Interactions on record — worth a quick check against your medications. Based on 11 of 24 ingredients. Check your meds →
Dietary supplement

Digestive Enzymes Ingredients & Drug Interactions

by Physician's Choice

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

First and foremost: checking Digestive Enzymes 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: Moderate

Digestive Enzymes is a dietary supplement by Physician's Choice with 24 active ingredients. Its ingredients are commonly taken for irritable bowel syndrome (ibs), indigestion and gas, nausea.Based on those ingredients, 2,198 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Acacia senegal, Ginger, Peppermint. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

Jump to a section

Check Your Meds Against Digestive Enzymes by Physician's Choice

Ask about any prescription or over-the-counter medication and we check it for interactions with Digestive Enzymes by Physician's Choice — and tell you which ingredient is responsible.

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HelloPharmacist Scorecard of Digestive Enzymes by Physician's Choice

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

Low disclosure
Ingredient Transparency · database check
Low

Most active ingredients don't disclose an individual amount — you can't tell how much of each you're getting.

Why this rating?
  • The label discloses an exact amount for 0 of its 24 active ingredients.
  • “Herbal Blend” is a proprietary blend — the label gives one combined amount (150 mg) without saying how much of each component you get.
  • “Digestive Enzyme Blend” is a proprietary blend — the label gives one combined amount (85 mg) without saying how much of each component you get.
  • “Prebiotic and Probiotic Blend” is a proprietary blend — the label gives one combined amount (159 mg) without saying how much of each component you get.

Physician's Choice Digestive Enzymes contains 24 ingredients, including 10 active enzymes and probiotics designed to support digestion. The enzyme blend includes amylase and glucoamylase (which break down starches), proteases 3.0, 4.5, and 6.0 (which break down proteins), lipase (which breaks down fats), cellulase and hemicellulase (which break down fiber), invertase and xylanase (which break down other carbohydrates), and lactase (which breaks down milk sugar).

The product also contains two live-culture probiotics—Bacillus coagulans and Bacillus subtilis—along with peppermint and ginger for digestive comfort, plus chicory root extract and a prebiotic blend. The remaining ingredients are inactive fillers and capsule materials like hypromellose, rice flour, and rice hull concentrate.

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: digestive support with enzymes, prebiotics and probiotics.
  • We looked for evidence on: Abdominal pain, Antibiotic-associated diarrhea, Celiac disease, Clostridioides difficile infection, Constipation, Diarrhea — and 4 related terms.
  • The strongest evidence on file: Peppermint is rated "Possibly Effective" for Dyspepsia (Natural Medicines).
  • Also on file: Bacillus Coagulans is rated "Possibly Effective" for Constipation.
  • Also on file: Bacillus Subtilis is rated "Possibly Effective" for Antibiotic-associated diarrhea.

The evidence supporting these ingredients is mixed. Lactase is effective for lactose intolerance.

Peppermint is likely effective for irritable bowel syndrome and possibly effective for indigestion and nausea. Ginger is possibly effective for pregnancy-related nausea, period pain, and osteoarthritis.

Bacillus coagulans is possibly effective for constipation and irritable bowel syndrome, and Bacillus subtilis is possibly effective for antibiotic-associated diarrhea. For most other uses—including the other enzymes and digestive conditions like inflammatory bowel disease—the evidence we hold is insufficient to rate them.

The product's overall benefit for general digestion has not been established in our data.

The evidence, ingredient by ingredient Peppermint Ginger Papain Bromelain Lipase Lactase Proteolytic Enzymes (proteases) Bacillus Coagulans

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 11 of the 11 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 11 of 11.
  • General safety write-ups exist for 11 of 11.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

The enzymes and probiotics in this product are generally well tolerated at standard doses in healthy adults. However, concentrated papain may irritate the digestive tract and cause allergic reactions in sensitive people, and bromelain commonly causes diarrhea, gas, and stomach upset.

Peppermint oil can cause abdominal pain, heartburn, and nausea, and in rare cases anaphylaxis. Ginger at doses above 5 grams per day increases side effects; common ones are heartburn, diarrhea, and a burning sensation in the mouth.

Chicory commonly causes bloating and gas. Probiotics are generally safe for healthy people but carry a theoretical risk of infection in severely ill or immunocompromised patients with central lines or catheters.

For pregnancy, concentrated papain and unripe papaya products should be avoided. Bromelain and the proteases are best avoided unless prescribed by your doctor.

Peppermint used as tea in food amounts is likely safe in pregnancy. Lactase is likely safe.

Ginger is often used for morning sickness but should be discussed with your doctor first. For breastfeeding, there isn't enough data on papain, bromelain, the proteases, or chicory at supplement doses—talk with your doctor or pharmacist before use.

Peppermint as food amounts and lactase have better safety profiles.

Side effects, ingredient by ingredient Peppermint Ginger Papain Bromelain Lipase Lactase Proteolytic Enzymes (proteases) Bacillus Coagulans

Meds to double-check

Moderate interaction found
Known Interaction Concern · database check
Moderate identified

The most serious documented interaction for these ingredients is Moderate. Check your medications for a personalized result.

Why this rating?
  • 8 of the 11 matched ingredients can interact with medications — Papain, Chicory, Gum Arabic, Peppermint, Bromelain, among others.
  • The most serious interaction on file is rated Moderate.
  • Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs; immunosuppressants / transplant drugs; diabetes medications.
  • For scale: 2,199 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 take any of these medication types: blood thinners (anticoagulants) like warfarin or phenprocoumon, antiplatelet drugs like aspirin or clopidogrel, blood pressure medications especially nifedipine or losartan, cyclosporine or other immunosuppressants, medications broken down by your liver's CYP3A4, CYP2C19, or CYP2C9 enzymes, diabetes drugs, or antibiotics. The peppermint, ginger, papain, and bromelain all carry moderate-severity interactions with these types.

If you take antibiotics, separate them from the Bacillus probiotics by several hours. No interactions are documented for lipase or lactase.

Check your own medication Run your meds through the checker above

The bottom line

Scorecard at a glanceFormula with limited ingredient disclosure with some supporting evidence for its stated purpose. Moderate medication interactions have been identified, and safety information is well characterized.

This product makes sense if you have lactose intolerance, mild irritable bowel syndrome, or occasional digestive upset and aren't on medications that interact with its ingredients—especially blood thinners, diabetes drugs, or medications metabolized by your liver. If you take any prescription medications, antibiotic, or blood pressure drug, check them against the medication tool below before starting.

Talk to your pharmacist if you're pregnant, breastfeeding, or have a serious digestive or immune condition.

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

Assessment coverage: 13 of 24 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Nov 22, 2024.

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 Digestive Enzymes, straight from the product label.

Brand Physician's Choice
Net contents 60 Capsule(s)
Market status On market
Date entered into DSLD Nov 22, 2024
DSLD ID 320108
Product type Other Combinations
Supplement form Capsule
Dietary claims / uses All Other, Structure/Function
Intended target group(s) Adult (18 - 50 Years), Dairy Free
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 Digestive Enzymes by Physician's Choice, 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:
1 Capsule(s)
Maximum serving Sizes:
1 Capsule(s)
Servings per container
60
IngredientAmount% DV
Amylase0 NP--
Papain0 NP--
Bromelain0 NP--
Lipase0 NP--
Lactase0 NP--
Cellulase0 NP--
Peptidase0 NP--
Invertase0 NP--
Herbal Blend150 mg--
Glucoamylase0 NP--
Xylanase0 NP--
Beta-Glucanase0 NP--
Hemicellulase0 NP--
Bacillus coagulans0 NP--
Digestive Enzyme Blend85 mg--
Protease 4.50 NP--
Alpha-Galactosidase0 NP--
Peppermint0 NP--
Bacillus clausii0 NP--
Bacillus subtilis0 NP--
Protease 3.00 NP--
Prebiotic and Probiotic Blend159 mg--
Protease 6.00 NP--
Chicory root extract0 NP--
Ginger0 NP--
Jerusalem Artichoke Extract0 NP--
Acacia senegal0 NP--

Other ingredients: Hypromellose, Rice Flour, Rice Hull Concentrate, Gum Arabic, Sunflower Oil

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.
Formula

Digestive Enzymes with prebiotics + probiotics 16 enzymes 150 mg prebiotics 1B CFUs probiotics

16 digestive enzymes to help break down problem foods in the stomach 150 mg botanical blend of organic ginger root and peppermint leaf to soothe the stomach 3 probiotic strains from soil-based organisms to help ensure they survive the journey to the gut

FDA Statement of Identity

Dietary Supplement

Formulation

150 mg botanical blend of organic ginger root and peppermint leaf to soothe the stomach

Made without GMOs, artificial flavors or colors, major allergens Peanut, tree nut, sesame, milk, eggs, fish, shellfish

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

See for yourself

Digestive Enzymes by Physician's Choice label

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

Digestive Enzymes 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 Digestive Enzymes by Physician's Choice

These are the 24 active ingredients this product is made of. Select any to open its full monograph.

