Dr. Cutler's Ultimate Gallbladder Support Ingredients & Drug Interactions
by True Health
What is this page for?
First and foremost: checking Dr. Cutler's Ultimate Gallbladder Support 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 Gallbladder Support is a dietary supplement by True Health with 11 active ingredients. Its ingredients are commonly taken for diabetic nerve pain (neuropathy), blood sugar support in diabetes, antioxidant support.Based on those ingredients, 1,305 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are Milk thistle leaf extract, organic Beet, organic Dandelion. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against Dr. Cutler's Ultimate Gallbladder Support by True Health
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HelloPharmacist Scorecard of Dr. Cutler's Ultimate Gallbladder Support 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 Gallbladder Support contains 11 active ingredients.
Alpha-lipoic acid is an antioxidant that may support blood sugar and cholesterol levels. Taurine is an amino acid with potential benefit for heart and liver health.
Inositol (a carbohydrate) may help with metabolic conditions. Vitamin C aids immune function and tissue repair.
Magnesium is a mineral critical for nerve and muscle function. Organic dandelion root and leaf have been used traditionally for digestive support.
Pancrelipase is an enzyme blend that aids fat digestion. Organic beet supplies nitrates and pigments.
Milk thistle seed extract contains silymarin, used traditionally for liver support. Phosphatidylcholine is a compound that supports cell membranes and may aid fat metabolism.
Betaine is a compound derived from beets that supports methylation and digestion. The product also contains inactive ingredients (L-leucine and hydroxypropylmethylcellulose) as capsule material and binders.
Does it work?
Not established
The evidence for this product's ingredients is mixed. Alpha-lipoic acid is possibly effective for diabetic nerve damage and high cholesterol.
Taurine may help with hepatitis and congestive heart failure but appears ineffective for weight loss. Inositol shows promise for polycystic ovary syndrome, metabolic syndrome, and preterm labor, but not for anxiety or depression.
Vitamin C is effective for vitamin C deficiency and possibly effective for anemia and exercise-related infections. Magnesium is effective for digestive upset and constipation.
For the remaining ingredients—dandelion, beet, milk thistle, and phosphatidylcholine—evidence ranges from possibly effective for specific conditions (milk thistle for type 2 diabetes, beet for athletic performance) to insufficient to rate. The product as a whole is not established to support gallbladder function; we hold no effectiveness data specifically for that claim.
How safe is it?
Well-documented data
Alpha-lipoic acid is generally well tolerated but can lower blood sugar; use only under medical guidance. Common side effects are headache, heartburn, nausea, and vomiting.
Safety in pregnancy and breastfeeding is not established—avoid during both unless directed by your doctor. Taurine is well tolerated short-term in healthy adults; long-term safety is less certain.
It is likely safe in pregnancy and breastfeeding. Inositol is generally well tolerated with mild digestive effects; it is possibly safe in pregnancy but only under medical supervision.
Vitamin C is safe at normal doses; very high doses can cause kidney stones, diarrhea, and other effects. Avoid high-dose supplements in pregnancy and breastfeeding.
Magnesium is generally safe at recommended amounts; avoid very high doses in pregnancy. Dandelion is well tolerated as food but less studied at supplement doses; avoid in pregnancy and use caution while breastfeeding.
Beet is safe as a food; concentrated supplements lack safety data. Milk thistle is well tolerated but should be avoided in pregnancy and used with caution while breastfeeding.
Phosphatidylcholine is generally well tolerated but high doses (over 30 grams daily) can cause digestive upset. No pregnancy safety data is on file for phosphatidylcholine or betaine.
Meds to double-check
Major interaction found
Before taking this product, check with your doctor or pharmacist if you take blood thinners or antiplatelet drugs (aspirin, clopidogrel, warfarin)—alpha-lipoic acid, vitamin C, dandelion, and beet may increase bleeding risk or reduce drug effect. If you take levodopa/carbidopa for Parkinson's disease, do not take this product without your doctor's approval—magnesium significantly reduces levodopa absorption.
Also check if you use diabetes medications, blood pressure drugs, heart medications (especially calcium channel blockers), lithium, chemotherapy, thyroid hormone, or certain antibiotics, as multiple ingredients in this product interact with these drug classes. No interactions are documented for the two ingredients we could not check (betaine and pancrelipase).
The bottom line
Scorecard at a glanceFully disclosed formula with no established evidence rating for its marketed use. Major medication interactions have been identified, and safety information is well characterized.
This product combines multiple herbs and nutrients traditionally used for digestive and liver support, but evidence for its specific gallbladder benefit is not established in our data. If you take any prescription medications—especially blood thinners, diabetes drugs, heart medications, chemotherapy, thyroid hormone, antibiotics, or lithium—you need to check with your doctor or pharmacist before starting this product, as several ingredients carry documented interactions.
Pregnant or breastfeeding individuals should discuss this product with their healthcare provider before use.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 9 of 11 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 Gallbladder Support, 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 | 16771 |
| 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 Gallbladder Support by True Health, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Alpha Lipoic Acid | 10 mg | -- |
| Taurine | 150 mg | -- |
| Inositol | 25 mg | -- |
| Vitamin C | 60 mg | 100% |
| Betaine | 25 mg | -- |
| Magnesium | 25 mg | 6% |
| organic Dandelion | 300 mg | -- |
| Pancrelipase | 35 mg | -- |
| organic Beet | 100 mg | -- |
| Milk thistle leaf extract | 120 mg | -- |
| Phosphatidylcholine | 120 mg | -- |
Other ingredients: L-Leucine, Hydroxypropylmethylcellulose
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 Optimum Bile Flow & Healthy Digestion*
This product is manufactured in a NSF GMP registered facility.
Contains the World's Finest Ingredients.
Seals/Symbols
SCIENTIFICALLY FORMULATED DOCTOR APPROVED
MADE IN U.S.A.
FDA Statement of Identity
Dietary Supplement
Suggested/Recommended/Usage/Directions
Suggested Use: Take three capsules two times per day.
Precautions
Caution: If you are taking medication or have a medical condition, consult with your healthcare professional before taking this or any other dietary supplement.
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-TUGSC-A
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Dr. Cutler's Ultimate Gallbladder Support 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 Gallbladder Support by True Health
These are the 11 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.
Alpha Lipoic Acid
Interacts with263 drugs
Alpha-lipoic acid (ALA) is an antioxidant made naturally by the body and found in small amounts in foods. It is most studied for diabetic nerve pain,...
Alpha Lipoic Acid monograph & interactionsTaurine
Interacts with173 drugs
Taurine is an amino acid your body makes naturally and that you also get from animal foods. It is widely used in energy drinks and sports supplements,...
Taurine monograph & interactionsInositol
Interacts with86 drugs
Inositol is a sugar alcohol made naturally in the body and found in many foods, and it is sold as a supplement (often myo-inositol) mainly for PCOS, m...
Inositol monograph & interactionsVitamin C
Interacts with207 drugs
Vitamin C (ascorbic acid) is an essential nutrient your body needs but cannot make, so you must get it from food or supplements. It's important for im...
Vitamin C monograph & interactionsBetaine
Magnesium
Interacts with295 drugs
Magnesium is an essential mineral your body needs for muscles, nerves, blood pressure, and many other functions, and supplements are useful for preven...
Magnesium monograph & interactionsOrganic Dandelion
Interacts with457 drugs
Dandelion is a common plant used in food and traditional medicine, often promoted as a natural 'water pill' and digestive aid. Human evidence for thes...
Organic Dandelion monograph & interactionsPancrelipase
Organic Beet
Interacts with861 drugs
Beet, especially beetroot juice, is a nitrate-rich food that may modestly lower blood pressure and slightly improve exercise performance in some peopl...
Organic Beet monograph & interactionsMilk thistle leaf extract
Interacts with954 drugs
Milk thistle is a popular herbal supplement most often used for liver health, and its main active component is a group of compounds called silymarin....
Milk thistle leaf extract monograph & interactionsPhosphatidylcholine
No knowninteractions
Phosphatidylcholine is a phospholipid that is part of every cell membrane and a source of choline. People take it for liver, brain, and gut health, bu...
Phosphatidylcholine monograph & interactionsOther (inactive) ingredients: L-Leucine, Hydroxypropylmethylcellulose. These complete the product’s ingredient list but are not active constituents.
Dr. Cutler's Ultimate Gallbladder Support by True Health Drug Interactions
HelloPharmacist Interaction Report
Dr.
Cutler's Ultimate Gallbladder Support by True Health contains several ingredients with documented interactions: alpha-lipoic acid, taurine, inositol, vitamin C, magnesium, dandelion, beet, and milk thistle. The most serious interaction is magnesium with levodopa/carbidopa (a Major severity), which can reduce levodopa levels by up to 35%, potentially worsening Parkinson's symptoms.
Read the full breakdown — every affected drug type, severity by severity
Alpha-lipoic acid carries Moderate interactions with blood thinners and antiplatelet drugs—it may increase bleeding risk—as well as with chemotherapy drugs (alkylating agents and antitumor antibiotics), thyroid hormones, and diabetes medications. Taurine may lower blood pressure with blood pressure drugs or increase lithium levels.
Inositol and dandelion both interact with diabetes drugs, raising the risk of low blood sugar. Vitamin C at high doses can reduce warfarin effectiveness and interacts with oral contraceptives, chemotherapy, and several other medication classes.
Magnesium beyond its levodopa interaction also interacts with muscle relaxants, potassium-sparing water pills, heart drugs (calcium channel blockers), some antibiotics, diabetes drugs, and bone drugs. Dandelion may affect liver metabolism of multiple drugs, increase lithium levels, raise potassium to risky heights with potassium-sparing diuretics, and reduce antibiotic absorption.
Beet can theoretically affect levels of certain heart and other medications through enzyme inhibition. Milk thistle interacts with multiple drug classes including blood thinners, diabetes drugs, and hepatitis C antivirals.
Altogether, these interactions span 1,306 individual medications. We could not check betaine or pancrelipase; no interaction data is on file for them.
Use the medication checker below to see if any of your drugs are affected before you start this product.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against Dr. Cutler's Ultimate Gallbladder Support?
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 Gallbladder Support interact with 1,305 drugs. Click any drug to see the details.
