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Dietary supplement

CC-A with Yerba Santa Combination Ingredients & Drug Interactions

by Nature's Sunshine

CC-A with Yerba Santa Combination label
See full label image
Liquid Category: Botanical
Most serious interaction: Moderate
Clinical methodology reviewed by · Updated Sep 16, 2026 · Label data from the NIH DSLD
What is this page for?

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

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

The interaction bottom line Most serious interaction: Moderate

CC-A with Yerba Santa Combination is a dietary supplement by Nature's Sunshine with 13 active ingredients. Its ingredients are commonly taken for immune support, colds and flu, upper respiratory infections.Based on those ingredients, 2,253 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Slippery Elm bark extract, Sage leaves extract, Goldenseal rhizome extract. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

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Check Your Meds Against CC-A with Yerba Santa Combination by Nature's Sunshine

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

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HelloPharmacist Scorecard of CC-A with Yerba Santa Combination by Nature's Sunshine

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

From our pharmacy team — supplement deep dive

Generated from HelloPharmacist’s pharmacist-curated databases and editorial rules · Last generated Jul 12, 2026

What’s inside

Low disclosure
Ingredient Transparency · database check
Low

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

Why this rating?
  • The label discloses an exact amount for 0 of its 13 active ingredients.
  • “Proprietary Blend” is a proprietary blend — the label gives one combined amount (100 mg) without saying how much of each component you get.

CC-A with Yerba Santa Combination contains 13 active ingredients in a proprietary blend formulation. The blend includes astragalus root extract, mullein leaves extract, capsicum fruit extract, rose hips fruit extract, German chamomile flowers extract, yarrow flowers extract, yerba santa leaves extract, goldenseal rhizome extract, myrrh gum extract, peppermint leaves extract, sage leaves extract, slippery elm bark extract, and lemongrass aerial parts extract.

The product is delivered as a liquid in a base of alcohol and water.

Does it work?

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

This product doesn't appear to be marketed for a specific use, so we graded its ingredients' overall clinical evidence instead.

Strong

Strong clinical evidence supports its ingredients for:

Why this rating?
  • We looked at the product name, claims, and label statements and couldn't find a stated purpose to grade.
  • Since the label doesn't commit to one use, we graded the ingredients' overall clinical evidence instead.
  • On file: Diabetic neuropathy — rated "Likely Effective" (Capsicum) (Natural Medicines).
  • On file: Irritable bowel syndrome (IBS) — rated "Likely Effective" (Peppermint) (Natural Medicines).
  • On file: Postherpetic neuralgia — rated "Likely Effective" (Capsicum) (Natural Medicines).
  • On file: Back pain — rated "Possibly Effective" (Capsicum) (Natural Medicines).
  • On file: Barium enema-related colonic spasm — rated "Possibly Effective" (Peppermint) (Natural Medicines).

The ingredients in this product have limited evidence for most of their traditional uses. Peppermint leaves extract is rated Likely Effective for irritable bowel syndrome (IBS) and Possibly Effective for indigestion (dyspepsia) and nausea from chemotherapy.

Capsicum fruit extract is Likely Effective for nerve pain after shingles (postherpetic neuralgia) and diabetic neuropathy, and Possibly Effective for cluster headaches, back pain, and postoperative nausea. Sage leaves extract is Possibly Effective for menopausal symptoms, cholesterol management (hyperlipidemia), and cognitive function.

Rose hips and several other ingredients are rated Possibly Effective for postoperative pain. For the remaining ingredients—astragalus, mullein, German chamomile, yarrow, yerba santa, goldenseal, myrrh, slippery elm, and lemongrass—evidence is insufficient to rate their effectiveness for their listed uses.

The evidence, ingredient by ingredient Astragalus Mullein Capsicum Rose Hip German Chamomile Yarrow Yerba Santa Goldenseal

How safe is it?

Well-documented data
Safety Information · database check
Well characterized

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

Why this rating?
  • We hold adverse-effect (side-effect) data for 11 of the 13 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 13 of 13.
  • General safety write-ups exist for 13 of 13.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

Most ingredients in this blend are generally well tolerated for short-term use, though human safety data are often limited. Astragalus is well tolerated short-term but should be avoided in pregnancy and while breastfeeding.

Mullein, yerba santa, and slippery elm are generally well tolerated but lack adequate pregnancy and breastfeeding safety data. Capsicum is considered safe in food amounts and approved topical doses but commonly causes burning and irritation; concentrated supplements are not well studied.

German chamomile can trigger allergic reactions in people sensitive to ragweed and related plants and should be avoided in pregnancy unless your doctor approves. Yarrow should be avoided in pregnancy (traditionally thought to affect the uterus) and while breastfeeding.

Goldenseal and myrrh are considered likely unsafe in pregnancy because of their constituent berberine and uterine stimulant properties, respectively, and should be avoided while breastfeeding. Sage is likely unsafe in pregnancy at medicinal doses because of thujone content and possibly unsafe while breastfeeding.

Peppermint leaf is rated likely safe in pregnancy and lactation. Lemongrass is likely unsafe in pregnancy at medicinal amounts.

Yarrow, goldenseal, sage, and German chamomile can cause dermatitis with topical exposure. Goldenseal's berberine constituent may cause gastrointestinal effects including abdominal pain, bitter taste, constipation, diarrhea, headache, nausea, and vomiting.

Side effects, ingredient by ingredient Astragalus Mullein Capsicum Rose Hip German Chamomile Yarrow Yerba Santa Goldenseal

Meds to double-check

Moderate interaction found
Known Interaction Concern · database check
Moderate identified

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

Why this rating?
  • 13 of the 13 matched ingredients can interact with medications — Yarrow, Yerba Santa, Sage, Myrrh, Mullein, among others.
  • The most serious interaction on file is rated Moderate.
  • Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs; seizure medications; immunosuppressants / transplant drugs; cancer treatments; diabetes medications; heart-rhythm medications; lithium.
  • For scale: 2,254 individual medications appear in the full list. A big number alone doesn't make a product dangerous — what matters is whether YOUR medication is on it, so run yours through the interaction checker on this page.

Before you take this product, run a medication check on: blood thinners and anticoagulants (warfarin especially), diabetes medications, lithium, blood pressure medications, antidepressants and other central nervous system depressants, immune-suppressing drugs like cyclophosphamide, theophylline, aspirin, cyclosporine, ciprofloxacin, and any drug your liver metabolizes through the CYP2D6, CYP2C9, CYP2C19, or CYP3A4 pathways. Your pharmacist can help identify these.

Check your own medication Run your meds through the checker above

The bottom line

Scorecard at a glanceFormula with limited ingredient disclosure with strong clinical evidence behind its ingredients' uses. Moderate medication interactions have been identified, and safety information is well characterized.

This product is a multi-ingredient herbal blend with significant interaction potential, especially if you take blood thinners, diabetes medications, lithium, or sedating drugs. Peppermint and capsicum have the strongest evidence for specific uses like IBS and nerve pain.

Because several ingredients are not recommended in pregnancy or while breastfeeding, discuss this product with your pharmacist or doctor before starting, particularly if you are pregnant, nursing, or taking any prescription medications.

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

Assessment coverage: 13 of 13 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Oct 24, 2022.

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

At a glance

General information

Key facts about CC-A with Yerba Santa Combination, straight from the product label.

Brand Nature's Sunshine
Barcode (UPC) 099904031654
Net contents 2 Fluid Ounce(s); 59 mL
Market status On market
Date entered into DSLD Oct 24, 2022
DSLD ID 278149
Product type Botanical
Supplement form Liquid
Dietary claims / uses All Other, Structure/Function
Intended target group(s) Adult (18 - 50 Years), Kosher
From the label
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.

