CholestMD Ingredients & Drug Interactions
What is this page for?
First and foremost: checking CholestMD 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
CholestMD is a dietary supplement by 1MD Nutrition with 4 active ingredients. Its ingredients are commonly taken for high cholesterol, vitamin b3 deficiency (pellagra), heart health support.Based on those ingredients, 1,266 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Garlic bulb extract, Niacin, Bergavit. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against CholestMD by 1MD Nutrition
Ask about any prescription or over-the-counter medication and we check it for interactions with CholestMD by 1MD Nutrition — 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 CholestMD by 1MD Nutrition
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
Full disclosure
CholestMD has four active ingredients. Niacin (also called vitamin B3) is a B vitamin that helps manage cholesterol and blood lipid levels, and is also used to prevent a deficiency disease called pellagra.
Olive leaf extract, garlic bulb extract, and bergavit (an extract from bergamot citrus fruit) are plant-based compounds added for their effects on cholesterol and metabolic health, though the evidence for most of these is preliminary or limited. The capsule shell is made from vegetable cellulose, and the product contains vegetable oil powder and silica as inactive ingredients to keep everything stable and help with absorption.
Does it work?
Moderate evidence
Niacin is likely effective for treating pellagra (a disease from severe niacin deficiency) and is possibly effective for managing cholesterol and blood lipid problems in people with HIV/AIDS and for metabolic syndrome. Garlic bulb extract is possibly effective for high blood pressure, diabetes, and atherosclerosis (clogged arteries), and for a liver condition called nonalcoholic fatty liver disease.
Bergavit is possibly effective for high cholesterol. Olive leaf extract has insufficient evidence in our data for any of its uses—we hold no reliable proof it works for what it's marketed to do.
How safe is it?
Well-documented data
Niacin at food amounts and in standard prenatal vitamins is safe, but this product contains supplemental doses that can cause flushing (affecting up to 70% of users), stomach upset, and liver damage with long-term use. Serious but rare side effects include liver toxicity, muscle damage, blood clotting problems, and vision changes.
High-dose niacin should be avoided in pregnancy unless prescribed by a doctor. Garlic bulb extract is generally well tolerated but may cause stomach pain, bloating, nausea, bad breath, body odor, and in rare cases increase bleeding risk or trigger allergic reactions.
Olive leaf extract seems well tolerated in short-term use, with occasional reports of headache or stomach discomfort. Bergavit (bergamot) appears well tolerated orally in the short term, but the facts advise against it in pregnancy and breastfeeding due to insufficient safety data.
Meds to double-check
Moderate interaction found
Before taking this product, double-check with your pharmacist if you take blood pressure medications, blood thinners (including warfarin), diabetes medications, statin drugs (cholesterol medications), gout medicines, bile acid sequestrants, drugs that stress your liver, or anything metabolized by your liver's CYP3A4 or CYP2E1 enzymes, as well as HIV protease inhibitors or tacrolimus (a transplant drug). Niacin and garlic can both significantly affect how these work.
The bottom line
Scorecard at a glanceFully disclosed formula with some supporting evidence for its stated purpose. Moderate medication interactions have been identified, and safety information is well characterized.
CholestMD is worth discussing with your pharmacist if you're interested in plant-based cholesterol support and don't take blood pressure, diabetes, or blood thinner medications. Because niacin can interact with so many common drugs—statins, blood pressure pills, diabetes medications, and more—you absolutely need to check your exact medication list before starting.
Pregnant or breastfeeding? Talk to your doctor or pharmacist first, especially about the niacin and bergamot.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 4 of 4 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Nov 22, 2022.
This Scorecard evaluates available label information, ingredient evidence, and known medication-safety considerations. It does not independently verify product identity, purity, potency, contamination, or manufacturing quality. How these ratings are computed
General information
Key facts about CholestMD, straight from the product label.
| Brand | 1MD Nutrition |
|---|---|
| Barcode (UPC) | X002YI9U9J |
| Net contents | 60 Capsule(s) |
| Market status | On market |
| Date entered into DSLD | Nov 22, 2022 |
| DSLD ID | 274795 |
| Product type | Botanical |
| Supplement form | Capsule |
| Dietary claims / uses | All Other, Structure/Function |
| Intended target group(s) | Adult (18 - 50 Years), Dairy 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 CholestMD by 1MD Nutrition, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Niacin | 400 mg NE | 2500% |
| Olive Leaf Extract | 50 mg | -- |
| Garlic bulb extract | 130 mg | -- |
| Bergavit | 550 mg | -- |
Other ingredients: Vegetable Cellulose Capsule, Vegetable Oil powder, Silica
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.
