Dr. Cutler's Ultimate Cholesterol Formula Ingredients & Drug Interactions
by True Health
What is this page for?
First and foremost: checking Dr. Cutler's Ultimate Cholesterol Formula 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
Dr. Cutler's Ultimate Cholesterol Formula is a dietary supplement by True Health with 5 active ingredients. Its ingredients are commonly taken for general antioxidant support, skin and hair care, heart health.Based on those ingredients, 1,206 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Tocotrienols, Guggul gum extract, Niacin. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against Dr. Cutler's Ultimate Cholesterol Formula by True Health
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HelloPharmacist Scorecard of Dr. Cutler's Ultimate Cholesterol Formula by True Health
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
Dr. Cutler's Ultimate Cholesterol Formula contains five active ingredients.
Tocotrienols are a form of vitamin E. Guggul gum extract comes from the guggul tree resin.
Niacin is a B vitamin. Policosanol is a plant-derived alcohol mixture.
Phytosterol complex is made from plant sterols. The capsule also includes inactive ingredients—gelatin, microcrystalline cellulose, silicon dioxide, magnesium silicate, and magnesium stearate—that serve as binders and fillers.
Does it work?
Moderate evidence
The evidence for this product's ingredients is mixed. Tocotrienols (vitamin E) are effective for treating vitamin E deficiency and a rare inherited disorder called AVED; they're possibly effective for Alzheimer's disease, beta-thalassemia, and G6PD deficiency.
Guggul shows insufficient evidence to rate its use for acne, hemorrhoids, or high cholesterol—and it's possibly ineffective for obesity. Niacin is likely effective for pellagra (a deficiency disease) and possibly effective for HIV-related lipid problems and metabolic syndrome.
Policosanol is likely effective for intermittent claudication (leg pain from poor blood flow) but shows insufficient evidence for coronary heart disease and familial high cholesterol. Data on phytosterol complex's effectiveness isn't on file.
How safe is it?
Well-documented data
Vitamin E is generally well-tolerated at dietary amounts, but high-dose long-term supplements may raise bleeding risk and other harms. Rare serious effects include bleeding, hemorrhagic stroke, and cardiovascular complications.
There's particular concern about hemorrhagic stroke in male smokers on synthetic vitamin E over years. Guggul is usually well-tolerated orally but commonly causes belching, bloating, diarrhea, headache, nausea, and unpleasant taste; skin reactions (rash, itching) occur in a dose-dependent manner and can range from mild to severe.
Niacin at food amounts is safe; high-dose supplements can cause flushing, gastrointestinal upset, liver problems, and rarely myopathy or blood-clotting issues. Policosanol is usually well-tolerated; headache, vertigo, insomnia, and weight loss are uncommon.
For pregnancy: vitamin E from food and prenatal vitamins is appropriate, but avoid high-dose supplements. Guggul should be avoided in pregnancy because it may stimulate the uterus.
Niacin in normal dietary amounts and standard prenatal vitamins is likely safe. Policosanol has insufficient safety data and should be avoided in pregnancy.
For breastfeeding: vitamin E in normal amounts is fine, but check with your doctor before high-dose supplements; guggul and policosanol have insufficient data and are best avoided. Niacin in normal dietary intake is fine, but avoid high-dose supplements unless directed by a doctor.
Meds to double-check
Moderate interaction found
Before taking this product, check with your doctor or pharmacist about: blood thinners and antiplatelet drugs (warfarin, aspirin, clopidogrel, others)—vitamin E, guggul, niacin, and policosanol all increase bleeding risk. Beta-blockers and other blood pressure medications—guggul, niacin, and policosanol may lower blood pressure further.
Diabetes medications—niacin and policosanol may raise blood sugar or lower it unpredictably. Liver-metabolized drugs (many common medications fall here)—vitamin E and guggul may speed up metabolism and reduce effectiveness.
Birth control pills and estrogen therapy—guggul may interfere. Heart medications like diltiazem—guggul may reduce effectiveness.
Thyroid hormone—guggul may interfere. Gout medications (allopurinol, probenecid)—niacin may reduce effectiveness.
Statins (cholesterol drugs)—niacin theoretically increases myopathy risk. Tamoxifen (cancer treatment)—guggul may interfere.
Antihypertensive and hepatotoxic drugs—niacin adds risk. No interactions are documented in our data for phytosterol complex.
The bottom line
Scorecard at a glanceFully disclosed formula with some supporting evidence for its stated purpose. Moderate medication interactions have been identified, and safety information is well characterized.
This formula targets cholesterol through multiple pathways, but its ingredients pack significant medication interactions—especially with blood thinners, blood pressure drugs, diabetes medications, and liver-metabolized drugs. If you're on any prescription medication, especially anticoagulants, heart drugs, or diabetes treatments, talk to your doctor or pharmacist before starting.
The blend may also cause digestive upset and skin reactions. High-dose vitamin E carries a small risk of bleeding and stroke in certain populations.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 4 of 5 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Dec 21, 2012.
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 Dr. Cutler's Ultimate Cholesterol Formula, straight from the product label.
| Brand | True Health |
|---|---|
| Net contents | 180 Capsule(s) |
| Market status | On market |
| Date entered into DSLD | Dec 21, 2012 |
| DSLD ID | 16742 |
| Product type | Other Combinations |
| Supplement form | Capsule |
| Dietary claims / uses | All Other, Structure/Function |
| Intended target group(s) | Adult (18 - 50 Years) |
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 Dr. Cutler's Ultimate Cholesterol Formula by True Health, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Tocotrienols | 3 mg | -- |
| Guggul gum extract | 375 mg | -- |
| Niacin | 250 mg | 1250% |
| Policosanol | 10 mg | -- |
| Phytosterol Complex | 400 mg | -- |
Other ingredients: Gelatin, Microcrystalline Cellulose, Silicon Dioxide, Magnesium Silicate, 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.
General Statements
For Healthy Cholesterol*
This product is manufactured in a NSF GMP registered facility.
Contains the World's Finest Ingredients.
