DIM Ingredients & Drug Interactions
What is this page for?
First and foremost: checking DIM 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
DIM is a dietary supplement by Envy Nutrition with 2 active ingredients. Its ingredients are commonly taken for flavoring and culinary use, digestive complaints like bloating and indigestion, boosting absorption of other supplements.Based on those ingredients, 1,089 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are BioPerine, DIM. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against DIM by Envy Nutrition
Ask about any prescription or over-the-counter medication and we check it for interactions with DIM by Envy Nutrition — and tell you which ingredient is responsible.
AI summaries are generated from our interaction database for education only — always confirm with your pharmacist. How we use AI
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HelloPharmacist Scorecard of DIM by Envy Nutrition
Our pharmacy team’s full take, with four database checks built into the cards below — a summary of what is known, not a grade of the product itself.
What’s inside
Full disclosure
This product contains 2 active ingredients. BioPerine is black pepper extract standardized to its piperine content — it's added to supplements mainly to help your body absorb other nutrients better.
DIM (diindolylmethane) is a compound derived from cruciferous vegetables like broccoli and cabbage. The remaining ingredients are vegetable cellulose (the capsule), rice flour, silicon dioxide, and magnesium stearate — all standard inactive fillers and binders.
Does it work?
Not established
The evidence we hold doesn't establish that either ingredient works for its commonly marketed purposes. Black pepper shows insufficient evidence to rate for hay fever, asthma, athletic performance, headache, depression, and diarrhea.
DIM likewise shows insufficient evidence to rate for benign prostate enlargement, breast cancer, colorectal cancer, cervical changes, and breast pain. That doesn't mean they don't work — it means the clinical data we have access to isn't robust enough to say either way.
How safe is it?
Well-documented data
Black pepper in food amounts is generally well tolerated; the most common mild side effects are a burning aftertaste, indigestion, and reduced taste. Allergic reactions are rare but possible in sensitive people.
DIM is generally well tolerated in short-term studies, though long-term safety isn't well established. Common side effects include diarrhea, gas, headache, nausea, rash, and vomiting.
A rare serious effect (drug rash with eosinophilia and systemic symptoms, or DRESS) has been reported. For pregnancy: black pepper is likely safe, but DIM's rating is mixed — pregnancy data are limited enough that you should talk it over with your doctor before taking it.
For nursing: no reliable safety data exist for DIM, so it's best avoided while breastfeeding; black pepper appears likely safe.
Meds to double-check
Moderate interaction found
Before taking this product, double-check with your pharmacist or doctor if you take any heart medications (especially propranolol), seizure medications (like phenytoin), birth control or hormone replacement therapy, water pills or diuretics, antiretroviral drugs, tuberculosis medications, immunosuppressants, sedatives, cholesterol drugs, or asthma or breathing medications. No interactions are documented in our data for the inactive ingredients.
The bottom line
Scorecard at a glanceFully disclosed formula with no established evidence rating for its marketed use. Moderate medication interactions have been identified, and safety information is well characterized.
If you take any regular medications — especially for the heart, seizures, infections, cholesterol, or breathing — you need to check your prescriptions against the medication interactions list on this page or with your own pharmacist before starting. If you're pregnant or breastfeeding, DIM carries enough uncertainty that you should discuss it with your doctor or pharmacist first.
For someone with no relevant drug interactions and not pregnant or nursing, the main safety concern is that long-term data are limited.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 2 of 2 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Jan 22, 2021.
This Scorecard evaluates available label information, ingredient evidence, and known medication-safety considerations. It does not independently verify product identity, purity, potency, contamination, or manufacturing quality. How these ratings are computed
General information
Key facts about DIM, straight from the product label.
| Brand | Envy Nutrition |
|---|---|
| Barcode (UPC) | X0023TJP99 |
| Net contents | 60 Capsule(s) |
| Market status | On market |
| Date entered into DSLD | Jan 22, 2021 |
| DSLD ID | 241798 |
| Product type | Other Combinations |
| Supplement form | Capsule |
| Dietary claims / uses | All Other, Structure/Function |
| Intended target group(s) | Adult Female (18 - 50 Years), Sugar Free |
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.
Supplement Facts
The label details for DIM by Envy Nutrition, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| BioPerine | 5 mg | -- |
| DIM | 300 mg | -- |
Other ingredients: Vegetable Cellulose, Rice Flour, Silicon Dioxide, Magnesium Stearate
Tap any ingredient to jump to its full detail below.
