Ester-C Bio Ingredients & Drug Interactions
by Klaire Labs
What is this page for?
First and foremost: checking Ester-C Bio 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
Ester-C Bio is a dietary supplement by Klaire Labs with 5 active ingredients. Its ingredients are commonly taken for seasonal allergies, antioxidant support, heart and blood pressure health.Based on those ingredients, 1,289 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Citrus Bioflavonoids, Pycnogenol, Rutin. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against Ester-C Bio by Klaire Labs
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AI summaries are generated from our interaction database for education only — always confirm with your pharmacist. How we use AI
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HelloPharmacist Scorecard of Ester-C Bio by Klaire Labs
Our pharmacy team’s full take, with four database checks built into the cards below — a summary of what is known, not a grade of the product itself.
What’s inside
Full disclosure
Ester-C Bio contains five active ingredients: two forms of Ester-C (a form of vitamin C we could not evaluate for interactions), citrus bioflavonoids (a plant compound that includes quercetin), rutin (another plant-derived compound), and pycnogenol (an extract from maritime pine bark). The product also holds several inactive ingredients — a vegetarian capsule, stearic acid, microcrystalline cellulose, and silicon dioxide — which are fillers and binders that help form and stabilize the capsule.
Does it work?
Moderate evidence
The evidence for citrus bioflavonoids and rutin in this product remains incomplete. For rutin specifically, the data we hold shows insufficient evidence to rate its use against aging skin, autism spectrum disorder, inflammatory bowel disease, diabetes, respiratory infections, or hemorrhoids.
For pycnogenol (maritime pine bark), the evidence is stronger: it is possibly effective for osteoarthritis and chronic venous insufficiency (a condition in which leg veins don't return blood well to the heart). For athletic performance, quercetin is rated possibly ineffective, and evidence on its use for age-related cognitive decline, hay fever, Alzheimer disease, asthma, and atherosclerosis is insufficient to rate.
Because we could not check the Ester-C components, we cannot speak to their effectiveness from our data.
How safe is it?
Well-documented data
Quercetin and rutin are generally well tolerated at food and typical supplement doses, though high doses and long-term safety have not been well studied. Orally, quercetin may cause headache and tingling in the hands or feet; rutin may cause headache, flushing, or rashes in some people.
Pycnogenol is generally well tolerated, but may cause gastrointestinal complaints, dizziness, or vertigo. The safety notes advise against supplemental doses of quercetin and pycnogenol during pregnancy and breastfeeding because data are insufficient.
For rutin, pregnancy safety is rated likely safe, but breastfeeding safety is unknown, so supplemental doses should be avoided unless your doctor advises otherwise. We hold no pregnancy or breastfeeding data for the Ester-C components.
Meds to double-check
Moderate interaction found
Before taking Ester-C Bio, check your exact medications with your doctor or pharmacist if you take blood thinners or antiplatelet drugs (major bleeding risk), antidiabetes medications, pravastatin or other statin drugs, warfarin, quinolone antibiotics (like ciprofloxacin), cyclosporine, sulfasalazine, mitoxantrone, or immunosuppressants. These are the drug types with documented moderate-severity interactions in this product.
The bottom line
Scorecard at a glanceFully disclosed formula with some supporting evidence for its stated purpose. Moderate medication interactions have been identified, and safety information is well characterized.
This product combines vitamin C with bioflavonoids and an herbal extract, intended to support general wellness — though robust evidence for most uses is lacking. If you take blood thinners, antidiabetes drugs, statins, quinolone antibiotics, cyclosporine, or other prescription medications, you should check with your doctor or pharmacist before starting.
Pregnant or breastfeeding women should talk with their provider first, since safety data are incomplete.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 3 of 5 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Jul 21, 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 Ester-C Bio, straight from the product label.
| Brand | Klaire Labs |
|---|---|
| Barcode (UPC) | 828054002159 |
| Net contents | 100 Vegetarian Capsule(s) |
| Market status | On market |
| Date entered into DSLD | Jul 21, 2022 |
| DSLD ID | 264871 |
| Product type | Other Combinations |
| Supplement form | Capsule |
| Dietary claims / uses | Nutrient, All Other |
| Intended target group(s) | Adult (18 - 50 Years), Gluten Free, Dairy 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 Ester-C Bio by Klaire Labs, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Ester-C | 540 mg | 600% |
| Ester-C | 60 mg | 5% |
| Citrus Bioflavonoids | 50 mg | -- |
| Rutin | 75 mg | -- |
| Pycnogenol | 3 mg | -- |
Other ingredients: Vegetarian Capsule, Stearic Acid, Microcrystalline Cellulose, Silicon Dioxide
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.
FDA Statement of Identity
Vitamin C Supplement
Formulation
Free of the following common allergens: Milk/casein, eggs, fish, shellfish, tree nuts, peanuts, wheat, gluten, and soybeans. Contains no artificial colors, flavors, or preservatives.
Produced under a strict quality management system in compliance with Good Manufacturing Practices (GMPs) and third-party quality certifications.
Suggested/Recommended/Usage/Directions
Suggested Use: 1 capsule, 1 to 2 times daily with food or as directed by a healthcare professional.
Formula
Ester-C calcium ascorbate is a non-acidic form of vitamin C manufactured by a unique water-based process that combines calcium with vitamin C. This process creates a patented mixture of mineral ascorbates and vitamin C metabolites.