FDA Statement of Identity
Dietary Supplement
Seals/Symbols
SCIENTIFICALLY FORMULATED DOCTOR APPROVED
MADE IN U.S.A.
Suggested/Recommended/Usage/Directions
Suggested Use: Take three capsules two times daily with meals or as directed by your healthcare professional.
Precautions
Caution: Due to potential blood-thinning effects of policosanol, please consult with your physician before taking this product if you take Coumadin(R) (Warfarin) or other blood thinners. Do not use this product if you are pregnant or nursing.
KEEP OUT OF REACH OF CHILDREN.
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.
General
300-TUCFC-8
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Dr. Cutler's Ultimate Cholesterol Formula by True Health 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 Dr. Cutler's Ultimate Cholesterol Formula by True Health
These are the 5 active ingredients this product is made of. Select any to open its full monograph.
Serving size3 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.
Tocotrienols
Interacts with764 drugs
Vitamin E is an essential fat-soluble vitamin and antioxidant that most people get in adequate amounts from a normal diet. Supplements can help correc...
Tocotrienols monograph & interactionsGuggul gum extract
Interacts with757 drugs
Guggul is a gum resin from the Commiphora wightii tree, long used in Ayurvedic medicine for cholesterol, joint, and skin problems. Modern studies are...
Guggul gum extract monograph & interactionsNiacin
Interacts with727 drugs
Niacin (vitamin B3) is an essential nutrient your body needs for energy and metabolism, and deficiency is uncommon in most developed countries. Prescr...
Niacin monograph & interactionsPolicosanol
Interacts with242 drugs
Policosanol is a mix of waxy alcohols (mostly octacosanol) made from sugar cane or other plant waxes, and it is often marketed as a natural way to low...
Policosanol monograph & interactionsPhytosterol Complex
Other (inactive) ingredients: Gelatin, Microcrystalline Cellulose, Silicon Dioxide, Magnesium Silicate, Magnesium Stearate. These complete the product’s ingredient list but are not active constituents.
Dr. Cutler's Ultimate Cholesterol Formula by True Health Drug Interactions
HelloPharmacist Interaction Report
Dr.
Cutler's Ultimate Cholesterol Formula by True Health interacts with medications through its tocotrienols (vitamin E), guggul gum extract, niacin, and policosanol. The most serious interaction is with blood thinner and antiplatelet drugs—vitamin E, guggul, niacin, and policosanol all increase bleeding risk, a Moderate severity concern that's particularly critical if you're on warfarin or other anticoagulants.
Read the full breakdown — every affected drug type, severity by severity
Beyond bleeding risk, this product affects how your liver processes many medications. Vitamin E and guggul both induce a major liver enzyme (CYP3A4), potentially reducing the effectiveness of dozens of common drugs.
Niacin has its own concerns: it can raise blood sugar (risky with diabetes medication), lower blood pressure (watch out with blood pressure drugs), stress the liver (especially with other liver-taxing medications), and reduce the benefit of gout medications. Guggul may also interfere with birth control pills, estrogen therapy, beta-blockers like propranolol, heart medication diltiazem, thyroid hormone, and tamoxifen for cancer.
Policosanol adds blood pressure-lowering effects on top of beta-blockers and other blood pressure drugs, and theoretically increases low blood sugar risk with diabetes medications.
Additionally, phytosterol complex—one of the five active ingredients—we could not check for interactions, as we hold no data on it.
Additionally, niacin may decrease the helpful effects of another cholesterol medication, niacin itself, on HDL (good cholesterol) if you're also taking antioxidants. Altogether, these interactions span 1,207 individual medications.
Check your exact medications with the search tool on this page before you start.
Check your own medications below · Editorial policy · How we use AI
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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 Dr. Cutler's Ultimate Cholesterol Formula interact with 1,206 drugs. Click any drug to see the details.
4 of the 5 ingredients in Dr. Cutler's Ultimate Cholesterol Formula interact with drugs. Each result below shows which ingredient is responsible. Tocotrienols Guggul gum extract Niacin Policosanol
6-mercaptopurinePurinethol
How 6-mercaptopurine interacts with Dr. Cutler's Ultimate Cholesterol Formula — through 1 ingredient. Tap an ingredient for the detail:
NiacinHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + 6-mercaptopurine interactionAdo-trastuzumab EmtansineKadcyla
How Ado-trastuzumab Emtansine interacts with Dr. Cutler's Ultimate Cholesterol Formula — through 2 ingredients. Tap an ingredient for the detail:
Guggul Gum ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, guggul might reduce the effects of CYP3A4 substrates.
Read the full Guggul Gum Extract + Ado-trastuzumab Emtansine interactionTocotrienolsCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Tocotrienols + Ado-trastuzumab Emtansine interactionAbacavir Sulfate, Dolutegravir, LamivudineTriumeq
How Abacavir Sulfate, Dolutegravir, Lamivudine interacts with Dr. Cutler's Ultimate Cholesterol Formula — through 1 ingredient. Tap an ingredient for the detail:
NiacinHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Abacavir Sulfate, Dolutegravir, Lamivudine interactionAbacavir, LamivudineEpzicom
How Abacavir, Lamivudine interacts with Dr. Cutler's Ultimate Cholesterol Formula — through 1 ingredient. Tap an ingredient for the detail:
NiacinHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Abacavir, Lamivudine interactionAbciximabReoPro
How Abciximab interacts with Dr. Cutler's Ultimate Cholesterol Formula — through 4 ingredients. Tap an ingredient for the detail:
NiacinAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, niacin may have additive effects when used with anticoagulant or antiplatelet drugs.
Read the full Niacin + Abciximab interactionPolicosanolAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, taking policosanol with other antiplatelet or anticoagulant drugs might increase the risk of bruising and bleeding.
Read the full Policosanol + Abciximab interactionTocotrienolsAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Concomitant use of vitamin E and anticoagulant or antiplatelet agents might increase the risk of bleeding.
Read the full Tocotrienols + Abciximab interactionGuggul Gum ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, guggul might increase the risk of bleeding when taken with anticoagulant/antiplatelet drugs.
