Major interaction on record — check this product against your medications before combining. Check your meds →
Dietary supplement

Energreen Ingredients & Drug Interactions

by Herbal Terra

Liquid Category: Botanical
Most serious interaction: Major
The interaction bottom line Most serious interaction: Major

Energreen is a dietary supplement by Herbal Terra with 11 active ingredients. Its ingredients are commonly taken for high cholesterol, digestive complaints, menopausal symptoms.Based on those ingredients, 1,401 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are Kelp Whole Plant Extract, Dry, Beet Root Extract, Dry, Alfalfa Leaf Extract, Dry. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

HelloPharmacist Scorecard of Energreen by Herbal Terra

Our pharmacy team’s full take, with four database checks built into the cards below — a summary of what is known, not a grade of the product itself.

From our pharmacy team — supplement deep dive

What’s inside

Low disclosure
Ingredient Transparency · database check
Low

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

Why this rating?
  • The label discloses an exact amount for 0 of its 11 active ingredients.
  • “Proprietary Extract Blend” is a proprietary blend — the label gives one combined amount (983 mg) without saying how much of each component you get.

Energreen contains 11 active ingredients in a liquid base with alcohol, water, and glycerin. The formula includes plant extracts: alfalfa leaf, barley grass, beet root, dandelion leaf, dulse (a seaweed), lemon peel, orange peel, spinach leaf, spirulina algae, kelp, and wheat grass.

Each is included as a dried extract in the proprietary blend, meaning their individual amounts are not disclosed separately.

Does it work?

Strong evidence
Evidence for Intended Use · database check
By FDA rules, dietary supplements can’t claim to treat, cure, or prevent disease — so labels speak in careful marketing language. We discern each product’s intended use from its name, label claims, and label statements, then grade the clinical evidence for that use. How these ratings are computed

This product doesn't appear to be marketed for a specific use, so we graded its ingredients' overall clinical evidence instead.

Strong

Strong clinical evidence supports its ingredients for:

Why this rating?
  • We looked at the product name, claims, and label statements and couldn't find a stated purpose to grade.
  • Since the label doesn't commit to one use, we graded the ingredients' overall clinical evidence instead.
  • On file: Coronary heart disease (CHD) — rated "Likely Effective" (Barley) (Natural Medicines).
  • On file: Hypercholesterolemia — rated "Likely Effective" (Barley) (Natural Medicines).
  • On file: Athletic performance — rated "Possibly Effective" (Beet) (Natural Medicines).
  • On file: Exercise-induced muscle soreness — rated "Possibly Effective" (Beet) (Natural Medicines).
  • On file: Hypertension — rated "Possibly Effective" (Blue-green Algae) (Natural Medicines).

The evidence for these ingredients is mixed and mostly limited. Barley grass is likely effective for high cholesterol and heart disease risk.

Beet root is possibly effective for athletic performance and exercise-related muscle soreness. Most other ingredients—alfalfa, dandelion, dulse, lemon peel, orange peel, spinach, spirulina, kelp, and wheat grass—lack sufficient reliable evidence to rate their effectiveness for the conditions they're traditionally used for.

The data we hold does not establish that this product is effective for any specific health goal.

The evidence, ingredient by ingredient Alfalfa Barley Beet Dandelion Dulse Lemon Sweet Orange Spinach

How safe is it?

Well-documented data
Safety Information · database check
Well characterized

Adverse-effect, pregnancy, and general safety data are on file for most of these ingredients.

Why this rating?
  • We hold adverse-effect (side-effect) data for 10 of the 11 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 11 of 11.
  • General safety write-ups exist for 11 of 11.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

Most ingredients in this product are generally well tolerated when used as foods, but supplement-strength doses raise more concerns. Alfalfa is possibly unsafe in pregnancy due to its estrogen-like activity and lacks enough safety data for breastfeeding.

Barley, beet, dandelion, lemon peel, orange peel, and wheat grass all have limited safety data in concentrated supplement form during pregnancy and lactation, though beet, orange peel, and spinach are rated likely safe. Spinach is considered safe during both pregnancy and breastfeeding as a food.

Common side effects include digestive upset (gas, bloating, diarrhea, stomach discomfort) with several ingredients. Alfalfa can cause dermatitis and, rarely, a lupus-like syndrome with long-term use.

Barley and wheat grass can trigger allergic reactions in sensitive individuals. Lemon peel may cause heartburn and gastrointestinal disturbance.

Dulse contains high iodine and potassium, which may be problematic for those with thyroid conditions or kidney issues. Wheat grass is best avoided in pregnancy and lactation unless your doctor approves.

Side effects, ingredient by ingredient Alfalfa Barley Beet Dandelion Dulse Lemon Sweet Orange Spinach

Meds to double-check

Major interaction found
Known Interaction Concern · database check
Major identified

At least one ingredient has a documented Major-severity interaction. Check your medications for a personalized result.

Why this rating?
  • 11 of the 11 matched ingredients can interact with medications — Alfalfa, Beet, Spinach, Lemon, Dandelion, among others.
  • The most serious interaction on file is rated Major.
  • Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs; immunosuppressants / transplant drugs; diabetes medications; heart-rhythm medications; lithium.
  • For scale: 1,402 individual medications appear in the full list. A big number alone doesn't make a product dangerous — what matters is whether YOUR medication is on it, so run yours through the interaction checker on this page.

Check with your pharmacist before starting Energreen if you take blood thinners like warfarin; diabetes medications; heart medications like pravastatin, digoxin, or beta-blockers; thyroid or antithyroid drugs; amiodarone; potassium-sparing water pills; ACE inhibitors or ARBs; lithium; immunosuppressive drugs; quinolone antibiotics; photosensitizing medications; birth control pills; hormone therapy; or any drug metabolized by CYP3A4 or CYP1A2 enzymes. No interactions are documented for spirulina algae or kelp extract — we could not check these ingredients.

Check your own medication Run your meds through the checker above

The bottom line

Scorecard at a glanceFormula with limited ingredient disclosure with strong clinical evidence behind its ingredients' uses. Major medication interactions have been identified, and safety information is well characterized.

This product combines multiple plant extracts with a long list of potential medication interactions—most notably with blood thinners, diabetes drugs, and thyroid medications. If you take any prescription medications, particularly warfarin, birth control, diabetes drugs, thyroid drugs, or immunosuppressants, check each one with the interaction tool before using Energreen.

Talk with your pharmacist about whether it's right for you, especially if you're pregnant or breastfeeding.

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

Assessment coverage: 11 of 11 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Feb 23, 2025.

This Scorecard evaluates available label information, ingredient evidence, and known medication-safety considerations. It does not independently verify product identity, purity, potency, contamination, or manufacturing quality. How these ratings are computed

At a glance

General information

Key facts about Energreen, straight from the product label.

Brand Herbal Terra
Barcode (UPC) 1977490952586
Net contents 4 Fluid Ounce(s); 120 mL
Market status On market
Date entered into DSLD Feb 23, 2025
DSLD ID 326970
Product type Botanical
Supplement form Liquid
Dietary claims / uses All Other, Structure/Function
Intended target group(s) Adult (18 - 50 Years), Gluten Free, Sugar Free
From the label
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.

Supplement Facts

The label details for Energreen by Herbal Terra, sourced from the NIH Dietary Supplement Label Database.

Supplement Facts

Daily Value (DV) Target Group(s):
Adults and children 4 or more years of age
Minimum serving Sizes:
1 mL
Maximum serving Sizes:
1 mL
Servings per container
120
UPC/BARCODE
1977490952586
IngredientAmount% DV
Proprietary Extract Blend983 mg--
Alfalfa Leaf Extract, Dry0 NP--
Barley Grass Extract, Dry0 NP--
Beet Root Extract, Dry0 NP--
Dandelion Leaf Extract, Dry0 NP--
Dulse Leaf Extract, Dry0 NP--
Lemon Peel Extract, Dry0 NP--
Orange Peel Extract, Dry0 NP--
Spinach Leaf Extract, Dry0 NP--
Spirulina Algae Extract, Dry0 NP--
Kelp Whole Plant Extract, Dry0 NP--
Wheat Grass Extract, Dry0 NP--

Other ingredients: Alcohol, Water, Glycerin

Tap any ingredient to jump to its full detail below.

Label statements
These statements are the manufacturer’s wording, reproduced from the product label — the label is saying it, not HelloPharmacist. We don’t verify or endorse them.
Suggested/Recommended/Usage/Directions

Shake well before use. Adults take up to 30 drops (1 mL, one full squeeze of the dropper bulb) in 3-4 fl. oz. of juice or water up to 4 times a day.

