End Fatigue Adrenal Stress-End Ingredients & Drug Interactions
What is this page for?
First and foremost: checking End Fatigue Adrenal Stress-End 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
End Fatigue Adrenal Stress-End is a dietary supplement by Integrative Therapeutics with 7 active ingredients. Its ingredients are commonly taken for morning sickness in pregnancy, premenstrual syndrome (pms), preventing or treating b6 deficiency.Based on those ingredients, 1,124 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Licorice (Glycyrrhiza glabra) root and rhizome extract, Vitamin B6, Vitamin C. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against End Fatigue Adrenal Stress-End by Integrative Therapeutics
Ask about any prescription or over-the-counter medication and we check it for interactions with End Fatigue Adrenal Stress-End by Integrative Therapeutics — and tell you which ingredient is responsible.
AI summaries are generated from our interaction database for education only — always confirm with your pharmacist. How we use AI
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HelloPharmacist Scorecard of End Fatigue Adrenal Stress-End by Integrative Therapeutics
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
End Fatigue Adrenal Stress-End contains 7 active ingredients. Vitamin B6, vitamin C, and pantothenic acid are B vitamins that support energy metabolism and nervous system function.
L-tyrosine is an amino acid involved in neurotransmitter production. Licorice root extract and adrenal cortex concentrate are adaptogenic plant and glandular ingredients traditionally used to support stress response and energy.
Betaine is another amino acid derivative. The product also contains several inactive ingredients including gelatin capsules, silicon dioxide, magnesium stearate, and titanium dioxide for color.
Does it work?
Moderate evidence
Evidence for this product's ingredients is mixed. Vitamin B6 is effective for treating B6 deficiency and sideroblastic anemia, and possibly effective for pregnancy-related nausea.
Vitamin C is effective for C deficiency and possibly effective for cataracts and exercise-related respiratory infections. L-tyrosine is effective for phenylketonuria (PKU) and possibly effective for cognitive function and memory, though the evidence on athletic performance is insufficient or points toward ineffectiveness.
Pantothenic acid is effective for pantothenic acid deficiency. Licorice is possibly effective for eczema and canker sores.
For adrenal fatigue or stress-related fatigue as a whole, we hold no effectiveness ratings in our data.
How safe is it?
Well-documented data
Most ingredients here are generally well tolerated at normal doses. Vitamin B6 is safe at standard amounts, but high doses taken over time can damage nerves (sensory neuropathy), particularly at doses over 1,000 mg daily.
Vitamin C is safe at normal supplement doses; above 2 grams daily you're more likely to experience stomach upset and diarrhea, and very high doses can affect kidney stones and kidney function. L-tyrosine seems well tolerated with no serious side effects documented, though common effects at high doses include fatigue and headache.
Pantothenic acid is generally safe with few side effects. Licorice is well tolerated in food amounts but glycyrrhizin (the active compound in licorice) can cause serious issues with high or long-term doses, including potassium loss and effects on blood pressure.
Pregnancy safety data is limited: vitamin C in normal food and prenatal amounts is considered likely safe, but avoid high-dose supplements; licorice should be avoided in pregnancy. For L-tyrosine and the others, we hold no pregnancy or breastfeeding safety data.
Meds to double-check
Moderate interaction found
Double-check before starting if you take seizure medications (phenytoin, phenobarbital), blood thinners (warfarin), heart medications (digoxin), oral contraceptives or hormone therapy, thyroid replacement (levothyroxine), levodopa for Parkinson's, or certain psychiatric or cancer medications. All interactions documented for this product's ingredients are moderate or minor in severity.
The bottom line
Scorecard at a glanceFully disclosed formula with some supporting evidence for its stated purpose. Moderate medication interactions have been identified, and safety information is well characterized.
This is a multi-ingredient supplement with several ingredients that interact with common medications, especially blood thinners, seizure drugs, heart medications, and hormonal medications. If you take prescription drugs—particularly for the heart, blood clotting, seizures, thyroid function, or psychiatric conditions—run your exact medication list through the checker below before starting.
Talk to your pharmacist about whether the doses in this product are right for you, especially if you're pregnant, nursing, or taking any seizure medications.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 5 of 7 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Sep 24, 2019.
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 End Fatigue Adrenal Stress-End, straight from the product label.
| Brand | Integrative Therapeutics |
|---|---|
| Barcode (UPC) | 871791000698 |
| Net contents | 50 Capsule(s) |
| Market status | On market |
| Date entered into DSLD | Sep 24, 2019 |
| DSLD ID | 202548 |
| Product type | Other Combinations |
| Supplement form | Capsule |
| Dietary claims / uses | All Other, Structure/Function |
| Intended target group(s) | Adult (18 - 50 Years), Gluten Free, Dairy Free, Sugar Free |
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.