Read the full Guggul Gum Extract + Abciximab interactionAbemaciclibVerzenio
How Abemaciclib interacts with Dr. Cutler's Ultimate Cholesterol Formula — through 2 ingredients. Tap an ingredient for the detail:
TocotrienolsCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Tocotrienols + Abemaciclib interactionGuggul Gum ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, guggul might reduce the effects of CYP3A4 substrates.
Read the full Guggul Gum Extract + Abemaciclib interactionAbiraterone
How Abiraterone interacts with Dr. Cutler's Ultimate Cholesterol Formula — through 3 ingredients. Tap an ingredient for the detail:
Guggul Gum ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, guggul might reduce the effects of CYP3A4 substrates.
Read the full Guggul Gum Extract + Abiraterone interactionNiacinHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Abiraterone interactionTocotrienolsCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Tocotrienols + Abiraterone interactionAbiraterone AcetateYonsa, Zytiga
How Abiraterone Acetate interacts with Dr. Cutler's Ultimate Cholesterol Formula — through 3 ingredients. Tap an ingredient for the detail:
Guggul Gum ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, guggul might reduce the effects of CYP3A4 substrates.
Read the full Guggul Gum Extract + Abiraterone Acetate interactionTocotrienolsCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Tocotrienols + Abiraterone Acetate interactionNiacinHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Abiraterone Acetate interactionAbrocitinibCibinqo
How Abrocitinib interacts with Dr. Cutler's Ultimate Cholesterol Formula — through 4 ingredients. Tap an ingredient for the detail:
NiacinAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, niacin may have additive effects when used with anticoagulant or antiplatelet drugs.
Read the full Niacin + Abrocitinib interactionTocotrienolsAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Concomitant use of vitamin E and anticoagulant or antiplatelet agents might increase the risk of bleeding.
Read the full Tocotrienols + Abrocitinib interactionGuggul Gum ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, guggul might increase the risk of bleeding when taken with anticoagulant/antiplatelet drugs.
Read the full Guggul Gum Extract + Abrocitinib interactionPolicosanolAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, taking policosanol with other antiplatelet or anticoagulant drugs might increase the risk of bruising and bleeding.
Read the full Policosanol + Abrocitinib interactionAcalabrutinibCalquence
How Acalabrutinib interacts with Dr. Cutler's Ultimate Cholesterol Formula — through 2 ingredients. Tap an ingredient for the detail:
Guggul Gum ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, guggul might reduce the effects of CYP3A4 substrates.
Read the full Guggul Gum Extract + Acalabrutinib interactionTocotrienolsCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Tocotrienols + Acalabrutinib interactionAcarboseGlucobay, Prandase, Precose
How Acarbose interacts with Dr. Cutler's Ultimate Cholesterol Formula — through 2 ingredients. Tap an ingredient for the detail:
PolicosanolAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, policosanol might have additive effects with antidiabetes drugs and increase the risk of hypoglycemia.
Read the full Policosanol + Acarbose interactionNiacinAntidiabetes Drugs, Hepatotoxic Drugs Moderate
Interaction Summary
Niacin can increase blood glucose levels and may diminish the effects of antidiabetes drugs.
Read the full Niacin + Acarbose interactionAcebutololRhotral, Sectral
How Acebutolol interacts with Dr. Cutler's Ultimate Cholesterol Formula — through 2 ingredients. Tap an ingredient for the detail:
NiacinHepatotoxic Drugs, Antihypertensive Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Acebutolol interactionPolicosanolBeta-blockers Moderate
Interaction Summary
Concomitant use of policosanol with beta-blockers can cause additive blood pressure-lowering effects.
Read the full Policosanol + Acebutolol interactionAcenocoumarolSintrom
How Acenocoumarol interacts with Dr. Cutler's Ultimate Cholesterol Formula — through 4 ingredients. Tap an ingredient for the detail:
Guggul Gum ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, guggul might increase the risk of bleeding when taken with anticoagulant/antiplatelet drugs.
Read the full Guggul Gum Extract + Acenocoumarol interactionTocotrienolsAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Concomitant use of vitamin E and anticoagulant or antiplatelet agents might increase the risk of bleeding.
Read the full Tocotrienols + Acenocoumarol interactionPolicosanolAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, taking policosanol with other antiplatelet or anticoagulant drugs might increase the risk of bruising and bleeding.
Read the full Policosanol + Acenocoumarol interactionNiacinAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, niacin may have additive effects when used with anticoagulant or antiplatelet drugs.
Read the full Niacin + Acenocoumarol interactionAcetaminophenChildren's Tylenol, Children's Tylenol Meltaways, Tylenol, Tylenol Ex Strength
How Acetaminophen interacts with Dr. Cutler's Ultimate Cholesterol Formula — through 1 ingredient. Tap an ingredient for the detail:
NiacinHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Acetaminophen interactionAcetaminophen, AspirinGemnisyn
How Acetaminophen, Aspirin interacts with Dr. Cutler's Ultimate Cholesterol Formula — through 4 ingredients. Tap an ingredient for the detail:
NiacinHepatotoxic Drugs, Anticoagulant/antiplatelet Drugs +1 Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Acetaminophen, Aspirin interactionGuggul Gum ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, guggul might increase the risk of bleeding when taken with anticoagulant/antiplatelet drugs.
Read the full Guggul Gum Extract + Acetaminophen, Aspirin interactionPolicosanolAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, taking policosanol with other antiplatelet or anticoagulant drugs might increase the risk of bruising and bleeding.
Read the full Policosanol + Acetaminophen, Aspirin interactionTocotrienolsAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Concomitant use of vitamin E and anticoagulant or antiplatelet agents might increase the risk of bleeding.
Read the full Tocotrienols + Acetaminophen, Aspirin interactionAcetaminophen, Aspirin, CaffeineExcedrin, Excedrin Extra Strength, Excedrin Migraine
How Acetaminophen, Aspirin, Caffeine interacts with Dr. Cutler's Ultimate Cholesterol Formula — through 4 ingredients. Tap an ingredient for the detail:
TocotrienolsAnticoagulant/antiplatelet Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Concomitant use of vitamin E and anticoagulant or antiplatelet agents might increase the risk of bleeding.
