Cardio Assurance Ingredients & Drug Interactions
What is this page for?
First and foremost: checking Cardio Assurance 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
Cardio Assurance is a dietary supplement by Nature's Sunshine with 6 active ingredients. Its ingredients are commonly taken for morning sickness in pregnancy, premenstrual syndrome (pms), preventing or treating b6 deficiency.Based on those ingredients, 1,026 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are Polygonum cuspidatum root extract, Vitamin B6, Hawthorn. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against Cardio Assurance by Nature's Sunshine
Ask about any prescription or over-the-counter medication and we check it for interactions with Cardio Assurance by Nature's Sunshine — and tell you which ingredient is responsible.
AI summaries are generated from our interaction database for education only — always confirm with your pharmacist. How we use AI
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HelloPharmacist Scorecard of Cardio Assurance 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.
What’s inside
Partial disclosure
Cardio Assurance contains 6 ingredients, including four active vitamins and minerals and an herbal extract. The active ingredients are vitamin B6, folic acid, vitamin B12, and vitamin K2 — all B vitamins and a fat-soluble vitamin involved in heart health and clotting.
The product also contains polygonum cuspidatum root extract (hu zhang), a plant used in traditional medicine, and a proprietary blend — a mix of other ingredients listed together without individual amounts shown. Two inactive ingredients, magnesium stearate and the capsule material itself, are also present.
Does it work?
Not established
The evidence for this product's ingredients is mixed. Vitamin B6 and B12 are effective for treating their respective deficiencies, and folic acid is effective for folate deficiency and for reducing the risk of neural tube birth defects in pregnancy.
Vitamin K2 is effective for certain bleeding disorders. However, the effectiveness ratings for hawthorn and hu zhang in the facts we hold show insufficient evidence to support claims about cardiovascular benefit — the evidence simply hasn't been established for those ingredients.
Folic acid is possibly effective for depression and cognitive function, and vitamin B6 is possibly effective for pregnancy-related nausea and vomiting, but the product's overall cardiovascular benefit is not well-supported by the data we have.
How safe is it?
Well-documented data
Vitamin B6 is generally well-tolerated at doses below 100 mg daily, though high doses over time can damage nerves (sensory neuropathy). Folic acid is well-tolerated at doses under 1 mg daily; at higher doses, it can cause confusion, sleep problems, and in rare cases, seizures.
Vitamin B12 is generally very safe with no established upper limit. Vitamin K2 is generally safe for healthy people at food amounts and most supplement doses, though it should be used cautiously if you take warfarin.
Hu zhang is not well-studied in humans — there's limited safety data, and pregnancy and breastfeeding are best avoided. Hawthorn is generally well-tolerated in studies but requires medical supervision if you have a heart condition, and pregnancy and breastfeeding should be avoided.
The most common side effects across these ingredients are mild digestive upset (nausea, diarrhea, abdominal discomfort) and, with high-dose B6, headache and nerve damage.
Meds to double-check
Major interaction found
Major severity: Check this product against any nitrates (like nitroglycerin), phosphodiesterase-5 inhibitors (Viagra, Cialis), and warfarin — hawthorn and vitamin K2 pose serious risks with these. Moderate severity: Blood pressure medications, heart rate medications (beta-blockers, calcium channel blockers), blood thinners and antiplatelet drugs (aspirin, clopidogrel), digoxin, amiodarone, seizure medications (phenobarbital, phenytoin, primidone, carbamazepine), metformin for diabetes, methotrexate and capecitabine for cancer, and multiple drugs metabolized by your liver's cytochrome P450 system.
Minor severity: levodopa for Parkinson's and pyrimethamine for parasites.
The bottom line
Scorecard at a glancePartially disclosed formula with no established evidence rating for its marketed use. Major medication interactions have been identified, and safety information is well characterized.
This product combines B vitamins (well-established for treating deficiencies) with two herbal ingredients whose cardiovascular benefits aren't yet proven in our data. If you take blood thinners like warfarin, blood pressure medications, heart rhythm drugs, or seizure medications, you need to check this product with your pharmacist before starting — the interactions are real and can be serious.
Talk to your doctor or pharmacist, especially if you have heart disease or are pregnant.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 6 of 6 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
General information
Key facts about Cardio Assurance, straight from the product label.
| Brand | Nature's Sunshine |
|---|---|
| Barcode (UPC) | 099904005532 |
| Net contents | 60 Capsule(s) |
| Market status | On market |
| Date entered into DSLD | Oct 24, 2022 |
| DSLD ID | 278037 |
| Product type | Botanical With Nutrients |
| Supplement form | Capsule |
| Dietary claims / uses | All Other, Structure/Function |
| Intended target group(s) | Adult (18 - 50 Years), Kosher |
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 Cardio Assurance by Nature's Sunshine, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Vitamin B6 | 4 mg | 235% |
| Folic Acid | 500 mcg | -- |
| Vitamin B12 | 12 mcg | 500% |
| Folate | 833 mcg DFE | 208% |
| Proprietary Blend | 409 mg | -- |
| Polygonum cuspidatum root extract | 0 NP | -- |
| Hawthorn | 0 NP | -- |
| Vitamin K2 | 20 mcg | 17% |
Other ingredients: Capsule, Magnesium Stearate
Tap any ingredient to jump to its full detail below.