Supplement Facts
The label details for End Fatigue Adrenal Stress-End by Integrative Therapeutics, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Vitamin B6 | 50 mg | 2941% |
| L-Tyrosine | 250 mg | -- |
| Vitamin C | 150 mg | 167% |
| Pantothenic Acid | 100 mg | 2000% |
| Licorice (Glycyrrhiza glabra) root and rhizome extract | 200 mg | -- |
| Adrenal Cortex concentrate | 433 mg | -- |
| Betaine | 250 mg | -- |
Other ingredients: Gelatin, Silicon Dioxide, Magnesium Stearate, Titanium Dioxide color
Tap any ingredient to jump to its full detail below.
These statements are the manufacturer’s wording, reproduced from the product label — the label is saying it, not HelloPharmacist. We don’t verify or endorse them.
Suggested/Recommended/Usage/Directions
Recommendation: Take 2 capsules daily with food, or as recommended by your healthcare professional.
Formulation
Contains no sugar, salt, yeast, wheat, gluten, soy, dairy products, artificial flavors or preservatives.
Precautions
Keep out of reach of children.
Safety sealed with printed inner seal. Do not use if seal is broken or missing.
Warning: Do not use this product if pregnant or nursing, have high blood pressure, or cardiovascular disease.
Do not exceed recommended dose unless advised by a healthcare professional.
If you are taking prescription drugs, consult your healthcare professional prior to use.
Brand IP Statement(s)
2018 Integrative Therapeutics, LLC
General
LZ74035.E01 BLK403E
FDA Disclaimer Statement
This statement has not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.
General Statements
Adrenal gland support
FDA Statement of Identity
Dietary Supplement
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
End Fatigue Adrenal Stress-End by Integrative Therapeutics 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 End Fatigue Adrenal Stress-End by Integrative Therapeutics
These are the 7 active ingredients this product is made of. Select any to open its full monograph.
Serving size2 Capsule(s) Dosage formCapsule Servings per container25 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.
Vitamin B6
Interacts with210 drugs
Vitamin B6 (pyridoxine) is an essential water-soluble vitamin that your body needs for metabolism, brain function, and making red blood cells. It is b...
Vitamin B6 monograph & interactionsL-Tyrosine
Interacts with21 drugs
L-tyrosine is an amino acid your body uses to make brain chemicals like dopamine and norepinephrine. Some studies suggest it may help mental performan...
L-Tyrosine 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 & interactionsPantothenic Acid
No knowninteractions
Pantothenic acid is vitamin B5, an essential nutrient your body uses to turn food into energy. True deficiency is very rare because it is found in nea...
Pantothenic Acid monograph & interactionsLicorice (Glycyrrhiza glabra) root and rhizome extract
Interacts with1,040 drugs
Licorice root is a traditional remedy used for sore throats, coughs, and digestive complaints, but solid human evidence is limited for most uses. Regu...
Licorice (Glycyrrhiza glabra) root and rhizome extract monograph & interactionsAdrenal Cortex concentrate
Betaine
Other (inactive) ingredients: Gelatin, Silicon Dioxide, Magnesium Stearate, Titanium Dioxide color. These complete the product’s ingredient list but are not active constituents.
End Fatigue Adrenal Stress-End by Integrative Therapeutics Drug Interactions
HelloPharmacist Interaction Report
End Fatigue Adrenal Stress-End by Integrative Therapeutics contains several ingredients with documented drug interactions.
The most serious concern is vitamin B6, which at high doses may reduce how your body processes two seizure medications—phenytoin (Dilantin) and phenobarbital (Luminal)—making them less effective.
Read the full breakdown — every affected drug type, severity by severity
Vitamin C can interact with a number of medications. It may increase blood levels of estrogens (including oral contraceptives and hormone replacement therapy), reduce the effectiveness of blood thinners like warfarin (Coumadin) at high doses, and theoretically interfere with certain chemotherapy drugs.
It can also increase absorption of levothyroxine (Synthroid), which may require dose adjustment. Additionally, vitamin C can increase aluminum absorption from aluminum-containing compounds.
L-tyrosine may compete with levodopa (a Parkinson's medication) for absorption and could theoretically have additive effects with thyroid hormone medications. Licorice root in this product interacts with digoxin (a heart medication), several blood thinners and cancer drugs, and certain sedatives and blood-pressure medications.
Vitamin B6 also has a minor interaction with levodopa when taken alone. We could not check two ingredients—adrenal cortex concentrate and betaine—because we hold no data for them.
Altogether, these interactions span 1,108 individual medications. Use the search tool below with your exact medications before starting.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against End Fatigue Adrenal Stress-End?
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 End Fatigue Adrenal Stress-End interact with 1,124 drugs. Click any drug to see the details.