Brand IP Statement(s)
Ester-C and Ester-C are registered trademarks of the Ester-C Company. Pycnogenol is a registered trademark of Horphag Research Ltd. Use of this product is protected by one or more U.S. patents and other international patents.
SFI
Precautions
Do not use if shrinkwrap is broken or missing.
Caution: If you are pregnant, nursing, have a medical condition, or taking prescription drugs, consult your physician before using this product.
Keep out of reach of children.
Storage
Store in a cool, dry place (59 degrees F - 85 degrees F) away from direct light.
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Ester-C Bio by Klaire Labs 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 Ester-C Bio by Klaire Labs
These are the 5 active ingredients this product is made of. Select any to open its full monograph.
Serving size1 Capsule(s) Dosage formCapsule Servings per container100 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.
Ester-C
Ester-C
Citrus Bioflavonoids
Interacts with1,169 drugs
Quercetin is a plant flavonoid with antioxidant and anti-inflammatory properties found in many common foods and sold as a supplement. While early rese...
Citrus Bioflavonoids monograph & interactionsRutin
Interacts with86 drugs
Rutin is a plant flavonoid (often taken from buckwheat or citrus) that people use mainly for blood vessel and circulation problems like varicose veins...
Rutin monograph & interactionsPycnogenol
Interacts with327 drugs
Maritime pine bark extract (often sold as Pycnogenol) is a plant-based antioxidant most studied for circulation, vein, and skin health. Some research...
Pycnogenol monograph & interactionsOther (inactive) ingredients: Vegetarian Capsule, Stearic Acid, Microcrystalline Cellulose, Silicon Dioxide. These complete the product’s ingredient list but are not active constituents.
Ester-C Bio by Klaire Labs Drug Interactions
HelloPharmacist Interaction Report
Ester-C Bio by Klaire Labs contains five ingredients, and we could not check two of them (both listed as Ester-C) — we hold no interaction data for those.
The other three ingredients do have documented interactions, chiefly through citrus bioflavonoids (which we checked as quercetin) and pycnogenol. The most serious concern involves blood thinners: pycnogenol may increase bleeding risk when combined with anticoagulant or antiplatelet drugs, and quercetin may raise warfarin levels and bleeding risk as well.
Read the full breakdown — every affected drug type, severity by severity
Quercetin also interacts with several medication types. It may reduce the effectiveness of quinolone antibiotics (by binding to their target site in bacteria).
It can increase blood levels and side effects of pravastatin and other OATP substrate drugs — a group that includes certain statins and other medications your liver transports. It may also raise cyclosporine levels and slow its breakdown, increase losartan's effects while lowering its active form, and boost sulfasalazine and mitoxantrone levels.
Rutin, another ingredient here, may heighten the risk of low blood sugar (hypoglycemia) if you take antidiabetes drugs. Pycnogenol shares that risk and may also reduce how well immunosuppressant drugs work.
Altogether, these interactions span 1,290 individual medications. Because two of the product's ingredients could not be checked, check your exact medications with the search tool on this page before starting.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against Ester-C Bio?
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 Ester-C Bio interact with 1,289 drugs. Click any drug to see the details.
3 of the 5 ingredients in Ester-C Bio interact with drugs. Each result below shows which ingredient is responsible. Citrus Bioflavonoids Pycnogenol Rutin
Aspirin, MethocarbamolRobaxisal
How Aspirin, Methocarbamol interacts with Ester-C Bio — through 2 ingredients. Tap an ingredient for the detail:
PycnogenolAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, maritime pine bark extract might increase the risk of bleeding when used with antiplatelet or anticoagulant drugs.
Read the full Pycnogenol + Aspirin, Methocarbamol interactionCitrus BioflavonoidsOrganic Anion Transporter 3 (oat3) Substrates, Organic Anion Transporter 1 (oat1) Substrates Moderate
Interaction Summary
Theoretically, concomitant use might increase the effects and adverse effects of OAT3 substrates.
Read the full Citrus Bioflavonoids + Aspirin, Methocarbamol interactionAspirin, OmeprazoleYosprala
How Aspirin, Omeprazole interacts with Ester-C Bio — through 2 ingredients. Tap an ingredient for the detail:
Citrus BioflavonoidsOrganic Anion Transporter 1 (oat1) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +2 Moderate
Interaction Summary
Theoretically, concomitant use might increase the effects and adverse effects of OAT1 substrates.
Read the full Citrus Bioflavonoids + Aspirin, Omeprazole interactionPycnogenolAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, maritime pine bark extract might increase the risk of bleeding when used with antiplatelet or anticoagulant drugs.
Read the full Pycnogenol + Aspirin, Omeprazole interactionAspirin, OxycodonePercodan
How Aspirin, Oxycodone interacts with Ester-C Bio — through 2 ingredients. Tap an ingredient for the detail:
Citrus BioflavonoidsOrganic Anion Transporter 1 (oat1) Substrates, Organic Anion Transporter 3 (oat3) Substrates +1 Moderate
Interaction Summary
Theoretically, concomitant use might increase the effects and adverse effects of OAT1 substrates.
Read the full Citrus Bioflavonoids + Aspirin, Oxycodone interactionPycnogenolAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, maritime pine bark extract might increase the risk of bleeding when used with antiplatelet or anticoagulant drugs.
Read the full Pycnogenol + Aspirin, Oxycodone interactionAspirin, PentazocineTalwin Compound
How Aspirin, Pentazocine interacts with Ester-C Bio — through 2 ingredients. Tap an ingredient for the detail:
PycnogenolAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, maritime pine bark extract might increase the risk of bleeding when used with antiplatelet or anticoagulant drugs.