Supplement Facts

The label details for CC-A with Yerba Santa Combination by Nature's Sunshine, sourced from the NIH Dietary Supplement Label Database.

Supplement Facts

Daily Value (DV) Target Group(s):
Adults and children 4 or more years of age
Minimum serving Sizes:
1 mL
Maximum serving Sizes:
1 mL
Servings per container
59
UPC/BARCODE
099904031654
IngredientAmount% DV
Proprietary Blend100 mg--
Astragalus root extract0 NP--
Mullein leaves extract0 NP--
Capsicum fruit extract0 NP--
Rose Hips fruit extract0 NP--
Chamomile flowers extract0 NP--
Yarrow flowers extract0 NP--
Yerba Santa leaves extract0 NP--
Goldenseal rhizome extract0 NP--
Myrrh Gum extract0 NP--
Peppermint leaves extract0 NP--
Sage leaves extract0 NP--
Slippery Elm bark extract0 NP--
Lemongrass aerial parts extract0 NP--

Other ingredients: Alcohol, Water

Tap any ingredient to jump to its full detail below.

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

Be a force of nature: Please recycle this bottle. 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

Do not use if inner seal is missing or damaged.

FDA Disclaimer Statement

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

Seals/Symbols

Ko Pareve (Kosher)

Formula

Ko Pareve (Kosher)

FDA Statement of Identity

Dietary Supplement

Formulation

Guaranteed pure

Traditional immune support Liquid herbal extracts

Brand IP Statement(s)

Natures Sunshine Herbal experts since 1972

Suggested/Recommended/Usage/Directions

Recommended Use: Adults: Take 1/4 teaspoon (1 mL) in 2 ounces (59 mL) of warm water with a meal twice daily.

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

See for yourself

CC-A with Yerba Santa Combination by Nature's Sunshine label

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

CC-A with Yerba Santa Combination label

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

View the full label (PDF)
What’s inside

The Ingredients in CC-A with Yerba Santa Combination by Nature's Sunshine

These are the 13 active ingredients this product is made of. Select any to open its full monograph.

Serving size1 mL Dosage formLiquid Servings per container59 Amounts shown are per serving.

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

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

Interaction report

CC-A with Yerba Santa Combination by Nature's Sunshine Drug Interactions

Want to check YOUR meds against CC-A with Yerba Santa Combination?

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

 Go to the checker
2,253Drugs
2,252 Moderate 1 Minor

Ingredients driving the most interactions

Slippery Elm bark extract 2,022
Sage leaves extract 1,296
Goldenseal rhizome extract 1,237
Chamomile flowers extract 960
Peppermint leaves extract 796

Individual Drug Interactions

The ingredients in CC-A with Yerba Santa Combination interact with 2,253 drugs. Click any drug to see the details.

13 of the 13 ingredients in CC-A with Yerba Santa Combination interact with drugs. Each result below shows which ingredient is responsible. Slippery Elm bark extract Sage leaves extract Goldenseal rhizome extract Chamomile flowers extract Peppermint leaves extract Lemongrass aerial parts extract Capsicum fruit extract Rose Hips fruit extract Astragalus root extract Mullein leaves extract Myrrh Gum extract Yarrow flowers extract Yerba Santa leaves extract

Each ingredient & the kinds of drugs it affects

For each ingredient in CC-A with Yerba Santa Combination 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.

Slippery Elm bark extract1 drug type · 2,022 drugs

Oral Drugs

Theoretically, slippery elm may slow the absorption and reduce serum levels of oral drugs.
Slippery elm inner bark contains mucilage, which may interfere with the absorption of orally administered drugs.

Likelihood Possible Evidence D
Slippery Elm bark extract full monograph & interactions

Sage leaves extract14 drug types · 1,296 drugs

Anticholinergic Drugs

Theoretically, sage might decrease the clinical effects of anticholinergic drugs.
In vitro evidence suggests that common sage (Salvia officinalis) and Spanish sage (Salvia lavandulaefolia) can inhibit acetylcholinesterase and might increase acetylcholine levels.

Likelihood Possible Evidence D
Anticonvulsants

Theoretically, sage might interfere with the clinical effects of anticonvulsant drugs.
Some species of sage can cause convulsions when consumed in large quantities.

Likelihood Possible Evidence D
Antidiabetes Drugs

Theoretically, taking sage with antidiabetes drugs might increase the risk of hypoglycemia.
In patients with polycystic ovary syndrome (PCOS) or inadequately controlled type 2 diabetes, common sage (Salvia officinalis) has demonstrated hypoglycemic activity. However, other clinical research in patients with inadequately controlled type 2 diabetes shows that common sage extract does not lower fasting blood glucose levels.

Likelihood Possible Evidence B
Antihypertensive Drugs

Theoretically, sage might increase or decrease the effects of antihypertensive drugs.
Animal research suggests that common sage (Salvia officinalis) can cause prolonged blood pressure reduction. However, clinical research suggests that Spanish sage (Salvia lavandulaefolia) can increase blood pressure in some people with hypertension. Until more is known, use with caution.

Likelihood Possible Evidence D
Benzodiazepines

Theoretically, taking sage might increase the sedative and adverse effects of benzodiazepines.
In vitro evidence suggests that certain components of common sage (Salvia officinalis) can bind to benzodiazepine receptors. This effect has not been reported in humans.

Likelihood Possible Evidence D
Cholinergic Drugs

Theoretically, sage might have additive effects when used with cholinergic drugs.
In vitro evidence suggests that common sage (Salvia officinalis) and Spanish sage (Salvia lavandulaefolia) can inhibit acetylcholinesterase and might increase acetylcholine levels.

Likelihood Possible Evidence D
Cns Depressants

Theoretically, taking sage might increase the sedative and adverse effects of CNS depressants.
Some constituents of sage have CNS depressant activity.

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

Theoretically, sage might increase the levels and clinical effects of drugs metabolized by CYP2C19.
In vitro evidence suggests that aqueous extracts of sage can inhibit CYP2C19. So far, this interaction has not been reported in humans.

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

Theoretically, sage might increase the levels and clinical effects of drugs metabolized by CYP2C9.
In vitro evidence suggests that aqueous extracts of sage can inhibit CYP2C9. So far, this interaction has not been reported in humans.

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

Theoretically, sage might increase the levels and clinical effects of drugs metabolized by CYP2D6.
In vitro evidence suggests that aqueous extracts of sage can inhibit CYP2D6. So far, this interaction has not been reported in humans.

Likelihood Possible Evidence D
Cytochrome P450 2E1 (Cyp2E1) Substrates

Theoretically, sage might decrease the levels and clinical effects of drugs metabolized by CYP2E1.
Animal research suggests that drinking common sage (Salvia officinalis) tea increases the expression of CYP2E1. So far, this interaction has not been reported in humans.

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

Theoretically, sage might increase the levels and clinical effects of drugs metabolized by CYP3A4.
In vitro evidence suggests that aqueous extracts of sage can inhibit CYP3A4. So far, this interaction has not been reported in humans.

Likelihood Possible Evidence D
Estrogens

Theoretically, sage might interfere with hormone therapy.
In vitro evidence suggests that geraniol, a constituent of Spanish sage (Salvia lavandulaefolia), exerts estrogenic activity. The clinical significance of this effect is unclear.

