Cold Season Support Ingredients & Drug Interactions
by Hawaii Pharm
What is this page for?
First and foremost: checking Cold Season Support 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
Cold Season Support is a dietary supplement by Hawaii Pharm with 2 active ingredients. Its ingredients are commonly taken for immune support, colds and flu, upper respiratory infections.Based on those ingredients, 1,318 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Goldenseal Leaf Extract, Dry, Astragalus Root Extract, Dry. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against Cold Season Support by Hawaii Pharm
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HelloPharmacist Scorecard of Cold Season Support by Hawaii Pharm
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
Low disclosure
Cold Season Support contains two active ingredients. Astragalus Root Extract, Dry is included as a dried extract of the astragalus root.
Goldenseal Leaf Extract, Dry is the dried extract of the goldenseal leaf. The product also contains inactive ingredients — alcohol, water, and glycerin — which serve as the liquid base and preservative.
Does it work?
Not established
The evidence for astragalus supporting cold season health is insufficient — we hold ratings of 'Insufficient Reliable Evidence' for the conditions listed in our data (hay fever, amenorrhea, aplastic anemia, angina, asthma, and beta-thalassemia). Goldenseal similarly carries 'Insufficient Reliable Evidence' ratings for the conditions documented in our facts (acne, hay fever, anorexia, and chronic fatigue syndrome), with one rating of 'Possibly Ineffective' for urine drug tests.
In short, the evidence to support either ingredient for their marketed uses is not established in the data we hold.
How safe is it?
Well-documented data
Astragalus is generally well tolerated short-term in healthy adults, but human safety data is limited overall. Some trial participants have reported dizziness and palpitations (though these may not have been caused by astragalus), and rare cases of rash or eczema have occurred with intravenous use.
Goldenseal is also generally used short-term, but safety data in humans is limited. Side effects tied to berberine (a goldenseal constituent) include abdominal distension, pain, constipation, diarrhea, flatulence, headache, nausea, vomiting, and bitter taste — though most have not been reported in actual goldenseal studies.
Astragalus is not recommended during pregnancy or while breastfeeding due to lack of safety data. Goldenseal should be avoided in pregnancy because berberine may harm the fetus and trigger contractions, and avoided while breastfeeding because berberine may pass to the infant.
Meds to double-check
Moderate interaction found
Before taking Cold Season Support, double-check it against any medications you take that work through your liver's CYP2D6, CYP2C9, or CYP3A4 pathways (goldenseal can raise their levels), as well as immunosuppressants, lithium, cyclophosphamide, diabetes drugs, blood pressure medications, blood thinners or anti-platelet drugs, and CNS depressants (sleep aids, opioids). Goldenseal's enzyme-inhibition interactions carry the broadest scope.
The bottom line
Scorecard at a glanceFormula with limited ingredient disclosure with no established evidence rating for its marketed use. Moderate medication interactions have been identified, and safety information is well characterized.
If you take immunosuppressants, lithium, diabetes drugs, blood pressure medication, blood thinners, or certain sedating drugs, check this product against your medications first — the interactions are real and potentially serious. Even if you're generally healthy, astragalus and goldenseal are not well studied in humans, so it's worth a quick conversation with your pharmacist before starting.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 2 of 2 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Oct 24, 2023.
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 Cold Season Support, straight from the product label.
| Brand | Hawaii Pharm |
|---|---|
| Barcode (UPC) | 840253661456 |
| Net contents | 4 Fluid Ounce(s); 120 mL |
| Market status | On market |
| Date entered into DSLD | Oct 24, 2023 |
| DSLD ID | 301484 |
| Product type | Botanical |
| Supplement form | Liquid |
| Dietary claims / uses | All Other, Structure/Function |
| Intended target group(s) | Adult (18 - 50 Years), Gluten 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 Cold Season Support by Hawaii Pharm, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Proprietary Extract Blend | 983 mg | -- |
| Astragalus Root Extract, Dry | 0 NP | -- |
| Goldenseal Leaf Extract, Dry | 0 NP | -- |
Other ingredients: Alcohol, Water, Glycerin
Tap any ingredient to jump to its full detail below.
These statements are the manufacturer’s wording, reproduced from the product label — the label is saying it, not HelloPharmacist. We don’t verify or endorse them.
Brand IP Statement(s)
Hawaii Pharm Herbal Extract Highest quality since 2008
Suggested/Recommended/Usage/Directions
Suggested use: Shake well before using. For adults add about 20-30 drops (0.7-1 mL, one full squeeze of the dropper bulb) to some juice or water, up to 4 times a day.
Precautions
Warning: We recommend to seek expert medical advice before taking.
Do not use if you are allergic to any ingredients.
Consult your physician before giving to children under 18, during pregnancy, if nursing or taking medications.
Consult your physician before giving to children under 18, during pregnancy, if nursing or taking medications.
May affect the ability to drive and operate machinery. May have contraindications, can cause side effects and adverse reactions. Do not use if seal is broken or missing.
Keep out of the reach of children!
Storage
Store in a cool dry place.
Seals/Symbols
cGMP Made in compliance with cGMP 21 CFR 111 in an FDA registered and inspected facility.
Organic Alcohol Based USA Made in United States of America
FDA Disclaimer Statement
This product has not been evaluated by the FDA and is not intended to diagnose, treat, cure or prevent any disease.
