Cholest Solutions Ingredients & Drug Interactions
What is this page for?
First and foremost: checking Cholest Solutions 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
Cholest Solutions is a dietary supplement by Vitamin World with 8 active ingredients. Its ingredients are commonly taken for high triglycerides, heart health, joint pain and inflammation.Based on those ingredients, 1,178 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Odorless Garlic, Niacin, Fish Oil. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against Cholest Solutions by Vitamin World
Ask about any prescription or over-the-counter medication and we check it for interactions with Cholest Solutions by Vitamin World — 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 Cholest Solutions by Vitamin World
Our pharmacy team’s full take, with four database checks built into the cards below — a summary of what is known, not a grade of the product itself.
What’s inside
Partial disclosure
Cholest Solutions contains nine ingredients, several of which are active compounds and others part of blended groups. The main actives include niacin (a B vitamin), pantethine (a derivative of pantothenic acid), garlic, inositol, and policosanol.
Fish oil and its component omega-3 fatty acids (eicosapentaenoic acid and docosahexaenoic acid) are also featured. A phytosterol complex with sterol esters rounds out the blend.
The product also contains inactive ingredients like gelatin, vegetable glycerin, and soybean oil as capsule material and fillers.
Does it work?
Moderate evidence
Niacin is likely effective for pellagra (a severe niacin-deficiency disease) and possibly effective for managing cholesterol abnormalities related to HIV/AIDS and metabolic syndrome. Policosanol is likely effective for intermittent claudication (leg pain with activity) but has insufficient evidence for other heart conditions.
Garlic is possibly effective for high blood pressure, diabetes, and fatty liver disease. Pantethine and inositol have mixed or limited evidence for cholesterol and metabolic issues.
The evidence for several ingredients in this formula — particularly their combined effect on cholesterol — isn't fully established in the data we hold.
How safe is it?
Well-documented data
Niacin is well tolerated at normal dietary amounts but can cause flushing, stomach upset, and liver problems at high supplemental doses. The most common effects are flushing (up to 70% of people in studies), nausea, vomiting, and diarrhea; serious but rare effects include liver toxicity and muscle damage.
Pantethine is generally well tolerated with mostly mild stomach complaints like nausea, diarrhea, and bloating. Garlic is well tolerated as food but may cause stomach upset, flatulence, and body odor at supplement doses; it can also increase bleeding risk.
Policosanol is usually well tolerated but may cause headache, dizziness, insomnia, or upset stomach in some people. For pregnancy, niacin in normal dietary amounts (as in prenatal vitamins) is likely safe, but high-dose supplements should be avoided.
Pantethine has insufficient safety data in pregnancy and should be avoided unless prescribed. Policosanol lacks adequate safety information — avoid it in pregnancy and breastfeeding.
Garlic as food is likely safe in pregnancy, though one monograph entry notes possibly unsafe — talk with your doctor about supplement doses.
Meds to double-check
Moderate interaction found
Check before taking if you're on blood pressure medications (niacin, garlic, and policosanol may lower pressure further), blood thinners or antiplatelet drugs (all of niacin, pantethine, garlic, and policosanol may increase bleeding risk), diabetes medications (niacin, garlic, inositol, and policosanol may lower blood sugar further), or statins (niacin carries a theoretical risk of muscle damage). Also check if you take uric acid medications (allopurinol, probenecid), bile acid sequestrants, HIV protease inhibitors, or tacrolimus.
The bottom line
Scorecard at a glancePartially disclosed formula with some supporting evidence for its stated purpose. Moderate medication interactions have been identified, and safety information is well characterized.
This product combines cholesterol-supporting ingredients backed by varying levels of evidence. If you're on blood pressure, diabetes, blood-thinning, or statin medications, you'll want to check your specific drugs before starting.
Talk with your pharmacist or doctor, especially if you're pregnant, breastfeeding, or taking multiple medications.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 5 of 9 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Apr 25, 2013.
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 Cholest Solutions, straight from the product label.
| Brand | Vitamin World |
|---|---|
| Barcode (UPC) | 766443170778 |
| Net contents | 120 Rapid Release Softgel(s) |
| Market status | On market |
| Date entered into DSLD | Apr 25, 2013 |
| DSLD ID | 20811 |
| Product type | Other Combinations |
| Supplement form | Softgel Capsule |
| Dietary claims / uses | Nutrient, All Other, Approved Health, Structure/Function |
| Intended target group(s) | Adult (18 - 50 Years), Gluten Free, Dairy Free, 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 Cholest Solutions by Vitamin World, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Calories | 20 {Calories} | -- |
| Total Carbohydrates | 1 g | 1% |
| Calories from Fat | 10 {Calories} | -- |
| Total Fat | 1.5 g | 2% |
| Eicosapentaenoic Acid | 0 NP | -- |
| Docosahexaenoic Acid | 0 NP | -- |
| Protein | 1 g | 2% |
| Cholesterol | 5 mg | 2% |
| Fish Oil | 750 mg | -- |
| Total Omega-3 Fatty Acids | 225 mg | -- |
| Niacin | 600 mg | 3000% |
| Pantethine | 37.5 mg | -- |
| Other Fatty Acids | 0 NP | -- |
| Phytosterol Complex | 975 mg | -- |
| Sterol Esters | 0 NP | -- |
| Odorless Garlic | 375 mg | -- |
| Inositol | 150 mg | -- |
| Policosanol | 7.5 mg | -- |
Other ingredients: Gelatin, Vegetable Glycerin, Soybean Oil, Contains <2% of
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.
