, check with your pharmacist if you're on digoxin, phenobarbital, phenytoin, irinotecan, protease inhibitors, tacrolimus, docetaxel, mephenytoin, blood pressure medications, corticosteroids, diabetes drugs, diuretics, warfarin, metformin, lithium, carbamazepine, olanzapine, or birth control pills. These are the drug types with documented interactions.

St. John's Wort alone accounts for the most serious ones.

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.

If you take digoxin, seizure medications, HIV drugs, cancer drugs, or an immunosuppressant, do not use this product without checking with your pharmacist or doctor first — St. John's Wort in particular can seriously reduce how well those drugs work.

If you're on blood pressure medication, diabetes drugs, a blood thinner, or a diuretic, you'll need the same conversation. Even if you're not on prescription medications, avoid this during pregnancy or while breastfeeding unless a clinician gives you the green light.

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

Assessment coverage: 4 of 4 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Feb 22, 2024.

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 Calm Bladder, straight from the product label.

Brand Herb Pharm
Barcode (UPC) 090900000101
Net contents 1 Fluid Ounce(s); 30 mL
Market status On market
Date entered into DSLD Feb 22, 2024
DSLD ID 307460
Product type Botanical
Supplement form Liquid
Dietary claims / uses All Other, Structure/Function
Intended target group(s) Children 4 or More Years of Age, Adult (18 - 50 Years), Gluten 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 Calm Bladder by Herb Pharm, 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:
0.35 mL
Maximum serving Sizes:
0.7 mL
Servings per container
42
UPC/BARCODE
090900000101
IngredientAmount% DV
Proprietary Extract Blend652 mg, 326 mg--
Corn Silk Extract, Fresh, Undried0 NP, 0 NP--
St. John's Wort Flowering Top Extract, Fresh, Undried0 NP, 0 NP--
Plantain Leaf Extract, Fresh, Undried0 NP, 0 NP--
Goldenrod Flowering Top Extract, Fresh, Undried0 NP, 0 NP--

Other ingredients: Cane Alcohol, Water, Distilled, Glycerin

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.
Suggested/Recommended/Usage/Directions

Suggested use Shake well before using Mix drops in 2 oz. of water or juice, 2 to 4 times per day. Best taken between meals. Adults: Use 1 squeeze of the dropper bulb (0.7 ml). Children over 2: Use 16 drops (0.35 ml).

Precautions

Caution: Seek expert medical advice before taking with medical drugs.

Keep out of the reach of children

Storage

Store away from heat & light

Formulation

System restoration Urinary

Gluten-free

FDA Statement of Identity

Herbal Supplement

FDA Disclaimer Statement

This statement has not been evaluated by the FDA. This product is not intended to diagnose, treat, cure or prevent any disease.

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

See for yourself

Calm Bladder by Herb Pharm label

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

Calm Bladder 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 Calm Bladder by Herb Pharm

These are the 4 active ingredients this product is made of. Select any to open its full monograph.

Serving size0.35 mL Dosage formLiquid Servings per container42 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.

Other (inactive) ingredients: Cane Alcohol, Water, Distilled, Glycerin. These complete the product’s ingredient list but are not active constituents.

Interaction report

Calm Bladder by Herb Pharm Drug Interactions

Want to check YOUR meds against Calm Bladder?

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
2,160Drugs
755 Major 515 Moderate 890 Minor

Ingredients driving the most interactions

Plantain Leaf Extract, Fresh, Undried 2,025
St. John's Wort Flowering Top Extract, Fresh, Undried 1,143
Corn Silk Extract, Fresh, Undried 290
Goldenrod Flowering Top Extract, Fresh, Undried 75

Individual Drug Interactions

The ingredients in Calm Bladder interact with 2,160 drugs. Click any drug to see the details.

4 of the 4 ingredients in Calm Bladder interact with drugs. Each result below shows which ingredient is responsible. Plantain Leaf Extract, Fresh, Undried St. John's Wort Flowering Top Extract, Fresh, Undried Corn Silk Extract, Fresh, Undried Goldenrod Flowering Top Extract, Fresh, Undried

Each ingredient & the kinds of drugs it affects

For each ingredient in Calm Bladder 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.

Plantain Leaf Extract, Fresh, Undried7 drug types · 2,025 drugs

Carbamazepine (Tegretol)

Theoretically, black psyllium might reduce the effects of carbamazepine and increase the risk for convulsions.
Theoretically, black psyllium might reduce carbamazepine absorption. A preliminary study using blond psyllium reported decreased carbamazepine bioavailability due to binding of the drug to psyllium, as well as reduction of available fluid in the gut for dissolution of the drug. This interaction may also occur with black psyllium.