Read the full Pycnogenol + Aspirin, Pentazocine interactionCitrus BioflavonoidsOrganic Anion Transporter 1 (oat1) Substrates, Organic Anion Transporter 3 (oat3) Substrates Moderate
Interaction Summary
Theoretically, concomitant use might increase the effects and adverse effects of OAT1 substrates.
Read the full Citrus Bioflavonoids + Aspirin, Pentazocine interactionAtazanavirReyataz
How Atazanavir interacts with Ester-C Bio — through 1 ingredient. Tap an ingredient for the detail:
Citrus BioflavonoidsCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, concomitant use might alter the effects and adverse effects of CYP3A4 substrates.
Read the full Citrus Bioflavonoids + Atazanavir interactionAtazanavir, CobicistatEvotaz
How Atazanavir, Cobicistat interacts with Ester-C Bio — through 1 ingredient. Tap an ingredient for the detail:
Citrus BioflavonoidsCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, concomitant use might alter the effects and adverse effects of CYP3A4 substrates.
Read the full Citrus Bioflavonoids + Atazanavir, Cobicistat interactionAtenololAtenix, Tenormin
How Atenolol interacts with Ester-C Bio — through 1 ingredient. Tap an ingredient for the detail:
Citrus BioflavonoidsAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, taking quercetin with antihypertensive drugs might increase the risk of hypotension.
Read the full Citrus Bioflavonoids + Atenolol interactionAtenolol, ChlortalidoneAtenixCo, Tenoret 50, Totaretic
How Atenolol, Chlortalidone interacts with Ester-C Bio — through 1 ingredient. Tap an ingredient for the detail:
Citrus BioflavonoidsAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, taking quercetin with antihypertensive drugs might increase the risk of hypotension.
Read the full Citrus Bioflavonoids + Atenolol, Chlortalidone interactionAtenolol, ChlorthalidoneTenoretic
How Atenolol, Chlorthalidone interacts with Ester-C Bio — through 1 ingredient. Tap an ingredient for the detail:
Citrus BioflavonoidsAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, taking quercetin with antihypertensive drugs might increase the risk of hypotension.
Read the full Citrus Bioflavonoids + Atenolol, Chlorthalidone interactionAtezolizumabTecentriq
How Atezolizumab interacts with Ester-C Bio — through 1 ingredient. Tap an ingredient for the detail:
PycnogenolImmunosuppressants Moderate
Interaction Summary
Theoretically, maritime pine bark extract might decrease the effectiveness of immunosuppressant therapy.
Read the full Pycnogenol + Atezolizumab interactionAtogepantQulipta
How Atogepant interacts with Ester-C Bio — through 1 ingredient. Tap an ingredient for the detail:
Citrus BioflavonoidsP-glycoprotein Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, concomitant use might alter the effects and adverse effects of P-glycoprotein substrates.
Read the full Citrus Bioflavonoids + Atogepant interactionAtomoxetineStrattera
How Atomoxetine interacts with Ester-C Bio — through 1 ingredient. Tap an ingredient for the detail:
Citrus BioflavonoidsCytochrome P450 2d6 (cyp2d6) Substrates Moderate
Interaction Summary
Theoretically, concomitant use might increase the levels and adverse effects of CYP2D6 substrates.
Read the full Citrus Bioflavonoids + Atomoxetine interactionAtorvastatinAtorvaliq
How Atorvastatin interacts with Ester-C Bio — through 1 ingredient. Tap an ingredient for the detail:
Citrus BioflavonoidsCytochrome P450 3a4 (cyp3a4) Substrates, Organic Anion-transporting Polypeptide Substrates (oatp) Moderate
Interaction Summary
Theoretically, concomitant use might alter the effects and adverse effects of CYP3A4 substrates.
Read the full Citrus Bioflavonoids + Atorvastatin interactionAtorvastatin CalciumLipitor
How Atorvastatin Calcium interacts with Ester-C Bio — through 1 ingredient. Tap an ingredient for the detail:
Citrus BioflavonoidsOrganic Anion-transporting Polypeptide Substrates (oatp), Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, concomitant use might increase the effects and adverse effects of OATP substrates.
Read the full Citrus Bioflavonoids + Atorvastatin Calcium interactionAtropine, Chlorpheniramine, Hyoscyamine, Phenylephrine, Phenylpropanolamine, ScopolamineAtrohist Plus, Pro Tuss, Ru-tuss, Stahist
How Atropine, Chlorpheniramine, Hyoscyamine, Phenylephrine, Phenylpropanolamine, Scopolamine interacts with Ester-C Bio — through 1 ingredient. Tap an ingredient for the detail:
Citrus BioflavonoidsCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, concomitant use might alter the effects and adverse effects of CYP3A4 substrates.
Read the full Citrus Bioflavonoids + Atropine, Chlorpheniramine, Hyoscyamine, Phenylephrine, Phenylpropanolamine, Scopolamine interactionAtropine, MeperidineAtropine, Meperidine
How Atropine, Meperidine interacts with Ester-C Bio — through 1 ingredient. Tap an ingredient for the detail:
Citrus BioflavonoidsCytochrome P450 2d6 (cyp2d6) Substrates Moderate
Interaction Summary
Theoretically, concomitant use might increase the levels and adverse effects of CYP2D6 substrates.