Serving size1 Capsule(s) Dosage formCapsule Servings per container60 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.

Herbal Blend

150 mg per serving

Digestive Enzyme Blend

85 mg per serving

Prebiotic and Probiotic Blend

159 mg per serving

Other (inactive) ingredients: Hypromellose, Rice Flour, Rice Hull Concentrate, Gum Arabic, Sunflower Oil. These complete the product’s ingredient list but are not active constituents.

Interaction report

Digestive Enzymes by Physician's Choice Drug Interactions

Want to check YOUR meds against Digestive Enzymes?

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
2,198Drugs
2,193 Moderate 5 Minor

Ingredients driving the most interactions

Acacia senegal 2,022
Ginger 1,007
Peppermint 796
Bacillus coagulans 182
Bacillus subtilis 182

Individual Drug Interactions

The ingredients in Digestive Enzymes interact with 2,198 drugs. Click any drug to see the details.

8 of the 24 ingredients in Digestive Enzymes interact with drugs. Each result below shows which ingredient is responsible. Acacia senegal Ginger Peppermint Bacillus coagulans Bacillus subtilis Bromelain Chicory root extract Papain

Each ingredient & the kinds of drugs it affects

For each ingredient in Digestive Enzymes 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.

Acacia senegal2 drug types · 2,022 drugs

Amoxicillin (Amoxil, Trimox)

Gum arabic can reduce the absorption of amoxicillin.
A small study in healthy volunteers shows that taking amoxicillin and gum arabic concurrently significantly reduces the absorption of amoxicillin. Separate doses of amoxicillin from gum arabic by at least 2 hours.

Likelihood Probable Evidence B
Oral Drugs

Theoretically, gum arabic can alter the absorption of oral drugs due to its fiber content.
Gum arabic has been used as a suspending osmotic agent in drug formulations. It might improve bioavailability of water-insoluble drugs like naproxen, but reduce absorption of polar drugs like amoxicillin. To avoid changes in absorption, take gum arabic 30-60 minutes after oral medications.

Likelihood Possible Evidence B
Acacia senegal full monograph & interactions

Ginger14 drug types · 1,007 drugs

Anticoagulant/Antiplatelet Drugs

Ginger may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs. However, research is conflicting.
Laboratory research suggests that ginger inhibits thromboxane synthetase and decreases platelet aggregation. However, this has not been demonstrated unequivocally in humans, with mixed results from clinical trials. Theoretically, excessive amounts of ginger might increase the risk of bleeding when used with anticoagulant/antiplatelet drugs.

Likelihood Possible Evidence B
Antidiabetes Drugs

Theoretically, taking ginger with antidiabetes drugs might increase the risk of hypoglycemia.
Animal and human research suggests that ginger might increase insulin levels and/or decrease blood glucose levels.

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

Ginger might increase or decrease the levels of CYP3A4 substrates.
In vitro research and some case reports suggest that ginger inhibits CYP3A4 activity. Three case reports from the World Health Organization (WHO) adverse drug reaction database describe increased toxicity in patients taking ginger and cancer medications that are CYP3A4 substrates (imatinib, dabrafenib, and crizotinib). However, the causality of this interaction is unclear due to the presence of multiple interacting drugs and routes of administration.
Conversely, other in vitro research suggests that ginger induces CYP3A4 activity, leading to reduced levels of CYP3A4 substrates. However, this interaction has not been reported in humans.

Likelihood Possible Evidence D
Losartan (Cozaar)

Theoretically, ginger might increase levels of losartan and the risk of hypotension.
In animal research, ginger increased the levels and hypotensive effects of a single dose of losartan. It is not clear if ginger alters the concentration or effects of losartan when taken continuously. Additionally, this interaction has not been shown in humans.

Likelihood Possible Evidence D
Nifedipine (Procardia)

Ginger may have antiplatelet effects and increase the risk of bleeding if used with nifedipine.
Clinical research shows that combined treatment with ginger 1 gram plus nifedipine 10 mg significantly inhibits platelet aggregation when compared to nifedipine or ginger alone.

Likelihood Possible Evidence B
P-Glycoprotein Substrates

Ginger might increase the absorption and blood levels of P-glycoprotein (P-gp) substrates.
In vitro research and case reports suggest that ginger inhibits drug efflux by P-gp, potentially increasing absorption and serum levels of P-gp substrates. Two case reports from the World Health Organization (WHO) adverse drug reaction database describe increased toxicity in patients taking ginger and cancer medications that are P-gp substrates (trametinib, crizotinib). However, the causality of this interaction is unclear due to the presence of multiple interacting drugs and routes of administration.

Likelihood Possible Evidence D
Phenprocoumon (Marcoumar, Others)

Ginger might increase the risk of bleeding with phenprocoumon.
Phenprocoumon, a warfarin-related anticoagulant, might increase the international normalized ratio (INR) when taken with ginger. There is one case report of a 76-year-old woman with a stable INR on phenprocoumon that increased to greater than 10 when she began consuming dried ginger and ginger tea.

Likelihood Possible Evidence D
Warfarin (Coumadin)

Ginger might increase the risk of bleeding with warfarin.
Laboratory research suggests that ginger might inhibit thromboxane synthetase and decrease platelet aggregation. In one case report, ginger increased the INR when taken with phenprocoumon, which has similar pharmacological effects as warfarin. In another case report, ginger increased the INR when taken with a combination of warfarin, hydrochlorothiazide, and acetaminophen. A longitudinal analysis suggests that taking ginger increases the risk of bleeding in patients taking warfarin for at least 4 months. However, research in healthy people suggests that ginger has no effect on INR, or the pharmacokinetics or pharmacodynamics of warfarin. Until more is known, monitor INRs closely in patients taking large amounts of ginger.

Likelihood Possible Evidence B
Calcium Channel Blockers

Theoretically, taking ginger with calcium channel blockers might increase the risk of hypotension.
Some animal and in vitro research suggests that ginger has hypotensive and calcium channel-blocking effects. Another animal study shows that concomitant administration of ginger and the calcium channel blocker amlodipine leads to greater reductions in blood pressure when compared with amlodipine alone.

Likelihood Unlikely Evidence D
Cyclosporine (Neoral, Sandimmune)

Theoretically, when taken prior to cyclosporine, ginger might decrease cyclosporine levels.
In an animal model, ginger juice taken 2 hours prior to cyclosporine administration reduced the maximum concentration and area under the curve of cyclosporine by 51% and 40%, respectively. This effect was not observed when ginger juice and cyclosporine were administered at the same time.

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

Theoretically, ginger might increase the levels of CYP1A2 substrates.
In vitro research shows that ginger inhibits CYP1A2 activity. However, this interaction has not been reported in humans.

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

Theoretically, ginger might increase the levels of CYP2B6 substrates.
In vitro research shows that ginger inhibits CYP2B6 activity. However, this interaction has not been reported in humans.

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

Theoretically, ginger might increase the levels of CYP2C9 substrates.
In vitro research shows that ginger inhibits CYP2C9 activity. However, this interaction has not been reported in humans.

Likelihood Possible Evidence D
Metronidazole (Flagyl)

Theoretically, ginger might increase levels of metronidazole.
In an animal model, ginger increased the absorption and plasma half-life of metronidazole. In addition, the elimination rate and clearance of metronidazole was significantly reduced.

Likelihood Possible Evidence D
Ginger full monograph & interactions

Peppermint5 drug types · 796 drugs

Cyclosporine (Neoral, Sandimmune)

Theoretically, peppermint oil might increase the levels and adverse effects of cyclosporine.
In animal research, peppermint oil inhibits cyclosporine metabolism and increases cyclosporine levels. Inhibition of cytochrome P450 3A4 (CYP3A4) may be partially responsible for this interaction. An interaction between peppermint oil and cyclosporine has not been reported in humans.