These statements are the manufacturer’s wording, reproduced from the product label — the label is saying it, not HelloPharmacist. We don’t verify or endorse them.
FDA 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.
New look! Same great product
Precautions
Pregnant or lactating women or persons taking any prescription medication should consult their health care professional prior to taking this supplement.
Do not use if inner seal is missing or damaged.
Seals/Symbols
Ko Pareve (Kosher)
Formula
Ko Pareve (Kosher)
Cardio Assurance with Resveratrol
Formulation
Circulatory system support Helps maintain healthy blood vessels
Guaranteed pure
FDA Statement of Identity
Dietary Supplement
Brand IP Statement(s)
Natures Sunshine Herbal experts since 1972
Suggested/Recommended/Usage/Directions
Suggested Use: Take 1 capsule with a meal two times daily.
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Cardio Assurance by Nature's Sunshine label
The label scan from the NIH Dietary Supplement Label Database. Tap to enlarge.
Label images are published by the NIH Dietary Supplement Label Database for the version of this product on file. Always read your actual product label.
View the full label (PDF)The Ingredients in Cardio Assurance by Nature's Sunshine
These are the 6 active ingredients this product is made of. Select any to open its full monograph.
Serving size1 Capsule(s) Dosage formCapsule Servings per container60 Amounts shown are per serving.
Most supplement products combine several ingredients, and a medication can interact with the product through any one of them. Each ingredient below shows whether it has known drug interactions.
Vitamin B6
Interacts with210 drugs
Vitamin B6 (pyridoxine) is an essential water-soluble vitamin that your body needs for metabolism, brain function, and making red blood cells. It is b...
Vitamin B6 monograph & interactionsVitamin B12
Interacts with20 drugs
Vitamin B12 (cobalamin) is an essential nutrient your body needs to make red blood cells, keep nerves healthy, and support DNA. Supplements are very h...
Vitamin B12 monograph & interactionsFolate
Proprietary Blend
Vitamin K2
Interacts with2 drugs
Vitamin K is an essential nutrient your body needs for normal blood clotting and to support healthy bones. Most people get enough from food, but suppl...
Vitamin K2 monograph & interactionsOther (inactive) ingredients: Capsule, Magnesium Stearate. These complete the product’s ingredient list but are not active constituents.
Cardio Assurance by Nature's Sunshine Drug Interactions
HelloPharmacist Interaction Report
Cardio Assurance by Nature's Sunshine contains several ingredients with documented interactions.
The most serious concerns come from hawthorn and vitamin K2, both of which can interact with heart and blood medications at Major severity.
Read the full breakdown — every affected drug type, severity by severity
Hawthorn interacts with nitrates and phosphodiesterase-5 inhibitors (like sildenafil/Viagra) — both can cause dangerous drops in blood pressure when combined. It also has Moderate interactions with blood thinners (anticoagulants and antiplatelet drugs), beta-blockers, calcium channel blockers, and digoxin, a heart medication.
Vitamin K2 has a Major interaction with warfarin, a common blood thinner — vitamin K can reverse warfarin's protective effects and increase clot risk.
Vitamin B6 interacts with antihypertensive drugs (blood pressure medications), amiodarone (a heart rhythm drug), phenobarbital and phenytoin (seizure medications), and levodopa (a Parkinson's medication) — all at Moderate severity except levodopa, which is Minor. Folic acid can interfere with seizure control in people taking phenobarbital, primidone, or phenytoin (Moderate severity), and may reduce effectiveness of methotrexate cancer treatment and pyrimethamine, an antiparasitic.
It also has Moderate interactions with capecitabine and 5-fluorouracil, both cancer drugs. Vitamin B12 has a Minor interaction with metformin, a diabetes medication.
Polygonum cuspidatum root extract (hu zhang) may increase levels of several drugs metabolized by your liver (CYP1A2, CYP2C19, CYP3A4, and CYP2E1 substrates — all Moderate), and theoretically may interfere with estrogens and blood thinners; it also has a Minor interaction with carbamazepine, a seizure medication.
Altogether, these interactions span 1,027 individual medications. Use the medication checker below to verify your exact prescriptions before starting this product.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against Cardio Assurance?