These statements are the manufacturer’s wording, reproduced from the product label — the label is saying it, not HelloPharmacist. We don’t verify or endorse them.
Suggested/Recommended/Usage/Directions
Suggested Use: As a dietary supplement take one (1) vegetarian capsule once a day. For best results take 20-30 min before a meal with an 8 oz. glass of water or as directed by your healthcare professional.
Precautions
Caution: Do not exceed recommended dose.
Pregnant or nursing mothers, children under the age of 18, and individuals with a known medical condition should consult a physician before using this or any dietary supplement.
Pregnant or nursing mothers, children under the age of 18, and individuals with a known medical condition should consult a physician before using this or any dietary supplement. Keep out of reach of children.
Do not use if safety seal is damaged or missing.
Allergens: None
Storage
Store in a cool, dry place.
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.
Formulation
Hormone balance Energy Balance Mood
Zero hormones, antibiotics, preservatives, soy, yeast, sugar.
FDA Statement of Identity
Dietary Supplement
Brand IP Statement(s)
Bioperine is a registered trademark of Sabinsa Corporation
Seals/Symbols
GMP Certified Good Manufacturing Practice FDA Registered Facility Made in the USA
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
DIM by Envy Nutrition label
The label scan from the NIH Dietary Supplement Label Database. Tap to enlarge.
Label images are published by the NIH Dietary Supplement Label Database for the version of this product on file. Always read your actual product label.
View the full label (PDF)The Ingredients in DIM by Envy Nutrition
These are the 2 active ingredients this product is made of. Select any to open its full monograph.
Serving size1 Vegetable 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.
BioPerine
Interacts with1,019 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 he...
BioPerine monograph & interactionsDIM
Interacts with269 drugs
Diindolylmethane (DIM) is a compound made when your body digests cruciferous vegetables, and it is sold as a supplement mainly for hormone balance and...
DIM monograph & interactionsOther (inactive) ingredients: Vegetable Cellulose, Rice Flour, Silicon Dioxide, Magnesium Stearate. These complete the product’s ingredient list but are not active constituents.
DIM by Envy Nutrition Drug Interactions
HelloPharmacist Interaction Report
DIM by Envy Nutrition contains two active ingredients — BioPerine (black pepper) and DIM — and both have documented interactions with medications.
The most serious interactions are Moderate in severity. Black pepper's piperine can raise blood levels of several drugs, including the heart medication propranolol and the seizure medication phenytoin, potentially making them stronger than intended.
DIM may interfere with estrogen-based medications and certain diuretics.
Read the full breakdown — every affected drug type, severity by severity
Black pepper interacts with the following medication types: antiretrovirals (nevirapine), tuberculosis drugs (rifampin), seizure medications (phenytoin), immunosuppressants (cyclosporine), sedatives (pentobarbital), cholesterol drugs (atorvastatin), and asthma/breathing medications (theophylline). All are Moderate severity — piperine raises their blood levels or effects.
DIM carries separate Moderate interactions with estrogens and diuretics, and a Minor theoretical interaction with drugs processed through a specific liver enzyme (CYP1A2 substrates).
Altogether, these interactions span 1,090 individual medications. Use the medication checker below to see whether any of your prescriptions are on this list before you start.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against DIM?
Ask about interactions with your drugs in plain English — “Can I take it with lisinopril?” — and we find you the answer in seconds, ingredient by ingredient.
Go to the checkerIngredients driving the most interactions
Individual Drug Interactions
The ingredients in DIM interact with 1,089 drugs. Click any drug to see the details.
2 of the 2 ingredients in DIM interact with drugs. Each result below shows which ingredient is responsible. BioPerine DIM
AmprenavirAgenerase
How Amprenavir interacts with DIM — through 1 ingredient. Tap an ingredient for the detail:
BioperineP-glycoprotein Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, black pepper might increase levels of P-glycoprotein substrates.
Read the full Bioperine + Amprenavir interactionAnacaulase-bcdbNexoBrid
How Anacaulase-bcdb interacts with DIM — through 1 ingredient. Tap an ingredient for the detail:
BioperineAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, black pepper might increase the risk of bleeding when taken with antiplatelet or anticoagulant drugs.
Read the full Bioperine + Anacaulase-bcdb interactionAnagrelideAgrylin
How Anagrelide interacts with DIM — through 2 ingredients. Tap an ingredient for the detail:
BioperineCytochrome P450 1a2 (cyp1a2) Substrates, Anticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, black pepper might decrease levels and clinical effects of drugs metabolized by CYP1A2.