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

Theoretically, peppermint might increase the levels of CYP2C19 substrates.
In vitro research shows that peppermint oil inhibits CYP2C19. So far, this interaction has not been reported in humans.

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

Theoretically, peppermint might increase the levels of CYP2C9 substrates.
In vitro research shows that peppermint oil inhibits CYP2C9. So far, this interaction has not been reported in humans.

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

Theoretically, peppermint might increase the levels of CYP3A4 substrates.
Clinical research in healthy volunteers shows that a single dose of peppermint oil 600 mg inhibits CYP3A4 enzymes and increases the AUC of felodipine, a CYP3A4 substrate. However, in vitro research suggests that peppermint oil only inhibits CYP3A4 at very high concentrations.

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

Theoretically, peppermint might increase the levels of CYP1A2 substrates.
In vitro and animal research shows that peppermint oil and peppermint leaf inhibit CYP1A2. However, in clinical research, peppermint tea did not significantly affect the metabolism of caffeine, a CYP1A2 substrate. It is possible that the 6-day duration of treatment may have been too short to identify a difference.

Likelihood Possible Evidence B
Peppermint full monograph & interactions

Bacillus coagulans1 drug type · 182 drugs

Antibiotic Drugs

Theoretically, taking antibiotics with Bacillus coagulans might decrease the effectiveness of B. coagulans.
B. coagulans preparations usually contain live and active organisms. Therefore, simultaneously taking antibiotics might kill a significant number of the organisms. Tell patients to separate administration of antibiotics and B. coagulans preparations by at least two hours.

Likelihood Probable Evidence D
Bacillus coagulans full monograph & interactions

Bacillus subtilis1 drug type · 182 drugs

Antibiotic Drugs

Theoretically, taking Bacillus subtilis with antibiotic drugs might decrease the effectiveness of B. subtilis.
Since B. subtilis preparations usually contain live and active organisms, simultaneously taking antibiotics might kill a significant number of the organisms. Tell patients to separate administration of antibiotics and B. subtilis preparations by at least 2 hours.

Likelihood Probable Evidence D
Bacillus subtilis full monograph & interactions

Bromelain2 drug types · 141 drugs

Anticoagulant/Antiplatelet Drugs

Bromelain may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
There is one case report of a patient experiencing minor bruising while taking bromelain with naproxen. Bromelain is thought to have antiplatelet activity. Whether this interaction is of concern with topical bromelain is unclear. Interference with coagulation of burn wounds has been reported in a patient receiving bromelain-based enzymatic debridement. However, observational research has found that topical bromelain debridement is not associated with increases or decreases in laboratory markers of coagulation when compared with surgical debridement.

Likelihood Possible Evidence D
Tetracycline Antibiotics

Theoretically, bromelain might increase levels of tetracycline antibiotics.
Laboratory research suggests that bromelain might increase the absorption of tetracycline antibiotics. However, a study in healthy adults reported no difference in tetracycline plasma levels when a 500 mg dose was taken with or without bromelain 80 mg.

Likelihood Possible Evidence B
Bromelain full monograph & interactions

Chicory root extract1 drug type · 86 drugs

Antidiabetes Drugs

Theoretically, chicory might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Animal and in vitro research shows that chicory extracts have antidiabetic effects.

Likelihood Possible Evidence D
Chicory root extract full monograph & interactions

Papain1 drug type · 2 drugs

Warfarin (Coumadin)

Theoretically, papain might increase the effects and side effects of warfarin.
In one case report, a patient previously stable on warfarin was found to have an international normalization ratio (INR) of 7.4, which was attributed to ingestion of a supplement containing papain from papaya extract.

Likelihood Possible Evidence D
Papain full monograph & interactions
The maker

Brand information

Manufacturer and brand details for Digestive Enzymes, from the product label.

Physician's Choice

See all Physician's Choice products
Name
Physician's Choice
Pharmacist Counseling Corner

Digestive Enzymes by Physician's Choice: Common Questions

Does Digestive Enzymes by Physician's Choice interact with any medications?
Yes. Based on its ingredients, Digestive Enzymes has a known interaction with 2,198 medications. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Digestive Enzymes contains 24 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.
Is this good for general digestion if I don't have a specific problem?
The data we hold doesn't establish whether these enzymes help healthy people without diagnosed digestive issues. Lactase works for lactose intolerance, and peppermint helps with irritable bowel syndrome, but for broad digestive support in otherwise healthy stomachs, we don't have evidence in our records.
Can I take this with antibiotics?
The Bacillus probiotics in this product lose effectiveness if taken at the same time as antibiotics. Ask your pharmacist to separate them by a few hours—take the antibiotic at one time of day and the digestive enzymes at another.
What does the peppermint do in this?
Peppermint is in the product to help settle your stomach and ease digestive discomfort. It's likely effective for irritable bowel syndrome and possibly helps with indigestion and nausea.
Will this help with my IBS?
Peppermint in this product is likely effective for irritable bowel syndrome, and Bacillus coagulans is possibly effective for it. You may see benefit, but results vary by person—talk to your doctor if symptoms don't improve.
Is it safe to use if I'm pregnant?
It depends on the ingredient. Lactase is likely safe; peppermint in food amounts is probably okay. But avoid concentrated papain and the proteases unless your doctor says it's okay. Ask your doctor or pharmacist about the others before taking it regularly.
What does the ginger do?
Ginger in the product helps ease nausea and stomach upset. It's possibly effective for indigestion and may help with nausea, though it can cause heartburn or a burning feeling in the mouth at higher doses.

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.

Digestive Enzymes label
Go deeper

The Full Monographs Behind Digestive Enzymes’s Ingredients

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

Herb & supplement monograph

Peppermint

Interacts with 796 drugs

Peppermint is a popular herb with the best evidence supporting enteric-coated peppermint oil for easing IBS symptoms. It is generally well tolerated for most adults, but it can cause heartbu...

Read the full Peppermint monograph → Herb & supplement monograph

Ginger

Interacts with 1,007 drugs

Ginger is a widely used culinary spice with a long history in traditional medicine, and it has the strongest evidence for helping with nausea and vomiting, including from motion sickness, pr...

Read the full Ginger monograph → Herb & supplement monograph

Papain

Interacts with 2 drugs

Papain is a protein-digesting enzyme from the papaya plant that is used in digestive supplements and some topical products. While it has clear food and laboratory uses, strong human evidence...

Read the full Papain monograph → Herb & supplement monograph

Bromelain

Interacts with 141 drugs

Bromelain is a group of protein-digesting enzymes from pineapple that people take mainly for inflammation, swelling, and sinus problems. Some early studies are promising, but the overall evi...

Read the full Bromelain monograph → Herb & supplement monograph

Lipase

Lipase is a digestive enzyme that helps your body break down dietary fats. It is well established as part of prescription pancreatic enzyme therapy for people who cannot make enough of their...

Read the full Lipase monograph → Herb & supplement monograph

Lactase

Lactase is a digestive enzyme supplement that helps people who lack enough natural lactase break down lactose, the sugar in milk and dairy. It can reduce gas, bloating, cramping, and diarrhe...

Read the full Lactase monograph → Herb & supplement monograph

Proteolytic Enzymes (proteases)

Proteolytic enzymes are proteins that help break down other proteins, and common examples include bromelain (from pineapple), papain (from papaya), trypsin, chymotrypsin, and pancreatin. Peo...

Read the full Proteolytic Enzymes (proteases) monograph → Herb & supplement monograph

Bacillus Coagulans

Interacts with 182 drugs

Bacillus coagulans is a spore-forming probiotic that survives stomach acid well and may help with some digestive problems such as IBS, constipation, and certain types of diarrhea. The eviden...

Read the full Bacillus Coagulans monograph → Herb & supplement monograph

Bacillus Subtilis

Interacts with 182 drugs

Bacillus subtilis is a spore-forming probiotic bacterium found in soil and some fermented foods, and it is used mainly to support gut health and digestion. Early research is promising for ce...

Read the full Bacillus Subtilis monograph → Herb & supplement monograph

Chicory

Interacts with 86 drugs

Chicory is best known as a caffeine-free coffee substitute and as a source of inulin, a soluble prebiotic fiber that may support digestion and regularity. Strong human evidence for most othe...

Read the full Chicory monograph → Herb & supplement monograph

Gum Arabic

Interacts with 2,022 drugs

Gum arabic is a soluble dietary fiber from the acacia tree that is widely used as a safe food additive and is sometimes taken as a supplement for digestive health and as a prebiotic. Early s...