Likelihood Probable Evidence D
Lithium

Theoretically, taking black psyllium at the same time as lithium might reduce lithium absorption.
The fiber in black psyllium might reduce lithium absorption and plasma levels. Some case reports describe a reduction in plasma lithium levels with concomitant administration of blond psyllium. This was reversed when psyllium was stopped. This interaction may also occur with black psyllium.

Likelihood Probable Evidence D
Metformin (Glucophage)

Theoretically, black psyllium might increase the therapeutic and adverse effects of metformin.
Animal research shows that concurrent consumption of blond psyllium with metformin slows and increases the absorption of metformin. This interaction may also occur with black psyllium. To avoid changes in absorption, take psyllium 30-60 minutes after metformin.

Likelihood Possible Evidence D
Olanzapine (Zyprexa)

Theoretically, taking black psyllium at the same time as olanzapine might reduce olanzapine absorption.
The fiber in black psyllium might decrease the absorption of olanzapine. A single case report describes a reduction in the effectiveness of olanzapine when it was concomitantly administered with an unspecified type of psyllium 3 grams orally twice daily. This effect was reversed when psyllium was stopped.

Likelihood Possible Evidence D
Digoxin (Lanoxin)

Theoretically, taking black psyllium at the same time as digoxin might reduce digoxin absorption and decrease digoxin levels.
Psyllium might bind digoxin in the gut. However, some clinical evidence suggests that psyllium does not impact digoxin absorption.

Likelihood Unlikely Evidence B
Ethinyl Estradiol

Theoretically, taking black psyllium at the same time as ethinyl estradiol might alter levels of estradiol.
Concurrent use of blond psyllium with ethinyl estradiol results in a slight increase in the extent of ethinyl estradiol absorption and a slower rate of absorption. This is unlikely to be clinically significant.

Likelihood Unlikely Evidence D
Oral Drugs

Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Psyllium seems to have variable effects on drug absorption. To avoid changes in absorption, take psyllium 30-60 minutes after oral medications. Animal research shows that blond psyllium delays and increases the absorption of metformin and ethinyl estradiol. Case reports and animal research suggest that blond psyllium might reduce absorption of lithium, digoxin, olanzapine, and carbamazepine. Finally, some pharmacokinetic studies show that psyllium does not affect the absorption of levothyroxine or warfarin. Although many of these studies evaluated blond psyllium, the fiber content in black psyllium may have similar effects.

Likelihood Possible Evidence B
Plantain Leaf Extract, Fresh, Undried full monograph & interactions

St. John's Wort Flowering Top Extract, Fresh, Undried47 drug types · 1,143 drugs

Alprazolam (Xanax)

St. John's wort increases the clearance of alprazolam and decreases its effects.
Alprazolam, which is used as a probe for cytochrome P450 3A4 (CYP3A4) activity, has a two-fold increase in clearance when given with St. John's wort. St. John's wort reduces the half-life of alprazolam from 12.4 hours to 6 hours.

Likelihood Likely Evidence B
Contraceptive Drugs

St. John's wort increases the clearance of contraceptive drugs and reduces their clinical effects.
Females taking St. John's wort and oral contraceptives concurrently should use an additional or alternative form of birth control. St. John's wort can decrease norethindrone and ethinyl estradiol levels by 13% to 15%, resulting in breakthrough bleeding, irregular menstrual bleeding, or unplanned pregnancy. Bleeding irregularities usually occur within a week of starting St. John's wort and regular cycles usually return when St. John's wort is discontinued. Unplanned pregnancy has occurred with concurrent use of oral contraceptives and St. John's wort extract. St. John's wort is thought to induce the cytochrome P450 1A2 (CYP1A2), 2C9 (CYP2C9), and 3A4 (CYP3A4) enzymes, which are responsible for metabolism of progestins and estrogens in contraceptives.

Likelihood Probable Evidence B
Cyclosporine (Neoral, Sandimmune)

St. John's wort reduces the levels and clinical effects of cyclosporine.
Concomitant use can decrease plasma cyclosporine levels by 30% to 70%. Using St. John's wort with cyclosporine in patients with heart, kidney, or liver transplants can cause subtherapeutic cyclosporine levels and acute transplant rejection. This interaction has occurred with a St. John's wort extract standardized to 0.3% hypericin and dosed at 300-600 mg per day. Withdrawal of St. John's wort can result in a 64% increase in cyclosporine levels. St. John's wort induces cytochrome P450 3A4 (CYP3A4) and the multi-drug transporter, P-glycoprotein/MDR-1, which increases cyclosporine clearance.

