Major interaction on record — check this product against your medications before combining. Based on 5 of 11 ingredients. Check your meds →
Dietary supplement

DCP Damage Control Protocol Ingredients & Drug Interactions

by EvoMuse

DCP Damage Control Protocol label
See full label image
Capsule Category: Other Combinations
Most serious interaction: Major
Clinical methodology reviewed by · Updated Sep 16, 2026 · Label data from the NIH DSLD
What is this page for?

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

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

The interaction bottom line Most serious interaction: Major

DCP Damage Control Protocol is a dietary supplement by EvoMuse with 11 active ingredients. Its ingredients are commonly taken for exercise performance and recovery, heart health, weight management.Based on those ingredients, 1,220 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are Hibiscus sabdariffa Dichloromethane extract, Piper retrofractum Vahl 50:1 Methanol extract, Panax notoginseng 20:1 ethanol extract. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

Jump to a section

Check Your Meds Against DCP Damage Control Protocol by EvoMuse

Ask about any prescription or over-the-counter medication and we check it for interactions with DCP Damage Control Protocol by EvoMuse — and tell you which ingredient is responsible.

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HelloPharmacist Scorecard of DCP Damage Control Protocol by EvoMuse

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

From our pharmacy team — supplement deep dive

Generated from HelloPharmacist’s pharmacist-curated databases and editorial rules · Last generated Jul 11, 2026

What’s inside

Full disclosure
Ingredient Transparency · database check
Full

Every active ingredient lists its own amount on the label.

Why this rating?
  • The label discloses an exact amount for 11 of its 11 active ingredients.
  • No proprietary blends here — you can verify the dose of every single component.

DCP Damage Control Protocol contains 11 ingredients. The active components include L-carnitine (as Carnitine Fumarate), a compound involved in energy metabolism and heart health; Hibiscus sabdariffa extract, a plant known for cardiovascular effects; Panax notoginseng extract, used traditionally for circulation and bleeding concerns; and several botanical extracts including Rose Ellagitannins, Gamma-Mangostin, Artemisia Iwayomogi, Momordin, Mangiferin, and Piper retrofractum.

Menthol and Quercetin-Theobromine Cocrystals round out the formula. The capsules also contain inactive ingredients: chitosan, rice flour, carbopol 940, and cellulose.

Does it work?

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

Some clinical evidence supports this product's ingredients for its stated purpose, but it isn't conclusive.

Why this rating?
  • The label markets this product for: non-stim fat burning and weight management.
  • We looked for evidence on: Athletic performance, Exercise-induced muscle damage, Exercise-induced muscle soreness, Obesity, Metabolic syndrome, Dyslipidemia — and 4 related terms.
  • The strongest evidence on file: Hibiscus Sabdariffa is rated "Possibly Effective" for Hypertension (Natural Medicines).
  • Also on file: L-carnitine is rated "Possibly Effective" for Hyperlipidemia.
  • Also on file: Panax Notoginseng is rated "Possibly Ineffective" for Myocardial infarction (MI).

Evidence for L-carnitine is established for L-carnitine deficiency itself, and it is possibly effective for high cholesterol, congestive heart failure, and angina. Panax notoginseng shows possibly effective evidence for angina, stroke prevention, and intracranial hemorrhage, though it appears ineffective for heart attack.

Hibiscus sabdariffa is possibly effective for high blood pressure but has insufficient evidence to rate for weight, kidney stones, urinary tract infections, and metabolic syndrome. We hold no effectiveness ratings for the other ingredients in this product.

The evidence, ingredient by ingredient L-carnitine Mugwort Hibiscus Sabdariffa Panax Notoginseng Black Pepper

How safe is it?

Well-documented data
Safety Information · database check
Well characterized

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

Why this rating?
  • We hold adverse-effect (side-effect) data for 5 of the 5 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 5 of 5.
  • General safety write-ups exist for 5 of 5.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

L-carnitine is generally well tolerated at typical doses, though high doses can cause stomach upset, diarrhea, nausea, heartburn, and a fishy-smelling body odor. Rarely, seizures have been reported.

Safety data are limited and it should be used only under medical supervision. We hold no pregnancy data for L-carnitine on file; breastfeeding safety is not well studied, so caution is advised.

Hibiscus sabdariffa is generally well tolerated as a tea, but concentrated extracts and high doses warrant caution. Reported effects include rare tremor, headache, tinnitus, and transient stomach symptoms.

Safety data advises against medicinal amounts during pregnancy due to possible hormonal and uterine effects. Breastfeeding safety is not well studied.

Panax notoginseng may be tolerated short-term by healthy adults, but quality human safety data are limited. Dry mouth, insomnia, nausea, nervousness, rash, and vomiting have been reported.

The safety data advises against use during pregnancy and breastfeeding.

Side effects, ingredient by ingredient L-carnitine Mugwort Hibiscus Sabdariffa Panax Notoginseng Black Pepper

Meds to double-check

Major interaction found
Known Interaction Concern · database check
Major identified

At least one ingredient has a documented Major-severity interaction. Check your medications for a personalized result.

Why this rating?
  • 4 of the 5 matched ingredients can interact with medications — Hibiscus Sabdariffa, Black Pepper, Panax Notoginseng, L-carnitine.
  • The most serious interaction on file is rated Major.
  • Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs; immunosuppressants / transplant drugs; diabetes medications; lithium.
  • For scale: 1,221 individual medications appear in the full list. A big number alone doesn't make a product dangerous — what matters is whether YOUR medication is on it, so run yours through the interaction checker on this page.

Before taking this product, check with your pharmacist if you're on chloroquine (Major risk of reduced drug levels), blood thinners like warfarin or acenocoumarol (Moderate bleeding risk), blood pressure medications (Moderate risk of low blood pressure), diabetes drugs (Moderate low blood sugar risk), aspirin (Moderate interaction with Panax notoginseng), or thyroid hormone replacement (Moderate reduced effectiveness risk). Additionally, check CYP2C19 and CYP1A2 substrate drugs — these carry Moderate to Minor theoretical concerns with this product.

Check your own medication Run your meds through the checker above

The bottom line

Scorecard at a glanceFully disclosed formula with some supporting evidence for its stated purpose. Major medication interactions have been identified, and safety information is well characterized.

DCP Damage Control Protocol is a complex formula with multiple documented medication interactions — most serious with blood thinners, blood pressure drugs, diabetes medications, and chloroquine. If you take any prescription medications, especially those for the heart, blood clotting, blood sugar, or malaria treatment, check your exact drugs with the tool on this page before starting.

Talk to your pharmacist or doctor, particularly if you're pregnant, breastfeeding, or on warfarin or blood pressure medication.

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

Assessment coverage: 5 of 11 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Sep 25, 2020.

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

At a glance

General information

Key facts about DCP Damage Control Protocol, straight from the product label.

Brand EvoMuse
Barcode (UPC) 758381476449
Net contents 180 Capsule(s)
Market status On market
Date entered into DSLD Sep 25, 2020
DSLD ID 236958
Product type Other Combinations
Supplement form Capsule
Dietary claims / uses All Other, Structure/Function
Intended target group(s) Adult (18 - 50 Years)
From the label
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.