Precautions
WARNING: Not intended for use by pregnant or nursing women. If you are taking any medications or planning any medical procedure, consult your doctor before use.
Discontinue use and consult your doctor if any adverse reactions occur.
Do not use if seal under cap is broken or missing.
NOTICE:Most people should not experience flushing when using this product. However, a few sensitive individuals may experience some flushing. Do not take on an empty stomach.
Keep out of reach of children.
Contains soy and fish (anchovy, mackerel, sardine) ingredients.
FDA Disclaimer Statement
*These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.
General Statements
For over 40 years, Vitamin World has pioneered the manufacture of premium nutritional supplements. Our commitment to quality is the highest in our industry. Every product undergoes rigorous analysis for purity, potency, safety and freshness. We guarantee it.
- Cholesterol Support* With Beneficial Phytosterols - May Reduce the Risk of Heart Disease** (see side panel) - Promotes Circulatory Health*
**Diets low in saturated fat and cholesterol that include 2 g per day of plant sterols eaten with meals or snacks may reduce the risk of heart disease.
Seals/Symbols
QA QUALITY ASSURED
Formulation
No Artificial Flavor or Sweetener, No Sugar, No Starch, No Milk, No Lactose, No Gluten, No Wheat, No Yeast, No Shellfish. Sodium Free.
Storage
Store at room temperature.
Brand IP Statement(s)
(C)2011 Vitamin World, Inc.
Get healthy.
General
PROD. #17077 B17077 05B
FDA Statement of Identity
DIETARY SUPPLEMENT
Suggested/Recommended/Usage/Directions
DIRECTIONS: For adults, take three (3) softgels daily with a meal.
Formula
A serving of Cholest Solutions supplies 0.6 g of plant sterols.
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Cholest Solutions by Vitamin World 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 Cholest Solutions by Vitamin World
These are the 8 active ingredients this product is made of. Select any to open its full monograph.
Serving size3 Softgel(s) Dosage formSoftgel Capsule Servings per container40 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.
Protein
Fish Oil
Interacts with327 drugs
Fish oil provides omega-3 fatty acids (EPA and DHA) that are best known for lowering high triglyceride levels. The evidence for other heart and health...
Fish Oil monograph & interactions- › Total Omega-3 Fatty Acids
Niacin
Interacts with727 drugs
Niacin (vitamin B3) is an essential nutrient your body needs for energy and metabolism, and deficiency is uncommon in most developed countries. Prescr...
Niacin monograph & interactionsPantethine
Interacts with122 drugs
Pantethine is a derivative of vitamin B5 (pantothenic acid) that some studies suggest may modestly lower cholesterol and triglycerides. The evidence i...
Pantethine monograph & interactionsPhytosterol Complex
- › Sterol Esters
Odorless Garlic
Interacts with989 drugs
Garlic is a common food and supplement that may modestly help with blood pressure and cholesterol, though the evidence is mixed and effects are usuall...
Odorless Garlic monograph & interactionsInositol
Interacts with86 drugs
Inositol is a sugar alcohol made naturally in the body and found in many foods, and it is sold as a supplement (often myo-inositol) mainly for PCOS, m...
Inositol monograph & interactionsPolicosanol
Interacts with242 drugs
Policosanol is a mix of waxy alcohols (mostly octacosanol) made from sugar cane or other plant waxes, and it is often marketed as a natural way to low...
Policosanol monograph & interactionsOther (inactive) ingredients: Gelatin, Vegetable Glycerin, Soybean Oil, Contains <2% of. These complete the product’s ingredient list but are not active constituents.
Cholest Solutions by Vitamin World Drug Interactions
HelloPharmacist Interaction Report
Cholest Solutions by Vitamin World contains several ingredients with documented interactions with medications.
The most serious concern involves niacin, which carries Moderate-severity interactions with multiple drug types, including antihypertensive drugs (blood pressure medications) where niacin's blood-vessel-dilating effects may lower blood pressure further.
Read the full breakdown — every affected drug type, severity by severity
Niacin also interacts moderately with statins (cholesterol drugs) — there's theoretical concern about muscle damage, though a significantly increased risk hasn't been proven in clinical trials. It can raise blood sugar levels, potentially reducing the effectiveness of diabetes medications.
Niacin may also interact with anticoagulants and antiplatelet drugs (blood thinners), uric acid medications (allopurinol and probenecid), bile acid sequestrants, and hepatotoxic drugs. Garlic in this product carries Moderate interactions with blood thinners, blood pressure medications, diabetes drugs, and certain HIV protease inhibitors.
Pantethine and policosanol also interact moderately with anticoagulant and antiplatelet drugs and diabetes medications.
Inositol interacts moderately with diabetes drugs by potentially lowering blood sugar further. Eicosapentaenoic acid, docosahexaenoic acid, other fatty acids, and sterol esters could not be checked against our interaction data — we hold no monographs for them.
Altogether, these interactions span 1,172 individual medications. If you're on any prescription medication, use the interaction checker on this page with your exact drug names before starting this product.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against Cholest Solutions?
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 Cholest Solutions interact with 1,178 drugs. Click any drug to see the details.
6 of the 8 ingredients in Cholest Solutions interact with drugs. Each result below shows which ingredient is responsible. Odorless Garlic Niacin Fish Oil Policosanol Pantethine Inositol
6-mercaptopurinePurinethol
How 6-mercaptopurine interacts with Cholest Solutions — through 1 ingredient. Tap an ingredient for the detail:
NiacinHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + 6-mercaptopurine interactionAdo-trastuzumab EmtansineKadcyla
How Ado-trastuzumab Emtansine interacts with Cholest Solutions — through 1 ingredient. Tap an ingredient for the detail:
Odorless GarlicCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, garlic products containing allicin might induce intestinal CYP3A4 and inhibit hepatic CYP3A4.