Likelihood Possible Evidence D
P-Glycoprotein Substrates

Theoretically, sage might increase levels of drugs transported by P-glycoprotein.
In vitro research suggests that common sage (Salvia officinalis) can inhibit the multi-drug transporter protein, P-glycoprotein. This effect has not been reported in humans.

Likelihood Possible Evidence D
Sage leaves extract full monograph & interactions

Goldenseal rhizome extract16 drug types · 1,237 drugs

Anticoagulant/Antiplatelet Drugs

Theoretically, goldenseal might increase the risk of bleeding when used with anticoagulant or antiplatelet drugs.
Goldenseal contains berberine. In vitro and animal research shows that berberine can inhibit platelet aggregation. However, this effect has not been reported in humans.

Likelihood Possible Evidence D
Antidiabetes Drugs

Theoretically, goldenseal might increase the risk of hypoglycemia when used with antidiabetes drugs.
Goldenseal contains berberine. Clinical research shows that berberine can lower blood glucose levels. However, this effect has not been reported with goldenseal.

Likelihood Possible Evidence D
Antihypertensive Drugs

Theoretically, goldenseal might increase the risk of hypotension when taken with antihypertensive drugs.
Goldenseal contains berberine. Animal research shows that berberine can have hypotensive effects. Also, an analysis of clinical research shows that taking berberine in combination with amlodipine can lower systolic and diastolic blood pressure when compared with amlodipine alone. However, this effect has not been reported with goldenseal.

Likelihood Possible Evidence D
Cns Depressants

Theoretically, goldenseal might increase the sedative effects of CNS depressants.
Goldenseal contains berberine. Animal research shows that berberine can have sedative effects. However, this effect has not been reported in humans.

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

Theoretically, goldenseal might increase serum levels of drugs metabolized by CYP2C9.
In vitro research shows that goldenseal root extract can modestly inhibit CYP2C9. This effect may be due to its alkaloid constituents, hydrastine and berberine. However, this effect has not been reported in humans.

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

Goldenseal might increase serum levels of drugs metabolized by CYP2D6.
Clinical and in vitro research shows that goldenseal can significantly inhibit CYP2D6 enzymes, potentially increasing levels of drugs metabolized by CYP2D6.

Likelihood Probable Evidence B
Cytochrome P450 2E1 (Cyp2E1) Substrates

Theoretically, goldenseal might increase serum levels of drugs metabolized by CYP2E1.
In vitro research shows that goldenseal root extract can inhibit the activity of CYP2E1. However, this effect has not been reported in humans.

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

Goldenseal might increase serum levels of drugs metabolized by CYP3A4.
Most clinical and in vitro research shows that goldenseal inhibits CYP3A4 enzyme activity and increases serum levels of CYP3A4 substrates, such as midazolam. However, in one small clinical study, goldenseal did not affect the levels of indinavir, a CYP3A4 substrate, in healthy volunteers. This is likely due to the fact that indinavir has a high oral bioavailability, making it an inadequate probe for CYP3A4 interactions and/or that it is primarily metabolized by hepatic CYP3A, while goldenseal has more potential to inhibit intestinal CYP3A enzyme activity. Both goldenseal extract and its isolated constituents berberine and hydrastine inhibit CYP3A, with hydrastine possibly having more inhibitory potential than berberine.

Likelihood Possible Evidence B
Dextromethorphan (Robitussin Dm, Others)

Theoretically, goldenseal might increase serum levels of dextromethorphan.
Goldenseal contains berberine. A small clinical study shows that berberine can inhibit cytochrome P450 2D6 (CYP2D6) activity and reduce the metabolism of dextromethorphan.

Likelihood Possible Evidence D
Digoxin (Lanoxin)

Goldenseal might increase serum levels of digoxin, although this effect is unlikely to be clinically significant.
Clinical research shows that goldenseal modestly increases digoxin peak levels by about 14% in healthy volunteers. However, goldenseal does not seem to affect other pharmacokinetic parameters such as area under the curve (AUC). This suggests that goldenseal does not cause a clinically significant interaction with digoxin. Digoxin is a P-glycoprotein substrate. Some evidence suggests that goldenseal constituents might affect P-glycoprotein; however, it is unclear whether these constituents inhibit or induce P-glycoprotein.

Likelihood Probable Evidence B
Losartan (Cozaar)

Theoretically, goldenseal might decrease the conversion of losartan to its active form.
Goldenseal contains berberine. A small clinical study shows that berberine inhibits cytochrome P450 2C9 (CYP2C9) activity and reduces the metabolism of losartan. However, this effect has not been reported with goldenseal.

Likelihood Possible Evidence D
Metformin (Glucophage)

Theoretically, goldenseal might reduce blood levels of metformin.
In vitro research shows that goldenseal extract decreases the bioavailability of metformin, likely by interfering with transport, intestinal permeability, or other processes involved in metformin absorption. It is unclear which, if any, of metformin's transporters are inhibited by goldenseal. Goldenseal does not appear to alter the clearance or half-life of metformin.

Likelihood Possible Evidence D
P-Glycoprotein Substrates

Theoretically, goldenseal might increase or decrease serum levels of P-glycoprotein (P-gp) substrates.
There is conflicting evidence about the effect of goldenseal on P-gp. In vitro research suggests that berberine, a constituent of goldenseal, modestly inhibits P-gp efflux. Other evidence suggests that berberine induces P-gp. In healthy volunteers, goldenseal modestly increases peak levels of the P-gp substrate digoxin by about 14%. However, it does not seem to affect other pharmacokinetic parameters such as area under the curve (AUC). This suggests that goldenseal is not a potent inhibitor of P-gp-mediated drug efflux. Until more is known, goldenseal should be used cautiously with P-gp substrates.

Likelihood Probable Evidence B
Pentobarbital (Nembutal)

Theoretically, goldenseal might increase the sedative effects of pentobarbital.
Animal research shows that berberine, a constituent of goldenseal, can prolong pentobarbital-induced sleeping time. However, this effect has not been reported with goldenseal.

Likelihood Possible Evidence D
Tacrolimus (Prograf)

Theoretically, goldenseal might increase serum levels of tacrolimus.
Goldenseal contains berberine. In a 16-year-old patient with idiopathic nephrotic syndrome who was being treated with tacrolimus 6.5 mg twice daily, intake of berberine 200 mg three times daily increased the blood concentration of tacrolimus from 8 to 22 ng/mL. Following a reduction of tacrolimus dosing to 3 mg daily, blood levels of tacrolimus decreased to 12 ng/mL.

Likelihood Possible Evidence D
Oseltamivir (Tamiflu)

Theoretically, goldenseal might reduce the therapeutic effects of oseltamivir by decreasing its conversion to its active form.
In vitro evidence suggests that goldenseal reduces the formation of the active compound from the prodrug oseltamivir. The mechanism of action and clinical relevance is unclear.

Likelihood Possible Evidence D
Goldenseal rhizome extract full monograph & interactions

Chamomile flowers extract9 drug types · 960 drugs

Cns Depressants

Theoretically, German chamomile might have additive effects when used with CNS depressants.
German chamomile has mild sedative effects. Theoretically, concomitant use with drugs with sedative properties can cause additive effects and side effects.

Likelihood Possible Evidence D
Contraceptive Drugs

Theoretically, large amounts of German chamomile might reduce the effectiveness of oral contraceptives.
In vitro, German chamomile has demonstrated antiestrogenic activity. Theoretically, concomitant use of large amounts of German chamomile might interfere with contraceptive drugs through competition for estrogen receptors.