Read the full Tocotrienols + Acetaminophen, Aspirin, Caffeine interactionNiacinAspirin, Hepatotoxic Drugs +1 Moderate
Interaction Summary
Large doses of aspirin might alter the clearance of niacin.
Read the full Niacin + Acetaminophen, Aspirin, Caffeine interactionGuggul Gum ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Anticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, guggul might reduce the effects of CYP3A4 substrates.
Read the full Guggul Gum Extract + Acetaminophen, Aspirin, Caffeine interactionPolicosanolAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, taking policosanol with other antiplatelet or anticoagulant drugs might increase the risk of bruising and bleeding.
Read the full Policosanol + Acetaminophen, Aspirin, Caffeine interactionAcetaminophen, Brompheniramine, PhenylpropanolamineDimetapp Cold and Flu
How Acetaminophen, Brompheniramine, Phenylpropanolamine interacts with Dr. Cutler's Ultimate Cholesterol Formula — through 1 ingredient. Tap an ingredient for the detail:
NiacinHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Acetaminophen, Brompheniramine, Phenylpropanolamine interactionAcetaminophen, ButalbitalAxocet, Bancap, Bucet, Butex Forte, Esgic CF, Orbivan CF +5 more
How Acetaminophen, Butalbital interacts with Dr. Cutler's Ultimate Cholesterol Formula — through 1 ingredient. Tap an ingredient for the detail:
NiacinHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Acetaminophen, Butalbital interactionAcetaminophen, Butalbital, CaffeineEsgic, Esgic Plus, Fiogesic, Fioricet, Repan, Tecnal +1 more
How Acetaminophen, Butalbital, Caffeine interacts with Dr. Cutler's Ultimate Cholesterol Formula — through 3 ingredients. Tap an ingredient for the detail:
NiacinHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Acetaminophen, Butalbital, Caffeine interactionTocotrienolsCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Tocotrienols + Acetaminophen, Butalbital, Caffeine interactionGuggul Gum ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, guggul might reduce the effects of CYP3A4 substrates.
Read the full Guggul Gum Extract + Acetaminophen, Butalbital, Caffeine interactionAcetaminophen, Butalbital, Caffeine, CodeineEsgic with Codeine, Fioricet w/ Codeine
How Acetaminophen, Butalbital, Caffeine, Codeine interacts with Dr. Cutler's Ultimate Cholesterol Formula — through 3 ingredients. Tap an ingredient for the detail:
Guggul Gum ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, guggul might reduce the effects of CYP3A4 substrates.
Read the full Guggul Gum Extract + Acetaminophen, Butalbital, Caffeine, Codeine interactionTocotrienolsCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Tocotrienols + Acetaminophen, Butalbital, Caffeine, Codeine interactionNiacinHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Acetaminophen, Butalbital, Caffeine, Codeine interactionAcetaminophen, Butalbital, CodeineBancap w/ Codeine
How Acetaminophen, Butalbital, Codeine interacts with Dr. Cutler's Ultimate Cholesterol Formula — through 1 ingredient. Tap an ingredient for the detail:
NiacinHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Acetaminophen, Butalbital, Codeine interactionAcetaminophen, Butalbital, Codeine PhosphatePhrenilin #3
How Acetaminophen, Butalbital, Codeine Phosphate interacts with Dr. Cutler's Ultimate Cholesterol Formula — through 1 ingredient. Tap an ingredient for the detail:
NiacinHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Acetaminophen, Butalbital, Codeine Phosphate interactionAcetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, PhenylephrineHycomine Compound
How Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interacts with Dr. Cutler's Ultimate Cholesterol Formula — through 3 ingredients. Tap an ingredient for the detail:
NiacinHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interactionTocotrienolsCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Tocotrienols + Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interactionGuggul Gum ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, guggul might reduce the effects of CYP3A4 substrates.
Read the full Guggul Gum Extract + Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interactionAcetaminophen, Caffeine, CodeineGesic C15, Gesic C30, Gesic C8, Lenoltec 1, Lenoltec 2, Lenoltec 3 +1 more
How Acetaminophen, Caffeine, Codeine interacts with Dr. Cutler's Ultimate Cholesterol Formula — through 3 ingredients. Tap an ingredient for the detail:
Guggul Gum ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, guggul might reduce the effects of CYP3A4 substrates.
Read the full Guggul Gum Extract + Acetaminophen, Caffeine, Codeine interactionTocotrienolsCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Tocotrienols + Acetaminophen, Caffeine, Codeine interactionNiacinHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Acetaminophen, Caffeine, Codeine interactionAcetaminophen, Caffeine, Codeine, SalicylamideCodalan No.1, Codalan No.2, Codalan No.3
How Acetaminophen, Caffeine, Codeine, Salicylamide interacts with Dr. Cutler's Ultimate Cholesterol Formula — through 3 ingredients. Tap an ingredient for the detail:
NiacinHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Acetaminophen, Caffeine, Codeine, Salicylamide interactionGuggul Gum ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, guggul might reduce the effects of CYP3A4 substrates.
Read the full Guggul Gum Extract + Acetaminophen, Caffeine, Codeine, Salicylamide interactionTocotrienolsCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Tocotrienols + Acetaminophen, Caffeine, Codeine, Salicylamide interactionAcetaminophen, Caffeine, DihydrocodeineDHC Plus, Panlor DC, Panlor SS
How Acetaminophen, Caffeine, Dihydrocodeine interacts with Dr. Cutler's Ultimate Cholesterol Formula — through 3 ingredients. Tap an ingredient for the detail:
Guggul Gum ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, guggul might reduce the effects of CYP3A4 substrates.