Read the full Odorless Garlic + Ado-trastuzumab Emtansine interactionAbacavir Sulfate, Dolutegravir, LamivudineTriumeq
How Abacavir Sulfate, Dolutegravir, Lamivudine interacts with Cholest Solutions — through 1 ingredient. Tap an ingredient for the detail:
NiacinHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Abacavir Sulfate, Dolutegravir, Lamivudine interactionAbacavir, LamivudineEpzicom
How Abacavir, Lamivudine interacts with Cholest Solutions — through 1 ingredient. Tap an ingredient for the detail:
NiacinHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Abacavir, Lamivudine interactionAbciximabReoPro
How Abciximab interacts with Cholest Solutions — through 5 ingredients. Tap an ingredient for the detail:
Odorless GarlicAnticoagulant/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 Odorless Garlic + Abciximab interactionNiacinAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, niacin may have additive effects when used with anticoagulant or antiplatelet drugs.
Read the full Niacin + Abciximab interactionPantethineAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, pantethine might increase the risk of bleeding with anticoagulant or antiplatelet drugs.
Read the full Pantethine + Abciximab interactionPolicosanolAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, taking policosanol with other antiplatelet or anticoagulant drugs might increase the risk of bruising and bleeding.
Read the full Policosanol + Abciximab interactionFish OilAnticoagulant/antiplatelet Drugs Minor
Interaction Summary
Fish oil may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Fish Oil + Abciximab interactionAbemaciclibVerzenio
How Abemaciclib interacts with Cholest Solutions — through 1 ingredient. Tap an ingredient for the detail:
Odorless GarlicCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, garlic products containing allicin might induce intestinal CYP3A4 and inhibit hepatic CYP3A4.
Read the full Odorless Garlic + Abemaciclib interactionAbiraterone
How Abiraterone interacts with Cholest Solutions — through 2 ingredients. Tap an ingredient for the detail:
Odorless GarlicCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, garlic products containing allicin might induce intestinal CYP3A4 and inhibit hepatic CYP3A4.
Read the full Odorless Garlic + Abiraterone interactionNiacinHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Abiraterone interactionAbiraterone AcetateYonsa, Zytiga
How Abiraterone Acetate interacts with Cholest Solutions — through 2 ingredients. Tap an ingredient for the detail:
NiacinHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Abiraterone Acetate interactionOdorless GarlicCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, garlic products containing allicin might induce intestinal CYP3A4 and inhibit hepatic CYP3A4.
Read the full Odorless Garlic + Abiraterone Acetate interactionAbrocitinibCibinqo
How Abrocitinib interacts with Cholest Solutions — through 5 ingredients. Tap an ingredient for the detail:
Odorless GarlicAnticoagulant/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 Odorless Garlic + Abrocitinib interactionPolicosanolAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, taking policosanol with other antiplatelet or anticoagulant drugs might increase the risk of bruising and bleeding.
Read the full Policosanol + Abrocitinib interactionNiacinAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, niacin may have additive effects when used with anticoagulant or antiplatelet drugs.
Read the full Niacin + Abrocitinib interactionPantethineAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, pantethine might increase the risk of bleeding with anticoagulant or antiplatelet drugs.
Read the full Pantethine + Abrocitinib interactionFish OilAnticoagulant/antiplatelet Drugs Minor
Interaction Summary
Fish oil may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Fish Oil + Abrocitinib interactionAcalabrutinibCalquence
How Acalabrutinib interacts with Cholest Solutions — through 1 ingredient. Tap an ingredient for the detail:
Odorless GarlicCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, garlic products containing allicin might induce intestinal CYP3A4 and inhibit hepatic CYP3A4.
Read the full Odorless Garlic + Acalabrutinib interactionAcarboseGlucobay, Prandase, Precose
How Acarbose interacts with Cholest Solutions — through 4 ingredients. Tap an ingredient for the detail:
NiacinHepatotoxic Drugs, Antidiabetes Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Acarbose interactionOdorless GarlicAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, taking garlic with antidiabetes drugs might increase the risk of hypoglycemia.
Read the full Odorless Garlic + Acarbose interactionInositolAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, taking inositol with antidiabetes drugs might increase the risk of hypoglycemia.
Read the full Inositol + Acarbose interactionPolicosanolAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, policosanol might have additive effects with antidiabetes drugs and increase the risk of hypoglycemia.
Read the full Policosanol + Acarbose interactionAcebutololRhotral, Sectral
How Acebutolol interacts with Cholest Solutions — through 4 ingredients. Tap an ingredient for the detail:
PolicosanolBeta-blockers Moderate
Interaction Summary
Concomitant use of policosanol with beta-blockers can cause additive blood pressure-lowering effects.
Read the full Policosanol + Acebutolol interactionNiacinHepatotoxic Drugs, Antihypertensive Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Acebutolol interactionFish OilAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, taking fish oil with antihypertensive drugs might increase the risk of hypotension.
Read the full Fish Oil + Acebutolol interactionOdorless GarlicAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, taking garlic with antihypertensive drugs might increase the risk of hypotension.
Read the full Odorless Garlic + Acebutolol interactionAcenocoumarolSintrom
How Acenocoumarol interacts with Cholest Solutions — through 5 ingredients. Tap an ingredient for the detail:
PolicosanolAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, taking policosanol with other antiplatelet or anticoagulant drugs might increase the risk of bruising and bleeding.
