D-Mannose Ingredients & Drug Interactions
by Vali
What is this page for?
First and foremost: checking D-Mannose 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
D-Mannose is a dietary supplement by Vali with 3 active ingredients. Its ingredients are commonly taken for preventing urinary tract infections (utis), treating mild utis, urinary tract health.Based on those ingredients, 712 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Cranberry Fruit Concentrate, Powder. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against D-Mannose by Vali
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HelloPharmacist Scorecard of D-Mannose by Vali
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
Vali D-Mannose contains three active ingredients. The main one is D-mannose itself, a simple sugar that your body doesn't break down the way it does glucose.
It also includes hibiscus flower extract and cranberry fruit concentrate powder. Beyond those, the capsule contains inactive ingredients — hydroxypropyl methylcellulose (the capsule material), magnesium stearate, and silicon dioxide — which are just fillers and binders.
Does it work?
Strong evidence
D-mannose is likely effective for carbohydrate-deficient glycoprotein syndrome type 1b, a rare metabolic condition, but the evidence suggests it's possibly ineffective for urinary tract infections (UTIs). Cranberry fruit concentrate is possibly effective for UTIs.
The other conditions listed in the research — age-related cognitive decline, benign prostatic hyperplasia, cancer, fatty liver disease, and chronic fatigue — don't have enough reliable evidence yet for either ingredient, so we can't rate them. If you're considering this product for a specific health reason, your doctor or pharmacist can help you weigh whether the evidence supports it.
How safe is it?
Well-documented data
D-mannose is generally well tolerated short-term, but long-term safety data are limited — so it's best to avoid it unless your doctor advises otherwise. The most common side effects are bloating, diarrhea, and nausea, especially at higher doses; loose stools and abdominal bloating have been seen even in children.
Cranberry concentrate is generally well tolerated as a food, but concentrated supplement doses haven't been well studied, so check with your provider first. Cranberry can also cause diarrhea and gastrointestinal discomfort, particularly at large doses.
For pregnancy, D-mannose safety data are not adequate — there isn't enough information to know either way, so talk with your doctor or pharmacist for personalized advice. Cranberry is likely safe in pregnancy.
Breastfeeding safety for D-mannose is not well studied, so caution is advised; cranberry breastfeeding safety data are not on file.
Meds to double-check
Moderate interaction found
If you take cholesterol medications (statins like atorvastatin), blood thinners like warfarin, or blood pressure drugs like nifedipine, check with your doctor or pharmacist before starting Vali D-Mannose — cranberry may increase drug levels and side effects. Also check if you take other medications broken down by your liver's cytochrome P450 system, as cranberry can affect how quickly your body clears them.
The bottom line
Scorecard at a glanceFully disclosed formula with clinical evidence supporting its stated purpose. Moderate medication interactions have been identified, and safety information is well characterized.
This product combines two ingredients studied for urinary tract health, though the evidence for D-mannose is weak for that purpose. The main concern is if you take statins, blood thinners, blood pressure medications, or other drugs that your liver processes — cranberry may increase their levels and side effects.
Talk with your doctor or pharmacist about whether it's right for you, especially if you're pregnant, breastfeeding, or on any medications.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 2 of 3 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Feb 21, 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 D-Mannose, straight from the product label.
| Brand | Vali |
|---|---|
| Barcode (UPC) | X001M0JS3N |
| Net contents | 60 Vegetarian Capsule(s) |
| Market status | On market |
| Date entered into DSLD | Feb 21, 2023 |
| DSLD ID | 284129 |
| Product type | Other Combinations |
| Supplement form | Capsule |
| Dietary claims / uses | All Other, Structure/Function |
| Intended target group(s) | Vegan, Vegetarian, Adult (18 - 50 Years), Women (not pregnant or lactating) |
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 D-Mannose by Vali, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| D-Mannose | 1000 mg | -- |
| Hibiscus flower extract | 200 mg | -- |
| Cranberry Fruit Concentrate, Powder | 200 mg | -- |
Other ingredients: Hydroxypropyl Methylcellulose, Magnesium Stearate, Silicon Dioxide
Tap any ingredient to jump to its full detail below.
These statements are the manufacturer’s wording, reproduced from the product label — the label is saying it, not HelloPharmacist. We don’t verify or endorse them.