Suggested/Recommended/Usage/Directions
Suggested Use: As a dietary supplement, adults take two (2) capsules, once (1x) daily, or as recommended by a healthcare practitioner.
Precautions
Warning: Consult a healthcare practitioner if you are pregnant or nursing, have a serious medical condition, or use any medications.
Do not use 7 days prior to surgery. Not recommended for persons with acute or chronic stomach inflammation or acid reflux.
Keep out of reach of children.
Do not use if safety seal is damaged or missing.
Storage
Store in a cool, dry place.
Formulation
Color may vary.
Non-GMO Shellfish-free Dairy-free Peanut-free Wheat-free
Promotes cholesterol health Promotes HDL production Helps maintain normal triglyceride levels Supports heart health
Manufactured in the USA from globally-sourced ingredients.
FDA Statement of Identity
Dietary Supplement
Brand IP Statement(s)
Bergavit Bergavit is a registered trademark of BIONAP S.r.l.
FDA Disclaimer Statement
These statements have not been evaluate by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.
Seals/Symbols
GMP Good Manufacturing Practice
General Statements
Questions? Call: (888)-393-4030 | Email: [email protected] | Visit: www.1md.org
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
CholestMD by 1MD Nutrition 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 CholestMD by 1MD Nutrition
These are the 4 active ingredients this product is made of. Select any to open its full monograph.
Serving size2 Capsule(s) Dosage formCapsule Servings per container30 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.
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 & interactionsOlive Leaf Extract
No knowninteractions
Olive comes from the same tree that gives us olives and olive oil, and its leaf and fruit contain antioxidant compounds like oleuropein and hydroxytyr...
Olive Leaf Extract monograph & interactionsGarlic bulb extract
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...
Garlic bulb extract monograph & interactionsBergavit
Interacts with410 drugs
Bergamot is a Mediterranean citrus fruit, and its standardized extract is most often used to support cholesterol and heart health, with some early but...
Bergavit monograph & interactionsOther (inactive) ingredients: Vegetable Cellulose Capsule, Vegetable Oil powder, Silica. These complete the product’s ingredient list but are not active constituents.
CholestMD by 1MD Nutrition Drug Interactions
HelloPharmacist Interaction Report
CholestMD by 1MD Nutrition contains four active ingredients, and niacin, garlic bulb extract, and bergavit (bergamot) all carry documented interactions with medications.
The most serious concerns involve niacin's moderate-severity interaction with blood pressure medications (antihypertensive drugs), which can theoretically lower your blood pressure further and cause dizziness or fainting.
Read the full breakdown — every affected drug type, severity by severity
Niacin also interacts moderately with cholesterol-lowering statin drugs—there's theoretical concern about muscle damage (myopathy) and a rare severe muscle breakdown condition (rhabdomyolysis), though this risk hasn't been proven large in real patients. It can raise blood sugar and weaken diabetes medications, increase bleeding risk with blood thinners (anticoagulants) and antiplatelet drugs, and raise liver toxicity risk if you're already on drugs that stress the liver.
Niacin also reduces the effectiveness of gout medications like allopurinol and probenecid, and bile acid sequestrants (cholesterol drugs) can prevent niacin absorption—you'd need to space them 4–6 hours apart.
Garlic bulb extract carries moderate interactions with blood pressure medications, blood sugar medications, blood thinners and antiplatelet drugs, warfarin specifically, drugs broken down by your liver's CYP3A4 and CYP2E1 enzymes, HIV protease inhibitors, and the transplant drug tacrolimus. Bergavit (bergamot) has moderate interactions with diabetes medications and sun-sensitizing drugs.
Olive leaf extract showed no interactions in our data.
Altogether, these interactions span 1,267 individual medications. Use the medication checker on this page to run your exact drugs against this product before you start.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against CholestMD?
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 CholestMD interact with 1,266 drugs. Click any drug to see the details.
3 of the 4 ingredients in CholestMD interact with drugs. Each result below shows which ingredient is responsible. Garlic bulb extract Niacin Bergavit
Acetaminophen, Chlorpheniramine, Codeine, PhenylephrineColrex
How Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interacts with CholestMD — through 3 ingredients. Tap an ingredient for the detail:
Garlic Bulb ExtractCytochrome P450 2e1 (cyp2e1) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Garlic might increase levels of drugs metabolized by CYP2E1.
