Cardiovascular Health Ingredients & Drug Interactions
by WellZymes
What is this page for?
First and foremost: checking Cardiovascular Health 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
Cardiovascular Health is a dietary supplement by WellZymes with 9 active ingredients. Its ingredients are commonly taken for general antioxidant support, skin and hair care, heart health.Based on those ingredients, 1,140 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are Garlic Bulb concentrate, Grape seed extract, Vitamin E. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against Cardiovascular Health by WellZymes
Ask about any prescription or over-the-counter medication and we check it for interactions with Cardiovascular Health by WellZymes — 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 Cardiovascular Health by WellZymes
Four independent checks of what is known — a summary of the available information, not a grade of the product itself.
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
The stated purpose hasn't been mapped to our evidence data yet.
Why this rating?
- We haven't mapped this product's purpose to our evidence data yet — it'll be graded on the next content refresh.
Every active ingredient lists its own amount on the label.
Why this rating?
- The label discloses an exact amount for 9 of its 9 active ingredients.
- “Plant-source N-zimes” is listed as a grouped ingredient — the label gives one combined amount (72 mg) without saying how much of each component you get.
- “Herbal Cardiovascular Support” is listed as a grouped ingredient — the label gives one combined amount (300 mg) without saying how much of each component you get.
At least one ingredient has a documented Major-severity interaction. Check your medications for a personalized result.
Why this rating?
- 5 of the 7 matched ingredients can interact with medications — Garlic, Grape, Hawthorn, Coenzyme Q10, Vitamin E.
- The most serious interaction on file is rated Major.
- Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs; immunosuppressants / transplant drugs; cancer treatments; diabetes medications; heart-rhythm medications.
- For scale: 1,141 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.
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 7 of the 7 matched ingredients.
- Pregnancy & breastfeeding safety ratings cover 7 of 7.
- General safety write-ups exist for 7 of 7.
- Remember: this measures how much safety information exists. Thin data is not the same as being safe.
HelloPharmacist summaryFully disclosed formula with no assessable stated purpose. Major medication interactions have been identified, and safety information is well characterized.
Assessment coverage: 7 of 9 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Mar 23, 2012.
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 Cardiovascular Health, straight from the product label.
| Brand | WellZymes |
|---|---|
| Barcode (UPC) | 707636173817 |
| Net contents | 30 Vegetarian Capsule(s) |
| Market status | Off market |
| Date entered into DSLD | Mar 23, 2012 |
| DSLD ID | 8031 |
| Product type | Other Combinations |
| Supplement form | Capsule |
| Dietary claims / uses | Nutrient, All Other, Structure/Function |
| Intended target group(s) | Vegan, Vegetarian, Adult (18 - 50 Years), Sugar Free |
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 Cardiovascular Health by WellZymes, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Lipase | 200 LU | -- |
| Vitamin E | 50 IU | 167% |
| Rice Bran | 20 mg | -- |
| Coenzyme Q10 | 25 mg | -- |
| CereCalase Plus | 40 MU | -- |
| Plant-source N-zimes | 72 mg | -- |
| pHysioProtease(TM) | 30000 HUT | -- |
| Herbal Cardiovascular Support | 300 mg | -- |
| Hawthorne Leaf and Flower extract | 200 mg | -- |
| Garlic Bulb concentrate | 60 mg | -- |
| Grape seed extract | 20 mg | -- |
Other ingredients: Vegetarian Capsule
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.
Brand IP Statement(s)
WellZymes™ Cardiovascular Health provides a superior blend of natural vitamin E, Coenzyme Q10 and the highest quality herbal extracts enhanced with n•zimes™ vegetarian enzymes, including the optimally effective pHysioProtease™ and lipase, to maintain healthy cardiovascular function.
pHysioProtease™ is a trademark of Enzymes, Inc. n•zimes™ and CereCalase Plus™ are trademarks of National Enzyme Company.
Suggested/Recommended/Usage/Directions
Recommended Use: Two capsules once per day on an empty stomach. (For best results, take at least two hours after and one hour prior to a meal.) Take with adequate liquid.
Precautions
Use only if tamper-evident seal is unbroken.
Keep out of reach of children.
Storage
Store tightly closed in a cool, dry place.
Formulation
Contains no animal/dairy products, wheat, yeast, corn, proteins, sugar, salt, preservatives or artificial ingredients.
FDA Disclaimer Statement
This statement has not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, mitigate, cure or prevent any disease.
FDA Statement of Identity
Enzyme Supplement
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Cardiovascular Health by WellZymes 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 Cardiovascular Health by WellZymes
These are the 9 active ingredients this product is made of. Select any to open its full monograph.
Serving size2 Vegetarian Capsule(s) Dosage formCapsule Servings per container15 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 E
Interacts with764 drugs
Vitamin E is an essential fat-soluble vitamin and antioxidant that most people get in adequate amounts from a normal diet. Supplements can help correc...
Vitamin E monograph & interactionsCoenzyme Q10
Interacts with198 drugs
CoQ10 is a vitamin-like substance your body makes naturally that helps cells produce energy and acts as an antioxidant. It is generally well tolerated...
Coenzyme Q10 monograph & interactionsPlant-source N-zimes
- › Lipase
- › CereCalase Plus
- › PHysioProtease(TM)
Herbal Cardiovascular Support
Other (inactive) ingredients: Vegetarian Capsule. These complete the product’s ingredient list but are not active constituents.
Cardiovascular Health by WellZymes Drug Interactions
Cardiovascular Health contains 9 ingredients, and 5 of them have known drug interactions. Altogether they interact with 1,140 medications. Here’s the picture, then you can look up your own drug.
Want to check YOUR meds against Cardiovascular Health?
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 Cardiovascular Health interact with 1,140 drugs. Click any drug to see the details.
5 of the 9 ingredients in Cardiovascular Health interact with drugs. Each result below shows which ingredient is responsible. Garlic Bulb concentrate Grape seed extract Vitamin E Coenzyme Q10 Hawthorne Leaf and Flower extract
AvanafilStendra
How Avanafil interacts with Cardiovascular Health — through 4 ingredients. Tap an ingredient for the detail:
Hawthorne Leaf And Flower ExtractPhosphodiesterase-5 Inhibitors Major
Interaction Summary
Theoretically, concomitant use might result in additive vasodilation and hypotension.