4 of the 7 ingredients in End Fatigue Adrenal Stress-End interact with drugs. Each result below shows which ingredient is responsible. Licorice (Glycyrrhiza glabra) root and rhizome extract Vitamin B6 Vitamin C L-Tyrosine
Ado-trastuzumab EmtansineKadcyla
How Ado-trastuzumab Emtansine interacts with End Fatigue Adrenal Stress-End — through 1 ingredient. Tap an ingredient for the detail:
Licorice (glycyrrhiza Glabra) Root And Rhizome ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, licorice might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full Licorice (glycyrrhiza Glabra) Root And Rhizome Extract + Ado-trastuzumab Emtansine interactionAbemaciclibVerzenio
How Abemaciclib interacts with End Fatigue Adrenal Stress-End — through 1 ingredient. Tap an ingredient for the detail:
Licorice (glycyrrhiza Glabra) Root And Rhizome ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, licorice might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full Licorice (glycyrrhiza Glabra) Root And Rhizome Extract + Abemaciclib interactionAbiraterone
How Abiraterone interacts with End Fatigue Adrenal Stress-End — through 1 ingredient. Tap an ingredient for the detail:
Licorice (glycyrrhiza Glabra) Root And Rhizome ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, licorice might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full Licorice (glycyrrhiza Glabra) Root And Rhizome Extract + Abiraterone interactionAbiraterone AcetateYonsa, Zytiga
How Abiraterone Acetate interacts with End Fatigue Adrenal Stress-End — through 1 ingredient. Tap an ingredient for the detail:
Licorice (glycyrrhiza Glabra) Root And Rhizome ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, licorice might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full Licorice (glycyrrhiza Glabra) Root And Rhizome Extract + Abiraterone Acetate interactionAbrocitinibCibinqo
How Abrocitinib interacts with End Fatigue Adrenal Stress-End — through 1 ingredient. Tap an ingredient for the detail:
Licorice (glycyrrhiza Glabra) Root And Rhizome ExtractCytochrome P450 2c19 (cyp2c19) Substrates, Cytochrome P450 2c9 (cyp2c9) Substrates Moderate
Interaction Summary
Theoretically, licorice might increase levels of drugs metabolized by CYP2C19.
Read the full Licorice (glycyrrhiza Glabra) Root And Rhizome Extract + Abrocitinib interactionAcalabrutinibCalquence
How Acalabrutinib interacts with End Fatigue Adrenal Stress-End — through 1 ingredient. Tap an ingredient for the detail:
Licorice (glycyrrhiza Glabra) Root And Rhizome ExtractCytochrome P450 3a4 (cyp3a4) Substrates, P-glycoprotein Substrates Moderate
Interaction Summary
Theoretically, licorice might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full Licorice (glycyrrhiza Glabra) Root And Rhizome Extract + Acalabrutinib interactionAcebutololRhotral, Sectral
How Acebutolol interacts with End Fatigue Adrenal Stress-End — through 2 ingredients. Tap an ingredient for the detail:
Vitamin B6Antihypertensive Drugs Moderate
Interaction Summary
Theoretically, vitamin B6 may have additive effects when used with antihypertensive drugs.
Read the full Vitamin B6 + Acebutolol interactionLicorice (glycyrrhiza Glabra) Root And Rhizome ExtractAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, licorice might reduce the effects of antihypertensive drugs.
Read the full Licorice (glycyrrhiza Glabra) Root And Rhizome Extract + Acebutolol interactionAcetaminophen, Aspirin, CaffeineExcedrin, Excedrin Extra Strength, Excedrin Migraine
How Acetaminophen, Aspirin, Caffeine interacts with End Fatigue Adrenal Stress-End — through 2 ingredients. Tap an ingredient for the detail:
Licorice (glycyrrhiza Glabra) Root And Rhizome ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, licorice might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full Licorice (glycyrrhiza Glabra) Root And Rhizome Extract + 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, Butalbital, CaffeineEsgic, Esgic Plus, Fiogesic, Fioricet, Repan, Tecnal +1 more
How Acetaminophen, Butalbital, Caffeine interacts with End Fatigue Adrenal Stress-End — through 2 ingredients. Tap an ingredient for the detail:
Licorice (glycyrrhiza Glabra) Root And Rhizome ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, licorice might decrease the levels and clinical effects of CYP1A2 substrates.
Read the full Licorice (glycyrrhiza Glabra) Root And Rhizome Extract + 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 End Fatigue Adrenal Stress-End — through 2 ingredients. Tap an ingredient for the detail:
Licorice (glycyrrhiza Glabra) Root And Rhizome ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, licorice might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full Licorice (glycyrrhiza Glabra) Root And Rhizome 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, Caffeine, Chlorpheniramine, Hydrocodone, PhenylephrineHycomine Compound
How Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interacts with End Fatigue Adrenal Stress-End — through 2 ingredients. Tap an ingredient for the detail:
Licorice (glycyrrhiza Glabra) Root And Rhizome ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, licorice might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full Licorice (glycyrrhiza Glabra) Root And Rhizome 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 End Fatigue Adrenal Stress-End — through 2 ingredients. Tap an ingredient for the detail:
Licorice (glycyrrhiza Glabra) Root And Rhizome ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, licorice might decrease the levels and clinical effects of CYP1A2 substrates.