Precautions
Warning: Do not exceed recommended dose.
Do not take if pregnant, nursing, or under 18 years old.
Do not take if pregnant, nursing, or under 18 years old.
If you have a medical condition, consult your physician before use. Do not use if safety seal is broken or missing.
Keep out of reach of children.
Manufactured in a facility and equipment that handles: eggs, wheat, milk, tree nuts, peanuts, soybeans, crustacean shellfish, and fish.
Storage
Store in a cool dry place.
Formulation
No Artificial flavors Preservatives Animal products
Suitable for vegetarians Vegan
Made with Non GMO ingredients
Full transparency formula
Urinary tract health and cleanse
Made with eco-friendly manufacturing in an FDA registered facility.
Extra strength anti-adherence to clean and flush away
Seals/Symbols
GMP Good Manufacturing Practice Quality Product Made in U.S.A.
Suggested/Recommended/Usage/Directions
Suggested Use: To support urinary health Take 2 capsules once daily with food. For best results drink plenty of water daily.
Formula
D-Mannose with hibiscus & cranberry
FDA Statement of Identity
Dietary Supplement
FDA Disclaimer Statement
Disclaimer: These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
D-Mannose by Vali 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 D-Mannose by Vali
These are the 3 active ingredients this product is made of. Select any to open its full monograph.
Serving size2 Vegetarian 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.
D-Mannose
No knowninteractions
D-mannose is a natural sugar most often used to help prevent urinary tract infections, especially those caused by E. coli. Early research is promising...
D-Mannose monograph & interactionsHibiscus flower extract
Cranberry Fruit Concentrate, Powder
Interacts with712 drugs
Cranberry is best known for helping to prevent repeated urinary tract infections (UTIs) in some people, and the evidence here is moderate but mixed. I...
Cranberry Fruit Concentrate, Powder monograph & interactionsOther (inactive) ingredients: Hydroxypropyl Methylcellulose, Magnesium Stearate, Silicon Dioxide. These complete the product’s ingredient list but are not active constituents.
D-Mannose by Vali Drug Interactions
HelloPharmacist Interaction Report
Vali D-Mannose has documented interactions through its cranberry fruit concentrate content.
The most serious concern is with cholesterol-lowering statins (a drug class that includes atorvastatin), where cranberry may increase drug levels and side effects to a Moderate degree — one case reported muscle breakdown and liver problems when combined with high-dose cranberry juice. Cranberry also interacts with blood pressure medications like nifedipine and blood thinners like warfarin at a Moderate level, both through effects on how your body processes these drugs.
Additionally, cranberry may affect a broader class of drugs broken down by your liver's cytochrome P450 system — including many common medications — at Minor to Moderate severity.
Read the full breakdown — every affected drug type, severity by severity
D-mannose itself has no documented interactions. Hibiscus flower extract was not checked — we hold no data for it.
Altogether, these interactions span 713 individual medications.
If you take any prescription medications, especially statins, blood thinners, or blood pressure drugs, run your exact medication list through the interaction checker below before starting this product.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against D-Mannose?
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 D-Mannose interact with 712 drugs. Click any drug to see the details.
1 of the 3 ingredients in D-Mannose interact with drugs. Each result below shows which ingredient is responsible. Cranberry Fruit Concentrate, Powder
Acetaminophen, Dextromethorphan, Guaifenesin, PhenylpropanolamineAnatuss
How Acetaminophen, Dextromethorphan, Guaifenesin, Phenylpropanolamine interacts with D-Mannose — through 1 ingredient. Tap an ingredient for the detail:
Cranberry Fruit Concentrate, PowderCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, cranberry might increase the levels and adverse effects of CYP3A4 substrates.
Read the full Cranberry Fruit Concentrate, Powder + Acetaminophen, Dextromethorphan, Guaifenesin, Phenylpropanolamine interactionAcetaminophen, Dextromethorphan, Guaifenesin, PseudoephedrineRobitussin Cold, Severe Cold, Suphedrine Cold/Cough
How Acetaminophen, Dextromethorphan, Guaifenesin, Pseudoephedrine interacts with D-Mannose — through 1 ingredient. Tap an ingredient for the detail:
Cranberry Fruit Concentrate, PowderCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, cranberry might increase the levels and adverse effects of CYP3A4 substrates.
