EPO SAP Ingredients & Drug Interactions
by NFH
What is this page for?
First and foremost: checking EPO SAP 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
EPO SAP is a dietary supplement by NFH with 2 active ingredients. Its ingredients are commonly taken for general antioxidant support, skin and hair care, heart health.Based on those ingredients, 833 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Vitamin E, Evening Primrose Seed Oil. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against EPO SAP by NFH
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HelloPharmacist Scorecard of EPO SAP by NFH
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
Partial disclosure
EPO SAP contains 4 active ingredients. Vitamin E is a fat-soluble antioxidant and the one with documented interactions.
Evening primrose seed oil, gamma-linolenic acid, and linolenic acid are fatty acid sources — evening primrose oil itself is a blend, so its component ingredients are listed separately here. The inactive ingredients are glycerin, bovine gelatin (the capsule), and purified water.
Does it work?
Moderate evidence
Vitamin E in this product is effective for treating vitamin E deficiency and a rare genetic disorder called ataxia with vitamin E deficiency (AVED). It's possibly effective for Alzheimer disease, beta-thalassemia, G6PD deficiency, and intracranial hemorrhage, though the evidence isn't conclusive.
We don't hold effectiveness data for the evening primrose oil, gamma-linolenic acid, or linolenic acid components.
How safe is it?
Well-documented data
Vitamin E from food and normal dietary amounts is generally well tolerated. High-dose long-term supplements, though, may raise your risk of bleeding and other problems.
In rare cases, high-dose vitamin E can cause serious bleeding or hemorrhagic stroke, particularly in male smokers taking synthetic forms over several years. For pregnancy, vitamin E in the amounts from food and prenatal vitamins is considered possibly safe, but avoid high-dose supplements unless your doctor directs it.
While breastfeeding, normal dietary amounts are fine, but the data rates high-dose supplements as possibly unsafe — check with your doctor before taking them. We don't have safety data on file for the other three ingredients.
Meds to double-check
Moderate interaction found
Before taking EPO SAP, check with your doctor or pharmacist if you're on blood thinners or antiplatelet agents like warfarin (moderate risk of bleeding), cancer drugs such as alkylating agents or antitumor antibiotics (moderate risk of reduced effectiveness), cyclosporine (moderate risk of increased levels), selumetinib (moderate risk of combined vitamin E dose becoming unsafe), niacin (minor risk of reduced cholesterol benefit), or any medication metabolized by CYP3A4. Altogether, these interactions span 765 individual medications.
The bottom line
Scorecard at a glancePartially disclosed formula with some supporting evidence for its stated purpose. Moderate medication interactions have been identified, and safety information is well characterized.
This product is worth considering if you have vitamin E deficiency or AVED, or if your doctor recommends it for another supported condition. If you take blood thinners, antiplatelet drugs, cancer medications, cyclosporine, or selumetinib, or if you're pregnant, breastfeeding, or a male smoker, talk with your doctor or pharmacist before starting it — the dose and your individual situation matter.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 1 of 4 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Sep 22, 2022.
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 EPO SAP, straight from the product label.
| Brand | NFH |
|---|---|
| Barcode (UPC) | 856711001443 |
| Net contents | 90 Softgel(s) |
| Market status | On market |
| Date entered into DSLD | Sep 22, 2022 |
| DSLD ID | 273083 |
| Product type | Fat/fatty Acid |
| Supplement form | Softgel Capsule |
| Dietary claims / uses | Nutrient, All Other, Structure/Function |
| Intended target group(s) | Adult (18 - 50 Years), Menopause, 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 EPO SAP by NFH, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Calories | 9 Calorie(s) | -- |
| Calories from Fat | 9 Calorie(s) | -- |
| Total Fat | 1 Gram(s) | 2% |
| Linolenic Acid | 680 mg | -- |
| Vitamin E | 1 mg | 7% |
| Evening Primrose Seed Oil | 1 Gram(s) | -- |
| Gamma-Linolenic Acid | 0 NP | -- |
| Essential Fatty Acid | 90 mg | 9% |
Other ingredients: Glycerin, Bovine Gelatin, Water, Purified
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.