Read the full Licorice (glycyrrhiza Glabra) Root And Rhizome 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 End Fatigue Adrenal Stress-End — through 2 ingredients. Tap an ingredient for the detail:
Licorice (glycyrrhiza Glabra) Root And Rhizome ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, licorice might decrease the levels and clinical effects of CYP1A2 substrates.
Read the full Licorice (glycyrrhiza Glabra) Root And Rhizome Extract + 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 End Fatigue Adrenal Stress-End — through 2 ingredients. Tap an ingredient for the detail:
Licorice (glycyrrhiza Glabra) Root And Rhizome ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, licorice might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full Licorice (glycyrrhiza Glabra) Root And Rhizome 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 End Fatigue Adrenal Stress-End — through 2 ingredients. Tap an ingredient for the detail:
Licorice (glycyrrhiza Glabra) Root And Rhizome ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, licorice might decrease the levels and clinical effects of CYP1A2 substrates.
Read the full Licorice (glycyrrhiza Glabra) Root And Rhizome 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 interactionAcetaminophen, Caffeine, PyrilamineMidol Max Strength Menstrual
How Acetaminophen, Caffeine, Pyrilamine interacts with End Fatigue Adrenal Stress-End — through 2 ingredients. Tap an ingredient for the detail:
Licorice (glycyrrhiza Glabra) Root And Rhizome ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Diuretic Drugs +1 Moderate
Interaction Summary
Theoretically, licorice might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full Licorice (glycyrrhiza Glabra) Root And Rhizome Extract + Acetaminophen, Caffeine, Pyrilamine 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, Pyrilamine interactionAcetaminophen, Chlorpheniramine Maleate, Dextromethorphan HbrVicks Formula 44M Cough, Cold & Flu Relief
How Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interacts with End Fatigue Adrenal Stress-End — through 2 ingredients. Tap an ingredient for the detail:
Licorice (glycyrrhiza Glabra) Root And Rhizome ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, licorice might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full Licorice (glycyrrhiza Glabra) Root And Rhizome Extract + Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interactionVitamin CAcetaminophen (tylenol, Others) Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C + Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interactionAcetaminophen, Chlorpheniramine, Codeine, PhenylephrineColrex
How Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interacts with End Fatigue Adrenal Stress-End — through 2 ingredients. Tap an ingredient for the detail:
Licorice (glycyrrhiza Glabra) Root And Rhizome ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, licorice might decrease the levels and clinical effects of CYP1A2 substrates.
Read the full Licorice (glycyrrhiza Glabra) Root And Rhizome Extract + Acetaminophen, Chlorpheniramine, Codeine, 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, Chlorpheniramine, Codeine, Phenylephrine interactionAcetaminophen, Chlorpheniramine, DextromethorphanCoricidin II Extra Strength Cold and Flu
How Acetaminophen, Chlorpheniramine, Dextromethorphan interacts with End Fatigue Adrenal Stress-End — through 2 ingredients. Tap an ingredient for the detail:
Licorice (glycyrrhiza Glabra) Root And Rhizome ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, licorice might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full Licorice (glycyrrhiza Glabra) Root And Rhizome Extract + Acetaminophen, Chlorpheniramine, Dextromethorphan interactionVitamin CAcetaminophen (tylenol, Others) Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C + Acetaminophen, Chlorpheniramine, Dextromethorphan interactionAcetaminophen, Chlorpheniramine, Dextromethorphan HydrobromideCoricidin HBP Maximum Strength Flu
How Acetaminophen, Chlorpheniramine, Dextromethorphan Hydrobromide interacts with End Fatigue Adrenal Stress-End — through 2 ingredients. Tap an ingredient for the detail:
Licorice (glycyrrhiza Glabra) Root And Rhizome ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, licorice might decrease the levels and clinical effects of CYP1A2 substrates.
Read the full Licorice (glycyrrhiza Glabra) Root And Rhizome Extract + Acetaminophen, Chlorpheniramine, Dextromethorphan Hydrobromide interactionVitamin CAcetaminophen (tylenol, Others) Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C + Acetaminophen, Chlorpheniramine, Dextromethorphan Hydrobromide interactionAcetaminophen, Chlorpheniramine, Dextromethorphan, PhenylpropanolamineMulti Symptom Cold Relief
How Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylpropanolamine interacts with End Fatigue Adrenal Stress-End — through 2 ingredients. Tap an ingredient for the detail:
Licorice (glycyrrhiza Glabra) Root And Rhizome ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, licorice might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full Licorice (glycyrrhiza Glabra) Root And Rhizome Extract + Acetaminophen, Chlorpheniramine, Dextromethorphan, 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, Chlorpheniramine, Dextromethorphan, Phenylpropanolamine interactionAcetaminophen, Chlorpheniramine, Dextromethorphan, PseudoephedrineChildren's Tylenol Cold Plus Cough, Tylenol Cold Ex Strength
How Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine interacts with End Fatigue Adrenal Stress-End — through 2 ingredients. Tap an ingredient for the detail:
Licorice (glycyrrhiza Glabra) Root And Rhizome ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, licorice might decrease the levels and clinical effects of CYP1A2 substrates.