Supplement Facts

The label details for DCP Damage Control Protocol by EvoMuse, sourced from the NIH Dietary Supplement Label Database.

Supplement Facts

Daily Value (DV) Target Group(s):
Adults and children 4 or more years of age
Minimum serving Sizes:
2 Capsule(s)
Maximum serving Sizes:
2 Capsule(s)
Servings per container
90
UPC/BARCODE
758381476449
IngredientAmount% DV
Menthol10 mg--
Carnitine Fumarate300 mg--
Rose Ellagitannins 20:1 Methanol Extract150 mg--
Gamma-Mangostin100 mg--
Artemisia Iwayomogi 20:1 Ethanol Extract330 mg--
Hibiscus sabdariffa Dichloromethane extract250 mg--
Momordin40 mg--
Mangiferin50 mg--
Quercetin-Theobromine Cocrystals150 mg--
Panax notoginseng 20:1 ethanol extract100 mg--
Piper retrofractum Vahl 50:1 Methanol extract100 mg--

Other ingredients: Chitosan, Rice Flour, Carbopol 940, Cellulose

Tap any ingredient to jump to its full detail below.

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

DCP has set the standard as the most highly innovative and effective non-stim fat burning formula on the market. Working primarily on PPAR alpha and delta receptors, DCP causes a massive increase in fat burning, without using stims that make you feel jittery.

DCP has set the standard as the most highly innovative and effective non-stim fat burning formula on the market. Working primarily on PPAR alpha and delta receptors, DCP causes a massive increase in fat burning, without using stims that make you feel jittery. DCP (short for Damage Control Protocol) causes your body to burn fat at the level of an elite athlete, causing a rapid leaning of the body and prevention of fat gain. DCP also addresses gene expression of the fat mass and obesity associated protein (FTO) and increases expression of the Uncoupling Proteins that cause the body to burn fat in a futile cycle, generating heat. Finally, DCP triggers activation of various temperature sensitive thermoreceptors, tricking your body in trying to simultaneously heat up and cool off the body, resulting in an even more dramatic fat loss effect.

General Statements

DCP: Live Elite.

Precautions

Warning: Do not use this product if you are at risk of or are being treated for high blood pressure, heart, kidney, thyroid, or psychiatric disease, difficulty in urinating, prostate enlargement, anxiety, depression, seizure disorder, or stroke. Consult a healthcare professional before use.

Use caution if allergic to shellfish.

Keep out of reach of children.

FDA Disclaimer Statement

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

FDA Statement of Identity

Dietary Supplement

Suggested/Recommended/Usage/Directions

Directions: As a dietary supplement, take 2 capsules three times daily as needed or as directed by your physician.

Seals/Symbols

Made in the USA

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

See for yourself

DCP Damage Control Protocol by EvoMuse label

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

DCP Damage Control Protocol label

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

View the full label (PDF)
What’s inside

The Ingredients in DCP Damage Control Protocol by EvoMuse

These are the 11 active ingredients this product is made of. Select any to open its full monograph.

Serving size2 Capsule(s) Dosage formCapsule Servings per container90 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.

Menthol

10 mg per serving

Carnitine Fumarate

Interacts with
19 drugs
300 mg per serving

L-carnitine is a compound your body makes naturally and also gets from foods like meat. It helps cells turn fat into energy, and supplements are most...

Carnitine Fumarate monograph & interactions

Rose Ellagitannins 20:1 Methanol Extract

150 mg per serving

Gamma-Mangostin

100 mg per serving Form: Mangosteen Ethanol extract

Artemisia Iwayomogi 20:1 Ethanol Extract

No known
interactions
330 mg per serving

Mugwort is a traditional herb used for digestion, menstrual issues, and sleep, but there is very little high-quality human research to confirm these u...

Artemisia Iwayomogi 20:1 Ethanol Extract monograph & interactions

Hibiscus sabdariffa Dichloromethane extract

Interacts with
1,087 drugs
250 mg per serving

Hibiscus sabdariffa is a tart, cranberry-flavored plant most often consumed as a tea, and its best-studied use is for mildly lowering blood pressure....

Hibiscus sabdariffa Dichloromethane extract monograph & interactions

Momordin

40 mg per serving Form: Bitter Melon Ethanol Extract

Mangiferin

50 mg per serving

Quercetin-Theobromine Cocrystals

150 mg per serving

Panax notoginseng 20:1 ethanol extract

Interacts with
207 drugs
100 mg per serving

Panax notoginseng (sanqi or tienchi ginseng) is a traditional Chinese herb most often used to help with bleeding, bruising, and circulation. Human evi...

Panax notoginseng 20:1 ethanol extract monograph & interactions

Piper retrofractum Vahl 50:1 Methanol extract

Interacts with
1,019 drugs
100 mg per serving

Black pepper is a common kitchen spice that is generally safe in the amounts used in food. Its extract, piperine, is mostly added to supplements to he...

Piper retrofractum Vahl 50:1 Methanol extract monograph & interactions

Other (inactive) ingredients: Chitosan, Rice Flour, Carbopol 940, Cellulose. These complete the product’s ingredient list but are not active constituents.

Interaction report

DCP Damage Control Protocol by EvoMuse Drug Interactions

Want to check YOUR meds against DCP Damage Control Protocol?

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

 Go to the checker
1,220Drugs
2 Major 1,153 Moderate 65 Minor

Ingredients driving the most interactions

Hibiscus sabdariffa Dichloromethane extract 1,087
Piper retrofractum Vahl 50:1 Methanol extract 1,019
Panax notoginseng 20:1 ethanol extract 207
Carnitine Fumarate 19

Individual Drug Interactions

The ingredients in DCP Damage Control Protocol interact with 1,220 drugs. Click any drug to see the details.

4 of the 11 ingredients in DCP Damage Control Protocol interact with drugs. Each result below shows which ingredient is responsible. Hibiscus sabdariffa Dichloromethane extract Piper retrofractum Vahl 50:1 Methanol extract Panax notoginseng 20:1 ethanol extract Carnitine Fumarate

Each ingredient & the kinds of drugs it affects

For each ingredient in DCP Damage Control Protocol 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.

Hibiscus sabdariffa Dichloromethane extract16 drug types · 1,087 drugs

Chloroquine (Aralen)

Taking Hibiscus sabdariffa tea along with chloroquine seems to reduce levels of chloroquine.
When taken together, Hibiscus sabdariffa tea significantly reduces the bioavailability of chloroquine. This may reduce its clinical effects. People taking chloroquine for the treatment or prevention of malaria should avoid Hibiscus sabdariffa tea.

Likelihood Probable Evidence B
Antidiabetes Drugs

Theoretically, taking Hibiscus sabdariffa with antidiabetes drugs might increase the risk of hypoglycemia.
Most clinical research shows that Hibiscus sabdariffa can reduce blood glucose levels.