Formula
EPO SAP is rich in gamma-linolenic acid (GLA), an essential fatty acid used to support healthy inflammatory responses in the body and promote healthy skin.
Evening primrose oil Essential fatty acid
Formulation
EPO SAP helps balance hormones and alleviates symptoms associated with PMS and menopause, including premenstrual irritability, hot flashes, blues, and fluid retention.
All ingredients listed for this product lot number have been tested by a third-party laboratory for identity, potency, and purity.
Contains no: Gluten, soy, wheat, corn, eggs, dairy, yeast, citrus, preservatives, artificial flavor or color, starch, or sugar. Solvent-free. This product is non-GMO
Suggested/Recommended/Usage/Directions
Directions for use: Adults: Take 1 softgel one to three times daily with a meal or as directed by your healthcare practitioner.
Storage
Store in a cool, dry place, away from heat and sunlight.
Precautions
Do not use if seal is broken.
Keep out of reach of children.
FDA Disclaimer Statement
These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.
General Statements
NPN 80032985
FDA Statement of Identity
Dietary Supplement
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
EPO SAP by NFH 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 EPO SAP by NFH
These are the 2 active ingredients this product is made of. Select any to open its full monograph.
Serving size1 Softgel(s) Dosage formSoftgel Capsule Servings per container90 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 E
Interacts with764 drugs
Vitamin E is an essential fat-soluble vitamin and antioxidant that most people get in adequate amounts from a normal diet. Supplements can help correc...
Vitamin E monograph & interactionsEvening Primrose Seed Oil
Interacts with233 drugs
Evening primrose oil is a seed oil rich in gamma-linolenic acid (GLA), an omega-6 fatty acid, that is popularly used for skin conditions, PMS, and bre...
Evening Primrose Seed Oil monograph & interactions- › Linolenic Acid
- › Gamma-Linolenic Acid
- › Essential Fatty Acid
Other (inactive) ingredients: Glycerin, Bovine Gelatin, Water, Purified. These complete the product’s ingredient list but are not active constituents.
EPO SAP by NFH Drug Interactions
HelloPharmacist Interaction Report
EPO SAP by NFH has documented interactions through its vitamin E content.
The most serious concern is a moderate-severity risk of bleeding with blood thinners and antiplatelet drugs, including warfarin — vitamin E can interfere with clotting factors and platelet function, especially at higher doses.
Read the full breakdown — every affected drug type, severity by severity
Vitamin E may also moderately affect how your body processes certain cancer drugs (alkylating agents and antitumor antibiotics), potentially reducing their effectiveness through its antioxidant effects. It can increase levels of cyclosporine (an immunosuppressant), and if you're taking selumetinib for cancer, adding a vitamin E supplement might push your total daily dose into a riskier range for bleeding.
There's also a minor concern that vitamin E might decrease niacin's beneficial effects on HDL cholesterol.
Vitamin E may theoretically speed up the metabolism of CYP3A4 substrates — a large group of medications processed by your liver — though the clinical significance isn't fully understood.
We could not check three other ingredients in this product: linolenic acid, gamma-linolenic acid, and essential fatty acid. Use the medication checker on this page to see if your specific drugs are affected.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against EPO SAP?
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 EPO SAP interact with 833 drugs. Click any drug to see the details.