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

Theoretically, German chamomile might inhibit CYP2C9 and increase levels of drugs metabolized by these enzymes.
In vitro evidence shows that German chamomile might inhibit CYP2C9. So far, this interaction has not been reported in humans. However, there might be an increase in the levels of drugs metabolized by CYP2C9 in patients taking German chamomile.

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

Theoretically, German chamomile might inhibit CYP2D6 and increase levels of drugs metabolized by these enzymes.
In vitro evidence shows that German chamomile might inhibit CYP2D6. So far, this interaction has not been reported in humans. However, there might be an increase in the levels of drugs metabolized by CYP2D6 in patients taking German chamomile.

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

Theoretically, German chamomile might inhibit CYP3A4 and increase levels of drugs metabolized by these enzymes.
In vitro evidence shows that German chamomile might inhibit CYP3A4. So far, this interaction has not been reported in humans. However, there might be an increase in the levels of drugs metabolized by CYP3A4 in patients taking German chamomile.

Likelihood Possible Evidence D
Estrogens

Theoretically, large amounts of German chamomile might reduce the effectiveness of estrogens.
In vitro, German chamomile has demonstrated antiestrogenic activity. Theoretically, large amounts of German chamomile might interfere with hormone replacement therapy through competition for estrogen receptors.

Likelihood Possible Evidence D
Tamoxifen (Nolvadex)

Theoretically, large amounts of German chamomile might interfere with the activity of tamoxifen.
In vitro, German chamomile has demonstrated antiestrogenic activity.

Likelihood Possible Evidence D
Warfarin (Coumadin)

German chamomile might increase the effects of warfarin and increase the risk of bleeding.
In one case, a 70-year-old female taking warfarin developed retroperitoneal hematoma and bilateral recti muscle bleeding along with an INR of 7.9 following ingestion of German chamomile tea 4-5 cups daily and use of a topical chamomile-based lotion applied 4-5 times daily.

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

Theoretically, German chamomile might inhibit CYP1A2 and increase levels of drugs metabolized by these enzymes.
In vitro and animal research shows that German chamomile might inhibit CYP1A2. So far, this interaction has not been reported in humans. However, there might be an increase in the levels of drugs metabolized by CYP1A2 in patients taking German chamomile.

Likelihood Possible Evidence D
Chamomile flowers extract full monograph & interactions

Peppermint leaves extract5 drug types · 796 drugs

Cyclosporine (Neoral, Sandimmune)

Theoretically, peppermint oil might increase the levels and adverse effects of cyclosporine.
In animal research, peppermint oil inhibits cyclosporine metabolism and increases cyclosporine levels. Inhibition of cytochrome P450 3A4 (CYP3A4) may be partially responsible for this interaction. An interaction between peppermint oil and cyclosporine has not been reported in humans.

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

Theoretically, peppermint might increase the levels of CYP2C19 substrates.
In vitro research shows that peppermint oil inhibits CYP2C19. So far, this interaction has not been reported in humans.

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

Theoretically, peppermint might increase the levels of CYP2C9 substrates.
In vitro research shows that peppermint oil inhibits CYP2C9. So far, this interaction has not been reported in humans.

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

Theoretically, peppermint might increase the levels of CYP3A4 substrates.
Clinical research in healthy volunteers shows that a single dose of peppermint oil 600 mg inhibits CYP3A4 enzymes and increases the AUC of felodipine, a CYP3A4 substrate. However, in vitro research suggests that peppermint oil only inhibits CYP3A4 at very high concentrations.

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

Theoretically, peppermint might increase the levels of CYP1A2 substrates.
In vitro and animal research shows that peppermint oil and peppermint leaf inhibit CYP1A2. However, in clinical research, peppermint tea did not significantly affect the metabolism of caffeine, a CYP1A2 substrate. It is possible that the 6-day duration of treatment may have been too short to identify a difference.

Likelihood Possible Evidence B
Peppermint leaves extract full monograph & interactions

Lemongrass aerial parts extract3 drug types · 708 drugs

Cytochrome P450 3A4 (Cyp3A4) Substrates

Theoretically, lemongrass might decrease the metabolism of CYP3A4 substrates.
Animal research shows that lemongrass and its constituent citral inhibit CYP3A4.

Likelihood Possible Evidence D
Glucuronidated Drugs

Theoretically, lemongrass might increase the clearance and decrease the levels of glucuronidated drugs.
Animal research shows that lemongrass and its constituent citral induce uridine diphosphoglucuronosyl transferase (UGT), the major phase 2 enzyme that is responsible for glucuronidation.

Likelihood Possible Evidence D
Pentobarbital (Nembutal)

Theoretically, lemongrass might increase the effects and adverse effects of pentobarbital.
Animal research shows that high doses of lemongrass essential oil increases sleep time and decreases time to fall asleep in animals administered pentobarbital.

Likelihood Possible Evidence D
Lemongrass aerial parts extract full monograph & interactions

Capsicum fruit extract6 drug types · 239 drugs

Anticoagulant/Antiplatelet Drugs

Theoretically, capsicum may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
In vitro research shows that capsicum might increase the effects of antiplatelet drugs. Also, population research shows that capsicum is associated with an increased risk of self-reported bleeding in patients taking warfarin. However, clinical research shows that taking a single dose of capsaicin (Asian Herbex Ltd.), the active ingredient in capsicum, 400-800 mcg orally in combination with aspirin 500 mg does not decrease platelet aggregation when compared with taking aspirin 500 mg alone. Also, there was no notable effect on measures of platelet aggregation with capsaicin. It is unclear whether capsaicin must be used in more than a single dose to affect platelet aggregation.

Likelihood Possible Evidence B
Antidiabetes Drugs

Theoretically, taking capsicum with antidiabetes drugs might increase the risk of hypoglycemia.
Preliminary clinical research shows that consuming capsicum 5 grams along with a glucose drink attenuates the rise in plasma glucose after 30 minutes by 21%, decreases the 2-hour postprandial area under the curve of plasma glucose by 11%, and increases the 2-hour postprandial area under the curve of plasma insulin by 58% in healthy individuals when compared with placebo. Other clinical research shows that taking capsicum 5 mg daily for 28 days significantly reduces postprandial blood glucose and insulin levels, but not fasting blood glucose and insulin levels, in patients with gestational diabetes.

Likelihood Possible Evidence B
Aspirin

Theoretically, taking capsicum with aspirin might reduce the bioavailability of aspirin.
Animal research shows that acute or chronic intake of capsicum pepper reduces oral aspirin bioavailability. This has not been shown in humans.

Likelihood Possible Evidence D
Theophylline

Theoretically, taking capsicum with theophylline might increase the levels and adverse effects of theophylline.
In animal research, oral administration of capsicum reduced excretion of theophylline. However, capsicum does not seem to affect the pharmacokinetics of theophylline when administered intravenously.

Likelihood Possible Evidence D
Ace Inhibitors (Aceis)

Theoretically, using topical capsaicin may increase the risk of ACE inhibitor-induced cough.
There is one case report of a topically applied capsaicin cream contributing to the cough reflex in a patient using an ACEI. However, it is unclear if this interaction is clinically significant.

Likelihood Unlikely Evidence D
Ciprofloxacin (Cipro)

Theoretically, taking capsicum with ciprofloxacin might increase levels and adverse effects of ciprofloxacin.
Animal research shows that concomitant use of capsaicin, the active constituent of capsicum, and ciprofloxacin increases the bioavailability of ciprofloxacin by up to 70%.

