Interactions on record — worth a quick check against your medications. Based on 6 of 7 ingredients. Check your meds →
Dietary supplement

Essigen Combination Ingredients & Drug Interactions

by Genestra Brands

Essigen Combination label
See full label image
Liquid Category: Botanical
Most serious interaction: Moderate
Clinical methodology reviewed by · Updated Sep 16, 2026 · Label data from the NIH DSLD
What is this page for?

First and foremost: checking Essigen Combination 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

The interaction bottom line Most serious interaction: Moderate

Essigen Combination is a dietary supplement by Genestra Brands with 7 active ingredients. Its ingredients are commonly taken for skin conditions like acne and eczema, digestive support, diuretic ('detox') and blood purifier.Based on those ingredients, 2,182 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Slippery Elm (Ulmus rubra) bark extract, Red Clover (Trifolium pratense) flower extract, Chinese Rhubarb (Rheum palmatum) root extract. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

Jump to a section

Check Your Meds Against Essigen Combination by Genestra Brands

Ask about any prescription or over-the-counter medication and we check it for interactions with Essigen Combination by Genestra Brands — and tell you which ingredient is responsible.

Pharmacist-reviewed data Checks every ingredient Answer in seconds
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HelloPharmacist Scorecard of Essigen Combination by Genestra Brands

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

Generated from HelloPharmacist’s pharmacist-curated databases and editorial rules · Last generated Jul 30, 2026

What’s inside

Full disclosure
Ingredient Transparency · database check
Full

Every active ingredient lists its own amount on the label.

Why this rating?
  • The label discloses an exact amount for 7 of its 7 active ingredients.
  • No proprietary blends here — you can verify the dose of every single component.

Essigen Combination is a liquid formula with seven active herbal extracts. These include burdock root, sorrel aerial parts, slippery elm bark, Chinese rhubarb root, cleavers aerial parts, red clover flower, and watercress aerial parts.

The product also contains two inactive ingredients: purified water and ethanol.

Does it work?

Moderate 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.

Moderate

Some 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: Menopausal symptoms — rated "Possibly Effective" (Rhubarb) (Natural Medicines).
  • On file: Pancreatitis — rated "Possibly Effective" (Rhubarb) (Natural Medicines).

The evidence supporting these ingredients is limited. Burdock, sorrel, slippery elm, and watercress have insufficient reliable evidence in our data to rate their effectiveness for any condition.

Rhubarb shows possibly effective evidence for pancreatitis and menopausal symptoms, but insufficient evidence for constipation and other uses listed. Red clover similarly shows insufficient evidence for the conditions we hold data on—including menopausal symptoms, osteoporosis, and hair loss.

If you're considering this product for a specific health concern, talk with your doctor or pharmacist about whether the evidence matches what you're hoping to treat.

The evidence, ingredient by ingredient Burdock Sorrel Slippery Elm Rhubarb Red Clover Watercress

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 6 of the 6 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 6 of 6.
  • General safety write-ups exist for 6 of 6.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

Most of these herbs are generally well tolerated in food amounts or short-term use, though safety data are often limited. Burdock is likely safe as a food but has few human safety studies; rare allergic reactions including anaphylaxis have been reported, and one case of liver injury was documented (though it's unclear if burdock alone was responsible).

Sorrel contains oxalates and in concentrated doses may pose kidney risk; food amounts are likely fine. Slippery elm may cause contact dermatitis or allergic reactions.

Rhubarb root commonly causes cramping and diarrhea and should not be used long-term; chronic overuse can deplete potassium and harm the kidneys. Red clover is generally well tolerated but may cause nausea, muscle pain, or vaginal spotting.

Watercress in food amounts is safe, but raw wild watercress can carry parasitic flukes that cause liver disease. For pregnancy: burdock and rhubarb should be avoided (possibly unsafe), and red clover is considered possibly unsafe.

Sorrel and slippery elm lack enough data—ask your doctor or pharmacist before use. Watercress is considered likely unsafe in pregnancy.

For breastfeeding: burdock, sorrel, slippery elm, and red clover all lack sufficient safety data and are best avoided; rhubarb should be avoided due to laxative compounds potentially passing into milk. Watercress safety while nursing is not documented in our data.

Side effects, ingredient by ingredient Burdock Sorrel Slippery Elm Rhubarb Red Clover Watercress

Meds to double-check

Moderate interaction found
Known Interaction Concern · database check
Moderate identified

The most serious documented interaction for these ingredients is Moderate. Check your medications for a personalized result.

Why this rating?
  • 6 of the 6 matched ingredients can interact with medications — Burdock, Rhubarb, Red Clover, Watercress, Sorrel, among others.
  • The most serious interaction on file is rated Moderate.
  • Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs; immunosuppressants / transplant drugs; heart-rhythm medications; lithium.
  • For scale: 2,183 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.

Before taking Essigen Combination, check with your doctor or pharmacist if you take blood thinners or antiplatelet drugs (anticoagulants)—burdock, sorrel, and red clover may theoretically increase bleeding risk. Watercress may blunt warfarin's effects.

Water pills (diuretics), steroids, heart medications like digoxin, and the immunosuppressant cyclosporine all interact with rhubarb; methotrexate, estrogen therapy, and tamoxifen interact with red clover. Watercress may raise lithium and chlorzoxazone levels.

Slippery elm may slow absorption of oral drugs generally. If you take any of these, verify your exact medications with the tool on this page or speak with your pharmacist.

Check your own medication Run your meds through the checker above

The bottom line

Scorecard at a glanceFully disclosed formula with some supporting evidence behind its ingredients' uses. Moderate medication interactions have been identified, and safety information is well characterized.

This product contains multiple herbs with documented interactions, particularly with blood thinners, water pills, heart and immunosuppressant medications, and methotrexate. If you take any prescription medications, use the checker below to verify your specific drugs before starting.

The evidence for what this formula treats is insufficient in our data, so discuss its purpose and safety with your own doctor or pharmacist before use.

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

Assessment coverage: 6 of 7 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Feb 23, 2016.

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 Essigen Combination, straight from the product label.