Read the full Guggul Gum Extract + Acetaminophen, Caffeine, Dihydrocodeine interactionTocotrienolsCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Tocotrienols + Acetaminophen, Caffeine, Dihydrocodeine interactionNiacinHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Acetaminophen, Caffeine, Dihydrocodeine interactionAcetaminophen, Caffeine, IsomethepteneMigralam
How Acetaminophen, Caffeine, Isometheptene interacts with Dr. Cutler's Ultimate Cholesterol Formula — through 3 ingredients. Tap an ingredient for the detail:
NiacinHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Acetaminophen, Caffeine, Isometheptene interactionTocotrienolsCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Tocotrienols + Acetaminophen, Caffeine, Isometheptene interactionGuggul Gum ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, guggul might reduce the effects of CYP3A4 substrates.
Read the full Guggul Gum Extract + Acetaminophen, Caffeine, Isometheptene interactionAcetaminophen, Caffeine, PyrilamineMidol Max Strength Menstrual
How Acetaminophen, Caffeine, Pyrilamine interacts with Dr. Cutler's Ultimate Cholesterol Formula — through 3 ingredients. Tap an ingredient for the detail:
Guggul Gum ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, guggul might reduce the effects of CYP3A4 substrates.
Read the full Guggul Gum Extract + Acetaminophen, Caffeine, Pyrilamine interactionTocotrienolsCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Tocotrienols + Acetaminophen, Caffeine, Pyrilamine interactionNiacinHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Acetaminophen, Caffeine, Pyrilamine interactionAcetaminophen, Chlorpheniramine Maleate, Dextromethorphan HbrVicks Formula 44M Cough, Cold & Flu Relief
How Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interacts with Dr. Cutler's Ultimate Cholesterol Formula — through 3 ingredients. Tap an ingredient for the detail:
TocotrienolsCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Tocotrienols + Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interactionNiacinHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interactionGuggul Gum ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, guggul might reduce the effects of CYP3A4 substrates.
Read the full Guggul Gum Extract + Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interactionAcetaminophen, Chlorpheniramine, Codeine, PhenylephrineColrex
How Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interacts with Dr. Cutler's Ultimate Cholesterol Formula — through 3 ingredients. Tap an ingredient for the detail:
TocotrienolsCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Tocotrienols + Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interactionNiacinHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interactionGuggul Gum ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, guggul might reduce the effects of CYP3A4 substrates.
Read the full Guggul Gum Extract + Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interactionEach ingredient & the kinds of drugs it affects
For each ingredient in Dr. Cutler's Ultimate Cholesterol Formula 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.
Tocotrienols
Alkylating Agents
Theoretically, antioxidant effects of vitamin E might reduce the effectiveness of alkylating agents.
There's concern that antioxidants could reduce the activity of chemotherapy drugs which generate free radicals, such as cyclophosphamide, chlorambucil, carmustine, busulfan, and thiotepa. However, some researchers theorize that antioxidants might make chemotherapy more effective by reducing oxidative stress that might interfere with apoptosis (cell death) of cancer cells. More evidence is needed to determine what effect, if any, antioxidants such as vitamin E have on chemotherapy. Advise patients to consult their oncologist before using vitamin E supplements, especially in high doses.
Anticoagulant/Antiplatelet Drugs
Concomitant use of vitamin E and anticoagulant or antiplatelet agents might increase the risk of bleeding.
Vitamin E seems to inhibit of platelet aggregation and antagonize the effects of vitamin K-dependent clotting factors. These effects appear to be dose-dependent, and are probably only likely to be clinically significant with doses of at least 800 units daily. Mixed tocopherols, such as those found in food, might have a greater antiplatelet effect than alpha-tocopherol. RRR alpha-tocopherol (natural vitamin E) 1000 IU daily antagonizes vitamin K-dependent clotting factors. Advise patients to avoid high doses of vitamin E, especially in people with low vitamin K intake or other risk factors for bleeding.
Antitumor Antibiotics
Theoretically, antioxidant effects of vitamin E might reduce the effectiveness of antitumor antibiotics.
There's concern that antioxidants could reduce the activity of antitumor antibiotic drugs such as doxorubicin, which generate free radicals. However, some researchers theorize that antioxidants might make chemotherapy more effective by reducing oxidative stress that might interfere with apoptosis (cell death) of cancer cells. More evidence is needed to determine what effect, if any, antioxidants such as vitamin E have on chemotherapy involving antitumor antibiotics. Advise patients to consult their oncologist before using vitamin E supplements, especially in high doses.
Cyclosporine (Neoral, Sandimmune)
A specific form of vitamin E might increase absorption and levels of cyclosporine.
There is some evidence that one specific formulation of vitamin E (D-alpha-tocopheryl-polyethylene glycol-1000 succinate, TPGS, tocophersolan, Liqui-E) might increase absorption of cyclosporine. This vitamin E formulation forms micelles which seems to increase absorption of cyclosporine by 40% to 72% in some patients. However, this interaction is unlikely to occur with the usual forms of vitamin E.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Vitamin E appears to bind with the nuclear receptor, pregnane X receptor (PXR), which results in increased expression of CYP3A4. Although the clinical significance of this is not known, use caution when considering concomitant use of vitamin E and other drugs affected by these enzymes.
Selumetinib (Koselugo)
Taking selumetinib with vitamin E can result in a total daily dose of vitamin E that exceeds safe limits and therefore might increase the risk of bleeding.
Selumetinib contains 48-54 IU vitamin E per capsule. The increased risk of bleeding with vitamin E appears to be dose-dependent. Be cautious when using selumetinib in combination with supplemental vitamin E, especially in patients at higher risk of bleed, such as those with chronic conditions and those taking antiplatelet drugs.
Warfarin (Coumadin)
Using vitamin E with warfarin might increase the risk of bleeding.
Due to interference with production of vitamin K-dependent clotting factors, use of more than 400 IU of vitamin E daily with warfarin might increase prothrombin time (PT), INR, and the risk of bleeding,. At a dose of 1000 IU per day, vitamin E can antagonize vitamin K-dependent clotting factors even in people not taking warfarin. Limited clinical evidence suggests that doses up to 1200 IU daily may be used safely by patients taking warfarin, but this may not be applicable in all patient populations.