Read the full Policosanol + Acenocoumarol interactionOdorless GarlicAnticoagulant/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 Odorless Garlic + Acenocoumarol interactionNiacinAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, niacin may have additive effects when used with anticoagulant or antiplatelet drugs.
Read the full Niacin + Acenocoumarol interactionPantethineAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, pantethine might increase the risk of bleeding with anticoagulant or antiplatelet drugs.
Read the full Pantethine + Acenocoumarol interactionFish OilAnticoagulant/antiplatelet Drugs Minor
Interaction Summary
Fish oil may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Fish Oil + Acenocoumarol interactionAcetaminophenChildren's Tylenol, Children's Tylenol Meltaways, Tylenol, Tylenol Ex Strength
How Acetaminophen interacts with Cholest Solutions — through 2 ingredients. Tap an ingredient for the detail:
Odorless GarlicCytochrome P450 2e1 (cyp2e1) Substrates Moderate
Interaction Summary
Garlic might increase levels of drugs metabolized by CYP2E1.
Read the full Odorless Garlic + Acetaminophen interactionNiacinHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Acetaminophen interactionAcetaminophen, AspirinGemnisyn
How Acetaminophen, Aspirin interacts with Cholest Solutions — through 5 ingredients. Tap an ingredient for the detail:
NiacinHepatotoxic Drugs, Anticoagulant/antiplatelet Drugs +1 Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Acetaminophen, Aspirin interactionOdorless GarlicCytochrome P450 2e1 (cyp2e1) Substrates, Anticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Garlic might increase levels of drugs metabolized by CYP2E1.
Read the full Odorless Garlic + Acetaminophen, Aspirin interactionPantethineAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, pantethine might increase the risk of bleeding with anticoagulant or antiplatelet drugs.
Read the full Pantethine + Acetaminophen, Aspirin interactionPolicosanolAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, taking policosanol with other antiplatelet or anticoagulant drugs might increase the risk of bruising and bleeding.
Read the full Policosanol + Acetaminophen, Aspirin interactionFish OilAnticoagulant/antiplatelet Drugs Minor
Interaction Summary
Fish oil may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Fish Oil + Acetaminophen, Aspirin interactionAcetaminophen, Aspirin, CaffeineExcedrin, Excedrin Extra Strength, Excedrin Migraine
How Acetaminophen, Aspirin, Caffeine interacts with Cholest Solutions — through 5 ingredients. Tap an ingredient for the detail:
Odorless GarlicAnticoagulant/antiplatelet Drugs, Cytochrome P450 2e1 (cyp2e1) 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 Odorless Garlic + Acetaminophen, Aspirin, Caffeine interactionPantethineAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, pantethine might increase the risk of bleeding with anticoagulant or antiplatelet drugs.
Read the full Pantethine + Acetaminophen, Aspirin, Caffeine interactionNiacinHepatotoxic Drugs, Anticoagulant/antiplatelet Drugs +1 Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Acetaminophen, Aspirin, Caffeine interactionPolicosanolAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, taking policosanol with other antiplatelet or anticoagulant drugs might increase the risk of bruising and bleeding.
Read the full Policosanol + Acetaminophen, Aspirin, Caffeine interactionFish OilAnticoagulant/antiplatelet Drugs Minor
Interaction Summary
Fish oil may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Fish Oil + Acetaminophen, Aspirin, Caffeine interactionAcetaminophen, Brompheniramine, PhenylpropanolamineDimetapp Cold and Flu
How Acetaminophen, Brompheniramine, Phenylpropanolamine interacts with Cholest Solutions — through 2 ingredients. Tap an ingredient for the detail:
NiacinHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Acetaminophen, Brompheniramine, Phenylpropanolamine interactionOdorless GarlicCytochrome P450 2e1 (cyp2e1) Substrates Moderate
Interaction Summary
Garlic might increase levels of drugs metabolized by CYP2E1.
Read the full Odorless Garlic + Acetaminophen, Brompheniramine, Phenylpropanolamine interactionAcetaminophen, ButalbitalAxocet, Bancap, Bucet, Butex Forte, Esgic CF, Orbivan CF +5 more
How Acetaminophen, Butalbital interacts with Cholest Solutions — through 2 ingredients. Tap an ingredient for the detail:
Odorless GarlicCytochrome P450 2e1 (cyp2e1) Substrates Moderate
Interaction Summary
Garlic might increase levels of drugs metabolized by CYP2E1.
Read the full Odorless Garlic + Acetaminophen, Butalbital interactionNiacinHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Acetaminophen, Butalbital interactionAcetaminophen, Butalbital, CaffeineEsgic, Esgic Plus, Fiogesic, Fioricet, Repan, Tecnal +1 more
How Acetaminophen, Butalbital, Caffeine interacts with Cholest Solutions — through 2 ingredients. Tap an ingredient for the detail:
NiacinHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Acetaminophen, Butalbital, Caffeine interactionOdorless GarlicCytochrome P450 2e1 (cyp2e1) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Garlic might increase levels of drugs metabolized by CYP2E1.
Read the full Odorless Garlic + Acetaminophen, Butalbital, Caffeine interactionAcetaminophen, Butalbital, Caffeine, CodeineEsgic with Codeine, Fioricet w/ Codeine
How Acetaminophen, Butalbital, Caffeine, Codeine interacts with Cholest Solutions — through 2 ingredients. Tap an ingredient for the detail:
Odorless GarlicCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 2e1 (cyp2e1) Substrates Moderate
Interaction Summary
Theoretically, garlic products containing allicin might induce intestinal CYP3A4 and inhibit hepatic CYP3A4.