Brand Genestra Brands
Barcode (UPC) 88319613380
Net contents 2 fl. Oz.; 60 mL
Market status On market
Date entered into DSLD Feb 23, 2016
DSLD ID 56480
Product type Botanical
Supplement form Liquid
Dietary claims / uses All Other
Intended target group(s) Vegan, Vegetarian, Adult (18 - 50 Years), Dairy 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 Essigen Combination by Genestra Brands, 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:
1.25 mL
Maximum serving Sizes:
1.25 mL
Servings per container
48
UPC/BARCODE
88319613380
IngredientAmount% DV
Burdock (Arctium lappa) root extract0.5 mL--
Sheep Sorrel (Rumex acetosella) aerial parts extract0.19 mL--
Slippery Elm (Ulmus rubra) bark extract0.13 mL--
Chinese Rhubarb (Rheum palmatum) root extract0.13 mL--
Cleavers (Galium aparine) aerial parts extract0.13 mL--
Red Clover (Trifolium pratense) flower extract0.13 mL--
Watercress (Rorippa nasturtium-aquaticum) aerial parts extract0.06 mL--

Other ingredients: purified Water, Ethanol

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

Recommended Adult Dose: Take 25 drops three to six times daily with warm water, thirty minutes before meals, or as recommended by your healthcare practitioner.

Precautions

Risk Information: If you are pregnant or breastfeeding; if you have abnormal constrictions of the gastrointestinal tract, atonic bowel, inflammatory bowel disease, appendicitis, abdominal pain, hemorrhoids, ulcerative colitis, undiagnosed rectal bleeding, severe dehydration with depleted water or electrolytes, do not use.

Hypersensitivity/allergy to burdock is known to occur; in which case, discontinue use.

Quality Assurance: Safety-sealed for your protection and for product freshness. Do not use if outer seal is missing or broken.

Formulation

Guaranteed to contain no added starch, soy, sodium, sugar, artificial coloring or flavoring, dairy or animal products.

Ideal for vegans.

Storage

Store in a cool, dry place.

General

V1.0 730

FDA Statement of Identity

HERBAL SUPPLEMENT

Seals/Symbols

Seroyal

Is this label outdated? Report a formula or label change and our pharmacy team will review it.

See for yourself

Essigen Combination by Genestra Brands label

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

Essigen Combination label

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)
What’s inside

The Ingredients in Essigen Combination by Genestra Brands

These are the 7 active ingredients this product is made of. Select any to open its full monograph.

Serving size1.25 mL Dosage formLiquid Servings per container48 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.

Burdock (Arctium lappa) root extract

Interacts with
122 drugs
0.5 mL per serving

Burdock is a traditional herb most often used for skin problems and as a so-called 'blood purifier,' but high-quality human studies are lacking and mo...

Burdock (Arctium lappa) root extract monograph & interactions

Sheep Sorrel (Rumex acetosella) aerial parts extract

Interacts with
169 drugs
0.19 mL per serving

Sorrel is a tangy, leafy herb used in cooking and traditional medicine, often for congestion, digestion, and inflammation. Solid human evidence for an...

Sheep Sorrel (Rumex acetosella) aerial parts extract monograph & interactions

Slippery Elm (Ulmus rubra) bark extract

Interacts with
2,022 drugs
0.13 mL per serving

Slippery elm is a traditional herbal remedy made from the inner bark of a North American elm tree, used mainly to soothe sore throats and irritated di...

Slippery Elm (Ulmus rubra) bark extract monograph & interactions

Chinese Rhubarb (Rheum palmatum) root extract

Interacts with
658 drugs
0.13 mL per serving

Rhubarb root has a long history of use as a laxative and in traditional Chinese medicine, and its edible stalks are a common food. Most medicinal clai...

Chinese Rhubarb (Rheum palmatum) root extract monograph & interactions

Cleavers (Galium aparine) aerial parts extract

0.13 mL per serving

Red Clover (Trifolium pratense) flower extract

Interacts with
867 drugs
0.13 mL per serving

Red clover is a plant rich in isoflavones (plant compounds with weak estrogen-like activity) that is most often used for menopause symptoms like hot f...

Red Clover (Trifolium pratense) flower extract monograph & interactions

Watercress (Rorippa nasturtium-aquaticum) aerial parts extract

Interacts with
6 drugs
0.06 mL per serving

Watercress is a nutrient-rich leafy green that provides vitamins A, C, and K plus minerals and antioxidant plant compounds. Eaten as a food it is gene...

Watercress (Rorippa nasturtium-aquaticum) aerial parts extract monograph & interactions

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

Interaction report

Essigen Combination by Genestra Brands Drug Interactions

Want to check YOUR meds against Essigen Combination?

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
2,182Drugs
2,133 Moderate 49 Minor

Ingredients driving the most interactions

Slippery Elm (Ulmus rubra) bark extract 2,022
Red Clover (Trifolium pratense) flower extract 867
Chinese Rhubarb (Rheum palmatum) root extract 658
Sheep Sorrel (Rumex acetosella) aerial parts extract 169
Burdock (Arctium lappa) root extract 122

Individual Drug Interactions

The ingredients in Essigen Combination interact with 2,182 drugs. Click any drug to see the details.

6 of the 7 ingredients in Essigen Combination interact with drugs. Each result below shows which ingredient is responsible. Slippery Elm (Ulmus rubra) bark extract Red Clover (Trifolium pratense) flower extract Chinese Rhubarb (Rheum palmatum) root extract Sheep Sorrel (Rumex acetosella) aerial parts extract Burdock (Arctium lappa) root extract Watercress (Rorippa nasturtium-aquaticum) aerial parts extract

Each ingredient & the kinds of drugs it affects

For each ingredient in Essigen Combination 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.

Slippery Elm (Ulmus rubra) bark extract1 drug type · 2,022 drugs

Oral Drugs

Theoretically, slippery elm may slow the absorption and reduce serum levels of oral drugs.
Slippery elm inner bark contains mucilage, which may interfere with the absorption of orally administered drugs.