Read the full Hawthorne Leaf And Flower Extract + Avanafil interactionVitamin ECytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Vitamin E + Avanafil interactionGrape Seed ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
It is unclear if grape seed extract inhibits or induces CYP3A4; research is conflicting.
Read the full Grape Seed Extract + Avanafil interactionGarlic Bulb ConcentrateCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, garlic products containing allicin might induce intestinal CYP3A4 and inhibit hepatic CYP3A4.
Read the full Garlic Bulb Concentrate + Avanafil interactionFinasteride, TadalafilEntadfi
How Finasteride, Tadalafil interacts with Cardiovascular Health — through 4 ingredients. Tap an ingredient for the detail:
Hawthorne Leaf And Flower ExtractPhosphodiesterase-5 Inhibitors Major
Interaction Summary
Theoretically, concomitant use might result in additive vasodilation and hypotension.
Read the full Hawthorne Leaf And Flower Extract + Finasteride, Tadalafil interactionGrape Seed ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
It is unclear if grape seed extract inhibits or induces CYP3A4; research is conflicting.
Read the full Grape Seed Extract + Finasteride, Tadalafil interactionVitamin ECytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Vitamin E + Finasteride, Tadalafil interactionGarlic Bulb ConcentrateCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, garlic products containing allicin might induce intestinal CYP3A4 and inhibit hepatic CYP3A4.
Read the full Garlic Bulb Concentrate + Finasteride, Tadalafil interactionGlyceryl TrinitrateNitronal
How Glyceryl Trinitrate interacts with Cardiovascular Health — through 1 ingredient. Tap an ingredient for the detail:
Hawthorne Leaf And Flower ExtractNitrates Major
Interaction Summary
Theoretically, concomitant use might cause additive coronary vasodilatory effects.
Read the full Hawthorne Leaf And Flower Extract + Glyceryl Trinitrate interactionIsosorbide DinitrateAngitak, Cedocard Retard, Isoket, Isoket Retard, Isordil
How Isosorbide Dinitrate interacts with Cardiovascular Health — through 1 ingredient. Tap an ingredient for the detail:
Hawthorne Leaf And Flower ExtractNitrates Major
Interaction Summary
Theoretically, concomitant use might cause additive coronary vasodilatory effects.
Read the full Hawthorne Leaf And Flower Extract + Isosorbide Dinitrate interactionIsosorbide Dinitrate, HydralazineBiDil
How Isosorbide Dinitrate, Hydralazine interacts with Cardiovascular Health — through 3 ingredients. Tap an ingredient for the detail:
Hawthorne Leaf And Flower ExtractNitrates Major
Interaction Summary
Theoretically, concomitant use might cause additive coronary vasodilatory effects.
Read the full Hawthorne Leaf And Flower Extract + Isosorbide Dinitrate, Hydralazine interactionGarlic Bulb ConcentrateAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, taking garlic with antihypertensive drugs might increase the risk of hypotension.
Read the full Garlic Bulb Concentrate + Isosorbide Dinitrate, Hydralazine interactionCoenzyme Q10Antihypertensive Drugs Minor
Interaction Summary
Theoretically, coenzyme Q10 might have additive effects with antihypertensive drugs.
Read the full Coenzyme Q10 + Isosorbide Dinitrate, Hydralazine interactionIsosorbide MononitrateAngeze, Angeze SR, Chemydur 60XL, Dynamin, Elantan, Elantan LA +13 more
How Isosorbide Mononitrate interacts with Cardiovascular Health — through 1 ingredient. Tap an ingredient for the detail:
Hawthorne Leaf And Flower ExtractNitrates Major
Interaction Summary
Theoretically, concomitant use might cause additive coronary vasodilatory effects.
Read the full Hawthorne Leaf And Flower Extract + Isosorbide Mononitrate interactionMacitentan, TadalafilOpsynvi
How Macitentan, Tadalafil interacts with Cardiovascular Health — through 5 ingredients. Tap an ingredient for the detail:
Hawthorne Leaf And Flower ExtractPhosphodiesterase-5 Inhibitors Major
Interaction Summary
Theoretically, concomitant use might result in additive vasodilation and hypotension.
Read the full Hawthorne Leaf And Flower Extract + Macitentan, Tadalafil interactionGarlic Bulb ConcentrateAntihypertensive Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, taking garlic with antihypertensive drugs might increase the risk of hypotension.
Read the full Garlic Bulb Concentrate + Macitentan, Tadalafil interactionGrape Seed ExtractCytochrome P450 2c9 (cyp2c9) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
It is unclear if grape juice or grape seed extract inhibits CYP2C9; research is conflicting.
Read the full Grape Seed Extract + Macitentan, Tadalafil interactionVitamin ECytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Vitamin E + Macitentan, Tadalafil interactionCoenzyme Q10Antihypertensive Drugs Minor
Interaction Summary
Theoretically, coenzyme Q10 might have additive effects with antihypertensive drugs.
Read the full Coenzyme Q10 + Macitentan, Tadalafil interactionNicorandilAprior, Dancor, Ikorel, Sigmart, Zynicor
How Nicorandil interacts with Cardiovascular Health — through 1 ingredient. Tap an ingredient for the detail:
Hawthorne Leaf And Flower ExtractNitrates Major
Interaction Summary
Theoretically, concomitant use might cause additive coronary vasodilatory effects.
Read the full Hawthorne Leaf And Flower Extract + Nicorandil interactionNitroglycerinGonitro, Nitro Time, Nitro-Bid, Nitrocine Timecaps, Nitrogard, Nitrogard SR +7 more
How Nitroglycerin interacts with Cardiovascular Health — through 1 ingredient. Tap an ingredient for the detail:
Hawthorne Leaf And Flower ExtractNitrates Major
Interaction Summary
Theoretically, concomitant use might cause additive coronary vasodilatory effects.
Read the full Hawthorne Leaf And Flower Extract + Nitroglycerin interactionPentaerythritol TetranitratePeritrate, Peritrate SA
How Pentaerythritol Tetranitrate interacts with Cardiovascular Health — through 1 ingredient. Tap an ingredient for the detail:
Hawthorne Leaf And Flower ExtractNitrates Major
Interaction Summary
Theoretically, concomitant use might cause additive coronary vasodilatory effects.