General Statements
Scan this QR-code to get 15% discount on your next purchase. Limited time deal.
Formulation
Only natural ingredients Purity is laboratory tested and verified
All the raw materials are gluten-free by their nature No artificial colors, flavors, or preservatives
Not tested on animals
Organic Alcohol Based
Made in USA, Hawaii
FDA Statement of Identity
Herbal Supplement
Formula
Organic Alcohol Based
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Cold Season Support by Hawaii Pharm 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 Cold Season Support by Hawaii Pharm
These are the 2 active ingredients this product is made of. Select any to open its full monograph.
Serving size0.7 mL Dosage formLiquid Servings per container120 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.
Proprietary Extract Blend
Other (inactive) ingredients: Alcohol, Water, Glycerin. These complete the product’s ingredient list but are not active constituents.
Cold Season Support by Hawaii Pharm Drug Interactions
HelloPharmacist Interaction Report
Cold Season Support by Hawaii Pharm contains astragalus and goldenseal, both of which carry documented interactions with medications.
The most serious concern is goldenseal's effect on how your body breaks down certain drugs — it inhibits several liver enzymes (CYP2D6, CYP2C9, and CYP3A4), which means it can raise levels of medications processed by those pathways, potentially causing overdose effects. This is a Moderate severity issue that affects a broad range of drugs, so checking your specific medications is important.
Read the full breakdown — every affected drug type, severity by severity
Astragalus raises four Moderate-severity concerns: it may interfere with immunosuppressants (drugs that deliberately weaken your immune system after transplant or for autoimmune conditions), increase lithium levels and side effects, potentially interfere with cyclophosphamide (a chemotherapy drug), and increase the risk of low blood sugar (hypoglycemia) if you're on diabetes medications.
Goldenseal adds further Moderate interactions: it may boost sedation from CNS depressants (like sleep aids or opioids), raise blood pressure medication effects and lower your blood pressure too much, increase bleeding risk with blood thinners (anticoagulants) or anti-platelet drugs, and raise hypoglycemia risk with diabetes drugs. Altogether, these interactions span 1,319 individual medications.
Please use the medication checker below with your exact prescriptions before starting this product.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against Cold Season Support?
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 Cold Season Support interact with 1,318 drugs. Click any drug to see the details.
2 of the 2 ingredients in Cold Season Support interact with drugs. Each result below shows which ingredient is responsible. Goldenseal Leaf Extract, Dry Astragalus Root Extract, Dry
6-mercaptopurinePurinethol
How 6-mercaptopurine interacts with Cold Season Support — through 1 ingredient. Tap an ingredient for the detail:
Astragalus Root Extract, DryImmunosuppressants Moderate
Interaction Summary
Theoretically, astragalus might interfere with immunosuppressive therapy.
Read the full Astragalus Root Extract, Dry + 6-mercaptopurine interactionAdo-trastuzumab EmtansineKadcyla
How Ado-trastuzumab Emtansine interacts with Cold Season Support — through 1 ingredient. Tap an ingredient for the detail:
Goldenseal Leaf Extract, DryCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Goldenseal might increase serum levels of drugs metabolized by CYP3A4.
Read the full Goldenseal Leaf Extract, Dry + Ado-trastuzumab Emtansine interactionAbciximabReoPro
How Abciximab interacts with Cold Season Support — through 1 ingredient. Tap an ingredient for the detail:
Goldenseal Leaf Extract, DryAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, goldenseal might increase the risk of bleeding when used with anticoagulant or antiplatelet drugs.
Read the full Goldenseal Leaf Extract, Dry + Abciximab interactionAbemaciclibVerzenio
How Abemaciclib interacts with Cold Season Support — through 1 ingredient. Tap an ingredient for the detail:
Goldenseal Leaf Extract, DryCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Goldenseal might increase serum levels of drugs metabolized by CYP3A4.
Read the full Goldenseal Leaf Extract, Dry + Abemaciclib interactionAbiraterone
How Abiraterone interacts with Cold Season Support — through 1 ingredient. Tap an ingredient for the detail:
Goldenseal Leaf Extract, DryCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Goldenseal might increase serum levels of drugs metabolized by CYP3A4.
Read the full Goldenseal Leaf Extract, Dry + Abiraterone interactionAbiraterone AcetateYonsa, Zytiga
How Abiraterone Acetate interacts with Cold Season Support — through 1 ingredient. Tap an ingredient for the detail:
Goldenseal Leaf Extract, DryCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Goldenseal might increase serum levels of drugs metabolized by CYP3A4.
Read the full Goldenseal Leaf Extract, Dry + Abiraterone Acetate interactionAbrocitinibCibinqo
How Abrocitinib interacts with Cold Season Support — through 2 ingredients. Tap an ingredient for the detail:
Goldenseal Leaf Extract, DryAnticoagulant/antiplatelet Drugs, Cytochrome P450 2c9 (cyp2c9) Substrates Moderate
Interaction Summary
Theoretically, goldenseal might increase the risk of bleeding when used with anticoagulant or antiplatelet drugs.
Read the full Goldenseal Leaf Extract, Dry + Abrocitinib interactionAstragalus Root Extract, DryImmunosuppressants Moderate
Interaction Summary
Theoretically, astragalus might interfere with immunosuppressive therapy.