Precautions

We recommend to seek expert medical advice before taking. May have contraindications and cause adverse reaction.

Consult a physician before giving to children under 18, before using during pregnancy, if nursing, or if you are on any medications.

Consult a physician before giving to children under 18, before using during pregnancy, if nursing, or if you are on any medications. Keep out of the reach of children!

Do not use if you are allergic to any ingredients.

Storage

Store in a cool, dry, dark place.

FDA Disclaimer Statement

This product has not been evaluated by the FDA and is not intended to diagnose, treat, cure or prevent any disease.

Formulation

cGMP Made in compliance with cGMP 21 CFR 111 in an FDA registered and inspected facility.

Sugar free

Expertly extracted 100% natural Premium product

Organic alcohol

No artificial ingredients, color additives, fillers or binders.

Natural Gluten free

Formula

Organic alcohol

FDA Statement of Identity

Herbal Supplement

General Statements

Extraction rate: about 1/3-4 (up to 333 mg of dry raw material per 1 ml of extract).

Seals/Symbols

Made in USA

See for yourself

Energreen by Herbal Terra label

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

What’s inside

The Ingredients in Energreen by Herbal Terra

These are the 11 active ingredients this product is made of. Select any to open its full monograph.

Serving size1 mL Dosage formLiquid Servings per container120 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.

Other (inactive) ingredients: Alcohol, Water, Glycerin. These complete the product’s ingredient list but are not active constituents.

Interaction report

Energreen by Herbal Terra Drug Interactions

Want to check YOUR meds against Energreen?

Ask about interactions with your drugs in plain English — “Can I take it with lisinopril?” — and we find you the answer in seconds, ingredient by ingredient.

Go to the checker
1,401Drugs
50 Major 1,228 Moderate 123 Minor

Each ingredient & the kinds of drugs it affects

For each ingredient in Energreen 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.

Kelp Whole Plant Extract, Dry9 drug types · 891 drugs

Amiodarone (Cordarone)

Theoretically, combining Fucus vesiculosus with amiodarone might cause excessively high iodine levels.
Fucus vesiculosus contains high concentrations of iodine. Amiodarone contains 37.3% iodine and can increase iodine levels. Concomitant use might increase the risk of having excessive iodine levels and adversely affecting thyroid function. Monitor thyroid function.

Likelihood Probable Evidence D
Antithyroid Drugs

Due to its iodine content, Fucus vesiculosus might alter the effects of antithyroid drugs.
Fucus vesiculosus contains high concentrations of iodine. Iodine in high doses has been reported to cause both hyperthyroidism and hypothyroidism, depending on the individual's past medical history. Taking Fucus vesiculosus while using antithyroid drugs could alter the effects of the antithyroid drugs.

Likelihood Possible Evidence D
Lithium

Concomitant use of Fucus vesiculosus and lithium has resulted in hyperthyroidism.
There is a case of hyperthyroidism occurring in a patient taking Fucus vesiculosus and lithium. Monitor thyroid hormones closely in patients taking lithium and Fucus vesiculosus concomitantly.

Likelihood Possible Evidence D
Thyroid Hormone

Due to its iodine content, Fucus vesiculosus might alter the effects of thyroid hormone.
Fucus vesiculosus contains high concentrations of iodine. Iodine in high doses has been reported to cause both hyperthyroidism and hypothyroidism, depending on the individual's past medical history. Taking Fucus vesiculosus while using thyroid hormone could alter the effects of thyroid hormone.

Likelihood Possible Evidence D
Anticoagulant/Antiplatelet Drugs

Theoretically, taking Fucus vesiculosus with antiplatelet or anticoagulant drugs might increase the risk of bruising and bleeding.
In vitro evidence suggests that a constituent of Fucus vesiculosus, known as fucoidan, has anticoagulant effects. However, in clinical research, fucoidan does not seem to have significant anticoagulant activity when taken orally, possibly due to poor absorption.

Likelihood Unlikely Evidence D
Cytochrome P450 2C8 (Cyp2C8) Substrates

Theoretically, concomitant use of Fucus vesiculosus with CYP2C8 substrates might increase the risk for adverse effects.
In vitro research shows that fucoidan, a constituent of Fucus vesiculosus, inhibits CYP2C8. This interaction has not been reported in humans.

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

Theoretically, concomitant use of Fucus vesiculosus with CYP2C9 substrates might increase the risk for adverse effects.
In vitro research shows that fucoidan, a constituent of Fucus vesiculosus, inhibits CYP2C9. This interaction has not been reported in humans.

Likelihood Possible Evidence D
Cytochrome P450 2D6 (Cyp2D6) Substrates

Theoretically, concomitant use of Fucus vesiculosus with CYP2D6 substrates might alter the effects of these substrates.
In vitro research shows that fucoidan, a constituent of Fucus vesiculosus, both inhibits and induces CYP2D6. This interaction has not been reported in humans.

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

Theoretically, concomitant use of Fucus vesiculosus with CYP3A4 substrates might increase the risk for adverse effects.
In vitro research shows that fucoidan, a constituent of Fucus vesiculosus, inhibits CYP3A4. This interaction has not been reported in humans.

Likelihood Possible Evidence D

Beet Root Extract, Dry3 drug types · 861 drugs

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.

Likelihood Possible Evidence D
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.

Likelihood Possible Evidence A
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.

Likelihood Possible Evidence D

Alfalfa Leaf Extract, Dry6 drug types · 583 drugs

Warfarin (Coumadin)

Theoretically, alfalfa might reduce the anticoagulant activity of warfarin.
Alfalfa contains a large amount of vitamin K. This could theoretically interfere with the activity of warfarin.

Likelihood Probable Evidence D
Antidiabetes Drugs

Theoretically, alfalfa might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Animal research suggests that alfalfa decreases blood sugar in diabetic mice. Also, in one case report, a diabetic patient experienced hypoglycemia after consuming alfalfa extract. Monitor blood glucose levels closely. Dose adjustments might be necessary.

Likelihood Possible Evidence D
Contraceptive Drugs

Theoretically, alfalfa might interfere with the activity of contraceptive drugs.
Alfalfa contains coumestrol, a phytoestrogen, and isoflavonoids, which have estrogenic effects.

Likelihood Possible Evidence D
Estrogens

Theoretically, alfalfa might interfere with hormone therapy.
Alfalfa contains coumestrol, a phytoestrogen, and isoflavonoids, which have estrogenic effects.

Likelihood Possible Evidence D
Immunosuppressants

Theoretically, alfalfa might decrease the efficacy of immunosuppressive therapy.
In vitro research and human case reports suggest that alfalfa may have immunostimulant effects.

Likelihood Possible Evidence D
Photosensitizing Drugs

Theoretically, concomitant use of alfalfa with photosensitizing drugs might have additive effects.
Animal research suggests that excessive doses of alfalfa may increase photosensitivity, possibly due to its chlorophyll content. It is unclear if this effect would be clinically relevant in humans.

Likelihood Possible Evidence D

Dandelion Leaf Extract, Dry7 drug types · 457 drugs

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.

Likelihood Possible Evidence D
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.

Likelihood Possible Evidence D
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.

Likelihood Possible Evidence D
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.

Likelihood Possible Evidence D
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.

Likelihood Probable Evidence D
Potassium-Sparing Diuretics

Theoretically, dandelion might increase the risk of hyperkalemia when taken with potassium-sparing diuretics.
Dandelion contains significant amounts of potassium.

Likelihood Possible Evidence D
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.

Likelihood Possible Evidence D

Spirulina Algae Extract, Dry3 drug types · 327 drugs

Anticoagulant/Antiplatelet Drugs

Theoretically, spirulina blue-green algae might increase the risk of bleeding if used with other anticoagulant or antiplatelet drugs. However, this is unlikely.
Spirulina blue-green algae have shown antiplatelet and anticoagulant effects in vitro. However, one preliminary study in 24 patients receiving spirulina blue-green algae 2.3 grams daily for 2 weeks showed no effect on platelet activation or measures of clotting time.

Likelihood Unlikely Evidence D
Antidiabetes Drugs

Theoretically, taking blue-green algae with antidiabetes drugs might increase the risk of hypoglycemia.
Human research shows that spirulina blue-green algae can have hypoglycemic effects in patients with diabetes, at least some of whom were using antidiabetes drugs. However, blue-green algae does not seem to improve glycated hemoglobin (HbA1c) levels in patients with diabetes. A meta-analysis of animal studies also suggests that spirulina blue-green algae have hypoglycemic effects.

