Extreme Flex Ingredients & Drug Interactions
What is this page for?
First and foremost: checking Extreme Flex 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
Extreme Flex is a dietary supplement by KingFisher Media with 7 active ingredients. Its ingredients are commonly taken for sleep problems and insomnia, anxiety and restlessness, menopausal symptoms.Based on those ingredients, 1,251 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Turmipure(R), Perluxan(R) Hops extract, Chondroitin Sulfate. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against Extreme Flex by KingFisher Media
Ask about any prescription or over-the-counter medication and we check it for interactions with Extreme Flex by KingFisher Media — and tell you which ingredient is responsible.
AI summaries are generated from our interaction database for education only — always confirm with your pharmacist. How we use AI
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HelloPharmacist Scorecard of Extreme Flex by KingFisher Media
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
Extreme Flex contains 7 active ingredients aimed at joint and skin support. Chondroitin sulfate and UC-II collagen are both cartilage-supporting compounds; hyaluronic acid acts as a lubricant and hydrator for joints and skin; OptiMSM and Turmipure (turmeric) are anti-inflammatory ingredients; Perluxan hops extract and Regenasure round out the formula.
The product also includes common inactive ingredients like gelatin capsule material, magnesium stearate, and colorants (FD&C Blue #1, Yellow #5, Yellow #6, and titanium dioxide).
Does it work?
Moderate evidence
Chondroitin is possibly effective for osteoarthritis and cataracts, though evidence remains modest. Hyaluronic acid is possibly effective for dry eye and venous leg ulcers.
Turmeric is possibly effective for depression, high cholesterol, allergies, and indigestion. For aging skin and osteoporosis — claims sometimes made for joint supplements — the evidence we hold rates as insufficient.
Hops, OptiMSM, Regenasure, and UC-II lack established effectiveness ratings in our data.
How safe is it?
Well-documented data
Chondroitin is generally well tolerated short-term, but quality varies and benefit is uncertain. The most common side effects are mild digestive: abdominal pain, bloating, constipation, diarrhea, heartburn, and nausea.
Rare reports include liver damage and skin symptoms like rash, eyelid swelling, and hair loss. Hyaluronic acid and hops are generally well tolerated orally, though hops may cause drowsiness.
Turmeric is generally safe as food but concentrated supplements may cause constipation, indigestion, diarrhea, nausea, or vomiting. Rare reports link turmeric supplements to liver damage after 2+ weeks of use, though most cases resolve when the supplement stops.
Altogether, these interactions span 1,252 individual medications. Pregnancy and breastfeeding: chondroitin has insufficient safety data — the facts advise against use in pregnancy and while nursing.
Hyaluronic acid safety during pregnancy and lactation is not established in our data. Hops also lacks safety data in pregnancy and breastfeeding.
Turmeric is rated likely safe in pregnancy for food amounts, but one entry rates it likely unsafe and another notes insufficient data on supplement doses, so talk to your doctor or pharmacist about dosing if you're pregnant or nursing.
Meds to double-check
Moderate interaction found
Before taking Extreme Flex, double-check with your doctor or pharmacist if you're on any of these: warfarin or other blood thinners; sedating drugs (sleep aids, anxiety medications, or opioid painkillers); hormone replacement therapy; chemotherapy (especially topoisomerase I inhibitors or antitumor antibiotics like doxorubicin); tacrolimus (an immunosuppressant); tamoxifen (a cancer drug); sulfasalazine (for inflammatory bowel disease or rheumatoid arthritis); methotrexate; tramadol; or medications that depend on liver metabolism or kidney transport. The hops and turmeric in this product carry potential interactions with each of these categories.
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.
Extreme Flex is designed for joint and skin support using chondroitin, collagen, and hyaluronic acid — ingredients with modest evidence for arthritis and dry eye. If you take blood thinners, especially warfarin, cancer drugs, immunosuppressants, or anti-inflammatory medications, check your exact list with your doctor or pharmacist before starting.
Expect mild digestive side effects from chondroitin and possible drowsiness from hops. Pregnancy and nursing require a conversation with your healthcare provider about the safety of each ingredient at your dose.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 4 of 7 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Feb 25, 2015.