Read the full Citrus Bioflavonoids + Atropine, Meperidine interactionAtropine, Morphine SulfateAtropine, Morphine Sulfate
How Atropine, Morphine Sulfate interacts with Ester-C Bio — through 1 ingredient. Tap an ingredient for the detail:
Citrus BioflavonoidsCytochrome P450 2d6 (cyp2d6) Substrates, P-glycoprotein Substrates Moderate
Interaction Summary
Theoretically, concomitant use might increase the levels and adverse effects of CYP2D6 substrates.
Read the full Citrus Bioflavonoids + Atropine, Morphine Sulfate interactionAvacopanTavneos
How Avacopan interacts with Ester-C Bio — through 1 ingredient. Tap an ingredient for the detail:
Citrus BioflavonoidsCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, concomitant use might alter the effects and adverse effects of CYP3A4 substrates.
Read the full Citrus Bioflavonoids + Avacopan interactionAvanafilStendra
How Avanafil interacts with Ester-C Bio — through 1 ingredient. Tap an ingredient for the detail:
Citrus BioflavonoidsCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, concomitant use might alter the effects and adverse effects of CYP3A4 substrates.
Read the full Citrus Bioflavonoids + Avanafil interactionAvapritinibAyvakit
How Avapritinib interacts with Ester-C Bio — through 1 ingredient. Tap an ingredient for the detail:
Citrus BioflavonoidsCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, concomitant use might alter the effects and adverse effects of CYP3A4 substrates.
Read the full Citrus Bioflavonoids + Avapritinib interactionAvatrombopag MaleateDoptelet
How Avatrombopag Maleate interacts with Ester-C Bio — through 1 ingredient. Tap an ingredient for the detail:
Citrus BioflavonoidsP-glycoprotein Substrates Moderate
Interaction Summary
Theoretically, concomitant use might alter the effects and adverse effects of P-glycoprotein substrates.
Read the full Citrus Bioflavonoids + Avatrombopag Maleate interactionAvibactam Sodium, CeftazidimeAvycaz
How Avibactam Sodium, Ceftazidime interacts with Ester-C Bio — through 1 ingredient. Tap an ingredient for the detail:
Citrus BioflavonoidsOrganic Anion Transporter 3 (oat3) Substrates, Organic Anion Transporter 1 (oat1) Substrates Moderate
Interaction Summary
Theoretically, concomitant use might increase the effects and adverse effects of OAT3 substrates.
Read the full Citrus Bioflavonoids + Avibactam Sodium, Ceftazidime interactionAxitinibInlyta
How Axitinib interacts with Ester-C Bio — through 1 ingredient. Tap an ingredient for the detail:
Citrus BioflavonoidsCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, concomitant use might alter the effects and adverse effects of CYP3A4 substrates.
Read the full Citrus Bioflavonoids + Axitinib interactionAzamuneImmunoprin
How Azamune interacts with Ester-C Bio — through 1 ingredient. Tap an ingredient for the detail:
PycnogenolImmunosuppressants Moderate
Interaction Summary
Theoretically, maritime pine bark extract might decrease the effectiveness of immunosuppressant therapy.
Read the full Pycnogenol + Azamune interactionAzathioprineAzamune, Imuran
How Azathioprine interacts with Ester-C Bio — through 1 ingredient. Tap an ingredient for the detail:
PycnogenolImmunosuppressants Moderate
Interaction Summary
Theoretically, maritime pine bark extract might decrease the effectiveness of immunosuppressant therapy.
Read the full Pycnogenol + Azathioprine interactionAzelastine Hydrochloride, Fluticasone PropionateDymista
How Azelastine Hydrochloride, Fluticasone Propionate interacts with Ester-C Bio — through 1 ingredient. Tap an ingredient for the detail:
Citrus BioflavonoidsCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, concomitant use might alter the effects and adverse effects of CYP3A4 substrates.
Read the full Citrus Bioflavonoids + Azelastine Hydrochloride, Fluticasone Propionate interactionAzilsartanEdarbi
How Azilsartan interacts with Ester-C Bio — through 1 ingredient. Tap an ingredient for the detail:
Citrus BioflavonoidsCytochrome P450 2c9 (cyp2c9) Substrates, Antihypertensive Drugs Moderate
Interaction Summary
Theoretically, concomitant use might increase the levels and adverse effects of CYP2C9 substrates.
Read the full Citrus Bioflavonoids + Azilsartan interactionAzilsartan, ChlorthalidoneEdarbyclor
How Azilsartan, Chlorthalidone interacts with Ester-C Bio — through 1 ingredient. Tap an ingredient for the detail:
Citrus BioflavonoidsAntihypertensive Drugs, Cytochrome P450 2c9 (cyp2c9) Substrates Moderate
Interaction Summary
Theoretically, taking quercetin with antihypertensive drugs might increase the risk of hypotension.
Read the full Citrus Bioflavonoids + Azilsartan, Chlorthalidone interactionBaricitinibOlumiant
How Baricitinib interacts with Ester-C Bio — through 1 ingredient. Tap an ingredient for the detail:
Citrus BioflavonoidsOrganic Anion Transporter 3 (oat3) Substrates Moderate
Interaction Summary
Theoretically, concomitant use might increase the effects and adverse effects of OAT3 substrates.
Read the full Citrus Bioflavonoids + Baricitinib interactionBasiliximabSimulect
How Basiliximab interacts with Ester-C Bio — through 1 ingredient. Tap an ingredient for the detail:
PycnogenolImmunosuppressants Moderate
Interaction Summary
Theoretically, maritime pine bark extract might decrease the effectiveness of immunosuppressant therapy.