Niacin
Vitamin E might decrease the beneficial effects of niacin on high-density lipoprotein (HDL) cholesterol levels.
A combination of niacin and simvastatin (Zocor) effectively raises high-density lipoprotein (HDL) cholesterol levels in people with coronary disease and low HDL levels. Clinical research shows that taking a combination of antioxidants (vitamin C, vitamin E, beta-carotene, and selenium) along with niacin and simvastatin (Zocor) attenuates this rise in HDL, specifically the HDL-2 and apolipoprotein A1 fractions, by more than 50%. Vitamin E alone combined with a statin does not seem to decrease HDL levels. It is not known whether the adverse effect on HDL is due to one of the other antioxidants or to the combination. It also is not known whether it will occur in other patient populations.
Guggul gum extract
Anticoagulant/Antiplatelet Drugs
Theoretically, guggul might increase the risk of bleeding when taken with anticoagulant/antiplatelet drugs.
In vitro research and preliminary clinical studies suggest that guggul might have antiplatelet and anticoagulant effects.
Contraceptive Drugs
Theoretically, guggul might increase the risk of adverse effects when taken with contraceptive drugs.
In vitro research shows that guggul has estrogen-alpha receptor agonist activity.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, guggul might reduce the effects of CYP3A4 substrates.
In vitro research shows that guggul constituents known as guggulsterones can induce CYP3A4.
Diltiazem (Cardizem, Others)
Guggul might reduce the effects of diltiazem.
A small pharmacokinetic study shows that concomitant use of guggul with diltiazem reduces the bioavailability of diltiazem.
Estrogens
Theoretically, guggul might increase the risk of adverse effects when taken with estrogens.
In vitro research shows that guggul constituents known as guggulsterones have estrogen-alpha receptor agonist activity.
Propranolol (Inderal)
Guggul might reduce the effects of propranolol.
A small pharmacokinetic study shows that concomitant use of guggul with propranolol reduces the bioavailability of propranolol.
Rosuvastatin (Crestor)
Theoretically, guggul might increase the effects and adverse effects of rosuvastatin.
Animal research shows that guggul increases the bioavailability and hypolipidemic effects of rosuvastatin. The mechanism of this interaction is unclear.
Tamoxifen (Nolvadex)
Theoretically, guggul might interfere with tamoxifen therapy.
In vitro research shows that guggul has estrogen-alpha receptor agonist activity.
Thyroid Hormone
Theoretically, guggul might increase the risk for adverse effects when taken with thyroid hormone therapy.
Animal research suggests that guggul has thyroid-stimulating effects.
Niacin
Alcohol (Ethanol)
Concomitant use of alcohol and niacin might increase the risk of flushing and hepatotoxicity.
Alcohol can exacerbate the flushing and pruritus associated with niacin. Large doses of niacin might also exacerbate liver dysfunction associated with chronic alcohol use. A case report describes delirium and lactic acidosis in a patient taking niacin 3 grams daily who ingested 1 liter of wine. Advise patients to avoid large amounts of alcohol while taking niacin.
Allopurinol (Zyloprim)
Theoretically, niacin might antagonize the therapeutic effects of uricosurics such as allopurinol.
Large doses of niacin can reduce urinary excretion of uric acid, potentially resulting in hyperuricemia. Doses of uricosurics such as allopurinol might need to be increased to maintain control of gout in patients who start taking niacin. People who have frequent attacks of gout despite uricosuric therapy should avoid niacin.
Anticoagulant/Antiplatelet Drugs
Theoretically, niacin may have additive effects when used with anticoagulant or antiplatelet drugs.
Several cases of clotting factor synthesis deficiency and coagulopathy have been reported in patients taking sustained-release niacin. Also, thrombocytopenia has been reported in patients treated with niacin or niacin plus lovastatin.
Antidiabetes Drugs
Niacin can increase blood glucose levels and may diminish the effects of antidiabetes drugs.
Niacin impairs glucose tolerance in a dose-dependent manner, probably by causing or aggravating insulin resistance and increasing hepatic production of glucose. In diabetes patients, niacin 4.5 grams daily for 5 weeks can increase plasma glucose by an average of 16% and glycated hemoglobin (HbA1c) by 21%. However, lower doses of 1.5 grams daily or less appear to have minimal effects on blood glucose. In some patients, glucose levels increase when niacin is started, but then return to baseline when a stable dose is reached. Up to 35% of patients with diabetes may need adjustments in hypoglycemic therapy when niacin is added.
Antihypertensive Drugs
Theoretically, niacin may increase the risk of hypotension when used with antihypertensive drugs.
The vasodilating effects of niacin can cause hypotension. Furthermore, some clinical evidence suggests that a one-hour infusion of niacin can reduce systolic, diastolic, and mean blood pressure in hypertensive patients. This effect is not observed in normotensive patients.
Bile Acid Sequestrants
Bile acid sequestrants can bind niacin and decrease absorption. Separate administration by 4-6 hours to avoid an interaction.
In vitro studies show that colestipol (Colestid) binds about 98% of available niacin and cholestyramine (Questran) binds 10% to 30%.
Gemfibrozil (Lopid)
Theoretically, concomitant use of niacin and gemfibrozil might increase the risk of myopathy in some patients.
A case of myopathy from concomitant use of niacin and gemfibrozil has been reported. Niacin alone has also been associated with cases of myopathy. Using gemfibrozil with niacin might further increase the risk of developing myopathy.
Hepatotoxic Drugs
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Niacin has been associated with cases of liver toxicity, especially when used in pharmacologic doses. Sustained-release niacin preparations appear to be associated with a higher risk of hepatotoxicity than immediate-release niacin.
Hmg-Coa Reductase Inhibitors ("Statins")
Theoretically, concomitant use of niacin and statins might increase the risk of myopathy and rhabdomyolysis in some patients.
Some case reports have raised concerns that niacin might increase the risk of myopathy and rhabdomyolysis when combined with statins. However, a significantly increased risk of myopathy has not been demonstrated in clinical trials, including those using an FDA-approved combination of lovastatin and niacin (Advicor).