Ask about interactions with your drugs in plain English — “Can I take it with lisinopril?” — and we find you the answer in seconds, ingredient by ingredient.
Go to the checkerIngredients driving the most interactions
Individual Drug Interactions
The ingredients in Cardio Assurance interact with 1,026 drugs. Click any drug to see the details.
6 of the 6 ingredients in Cardio Assurance interact with drugs. Each result below shows which ingredient is responsible. Polygonum cuspidatum root extract Vitamin B6 Hawthorn Folic Acid Vitamin B12 Vitamin K2
AvanafilStendra
How Avanafil interacts with Cardio Assurance — through 2 ingredients. Tap an ingredient for the detail:
HawthornPhosphodiesterase-5 Inhibitors Major
Interaction Summary
Theoretically, concomitant use might result in additive vasodilation and hypotension.
Read the full Hawthorn + Avanafil interactionPolygonum Cuspidatum Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, hu zhang might increase levels of drugs metabolized by CYP3A4.
Read the full Polygonum Cuspidatum Root Extract + Avanafil interactionFinasteride, TadalafilEntadfi
How Finasteride, Tadalafil interacts with Cardio Assurance — through 2 ingredients. Tap an ingredient for the detail:
HawthornPhosphodiesterase-5 Inhibitors Major
Interaction Summary
Theoretically, concomitant use might result in additive vasodilation and hypotension.
Read the full Hawthorn + Finasteride, Tadalafil interactionPolygonum Cuspidatum Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, hu zhang might increase levels of drugs metabolized by CYP3A4.
Read the full Polygonum Cuspidatum Root Extract + Finasteride, Tadalafil interactionGlyceryl TrinitrateNitronal
How Glyceryl Trinitrate interacts with Cardio Assurance — through 1 ingredient. Tap an ingredient for the detail:
HawthornNitrates Major
Interaction Summary
Theoretically, concomitant use might cause additive coronary vasodilatory effects.
Read the full Hawthorn + Glyceryl Trinitrate interactionIsosorbide DinitrateAngitak, Cedocard Retard, Isoket, Isoket Retard, Isordil
How Isosorbide Dinitrate interacts with Cardio Assurance — through 1 ingredient. Tap an ingredient for the detail:
HawthornNitrates Major
Interaction Summary
Theoretically, concomitant use might cause additive coronary vasodilatory effects.
Read the full Hawthorn + Isosorbide Dinitrate interactionIsosorbide Dinitrate, HydralazineBiDil
How Isosorbide Dinitrate, Hydralazine interacts with Cardio Assurance — through 2 ingredients. Tap an ingredient for the detail:
HawthornNitrates Major
Interaction Summary
Theoretically, concomitant use might cause additive coronary vasodilatory effects.
Read the full Hawthorn + Isosorbide Dinitrate, Hydralazine interactionVitamin B6Antihypertensive Drugs Moderate
Interaction Summary
Theoretically, vitamin B6 may have additive effects when used with antihypertensive drugs.
Read the full Vitamin B6 + Isosorbide Dinitrate, Hydralazine interactionIsosorbide MononitrateAngeze, Angeze SR, Chemydur 60XL, Dynamin, Elantan, Elantan LA +13 more
How Isosorbide Mononitrate interacts with Cardio Assurance — through 1 ingredient. Tap an ingredient for the detail:
HawthornNitrates Major
Interaction Summary
Theoretically, concomitant use might cause additive coronary vasodilatory effects.
Read the full Hawthorn + Isosorbide Mononitrate interactionMacitentan, TadalafilOpsynvi
How Macitentan, Tadalafil interacts with Cardio Assurance — through 3 ingredients. Tap an ingredient for the detail:
HawthornPhosphodiesterase-5 Inhibitors Major
Interaction Summary
Theoretically, concomitant use might result in additive vasodilation and hypotension.
Read the full Hawthorn + Macitentan, Tadalafil interactionVitamin B6Antihypertensive Drugs Moderate
Interaction Summary
Theoretically, vitamin B6 may have additive effects when used with antihypertensive drugs.
Read the full Vitamin B6 + Macitentan, Tadalafil interactionPolygonum Cuspidatum Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, hu zhang might increase levels of drugs metabolized by CYP3A4.
Read the full Polygonum Cuspidatum Root Extract + Macitentan, Tadalafil interactionNicorandilAprior, Dancor, Ikorel, Sigmart, Zynicor
How Nicorandil interacts with Cardio Assurance — through 1 ingredient. Tap an ingredient for the detail:
HawthornNitrates Major
Interaction Summary
Theoretically, concomitant use might cause additive coronary vasodilatory effects.