Read the full Licorice (glycyrrhiza Glabra) Root And Rhizome Extract + Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine interactionVitamin CAcetaminophen (tylenol, Others) Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C + Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine interactionAcetaminophen, Chlorpheniramine, Guaifenesin, Phenylephrine, SalicylamideRhinogesic GG
How Acetaminophen, Chlorpheniramine, Guaifenesin, Phenylephrine, Salicylamide interacts with End Fatigue Adrenal Stress-End — through 2 ingredients. Tap an ingredient for the detail:
Licorice (glycyrrhiza Glabra) Root And Rhizome ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, licorice might decrease the levels and clinical effects of CYP1A2 substrates.
Read the full Licorice (glycyrrhiza Glabra) Root And Rhizome Extract + Acetaminophen, Chlorpheniramine, Guaifenesin, Phenylephrine, 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, Chlorpheniramine, Guaifenesin, Phenylephrine, Salicylamide interactionAcetaminophen, Chlorpheniramine, PhenylephrineAlka-Seltzer PLUS, Histex SR, Protid
How Acetaminophen, Chlorpheniramine, Phenylephrine interacts with End Fatigue Adrenal Stress-End — through 2 ingredients. Tap an ingredient for the detail:
Licorice (glycyrrhiza Glabra) Root And Rhizome ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, licorice might decrease the levels and clinical effects of CYP1A2 substrates.
Read the full Licorice (glycyrrhiza Glabra) Root And Rhizome Extract + Acetaminophen, Chlorpheniramine, 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, Chlorpheniramine, Phenylephrine interactionAcetaminophen, Chlorpheniramine, Phenylephrine, SalicylamideRhinogesic, Rhinogesic JR
How Acetaminophen, Chlorpheniramine, Phenylephrine, Salicylamide interacts with End Fatigue Adrenal Stress-End — through 2 ingredients. Tap an ingredient for the detail:
Licorice (glycyrrhiza Glabra) Root And Rhizome ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, licorice might decrease the levels and clinical effects of CYP1A2 substrates.
Read the full Licorice (glycyrrhiza Glabra) Root And Rhizome Extract + Acetaminophen, Chlorpheniramine, Phenylephrine, 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, Chlorpheniramine, Phenylephrine, Salicylamide interactionAcetaminophen, Chlorpheniramine, PhenylpropanolamineAlumadrine, Conex, Sinadrin Max Strength, Sinulin
How Acetaminophen, Chlorpheniramine, Phenylpropanolamine interacts with End Fatigue Adrenal Stress-End — through 2 ingredients. Tap an ingredient for the detail:
Licorice (glycyrrhiza Glabra) Root And Rhizome ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, licorice might decrease the levels and clinical effects of CYP1A2 substrates.
Read the full Licorice (glycyrrhiza Glabra) Root And Rhizome Extract + Acetaminophen, Chlorpheniramine, 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, Chlorpheniramine, Phenylpropanolamine interactionAcetaminophen, Chlorpheniramine, Phenylpropanolamine, OpiumHista-Derfule
How Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium interacts with End Fatigue Adrenal Stress-End — through 2 ingredients. Tap an ingredient for the detail:
Licorice (glycyrrhiza Glabra) Root And Rhizome ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, licorice might decrease the levels and clinical effects of CYP1A2 substrates.
Read the full Licorice (glycyrrhiza Glabra) Root And Rhizome Extract + Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium interactionVitamin CAcetaminophen (tylenol, Others) Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C + Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium interactionAcetaminophen, Chlorpheniramine, Phenylpropanolamine, PhenyltoloxamineNorel Plus
How Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Phenyltoloxamine interacts with End Fatigue Adrenal Stress-End — through 2 ingredients. Tap an ingredient for the detail:
Licorice (glycyrrhiza Glabra) Root And Rhizome ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, licorice might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full Licorice (glycyrrhiza Glabra) Root And Rhizome Extract + Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Phenyltoloxamine interactionVitamin CAcetaminophen (tylenol, Others) Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C + Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Phenyltoloxamine interactionAcetaminophen, Chlorpheniramine, PseudoephedrineAlka-Seltzer PLUS Liquid Gels, Children's Tylenol Cold, Codimal, Comtrex, Extra Strength Tylenol Allergy Sinus, Lorsin +3 more
How Acetaminophen, Chlorpheniramine, Pseudoephedrine interacts with End Fatigue Adrenal Stress-End — through 2 ingredients. Tap an ingredient for the detail:
Licorice (glycyrrhiza Glabra) Root And Rhizome ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, licorice might decrease the levels and clinical effects of CYP1A2 substrates.