Likelihood Possible Evidence B
Immunosuppressants

Theoretically, concurrent use of blue-green algae might interfere with immunosuppressive therapy.
Blue-green algae have been shown to stimulate the immune system.

Likelihood Possible Evidence D

Wheat Grass Extract, Dry2 drug types · 272 drugs

Antidiabetes Drugs

Theoretically, taking wheatgrass with antidiabetes drugs might lower blood glucose levels and increase the risk of hypoglycemia.
Animal research shows that taking wheatgrass stimulates the release of insulin from beta-cells and lowers blood glucose.

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

Theoretically, wheatgrass might decrease the levels and clinical effects of CYP1A2 substrates.
In vitro research shows that wheatgrass induces CYP1A2 enzymes.

Likelihood Possible Evidence D

Orange Peel Extract, Dry7 drug types · 246 drugs

Celiprolol (Celicard)

Consuming sweet orange with celiprolol can decrease oral absorption of celiprolol.
A pharmacokinetic study in healthy volunteers shows that celiprolol levels, after a single dose of 100 mg, are decreased by up to 90% in people who drink sweet orange juice 200 mL three times daily. It's not known if lower consumption of sweet orange juice will have the same effect. Theoretically, this occurs due to short-term inhibition of organic anion transporting polypeptide (OATP). Recommend separating drug administration and consumption of sweet orange by at least 4 hours.

Likelihood Likely Evidence B
Ivermectin (Stromectol, Others)

Consuming sweet orange juice with ivermectin can decrease the oral absorption of ivermectin.
A pharmacokinetic study in healthy volunteers shows that taking ivermectin orally with sweet orange juice 750 mL over 4 hours reduces the bioavailability of ivermectin. This effect does not seem to be related to effects on P-glycoprotein. The effect on ivermectin is more pronounced in males compared to females.

Likelihood Likely Evidence B
Organic Anion-Transporting Polypeptide Substrates (Oatp)

Consuming sweet orange juice can decrease oral absorption of OATP substrates. Separate administration by at least 4 hours.
Clinical research shows that consuming sweet orange juice inhibits OATP, which reduces bioavailability of oral drugs that are substrates of OATP. For example, sweet orange juice decreases bioavailability of fexofenadine, a substrate of OATP, by about 72% and of celiprolol, another OATP substrate, by up to 90%. Since sweet orange juice seems to affect OATP for a short time, recommend separating drug administration and consumption of sweet orange juice by at least 4 hours.

Likelihood Likely Evidence B
Pravastatin (Pravachol)

Consuming sweet orange juice with pravastatin can increase the absorption of pravastatin.
A small pharmacokinetic study in healthy volunteers shows that consuming sweet orange juice 800 mL over 3 hours, including before, during, and after taking pravastatin 10 mg, increases pravastatin levels by about 149%, without affecting pravastatin elimination. Theoretically this effect might be due to modulation of organic anion transporting polypeptides (OATPs) by sweet orange juice. Sweet orange juice does not seem to affect simvastatin levels, but it is not known if sweet orange affects any of the other statins.

Likelihood Likely Evidence B
Fexofenadine (Allegra)

Consuming sweet orange juice with fexofenadine can decrease oral absorption of fexofenadine.
Clinical research shows that coadministration of sweet orange juice 1200 mL decreases bioavailability of fexofenadine by about 72%. In an animal model, sweet orange juice decreased bioavailability of fexofenadine by 31%. Fexofenadine manufacturer data indicates that concomitant administration of sweet orange juice and fexofenadine results in larger wheal and flare sizes in research models. This suggests that sweet orange reduces the clinical response to fexofenadine. Theoretically, this occurs due to short-term inhibition of organic anion transporting polypeptide (OATP). Recommend separating drug administration and consumption of sweet orange by at least 4 hours.

Likelihood Likely Evidence B
P-Glycoprotein Substrates

Sweet orange juice seems to modulate P-glycoprotein (P-gp), which might affect the blood levels of P-gp substrates.
Animal and in vitro research suggest that orange juice extract inhibits drug efflux by P-gp, increasing absorption and levels of P-gp substrates. In contrast, pharmacokinetic research in humans shows that drinking large amounts of sweet orange juice decreases absorption and levels of the P-gp substrate celiprolol. This suggests that orange juice actually induces drug efflux by P-gp or affects drug levels by another mechanism such as inhibiting the gut drug transporter called organic anion transporting polypeptide (OATP). Until more is known, sweet orange juice should be used cautiously in people taking P-gp substrates.

Likelihood Possible Evidence B
Quinolone Antibiotics

Calcium-fortified sweet orange juice might reduce quinolone absorption.
Calcium binds to quinolones in the gut. Theoretically, the calcium in certain fortified orange juices can also bind to quinolone antibiotics and reduce their absorption and levels.

Likelihood Possible Evidence D

Spinach Leaf Extract, Dry2 drug types · 88 drugs

Antidiabetes Drugs

There are claims that spinach leaves have hypoglycemic effects. Evidence from clinical research suggests that consumption of a spinach-rich meal reduces post-meal blood glucose levels. Theoretically, spinach might have additive effects with antidiabetes drugs and increase the risk of hypoglycemia. Monitor blood glucose levels closely. Dose adjustments might be necessary. Some antidiabetes drugs include glimepiride (Amaryl), glyburide (DiaBeta, Glynase PresTab, Micronase), insulin, pioglitazone (Actos), rosiglitazone (Avandia), and others.

Likelihood Possible Evidence D
Warfarin (Coumadin)

Spinach contains vitamin K, which can interfere with the activity of warfarin.
In human research, although eating spinach with one meal does not result in coagulation test results outside the therapeutic range, daily consumption for one week necessitates dose adjustment of warfarin. Individuals using anticoagulants should consume a consistent daily amount of spinach to maintain the effect of anticoagulant therapy.

Likelihood Possible Evidence D

Dulse Leaf Extract, Dry7 drug types · 85 drugs

Amiodarine (Cordarone)

Theoretically, combining dulse with amiodarone might cause excessively high iodine levels.
Dulse is rich in iodine, and amiodarone contains 37.3% iodine and can increase iodine levels.

Likelihood Possible Evidence D
Antithyroid Drugs

Theoretically, due to its iodine content, dulse might alter the effects of antithyroid drugs.
Dulse is rich in iodine. Iodine in high doses has been reported to cause both hyperthyroidism and hypothyroidism, depending on the individual's past medical history.

Likelihood Possible Evidence D
Digoxin (Lanoxin)

Theoretically, dulse might increase the risk of hyperkalemia when taken with digoxin.
Dulse is rich in potassium, and digoxin can increase potassium levels in the blood. This interaction has not been demonstrated in humans.

Likelihood Possible Evidence D
Thyroid Hormone

Theoretically, due to its iodine content, dulse might alter the effects of thyroid hormone.
Dulse is rich in iodine. Iodine in high doses has been reported to cause both hyperthyroidism and hypothyroidism, depending on the individual's past medical history. Although dulse has been associated with a statistically significant increase in thyroid stimulating hormone (TSH) levels in clinical research, clinically significant increases have not been documented.

Likelihood Possible Evidence D
Ace Inhibitors (Aceis)

Theoretically, dulse might increase the risk of hyperkalemia when taken with ACEIs.
Dulse is rich in potassium. ACEIs block the actions of the renin-angiotensin-aldosterone system and reduce potassium excretion. Concomitant use of these drugs with moderate dietary potassium intake (about 3775-5200 mg daily) does not increase serum potassium levels. However, using these drugs while consuming dulse in quantities that provide larger amounts of potassium daily might increase the risk of hyperkalemia. Additionally, in vitro research suggests that dulse protein hydrolysates inhibit the activity of ACE. However, these effects have not been demonstrated in humans.

Likelihood Possible Evidence D
Angiotensin Receptor Blockers (Arbs)

Theoretically, dulse might increase the risk of hyperkalemia when taken with ARBs.
Dulse is rich in potassium. ARBs block the actions of the renin-angiotensin-aldosterone system and reduce potassium excretion. Concomitant use of these drugs with moderate dietary potassium intake (about 3775-5200 mg daily) does not increase serum potassium levels. However, using these drugs while consuming dulse in quantities that provide higher amounts of potassium daily might increase the risk of hyperkalemia. Additionally, in vitro research suggests that dulse protein hydrolysates inhibit the activity of angiotensin converting enzyme (ACE). However, these effects have not been demonstrated in humans.