Likelihood Possible Evidence D
Capsicum fruit extract full monograph & interactions

Rose Hips fruit extract8 drug types · 213 drugs

Alkylating Agents

Theoretically, the antioxidant effects of rose hip might reduce the effectiveness of alkylating agents but might also reduce the oxidative damage caused by certain alkylating agents.
Rose hip contains vitamin C. The use of antioxidants like vitamin C during chemotherapy is controversial. There is concern that antioxidants could reduce the activity of chemotherapy drugs that generate free radicals, such as cyclophosphamide, chlorambucil, carmustine, busulfan, and thiotepa. In contrast, some researchers theorize that antioxidants might make chemotherapy more effective by reducing oxidative stress that could interfere with apoptosis (cell death) of cancer cells. Further, some animal research suggests that the antioxidant effects of rose hip might attenuate cyclophosphamide-induced testicular toxicity. More evidence is needed to determine what effect, if any, antioxidants found in rose hip, such as vitamin C, have on the effectiveness and adverse effects of chemotherapy.

Likelihood Possible Evidence D
Aluminum

Theoretically, rose hip might increase the amount of aluminum absorbed from aluminum compounds.
Rose hip contains vitamin C. Theoretically, vitamin C increases the absorption of aluminum. Concomitant use might increase aluminum absorption, but the clinical significance of this is unknown. Administer rose hip two hours before or four hours after antacids.

Likelihood Probable Evidence D
Anticoagulant/Antiplatelet Drugs

Theoretically, rose hip might reduce the effectiveness of anticoagulant or antiplatelet drugs.
In vitro and animal research suggests that a constituent of rose hip, rugosin E, can induce platelet aggregation. This has not been shown in humans. Theoretically, concomitant use of rose hip might reduce the effectiveness of antiplatelet or anticoagulant drugs.

Likelihood Possible Evidence D
Antitumor Antibiotics

Theoretically, the antioxidant effects of rose hip might reduce the effectiveness of antitumor antibiotics.
Rose hip contains the antioxidant vitamin C. There is concern that antioxidants might reduce the activity of chemotherapy drugs that generate free radicals, such as antitumor antibiotics. In contrast, other researchers theorize that antioxidants might make antitumor antibiotic chemotherapy more effective by reducing oxidative stress that could interfere with apoptosis (cell death) of cancer cells. More evidence is needed to determine what effects, if any, antioxidants such as vitamin C have on antitumor antibiotic chemotherapy.

Likelihood Possible Evidence D
Estrogens

Theoretically, rose hip might increase blood levels of estrogens.
Rose hip contains vitamin C. Increases in plasma estrogen levels of up to 55% have occured under some circumstances when vitamin C is taken concurrently with oral contraceptives or hormone replacement therapy, including topical products. It is suggested that vitamin C prevents oxidation of estrogen in the tissues, regenerates oxidized estrogen, and reduces sulfate conjugation of estrogen in the gut wall. When tissue levels of vitamin C are high, these processes are already maximized and supplemental vitamin C does not have any effect on estrogen levels. However, increases in plasma estrogen levels may occur when women who are deficient in vitamin C take supplements.

Likelihood Possible Evidence D
Lithium

Theoretically, rose hip might increase blood levels of lithium.
Rose hip is thought to have diuretic properties. Theoretically, due to these potential diuretic effects, rose hip might reduce excretion and increase levels of lithium. The dose of lithium might need to be decreased.

Likelihood Probable Evidence D
Aspirin

Theoretically, rose hip might reduce the clearance of aspirin; however, its vitamin C content is likely too low to produce clinically significant effects.
Rose hip contains vitamin C. It has been suggested that acidification of the urine by vitamin C can decrease the urinary excretion of salicylates, increasing plasma salicylate levels. However, short-term use of up to 6 grams daily of vitamin C does not seem to affect urinary pH or salicylate excretion. The vitamin C content of rose hip is typically about 500 mg per 100 grams. Thus, a clinically significant interaction between rose hip and aspirin is unlikely.

Likelihood Unlikely Evidence B
Warfarin (Coumadin)

Theoretically, rose hip might reduce the effectiveness of warfarin; however, its vitamin C content is likely too low to produce clinically significant effects.
Rose hip contains vitamin C. High doses of vitamin C may reduce the response to warfarin, possibly by causing diarrhea and reducing warfarin absorption. This occurred in two people who took up to 16 grams daily of vitamin C, and resulted in decreased prothrombin time. Lower doses of 5-10 grams daily of vitamin C can also reduce warfarin absorption, but this does not seem to be clinically significant. The vitamin C content of rose hip is typically about 500 mg per 100 grams. Thus, a clinically significant interaction between rose hip and warfarin is unlikely.

Likelihood Unlikely Evidence D
Rose Hips fruit extract full monograph & interactions

Astragalus root extract4 drug types · 208 drugs

Antidiabetes Drugs

Theoretically, taking astragalus with antidiabetes drugs might increase the risk of hypoglycemia.
Clinical research in humans shows that astragalus might have hypoglycemic effects. Theoretically, taking astragalus, especially in combination with other hypoglycemic agents, might increase the risk of hypoglycemia.

Likelihood Probable Evidence A
Cyclophosphamide

Theoretically, astragalus might interfere with cyclophosphamide therapy.
Evidence regarding the effect of astragalus on immunosuppression caused by cyclophosphamide is conflicting. Some animal research suggests that astragalus reverses cyclophosphamide-induced immunosuppression. However, other animal research shows no effect.

Likelihood Possible Evidence D
Immunosuppressants

Theoretically, astragalus might interfere with immunosuppressive therapy.
Astragalus seems to stimulate immune function. Theoretically, taking astragalus might decrease the effects of immunosuppressive therapy.

Likelihood Possible Evidence D
Lithium

Theoretically, astragalus might increase levels and adverse effects of lithium.
Animal research suggests that astragalus has diuretic properties. Theoretically, due to this diuretic effect, astragalus might reduce excretion and increase levels of lithium.

Likelihood Probable Evidence D
Astragalus root extract full monograph & interactions

Mullein leaves extract1 drug type · 122 drugs

Anticoagulant/Antiplatelet Drugs

Lab tests on extracts from different parts of common and dense-flowered mullein plants show that they do have some blood-thinning effects, as they increase the time it takes for blood to clot. This is likely due to at least one of the known constituents of muellein, triterpenoid saponins. However, the effects appear to be mild and results have been inconsistent. Extracts from different plant parts have been show to have varying anticoagulant strengths, with water-based ones being more potent than alcohol-based extracts.

Likelihood Unlikely Evidence A
Mullein leaves extract full monograph & interactions

Myrrh Gum extract2 drug types · 88 drugs

Antidiabetes Drugs

Theoretically, myrrh might increase the risk of hypoglycemia when taken with antidiabetes drugs.
In vitro and animal research suggests that myrrh has hypoglycemic effects.

Likelihood Possible Evidence D
Warfarin (Coumadin)

Theoretically, myrrh might decrease the effectiveness of warfarin.
In one case, a patient who was previously stable on warfarin had a significant decline in international normalized ratio (INR) following consumption of an aqueous extract of myrrh.

Likelihood Possible Evidence D
Myrrh Gum extract full monograph & interactions

Yarrow flowers extract1 drug type · 1 drug

Lithium

Theoretically, taking yarrow with lithium might increase the levels and adverse effects of lithium.
Animal research shows that yarrow has diuretic activity. Theoretically, due to these potential diuretic effects, yarrow might reduce excretion and increase levels of lithium. The dose of lithium might need to be decreased.