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 Extreme Flex, straight from the product label.
| Brand | KingFisher Media |
|---|---|
| Net contents | 60 Capsule(s) |
| Market status | On market |
| Date entered into DSLD | Feb 25, 2015 |
| DSLD ID | 42133 |
| Product type | Other Combinations |
| Supplement form | Capsule |
| Dietary claims / uses | All Other, Structure/Function |
| Intended target group(s) | Adult (18 - 50 Years) |
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 Extreme Flex by KingFisher Media, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Chondroitin Sulfate | 100 mg | -- |
| Hyaluronic Acid | 50 mg | -- |
| OptiMSM | 125 mg | -- |
| Perluxan(R) Hops extract | 500 mg | -- |
| BioCell Collagen II | 500 mg | -- |
| Regenasure | 250 mg | -- |
| Turmipure(R) | 50 mg | -- |
| UC-II(R) | 20 mg | -- |
Other ingredients: Magnesium Stearate, FD&C Blue #1, FD&C Yellow #5, FD&C Yellow #6, Titanium Dioxide, Gelatin
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.
General Statements
FLEXIBILITY- MOBILITY - RECOVERY
INCREASE MOBILITY - JOINT RELIEF & RECOVERY
ALL NATURAL EQUIVALENT TO IBUPROFEN FOR TEMPORARY RELIEF OF MINOR PAIN++
RELIEF IN AS LITTLE AS 3 DAYS!* RESULTS MAY VARY.
++DSHEA Approved Claim
Made in USA
2X STRONGER THAN GLUCOSAMINE & CHONDROITIN+
Brand IP Statement(s)
Extreme Flex(TM) has been scientifically formulated to provide maximum joint pain relief.
UC-II(R) improves flexibility and mobility.
Supporting and strengthening both bone and joint, Extreme Flex(TM) enables the body to perform and recover at its optimum level.
(C) 2014 KINGFISHER MEDIA, LLC.
BioCell Collagen(TM) is a trademark of BioCell Technology LLC, Newport Beach, California USA (US Patents 6,025,327; 6,323,319; 6,780,841; 7,091,180; 7,799,348; 8,563,045) UC-II(R) is a trademark of InterHealth N.I.UC-II(R) is a patented form of undenatured (native) type II collagen. UC-II supports joint comfort, mobility and function.+UC-II(R) brand undenatured type II collagen (U.S. Patents 7,846,487, 7,083,820 and EPO Patent EP1435906B1; Canadian patent CA 2459981C; and Japanese Patent JP 4800574B2). Regenasure(R) is a licensed Trademark of Cargill, Incorporated. Perluxan(R) is a registered trademark of Pharmachem Laboratories.
Formula
It utilizes the revolutionary ingredient UC-II(R), which is 2x stronger than Glucosamine and Chondroitin - common ingredients in joint formulas.
Extreme Flex(TM) also contains Perluxan(R), working as an all-natural equivalent to ibuprofen for temporary relief of minor pain++.
Storage
USAGE: As a dietary supplement, Take one (1) serving (2) capsules daily. For temporary relief of minor pain: Take two (2) servings - (4) capsules daily.
Precautions
PRECAUTIONS: Use only as directed.
Do not take this product if you are pregnant or nursing. Consult a health care professional before use if you are allergic to any ingredients, have a serious medical condition, or use prescription medications.
Consult a health care professional before use if you are allergic to any ingredients, have a serious medical condition, or use prescription medications.
For adult use only.
Seals/Symbols
UC-II(R)
BioCell Collagen(TM)
perluxan
Regenasure(R) GLUCOSAMINE
GOOD MANUFACTURING PRACTICE MANUFACTURED IN A GMP CERTIFIED FACILITY QUALITY GUARANTEED
kingfisher media
FDA Disclaimer Statement
+These statements have not been evaluated by the FDA. This product is not intended to diagnose, treat, cure, or prevent any disease.
FDA Statement of Identity
DIETARY SUPPLEMENT
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Extreme Flex by KingFisher Media 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 Extreme Flex by KingFisher Media
These are the 7 active ingredients this product is made of. Select any to open its full monograph.
Serving size2 Capsule(s) Dosage formCapsule Servings per container30 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.
OptiMSM
Perluxan(R) Hops extract
Interacts with863 drugs
Hops are most often used for sleep and mild anxiety, frequently combined with valerian, but the human evidence is limited and not very strong. They ar...
Perluxan(R) Hops extract monograph & interactionsBioCell Collagen II
Regenasure
Turmipure(R)
Interacts with1,133 drugs
Turmeric is a popular spice whose main active compounds, curcuminoids, are studied mostly for inflammation and joint pain. Some research is promising,...
Turmipure(R) monograph & interactionsUC-II(R)
Other (inactive) ingredients: Magnesium Stearate, FD&C Blue #1, FD&C Yellow #5, FD&C Yellow #6, Titanium Dioxide, Gelatin. These complete the product’s ingredient list but are not active constituents.