Likelihood Possible Evidence D
Slippery Elm (Ulmus rubra) bark extract full monograph & interactions

Red Clover (Trifolium pratense) flower extract9 drug types · 867 drugs

Estrogens

Theoretically, concomitant use of large amounts of red clover might interfere with estrogen therapy.
Red clover contains phytoestrogens which might have estrogenic activity in some people. Theoretically, red clover might compete for estrogen receptors and interfere with estrogen-containing drug therapy.

Likelihood Probable Evidence D
Methotrexate (Trexall, Others)

Theoretically, red clover might increase the risk of methotrexate toxicity.
In a case report, a 52-year-old female receiving weekly methotrexate injections for psoriasis developed symptoms of methotrexate toxicity, including severe vomiting and epigastric pain, after three days of taking red clover 430 mg daily. Toxicity resolved after red clover was discontinued. However, no liver function tests or methotrexate levels were reported.

Likelihood Possible Evidence D
Tamoxifen (Nolvadex)

Theoretically, the phytoestrogens in red clover might interfere with tamoxifen.
In vitro and animal research suggests that genistein, a constituent of red clover, might antagonize the antitumor effects of tamoxifen. However, there is some evidence from an animal study that red clover does not reduce the efficacy of tamoxifen. Until more is known, tell patients taking tamoxifen to avoid red clover.

Likelihood Possible Evidence D
Anticoagulant/Antiplatelet Drugs

Although some laboratory research suggests that red clover may have anticoagulant and antiplatelet activity, clinical research has not shown this effect.
In vitro research suggests that genistein in red clover has antiplatelet effects, and historically, red clover was thought to have anticoagulant effects due to its coumarin content. However, some experts state that this is unlikely as most natural coumarins have not been shown to have anticoagulant effects, and their content in red clover is low. Additionally, some clinical research in postmenopausal patients found no effect on coagulation or prothrombin time with the use of red clover flowering tops 378 mg daily for 12 months or red clover isoflavone (Rimostil) 50 mg daily for 2 years.

Likelihood Unlikely Evidence B
Caffeine

Theoretically, soy might reduce the clearance of caffeine; however, a small clinical study found no effect.
Red clover contains genistein. Taking genistein 1 gram daily for 14 days seems to inhibit caffeine clearance and metabolism in healthy females. However, this effect does not seem to occur with the lower amounts of genistein found in red clover. A clinical study in healthy postmenopausal individuals shows that taking red clover capsules standardized to contain 60 mg isoflavones twice daily for 14 days does not affect the pharmacokinetics of caffeine.

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

Theoretically, red clover might increase levels of drugs metabolized by CYP1A2; however, a small clinical study found no effect.
In vitro evidence shows that red clover inhibits CYP1A2. However, a clinical study in healthy postmenopausal individuals shows that taking red clover capsules standardized to contain 60 mg isoflavones twice daily for 14 days does not affect the pharmacokinetics of caffeine, a CYP1A2 probe substrate.

Likelihood Unlikely Evidence D
Cytochrome P450 2C19 (Cyp2C19) Substrates

Theoretically, red clover might increase the levels and clinical effects of drugs metabolized by CYP2C19.
In vitro evidence suggests that red clover weakly inhibits CYP2C19. This interaction has not been reported in humans.

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

Theoretically, red clover might increase levels of drugs metabolized by CYP2C9; however, a small clinical study found no effect.
In vitro evidence suggests that red clover might inhibit CYP2C9. However, a clinical study in healthy postmenopausal individuals shows that taking red clover capsules standardized to contain 60 mg isoflavones twice daily for 14 days does not affect the pharmacokinetics of tolbutamide, a CYP2C9 probe substrate.

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

Theoretically, red clover might increase levels of drugs metabolized by CYP3A4; however, a small clinical study found no effect.
In vitro evidence shows that red clover might inhibit CYP3A4 isoenzymes. However, a clinical study in healthy postmenopausal individuals shows that taking red clover capsules standardized to contain 60 mg isoflavones twice daily for 14 days does not affect the pharmacokinetics of alprazolam, a CYP3A4 probe substrate.

Likelihood Unlikely Evidence B
Red Clover (Trifolium pratense) flower extract full monograph & interactions

Chinese Rhubarb (Rheum palmatum) root extract8 drug types · 658 drugs

Corticosteroids

Theoretically, frequent and high doses of rhubarb might increase the risk of hypokalemia when taken with corticosteroids.
Rhubarb has stimulant laxative effects. Overuse of rhubarb might compound corticosteroid-induced potassium loss.

Likelihood Possible Evidence D
Cyclosporine (Neoral, Sandimmune)

Theoretically, taking rhubarb with cyclosporine might reduce cyclosporine levels.
Animal research shows that co-administration of rhubarb decoction 0.25 or 1 gram/kg with cyclosporine 2.5 mg/kg, decreases cyclosporine maximum plasma concentration and overall exposure levels when compared with taking cyclosporine alone. The authors theorize that rhubarb might reduce cyclosporine bioavailability by inducing of P-glycoprotein and/or cytochrome P450 3A4. However, since rhubarb was administered as a single oral dose and enzyme induction usually occurs after multiple doses, it is possible that cyclosporine absorption was actually reduced via rhubarb's stimulant laxative effects. Also, the composition of the rhubarb decoction was not described.

Likelihood Possible Evidence D
Digoxin (Lanoxin)

Theoretically, overuse of rhubarb might increase the risk of adverse effects when taken with digoxin.
Rhubarb has stimulant laxative effects. Overuse of rhubarb might cause potassium depletion, increasing the risk of digoxin toxicity.

Likelihood Possible Evidence D
Diuretic Drugs

Theoretically, frequent and high doses of rhubarb might increase the risk of hypokalemia.
Rhubarb has stimulant laxative effects. Overuse of rhubarb might cause potassium depletion and compound diuretic-induced potassium loss.

Likelihood Possible Evidence D
Hepatotoxic Drugs

Theoretically, concomitant use of rhubarb with potentially hepatotoxic drugs might increase the risk of developing liver damage.
Some animal research suggests that anthraquinones in rhubarb might have hepatotoxic effects. Also, rhubarb use has been linked to at least 24 cases of liver injury, although details on the dose of rhubarb and duration of use in these cases is unclear.