2 of the 2 ingredients in EPO SAP interact with drugs. Each result below shows which ingredient is responsible. Vitamin E Evening Primrose Seed Oil
Acetaminophen, Chlorpheniramine, Phenylpropanolamine, PhenyltoloxamineNorel Plus
How Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Phenyltoloxamine interacts with EPO SAP — through 1 ingredient. Tap an ingredient for the detail:
Vitamin ECytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Vitamin E + 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 EPO SAP — through 1 ingredient. Tap an ingredient for the detail:
Vitamin ECytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Vitamin E + Acetaminophen, Chlorpheniramine, Pseudoephedrine interactionAcetaminophen, DextromethorphanTylenol Cough Ex Strength
How Acetaminophen, Dextromethorphan interacts with EPO SAP — through 1 ingredient. Tap an ingredient for the detail:
Vitamin ECytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Vitamin E + Acetaminophen, Dextromethorphan interactionAcetaminophen, Dextromethorphan, Doxylamine, PseudoephedrineVicks NyQuil
How Acetaminophen, Dextromethorphan, Doxylamine, Pseudoephedrine interacts with EPO SAP — through 1 ingredient. Tap an ingredient for the detail:
Vitamin ECytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Vitamin E + Acetaminophen, Dextromethorphan, Doxylamine, Pseudoephedrine interactionAcetaminophen, Dextromethorphan, Guaifenesin, PhenylephrineConar-A
How Acetaminophen, Dextromethorphan, Guaifenesin, Phenylephrine interacts with EPO SAP — through 1 ingredient. Tap an ingredient for the detail:
Vitamin ECytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Vitamin E + Acetaminophen, Dextromethorphan, Guaifenesin, Phenylephrine interactionAcetaminophen, Dextromethorphan, Guaifenesin, PhenylpropanolamineAnatuss
How Acetaminophen, Dextromethorphan, Guaifenesin, Phenylpropanolamine interacts with EPO SAP — through 1 ingredient. Tap an ingredient for the detail:
Vitamin ECytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Vitamin E + Acetaminophen, Dextromethorphan, Guaifenesin, Phenylpropanolamine interactionAcetaminophen, Dextromethorphan, Guaifenesin, PseudoephedrineRobitussin Cold, Severe Cold, Suphedrine Cold/Cough
How Acetaminophen, Dextromethorphan, Guaifenesin, Pseudoephedrine interacts with EPO SAP — through 1 ingredient. Tap an ingredient for the detail:
Vitamin ECytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Vitamin E + Acetaminophen, Dextromethorphan, Guaifenesin, Pseudoephedrine interactionAcetaminophen, Dextromethorphan, Phenylpropanolamine, PyrilamineTheracaps
How Acetaminophen, Dextromethorphan, Phenylpropanolamine, Pyrilamine interacts with EPO SAP — through 1 ingredient. Tap an ingredient for the detail:
Vitamin ECytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Vitamin E + Acetaminophen, Dextromethorphan, Phenylpropanolamine, Pyrilamine interactionAcetaminophen, Dextromethorphan, PseudoephedrineAlka-Seltzer PLUS Flu Liquid Gels, Non Aspirin Cold Caps, Tylenol Cold, Tylenol Flu Daytime Ex Strength, Tylenol Flu Ex Strength
How Acetaminophen, Dextromethorphan, Pseudoephedrine interacts with EPO SAP — through 1 ingredient. Tap an ingredient for the detail:
Vitamin ECytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Vitamin E + Acetaminophen, Dextromethorphan, Pseudoephedrine interactionAcetaminophen, HydrocodoneAnexsia, Anodynos DHC, Azdone, Co-Gesic, Doucet, Lorcet +9 more
How Acetaminophen, Hydrocodone interacts with EPO SAP — through 1 ingredient. Tap an ingredient for the detail:
Vitamin ECytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Vitamin E + Acetaminophen, Hydrocodone interactionAcetaminophen, IbuprofenCombogesic
How Acetaminophen, Ibuprofen interacts with EPO SAP — through 2 ingredients. Tap an ingredient for the detail:
Vitamin EAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Concomitant use of vitamin E and anticoagulant or antiplatelet agents might increase the risk of bleeding.
Read the full Vitamin E + Acetaminophen, Ibuprofen interactionEvening Primrose Seed OilCytochrome P450 2c9 (cyp2c9) Substrates, Anticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, evening primrose may increase the levels and clinical effects of CYP2C9 substrates.