Extreme Flex by KingFisher Media Drug Interactions
HelloPharmacist Interaction Report
Extreme Flex by KingFisher Media interacts with medications through its chondroitin sulfate, hops extract, and turmeric content.
The most serious interaction is a Moderate risk: chondroitin may increase the blood-thinning effects of warfarin (Coumadin), raising your bleeding risk. The effect is clearest when chondroitin is combined with glucosamine, but chondroitin alone carries unclear risk.
Read the full breakdown — every affected drug type, severity by severity
Hops extract poses Moderate interactions with sedating drugs (CNS depressants) — it may add to drowsiness — and with hormone therapies (estrogens), though the amount in this product is small. It also has Minor interactions with certain drugs metabolized through liver pathways (CYP1A2 and CYP3A4 substrates), though the clinical significance is uncertain.
Turmeric brings the most extensive interactions, all Moderate severity: chemotherapy drugs that work by generating free radicals (topoisomerase I inhibitors and antitumor antibiotics), the immunosuppressant tacrolimus (Prograf), the cancer drug tamoxifen (Nolvadex), the anti-inflammatory sulfasalazine (Azulfidine), methotrexate for rheumatoid arthritis and cancer, the painkiller tramadol (Ultram), and drugs transported via OATP pathways in the kidney. Turmeric may also interact with certain medications that depend on liver metabolism.
We could not check three other ingredients in this product — OptiMSM, Regenasure, and UC-II. Check your exact medications with the search tool below before you start.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against Extreme Flex?
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 Extreme Flex interact with 1,251 drugs. Click any drug to see the details.
3 of the 7 ingredients in Extreme Flex interact with drugs. Each result below shows which ingredient is responsible. Turmipure(R) Perluxan(R) Hops extract Chondroitin Sulfate
6-mercaptopurinePurinethol
How 6-mercaptopurine interacts with Extreme Flex — through 1 ingredient. Tap an ingredient for the detail:
Turmipure(r)Hepatotoxic Drugs Moderate
Interaction Summary
Theoretically, turmeric might increase the risk of liver damage when taken with hepatotoxic drugs.
Read the full Turmipure(r) + 6-mercaptopurine interactionAdo-trastuzumab EmtansineKadcyla
How Ado-trastuzumab Emtansine interacts with Extreme Flex — through 2 ingredients. Tap an ingredient for the detail:
Turmipure(r)Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Turmeric might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full Turmipure(r) + Ado-trastuzumab Emtansine interactionPerluxan(r) Hops ExtractCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, hops extract might alter metabolism of CYP3A4 substrates; however, this effect may not be clinically significant.
Read the full Perluxan(r) Hops Extract + Ado-trastuzumab Emtansine interactionAbacavir Sulfate, Dolutegravir, LamivudineTriumeq
How Abacavir Sulfate, Dolutegravir, Lamivudine interacts with Extreme Flex — through 1 ingredient. Tap an ingredient for the detail:
Turmipure(r)Hepatotoxic Drugs Moderate
Interaction Summary
Theoretically, turmeric might increase the risk of liver damage when taken with hepatotoxic drugs.
Read the full Turmipure(r) + Abacavir Sulfate, Dolutegravir, Lamivudine interactionAbacavir, LamivudineEpzicom
How Abacavir, Lamivudine interacts with Extreme Flex — through 1 ingredient. Tap an ingredient for the detail:
Turmipure(r)Hepatotoxic Drugs Moderate
Interaction Summary
Theoretically, turmeric might increase the risk of liver damage when taken with hepatotoxic drugs.
Read the full Turmipure(r) + Abacavir, Lamivudine interactionAbciximabReoPro
How Abciximab interacts with Extreme Flex — through 1 ingredient. Tap an ingredient for the detail:
Turmipure(r)Anticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Turmeric may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Turmipure(r) + Abciximab interactionAbemaciclibVerzenio
How Abemaciclib interacts with Extreme Flex — through 2 ingredients. Tap an ingredient for the detail:
Turmipure(r)Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Turmeric might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full Turmipure(r) + Abemaciclib interactionPerluxan(r) Hops ExtractCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, hops extract might alter metabolism of CYP3A4 substrates; however, this effect may not be clinically significant.