8 of the 11 ingredients in Dr. Cutler's Ultimate Gallbladder Support interact with drugs. Each result below shows which ingredient is responsible. Milk thistle leaf extract organic Beet organic Dandelion Magnesium Alpha Lipoic Acid Vitamin C Taurine Inositol
Benserazide, LevodopaMadopar, Prolopa
How Benserazide, Levodopa interacts with Dr. Cutler's Ultimate Gallbladder Support — through 1 ingredient. Tap an ingredient for the detail:
MagnesiumLevodopa/carbidopa (sinemet) Major
Interaction Summary
Magnesium can reduce the bioavailability of levodopa/carbidopa.
Read the full Magnesium + Benserazide, Levodopa interactionCarbidopaLodosyn
How Carbidopa interacts with Dr. Cutler's Ultimate Gallbladder Support — through 1 ingredient. Tap an ingredient for the detail:
MagnesiumLevodopa/carbidopa (sinemet) Major
Interaction Summary
Magnesium can reduce the bioavailability of levodopa/carbidopa.
Read the full Magnesium + Carbidopa interactionCarbidopa, LevodopaDhivy, Rytary, Sinemet, Sinemet CR
How Carbidopa, Levodopa interacts with Dr. Cutler's Ultimate Gallbladder Support — through 1 ingredient. Tap an ingredient for the detail:
MagnesiumLevodopa/carbidopa (sinemet) Major
Interaction Summary
Magnesium can reduce the bioavailability of levodopa/carbidopa.
Read the full Magnesium + Carbidopa, Levodopa interactionCarbidopa, Levodopa, EntacaponeStalevo
How Carbidopa, Levodopa, Entacapone interacts with Dr. Cutler's Ultimate Gallbladder Support — through 3 ingredients. Tap an ingredient for the detail:
MagnesiumLevodopa/carbidopa (sinemet) Major
Interaction Summary
Magnesium can reduce the bioavailability of levodopa/carbidopa.
Read the full Magnesium + Carbidopa, Levodopa, Entacapone interactionMilk Thistle Leaf ExtractGlucuronidated Drugs Moderate
Interaction Summary
Theoretically, milk thistle might affect the clearance of drugs that undergo glucuronidation.
Read the full Milk Thistle Leaf Extract + Carbidopa, Levodopa, Entacapone interactionOrganic DandelionGlucuronidated Drugs Moderate
Interaction Summary
Theoretically, dandelion might increase the clearance of drugs that are UDP-glucuronosyltransferase substrates.
Read the full Organic Dandelion + Carbidopa, Levodopa, Entacapone interactionLevodopaInbrija, Larodopa
How Levodopa interacts with Dr. Cutler's Ultimate Gallbladder Support — through 1 ingredient. Tap an ingredient for the detail:
MagnesiumLevodopa/carbidopa (sinemet) Major
Interaction Summary
Magnesium can reduce the bioavailability of levodopa/carbidopa.
Read the full Magnesium + Levodopa interactionLevodopa, CarbidopaDuodopa
How Levodopa, Carbidopa interacts with Dr. Cutler's Ultimate Gallbladder Support — through 1 ingredient. Tap an ingredient for the detail:
MagnesiumLevodopa/carbidopa (sinemet) Major
Interaction Summary
Magnesium can reduce the bioavailability of levodopa/carbidopa.
Read the full Magnesium + Levodopa, Carbidopa interactionAdo-trastuzumab EmtansineKadcyla
How Ado-trastuzumab Emtansine interacts with Dr. Cutler's Ultimate Gallbladder Support — through 2 ingredients. Tap an ingredient for the detail:
Organic BeetCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, beet might increase the levels of CYP3A4 substrates.
Read the full Organic Beet + Ado-trastuzumab Emtansine interactionMilk Thistle Leaf ExtractCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
It is unclear if milk thistle inhibits CYP3A4; research is conflicting.
Read the full Milk Thistle Leaf Extract + Ado-trastuzumab Emtansine interactionAbciximabReoPro
How Abciximab interacts with Dr. Cutler's Ultimate Gallbladder Support — through 3 ingredients. Tap an ingredient for the detail:
Alpha Lipoic AcidAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, alpha-lipoic acid may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Alpha Lipoic Acid + Abciximab interactionOrganic DandelionAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, taking dandelion root along with anticoagulant or antiplatelet drugs might increase the risk of bruising and bleeding.
Read the full Organic Dandelion + Abciximab interactionMagnesiumAnticoagulant/antiplatelet Drugs Minor
Interaction Summary
Theoretically, magnesium may have antiplatelet effects, but the evidence is conflicting.
Read the full Magnesium + Abciximab interactionAbemaciclibVerzenio
How Abemaciclib interacts with Dr. Cutler's Ultimate Gallbladder Support — through 2 ingredients. Tap an ingredient for the detail:
Organic BeetCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, beet might increase the levels of CYP3A4 substrates.
Read the full Organic Beet + Abemaciclib interactionMilk Thistle Leaf ExtractCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
It is unclear if milk thistle inhibits CYP3A4; research is conflicting.
Read the full Milk Thistle Leaf Extract + Abemaciclib interactionAbiraterone
How Abiraterone interacts with Dr. Cutler's Ultimate Gallbladder Support — through 2 ingredients. Tap an ingredient for the detail:
Organic BeetCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, beet might increase the levels of CYP3A4 substrates.
Read the full Organic Beet + Abiraterone interactionMilk Thistle Leaf ExtractCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
It is unclear if milk thistle inhibits CYP3A4; research is conflicting.
Read the full Milk Thistle Leaf Extract + Abiraterone interactionAbiraterone AcetateYonsa, Zytiga
How Abiraterone Acetate interacts with Dr. Cutler's Ultimate Gallbladder Support — through 2 ingredients. Tap an ingredient for the detail:
Organic BeetCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, beet might increase the levels of CYP3A4 substrates.
Read the full Organic Beet + Abiraterone Acetate interactionMilk Thistle Leaf ExtractCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
It is unclear if milk thistle inhibits CYP3A4; research is conflicting.
Read the full Milk Thistle Leaf Extract + Abiraterone Acetate interactionAbrocitinibCibinqo
How Abrocitinib interacts with Dr. Cutler's Ultimate Gallbladder Support — through 4 ingredients. Tap an ingredient for the detail:
Alpha Lipoic AcidAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, alpha-lipoic acid may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Alpha Lipoic Acid + Abrocitinib interactionOrganic DandelionAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, taking dandelion root along with anticoagulant or antiplatelet drugs might increase the risk of bruising and bleeding.
Read the full Organic Dandelion + Abrocitinib interactionMilk Thistle Leaf ExtractCytochrome P450 2c9 (cyp2c9) Substrates Minor
Interaction Summary
It is unclear if milk thistle inhibits CYP2C9; research is conflicting.
Read the full Milk Thistle Leaf Extract + Abrocitinib interactionMagnesiumAnticoagulant/antiplatelet Drugs Minor
Interaction Summary
Theoretically, magnesium may have antiplatelet effects, but the evidence is conflicting.
Read the full Magnesium + Abrocitinib interactionAcalabrutinibCalquence
How Acalabrutinib interacts with Dr. Cutler's Ultimate Gallbladder Support — through 2 ingredients. Tap an ingredient for the detail:
Organic BeetCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, beet might increase the levels of CYP3A4 substrates.
Read the full Organic Beet + Acalabrutinib interactionMilk Thistle Leaf ExtractCytochrome P450 3a4 (cyp3a4) Substrates, P-glycoprotein Substrates Minor
Interaction Summary
It is unclear if milk thistle inhibits CYP3A4; research is conflicting.
Read the full Milk Thistle Leaf Extract + Acalabrutinib interactionAcarboseGlucobay, Prandase, Precose
How Acarbose interacts with Dr. Cutler's Ultimate Gallbladder Support — through 4 ingredients. Tap an ingredient for the detail:
Organic DandelionAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, dandelion might increase the risk for hypoglycemia when used with antidiabetes drugs.
Read the full Organic Dandelion + Acarbose interactionMilk Thistle Leaf ExtractAntidiabetes Drugs Moderate
Interaction Summary
Taking milk thistle with antidiabetes drugs may increase the risk of hypoglycemia.
Read the full Milk Thistle Leaf Extract + Acarbose interactionInositolAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, taking inositol with antidiabetes drugs might increase the risk of hypoglycemia.
Read the full Inositol + Acarbose interactionAlpha Lipoic AcidAntidiabetes Drugs Minor
Interaction Summary
Theoretically, taking alpha-lipoic acid with antidiabetes drugs might increase the risk of hypoglycemia.
Read the full Alpha Lipoic Acid + Acarbose interactionAcebutololRhotral, Sectral
How Acebutolol interacts with Dr. Cutler's Ultimate Gallbladder Support — through 2 ingredients. Tap an ingredient for the detail:
TaurineAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, taurine might increase the risk of hypotension when taken with antihypertensive drugs.
Read the full Taurine + Acebutolol interactionOrganic BeetAntihypertensive Drugs Minor
Interaction Summary
Beet and beetroot contain nitrates, which can cause vasodilation, potentially leading to lower blood pressure.
Read the full Organic Beet + Acebutolol interactionAcenocoumarolSintrom
How Acenocoumarol interacts with Dr. Cutler's Ultimate Gallbladder Support — through 3 ingredients. Tap an ingredient for the detail:
Alpha Lipoic AcidAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, alpha-lipoic acid may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Alpha Lipoic Acid + Acenocoumarol interactionOrganic DandelionAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, taking dandelion root along with anticoagulant or antiplatelet drugs might increase the risk of bruising and bleeding.
Read the full Organic Dandelion + Acenocoumarol interactionMagnesiumAnticoagulant/antiplatelet Drugs Minor
Interaction Summary
Theoretically, magnesium may have antiplatelet effects, but the evidence is conflicting.
Read the full Magnesium + Acenocoumarol interactionAcetaminophenChildren's Tylenol, Children's Tylenol Meltaways, Tylenol, Tylenol Ex Strength
How Acetaminophen interacts with Dr. Cutler's Ultimate Gallbladder Support — through 4 ingredients. Tap an ingredient for the detail:
Organic DandelionGlucuronidated Drugs, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, dandelion might increase the clearance of drugs that are UDP-glucuronosyltransferase substrates.