Read the full Garlic Bulb Extract + 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 interactionBergavitPhotosensitizing Drugs Moderate
Interaction Summary
Theoretically, topical bergamot essential oil might increase the risk of side effects when used along with photosensitizing drugs.
Read the full Bergavit + Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interactionAcetaminophen, Chlorpheniramine, DextromethorphanCoricidin II Extra Strength Cold and Flu
How Acetaminophen, Chlorpheniramine, Dextromethorphan interacts with CholestMD — through 3 ingredients. Tap an ingredient for the detail:
Garlic Bulb ExtractCytochrome P450 2e1 (cyp2e1) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Garlic might increase levels of drugs metabolized by CYP2E1.
Read the full Garlic Bulb Extract + Acetaminophen, Chlorpheniramine, Dextromethorphan 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, Dextromethorphan interactionBergavitPhotosensitizing Drugs Moderate
Interaction Summary
Theoretically, topical bergamot essential oil might increase the risk of side effects when used along with photosensitizing drugs.
Read the full Bergavit + Acetaminophen, Chlorpheniramine, Dextromethorphan interactionAcetaminophen, Chlorpheniramine, Dextromethorphan HydrobromideCoricidin HBP Maximum Strength Flu
How Acetaminophen, Chlorpheniramine, Dextromethorphan Hydrobromide interacts with CholestMD — through 3 ingredients. Tap an ingredient for the detail:
BergavitPhotosensitizing Drugs Moderate
Interaction Summary
Theoretically, topical bergamot essential oil might increase the risk of side effects when used along with photosensitizing drugs.
Read the full Bergavit + Acetaminophen, Chlorpheniramine, Dextromethorphan Hydrobromide interactionGarlic Bulb ExtractCytochrome 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 Garlic Bulb Extract + Acetaminophen, Chlorpheniramine, Dextromethorphan Hydrobromide 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, Dextromethorphan Hydrobromide interactionAcetaminophen, Chlorpheniramine, Dextromethorphan, PhenylpropanolamineMulti Symptom Cold Relief
How Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylpropanolamine interacts with CholestMD — through 3 ingredients. Tap an ingredient for the detail:
Garlic Bulb ExtractCytochrome 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 Garlic Bulb Extract + Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylpropanolamine interactionBergavitPhotosensitizing Drugs Moderate
Interaction Summary
Theoretically, topical bergamot essential oil might increase the risk of side effects when used along with photosensitizing drugs.
Read the full Bergavit + Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylpropanolamine 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, Dextromethorphan, Phenylpropanolamine interactionAcetaminophen, Chlorpheniramine, Dextromethorphan, PseudoephedrineChildren's Tylenol Cold Plus Cough, Tylenol Cold Ex Strength
How Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine interacts with CholestMD — through 3 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, Chlorpheniramine, Dextromethorphan, Pseudoephedrine interactionBergavitPhotosensitizing Drugs Moderate
Interaction Summary
Theoretically, topical bergamot essential oil might increase the risk of side effects when used along with photosensitizing drugs.
Read the full Bergavit + Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine interactionGarlic Bulb ExtractCytochrome 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 Garlic Bulb Extract + Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine interactionAcetaminophen, Chlorpheniramine, Guaifenesin, Phenylephrine, SalicylamideRhinogesic GG
How Acetaminophen, Chlorpheniramine, Guaifenesin, Phenylephrine, Salicylamide interacts with CholestMD — through 3 ingredients. Tap an ingredient for the detail:
Garlic Bulb ExtractCytochrome P450 2e1 (cyp2e1) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Garlic might increase levels of drugs metabolized by CYP2E1.
Read the full Garlic Bulb Extract + Acetaminophen, Chlorpheniramine, Guaifenesin, Phenylephrine, Salicylamide 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, Guaifenesin, Phenylephrine, Salicylamide interactionBergavitPhotosensitizing Drugs Moderate
Interaction Summary
Theoretically, topical bergamot essential oil might increase the risk of side effects when used along with photosensitizing drugs.
Read the full Bergavit + Acetaminophen, Chlorpheniramine, Guaifenesin, Phenylephrine, Salicylamide interactionAcetaminophen, Chlorpheniramine, PhenylephrineAlka-Seltzer PLUS, Histex SR, Protid
How Acetaminophen, Chlorpheniramine, Phenylephrine interacts with CholestMD — through 3 ingredients. Tap an ingredient for the detail:
BergavitPhotosensitizing Drugs Moderate
Interaction Summary
Theoretically, topical bergamot essential oil might increase the risk of side effects when used along with photosensitizing drugs.