Read the full Cranberry Fruit Concentrate, Powder + Acetaminophen, Dextromethorphan, Guaifenesin, Pseudoephedrine interactionAcetaminophen, Dextromethorphan, Phenylpropanolamine, PyrilamineTheracaps
How Acetaminophen, Dextromethorphan, Phenylpropanolamine, Pyrilamine interacts with D-Mannose — through 1 ingredient. Tap an ingredient for the detail:
Cranberry Fruit Concentrate, PowderCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, cranberry might increase the levels and adverse effects of CYP3A4 substrates.
Read the full Cranberry Fruit Concentrate, Powder + 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 D-Mannose — through 1 ingredient. Tap an ingredient for the detail:
Cranberry Fruit Concentrate, PowderCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, cranberry might increase the levels and adverse effects of CYP3A4 substrates.
Read the full Cranberry Fruit Concentrate, Powder + Acetaminophen, Dextromethorphan, Pseudoephedrine interactionAcetaminophen, HydrocodoneAnexsia, Anodynos DHC, Azdone, Co-Gesic, Doucet, Lorcet +9 more
How Acetaminophen, Hydrocodone interacts with D-Mannose — through 1 ingredient. Tap an ingredient for the detail:
Cranberry Fruit Concentrate, PowderCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, cranberry might increase the levels and adverse effects of CYP3A4 substrates.
Read the full Cranberry Fruit Concentrate, Powder + Acetaminophen, Hydrocodone interactionAcetaminophen, Phenylephrine, ChlorpheniramineSuper Cold Tabs
How Acetaminophen, Phenylephrine, Chlorpheniramine interacts with D-Mannose — through 1 ingredient. Tap an ingredient for the detail:
Cranberry Fruit Concentrate, PowderCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, cranberry might increase the levels and adverse effects of CYP3A4 substrates.
Read the full Cranberry Fruit Concentrate, Powder + Acetaminophen, Phenylephrine, Chlorpheniramine interactionAdagrasibKrazati
How Adagrasib interacts with D-Mannose — through 1 ingredient. Tap an ingredient for the detail:
Cranberry Fruit Concentrate, PowderCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, cranberry might increase the levels and adverse effects of CYP3A4 substrates.
Read the full Cranberry Fruit Concentrate, Powder + Adagrasib interactionAlfentanilAlfenta
How Alfentanil interacts with D-Mannose — through 1 ingredient. Tap an ingredient for the detail:
Cranberry Fruit Concentrate, PowderCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, cranberry might increase the levels and adverse effects of CYP3A4 substrates.
Read the full Cranberry Fruit Concentrate, Powder + Alfentanil interactionAlfuzosinUroxatral
How Alfuzosin interacts with D-Mannose — through 1 ingredient. Tap an ingredient for the detail:
Cranberry Fruit Concentrate, PowderCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, cranberry might increase the levels and adverse effects of CYP3A4 substrates.
Read the full Cranberry Fruit Concentrate, Powder + Alfuzosin interactionAliskirenTekturna
How Aliskiren interacts with D-Mannose — through 1 ingredient. Tap an ingredient for the detail:
Cranberry Fruit Concentrate, PowderCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, cranberry might increase the levels and adverse effects of CYP3A4 substrates.
Read the full Cranberry Fruit Concentrate, Powder + Aliskiren interactionAlmotriptanAlmogran, Axert
How Almotriptan interacts with D-Mannose — through 1 ingredient. Tap an ingredient for the detail:
Cranberry Fruit Concentrate, PowderCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, cranberry might increase the levels and adverse effects of CYP3A4 substrates.
Read the full Cranberry Fruit Concentrate, Powder + Almotriptan interactionAlogliptinNesina
How Alogliptin interacts with D-Mannose — through 1 ingredient. Tap an ingredient for the detail:
Cranberry Fruit Concentrate, PowderCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, cranberry might increase the levels and adverse effects of CYP3A4 substrates.
Read the full Cranberry Fruit Concentrate, Powder + Alogliptin interactionAlogliptin, PioglitazoneOseni
How Alogliptin, Pioglitazone interacts with D-Mannose — through 1 ingredient. Tap an ingredient for the detail:
Cranberry Fruit Concentrate, PowderCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, cranberry might increase the levels and adverse effects of CYP3A4 substrates.