Read the full Hawthorne Leaf And Flower Extract + Pentaerythritol Tetranitrate interactionSildenafilRevatio
How Sildenafil interacts with Cardiovascular Health — through 4 ingredients. Tap an ingredient for the detail:
Hawthorne Leaf And Flower ExtractPhosphodiesterase-5 Inhibitors Major
Interaction Summary
Theoretically, concomitant use might result in additive vasodilation and hypotension.
Read the full Hawthorne Leaf And Flower Extract + Sildenafil interactionGarlic Bulb ConcentrateCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, garlic products containing allicin might induce intestinal CYP3A4 and inhibit hepatic CYP3A4.
Read the full Garlic Bulb Concentrate + Sildenafil interactionGrape Seed ExtractCytochrome P450 2c9 (cyp2c9) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
It is unclear if grape juice or grape seed extract inhibits CYP2C9; research is conflicting.
Read the full Grape Seed Extract + Sildenafil interactionVitamin ECytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Vitamin E + Sildenafil interactionSildenafil CitrateViagra
How Sildenafil Citrate interacts with Cardiovascular Health — through 4 ingredients. Tap an ingredient for the detail:
Hawthorne Leaf And Flower ExtractPhosphodiesterase-5 Inhibitors Major
Interaction Summary
Theoretically, concomitant use might result in additive vasodilation and hypotension.
Read the full Hawthorne Leaf And Flower Extract + Sildenafil Citrate interactionVitamin ECytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Vitamin E + Sildenafil Citrate interactionGrape Seed ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 2c9 (cyp2c9) Substrates Moderate
Interaction Summary
It is unclear if grape seed extract inhibits or induces CYP3A4; research is conflicting.
Read the full Grape Seed Extract + Sildenafil Citrate interactionGarlic Bulb ConcentrateCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, garlic products containing allicin might induce intestinal CYP3A4 and inhibit hepatic CYP3A4.
Read the full Garlic Bulb Concentrate + Sildenafil Citrate interactionTadalafilCialis, Tadliq
How Tadalafil interacts with Cardiovascular Health — through 4 ingredients. Tap an ingredient for the detail:
Hawthorne Leaf And Flower ExtractPhosphodiesterase-5 Inhibitors Major
Interaction Summary
Theoretically, concomitant use might result in additive vasodilation and hypotension.
Read the full Hawthorne Leaf And Flower Extract + Tadalafil interactionGrape Seed ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
It is unclear if grape seed extract inhibits or induces CYP3A4; research is conflicting.
Read the full Grape Seed Extract + Tadalafil interactionVitamin ECytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Vitamin E + Tadalafil interactionGarlic Bulb ConcentrateCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, garlic products containing allicin might induce intestinal CYP3A4 and inhibit hepatic CYP3A4.
Read the full Garlic Bulb Concentrate + Tadalafil interactionVardenafilLevitra, Staxyn
How Vardenafil interacts with Cardiovascular Health — through 4 ingredients. Tap an ingredient for the detail:
Hawthorne Leaf And Flower ExtractPhosphodiesterase-5 Inhibitors Major
Interaction Summary
Theoretically, concomitant use might result in additive vasodilation and hypotension.
Read the full Hawthorne Leaf And Flower Extract + Vardenafil interactionVitamin ECytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Vitamin E + Vardenafil interactionGrape Seed ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
It is unclear if grape seed extract inhibits or induces CYP3A4; research is conflicting.
Read the full Grape Seed Extract + Vardenafil interactionGarlic Bulb ConcentrateCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, garlic products containing allicin might induce intestinal CYP3A4 and inhibit hepatic CYP3A4.
Read the full Garlic Bulb Concentrate + Vardenafil interactionAdo-trastuzumab EmtansineKadcyla
How Ado-trastuzumab Emtansine interacts with Cardiovascular Health — through 3 ingredients. Tap an ingredient for the detail:
Garlic Bulb ConcentrateCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, garlic products containing allicin might induce intestinal CYP3A4 and inhibit hepatic CYP3A4.
Read the full Garlic Bulb Concentrate + Ado-trastuzumab Emtansine interactionGrape Seed ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
It is unclear if grape seed extract inhibits or induces CYP3A4; research is conflicting.
Read the full Grape Seed Extract + Ado-trastuzumab Emtansine interactionVitamin ECytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Vitamin E + Ado-trastuzumab Emtansine interactionAbciximabReoPro
How Abciximab interacts with Cardiovascular Health — through 4 ingredients. Tap an ingredient for the detail:
Vitamin EAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Concomitant use of vitamin E and anticoagulant or antiplatelet agents might increase the risk of bleeding.
Read the full Vitamin E + Abciximab interactionHawthorne Leaf And Flower ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, hawthorn may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Hawthorne Leaf And Flower Extract + Abciximab interactionGrape Seed ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, grape extracts may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Grape Seed Extract + Abciximab interactionGarlic Bulb ConcentrateAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Garlic may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Garlic Bulb Concentrate + Abciximab interactionAbemaciclibVerzenio
How Abemaciclib interacts with Cardiovascular Health — through 3 ingredients. Tap an ingredient for the detail:
Garlic Bulb ConcentrateCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, garlic products containing allicin might induce intestinal CYP3A4 and inhibit hepatic CYP3A4.
Read the full Garlic Bulb Concentrate + Abemaciclib interactionVitamin ECytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Vitamin E + Abemaciclib interactionGrape Seed ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
It is unclear if grape seed extract inhibits or induces CYP3A4; research is conflicting.
Read the full Grape Seed Extract + Abemaciclib interactionAbiraterone
How Abiraterone interacts with Cardiovascular Health — through 3 ingredients. Tap an ingredient for the detail:
Grape Seed ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
It is unclear if grape seed extract inhibits or induces CYP3A4; research is conflicting.
Read the full Grape Seed Extract + Abiraterone interactionVitamin ECytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Vitamin E + Abiraterone interactionGarlic Bulb ConcentrateCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, garlic products containing allicin might induce intestinal CYP3A4 and inhibit hepatic CYP3A4.