Likelihood Probable Evidence D
Yarrow flowers extract full monograph & interactions

Yerba Santa leaves extract1 drug type · 1 drug

Lithium

Yerba santa is thought to have diuretic properties. Theoretically, due to these potential diuretic effects, yerba santa might reduce excretion and increase levels of lithium. The dose of lithium might need to be decreased.

Likelihood Probable Evidence D
Yerba Santa leaves extract full monograph & interactions
The maker

Brand information

Manufacturer and brand details for CC-A with Yerba Santa Combination, from the product label.

Nature's Sunshine

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

CC-A with Yerba Santa Combination by Nature's Sunshine: Common Questions

Does CC-A with Yerba Santa Combination by Nature's Sunshine interact with any medications?
Yes. Based on its ingredients, CC-A with Yerba Santa Combination has a known interaction with 2,253 medications. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
CC-A with Yerba Santa Combination contains 13 active ingredients, and an interaction can come from any of them. We check every ingredient, combine the results into one list per medication, and show which ingredient and mechanism is responsible.
Where does this information come from?
The product label data comes from the NIH Dietary Supplement Label Database (DSLD); the interaction data is built on the Natural Medicines database and reviewed by HelloPharmacist pharmacists.
Is this product safe to take during pregnancy?
No—several ingredients are not recommended in pregnancy. Yarrow, goldenseal, myrrh, and lemongrass are rated likely unsafe or should be avoided. Sage is likely unsafe at medicinal doses. German chamomile should be avoided unless your doctor approves. Only peppermint is rated likely safe. Talk with your pharmacist or doctor before using this product if you are pregnant.
Is this safe while breastfeeding?
Most ingredients lack adequate safety data for breastfeeding. Yarrow, goldenseal, myrrh, lemongrass, and sage should be avoided. German chamomile and mullein require caution and a conversation with your doctor. Only peppermint is rated likely safe. Check with your pharmacist or doctor before using.
Can peppermint in this product help with stomach upset?
Peppermint leaf extract is rated Likely Effective for irritable bowel syndrome and Possibly Effective for indigestion, so it may help with some forms of stomach upset. However, peppermint can also cause abdominal pain, heartburn, and nausea in some people, and it should not be used in undiluted form.
Does capsicum help with pain?
Yes—capsicum is Likely Effective for nerve pain after shingles and diabetic nerve pain, and Possibly Effective for back pain. It works in topical and oral forms, though it commonly causes a burning sensation and digestive irritation.
What does astragalus do in this blend?
Astragalus root extract is traditionally used to support immune function—evidence for hay fever, asthma, and other conditions is insufficient to rate. However, astragalus can interfere with immune-suppressing medications and diabetes drugs, so it's important to mention this product to your pharmacist if you take either type.
Can I take this product with my blood thinner?
You need to check with your pharmacist first. Several ingredients—mullein, capsicum, rose hips, goldenseal, German chamomile, and myrrh—interact with blood thinners, and some have been linked to increased bleeding risk. This is important enough that you should verify your specific medication before starting.

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.

CC-A with Yerba Santa Combination label
Go deeper

The Full Monographs Behind CC-A with Yerba Santa Combination’s Ingredients

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

Herb & supplement monograph

Astragalus

Interacts with 208 drugs

Astragalus is a root used for centuries in traditional Chinese medicine, mainly to support the immune system and help the body cope with stress. While early studies are interesting, strong h...

Read the full Astragalus monograph → Herb & supplement monograph

Mullein

Interacts with 122 drugs

Mullein is a traditional herbal remedy most often used as a tea or syrup to soothe coughs, sore throats, and respiratory irritation. High-quality human studies are lacking, so its benefits a...

Read the full Mullein monograph → Herb & supplement monograph

Capsicum

Interacts with 239 drugs

Capsicum (chili pepper) contains capsaicin, which is best known and best studied as a topical treatment for certain types of pain. Topical capsaicin products are supported by reasonable evid...

Read the full Capsicum monograph → Herb & supplement monograph

Rose Hip

Interacts with 213 drugs

Rose hip is the vitamin C–rich fruit of the wild rose, used traditionally for colds and joint pain. A standardized rose hip powder has some research support for easing osteoarthritis symptom...

Read the full Rose Hip monograph → Herb & supplement monograph

German Chamomile

Interacts with 960 drugs

German chamomile is a widely used herbal remedy taken mainly as a tea for calming, sleep, and digestive complaints. Early research suggests possible benefits for mild anxiety and some skin o...

Read the full German Chamomile monograph → Herb & supplement monograph

Yarrow

Interacts with 1 drug

Yarrow is a traditional herb long used for wounds, digestive complaints, and colds, but high-quality human studies are very limited, so its benefits are not well proven. It is generally used...

Read the full Yarrow monograph → Herb & supplement monograph

Yerba Santa

Interacts with 1 drug

Yerba Santa is an aromatic shrub from the western United States and Mexico that has long been used in folk medicine for coughs, congestion, and other respiratory complaints. Modern scientifi...

Read the full Yerba Santa monograph → Herb & supplement monograph

Goldenseal

Interacts with 1,237 drugs

Goldenseal is a popular North American herb that contains berberine, a compound studied for antimicrobial effects. However, strong human evidence for its many traditional uses is largely lac...

Read the full Goldenseal monograph → Herb & supplement monograph

Myrrh

Interacts with 88 drugs

Myrrh is a fragrant gum resin from Commiphora trees that has long been used in mouthwashes, throat remedies, and skin care. Modern evidence for most of its uses is limited and comes mostly f...

Read the full Myrrh monograph → Herb & supplement monograph

Peppermint

Interacts with 796 drugs

Peppermint is a popular herb with the best evidence supporting enteric-coated peppermint oil for easing IBS symptoms. It is generally well tolerated for most adults, but it can cause heartbu...

Read the full Peppermint monograph → Herb & supplement monograph

Sage

Interacts with 1,296 drugs

Sage is a common kitchen herb that is generally safe in food amounts and is traditionally used for sore throats, digestion, sweating, and memory. Some early research is encouraging for sore...

Read the full Sage monograph → Herb & supplement monograph

Slippery Elm

Interacts with 2,022 drugs

Slippery elm is a traditional herbal remedy made from the inner bark of a North American elm tree, used mainly to soothe sore throats and irritated digestive tracts. Its mucilage can coat an...

Read the full Slippery Elm monograph → Herb & supplement monograph

Lemongrass

Interacts with 708 drugs

Lemongrass is a fragrant tropical grass widely used as a cooking herb, a tea, and an aromatherapy oil. It is generally considered safe in the small amounts used in food, but most of its clai...

Read the full Lemongrass monograph →
Sources

Sources & How We Checked

CC-A with Yerba Santa Combination's label data comes from the NIH Dietary Supplement Label Database; the ingredient interaction data is from the Natural Medicines database, reviewed by our pharmacists.

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

The 266 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.