Read the full Astragalus Root Extract, Dry + Abrocitinib interactionAcalabrutinibCalquence
How Acalabrutinib interacts with Cold Season Support — through 1 ingredient. Tap an ingredient for the detail:
Goldenseal Leaf Extract, DryCytochrome P450 3a4 (cyp3a4) Substrates, P-glycoprotein Substrates Moderate
Interaction Summary
Goldenseal might increase serum levels of drugs metabolized by CYP3A4.
Read the full Goldenseal Leaf Extract, Dry + Acalabrutinib interactionAcarboseGlucobay, Prandase, Precose
How Acarbose interacts with Cold Season Support — through 2 ingredients. Tap an ingredient for the detail:
Goldenseal Leaf Extract, DryAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, goldenseal might increase the risk of hypoglycemia when used with antidiabetes drugs.
Read the full Goldenseal Leaf Extract, Dry + Acarbose interactionAstragalus Root Extract, DryAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, taking astragalus with antidiabetes drugs might increase the risk of hypoglycemia.
Read the full Astragalus Root Extract, Dry + Acarbose interactionAcebutololRhotral, Sectral
How Acebutolol interacts with Cold Season Support — through 1 ingredient. Tap an ingredient for the detail:
Goldenseal Leaf Extract, DryAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, goldenseal might increase the risk of hypotension when taken with antihypertensive drugs.
Read the full Goldenseal Leaf Extract, Dry + Acebutolol interactionAcenocoumarolSintrom
How Acenocoumarol interacts with Cold Season Support — through 1 ingredient. Tap an ingredient for the detail:
Goldenseal Leaf Extract, DryAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, goldenseal might increase the risk of bleeding when used with anticoagulant or antiplatelet drugs.
Read the full Goldenseal Leaf Extract, Dry + Acenocoumarol interactionAcepromazineAtravet
How Acepromazine interacts with Cold Season Support — through 1 ingredient. Tap an ingredient for the detail:
Goldenseal Leaf Extract, DryCns Depressants Moderate
Interaction Summary
Theoretically, goldenseal might increase the sedative effects of CNS depressants.
Read the full Goldenseal Leaf Extract, Dry + Acepromazine interactionAcetaminophenChildren's Tylenol, Children's Tylenol Meltaways, Tylenol, Tylenol Ex Strength
How Acetaminophen interacts with Cold Season Support — through 1 ingredient. Tap an ingredient for the detail:
Goldenseal Leaf Extract, DryCytochrome P450 2e1 (cyp2e1) Substrates Moderate
Interaction Summary
Theoretically, goldenseal might increase serum levels of drugs metabolized by CYP2E1.
Read the full Goldenseal Leaf Extract, Dry + Acetaminophen interactionAcetaminophen, AspirinGemnisyn
How Acetaminophen, Aspirin interacts with Cold Season Support — through 1 ingredient. Tap an ingredient for the detail:
Goldenseal Leaf Extract, DryCytochrome P450 2e1 (cyp2e1) Substrates, Anticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, goldenseal might increase serum levels of drugs metabolized by CYP2E1.
Read the full Goldenseal Leaf Extract, Dry + Acetaminophen, Aspirin interactionAcetaminophen, Aspirin, CaffeineExcedrin, Excedrin Extra Strength, Excedrin Migraine
How Acetaminophen, Aspirin, Caffeine interacts with Cold Season Support — through 1 ingredient. Tap an ingredient for the detail:
Goldenseal Leaf Extract, DryAnticoagulant/antiplatelet Drugs, Cytochrome P450 2e1 (cyp2e1) Substrates +1 Moderate
Interaction Summary
Theoretically, goldenseal might increase the risk of bleeding when used with anticoagulant or antiplatelet drugs.
Read the full Goldenseal Leaf Extract, Dry + Acetaminophen, Aspirin, Caffeine interactionAcetaminophen, Brompheniramine, PhenylpropanolamineDimetapp Cold and Flu
How Acetaminophen, Brompheniramine, Phenylpropanolamine interacts with Cold Season Support — through 1 ingredient. Tap an ingredient for the detail:
Goldenseal Leaf Extract, DryCytochrome P450 2e1 (cyp2e1) Substrates Moderate
Interaction Summary
Theoretically, goldenseal might increase serum levels of drugs metabolized by CYP2E1.
Read the full Goldenseal Leaf Extract, Dry + Acetaminophen, Brompheniramine, Phenylpropanolamine interactionAcetaminophen, ButalbitalAxocet, Bancap, Bucet, Butex Forte, Esgic CF, Orbivan CF +5 more
How Acetaminophen, Butalbital interacts with Cold Season Support — through 1 ingredient. Tap an ingredient for the detail:
Goldenseal Leaf Extract, DryCytochrome P450 2e1 (cyp2e1) Substrates Moderate
Interaction Summary
Theoretically, goldenseal might increase serum levels of drugs metabolized by CYP2E1.
Read the full Goldenseal Leaf Extract, Dry + Acetaminophen, Butalbital interactionAcetaminophen, Butalbital, CaffeineEsgic, Esgic Plus, Fiogesic, Fioricet, Repan, Tecnal +1 more
How Acetaminophen, Butalbital, Caffeine interacts with Cold Season Support — through 1 ingredient. Tap an ingredient for the detail:
Goldenseal Leaf Extract, DryCytochrome P450 2e1 (cyp2e1) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, goldenseal might increase serum levels of drugs metabolized by CYP2E1.