Read the full Pycnogenol + Basiliximab interactionEach ingredient & the kinds of drugs it affects
For each ingredient in Ester-C Bio 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.
Citrus Bioflavonoids
Antidiabetes Drugs
Theoretically, concomitant use of quercetin and antidiabetes drugs might increase the risk of hypoglycemia.
Clinical research suggests that a combination of quercetin, myricetin, and chlorogenic acid reduce levels of fasting glucose in patients with type 2 diabetes, including those already taking antidiabetes agents. The effect of quercetin alone is unknown.
Antihypertensive Drugs
Theoretically, taking quercetin with antihypertensive drugs might increase the risk of hypotension.
Quercetin can modestly decrease blood pressure in people with mild hypertension. Theoretically, it might have additive blood pressure lowering effects when used with antihypertensive drugs.
Cyclosporine (Neoral, Sandimmune)
Theoretically, concomitant use might increase the levels and adverse effects of cyclosporine.
A small study in healthy volunteers shows that pretreatment with quercetin increases plasma levels and prolongs the half-life of a single dose of cyclosporine, possibly due to inhibition of p-glycoprotein or cytochrome P450 3A4 (CYP3A4), which metabolizes cyclosporin.
Cytochrome P450 2C8 (Cyp2C8) Substrates
Theoretically, concomitant use might increase the levels and adverse effects of CYP2C8 substrates.
In vitro research shows that quercetin inhibits CYP2C8. Inhibition of paclitaxel (Taxol) metabolism via CYP2C8 has been reported in vitro. However, a small study in humans found no effect of quercetin on rosiglitazone (Avandia), which is also a CYP2C8 substrate.
Cytochrome P450 2C9 (Cyp2C9) Substrates
Theoretically, concomitant use might increase the levels and adverse effects of CYP2C9 substrates.
A small clinical study in healthy volunteers shows that taking quercetin 500 mg twice daily for 10 days prior to taking diclofenac, a CYP2C9 substrate, increases diclofenac plasma levels by 75% and prolongs the half-life by 32.5%. Animal research also shows that pretreatment with quercetin increases plasma levels and prolongs the half-life of losartan (Cozaar), a substrate of CYP2C9. Furthermore, laboratory research shows that quercetin inhibits CYP2C9.
Cytochrome P450 2D6 (Cyp2D6) Substrates
Theoretically, concomitant use might increase the levels and adverse effects of CYP2D6 substrates.
In vitro research show that quercetin inhibits CYP2D6. This effect has not been reported in humans.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, concomitant use might alter the effects and adverse effects of CYP3A4 substrates.
A small clinical study in healthy volunteers shows that pretreatment with quercetin increases plasma levels and prolongs the half-life of a single dose of cyclosporine (Neoral, Sandimmune), a substrate of CYP3A4. Animal research also shows that pretreatment with quercetin increases plasma levels and prolongs the half-life of losartan (Cozaar) and quetiapine (Seroquel), substrates of CYP3A4. Other laboratory research also shows that quercetin inhibits CYP3A4. However, one clinical study shows that quercetin can increase the metabolism of midazolam, a substrate of CYP3A4, and decrease serum concentrations of midazolam by about 24% in some healthy individuals, suggesting possible induction of CYP3A4.
Diclofenac (Voltaren, Others)
Theoretically, concomitant use might increase the levels and adverse effects of diclofenac.
A small clinical study in healthy volunteers shows that taking quercetin 500 mg twice daily for 10 days prior to taking diclofenac increases diclofenac plasma levels by 75% and prolongs the half-life by 32.5%. This is thought to be due to inhibition of CYP2C9 by quercetin.
Losartan (Cozaar)
Theoretically, concomitant use might increase the effects and adverse effects of losartan and decrease the effects of its active metabolite.
Animal research shows that pretreatment with quercetin increases plasma levels and prolongs the half-life of losartan (Cozaar) while decreasing plasma levels of losartan's active metabolite. This metabolite, which is around 10-fold more potent than losartan, is the result of cytochrome P450 (CYP) 2C9- and CYP3A4-mediated transformation of losartan. Additionally, in vitro research shows that quercetin may inhibit P-glycoprotein-mediated efflux of losartan from the intestines, resulting in increased absorption of losartan. These results suggest that concomitant use of quercetin and losartan might increase systemic exposure to losartan while also decreasing plasma concentrations of losartan's active and more potent metabolite.
Midazolam (Versed)
Theoretically, concomitant use might decrease the levels and effects of midazolam.
A small clinical study in healthy volunteers shows that quercetin can increase the metabolism of midazolam, with a decrease in AUC of about 24%.
Mitoxantrone
Theoretically, quercetin might increase the effects and adverse effects of mitoxantrone.
In vitro research shows that quercetin increases the intracellular accumulation and cytotoxicity of mitoxantrone, possibly through inhibition of breast cancer resistance protein (BCRP), of which mitoxantrone is a substrate. So far, this interaction has not been reported in humans.
Organic Anion Transporter 1 (Oat1) Substrates
Theoretically, concomitant use might increase the effects and adverse effects of OAT1 substrates.
In vitro research shows that quercetin is a strong non-competitive inhibitor of OAT1, with half-maximal inhibitory concentration (IC50) values less than 10 mcM. So far, this interaction has not been reported in humans.
Organic Anion Transporter 3 (Oat3) Substrates
Theoretically, concomitant use might increase the effects and adverse effects of OAT3 substrates.