Likelihood Possible Evidence D
Antihypertensive Drugs

Theoretically, taking Hibiscus sabdariffa with antihypertensive drugs might increase the risk of hypotension.
Most clinical evidence suggests that taking Hibiscus sabdariffa reduces systolic and diastolic blood pressure. In animal research, Hibiscus sabdariffa increased the hypotensive effects of single doses of losartan and amlodipine.

Likelihood Possible Evidence D
Diclofenac (Voltaren, Others)

Taking Hibiscus sabdariffa with diclofenac may increase the levels and adverse effects of diclofenac.
Pharmacokinetic research in humans shows that drinking a beverage made with Hibiscus sabdariffa flowers reduces the excretion of diclofenac by approximately 38% when compared with water. The clinical significance of this is unknown.

Likelihood Possible Evidence B
Losartan (Cozaar)

Theoretically, Hibiscus sabdariffa might increase the levels and clinical effects of losartan.
Animal research in rats with laboratory-induced hypertension shows that providing Hibiscus sabdariffa for 14-17 days prior to a single administration with losartan modestly increases losartan concentrations and increases hypotensive effects when compared with a single administration of losartan alone. It is not clear if Hibiscus sabdariffa alters the concentration or effects of losartan when taken continuously. Additionally, this interaction has not been shown in humans.

Likelihood Possible Evidence D
Simvastatin (Zocor)

Taking Hibiscus sabdariffa with simvastatin might reduce the levels and clinical effects of simvastatin.
A pharmacokinetic study in humans shows that taking a beverage prepared with dried Hibiscus sabdariffa flower 300 grams concurrently with a single dose of simvastatin 40 mg increases the clearance of simvastatin by about 45% and reduces peak levels of simvastatin by 18%.

Likelihood Probable Evidence B
Acetaminophen (Tylenol, Others)

Theoretically, taking Hibiscus sabdariffa with acetaminophen might decrease the clinical effects of acetaminophen.
There is some evidence that consuming a Hibiscus sabdariffa beverage (Zobo drink) before taking acetaminophen can decrease the elimination half-life of acetaminophen. Hibiscus sabdariffa does not seem to decrease maximum concentration or area under the curve of acetaminophen. The clinical significance of this is unknown.

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

Theoretically, Hibiscus sabdariffa extract might reduce the metabolism of CYP1A2 substrates.
In vitro research shows that Hibiscus sabdariffa calyx extract inhibits CYP1A2. This interaction has not been reported in humans.

Likelihood Possible Evidence D
Cytochrome P450 2A6 (Cyp2A6) Substrates

Theoretically, Hibiscus sabdariffa extract might reduce the metabolism of CYP2A6 substrates.
In vitro research shows that Hibiscus sabdariffa calyx extract inhibits CYP2A6. This interaction has not been reported in humans.

Likelihood Possible Evidence D
Cytochrome P450 2B6 (Cyp2B6) Substrates

Theoretically, Hibiscus sabdariffa extract might reduce the metabolism of CYP2B6 substrates.
In vitro research shows that Hibiscus sabdariffa calyx extract inhibits CYP2B6. This interaction has not been reported in humans.

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

Theoretically, Hibiscus sabdariffa extract might reduce the metabolism of CYP2C19 substrates.
In vitro research shows that Hibiscus sabdariffa calyx extract inhibits CYP2C19. This interaction has not been reported in humans.

Likelihood Possible Evidence D
Cytochrome P450 2C8 (Cyp2C8) Substrates

Theoretically, Hibiscus sabdariffa might reduce the metabolism of CYP2C8 substrates.
In vitro research shows that Hibiscus sabdariffa calyx extract inhibits CYP2C8. This interaction has not been reported in humans.

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

Theoretically, Hibiscus sabdariffa extract might reduce the metabolism of CYP2C9 substrates.
In vitro research shows that Hibiscus sabdariffa calyx extract inhibits CYP2C9. This interaction has not been reported in humans.

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

Theoretically, Hibiscus sabdariffa extract might reduce the metabolism of CYP2D6 substrates.
In vitro research shows that Hibiscus sabdariffa calyx extract inhibits CYP2D6. This interaction has not been reported in humans.

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

Theoretically, Hibiscus sabdariffa extract might reduce the metabolism of CYP2E1 substrates.
In vitro research shows that Hibiscus sabdariffa calyx extract inhibits CYP2E1. This interaction has not been reported in humans.

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

Theoretically, Hibiscus sabdariffa extract might reduce the metabolism of CYP3A4 substrates.
In vitro research shows that Hibiscus sabdariffa calyx extract inhibits CYP3A4. This interaction has not been reported in humans.

Likelihood Possible Evidence D
Hibiscus sabdariffa Dichloromethane extract full monograph & interactions

Piper retrofractum Vahl 50:1 Methanol extract17 drug types · 1,019 drugs

Anticoagulant/Antiplatelet Drugs

Theoretically, black pepper might increase the risk of bleeding when taken with antiplatelet or anticoagulant drugs.
In vitro research shows that piperine, a constituent of black pepper, seems to inhibit platelet aggregation. This has not been reported in humans.

Likelihood Possible Evidence D
Antidiabetes Drugs

Theoretically, black pepper might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Animal research shows that piperine, a constituent of black pepper, can reduce blood glucose levels. Monitor blood glucose levels closely. Dose adjustments might be necessary.

Likelihood Possible Evidence D
Atorvastatin (Lipitor)

Theoretically, black pepper might increase blood levels of atorvastatin.
Animal research shows that taking piperine, a constituent of black pepper, 35 mg/kg can increase the maximum serum concentration of atorvastatin three-fold. This has not been reported in humans.

Likelihood Possible Evidence D
Cyclosporine (Neoral, Sandimmune)

Theoretically, black pepper might increase the effects and side effects of cyclosporine.
In vitro research shows that piperine, a constituent of black pepper, increases the bioavailability of cyclosporine. This has not been reported in humans.

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

Theoretically, black pepper might increase levels of drugs metabolized by CYP2D6.
In vitro research suggests that some constituents of black pepper inhibit CYP2D6. This has not been reported in humans.

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

Theoretically, black pepper might increase levels of drugs metabolized by CYP3A4.
In vitro research and pharmacokinetic simulation data suggest that piperine, a constituent of black pepper, as well as the pepper fruit seem to inhibit CYP3A4. This has not been reported in humans.

Likelihood Possible Evidence D
Lithium

Theoretically, black pepper might increase blood levels of lithium due to its diuretic effects. The dose of lithium might need to be reduced.
Black pepper is thought to have diuretic properties.

Likelihood Probable Evidence D
Nevirapine (Viramune)

Black pepper might increase blood levels of nevirapine.
Clinical research shows that piperine, a constituent of black pepper, increases the plasma concentration of nevirapine. However, no adverse effects were observed in this study.

Likelihood Probable Evidence D
P-Glycoprotein Substrates

Theoretically, black pepper might increase levels of P-glycoprotein substrates.
In vitro research shows that piperine, a constituent of black pepper, seems to inhibit P-glycoprotein.

Likelihood Possible Evidence D
Pentobarbital (Nembutal)

Theoretically, black pepper might increase the sedative effects of pentobarbital.
Animal research shows that piperine, a constituent of black pepper, increases pentobarbital-induced sleeping time.