Read the full Organic Dandelion + Acetaminophen interactionMilk Thistle Leaf ExtractGlucuronidated Drugs Moderate
Interaction Summary
Theoretically, milk thistle might affect the clearance of drugs that undergo glucuronidation.
Read the full Milk Thistle Leaf Extract + Acetaminophen interactionOrganic BeetCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, beet might decrease the levels and clinical effects of CYP1A2 substrates.
Read the full Organic Beet + Acetaminophen interactionVitamin CAcetaminophen (tylenol, Others) Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C + Acetaminophen interactionAcetaminophen, AspirinGemnisyn
How Acetaminophen, Aspirin interacts with Dr. Cutler's Ultimate Gallbladder Support — through 6 ingredients. Tap an ingredient for the detail:
Alpha Lipoic AcidAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, alpha-lipoic acid may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Alpha Lipoic Acid + Acetaminophen, Aspirin interactionOrganic DandelionCytochrome P450 1a2 (cyp1a2) Substrates, Anticoagulant/antiplatelet Drugs +1 Moderate
Interaction Summary
Theoretically, dandelion might increase levels of drugs metabolized by CYP1A2.
Read the full Organic Dandelion + Acetaminophen, Aspirin interactionMilk Thistle Leaf ExtractGlucuronidated Drugs Moderate
Interaction Summary
Theoretically, milk thistle might affect the clearance of drugs that undergo glucuronidation.
Read the full Milk Thistle Leaf Extract + Acetaminophen, Aspirin interactionVitamin CAcetaminophen (tylenol, Others), Aspirin Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C + Acetaminophen, Aspirin interactionMagnesiumAnticoagulant/antiplatelet Drugs Minor
Interaction Summary
Theoretically, magnesium may have antiplatelet effects, but the evidence is conflicting.
Read the full Magnesium + Acetaminophen, Aspirin interactionOrganic BeetCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, beet might decrease the levels and clinical effects of CYP1A2 substrates.
Read the full Organic Beet + Acetaminophen, Aspirin interactionAcetaminophen, Aspirin, CaffeineExcedrin, Excedrin Extra Strength, Excedrin Migraine
How Acetaminophen, Aspirin, Caffeine interacts with Dr. Cutler's Ultimate Gallbladder Support — through 6 ingredients. Tap an ingredient for the detail:
Milk Thistle Leaf ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Glucuronidated Drugs Moderate
Interaction Summary
It is unclear if milk thistle inhibits CYP3A4; research is conflicting.
Read the full Milk Thistle Leaf Extract + Acetaminophen, Aspirin, Caffeine interactionOrganic DandelionGlucuronidated Drugs, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Moderate
Interaction Summary
Theoretically, dandelion might increase the clearance of drugs that are UDP-glucuronosyltransferase substrates.
Read the full Organic Dandelion + Acetaminophen, Aspirin, Caffeine interactionOrganic BeetCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, beet might increase the levels of CYP3A4 substrates.
Read the full Organic Beet + Acetaminophen, Aspirin, Caffeine interactionAlpha Lipoic AcidAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, alpha-lipoic acid may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Alpha Lipoic Acid + Acetaminophen, Aspirin, Caffeine interactionMagnesiumAnticoagulant/antiplatelet Drugs Minor
Interaction Summary
Theoretically, magnesium may have antiplatelet effects, but the evidence is conflicting.
Read the full Magnesium + Acetaminophen, Aspirin, Caffeine interactionVitamin CAcetaminophen (tylenol, Others), Aspirin Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C + Acetaminophen, Aspirin, Caffeine interactionAcetaminophen, Brompheniramine, PhenylpropanolamineDimetapp Cold and Flu
How Acetaminophen, Brompheniramine, Phenylpropanolamine interacts with Dr. Cutler's Ultimate Gallbladder Support — through 4 ingredients. Tap an ingredient for the detail:
Organic DandelionCytochrome P450 1a2 (cyp1a2) Substrates, Glucuronidated Drugs Moderate
Interaction Summary
Theoretically, dandelion might increase levels of drugs metabolized by CYP1A2.
Read the full Organic Dandelion + Acetaminophen, Brompheniramine, Phenylpropanolamine interactionMilk Thistle Leaf ExtractGlucuronidated Drugs Moderate
Interaction Summary
Theoretically, milk thistle might affect the clearance of drugs that undergo glucuronidation.
Read the full Milk Thistle Leaf Extract + Acetaminophen, Brompheniramine, Phenylpropanolamine interactionOrganic BeetCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, beet might decrease the levels and clinical effects of CYP1A2 substrates.
Read the full Organic Beet + Acetaminophen, Brompheniramine, Phenylpropanolamine interactionVitamin CAcetaminophen (tylenol, Others) Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C + Acetaminophen, Brompheniramine, Phenylpropanolamine interactionAcetaminophen, ButalbitalAxocet, Bancap, Bucet, Butex Forte, Esgic CF, Orbivan CF +5 more
How Acetaminophen, Butalbital interacts with Dr. Cutler's Ultimate Gallbladder Support — through 4 ingredients. Tap an ingredient for the detail:
Organic DandelionGlucuronidated Drugs, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, dandelion might increase the clearance of drugs that are UDP-glucuronosyltransferase substrates.
Read the full Organic Dandelion + Acetaminophen, Butalbital interactionMilk Thistle Leaf ExtractGlucuronidated Drugs Moderate
Interaction Summary
Theoretically, milk thistle might affect the clearance of drugs that undergo glucuronidation.
Read the full Milk Thistle Leaf Extract + Acetaminophen, Butalbital interactionVitamin CAcetaminophen (tylenol, Others) Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C + Acetaminophen, Butalbital interactionOrganic BeetCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, beet might decrease the levels and clinical effects of CYP1A2 substrates.
Read the full Organic Beet + Acetaminophen, Butalbital interactionAcetaminophen, Butalbital, CaffeineEsgic, Esgic Plus, Fiogesic, Fioricet, Repan, Tecnal +1 more
How Acetaminophen, Butalbital, Caffeine interacts with Dr. Cutler's Ultimate Gallbladder Support — through 4 ingredients. Tap an ingredient for the detail:
Milk Thistle Leaf ExtractGlucuronidated Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, milk thistle might affect the clearance of drugs that undergo glucuronidation.
Read the full Milk Thistle Leaf Extract + Acetaminophen, Butalbital, Caffeine interactionOrganic BeetCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, beet might decrease the levels and clinical effects of CYP1A2 substrates.
Read the full Organic Beet + Acetaminophen, Butalbital, Caffeine interactionOrganic DandelionCytochrome P450 1a2 (cyp1a2) Substrates, Glucuronidated Drugs Moderate
Interaction Summary
Theoretically, dandelion might increase levels of drugs metabolized by CYP1A2.
Read the full Organic Dandelion + Acetaminophen, Butalbital, Caffeine interactionVitamin CAcetaminophen (tylenol, Others) Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C + Acetaminophen, Butalbital, Caffeine interactionAcetaminophen, Butalbital, Caffeine, CodeineEsgic with Codeine, Fioricet w/ Codeine
How Acetaminophen, Butalbital, Caffeine, Codeine interacts with Dr. Cutler's Ultimate Gallbladder Support — through 4 ingredients. Tap an ingredient for the detail:
Organic BeetCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, beet might increase the levels of CYP3A4 substrates.
Read the full Organic Beet + Acetaminophen, Butalbital, Caffeine, Codeine interactionOrganic DandelionGlucuronidated Drugs, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, dandelion might increase the clearance of drugs that are UDP-glucuronosyltransferase substrates.
Read the full Organic Dandelion + Acetaminophen, Butalbital, Caffeine, Codeine interactionMilk Thistle Leaf ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Glucuronidated Drugs Moderate
Interaction Summary
It is unclear if milk thistle inhibits CYP3A4; research is conflicting.
Read the full Milk Thistle Leaf Extract + Acetaminophen, Butalbital, Caffeine, Codeine interactionVitamin CAcetaminophen (tylenol, Others) Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C + Acetaminophen, Butalbital, Caffeine, Codeine interactionAcetaminophen, Butalbital, CodeineBancap w/ Codeine
How Acetaminophen, Butalbital, Codeine interacts with Dr. Cutler's Ultimate Gallbladder Support — through 4 ingredients. Tap an ingredient for the detail:
Organic DandelionCytochrome P450 1a2 (cyp1a2) Substrates, Glucuronidated Drugs Moderate
Interaction Summary
Theoretically, dandelion might increase levels of drugs metabolized by CYP1A2.
Read the full Organic Dandelion + Acetaminophen, Butalbital, Codeine interactionMilk Thistle Leaf ExtractGlucuronidated Drugs Moderate
Interaction Summary
Theoretically, milk thistle might affect the clearance of drugs that undergo glucuronidation.
Read the full Milk Thistle Leaf Extract + Acetaminophen, Butalbital, Codeine interactionVitamin CAcetaminophen (tylenol, Others) Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C + Acetaminophen, Butalbital, Codeine interactionOrganic BeetCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, beet might decrease the levels and clinical effects of CYP1A2 substrates.
Read the full Organic Beet + Acetaminophen, Butalbital, Codeine interactionAcetaminophen, Butalbital, Codeine PhosphatePhrenilin #3
How Acetaminophen, Butalbital, Codeine Phosphate interacts with Dr. Cutler's Ultimate Gallbladder Support — through 4 ingredients. Tap an ingredient for the detail:
Milk Thistle Leaf ExtractGlucuronidated Drugs Moderate
Interaction Summary
Theoretically, milk thistle might affect the clearance of drugs that undergo glucuronidation.
Read the full Milk Thistle Leaf Extract + Acetaminophen, Butalbital, Codeine Phosphate interactionOrganic DandelionCytochrome P450 1a2 (cyp1a2) Substrates, Glucuronidated Drugs Moderate
Interaction Summary
Theoretically, dandelion might increase levels of drugs metabolized by CYP1A2.
Read the full Organic Dandelion + Acetaminophen, Butalbital, Codeine Phosphate interactionVitamin CAcetaminophen (tylenol, Others) Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C + Acetaminophen, Butalbital, Codeine Phosphate interactionOrganic BeetCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, beet might decrease the levels and clinical effects of CYP1A2 substrates.