Read the full Hawthorn + Nicorandil interactionNitroglycerinGonitro, Nitro Time, Nitro-Bid, Nitrocine Timecaps, Nitrogard, Nitrogard SR +7 more
How Nitroglycerin interacts with Cardio Assurance — through 1 ingredient. Tap an ingredient for the detail:
HawthornNitrates Major
Interaction Summary
Theoretically, concomitant use might cause additive coronary vasodilatory effects.
Read the full Hawthorn + Nitroglycerin interactionPentaerythritol TetranitratePeritrate, Peritrate SA
How Pentaerythritol Tetranitrate interacts with Cardio Assurance — through 1 ingredient. Tap an ingredient for the detail:
HawthornNitrates Major
Interaction Summary
Theoretically, concomitant use might cause additive coronary vasodilatory effects.
Read the full Hawthorn + Pentaerythritol Tetranitrate interactionSildenafilRevatio
How Sildenafil interacts with Cardio Assurance — through 2 ingredients. Tap an ingredient for the detail:
HawthornPhosphodiesterase-5 Inhibitors Major
Interaction Summary
Theoretically, concomitant use might result in additive vasodilation and hypotension.
Read the full Hawthorn + Sildenafil interactionPolygonum Cuspidatum Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, hu zhang might increase levels of drugs metabolized by CYP3A4.
Read the full Polygonum Cuspidatum Root Extract + Sildenafil interactionSildenafil CitrateViagra
How Sildenafil Citrate interacts with Cardio Assurance — through 2 ingredients. Tap an ingredient for the detail:
HawthornPhosphodiesterase-5 Inhibitors Major
Interaction Summary
Theoretically, concomitant use might result in additive vasodilation and hypotension.
Read the full Hawthorn + Sildenafil Citrate interactionPolygonum Cuspidatum Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, hu zhang might increase levels of drugs metabolized by CYP3A4.
Read the full Polygonum Cuspidatum Root Extract + Sildenafil Citrate interactionTadalafilCialis, Tadliq
How Tadalafil interacts with Cardio Assurance — through 2 ingredients. Tap an ingredient for the detail:
HawthornPhosphodiesterase-5 Inhibitors Major
Interaction Summary
Theoretically, concomitant use might result in additive vasodilation and hypotension.
Read the full Hawthorn + Tadalafil interactionPolygonum Cuspidatum Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, hu zhang might increase levels of drugs metabolized by CYP3A4.
Read the full Polygonum Cuspidatum Root Extract + Tadalafil interactionVardenafilLevitra, Staxyn
How Vardenafil interacts with Cardio Assurance — through 2 ingredients. Tap an ingredient for the detail:
HawthornPhosphodiesterase-5 Inhibitors Major
Interaction Summary
Theoretically, concomitant use might result in additive vasodilation and hypotension.
Read the full Hawthorn + Vardenafil interactionPolygonum Cuspidatum Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, hu zhang might increase levels of drugs metabolized by CYP3A4.
Read the full Polygonum Cuspidatum Root Extract + Vardenafil interactionWarfarinWarfarin
How Warfarin interacts with Cardio Assurance — through 3 ingredients. Tap an ingredient for the detail:
Vitamin K2Warfarin (coumadin) Major
Interaction Summary
Vitamin K can antagonize and reverse the therapeutic effects of warfarin.
Read the full Vitamin K2 + Warfarin interactionPolygonum Cuspidatum Root ExtractCytochrome P450 2c19 (cyp2c19) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates +2 Moderate
Interaction Summary
Theoretically, hu zhang might increase levels of drugs metabolized by CYP2C19.
Read the full Polygonum Cuspidatum Root Extract + Warfarin interactionHawthornAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, hawthorn may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Hawthorn + Warfarin interactionWarfarin SodiumCoumadin, Panwarfin, Sofarin
How Warfarin Sodium interacts with Cardio Assurance — through 3 ingredients. Tap an ingredient for the detail:
Vitamin K2Warfarin (coumadin) Major
Interaction Summary
Vitamin K can antagonize and reverse the therapeutic effects of warfarin.
Read the full Vitamin K2 + Warfarin Sodium interactionPolygonum Cuspidatum Root ExtractAnticoagulant/antiplatelet Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates +2 Moderate
Interaction Summary
Theoretically, hu zhang might increase the risk of bleeding when taken with anticoagulant or antiplatelet drugs.
Read the full Polygonum Cuspidatum Root Extract + Warfarin Sodium interactionHawthornAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, hawthorn may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Hawthorn + Warfarin Sodium interactionAdo-trastuzumab EmtansineKadcyla
How Ado-trastuzumab Emtansine interacts with Cardio Assurance — through 1 ingredient. Tap an ingredient for the detail:
Polygonum Cuspidatum Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, hu zhang might increase levels of drugs metabolized by CYP3A4.