Read the full Licorice (glycyrrhiza Glabra) Root And Rhizome Extract + Acetaminophen, Chlorpheniramine, Pseudoephedrine interactionVitamin CAcetaminophen (tylenol, Others) Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C + Acetaminophen, Chlorpheniramine, Pseudoephedrine interactionAcetaminophen, DextromethorphanTylenol Cough Ex Strength
How Acetaminophen, Dextromethorphan interacts with End Fatigue Adrenal Stress-End — through 2 ingredients. Tap an ingredient for the detail:
Licorice (glycyrrhiza Glabra) Root And Rhizome ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, licorice might decrease the levels and clinical effects of CYP1A2 substrates.
Read the full Licorice (glycyrrhiza Glabra) Root And Rhizome Extract + Acetaminophen, Dextromethorphan interactionVitamin CAcetaminophen (tylenol, Others) Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C + Acetaminophen, Dextromethorphan interactionEach ingredient & the kinds of drugs it affects
For each ingredient in End Fatigue Adrenal Stress-End 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.
Licorice (Glycyrrhiza glabra) root and rhizome extract
Antihypertensive Drugs
Theoretically, licorice might reduce the effects of antihypertensive drugs.
In human research, licorice increases blood pressure in a dose-dependent manner.
Cisplatin (Platinol-Aq)
Theoretically, licorice might reduce the effects of cisplatin.
In animal research, licorice diminished the therapeutic efficacy of cisplatin.
Corticosteroids
Theoretically, concomitant use of licorice and corticosteroids might increase the side effects of corticosteroids.
Case reports suggest that concomitant use of licorice and oral corticosteroids, such as hydrocortisone, can potentiate the duration of activity and increase blood levels of corticosteroids. Additionally, in one case report, a patient with neurogenic orthostatic hypertension stabilized on fludrocortisone 0.1 mg twice daily developed pseudohyperaldosteronism after recent consumption of large amounts of black licorice.
Cytochrome P450 2B6 (Cyp2B6) Substrates
Theoretically, licorice might increase levels of drugs metabolized by CYP2B6.
In vitro research shows that licorice extract and glabridin, a licorice constituent, inhibit CYP2B6 isoenzymes. Licorice extract from the species G. uralensis seems to inhibit CYP2B6 isoenzymes to a greater degree than G. glabra extract in vitro. Theoretically, these species of licorice might increase levels of drugs metabolized by CYP2B6; however, these interactions have not yet been reported in humans.
Cytochrome P450 2C19 (Cyp2C19) Substrates
Theoretically, licorice might increase levels of drugs metabolized by CYP2C19.
In vitro, licorice extracts from the species G. glabra and G. uralensis inhibit CYP2C19 isoenzymes in vitro. Theoretically, these species of licorice might increase levels of drugs metabolized by CYP2C19; however, this interaction has not yet been reported in humans.
Cytochrome P450 2C8 (Cyp2C8) Substrates
Theoretically, licorice might increase levels of drugs metabolized by CYP2C8.
In vitro, licorice extract from the species G. glabra and G. uralensis inhibits CYP2C8 isoenzymes. Theoretically, these species of licorice might increase levels of drugs metabolized by CYP2C8; however, this interaction has not yet been reported in humans.
Cytochrome P450 2C9 (Cyp2C9) Substrates
Theoretically, licorice might increase or decrease levels of drugs metabolized by CYP2C9.
There is conflicting evidence about the effect of licorice on CYP2C9 enzyme activity. In vitro research shows that extracts from the licorice species G. glabra and G. uralensis moderately inhibit CYP2C9 isoenzymes. However, evidence from an animal model shows that licorice extract from the species G. uralensis can induce hepatic CYP2C9 activity. Until more is known, licorice should be used cautiously in people taking CYP2C9 substrates.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, licorice might increase or decrease levels of drugs metabolized by CYP3A4.
Pharmacokinetic research shows that the licorice constituent glycyrrhizin, taken in a dosage of 150 mg orally twice daily for 14 days, modestly decreases the area under the concentration-time curve of midazolam by about 20%. Midazolam is a substrate of CYP3A4, suggesting that glycyrrhizin modestly induces CYP3A4 activity. Animal research also shows that licorice extract from the species G. uralensis induces CYP3A4 activity. However, licorice extract from G. glabra species appear to inhibit CYP3A4-induced metabolism of testosterone in vitro. It is thought that the G. glabra inhibits CYP3A4 due to its constituent glabridin, which is a moderate CYP3A4 inhibitor in vitro and not present in other licorice species. Until more is known, licorice should be used cautiously in people taking CYP3A4 substrates.
Digoxin (Lanoxin)
Theoretically, concomitant use of licorice with digoxin might increase the risk of cardiac toxicity.
Overuse or misuse of licorice with cardiac glycoside therapy might increase the risk of cardiac toxicity due to potassium loss.