Read the full Organic Beet + Acetaminophen, Butalbital, Codeine Phosphate interactionAcetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, PhenylephrineHycomine Compound
How Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interacts with Dr. Cutler's Ultimate Gallbladder Support — through 4 ingredients. Tap an ingredient for the detail:
Organic DandelionGlucuronidated Drugs, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, dandelion might increase the clearance of drugs that are UDP-glucuronosyltransferase substrates.
Read the full Organic Dandelion + Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interactionOrganic BeetCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, beet might decrease the levels and clinical effects of CYP1A2 substrates.
Read the full Organic Beet + Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interactionMilk Thistle Leaf ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Glucuronidated Drugs Moderate
Interaction Summary
It is unclear if milk thistle inhibits CYP3A4; research is conflicting.
Read the full Milk Thistle Leaf Extract + Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interactionVitamin CAcetaminophen (tylenol, Others) Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C + 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 Gallbladder Support — through 4 ingredients. Tap an ingredient for the detail:
Organic DandelionCytochrome P450 1a2 (cyp1a2) Substrates, Glucuronidated Drugs Moderate
Interaction Summary
Theoretically, dandelion might increase levels of drugs metabolized by CYP1A2.
Read the full Organic Dandelion + Acetaminophen, Caffeine, Codeine interactionOrganic BeetCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, beet might decrease the levels and clinical effects of CYP1A2 substrates.
Read the full Organic Beet + Acetaminophen, Caffeine, Codeine interactionMilk Thistle Leaf ExtractGlucuronidated Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, milk thistle might affect the clearance of drugs that undergo glucuronidation.
Read the full Milk Thistle Leaf Extract + Acetaminophen, Caffeine, Codeine interactionVitamin CAcetaminophen (tylenol, Others) Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C + 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 Gallbladder Support — through 4 ingredients. Tap an ingredient for the detail:
Milk Thistle Leaf ExtractGlucuronidated Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, milk thistle might affect the clearance of drugs that undergo glucuronidation.
Read the full Milk Thistle Leaf Extract + Acetaminophen, Caffeine, Codeine, Salicylamide interactionOrganic BeetCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, beet might increase the levels of CYP3A4 substrates.
Read the full Organic Beet + Acetaminophen, Caffeine, Codeine, Salicylamide interactionOrganic DandelionGlucuronidated Drugs, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, dandelion might increase the clearance of drugs that are UDP-glucuronosyltransferase substrates.
Read the full Organic Dandelion + Acetaminophen, Caffeine, Codeine, Salicylamide interactionVitamin CAcetaminophen (tylenol, Others) Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C + Acetaminophen, Caffeine, Codeine, Salicylamide interactionAcetaminophen, Caffeine, DihydrocodeineDHC Plus, Panlor DC, Panlor SS
How Acetaminophen, Caffeine, Dihydrocodeine interacts with Dr. Cutler's Ultimate Gallbladder Support — through 4 ingredients. Tap an ingredient for the detail:
Organic BeetCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, beet might increase the levels of CYP3A4 substrates.
Read the full Organic Beet + Acetaminophen, Caffeine, Dihydrocodeine interactionOrganic DandelionCytochrome P450 1a2 (cyp1a2) Substrates, Glucuronidated Drugs Moderate
Interaction Summary
Theoretically, dandelion might increase levels of drugs metabolized by CYP1A2.
Read the full Organic Dandelion + Acetaminophen, Caffeine, Dihydrocodeine interactionMilk Thistle Leaf ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Glucuronidated Drugs Moderate
Interaction Summary
It is unclear if milk thistle inhibits CYP3A4; research is conflicting.
Read the full Milk Thistle Leaf Extract + Acetaminophen, Caffeine, Dihydrocodeine interactionVitamin CAcetaminophen (tylenol, Others) Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C + Acetaminophen, Caffeine, Dihydrocodeine interactionAcetaminophen, Caffeine, IsomethepteneMigralam
How Acetaminophen, Caffeine, Isometheptene interacts with Dr. Cutler's Ultimate Gallbladder Support — through 4 ingredients. Tap an ingredient for the detail:
Organic BeetCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, beet might decrease the levels and clinical effects of CYP1A2 substrates.
Read the full Organic Beet + Acetaminophen, Caffeine, Isometheptene interactionOrganic DandelionGlucuronidated Drugs, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, dandelion might increase the clearance of drugs that are UDP-glucuronosyltransferase substrates.
Read the full Organic Dandelion + Acetaminophen, Caffeine, Isometheptene interactionMilk Thistle Leaf ExtractGlucuronidated Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, milk thistle might affect the clearance of drugs that undergo glucuronidation.
Read the full Milk Thistle Leaf Extract + Acetaminophen, Caffeine, Isometheptene interactionVitamin CAcetaminophen (tylenol, Others) Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C + Acetaminophen, Caffeine, Isometheptene interactionEach ingredient & the kinds of drugs it affects
For each ingredient in Dr. Cutler's Ultimate Gallbladder Support 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.
Milk thistle leaf extract
Antidiabetes Drugs
Taking milk thistle with antidiabetes drugs may increase the risk of hypoglycemia.
Clinical research shows that milk thistle extract, alone or along with tree turmeric extract, can lower blood glucose levels and glycated hemoglobin (HbA1c) in patients with type 2 diabetes, including those already taking antidiabetes drugs. Additionally, animal research shows that milk thistle extract increases the metformin maximum plasma concentration and area under the curve and decreases the renal clearance of metformin, due to inhibition of the multi-drug and toxin extrusion protein 1 (MATE1) renal tubular transport protein.
Cytochrome P450 2B6 (Cyp2B6) Substrates
Theoretically, milk thistle might inhibit CYP2B6.
An in vitro study shows that silybin, a constituent of milk thistle, binds to and noncompetitively inhibits CYP2B6. Additionally, silybin might downregulate the expression of CYP2B6 by decreasing mRNA and protein levels.
Glucuronidated Drugs
Theoretically, milk thistle might affect the clearance of drugs that undergo glucuronidation.
Laboratory research shows that milk thistle constituents inhibit uridine diphosphoglucuronosyl transferase (UGT), the major phase 2 enzyme that is responsible for glucuronidation. Theoretically, this could decrease the clearance and increase levels of glucuronidated drugs. Other laboratory research suggests that a milk thistle extract of silymarin might inhibit beta-glucuronidase, although the significance of this effect is unclear.
Ledipasvir
Theoretically, milk thistle might increase the levels and clinical effects of ledipasvir.
Animal research in rats shows that milk thistle increases the area under the curve (AUC) for ledipasvir and slows its elimination.
Morphine
Theoretically, concomitant use of milk thistle with morphine might affect serum levels of morphine and either increase or decrease its effects.
Animal research shows that milk thistle reduces serum levels of morphine by up to 66%. In contrast, laboratory research shows that milk thistle constituents inhibit uridine diphosphoglucuronosyl transferase (UGT), the major phase 2 enzyme that is responsible for glucuronidation. Theoretically, this could decrease the clearance and increase morphine levels. The effect of taking milk thistle on morphine metabolism in humans is not known.
Raloxifene (Evista)
Theoretically, milk thistle might decrease the clearance and increase levels of raloxifene.
Laboratory research suggests that the milk thistle constituents silibinin and silymarin inhibit the glucuronidation of raloxifene in the intestines.
Sirolimus (Rapamune)
Milk thistle might decrease the clearance of sirolimus.
Pharmacokinetic research shows that a milk thistle extract of silymarin decreases the apparent clearance of sirolimus in hepatically impaired renal transplant patients. It is unclear if this interaction occurs in patients without hepatic impairment.
Sofosbuvir (Solvaldi)
Theoretically, milk thistle might decrease the levels and clinical effects of sofosbuvir.
Animal research in rats shows that milk thistle reduces the metabolism of sofosbuvir, as well as the hepatic uptake of its active metabolite.
Tamoxifen (Nolvadex)
Theoretically, the milk thistle constituent silibinin might increase tamoxifen levels and interfere with its conversion to an active metabolite.
Animal research suggests that the milk thistle constituent silibinin might increase plasma levels of tamoxifen and alter its conversion to an active metabolite. The mechanism appears to involve inhibition of pre-systemic metabolism of tamoxifen by cytochrome P450 (CYP) 2C9 and CYP3A4, and inhibition of P-glycoprotein-mediated efflux of tamoxifen into the intestine for excretion. Whether this interaction occurs in humans is not known.
Warfarin (Coumadin)
Theoretically, milk thistle might increase the effects of warfarin.
In one case report, a man stabilized on warfarin experienced an increase in INR from 2.64 to 4.12 after taking a combination product containing milk thistle 200 mg daily, as well as dandelion, wild yam, niacinamide, and vitamin B12. Levels returned to normal after stopping the supplement. Although a direct correlation between milk thistle and the change in INR cannot be confirmed, some in vitro research suggests that milk thistle might inhibit cytochrome P450 2C9 (CYP2C9), an enzyme involved in the metabolism of various drugs, including warfarin.
Cytochrome P450 2C9 (Cyp2C9) Substrates
It is unclear if milk thistle inhibits CYP2C9; research is conflicting.
In vitro research suggests that milk thistle might inhibit CYP2C9. Additionally, 3 case reports from the World Health Organization (WHO) adverse drug reaction database describe increased toxicity in patients taking milk thistle and cancer medications that are CYP2C9 substrates, including imatinib and capecitabine. However, contradictory clinical research shows that milk thistle extract does not inhibit CYP2C9 or significantly affect levels of the CYP2C9 substrate tolbutamide. Differences in results could be due to differences in dosages or formulations utilized.
Cytochrome P450 3A4 (Cyp3A4) Substrates
It is unclear if milk thistle inhibits CYP3A4; research is conflicting.
While laboratory research shows conflicting results, pharmacokinetic research shows that taking milk thistle extract 420-1350 mg daily does not significantly affect the metabolism of the CYP3A4 substrates irinotecan, midazolam, or indinavir. However, 8 case reports from the World Health Organization (WHO) adverse drug reaction database describe increased toxicity in patients taking milk thistle and cancer medications that are CYP3A4 substrates, including gefitinib, sorafenib, doxorubicin, and vincristine.