Read the full Goldenseal Leaf Extract, Dry + Acetaminophen, Butalbital, Caffeine interactionAcetaminophen, Butalbital, Caffeine, CodeineEsgic with Codeine, Fioricet w/ Codeine
How Acetaminophen, Butalbital, Caffeine, Codeine interacts with Cold Season Support — through 1 ingredient. Tap an ingredient for the detail:
Goldenseal Leaf Extract, DryCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 2e1 (cyp2e1) Substrates +2 Moderate
Interaction Summary
Goldenseal might increase serum levels of drugs metabolized by CYP3A4.
Read the full Goldenseal Leaf Extract, Dry + Acetaminophen, Butalbital, Caffeine, Codeine interactionAcetaminophen, Butalbital, CodeineBancap w/ Codeine
How Acetaminophen, Butalbital, Codeine interacts with Cold Season Support — through 1 ingredient. Tap an ingredient for the detail:
Goldenseal Leaf Extract, DryCytochrome P450 2d6 (cyp2d6) Substrates, Cns Depressants +1 Moderate
Interaction Summary
Goldenseal might increase serum levels of drugs metabolized by CYP2D6.
Read the full Goldenseal Leaf Extract, Dry + Acetaminophen, Butalbital, Codeine interactionAcetaminophen, Butalbital, Codeine PhosphatePhrenilin #3
How Acetaminophen, Butalbital, Codeine Phosphate interacts with Cold Season Support — through 1 ingredient. Tap an ingredient for the detail:
Goldenseal Leaf Extract, DryCytochrome P450 2e1 (cyp2e1) Substrates, Cytochrome P450 2d6 (cyp2d6) Substrates +1 Moderate
Interaction Summary
Theoretically, goldenseal might increase serum levels of drugs metabolized by CYP2E1.
Read the full Goldenseal Leaf Extract, Dry + Acetaminophen, Butalbital, Codeine Phosphate interactionAcetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, PhenylephrineHycomine Compound
How Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interacts with Cold Season Support — through 1 ingredient. Tap an ingredient for the detail:
Goldenseal Leaf Extract, DryCns Depressants, Cytochrome P450 2e1 (cyp2e1) Substrates +2 Moderate
Interaction Summary
Theoretically, goldenseal might increase the sedative effects of CNS depressants.
Read the full Goldenseal Leaf Extract, Dry + 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 Cold Season Support — through 1 ingredient. Tap an ingredient for the detail:
Goldenseal Leaf Extract, DryCytochrome P450 2d6 (cyp2d6) Substrates, Cytochrome P450 2e1 (cyp2e1) Substrates +2 Moderate
Interaction Summary
Goldenseal might increase serum levels of drugs metabolized by CYP2D6.
Read the full Goldenseal Leaf Extract, Dry + Acetaminophen, Caffeine, Codeine interactionAcetaminophen, Caffeine, Codeine, SalicylamideCodalan No.1, Codalan No.2, Codalan No.3
How Acetaminophen, Caffeine, Codeine, Salicylamide interacts with Cold Season Support — through 1 ingredient. Tap an ingredient for the detail:
Goldenseal Leaf Extract, DryCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 2e1 (cyp2e1) Substrates +2 Moderate
Interaction Summary
Goldenseal might increase serum levels of drugs metabolized by CYP3A4.
Read the full Goldenseal Leaf Extract, Dry + Acetaminophen, Caffeine, Codeine, Salicylamide interactionAcetaminophen, Caffeine, DihydrocodeineDHC Plus, Panlor DC, Panlor SS
How Acetaminophen, Caffeine, Dihydrocodeine interacts with Cold Season Support — through 1 ingredient. Tap an ingredient for the detail:
Goldenseal Leaf Extract, DryCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 2d6 (cyp2d6) Substrates +2 Moderate
Interaction Summary
Goldenseal might increase serum levels of drugs metabolized by CYP3A4.
Read the full Goldenseal Leaf Extract, Dry + Acetaminophen, Caffeine, Dihydrocodeine interactionAcetaminophen, Caffeine, IsomethepteneMigralam
How Acetaminophen, Caffeine, Isometheptene interacts with Cold Season Support — through 1 ingredient. Tap an ingredient for the detail:
Goldenseal Leaf Extract, DryCytochrome P450 2e1 (cyp2e1) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, goldenseal might increase serum levels of drugs metabolized by CYP2E1.
Read the full Goldenseal Leaf Extract, Dry + Acetaminophen, Caffeine, Isometheptene interactionAcetaminophen, Caffeine, PyrilamineMidol Max Strength Menstrual
How Acetaminophen, Caffeine, Pyrilamine interacts with Cold Season Support — through 1 ingredient. Tap an ingredient for the detail:
Goldenseal Leaf Extract, DryCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 2e1 (cyp2e1) Substrates Moderate
Interaction Summary
Goldenseal might increase serum levels of drugs metabolized by CYP3A4.
Read the full Goldenseal Leaf Extract, Dry + Acetaminophen, Caffeine, Pyrilamine interactionAcetaminophen, Chlorpheniramine Maleate, Dextromethorphan HbrVicks Formula 44M Cough, Cold & Flu Relief
How Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interacts with Cold Season Support — through 1 ingredient. Tap an ingredient for the detail:
Goldenseal Leaf Extract, DryCytochrome P450 2e1 (cyp2e1) Substrates, Dextromethorphan (robitussin Dm, Others) +2 Moderate
Interaction Summary
Theoretically, goldenseal might increase serum levels of drugs metabolized by CYP2E1.