Read the full Evening Primrose Seed Oil + Acetaminophen, Ibuprofen interactionAcetaminophen, Phenylephrine, ChlorpheniramineSuper Cold Tabs
How Acetaminophen, Phenylephrine, Chlorpheniramine interacts with EPO SAP — through 1 ingredient. Tap an ingredient for the detail:
Vitamin ECytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Vitamin E + Acetaminophen, Phenylephrine, Chlorpheniramine interactionAcetylsalicylic AcidEntrophen
How Acetylsalicylic Acid interacts with EPO SAP — through 2 ingredients. Tap an ingredient for the detail:
Evening Primrose Seed OilAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, evening primrose oil may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Evening Primrose Seed Oil + Acetylsalicylic Acid interactionVitamin EAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Concomitant use of vitamin E and anticoagulant or antiplatelet agents might increase the risk of bleeding.
Read the full Vitamin E + Acetylsalicylic Acid interactionAdagrasibKrazati
How Adagrasib interacts with EPO SAP — through 1 ingredient. Tap an ingredient for the detail:
Vitamin ECytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Vitamin E + Adagrasib interactionAlfentanilAlfenta
How Alfentanil interacts with EPO SAP — through 1 ingredient. Tap an ingredient for the detail:
Vitamin ECytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Vitamin E + Alfentanil interactionAlfuzosinUroxatral
How Alfuzosin interacts with EPO SAP — through 1 ingredient. Tap an ingredient for the detail:
Vitamin ECytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Vitamin E + Alfuzosin interactionAliskirenTekturna
How Aliskiren interacts with EPO SAP — through 1 ingredient. Tap an ingredient for the detail:
Vitamin ECytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Vitamin E + Aliskiren interactionAlmotriptanAlmogran, Axert
How Almotriptan interacts with EPO SAP — through 1 ingredient. Tap an ingredient for the detail:
Vitamin ECytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Vitamin E + Almotriptan interactionAlogliptinNesina
How Alogliptin interacts with EPO SAP — through 1 ingredient. Tap an ingredient for the detail:
Vitamin ECytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Vitamin E + Alogliptin interactionAlogliptin, PioglitazoneOseni
How Alogliptin, Pioglitazone interacts with EPO SAP — through 1 ingredient. Tap an ingredient for the detail:
Vitamin ECytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Vitamin E + Alogliptin, Pioglitazone interactionAlpelisibPiqray
How Alpelisib interacts with EPO SAP — through 1 ingredient. Tap an ingredient for the detail:
Vitamin ECytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Vitamin E + Alpelisib interactionAlprazolamNiravam, Xanax
How Alprazolam interacts with EPO SAP — through 1 ingredient. Tap an ingredient for the detail:
Vitamin ECytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Vitamin E + Alprazolam interactionAlteplase, TpaActilyse, Activase
How Alteplase, Tpa interacts with EPO SAP — through 2 ingredients. Tap an ingredient for the detail:
Vitamin EAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Concomitant use of vitamin E and anticoagulant or antiplatelet agents might increase the risk of bleeding.
Read the full Vitamin E + Alteplase, Tpa interactionEvening Primrose Seed OilAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, evening primrose oil may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Evening Primrose Seed Oil + Alteplase, Tpa interactionAltretamineHexalen
How Altretamine interacts with EPO SAP — through 1 ingredient. Tap an ingredient for the detail:
Vitamin EAlkylating Agents Moderate
Interaction Summary
Theoretically, antioxidant effects of vitamin E might reduce the effectiveness of alkylating agents.
Read the full Vitamin E + Altretamine interactionAluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium HydroxideAscriptin Codeine #2
How Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide interacts with EPO SAP — through 2 ingredients. Tap an ingredient for the detail:
Vitamin EAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Concomitant use of vitamin E and anticoagulant or antiplatelet agents might increase the risk of bleeding.