Astragalus 13 references
  1. Upton R, ed. Astragalus Root: Analytical, quality control, and therapeutic monograph. Santa Cruz, CA: American Herbal Pharmacopoeia. 1999:1-25.
  2. Khoo KS, Ang PT. Extract of astragalus membranaceus and ligustrum lucidum does not prevent cyclophosphamide-induced myelosuppression. Singapore Med J 1995;36:387-90.
  3. Chu DT, Wong WL, Mavligit GM. Immunotherapy with Chinese medicinal herbs. II. Reversal of cyclophosphamide-induced immune suppression by administration of fractionated Astragalus membranaceus in vivo. J Clin Lab Immunol 1988;25:125-9.
  4. Sun Y, Hersh EM, Lee SL, et al. Preliminary observations on the effects of the Chinese medicinal herbs Astragalus membranaceus and Ligustrum lucidum on lymphocyte blastogenic responses. J Biol Response Mod 1983;2:227-37..
  5. Ma J, Peng A, Lin S. Mechanisms of the therapeutic effect of astragalus membranaceus on sodium and water retention in experimental heart failure. Chin Med J (Engl) 1998;111:17-23.
  6. Matkovic Z, Zivkovic V, Korica M, et al. Efficacy and safety of Astragalus membranaceus in the treatment of patients with seasonal allergic rhinitis. Phytother Res 2010;24:175-81.
  7. Zhang, J. G., Yang, N., He, H., Wei, G. H., Gao, D. S., Wang, X. L., Wang, X. Z., and Song, G. Y. [Effect of Astragalus injection on plasma levels of apoptosis-related factors in aged patients with chronic heart failure.]. Chin J Integr.Med 2005;11(3):18 PubMed
  8. Chen, H. W., Lin, I. H., Chen, Y. J., Chang, K. H., Wu, M. H., Su, W. H., Huang, G. C., and Lai, Y. L. A novel infusible botanically-derived drug, PG2, for cancer-related fatigue: a phase II double-blind, randomized placebo-controlled study. Clin Invest PubMed
  9. Tian H, Lu J, He H, et al.The effect of Astragalus as an adjuvant treatment in type 2 diabetes mellitus: A (preliminary) meta-analysis. J Ethnopharmacol. 2016;191:206-215. doi: 10.1016/j.jep.2016.05.062. PubMed
  10. Hong KF, Liu PY, Zhang W, Gui DK, Xu YH. The Efficacy and Safety of Astragalus as an Adjuvant Treatment for Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis. J Integr Complement Med 2023. PubMed
  11. Chan KW, Kwong ASK, Tsui PN, et al. Add-on astragalus in type 2 diabetes and chronic kidney disease: A multi-center, assessor-blind, randomized controlled trial. Phytomedicine 2024;130:155457. PubMed
  12. Han X, Yu T, Chen X, Du Z, Yu M, Xiong J. Effect of Astragalus membranaceus on left ventricular remodeling in HFrEF: a systematic review and meta-analysis. Front Pharmacol 2024;15:1345797. PubMed
  13. Jing P, Hongzheng H, Zhenqi WU, Meijuan Z, Zuojing LI, Gang C. Long-term efficacy and safety of Huangqi ()-based Traditional Chinese Medicine in diabetic peripheral neuropathy: a Meta-analysis of randomized controlled trials. J Tradit Chin Med 2024;44(2):

See these in context on the Astragalus monograph →

Mullein 2 references
  1. Castro AI, Carmona JB, Gonzales FG, Nestar OB. Occupational airborne dermatitis from gordolobo (Verbascum densiflorum). Contact Dermatitis 2006;55(5):301.
  2. Flores Echaiz C, Al Ali A, Cao AQ, Sasseville D. Simultaneous contact dermatitis caused by Asteraceae and Verbascum thapsus. Contact Dermatitis 2017;76(5):316-8.

See these in context on the Mullein monograph →

Capsicum 89 references
  1. Covington TR, et al. Handbook of Nonprescription Drugs. 11th ed. Washington, DC: American Pharmaceutical Association, 1996.
  2. Cooper RL, Cooper MM. Red pepper-induced dermatitis in breast-fed infants. Dermatol 1996;93:61-2. PubMed
  3. Millqvist E. Cough provocation with capsaicin is an objective way to test sensory hyperreactivity in patients with asthma-like symptoms. Allergy 2000;55:546-50. DOI
  4. Locock RA. Capsicum. Can Pharm J 1985;118:517-9.
  5. Mason L, Moore RA, Derry S, et al. Systematic review of topical capsaicin for the treatment of chronic pain. BMJ 2004;328:991. PubMed
  6. Schmulson MJ, Valdovinos MA, Milke P. Chili pepper and rectal hyperalgesia in irritable bowel syndrome. Am J Gastroenterol 2003;98:1214-5. PubMed
  7. Surh YJ, Lee SS. Capsaicin in hot chili pepper: carcinogen, co-carcinogen or anticarcinogen? Food Chem Toxicol 1996;34:313-6. PubMed
  8. Bouraoui A, Brazier JL, Zouaghi H, Rousseau M. Theophylline pharmacokinetics and metabolism in rabbits following single and repeated administration of Capsicum fruit. Eur J Drug Metab Pharmacokinet 1995;20:173-8.
  9. Hogaboam CM, Wallace JL. Inhibition of platelet aggregation by capsaicin. An effect unrelated to actions on sensory afferent neurons. Eur J Pharmacol 1991;202:129-31. PubMed
  10. Wang JP, Hsu MF, Teng CM. Antiplatelet effect of capsaicin. Thromb Res 1984;36:497-507. PubMed
  11. Williams SR, Clark RF, Dunford JV. Contact dermatitis associated with capsaicin: Hunan hand syndrome. Ann Emerg Med 1995;25:713-5. PubMed
  12. Zollman TM, Bragg RM, Harrison DA. Clinical effects of oleoresin capsicum (pepper spray) on the human cornea and conjunctiva. Ophthalmology 2000;107:2186-9. PubMed
  13. Bortolotti M, Coccia G, Grossi G, Miglioli M. The treatment of functional dyspepsia with red pepper. Aliment Pharmacol Ther 2002;16:1075-82. PubMed
  14. Hakas JF Jr. Topical capsaicin induces cough in patient receiving ACE inhibitor. Ann Allergy 1990;65:322-3.
  15. Rapoport AM, Bigal ME, Tepper SJ, Sheftell FD. Intranasal medications for the treatment of migraine and cluster headache. CNS Drugs 2004;18:671-85. PubMed
  16. Stjarne P, Rinder J, Heden-Blomquist E, et al. Capsaicin desensitization of the nasal mucosa reduces symptoms upon allergen challenge in patients with allergic rhinitis. Acta Otolaryngol 1998;118:235-9. PubMed
  17. Levy RL. Intranasal capsaicin for acute abortive treatment of migraine without aura. Headache 1995;35:277.
  18. Fusco BM, Marabini S, Maggi CA, et al. Preventative effect of repeated nasal applications of capsaicin in cluster headache. Pain 1994;59:321-5. PubMed
  19. Sicuteri F, Fusco BM, Marabini S, et al. Beneficial effect of capsaicin application to the nasal mucosa in cluster headache. Clin J Pain 1989;5:49-53. PubMed
  20. Marabini S, Ciabatti PG, Polli G, et al. Beneficial effects of intranasal applications of capsaicin in patients with vasomotor rhinitis. Eur Arch Otorhinolaryngol 1991;248:191-4. PubMed
  21. Frerick H, Keitel W, Kuhn U, et al. Topical treatment of chronic low back pain with a capsicum plaster. Pain 2003;106:59-64. PubMed
  22. Keitel W, Frerick H, Kuhn U, et al. Capsicum pain plaster in chronic non-specific low back pain. Arzneimittelforschung 2001;51:896-903. PubMed
  23. Shalansky S, Lynd L, Richardson K, et al. Risk of warfarin-related bleeding events and supratherapeutic international normalized ratios associated with complementary and alternative medicine: a longitudinal analysis. Pharmacotherapy. 2007;27:1237-47. PubMed
  24. Sumano-López H, Gutiérrez-Olvera L, Aguilera-Jiménez R, et al. Administration of ciprofloxacin and capsaicin in rats to achieve higher maximal serum concentrations. Arzneimittelforschung. 2007;57(5):286-90. PubMed
  25. Wanwimolruk S, Nyika S, Kepple M, et al. Effects of capsaicin on the pharmacokinetics of antipyrine, theophylline and quinine in rats. J Pharm Pharmacol. 1993;45(7):618-21. PubMed
  26. Cruz L, Castañeda-Hernández G, Navarrete A. Ingestion of chilli pepper (Capsicum annuum) reduces salicylate bioavailability after oral asprin administration in the rat. Can J Physiol Pharmacol.
  27. Rodriguez-Stanley, S., Collings, K. L., Robinson, M., Owen, W., and Miner, P. B., Jr. The effects of capsaicin on reflux, gastric emptying and dyspepsia. Aliment.Pharmacol.Ther. 2000;14(1):129-134. PubMed
  28. Brown, L., Takeuchi, D., and Challoner, K. Corneal abrasions associated with pepper spray exposure. Am.J.Emerg.Med. 2000;18(3):271-272. PubMed
  29. Vesaluoma, M., Muller, L., Gallar, J., Lambiase, A., Moilanen, J., Hack, T., Belmonte, C., and Tervo, T. Effects of oleoresin capsicum pepper spray on human corneal morphology and sensitivity. Invest Ophthalmol.Vis.Sci. 2000;41(8):2138-2147.
  30. Stam, C., Bonnet, M. S., and van Haselen, R. A. The efficacy and safety of a homeopathic gel in the treatment of acute low back pain: a multi-centre, randomised, double-blind comparative clinical trial. Br Homeopath J 2001;90(1):21-28. PubMed
  31. Olajos, E. J. and Salem, H. Riot control agents: pharmacology, toxicology, biochemistry and chemistry. J.Appl.Toxicol. 2001;21(5):355-391. PubMed
  32. Fett, D. D. Botanical briefs: Capsicum peppers. Cutis 2003;72(1):21-23.
  33. McCarthy, G. M. and McCarty, D. J. Effect of topical capsaicin in the therapy of painful osteoarthritis of the hands. J.Rheumatol. 1992;19(4):604-607.
  34. Chaiyata, P., Puttadechakum, S., and Komindr, S. Effect of chili pepper (Capsicum frutescens) ingestion on plasma glucose response and metabolic rate in Thai women. J.Med.Assoc.Thai. 2003;86(9):854-860.
  35. Petruzzi, M., Lauritano, D., De Benedittis, M., Baldoni, M., and Serpico, R. Systemic capsaicin for burning mouth syndrome: short-term results of a pilot study. J.Oral Pathol.Med. 2004;33(2):111-114. PubMed
  36. Misra, M. N., Pullani, A. J., and Mohamed, Z. U. Prevention of PONV by acustimulation with capsicum plaster is comparable to ondansetron after middle ear surgery: [La prevention des NVPO par acustimulation avec un emplatre de Capsicum est comparable a ce PubMed
  37. Milke, P., Diaz, A., Valdovinos, M. A., and Moran, S. Gastroesophageal reflux in healthy subjects induced by two different species of chilli (Capsicum annum). Dig.Dis. 2006;24(1-2):184-188.
  38. de Jong, N. W., van der Steen, J. J., Smeekens, C. C., Blacquiere, T., Mulder, P. G., van Wijk, R. G., and de Groot, H. Honeybee interference as a novel aid to reduce pollen exposure and nasal symptoms among greenhouse workers allergic to sweet bell pepp
  39. Final report on the safety assessment of capsicum annuum extract, capsicum annuum fruit extract, capsicum annuum resin, capsicum annuum fruit powder, capsicum frutescens fruit, capsicum frutescens fruit extract, capsicum frutescens resin, and capsaicin.
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  6. Al-Jaroudi D, Kaddour O, Al-Amin N. Risks of myrrh use in pregnancy. JBRA Assist Reprod 2016;20(4):257-8.
  7. Xu YY, Li L, Xuan L, Guan K. Patch test diagnosis of non-immediate cutaneous reaction to myrrh following oral intake of a traditional Chinese medicine decoction. Contact Dermatitis. 2019;80(2):135-136. PubMed
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See these in context on the Myrrh monograph →