Likelihood Possible Evidence D
Potassium-Sparing Diuretics

Theoretically, dulse might increase the risk of hyperkalemia when taken with potassium-sparing diuretics.
Dulse is rich in potassium, and potassium-sparing diuretics can increase potassium levels in the blood. This interaction has not been shown in humans.

Likelihood Possible Evidence D

Barley Grass Extract, Dry1 drug type · 1 drug

Triclabendazole (Egaten)

Theoretically, barley might decrease the clinical effects of triclabendazole.
Animal research suggests that a diet supplemented with barley can reduce the bioavailability of triclabendazole when taken concomitantly. This effect has not been shown in humans.

Likelihood Possible Evidence D

Lemon Peel Extract, Dry1 drug type · 1 drug

Itraconazole (Sporanox)

Theoretically, taking itraconazole capsules or tablets with a beverage containing lemon might increase the levels and clinical effects of itraconazole.
In one case report, dissolving itraconazole tablets in a small amount of specific beverages containing lemon prior to administration increased the level of itraconazole in a lung transplant patient. In this case, the increased bioavailability was desirable and was likely due to improved tablet dissolution in the acidic beverage.

Likelihood Possible Evidence D
The maker

Brand information

Manufacturer and brand details for Energreen, from the product label.

Herbal Terra

See all Herbal Terra products
Name
Herbal Terra LLC
Phone Number
+18083857868
Web Address
herbalterra.com
Pharmacist Counseling Corner

Energreen by Herbal Terra: Common Questions

Does Energreen by Herbal Terra interact with any medications?
Yes. Based on its ingredients, Energreen has a known interaction with 1,401 medications, including 50 rated major. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Energreen contains 11 active ingredients, and an interaction can come from any of them. We check every ingredient, combine the results into one list per medication, and show which ingredient and mechanism is responsible.
Where does this information come from?
The product label data comes from the NIH Dietary Supplement Label Database (DSLD); the interaction data is built on the Natural Medicines database and reviewed by HelloPharmacist pharmacists.
Can I take this while I'm pregnant?
Alfalfa in this product is rated possibly unsafe in pregnancy because of its estrogen-like activity. Wheat grass is best avoided unless your doctor clears it. Barley, dandelion, lemon peel, and orange peel lack enough safety data. Beet, orange peel, and spinach are considered likely safe as foods, but concentrated supplements haven't been well studied. Talk with your doctor or pharmacist before using Energreen during pregnancy.
Does this product actually work?
Barley grass has evidence supporting its use for high cholesterol and heart disease risk. Beet root is possibly effective for athletic performance and exercise soreness. For the other ingredients—alfalfa, dandelion, dulse, lemon peel, orange peel, spinach, spirulina, kelp, and wheat grass—we don't have reliable evidence establishing effectiveness for any specific condition in the data we hold.
What are the most common side effects?
Digestive upset is the most frequent issue: gas, bloating, diarrhea, stomach discomfort, and heartburn appear across multiple ingredients. Lemon peel is more likely to cause heartburn. Barley and wheat grass can trigger allergic reactions in sensitive people. Alfalfa and dandelion may cause dermatitis. Most people tolerate these extracts without serious problems in the short term.
Is there gluten in this product?
The facts on file don't specify whether this product is gluten-free. Since barley and wheat grass both contain gluten, this product likely contains it or carries a cross-contamination risk. Check the label or contact the manufacturer if gluten sensitivity is a concern.
Can I take this with my blood pressure medication?
Several ingredients may affect blood pressure or interact with blood pressure drugs. Beet contains nitrates that can theoretically lower blood pressure slightly. Dandelion has diuretic properties and could affect certain blood pressure medications. Dulse is high in potassium, which matters if you take ACE inhibitors or ARBs. Run your specific blood pressure medication through the interaction checker on this page before starting.
What's in the liquid base?
The product is preserved and suspended in alcohol, water, and glycerin. If you need to avoid alcohol, this formulation may not be suitable for you.

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.

Energreen label
Go deeper

The Full Monographs Behind Energreen’s Ingredients

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

Herb & supplement monograph

Alfalfa

Interacts with 583 drugs

Alfalfa is a nutrient-rich legume that people use for high cholesterol, menopause symptoms, and general wellness, but solid human evidence for most of these uses is limited. It is best avoid...

Read the full Alfalfa monograph →
Herb & supplement monograph

Barley

Interacts with 1 drug

Barley is a nutritious whole grain that is a good source of soluble fiber called beta-glucan, which has solid evidence for modestly lowering LDL ('bad') cholesterol when eaten regularly. It...

Read the full Barley monograph →
Herb & supplement monograph

Beet

Interacts with 861 drugs

Beet, 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 monograph

Dandelion

Interacts with 457 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 these uses is very limited, so its benefits...

Read the full Dandelion monograph →
Herb & supplement monograph

Dulse

Interacts with 85 drugs

Dulse is a red seaweed eaten as a food in many coastal cultures and is a natural source of iodine, potassium, protein, and antioxidant compounds. As a food it is generally considered safe fo...

Read the full Dulse monograph →
Herb & supplement monograph

Lemon

Interacts with 1 drug

Lemon is a common citrus fruit that is a good source of vitamin C and citric acid, and it is widely used in food, drinks, and home remedies. While it can support hydration and a healthy diet...

Read the full Lemon monograph →
Herb & supplement monograph

Sweet Orange

Interacts with 246 drugs

Sweet orange is a common citrus fruit that is a good source of vitamin C, fiber, and antioxidants, and is enjoyed as a food worldwide. Its peel and essential oil are used in aromatherapy and...

Read the full Sweet Orange monograph →
Herb & supplement monograph

Spinach

Interacts with 88 drugs

Spinach is a nutrient-dense leafy green that is a healthy part of a balanced diet, providing vitamins, minerals, fiber, and antioxidants. While it is very safe as a food, concentrated supple...

Read the full Spinach monograph →
Herb & supplement monograph

Blue-green Algae

Interacts with 327 drugs

Blue-green algae are nutrient-rich aquatic microorganisms (such as spirulina and Klamath Lake algae) taken as a supplement for energy, nutrition, and general wellness. Evidence for most heal...

Read the full Blue-green Algae monograph →
Herb & supplement monograph

Fucus Vesiculosus

Interacts with 891 drugs

Fucus vesiculosus (bladderwrack) is a brown seaweed rich in iodine that has been used traditionally for thyroid concerns, weight, and skin. There is little solid human evidence to support mo...

Read the full Fucus Vesiculosus monograph →
Herb & supplement monograph

Wheatgrass

Interacts with 272 drugs

Wheatgrass is the young grass of the wheat plant, taken as a juice or powder, and is mainly used as a concentrated source of vitamins and plant nutrients. Solid scientific evidence for most...

Read the full Wheatgrass monograph →
Sources

Sources & How We Checked

Energreen's label data comes from the NIH Dietary Supplement Label Database; the ingredient interaction data is from the Natural Medicines database, reviewed by our pharmacists.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

The 160 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.