In vitro research shows that quercetin is a strong non-competitive inhibitor of OAT3, with half-maximal inhibitory concentration (IC50) values as low as 0.75 mcM. So far, this interaction has not been reported in humans.
Organic Anion-Transporting Polypeptide Substrates (Oatp)
Theoretically, concomitant use might increase the effects and adverse effects of OATP substrates.
In vitro evidence shows that quercetin can inhibit organic anion-transporting peptide (OATP) 1B1-mediated uptake of estrone-3-sulfate and pravastatin. Furthermore, clinical research in healthy males shows that intake of quercetin along with pravastatin increases the AUC of pravastatin by 24%, prolongs its half-life by 14%, and decreases its apparent clearance by 18%, suggesting that quercetin modestly inhibits the uptake of pravastatin in hepatic cells.
P-Glycoprotein Substrates
Theoretically, concomitant use might alter the effects and adverse effects of P-glycoprotein substrates.
There is preliminary evidence that quercetin inhibits the gastrointestinal P-glycoprotein efflux pump, which might increase the bioavailability and serum levels of drugs transported by the pump. A small study in healthy volunteers reported that pretreatment with quercetin increased bioavailability and plasma levels after a single dose of cyclosporine (Neoral, Sandimmune). Also, two small studies have shown that quercetin might decrease the absorption of talinolol, a substrate transported by the gastrointestinal P-glycoprotein efflux pump. However, in another small study, several days of quercetin treatment did not significantly affect the pharmacokinetics of saquinavir (Invirase). The reason for these discrepancies is not entirely clear. Until more is known, use quercetin cautiously in combination with P-glycoprotein substrates.
Pravastatin (Pravachol)
Theoretically, concomitant use might increase the effects and adverse effects of pravastatin.
In vitro evidence shows that quercetin can inhibit OATP 1B1-mediated uptake of pravastatin. Also, preliminary clinical research in healthy males shows that intake of quercetin along with pravastatin increases the maximum concentration of pravastatin by 24%, prolongs its half-life by 14%, and decreases its apparent clearance by 18%, suggesting that quercetin modestly inhibits the uptake of pravastatin in hepatic cells.
Prazosin (Minipress)
Theoretically, quercetin might increase the effects and adverse effects of prazosin.
In vitro research shows that quercetin inhibits the transcellular efflux of prazosin, possibly through inhibition of breast cancer resistance protein (BCRP), of which prazosin is a substrate. BCRP is an ATP-binding cassette efflux transporter in the intestines, kidneys, and liver. So far, this interaction has not been reported in humans.
Quetiapine (Seroquel)
Theoretically, concomitant use might increase the effects and adverse effects of quetiapine.
Animal research shows that pretreatment with quercetin can increase plasma levels of quetiapine and prolong its clearance, possibly due to inhibition of cytochrome P450 3A4 (CYP3A4) by quercetin. Additionally, the brain-to-plasma ratio of quetiapine concentrations increased, possibly due to inhibition of P-glycoprotein at the blood-brain barrier. This interaction has not been reported in humans.
Quinolone Antibiotics
Theoretically, concomitant use might inhibit the effects of quinolone antibiotics.
In vitro, quercetin binds to the DNA gyrase site on bacteria, which may interfere with the activity of quinolone antibiotics.
Sulfasalazine (Azulfidine)
Theoretically, quercetin might increase the effects and adverse effects of sulfasalazine.
Animal research shows that quercetin increases the maximum serum concentration (Cmax) and area under the curve (AUC) of sulfasalazine, possibly through inhibition of breast cancer resistance protein (BCRP), of which sulfasalazine is a substrate. So far, this interaction has not been reported in humans.
Warfarin (Coumadin)
Theoretically, quercetin may increase the risk of bleeding if used with warfarin.
Animal and in vitro studies show that quercetin might increase serum levels of warfarin. Quercetin and warfarin have the same human serum albumin (HSA) binding site, and in vitro research shows that quercetin has stronger affinity for the HSA binding site and can theoretically displace warfarin, causing higher serum levels of warfarin. Animal research shows that taking quercetin for 2 weeks before initiating warfarin increases the maximum serum level of warfarin by 30%, the half-life by 10%, and the overall exposure by 63% when compared with control. Concomitant administration of quercetin and warfarin, without quercetin pre-treatment, also increased these measures, but to a lesser degree. Researchers theorize that inhibition of CYP3A4 by quercetin may explain these effects. So far, this interaction has not been reported in humans.
Pycnogenol
Anticoagulant/Antiplatelet Drugs
Theoretically, maritime pine bark extract might increase the risk of bleeding when used with antiplatelet or anticoagulant drugs.
Clinical research suggests that maritime pine bark extract inhibits platelet aggregation. However, the clinical significance of this effect is unclear.
Antidiabetes Drugs
Theoretically, maritime pine bark extract might increase the risk of hypoglycemia when used with antidiabetes drugs.
One clinical study shows that maritime pine bark extract decreases blood sugar in patients with diabetes being treated with antidiabetes agents. Monitor blood glucose levels closely. Dose adjustments might be necessary.
Immunosuppressants
Theoretically, maritime pine bark extract might decrease the effectiveness of immunosuppressant therapy.
In vitro and animal research suggests that maritime pine bark extract has immunostimulant activity. This effect has not been reported in humans.
Rutin
Antidiabetes Drugs
Theoretically, taking rutin with antidiabetes drugs might increase the risk of hypoglycemia.