Read the full Polygonum Cuspidatum Root Extract + Ado-trastuzumab Emtansine interactionAbciximabReoPro
How Abciximab interacts with Cardio Assurance — through 2 ingredients. Tap an ingredient for the detail:
Polygonum Cuspidatum Root ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, hu zhang might increase the risk of bleeding when taken with anticoagulant or antiplatelet drugs.
Read the full Polygonum Cuspidatum Root Extract + Abciximab interactionHawthornAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, hawthorn may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Hawthorn + Abciximab interactionAbemaciclibVerzenio
How Abemaciclib interacts with Cardio Assurance — through 1 ingredient. Tap an ingredient for the detail:
Polygonum Cuspidatum Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, hu zhang might increase levels of drugs metabolized by CYP3A4.
Read the full Polygonum Cuspidatum Root Extract + Abemaciclib interactionAbiraterone
How Abiraterone interacts with Cardio Assurance — through 1 ingredient. Tap an ingredient for the detail:
Polygonum Cuspidatum Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, hu zhang might increase levels of drugs metabolized by CYP3A4.
Read the full Polygonum Cuspidatum Root Extract + Abiraterone interactionAbiraterone AcetateYonsa, Zytiga
How Abiraterone Acetate interacts with Cardio Assurance — through 1 ingredient. Tap an ingredient for the detail:
Polygonum Cuspidatum Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, hu zhang might increase levels of drugs metabolized by CYP3A4.
Read the full Polygonum Cuspidatum Root Extract + Abiraterone Acetate interactionAbrocitinibCibinqo
How Abrocitinib interacts with Cardio Assurance — through 2 ingredients. Tap an ingredient for the detail:
Polygonum Cuspidatum Root ExtractCytochrome P450 2c19 (cyp2c19) Substrates, Anticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, hu zhang might increase levels of drugs metabolized by CYP2C19.
Read the full Polygonum Cuspidatum Root Extract + Abrocitinib interactionHawthornAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, hawthorn may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Hawthorn + Abrocitinib interactionAcalabrutinibCalquence
How Acalabrutinib interacts with Cardio Assurance — through 1 ingredient. Tap an ingredient for the detail:
Polygonum Cuspidatum Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, hu zhang might increase levels of drugs metabolized by CYP3A4.
Read the full Polygonum Cuspidatum Root Extract + Acalabrutinib interactionAcebutololRhotral, Sectral
How Acebutolol interacts with Cardio Assurance — through 2 ingredients. Tap an ingredient for the detail:
HawthornBeta-blockers Moderate
Interaction Summary
Theoretically, concomitant use might cause additive effects on blood pressure and heart rate.
Read the full Hawthorn + Acebutolol interactionVitamin B6Antihypertensive Drugs Moderate
Interaction Summary
Theoretically, vitamin B6 may have additive effects when used with antihypertensive drugs.
Read the full Vitamin B6 + Acebutolol interactionAcenocoumarolSintrom
How Acenocoumarol interacts with Cardio Assurance — through 2 ingredients. Tap an ingredient for the detail:
HawthornAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, hawthorn may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Hawthorn + Acenocoumarol interactionPolygonum Cuspidatum Root ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, hu zhang might increase the risk of bleeding when taken with anticoagulant or antiplatelet drugs.
Read the full Polygonum Cuspidatum Root Extract + Acenocoumarol interactionAcetaminophenChildren's Tylenol, Children's Tylenol Meltaways, Tylenol, Tylenol Ex Strength
How Acetaminophen interacts with Cardio Assurance — through 1 ingredient. Tap an ingredient for the detail:
Polygonum Cuspidatum Root ExtractCytochrome P450 2e1 (cyp2e1) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, hu zhang might increase levels of drugs metabolized by CYP2E1.
Read the full Polygonum Cuspidatum Root Extract + Acetaminophen interactionAcetaminophen, AspirinGemnisyn
How Acetaminophen, Aspirin interacts with Cardio Assurance — through 2 ingredients. Tap an ingredient for the detail:
Polygonum Cuspidatum Root ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 2e1 (cyp2e1) Substrates +1 Moderate
Interaction Summary
Theoretically, hu zhang might increase levels of drugs metabolized by CYP1A2.
Read the full Polygonum Cuspidatum Root Extract + Acetaminophen, Aspirin interactionHawthornAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, hawthorn may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Hawthorn + Acetaminophen, Aspirin interactionAcetaminophen, Aspirin, CaffeineExcedrin, Excedrin Extra Strength, Excedrin Migraine
How Acetaminophen, Aspirin, Caffeine interacts with Cardio Assurance — through 2 ingredients. Tap an ingredient for the detail:
Polygonum Cuspidatum Root ExtractAnticoagulant/antiplatelet Drugs, Cytochrome P450 2e1 (cyp2e1) Substrates +2 Moderate
Interaction Summary
Theoretically, hu zhang might increase the risk of bleeding when taken with anticoagulant or antiplatelet drugs.