Read the full Perluxan(r) Hops Extract + Abemaciclib interactionAbiraterone
How Abiraterone interacts with Extreme Flex — through 2 ingredients. Tap an ingredient for the detail:
Turmipure(r)Cytochrome P450 3a4 (cyp3a4) Substrates, Hepatotoxic Drugs Moderate
Interaction Summary
Turmeric might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full Turmipure(r) + Abiraterone interactionPerluxan(r) Hops ExtractCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, hops extract might alter metabolism of CYP3A4 substrates; however, this effect may not be clinically significant.
Read the full Perluxan(r) Hops Extract + Abiraterone interactionAbiraterone AcetateYonsa, Zytiga
How Abiraterone Acetate interacts with Extreme Flex — through 2 ingredients. Tap an ingredient for the detail:
Turmipure(r)Hepatotoxic Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, turmeric might increase the risk of liver damage when taken with hepatotoxic drugs.
Read the full Turmipure(r) + Abiraterone Acetate interactionPerluxan(r) Hops ExtractCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, hops extract might alter metabolism of CYP3A4 substrates; however, this effect may not be clinically significant.
Read the full Perluxan(r) Hops Extract + Abiraterone Acetate interactionAbrocitinibCibinqo
How Abrocitinib interacts with Extreme Flex — through 1 ingredient. Tap an ingredient for the detail:
Turmipure(r)Anticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Turmeric may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Turmipure(r) + Abrocitinib interactionAcalabrutinibCalquence
How Acalabrutinib interacts with Extreme Flex — through 2 ingredients. Tap an ingredient for the detail:
Turmipure(r)P-glycoprotein Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, turmeric might increase the absorption of P-glycoprotein substrates.
Read the full Turmipure(r) + Acalabrutinib interactionPerluxan(r) Hops ExtractCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, hops extract might alter metabolism of CYP3A4 substrates; however, this effect may not be clinically significant.
Read the full Perluxan(r) Hops Extract + Acalabrutinib interactionAcarboseGlucobay, Prandase, Precose
How Acarbose interacts with Extreme Flex — through 1 ingredient. Tap an ingredient for the detail:
Turmipure(r)Antidiabetes Drugs, Hepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking turmeric with antidiabetes drugs might increase the risk of hypoglycemia.
Read the full Turmipure(r) + Acarbose interactionAcebutololRhotral, Sectral
How Acebutolol interacts with Extreme Flex — through 1 ingredient. Tap an ingredient for the detail:
Turmipure(r)Hepatotoxic Drugs Moderate
Interaction Summary
Theoretically, turmeric might increase the risk of liver damage when taken with hepatotoxic drugs.
Read the full Turmipure(r) + Acebutolol interactionAcenocoumarolSintrom
How Acenocoumarol interacts with Extreme Flex — through 1 ingredient. Tap an ingredient for the detail:
Turmipure(r)Anticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Turmeric may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Turmipure(r) + Acenocoumarol interactionAcepromazineAtravet
How Acepromazine interacts with Extreme Flex — through 1 ingredient. Tap an ingredient for the detail:
Perluxan(r) Hops ExtractCns Depressants Moderate
Interaction Summary
Theoretically, concomitant use of hops with sedative drugs might cause additive sedation.
Read the full Perluxan(r) Hops Extract + Acepromazine interactionAcetaminophenChildren's Tylenol, Children's Tylenol Meltaways, Tylenol, Tylenol Ex Strength
How Acetaminophen interacts with Extreme Flex — through 2 ingredients. Tap an ingredient for the detail:
Turmipure(r)Cytochrome P450 1a2 (cyp1a2) Substrates, Hepatotoxic Drugs Moderate
Interaction Summary
Theoretically, turmeric might increase levels of drugs metabolized by CYP1A2.
Read the full Turmipure(r) + Acetaminophen interactionPerluxan(r) Hops ExtractCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Hops extract does not seem to affect the metabolism of CYP1A2 substrates.
Read the full Perluxan(r) Hops Extract + Acetaminophen interactionAcetaminophen, AspirinGemnisyn
How Acetaminophen, Aspirin interacts with Extreme Flex — through 2 ingredients. Tap an ingredient for the detail:
Turmipure(r)Cytochrome P450 1a2 (cyp1a2) Substrates, Anticoagulant/antiplatelet Drugs +1 Moderate
Interaction Summary
Theoretically, turmeric might increase levels of drugs metabolized by CYP1A2.
Read the full Turmipure(r) + Acetaminophen, Aspirin interactionPerluxan(r) Hops ExtractCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Hops extract does not seem to affect the metabolism of CYP1A2 substrates.