Read the full Goldenseal Leaf Extract, Dry + Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interactionAcetaminophen, Chlorpheniramine, Codeine, PhenylephrineColrex
How Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interacts with Cold Season Support — through 1 ingredient. Tap an ingredient for the detail:
Goldenseal Leaf Extract, DryCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 2e1 (cyp2e1) Substrates +2 Moderate
Interaction Summary
Goldenseal might increase serum levels of drugs metabolized by CYP3A4.
Read the full Goldenseal Leaf Extract, Dry + Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interactionAcetaminophen, Chlorpheniramine, DextromethorphanCoricidin II Extra Strength Cold and Flu
How Acetaminophen, Chlorpheniramine, Dextromethorphan interacts with Cold Season Support — through 1 ingredient. Tap an ingredient for the detail:
Goldenseal Leaf Extract, DryCytochrome P450 2d6 (cyp2d6) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +2 Moderate
Interaction Summary
Goldenseal might increase serum levels of drugs metabolized by CYP2D6.
Read the full Goldenseal Leaf Extract, Dry + Acetaminophen, Chlorpheniramine, Dextromethorphan interactionEach ingredient & the kinds of drugs it affects
For each ingredient in Cold Season Support 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.
Goldenseal Leaf Extract, Dry
Anticoagulant/Antiplatelet Drugs
Theoretically, goldenseal might increase the risk of bleeding when used with anticoagulant or antiplatelet drugs.
Goldenseal contains berberine. In vitro and animal research shows that berberine can inhibit platelet aggregation. However, this effect has not been reported in humans.
Antidiabetes Drugs
Theoretically, goldenseal might increase the risk of hypoglycemia when used with antidiabetes drugs.
Goldenseal contains berberine. Clinical research shows that berberine can lower blood glucose levels. However, this effect has not been reported with goldenseal.
Antihypertensive Drugs
Theoretically, goldenseal might increase the risk of hypotension when taken with antihypertensive drugs.
Goldenseal contains berberine. Animal research shows that berberine can have hypotensive effects. Also, an analysis of clinical research shows that taking berberine in combination with amlodipine can lower systolic and diastolic blood pressure when compared with amlodipine alone. However, this effect has not been reported with goldenseal.
Cns Depressants
Theoretically, goldenseal might increase the sedative effects of CNS depressants.
Goldenseal contains berberine. Animal research shows that berberine can have sedative effects. However, this effect has not been reported in humans.
Cytochrome P450 2C9 (Cyp2C9) Substrates
Theoretically, goldenseal might increase serum levels of drugs metabolized by CYP2C9.
In vitro research shows that goldenseal root extract can modestly inhibit CYP2C9. This effect may be due to its alkaloid constituents, hydrastine and berberine. However, this effect has not been reported in humans.
Cytochrome P450 2D6 (Cyp2D6) Substrates
Goldenseal might increase serum levels of drugs metabolized by CYP2D6.
Clinical and in vitro research shows that goldenseal can significantly inhibit CYP2D6 enzymes, potentially increasing levels of drugs metabolized by CYP2D6.
Cytochrome P450 2E1 (Cyp2E1) Substrates
Theoretically, goldenseal might increase serum levels of drugs metabolized by CYP2E1.
In vitro research shows that goldenseal root extract can inhibit the activity of CYP2E1. However, this effect has not been reported in humans.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Goldenseal might increase serum levels of drugs metabolized by CYP3A4.
Most clinical and in vitro research shows that goldenseal inhibits CYP3A4 enzyme activity and increases serum levels of CYP3A4 substrates, such as midazolam. However, in one small clinical study, goldenseal did not affect the levels of indinavir, a CYP3A4 substrate, in healthy volunteers. This is likely due to the fact that indinavir has a high oral bioavailability, making it an inadequate probe for CYP3A4 interactions and/or that it is primarily metabolized by hepatic CYP3A, while goldenseal has more potential to inhibit intestinal CYP3A enzyme activity. Both goldenseal extract and its isolated constituents berberine and hydrastine inhibit CYP3A, with hydrastine possibly having more inhibitory potential than berberine.
Dextromethorphan (Robitussin Dm, Others)
Theoretically, goldenseal might increase serum levels of dextromethorphan.
Goldenseal contains berberine. A small clinical study shows that berberine can inhibit cytochrome P450 2D6 (CYP2D6) activity and reduce the metabolism of dextromethorphan.
Digoxin (Lanoxin)
Goldenseal might increase serum levels of digoxin, although this effect is unlikely to be clinically significant.
Clinical research shows that goldenseal modestly increases digoxin peak levels by about 14% in healthy volunteers. However, goldenseal does not seem to affect other pharmacokinetic parameters such as area under the curve (AUC). This suggests that goldenseal does not cause a clinically significant interaction with digoxin. Digoxin is a P-glycoprotein substrate. Some evidence suggests that goldenseal constituents might affect P-glycoprotein; however, it is unclear whether these constituents inhibit or induce P-glycoprotein.
Losartan (Cozaar)
Theoretically, goldenseal might decrease the conversion of losartan to its active form.
Goldenseal contains berberine. A small clinical study shows that berberine inhibits cytochrome P450 2C9 (CYP2C9) activity and reduces the metabolism of losartan. However, this effect has not been reported with goldenseal.