Read the full Polygonum Cuspidatum Root Extract + Acetaminophen, Aspirin, Caffeine interactionHawthornAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, hawthorn may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Hawthorn + Acetaminophen, Aspirin, Caffeine interactionAcetaminophen, Brompheniramine, PhenylpropanolamineDimetapp Cold and Flu
How Acetaminophen, Brompheniramine, Phenylpropanolamine interacts with Cardio Assurance — through 1 ingredient. Tap an ingredient for the detail:
Polygonum Cuspidatum Root ExtractCytochrome P450 2e1 (cyp2e1) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, hu zhang might increase levels of drugs metabolized by CYP2E1.
Read the full Polygonum Cuspidatum Root Extract + Acetaminophen, Brompheniramine, Phenylpropanolamine interactionAcetaminophen, ButalbitalAxocet, Bancap, Bucet, Butex Forte, Esgic CF, Orbivan CF +5 more
How Acetaminophen, Butalbital interacts with Cardio Assurance — through 1 ingredient. Tap an ingredient for the detail:
Polygonum Cuspidatum Root ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 2e1 (cyp2e1) Substrates Moderate
Interaction Summary
Theoretically, hu zhang might increase levels of drugs metabolized by CYP1A2.
Read the full Polygonum Cuspidatum Root Extract + Acetaminophen, Butalbital interactionEach ingredient & the kinds of drugs it affects
For each ingredient in Cardio Assurance 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.
Polygonum cuspidatum root extract
Anticoagulant/Antiplatelet Drugs
Theoretically, hu zhang might increase the risk of bleeding when taken with anticoagulant or antiplatelet drugs.
Hu zhang contains the constituent resveratrol. Resveratrol seems to have antiplatelet effects.
Cytochrome P450 1A2 (Cyp1A2) Substrates
Theoretically, hu zhang might increase levels of drugs metabolized by CYP1A2.
Hu zhang contains the constituent resveratrol. In vitro research shows that resveratrol might inhibit the CYP1A2 enzyme. This interaction has not been reported in humans.
Cytochrome P450 2C19 (Cyp2C19) Substrates
Theoretically, hu zhang might increase levels of drugs metabolized by CYP2C19.
Hu zhang contains the constituent resveratrol. In vitro research shows that resveratrol might inhibit the CYP2C19 enzyme. This interaction has not been reported in humans.
Cytochrome P450 2E1 (Cyp2E1) Substrates
Theoretically, hu zhang might increase levels of drugs metabolized by CYP2E1.
Hu zhang contains the constituent resveratrol. In vitro research shows that resveratrol might inhibit the CYP2E1 enzyme. Also, a pharmacokinetic study shows that taking resveratrol 500 mg daily for 10 days prior to taking a single dose of chlorzoxazone 250 mg increases the maximum concentration of chlorzoxazone by about 54%, the area under the curve of chlorzoxazone by about 72%, and the half-life of chlorzoxazone by about 35%. Chlorzoxazone is used as a probe drug for CYP2E1.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, hu zhang might increase levels of drugs metabolized by CYP3A4.
Hu zhang contains the constituent resveratrol. In vitro research shows that resveratrol might inhibit the CYP3A4 enzyme. However, a clinical study in adults with NAFLD found that adding resveratrol 3000 mg daily for 8 weeks did not necessitate dose adjustments to any established medications metabolized by CYP3A4.
Estrogens
Theoretically, hu zhang might competitively inhibit the effects of estrogen replacement therapy.
In vitro research shows that hu zhang might have estrogenic activity.
Carbamazepine (Tegretol)
Theoretically, hu zhang might increase the effects and adverse effects of carbamazepine.
In animals, blood and tissue levels of carbamazepine were increased when given in combination with hu zhang. It is thought that increased levels of carbamazepine are due to cytochrome P450 3A4 (CYP3A4) inhibition. This interaction has not been reported in humans.
Vitamin B6
Amiodarone (Cordarone)
Theoretically, vitamin B6 might increase the photosensitivity caused by amiodarone.
Despite initial case reports suggesting that pyridoxine may have a protective effect against amiodarone-induced photosensitivity, preliminary clinical research suggests that pyridoxine may actually exacerbate this adverse effect.
Antihypertensive Drugs
Theoretically, vitamin B6 may have additive effects when used with antihypertensive drugs.
Research in hypertensive rats shows that vitamin B6 can decrease systolic blood pressure. Similarly, clinical research in patients with hypertension shows that taking high doses of vitamin B6 may reduce systolic and diastolic blood pressure, possibly by reducing plasma levels of epinephrine and norepinephrine.
Phenobarbital (Luminal)
High doses of vitamin B6 may reduce the levels and clinical effects of phenobarbital.