Likelihood Possible Evidence D
Phenytoin (Dilantin)

Black pepper might increase blood levels of phenytoin.
Clinical research shows that piperine, a constituent of black pepper, seems to increase absorption, slow elimination, and increase levels of phenytoin. Taking a single dose of black pepper 1 gram along with phenytoin seems to double the serum concentration of phenytoin. Consuming a soup with black pepper providing piperine 44 mg/200 mL of soup along with phenytoin also seems to increase phenytoin levels when compared with consuming the same soup without black pepper.

Likelihood Possible Evidence B
Propranolol (Inderal)

Black pepper might increase blood levels of propranolol.
Clinical research shows that piperine, a constituent of black pepper, seems to increase absorption and slow elimination of propranolol.

Likelihood Possible Evidence B
Rifampin (Rifadin)

Black pepper might increase blood levels of rifampin.
Clinical research shows that piperine, a constituent of black pepper, seems to increase absorption and serum levels of rifampin.

Likelihood Possible Evidence B
Theophylline

Black pepper might increase blood levels of theophylline.
Clinical research shows that piperine, a constituent of black pepper, seems to increase absorption and slow elimination of theophylline.

Likelihood Possible Evidence D
Amoxicillin (Amoxil, Trimox)

Theoretically, black pepper might increase the effects and side effects of amoxicillin.
Animal research shows that taking piperine, a constituent of black pepper, with amoxicillin increases plasma levels of amoxicillin. This has not been reported in humans.

Likelihood Possible Evidence D
Carbamazepine (Tegretol)

Theoretically, black pepper might increase blood levels of carbamazepine, potentially increasing the effects and side effects of carbamazepine.
One clinical study in patients taking carbamazepine 300 mg or 500 mg twice daily shows that taking a single 20 mg dose of purified piperine, a constituent of black pepper, increases carbamazepine levels. Piperine may increase carbamazepine absorption by increasing blood flow to the GI tract, increasing the surface area of the small intestine, or inhibiting cytochrome P450 3A4 (CYP3A4) in the gut wall. Absorption was significantly increased by 7-10 mcg/mL/hour. The time to eliminate carbamazepine was also increased by 4-8 hours. Although carbamazepine levels were increased, this did not appear to increase side effects. In vitro research also shows that piperine can increase carbamazepine levels by 11% in a time-dependent manner.

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

Theoretically, black pepper might decrease levels and clinical effects of drugs metabolized by CYP1A2.
In vitro research suggests that black pepper induces CYP1A2. This has not been reported in humans.

Likelihood Possible Evidence D
Piper retrofractum Vahl 50:1 Methanol extract full monograph & interactions

Panax notoginseng 20:1 ethanol extract4 drug types · 207 drugs

Aspirin

Theoretically, taking Panax notoginseng concomitantly with aspirin may increase the risk of adverse effects from both products.
Animal research shows that taking Panax notoginseng extract with aspirin increases blood levels of salicylic acid by approximately 50% and blood levels of Panax notoginseng by 75% to 196%. This effect may be due to increased absorption of both products.

Likelihood Possible Evidence D
Caffeine

Theoretically, taking Panax notoginseng may decrease the levels and clinical effects of caffeine.
Animal research shows that administering Panax notoginseng intravenously for 7 days before intraperitoneal injection of caffeine can decrease maximal blood levels of caffeine by 37%. This interaction is attributed to the ability of Panax notoginseng to increase the activity of cytochrome P450 1A2 (CYP1A2) enzymes.

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

Theoretically, taking Panax notoginseng might reduce the levels and clinical effects of CYP1A2 substrates.
Animal research shows that administering Panax notoginseng intravenously for 7 days before intraperitoneal injection of caffeine can decrease maximal blood levels of caffeine by 37%. This interaction was attributed to the ability of Panax notoginseng to increase the activity of CYP1A2.

Likelihood Possible Evidence D
Warfarin (Coumadin)

Theoretically, taking Panax notoginseng concomitantly with warfarin may increase the risk of bleeding.
Animal research shows that taking Panax notoginseng concomitantly with warfarin increases plasma warfarin levels, prothrombin time, and international normalized ratio when compared with control. In vitro research also suggests that Panax notoginseng may downregulate expression of cytochrome P450 3A4 enzymes, which may affect warfarin metabolism.

Likelihood Possible Evidence D
Panax notoginseng 20:1 ethanol extract full monograph & interactions

Carnitine Fumarate3 drug types · 19 drugs

Acenocoumarol (Sintrom)

Theoretically, L-carnitine might increase the anticoagulant effects of acenocoumarol.
L-carnitine might enhance the anticoagulant effects of acenocoumarol, an oral anticoagulant similar to warfarin, but shorter-acting. There are at least two case reports of INR elevation with concomitant use. In one case, a 33-year-old male with a previously stable INR had an elevated INR of 4.65 after L-carnitine was started and continued for 10 weeks. INR normalized after discontinuation of the L-carnitine-containing product.

Likelihood Possible Evidence D
Thyroid Hormone

Theoretically, L-carnitine might decrease the effectiveness of thyroid hormone replacement.
L-carnitine appears to act as a peripheral thyroid hormone antagonist by inhibiting entry of thyroid hormone into the nucleus of cells. Taking L-carnitine also seems to diminish some of the symptoms of hyperthyroidism.

Likelihood Probable Evidence B
Warfarin (Coumadin)

Theoretically, L-carnitine might increase the anticoagulant effects of warfarin.
L-carnitine might increase the anticoagulant effects of acenocoumarol, a shorter-acting oral anticoagulant similar to warfarin. There is not enough information to know whether this interaction occurs with L-carnitine and warfarin.

Likelihood Possible Evidence D
Carnitine Fumarate full monograph & interactions
The maker

Brand information

Manufacturer and brand details for DCP Damage Control Protocol, from the product label.

EvoMuse

See all EvoMuse products
Name
EvoMuse
City
Hillard
State
OH
ZipCode
43026
Pharmacist Counseling Corner