Estrogens
Theoretically, milk thistle might interfere with estrogen therapy through competition for estrogen receptors.
Animal research suggests that a milk thistle extract of silymarin binds to estrogen receptor beta.
Hmg-Coa Reductase Inhibitors ("Statins")
Theoretically, milk thistle might interfere with statin therapy by decreasing the activity of organic anion transporting polypeptide 1B1 (OATB1B1) and inhibiting breast cancer resistance protein (BCRP).
Preliminary evidence suggests that a milk thistle extract of silymarin can decrease the activity of the OATP1B1, which transports HMG-CoA reductase inhibitors into the liver to their site of action, and animal research shows this increases the maximum plasma concentration of pitavastatin and pravastatin. The silibinin component also inhibits BCRP, which transports statins from the liver into the bile for excretion. However, in a preliminary study in healthy males, silymarin 140 mg three times daily had no effect on the pharmacokinetics of a single 10 mg dose of rosuvastatin.
Indinavir (Crixivan)
Theoretically, milk thistle may induce cytochrome P450 3A4 (CYP3A4) enzymes and increase the metabolism of indinavir; however, results are conflicting.
One pharmacokinetic study shows that taking milk thistle (Standardized Milk Thistle, General Nutrition Corp.) 175 mg three times daily in combination with multiple doses of indinavir 800 mg every 8 hours decreases the mean trough levels of indinavir by 25%. However, results from the same pharmacokinetic study show that milk thistle does not affect the overall exposure to indinavir. Furthermore, two other pharmacokinetic studies show that taking specific milk thistle extract (Legalon, Rottapharm Madaus; Thisilyn, Nature's Way) 160-450 mg every 8 hours in combination with multiple doses of indinavir 800 mg every 8 hours does not reduce levels of indinavir.
Organic Anion-Transporting Polypeptide Substrates (Oatp)
Milk thistle may inhibit one form of OATP, OATP-B1, which could reduce the bioavailability and clinical effects of OATP-B1 substrates.
In vitro research shows that milk thistle inhibits OATP-B1. Two case reports from the World Health Organization (WHO) adverse drug reaction database describe increased toxicity in patients taking milk thistle and cancer medications that are OATP substrates, including sorafenib and methotrexate. OATPs are expressed in the small intestine and liver and are responsible for the uptake of drugs and other compounds into the body. Inhibition of OATP may reduce the bioavailability of oral drugs that are substrates of OATP.
P-Glycoprotein Substrates
Theoretically, milk thistle might increase the absorption of P-glycoprotein substrates. However, this effect does not seem to be clinically significant.
In vitro research shows that milk thistle can inhibit P-glycoprotein activity and 1 case report from the World Health Organization (WHO) adverse drug reaction database describes increased abdominal pain in a patient taking milk thistle and the cancer medication vincristine, a P-glycoprotein substrate, though this patient was also taking methotrexate. However, a small pharmacokinetic study in healthy volunteers shows that taking milk thistle (Enzymatic Therapy Inc.) 900 mg, standardized to 80% silymarin, in 3 divided doses daily for 14 days does not affect absorption of digoxin, a P-glycoprotein substrate.
organic Beet
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, beet might increase the levels of CYP3A4 substrates.
In vitro research suggests that betanin, the major pigment in beet, competitively inhibits CYP3A4 in a dose-dependent manner similarly to strong CYP3A4 inhibitor ketoconazole.
Antihypertensive Drugs
Beet and beetroot contain nitrates, which can cause vasodilation, potentially leading to lower blood pressure. However, a study published in the European Journal of Clinical Nutrition using concentrated beetroot juice found no significant impact on blood pressure or heart rate in different age groups. Other small clinical studies suggest that while beet consumption might transiently lower blood pressure due to vessel dilation, there's no consistent evidence of a lasting effect. Overall, the theoretical risk of reduced blood pressure due to beet's nitrate content exists, but studies generally indicate a low and temporary impact rather than a sustained decrease.
Cytochrome P450 1A2 (Cyp1A2) Substrates
Theoretically, beet might decrease the levels and clinical effects of CYP1A2 substrates.
In vitro research suggests that beet induces CYP1A2 enzymes.
organic Dandelion
Anticoagulant/Antiplatelet Drugs
Theoretically, taking dandelion root along with anticoagulant or antiplatelet drugs might increase the risk of bruising and bleeding.
In vitro research suggests that dandelion root inhibits platelet aggregation.
Antidiabetes Drugs
Theoretically, dandelion might increase the risk for hypoglycemia when used with antidiabetes drugs.
Laboratory research suggests that dandelion extract may have moderate alpha-glucosidase inhibitor activity and might also increase insulin secretion. Also, in a case report, a 58-year-old woman with type 2 diabetes who was being treated with insulin developed hypoglycemia 2 weeks after beginning to eat salads containing dandelion.
Cytochrome P450 1A2 (Cyp1A2) Substrates
Theoretically, dandelion might increase levels of drugs metabolized by CYP1A2.
Laboratory research suggests that dandelion might inhibit CYP1A2. So far, this interaction has not been reported in humans. However, until more is known, watch for an increase in the levels of drugs metabolized by CYP1A2 in patients taking dandelion.
Glucuronidated Drugs
Theoretically, dandelion might increase the clearance of drugs that are UDP-glucuronosyltransferase substrates.
There is some preliminary evidence that dandelion might induce UDP-glucuronosyltransferase, a phase II enzyme.
Lithium
Theoretically, through diuretic effects, dandelion might reduce excretion and increase levels of lithium.
Animal research suggests that dandelion has diuretic properties. As diuretics can increase serum lithium levels, the dose of lithium might need to be decreased when taken with dandelion.
Potassium-Sparing Diuretics
Theoretically, dandelion might increase the risk of hyperkalemia when taken with potassium-sparing diuretics.
Dandelion contains significant amounts of potassium.
Quinolone Antibiotics
Theoretically, dandelion might lower fluoroquinolone levels.
Animal research shows that dandelion reduces absorption of ciprofloxacin and can lower levels by 73%. However, this effect has not been reported in humans.
Magnesium
Levodopa/Carbidopa (Sinemet)
Magnesium can reduce the bioavailability of levodopa/carbidopa.
Clinical research in healthy volunteers shows that taking magnesium oxide 1000 mg with levodopa 100 mg/carbidopa 10 mg reduces the area under the curve (AUC) of levodopa by 35% and of carbidopa by 81%. In vitro and animal research shows that magnesium produces an alkaline environment in the digestive tract, which might lead to degradation and reduced bioavailability of levodopa/carbidopa.
Aminoglycoside Antibiotics
Concomitant use of aminoglycoside antibiotics and magnesium can increase the risk for neuromuscular weakness.
Both aminoglycosides and magnesium reduce presynaptic acetylcholine release, which can lead to neuromuscular blockade and possible paralysis. This is most likely to occur with high doses of magnesium given intravenously.
Antacids
Use of acid reducers may reduce the laxative effect of magnesium oxide.
A retrospective analysis shows that, in the presence of H2 receptor antagonists (H2RAs) or proton pump inhibitors (PPIs), a higher dose of magnesium oxide is needed for a laxative effect. This may also occur with antacids. Under acidic conditions, magnesium oxide is converted to magnesium chloride and then to magnesium bicarbonate, which has an osmotic laxative effect. By reducing acidity, antacids may reduce the conversion of magnesium oxide to the active bicarbonate salt.
Bictegravir/Emtricitabine/Tenofovir Alafenamide (Biktarvy)
Magnesium might decrease levels of bictegravir/emtricitabine/tenofovir alafenamide by reducing its absorption.
Advise patients that bictegravir/emtricitabine/tenofovir alafenamide should be taken at least 2 hours before or 6 hours after magnesium containing products.
Bisphosphonates
Magnesium can decrease absorption of bisphosphonates.
Cations, including magnesium, can decrease bisphosphonate absorption. Advise patients to separate doses of magnesium and these drugs by at least 2 hours.
Calcium Channel Blockers
Magnesium can have additive effects with calcium channel blockers, although evidence is conflicting.
Magnesium inhibits calcium entry into smooth muscle cells and may therefore have additive effects with calcium channel blockers. Severe hypotension and neuromuscular blockades may occur when nifedipine is used with intravenous magnesium, although some contradictory evidence suggests that concurrent use of magnesium with nifedipine does not increase the risk of neuromuscular weakness. High doses of magnesium could theoretically have additive effects with other calcium channel blockers.
Digoxin
Magnesium salts may reduce absorption of digoxin.
Clinical evidence suggests that treatment with oral magnesium hydroxide or magnesium trisilicate reduces absorption of digoxin from the intestines. This may reduce the blood levels of digoxin and decrease its therapeutic effects.
Potassium-Sparing Diuretics
Potassium-sparing diuretics decrease excretion of magnesium, possibly increasing magnesium levels.
Potassium-sparing diuretics also have magnesium-sparing properties, which can counteract the magnesium losses associated with loop and thiazide diuretics. Theoretically, increased magnesium levels could result from concomitant use of potassium-sparing diuretics and magnesium supplements.
Quinolone Antibiotics
Magnesium decreases absorption of quinolones.
Magnesium can form insoluble complexes with quinolones and decrease their absorption. Advise patients to take these drugs at least 2 hours before, or 4 to 6 hours after, magnesium supplements.
Skeletal Muscle Relaxants
Parenteral magnesium alters the pharmacokinetics of skeletal muscle relaxants, increasing their effects and accelerating the onset of effect.
Parenteral magnesium shortens the time to onset of skeletal muscle relaxants by about 1 minute and prolongs the duration of action by about 2 minutes. Magnesium potentiates the effects of skeletal muscle relaxants by decreasing calcium-mediated release of acetylcholine from presynaptic nerve terminals, reducing postsynaptic sensitivity to acetylcholine, and having a direct effect on the membrane potential of myocytes. Magnesium also has vasodilatory actions and increases cardiac output, allowing a greater amount of muscle relaxant to reach the motor end plate. A clinical study found that low-dose rocuronium (0.45 mg/kg), when given after administration of magnesium 30 mg/kg over 10 minutes, has an accelerated onset of effect, which matches the onset of effect seen with a full-dose rocuronium regimen (0.6 mg/kg). In another clinical study, onset times for rocuronium doses of 0.3, 0.6, and 1.2 mg/kg were 86, 76, and 50 seconds, respectively, when given alone, but were reduced to 66, 44, and 38 seconds, respectively, when the doses were given after a 15-minute infusion of magnesium sulfate 60 mg/kg. Giving intraoperative intravenous magnesium sulfate, 50 mg/kg loading dose followed by 15 mg/kg/hour, reduces the onset time of rocuronium, enhances its clinical effects, reduces the dose of intraoperative opiates, and prolongs the spontaneous recovery time. It does not affect the activity of subsequently administered neostigmine.