Read the full Odorless Garlic + Acetaminophen, Butalbital, Caffeine, Codeine interactionNiacinHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Acetaminophen, Butalbital, Caffeine, Codeine interactionAcetaminophen, Butalbital, CodeineBancap w/ Codeine
How Acetaminophen, Butalbital, Codeine interacts with Cholest Solutions — through 2 ingredients. Tap an ingredient for the detail:
NiacinHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Acetaminophen, Butalbital, Codeine interactionOdorless GarlicCytochrome P450 2e1 (cyp2e1) Substrates Moderate
Interaction Summary
Garlic might increase levels of drugs metabolized by CYP2E1.
Read the full Odorless Garlic + Acetaminophen, Butalbital, Codeine interactionAcetaminophen, Butalbital, Codeine PhosphatePhrenilin #3
How Acetaminophen, Butalbital, Codeine Phosphate interacts with Cholest Solutions — through 2 ingredients. Tap an ingredient for the detail:
Odorless GarlicCytochrome P450 2e1 (cyp2e1) Substrates Moderate
Interaction Summary
Garlic might increase levels of drugs metabolized by CYP2E1.
Read the full Odorless Garlic + Acetaminophen, Butalbital, Codeine Phosphate interactionNiacinHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Acetaminophen, Butalbital, Codeine Phosphate interactionAcetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, PhenylephrineHycomine Compound
How Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interacts with Cholest Solutions — through 2 ingredients. Tap an ingredient for the detail:
NiacinHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interactionOdorless GarlicCytochrome P450 2e1 (cyp2e1) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Garlic might increase levels of drugs metabolized by CYP2E1.
Read the full Odorless Garlic + Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interactionAcetaminophen, Caffeine, CodeineGesic C15, Gesic C30, Gesic C8, Lenoltec 1, Lenoltec 2, Lenoltec 3 +1 more
How Acetaminophen, Caffeine, Codeine interacts with Cholest Solutions — through 2 ingredients. Tap an ingredient for the detail:
Odorless GarlicCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 2e1 (cyp2e1) Substrates Moderate
Interaction Summary
Theoretically, garlic products containing allicin might induce intestinal CYP3A4 and inhibit hepatic CYP3A4.
Read the full Odorless Garlic + Acetaminophen, Caffeine, Codeine interactionNiacinHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Acetaminophen, Caffeine, Codeine interactionAcetaminophen, Caffeine, Codeine, SalicylamideCodalan No.1, Codalan No.2, Codalan No.3
How Acetaminophen, Caffeine, Codeine, Salicylamide interacts with Cholest Solutions — through 2 ingredients. Tap an ingredient for the detail:
NiacinHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Acetaminophen, Caffeine, Codeine, Salicylamide interactionOdorless GarlicCytochrome P450 2e1 (cyp2e1) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Garlic might increase levels of drugs metabolized by CYP2E1.
Read the full Odorless Garlic + Acetaminophen, Caffeine, Codeine, Salicylamide interactionAcetaminophen, Caffeine, DihydrocodeineDHC Plus, Panlor DC, Panlor SS
How Acetaminophen, Caffeine, Dihydrocodeine interacts with Cholest Solutions — through 2 ingredients. Tap an ingredient for the detail:
Odorless GarlicCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 2e1 (cyp2e1) Substrates Moderate
Interaction Summary
Theoretically, garlic products containing allicin might induce intestinal CYP3A4 and inhibit hepatic CYP3A4.
Read the full Odorless Garlic + Acetaminophen, Caffeine, Dihydrocodeine interactionNiacinHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Acetaminophen, Caffeine, Dihydrocodeine interactionAcetaminophen, Caffeine, IsomethepteneMigralam
How Acetaminophen, Caffeine, Isometheptene interacts with Cholest Solutions — through 2 ingredients. Tap an ingredient for the detail:
NiacinHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Acetaminophen, Caffeine, Isometheptene interactionOdorless GarlicCytochrome P450 2e1 (cyp2e1) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Garlic might increase levels of drugs metabolized by CYP2E1.
Read the full Odorless Garlic + Acetaminophen, Caffeine, Isometheptene interactionAcetaminophen, Caffeine, PyrilamineMidol Max Strength Menstrual
How Acetaminophen, Caffeine, Pyrilamine interacts with Cholest Solutions — through 2 ingredients. Tap an ingredient for the detail:
Odorless GarlicCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 2e1 (cyp2e1) Substrates Moderate
Interaction Summary
Theoretically, garlic products containing allicin might induce intestinal CYP3A4 and inhibit hepatic CYP3A4.
Read the full Odorless Garlic + Acetaminophen, Caffeine, Pyrilamine interactionNiacinHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Acetaminophen, Caffeine, Pyrilamine interactionAcetaminophen, Chlorpheniramine Maleate, Dextromethorphan HbrVicks Formula 44M Cough, Cold & Flu Relief
How Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interacts with Cholest Solutions — through 2 ingredients. Tap an ingredient for the detail:
Odorless GarlicCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 2e1 (cyp2e1) Substrates Moderate
Interaction Summary
Theoretically, garlic products containing allicin might induce intestinal CYP3A4 and inhibit hepatic CYP3A4.
Read the full Odorless Garlic + Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interactionNiacinHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interactionAcetaminophen, Chlorpheniramine, Codeine, PhenylephrineColrex
How Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interacts with Cholest Solutions — through 2 ingredients. Tap an ingredient for the detail:
Odorless GarlicCytochrome P450 2e1 (cyp2e1) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Garlic might increase levels of drugs metabolized by CYP2E1.