Alfalfa 32 references
  1. Newall CA, Anderson LA, Philpson JD. Herbal Medicine: A Guide for Healthcare Professionals. London, UK: The Pharmaceutical Press, 1996.
  2. The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999.
  3. Leung AY, Foster S. Encyclopedia of Common Natural Ingredients Used in Food, Drugs and Cosmetics. 2nd ed. New York, NY: John Wiley & Sons, 1996.
  4. Kurzer MS, Xu X. Dietary phytoestrogens. Annu Rev Nutr 1997;17:353-81. PubMed
  5. Farber JM, Carter AO, Varughese PV, et al. Listeriosis traced to the consumption of alfalfa tablets and soft cheese [Letter to the Editor]. N Engl J Med 1990;322:338. PubMed
  6. Molgaard J, von Schenck H, Olsson AG. Alfalfa seeds lower low density lipoprotein cholesterol and apolipoprotein B concentrations in patients with type II hyperlipoproteinemia. Atherosclerosis 1987;65:173-9. PubMed
  7. Light TD, Light JA. Acute renal transplant rejection possibly related to herbal medications. Am J Transplant 2003;3:1608-9. PubMed
  8. Prete PE. The mechanism of action of L-canavanine in inducing autoimmune phenomena. Arthritis Rheum 1985;28:1198-200. PubMed
  9. Alcocer-Varela J, Iglesias A, Llorente L, Alarcon-Segovia D. Effects of L-canavanine on T cells may explain the induction of systemic lupus erythematosus by alfalfa. Arthritis Rheum 1985;28:52-7. PubMed
  10. Roberts JL, Hayashi JA. Exacerbation of SLE associated with alfalfa ingestion. N Engl J Med 1983;308:1361. DOI
  11. Feingold, R. M. Should we fear "health foods"? Arch Intern Med 7-12-1999;159(13):1502. PubMed
  12. Taormina, P. J., Beuchat, L. R., and Slutsker, L. Infections associated with eating seed sprouts: an international concern. Emerg.Infect.Dis 1999;5(5):626-634. PubMed
  13. Backer, H. D., Mohle-Boetani, J. C., Werner, S. B., Abbott, S. L., Farrar, J., and Vugia, D. J. High incidence of extra-intestinal infections in a Salmonella Havana outbreak associated with alfalfa sprouts. Public Health Rep. 2000;115(4):339-345. PubMed
  14. Mohle-Boetani J, Werner B, Polumbo M, and et al. From the Centers for Disease Control and Prevention. Alfalfa sprouts-- Arizona, California, Colorado, and New Mexico, February-April, 2001. JAMA 2-6-2002;287(5):581-582.
  15. Howard, M. B. and Hutcheson, S. W. Growth dynamics of Salmonella enterica strains on alfalfa sprouts and in waste seed irrigation water. Appl.Environ.Microbiol. 2003;69(1):548-553.
  16. Winthrop, K. L., Palumbo, M. S., Farrar, J. A., Mohle-Boetani, J. C., Abbott, S., Beatty, M. E., Inami, G., and Werner, S. B. Alfalfa sprouts and Salmonella Kottbus infection: a multistate outbreak following inadequate seed disinfection with heat and chl
  17. Strapp, C. M., Shearer, A. E., and Joerger, R. D. Survey of retail alfalfa sprouts and mushrooms for the presence of Escherichia coil O157:H7, Salmonella, and Listeria with BAX, and evaluation of this polymerase chain reaction-based system with experimen
  18. Akaogi, J., Barker, T., Kuroda, Y., Nacionales, D. C., Yamasaki, Y., Stevens, B. R., Reeves, W. H., and Satoh, M. Role of non-protein amino acid L-canavanine in autoimmunity. Autoimmun.Rev 2006;5(6):429-435. PubMed
  19. Burden and causes of foodborne disease in Australia: Annual report of the OzFoodNet network, 2005. Commun.Dis Intell. 2006;30(3):278-300.
  20. Shemesh, M., Lindner, H. R., and Ayalon, N. Affinity of rabbit uterine oestradiol receptor for phyto-oestrogens and its use in a competitive protein-binding radioassay for plasma coumestrol. J Reprod.Fertil. 1972;29(1):1-9. PubMed
  21. Elakovich, S. D. and Hampton, J. M. Analysis of coumestrol, a phytoestrogen, in alfalfa tablets sold for human consumption. J Agric.Food Chem. 1984;32(1):173-175. PubMed
  22. Malinow, M. R., Bardana, E. J., Jr., Pirofsky, B., Craig, S., and McLaughlin, P. Systemic lupus erythematosus-like syndrome in monkeys fed alfalfa sprouts: role of a nonprotein amino acid. Science 4-23-1982;216(4544):415-417. PubMed
  23. Malinow, M. R., McLaughlin, P., and Stafford, C. Alfalfa seeds: effects on cholesterol metabolism. Experientia 5-15-1980;36(5):562-564. PubMed
  24. Farnsworth, N. R. Alfalfa pills and autoimmune diseases. Am J Clin Nutr. 1995;62(5):1026-1028. DOI
  25. Herbert, V. and Kasdan, T. S. Alfalfa, vitamin E, and autoimmune disorders. Am J Clin Nutr 1994;60(4):639-640.
  26. Mahon, B. E., Ponka, A., Hall, W. N., Komatsu, K., Dietrich, S. E., Siitonen, A., Cage, G., Hayes, P. S., Lambert-Fair, M. A., Bean, N. H., Griffin, P. M., and Slutsker, L. An international outbreak of Salmonella infections caused by alfalfa sprouts grow
  27. Gray, A. M. and Flatt, P. R. Pancreatic and extra-pancreatic effects of the traditional anti- diabetic plant, Medicago sativa (lucerne). Br J Nutr. 1997;78(2):325-334.
  28. Van Beneden, C. A., Keene, W. E., Strang, R. A., Werker, D. H., King, A. S., Mahon, B., Hedberg, K., Bell, A., Kelly, M. T., Balan, V. K., Mac Kenzie, W. R., and Fleming, D. Multinational outbreak of Salmonella enterica serotype Newport infections due to
  29. Rubenstein AH, Levin NW, and Elliott GA. Manganese-induced hypoglycemia. Lancet 1962;1348-1351.
  30. Kaufman W. Alfalfa seed dermatitis. JAMA 1954;155(12):1058-1059. PubMed
  31. Ponka A, Andersson Y, Siitonen A, and et al. Salmonella in alfalfa sprouts. Lancet 1995;345:462-463. PubMed
  32. Puschner B, Chen X, Read D, Affolter VK. Alfalfa hay induced primary photosensitization in horses. Vet J. 2016 May;211:32-8. PubMed

See these in context on the Alfalfa monograph →

Barley 15 references
  1. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
  2. Fernandez-Anaya S, Crespo JF, Rodriguez JR, et al. Beer anaphylaxis. J Allergy Clin Immunol 1999;103:959-60.
  3. Lembo A, Camilleri M. Chronic constipation. N Engl J Med 2003;349:1360-8. . PubMed
  4. Ferre, I., Giraldez, F. J., Alvarez-Bujidos, M. L., and Mantecon, A. R. Influence of barley supplement on plasma concentration of triclabendazole metabolites in sheep. Vet.Rec. 11-22-1997;141(21):549-551. PubMed
  5. Curioni, A., Santucci, B., Cristaudo, A., Canistraci, C., Pietravalle, M., Simonato, B., and Giannattasio, M. Urticaria from beer: an immediate hypersensitivity reaction due to a 10- kDa protein derived from barley. Clin Exp Allergy 1999;29(3):407-413. PubMed
  6. Fernandez-Anaya, S., Crespo, J. F., Rodriguez, J. R., Daroca, P., Carmona, E., Herraez, L., and Lopez-Rubio, A. Beer anaphylaxis. J Allergy Clin Immunol. 1999;103(5 Pt 1):959-960.
  7. Cronin, E. Contact dermatitis from barley dust. Contact Dermatitis 1979;5(3):196. PubMed
  8. Block, G., Tse, K. S., Kijek, K., Chan, H., and Chan-Yeung, M. Baker's asthma. Studies of the cross-antigenicity between different cereal grains. Clin Allergy 1984;14(2):177-185.
  9. van Ketel, W. G. Immediate type allergy to malt in beer. Contact Dermatitis 1980;6(4):297-298. PubMed
  10. Ellis, H. J., Doyle, A. P., Day, P., Wieser, H., and Ciclitira, P. J. Demonstration of the presence of coeliac-activating gliadin-like epitopes in malted barley. Int Arch Allergy Immunol. 1994;104(3):308-310. PubMed
  11. Vidal, C. and Gonzalez-Quintela, A. Food-induced and occupational asthma due to barley flour. Ann Allergy Asthma Immunol. 1995;75(2):121-124.
  12. Gutgesell, C. and Fuchs, T. Contact urticaria from beer. Contact Dermatitis 1995;33(6):436-437. PubMed
  13. Baker, P. G. and Read, A. E. Oats and barley toxicity in coeliac patients. Postgrad.Med J 1976;52(607):264-268. PubMed
  14. Nakase, M., Usui, Y., Alvarez-Nakase, A. M., Adachi, T., Urisu, A., Nakamura, R., Aoki, N., Kitajima, K., and Matsuda, T. Cereal allergens: rice-seed allergens with structural similarity to wheat and barley allergens. Allergy 1998;53(46 Suppl):55-57. PubMed
  15. Pereira, F., Rafael, M., and Lacerda, M. H. Contact dermatitis from barley. Contact Dermatitis 1998;39(5):261-262. PubMed