Likelihood Possible Evidence D
Nephrotoxic Drugs

Theoretically, long-term use of anthraquinones from rhubarb might increase the risk of nephrotoxicity when used with nephrotoxic drugs.
The anthraquinone constituents of rhubarb have been shown to induce nephrotoxicity in animal research. Additionally, in a case report, a 23-year old female presented with kidney failure after taking 6 tablets of a proprietary slimming agent (found to contain the anthraquinones emodin and aloe-emodin from rhubarb) daily for 6 weeks and then adding diclofenac 25 mg 4 times daily for 2 days. The authors postulate that the anthraquinone constituents of rhubarb contributed to the renal dysfunction, and the addition of diclofenac, a nephrotoxic drug, led to renal failure. Until more is known, advise patients to avoid taking rhubarb if they are taking other potentially nephrotoxic drugs.

Likelihood Possible Evidence D
Stimulant Laxatives

Theoretically, rhubarb might increase the risk for fluid and electrolyte loss when taken with other stimulant laxatives.
Rhubarb has stimulant laxative effects. Concomitant use with stimulant laxatives might compound fluid and electrolyte loss.

Likelihood Possible Evidence D
Warfarin (Coumadin)

Theoretically, excessive use of rhubarb might increase the risk of bleeding when taken with warfarin.
Rhubarb has stimulant laxative effects and can cause diarrhea. Diarrhea can increase the effects of warfarin, increase international normalized ratio (INR), and increase the risk of bleeding. Advise patients who take warfarin not to take excessive amounts of rhubarb.

Likelihood Possible Evidence D
Chinese Rhubarb (Rheum palmatum) root extract full monograph & interactions

Sheep Sorrel (Rumex acetosella) aerial parts extract3 drug types · 169 drugs

Anticoagulant/Antiplatelet Drugs

Theoretically, sorrel might cause additive effects and side effects when used with anticoagulant or antiplatelet drugs.
In vitro, sorrel has been shown to inhibit platelet aggregation. However, this effect has not been reported in humans.

Likelihood Possible Evidence D
Fexofenadine (Allegra)

Sorrel might reduce the effectiveness of fexofenadine by reducing its absorption from the gut.
In vitro research shows that an ethanol extract of sorrel inhibits organic anion-transporting polypeptide 1A2 (OATP1A2), which transports fexofenadine from the intestine into cells. In rats, concomitant administration of sorrel extract with fexofenadine reduces oral absorption of fexofenadine and the area under the plasma concentration-time curve (AUC).

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

Sorrel might reduce the effectiveness of OATP substrates by reducing their absorption from the gut.
In vitro research shows that sorrel inhibits OATP1A2. Theoretically it may inhibit other OATPs. The OATPs are expressed in the small intestine and liver and transport drugs into cells. Inhibition of OATP may reduce the bioavailability of oral drugs that are substrates of OATP.

Likelihood Possible Evidence D
Sheep Sorrel (Rumex acetosella) aerial parts extract full monograph & interactions

Burdock (Arctium lappa) root extract1 drug type · 122 drugs

Anticoagulant/Antiplatelet Drugs

Theoretically, taking burdock with anticoagulant or antiplatelet drugs might increase the risk of bleeding.

In vitro research shows that lignans from burdock reduce rabbit platelet aggregation by inhibiting platelet activating factor. This interaction has not been reported in humans.

Likelihood Possible Evidence D
Burdock (Arctium lappa) root extract full monograph & interactions

Watercress (Rorippa nasturtium-aquaticum) aerial parts extract3 drug types · 6 drugs

Chlorzoxazone (Parafon Forte, Paraflex)

Watercress might reduce the metabolism of chlorzoxazone and increase its effects and side effects. Clinical research in healthy volunteers shows that a single ingestion of watercress 50 grams increases the chlorzoxazone plasma concentration-time curve by about 56% and increases its half-life by about 53%.

Likelihood Probable Evidence B
Lithium

Watercress is thought to have diuretic properties. Theoretically, due to these potential diuretic effects, watercress might reduce excretion and increase levels of lithium.

Likelihood Probable Evidence D
Warfarin (Coumadin)

Watercress contains vitamin K. Consuming large amounts of watercress might antagonize the anticoagulant effects of warfarin.

Likelihood Possible Evidence B
Watercress (Rorippa nasturtium-aquaticum) aerial parts extract full monograph & interactions
The maker

Brand information

Manufacturer and brand details for Essigen Combination, from the product label.

Genestra Brands

Name
Seroyal USA
City
Pittsburgh
State
PA
ZipCode
15275
Phone Number
1-888-737-6925
Web Address
seroyal.com
Pharmacist Counseling Corner

Essigen Combination by Genestra Brands: Common Questions

Does Essigen Combination by Genestra Brands interact with any medications?
Yes. Based on its ingredients, Essigen Combination has a known interaction with 2,182 medications. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Essigen Combination contains 7 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 if I'm pregnant or breastfeeding?
No—the data advise against it. Burdock and rhubarb may stimulate the uterus; red clover and watercress are considered possibly or likely unsafe in pregnancy. For breastfeeding, burdock, sorrel, slippery elm, and red clover lack enough safety data to recommend them. Discuss this product with your doctor or midwife if you're pregnant or nursing.
What is burdock root supposed to do?
Our data don't have strong evidence that burdock works for any specific condition—the evidence is rated insufficient for acne, aging skin, breast cancer, colds, and eczema. It has a long history of use in traditional herbalism, but modern research backing its benefits is limited.
Is rhubarb safe to use long-term?
No. Rhubarb root commonly causes cramping and diarrhea and shouldn't be used long-term. Chronic overuse can deplete potassium and damage the kidneys. Use only occasionally and in modest amounts, and avoid it altogether if you take water pills, steroids, heart medications, or blood thinners.
What does red clover do?
Red clover shows possibly effective evidence in our data for menopausal symptoms, but the evidence for other uses—including osteoporosis, hair loss, and arthritis—is insufficient. Since it acts like estrogen, it shouldn't be used with estrogen therapy, tamoxifen, or methotrexate.
Does watercress interact with anything?
Yes. Watercress may increase lithium levels, raise chlorzoxazone (a muscle relaxant) levels and side effects, and counteract warfarin's blood-thinning action because of its vitamin K content. Check with your pharmacist if you take any of these.
What adverse effects are most common?
Rhubarb most often causes cramping, diarrhea, nausea, and vomiting. Red clover may cause nausea, muscle pain, or vaginal spotting. Sorrel in combination with other herbs has caused nausea and an unpleasant aftertaste. Allergic reactions, including contact dermatitis, are possible with burdock, slippery elm, and watercress.