Read the full Bergavit + Acetaminophen, Chlorpheniramine, Phenylephrine interactionGarlic Bulb ExtractCytochrome P450 2e1 (cyp2e1) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Garlic might increase levels of drugs metabolized by CYP2E1.
Read the full Garlic Bulb Extract + Acetaminophen, Chlorpheniramine, 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, Phenylephrine interactionAcetaminophen, Chlorpheniramine, Phenylephrine, SalicylamideRhinogesic, Rhinogesic JR
How Acetaminophen, Chlorpheniramine, Phenylephrine, Salicylamide interacts with CholestMD — through 3 ingredients. Tap an ingredient for the detail:
BergavitPhotosensitizing Drugs Moderate
Interaction Summary
Theoretically, topical bergamot essential oil might increase the risk of side effects when used along with photosensitizing drugs.
Read the full Bergavit + Acetaminophen, Chlorpheniramine, Phenylephrine, Salicylamide 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, Phenylephrine, Salicylamide interactionGarlic Bulb ExtractCytochrome 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 Garlic Bulb Extract + Acetaminophen, Chlorpheniramine, Phenylephrine, Salicylamide interactionAcetaminophen, Chlorpheniramine, PhenylpropanolamineAlumadrine, Conex, Sinadrin Max Strength, Sinulin
How Acetaminophen, Chlorpheniramine, Phenylpropanolamine interacts with CholestMD — through 3 ingredients. Tap an ingredient for the detail:
Garlic Bulb ExtractCytochrome P450 2e1 (cyp2e1) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Garlic might increase levels of drugs metabolized by CYP2E1.
Read the full Garlic Bulb Extract + Acetaminophen, Chlorpheniramine, Phenylpropanolamine interactionBergavitPhotosensitizing Drugs Moderate
Interaction Summary
Theoretically, topical bergamot essential oil might increase the risk of side effects when used along with photosensitizing drugs.
Read the full Bergavit + Acetaminophen, Chlorpheniramine, Phenylpropanolamine 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, Phenylpropanolamine interactionAcetaminophen, Chlorpheniramine, Phenylpropanolamine, OpiumHista-Derfule
How Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium interacts with CholestMD — through 3 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, Chlorpheniramine, Phenylpropanolamine, Opium interactionBergavitPhotosensitizing Drugs Moderate
Interaction Summary
Theoretically, topical bergamot essential oil might increase the risk of side effects when used along with photosensitizing drugs.
Read the full Bergavit + Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium interactionGarlic Bulb ExtractCytochrome P450 2e1 (cyp2e1) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Garlic might increase levels of drugs metabolized by CYP2E1.
Read the full Garlic Bulb Extract + Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium interactionAcetaminophen, Chlorpheniramine, Phenylpropanolamine, PhenyltoloxamineNorel Plus
How Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Phenyltoloxamine interacts with CholestMD — through 3 ingredients. Tap an ingredient for the detail:
BergavitPhotosensitizing Drugs Moderate
Interaction Summary
Theoretically, topical bergamot essential oil might increase the risk of side effects when used along with photosensitizing drugs.
Read the full Bergavit + Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Phenyltoloxamine 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, Phenylpropanolamine, Phenyltoloxamine interactionGarlic Bulb ExtractCytochrome P450 2e1 (cyp2e1) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Garlic might increase levels of drugs metabolized by CYP2E1.
Read the full Garlic Bulb Extract + Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Phenyltoloxamine interactionAcetaminophen, Chlorpheniramine, PseudoephedrineAlka-Seltzer PLUS Liquid Gels, Children's Tylenol Cold, Codimal, Comtrex, Extra Strength Tylenol Allergy Sinus, Lorsin +3 more
How Acetaminophen, Chlorpheniramine, Pseudoephedrine interacts with CholestMD — through 3 ingredients. Tap an ingredient for the detail:
Garlic Bulb ExtractCytochrome 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 Garlic Bulb Extract + Acetaminophen, Chlorpheniramine, Pseudoephedrine interactionBergavitPhotosensitizing Drugs Moderate
Interaction Summary
Theoretically, topical bergamot essential oil might increase the risk of side effects when used along with photosensitizing drugs.