Read the full Cranberry Fruit Concentrate, Powder + Alogliptin, Pioglitazone interactionAlpelisibPiqray
How Alpelisib interacts with D-Mannose — through 1 ingredient. Tap an ingredient for the detail:
Cranberry Fruit Concentrate, PowderCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, cranberry might increase the levels and adverse effects of CYP3A4 substrates.
Read the full Cranberry Fruit Concentrate, Powder + Alpelisib interactionAlprazolamNiravam, Xanax
How Alprazolam interacts with D-Mannose — through 1 ingredient. Tap an ingredient for the detail:
Cranberry Fruit Concentrate, PowderCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, cranberry might increase the levels and adverse effects of CYP3A4 substrates.
Read the full Cranberry Fruit Concentrate, Powder + Alprazolam interactionAmbrisentanLetairis, Volibris
How Ambrisentan interacts with D-Mannose — through 1 ingredient. Tap an ingredient for the detail:
Cranberry Fruit Concentrate, PowderCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, cranberry might increase the levels and adverse effects of CYP3A4 substrates.
Read the full Cranberry Fruit Concentrate, Powder + Ambrisentan interactionAmiodaroneCordarone, Pacerone
How Amiodarone interacts with D-Mannose — through 1 ingredient. Tap an ingredient for the detail:
Cranberry Fruit Concentrate, PowderCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, cranberry might increase the levels and adverse effects of CYP3A4 substrates.
Read the full Cranberry Fruit Concentrate, Powder + Amiodarone interactionAmitriptylineElavil
How Amitriptyline interacts with D-Mannose — through 1 ingredient. Tap an ingredient for the detail:
Cranberry Fruit Concentrate, PowderCytochrome P450 2c9 (cyp2c9) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, cranberry might increase the levels and adverse effects of CYP2C9 substrates.
Read the full Cranberry Fruit Concentrate, Powder + Amitriptyline interactionAmitriptyline, ChlordiazepoxideLimbitrol DS
How Amitriptyline, Chlordiazepoxide interacts with D-Mannose — through 1 ingredient. Tap an ingredient for the detail:
Cranberry Fruit Concentrate, PowderCytochrome P450 2c9 (cyp2c9) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, cranberry might increase the levels and adverse effects of CYP2C9 substrates.
Read the full Cranberry Fruit Concentrate, Powder + Amitriptyline, Chlordiazepoxide interactionAmitriptyline, PerphenazineEtrafon, Etrafon-A, Etrafon-Forte, Triavil
How Amitriptyline, Perphenazine interacts with D-Mannose — through 1 ingredient. Tap an ingredient for the detail:
Cranberry Fruit Concentrate, PowderCytochrome P450 2c9 (cyp2c9) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, cranberry might increase the levels and adverse effects of CYP2C9 substrates.
Read the full Cranberry Fruit Concentrate, Powder + Amitriptyline, Perphenazine interactionAmlodipineNorliqva
How Amlodipine interacts with D-Mannose — through 1 ingredient. Tap an ingredient for the detail:
Cranberry Fruit Concentrate, PowderCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, cranberry might increase the levels and adverse effects of CYP3A4 substrates.
Read the full Cranberry Fruit Concentrate, Powder + Amlodipine interactionAmlodipine BenzoateKaterzia
How Amlodipine Benzoate interacts with D-Mannose — through 1 ingredient. Tap an ingredient for the detail:
Cranberry Fruit Concentrate, PowderCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, cranberry might increase the levels and adverse effects of CYP3A4 substrates.
Read the full Cranberry Fruit Concentrate, Powder + Amlodipine Benzoate interactionAmlodipine BesilateIstin
How Amlodipine Besilate interacts with D-Mannose — through 1 ingredient. Tap an ingredient for the detail:
Cranberry Fruit Concentrate, PowderCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, cranberry might increase the levels and adverse effects of CYP3A4 substrates.
Read the full Cranberry Fruit Concentrate, Powder + Amlodipine Besilate interactionAmlodipine BesylateNorvasc
How Amlodipine Besylate interacts with D-Mannose — through 1 ingredient. Tap an ingredient for the detail:
Cranberry Fruit Concentrate, PowderCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, cranberry might increase the levels and adverse effects of CYP3A4 substrates.