Metformin (Glucophage)
Theoretically, goldenseal might reduce blood levels of metformin.
In vitro research shows that goldenseal extract decreases the bioavailability of metformin, likely by interfering with transport, intestinal permeability, or other processes involved in metformin absorption. It is unclear which, if any, of metformin's transporters are inhibited by goldenseal. Goldenseal does not appear to alter the clearance or half-life of metformin.
P-Glycoprotein Substrates
Theoretically, goldenseal might increase or decrease serum levels of P-glycoprotein (P-gp) substrates.
There is conflicting evidence about the effect of goldenseal on P-gp. In vitro research suggests that berberine, a constituent of goldenseal, modestly inhibits P-gp efflux. Other evidence suggests that berberine induces P-gp. In healthy volunteers, goldenseal modestly increases peak levels of the P-gp substrate digoxin by about 14%. However, it does not seem to affect other pharmacokinetic parameters such as area under the curve (AUC). This suggests that goldenseal is not a potent inhibitor of P-gp-mediated drug efflux. Until more is known, goldenseal should be used cautiously with P-gp substrates.
Pentobarbital (Nembutal)
Theoretically, goldenseal might increase the sedative effects of pentobarbital.
Animal research shows that berberine, a constituent of goldenseal, can prolong pentobarbital-induced sleeping time. However, this effect has not been reported with goldenseal.
Tacrolimus (Prograf)
Theoretically, goldenseal might increase serum levels of tacrolimus.
Goldenseal contains berberine. In a 16-year-old patient with idiopathic nephrotic syndrome who was being treated with tacrolimus 6.5 mg twice daily, intake of berberine 200 mg three times daily increased the blood concentration of tacrolimus from 8 to 22 ng/mL. Following a reduction of tacrolimus dosing to 3 mg daily, blood levels of tacrolimus decreased to 12 ng/mL.
Oseltamivir (Tamiflu)
Theoretically, goldenseal might reduce the therapeutic effects of oseltamivir by decreasing its conversion to its active form.
In vitro evidence suggests that goldenseal reduces the formation of the active compound from the prodrug oseltamivir. The mechanism of action and clinical relevance is unclear.
Astragalus Root Extract, Dry
Antidiabetes Drugs
Theoretically, taking astragalus with antidiabetes drugs might increase the risk of hypoglycemia.
Clinical research in humans shows that astragalus might have hypoglycemic effects. Theoretically, taking astragalus, especially in combination with other hypoglycemic agents, might increase the risk of hypoglycemia.
Cyclophosphamide
Theoretically, astragalus might interfere with cyclophosphamide therapy.
Evidence regarding the effect of astragalus on immunosuppression caused by cyclophosphamide is conflicting. Some animal research suggests that astragalus reverses cyclophosphamide-induced immunosuppression. However, other animal research shows no effect.
Immunosuppressants
Theoretically, astragalus might interfere with immunosuppressive therapy.
Astragalus seems to stimulate immune function. Theoretically, taking astragalus might decrease the effects of immunosuppressive therapy.
Lithium
Theoretically, astragalus might increase levels and adverse effects of lithium.
Animal research suggests that astragalus has diuretic properties. Theoretically, due to this diuretic effect, astragalus might reduce excretion and increase levels of lithium.
Brand information
Manufacturer and brand details for Cold Season Support, from the product label.
Hawaii Pharm
See all Hawaii Pharm products- Name
- Hawaii Pharm LLC
- Street Address
- 510 Sumner St. Ste. 613
- City
- Honolulu
- State
- HI
- ZipCode
- 96817
- Phone Number
- 888-854-2924
- Web Address
- www.hawaiipharm.com
Cold Season Support by Hawaii Pharm: 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 Cold Season Support’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Astragalus
Interacts with 208 drugsAstragalus is a root used for centuries in traditional Chinese medicine, mainly to support the immune system and help the body cope with stress. While early studies are interesting, strong h...
Read the full Astragalus monograph → Herb & supplement monographGoldenseal
Interacts with 1,237 drugsGoldenseal is a popular North American herb that contains berberine, a compound studied for antimicrobial effects. However, strong human evidence for its many traditional uses is largely lac...
Read the full Goldenseal monograph →Sources & How We Checked
Cold Season Support'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 47 references behind this product’s interaction data
Every citation that drives the interaction findings for this product’s ingredients, from the evidence-graded Natural Medicines (TRC Healthcare) database. Open an ingredient to browse its citations — links open the study on PubMed or the publisher’s site.
Astragalus 13 references
- Upton R, ed. Astragalus Root: Analytical, quality control, and therapeutic monograph. Santa Cruz, CA: American Herbal Pharmacopoeia. 1999:1-25.
- Khoo KS, Ang PT. Extract of astragalus membranaceus and ligustrum lucidum does not prevent cyclophosphamide-induced myelosuppression. Singapore Med J 1995;36:387-90.
- Chu DT, Wong WL, Mavligit GM. Immunotherapy with Chinese medicinal herbs. II. Reversal of cyclophosphamide-induced immune suppression by administration of fractionated Astragalus membranaceus in vivo. J Clin Lab Immunol 1988;25:125-9.