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Sources

Sources & How We Checked

Digestive Enzymes'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 191 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.

Papain 11 references
  1. The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999.
  2. Shaw D, Leon C, Kolev S, Murray V. Traditional remedies and food supplements: a 5-year toxicological study (1991-1995). Drug Saf 1997;17:342-56.
  3. Shuttleworth D, Hill S, Marks R, Connelly DM. Relief of experimentally induced pruritus with a novel eutectic mixture of local anaesthetic agents. Br J Dermatol 1988;119:535-40.
  4. Mansfield LE, Ting S, Haverly RW, Yoo TJ. The incidence and clinical implications of hypersensitivity to papain in an allergic population, confirmed by blinded oral challenge. Ann Allergy 1985;55:541-3.
  5. Martin, T., Uhder, K., Kurek, R., Roeddiger, S., Schneider, L., Vogt, H. G., Heyd, R., and Zamboglou, N. Does prophylactic treatment with proteolytic enzymes reduce acute toxicity of adjuvant pelvic irradiation? Results of a double-blind randomized trial PubMed
  6. Walker-Renard, P. Update on the medicinal management of phytobezoars. Am J Gastroenterol. 1993;88(10):1663-1666.
  7. Tymoszuk D, Wiszniewska M, Walusiak-Skorupa J. Papain-induced occupational rhinoconjunctivitis and asthma - A case report. Med Pr 2016;67(1):109-12. PubMed
  8. Soto-Mera MT, López-Rico MR, Filgueira JF, et al. Occupational allergy to papain. Allergy 2000;55(10):983-4. PubMed
  9. Tarlo SM, Shaikh W, Bell B, et al. Papain-induced allergic reactions. Clin Allergy 1978;8(3):207-15. PubMed
  10. Baur X, König G, Bencze K, Fruhmann G. Clinical symptoms and results of skin test, RAST and bronchial provocation test in thirty-three papain workers: Evidence for strong immunogenic potency and clinically relevant proteolytic e?ects of airborne papain. C
  11. Novey HS, Keenan WJ, Fairshter RD, Wells ID, Wilson AF, Culver BD. Pulmonary disease in workers exposed to papain: clinico-physiological and immunological studies. Clin Allergy 1980;10(6):721-31. PubMed

See these in context on the Papain monograph →

Bromelain 19 references
  1. Nettis E, Napoli G, Ferrannini A, Tursi A. IgE-mediated allergy to bromelain. Allergy 2001;56:257-8. PubMed
  2. Taussig SJ, Batkin S. Bromelain, the enzyme complex of pineapple (Ananas comosus) and its clinical application. An update. J Ethnopharmacol 1988;22:191-203.. PubMed
  3. Bradbrook ID, Morrison PJ, Rogers HJ. The effect of bromelain on the absorption of orally administered tetracycline. Br J Clin Pharmacol 1978;6:552-4. PubMed
  4. Bush TM, Rayburn KS, Holloway SW, et al. Adverse interactions between herbal and dietary substances and prescription medications: a clinical survey. Altern Ther Health Med 2007;13:30-5.
  5. Brien S, Lewith G, Walker AF, et al. Bromelain as an adjunctive treatment for moderate-to-severe osteoarthritis of the knee: a randomized placebo-controlled pilot study. QJM 2006;99:841-50. PubMed
  6. Mori S, Ojima Y, Hirose T, et al. The clinical effect of proteolytic enzyme containing bromelain and trypsin on urinary tract infection evaluated by double blind method. Acta Obstet Gynaecol Jpn 1972;19:147-53.
  7. Glaser D, Hilberg T. The influence of bromelain on platelet count and platelet activity in vitro. Platelets 2006;17:37-41. PubMed
  8. Heinicke R M, van der Wal L, Yokoyama M. Effect of bromelain (Ananase) on human platelet aggregation. Experientia 1972;28:844-5. PubMed
  9. Gailhofer, G., Wilders-Truschnig, M., Smolle, J., and Ludvan, M. Asthma caused by bromelain: an occupational allergy. Clin Allergy 1988;18(5):445-450. PubMed
  10. Mattei, O., Fabri, G., and Farina, G. [Occupational health experience regarding four cases of asthma due to bromelain (author's transl)]. Medicina del Lavoro 1979;70(5):404-409.
  11. Galleguillos, F. and Rodriguez, J. C. Asthma caused by bromelin inhalation. Clin Allergy 1978;8(1):21-24. PubMed
  12. Perez-Camo I, Quirce S, Duran MA, and et al. Latex allergy: evidence of cross-reactivity with papain and bromelain [abstract]. Allergy 1996;51(suppl 31):48.
  13. Martin GJ, Ehrenreich J, and Asbell N. Bromelain: pineapple proteases with anti-edema activity. Exp Med Surg 1962;20:227-247.
  14. Kasemsuk T, Saengpetch N, Sibmooh N, Unchern S. Improved WOMAC score following 16-week treatment with bromelain for knee osteoarthritis. Clin Rheumatol. 2016 Oct;35(10):2531-40. PubMed
  15. Kutlu Ö, DemirbaS A, Elmas ÖF, Güvenç U, Metin A. Fixed drug eruption: a new side effect of bromelain. Contact Dermatitis 2020. Online ahead of print. PubMed
  16. Shoham Y, Shapira E, Haik J, et al. Bromelain-based enzymatic debridement of chronic wounds: Results of a multicentre randomized controlled trial. Wound Repair Regen 2021;29(6):899-907. PubMed
  17. Pfister P, Garcia Wendel PD, Kim BS, et al. Coagulation side effects of enzymatic debridement in burned patients. Burns 2022. PubMed
  18. Hasham S, Riyat H, Fletcher A, O'Boyle CP, Alexander S. To bleed or not to bleed? Case series and discussion of haemorrhage risk with enzymatic debridement in burn injuries. Scars Burn Heal 2023;9:20595131231168333. PubMed
  19. Leelakanok N, Petchsomrit A, Janurai T, Saechan C, Sunsandee N. Efficacy and safety of bromelain: A systematic review and meta-analysis. Nutr Health 2023. PubMed

See these in context on the Bromelain monograph →

Lipase 1 reference
  1. Casper C, Hascoet JM, Ertl T, et al. Recombinant bile salt-stimulated lipase in preterm infant feeding: A randomized phase 3 study. PLoS One. 2016;11(5):e0156071. PubMed

See these in context on the Lipase monograph →

Lactase 1 reference
  1. Laukkanen A, Ruoppi P, Remes S, Koistinen T, Mäkinen-Kiljunen S. Lactase-induced occupational protein contact dermatitis and allergic rhinoconjunctivitis. Contact Dermatitis. 2007;57(2):89-93. PubMed