DCP Damage Control Protocol by EvoMuse: Common Questions

Does DCP Damage Control Protocol by EvoMuse interact with any medications?
Yes. Based on its ingredients, DCP Damage Control Protocol has a known interaction with 1,220 medications, including 2 rated major. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
DCP Damage Control Protocol contains 11 active ingredients, and an interaction can come from any of them. We check every ingredient, combine the results into one list per medication, and show which ingredient and mechanism is responsible.
Where does this information come from?
The product label data comes from the NIH Dietary Supplement Label Database (DSLD); the interaction data is built on the Natural Medicines database and reviewed by HelloPharmacist pharmacists.
What is L-carnitine, and what does it do?
L-carnitine is a compound your body uses to convert fat into energy. In this product it comes as Carnitine Fumarate. It's established as effective for L-carnitine deficiency and is possibly effective for high cholesterol, congestive heart failure, and angina — but we hold no data on whether it works for any other condition this product might claim.
Can I take this if I'm on blood thinners?
Not safely without checking with your pharmacist first. L-carnitine and Panax notoginseng can both increase the effects of blood thinners like warfarin and acenocoumarol, raising your bleeding risk. Hibiscus sabdariffa also has its own interactions with blood thinners. Your dose may need adjusting.
What are the most common side effects?
L-carnitine can cause stomach cramps, diarrhea, nausea, heartburn, and loss of appetite — even a fishy body odor at higher doses. Hibiscus sabdariffa may cause mild stomach symptoms. Panax notoginseng can cause dry mouth, insomnia, nausea, nervousness, and rash. Most people don't experience these, but they're the ones we see reported most often.
Is this safe during pregnancy?
The data advise against Hibiscus sabdariffa and Panax notoginseng in pregnancy. We hold no pregnancy safety data for L-carnitine on file. Talk with your obstetrician or pharmacist before taking this product if you're pregnant or planning to become pregnant.
Is this safe while breastfeeding?
The safety data advise against Panax notoginseng while breastfeeding. Hibiscus sabdariffa and L-carnitine breastfeeding safety are not well studied. Talk with your doctor or pharmacist about whether this product is right for you while nursing.
Does this interact with diabetes medications?
Yes. Hibiscus sabdariffa can lower blood sugar, so if you're on a diabetes drug it may increase your low blood sugar risk. Your blood sugar and medication dose may need monitoring. Check with your pharmacist before starting.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

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Label information is sourced from the NIH Dietary Supplement Label Database and reflects the product version on file; always read your actual product label. This page is for education only and is not a substitute for professional medical advice. Confirm with your pharmacist or doctor before combining supplements and medications.

DCP Damage Control Protocol label
Go deeper

The Full Monographs Behind DCP Damage Control Protocol’s Ingredients

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

Herb & supplement monograph

L-carnitine

Interacts with 19 drugs

L-carnitine is a compound your body makes naturally and also gets from foods like meat. It helps cells turn fat into energy, and supplements are most clearly useful for people with a true ca...

Read the full L-carnitine monograph → Herb & supplement monograph

Mugwort

Mugwort is a traditional herb used for digestion, menstrual issues, and sleep, but there is very little high-quality human research to confirm these uses. It is closely related to ragweed an...

Read the full Mugwort monograph → Herb & supplement monograph

Hibiscus Sabdariffa

Interacts with 1,087 drugs

Hibiscus sabdariffa is a tart, cranberry-flavored plant most often consumed as a tea, and its best-studied use is for mildly lowering blood pressure. Evidence for other uses is limited, and...

Read the full Hibiscus Sabdariffa monograph → Herb & supplement monograph

Panax Notoginseng

Interacts with 207 drugs

Panax notoginseng (sanqi or tienchi ginseng) is a traditional Chinese herb most often used to help with bleeding, bruising, and circulation. Human evidence for these uses is limited and most...

Read the full Panax Notoginseng monograph → Herb & supplement monograph

Black Pepper

Interacts with 1,019 drugs

Black pepper is a common kitchen spice that is generally safe in the amounts used in food. Its extract, piperine, is mostly added to supplements to help the body absorb other ingredients (li...

Read the full Black Pepper monograph →
Sources

Sources & How We Checked

DCP Damage Control Protocol's label data comes from the NIH Dietary Supplement Label Database; the ingredient interaction data is from the Natural Medicines database, reviewed by our pharmacists.

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

The 111 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.