Read the full Bergavit + Acetaminophen, Chlorpheniramine, Pseudoephedrine 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, Pseudoephedrine interactionAcetaminophen, ChlorzoxazoneAcetazone Forte, Extra Strength Tylenol Aches & Strains, Parafon Forte
How Acetaminophen, Chlorzoxazone interacts with CholestMD — 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, Chlorzoxazone interactionGarlic Bulb ExtractCytochrome P450 2e1 (cyp2e1) Substrates Moderate
Interaction Summary
Garlic might increase levels of drugs metabolized by CYP2E1.
Read the full Garlic Bulb Extract + Acetaminophen, Chlorzoxazone interactionAcetaminophen, Chlorzoxazone, CodeineAcetazone Forte C8, Parafon Forte C8
How Acetaminophen, Chlorzoxazone, Codeine interacts with CholestMD — through 2 ingredients. Tap an ingredient for the detail:
Garlic Bulb ExtractCytochrome P450 2e1 (cyp2e1) Substrates Moderate
Interaction Summary
Garlic might increase levels of drugs metabolized by CYP2E1.
Read the full Garlic Bulb Extract + Acetaminophen, Chlorzoxazone, 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, Chlorzoxazone, Codeine interactionAcetaminophen, CodeineTylenol No.3, Tylenol w/ Codeine
How Acetaminophen, Codeine interacts with CholestMD — 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, Codeine interactionGarlic Bulb ExtractCytochrome P450 2e1 (cyp2e1) Substrates Moderate
Interaction Summary
Garlic might increase levels of drugs metabolized by CYP2E1.
Read the full Garlic Bulb Extract + Acetaminophen, Codeine interactionAcetaminophen, Codeine, DoxylamineMersyndol
How Acetaminophen, Codeine, Doxylamine interacts with CholestMD — through 2 ingredients. Tap an ingredient for the detail:
Garlic Bulb ExtractCytochrome P450 2e1 (cyp2e1) Substrates Moderate
Interaction Summary
Garlic might increase levels of drugs metabolized by CYP2E1.
Read the full Garlic Bulb Extract + Acetaminophen, Codeine, Doxylamine interactionNiacinHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Acetaminophen, Codeine, Doxylamine interactionAcetaminophen, Codeine, MethocarbamolAcetaminophen, Codeine, Methocarbamol, Robaxacet 8
How Acetaminophen, Codeine, Methocarbamol interacts with CholestMD — 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, Codeine, Methocarbamol interactionGarlic Bulb ExtractCytochrome P450 2e1 (cyp2e1) Substrates Moderate
Interaction Summary
Garlic might increase levels of drugs metabolized by CYP2E1.
Read the full Garlic Bulb Extract + Acetaminophen, Codeine, Methocarbamol interactionAcetaminophen, Dexbrompheniramine, PseudoephedrineSinadrin Plus
How Acetaminophen, Dexbrompheniramine, Pseudoephedrine interacts with CholestMD — through 3 ingredients. Tap an ingredient for the detail:
Garlic Bulb ExtractCytochrome P450 2e1 (cyp2e1) Substrates Moderate
Interaction Summary
Garlic might increase levels of drugs metabolized by CYP2E1.
Read the full Garlic Bulb Extract + Acetaminophen, Dexbrompheniramine, Pseudoephedrine interactionNiacinHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Acetaminophen, Dexbrompheniramine, Pseudoephedrine interactionBergavitPhotosensitizing Drugs Moderate
Interaction Summary
Theoretically, topical bergamot essential oil might increase the risk of side effects when used along with photosensitizing drugs.
Read the full Bergavit + Acetaminophen, Dexbrompheniramine, Pseudoephedrine interactionAcetaminophen, DextromethorphanTylenol Cough Ex Strength
How Acetaminophen, Dextromethorphan interacts with CholestMD — through 2 ingredients. Tap an ingredient for the detail:
Garlic Bulb ExtractCytochrome 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 Garlic Bulb Extract + Acetaminophen, Dextromethorphan interactionNiacinHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Acetaminophen, Dextromethorphan interactionAcetaminophen, Dextromethorphan, Doxylamine, PseudoephedrineVicks NyQuil
How Acetaminophen, Dextromethorphan, Doxylamine, Pseudoephedrine interacts with CholestMD — through 2 ingredients. Tap an ingredient for the detail:
Garlic Bulb ExtractCytochrome P450 2e1 (cyp2e1) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Garlic might increase levels of drugs metabolized by CYP2E1.