Read the full Odorless Garlic + Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interactionNiacinHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interactionEach ingredient & the kinds of drugs it affects
For each ingredient in Cholest Solutions 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.
Odorless Garlic
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.
Niacin
Alcohol (Ethanol)
Concomitant use of alcohol and niacin might increase the risk of flushing and hepatotoxicity.
Alcohol can exacerbate the flushing and pruritus associated with niacin. Large doses of niacin might also exacerbate liver dysfunction associated with chronic alcohol use. A case report describes delirium and lactic acidosis in a patient taking niacin 3 grams daily who ingested 1 liter of wine. Advise patients to avoid large amounts of alcohol while taking niacin.
Allopurinol (Zyloprim)
Theoretically, niacin might antagonize the therapeutic effects of uricosurics such as allopurinol.
Large doses of niacin can reduce urinary excretion of uric acid, potentially resulting in hyperuricemia. Doses of uricosurics such as allopurinol might need to be increased to maintain control of gout in patients who start taking niacin. People who have frequent attacks of gout despite uricosuric therapy should avoid niacin.
Anticoagulant/Antiplatelet Drugs
Theoretically, niacin may have additive effects when used with anticoagulant or antiplatelet drugs.
Several cases of clotting factor synthesis deficiency and coagulopathy have been reported in patients taking sustained-release niacin. Also, thrombocytopenia has been reported in patients treated with niacin or niacin plus lovastatin.
Antidiabetes Drugs
Niacin can increase blood glucose levels and may diminish the effects of antidiabetes drugs.
Niacin impairs glucose tolerance in a dose-dependent manner, probably by causing or aggravating insulin resistance and increasing hepatic production of glucose. In diabetes patients, niacin 4.5 grams daily for 5 weeks can increase plasma glucose by an average of 16% and glycated hemoglobin (HbA1c) by 21%. However, lower doses of 1.5 grams daily or less appear to have minimal effects on blood glucose. In some patients, glucose levels increase when niacin is started, but then return to baseline when a stable dose is reached. Up to 35% of patients with diabetes may need adjustments in hypoglycemic therapy when niacin is added.
Antihypertensive Drugs
Theoretically, niacin may increase the risk of hypotension when used with antihypertensive drugs.
The vasodilating effects of niacin can cause hypotension. Furthermore, some clinical evidence suggests that a one-hour infusion of niacin can reduce systolic, diastolic, and mean blood pressure in hypertensive patients. This effect is not observed in normotensive patients.
Bile Acid Sequestrants
Bile acid sequestrants can bind niacin and decrease absorption. Separate administration by 4-6 hours to avoid an interaction.
In vitro studies show that colestipol (Colestid) binds about 98% of available niacin and cholestyramine (Questran) binds 10% to 30%.
Gemfibrozil (Lopid)
Theoretically, concomitant use of niacin and gemfibrozil might increase the risk of myopathy in some patients.
A case of myopathy from concomitant use of niacin and gemfibrozil has been reported. Niacin alone has also been associated with cases of myopathy. Using gemfibrozil with niacin might further increase the risk of developing myopathy.
Hepatotoxic Drugs
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Niacin has been associated with cases of liver toxicity, especially when used in pharmacologic doses. Sustained-release niacin preparations appear to be associated with a higher risk of hepatotoxicity than immediate-release niacin.
Hmg-Coa Reductase Inhibitors ("Statins")
Theoretically, concomitant use of niacin and statins might increase the risk of myopathy and rhabdomyolysis in some patients.
Some case reports have raised concerns that niacin might increase the risk of myopathy and rhabdomyolysis when combined with statins. However, a significantly increased risk of myopathy has not been demonstrated in clinical trials, including those using an FDA-approved combination of lovastatin and niacin (Advicor).
Probenecid (Benemid)
Theoretically, niacin might antagonize the therapeutic effects of uricosurics such as probenecid.
Large doses of niacin reduce urinary excretion of uric acid, potentially causing hyperuricemia. Doses of uricosurics such as probenecid might need to be increased to maintain control of gout in patients who start taking niacin. People who have frequent attacks of gout despite uricosuric therapy should avoid niacin.
Sulfinpyrazone (Anturane)
Theoretically, niacin might antagonize the therapeutic effects of uricosurics such as sulfinpyrazone.
Large doses of niacin reduce urinary excretion of uric acid, potentially causing hyperuricemia. Doses of uricosurics such as sulfinpyrazone might need to be increased to maintain control of gout in patients who start taking niacin. People who have frequent attacks of gout despite uricosuric therapy should avoid niacin.
Thyroid Hormone
Theoretically, niacin might antagonize the therapeutic effects of thyroid hormones.
Clinical research and case reports suggests that taking niacin can reduce serum levels of thyroxine-binding globulin by up to 25% and moderately reduce levels of thyroxine (T4). Patients taking thyroid hormone for hypothyroidism might need dose adjustments when using niacin.
Transdermal Nicotine (Nicoderm)
Theoretically, concomitant use of niacin and transdermal nicotine might increase the risk of flushing and dizziness.
Niacin and nicotine can both cause flushing and dizziness.
Warfarin (Coumadin)
There is limited evidence that niacin may increase the anticoagulant effects of warfarin.
In a case report, a patient on warfarin developed an elevated international normalized ratio (INR) of 3.9 after taking niacin for two weeks. The patient's INR was previously stable, ranging between 2 and 3 in recent months, and no other medication changes were identified. The elevated INR returned to therapeutic range within 4 days following the discontinuation of niacin.