L-carnitine 41 references
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  2. Anon. Carnitor (levocarnitine) package insert. Sigma-Tau Pharmaceuticals Inc, Gaithersburg, MD. December 1999.
  3. Cherchi A, Lai C, Angelino F, et al. Effects of L-carnitine on exercise tolerance in chronic stable angina: a multicenter, double-blind, randomized, placebo-controlled, crossover study. Int J Clin Pharmacol Ther Toxicol 1985;23:569-72.
  4. Plioplys AV, Plioplys S. Amantadine and L-carnitine treatment of Chronic Fatigue Syndrome. Neuropsychobiology 1997;35:16-23. PubMed
  5. Benvenga S, Ruggeri RM, Russo A, et al. Usefulness of L-carnitine, a naturally occurring peripheral antagonist of thyroid hormone action, in iatrogenic hyperthyroidism: a randomized, double-blind, placebo-controlled clinical trial. J Clin Endocrinol Meta
  6. Martinez E, Domingo P, Roca-Cusachs A. Potentiation of acenocoumarol action by L-carnitine. J Intern Med 1993;233:94.
  7. Bachmann HU, Hoffmann A. Interaction of food supplement L-carnitine with oral anticoagulant acenocoumarol. Swiss Med Wkly 2004;134:385. PubMed
  8. Evans AM, Fornasini G. Pharmacokinetics of L-carnitine. Clin Pharmacokinet 2003;42:941-67. PubMed
  9. 12761 Benvenga S, Amato A, Calvani M, Trimarchi F. Effects of carnitine on thyroid hormone action. Ann N Y Acad Sci 2004;1033:158-67. PubMed
  10. Ciacci C, Peluso G, Iannoni E, et al. L-Carnitine in the treatment of fatigue in adult celiac disease patients: a pilot study. Dig Liver Dis 2007;39:922-8. PubMed
  11. Cruciani RA, Dvorkin E, Homel P, et al. Safety, tolerability and symptom outcomes associated with L-carnitine supplementation in patients with cancer, fatigue, and carnitine deficiency: a phase I/II study. J Pain Symptom Manage 2006;32:551-9. PubMed
  12. Lebrun C, Alchaar H, Candito M, et al. Levocarnitine administration in multiple sclerosis patients with immunosuppressive therapy-induced fatigue. Mult Scler 2006;12:321-4. PubMed
  13. Malaguarnera M, Cammalleri L, Gargante MP, et al. L-Carnitine treatment reduces severity of physical and mental fatigue and increases cognitive functions in centenarians: a randomized and controlled clinical trial. Am J Clin Nutr 2007;86:1738-44. PubMed
  14. Mantovani G, Maccio A, Madeddu C, et al. Randomized phase III clinical trial of five different arms of treatment in 322 patients with cancer cachexia. Oncologist 2010;15:200-11.
  15. Angelova-Fischer I, Rippke F, Fischer TW, Neufang G, Zillikens D. A double-blind, randomized, vehicle-controlled efficacy assessment study of a skin care formulation for improvement of mild to moderately severe acne. J Eur Acad Dermatol Venereol. 2013 Jul PubMed
  16. Hatamkhani S, Khalili H, Karimzadeh I, Dashti-Khavidaki S, Abdollahi A, Jafari S. Carnitine for prevention of antituberculosis drug-induced hepatotoxicity: a randomized, clinical trial. J Gastroenterol. Hepatol. 2014 May;29(5):997-1004. PubMed
  17. Boehm G, Stahl B. Oligosaccharides from milk. J Nutr 2007;137(3 Suppl 2):847S-849S.
  18. Van Oudheusden, L. J. and Scholte, H. R. Efficacy of carnitine in the treatment of children with attention-deficit hyperactivity disorder. Prostaglandins Leukot.Essent.Fatty Acids 2002;67(1):33-38. PubMed
  19. Derosa, G., Cicero, A. F., Gaddi, A., Mugellini, A., Ciccarelli, L., and Fogari, R. The effect of L-carnitine on plasma lipoprotein(a) levels in hypercholesterolemic patients with type 2 diabetes mellitus. Clin Ther 2003;25(5):1429-1439. PubMed
  20. Foitzik, K., Hoting, E., Heinrich, U., Tronnier, H., and Paus, R. Indications that topical L-carnitin-L-tartrate promotes human hair growth in vivo. J Dermatol.Sci 2007;48(2):141-144. PubMed
  21. Kumar, A., Singh, R. B., Saxena, M., Niaz, M. A., Josh, S. R., Chattopadhyay, P., Mechirova, V., Pella, D., and Fedacko, J. Effect of carni Q-gel (ubiquinol and carnitine) on cytokines in patients with heart failure in the Tishcon study. Acta Cardiol. 20
  22. Cruciani, R. A., Dvorkin, E., Homel, P., Culliney, B., Malamud, S., Lapin, J., Portenoy, R. K., and Esteban-Cruciani, N. L-carnitine supplementation in patients with advanced cancer and carnitine deficiency: a double-blind, placebo-controlled study. J Pa PubMed
  23. Malaguarnera, M., Vacante, M., Avitabile, T., Malaguarnera, M., Cammalleri, L., and Motta, M. L-Carnitine supplementation reduces oxidized LDL cholesterol in patients with diabetes. Am J Clin.Nutr 2009;89(1):71-76. PubMed
  24. Alvarez, T. M., Guardiola, P. D., Roldan, J. O., Elviro, R., Wevers, R., and Guijarro, G. [Primary trimethylaminuria: the fish odor syndrome]. Endocrinol.Nutr. 2009;56(6):337-340.
  25. Wu, Z. M., Lu, X., Wang, Y. W., Sun, J., Tao, J. W., Yin, F. H., and Cheng, H. J. [Short-term medication of L-carnitine before intracytoplasmic sperm injection for infertile men with oligoasthenozoospermia]. Zhonghua Nan.Ke.Xue 2012;18(3):253-256.
  26. Tarighat, Esfanjani A., Mahdavi, R., Ebrahimi, Mameghani M., Talebi, M., Nikniaz, Z., and Safaiyan, A. The effects of magnesium, L-carnitine, and concurrent magnesium-L-carnitine supplementation in migraine prophylaxis. Biol.Trace Elem.Res 2012;150(1-3): PubMed
  27. DiNicolantonio, J. J., Lavie, C. J., Fares, H., Menezes, A. R., and O'Keefe, J. H. L-carnitine in the secondary prevention of cardiovascular disease: systematic review and meta-analysis. Mayo Clin Proc. 2013;88(6):544-551. PubMed
  28. Huang, W. W., Wang, M. Y., Shi, H. M., Peng, Y., Peng, C. S., Zhang, M., Li, Y., Lu, J., and Li, X. B. Comparative study of bioactive constituents in crude and processed Glycyrrhizae radix and their respective metabolic profiles in gastrointestinal tract
  29. Madsen KL, Preisler N, Orngreen MC, Andersen SP, Olesen JH, Lund AM, Vissing J. Patients with medium-chain acyl-coenzyme a dehydrogenase deficiency have impaired oxidation of fat during exercise but no effect of L-carnitine supplementation. J Clin Endocri
  30. Prohaska ES, Muzyk AJ, Rivelli SK. Levocarnitine-induced hypophosphatemia in a hemodialysis patient with acute valproic acid toxicity. J Neuropsychiatry Clin Neurosci. 2012 Winter;24(1):E18-9. PubMed
  31. Shang R, Sun Z, Li H. Effective dosing of L-carnitine in the secondary prevention of cardiovascular disease: a systematic review and meta-analysis. BMC Cardiovasc Disord. 2014 Jul 21;14:88. PubMed
  32. Zhang JJ, Wu ZB, Cai YJ, Ke B, Huang YJ, Qiu CP, Yang YB, Shi LY, Qin J. L-carnitine ameliorated fasting-induced fatigue, hunger, and metabolic abnormalities in patients with metabolic syndrome: a randomized controlled study. Nutr J. 2014 Nov 26;13:110. PubMed
  33. Koeth RA, Wang Z, Levison BS, Buffa JA, Org E, Sheehy BT, Britt EB, Fu X, Wu Y, Li L, Smith JD, DiDonato JA, Chen J, Li H, Wu GD, Lewis JD, Warrier M, Brown JM, Krauss RM, Tang WH, Bushman FD, Lusis AJ, Hazen SL. Intestinal microbiota metabolism of L-carn
  34. Jun DW, Kim BI, Cho YK, Kim HJ, Kwon YO, Park SY, Han SY, Baek YH, Jung YJ, Kim HY, Kim W, Heo J, Woo HY, Hwang SG, Rim KS, Choi JY, Bae SH, Lee YS, Lim YS,Cheong JY, Cho SW, Lee BS, Kim SH, Sohn JH, Kim TY, Paik YH, Kim JK, Lee KS. Efficacy and safety of
  35. An JH, Kim YJ, Kim KJ, et al. L-carnitine supplementation for the management of fatigue in patients with hypothyroidism on levothyroxine treatment: a randomized, double-blind, placebo-controlled trial. Endocr J. 2016;63(10):885-95. PubMed
  36. Chen N, Yang M, Zhou M, Xiao J, Guo J, He L. L-carnitine for cognitive enhancement in people without cognitive impairment. Cochrane Database Syst Rev. 2017;3:CD009374. PubMed
  37. Khajeh B, Dashti-Khavidaki S, Nasiri-Toosi M, Mohammadi K, Jafari A. Effects of pre-transplant L-carnitine supplementation on primary graft dysfunction in liver transplant recipients: a pilot, randomized, placebo-controlled clinical trial. Res Pharm Sci. PubMed
  38. Kubota K, Uojima H, Shao X, et al. Additional L-carnitine Reduced the Risk of Hospitalization in Patients with Overt Hepatic Encephalopathy on Rifaximin. Dig Dis 2021. PubMed
  39. Amini L, Yaghini O, Ghazavi M, Aslani N. L-carnitine versus propranolol for pediatric migraine prophylaxis. Iran J Child Neurol 2021;15(2):77-86.
  40. Shakibaei F, Jelvani D. Effect of adding l -carnitine to risperidone on behavioral, cognitive, social, and physical symptoms in children and adolescents with autism: A randomized double-blinded placebo-controlled clinical trial. Clin Neuropharmacol 2023;4 PubMed
  41. Moustafa I, Connolly C, Anis M, Mustafa H, Oosthuizen F, Viljoen M. A prospective study to evaluate the efficacy and safety of vitamin E and levocarnitine prophylaxis against doxorubicin-induced cardiotoxicity in adult breast cancer patients. J Oncol Phar PubMed