Read the full Garlic Bulb Concentrate + Abiraterone interactionAbiraterone AcetateYonsa, Zytiga
How Abiraterone Acetate interacts with Cardiovascular Health — through 3 ingredients. Tap an ingredient for the detail:
Garlic Bulb ConcentrateCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, garlic products containing allicin might induce intestinal CYP3A4 and inhibit hepatic CYP3A4.
Read the full Garlic Bulb Concentrate + Abiraterone Acetate interactionGrape Seed ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
It is unclear if grape seed extract inhibits or induces CYP3A4; research is conflicting.
Read the full Grape Seed Extract + Abiraterone Acetate interactionVitamin ECytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Vitamin E + Abiraterone Acetate interactionAbrocitinibCibinqo
How Abrocitinib interacts with Cardiovascular Health — through 4 ingredients. Tap an ingredient for the detail:
Vitamin EAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Concomitant use of vitamin E and anticoagulant or antiplatelet agents might increase the risk of bleeding.
Read the full Vitamin E + Abrocitinib interactionHawthorne Leaf And Flower ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, hawthorn may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Hawthorne Leaf And Flower Extract + Abrocitinib interactionGrape Seed ExtractAnticoagulant/antiplatelet Drugs, Cytochrome P450 2c9 (cyp2c9) Substrates Moderate
Interaction Summary
Theoretically, grape extracts may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Grape Seed Extract + Abrocitinib interactionGarlic Bulb ConcentrateAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Garlic may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Garlic Bulb Concentrate + Abrocitinib interactionAcalabrutinibCalquence
How Acalabrutinib interacts with Cardiovascular Health — through 3 ingredients. Tap an ingredient for the detail:
Garlic Bulb ConcentrateCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, garlic products containing allicin might induce intestinal CYP3A4 and inhibit hepatic CYP3A4.
Read the full Garlic Bulb Concentrate + Acalabrutinib interactionVitamin ECytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Vitamin E + Acalabrutinib interactionGrape Seed ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
It is unclear if grape seed extract inhibits or induces CYP3A4; research is conflicting.
Read the full Grape Seed Extract + Acalabrutinib interactionAcarboseGlucobay, Prandase, Precose
How Acarbose interacts with Cardiovascular Health — through 1 ingredient. Tap an ingredient for the detail:
Garlic Bulb ConcentrateAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, taking garlic with antidiabetes drugs might increase the risk of hypoglycemia.
Read the full Garlic Bulb Concentrate + Acarbose interactionAcebutololRhotral, Sectral
How Acebutolol interacts with Cardiovascular Health — through 3 ingredients. Tap an ingredient for the detail:
Garlic Bulb ConcentrateAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, taking garlic with antihypertensive drugs might increase the risk of hypotension.
Read the full Garlic Bulb Concentrate + Acebutolol interactionHawthorne Leaf And Flower ExtractBeta-blockers Moderate
Interaction Summary
Theoretically, concomitant use might cause additive effects on blood pressure and heart rate.
Read the full Hawthorne Leaf And Flower Extract + Acebutolol interactionCoenzyme Q10Antihypertensive Drugs Minor
Interaction Summary
Theoretically, coenzyme Q10 might have additive effects with antihypertensive drugs.
Read the full Coenzyme Q10 + Acebutolol interactionAcenocoumarolSintrom
How Acenocoumarol interacts with Cardiovascular Health — through 4 ingredients. Tap an ingredient for the detail:
Grape Seed ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, grape extracts may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Grape Seed Extract + Acenocoumarol interactionVitamin EAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Concomitant use of vitamin E and anticoagulant or antiplatelet agents might increase the risk of bleeding.
Read the full Vitamin E + Acenocoumarol interactionHawthorne Leaf And Flower ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, hawthorn may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Hawthorne Leaf And Flower Extract + Acenocoumarol interactionGarlic Bulb ConcentrateAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Garlic may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Garlic Bulb Concentrate + Acenocoumarol interactionAcetaminophenChildren's Tylenol, Children's Tylenol Meltaways, Tylenol, Tylenol Ex Strength
How Acetaminophen interacts with Cardiovascular Health — through 2 ingredients. Tap an ingredient for the detail:
Garlic Bulb ConcentrateCytochrome P450 2e1 (cyp2e1) Substrates Moderate
Interaction Summary
Garlic might increase levels of drugs metabolized by CYP2E1.
Read the full Garlic Bulb Concentrate + Acetaminophen interactionGrape Seed ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 2e1 (cyp2e1) Substrates Moderate
Interaction Summary
Theoretically, grape juice might reduce the levels of CYP1A2 substrates.
Read the full Grape Seed Extract + Acetaminophen interactionAcetaminophen, AspirinGemnisyn
How Acetaminophen, Aspirin interacts with Cardiovascular Health — through 4 ingredients. Tap an ingredient for the detail:
Grape Seed ExtractAnticoagulant/antiplatelet Drugs, Cytochrome P450 2e1 (cyp2e1) Substrates +1 Moderate
Interaction Summary
Theoretically, grape extracts may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Grape Seed Extract + Acetaminophen, Aspirin interactionHawthorne Leaf And Flower ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, hawthorn may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Hawthorne Leaf And Flower Extract + Acetaminophen, Aspirin interactionVitamin EAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Concomitant use of vitamin E and anticoagulant or antiplatelet agents might increase the risk of bleeding.
Read the full Vitamin E + Acetaminophen, Aspirin interactionGarlic Bulb ConcentrateCytochrome P450 2e1 (cyp2e1) Substrates, Anticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Garlic might increase levels of drugs metabolized by CYP2E1.
Read the full Garlic Bulb Concentrate + Acetaminophen, Aspirin interactionAcetaminophen, Aspirin, CaffeineExcedrin, Excedrin Extra Strength, Excedrin Migraine
How Acetaminophen, Aspirin, Caffeine interacts with Cardiovascular Health — through 4 ingredients. Tap an ingredient for the detail:
Garlic Bulb ConcentrateAnticoagulant/antiplatelet Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Moderate
Interaction Summary
Garlic may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Garlic Bulb Concentrate + Acetaminophen, Aspirin, Caffeine interactionGrape Seed ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Anticoagulant/antiplatelet Drugs +2 Moderate
Interaction Summary
Theoretically, grape juice might reduce the levels of CYP1A2 substrates.