Read the full Garlic Bulb Extract + Acetaminophen, Dextromethorphan, Doxylamine, Pseudoephedrine interactionNiacinHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Acetaminophen, Dextromethorphan, Doxylamine, Pseudoephedrine interactionAcetaminophen, Dextromethorphan, Guaifenesin, PhenylephrineConar-A
How Acetaminophen, Dextromethorphan, Guaifenesin, Phenylephrine interacts with CholestMD — 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, Dextromethorphan, Guaifenesin, Phenylephrine interactionGarlic Bulb ExtractCytochrome P450 2e1 (cyp2e1) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Garlic might increase levels of drugs metabolized by CYP2E1.
Read the full Garlic Bulb Extract + Acetaminophen, Dextromethorphan, Guaifenesin, Phenylephrine interactionAcetaminophen, Dextromethorphan, Guaifenesin, PhenylpropanolamineAnatuss
How Acetaminophen, Dextromethorphan, Guaifenesin, Phenylpropanolamine interacts with CholestMD — through 2 ingredients. Tap an ingredient for the detail:
Garlic Bulb ExtractCytochrome P450 2e1 (cyp2e1) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Garlic might increase levels of drugs metabolized by CYP2E1.
Read the full Garlic Bulb Extract + Acetaminophen, Dextromethorphan, Guaifenesin, Phenylpropanolamine interactionNiacinHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Acetaminophen, Dextromethorphan, Guaifenesin, Phenylpropanolamine interactionAcetaminophen, Dextromethorphan, Guaifenesin, PseudoephedrineRobitussin Cold, Severe Cold, Suphedrine Cold/Cough
How Acetaminophen, Dextromethorphan, Guaifenesin, Pseudoephedrine interacts with CholestMD — 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, Dextromethorphan, Guaifenesin, Pseudoephedrine interactionGarlic Bulb ExtractCytochrome 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 Garlic Bulb Extract + Acetaminophen, Dextromethorphan, Guaifenesin, Pseudoephedrine interactionAcetaminophen, Dextromethorphan, Phenylpropanolamine, PyrilamineTheracaps
How Acetaminophen, Dextromethorphan, Phenylpropanolamine, Pyrilamine interacts with CholestMD — through 2 ingredients. Tap an ingredient for the detail:
Garlic Bulb ExtractCytochrome P450 2e1 (cyp2e1) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Garlic might increase levels of drugs metabolized by CYP2E1.
Read the full Garlic Bulb Extract + Acetaminophen, Dextromethorphan, Phenylpropanolamine, 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, Dextromethorphan, Phenylpropanolamine, Pyrilamine interactionAcetaminophen, Dextromethorphan, PseudoephedrineAlka-Seltzer PLUS Flu Liquid Gels, Non Aspirin Cold Caps, Tylenol Cold, Tylenol Flu Daytime Ex Strength, Tylenol Flu Ex Strength
How Acetaminophen, Dextromethorphan, Pseudoephedrine interacts with CholestMD — through 2 ingredients. Tap an ingredient for the detail:
Garlic Bulb ExtractCytochrome 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 Garlic Bulb Extract + Acetaminophen, Dextromethorphan, Pseudoephedrine interactionNiacinHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Acetaminophen, Dextromethorphan, Pseudoephedrine interactionAcetaminophen, Dichloralantipyrine, IsomethepteneAmidrine, Midchlor, Migquin, Migratine
How Acetaminophen, Dichloralantipyrine, Isometheptene interacts with CholestMD — 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, Dichloralantipyrine, Isometheptene interactionGarlic Bulb ExtractCytochrome P450 2e1 (cyp2e1) Substrates Moderate
Interaction Summary
Garlic might increase levels of drugs metabolized by CYP2E1.
Read the full Garlic Bulb Extract + Acetaminophen, Dichloralantipyrine, Isometheptene interactionAcetaminophen, Dichloralphenazone, IsomethepteneMidrin
How Acetaminophen, Dichloralphenazone, Isometheptene interacts with CholestMD — through 2 ingredients. Tap an ingredient for the detail:
Garlic Bulb ExtractCytochrome P450 2e1 (cyp2e1) Substrates Moderate
Interaction Summary
Garlic might increase levels of drugs metabolized by CYP2E1.
Read the full Garlic Bulb Extract + Acetaminophen, Dichloralphenazone, Isometheptene interactionNiacinHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Acetaminophen, Dichloralphenazone, Isometheptene interactionAcetaminophen, Dichlorophenazone, IsometheptaneIsocom
How Acetaminophen, Dichlorophenazone, Isometheptane interacts with CholestMD — 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, Dichlorophenazone, Isometheptane interactionGarlic Bulb ExtractCytochrome P450 2e1 (cyp2e1) Substrates Moderate
Interaction Summary
Garlic might increase levels of drugs metabolized by CYP2E1.