Read the full Vitamin E + Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide interactionEvening Primrose Seed OilAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, evening primrose oil may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Evening Primrose Seed Oil + Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide interactionAluminum Hydroxide, Aspirin, Magnesium HydroxideAscriptin
How Aluminum Hydroxide, Aspirin, Magnesium Hydroxide interacts with EPO SAP — through 2 ingredients. Tap an ingredient for the detail:
Evening Primrose Seed OilAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, evening primrose oil may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Evening Primrose Seed Oil + Aluminum Hydroxide, Aspirin, Magnesium Hydroxide interactionVitamin EAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Concomitant use of vitamin E and anticoagulant or antiplatelet agents might increase the risk of bleeding.
Read the full Vitamin E + Aluminum Hydroxide, Aspirin, Magnesium Hydroxide interactionAmbrisentanLetairis, Volibris
How Ambrisentan interacts with EPO SAP — through 1 ingredient. Tap an ingredient for the detail:
Vitamin ECytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Vitamin E + Ambrisentan interactionAmiodaroneCordarone, Pacerone
How Amiodarone interacts with EPO SAP — through 1 ingredient. Tap an ingredient for the detail:
Vitamin ECytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Vitamin E + Amiodarone interactionAmitriptylineElavil
How Amitriptyline interacts with EPO SAP — through 2 ingredients. Tap an ingredient for the detail:
Vitamin ECytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Vitamin E + Amitriptyline interactionEvening Primrose Seed OilCytochrome P450 2c9 (cyp2c9) Substrates Minor
Interaction Summary
Theoretically, evening primrose may increase the levels and clinical effects of CYP2C9 substrates.
Read the full Evening Primrose Seed Oil + Amitriptyline interactionAmitriptyline, ChlordiazepoxideLimbitrol DS
How Amitriptyline, Chlordiazepoxide interacts with EPO SAP — through 2 ingredients. Tap an ingredient for the detail:
Vitamin ECytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Vitamin E + Amitriptyline, Chlordiazepoxide interactionEvening Primrose Seed OilCytochrome P450 2c9 (cyp2c9) Substrates Minor
Interaction Summary
Theoretically, evening primrose may increase the levels and clinical effects of CYP2C9 substrates.
Read the full Evening Primrose Seed Oil + Amitriptyline, Chlordiazepoxide interactionEach ingredient & the kinds of drugs it affects
For each ingredient in EPO SAP 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.
Vitamin E
Alkylating Agents
Theoretically, antioxidant effects of vitamin E might reduce the effectiveness of alkylating agents.
There's concern that antioxidants could reduce the activity of chemotherapy drugs which generate free radicals, such as cyclophosphamide, chlorambucil, carmustine, busulfan, and thiotepa. However, some researchers theorize that antioxidants might make chemotherapy more effective by reducing oxidative stress that might interfere with apoptosis (cell death) of cancer cells. More evidence is needed to determine what effect, if any, antioxidants such as vitamin E have on chemotherapy. Advise patients to consult their oncologist before using vitamin E supplements, especially in high doses.
Anticoagulant/Antiplatelet Drugs
Concomitant use of vitamin E and anticoagulant or antiplatelet agents might increase the risk of bleeding.
Vitamin E seems to inhibit of platelet aggregation and antagonize the effects of vitamin K-dependent clotting factors. These effects appear to be dose-dependent, and are probably only likely to be clinically significant with doses of at least 800 units daily. Mixed tocopherols, such as those found in food, might have a greater antiplatelet effect than alpha-tocopherol. RRR alpha-tocopherol (natural vitamin E) 1000 IU daily antagonizes vitamin K-dependent clotting factors. Advise patients to avoid high doses of vitamin E, especially in people with low vitamin K intake or other risk factors for bleeding.
Antitumor Antibiotics
Theoretically, antioxidant effects of vitamin E might reduce the effectiveness of antitumor antibiotics.
There's concern that antioxidants could reduce the activity of antitumor antibiotic drugs such as doxorubicin, which generate free radicals. However, some researchers theorize that antioxidants might make chemotherapy more effective by reducing oxidative stress that might interfere with apoptosis (cell death) of cancer cells. More evidence is needed to determine what effect, if any, antioxidants such as vitamin E have on chemotherapy involving antitumor antibiotics. Advise patients to consult their oncologist before using vitamin E supplements, especially in high doses.