Read the full Grape Seed Extract + Acetaminophen, Aspirin, Caffeine interactionVitamin EAnticoagulant/antiplatelet Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Concomitant use of vitamin E and anticoagulant or antiplatelet agents might increase the risk of bleeding.
Read the full Vitamin E + Acetaminophen, Aspirin, Caffeine interactionHawthorne Leaf And Flower ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, hawthorn may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Hawthorne Leaf And Flower Extract + Acetaminophen, Aspirin, Caffeine interactionAcetaminophen, Brompheniramine, PhenylpropanolamineDimetapp Cold and Flu
How Acetaminophen, Brompheniramine, Phenylpropanolamine interacts with Cardiovascular Health — through 2 ingredients. Tap an ingredient for the detail:
Grape Seed ExtractCytochrome P450 2e1 (cyp2e1) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, grape seed extract might increase the levels of CYP2E1 substrates.
Read the full Grape Seed Extract + Acetaminophen, Brompheniramine, Phenylpropanolamine interactionGarlic Bulb ConcentrateCytochrome P450 2e1 (cyp2e1) Substrates Moderate
Interaction Summary
Garlic might increase levels of drugs metabolized by CYP2E1.
Read the full Garlic Bulb Concentrate + Acetaminophen, Brompheniramine, Phenylpropanolamine interactionAcetaminophen, ButalbitalAxocet, Bancap, Bucet, Butex Forte, Esgic CF, Orbivan CF +5 more
How Acetaminophen, Butalbital interacts with Cardiovascular Health — through 2 ingredients. Tap an ingredient for the detail:
Garlic Bulb ConcentrateCytochrome P450 2e1 (cyp2e1) Substrates Moderate
Interaction Summary
Garlic might increase levels of drugs metabolized by CYP2E1.
Read the full Garlic Bulb Concentrate + Acetaminophen, Butalbital interactionGrape Seed ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 2e1 (cyp2e1) Substrates Moderate
Interaction Summary
Theoretically, grape juice might reduce the levels of CYP1A2 substrates.
Read the full Grape Seed Extract + Acetaminophen, Butalbital interactionAcetaminophen, Butalbital, CaffeineEsgic, Esgic Plus, Fiogesic, Fioricet, Repan, Tecnal +1 more
How Acetaminophen, Butalbital, Caffeine interacts with Cardiovascular Health — through 3 ingredients. Tap an ingredient for the detail:
Grape Seed ExtractCytochrome P450 2e1 (cyp2e1) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Moderate
Interaction Summary
Theoretically, grape seed extract might increase the levels of CYP2E1 substrates.
Read the full Grape Seed Extract + Acetaminophen, Butalbital, Caffeine interactionVitamin ECytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Vitamin E + Acetaminophen, Butalbital, Caffeine interactionGarlic Bulb ConcentrateCytochrome P450 2e1 (cyp2e1) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Garlic might increase levels of drugs metabolized by CYP2E1.
Read the full Garlic Bulb Concentrate + Acetaminophen, Butalbital, Caffeine interactionEach ingredient & the kinds of drugs it affects
For each ingredient in Cardiovascular Health 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.
Garlic Bulb concentrate
Anticoagulant/Antiplatelet Drugs
Garlic may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Raw garlic and a variety of garlic extracts have antiplatelet activity and can increase prothrombin time.
Antidiabetes Drugs
Theoretically, taking garlic with antidiabetes drugs might increase the risk of hypoglycemia.
Clinical research suggests that garlic and garlic extract lower blood glucose levels in healthy and diabetic individuals.
Antihypertensive Drugs
Theoretically, taking garlic with antihypertensive drugs might increase the risk of hypotension.
In human research, both garlic and garlic extracts have blood pressure-lowering effects.
Atazanavir (Reyataz)
Theoretically, garlic might decrease levels and effects of atazanavir.
In a case report, a patient consuming six stir-fried garlic cloves three times weekly developed suboptimal atazanavir levels and increases in HIV viral load. While the exact cause of this interaction is unclear, there is speculation that garlic might decrease the intestinal absorption of atazanavir or increase its metabolism by inducing cytochrome P450 3A4 (CYP3A4). Until more is known, advise patients not to consume large amounts of garlic while taking atazanavir.
Cytochrome P450 2E1 (Cyp2E1) Substrates
Garlic might increase levels of drugs metabolized by CYP2E1.
Clinical research suggests garlic oil can inhibit the activity of CYP2E1 by 39%. Use garlic oil cautiously in patients taking drugs metabolized by these enzymes.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, garlic products containing allicin might induce intestinal CYP3A4 and inhibit hepatic CYP3A4. This may increase or decrease levels of drugs metabolized by CYP3A4.
Some human research suggests that garlic may induce INTESTINAL CYP3A4, reducing levels of drugs metabolized by this enzyme. This is primarily based on a study showing that taking a specific allicin-containing garlic product (GarliPure Maximum Allicin Formula, Natrol Inc.) twice daily for 3 days reduces saquinavir levels by approximately 50%. It is speculated that the allicin constituent induced CYP3A4 in the gut mucosa. Another study shows that giving docetaxel intravenously, bypassing the CYP3A4 enzymes in the gut mucosa, along with the same specific garlic product for 12 consecutive days, does not affect docetaxel levels. Conversely, there is concern that garlic may inhibit HEPATIC CYP3A4. In a single case report, increased tacrolimus levels and liver injury occurred in a liver transplant patient after taking a specific garlic supplement (Garlicin Cardio, Nature's Way) at up to three times the manufacturer recommended dose for 7 days. Several other studies have evaluated the impact of other garlic formulations on CYP3A4 substrates and have found no effect. Most of the products in these studies provided little or no allicin.
Isoniazid
Theoretically, garlic might decrease levels of isoniazid.
Animal research suggests that an aqueous extract of garlic reduces isoniazid levels by about 65%. Garlic reduced the maximum concentration (Cmax) and area under the curve (AUC), but not the half-life, of isoniazid. This suggests that garlic extract might inhibit isoniazid absorption across the intestinal mucosa; however, the exact mechanism of this potential interaction is not known.
Protease Inhibitors (Pis)
Theoretically, garlic products containing allicin might decrease levels of PIs.