Read the full Garlic Bulb Extract + Acetaminophen, Dichlorophenazone, Isometheptane interactionAcetaminophen, DiphenhydramineTylenol PM, Tylenol PM Ex Strength
How Acetaminophen, Diphenhydramine interacts with CholestMD — through 3 ingredients. Tap an ingredient for the detail:
Garlic Bulb ExtractCytochrome P450 2e1 (cyp2e1) Substrates Moderate
Interaction Summary
Garlic might increase levels of drugs metabolized by CYP2E1.
Read the full Garlic Bulb Extract + Acetaminophen, Diphenhydramine interactionBergavitPhotosensitizing Drugs Moderate
Interaction Summary
Theoretically, topical bergamot essential oil might increase the risk of side effects when used along with photosensitizing drugs.
Read the full Bergavit + Acetaminophen, Diphenhydramine interactionNiacinHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Acetaminophen, Diphenhydramine interactionAcetaminophen, Diphenhydramine, PseudoephedrineChildren's Tylenol Allergy, Cold Control, Contac Night Allergy Relief
How Acetaminophen, Diphenhydramine, Pseudoephedrine interacts with CholestMD — through 3 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, Diphenhydramine, Pseudoephedrine interactionGarlic Bulb ExtractCytochrome P450 2e1 (cyp2e1) Substrates Moderate
Interaction Summary
Garlic might increase levels of drugs metabolized by CYP2E1.
Read the full Garlic Bulb Extract + Acetaminophen, Diphenhydramine, Pseudoephedrine interactionBergavitPhotosensitizing Drugs Moderate
Interaction Summary
Theoretically, topical bergamot essential oil might increase the risk of side effects when used along with photosensitizing drugs.
Read the full Bergavit + Acetaminophen, Diphenhydramine, Pseudoephedrine interactionEach ingredient & the kinds of drugs it affects
For each ingredient in CholestMD with known interactions, here are the types of medications they can affect. Open any type for the detail — or search your exact drug in the checker above.
Garlic bulb extract
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.
Bergavit
Antidiabetes Drugs
Theoretically, taking bergamot with antidiabetes drugs might increase the risk of hypoglycemia.
Animal research suggests that bergamot juice has hypoglycemic effects.
Photosensitizing Drugs
Theoretically, topical bergamot essential oil might increase the risk of side effects when used along with photosensitizing drugs.
Bergamot contains bergapten, which has photosensitizing effects.
Brand information
Manufacturer and brand details for CholestMD, from the product label.
1MD Nutrition
See all 1MD Nutrition products- Name
- 1MD
- City
- Irvine
- State
- CA
- ZipCode
- 92618
- Phone Number
- 888-393-4030
- Web Address
- www.1md.org
CholestMD by 1MD Nutrition: Common Questions
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What does olive leaf extract do in this formula?
Can garlic in this product thin my blood?
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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 CholestMD’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Niacin
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 monographOlive
Olive comes from the same tree that gives us olives and olive oil, and its leaf and fruit contain antioxidant compounds like oleuropein and hydroxytyrosol. Olive oil as part of a Mediterrane...
Read the full Olive 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 monographBergamot
Interacts with 410 drugsBergamot is a Mediterranean citrus fruit, and its standardized extract is most often used to support cholesterol and heart health, with some early but promising research. The essential oil i...
Read the full Bergamot monograph →Sources & How We Checked
CholestMD'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 239 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.
Niacin 66 references
- Garg R, Malinow MR, Pettinger M, et al. Niacin treatment increases plasma homocysteine levels. Am Heart J 1999;138:1082-7.
- Anon. Inositol hexaniacinate. Altern Med Rev 1998;3:222-3.
- Knodel LC, Talbert RL. Adverse effects of hypolipidaemic drugs. Med Toxicol 1987;2:10-32. PubMed
- Guyton JR, Blazing MA, Hagar J, et al. Extended-release niacin vs gemfibrozil for the treatment of low levels of high-density lipoprotein cholesterol. Niaspan-Gemfibrozil Study Group. Arch Intern Med 2000;160:1177-84. PubMed
- Gibbons LW, Gonzalez V, Gordon N, Grundy S. The prevalence of side effects with regular and sustained-release nicotinic acid. Am J Med 1995;99:378-85. PubMed
- Whelan AM, Price SO, Fowler SF, Hainer BL. The effect of aspirin on niacin-induced cutaneous reactions. J Fam Pract 1992;34:165-8.