Cyclosporine (Neoral, Sandimmune)
A specific form of vitamin E might increase absorption and levels of cyclosporine.
There is some evidence that one specific formulation of vitamin E (D-alpha-tocopheryl-polyethylene glycol-1000 succinate, TPGS, tocophersolan, Liqui-E) might increase absorption of cyclosporine. This vitamin E formulation forms micelles which seems to increase absorption of cyclosporine by 40% to 72% in some patients. However, this interaction is unlikely to occur with the usual forms of vitamin E.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Vitamin E appears to bind with the nuclear receptor, pregnane X receptor (PXR), which results in increased expression of CYP3A4. Although the clinical significance of this is not known, use caution when considering concomitant use of vitamin E and other drugs affected by these enzymes.
Selumetinib (Koselugo)
Taking selumetinib with vitamin E can result in a total daily dose of vitamin E that exceeds safe limits and therefore might increase the risk of bleeding.
Selumetinib contains 48-54 IU vitamin E per capsule. The increased risk of bleeding with vitamin E appears to be dose-dependent. Be cautious when using selumetinib in combination with supplemental vitamin E, especially in patients at higher risk of bleed, such as those with chronic conditions and those taking antiplatelet drugs.
Warfarin (Coumadin)
Using vitamin E with warfarin might increase the risk of bleeding.
Due to interference with production of vitamin K-dependent clotting factors, use of more than 400 IU of vitamin E daily with warfarin might increase prothrombin time (PT), INR, and the risk of bleeding,. At a dose of 1000 IU per day, vitamin E can antagonize vitamin K-dependent clotting factors even in people not taking warfarin. Limited clinical evidence suggests that doses up to 1200 IU daily may be used safely by patients taking warfarin, but this may not be applicable in all patient populations.
Niacin
Vitamin E might decrease the beneficial effects of niacin on high-density lipoprotein (HDL) cholesterol levels.
A combination of niacin and simvastatin (Zocor) effectively raises high-density lipoprotein (HDL) cholesterol levels in people with coronary disease and low HDL levels. Clinical research shows that taking a combination of antioxidants (vitamin C, vitamin E, beta-carotene, and selenium) along with niacin and simvastatin (Zocor) attenuates this rise in HDL, specifically the HDL-2 and apolipoprotein A1 fractions, by more than 50%. Vitamin E alone combined with a statin does not seem to decrease HDL levels. It is not known whether the adverse effect on HDL is due to one of the other antioxidants or to the combination. It also is not known whether it will occur in other patient populations.
Evening Primrose Seed Oil
Anticoagulant/Antiplatelet Drugs
Theoretically, evening primrose oil may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Evening primrose oil contains gamma linolenic acid (GLA). There is preliminary clinical evidence that GLA can reduce platelet aggregation and prolong bleeding time.
Lithium
Theoretically, concomitant use of lithium with evening primrose oil might decrease lithium levels and effects.
In a case report, a patient on a stable dose of lithium for 10 years experienced a reduction in lithium levels after taking evening primrose oil 500 mg daily. Baseline levels were 0.69 mmol/L, which decreased to 0.37 mmol/L after 2 months and 0.23 mmol/L after 3 months of use. Lithium levels increased within 6 weeks of discontinuing evening primrose oil, to 0.73 mmol/L; no clinical effects were noted.
Lopinavir/Ritonavir (Kaletra)
Theoretically, evening primrose oil might increase the levels and effects of lopinavir.
In a case report, an HIV patient who took evening primrose oil (Efamol) along with lopinavir/ritonavir experienced an increase in serum levels of lopinavir to 15.2 mg/L. Six weeks after discontinuing evening primrose oil, levels of lopinavir returned to the normal range of 5-10 mg/L. When re-challenged with evening primrose oil for a week, the patient's lopinavir levels increased from 6.69 to 8.11 mg/L. It is suspected that evening primrose oil increases levels of lopinavir by inhibiting cytochrome P450 3A4 (CYP3A4), which metabolizes lopinavir. However, this effect has not been reported in other research.