See these in context on the Lactase monograph →

Bacillus Coagulans 20 references
  1. Saxelin M, Chuang NH, Chassy B, et al. Lactobacilli and bacteremia in southern Finland 1989-1992. Clin Infect Dis 1996;22:564-6. PubMed
  2. Tynkkynen S, Singh KV, Varmanen P. Vancomycin resistance factor of Lactobacillus rhamnosus GG in relation to enterococcal vancomycin resistance (van) genes. Int J Food Microbiol 1998;41:195-204. PubMed
  3. Klein G, Zill E, Schindler R, et al. Peritonitis associated with vancomycin-resistant Lactobacillus rhamnosus in a continuous ambulatory peritoneal dialysis patient; organism identification, antibiotic therapy, and case report. J Clin Microbiol 1998;36:
  4. Kalima P, Masterton RG, Roddie PH, et al. Lactobacillus rhamnosus infection in a child following bone marrow transplant. J Infect 1996;32:165-7. PubMed
  5. Goldin BR. Health Benefits of probiotics. Br J Nutr 1998;80:S203-7. DOI
  6. Rautio M, Jousimies-Somer H, Kauma H, et al. Liver abscess due to Lactobacillus rhamnosus strain indistinguishable from L. rhamnosus strain GG. Clin Infect Dis 1999;28:1159-60.
  7. MacGregor G, Smith AJ, Thakker B, Kinsella J. Yoghurt biotherapy: contraindicated in immunosuppressed patients? Postgrad Med J 2002;78:366-7. PubMed
  8. Land MH, Rouster-Stevens K, Woods CR, et al. Lactobacillus sepsis associated with probiotic therapy. Pediatrics 2005;115:178-81.
  9. De Groote MA, Frank DN, Dowell E, et al. Lactobacillus rhamnosus GG bacteremia associated with probiotic use in a child with short gut syndrome. Pediatr Infect Dis J 2005;24:278-80. PubMed
  10. Vahabnezhad E, Mochon AB, Wozniak LJ, Ziring DA. Lactobacillus bacteremia associated with probiotic use in a pediatric patient with ulcerative colitis. J Clin Gastroenterol. 2013;47(5):437-9. PubMed
  11. Pruccoli G, Silvestro E, Pace Napoleone C, Aidala E, Garazzino S, Scolfaro C. Are probiotics safe? Bifidobacterium bacteremia in a child with severe heart failure. Infez Med. 2019;27(2):175-178.
  12. Sendil S, Shrimanker I, Mansoora Q, Goldman J, Nookala VK. Lactobacillus rhamnosus bacteremia in an immunocompromised renal transplant patient. Cureus. 2020;12(2):e6887. PubMed
  13. Albarillo FS, Shah U, Joyce C, Slade D. Lactobacillus rhamnosus Infection: A single-center 4-year descriptive analysis. J Glob Infect Dis. 2020;12(3):119-123. PubMed
  14. Pasala S, Singer L, Arshad T, Roach K. Lactobacillus endocarditis in a healthy patient with probiotic use. IDCases. 2020;22:e00915. PubMed
  15. Agrawal S, Tuchman ES, Bruce MJ, Theodorou ME. Fatal Lactobacillus endocarditis in a patient with transcatheter aortic valve replacement. BMJ Case Rep. 2020;13(11):e236835.
  16. Antoun M, Hattab Y, Akhrass FA, Hamilton LD. Uncommon pathogen, Lactobacillus, causing infective endocarditis: Case report and review. Case Rep Infect Dis. 2020;2020:8833948. PubMed
  17. Rossi F, Amadoro C, Gasperi M, Colavita G. Lactobacilli infection case reports in the last three years and safety implications. Nutrients. 2022;14(6):1178. PubMed
  18. Franko B, Vaillant M, Recule C, Vautrin E, et al. Lactobacillus paracasei endocarditis in a consumer of probiotics. Med Mal Infect. 2013;43(4):171-3. PubMed
  19. Campbell RE, Miller A, Afroze A. Native valve endocarditis secondary to Lactobacillus paracasei bacteremia. Consultant. 2020;60(9):27-8. DOI
  20. Kato K, Funabashi N, Takaoka H, et al. Lactobacillus paracasei endocarditis in a consumer of probiotics with advanced and severe bicuspid aortic valve stenosis complicated with diffuse left ventricular mid-layer fibrosis. Int J Cardiol. 2016;224:157-161. PubMed

See these in context on the Bacillus Coagulans monograph →

Proteolytic Enzymes (proteases) 3 references
  1. Weeks JA, Harper RA, Simon RA, Burdick JD. Assessment of sensitization risk of a laundry pre-spotter containing protease. Cutan Ocul Toxicol. 2011;30(4):272-9. PubMed
  2. Marquès LI, Lara S, Abós T, Bartolomé B. Occupational rhinitis due to pepsin. J Investig Allergol Clin Immunol. 2006;16(2):136-7. DOI
  3. Cartier A, Malo JL, Pineau L, Dolovich J. Occupational asthma due to pepsin. J Allergy Clin Immunol. 1984;73(5 Pt 1):574-7. PubMed

See these in context on the Proteolytic Enzymes (proteases) monograph →

Peppermint 41 references
  1. Liu JH, Chen GH, Yeh HZ, et al. Enteric-coated peppermint-oil capsules in the treatment of irritable bowel syndrome: a prospective, randomized trial. J Gastroenterol 1997;32:765-8. PubMed
  2. Pittler MH, Ernst E. Peppermint oil for irritable bowel syndrome: a critical review and metaanalysis. Am J Gastroenterol 1998;93:1131-5. PubMed
  3. Kline RM, Kline JJ, Di Palma J, Barbero GJ. Enteric-coated, pH-dependent peppermint oil capsules for the treatment of irritable bowel syndrome in children. J Pediatr 2001;138:125-8. PubMed
  4. Madisch A, Heydenreich CJ, Wieland V, et al. Treatment of functional dyspepsia with a fixed peppermint oil and caraway oil combination preparation as compared to cisapride. A multicenter, reference-controlled, double-blind equivalence study. Arzneimittel
  5. May B, Kuntz HD, Kieser M, Kohler S. Efficacy of a fixed peppermint oil/caraway oil combination in non-ulcer dyspepsia. Arzneimittelforschung 1996;46:1149-53.
  6. Micklefield GH, Greving I, May B. Effects of peppermint oil and caraway oil on gastroduodenal motility. Phytother Res 2000;14:20-3. DOI
  7. Morton CA, Garioch J, Todd P, et al. Contact sensitivity to menthol and peppermint in patients with intra-oral symptoms. Contact Dermatitis 1995;32:281-4. PubMed
  8. May B, Kohler S, Schneider B. Efficacy and tolerability of a fixed combination of peppermint oil and caraway oil in patients suffering from functional dyspepsia. Aliment Pharmacol Ther 2000;14:1671-7. PubMed
  9. Nash P, Gould SR, Bernardo DE. Peppermint oil does not relieve the pain of irritable bowel syndrome. Br J Clin Pract 1986;40:292-3. DOI
  10. Rees WD, Evans BK, Rhodes J. Treating irritable bowel syndrome with peppermint oil. Br Med J 1979;2:835-6. PubMed
  11. Davies SJ, Harding LM, Baranowski AP. A novel treatment of postherpetic neuralgia using peppermint oil. Clin J Pain 2002;18:200-2. PubMed
  12. Weston CF. Anal burning and peppermint oil. Postgrad Med J 1987;63:717. PubMed
  13. Dresser GK, Wacher V, Wong S, et al. Evaluation of peppermint oil and ascorbyl palmitate as inhibitors of cytochrome P4503A4 activity in vitro and in vivo. Clin Pharmacol Ther 2002;72:247-55. PubMed
  14. Wacher VJ, Wong S, Wong HT. Peppermint oil enhances cyclosporine oral bioavailability in rats: comparison with D-alpha-tocopheryl poly(ethylene glycol 1000) succinate (TPGS) and ketoconazole. J Pharm Sci 2002;91:77-90.
  15. Lawson MJ, Knight RE, Tran K, et al. Failure of enteric-coated peppermint oil in the irritable bowel syndrome: a randomized double-blind crossover study. J Gastroenterol Hepatol 1988;3:235-8. DOI
  16. Unger M, Frank A. Simultaneous determination of the inhibitory potency of herbal extracts on the activity of six major cytochrome P450 enzymes using liquid chromatography/mass spectrometry and automated online extraction. Rapid Commun Mass Spectrom 2004;1 PubMed
  17. Maliakal PP, Wanwimolruk S. Effect of herbal teas on hepatic drug metabolizing enzymes in rats. J Pharm Pharmacol 2001;53:1323-9. PubMed
  18. Rogers SN, Pahor AL. A form of stomatitis induced by excessive peppermint consumption. Dent Update 1995;22:36-7.
  19. Cappello G, Spezzaferro M, Grossi L, et al. Peppermint oil (Mintoil) in the treatment of irritable bowel syndrome: a prospective double blind placebo-controlled randomized trial. Dig Liver Dis 2007;39:530-6. PubMed
  20. Moghadam BK, Gier R, and Thurlow T. Extensive oral mucosal ulcerations caused by misuse of a commercial mouthwash. Cutis 1999;64:131-134.
  21. Andersen, K. E. Contact allergy to toothpaste flavors. Contact Dermatitis 1978;4(4):195-198. PubMed
  22. Barnard, D. R. Repellency of essential oils to mosquitoes (Diptera: Culicidae). J Med Entomol. 1999;36(5):625-629. PubMed
  23. Tamir, S., Davidovich, Z., Attal, P., and Eliashar, R. Peppermint oil chemical burn. Otolaryngol.Head Neck Surg. 2005;133(5):801-802. PubMed
  24. Kalavala, M., Hughes, T. M., Goodwin, R. G., Anstey, A. V., and Stone, N. M. Allergic contact dermatitis to peppermint foot spray. Contact Dermatitis 2007;57(1):57-58. PubMed
  25. Vermaat, H., van Meurs, T., Rustemeyer, T., Bruynzeel, D. P., and Kirtschig, G. Vulval allergic contact dermatitis due to peppermint oil in herbal tea. Contact Dermatitis 2008;58(6):364-365. PubMed
  26. Merat, S., Khalili, S., Mostajabi, P., Ghorbani, A., Ansari, R., and Malekzadeh, R. The effect of enteric-coated, delayed-release peppermint oil on irritable bowel syndrome. Dig.Dis.Sci. 2010;55(5):1385-1390. PubMed
  27. Tran, A., Pratt, M., and DeKoven, J. Acute allergic contact dermatitis of the lips from peppermint oil in a lip balm. Dermatitis 2010;21(2):111-115. DOI
  28. Hitz, Lindenmuller, I and Lambrecht, J. T. Oral care. Curr Probl.Dermatol 2011;40:107-115.
  29. Shavakhi, A., Ardestani, S. K., Taki, M., Goli, M., and Keshteli, A. H. Premedication with peppermint oil capsules in colonoscopy: a double blind placebo-controlled randomized trial study. Acta Gastroenterol Belg 2012;75(3):349-353.
  30. Lech, Y., Olesen, K. M., Hey, H., Rask-Pedersen, E., Vilien, M., and Ostergaard, O. [Treatment of irritable bowel syndrome with peppermint oil. A double- blind study with a placebo]. Ugeskr.Laeger 10-3-1988;150(40):2388-2389.
  31. Parys, B. T. Chemical burns resulting from contact with peppermint oil mar: a case report. Burns Incl.Therm.Inj. 1983;9(5):374-375. PubMed
  32. Bayat R, Borici-Mazi R. A case of anaphylaxis to peppermint. Allergy Asthma Clin Immunol. 2014;10(1):6. PubMed
  33. Rich G, Shah A, Koloski N, et al. A randomized placebo-controlled trial on the effects of Menthacarin, a proprietary peppermint- and caraway-oil-preparation, on symptoms and quality of life in patients with functional dyspepsia. Neurogastroenterol Motil 2 PubMed
  34. Douros A, Bronder E, Andersohn F, et al. Herb-Induced Liver Injury in the Berlin Case-Control Surveillance Study. Int J Mol Sci 2016;17(1). PubMed
  35. Begas E, Tsioutsiouliti A, Kouvaras E, et al. Effects of peppermint tea consumption on the activities of CYP1A2, CYP2A6, Xanthine Oxidase, N-acetyltranferase-2 and UDP-glucuronosyltransferases-1A1/1A6 in healthy volunteers. Food Chem Toxicol 2017;100:80-9 PubMed
  36. Cash BD, Epstein MS, Shah SM. A Novel Delivery System of Peppermint Oil Is an Effective Therapy for Irritable Bowel Syndrome Symptoms. Dig Dis Sci 2016;61(2):560-71. PubMed
  37. Elsaie LT, El Mohsen AM, Ibrahim IM, Mohey-Eddin MH, Elsaie ML. Effectiveness of topical peppermint oil on symptomatic treatment of chronic pruritus. Clin Cosmet Investig Dermatol 2016;9:333-8. PubMed
  38. Wu J, Xu R, Zhan R, et al. Effective symptomatic treatment for severe and intractable pruritus associated with severe burn-induced hypertrophic scars: A prospective, multicenter, controlled trial. Burns 2016;42(5):1059-66. PubMed
  39. Weerts ZZRM, Masclee AAM, Witteman BJM, et al. Efficacy and safety of peppermint oil in a randomized, double-blind trial of patients with irritable bowel syndrome. Gastroenterology. 2020;158(1):123-136. PubMed
  40. Nee J, Ballou S, Kelley JM, et al. Peppermint Oil Treatment for Irritable Bowel Syndrome: A Randomized Placebo-Controlled Trial. Am J Gastroenterol 2021;116(11):2279-2285. PubMed
  41. Ingrosso MR, Ianiro G, Nee J, et al. Systematic review and meta-analysis: efficacy of peppermint oil in irritable bowel syndrome. Aliment Pharmacol Ther 2022;56(6):932-41. PubMed