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

St. John's wort increases the metabolism and reduces the levels of CYP3A4 substrates.
St. John's wort induces CYP3A4 enzymes and increases metabolism of CYP3A4 substrates. Clinically significant interactions have been reported with St. John's wort products containing hyperforin 1 mg or more.

Likelihood Probable Evidence B
Digoxin (Lanoxin)

St. John's wort reduces the levels and clinical effects of digoxin.
St. John's wort can reduce the bioavailability, serum levels, and therapeutic effects of digoxin. Taking an extract of St. John's wort 900 mg, containing hyperforin 7.5 mg or more, daily for 10-14 days, can reduce serum digoxin levels by 25% in healthy people. St. John's wort is thought to affect the multidrug transporter, P-glycoprotein, which mediates the absorption and elimination of digoxin and other drugs. St. John's wort products providing less than 7.5 mg of hyperforin daily do not appear to affect digoxin levels.

Likelihood Likely Evidence B
Docetaxel (Taxotere)

St. John's wort reduces the levels and clinical effects of docetaxel.
Clinical research shows that taking a specific St. John's wort product (Hyperiplant, VSM) 300 mg three times daily for 14 days increases docetaxel clearance by about 14%, resulting in decreased plasma concentrations of docetaxel in cancer patients. This is most likely due to induction of cytochrome P450 3A4 (CYP3A4) by St. John's wort.

Likelihood Probable Evidence B
Imatinib (Gleevec)

St. John's wort reduces the levels and clinical effects of imatinib.
Taking St. John's wort 900 mg daily for 2 weeks reduces the bioavailability and half-life of a single dose of imatinib and decreases its serum levels by 30% in healthy volunteers. This is most likely due to induction of cytochrome P450 3A4 (CYP3A4) by St. John's wort, which increases clearance of imatinib.

Likelihood Likely Evidence A
Irinotecan (Camptosar)

St. John's wort reduces the levels and clinical effects of irinotecan.
St. John's wort 900 mg daily for 18 days decreases serum levels of irinotecan by at least 50%. Clearance of the active metabolite of irinotecan, SN-38, is also increased, resulting in a 42% decrease in the area under the concentration-time curve. This is thought to be due to induction of cytochrome P450 3A4 (CYP3A4) by St. John's wort.

Likelihood Likely Evidence A
Mephenytoin (Mesantoin)

St. John's wort reduces the levels and clinical effects of mephenytoin.
Preliminary clinical research in healthy males shows that taking St. John's wort for 14 days induces cytochrome P450 2C19 (CYP2C19) and significantly increases metabolism of mephenytoin (Mesantoin). In people with wild-type 2C19, metabolism was almost 4-fold greater in subjects who received St. John's wort compared to placebo. In contrast, patients with 2C19*2/*2 and *2/*3 genotypes did not demonstrate a similar increase in metabolism.

Likelihood Likely Evidence B
Non-Nucleoside Reverse Transcriptase Inhibitors (Nnrtis)

St. John's wort decreases the levels and clinical effects of NNRTIs.
St. John's wort increases the oral clearance of nevirapine (Viramune) by 35%. Subtherapeutic concentrations are associated with therapeutic failure, development of viral resistance, and development of drug class resistance. St. John's wort induces intestinal and hepatic cytochrome P450 3A4 (CYP3A4) and intestinal P-glycoprotein/MDR-1, a drug transporter.

Likelihood Likely Evidence B
Omeprazole (Prilosec)

St. John's wort decreases the levels and clinical effects of omeprazole.
Taking St. John's wort, 300 mg orally three times daily for 14 days, reduces serum concentrations of omeprazole by inducing its metabolism via cytochrome P450 (CYP) 2C19 and 3A4. The reduction of omeprazole serum levels is dependent on CYP2C19 genotype, with reductions up to 50% in extensive metabolizers and 38% in poor metabolizers.

Likelihood Likely Evidence B
Oxycodone (Oxycontin)

St. John's wort decreases the levels and clinical effects of oxycodone.
St. John's wort can increase oxycodone metabolism by inducing cytochrome P450 3A4 (CYP3A4), reducing plasma levels and analgesic activity.