Animal research suggests that rutin has hypoglycemic effects.
Brand information
Manufacturer and brand details for Ester-C Bio, from the product label.
Klaire Labs
See all Klaire Labs products- Name
- SFI USA
- City
- Reno
- State
- NV
- ZipCode
- 89521
- Web Address
- Klaire.com
Ester-C Bio by Klaire Labs: Common Questions
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Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
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The Full Monographs Behind Ester-C Bio’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Quercetin
Interacts with 1,169 drugsQuercetin is a plant flavonoid with antioxidant and anti-inflammatory properties found in many common foods and sold as a supplement. While early research is interesting for allergies, blood...
Read the full Quercetin monograph → Herb & supplement monographRutin
Interacts with 86 drugsRutin is a plant flavonoid (often taken from buckwheat or citrus) that people use mainly for blood vessel and circulation problems like varicose veins and hemorrhoids. The evidence is limite...
Read the full Rutin monograph → Herb & supplement monographMaritime Pine
Interacts with 327 drugsMaritime pine bark extract (often sold as Pycnogenol) is a plant-based antioxidant most studied for circulation, vein, and skin health. Some research is promising, but many studies are small...
Read the full Maritime Pine monograph →Sources & How We Checked
Ester-C Bio'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 42 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.
Quercetin 26 references
- Shoskes DA, Zeitlin SI, Shahed A, Rajfer J. Quercetin in men with category III chronic prostatitis: A preliminary prospective, double-blind, placebo-controlled trial. Urol 1999;54:960-3. PubMed
- Starvic B. Quercetin in our diet: from potent mutagen to probable anticarcinogen. Clin Biochem 1994;27:245-8. PubMed
- Ferry DR, Smith A, Malkhandi J, et al. Phase I clinical trial of the flavonoid quercetin: Pharmacokinetics and evidence for in vivo tyrosine kinase inhibition. Clin Cancer Res 1996;2:659-67..
- Obach RS. Inhibition of human cytochrome P450 enzymes by constituents of St. John's wort, an herbal preparation used in the treatment of depression. J Pharmacol Exp Ther 2000;294:88-95. DOI
- Edwards RL, Lyon T, Litwin SE, et al. Quercetin reduces blood pressure in hypertensive subjects. J Nutr 2007;137:2405-11.
- Kim KA, Park PW, Kim HK, et al. Effect of quercetin on the pharmacokinetics of rosiglitazone, a CYP2C8 substrate, in healthy subjects. J Clin Pharmacol 2005;45:941-6. PubMed
- DiCenzo R, Frerichs V, Larppanichpoonphol P, et al. Effect of quercetin on the plasma and intracellular concentrations of saquinavir in healthy adults. Pharmacotherapy 2006;26:1255-61. PubMed
- Choi JS, Choi BC, Choi KE. Effect of quercetin on the pharmacokinetics of oral cyclosporine. Am J Health Syst Pharm 2004;61:2406-9. PubMed
- Choi JS, Jo BW, Kim YC. Enhanced paclitaxel bioavailability after oral administration of paclitaxel or prodrug to rats pretreated with quercetin. Eur J Pharm Biopharm 2004;57:313-8. PubMed
- Vaclavikova R, Horsky S, Simek P, Gut I. Paclitaxel metabolism in rat and human liver microsomes is inhibited by phenolic antioxidants. Naunyn Schmiedebergs Arch Pharmacol 2003;368:200-9. PubMed
- Di Bari L, Ripoli S, Pradhan S, Salvadori P. Interactions between quercetin and warfarin for albumin binding: A new eye on food/drug interference. Chirality 2010;22:593-6. PubMed
- Lamson, D. W. and Brignall, M. S. Antioxidants and cancer, part 3: quercetin. Altern.Med.Rev. 2000;5(3):196-208.
- Duan KM, Wang SY, Ouyang W, Mao YM, Yang LJ. Effect of quercetin on CYP3A activity in Chinese healthy participants. J Clin Pharmacol 2012;52(6):940-6. PubMed
- Wang SY, Duan KM, Li Y, et al. Effect of quercetin on P-glycoprotein transport ability in Chinese healthy subjects. Eur J Clin Nutr 2013;67(4):390-4. PubMed
- Nguyen MA, Staubach P, Wolffram S, Langguth P. Effect of single-dose and short-term administration of quercetin on the pharmacokinetics of talinolol in humans - Implications for the evaluation of transporter-mediated flavonoid-drug interactions. Eur J Pha PubMed
- Wu LX, Guo CX, Chen WQ, et al. Inhibition of the organic anion-transporting polypeptide 1B1 by quercetin: an in vitro and in vivo assessment. Br J Clin Pharmacol 2012;73(5):750-7.
- Ahrens MJ, Thompson DL. Effect of emulin on blood glucose in type 2 diabetics. J Med Food. 2013;16(3):211-5. PubMed
- Larson A, Witman MA, Guo Y, et al. Acute, quercetin-induced reductions in blood pressure in hypertensive individuals are not secondary to lower plasma angiotensin-converting enzyme activity or endothelin-1: nitric oxide. Nutr Res. 2012;32(8):557-64. PubMed
- Bedada SK, Neerati P. Evaluation of the effect of quercetin treatment on CYP2C9 enzyme activity of diclofenac in healthy human volunteers. Phytother Res. 2018 Feb;32(2):305-311. doi: 10.1002/ptr.5978. PubMed
- Zhao Q, Wei J, Zhang H. Effects of quercetin on the pharmacokinetics of losartan and its metabolite EXP3174 in rats. Xenobiotica 2019;49(5):563-8. PubMed
- Bhutani P, Rajanna PK, Paul AT. Impact of quercetin on pharmacokinetics of quetiapine: insights from in-vivo studies in wistar rats. Xenobiotica. 2020:1-7.