See these in context on the Peppermint monograph →

Bacillus Subtilis 10 references
  1. Pierce A. The American Pharmaceutical Association Practical Guide to Natural Medicines. New York: The Stonesong Press, 1999:19.
  2. Lampropoulos PK, Gkentzi D, Tzifas S, Dimitriou G. Neonatal sepsis due to Bacillus subtilis. Cureus 2021;13(9):e17692. PubMed
  3. La Jeon Y, Yang JJ, Kim MJ, et al. Combined Bacillus licheniformis and Bacillus subtilis infection in a patient with oesophageal perforation. J Med Microbiol 2012;61(Pt 12):1766-1769. PubMed
  4. Wallet F, Crunelle V, Roussel-Delvallez M, Fruchart A, Saunier P, Courcol RJ. Bacillus subtilis as a cause of cholangitis in polycystic kidney and liver disease. Am J Gastroenterol 1996;91(7):1477-8.
  5. Velasco E, Martins CA, Tabak D, Bouzas LF. "Bacillus subtilis" infection in a patient submitted to a bone marrow transplantation. Rev Paul Med 1992;110(3):116-7.
  6. Kato A, Yoshifuji A, Komori K, et al. A case of Bacillus subtilis var. natto bacteremia caused by ingestion of natto during COVID-19 treatment in a maintenance hemodialysis patient with multiple myeloma. J Infect Chemother 2022;28(8):1212-1215. PubMed
  7. Freedman KE, Hill JL, Wei Y, et al. Examining the gastrointestinal and immunomodulatory effects of the novel probiotic Bacillus subtilis DE111. Int J Mol Sci 2021;22(5):2453. PubMed
  8. Lefevre M, Racedo SM, Denayrolles M, et al. Safety assessment of Bacillus subtilis CU1 for use as a probiotic in humans. Regul Toxicol Pharmacol 2017;83:54-65. PubMed
  9. Hanifi A, Culpepper T, Mai V, et al. Evaluation of Bacillus subtilis R0179 on gastrointestinal viability and general wellness: a randomised, double-blind, placebo-controlled trial in healthy adults. Benef Microbes 2015;6(1):19-27. PubMed
  10. Tokano M, Tarumoto N, Imai K, et al. A case of bacterial meningitis caused by Bacillus subtilis var. natto. Intern Med. 2022. Epub ahead of print.

See these in context on the Bacillus Subtilis monograph →

Chicory 13 references
  1. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
  2. Stone-Dorshow T, Levitt MD. Gaseous response to ingestion of a poorly absorbed fructo-oligosaccharide sweetener. Am J Clin Nutr 1987;46:61-5. PubMed
  3. Briet F, et al. Symptomatic response to varying levels of fructo-oligosaccharides consumed occasionally or regularly. Eur J Clin Nutr 1995;49:501-7.
  4. Bouhnik Y, Vahedi K, Achour L, et al. Short-chain fructo-oligosaccharide administration dose-dependently increases fecal bifidobacteria in healthy humans. J Nutr 1999;129:113-6. PubMed
  5. Cummings JH, Macfarlane GT, Englyst HN. Prebiotic digestion and fermentation. Am J Clin Nutr 2001;73:415S-420S. PubMed
  6. Cadot, P., Kochuyt, A. M., van Ree, R., and Ceuppens, J. L. Oral allergy syndrome to chicory associated with birch pollen allergy. Int.Arch.Allergy Immunol. 2003;131(1):19-24. PubMed
  7. Friis, B., Hjorth, N., Vail, J. T., Jr., and Mitchell, J. C. Occupational contact dermatitis from Cichorium (chicory, endive) and Lactuca (lettuce). Contact Dermatitis 1975;1(5):311-313.
  8. Nemery, B. and Demedts, M. Occupational asthma in a chicory grower. Lancet 3-25-1989;1(8639):672-673. PubMed
  9. Pirson F, Detry B, Pilette C. Occupational rhinoconjunctivitis and asthma caused by chicory and oral allergy syndrome associated with bet v 1-related protein. J Investig Allergol Clin Immunol 2009;19(4):306-10.
  10. Willi R, Pfab F, Huss-Marp J, et al. Contact anaphylaxis and protein contact dermatitis in a cook handling chicory leaves. Contact Dermatitis 2009;60(4):226-7. PubMed
  11. Street RA, Sidana J, Prinsloo G. Cichorium intybus: traditional uses, phytochemistry, pharmacology, and toxicology. Evid Based Complement Alternat Med 2013;2013:579319.
  12. Bonnema AL, Kolberg LW, Thomas W, Slavin JL. Gastrointestinal tolerance of chicory inulin products. J Am Diet Assoc 2010;110(6):865-8. PubMed
  13. Devi Kt R, Sivalingam N. Cichorium intybus attenuates Streptozotocin-induced pancreatic ß-cell damage by inhibiting NF-?B activation and oxidative stress. J Appl Biomed 2020;18(2-3):70-9. PubMed