Read the full Bioperine + Anagrelide interactionDimCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, diindolylmethane might lower serum levels of CYP1A2 substrates.
Read the full Dim + Anagrelide interactionAnisindioneMiradon
How Anisindione interacts with DIM — through 1 ingredient. Tap an ingredient for the detail:
BioperineAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, black pepper might increase the risk of bleeding when taken with antiplatelet or anticoagulant drugs.
Read the full Bioperine + Anisindione interactionAntidiabetes, Dipeptidyl Peptidase-4 (dpp-iv) InhibitorGlyxambi
How Antidiabetes, Dipeptidyl Peptidase-4 (dpp-iv) Inhibitor interacts with DIM — through 1 ingredient. Tap an ingredient for the detail:
BioperineAntidiabetes Drugs, P-glycoprotein Substrates Moderate
Interaction Summary
Theoretically, black pepper might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Read the full Bioperine + Antidiabetes, Dipeptidyl Peptidase-4 (dpp-iv) Inhibitor interactionAntithrombin IiiThrombate III
How Antithrombin Iii interacts with DIM — through 1 ingredient. Tap an ingredient for the detail:
BioperineAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, black pepper might increase the risk of bleeding when taken with antiplatelet or anticoagulant drugs.
Read the full Bioperine + Antithrombin Iii interactionApalutamideErleada
How Apalutamide interacts with DIM — through 1 ingredient. Tap an ingredient for the detail:
BioperineCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP3A4.
Read the full Bioperine + Apalutamide interactionApixabanEliquis
How Apixaban interacts with DIM — through 1 ingredient. Tap an ingredient for the detail:
BioperineCytochrome P450 3a4 (cyp3a4) Substrates, P-glycoprotein Substrates +1 Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP3A4.
Read the full Bioperine + Apixaban interactionApomorphineAPO-go, APO-go Pen, APO-go PFS, Apokyn, Uprima
How Apomorphine interacts with DIM — through 1 ingredient. Tap an ingredient for the detail:
BioperineP-glycoprotein Substrates Moderate
Interaction Summary
Theoretically, black pepper might increase levels of P-glycoprotein substrates.
Read the full Bioperine + Apomorphine interactionApomorphine HydrochlorideKynmobi
How Apomorphine Hydrochloride interacts with DIM — through 1 ingredient. Tap an ingredient for the detail:
BioperineP-glycoprotein Substrates Moderate
Interaction Summary
Theoretically, black pepper might increase levels of P-glycoprotein substrates.
Read the full Bioperine + Apomorphine Hydrochloride interactionApremilastOtezla
How Apremilast interacts with DIM — through 1 ingredient. Tap an ingredient for the detail:
BioperineCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP3A4.
Read the full Bioperine + Apremilast interactionAprepitantCinvanti, Emend
How Aprepitant interacts with DIM — through 1 ingredient. Tap an ingredient for the detail:
BioperineCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP3A4.
Read the full Bioperine + Aprepitant interactionArgatrobanArgatroban
How Argatroban interacts with DIM — through 1 ingredient. Tap an ingredient for the detail:
BioperineAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, black pepper might increase the risk of bleeding when taken with antiplatelet or anticoagulant drugs.
Read the full Bioperine + Argatroban interactionAripiprazoleAbilify, Abilify Maintena, Abilify Mycite
How Aripiprazole interacts with DIM — through 1 ingredient. Tap an ingredient for the detail:
BioperineCytochrome P450 2d6 (cyp2d6) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP2D6.
Read the full Bioperine + Aripiprazole interactionAripiprazole LauroxilAristada, Aristada Initio Kit
How Aripiprazole Lauroxil interacts with DIM — through 1 ingredient. Tap an ingredient for the detail:
BioperineCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 2d6 (cyp2d6) Substrates Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP3A4.
Read the full Bioperine + Aripiprazole Lauroxil interactionArmodafinilNuvigil
How Armodafinil interacts with DIM — through 1 ingredient. Tap an ingredient for the detail:
BioperineCytochrome P450 3a4 (cyp3a4) Substrates, P-glycoprotein Substrates Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP3A4.