See these in context on the L-carnitine monograph →

Mugwort 7 references
  1. Blumenthal M, ed. The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. Trans. S. Klein. Boston, MA: American Botanical Council, 1998.
  2. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
  3. Borghesan F, Mistrello G, Amato S, Giuffrida MG, Villalta D, Asero R. Mugwort-fennel-allergy-syndrome associated with sensitization to an allergen homologous to Api g 5. Eur Ann Allergy Clin Immunol. 2013;45(4):130-7.
  4. Kim SH, Lee SM, Park HW, et al. Chinese bellflower root anaphylaxis: IgE-binding components and cross-reactivity with mugwort and birch. Korean J Intern Med. 2009;24(3):279-82. PubMed
  5. Silva R, Lopes C, Castro E, et al. Anaphylaxis to mango fruit and crossreactivity with Artemisia vulgaris pollen. J Investig Allergol Clin Immunol. 2009;19(5):420-2.
  6. Rodrigues-Alves R, Pregal A, Pereira-Santos MC, et al. Anaphylaxis to pine nut: cross-reactivity to Artemisia vulgaris? Allergol Immunopathol (Madr). 2008;36(2):113-6. PubMed
  7. Di Lorenzo C, Ferretti F, Moro E, et al. Identification and quantification of thujone in a case of poisoning due to repeated ingestion of an infusion of Artemisia vulgaris L. J Food Sci. 2018;83(8):2257-2264.

See these in context on the Mugwort monograph →

Hibiscus Sabdariffa 19 references
  1. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
  2. Kolawole JA, Maduenyi A. Effect of zobo drink (Hibiscus sabdariffa water extract) on pharmacokinetics of acetaminophen in human volunteers. Eur J Drug Metab Pharmacokinet 2004;29:25-9.
  3. McKay DL, Chen CY, Saltzman E, Blumberg JB. Hibiscus Sabdariffa L. tea (tisane) lowers blood pressure in prehypertensive and mildly hypertensive adults. J Nutr 2010;140:298-303. PubMed
  4. Kuriyan R, Kumar DR, Rajendran R, Kurpad AV. An evaluation of the hypolipidemic effect of an extract of Hibiscus Sabdariffa leaves in hyperlipidemic Indians: a double blind, placebo controlled trial. BMC Complement Altern Med 2010;10:27. PubMed
  5. Haji, Faraji M. and Haji, Tarkhani A. The effect of sour tea (Hibiscus sabdariffa) on essential hypertension. J.Ethnopharmacol. 1999;65(3):231-236. PubMed
  6. Mozaffari-Khosravi, H., Jalali-Khanabadi, B. A., Afkhami-Ardekani, M., Fatehi, F., and Noori-Shadkam, M. The effects of sour tea (Hibiscus sabdariffa) on hypertension in patients with type II diabetes. J Hum.Hypertens 2009;23(1):48-54. PubMed
  7. Gurrola-Diaz, C. M., Garcia-Lopez, P. M., Sanchez-Enriquez, S., Troyo-Sanroman, R., Andrade-Gonzalez, I., and Gomez-Leyva, J. F. Effects of Hibiscus sabdariffa extract powder and preventive treatment (diet) on the lipid profiles of patients with metaboli
  8. Hernandez-Perez, F. and Herrera-Arellano, A. [Therapeutic use Hibiscus sabadariffa extract in the treatment of hypercholesterolemia. A randomized clinical trial]. Rev.Med Inst.Mex.Seguro.Soc. 2011;49(5):469-480.
  9. Mahmoud, B. M., Ali, H. M., Homeida, M. M., and Bennett, J. L. Significant reduction in chloroquine bioavailability following coadministration with the Sudanese beverages Aradaib, Karkadi and Lemon. J.Antimicrob.Chemother. 1994;33(5):1005-1009.
  10. Iyare EE, Adegoke OA. Maternal consumption of an aqueous extract of Hibiscus sabdariffa during lactation accelerates postnatal weight and delays onset of puberty in female offspring. Niger J Physiol Sci. 2008 Jun-Dec;23(1-2):89-94. PubMed
  11. Johnson SS, Oyelola FT, Ari T, Juho H. In vitro inhibitory activities of the extract of Hibiscus sabdariffa L. (family Malvaceae) on selected cytochrome P450 isoforms. Afr J Tradit Complement Altern Med. 2013 Apr 12;10(3):533-40.
  12. Sabzghabaee AM, Ataei E, Kelishadi R, Ghannadi A, Soltani R, Badri S, Shirani S. Effect of Hibiscus sabdariffa Calices on Dyslipidemia in Obese Adolescents: A Triple-masked Randomized Controlled Trial. Mater Sociomed. 2013;25(2):76-9. PubMed
  13. Showande SJ, Adegbolagun OM, Igbinoba SI, Fakeye TO. In vivo pharmacodynamic and pharmacokinetic interactions of Hibiscus sabdariffa calyces extracts with simvastatin. J Clin Pharm Ther. 2017;42(6):695-703.
  14. Fakeye TO, Adegoke AO, Omoyeni OC, Famakinde AA. Effects of water extract of Hibiscus sabdariffa, Linn (Malvaceae) 'Roselle' on excretion of a diclofenac formulation. Phytother Res. 2007;21(1):96-8.
  15. Al-Anbaki M, Nogueira RC, Cavin AL, et al. Treating uncontrolled hypertension with Hibiscus sabdariffa when standard treatment is insufficient: Pilot intervention. J Altern Complement Med. 2019;25(12):1200-1205.
  16. Ahad A, Raish M, Bin Jardan YA, Alam MA, Al-Mohizea AM, Al-Jenoobi FI. Effect of Hibiscus sabdariffa and Zingiber officinale on the antihypertensive activity and pharmacokinetic of losartan in hypertensive rats. Xenobiotica. 2020:1-11.
  17. Najafpour Boushehri S, Karimbeiki R, Ghasempour S, et al. The efficacy of sour tea (Hibiscus sabdariffa L.) on selected cardiovascular disease risk factors: A systematic review and meta-analysis of randomized clinical trials. Phytother Res. 2020;34(2):329
  18. Bule M, Albelbeisi AH, Nikfar S, Amini M, Abdollahi M. The antidiabetic and antilipidemic effects of Hibiscus sabdariffa: A systematic review and meta-analysis of randomized clinical trials. Food Res Int. 2020;130:108980. PubMed
  19. Alam MA, Bin Jardan YA, Alzenaidy B, et al. Effect of Hibiscus sabdariffa and Zingiber officinale on pharmacokinetics and pharmacodynamics of amlodipine. J Pharm Pharmacol 2021;73(9):1151-60.