See these in context on the Barley monograph →

Beet 14 references
  1. Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.
  2. Clifford T, Berntzen B, Davison GW, et al. Effects of beetroot juice on recovery of muscle function and performance between bouts of repeated sprint exercise. Nutrients 2016;8. pii: E506. PubMed
  3. Siervo M, Lara J, Ogbonmwan I, Mathers JC. Inorganic nitrate and beetroot juice supplementation reduces blood pressure in adults: a systematic review and meta-analysis. J Nutr 2013;143:818-26. PubMed
  4. Clifford T, Howatson G, West DJ, Stevenson EJ. Beetroot juice is more beneficial than sodium nitrate for attenuating muscle pain after strenuous eccentric-bias exercise. Appl Physiol Nutr Metab. 2017;42(11):1185-1191. PubMed
  5. Clifford T, Bell O, West DJ, Howatson G, Stevenson EJ. The effects of beetroot juice supplementation on indices of muscle damage following eccentric exercise. Eur J Appl Physiol. 2016;116(2):353-62. PubMed
  6. Wylie LJ, Kelly J, Bailey SJ, et al. Beetroot juice and exercise: pharmacodynamic and dose-response relationships. J Appl Physiol (1985). 2013;115(3):325-36. PubMed
  7. Garnacho-Castaño MV, Palau-Salvà G, Cuenca E, et al. Effects of a single dose of beetroot juice on cycling time trial performance at ventilatory thresholds intensity in male triathletes. J Int Soc Sports Nutr. 2018;15(1):49. PubMed
  8. Rasica L, Porcelli S, Marzorati M, et al. Ergogenic effects of beetroot juice supplementation during severe-intensity exercise in obese adolescents. Am J Physiol Regul Integr Comp Physiol. 2018;315(3):R453-R460. PubMed
  9. Henrohn D, Björkstrand K, Lundberg JO, et al. Effects of oral supplementation with nitrate-rich beetroot juice in patients with pulmonary arterial hypertension-results from BEET-PAH, an exploratory randomized, double-blind, placebo-controlled, crosso
  10. Serra-Payá N, Garnacho-Castaño MV, Sánchez-Nuño S, et al. The relationship between resistance exercise performance and ventilatory efficiency after beetroot juice intake in well-trained athletes. Nutrients 2021;13(4):1094. PubMed
  11. Haron MH, Dale O, Martin K, et al. Evaluation of the Herb-Drug Interaction Potential of Commonly Used Botanicals on the US Market with Regard to PXR- and AhR-Mediated Influences on CYP3A4 and CYP1A2. J Diet Suppl 2022. PubMed
  12. Hemmatinafar M, Zaremoayedi L, Koushkie Jahromi M, et al. Effect of Beetroot Juice Supplementation on Muscle Soreness and Performance Recovery after Exercise-Induced Muscle Damage in Female Volleyball Players. Nutrients 2023;15(17):3763. PubMed
  13. Lim SH, Bae S, Lee HS, Han HK, Choi CI. Effect of Betanin, the Major Pigment of Red Beetroot (Beta vulgaris L.), on the Activity of Recombinant Human Cytochrome P450 Enzymes. Pharmaceuticals (Basel) 2023;16(9):1224. PubMed
  14. Oscherwitz M, Tamayo RM, Heudebert A, Centor R. A Case of Pseudo-Hematochezia from Beet Supplement Ingestion. Am J Med 2023;136(9):e177-e178. PubMed

See these in context on the Beet monograph →

Dandelion 27 references
  1. Maliakal PP, Wanwimolruk S. Effect of herbal teas on hepatic drug metabolizing enzymes in rats. J Pharm Pharmacol 2001;53:1323-9. PubMed
  2. Williams CA, Goldstone F, Greenham J. Flavonoids, cinnamic acids and coumarins from the different tissues and medicinal preparations of Taraxacum officinale. Phytochemistry 1996;42:121-7. PubMed
  3. Hussain Z, Waheed A, Qureshi RA, et al. The effect of medicinal plants of Islamabad and Murree region of Pakistan on insulin secretion from INS-1 cells. Phytother Res 2004;18:73-7. PubMed
  4. Racz-Kotilla E, Racz G, Solomon A. The action of Taraxacum officinale extracts on the body weight and diuresis of laboratory animals. Planta Med 1974;26:212-7. PubMed
  5. Zhu M, Wong PY, Li RC. Effects of taraxacum mongolicum on the bioavailability and disposition of ciprofloxacin in rats. J Pharm Sci 1999;88:632-4. PubMed
  6. Jovanovic M, Mimica-Dukic N, Poljacki M, Boza P. Erythema multiforme due to contact with weeds: a recurrence after patch testing. Contact Dermatitis 2003;48:17-25. PubMed
  7. Chivato T, Juan F, Montoro A, Laguna R. Anaphylaxis induced by ingestion of a pollen compound. J Investig Allergol Clin Immunol 1996;6:208-9.
  8. Cohen SH, Yunginger JW, Rosenberg N, Fink JN. Acute allergic reaction after composite pollen ingestion. J Allergy Clin Immunol 1979;64:270-4. PubMed
  9. Lovell CR, Rowan M. Dandelion dermatitis. Contact Dermatitis 1991;25:185-8. PubMed
  10. Agarwal SC, Crook JR, Pepper CB. Herbal remedies -- how safe are they? A case report of polymorphic ventricular tachycardia/ventricular fibrillation induced by herbal medication used for obesity. Int J Cardiol 2006;106:260-1. PubMed
  11. Martín-Muñoz MF, Bartolome B, Caminoa M, et al. Bee pollen: a dangerous food for allergic children. Identification of responsible allergens. Allergol Immunopathol (Madr) 2010;38:263-5. PubMed
  12. Neef H, Cilli F, Declerck PJ, et al. Platelet anti-aggregating activity of Taraxacum officinale Weber. Phytotherapy Research 1996;10:s138-s140.
  13. Cuzzolin L, Zaffani S, and Benoni G. Safety implications regarding use of phytomedicines. Eur.J Clin Pharmacol. 2006;62:37-42. PubMed
  14. Posadzki, P., Watson, L. K., and Ernst, E. Adverse effects of herbal medicines: an overview of systematic reviews. Clin Med 2013;13(1):7-12. PubMed
  15. Wakelin, S. H., Marren, P., Young, E., and Shaw, S. Compositae sensitivity and chronic hand dermatitis in a seven-year-old boy. Br J Dermatol 1997;137(2):289-291. PubMed
  16. Ingber, A. Seasonal allergic contact dermatitis from Taraxacum officinale (dandelion) in an Israeli florist. Contact Dermatitis 2000;43(1):49.
  17. Rodriguez, B., Rodriguez, A., de Barrio, M., Tornero, P., and Baeza, M. L. Asthma induced by canary food mix. Allergy Asthma Proc. 2003;24(4):265-268.
  18. Syhaieva, I. A. [Efficiency of specific immunotherapy in treatment of patients with seasonal allergic rhinitis]. Lik.Sprava. 2006;(1-2):51-53.
  19. Catania, M. A., Oteri, A., Caiello, P., Russo, A., Salvo, F., Giustini, E. S., Caputi, A. P., and Polimeni, G. Hemorrhagic cystitis induced by an herbal mixture. South.Med.J. 2010;103(1):90-92. PubMed
  20. Goksu, E., Eken, C., Karadeniz, O., and Kucukyilmaz, O. First report of hypoglycemia secondary to dandelion (Taraxacum officinale) ingestion. Am J Emerg.Med 2010;28(1):111-112. PubMed
  21. Fernandez-Gonzalez, D., Gonzalez-Parrado, Z., Vega-Maray, A. M., Valencia-Barrera, R. M., Camazon-Izquierdo, B., De, Nuntiis P., and Mandrioli, P. Platanus pollen allergen, Pla a 1: quantification in the atmosphere and influence on a sensitizing populati
  22. Liang, K. L., Su, M. C., Shiao, J. Y., Wu, S. H., Li, Y. H., and Jiang, R. S. Role of pollen allergy in Taiwanese patients with allergic rhinitis. J Formos.Med Assoc. 2010;109(12):879-885. PubMed
  23. Yang, Y., Zhao, Y., Wang, C. S., Wang, X. D., and Zhang, L. [Prevalence of sensitization to aeroallergens in 10 030 patients with allergic rhinitis]. Zhonghua Er.Bi Yan.Hou Tou.Jing.Wai Ke Za Zhi 2011;46(11):914-920.
  24. Davies, M. G. and Kersey, P. J. Contact allergy to yarrow and dandelion. Contact Dermatitis 1986;14(4):256-257. PubMed
  25. Collins JM and Miller DR. Dandelion green bezoar following antrectomy and vagotomy - case report. J Kansas Med Soc 1966;67(6):303-304.
  26. Moriarty B, Pinney JH, Owen-Casey MP, Rustin MH, Deroide F, Laing C, Davenport A. Digital necrosis from dandelion tea. Br J Dermatol. 2013 Jul;169(1):227-30. PubMed
  27. Onal S, Timur S, Okutucu B, Zihnioglu F. Inhibition of alphaglucosidase by aqueous extracts of some potent antidiabetic medicinal herbs. Prep Biochem Biotechnol 2005;35:29-36.