Protease inhibitors are metabolized by cytochrome P450 3A4 (CYP3A4) isoenzymes. There is concern that garlic products containing allicin might induce intestinal CYP3A4, reducing plasma levels of protease inhibitors. This is primarily based on a study showing that taking a specific garlic product (GarliPure Maximum Allicin Formula, Natrol Inc.) twice daily for 3 days reduces levels of saquinavir, a PI, by approximately 50%. It is speculated that the allicin constituent induce CYP3A4 in the gut mucosa. Several studies have evaluated the impact of other garlic formulations on CYP3A4 substrates and have found no effect. Most of the products in these studies provided little or no allicin.
Saquinavir (Fortovase, Invirase)
Theoretically, garlic containing allicin might decrease levels of saquinavir.
Saquinavir is a substrate of cytochrome P450 3A4 (CYP3A4) isoenzymes. There is concern that garlic products containing allicin might induce intestinal CYP3A4 and cause subtherapeutic levels of saquinavir. This is primarily based on a pharmacokinetic study showing that taking a specific garlic product (GarliPure Maximum Allicin Formula, Natrol Inc.) twice daily for 3 days reduces saquinavir levels by approximately 50%. It is speculated that the allicin constituent induces CYP3A4 in the gut mucosa. Several pharmacokinetic studies have evaluated the impact of other garlic formulations on CYP3A4 substrates and have found no effect. Most of the products in these studies provided little or no allicin. Until more is known about this potential interaction, use garlic containing allicin cautiously in patients taking saquinavir.
Sofosbuvir (Sovaldi)
Theoretically, taking garlic with sofosbuvir might decrease its effectiveness.
Animal research in rats shows that giving aged garlic extract 120 mg/kg orally daily for 14 days decreases the area under the concentration time curve (AUC) after a single sofosbuvir dose of 40 mg/kg by 36%, increases the clearance by 63%, and decreases the plasma concentrations at 1 and 8 hours by 35% and 58%, respectively. This interaction is hypothesized to be due to induction of intestinal P-glycoprotein expression by garlic.
Tacrolimus (Prograf)
Theoretically, garlic might increase levels of tacrolimus.
In one case report, a liver transplant patient taking tacrolimus experienced increased tacrolimus levels and liver injury after taking a specific garlic supplement (Garlicin Cardio, Nature's Way) at up to three times the manufacturer recommended dose for 7 days. It is speculated that garlic inhibited hepatic cytochrome P450 3A4 (CYP3A4), which increased plasma levels of tacrolimus.
Warfarin (Coumadin)
Theoretically, garlic might increase the risk of bleeding with warfarin.
Raw garlic and a variety of garlic extracts have antiplatelet activity and can increase prothrombin time. In addition, there is a report of two patients who experienced an increase in a previously stabilized international normalized ratio (INR) with concomitant garlic and warfarin use. However, this report has been subsequently debated due to limited clinical information. Other clinical studies have not identified an effect of garlic on INR, warfarin pharmacokinetics, or bleeding risk. More evidence is needed to determine the safety of using garlic with warfarin.
Grape seed extract
Anticoagulant/Antiplatelet Drugs
Theoretically, grape extracts may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
In vitro evidence suggests that grape extracts might decrease platelet aggregation.
Cyclosporine (Neoral, Sandimmune)
Ingesting grape juice with cyclosporine can reduce cyclosporine absorption.
A small pharmacokinetic study in healthy young adults shows that intake of purple grape juice 200 mL along with cyclosporine can decrease the absorption of cyclosporine by up to 30% when compared with water. Separate doses of grape juice and cyclosporine by at least 2 hours to avoid this interaction.
Cytochrome P450 1A2 (Cyp1A2) Substrates
Theoretically, grape juice might reduce the levels of CYP1A2 substrates.
A small pharmacokinetic study in healthy adults shows that ingestion of 200 mL of grape juice decreases phenacetin plasma levels. This is thought to be due to induction of CYP1A2.
Cytochrome P450 2D6 (Cyp2D6) Substrates
Theoretically, grape seed extract may increase the levels of CYP2D6 substrates.
In vitro evidence suggests that grape seed extract might inhibit CYP2D6 enzymes. However, this interaction has not been reported in humans.
Cytochrome P450 2E1 (Cyp2E1) Substrates
Theoretically, grape seed extract might increase the levels of CYP2E1 substrates.
In vitro and animal research suggests that grape seed proanthocyanidin extract inhibits CYP2E1 enzymes. However, this interaction has not been reported in humans.
Cytochrome P450 3A4 (Cyp3A4) Substrates
It is unclear if grape seed extract inhibits or induces CYP3A4; research is conflicting.
In vitro evidence suggests that grape seed extract might inhibit CYP3A4 enzymes. However, evidence from animal research shows that grape seed extract may induce CYP3A4 in the liver. So far, these interactions have not been reported in humans.
Midazolam (Versed)
Theoretically, long-term intake of grape seed extract might decrease the effects of midazolam.
Animal research shows that subchronic ingestions of grape seed extract can increase the elimination of intravenous midazolam by increasing hepatic CYP3A4 activity. Single doses of grape seed extract do not appear to affect midazolam elimination.
Phenacetin
Grape juice might decrease phenacetin absorption.
A small pharmacokinetic study in healthy adults shows that ingestion of 200 mL of grape juice decreases phenacetin plasma levels. This is thought to be due to induction of cytochrome P450 1A2 (CYP1A2).
Cytochrome P450 2C9 (Cyp2C9) Substrates
It is unclear if grape juice or grape seed extract inhibits CYP2C9; research is conflicting.
In vitro evidence shows that grape seed extract or grape juice might inhibit CYP2C9 enzymes. However, a small pharmacokinetic study in healthy adults shows that drinking 8 ounces of grape juice once does not affect the clearance of flurbiprofen, a probe-drug for CYP2C9 metabolism. The effects of continued grape juice consumption are unclear.
Vitamin E
Alkylating Agents
Theoretically, antioxidant effects of vitamin E might reduce the effectiveness of alkylating agents.
There's concern that antioxidants could reduce the activity of chemotherapy drugs which generate free radicals, such as cyclophosphamide, chlorambucil, carmustine, busulfan, and thiotepa. However, some researchers theorize that antioxidants might make chemotherapy more effective by reducing oxidative stress that might interfere with apoptosis (cell death) of cancer cells. More evidence is needed to determine what effect, if any, antioxidants such as vitamin E have on chemotherapy. Advise patients to consult their oncologist before using vitamin E supplements, especially in high doses.