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.

Essigen Combination label
Go deeper

The Full Monographs Behind Essigen Combination’s Ingredients

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

Herb & supplement monograph

Burdock

Interacts with 122 drugs

Burdock is a traditional herb most often used for skin problems and as a so-called 'blood purifier,' but high-quality human studies are lacking and most claims are not well proven. It is wid...

Read the full Burdock monograph → Herb & supplement monograph

Sorrel

Interacts with 169 drugs

Sorrel is a tangy, leafy herb used in cooking and traditional medicine, often for congestion, digestion, and inflammation. Solid human evidence for any health benefit is limited, and its hig...

Read the full Sorrel monograph → Herb & supplement monograph

Slippery Elm

Interacts with 2,022 drugs

Slippery elm is a traditional herbal remedy made from the inner bark of a North American elm tree, used mainly to soothe sore throats and irritated digestive tracts. Its mucilage can coat an...

Read the full Slippery Elm monograph → Herb & supplement monograph

Rhubarb

Interacts with 658 drugs

Rhubarb root has a long history of use as a laxative and in traditional Chinese medicine, and its edible stalks are a common food. Most medicinal claims are backed by limited or low-quality...

Read the full Rhubarb monograph → Herb & supplement monograph

Red Clover

Interacts with 867 drugs

Red clover is a plant rich in isoflavones (plant compounds with weak estrogen-like activity) that is most often used for menopause symptoms like hot flashes. The evidence is mixed and genera...

Read the full Red Clover monograph → Herb & supplement monograph

Watercress

Interacts with 6 drugs

Watercress is a nutrient-rich leafy green that provides vitamins A, C, and K plus minerals and antioxidant plant compounds. Eaten as a food it is generally safe and healthy for most people,...

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Sources

Sources & How We Checked

Essigen Combination'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 100 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.

Burdock 11 references
  1. Iwakami S, Wu JB, Ebizuka Y, Sankawa U. Platelet activating factor (PAF) antagonists contained in medicinal plants: lignans and sesquiterpenes. Chem Pharm Bull (Tokyo) 1992;40:1196-8. PubMed
  2. Sasaki Y, Kimura Y, Tsunoda T, Tagami H. Anaphylaxis due to burdock. Int J Dermatol 2003;42:472-3. PubMed
  3. Rhoads PM, Tong TG, Banner W Jr, Anderson R. Anticholinergic poisonings associated with commercial burdock root tea. J Toxicol Clin Toxicol 1984-85;22:581-4. PubMed
  4. Rodriguez P, Blanco J, Juste S, et al. Allergic contact dermatitis due to burdock (Arctium lappa). Contact Dermatitis 1995;33:134-5.
  5. Kassler, W. J., Blanc, P., and Greenblatt, R. The use of medicinal herbs by human immunodeficiency virus-infected patients. Arch Intern Med 1991;151(11):2281-2288. DOI
  6. Chan, Y. S., Cheng, L. N., Wu, J. H., Chan, E., Kwan, Y. W., Lee, S. M., Leung, G. P., Yu, P. H., and Chan, S. W. A review of the pharmacological effects of Arctium lappa (burdock). Inflammopharmacology. 2011;19(5):245-254. PubMed
  7. Breed, F. B. and Kuwabara, T. Burdock ophthalmia. Arch Ophthalmol 1966;75(1):16-20.
  8. Bryson, P. D., Watanabe, A. S., Rumack, B. H., and Murphy, R. C. Burdock root tea poisoning. Case report involving a commercial preparation. JAMA 5-19-1978;239(20):2157. DOI
  9. <p>Fletcher GF<span>, </span>Cantwell JD. Burdock root tea poisoning. JAMA <span>1978 Oct 6;240(15):1586.</span></p> DOI
  10. Latif A, Fichadiya H, Abid F, Capo G. Herbal Teas and Thrombocytopenia: A Curious Case of Yellow Dock and Burdock-Induced Thrombocytopenia. Eur J Case Rep Intern Med 2022;9(3):003247. PubMed
  11. Niazi B, Ahmed K, Ahmed M, Ali S, Song K, Elias S. Drug-Induced Liver Injury from Herbal Liver Detoxification Tea. Case Rep Gastroenterol 2022;16(3):612-617. PubMed

See these in context on the Burdock monograph →

Sorrel 8 references
  1. Neubauer N, Marz RW. Placebo-controlled, randomized, double-blind, clincal trial with Sinupret sugar coated tablets on the basis of a therapy with antibiotics and decongestant nasal drops in acute sinusitis. Phytomedicine 1994;1:177-81.
  2. Marz RW, Ismail C, Popp MA. Action profile and efficacy of a herbal combination preparation for the treatment of sinusitis. Wien Med Wochenschr 1999;149:202-8.
  3. Zick, S. M., Sen, A., Feng, Y., Green, J., Olatunde, S., and Boon, H. Trial of Essiac to ascertain its effect in women with breast cancer (TEA-BC). J Altern Complement Med 2006;12(10):971-980. PubMed
  4. Sanz, P. and Reig, R. Clinical and pathological findings in fatal plant oxalosis. A review. Am J Forensic Med Pathol. 1992;13(4):342-345. PubMed
  5. Gniazdowska, B., Doroszewska, G., and Doroszewski, W. [Hypersensitivity to weed pollen allergens in the region of Bygdoszcz]. Pneumonol.Alergol.Pol. 1993;61(7-8):367-372.
  6. Selçuk SN, Gülhan B, Düzova A, Teksam Ö. Acute tubulointerstitial nephritis due to large amount of sorrel (Rumex acetosa) intake. Clin Toxicol (Phila) 2015;53(5):497. PubMed
  7. Ahn JH, Kim J, Rehman NU, Kim HJ, Ahn MJ, Chung HJ. Effect of Rumex Acetosa Extract, a Herbal Drug, on the Absorption of Fexofenadine. Pharmaceutics. 2020;12(6):E547. PubMed
  8. Jeong D, Irfan M, Lee DH, Hong SB, Oh JW, Rhee MH. Rumex acetosa modulates platelet function and inhibits thrombus formation in rats. BMC Complement Med Ther. 2020;20(1):98. PubMed