See these in context on the Dandelion monograph →

Dulse 5 references
  1. Malta D, Arcand J, Ravindran A, Floras V, Allard JP, Newton GE. Adequate intake of potassium does not cause hyperkalemia in hypertensive individuals taking medications that antagonize the renin angiotensin aldosterone system. Am J Clin Nutr 2016 Oct;104(4 PubMed
  2. Allsopp P, Crowe W, Bahar B, et al. The effect of consuming Palmaria palmata-enriched bread on inflammatory markers, antioxidant status, lipid profile and thyroid function in a randomised placebo-controlled intervention trial in healthy adults. Eur J Nutr PubMed
  3. McGrath BM, Harmon JP, Bishop G. Palmaria palmata (Dulse) as an unusual maritime aetiology of hyperkalemia in a patient with chronic renal failure: a case report. J Med Case Rep. 2010;4:301. PubMed
  4. Furuta T, Miyabe Y, Yasui H, Kinoshita Y, Kishimura H. Angiotensin I converting enzyme inhibitory peptides derived from phycobiliproteins of dulse Palmaria palmata. Mar Drugs. 2016;14(2):32. PubMed
  5. Takase T, Nakamura A, Miyoshi H, et al. Effects of Palmaria palmata on lipid metabolism and glycemic control in participants with hypercholesterolemia in a randomized double-blind placebo-controlled trial. Phytother Res. 2020.

See these in context on the Dulse monograph →

Lemon 2 references
  1. Ruggenenti P, Caruso MR, Cortinovis M, et al. Fresh lemon juice supplementation for the prevention of recurrent stones in calcium oxalate nephrolithiasis: A pragmatic, prospective, randomised, open, blinded endpoint (PROBE) trial. EClinicalMedicine 2021;4 PubMed
  2. Umemura K, Katada Y, Nakagawa S, et al. Improved absorption of itraconazole tablet by co-administration with lemon beverages in a lung transplant recipient: A case report. J Infect Chemother 2022;28(8):1203-1207. PubMed

See these in context on the Lemon monograph →

Sweet Orange 17 references
  1. Leung AY, Foster S. Encyclopedia of Common Natural Ingredients Used in Food, Drugs and Cosmetics. 2nd ed. New York, NY: John Wiley & Sons, 1996.
  2. FDA, CFSAN. FDA-approved potassium health claim notification for potassium containing foods. 2000. Available at: www.cfsan.fda.gov/~dms/hclm-k.html.
  3. Kurowska EM, Spence JD, Jordan J, et al. HDL-cholesterol-raising effect of orange juice in subjects with hypercholesterolemia. Am J Clin Nutr 2000;72:1095-100. PubMed
  4. Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
  5. Bailey DG, Dresser GK, Munoz C, et al. Reduction of fexofenadine bioavailability by fruit juices. Clin Pharmacol Ther 2001;69:P21.
  6. Pletz MW, Petzold P, Allen A, et al. Effect of calcium carbonate on bioavailability of orally administered gemifloxacin. Antimicrob Agents Chemother 2003;47:2158-60.. PubMed
  7. Lilja JJ, Juntti-Patinen L, Neuvonen PJ. Orange juice substantially reduces the bioavailability of the beta-adrenergic-blocking agent celiprolol. Clin Pharmacol Ther 2004;75:184-90.
  8. Tian R, Koyabu N, Takanaga H, et al. Effects of grapefruit juice and orange juice on the intestinal efflux of P-glycoprotein substrates. Pharm Res 2002;19:802-9. PubMed
  9. Vanapalli SR, Chen Y, Ellingrod VL, et al. Orange juice decreases the oral bioavailability of ivermectin in health volunteers. Clin Pharmacol Ther 2003;73 (Abstract PDII-A-10):P94.
  10. Huang SM, Lesko LJ. Drug-drug, drug-dietary supplement, and drug-citrus fruit and other food interactions: what have we learned? J Clin Pharmacol 2004;44:559-69. PubMed
  11. Koitabashi Y, Kumai T, Matsumoto N, et al. Orange juice increased the bioavailability of pravastatin, 3-hydroxy-3-methylglutaryl CoA reductase inhibitor, in rats and healthy human subjects. Life Sci 2006;78:2852-9. PubMed
  12. Takanaga H, Ohnishi A, Yamada S, et al. Polymethoxylated flavones in orange juice are inhibitors of P-glycoprotein but not cytochrome P450 3A4. J Pharmacol Exp Ther 2000;293:230-6. DOI
  13. Greenblatt DJ. Analysis of drug interactions involving fruit beverages and organic anion-transporting polypeptides. J Clin Pharmacol 2009;49:1403-7. PubMed
  14. Bailey DG. Fruit juice inhibition of uptake transport: a new type of food-drug interaction. Br J Clin Pharmacol 2010;70:645-55. PubMed
  15. Kamath AV, Yao M, Zhang Y, Chong S. Effect of fruit juices on the oral bioavailability of fexofenadine in rats. J Pharm Sci 2005;94:233-9. PubMed
  16. Kays MB, Overholser BR, Mueller BA, et al. Effects of sevelamer hydrochloride and calcium acetate on the oral bioavailability of ciprofloxacin. Am J Kidney Dis. 2003;42(6):1253-9. PubMed
  17. Neuhofel, A. L., Wilton, J. H., Victory, J. M., Hejmanowsk, L. G., and Amsden, G. W. Lack of bioequivalence of ciprofloxacin when administered with calcium-fortified orange juice: a new twist on an old interaction. J Clin Pharmacol. 2002;42(4):461-466. DOI

See these in context on the Sweet Orange monograph →

Spinach 6 references
  1. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
  2. Karlson, B., Leijd, B., and Hellstrom, K. On the influence of vitamin K-rich vegetables and wine on the effectiveness of warfarin treatment. Acta Med Scand. 1986;220(4):347-350. PubMed
  3. Roller, E., Meller, S., Homey, B., Ruzicka, T., and Neumann, N. J. [Contact dermatitis caused by spinach, hedge mustard and chives]. Hautarzt 2003;54(4):374-375.
  4. Schuller, A., Morisset, M., Maadi, F., Kolopp Sarda, M. N., Fremont, S., Parisot, L., Kanny, G., and Moneret-Vautrin, D. A. Occupational asthma due to allergy to spinach powder in a pasta factory. Allergy 2005;60(3):408-409. PubMed
  5. Gustafsson, K., Asp, N. G., Hagander, B., and Nyman, M. Satiety effects of spinach in mixed meals: comparison with other vegetables. Int.J.Food Sci.Nutr. 1995;46(4):327-334. PubMed
  6. Schreiber, J., Muller, E., Becker, W. M., Zabel, P., Schlaak, M., and Amthor, M. [Spinach powder-induced exogenous allergic alveolitis]. Pneumologie 1998;52(1):61-65.