See these in context on the Hibiscus Sabdariffa monograph →

Panax Notoginseng 15 references
  1. Huang KC. The Pharmacology of Chinese Herbs. 2nd ed. New York, NY: CRC Press, LLC 1999:101-102.
  2. Bensky D, Gamble A, Kaptchuk T. Chinese Herbal Medicine Materia Medica. Seattle, WA: Eastland Press, 1996:359-60.
  3. Chan LY, Chiu PY, Lau TK. An in-vitro study of ginsenoside Rb(1)-induced teratogenicity using a whole rat embryo culture model. Hum Reprod 2003;18:2166-8..
  4. Du XF, Yin XP, Zhang GL, Shi HJ, Shao MH. Interstitial granulomatous drug reaction to a Chinese herb extract. Eur J Dermatol. 2012 May-Jun;22(3):419-20. PubMed
  5. Liu R, Qin M, Hang P, Liu Y, Zhang Z, Liu G. Effects of Panax notoginseng saponins on the activities of CYP1A2, CYP2C9, CYP2D6 and CYP3A4 in rats in vivo. Phytother Res. 2012 Aug;26(8):1113-8.
  6. Shang Q, Xu H, Liu Z, Chen K, Liu J. Oral Panax notoginseng Preparation for Coronary Heart Disease: A Systematic Review of Randomized Controlled Trials. Evid Based Complement Alternat Med. 2013;2013:940125.
  7. Tian Z, Pang H, Du S, Lu Y, Zhang L, Wu H, Guo S, Wang M, Zhang Q. Effect of Panax notoginseng saponins on the pharmacokinetics of aspirin in rats. J Chromatogr B Analyt Technol Biomed Life Sci. 2017 Jan 1;1040:136-143. PubMed
  8. Xu D, Huang P, Yu Z, Xing DH, Ouyang S, Xing G. Efficacy and Safety of Panax notoginseng Saponin Therapy for Acute Intracerebral Hemorrhage, Meta-Analysis, and Mini Review of Potential Mechanisms of Action. Front Neurol. 2015 Jan 7;5:274. PubMed
  9. Yang X, Xiong X, Wang J. Sanqi panax notoginseng injection for angina pectoris. Evid Based Complement Alternat Med. 2014;2014:963208. PubMed
  10. Yin Z, Ma L, Xu J, Xia J, Luo D. Pustular drug eruption due to Panax notoginseng saponins. Drug Des Devel Ther. 2014 Jul 16;8:957-61. PubMed
  11. Song H, Wang P, Liu J, Wang C. Panax notoginseng Preparations for Unstable Angina Pectoris: A Systematic Review and Meta-Analysis. Phytother Res. 2017 Jun 20.
  12. Tian Z, Pang H, Zhang Q, et al. Effect of aspirin on the pharmacokinetics and absorption of panax notoginsengsaponins. J Chromatogr B Analyt Technol Biomed Life Sci. 2018 Jan 2;1074-75.
  13. Li C, Xu T, Zhou P, et al. Post-marketing safety surveillance and re-evaluation of Xueshuantong injection. BMC Complement Altern Med. 2018;18(1):277. PubMed
  14. Liu L, Shen XJ, Xue LJ, Yao SK, Zhu JY. Submucosal hematoma with a wide range of lesions, severe condition and atypical clinical symptoms: A case report. World J Clin Cases 2021;9(20):5683-5688. PubMed
  15. Qian J, Chen W, Wu J, et al. Effects and Mechanism of Action of Panax notoginseng Saponins on the Pharmacokinetics of Warfarin. Eur J Drug Metab Pharmacokinet 2022;47(3):331-342. PubMed

See these in context on the Panax Notoginseng monograph →

Black Pepper 29 references
  1. Leung AY, Foster S. Encyclopedia of Common Natural Ingredients Used in Food, Drugs and Cosmetics. 2nd ed. New York, NY: John Wiley & Sons, 1996.
  2. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
  3. Bano G, Amla V, Raina RK, et al. The effect of piperine on pharmacokinetics of phenytoin in healthy volunteers. Planta Med 1987;53:568-9. PubMed
  4. Bano G, et al. Effect of piperine on bioavailability and pharmacokinetics of propranolol and theophylline in healthy volunteers. Eur J Clin Pharmacol 1991;41;615-7. PubMed
  5. Cohle SD, Trestrail JD III, Graham MA, et al. Fatal pepper aspiration. Am J Dis Child 1988;142:633-6. PubMed
  6. Bhardwaj RK, Glaeser H, Becquemont L, et al. Piperine, a major constituent of black pepper, inhibits human P-glycoprotein and CYP3A4. J Pharmacol Exp Ther 2002;302:645-50. PubMed
  7. Velpandian T, Jasuja R, Bhardwaj RK, et al. Piperine in food: interference in the pharmacokinetics of phenytoin. Eur J Drug Metab Pharmacokinet 2001;26:241-7. PubMed
  8. Pattanaik S, Hota D, Prabhakar S, et al. Pharmacokinetic interaction of a single dose of piperine with steady-state carbamazepine in epilepsy patients. Phytother Res 2009;23:1281-6.
  9. Munakata, M., Kobayashi, K., Niisato-Nezu, J., Tanaka, S., Kakisaka, Y., Ebihara, T., Ebihara, S., Haginoya, K., Tsuchiya, S., and Onuma, A. Olfactory stimulation using black pepper oil facilitates oral feeding in pediatric patients receiving long-term en
  10. Myers, B. M., Smith, J. L., and Graham, D. Y. Effect of red pepper and black pepper on the stomach. Am J Gastroenterol 1987;82(3):211-214.
  11. Raghavendra, R. H. and Naidu, K. A. Spice active principles as the inhibitors of human platelet aggregation and thromboxane biosynthesis. Prostaglandins Leukot.Essent.Fatty Acids 2009;81(1):73-78. PubMed
  12. Subehan, Usia, T., Kadota, S., and Tezuka, Y. Mechanism-based inhibition of human liver microsomal cytochrome P450 2D6 (CYP2D6) by alkamides of Piper nigrum. Planta Med 2006;72(6):527-532.
  13. Kasibhatta, R. and Naidu, M. U. Influence of piperine on the pharmacokinetics of nevirapine under fasting conditions: a randomised, crossover, placebo-controlled study. Drugs R.D. 2007;8(6):383-391. PubMed
  14. Usia, T., Iwata, H., Hiratsuka, A., Watabe, T., Kadota, S., and Tezuka, Y. CYP3A4 and CYP2D6 inhibitory activities of Indonesian medicinal plants. Phytomedicine. 2006;13(1-2):67-73. PubMed
  15. Mujumdar, A. M., Dhuley, J. N., Deshmukh, V. K., Raman, P. H., Thorat, S. L., and Naik, S. R. Effect of piperine on pentobarbitone induced hypnosis in rats. Indian J Exp.Biol. 1990;28(5):486-487.
  16. Panda, S. and Kar, A. Piperine lowers the serum concentrations of thyroid hormones, glucose and hepatic 5'D activity in adult male mice. Horm.Metab Res. 2003;35(9):523-526. PubMed
  17. Lawless, H. and Stevens, D. A. Effects of oral chemical irritation on taste. Physiol Behav. 1984;32(6):995-998. PubMed
  18. Hiwale, A. R., Dhuley, J. N., and Naik, S. R. Effect of co-administration of piperine on pharmacokinetics of beta-lactam antibiotics in rats. Indian J Exp.Biol. 2002;40(3):277-281.
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See these in context on the Black Pepper monograph →

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

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