Anticoagulant/Antiplatelet Drugs
Concomitant use of vitamin E and anticoagulant or antiplatelet agents might increase the risk of bleeding.
Vitamin E seems to inhibit of platelet aggregation and antagonize the effects of vitamin K-dependent clotting factors. These effects appear to be dose-dependent, and are probably only likely to be clinically significant with doses of at least 800 units daily. Mixed tocopherols, such as those found in food, might have a greater antiplatelet effect than alpha-tocopherol. RRR alpha-tocopherol (natural vitamin E) 1000 IU daily antagonizes vitamin K-dependent clotting factors. Advise patients to avoid high doses of vitamin E, especially in people with low vitamin K intake or other risk factors for bleeding.
Antitumor Antibiotics
Theoretically, antioxidant effects of vitamin E might reduce the effectiveness of antitumor antibiotics.
There's concern that antioxidants could reduce the activity of antitumor antibiotic drugs such as doxorubicin, which generate free radicals. However, some researchers theorize that antioxidants might make chemotherapy more effective by reducing oxidative stress that might interfere with apoptosis (cell death) of cancer cells. More evidence is needed to determine what effect, if any, antioxidants such as vitamin E have on chemotherapy involving antitumor antibiotics. Advise patients to consult their oncologist before using vitamin E supplements, especially in high doses.
Cyclosporine (Neoral, Sandimmune)
A specific form of vitamin E might increase absorption and levels of cyclosporine.
There is some evidence that one specific formulation of vitamin E (D-alpha-tocopheryl-polyethylene glycol-1000 succinate, TPGS, tocophersolan, Liqui-E) might increase absorption of cyclosporine. This vitamin E formulation forms micelles which seems to increase absorption of cyclosporine by 40% to 72% in some patients. However, this interaction is unlikely to occur with the usual forms of vitamin E.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Vitamin E appears to bind with the nuclear receptor, pregnane X receptor (PXR), which results in increased expression of CYP3A4. Although the clinical significance of this is not known, use caution when considering concomitant use of vitamin E and other drugs affected by these enzymes.
Selumetinib (Koselugo)
Taking selumetinib with vitamin E can result in a total daily dose of vitamin E that exceeds safe limits and therefore might increase the risk of bleeding.
Selumetinib contains 48-54 IU vitamin E per capsule. The increased risk of bleeding with vitamin E appears to be dose-dependent. Be cautious when using selumetinib in combination with supplemental vitamin E, especially in patients at higher risk of bleed, such as those with chronic conditions and those taking antiplatelet drugs.
Warfarin (Coumadin)
Using vitamin E with warfarin might increase the risk of bleeding.
Due to interference with production of vitamin K-dependent clotting factors, use of more than 400 IU of vitamin E daily with warfarin might increase prothrombin time (PT), INR, and the risk of bleeding,. At a dose of 1000 IU per day, vitamin E can antagonize vitamin K-dependent clotting factors even in people not taking warfarin. Limited clinical evidence suggests that doses up to 1200 IU daily may be used safely by patients taking warfarin, but this may not be applicable in all patient populations.
Niacin
Vitamin E might decrease the beneficial effects of niacin on high-density lipoprotein (HDL) cholesterol levels.
A combination of niacin and simvastatin (Zocor) effectively raises high-density lipoprotein (HDL) cholesterol levels in people with coronary disease and low HDL levels. Clinical research shows that taking a combination of antioxidants (vitamin C, vitamin E, beta-carotene, and selenium) along with niacin and simvastatin (Zocor) attenuates this rise in HDL, specifically the HDL-2 and apolipoprotein A1 fractions, by more than 50%. Vitamin E alone combined with a statin does not seem to decrease HDL levels. It is not known whether the adverse effect on HDL is due to one of the other antioxidants or to the combination. It also is not known whether it will occur in other patient populations.
Coenzyme Q10
Alkylating Agents
Coenzyme Q10 has antioxidant effects. Theoretically, this may reduce the activity of chemotherapy drugs that generate free radicals.
Theoretically, antioxidants such as coenzyme Q10 might protect tumor cells from chemotherapeutic agents that work by inducing oxidative stress, such as alkylating agents (e.g., cyclophosphamide) and radiation therapy. The clinical importance of this interaction is unknown.
Warfarin (Coumadin)
Coenzyme Q10 is chemically similar to menaquinone and might have vitamin K-like procoagulant effects, which could decrease the effects of warfarin.
Concomitant use of coenzyme Q10 and warfarin might reduce the anticoagulant effects of warfarin. Four cases of decreased warfarin efficacy thought to be due to coenzyme Q10 have been reported. However, there is some preliminary clinical research that suggests coenzyme Q10 might not significantly decrease the effects of warfarin in patients who have a stable INR.
Antihypertensive Drugs
Theoretically, coenzyme Q10 might have additive effects with antihypertensive drugs.
Some clinical research shows that coenzyme Q10 can significantly lower blood pressure, although other studies have shown conflicting results.
Hawthorne Leaf and Flower extract
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.
Brand information
Manufacturer and brand details for Cardiovascular Health, from the product label.
WellZymes
See all WellZymes products- Name
- Enzymes, Inc.
- City
- Parkville
- State
- MO
- ZipCode
- 64152
- Phone Number
- 800-228-1501
Cardiovascular Health by WellZymes: Common Questions
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Where does this information come from?
Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
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Label information is sourced from the NIH Dietary Supplement Label Database and reflects the product version on file; always read your actual product label. This page is for education only and is not a substitute for professional medical advice. Confirm with your pharmacist or doctor before combining supplements and medications.
The Full Monographs Behind Cardiovascular Health’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Vitamin E
Interacts with 764 drugsVitamin E is an essential fat-soluble vitamin and antioxidant that most people get in adequate amounts from a normal diet. Supplements can help correct a true deficiency, but high-dose vitam...
Read the full Vitamin E monograph → Herb & supplement monographCoenzyme Q10
Interacts with 198 drugsCoQ10 is a vitamin-like substance your body makes naturally that helps cells produce energy and acts as an antioxidant. It is generally well tolerated and is most studied for heart condition...