Preliminary clinical evidence suggests that vitamin B6 200 mg daily can reduce plasma levels of phenobarbital, possibly by increasing metabolism. It is not known whether lower doses have any effect. Advise people taking phenobarbital to avoid high doses of vitamin B6.
Phenytoin (Dilantin)
High doses of vitamin B6 may reduce the levels and clinical effects of phenytoin.
Preliminary clinical evidence suggests that vitamin B6 200 mg daily can reduce plasma levels of phenytoin, possibly by increasing metabolism. It is not known whether lower doses have any effect. Advise people taking phenytoin to avoid high doses of vitamin B6.
Levodopa
Vitamin B6 may increase the metabolism of levodopa when taken alone, but not when taken in conjunction with carbidopa.
Vitamin B6 (pyridoxine) enhances the metabolism of levodopa, reducing its clinical effects. However, this interaction does not occur when carbidopa is used concurrently with levodopa (Sinemet). Therefore, it is not likely to be a problem in most people.
Hawthorn
Nitrates
Theoretically, concomitant use might cause additive coronary vasodilatory effects.
Some evidence shows that hawthorn might lower blood pressure due to vasodilatory effects.
Phosphodiesterase-5 Inhibitors
Theoretically, concomitant use might result in additive vasodilation and hypotension.
Hawthorn might inhibit PDE-5 and cause vasodilation.
Anticoagulant/Antiplatelet Drugs
Theoretically, hawthorn may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
In vitro and animal research shows that hawthorn can inhibit platelet aggregation. However, its effect in humans is unclear. One observational study shows that patients taking hawthorn shortly before undergoing coronary artery bypass graft (CABG) surgery or valve replacement surgery have a 10% incidence of postoperative bleeding, compared with 1% in those who never consumed hawthorn extract. However, clinical research shows that taking a specific preparation of dried hawthorn leaves and flowers (Crataesor, Soria Natural Lab) 800 mg three times daily for 15 days does not affect platelet aggregation or levels of thromboxane B2, the metabolite of thromboxane A2, in healthy humans.
Beta-Blockers
Theoretically, concomitant use might cause additive effects on blood pressure and heart rate.
Some evidence shows that hawthorn might lower blood pressure and heart rate.
Calcium Channel Blockers
Theoretically, concomitant use might cause additive coronary vasodilation and hypotensive effects.
Some evidence shows that hawthorn might lower blood pressure due to vasodilatory effects.
Digoxin (Lanoxin)
Theoretically, hawthorn might potentiate the effects and adverse effects of digoxin.
Hawthorn appears to improve cardiac output; however, hawthorn does not appear to affect digoxin pharmacokinetics. Case reports suggest that at least one species of hawthorn root extract (Crataegus mexicana) may produce adverse effects similar to digoxin and can cross-react with digoxin assays, leading to falsely elevated plasma digoxin levels.
Folic Acid
5-Fluorouracil
Theoretically, high doses of folic acid might increase the toxicity of 5-fluorouracil.
Increases in gastrointestinal side effects of 5-fluorouracil, such as stomatitis and diarrhea, have been described in two clinical studies when leucovorin, a form of folic acid, was administered with 5-fluorouracil.
Capecitabine (Xeloda)
Use of high-dose folic acid might contribute to capecitabine toxicity.
Clinical research suggests that higher serum folate levels are associated with an increased risk for moderate or severe toxicity during capecitabine-based treatment for colorectal cancer. Additionally, in one case report, taking folic acid 15 mg daily might have contributed to increased toxicity, including severe diarrhea, vomiting, edema, hand-foot syndrome, and eventually death, in a patient prescribed capecitabine.
Methotrexate (Trexall, Others)
Folic acid might reduce the efficacy of methotrexate as a cancer treatment when given concurrently.
Methotrexate exerts its cytotoxic effects by preventing conversion of folic acid to the active form needed by cells. There is some evidence that folic acid supplements reduce the efficacy of methotrexate in the treatment of acute lymphoblastic leukemia, and theoretically they could reduce its efficacy in the treatment of other cancers. Advise cancer patients to consult their oncologist before using folic acid supplements. In patients treated with long-term, low-dose methotrexate for rheumatoid arthritis (RA) or psoriasis, folic acid supplements can reduce the incidence of side effects, without reducing efficacy.
Phenobarbital (Luminal)
Folic acid might have antagonistic effects on phenobarbital and increase the risk for seizures.
Folic acid can have direct convulsant activity in some people, reversing the effects of phenobarbital and worsening seizure control. Monitor closely for increased seizure activity.
Phenytoin (Dilantin)
Folic acid might reduce serum levels of phenytoin in some patients.