Aspirin
Large doses of aspirin might alter the clearance of niacin.
Aspirin is often used with niacin to reduce niacin-induced flushing. Doses of 80-975 mg aspirin have been used, but 325 mg appears to be optimal. Aspirin also seems to reduce the clearance of niacin by competing for glycine conjugation. Taking aspirin 1 gram seems to reduce niacin clearance by 45%. This is probably a dose-related effect and not clinically significant with the more common aspirin dose of 325 mg.
Fish Oil
Antihypertensive Drugs
Theoretically, taking fish oil with antihypertensive drugs might increase the risk of hypotension.
Clinical evidence indicates that fish oils can modestly lower blood pressure and might have additive effects in patients treated with antihypertensives.
Contraceptive Drugs
Theoretically, taking fish oil with contraceptive drugs might decrease the triglyceride-lowering effects of fish oil.
There is some evidence that contraceptive drugs might interfere with the triglyceride lowering effects of fish oils.
Cyclosporine (Neoral, Sandimmune)
Taking fish oil with cyclosporine might increase levels and adverse effects of cyclosporine.
In kidney transplant recipients on a general immunosuppressive regimen, taking omega-3 fatty acids daily seems to increase peak blood levels of cyclosporine when compared with placebo. This increase was as much as 20% after one month. However, the area under the curve was not significantly affected.
Orlistat (Xenical, Alli)
Theoretically, taking fish oil with orlistat might decrease the absorption of fish oil fatty acids.
Orlistat binds lipase in the gastrointestinal tract and reduces fat absorption. Theoretically, taking fish oil with orlistat might decrease absorption of fish oil fatty acids. To avoid this potential interaction, recommend separating administration of orlistat and fish oil by at least 2 hours.
Sirolimus (Rapamune)
Taking fish oil with sirolimus might increase levels and adverse effects of sirolimus.
Pharmacokinetic research shows that omega-3 fatty acids increase exposure to sirolimus in kidney transplant patients on a calcineurin inhibitor-free immunosuppressive regimen. A 25% dose reduction in sirolimus was required to keep patients within the expected trough-concentration window. Researchers hypothesize that this may be due to inhibition of cytochrome P450 3A4 (CYP3A4) by fish oil, although this has not been confirmed in clinical research.
Tacrolimus (Prograf)
Taking fish oil with tacrolimus might increase levels and adverse effects of tacrolimus.
In a small group of patients, taking fish oil 2.6 grams (Omacor) daily for 4 weeks increased the 8-hour area under the curve of tacrolimus by 25% when compared with baseline. Peak levels were increased by approximately 22%. Researchers hypothesize that this may be due either to an increase in bioavailability or to inhibition of cytochrome P450 3A4 (CYP3A4) by fish oil, although this has not been confirmed in clinical research.
Anticoagulant/Antiplatelet Drugs
Fish oil may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs. However, evidence is conflicting.
While fish oil may not be a potent inhibitor of platelet function, high doses of fish oil might have antiplatelet effects. Theoretically, concomitant use of fish oil with anticoagulant or antiplatelet drugs may increase the risk of bleeding. However, the most rigorous research shows that short-term doses of fish oil 10 grams daily or long-term doses of 1.5 grams daily for up to 52 weeks does not increase the risk of bleeding or affect coagulation parameters in chronically ill and vulnerable patients. Other controlled research shows that fish oil does not affect platelet function or increase the risk of bleeding. Some research even suggests that perioperative fish oil use decreases bleeding risk. Some research suggests fish oil does not have additive antiplatelet effects when combined with aspirin, but other clinical evidence suggests that adding fish oil to low-dose aspirin treatment increases antiplatelet effects in patients who are aspirin-resistant. Also, some clinical research seems to show that fish oil has additive antiplatelet effects when used with aspirin and clopidogrel compared to aspirin and clopidogrel alone.
Platinum Agents
Theoretically, taking fish oil with platinum agents can cause resistance to platinum agents, potentially decreasing their effectiveness.
Platinum-induced fatty acids (PIFAs) are fatty acids secreted from human and mouse stem cells when exposed to platinum-based chemotherapy. Animal research suggests that PIFAs cause resistance to chemotherapy by stimulating lysophospholipid production in the spleen, which interferes with the DNA damage caused by certain chemotherapy drugs. One PIFA, known as 16:4(n-3), has been found in both raw fish and some commercially available fish oil products. Mackerel and herring have high PIFA concentrations, while salmon and tuna have low PIFA concentrations. Levels of PIFA in commercial fish oil products ranged from 0.2- 5.7 microMol. Animal research shows that PIFA-containing fish oil products cause resistance to cisplatin, fluorouracil, irinotecan, and oxaliplatin. It is unclear if all commercially available fish oil products contain PIFAs. Additionally, it is argued that levels of PIFA found in some fish oil products are too low to be of clinical concern. Furthermore, a lack of chemotherapy resistance in countries with high fish intake, such as Greenland, Japan, and Norway, suggest that this interaction may not be clinically significant.
Warfarin (Coumadin)
Fish oil may have antiplatelet effects and might increase the risk of bleeding if used with warfarin.
Fish oil has antiplatelet effects at high doses. Case reports show elevated INR in patients taking warfarin and fish oil 1-2 grams daily. However, some clinical research shows that taking fish oil 3-6 grams daily does not significantly increase INR in patients taking warfarin.
Policosanol
Anticoagulant/Antiplatelet Drugs
Theoretically, taking policosanol with other antiplatelet or anticoagulant drugs might increase the risk of bruising and bleeding.