Read the full Cranberry Fruit Concentrate, Powder + Amlodipine Besylate interactionAmlodipine Besylate, BenazeprilLotrel
How Amlodipine Besylate, Benazepril interacts with D-Mannose — through 1 ingredient. Tap an ingredient for the detail:
Cranberry Fruit Concentrate, PowderCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, cranberry might increase the levels and adverse effects of CYP3A4 substrates.
Read the full Cranberry Fruit Concentrate, Powder + Amlodipine Besylate, Benazepril interactionAmlodipine, CelecoxibConsensi
How Amlodipine, Celecoxib interacts with D-Mannose — through 1 ingredient. Tap an ingredient for the detail:
Cranberry Fruit Concentrate, PowderCytochrome P450 2c9 (cyp2c9) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, cranberry might increase the levels and adverse effects of CYP2C9 substrates.
Read the full Cranberry Fruit Concentrate, Powder + Amlodipine, Celecoxib interactionAmoxicillin, Omeprazole Magnesium, RifabutinTalicia
How Amoxicillin, Omeprazole Magnesium, Rifabutin interacts with D-Mannose — through 1 ingredient. Tap an ingredient for the detail:
Cranberry Fruit Concentrate, PowderCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 2c9 (cyp2c9) Substrates Moderate
Interaction Summary
Theoretically, cranberry might increase the levels and adverse effects of CYP3A4 substrates.
Read the full Cranberry Fruit Concentrate, Powder + Amoxicillin, Omeprazole Magnesium, Rifabutin interactionAmprenavirAgenerase
How Amprenavir interacts with D-Mannose — through 1 ingredient. Tap an ingredient for the detail:
Cranberry Fruit Concentrate, PowderCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, cranberry might increase the levels and adverse effects of CYP3A4 substrates.
Read the full Cranberry Fruit Concentrate, Powder + Amprenavir interactionApalutamideErleada
How Apalutamide interacts with D-Mannose — through 1 ingredient. Tap an ingredient for the detail:
Cranberry Fruit Concentrate, PowderCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, cranberry might increase the levels and adverse effects of CYP3A4 substrates.
Read the full Cranberry Fruit Concentrate, Powder + Apalutamide interactionApixabanEliquis
How Apixaban interacts with D-Mannose — through 1 ingredient. Tap an ingredient for the detail:
Cranberry Fruit Concentrate, PowderCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, cranberry might increase the levels and adverse effects of CYP3A4 substrates.
Read the full Cranberry Fruit Concentrate, Powder + Apixaban interactionEach ingredient & the kinds of drugs it affects
For each ingredient in D-Mannose with known interactions, here are the types of medications it can affect. Open any type for the detail — or search your exact drug in the checker above.
Cranberry Fruit Concentrate, Powder
Atorvastatin (Lipitor)
Theoretically, cranberry might increase levels and adverse effects of atorvastatin.
In one case report, a patient taking atorvastatin experienced upper back pain, rhabdomyolysis, and abnormal liver function after drinking cranberry juice 16 ounces daily for 2 weeks. Theoretically, this may have been caused by inhibition of cytochrome P450 3A4 (CYP3A4) enzymes by cranberry juice, as atorvastatin is a CYP3A4 substrate. Creatinine kinase and liver enzymes normalized within 2 weeks of stopping cranberry juice. Patients taking atorvastatin should avoid large quantities of cranberry juice.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, cranberry might increase the levels and adverse effects of CYP3A4 substrates.
A case of upper back pain, rhabdomyolysis, and abnormal liver function has been reported for a patient taking atorvastatin, a CYP3A4 substrate, in combination with cranberry juice 16 ounces daily for 2 weeks. Creatinine kinase and liver enzymes normalized within 2 weeks of stopping cranberry juice. Also, animal research suggests that cranberry juice, administered intraduodenally 30 minutes prior to nifedipine, a CYP3A4 substrate, inhibits nifedipine metabolism and increases the area under the concentration-time curve by 1.6-fold compared to control.
Nifedipine (Procardia)
Theoretically, cranberry might increase the levels and adverse effects of nifedipine.