Probenecid (Benemid)
Theoretically, niacin might antagonize the therapeutic effects of uricosurics such as probenecid.
Large doses of niacin reduce urinary excretion of uric acid, potentially causing hyperuricemia. Doses of uricosurics such as probenecid might need to be increased to maintain control of gout in patients who start taking niacin. People who have frequent attacks of gout despite uricosuric therapy should avoid niacin.
Sulfinpyrazone (Anturane)
Theoretically, niacin might antagonize the therapeutic effects of uricosurics such as sulfinpyrazone.
Large doses of niacin reduce urinary excretion of uric acid, potentially causing hyperuricemia. Doses of uricosurics such as sulfinpyrazone might need to be increased to maintain control of gout in patients who start taking niacin. People who have frequent attacks of gout despite uricosuric therapy should avoid niacin.
Thyroid Hormone
Theoretically, niacin might antagonize the therapeutic effects of thyroid hormones.
Clinical research and case reports suggests that taking niacin can reduce serum levels of thyroxine-binding globulin by up to 25% and moderately reduce levels of thyroxine (T4). Patients taking thyroid hormone for hypothyroidism might need dose adjustments when using niacin.
Transdermal Nicotine (Nicoderm)
Theoretically, concomitant use of niacin and transdermal nicotine might increase the risk of flushing and dizziness.
Niacin and nicotine can both cause flushing and dizziness.
Warfarin (Coumadin)
There is limited evidence that niacin may increase the anticoagulant effects of warfarin.
In a case report, a patient on warfarin developed an elevated international normalized ratio (INR) of 3.9 after taking niacin for two weeks. The patient's INR was previously stable, ranging between 2 and 3 in recent months, and no other medication changes were identified. The elevated INR returned to therapeutic range within 4 days following the discontinuation of niacin.
Aspirin
Large doses of aspirin might alter the clearance of niacin.
Aspirin is often used with niacin to reduce niacin-induced flushing. Doses of 80-975 mg aspirin have been used, but 325 mg appears to be optimal. Aspirin also seems to reduce the clearance of niacin by competing for glycine conjugation. Taking aspirin 1 gram seems to reduce niacin clearance by 45%. This is probably a dose-related effect and not clinically significant with the more common aspirin dose of 325 mg.
Policosanol
Anticoagulant/Antiplatelet Drugs
Theoretically, taking policosanol with other antiplatelet or anticoagulant drugs might increase the risk of bruising and bleeding.
Some clinical research shows that taking policosanol 10-50 mg daily for 7-15 days can inhibit platelet aggregation in healthy patients. Although, one clinical trial shows that taking policosanol 10 mg twice daily for 2 weeks prior to warfarin dosing does not affect warfarin pharmacokinetics or warfarin response. Furthermore, a study in patients undergoing percutaneous coronary intervention with a drug-eluting stent found that taking policosanol 40 mg plus clopidogrel and aspirin daily for 30 days modestly reduced the risk for minor bleeding events when compared with taking clopidogrel and aspirin alone. Until more is known, use with caution.
Antidiabetes Drugs
Theoretically, policosanol might have additive effects with antidiabetes drugs and increase the risk of hypoglycemia.
Clinical research shows that policosanol can lower blood glucose levels.
Beta-Blockers
Concomitant use of policosanol with beta-blockers can cause additive blood pressure-lowering effects.
Clinical research shows that policosanol 5 mg daily can have additive blood pressure-lowering effects in patients with hypertension who are taking beta-blockers. Also, animal research shows that policosanol can increase the blood-pressure lowering effects of propranolol.
Nitroprusside (Nitropress)
Theoretically, concomitant use of policosanol with nitroprusside might cause additive blood pressure-lowering effects.
Animal research shows that taking policosanol along with nitroprusside can increase the blood pressure-lowering effects of nitroprusside.
Propranolol (Inderal)
Animal research shows that taking policosanol along with propranolol can increase the blood pressure-lowering effects of propranolol.
Warfarin (Coumadin)
Theoretically, taking policosanol with warfarin might increase the risk of bruising and bleeding.
Some clinical research shows that taking policosanol 10-50 mg daily for 7-15 days can inhibit platelet aggregation in healthy patients. However, one clinical trial shows that taking policosanol 10 mg twice daily for 2 weeks prior to warfarin dosing does not affect warfarin pharmacokinetics or warfarin response.
Brand information
Manufacturer and brand details for Dr. Cutler's Ultimate Cholesterol Formula, from the product label.
True Health
See all True Health products- Name
- True Health(TM)
- Street Address
- P.O. Box 3703
- City
- Hueytown
- State
- AL
- ZipCode
- 35023
- Phone Number
- 1-800-746-4513
- Web Address
- www.TrueHealth.com
Dr. Cutler's Ultimate Cholesterol Formula by True Health: Common Questions
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Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
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Label information is sourced from the NIH Dietary Supplement Label Database and reflects the product version on file; always read your actual product label. This page is for education only and is not a substitute for professional medical advice. Confirm with your pharmacist or doctor before combining supplements and medications.
The Full Monographs Behind Dr. Cutler's Ultimate Cholesterol Formula’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Vitamin E
Interacts with 764 drugsVitamin E is an essential fat-soluble vitamin and antioxidant that most people get in adequate amounts from a normal diet. Supplements can help correct a true deficiency, but high-dose vitam...
Read the full Vitamin E monograph → Herb & supplement monographGuggul
Interacts with 757 drugsGuggul is a gum resin from the Commiphora wightii tree, long used in Ayurvedic medicine for cholesterol, joint, and skin problems. Modern studies are mixed and often low-quality, and it can...
Read the full Guggul monograph → Herb & supplement monographNiacin
Interacts with 727 drugsNiacin (vitamin B3) is an essential nutrient your body needs for energy and metabolism, and deficiency is uncommon in most developed countries. Prescription-strength niacin has been used to...