Phenothiazines
Theoretically, taking evening primrose oil with phenothiazines might increase the risk of convulsions.
Evening primrose oil contains gamma-linolenic acid (GLA). There is some concern that taking supplements containing GLA might cause seizures, or lower the seizure threshold, when taken with phenothiazines. In one report, three patients with schizophrenia who had received phenothiazines developed EEG changes suggestive of temporal lobe epilepsy after starting treatment with GLA, although none experienced an actual seizure. In another report, two patients with schizophrenia who were stabilized on phenothiazines developed seizures when evening primrose oil 4 grams daily was added. One of these patients had a prior history of seizures. It is unclear whether evening primrose oil had any additive epileptogenic effects with the phenothiazines; there is no evidence that taking evening primrose oil alone causes seizures.
Cytochrome P450 2C9 (Cyp2C9) Substrates
Theoretically, evening primrose may increase the levels and clinical effects of CYP2C9 substrates.
In vitro research shows that linoleic acid, a constituent of evening primrose oil, inhibits CYP2C9.
Brand information
Manufacturer and brand details for EPO SAP, from the product label.
NFH
See all NFH products- Name
- NFH - Nutritional Fundamentals for Health, Inc.
- Street Address
- 351 Rue Joseph-Carrier
- City
- Vaudreuil
- State
- QC
- ZipCode
- J7V 5V5
- Web Address
- nfh.ca
EPO SAP by NFH: Common Questions
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The Full Monographs Behind EPO SAP’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Vitamin E
Interacts with 764 drugsVitamin E is an essential fat-soluble vitamin and antioxidant that most people get in adequate amounts from a normal diet. Supplements can help correct a true deficiency, but high-dose vitam...
Read the full Vitamin E monograph → Herb & supplement monographEvening Primrose
Interacts with 233 drugsEvening primrose oil is a seed oil rich in gamma-linolenic acid (GLA), an omega-6 fatty acid, that is popularly used for skin conditions, PMS, and breast pain. The evidence behind most of th...
Read the full Evening Primrose monograph →Sources & How We Checked
EPO SAP'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 97 references behind this product’s interaction data
Every citation that drives the interaction findings for this product’s ingredients, from the evidence-graded Natural Medicines (TRC Healthcare) database. Open an ingredient to browse its citations — links open the study on PubMed or the publisher’s site.
Vitamin E 64 references
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- Rahimi, R., Nikfar, S., Rezaie, A., and Abdollahi, M. A meta-analysis on the efficacy and safety of combined vitamin C and E supplementation in preeclamptic women. Hypertens.Pregnancy. 2009;28(4):417-434. PubMed
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- Barak, Y., Swartz, M., Shamir, E., Stein, D., and Weizman, A. Vitamin E (alpha-tocopherol) in the treatment of tardive dyskinesia: a statistical meta-analysis. Ann.Clin.Psychiatry 1998;10(3):101-105.
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Evening Primrose 33 references
- Shaw D, Leon C, Kolev S, Murray V. Traditional remedies and food supplements: a 5-year toxicological study (1991-1995). Drug Saf 1997;17:342-56.
- Laivuori H, Hovatta O, Viinikka L, et al. Dietary supplementation with primrose oil or fish oil does not change urinary excretion of prostacyclin and thromboxane metabolites in pre-eclamptic women. Prostaglandins Leukot Essent Fatty Acids 1993;49:691-4. PubMed
- Dove D, Johnson P. Oral evening primrose oil: its effect on length of pregnancy and selected intrapartum outcomes in low-risk nulliparous women (abstract). J Nurse Midwifery 1999;44:320-4. PubMed
- Guivernau M, Meza N, Barja P, Roman O. Clinical and experimental study on the long-term effect of dietary gamma-linolenic acid on plasma lipids, platelet aggregation, thromboxane formation, and prostacyclin production. Prostaglandins Leukot Essent Fatty A PubMed
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DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.
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