Likelihood Probable Evidence B
P-Glycoprotein Substrates

St. John's wort decreases the levels and clinical effects of P-glycoprotein substrates.
St. John's wort induces P-glycoprotein. P-glycoprotein is a carrier mechanism responsible for transporting drugs and other substances across cell membranes. When P-glycoprotein is induced in the gastrointestinal (GI) tract, it can prevent the absorption of some medications. In addition, induction of p-glycoprotein can decrease entry of drugs into the central nervous system (CNS) and decrease access to other sites of action.

Likelihood Probable Evidence B
Phenobarbital (Luminal)

St. John's wort decreases the levels and clinical effects of phenobarbital.
St. John's wort may increase the metabolism of phenobarbital. Plasma concentrations of phenobarbital should be monitored carefully. The dose of phenobarbital may need to be increased when St. John's wort is started and decreased when it is stopped.

Likelihood Likely Evidence B
Phenprocoumon (Marcoumar, Others)

St. John's wort decreases the levels and clinical effects of phenprocoumon.
St. John's wort appears to increase the metabolism of phenprocoumon (an anticoagulant that is not available in the US) by increasing the activity of the cytochrome P450 2C9 (CYP2C9) enzyme. This may result in decreases in the anticoagulant effect and international normalized ratio (INR).

Likelihood Likely Evidence B
Phenytoin (Dilantin)

St. John's wort decreases the levels and clinical effects of phenytoin.
St. John's wort may increase the metabolism of phenytoin. Plasma concentrations of phenytoin should be monitored closely. The dose of phenytoin may need to be increased when St. John's wort is started and decreased when it is stopped.

Likelihood Likely Evidence B
Protease Inhibitors (Pis)

St. John's wort reduces the levels and clinical effects of PIs.
In healthy volunteers, St. John's wort can reduce the plasma concentrations of indinavir (Crixivan) by inducing cytochrome P450 3A4 (CYP3A4). This might result in treatment failure and viral resistance. St. John's wort also induces P-glycoprotein, which can result in decreased intracellular protease inhibitor concentrations and increased elimination.

Likelihood Likely Evidence B
Rivaroxaban (Xarelto)

St. John's wort decreases the levels and clinical effects of rivaroxaban.
A small pharmacokinetic study in healthy volunteers shows that taking a single dose of rivaroxaban 20 mg after using a specific St. John's wort extract (Jarsin, Vifor SA) 450 mg orally twice daily for 14 days reduces the bioavailability of rivaroxaban by 24% and reduces rivaroxaban's therapeutic inhibition of factor Xa by 20%.

Likelihood Probable Evidence B
Tacrolimus (Prograf)

St. John's wort decreases the levels and clinical effects of tacrolimus.
Taking a St. John's wort extract (Jarsin) 600 mg daily significantly decreases tacrolimus serum levels. Dose increases of 60% may be required to maintain therapeutic tacrolimus levels in patients taking St. John's wort. St. John's wort is thought to lower tacrolimus levels by inducing cytochrome P450 3A4 (CYP3A4) enzymes. A small clinical study in healthy adults also shows that taking St. John's wort 300 mg three times daily for 10 days decreases the total systemic exposure to tacrolimus by 27% and 33% after taking a single 5 mg dose of immediate-release or prolonged-release tacrolimus, respectively.

Likelihood Likely Evidence B
Warfarin (Coumadin)

St. John's wort decreases the levels and clinical effects of warfarin.
Taking St. John's wort significantly increases clearance of warfarin, including both its R- and S-isomers. This is likely due to induction of cytochrome P450 (CYP) 1A2 and CYP3A4. St. John's wort can also significantly decrease International Normalized Ratio (INR) in people taking warfarin. In addition, taking warfarin at the same time as St. John's wort might reduce warfarin bioavailability. When a dried extract is mixed with warfarin in an aqueous medium, up to 30% of warfarin is bound to particles, reducing its absorption.

Likelihood Likely Evidence B
Aminolevulinic Acid

St. John's wort might have additive phototoxic effects with aminolevulinic acid.
Concomitant use with St. John's wort extract may cause synergistic phototoxicity. Delta-aminolevulinic acid can cause a burning erythematous rash and severe swelling of the face, neck, and hands when taken with St. John's wort.

Likelihood Possible Evidence D
Bupropion (Wellbutrin)

St. John's wort might reduce the levels and effects of bupropion.
Clinical research shows that taking St. John's wort 325 mg three times daily for 14 days along with bupropion reduces the area under the concentration-time curve by approximately 14% and increases the clearance of bupropion by approximately 20%. This effect is attributed to the induction of cytochrome P450 2B6 (CYP2B6) by St. John's wort.