Read the full Bioperine + Armodafinil interactionAspirinAngettes 75, ASA, Asaphen, Aspirin, Caprin, Cartia +8 more
How Aspirin interacts with DIM — through 1 ingredient. Tap an ingredient for the detail:
BioperineAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, black pepper might increase the risk of bleeding when taken with antiplatelet or anticoagulant drugs.
Read the full Bioperine + Aspirin interactionAspirin, Aluminum Hydroxide, Codeine Phosphate, Magnesium HydroxideAscriptin Codeine #3
How Aspirin, Aluminum Hydroxide, Codeine Phosphate, Magnesium Hydroxide interacts with DIM — through 1 ingredient. Tap an ingredient for the detail:
BioperineAnticoagulant/antiplatelet Drugs, Cytochrome P450 2d6 (cyp2d6) Substrates Moderate
Interaction Summary
Theoretically, black pepper might increase the risk of bleeding when taken with antiplatelet or anticoagulant drugs.
Read the full Bioperine + Aspirin, Aluminum Hydroxide, Codeine Phosphate, Magnesium Hydroxide interactionAspirin, ButalbitalAxotal
How Aspirin, Butalbital interacts with DIM — through 1 ingredient. Tap an ingredient for the detail:
BioperineAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, black pepper might increase the risk of bleeding when taken with antiplatelet or anticoagulant drugs.
Read the full Bioperine + Aspirin, Butalbital interactionAspirin, Butalbital, CaffeineFiorinal
How Aspirin, Butalbital, Caffeine interacts with DIM — through 2 ingredients. Tap an ingredient for the detail:
BioperineAnticoagulant/antiplatelet Drugs, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Moderate
Interaction Summary
Theoretically, black pepper might increase the risk of bleeding when taken with antiplatelet or anticoagulant drugs.
Read the full Bioperine + Aspirin, Butalbital, Caffeine interactionDimCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, diindolylmethane might lower serum levels of CYP1A2 substrates.
Read the full Dim + Aspirin, Butalbital, Caffeine interactionAspirin, Butalbital, Caffeine, Codeine PhosphateFiorinal w/ Codeine
How Aspirin, Butalbital, Caffeine, Codeine Phosphate interacts with DIM — through 2 ingredients. Tap an ingredient for the detail:
BioperineCytochrome P450 3a4 (cyp3a4) Substrates, Anticoagulant/antiplatelet Drugs +2 Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP3A4.
Read the full Bioperine + Aspirin, Butalbital, Caffeine, Codeine Phosphate interactionDimCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, diindolylmethane might lower serum levels of CYP1A2 substrates.
Read the full Dim + Aspirin, Butalbital, Caffeine, Codeine Phosphate interactionAspirin, Butalbital, Caffeine, PhenacetinMarnal
How Aspirin, Butalbital, Caffeine, Phenacetin interacts with DIM — through 2 ingredients. Tap an ingredient for the detail:
BioperineCytochrome P450 1a2 (cyp1a2) Substrates, Anticoagulant/antiplatelet Drugs +1 Moderate
Interaction Summary
Theoretically, black pepper might decrease levels and clinical effects of drugs metabolized by CYP1A2.
Read the full Bioperine + Aspirin, Butalbital, Caffeine, Phenacetin interactionDimCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, diindolylmethane might lower serum levels of CYP1A2 substrates.
Read the full Dim + Aspirin, Butalbital, Caffeine, Phenacetin interactionAspirin, CaffeineAnacin
How Aspirin, Caffeine interacts with DIM — through 2 ingredients. Tap an ingredient for the detail:
BioperineCytochrome P450 3a4 (cyp3a4) Substrates, Anticoagulant/antiplatelet Drugs +1 Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP3A4.
Read the full Bioperine + Aspirin, Caffeine interactionDimCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, diindolylmethane might lower serum levels of CYP1A2 substrates.
Read the full Dim + Aspirin, Caffeine interactionAspirin, Caffeine, Codeine PhosphateAnacin w/ Codeine
How Aspirin, Caffeine, Codeine Phosphate interacts with DIM — through 2 ingredients. Tap an ingredient for the detail:
BioperineCytochrome P450 1a2 (cyp1a2) Substrates, Anticoagulant/antiplatelet Drugs +2 Moderate
Interaction Summary
Theoretically, black pepper might decrease levels and clinical effects of drugs metabolized by CYP1A2.
Read the full Bioperine + Aspirin, Caffeine, Codeine Phosphate interactionDimCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, diindolylmethane might lower serum levels of CYP1A2 substrates.