Sulfonylureas
Magnesium increases the systemic absorption of sulfonylureas, increasing their effects and side effects.
Clinical research shows that administration of magnesium hydroxide with glyburide increases glyburide absorption, increases maximal insulin response by 35-fold, and increases the risk of hypoglycemia, when compared with glyburide alone. A similar interaction occurs between magnesium hydroxide and glipizide. The mechanism of this effect appears to be related to the elevation of gastrointestinal pH by magnesium-based antacids, increasing solubility and enhancing absorption of sulfonylureas.
Tetracycline Antibiotics
Magnesium decreases absorption of tetracyclines.
Magnesium can form insoluble complexes with tetracyclines in the gut and decrease their absorption and antibacterial activity. Advise patients to take these drugs 1 hour before or 2 hours after magnesium supplements.
Anticoagulant/Antiplatelet Drugs
Theoretically, magnesium may have antiplatelet effects, but the evidence is conflicting.
In vitro evidence shows that magnesium sulfate inhibits platelet aggregation, even at low concentrations. Some preliminary clinical evidence shows that infusion of magnesium sulfate increases bleeding time by 48% and reduces platelet activity. However, other clinical research shows that magnesium does not affect platelet aggregation, although inhibition of platelet-dependent thrombosis can occur.
Gabapentin (Neurontin)
Gabapentin absorption can be decreased by magnesium.
Clinical research shows that giving magnesium oxide orally along with gabapentin decreases the maximum plasma concentration of gabapentin by 33%, time to maximum concentration by 36%, and area under the curve by 43%. Advise patients to take gabapentin at least 2 hours before, or 4 to 6 hours after, magnesium supplements.
Sevelamer (Renagel, Renvela)
Sevelamer may increase serum magnesium levels.
In patients on hemodialysis, sevelamer use was associated with a 0.28 mg/dL increase in serum magnesium. The mechanism of this interaction remains unclear.
Alpha Lipoic Acid
Alkylating Agents
Theoretically, the antioxidant effects of alpha-lipoic acid might alter the effectiveness of alkylating agents.
The use of antioxidants like alpha-lipoic acid during chemotherapy is controversial. There are concerns that antioxidants could reduce the activity of chemotherapy drugs that 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 alpha-lipoic acid have on chemotherapy. Advise patients to consult their oncologist before using alpha-lipoic acid.
Anticoagulant/Antiplatelet Drugs
Theoretically, alpha-lipoic acid may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
In vitro, alpha-lipoic acid inhibits platelet aggregation.
Antitumor Antibiotics
Theoretically, the antioxidant effects of alpha-lipoic acid might alter the effectiveness of antitumor antibiotics.
The use of antioxidants like alpha-lipoic acid during chemotherapy is controversial. There are concerns that antioxidants could reduce the activity of antitumor antibiotic drugs, which work by generating 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 alpha-lipoic acid have on chemotherapy involving antitumor antibiotics. Advise patients to consult their oncologist before using alpha-lipoic acid.
Thyroid Hormone
Theoretically, alpha-lipoic acid might decrease the effects of thyroid hormone drugs.
Animal research suggests that co-administration of thyroxine with alpha-lipoic acid reduces conversion into the active T3 form.
Antidiabetes Drugs
Theoretically, taking alpha-lipoic acid with antidiabetes drugs might increase the risk of hypoglycemia.
Although some small clinical studies have suggested that alpha-lipoic acid can lower blood glucose levels, larger clinical studies in patients with diabetes have shown no clinically meaningful effect. Additionally, co-administration of single doses of alpha-lipoic acid and glyburide or acarbose did not cause detectable drug interactions in healthy volunteers.
Vitamin C
Alkylating Agents
Theoretically, antioxidant effects of vitamin C might reduce the effectiveness of alkylating agents.
The use of antioxidants like vitamin C during chemotherapy is controversial. There is concern that antioxidants could reduce the activity of chemotherapy drugs that generate free radicals, such as cyclophosphamide, chlorambucil, carmustine, busulfan, and thiotepa. In contrast, some researchers theorize that antioxidants might make chemotherapy more effective by reducing oxidative stress that could interfere with apoptosis (cell death) of cancer cells. More evidence is needed to determine what effect, if any, antioxidants such as vitamin C have on chemotherapy.
Aluminum
Vitamin C can increase the amount of aluminum absorbed from aluminum compounds.
Research in animals and humans shows that vitamin C increases aluminum absorption, theoretically by chelating aluminum and keeping it in solution where it is available for absorption. In people with normal renal function, urinary excretion of aluminum will likely increase, making aluminum retention and toxicity unlikely. Patients with renal failure who take aluminum-containing compounds such as phosphate binders should avoid vitamin C supplements in doses above the recommended dietary allowances.
Antitumor Antibiotics
Theoretically, the antioxidant effects of vitamin C might reduce the effectiveness of antitumor antibiotics.
The use of antioxidants like vitamin C during chemotherapy is controversial. There is concern that antioxidants could reduce the activity of chemotherapy drugs which generate free radicals, such as doxorubicin. In contrast, some researchers theorize that antioxidants might make chemotherapy more effective by reducing oxidative stress that could interfere with apoptosis (cell death) of cancer cells. More evidence is needed to determine what effects, if any, antioxidants such as vitamin C have on chemotherapy.
Estrogens
Vitamin C might increase blood levels of estrogens.
Increases in plasma estrogen levels of up to 55% occur under some circumstances when vitamin C is taken concurrently with oral contraceptives or hormone replacement therapy, including topical products. It is suggested that vitamin C prevents oxidation of estrogen in the tissues, regenerates oxidized estrogen, and reduces sulfate conjugation of estrogen in the gut wall. When tissue levels of vitamin C are high, these processes are already maximized and supplemental vitamin C does not have any effect on estrogen levels. Increases in plasma estrogen levels may occur when patients who are deficient in vitamin C take supplements. Monitor these patients for estrogen-related side effects.
Fluphenazine (Prolixin)
Theoretically, vitamin C might decrease levels of fluphenazine.
In one patient there was a clinically significant decrease in fluphenazine levels when vitamin C (500 mg twice daily) was started. The mechanism is not known, and there is no further data to confirm this interaction.
Indinavir (Crixivan)
Vitamin C can modestly reduce indinavir levels.
One pharmacokinetic study shows that taking vitamin C 1 gram orally once daily along with indinavir 800 mg orally three times daily reduces the area under the concentration-time curve of indinavir by 14%. The mechanism of this interaction is unknown, but it is unlikely to be clinically significant in most patients. The effect of higher doses of vitamin C on indinavir levels is unknown.
Levothyroxine (Synthroid, Others)
Vitamin C can increase levothyroxine absorption.
Two clinical studies in adults with poorly controlled hypothyroidism show that swallowing levothyroxine with a glass of water containing vitamin C 500-1000 mg in solution reduces thyroid stimulating hormone (TSH) levels and increases thyroxine (T4) levels when compared with taking levothyroxine alone. This suggests that vitamin C increases the oral absorption of levothyroxine, possibly due to a reduction in pH.
Warfarin (Coumadin)
High-dose vitamin C might reduce the levels and effectiveness of warfarin.
Vitamin C in high doses may cause diarrhea and possibly reduce warfarin absorption. There are reports of two people who took up to 16 grams daily of vitamin C and had a reduction in prothrombin time. Lower doses of 5-10 grams daily can also reduce warfarin absorption. In many cases, this does not seem to be clinically significant. However, a case of warfarin resistance has been reported for a patient who took vitamin C 500 mg twice daily. Cessation of vitamin C supplementation resulted in a rapid increase in international normalized ratio (INR). Tell patients taking warfarin to avoid taking vitamin C in excessively high doses (greater than 10 grams daily). Lower doses may be safe, but the anticoagulation activity of warfarin should be monitored. Patients who are stabilized on warfarin while taking vitamin C should avoid adjusting vitamin C dosage to prevent the possibility of warfarin resistance.
Acetaminophen (Tylenol, Others)
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
A small pharmacokinetic study in healthy volunteers shows that taking high-dose vitamin C (3 grams) 1.5 hours after taking acetaminophen 1 gram slightly increases the apparent half-life of acetaminophen from around 2.3 hours to 3.1 hours. Ascorbic acid competitively inhibits sulfate conjugation of acetaminophen. However, to compensate, elimination of acetaminophen glucuronide and unconjugated acetaminophen increases. This effect is not likely to be clinically significant.
Aspirin
Acidification of the urine by vitamin C might increase aspirin levels.
It has been suggested that acidification of the urine by vitamin C could increase reabsorption of salicylates by the renal tubules, and increase plasma salicylate levels. However, short-term use of up to 6 grams daily of vitamin C does not seem to affect urinary pH or salicylate excretion, suggesting this interaction is not clinically significant.
Choline Magnesium Trisalicylate (Trilisate)
Acidification of the urine by vitamin C might increase choline magnesium trisalicylate levels.
It has been suggested that acidification of the urine by vitamin C could increase reabsorption of salicylates by the renal tubules, and increase plasma salicylate levels. However, short-term use of up to 6 grams daily of vitamin C does not seem to affect urinary pH or salicylate excretion, suggesting this interaction probably is not clinically significant.
Niacin
Vitamin C might decrease the beneficial effects of niacin on high-density lipoprotein (HDL) cholesterol levels.
A combination of niacin and simvastatin (Zocor) effectively raises HDL cholesterol levels in patients 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% in patients with coronary disease. It is not known whether this adverse effect is due to a single antioxidant such as vitamin C, or to the combination. It also is not known whether it will occur in other patient populations.