- Li C, Wang X, Bi Y, et al. Potent Inhibitors of Organic Anion Transporters 1 and 3 From Natural Compounds and Their Protective Effect on Aristolochic Acid Nephropathy. Toxicol Sci. 2020;175(2):279-291. PubMed
- Ni Y, Duan Z, Zhou D, et al. Identification of Structural Features for the Inhibition of OAT3-Mediated Uptake of Enalaprilat by Selected Drugs and Flavonoids. Front Pharmacol. 2020;11:802. PubMed
- Song YK, Yoon JH, Woo JK, et al. Quercetin is a flavonoid breast cancer resistance protein inhibitor with an impact on the oral pharmacokinetics of sulfasalazine in rats. Pharmaceutics 2020;12(5):397. PubMed
- Ahmad E, Jahangir M, Ismail MA, et al. Influence of quercetin pretreatment on pharmacokinetics of warfarin in rats. Curr Drug Saf 2022. PubMed
- Nambiar A, Kellogg D 3rd, Justice J, et al. Senolytics dasatinib and quercetin in idiopathic pulmonary fibrosis: results of a phase I, single-blind, single-center, randomized, placebo-controlled pilot trial on feasibility and tolerability. EBioMedicine 20 PubMed
Rutin 2 references
- Mehta DK (Ex Ed). British National Formulary, Number 37. British Medical Association and Royal Pharmaceutical Society of Great Britain: London, England, March 1999.
- Sun C, Wang L, Sun J, Wang Z, Tang Z. Hypoglycemic and hypolipidemic effects of rutin on hyperglycemic rats. J Tradit Chin Med. 2020;40(4):640-645.
Maritime Pine 14 references
- Rice-Evans CA, Packer L, eds. Flavonoids in Health and Disease. Manhattan, NY: Marcel Dekker, Inc., 1998.
- Liu FJ, Zhang YX, Lau BH. Pycnogenol enhances immune and haemopoietic functions in senescence-accelerated mice. Cell Mol Life Sci 1998;54:1168-72. PubMed
- Putter M, Grotemeyer KH, Wurthwein G, et al. Inhibition of smoking-induced platelet aggregation by aspirin and pycnogenol. Thromb Res 1999;95:155-61. PubMed
- Kohama T, Inoue M. Pycnogenol alleviates pain associated with pregnancy. Phytother Res 2006;20:232-4.
- Liu X, Zhou HJ, Rohdewald P. French maritime pine bark extract pycnogenol dose-dependently lowers glucose in type 2 diabetic patients (letter). Diabetes Care 2004;27:839. PubMed
- Liu X, Wei J, Tan F, et al. Antidiabetic effect of Pycnogenol French maritime pine bark extract in patients with diabetes type II. Life Sci 2004;75:2505-13. PubMed
- Wilson D, Evans M, Guthrie N et al. A randomized, double-blind, placebo-controlled exploratory study to evaluate the potential of pycnogenol for improving allergic rhinitis symptoms. Phytother Res 2010;24:1115-9.
- Araghi-Niknam, M., Hosseini, S., Larson, D., Rohdewald, P., and Watson, R. R. Pine bark extract reduces platelet aggregation. Integr.Med. 3-21-2000;2(2):73-77. PubMed
- Trebaticka, J., Kopasova, S., Hradecna, Z., Cinovsky, K., Skodacek, I., Suba, J., Muchova, J., Zitnanova, I., Waczulikova, I., Rohdewald, P., and Durackova, Z. Treatment of ADHD with French maritime pine bark extract, Pycnogenol. Eur.Child Adolesc.Psychi PubMed
- Suzuki, N., Uebaba, K., Kohama, T., Moniwa, N., Kanayama, N., and Koike, K. French maritime pine bark extract significantly lowers the requirement for analgesic medication in dysmenorrhea: a multicenter, randomized, double-blind, placebo-controlled study
- Cisar, P., Jany, R., Waczulikova, I., Sumegova, K., Muchova, J., Vojtassak, J., Durackova, Z., Lisy, M., and Rohdewald, P. Effect of pine bark extract (Pycnogenol) on symptoms of knee osteoarthritis. Phytother.Res. 2008;22(8):1087-1092.
- Enseleit, F., Sudano, I., Periat, D., Winnik, S., Wolfrum, M., Flammer, A. J., Frohlich, G. M., Kaiser, P., Hirt, A., Haile, S. R., Krasniqi, N., Matter, C. M., Uhlenhut, K., Hogger, P., Neidhart, M., Luscher, T. F., Ruschitzka, F., and Noll, G. Effects
- Schoonees, A., Visser, J., Musekiwa, A., and Volmink, J. Pycnogenol(R) (extract of French maritime pine bark) for the treatment of chronic disorders. Cochrane.Database.Syst.Rev. 2012;4:CD008294.
- Wang S, Tan D Zhao Y et al. The effect of pycnogenol on the microcirculation, platelet function and ischemic myocardium in patients with coronary artery diseases. Eur Bull Drug Res 1999;7:19-25.
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.
© 2021 Therapeutic Research Center, LLC