Folic acid may be a cofactor in phenytoin metabolism. Folic acid, in doses of 1 mg daily or more, can reduce serum levels of phenytoin in some patients. Increases in seizure frequency have been reported. If folic acid supplements are added to established phenytoin therapy, monitor serum phenytoin levels closely. If phenytoin and folic acid are started at the same time and continued together, adverse changes in phenytoin pharmacokinetics are avoided. Note that phenytoin also reduces serum folate levels.
Primidone (Mysoline)
Folic acid might have antagonistic effects on primidone and increase the risk for seizures.
Folic acid can have direct convulsant activity in some people, reversing the effects of primidone and worsening seizure control. Monitor closely for increased seizure activity. Note that primidone also reduces serum folate levels.
Pyrimethamine (Daraprim)
Folic acid might antagonize the effects of pyrimethamine.
Folic acid can antagonize the antiparasitic effects of pyrimethamine against toxoplasmosis and Pneumocystis carinii pneumonia. Folic acid doesn't antagonize the effects of pyrimethamine in the treatment of malaria, because malarial parasites cannot use exogenous folic acid. Use folinic acid as an alternative to folic acid when indicated.
Vitamin B12
Metformin (Glucophage)
Metformin, a common medication used to manage type 2 diabetes, has been associated with lower vitamin B12 levels in some individuals. Prolonged use of metformin can interfere with the absorption of B12 in the digestive system, potentially leading to a deficiency in this essential vitamin.
Vitamin K2
Warfarin (Coumadin)
Vitamin K can antagonize and reverse the therapeutic effects of warfarin.
Vitamin K antagonizes the effects of warfarin. Excessive vitamin K intake, either from supplements or from changes in the diet, can reduce the anticoagulant effect of warfarin.
Brand information
Manufacturer and brand details for Cardio Assurance, from the product label.
Nature's Sunshine
See all Nature's Sunshine products- Name
- Nature's Sunshine Products, Inc.
- City
- Spanish Fork
- State
- UT
- ZipCode
- 84660
- Phone Number
- 1-800-223-8225
- Web Address
- www.naturessunshine.com
Cardio Assurance by Nature's Sunshine: Common Questions
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Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
Not sure if Cardio Assurance 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.
The Full Monographs Behind Cardio Assurance’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Vitamin B6
Interacts with 210 drugsVitamin B6 (pyridoxine) is an essential water-soluble vitamin that your body needs for metabolism, brain function, and making red blood cells. It is best known for helping with pregnancy-rel...
Read the full Vitamin B6 monograph → Herb & supplement monographVitamin B12
Interacts with 20 drugsVitamin B12 (cobalamin) is an essential nutrient your body needs to make red blood cells, keep nerves healthy, and support DNA. Supplements are very helpful for people who are deficient — su...
Read the full Vitamin B12 monograph → Herb & supplement monographFolic Acid
Interacts with 40 drugsFolic acid is the man-made form of vitamin B9 and is one of the most well-studied supplements, especially for preventing serious birth defects when taken before and during early pregnancy. I...
Read the full Folic Acid monograph → Herb & supplement monographHu Zhang
Interacts with 826 drugsHu Zhang (Japanese knotweed root) is a traditional Chinese herb that is one of the richest natural sources of resveratrol and emodin. Some lab and early human research looks interesting for...
Read the full Hu Zhang monograph → Herb & supplement monographHawthorn
Interacts with 191 drugsHawthorn is a plant traditionally used for heart-related complaints, and some studies suggest it may modestly help symptoms of mild heart failure when added to standard care. However, the ev...
Read the full Hawthorn monograph → Herb & supplement monographVitamin K
Interacts with 2 drugsVitamin K is an essential nutrient your body needs for normal blood clotting and to support healthy bones. Most people get enough from food, but supplements are sometimes used for deficiency...
Read the full Vitamin K monograph →Sources & How We Checked
Cardio Assurance's label data comes from the NIH Dietary Supplement Label Database; the ingredient interaction data is from the Natural Medicines database, reviewed by our pharmacists.
- NIH Dietary Supplement Label Database (DSLD) — The official product label on file for this supplement.
- Natural Medicines (Therapeutic Research Center) — Evidence-graded clinical reference behind the ingredient interaction data.
Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.
The 173 references behind this product’s interaction data
Every citation that drives the interaction findings for this product’s ingredients, from the evidence-graded Natural Medicines (TRC Healthcare) database. Open an ingredient to browse its citations — links open the study on PubMed or the publisher’s site.
Vitamin B6 32 references
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Folic Acid 56 references
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- Houghton LA, Sherwood KL, Pawlosky R, Ito S, O'Connor DL. [6S]-5-Methyltetrahydrofolate is at least as effective as folic acid in preventing a decline in blood folate concentrations during lactation. Am J Clin Nutr. 2006 Apr;83(4):842-50. PubMed
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