Read the full Dim + Aspirin, Caffeine, Codeine Phosphate interactionAspirin, Caffeine, Dihydrocodeine BitartrateSynalgos DC
How Aspirin, Caffeine, Dihydrocodeine Bitartrate interacts with DIM — through 2 ingredients. Tap an ingredient for the detail:
BioperineCytochrome P450 2d6 (cyp2d6) Substrates, Anticoagulant/antiplatelet Drugs +2 Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP2D6.
Read the full Bioperine + Aspirin, Caffeine, Dihydrocodeine Bitartrate interactionDimCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, diindolylmethane might lower serum levels of CYP1A2 substrates.
Read the full Dim + Aspirin, Caffeine, Dihydrocodeine Bitartrate interactionAspirin, Caffeine, Dover's PwdAcedoval, Dovacet
How Aspirin, Caffeine, Dover's Pwd interacts with DIM — through 2 ingredients. Tap an ingredient for the detail:
BioperineCytochrome P450 3a4 (cyp3a4) Substrates, Anticoagulant/antiplatelet Drugs +1 Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP3A4.
Read the full Bioperine + Aspirin, Caffeine, Dover's Pwd interactionDimCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, diindolylmethane might lower serum levels of CYP1A2 substrates.
Read the full Dim + Aspirin, Caffeine, Dover's Pwd interactionAspirin, Caffeine, HydrocodoneDamason-P
How Aspirin, Caffeine, Hydrocodone interacts with DIM — through 2 ingredients. Tap an ingredient for the detail:
BioperineCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +2 Moderate
Interaction Summary
Theoretically, black pepper might decrease levels and clinical effects of drugs metabolized by CYP1A2.
Read the full Bioperine + Aspirin, Caffeine, Hydrocodone interactionDimCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, diindolylmethane might lower serum levels of CYP1A2 substrates.
Read the full Dim + Aspirin, Caffeine, Hydrocodone interactionAspirin, Caffeine, Isobutylallylbarbituric Acid, PhenacetinLanorinal
How Aspirin, Caffeine, Isobutylallylbarbituric Acid, Phenacetin interacts with DIM — through 2 ingredients. Tap an ingredient for the detail:
BioperineCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP3A4.
Read the full Bioperine + Aspirin, Caffeine, Isobutylallylbarbituric Acid, Phenacetin interactionDimCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, diindolylmethane might lower serum levels of CYP1A2 substrates.
Read the full Dim + Aspirin, Caffeine, Isobutylallylbarbituric Acid, Phenacetin interactionAspirin, Caffeine, OrphenadrineInvagesic, Invagesic Forte, Norgesic, Norgesic Forte, Orphengesic, Orphengesic Forte
How Aspirin, Caffeine, Orphenadrine interacts with DIM — through 2 ingredients. Tap an ingredient for the detail:
BioperineAnticoagulant/antiplatelet Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Moderate
Interaction Summary
Theoretically, black pepper might increase the risk of bleeding when taken with antiplatelet or anticoagulant drugs.
Read the full Bioperine + Aspirin, Caffeine, Orphenadrine interactionDimCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, diindolylmethane might lower serum levels of CYP1A2 substrates.
Read the full Dim + Aspirin, Caffeine, Orphenadrine interactionAspirin, Caffeine, Phenacetin, PropoxypheneMargesic Comp. 65
How Aspirin, Caffeine, Phenacetin, Propoxyphene interacts with DIM — through 2 ingredients. Tap an ingredient for the detail:
BioperineCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +2 Moderate
Interaction Summary
Theoretically, black pepper might decrease levels and clinical effects of drugs metabolized by CYP1A2.
Read the full Bioperine + Aspirin, Caffeine, Phenacetin, Propoxyphene interactionDimCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, diindolylmethane might lower serum levels of CYP1A2 substrates.
Read the full Dim + Aspirin, Caffeine, Phenacetin, Propoxyphene interactionEach ingredient & the kinds of drugs it affects
For each ingredient in DIM 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.
BioPerine
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
DIM
Diuretic Drugs
Theoretically, diindolylmethane might increase the risk of hyponatremia if used with sodium-depleting diuretics.
Large doses of diindolylmethane (600 mg daily) have been associated with two cases of asymptomatic hyponatremia in clinical research.
Estrogens
Theoretically, diindolylmethane might increase or decrease the effects of estrogens.