Animal research suggests that cranberry juice, administered intraduodenally 30 minutes prior to nifedipine treatment, inhibits nifedipine metabolism and increases the area under the concentration-time curve by 1.6-fold compared to control. This interaction has not been reported in humans.
Warfarin (Coumadin)
Theoretically, cranberry might increase the levels and adverse effects of warfarin. However, research is conflicting.
There is contradictory evidence about the effect of cranberry juice on warfarin. Case reports have linked cranberry juice consumption to increases in the international normalized ratio (INR) in patients taking warfarin, resulting in severe spontaneous bleeding and excessive postoperative bleeding. Daily consumption of cranberry sauce for one week has also been linked to an increase in INR in one case report. In a small study in healthy young males, taking a high dose of 3 grams of cranberry juice concentrate capsules, equivalent to 57 grams of fruit daily, for 2 weeks produced a 30% increase in the area under the INR-time curve after a single 25-mg dose of warfarin. However, 3 very small clinical studies in patients stabilized on warfarin reported that cranberry juice 250 mL once or twice daily for 7 days (27% cranberry juice or pure cranberry juice) or 240 mL once daily for 14 days does not significantly increase INR or affect plasma warfarin levels. The reasons for these discrepant findings are unclear. It is possible that the form and dose of cranberry may play a role, as cranberry extracts and juices contain different constituents. Additionally, an in vitro study evaluating 5 different cranberry juices found varying effects, with only a cranberry concentrate, and not diluted cranberry juices, inhibiting CYP2C9. However, this concentrate did not inhibit CYP2C9 activity in humans.
Cytochrome P450 2C9 (Cyp2C9) Substrates
Theoretically, cranberry might increase the levels and adverse effects of CYP2C9 substrates. However, research is conflicting.
There is contradictory evidence about the effect of cranberry on CYP2C9 enzymes. In vitro evidence suggests that flavonoids in cranberry inhibit CYP2C9 enzymes. However, clinical research shows that cranberry juice does not significantly affect the levels, metabolism, or elimination of the CYP2C9 substrates flurbiprofen or diclofenac. Also, in patients stabilized on warfarin, drinking cranberry juice 250 mL daily for 7 days does not significantly increase the anticoagulant activity of warfarin, a CYP2C9 substrate. Additional pharmacokinetic research shows that cranberry juice does not increase peak plasma concentrations or area under the concentration-time curve of warfarin.
Diclofenac (Voltaren, Others)
Theoretically, cranberry might modestly increase the levels and adverse effects of diclofenac.
In vitro evidence suggests that cranberry juice inhibits diclofenac metabolism by human liver microsomes. However, drinking cranberry juice does not seem to affect diclofenac metabolism in humans.
Brand information
Manufacturer and brand details for D-Mannose, from the product label.
Vali
See all Vali products- Name
- The BSD Project LLC
- City
- Nashville
- State
- TN
- ZipCode
- 37204
- Phone Number
- (615) 436-3676
- Web Address
- www.valiup.com
D-Mannose by Vali: Common Questions
Does D-Mannose by Vali interact with any medications?
How can one product interact with so many drugs?
Where does this information come from?
Can I take this if I'm pregnant?
Can I take this while breastfeeding?
What are the side effects?
Does D-mannose actually help with UTIs?
Is this a substitute for antibiotics if I have a UTI?
What is D-mannose?
Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
Not sure if D-Mannose is safe with your meds?
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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 D-Mannose’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
D-mannose
D-mannose is a natural sugar most often used to help prevent urinary tract infections, especially those caused by E. coli. Early research is promising for prevention, but the evidence is sti...
Read the full D-mannose monograph → Herb & supplement monographCranberry
Interacts with 712 drugsCranberry is best known for helping to prevent repeated urinary tract infections (UTIs) in some people, and the evidence here is moderate but mixed. It is not a reliable treatment for an act...
Read the full Cranberry monograph →Sources & How We Checked
D-Mannose'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 39 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.
D-mannose 6 references
- Westphal V, Kjaergaard S, Davis JA, et al. Genetic and metabolic analysis of the first adult with congenital disorder of glycosylation type Ib: long-term outcome and effects of mannose supplementation. Mol Genet Metab 2001;73:77-85. PubMed
- Kranjcec B, Papes D, Altarac S. D-mannose powder for prophylaxis of recurrent urinary tract infections in women: a randomized clinical trial. World J Urol. 2014 Feb;32(1):79-84.