See these in context on the Chicory monograph →

Ginger 64 references
  1. Fischer-Rasmussen W, Kjaer SK, Dahl C, Asping U. Ginger treatment of hyperemesis gravidarum. Eur J Obstet Gynecol Reprod Biol 1991;38:19-24. PubMed
  2. Jewell D, Young G. Interventions for nausea and vomiting in early pregnancy. Cochrane Database Syst Rev 2000;(2):CD000145. PubMed
  3. Vutyavanich T, Kraisarin T, Ruangsri R. Ginger for nausea and vomiting in pregnancy: randomized, double-masked, placebo-controlled trial. Obstet Gynecol 2001;97:577-82. DOI
  4. Backon J. Ginger in preventing nausea and vomiting of pregnancy; a caveat due to its thromboxane synthetase activity and effect on testosterone binding. Eur J Obstet Gynecol Reprod Biol 1991;42:163-4. PubMed
  5. Srivastava KC. Effect of onion and ginger consumption on platelet thromboxane production in humans. Prostaglandins Leukot Essent Fatty Acids 1989;35:183-5. PubMed
  6. Stewart JJ, Wood MJ, Wood CD, Mims ME. Effects of ginger on motion sickness susceptibility and gastric function. Pharmacology 1991;42:111-20. PubMed
  7. Smith C, Crowther C, Willson K, et al. A randomized controlled trial of ginger to treat nausea and vomiting in pregnancy. Obstet Gynecol 2004;103:639-45. PubMed
  8. Portnoi G, Chng LA, Karimi-Tabesh L, et al. Prospective comparative study of the safety and effectiveness of ginger for the treatment of nausea and vomiting in pregnancy. Am J Obstet Gynecol 2003;189:1374-7.. PubMed
  9. Wigler I, Grotto I, Caspi D, Yaron M. The effects of Zintona EC (a ginger extract) on symptomatic gonarthritis. Osteoarthritis Cartilage 2003;11:783-9. PubMed
  10. Ghayur MN, Gilani AH. Ginger lowers blood pressure through blockade of voltage-dependent calcium channels. J Cardiovasc Pharmacol 2005;45:74-80. PubMed
  11. Thomson M, Al-Qattan KK, Al-Sawan SM, et al. The use of ginger (Zingiber officinale Rosc.) as a potential anti-inflammatory and antithrombotic agent. Prostaglandins Leukot Essent Fatty Acids 2002;67:475-8. PubMed
  12. Kanerva L, Estlander T, Jolanki R. Occupational allergic contact dermatitis from spices. Contact Dermatitis 1996;35:157-62. PubMed
  13. Akhani SP, Vishwakarma SL, Goyal RK. Anti-diabetic activity of Zingiber officinale in streptozotocin-induced type I diabetic rats. J Pharm Pharmacol 2004;56:101-5.
  14. Kruth P, Brosi E, Fux R, et al. Ginger-associated overanticoagulation by phenprocoumon. Ann Pharmacother 2004;38:257-60. PubMed
  15. Jiang X, Williams KM, Liauw WS, et al. Effect of ginkgo and ginger on the pharmacokinetics and pharmacodynamics of warfarin in healthy subjects. Br J Clin Pharmacol 2005;59:425-32. PubMed
  16. Borrelli F, Capasso R, Aviello G, et al. Effectiveness and safety of ginger in the treatment of pregnancy-induced nausea and vomiting. Obstet Gynecol 2005;105:849-56. PubMed
  17. Smith C, Crowther C, Wilson K et al. A randomized controlled trial of ginger to treat nausea and vomiting in pregnancy. Obstet Gynecol 2004;103:639-45. PubMed
  18. Jiang X, Blair EY, McLachlan AJ. Investigation of the effects of herbal medicines on warfarin response in healthy subjects: a population pharmacokinetic-pharmacodynamic modeling approach. J Clin Pharmacol 2006;46:1370-8. PubMed
  19. Chittumma P, Kaewkiattikun K, Wiriyasiriwach B. Comparison of the effectiveness of ginger and vitamin B6 for treatment of nausea and vomiting in early pregnancy: a randomized double-blind controlled trial. J Med Assoc Thai 2007;90:15-20.
  20. Ozgoli G, Goli M, Moattar F. Comparison of effects of ginger, mefenamic acid, and ibuprofen on pain in women with primary dysmenorrhea. J Altern Complement Med 2009;15:129-32. PubMed
  21. Black CD, Herring MP, Hurley DJ, O'Connor PJ. Ginger (Zingiber officinale) reduces muscle pain caused by eccentric exercise. J Pain 2010;11:894-903. PubMed
  22. Heitmann K, Nordeng H, Holst L. Safety of ginger use in pregnancy: results from a large population-based cohort study. Eur J Clin Pharmacol 2012 Jun 17. PubMed
  23. Ryan JL, Heckler CE, Roscoe JA, et al. Ginger (Zingiber officinale) reduces acute chemotherapy-induced nausea: a URCC CCOP study of 576 patients. Support Care Cancer. 2012;20:1479-89. PubMed
  24. Backon J. Ginger as an antiemetic: possible side effects due to its thromboxane synthetase activity. Anaesthesia. 1991;46(8):705-6.. PubMed
  25. Abebe W. Herbal medication: potential for adverse interactions with analgesic drugs. J Clin Pharm Ther. 2002;27:391-401. PubMed
  26. Argento A, Tiraferri E, Marzaloni M. [Oral anticoagulants and medicinal plants. An emerging interaction]. Ann Ital Med Int. 2000;15:139-43.
  27. Young HY, Liao JC, Chang YS, et al. Synergistic effect of ginger and nifedipine on human platelet aggregation: a study in hypertensive patients and normal volunteers. Am J Chin Med. 2006;34:545-51. PubMed
  28. Greenway FL, Liu Z, Martin CK, et al. Safety and efficacy of NT, an herbal supplement, in treating human obesity. Int J Obes (Lond). 2006;30:1737-41. PubMed
  29. Shalansky S, Lynd L, Richardson K, et al. Risk of warfarin-related bleeding events and supratherapeutic international normalized ratios associated with complementary and alternative medicine: a longitudinal analysis. Pharmacotherapy. 2007;27:1237-47. PubMed
  30. Lesho EP, Saullo L, Udvari-Nagy S. A 76-year-old woman with erratic anticoagulation. Cleve Clin J Med. 2004;71:651-6. PubMed
  31. Okonta JM, Uboh M, Obonga WO. Herb-Drug Interaction: A Case Study of Effect of Ginger on the Pharmacokinetic of Metronidazole in Rabbit. Indian Journal of Pharmaceutical Sciences (India) 2008;70(230):232. PubMed
  32. Chiang HM, Chao PD, Hsiu SL, et al. Ginger significantly decreased the oral bioavailability of cyclosporine in rats. Am J Chin Med. 2006;34:845-55. PubMed
  33. Bhandari U, Kanojia R, Pillai KK. Effect of ethanolic extract of Zingiber officinale on dyslipidaemia in diabetic rats. J Ethnopharmacol. 2005;97:227-30. PubMed
  34. Ojewole JA. Analgesic, antiinflammatory and hypoglycaemic effects of ethanol extract of Zingiber officinale (Roscoe) rhizomes (Zingiberaceae) in mice and rats. Phytother Res. 2006;20:764-72.
  35. Al-Amin ZM, Thomson M, Al-Qattan KK, et al. Anti-diabetic and hypolipidaemic properties of ginger (Zingiber officinale) in streptozotocin-induced diabetic rats. Br J Nutr. 2006;96:660-6.
  36. Islam MS, Choi H. Comparative effects of dietary ginger (Zingiber officinale) and garlic (Allium sativum) investigated in a type 2 diabetes model of rats. J Med Food. 2008;11:152-9.
  37. Cady RK, Goldstein J, Nett R, et al. A double-blind placebo-controlled pilot study of sublingual feverfew and ginger (LipiGesic M) in the treatment of migraine. Headache 2011;51:1078-86.
  38. Futrell, J. M. and Rietschel, R. L. Spice allergy evaluated by results of patch tests. Cutis 1993;52(5):288-290.
  39. Sripramote, M. and Lekhyananda, N. A randomized comparison of ginger and vitamin B6 in the treatment of nausea and vomiting of pregnancy. J Med Assoc.Thai. 2003;86(9):846-853.
  40. Lohsiriwat, S., Rukkiat, M., Chaikomin, R., and Leelakusolvong, S. Effect of ginger on lower esophageal sphincter pressure. J.Med.Assoc.Thai. 2010;93(3):366-372.
  41. Liu, P. H. and Ho, H. L. Ginger and drug bezoar induced small bowel obstruction. J R.Coll.Surg.Edinb. 1983;28(6):397-398.
  42. Maghbooli M, Golipour F, Moghimi Esfandabadi A, Yousefi M. Comparison between the efficacy of ginger and sumatriptan in the ablative treatment of the common migraine. Phytother Res 2014;28(3):412-5. PubMed
  43. Mahluji S, Attari VE, Mobasseri M, Payahoo L, Ostadrahimi A, Golzari SE. Effects of ginger (Zingiber officinale) on plasma glucose level, HbA1c and insulin sensitivity in type 2 diabetic patients. Int J Food Sci Nutr 2013;64(6):682-6.
  44. Mozaffari-Khosravi H, Talaei B, Jalali BA, Najarzadeh A, Mozayan MR. The effect of ginger powder supplementation on insulin resistance and glycemic indices in patients with type 2 diabetes: a randomized, double-blind, placebo-controlled trial. Complement PubMed
  45. Paramdeep G. Efficacy and tolerability of ginger (Zingiber officinale) in patients of osteoarthritis of knee. Indian J Physiol Pharmacol 2013;57(2):177-83.
  46. Rahnama P, Montazeri A, Huseini HF, Kianbakht S, Naseri M. Effect of Zingiber officinale R. rhizomes (ginger) on pain relief in primary dysmenorrhea: a placebo randomized trial. BMC Complement Altern Med 2012;12:92. PubMed
  47. Viljoen E, Visser J, Koen N, Musekiwa A. A systematic review and meta-analysis of the effect and safety of ginger in the treatment of pregnancy-associated nausea and vomiting. Nutr J 2014;13:20. PubMed
  48. Bartels EM, Folmer VN, Bliddal H, et al. Efficacy and safety of ginger in osteoarthritis patients: a meta-analysis of randomized placebo-controlled trials. Osteoarthritis Cartilage. 2015;23(1):13-21. PubMed
  49. Choi JS, Han JY, Ahn HK, et al. Assessment of fetal and neonatal outcomes in the offspring of women who had been treated with dried ginger (Zingiberis rhizoma siccus) for a variety of illnesses during pregnancy. J Obstet Gynaecol. 2015;35(2):125-30.
  50. Marx W, McKavanagh D, McCarthy AL, Bird R, Ried K, Chan A, Isenring L. The effect of ginger (Zingiber officinale) on platelet aggregation: A systematic literature review. PLoS One. 2015;10(10):e0141119. PubMed
  51. Crichton M, Marshall S, Marx W, McCarthy AL, Isenring E. Efficacy of ginger (Zingiber officinale) in ameliorating chemotherapy-induced nausea and vomiting and chemotherapy-related outcomes: A systematic review update and meta-analysis. J Acad Nutr Diet. 2 PubMed
  52. Martins LB, Rodrigues AMDS, Monteze NM, et al. Double-blind placebo-controlled randomized clinical trial of ginger (Zingiber officinale Rosc.) in the prophylactic treatment of migraine. Cephalalgia. 2020;40(1):88-95.
  53. Martins LB, Rodrigues AMDS, Rodrigues DF, Dos Santos LC, Teixeira AL, Ferreira AVM. Double-blind placebo-controlled randomized clinical trial of ginger (Zingiber officinale Rosc.) addition in migraine acute treatment. Cephalalgia. 2019;39(1):68-76.
  54. 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.
  55. Okuhira H, Nakatani Y, Furukawa F, Kanazawa N. Anaphylaxis to ginger induced by herbal medicine. Allergol Int. 2020;69(1):159-160. PubMed
  56. Yamprasert R, Chanvimalueng W, Mukkasombut N, Itharat A. Ginger extract versus Loratadine in the treatment of allergic rhinitis: a randomized controlled trial. BMC Complement Med Ther. 2020;20(1):116. PubMed
  57. Ebrahimzadeh A, Ebrahimzadeh A, Mirghazanfari SM, Hazrati E, Hadi S, Milajerdi A. The effect of ginger supplementation on metabolic profiles in patients with type 2 diabetes mellitus: a systematic review and meta-analysis of randomized controlled trials. PubMed
  58. 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.
  59. Akbarzadeh E, Heydari M, Atarzadeh F, Jaladat AM. Chronic dysuria following ginger (Zingiber officinale) use: a case report. Galen Med J 2018;7:e1086. DOI
  60. Haron MH, Dale O, Martin K, et al. Evaluation of the Herb-Drug Interaction Potential of Commonly Used Botanicals on the US Market with Regard to PXR- and AhR-Mediated Influences on CYP3A4 and CYP1A2. J Diet Suppl 2022. PubMed
  61. Rostamkhani H, Veisi P, Niknafs B, Jafarabadi MA, Ghoreishi Z. The effect of zingiber officinale on prooxidant-antioxidant balance and glycemic control in diabetic patients with ESRD undergoing hemodialysis: a double-blind randomized control trial. BMC Co PubMed
  62. Husain I, Dale OR, Idrisi M, et al. Evaluation of the Herb-Drug Interaction (HDI) Potential of Zingiber officinale and Its Major Phytoconstituents. J Agric Food Chem. 2023;71(19):7521-7534.
  63. Committee on Practice Bulletins-Obstetrics. ACOG Practice Bulletin No. 189: Nausea And Vomiting Of Pregnancy. Obstet Gynecol. 2018;131(1):e15-e30. PubMed
  64. Pochet S, Lechon AS, Lescrainier C, et al. Herb-anticancer drug interactions in real life based on VigiBase, the WHO global database. Sci Rep 2022;12(1):14178. PubMed