Diuretic Drugs
Theoretically, concomitant use of licorice with diuretic drugs might increase the risk of hypokalemia.
Overuse of licorice might compound diuretic-induced potassium loss. In one case report, a 72-year-old male with a past medical history of hypertension, type 2 diabetes, hyperlipidemia, arrhythmia, stroke, and hepatic dysfunction was hospitalized with severe hypokalemia and uncontrolled hypertension due to pseudohyperaldosteronism. This was thought to be provoked by concomitant daily consumption of a product containing 225 mg of glycyrrhizin, a constituent of licorice, and hydrochlorothiazide 12.5 mg for 1 month.
Estrogens
Theoretically, licorice might increase or decrease the effects of estrogen therapy.
Theoretically, licorice might interfere with estrogen therapy due to estrogenic and anti-estrogenic effects.
Loop Diuretics
Theoretically, loop diuretics might increase the mineralocorticoid effects of licorice.
Theoretically, loop diuretics might enhance the mineralocorticoid effects of licorice by inhibiting the enzyme that converts cortisol to cortisone; however, bumetanide (Bumex) does not appear to have this effect.
Midazolam (Versed)
Theoretically, licorice might decrease levels of midazolam.
In humans, the licorice constituent glycyrrhizin appears to moderately induce the metabolism of midazolam. This is likely due to induction of cytochrome P450 3A4 by licorice. Until more is known, licorice should be used cautiously in people taking midazolam.
P-Glycoprotein Substrates
Theoretically, licorice might decrease the absorption of P-glycoprotein substrates.
In vitro research shows that licorice can increase P-glycoprotein activity.
Paclitaxel (Abraxane, Onxol)
Theoretically, licorice might decrease plasma levels and clinical effects of paclitaxel.
Multiple doses of licorice taken concomitantly with paclitaxel might reduce the effectiveness of paclitaxel. Animal research shows that licorice 3 grams/kg given orally for 14 days before intravenous administration of paclitaxel decreases the exposure to paclitaxel and increases its clearance. Theoretically, this occurs because licorice induces cytochrome P450 3A4 enzymes, which metabolize paclitaxel. Notably, a single dose of licorice did not affect exposure or clearance of paclitaxel.
Warfarin (Coumadin)
Theoretically, licorice might decrease plasma levels and clinical effects of warfarin.
Licorice seems to increase metabolism and decrease levels of warfarin in animal models. This is likely due to induction of cytochrome P450 2C9 (CYP2C9) metabolism by licorice. Advise patients taking warfarin to avoid taking licorice.
Cytochrome P450 1A2 (Cyp1A2) Substrates
Theoretically, licorice might decrease the levels and clinical effects of CYP1A2 substrates.
In vitro research shows that licorice induces CYP1A2 enzymes.
Methotrexate (Trexall, Others)
Theoretically, licorice might increase levels of methotrexate.
Animal research suggests that intravenous administration of glycyrrhizin, a licorice constituent, and high-dose methotrexate may delay methotrexate excretion and increase systemic exposure, leading to transient elevations in liver enzymes and total bilirubin. This interaction has not yet been reported in humans.
Vitamin B6
Amiodarone (Cordarone)
Theoretically, vitamin B6 might increase the photosensitivity caused by amiodarone.
Despite initial case reports suggesting that pyridoxine may have a protective effect against amiodarone-induced photosensitivity, preliminary clinical research suggests that pyridoxine may actually exacerbate this adverse effect.
Antihypertensive Drugs
Theoretically, vitamin B6 may have additive effects when used with antihypertensive drugs.
Research in hypertensive rats shows that vitamin B6 can decrease systolic blood pressure. Similarly, clinical research in patients with hypertension shows that taking high doses of vitamin B6 may reduce systolic and diastolic blood pressure, possibly by reducing plasma levels of epinephrine and norepinephrine.
Phenobarbital (Luminal)
High doses of vitamin B6 may reduce the levels and clinical effects of phenobarbital.
Preliminary clinical evidence suggests that vitamin B6 200 mg daily can reduce plasma levels of phenobarbital, possibly by increasing metabolism. It is not known whether lower doses have any effect. Advise people taking phenobarbital to avoid high doses of vitamin B6.
Phenytoin (Dilantin)
High doses of vitamin B6 may reduce the levels and clinical effects of phenytoin.
Preliminary clinical evidence suggests that vitamin B6 200 mg daily can reduce plasma levels of phenytoin, possibly by increasing metabolism. It is not known whether lower doses have any effect. Advise people taking phenytoin to avoid high doses of vitamin B6.
Levodopa
Vitamin B6 may increase the metabolism of levodopa when taken alone, but not when taken in conjunction with carbidopa.
Vitamin B6 (pyridoxine) enhances the metabolism of levodopa, reducing its clinical effects. However, this interaction does not occur when carbidopa is used concurrently with levodopa (Sinemet). Therefore, it is not likely to be a problem in most people.