- de Lonlay P, Seta N. The clinical spectrum of phosphomannose isomerase deficiency, with an evaluation of mannose treatment for CDG-Ib. Biochim Biophys Acta. 2009;1792(9):841-3. PubMed
- Harms HK, Zimmer KP, Kurnik K, Bertele-Harms RM, Weidinger S, Reiter K. Oral mannose therapy persistently corrects the severe clinical symptoms and biochemical abnormalities of phosphomannose isomerase deficiency. Acta Paediatr. 2002;91(10):1065-72. DOI
- . Damen G, de Klerk H, Huijmans J, den Hollander J, Sinaasappel M. Gastrointestinal and other clinical manifestations in 17 children with congenital disorders of glycosylation type Ia, Ib, and Ic. J Pediatr Gastroenterol Nutr. 2004;38(3):282-7. DOI
- Lenger SM, Bradley MS, Thomas DA, Bertolet MH, Lowder JL, Sutcliffe S. D-mannose vs other agents for recurrent urinary tract infection prevention in adult women: a systematic review and meta-analysis. Am J Obstet Gynecol. 2020;223(2):265.e1-265.e13. PubMed
Cranberry 33 references
- Anon. Possible interaction between warfarin and cranberry juice. Current Problems in Pharmacovigilance 2003;29:8. PubMed
- Greenblatt DJ, von Moltke LL, Perloff ES, et al. Interaction of flurbiprofen with cranberry juice, grape juice, tea, and fluconazole: in vitro and clinical studies. Clin Pharmacol Ther 2006;79:125-33. PubMed
- Hodek P, Trefil P, Stiborova M. Flavonoids-potent and versatile biologically active compounds interacting with cytochromes P450. Chem Biol Interact 2002;139:1-21.. PubMed
- Grant P. Warfarin and cranberry juice: An interaction? J Heart Valve Dis 2004;13:25-6.
- Suvarna R, Pirmohamed M, Henderson L. Possible interaction between warfarin and cranberry juice. BMJ 2003;327:1454. PubMed
- Li Z, Seeram NP, Carpenter CL, et al. Cranberry does not affect prothrombin time in male subjects on warfarin. J Am Diet Assoc 2006;106:2057-61. PubMed
- Lilja JJ, Backman JT, Neuvonen PJ. Effects of daily ingestion of cranberry juice on the pharmacokinetics of warfarin, tizanidine, and midazolam - probes of CYP2C9, CYP1A2 and CYP3A4. Clin Pharmacol The 2007:81:833-9. PubMed
- Wing DA, Rumney PJ, Preslicka CW, Chung JH. Daily cranberry juice for the prevention of asymptomatic bacteriuria in pregnancy: a randomized, controlled pilot study. J Urol 2008;180:1367-72. PubMed
- Mohammed Abdul MI, Jiang X, Williams KM, et al. Pharmacodynamic interaction of warfarin with cranberry but not with garlic in healthy subjects. Br J Pharmacol 2008;154:1691-700. PubMed
- McMurdo MET, Argo I, Phillips G, et al. Cranberry or trimethoprim for the prevention of recurrently urinary tract infections? A randomized controlled trial in older women. J Antimicrob Chemother 2009;63:389-95.
- Mergenhagen KA, Sherman O. Elevated International Normalized Ratio after concurrent ingestion of cranberry sauce and warfarin. Am J Health-Syst Pharm 2008;65:2113-6. PubMed
- Ansell J, McDonough M, Zhao Y, et al. The absence of an interaction between warfarin and cranberry juice: a randomized, double-blind trial. J Clin Pharmacol 2009;49:824-30. PubMed
- Haber SL, Cauthon KA, Raney EC. Cranberry and warfarin interaction: a case report and review of the literature. Consult Pharm 2012;27:58-65. PubMed
- Hamann GL, Campbell JD, George CM. Warfarin-cranberry juice interaction. Ann Pharmacother 2011;45:e17. PubMed
- Roberts D, Flanagan P. Case report: Cranberry juice and warfarin. Home Healthc Nurse 2011;29:92-7.