See these in context on the Ginger monograph →

Gum Arabic 8 references
  1. Jensen CD, Spiller GA, Gates JE, et al. The effect of acacia gum and a water-soluble dietary fiber mixture on blood lipids in humans. J Am Coll Nutr 1993;12:147-54. PubMed
  2. Eltayeb IB, Awad AI, Elderbi MA, Shadad SA. Effect of gum arabic on the absorption of a single oral dose of amoxicillin in healthy Sudanese volunteers. J Antimicrob Chemother 2004;54:577-8. PubMed
  3. Babiker R, Merghani TH, Elmusharaf K, et al. Effects of gum Arabic ingestion on body mass index and body fat percentage in healthy adult females: two-arm randomized, placebo controlled, double-blind trial. Nutr J 2012;11:111. PubMed
  4. Babiker R, Elmusharaf K, Keogh MB, Banaga AS, Saeed AM. Metabolic effect of gum Arabic (Acacia senegal) in patients with type 2 diabetes mellitus (T2DM): randomized, placebo controlled double blind trial. Functional Foods in Health and Disease. 2017;7(3): DOI
  5. Beneke CE, Viljoen AM, Hamman JH. Polymeric plant-derived excipients in drug delivery. Molecules. 2009;14(7):2602-20. PubMed
  6. Ali NE, Kaddam LA, Alkarib SY, et al. Gum Arabic (Acacia Senegal) Augmented Total Antioxidant Capacity and Reduced C-Reactive Protein among Haemodialysis Patients in Phase II Trial. Int J Nephrol. 2020;2020:7214673.
  7. Mortensen A, Aguilar F, Crebelli R, et al. Re-evaluation of acacia gum (E 414) as a food additive. EFSA J. 2017;15(4):e04741. PubMed
  8. Larson R, Nelson C, Korczak R, et al. Acacia Gum Is Well Tolerated While Increasing Satiety and Lowering Peak Blood Glucose Response in Healthy Human Subjects. Nutrients 2021;13(2):618. PubMed

See these in context on the Gum Arabic 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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