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.
L-Tyrosine
Levodopa
Theoretically, tyrosine might decrease the effectiveness of levodopa.
Tyrosine and levodopa compete for absorption in the proximal duodenum by the large neutral amino acid (LNAA) transport system. Advise patients to separate doses of tyrosine and levodopa by at least 2 hours.
Thyroid Hormone
Theoretically, tyrosine might have additive effects with thyroid hormone medications.
Tyrosine is a precursor to thyroxine and might increase levels of thyroid hormones.
Brand information
Manufacturer and brand details for End Fatigue Adrenal Stress-End, from the product label.
Integrative Therapeutics
See all Integrative Therapeutics products- Name
- Integrative Therapeutics, LLC
- City
- Green Bay
- State
- WI
- ZipCode
- 54311
- Phone Number
- 800.931.1709
- Web Address
- integrativepro.com
End Fatigue Adrenal Stress-End by Integrative Therapeutics: Common Questions
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Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
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The Full Monographs Behind End Fatigue Adrenal Stress-End’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Vitamin B6
Interacts with 210 drugsVitamin B6 (pyridoxine) is an essential water-soluble vitamin that your body needs for metabolism, brain function, and making red blood cells. It is best known for helping with pregnancy-rel...
Read the full Vitamin B6 monograph → Herb & supplement monographTyrosine
Interacts with 21 drugsL-tyrosine is an amino acid your body uses to make brain chemicals like dopamine and norepinephrine. Some studies suggest it may help mental performance during short-term stress, sleep loss,...
Read the full Tyrosine 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 monographPantothenic Acid
Pantothenic acid is vitamin B5, an essential nutrient your body uses to turn food into energy. True deficiency is very rare because it is found in nearly all foods, and most people meet thei...
Read the full Pantothenic Acid monograph → Herb & supplement monographLicorice
Interacts with 1,040 drugsLicorice root is a traditional remedy used for sore throats, coughs, and digestive complaints, but solid human evidence is limited for most uses. Regular licorice contains glycyrrhizin, whic...
Read the full Licorice monograph →Sources & How We Checked
End Fatigue Adrenal Stress-End'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 190 references behind this product’s interaction data
Every citation that drives the interaction findings for this product’s ingredients, from the evidence-graded Natural Medicines (TRC Healthcare) database. Open an ingredient to browse its citations — links open the study on PubMed or the publisher’s site.
Vitamin B6 32 references
- Hansten PD, Horn JR. Drug Interactions Analysis and Management. Vancouver, WA: Applied Therapeutics Inc., 1997 and updates.
- Yates AA, Schlicker SA, Suitor CW. Dietary reference intakes: The new basis for recommendations for calcium and related nutrients, B vitamins, and choline. J Am Diet Assoc 1998;98:699-706. PubMed
- Geerling BJ, Dagnelie PC, Badart-Smook A, et al. Diet as a risk factor for the development of ulcerative colitis. Am J Gastroenterol 2000;95:1008-13. PubMed
- South M. Neonatal seizures after pyridoxine use -- reply. Lancet 1999;354:2083. PubMed
- Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline (2000). Washington, DC: National Academy Press, 2000. Available at: http://b
- Baxter P, Aicardi J. Neonatal seizures after pyridoxine use. Lancet 1999;354:2082-3. PubMed
- Bendich A, Cohen M. Vitamin B6 safety issues. Ann N Y Acad Sci 1990;585:321-30.
- Schaumburg H, Kaplan J, Windebank A. Sensory neuropathy from pyridoxine abuse. A new megavitamin syndrome. N Engl J Med 1983;309:445-8. PubMed
- Gordon N. Pyridoxine dependency: an update. Dev Med Child Neurol 1997;39:63-5. PubMed
- Lewis PJ. Pain in the hand and wrist. Pyridoxine supplements may help patients with carpal tunnel syndrome. BMJ 1995;310:1534. PubMed
- Kaufman G. Pyridoxine against amiodarone-induced photosensitivity (letter). Lancet 1984;1:51-2. PubMed
- Mulrow JP, Mulrow CD, McKenna WJ. Pyridoxine and amiodarone-induced photosensitivity. Ann Intern Med 1985;103:68-9. PubMed
- Kawada A, Kashima A, Shiraishi H, et al. Pyridoxine-induced photosensitivity and hypophosphatasia. Dermatology 2000;201:356-60.. PubMed
- Vasile A, Goldberg R, Kornberg B. Pyridoxine toxicity: report of a case. J Am Osteopath Assoc 1984;83:790-1. DOI
- Hansson O, Sillanpaa M. Pyridoxine and serum concentration of phenytoin and phenobarbitone. Lancet 1976;1:256. DOI
- Jansen T, Romiti R, Kreuter A, Altmeyer P. Rosacea fulminans triggered by high-dose vitamins B6 and B12. J Eur Acad Dermatol Venereol 2001;15:484-5..
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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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