- Sun Y, Hersh EM, Lee SL, et al. Preliminary observations on the effects of the Chinese medicinal herbs Astragalus membranaceus and Ligustrum lucidum on lymphocyte blastogenic responses. J Biol Response Mod 1983;2:227-37..
- Ma J, Peng A, Lin S. Mechanisms of the therapeutic effect of astragalus membranaceus on sodium and water retention in experimental heart failure. Chin Med J (Engl) 1998;111:17-23.
- Matkovic Z, Zivkovic V, Korica M, et al. Efficacy and safety of Astragalus membranaceus in the treatment of patients with seasonal allergic rhinitis. Phytother Res 2010;24:175-81.
- Zhang, J. G., Yang, N., He, H., Wei, G. H., Gao, D. S., Wang, X. L., Wang, X. Z., and Song, G. Y. [Effect of Astragalus injection on plasma levels of apoptosis-related factors in aged patients with chronic heart failure.]. Chin J Integr.Med 2005;11(3):18 PubMed
- Chen, H. W., Lin, I. H., Chen, Y. J., Chang, K. H., Wu, M. H., Su, W. H., Huang, G. C., and Lai, Y. L. A novel infusible botanically-derived drug, PG2, for cancer-related fatigue: a phase II double-blind, randomized placebo-controlled study. Clin Invest PubMed
- Tian H, Lu J, He H, et al.The effect of Astragalus as an adjuvant treatment in type 2 diabetes mellitus: A (preliminary) meta-analysis. J Ethnopharmacol. 2016;191:206-215. doi: 10.1016/j.jep.2016.05.062. PubMed
- Hong KF, Liu PY, Zhang W, Gui DK, Xu YH. The Efficacy and Safety of Astragalus as an Adjuvant Treatment for Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis. J Integr Complement Med 2023. PubMed
- Chan KW, Kwong ASK, Tsui PN, et al. Add-on astragalus in type 2 diabetes and chronic kidney disease: A multi-center, assessor-blind, randomized controlled trial. Phytomedicine 2024;130:155457. PubMed
- Han X, Yu T, Chen X, Du Z, Yu M, Xiong J. Effect of Astragalus membranaceus on left ventricular remodeling in HFrEF: a systematic review and meta-analysis. Front Pharmacol 2024;15:1345797. PubMed
- Jing P, Hongzheng H, Zhenqi WU, Meijuan Z, Zuojing LI, Gang C. Long-term efficacy and safety of Huangqi ()-based Traditional Chinese Medicine in diabetic peripheral neuropathy: a Meta-analysis of randomized controlled trials. J Tradit Chin Med 2024;44(2):
Goldenseal 34 references
- Chan E. Displacement of bilirubin from albumin by berberine. Biol Neonate 1993;63:201-8. PubMed
- Budzinski JW, Foster BC, Vandenhoek S, Arnason JT. An in vitro evaluation of human cytochrome P450 3A4 inhibition by selected commercial herbal extracts and tinctures. Phytomedicine 2000;7:273-82. PubMed
- Sandhu RS, Prescilla RP, Simonelli TM, Edwards DJ. Influence of goldenseal root on the pharmacokinetics of indinavir. J Clin Pharmacol 2003;43:1283-8.. PubMed
- Janbaz KH, Gilani AH. Studies on preventive and curative effects of berberine on chemical-induced hepatotoxicity in rodents. Fitoterapia 2000;71:25-33.. PubMed
- Gurley BJ, Gardner SF, Hubbard MA, et al. In vivo effects of goldenseal, kava kava, black cohosh, and valerian on human cytochrome P450 1A2, 2D6, 2E1, and 3A4/5 phenotypes. Clin Pharmacol Ther 2005;77:415-26. PubMed
- Gurley BJ, Swain A, Barone GW, et al. Effect of goldenseal (Hydrastis canadensis) and kava kava (Piper methysticum) supplementation on digoxin pharmacokinetics in humans. Drug Metab Dispos 2007;35:240-5. PubMed
- Gurley BJ, Swain A, Hubbard MA, et al. Clinical assessement of CYP2D6-mediated herb-drug interactions in humans: Effects of milk-thistle, black cohosh, goldenseal, kava kava, St. John's wort, and Echinacea. Mol Nutr Food Res 2008;52:755-63.
- Zhang Y, Li X, Zou D, et al. Treatment of type 2 diabetes and dyslipidemia with the natural plant alkaloid berberine. J Clin Endocrinol Metab 2008;93:2559-65. PubMed
- Chatterjee P, Franklin MR. Human cytochrome p450 inhibition and metabolic-intermediate complex formation by goldenseal extract and its methylenedioxyphenyl components. Drug Metab Dispos 2003;31:1391-7. PubMed
- Choudhry, V. P., Sabir, M., and Bhide, V. N. Berberine in giardiasis. Indian Pediatr. 1972;9(3):143-146.
- Shanbhag, S. M., Kulkarni, H. J., and Gaitonde, B. B. Pharmacological actions of berberine on the central nervous system. Jpn.J Pharmacol 1970;20(4):482-487. PubMed
- Wu, J. F. and Liu, T. P. [Effects of berberine on platelet aggregation and plasma levels of TXB2 and 6-keto-PGF1 alpha in rats with reversible middle cerebral artery occlusion]. Yao Xue.Xue.Bao. 1995;30(2):98-102.