Salsalate (Disalcid)
Acidification of the urine by vitamin C might increase salsalate levels.
It has been suggested that acidification of the urine by vitamin C could increase reabsorption of salicylates by the renal tubules, and increase plasma salicylate levels. However, short-term use of up to 6 grams/day vitamin C does not seem to affect urinary pH or salicylate excretion, suggesting this interaction probably is not clinically significant.
Taurine
Antihypertensive Drugs
Theoretically, taurine might increase the risk of hypotension when taken with antihypertensive drugs.
Some clinical evidence suggests that taurine can reduce both systolic and diastolic blood pressure.
Lithium
Theoretically, taurine might reduce excretion and increase plasma levels of lithium.
Taurine is thought to have diuretic properties, which might reduce the excretion of lithium.
Inositol
Antidiabetes Drugs
Theoretically, taking inositol with antidiabetes drugs might increase the risk of hypoglycemia.
Clinical research shows that inositol lowers blood glucose levels and glycated hemoglobin (HbA1c) levels in patients with diabetes.
Brand information
Manufacturer and brand details for Dr. Cutler's Ultimate Gallbladder Support, 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 Gallbladder Support 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 Gallbladder Support’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Alpha-lipoic Acid
Interacts with 263 drugsAlpha-lipoic acid (ALA) is an antioxidant made naturally by the body and found in small amounts in foods. It is most studied for diabetic nerve pain, where some evidence suggests it may help...
Read the full Alpha-lipoic Acid monograph → Herb & supplement monographTaurine
Interacts with 173 drugsTaurine is an amino acid your body makes naturally and that you also get from animal foods. It is widely used in energy drinks and sports supplements, and short-term use appears generally sa...
Read the full Taurine monograph → Herb & supplement monographInositol
Interacts with 86 drugsInositol is a sugar alcohol made naturally in the body and found in many foods, and it is sold as a supplement (often myo-inositol) mainly for PCOS, mood, and metabolic concerns. The stronge...
Read the full Inositol monograph → Herb & supplement monographVitamin C
Interacts with 207 drugsVitamin C (ascorbic acid) is an essential nutrient your body needs but cannot make, so you must get it from food or supplements. It's important for immune function, collagen, and acts as an...
Read the full Vitamin C monograph → Herb & supplement monographMagnesium
Interacts with 295 drugsMagnesium is an essential mineral your body needs for muscles, nerves, blood pressure, and many other functions, and supplements are useful for preventing or correcting deficiency. Some othe...
Read the full Magnesium monograph → Herb & supplement monographDandelion
Interacts with 457 drugsDandelion is a common plant used in food and traditional medicine, often promoted as a natural 'water pill' and digestive aid. Human evidence for these uses is very limited, so its benefits...
Read the full Dandelion monograph → Herb & supplement monographBeet
Interacts with 861 drugsBeet, especially beetroot juice, is a nitrate-rich food that may modestly lower blood pressure and slightly improve exercise performance in some people. It is generally safe as a food, but s...
Read the full Beet monograph → Herb & supplement monographMilk Thistle
Interacts with 954 drugsMilk thistle is a popular herbal supplement most often used for liver health, and its main active component is a group of compounds called silymarin. While it is generally well tolerated, th...
Read the full Milk Thistle monograph → Herb & supplement monographPhosphatidylcholine
Phosphatidylcholine is a phospholipid that is part of every cell membrane and a source of choline. People take it for liver, brain, and gut health, but solid human evidence is limited for mo...
Read the full Phosphatidylcholine monograph →Sources & How We Checked
Dr. Cutler's Ultimate Gallbladder Support'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 341 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.
Alpha-lipoic Acid 48 references
- Labriola D, Livingston R. Possible interactions between dietary antioxidants and chemotherapy. Oncology 1999;13:1003-8.
- Anon. Alpha-lipoic acid. Altern Med Rev 1998;3:308-10.
- Konrad T, Vicini P, Kusterer K, et al. Alpha-lipoic acid treatment decreases serum lactate and pyruvate concentrations and improves glucose effectiveness in lean and obese patients with Type 2 diabetes. Diabetes Care 1999;22:280-7. PubMed
- Ziegler D, Hanefeld M, Ruhnau KJ, et al. Treatment of symptomatic diabetic peripheral neuropathy with the antioxidant alpha-lipoic acid: A 3-week, multicentre randomized controlled trial (ALADIN Study). Diabetologia 1995;38:1425-33.
- Gleiter CH, Schreeb KH, Freudenthaler S, et al. Lack of interaction between thioctic acid, glibenclamide and acarbose. Br J Clin Pharmacol 1999;48:819-25. PubMed
- Jacob S, Henriksen EJ, Tritschler HJ, et al. Improvement of insulin-stimulated glucose-disposal in type 2 diabetes after repeated parenteral administration of thioctic acid. Exp Clin Endocrinol Diabet 1996;104:284-8. PubMed
- Jacob S, Henriksen EJ, Schiemann AL, et al. Enhancement of glucose disposal in patients with type 2 diabetes by alpha-lipoic acid. Arzneimittelforschung 1995;45:872-4.
- Jacob S, Ruus P, Hermann R, et al. Oral administration of RAC-alpha-lipoic acid modulates insulin sensitivity in patients with type-2 diabetes mellitus: a placebo-controlled, pilot trial. Free Rad Biol Med 1999;27:309-14.
- Segermann J, Hotze A, Ulrich H, Rao GS. Effect of alpha-lipoic acid on the peripheral conversion of thyroxine to triiodothyronine and on serum lipid-, protein- and glucose levels. Arzneimittelforschung 1991;41:1294-8.
- Beitner H. Randomized, placebo controlled, double-blind study on the clinical efficacy of a cream containing 5% alpha-lipoic acid related to photoaging of facial skin. Br J Dermatol 2003;149:841-9.
- Ziegler D, Nowak H, Kempler P, et al. Treatment of symptomatic diabetic polyneuropathy with the antioxidant alpha-lipoic acid: A meta-analysis. Diabet Med 2004;21:114-21.
- Prasad KN. Rationale for using high-dose multiple dietary antioxidants as an adjunct to radiation therapy and chemotherapy. J Nutr 2004;134:3182S-3S. PubMed
- Conklin KA. Cancer chemotherapy and antioxidants. J Nutr 2004;134:3201S-3204S. PubMed
- Vincent HK, Bourguignon CM, Vincent KR, Taylor AG. Effects of alpha-lipoic acid supplementation in peripheral arterial disease: a pilot study. J Alt Complement Med 2007;13:577-84. PubMed
- Furukawa N, Miyamura N, Nishida K, et al. Possible relevance of alpha lipoic acid contained in a health supplement in a case of insulin autoimmune syndrome. Diabetes Res Clin Pract 2007;75:366-7. PubMed
- Ziegler D., Ametov A., Barinov A., Dyck P. J., Gurieva I., Low P. A., Munzel U., Yakhno N., Raz I., Novosadova M., Maus J., Samigullin, R. Oral treatment with alpha-lipoic acid improves symptomatic diabetic polyneuropathy: the SYDNEY 2 trial. Diabetes Car
- Gu X. M., Zhang S. S., Wu J. C., Tang Z. Y., Lu Z. Q., Li H., Liu C., Chen L., Ning, G. [Efficacy and safety of high-dose a-lipoic acid in the treatment of diabetic polyneuropathy]. Zhonghua Yi Xue Za Zhi 2010;90(35):2473-2476.
- Porasuphatana S., Suddee S., Nartnampong A., Konsil J., Harnwong B., Santaweesuk A. Glycemic and oxidative status of patients with type 2 diabetes mellitus following oral administration of alpha-lipoic acid: a randomized double-blinded placebo-controlled
- Ansar H., Mazloom Z., Kazemi F., Hejazi N. Effect of alpha-lipoic acid on blood glucose, insulin resistance and glutathione peroxidase of type 2 diabetic patients. Saudi Med J 2011;32(6):584-588. DOI
- de Oliveira A. M., Rondó P. H., Luzia L. A., D'Abronzo F. H., Illison V. K. The effects of lipoic acid and a-tocopherol supplementation on the lipid profile and insulin sensitivity of patients with type 2 diabetes mellitus: a randomized, double-blind, pla
- Mazloom Z., Ansar H. The Effect of Alpha-Lipoic Acid on Blood Pressure in Type 2 Diabetics. Iranian Journal of Endocrinology and Metabolism 2009;11(3):245-250.
- Volchegorskii I. A., Rassokhina L. M., Koliadich M. I., Alekseev M. I. [Comparative study of alpha-lipoic acid and mexidol effects on affective status, cognitive functions and quality of life in diabetes mellitus patients]. Eksp Klin Farmakol 2011;74(11):
- Cavalcanti D. R., da Silveira F. R. Alpha lipoic acid in burning mouth syndrome--a randomized double-blind placebo-controlled trial. J Oral Pathol Med 2009;38(3):254-261. PubMed
- Koh E. H., Lee W. J., Lee S. A., Kim E. H., Cho E. H., Jeong E., Kim D. W., Kim M. S., Park J. Y., Park K. G., Lee H. J., Lee I. K., Lim S., Jang H. C., Lee K. H., Lee K. U. Effects of alpha-lipoic Acid on body weight in obese subjects. Am J Med 2011;124( PubMed
- Bergqvist-Karlsson, A., Thelin, I., and Bergendorff, O. Contact dermatitis to alpha-lipoic acid in an anti-wrinkle cream. Contact Dermatitis 2006;55(1):56-57.