Peppermint 41 references
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See these in context on the Peppermint monograph →

Sage 27 references
  1. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
  2. Todorov S, Philianos S, Petkov V, et al. Experimental pharmacological study of three species from genus Salvia. Acta Physiol Pharmacol (Bulg) 1984;10:13-20.
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  6. Perry NB, Anderson RE, Brennan NJ, et al. Essential oils from dalmatian sage (Salvia officinalis l.): variations among individuals, plant parts, seasons, and sites. J Agric Food Chem 1999;47:2048-54..
  7. Foster BC, Vandenhoek S, Hana J, et al. In vitro inhibition of human cytochrome P450-mediated metabolism of marker substrates by natural products. Phytomedicine 2003;10:334-42.. PubMed
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  11. Orhan, I., Kartal, M., Kan, Y., and Sener, B. Activity of essential oils and individual components against acetyl- and butyrylcholinesterase. Z.Naturforsch.C. 2008;63(7-8):547-553.
  12. Perry, N. S., Houghton, P. J., Theobald, A., Jenner, P., and Perry, E. K. In-vitro inhibition of human erythrocyte acetylcholinesterase by salvia lavandulaefolia essential oil and constituent terpenes. J Pharm Pharmacol 2000;52(7):895-902.
  13. Perry, N. S., Houghton, P. J., Sampson, J., Theobald, A. E., Hart, S., Lis-Balchin, M., Hoult, J. R., Evans, P., Jenner, P., Milligan, S., and Perry, E. K. In-vitro activity of S. lavandulaefolia (Spanish sage) relevant to treatment of Alzheimer's diseas
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  15. Kavvadias, D., Monschein, V., Sand, P., Riederer, P., and Schreier, P. Constituents of sage (Salvia officinalis) with in vitro affinity to human brain benzodiazepine receptor. Planta Med. 2003;69(2):113-117.
  16. Savelev, S. U., Okello, E. J., and Perry, E. K. Butyryl- and acetyl-cholinesterase inhibitory activities in essential oils of Salvia species and their constituents. Phytother Res 2004;18(4):315-324.
  17. Kennedy, D. O., Pace, S., Haskell, C., Okello, E. J., Milne, A., and Scholey, A. B. Effects of cholinesterase inhibiting sage (Salvia officinalis) on mood, anxiety and performance on a psychological stressor battery. Neuropsychopharmacology 2006;31(4):84 PubMed
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  24. Vandecasteele K, Ost P, Oosterlinck W, et al. Evaluation of the efficacy and safety of Salvia officinalis in controlling hot flashes in prostate cancer patients treated with androgen deprivation. Phytother Res. 2012;26(2):208-13.
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See these in context on the Sage monograph →

Slippery Elm 3 references
  1. The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999.
  2. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
  3. Czarnecki D, Nixon R, Bekhor P, and et al. Delayed prolonged contact urticaria from the elm tree. Contact Dermatitis 1993;28:196-197. PubMed

See these in context on the Slippery Elm monograph →

Lemongrass 2 references
  1. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
  2. Li CC, Yu HF, Chang CH, Liu YT, Yao HT. Effects of lemongrass oil and citral on hepatic drug-metabolizing enzymes, oxidative stress, and acetaminophen toxicity in rats. J Food Drug Anal 2018;26(1):432-8. PubMed

See these in context on the Lemongrass monograph →

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

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