Read the full Niacin monograph → Herb & supplement monographPolicosanol
Interacts with 242 drugsPolicosanol is a mix of waxy alcohols (mostly octacosanol) made from sugar cane or other plant waxes, and it is often marketed as a natural way to lower cholesterol. Early studies from Cuba...
Read the full Policosanol monograph →Sources & How We Checked
Dr. Cutler's Ultimate Cholesterol Formula'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 166 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.
Vitamin E 64 references
- Kim JM, White RH. Effect of vitamin E on the anticoagulant response to warfarin. Am J Cardiol 1996;77:545-6. PubMed
- Corrigan JJ Jr. The effect of vitamin E on warfarin-induced vitamin K deficiency. Ann N Y Acad Sci 1982;393:361-8. PubMed
- Corrigan JJ Jr. Coagulation problems relating to vitamin E. Am J Pediatr Hematol Oncol 1979;1:169-73.
- Corrigan JJ Jr, Marcus FI. Coagulopathy associated with vitamin E ingestion. JAMA 1974;230:1300-1. DOI
- Labriola D, Livingston R. Possible interactions between dietary antioxidants and chemotherapy. Oncology 1999;13:1003-8.
- Chang T, Benet LZ, Hebert MF. The effect of water-soluble vitamin E on cyclosporine pharmacokinetics in healthy volunteers. Clin Pharmacol Ther 1996;59:297-303. PubMed
- Pan SH, Lopez RR Jr, Sher LS, et al. Enhanced oral cyclosporine absorption with water-soluble vitamin E early after liver transplantation. Pharmacother 1996;16:59-65. DOI
- Anon. Dietary supplementation with n-3 polyunsaturated fatty acids and vitamin E after myocardial infarction: results of the GISSI-Prevenzione trial. Gruppo Italiano per lo Studio della Soprawivenza nell'Infarto miocardico. Lancet 1999;354:447-55. DOI
- Chappell LC, Seed PT, Briley AL, et al. Effect of antioxidants on the occurrence of pre-eclampsia in women at increased risk: a randomised trial. Lancet 1999;354:810-6. DOI
- Yusuf S, Dagenais G, Pogue J, et al. Vitamin E supplementation and cardiovascular events in high-risk patients. The heart outcomes prevention evaluation study investigators. N Engl J Med 2000;342:154-60. PubMed
- Stephens NG, Parsons A, Schofield PM, et al. Randomised controlled trial of vitamin E in patients with coronary disease: Cambridge Heart Antioxidant Study. Lancet 1996;347:781-6.
- The Alpha-Tocopherol, Beta Carotene Cancer Prevention Study Group. The effect of vitamin E and beta carotene on the incidence of lung cancer and other cancers in male smokers. N Engl J Med 1994;330:1029-35. PubMed
- Takahashi O. Haemorrhagic toxicity of a large dose of alpha-, beta-, gamma- and delta-tocopherols, ubiquinone, beta-carotene, retinol acetate and L-ascorbic acid in the rat. Food Chem Toxicol 1995;33:121-8.
- Briggs GB, Freeman RK, Yaffe SJ. Drugs in Pregnancy and Lactation. 5th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 1998.
- Sano M, Ernesto C, Thomas RG, et al. A controlled trial of selegiline, alpha-tocopherol, or both as treatment for Alzheimer's disease. The Alzheimer's Disease Cooperative Study. N Engl J Med 1997;336:1216-22. PubMed
- Liede KE, Haukka JK, Saxen LM, Heinonen OP. Increased tendency towards gingival bleeding caused by joint effect of alpha-tocopherol supplementation and acetylsalicylic acid. Ann Med 1998;30:542-6.
- Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes for Vitamin C, Vitamin E, Selenium, and Carotenoids. Washington, DC: National Academy Press, 2000. Available at: http://www.nap.edu/books/0309069351/html/.
- Brown BG, Zhao XQ, Chait A, et al. Simvastatin and niacin, antioxidant vitamins, or the combination for the prevention of coronary disease. N Engl J Med 2001;345:1583-93. DOI
- Liu M, Wallmon A, Olsson-Mortlock C, et al. Mixed tocopherols inhibit platelet aggregation in humans: potential mechanisms. Am J Clin Nutr 2003;77:700-6. PubMed
- Sokol RJ, Johnson KE, Karrer FM, et al. Improvement of cyclosporin absorption in children after liver transplantation by means of water-soluble vitamin E. Lancet 1991;338:212-4.. PubMed
- Stein JH, Carlsson CM, Papcke-Benson K, et al. The effects of lipid-lowering and antioxidant vitamin therapies on flow-mediated vasodilation of the brachial artery in older adults with hypercholesterolemia. J Am Coll Cardiol 2001;38:1806-13.. PubMed
- Carlsson CM, Papcke-Benson K, Carnes M, et al. Health-related quality of life and long-term therapy with pravastatin and tocopherol (vitamin E) in older adults. Drugs Aging 2002;19:793-805. . PubMed
- Cheung MC, Zhao XQ, Chait A, et al. Antioxidant supplements block the response of HDL to simvastatin-niacin therapy in patients with coronary artery disease and low HDL. Arterioscler Thromb Vasc Biol 2001;21:1320-6. PubMed
- Schrogie JJ. Coagulopathy and fat-soluble vitamins (letter). JAMA 1975;232:19. DOI
- Celestini A, Pulcinelli FM, Pignatelli P, et al. Vitamin E potentiates the antiplatelet activity of aspirin in collagen-stimulated platelets. Haematologica 2002;87:420-6.
- Stampfer MJ, Jakubowski JA, Faigel D, et al. Vitamin E supplementation effect on human platelet function, arachidonic acid metabolism, and plasma prostacyclin levels. Am J Clin Nutr 1988;47:700-6. PubMed
- Jandak J, Steiner M, Richardson PD. Alpha-tocopherol, an effective inhibitor of platelet adhesion. Blood 1989;73:141-9. DOI
- Freedman JE, Farhat JH, Loscalzo J, Keaney JF. Alpha-tocopherol inhibits aggregation of human platelets by a protein kinase C-dependent mechanism. Circulation 1996;94:2434-40. PubMed
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