- Jungnickel PW, Maloley PA, Vander Tuin EL, et al. Effect of two aspirin pretreatment regimens on niacin-induced cutaneous reactions. J Gen Intern Med 1997;12:591-6. PubMed
- Capuzzi DM, Guyton JR, Morgan JM, et al. Efficacy and safety of an extended-release niacin (Niaspan): a long-term study. Am J Cardiol 1998;82:74-81;disc. 85U-6U. PubMed
- Gray DR, Morgan T, Chretien SD, Kashyap ML. Efficacy and safety of controlled-release niacin in dyslipoproteinemic veterans. Ann Intern Med 1994;121:252-8. PubMed
- McKenney JM, Proctor JD, Harris S, Chinchili VM. A comparison of the efficacy and toxic effects of sustained- vs immediate-release niacin in hypercholesterolemic patients. JAMA 1994;271:672-7. DOI
- Knopp RH, Alagona P, Davidson M, et al. Equivalent efficacy of a time-release form of niacin (Niaspan) given once-a-night versus plain niacin in the management of hyperlipidemia. Metabolism 1998;47:1097-104. PubMed
- Knopp RH. Clinical profiles of plain versus sustained-release niacin (Niaspan) and the physiologic rationale for nighttime dosing. Am J Cardiol 1998;82:24U-28U;discussion 39U-41U. PubMed
- Garg A, Grundy SM. Nicotinic acid as therapy for dyslipidemia in non-insulin-dependent diabetes mellitus. JAMA 1990;264:723-6. DOI
- Leighton RF, Gordon NF, Small GS, et al. Dental and gingival pain as side effects of niacin therapy. Chest 1998;114:1472-4. PubMed
- American Society of Health-System Pharmacists. ASHP Therapeutic Position Statement on the safe use of niacin in the management of dyslipidemias. Am J Health Syst Pharm 1997;54:2815-9. DOI
- Vega GL, Grundy SM. Lipoprotein responses to treatment with lovastatin, gemfibrozil, and nicotinic acid in normolipidemic patients with hypoalphalipoproteinemia. Arch Intern Med 1994;154:73-82. DOI
- Guyton JR, Goldberg AC, Kreisberg RA, et al. Effectiveness of once-nightly dosing of extended-release niacin alone and in combination for hypercholesterolemia. Am J Cardiol 1998;82:737-43.
- Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline (2000). Washington, DC: National Academy Press, 2000. Available at: http://b
- Brown BG, Zhao XQ, Chait A, et al. Simvastatin and niacin, antioxidant vitamins, or the combination for the prevention of coronary disease. N Engl J Med 2001;345:1583-93. DOI
- Bays HE, Dujovne CA. Drug interactions of lipid-altering drugs. Drug Saf 1998;19:355-71. PubMed
- Rader JI, Calvert RJ, Hathcock JN. Hepatic toxicity of unmodified and time-release preparations of niacin. Am J Med 1992;92:77-81. PubMed
- Kahn SE, Beard JC, Schwartz MW, et al. Increased B-cell secretory capacity as mechanism for islet adaptation to nicotinic acid-induced insulin resistance. Diabetes 1989;38:562-8.
- Schwartz ML. Severe reversible hyperglycemia as a consequence of niacin therapy. Arch Int Med 1993;153:2050-2. DOI
- Raising HDL and Niacin Use. Pharmacist's Letter/Prescriber's Letter 2004;20(5):200504.
- McKenney J. New perspectives on the use of niacin in the treatment of lipid disorders. Arch Intern Med 2004;164:697-705. PubMed
- Reaven P, Witztum JL. Lovastatin, nicotinic acid and rhabdomyolysis (letter). Ann Int Med 1988;109:597-8. PubMed
- Ito MK. Advances in the understanding and management of dyslipidemia: using niacin-based therapies. Am J Health-Syst Pharm 2003;60(suppl 2):s15-21. PubMed
- Schwab RA, Bachhuber BH. Delirium and lactic acidosis caused by ethanol and niacin coingestion. Am J Emerg Med 1991;9:363-5. PubMed
- Product information: Niaspan. Kos Pharmaceuticals. Cranbury, NJ. 2005. Available at www.niaspan.com/professional/content/pdfs/productinfo.pdf. (Accessed 3 March 2006).
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