Likelihood Probable Evidence B
Clopidogrel (Plavix)

St. John's wort might increase the levels and effects of clopidogrel.
Taking St. John's wort with clopidogrel seems to increase the activity of clopidogrel. In clopidogrel non-responders, taking St. John's wort seems to induce metabolism of clopidogrel to its active metabolite by cytochrome P450 enzymes 3A4 and 2C19. This leads to increased antiplatelet activity. Theoretically, this might lead to an increased risk of bleeding in clopidogrel responders.

Likelihood Possible Evidence B
Clozapine (Clozaril)

St. John's wort might decrease the levels and clinical effects of clozapine.
A case report describes a female with schizophrenia controlled on clozapine who had a return of symptoms when she started taking St. John's wort. The plasma concentration of clozapine was reduced, likely because its clearance was increased due to induction of the cytochrome P450 enzymes 3A4, 1A2, 2C9, and 2C19 by St. John's wort.

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

St. John's wort may increase the metabolism and reduce the levels of CYP1A2 substrates.
Clinical and in vitro research shows that St. John's wort induces CYP1A2, but to a lesser extent than CYP3A4.

Likelihood Possible Evidence B
St. John's Wort Flowering Top Extract, Fresh, Undried full monograph & all 47 interactions

Corn Silk Extract, Fresh, Undried5 drug types · 290 drugs

Antidiabetes Drugs

Theoretically, taking corn silk with antidiabetes drugs might increase the risk of hypoglycemia.
Animal research in diabetic mice shows that taking corn silk extract lowers fasting blood glucose levels.

Likelihood Possible Evidence D
Antihypertensive Drugs

Taking corn silk extract with antihypertensive drugs might increase the risk of hypotension.
Clinical research in both hypertensive and normotensive adults shows that taking corn silk extract lowers systolic and diastolic blood pressure.

Likelihood Possible Evidence D
Corticosteroids

Taking corn silk with corticosteroids might increase the risk of hypokalemia.
Clinical research shows that taking corn silk extract increases the urinary excretion of potassium.

Likelihood Possible Evidence D
Diuretic Drugs

Taking corn silk with diuretic drugs might increase the risk of adverse effects such as hyponatremia and hypokalemia.
Clinical research shows that taking corn silk extract increases urine volume and promotes the urinary excretion of sodium and potassium. Some patients may require electrolyte supplementation.

Likelihood Possible Evidence D
Warfarin (Coumadin)

Theoretically, suddenly stopping, starting, or changing corn silk treatment may alter the effects of warfarin.
Corn silk contains vitamin K. Individuals taking warfarin should consume a consistent daily amount of corn silk to maintain consistent anticoagulation.

Likelihood Likely Evidence D
Corn Silk Extract, Fresh, Undried full monograph & interactions

Goldenrod Flowering Top Extract, Fresh, Undried1 drug type · 75 drugs

Diuretic Drugs

Theoretically, goldenrod might increase the effects and adverse effects of diuretic drugs.
In vitro and animal research suggests that goldenrod has diuretic effects.

Likelihood Possible Evidence D
Goldenrod Flowering Top Extract, Fresh, Undried full monograph & interactions
The maker

Brand information

Manufacturer and brand details for Calm Bladder, from the product label.

Herb Pharm

See all Herb Pharm products
Name
Herb Pharm
City
Williams
State
OR
ZipCode
97544
Phone Number
800-348-4372
Web Address
www.herb-pharm.com
Pharmacist Counseling Corner