Diindolylmethane might have mild estrogenic or antiestrogenic effects. Theoretically, large amounts of diindolylmethane might interfere with hormone replacement therapy.
Cytochrome P450 1A2 (Cyp1A2) Substrates
Theoretically, diindolylmethane might lower serum levels of CYP1A2 substrates.
In vitro evidence suggests that diindolylmethane can induce CYP1A2. Theoretically, it might increase metabolism of CYP1A2 substrates and lower serum concentrations. This interaction has not been reported in humans.
Brand information
Manufacturer and brand details for DIM, from the product label.
Envy Nutrition
See all Envy Nutrition products- Name
- Envy Nutrition
- Street Address
- 4605 E Chandler Blvd Suite 110-112
- City
- Phoenix
- State
- AZ
- ZipCode
- 85048
- Phone Number
- 888-441-9993
DIM by Envy Nutrition: Common Questions
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How can one product interact with so many drugs?
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Why is BioPerine in this product?
Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
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Our pharmacists answer your medication & supplement questions — free.
Label information is sourced from the NIH Dietary Supplement Label Database and reflects the product version on file; always read your actual product label. This page is for education only and is not a substitute for professional medical advice. Confirm with your pharmacist or doctor before combining supplements and medications.
The Full Monographs Behind DIM’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Black Pepper
Interacts with 1,019 drugsBlack 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 → Herb & supplement monographDiindolylmethane
Interacts with 269 drugsDiindolylmethane (DIM) is a compound made when your body digests cruciferous vegetables, and it is sold as a supplement mainly for hormone balance and cancer prevention. Although early lab s...
Read the full Diindolylmethane monograph →Sources & How We Checked
DIM's label data comes from the NIH Dietary Supplement Label Database; the ingredient interaction data is from the Natural Medicines database, reviewed by our pharmacists.
- NIH Dietary Supplement Label Database (DSLD) — The official product label on file for this supplement.
- Natural Medicines (Therapeutic Research Center) — Evidence-graded clinical reference behind the ingredient interaction data.
Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.
The 43 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.
Black Pepper 29 references
- Leung AY, Foster S. Encyclopedia of Common Natural Ingredients Used in Food, Drugs and Cosmetics. 2nd ed. New York, NY: John Wiley & Sons, 1996.
- Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
- 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
- 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
- Cohle SD, Trestrail JD III, Graham MA, et al. Fatal pepper aspiration. Am J Dis Child 1988;142:633-6. PubMed
- 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
- 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
- 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.
- 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
- 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.
- 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
- 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.
- 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
- 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
- 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.
- 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
- Lawless, H. and Stevens, D. A. Effects of oral chemical irritation on taste. Physiol Behav. 1984;32(6):995-998. PubMed
- 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.
- Han, Y., Chin Tan, T. M., and Lim, L. Y. In vitro and in vivo evaluation of the effects of piperine on P-gp function and expression. Toxicol.Appl.Pharmacol. 8-1-2008;230(3):283-289. PubMed
- Sharma, P., Varma, M. V., Chawla, H. P., and Panchagnula, R. In situ and in vivo efficacy of peroral absorption enhancers in rats and correlation to in vitro mechanistic studies. Farmaco 2005;60(11-12):874-883. PubMed
- Aher, S., Biradar, S., Gopu, C. L., and Paradkar, A. Novel pepper extract for enhanced P-glycoprotein inhibition. J Pharm.Pharmacol. 2009;61(9):1179-1186. PubMed
- Zutshi, R. K., Singh, R., Zutshi, U., Johri, R. K., and Atal, C. K. Influence of piperine on rifampicin blood levels in patients of pulmonary tuberculosis. J Assoc.Physicians India 1985;33(3):223-224.
- Marotta, R. B. and Floch, M. H. Diet and nutrition in ulcer disease. Med Clin North Am 1991;75(4):967-979. PubMed
- Subehan, Usia, T., Iwata, H., Kadota, S., and Tezuka, Y. Mechanism-based inhibition of CYP3A4 and CYP2D6 by Indonesian medicinal plants. J Ethnopharmacol. 5-24-2006;105(3):449-455. PubMed
- Gimenez L, Zacharisen M. Severe pepper allergy in a young child. WMJ. 2011 Jun;110(3):138-9.