See these in context on the Sorrel monograph →

Slippery Elm 3 references
  1. The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999.
  2. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
  3. Czarnecki D, Nixon R, Bekhor P, and et al. Delayed prolonged contact urticaria from the elm tree. Contact Dermatitis 1993;28:196-197. PubMed

See these in context on the Slippery Elm monograph →

Rhubarb 20 references
  1. Blumenthal M, ed. The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. Trans. S. Klein. Boston, MA: American Botanical Council, 1998.
  2. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
  3. Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.
  4. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
  5. Nusko G, Schneider B, Schneider I, et al. Anthranoid laxative use is not a risk factor for colorectal neoplasia: results of a prospective case control study. Gut 2000;46:651-5. PubMed
  6. Kwan TH, Tong MK, Leung KT, et al. Acute renal failure associated with prolonged intake of slimming pills containing anthraquinones. Hong Kong Med J 2006;12:394-7.
  7. Fairbairn JW. The anthraquinone laxatives. Biological assay and its relation to chemical structure. Pharmacology 1976;14:48-61. PubMed
  8. Siegers, C. P., Hertzberg-Lottin, E., Otte, M., and Schneider, B. Anthranoid laxative abuse--a risk for colorectal cancer? Gut 1993;34(8):1099-1101. PubMed
  9. Fan, J. G. Evaluating the efficacy and safety of Danning Pian in the short-term treatment of patients with non-alcoholic fatty liver disease: a multicenter clinical trial. Hepatobiliary.Pancreat.Dis.Int 2004;3(3):375-380.
  10. Yan, M., Zhang, L. Y., Sun, L. X., Jiang, Z. Z., and Xiao, X. H. Nephrotoxicity study of total rhubarb anthraquinones on Sprague Dawley rats using DNA microarrays. J Ethnopharmacol. 4-15-2006; PubMed
  11. Zhang, J. H., Li, L. S., and Zhang, M. Clinical effects of rheum and captopril on preventing progression of chronic renal failure. Chin Med J (Engl.) 1990;103(10):788-793.
  12. Mitsuma, T., Yokozawa, T., Oura, H., and Terasawa, K. [Rhubarb therapy in patients with chronic renal failure (Part 2)]. Nippon Jinzo Gakkai Shi 1987;29(2):195-207.
  13. Wu, C. X. [A preliminary study on the effect of a single Rheum officinale in heavy doses in the treatment of acute icteric hepatitis]. Zhong.Xi.Yi.Jie.He.Za Zhi.(Chinese Journal of Modern Developments in Traditional Medicine) 1984;4(2):88-89.
  14. Jiao, D. H. [Clinical research on the hemostatic effect of rhubarb on peptic ulcer with acute bleeding]. Zhong.Xi.Yi.Jie.He.Za Zhi.(Chinese Journal of Modern Developments in Traditional Medicine) 1984;4(10):597-600, 579.
  15. Jiao, D. H., Ma, Y. H., Chen, S. J., Liu, C. T., Shu, H. N., and Chu, C. M. Resume of 400 cases of acute upper digestive tract bleeding treated by rhubarb alone. Pharmacology 1980;20 Suppl 1:128-130.
  16. Zhang, JH, Yao, XD, Song, Y, and et al. [Long-term treating effects of rhubarb and captopril in delaying the progression of renal failure]. Chinese Kidney Disease Journal 1993;9(4):197-201.
  17. Rehman H, Begum W, Anjum F, Tabasum H, Zahid S. Effect of rhubarb (Rheum emodi) in primary dysmenorrhoea: a single-blind randomized controlled trial. J Complement Integr Med. 2015 Mar;12(1):61-9.
  18. Yu CP, Lin HJ, Lin SP, Shia CS, Chang PH, Hou YC, Hsieh YW. Rhubarb decreased the systemic exposure of cyclosporine, a probe substrate of P-glycoprotein and CYP 3A. Xenobiotica. 2016 Aug;46(8):677-82. PubMed
  19. Byeon JH, Kil JH, Ahn YC, Son CG. Systematic review of published data on herb induced liver injury. J Ethnopharmacol 2019;233:190-6. PubMed
  20. Zhao D, Feng SX, Zhang HJ, et al. Pharmacokinetics, tissue distribution and excretion of five rhubarb anthraquinones in rats after oral administration of effective fraction of anthraquinones from rheum officinale. Xenobiotica. 2021;51(8):916-925. PubMed