Some clinical research shows that taking policosanol 10-50 mg daily for 7-15 days can inhibit platelet aggregation in healthy patients. Although, one clinical trial shows that taking policosanol 10 mg twice daily for 2 weeks prior to warfarin dosing does not affect warfarin pharmacokinetics or warfarin response. Furthermore, a study in patients undergoing percutaneous coronary intervention with a drug-eluting stent found that taking policosanol 40 mg plus clopidogrel and aspirin daily for 30 days modestly reduced the risk for minor bleeding events when compared with taking clopidogrel and aspirin alone. Until more is known, use with caution.
Antidiabetes Drugs
Theoretically, policosanol might have additive effects with antidiabetes drugs and increase the risk of hypoglycemia.
Clinical research shows that policosanol can lower blood glucose levels.
Beta-Blockers
Concomitant use of policosanol with beta-blockers can cause additive blood pressure-lowering effects.
Clinical research shows that policosanol 5 mg daily can have additive blood pressure-lowering effects in patients with hypertension who are taking beta-blockers. Also, animal research shows that policosanol can increase the blood-pressure lowering effects of propranolol.
Nitroprusside (Nitropress)
Theoretically, concomitant use of policosanol with nitroprusside might cause additive blood pressure-lowering effects.
Animal research shows that taking policosanol along with nitroprusside can increase the blood pressure-lowering effects of nitroprusside.
Propranolol (Inderal)
Animal research shows that taking policosanol along with propranolol can increase the blood pressure-lowering effects of propranolol.
Warfarin (Coumadin)
Theoretically, taking policosanol with warfarin might increase the risk of bruising and bleeding.
Some clinical research shows that taking policosanol 10-50 mg daily for 7-15 days can inhibit platelet aggregation in healthy patients. However, one clinical trial shows that taking policosanol 10 mg twice daily for 2 weeks prior to warfarin dosing does not affect warfarin pharmacokinetics or warfarin response.
Pantethine
Anticoagulant/Antiplatelet Drugs
Theoretically, pantethine might increase the risk of bleeding with anticoagulant or antiplatelet drugs.
Some evidence suggests that pantethine reduces platelet aggregation.
Inositol
Antidiabetes Drugs
Theoretically, taking inositol with antidiabetes drugs might increase the risk of hypoglycemia.
Clinical research shows that inositol lowers blood glucose levels and glycated hemoglobin (HbA1c) levels in patients with diabetes.
Brand information
Manufacturer and brand details for Cholest Solutions, from the product label.
Vitamin World
See all Vitamin World products- Name
- Vitamin World, Inc.
- City
- Ronkonkoma
- State
- NY
- ZipCode
- 11779
Cholest Solutions by Vitamin World: Common Questions
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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 Cholest Solutions’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Fish Oil
Interacts with 327 drugsFish oil provides omega-3 fatty acids (EPA and DHA) that are best known for lowering high triglyceride levels. The evidence for other heart and health benefits is mixed, and it is generally...
Read the full Fish Oil monograph → Herb & supplement monographNiacin
Interacts with 727 drugsNiacin (vitamin B3) is an essential nutrient your body needs for energy and metabolism, and deficiency is uncommon in most developed countries. Prescription-strength niacin has been used to...
Read the full Niacin monograph → Herb & supplement monographPantethine
Interacts with 122 drugsPantethine is a derivative of vitamin B5 (pantothenic acid) that some studies suggest may modestly lower cholesterol and triglycerides. The evidence is limited and not strong enough to repla...
Read the full Pantethine 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 monographInositol
Interacts with 86 drugsInositol is a sugar alcohol made naturally in the body and found in many foods, and it is sold as a supplement (often myo-inositol) mainly for PCOS, mood, and metabolic concerns. The stronge...
Read the full Inositol monograph → Herb & supplement monographPolicosanol
Interacts with 242 drugsPolicosanol is a mix of waxy alcohols (mostly octacosanol) made from sugar cane or other plant waxes, and it is often marketed as a natural way to lower cholesterol. Early studies from Cuba...
Read the full Policosanol monograph →Sources & How We Checked
Cholest Solutions'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 415 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.
Fish Oil 157 references
- Prisco D, Paniccia R, Bandinelli B, et al. Effect of medium-term supplementation with a moderate dose of n-3 polyunsaturated fatty acids on blood pressure in mild hypertensive patients. Thromb Res 1998;1:105-12.
- Allard JP, Kurian R, Aghdassi E, Muggli R, et al. Lipid peroxidation during n-3 fatty acid and vitamin E supplementation in humans. Lipids 1997;32:535-41.. PubMed
- Toft I, Bonaa KH, Ingebretsen OC, et al. Effects of n-3 polyunsaturated fatty acids on glucose homeostasis and blood pressure in essential hypertension. A randomized, controlled trial. Ann Intern Med 1995;123:911-8.
- Onwude JL, Lilford RJ, Hjartardottir H, et al. A randomised double blind placebo controlled trial of fish oil in high risk pregnancy. Br J Obstet Gynaecol 1995;102:95-100. PubMed
- Bulstra-Ramakers MT, Huisjes HJ, Visser GH. The effects of 3g eicosapentaenoic acid daily on recurrence of intrauterine growth retardation and pregnancy induced hypertension. Br J Obstet Gynaecol 1995;102:123-6. PubMed
- Sacks FM, Hebert P, Appel LJ, et al. Short report: the effect of fish oil on blood pressure and high-density lipoprotein-cholesterol levels in phase I of the trials of hypertension prevention. J Hypertens 1994;12:209-13.
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