Read the full Perluxan(r) Hops Extract + Acetaminophen, Aspirin interactionAcetaminophen, Aspirin, CaffeineExcedrin, Excedrin Extra Strength, Excedrin Migraine
How Acetaminophen, Aspirin, Caffeine interacts with Extreme Flex — through 2 ingredients. Tap an ingredient for the detail:
Turmipure(r)Anticoagulant/antiplatelet Drugs, Cytochrome P450 1a2 (cyp1a2) Substrates +2 Moderate
Interaction Summary
Turmeric may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Turmipure(r) + Acetaminophen, Aspirin, Caffeine interactionPerluxan(r) Hops ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Hops extract does not seem to affect the metabolism of CYP1A2 substrates.
Read the full Perluxan(r) Hops Extract + Acetaminophen, Aspirin, Caffeine interactionAcetaminophen, Brompheniramine, PhenylpropanolamineDimetapp Cold and Flu
How Acetaminophen, Brompheniramine, Phenylpropanolamine interacts with Extreme Flex — through 2 ingredients. Tap an ingredient for the detail:
Turmipure(r)Cytochrome P450 1a2 (cyp1a2) Substrates, Hepatotoxic Drugs Moderate
Interaction Summary
Theoretically, turmeric might increase levels of drugs metabolized by CYP1A2.
Read the full Turmipure(r) + Acetaminophen, Brompheniramine, Phenylpropanolamine interactionPerluxan(r) Hops ExtractCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Hops extract does not seem to affect the metabolism of CYP1A2 substrates.
Read the full Perluxan(r) Hops Extract + Acetaminophen, Brompheniramine, Phenylpropanolamine interactionAcetaminophen, ButalbitalAxocet, Bancap, Bucet, Butex Forte, Esgic CF, Orbivan CF +5 more
How Acetaminophen, Butalbital interacts with Extreme Flex — through 2 ingredients. Tap an ingredient for the detail:
Turmipure(r)Cytochrome P450 1a2 (cyp1a2) Substrates, Hepatotoxic Drugs Moderate
Interaction Summary
Theoretically, turmeric might increase levels of drugs metabolized by CYP1A2.
Read the full Turmipure(r) + Acetaminophen, Butalbital interactionPerluxan(r) Hops ExtractCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Hops extract does not seem to affect the metabolism of CYP1A2 substrates.
Read the full Perluxan(r) Hops Extract + Acetaminophen, Butalbital interactionAcetaminophen, Butalbital, CaffeineEsgic, Esgic Plus, Fiogesic, Fioricet, Repan, Tecnal +1 more
How Acetaminophen, Butalbital, Caffeine interacts with Extreme Flex — through 2 ingredients. Tap an ingredient for the detail:
Turmipure(r)Cytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Moderate
Interaction Summary
Theoretically, turmeric might increase levels of drugs metabolized by CYP1A2.
Read the full Turmipure(r) + Acetaminophen, Butalbital, Caffeine interactionPerluxan(r) Hops ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Hops extract does not seem to affect the metabolism of CYP1A2 substrates.
Read the full Perluxan(r) Hops Extract + Acetaminophen, Butalbital, Caffeine interactionAcetaminophen, Butalbital, Caffeine, CodeineEsgic with Codeine, Fioricet w/ Codeine
How Acetaminophen, Butalbital, Caffeine, Codeine interacts with Extreme Flex — through 2 ingredients. Tap an ingredient for the detail:
Perluxan(r) Hops ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cns Depressants +1 Moderate
Interaction Summary
Theoretically, hops extract might alter metabolism of CYP3A4 substrates; however, this effect may not be clinically significant.
Read the full Perluxan(r) Hops Extract + Acetaminophen, Butalbital, Caffeine, Codeine interactionTurmipure(r)Cytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Moderate
Interaction Summary
Turmeric might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full Turmipure(r) + Acetaminophen, Butalbital, Caffeine, Codeine interactionAcetaminophen, Butalbital, CodeineBancap w/ Codeine
How Acetaminophen, Butalbital, Codeine interacts with Extreme Flex — through 2 ingredients. Tap an ingredient for the detail:
Perluxan(r) Hops ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cns Depressants Moderate
Interaction Summary
Hops extract does not seem to affect the metabolism of CYP1A2 substrates.
Read the full Perluxan(r) Hops Extract + Acetaminophen, Butalbital, Codeine interactionTurmipure(r)Hepatotoxic Drugs, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, turmeric might increase the risk of liver damage when taken with hepatotoxic drugs.