Read the full Coenzyme Q10 monograph → Herb & supplement monographLipase
Lipase is a digestive enzyme that helps your body break down dietary fats. It is well established as part of prescription pancreatic enzyme therapy for people who cannot make enough of their...
Read the full Lipase monograph → Herb & supplement monographRice Bran
Rice bran is the nutrient-rich outer layer of the rice grain and is a good source of fiber, healthy fats, and plant compounds. It is most studied for helping lower cholesterol, but for most...
Read the full Rice Bran 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 monographGarlic
Interacts with 989 drugsGarlic is a common food and supplement that may modestly help with blood pressure and cholesterol, though the evidence is mixed and effects are usually small. It is generally safe in food am...
Read the full Garlic monograph → Herb & supplement monographGrape
Interacts with 910 drugsGrapes and grape products like grape seed extract contain antioxidant compounds such as resveratrol and proanthocyanidins that may support heart and blood vessel health. While the food is he...
Read the full Grape monograph →Sources & How We Checked
Cardiovascular Health'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 325 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.
Lipase 1 reference
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Vitamin E 64 references
- Kim JM, White RH. Effect of vitamin E on the anticoagulant response to warfarin. Am J Cardiol 1996;77:545-6. PubMed
- Corrigan JJ Jr. The effect of vitamin E on warfarin-induced vitamin K deficiency. Ann N Y Acad Sci 1982;393:361-8. PubMed
- Corrigan JJ Jr. Coagulation problems relating to vitamin E. Am J Pediatr Hematol Oncol 1979;1:169-73.
- Corrigan JJ Jr, Marcus FI. Coagulopathy associated with vitamin E ingestion. JAMA 1974;230:1300-1. DOI
- Labriola D, Livingston R. Possible interactions between dietary antioxidants and chemotherapy. Oncology 1999;13:1003-8.
- Chang T, Benet LZ, Hebert MF. The effect of water-soluble vitamin E on cyclosporine pharmacokinetics in healthy volunteers. Clin Pharmacol Ther 1996;59:297-303. PubMed
- Pan SH, Lopez RR Jr, Sher LS, et al. Enhanced oral cyclosporine absorption with water-soluble vitamin E early after liver transplantation. Pharmacother 1996;16:59-65. DOI
- Anon. Dietary supplementation with n-3 polyunsaturated fatty acids and vitamin E after myocardial infarction: results of the GISSI-Prevenzione trial. Gruppo Italiano per lo Studio della Soprawivenza nell'Infarto miocardico. Lancet 1999;354:447-55. DOI
- Chappell LC, Seed PT, Briley AL, et al. Effect of antioxidants on the occurrence of pre-eclampsia in women at increased risk: a randomised trial. Lancet 1999;354:810-6. DOI
- Yusuf S, Dagenais G, Pogue J, et al. Vitamin E supplementation and cardiovascular events in high-risk patients. The heart outcomes prevention evaluation study investigators. N Engl J Med 2000;342:154-60. PubMed
- Stephens NG, Parsons A, Schofield PM, et al. Randomised controlled trial of vitamin E in patients with coronary disease: Cambridge Heart Antioxidant Study. Lancet 1996;347:781-6.
- The Alpha-Tocopherol, Beta Carotene Cancer Prevention Study Group. The effect of vitamin E and beta carotene on the incidence of lung cancer and other cancers in male smokers. N Engl J Med 1994;330:1029-35. PubMed
- Takahashi O. Haemorrhagic toxicity of a large dose of alpha-, beta-, gamma- and delta-tocopherols, ubiquinone, beta-carotene, retinol acetate and L-ascorbic acid in the rat. Food Chem Toxicol 1995;33:121-8.
- Briggs GB, Freeman RK, Yaffe SJ. Drugs in Pregnancy and Lactation. 5th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 1998.
- Sano M, Ernesto C, Thomas RG, et al. A controlled trial of selegiline, alpha-tocopherol, or both as treatment for Alzheimer's disease. The Alzheimer's Disease Cooperative Study. N Engl J Med 1997;336:1216-22. PubMed
- Liede KE, Haukka JK, Saxen LM, Heinonen OP. Increased tendency towards gingival bleeding caused by joint effect of alpha-tocopherol supplementation and acetylsalicylic acid. Ann Med 1998;30:542-6.
- Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes for Vitamin C, Vitamin E, Selenium, and Carotenoids. Washington, DC: National Academy Press, 2000. Available at: http://www.nap.edu/books/0309069351/html/.
- Brown BG, Zhao XQ, Chait A, et al. Simvastatin and niacin, antioxidant vitamins, or the combination for the prevention of coronary disease. N Engl J Med 2001;345:1583-93. DOI
- Liu M, Wallmon A, Olsson-Mortlock C, et al. Mixed tocopherols inhibit platelet aggregation in humans: potential mechanisms. Am J Clin Nutr 2003;77:700-6. PubMed
- Sokol RJ, Johnson KE, Karrer FM, et al. Improvement of cyclosporin absorption in children after liver transplantation by means of water-soluble vitamin E. Lancet 1991;338:212-4.. PubMed
- Stein JH, Carlsson CM, Papcke-Benson K, et al. The effects of lipid-lowering and antioxidant vitamin therapies on flow-mediated vasodilation of the brachial artery in older adults with hypercholesterolemia. J Am Coll Cardiol 2001;38:1806-13.. PubMed
- Carlsson CM, Papcke-Benson K, Carnes M, et al. Health-related quality of life and long-term therapy with pravastatin and tocopherol (vitamin E) in older adults. Drugs Aging 2002;19:793-805. . PubMed
- Cheung MC, Zhao XQ, Chait A, et al. Antioxidant supplements block the response of HDL to simvastatin-niacin therapy in patients with coronary artery disease and low HDL. Arterioscler Thromb Vasc Biol 2001;21:1320-6. PubMed
- Schrogie JJ. Coagulopathy and fat-soluble vitamins (letter). JAMA 1975;232:19. DOI
- Celestini A, Pulcinelli FM, Pignatelli P, et al. Vitamin E potentiates the antiplatelet activity of aspirin in collagen-stimulated platelets. Haematologica 2002;87:420-6.
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