- Ren T, Yang M, Xiao M, Zhu J, Xie W, Zuo Z. Time-dependent inhibition of carbamazepine metabolism by piperine in anti-epileptic treatment. Life Sci. 2019;218:314-323. PubMed
- Thomas AB, Choudhary DC, Raje A, Nagrik SS. Pharmacokinetics and pharmacodynamic herb-drug interaction of piperine with atorvastatin in rats. J Chromatogr Sci 2021;59(4):371-80. PubMed
- 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
- Lin F, Hu Y, Zhang Y, Zhao L, Zhong D, Liu J. Predicting Food-Drug Interactions between Piperine and CYP3A4 Substrate Drugs Using PBPK Modeling. Int J Mol Sci 2024;25(20):10955. PubMed
Diindolylmethane 14 references
- Natl Inst Health, Natl Inst Environmental Health Sci. Indole-3-carbinol. Available at: http://ntp-server.niehs.nih.gov.
- Balk JL. Indole-3-carbinol for cancer prevention. Altern Med Alert 2000; 3:105-7.
- Riby JE, Chang GHF, Firestone GL, Bjeldanes LF. Ligand-independent activation of estrogen receptor function by 3,3'-diindolylmethane in human breast cancer cells. Biochem Pharmacol 2000;60:167-77. PubMed
- Lake BG, Tredger JM, Renwick AB, et al. 3'3-diindolylmethane induces CYP1A2 in cultured precision-cut human liver slices. Xenobiotica 1998;28:803-11. PubMed
- Dalessandri, K. M., Firestone, G. L., Fitch, M. D., Bradlow, H. L., and Bjeldanes, L. F. Pilot study: effect of 3,3'-diindolylmethane supplements on urinary hormone metabolites in postmenopausal women with a history of early-stage breast cancer. Nutr Canc PubMed
- Reed, G. A., Arneson, D. W., Putnam, W. C., Smith, H. J., Gray, J. C., Sullivan, D. K., Mayo, M. S., Crowell, J. A., and Hurwitz, A. Single-dose and multiple-dose administration of indole-3-carbinol to women: pharmacokinetics based on 3,3'-diindolylmetha
- Reed, G. A., Sunega, J. M., Sullivan, D. K., Gray, J. C., Mayo, M. S., Crowell, J. A., and Hurwitz, A. Single-dose pharmacokinetics and tolerability of absorption-enhanced 3,3'-diindolylmethane in healthy subjects. Cancer Epidemiol.Biomarkers Prev. 2008; PubMed
- Del Priore G., Gudipudi, D. K., Montemarano, N., Restivo, A. M., Malanowska-Stega, J., and Arslan, A. A. Oral diindolylmethane (DIM): pilot evaluation of a nonsurgical treatment for cervical dysplasia. Gynecol.Oncol. 2010;116(3):464-467. PubMed
- Heath, E. I., Heilbrun, L. K., Li, J., Vaishampayan, U., Harper, F., Pemberton, P., and Sarkar, F. H. A phase I dose-escalation study of oral BR-DIM (BioResponse 3,3'- Diindolylmethane) in castrate-resistant, non-metastatic prostate cancer. Am.J.Transl.R
- Jellinck, P. H., Forkert, P. G., Riddick, D. S., Okey, A. B., Michnovicz, J. J., and Bradlow, H. L. Ah receptor binding properties of indole carbinols and induction of hepatic estradiol hydroxylation. Biochem.Pharmacol. 3-9-1993;45(5):1129-1136. PubMed
- Bui PV, Moualla M, Upson DJ. A Possible Association of Diindolylmethane with Pulmonary Embolism and Deep Venous Thrombosis. Case Rep Med. 2016;2016:7527098. PubMed
- Castañon A, Tristram A, Mesher D, Powell N, Beer H, Ashman S, Rieck G, Fielder H, Fiander A, Sasieni P. Effect of diindolylmethane supplementation on low-grade cervical cytological abnormalities: double-blind, randomised, controlled trial. Br J Cancer. 20 PubMed
- Le TM, Sanders CJ, van de Corput L, van Erpecum KJ, Röckmann H. Drug rash with eosinophilia and systemic symptoms caused by the dietary supplement diindolylmethane. J Allergy Clin Immunol Pract. 2016 Jan-Feb;4(1):175-6. PubMed
- Pence ST, Mehta K, Crum-Bailey J. The Serious Side of Supplements: An Ischemic Stroke in a Healthy 38-year-old Female. Mil Med 2022. PubMed
Parts of this content are provided by the Therapeutic Research Center, LLC.
DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.
© 2021 Therapeutic Research Center, LLC