See these in context on the Rhubarb monograph →

Red Clover 24 references
  1. Kurzer MS, Xu X. Dietary phytoestrogens. Annu Rev Nutr 1997;17:353-81. PubMed
  2. Electronic Code of Federal Regulations. Title 21. Part 182 -- Substances Generally Recognized As Safe. Available at: https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?CFRPart=182
  3. Budzinski JW, Foster BC, Vandenhoek S, Arnason JT. An in vitro evaluation of human cytochrome P450 3A4 inhibition by selected commercial herbal extracts and tinctures. Phytomedicine 2000;7:273-82. PubMed
  4. This P, De La Rochefordiere A, Clough K, et al. Phytoestrogens after breast cancer. Endocr Relat Cancer 2001;8:129-34. PubMed
  5. Tice J, Cummings SR, Ettinger B, et al. Few adverse effects of two red clover extracts rich in phytoestrogens: a multicenter, placebo-controlled trial. Alt Ther 2001;7:S33.
  6. Ingram DM, Hickling C, West L, et al. A double-blind randomized controlled trial of isoflavones in the treatment of cyclical mastalgia. The Breast 2002;11:170-4. PubMed
  7. Unger M, Frank A. Simultaneous determination of the inhibitory potency of herbal extracts on the activity of six major cytochrome P450 enzymes using liquid chromatography/mass spectrometry and automated online extraction. Rapid Commun Mass Spectrom 2004;1 PubMed
  8. Cheong JL, Bucknall R. Retinal vein thrombosis associated with a herbal phytoestrogen preparation in a susceptible patient. Postgrad Med J 2005;81:266-7.. PubMed
  9. Geller SE, Shulman LP, van Breemen RB, et al. Safety and efficacy of black cohosh and red clover for the management of vasomotor symptoms: a randomized controlled trial. Menopause 2009;16:1156-66. PubMed
  10. Hidalgo LA, Chedraui PA, Morocho N, et al. The effect of red clover isoflavones on menopausal symptoms, lipids and vaginal cytology in menopausal women: a randomized, double-blind, placebo-controlled study. Gynecol Endocrinol 2005;21(5):257-264. PubMed
  11. Campbell MJ, Woodside JV, Honour JW, et al. Effect of red clover-derived isoflavone supplementation on insulin-like growth factor, lipid and antioxidant status in healthy female volunteers: a pilot study. Eur J Clin Nutr 2004;58(1):173-179. PubMed
  12. Guerrero JA, Lozano ML, Castillo J, et al. Flavonoids inhibit platelet function through binding to the thromboxane A2 receptor. J Thromb Haemost 2005;3(2):369-376. PubMed
  13. Kondo K, Suzuki Y, Ikeda Y, Umemura K. Genistein, an isoflavone included in soy, inhibits thrombotic vessel occlusion in the mouse femoral artery and in vitro platelet aggregation. Eur J Pharmacol 2002;455(1):53-57. PubMed
  14. Polini N, Rauschemberger MB, Mendiberri J, et al. Effect of genistein and raloxifene on vascular dependent platelet aggregation. Mol Cell Endocrinol 2007;267(1-2):55-62. PubMed
  15. Wuttke W, Jarry H, Seidlova-Wuttke D. Plant-derived alternative treatments for the aging male: facts and myths. Aging Male 2010;13(2):75-81. PubMed
  16. Villaseca P. Non-estrogen conventional and phytochemical treatments for vasomotor symptoms: what needs to be known for practice. Climacteric 2012;15(2):115-124. PubMed
  17. Chen, Y., Xiao, C. Q., He, Y. J., Chen, B. L., Wang, G., Zhou, G., Zhang, W., Tan, Z. R., Cao, S., Wang, L. P., and Zhou, H. H. Genistein alters caffeine exposure in healthy female volunteers. Eur.J Clin.Pharmacol. 2011;67(4):347-353. PubMed
  18. Friedman, J. A., Taylor, S. A., McDermott, W., and Alikhani, P. Multifocal and recurrent subarachnoid hemorrhage due to an herbal supplement containing natural coumarins. Neurocrit.Care 2007;7(1):76-80. PubMed
  19. Hooper, L., Madhavan, G., Tice, J. A., Leinster, S. J., and Cassidy, A. Effects of isoflavones on breast density in pre- and post-menopausal women: a systematic review and meta-analysis of randomized controlled trials. Hum.Reprod.Update. 2010;16(6):745-7 PubMed
  20. Orr A and Parker R. Red clover causing symptoms suggestive of methotrexate toxicity in a patient on high-dose methotrexate. Menopause Int. 2013;19(3):133-134. PubMed
  21. Clifton-Bligh PB, et al. Red cover isoflavones enriched with formononetin lower serum LDL cholesterol- a randomized, double-blind, placebo-controlled trial. Eur J Clin Nutr. 2015;69(1):134-142.
  22. Risk assessment for peri- and post-menopausal women taking food supplements containing isolated isoflavones. EFSA Panel on Food Additives and Nutrient Sources added to Food (ANS). 2015. DOI
  23. Ferraris C, Ballestra B, Listorti C, et al. Red clover and lifestyle changes to contrast menopausal symptoms in premenopausal patients with hormone-sensitive breast cancer receiving tamoxifen. Breast Cancer Res Treat 2020;180(1):157-65. doi: 10.1007/s1054 PubMed
  24. Chen L, Choi J, Leonard SW, et al. No Clinically Relevant Pharmacokinetic Interactions of a Red Clover Dietary Supplement with Cytochrome P450 Enzymes in Women. J Agric Food Chem. 2020;68(47):13929-13939. PubMed