- Peng, W. H., Hsieh, M. T., and Wu, C. R. Effect of long-term administration of berberine on scopolamine-induced amnesia in rats. Jpn J Pharmacol 1997;74(3):261-266. DOI
- Sharda DC. Berberine in the treatment of diarrhoea of infancy and childhood. J Indian M A 1970;54(1):22-24.
- Sabir M and Bhide NK. Study of some pharmacological actions of berberine. Ind J Physiol & Pharmac 1971;15(3):111-132.
- Tripathi YB and Shukla SD. Berberis artistata inhibits PAF induced aggregation of rabbit platelets. Phytotherapy Research 1996;10:628-630.
- Zhang, Y., Li, X., Zou, D., Liu, W., Yang, J., Zhu, N., Huo, L., Wang, M., Hong, J., Wu, P., Ren, G., and Ning, G. Treatment of type 2 diabetes and dyslipidemia with the natural plant alkaloid berberine. J Clin Endocrinol.Metab 2008;93(7):2559-2565. PubMed
- Yin, J., Xing, H., and Ye, J. Efficacy of berberine in patients with type 2 diabetes mellitus. Metabolism 2008;57(5):712-717. PubMed
- Zhang, H., Wei, J., Xue, R., Wu, J. D., Zhao, W., Wang, Z. Z., Wang, S. K., Zhou, Z. X., Song, D. Q., Wang, Y. M., Pan, H. N., Kong, W. J., and Jiang, J. D. Berberine lowers blood glucose in type 2 diabetes mellitus patients through increasing insulin re
- Guo, Y., Chen, Y., Tan, Z. R., Klaassen, C. D., and Zhou, H. H. Repeated administration of berberine inhibits cytochromes P450 in humans. Eur J Clin Pharmacol 2012;68(2):213-217. PubMed
- Wei, W., Zhao, H., Wang, A., Sui, M., Liang, K., Deng, H., Ma, Y., Zhang, Y., Zhang, H., and Guan, Y. A clinical study on the short-term effect of berberine in comparison to metformin on the metabolic characteristics of women with polycystic ovary syndro
- Meng, S., Wang, L. S., Huang, Z. Q., Zhou, Q., Sun, Y. G., Cao, J. T., Li, Y. G., and Wang, C. Q. Berberine ameliorates inflammation in patients with acute coronary syndrome following percutaneous coronary intervention. Clin Exp.Pharmacol Physiol 2012;39 PubMed
- Chun YT, Yip TT, Lau KL, and et al. A biochemical study on the hypotensive effect of berberine in rats. Gen Pharmac 1979;10:177-182. PubMed
- Sevior, D. K., Hokkanen, J., Tolonen, A., Abass, K., Tursas, L., Pelkonen, O., and Ahokas, J. T. Rapid screening of commercially available herbal products for the inhibition of major human hepatic cytochrome P450 enzymes using the N-in-one cocktail. Xeno PubMed
- Bhowmick, S. K., Hundley, O. T., and Rettig, K. R. Severe hypernatremia and hyperosmolality exacerbated by an herbal preparation in a patient with diabetic ketoacidosis. Clin Pediatr (Phila) 2007;46(9):831-834. PubMed
- Gurley BJ, et al. Supplementation with goldenseal (Hydrastis canadensis), but not kava kava (Piper methysticum), inhibits human CYP3A activitiy In Vivo. Clin Pharmacol Ther. 2008;83(1):61-69.
- Dong H, Zhao Y, Zhao L, Lu F. The effects of berberine on blood lipids: a systemic review and meta-analysis of randomized controlled trials. Planta Med 2013;79(6):437-46. PubMed
- Hou Q, Han W, Fu X. Pharmacokinetic interaction between tacrolimus and berberine in a child with idiopathic nephrotic syndrome. Eur J Clin Pharmacol 2013;69(10):1861-2. PubMed
- Lan J, Zhao Y, Dong F, et al. Meta-analysis of the effect and safety of berberine in the treatment of type 2 diabetes mellitus, hyperlipemia and hypertension. J Ethnopharmacol. 2015;161:69-81. PubMed
- Jalloh MA, Gregory PJ, Hein D, et al. Dietary supplement interactions with antiretrovirals: a systematic review. Int J STD AIDS. 2017 Jan;28(1):4-15. PubMed
- Yamaura K, Shimada M, Nakayama N, Ueno K. Protective effects of goldenseal (Hydrastis canadensis L.) on acetaminophen-induced hepatotoxicity through inhibition of CYP2E1 in rats. Pharmacognosy Res. 2011;3(4):250-5. PubMed
- Nguyen JT, Tian DD, Tanna RS, et al. Assessing transporter-mediated natural product-drug interactions via in vitro-in vivo extrapolation: clinical evaluation with a probe cocktail. Clin Pharmacol Ther 2021;109(5):1342-52.
- Liu R, Tam TW, Mao J, et al. The effect of natural health products and traditional medicines on the activity of human hepatic microsomal-mediated metabolism of oseltamivir. J Pharm Pharm Sci 2010;13(1):43-55. PubMed
- Nguyen JT, Tian DD, Tanna RS, et al. An Integrative Approach to Elucidate Mechanisms Underlying the Pharmacokinetic Goldenseal-Midazolam Interaction: Application of In Vitro Assays and Physiologically Based Pharmacokinetic Models to Understand Clinical Ob
Parts of this content are provided by the Therapeutic Research Center, LLC.
DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.
© 2021 Therapeutic Research Center, LLC