- Garcia-Calatayud, S., Larreina Cordoba, J. J., and Lozano De La Torre MJ. [Severe cranberry juice poisoning]. An.Esp.Pediatr. 2002;56(1):72-73.
- Patel, D. A., Gillespie, B., Sobel, J. D., Leaman, D., Nyirjesy, P., Weitz, M. V., and Foxman, B. Risk factors for recurrent vulvovaginal candidiasis in women receiving maintenance antifungal therapy: results of a prospective cohort study. Am J Obstet.Gy PubMed
- Isele, H. [Fatal bleeding under warfarin plus cranberry juice. Is it due to salicylic acid?]. MMW.Fortschr.Med 3-11-2004;146(11):13.
- Linsenmeyer, T. A., Harrison, B., Oakley, A., Kirshblum, S., Stock, J. A., and Millis, S. R. Evaluation of cranberry supplement for reduction of urinary tract infections in individuals with neurogenic bladders secondary to spinal cord injury. A prospecti
- McMurdo, M. E., Bissett, L. Y., Price, R. J., Phillips, G., and Crombie, I. K. Does ingestion of cranberry juice reduce symptomatic urinary tract infections in older people in hospital? A double-blind, placebo-controlled trial. Age Ageing 2005;34(3):256- PubMed
- Sylvan, L. and Justice, N. P. Possible interaction between warfarin and cranberry juice. Am Fam.Physician 9-15-2005;72(6):1000.
- Niklasson, A. and Andren, L. [Interaction between Waran and cranberry juice]. Lakartidningen 3-15-2006;103(11):853-854.
- Rindone, J. P. and Murphy, T. W. Warfarin-cranberry juice interaction resulting in profound hypoprothrombinemia and bleeding. Am J Ther 2006;13(3):283-284. PubMed
- Uesawa, Y. and Mohri, K. Effects of cranberry juice on nifedipine pharmacokinetics in rats. J Pharm Pharmacol 2006;58(8):1067-1072. PubMed
- Valentova, K., Stejskal, D., Bednar, P., Vostalova, J., Cihalik, C., Vecerova, R., Koukalova, D., Kolar, M., Reichenbach, R., Sknouril, L., Ulrichova, J., and Simanek, V. Biosafety, antioxidant status, and metabolites in urine after consumption of dried
- Royer, D. J., George, J. N., and Terrell, D. R. Thrombocytopenia as an adverse effect of complementary and alternative medicines, herbal remedies, nutritional supplements, foods, and beverages. Eur J Haematol 2010;84(5):421-429. PubMed
- Stapleton, A. E., Dziura, J., Hooton, T. M., Cox, M. E., Yarova-Yarovaya, Y., Chen, S., and Gupta, K. Recurrent urinary tract infection and urinary Escherichia coli in women ingesting cranberry juice daily: a randomized controlled trial. Mayo.Clin.Proc. PubMed
- Doad GJ, Kabange W. Cranberry juice, atorvastatin and back pain. J Med Assoc Ga 2014;103(1):14.
- Griffiths AP, Beddall A, Pegler S. Fatal haemopericardium and gastrointestinal haemorrhage due to possible interaction of cranberry juice with warfarin. J R Soc Promot Health 2008;128(6):324-6. PubMed
- Mellen CK, Ford M, Rindone JP. Effect of high-dose cranberry juice on the pharmacodynamics of warfarin in patients. Br J Clin Pharmacol 2010;70(1):139-42. PubMed
- Ushijima K, Tsuruoka S, Tsuda H, Hasegawa G, Obi Y, Kaneda T, Takahashi M, Maekawa T, Sasaki T, Koshimizu TA, Fujimura A. Cranberry juice suppressed the diclofenac metabolism by human liver microsomes, but not in healthy human subjects. Br J Clin Pharmaco PubMed
- Ngo N, Brantley SJ, Carrizosa DR, et al. The warfarin-cranberry juice interaction revisited: A systematic in vitro-in vivo evaluation. J Exp Pharmacol. 2010;2010(2):83-91.
- Williams G, Stothart CI, Hahn D, Stephens JH, Craig JC, Hodson EM. Cranberries for preventing urinary tract infections. Cochrane Database Syst Rev 2023;11(11):CD001321. PubMed
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.
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