- Tang, J., Wingerchuk, D. M., Crum, B. A., Rubin, D. I., and Demaerschalk, B. M. Alpha-lipoic acid may improve symptomatic diabetic polyneuropathy. Neurologist. 2007;13(3):164-167. PubMed
- Hegazy SK, Tolba OA, Mostafa TM, Eid MA, El-Afify DR. Alpha-lipoic acid improves subclinical left ventricular dysfunction in asymptomatic patients with type 1 diabetes. Rev Diabet Stud 2013;10(1):58-67. PubMed
- Huang Z, Wan X, Liu J, et al. Short-term continuous subcutaneous insulin infusion combined with insulin sensitizers rosiglitazone, metformin, or antioxidant a-lipoic acid in patients with newly diagnosed type 2 diabetes mellitus. Diabetes Technol Ther 201
- Sarezky D, Raquib AR, Dunaief JL, Kim BJ. Tolerability in the elderly population of high-dose alpha lipoic acid: a potential antioxidant therapy for the eye. Clin Ophthalmol. 2016 Sep 29;10:1899-1903. PubMed
- Boriani F, Granchi D, Roatti G, Merlini L, Sabattini T, Baldini N. Alpha-lipoic acid after median nerve decompression at the carpal tunnel: a randomized controlled trial. J Hand Surg Am. 2017 Apr;42(4):236-42. PubMed
- Karkabounas S, Papadopoulos N, Anastasiadou C, et al. Effects of a-lipoic Acid, carnosine, and thiamine supplementation in obese patients with type 2 diabetes mellitus: A randomized, double-blind study. J Med Food. 2018;21(12):1197-1203.
- Murray GL, Colombo J. (r)Alpha lipoic acid is a safe, effective pharmacologic therapy of chronic orthostatic hypotension associated with low sympathetic tone. Int J Angiol. 2019;28(3):188-193. PubMed
- Bobe G, Michels AJ, Zhang WJ, et al. A randomized controlled trial of long-term (R)-α-lipoic acid supplementation promotes weight loss in overweight or obese adults without altering baseline elevated plasma triglyceride concentrations. J Nutr. 2020:
- Passiatore M, Perna A, De-Vitis R, Taccardo G. The use of alfa-lipoic acid-R (ALA-R) in patients with mild-moderate carpal tunnel syndrome: A randomised controlled open label prospective study. Malays Orthop J. 2020;14(1):1-6. PubMed
- El-Nahas MR, Elkannishy G, Abdelhafez H, Elkhamisy ET, El-Sehrawy AA. Oral alpha lipoic acid treatment for symptomatic diabetic peripheral neuropathy: A randomized double-blinded placebo-controlled study. Endocr Metab Immune Disord Drug Targets. 2020. PubMed
- Kim BJ, Hunter A, Brucker AJ, et al. Orally administered alpha lipoic acid as a treatment for geographic atrophy: A randomized clinical trial. Ophthalmol Retina. 2020;4(9):889-898. PubMed
- Derosa G, D'Angelo A, Preti P, Maffioli P. Safety and efficacy of alpha lipoic acid during 4 years of observation: A retrospective, clinical trial in healthy subjects in primary prevention. Drug Des Devel Ther. 2020;14:5367-5374.
- Sun Y, Guan X, Wang H, et al. Randomized clinical trial of combined therapy with oral a-lipoic acid and NB-UVB for nonsegmental stable vitiligo. Dermatol Ther. 2021;34(1):e14610.
- Gilron I, Robb S, Tu D, et al. Double-blind, randomized, placebo-controlled crossover trial of alpha-lipoic acid for the treatment of fibromyalgia pain: the IMPALA trial. Pain. 2021;162(2):561-568. PubMed
- Gullo D, Evans JL, Sortino G, Goldfine ID, Vigneri R. Insulin autoimmune syndrome (Hirata Disease) in European Caucasians taking a-lipoic acid. Clin Endocrinol (Oxf). 2014;81(2):204-9.
- Yukina M, Nuralieva N, Solovyev M, Troshina E, Vasilyev E. Insulin autoimmune syndrome. Endocrinol Diabetes Metab Case Rep. 2020;2020:19-0159. PubMed
- Moffa S, Improta I, Rocchetti S, Mezza T, Giaccari A. Potential cause-effect relationship between insulin autoimmune syndrome and alpha lipoic acid: Two case reports. Nutrition. 2019;57:1-4. PubMed
- Izzo V, Greco C, Corradini D, et al. Insulin autoimmune syndrome in an Argentine woman taking a-lipoic acid: A case report and review of the literature. SAGE Open Med Case Rep. 2018;6:2050313X18819601.
- EFSA Panel on Nutrition, Novel Foods and Food Allergens (NDA), Turck D, et al. Scientific opinion on the relationship between intake of alpha-lipoic acid (thioctic acid) and the risk of insulin autoimmune syndrome. EFSA J 2021;19(6):e06577. PubMed
- Jibril AT, Jayedi A, Shab-Bidar S. Efficacy and safety of oral alpha-lipoic acid supplementation for type 2 diabetes management: a systematic review and dose-response meta-analysis of randomized trials. Endocr Connect 2022;11(10):e220322. PubMed
- Corazza M, Arlotti E, Schettini N, Pacetti L, Bianchi A, Borghi A. Allergic contact dermatitis due to a-lipoic acid in a topical over-the-counter product: A case report. Contact Dermatitis 2023.
- Velasco-Amador JP, Prados-Carmona Á, Navarro-Triviño FJ. Contact urticaria syndrome caused by alpha-lipoic acid in a master formula for vulvar lichen sclerosus. Contact Dermatitis 2023;89(2):136-137. PubMed
- Sehgal T, Ohri U, Mittal N, Attri P, Dishant F. A Case of Insulin Autoimmune Syndrome in an Indian Male Taking Alpha-Lipoic Acid. Cureus 2023;15(8):e43743. PubMed
Taurine 21 references
- Ahmad S, Robertson HT, Golper TA, et al. Multicenter trial of L-carnitine in maintenance hemodialysis patients. II. Clinical and biochemical effects. Kidney Int 1990;38:912-8. PubMed
- Machado-Vieira R, Viale CI, Kapczinski F. Mania associated with an energy drink: the possible role of caffeine, taurine, and inositol. Can J Psychiatry 2001;46:454-5. PubMed
- Obermann M, Schorn CF, Mummel P, et al. Taurine induced toxic encephalopathy? Clin Neurol Neurosurg 2006;108:812-3. PubMed
- Bichler, A., Swenson, A., and Harris, M. A. A combination of caffeine and taurine has no effect on short term memory but induces changes in heart rate and mean arterial blood pressure. Amino Acids 2006;31(4):471-476. PubMed
- Iyadurai, S. J. and Chung, S. S. New-onset seizures in adults: possible association with consumption of popular energy drinks. Epilepsy Behav 2007;10(3):504-508. PubMed
- Berger, A. J. and Alford, K. Cardiac arrest in a young man following excess consumption of caffeinated "energy drinks". Med J Aust. 1-5-2009;190(1):41-43. PubMed
- Worthley, M. I., Prabhu, A., De, Sciscio P., Schultz, C., Sanders, P., and Willoughby, S. R. Detrimental effects of energy drink consumption on platelet and endothelial function. Am J Med 2010;123(2):184-187. PubMed
- Morchon, Simon D. and Perez Castrillon, J. L. [Hypoglycemia by intake of taurine]. Rev.Clin Esp. 2010;210(1):49.
- Livshits, Z., Hoffman, R. S., Hymes, K. B., and Nelson, L. S. If vitamins could kill: massive hemolysis following naturopathic vitamin infusion. J Med Toxicol. 2011;7(3):224-226. PubMed
- Schoffl, I., Kothmann, J. F., Schoffl, V., Rupprecht, H. D., and Rupprecht, T. "Vodka energy": too much for the adolescent nephron? Pediatrics 2011;128(1):e227-e231. PubMed
- Calabro, R. S., Italiano, D., Gervasi, G., and Bramanti, P. Single tonic-clonic seizure after energy drink abuse. Epilepsy Behav 2012;23(3):384-385. PubMed
- Fujita, T., Ando, K., Noda, H., Ito, Y., and Sato, Y. Effects of increased adrenomedullary activity and taurine in young patients with borderline hypertension. Circulation 1987;75(3):525-532. PubMed
- Darling, P. B., Lepage, G., Leroy, C., Masson, P., and Roy, C. C. Effect of taurine supplements on fat absorption in cystic fibrosis. Pediatr Res 1985;19(6):578-582. PubMed
- Fukuyama, Y. and Ochiai, Y. Therapeutic trial by taurine for intractable childhood epilepsies. Brain Dev. 1982;4(1):63-69. PubMed
- Franconi, F., Bennardini, F., Mattana, A., Miceli, M., Ciuti, M., Mian, M., Gironi, A., Anichini, R., and Seghieri, G. Plasma and platelet taurine are reduced in subjects with insulin-dependent diabetes mellitus: effects of taurine supplementation. Am.J. DOI
- Stohs SJ, Miller M. A case study involving allergic reactions to sulfur-containing compounds including, sulfite, taurine, acesulfame potassium and sulfonamides. Food Chem Toxicol. 2014 Jan;63:240-3. PubMed
- Sun Q, Wang B, Li Y, Sun F, et al. Taurine supplementation lowers blood pressure and improves vascular function in prehypertension: randomized, double-blind, placebo-controlled study. Hypertension 2016 Mar;67(3):541-9. PubMed
- Jang ES, Hwang SH, Kim JW, Jeong SH. Effectiveness of 4-week oral taurine treatment for muscle cramps in patients with liver cirrhosis: a single-arm pilot study. Yonsei Med J 2021;62(1):21-8. PubMed
- Guan L, Miao P. The effects of taurine supplementation on obesity, blood pressure and lipid profile: A meta-analysis of randomized controlled trials. Eur J Pharmacol 2020;885:173533. PubMed
- Higgins JP, Liras GN, Liras IN, et al. Energy Drink Effects on Hemodynamics and Endothelial Function in Young Adults. Cardiology. 2021;146(2):258-262. PubMed
- Pallangyo P, Bhalia SV, Komba M, et al. Acute Myocardial Infarction Following the Consumption of Energy Drink in a 28-Year-Old Male: A Case Report. J Investig Med High Impact Case Rep. 2023 Jan-Dec;11:23247096231168811. PubMed
Inositol 14 references
- Palatnik A, Frolov K, Fux M, Benjamin J. Double-blind, controlled, crossover trial of inositol versus fluvoxamine for the treatment of panic disorder. J Clin Psychopharmacol 2001;21:335-9.. PubMed
- Allan SJ, Kavanagh GM, Herd RM, Savin JA. The effect of inositol supplements on the psoriasis of patients taking lithium: a randomized, placebo-controlled trial. Br J Dermatol 2004;150:966-9. PubMed
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DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.
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