See these in context on the Spinach monograph →

Blue-green Algae 22 references
  1. Jensen GS, Ginsberg DJ, Huerta P, et al. Consumption of Aphanizomenon flos-aquae has rapid effects on the circulation and function of immune cells in humans. A novel approach to nutritional mobilization of the immune system. JANA 2000;2:50-6.
  2. Iwasa M, Yamamoto M, Tanaka Y, et al. Spirulina-associated hepatotoxicity. Am J Gastroenterol 2002;97:3212-13. PubMed
  3. Hayashi O, Katoh T, Okuwaki Y. Enhancement of antibody production in mice by dietary Spirulina platensis. J Nutr Sci Vitaminol (Tokyo) 1994;40:431-41.. PubMed
  4. Vitale S, Miller NR, Mejico LJ, et al. A randomized, placebo-controlled, crossover clinical trial of super blue-green algae in patients with essential blepharospasm or Meige syndrome. Am J Ophthalmol 2004;138:18-32. PubMed
  5. Mani UV, Desai S, Iyer U. Studies on the long-term effect of spirulina supplementation on serum lipid profile and glycated proteins in NIDDM patients. J Nutraceut 2000;2(3):25-32. DOI
  6. Chiu HF, Yang SP, Kuo YL, et al. Mechanisms involved in the antiplatelet effect of C-phycocyanin. Br J Nutr 2006;95:435-40. PubMed
  7. Hsiao G, Chou PH, Shen MY, et al. C-phycocyanin, a very potent and novel platelet aggregation inhibitor from Spirulina platensis. J Agric Food Chem 2005;53:7734-40.
  8. Katz M, Levine AA, Kol-Degani H, Kav-Venaki L. A compound herbal preparation (CHP) in the treatment of children with ADHD: a randomized controlled trial. J Atten Disord 2010;14:281-91. PubMed
  9. Madhyastha, H. K., Radha, K. S., Sugiki, M., Omura, S., and Maruyama, M. Purification of c-phycocyanin from Spirulina fusiformis and its effect on the induction of urokinase-type plasminogen activator from calf pulmonary endothelial cells. Phytomedicine PubMed
  10. Mazokopakis, E. E., Karefilakis, C. M., Tsartsalis, A. N., Milkas, A. N., and Ganotakis, E. S. Acute rhabdomyolysis caused by Spirulina (Arthrospira platensis). Phytomedicine. 2008;15(6-7):525-527. PubMed
  11. Halidou, Doudou M., Degbey, H., Daouda, H., Leveque, A., Donnen, P., Hennart, P., and Dramaix-Wilmet, M. [The effect of spiruline during nutritional rehabilitation: systematic review]. Rev.Epidemiol.Sante Publique 2008;56(6):425-431.
  12. Konno, T., Umeda, Y., Umeda, M., Kawachi, I., Oyake, M., and Fujita, N. [A case of inflammatory myopathy with widely skin rash following use of supplements containing Spirulina]. Rinsho Shinkeigaku 2011;51(5):330-333. PubMed
  13. Le TM, Knulst AC, Röckmann H. Anaphylaxis to Spirulina confirmed by skin prick test with ingredients of Spirulina tablets. Food Chem Toxicol 2014;74:309-10. PubMed
  14. Rzymski P, Niedzielski P, Kaczmarek N, Jurczak T, Klimaszyk P. The multidisciplinary approach to safety and toxicity assessment of microalgae-based food supplements following clinical cases of poisoning. Harmful Algae 2015;46:34-42. DOI
  15. Petrus M, Culerrier R, Campistron M, et al. First case report of anaphylaxis to spirulin: identification of phycocyanin as responsible allergen. Allergy 2010;65(7):924-5. PubMed
  16. Marles RJ, Barrett ML, Barnes J, et al. United States Pharmacopeia safety evaluation of spirulina. Crit Rev Food Sci Nutr 2011;51(7):593-604. PubMed
  17. Majdoub H, Ben Mansour M, Chaubet F, et al. Anticoagulant activity of a sulfated polysaccharide from the green alga Arthrospira platensis. Biochim Biophys Acta 2009;1790(10):1377-81. PubMed
  18. Cha BG, Kwak HW, Park AR, et al. Structural characteristics and biological performance of silk fibroin nanofiber containing microalgae spirulina extract. Biopolymers 2014;101(4):307-18. PubMed
  19. Jensen GS, Drapeau C, Lenninger M, Benson KF. Clinical safety of a high dose of phycocyanin-enriched aqueous extract from Arthrospira (Spirulina) platensis: results from a randomized, double-Blind, placebo-controlled study with a focus on anticoagulant ac
  20. Hamedifard Z, Milajerdi A, Reiner Z, Taghizadeh M, Kolahdooz F, Asemi Z. The effects of spirulina on glycemic control and serum lipoproteins in patients with metabolic syndrome and related disorders: A systematic review and meta-analysis of randomized con
  21. Moradi S, Zobeiri M, Feizi A, Clark CCT, Entezari MH. The effects of spirulina (Arthrospira platensis) supplementation on anthropometric indices, blood pressure, sleep quality, mental health, fatigue status and quality of life in patients with ulcerative
  22. Ghanbari F, Amerizadeh A, Behshood P, Moradi S, Asgary S. Effect of microalgae arthrospira on biomarkers of glycemic control and glucose metabolism: a systematic Review and meta-analysis. Curr Probl Cardiol 2022;47(10):100942. PubMed

See these in context on the Blue-green Algae monograph →

Fucus Vesiculosus 15 references
  1. Goodman GA, Rall TW, Nies AS, Taylor P. The Pharmacological Basis of Therapeutics, 9th ed.
  2. Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. Washington, DC: National Academy Press, 2002.
  3. Phaneuf D, Cote I, Dumas P, et al. Evaluation of the contamination of marine algae (Seaweed) from the St. Lawrence River and likely to be consumed by humans. Environ Res 1999;80:S175-S182. PubMed
  4. Durig J, Bruhn T, Zurborn KH, et al. Anticoagulant fucoidan fractions from Fucus vesiculosus induce platelet activation in vitro. Thromb Res 1997;85:479-91. PubMed
  5. Conz PA, La Greca G, Benedetti P, et al. Fucus vesiculosus: a nephrotoxic alga? Nephrol Dial Transplant 1998;13:526-7.
  6. Ohye H, Fukata S, Kanoh M, et al. Thyrotoxicosis caused by weight-reducing herbal medicines. Arch Intern Med 2005;165:831-4. PubMed
  7. Okamura K, Inoue K, Omae T. A case of Hashimoto's thyroiditis with thyroid immunological abnormality manifested after habitual ingestion of seaweed. Acta Endocrinol (Copenh) 1978;88:703-12. PubMed
  8. Agarwal SC, Crook JR, Pepper CB. Herbal remedies -- how safe are they? A case report of polymorphic ventricular tachycardia/ventricular fibrillation induced by herbal medication used for obesity. Int J Cardiol 2006;106:260-1. PubMed
  9. Sterling JB, Heymann WR. Potassium iodide in dermatology: a 19th century drug for the 21st century-uses, pharmacology, adverse effects, and contraindications. J Am Acad Dermatol 2000;43:691-7. PubMed
  10. Catania, M. A., Oteri, A., Caiello, P., Russo, A., Salvo, F., Giustini, E. S., Caputi, A. P., and Polimeni, G. Hemorrhagic cystitis induced by an herbal mixture. South.Med.J. 2010;103(1):90-92. PubMed
  11. Cumashi, A., Ushakova, N. A., Preobrazhenskaya, M. E., D'Incecco, A., Piccoli, A., Totani, L., Tinari, N., Morozevich, G. E., Berman, A. E., Bilan, M. I., Usov, A. I., Ustyuzhanina, N. E., Grachev, A. A., Sanderson, C. J., Kelly, M., Rabinovich, G. A., I
  12. Irhimeh, M. R., Fitton, J. H., and Lowenthal, R. M. Pilot clinical study to evaluate the anticoagulant activity of fucoidan. Blood Coagul.Fibrinolysis 2009;20(7):607-610. PubMed
  13. Arbaizar, B. and Llorca, J. [Fucus vesiculosus induced hyperthyroidism in a patient undergoing concomitant treatment with lithium]. Actas Esp.Psiquiatr. 2011;39(6):401-403.
  14. Church FC, Meade JB, Treanor RE, and et al. Antithrombin activity of fucoidan. The interaction of fucoidan with heparin cofactor II, antithrombin III, and thrombin. J Biol Chem 2-25-1989;264(6):3618-3623. DOI
  15. Mathew L, Burney M, Gaikwad A, et al. Preclinical evaluation of safety of fucoidan extracts from Undaria pinnatifida and Fucus vesiculosus for use in cancer treatment. Integr Cancer Ther 2017;16(4):572-84.

See these in context on the Fucus Vesiculosus monograph →

Wheatgrass 5 references
  1. Ben-Arye E, Golden E, Wengrower D, et al. Wheat grass juice in the treatment of active distal ulcerative colitis a randomized double-blind placebo-controlled trial. Scand J Gastroenterol 2002;4:444-9.. PubMed
  2. Mohan Y, Jesuthankaraj GN1, Ramasamy Thangavelu N. Antidiabetic and antioxidant properties of Triticum aestivum in streptozotocin-induced diabetic rats. Adv Pharmacol Sci 2013;2013:716073.
  3. Shakya G, Randhi PK, Pajaniradje S, Mohankumar K, Rajagopalan R. Hypoglycaemic role of wheatgrass and its effect on carbohydrate metabolic enzymes in type II diabetic rats. Toxicol Ind Health 2016;32(6):1026-32. PubMed
  4. Food and Drug Administration. Food Allergen Labeling and Consumer Protection Act of 2004 (FALCPA); Public Law 108-282, Title II. Accessed on May 19, 2021. Available at: https://www.fda.gov/food/food-allergensgluten-free-guidance-documents-regulatory-infor
  5. Haron MH, Dale O, Martin K, et al. Evaluation of the Herb-Drug Interaction Potential of Commonly Used Botanicals on the US Market with Regard to PXR- and AhR-Mediated Influences on CYP3A4 and CYP1A2. J Diet Suppl 2022. PubMed

See these in context on the Wheatgrass monograph →

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

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