Calm Bladder by Herb Pharm: Common Questions

Does Calm Bladder by Herb Pharm interact with any medications?
Yes. Based on its ingredients, Calm Bladder has a known interaction with 2,160 medications, including 755 rated major. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Calm Bladder contains 4 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.
What is St. John's Wort in this product for?
St. John's Wort is included for its traditional use in supporting mood and emotional well-being. In our data, it's rated likely effective for depression. However, it has major interactions with many prescription medications, so it's not right for everyone — check with your pharmacist first.
Why does this product contain psyllium (Plantain Leaf)?
Plantain Leaf (also called Black Psyllium) is a soluble fiber often used to support digestive and urinary tract health. In our data, it's rated effective for constipation and likely effective for heart health. Make sure to drink plenty of water when you take it.
Can I take this if I'm pregnant?
St. John's Wort and Corn Silk should be avoided during pregnancy — there isn't enough reliable safety data. Plantain Leaf is likely safe. Goldenrod lacks enough safety information, so it's best avoided too. Talk to your doctor or pharmacist before taking this product.
Can I take this while breastfeeding?
St. John's Wort may pass into breast milk and cause side effects in infants, so avoid it. Corn Silk is possibly safe. Plantain Leaf is likely safe. Goldenrod doesn't have enough safety data — avoid unless a clinician approves. Ask your doctor or pharmacist for personalized advice.
Does St. John's Wort in this product make me more likely to sunburn?
Yes. St. John's Wort can increase your skin's sensitivity to sunlight, especially at higher doses or with longer use. If you take this product, be extra careful in the sun and consider using sunscreen more often.
What are the most common side effects I might notice?
From St. John's Wort: diarrhea, dizziness, dry mouth, headache, insomnia, and fatigue. From Plantain Leaf: bloating and gas, which usually improve as you adjust and are less likely if you drink plenty of water. Corn Silk and Goldenrod adverse effects are generally rare in the data we hold.

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

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

Calm Bladder label
Go deeper

The Full Monographs Behind Calm Bladder’s Ingredients

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

Herb & supplement monograph

Corn Silk

Interacts with 290 drugs

Corn silk is a traditional herbal remedy taken as a tea or extract, mostly for urinary and mild fluid-related complaints. High-quality human evidence for these uses is limited, so it should...

Read the full Corn Silk monograph → Herb & supplement monograph

St. John's Wort

Interacts with 1,143 drugs

St. John's wort is a well-studied herb most often used for mild to moderate depression, and some research suggests it may help with this. However, it has many serious interactions with presc...

Read the full St. John's Wort monograph → Herb & supplement monograph

Black Psyllium

Interacts with 2,025 drugs

Black psyllium is a soluble-fiber supplement made from the seeds of a Plantago plant, used mostly to ease constipation and support digestive health. It is best known and most studied for rel...

Read the full Black Psyllium monograph → Herb & supplement monograph

Goldenrod

Interacts with 75 drugs

Goldenrod is a flowering plant traditionally used as an herbal diuretic and for urinary tract health. Human evidence is limited, and while it is generally well tolerated, people with certain...

Read the full Goldenrod monograph →
Sources

Sources & How We Checked

Calm Bladder'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 180 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.

Corn Silk 4 references
  1. Newall CA, Anderson LA, Philpson JD. Herbal Medicine: A Guide for Healthcare Professionals. London, UK: The Pharmaceutical Press, 1996.
  2. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
  3. George GO, Idu FK. Corn silk aqueous extracts and intraocular pressure of systemic and non-systemic hypertensive subjects. Clin Exp Optom. 2015 Mar;98(2):138-49. PubMed
  4. Sheng L, Chen Q, Di L, Li N. Evaluation of anti-diabetic potential of corn silk in high-fat diet/streptozotocin- induced type 2 diabetes mice model. Endocr Metab Immune Disord Drug Targets. 2020. PubMed

See these in context on the Corn Silk monograph →

St. John's Wort 152 references
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  2. Gulick RM, McAuliffe V, Holden-Wiltse J, et al. Phase I studies of hypericin, the active compound in St. John's Wort, as an antiretroviral agent in HIV-infected adults. AIDS Clinical Trials Group Protocols 150 and 258. Ann Intern Med 1999;130:510-4. PubMed
  3. O'Breasail AM, Argouarch S. Hypomania and St John's wort. Can J Psychiatry 1998;43:746-7.
  4. Johne A, Brockmoller J, Bauer S, et al. Pharmacokinetic interaction of digoxin with an herbal extract from St John's wort (Hypericum perforatum). Clin Pharmacol Ther 1999;66:338-45.
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  8. Brockmoller J, Reum T, Bauer S, et al. Hypericin and pseudohypericin: pharmacokinetics and effects on photosensitivity in humans. Pharmacopsychiatry 1997;30:94-101. PubMed
  9. Upton R, ed. St. John's wort, Hypericum perforatum: Quality control, analytical and therapeutic monograph. Santa Cruz, CA: American Herbal Pharmacopoeia 1997;1-32.
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  15. Roberts JE, Wang RH, Tan IP, et al. Hypericin (active ingredient in St. John's wort) photo-oxidation of lens proteins. Photochem Photobiol 1999;69:42S.
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  27. Schempp CM, Ludtke R, Winghofer B, Simon JC. Effect of topical application of hypericum perforatum extract on skin sensitivity to solar simulated radiation. Photodermatol Photoimmunol Photomed 2000;16:125-8.
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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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