See these in context on the Red Clover monograph →

Watercress 34 references
  1. Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.
  2. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
  3. Leclercq I, Desager JP, Horsmans Y. Inhibition of chlorzoxazone metabolism, a clinical probe for CYP2E1, by a single ingestion of watercress. Clin Pharmacol Ther 1998;64:144-9. PubMed
  4. Bolton-Smith C, Price RJ, Fenton ST, et al. Compilation of a provisional UK database for the phylloquinone (vitamin K1) content of foods. Br J Nutr 2000;83:389-99.
  5. Rondelaud, D., Dreyfuss, G., Bouteille, B., and Darde, M. L. Changes in human fasciolosis in a temperate area: about some observations over a 28-year period in central France. Parasitol.Res 2000;86(9):753-757. PubMed
  6. Sanchez-Sosa, S., Rojas-Ortega, S., Reed-San Roman, G., and Torres-Santana, M. A. [Massive hepatobiliary fascioliasis]. Rev Gastroenterol.Mex. 2000;65(4):179-183.
  7. van Daele, P. L., Madretsma, G. S., and van Agtmael, M. A. [Stomach ache and fever after consumption of watercress in Turkey: fascioliasis]. Ned.Tijdschr.Geneeskd. 9-29-2001;145(39):1896-1899.
  8. Cosme, A., Ojeda, E., Cilla, G., Torrado, J., Alzate, L., Beristain, X., Orive, V., and Arenas, J. [Fasciola hepatica. study of a series of 37 patients]. Gastroenterol.Hepatol. 2001;24(8):375-380.
  9. Martinez-Bebert, K., Rodriguez-Baez, R., Pila-Perez, R., Pila-Pelaez, R., and Tamakloe, K. [Hepatic hematoma caused by fascioliasis]. Gac.Med Mex. 2002;138(3):271-274.
  10. Dreyfuss, G., Vignoles, P., Abrous, M., and Rondelaud, D. Unusual snail species involved in the transmission of Fasciola hepatica in watercress beds in central France. Parasite 2002;9(2):113-120.
  11. Christmann, M., Henrich, R., Mayer, G., and Ell, C. [Infection with fasciola hepatica causing elevated liver-enzyme results and eosinophilia - serologic and endoscopic diagnosis and therapy]. Z.Gastroenterol. 2002;40(9):801-806.
  12. Cosme, A., Ojeda, E., Poch, M., Bujanda, L., Castiella, A., and Fernandez, J. Sonographic findings of hepatic lesions in human fascioliasis. J Clin Ultrasound 2003;31(7):358-363. PubMed
  13. Sapunar, J., Latorre, R., Guerra, M., and Defilippi, C. [Clinical considerations on 2 cases of hepatic fascioliasis. Importance of the imaging examinations]. Bol.Chil.Parasitol. 1992;47(3-4):70-76.
  14. de Gorgolas, M., Torres, R., Verdejo, C., Garay, J., Robledo, A., Ponte, M. C., and Fernandez Guerrero, M. L. [Fasciola hepatica infestation. Biopathology and new diagnostic and therapeutic aspects]. Enferm.Infecc.Microbiol.Clin 1992;10(9):514-519.
  15. Carrada-Bravo, T. [Fascioliasis: diagnosis, epidemiology and treatment]. Rev Gastroenterol.Mex. 2003;68(2):135-142.
  16. Yilmaz, H. and Godekmerdan, A. Human fasciolosis in Van province, Turkey. Acta Trop. 2004;92(2):161-162.
  17. Dobrucali, A., Yigitbasi, R., Erzin, Y., Sunamak, O., Polat, E., and Yakar, H. Fasciola hepatica infestation as a very rare cause of extrahepatic cholestasis. World J Gastroenterol. 10-15-2004;10(20):3076-3077. PubMed
  18. Alvarez-Chacon, R., Garcia-Rosales, J. J., de la Cruz-Otero MC, Wong-Chio, M., Cabrera-Bravo, M., Gomez-Gomez, J. V., and Gamez-Aranda, V. [Fascioliasis in children. A study of 10 cases]. Bol.Med Hosp.Infant Mex. 1992;49(6):365-371.
  19. Mailles, A., Capek, I., Ajana, F., Schepens, C., Ilef, D., and Vaillant, V. Commercial watercress as an emerging source of fascioliasis in Northern France in 2002: results from an outbreak investigation. Epidemiol.Infect. 2006;134(5):942-945.
  20. Cruz, Lopez O., Adan, Pimentel A., Tamariz Cruz, O. J., Munoz, Lopez A., Cruz Lopez, M. C., Cruz Lopez, M. E., and Munoz, Lopez S. [Hepatic fasciolasis diagnosed in state phase]. Rev Gastroenterol Mex. 2006;71(1):59-62.
  21. el Shazly, A. M., Handousa, A. E., Youssef, M. E., Rizk, H., and Hamouda, M. M. Human fascioliasis: a parasitic health problem in Dakahlia Governorate, Egypt. J Egypt.Soc Parasitol. 1991;21(2):553-559.
  22. Cosme, A., Alzate, L., Orive, V., Recasens, M., Torrado, J., Ruiz, I., and Arenas, J. [Laparoscopic findings in liver fascioliasis. Study of 13 cases]. Rev Esp.Enferm.Dig. 1990;78(6):359-362.
  23. Diaz, J., Pina, B., Lastre, M., Rivera, L., and Perez, O. [Epidemic human fascioliasis. Cuba 1983. VI. Clinical study of 40 children in the Hospital Provincial of Sagua la Grande]. G.E.N. 1990;44(4):385-388.
  24. Borie, C., Corona, S., Garin, A., Olea, P., Salcedo, M., Perez, C., and Apt, W. [A family outbreak of acute hepatic fascioliasis]. Rev Med Chil. 1990;118(1):67-72.
  25. Diamond, S. P., Wiener, S. G., and Marks, J. G., Jr. Allergic contact dermatitis to nasturtium. Dermatol.Clin. 1990;8(1):77-80. DOI
  26. Delasalle, P., Beytout, J., Cambon, M., and Bommelaer, G. [Distomatosis: diagnosis and treatment]. Rev Prat. 1-21-1990;40(3):230-236.
  27. Rivera, J. V. and Bermudez, R. H. Radionuclide imaging of the liver in human fascioliasis. Clin Nucl.Med 1984;9(8):450-453. PubMed
  28. Croese, J., Chapman, G., and Gallagher, N. D. Evolution of fascioliasis after eating wild watercress. Aust.N.Z.J.Med. 1982;12(5):525-527. PubMed
  29. Bendezu, P., Frame, A., and Hillyer, G. V. Human fascioliasis in Corozal, Puerto Rico. J Parasitol. 1982;68(2):297-299. DOI
  30. Derrick, E. and Darley, C. Contact dermatitis to nasturtium. Br.J Dermatol 1997;136(2):290-291. PubMed
  31. Narain, K., Biswas, D., Rajguru, S. K., and Mahanta, J. Human distomatosis due to Fasciola hepatica infection in Assam, India. J Commun.Dis 1997;29(2):161-165.
  32. Brinker, F. Herb Contraindications and Drug Interactions. 1998;2nd edition.
  33. Gruenwald, J. PDR for Herbal Medicines. 1998;1st ed.
  34. Clemente M, Miguel MD, Felipe KB, et al. Effect of watercress extract supplementation on lipid profile and oxidative stress markers in overweight people with physical disability: A randomized, double-blind, and placebo-controlled trial. Phytother Res. 202 PubMed

See these in context on the Watercress monograph →

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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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