Read the full Turmipure(r) + Acetaminophen, Butalbital, Codeine interactionAcetaminophen, Butalbital, Codeine PhosphatePhrenilin #3
How Acetaminophen, Butalbital, Codeine Phosphate interacts with Extreme Flex — through 2 ingredients. Tap an ingredient for the detail:
Turmipure(r)Cytochrome P450 1a2 (cyp1a2) Substrates, Hepatotoxic Drugs Moderate
Interaction Summary
Theoretically, turmeric might increase levels of drugs metabolized by CYP1A2.
Read the full Turmipure(r) + Acetaminophen, Butalbital, Codeine Phosphate interactionPerluxan(r) Hops ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cns Depressants Moderate
Interaction Summary
Hops extract does not seem to affect the metabolism of CYP1A2 substrates.
Read the full Perluxan(r) Hops Extract + Acetaminophen, Butalbital, Codeine Phosphate interactionAcetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, PhenylephrineHycomine Compound
How Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interacts with Extreme Flex — through 2 ingredients. Tap an ingredient for the detail:
Turmipure(r)Cytochrome P450 1a2 (cyp1a2) Substrates, Hepatotoxic Drugs +1 Moderate
Interaction Summary
Theoretically, turmeric might increase levels of drugs metabolized by CYP1A2.
Read the full Turmipure(r) + Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interactionPerluxan(r) Hops ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Moderate
Interaction Summary
Theoretically, hops extract might alter metabolism of CYP3A4 substrates; however, this effect may not be clinically significant.
Read the full Perluxan(r) Hops Extract + Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interactionAcetaminophen, Caffeine, CodeineGesic C15, Gesic C30, Gesic C8, Lenoltec 1, Lenoltec 2, Lenoltec 3 +1 more
How Acetaminophen, Caffeine, Codeine interacts with Extreme Flex — through 2 ingredients. Tap an ingredient for the detail:
Perluxan(r) Hops ExtractCns Depressants, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Moderate
Interaction Summary
Theoretically, concomitant use of hops with sedative drugs might cause additive sedation.
Read the full Perluxan(r) Hops Extract + Acetaminophen, Caffeine, Codeine interactionTurmipure(r)Cytochrome P450 1a2 (cyp1a2) Substrates, Hepatotoxic Drugs +1 Moderate
Interaction Summary
Theoretically, turmeric might increase levels of drugs metabolized by CYP1A2.
Read the full Turmipure(r) + Acetaminophen, Caffeine, Codeine interactionAcetaminophen, Caffeine, Codeine, SalicylamideCodalan No.1, Codalan No.2, Codalan No.3
How Acetaminophen, Caffeine, Codeine, Salicylamide interacts with Extreme Flex — through 2 ingredients. Tap an ingredient for the detail:
Turmipure(r)Cytochrome P450 3a4 (cyp3a4) Substrates, Hepatotoxic Drugs +1 Moderate
Interaction Summary
Turmeric might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full Turmipure(r) + Acetaminophen, Caffeine, Codeine, Salicylamide interactionPerluxan(r) Hops ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Moderate
Interaction Summary
Theoretically, hops extract might alter metabolism of CYP3A4 substrates; however, this effect may not be clinically significant.
Read the full Perluxan(r) Hops Extract + Acetaminophen, Caffeine, Codeine, Salicylamide interactionAcetaminophen, Caffeine, DihydrocodeineDHC Plus, Panlor DC, Panlor SS
How Acetaminophen, Caffeine, Dihydrocodeine interacts with Extreme Flex — through 2 ingredients. Tap an ingredient for the detail:
Turmipure(r)Cytochrome P450 1a2 (cyp1a2) Substrates, Hepatotoxic Drugs +1 Moderate
Interaction Summary
Theoretically, turmeric might increase levels of drugs metabolized by CYP1A2.
Read the full Turmipure(r) + Acetaminophen, Caffeine, Dihydrocodeine interactionPerluxan(r) Hops ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cns Depressants +1 Moderate
Interaction Summary
Theoretically, hops extract might alter metabolism of CYP3A4 substrates; however, this effect may not be clinically significant.
Read the full Perluxan(r) Hops Extract + Acetaminophen, Caffeine, Dihydrocodeine interactionAcetaminophen, Caffeine, IsomethepteneMigralam
How Acetaminophen, Caffeine, Isometheptene interacts with Extreme Flex — through 2 ingredients. Tap an ingredient for the detail:
Turmipure(r)Cytochrome P450 3a4 (cyp3a4) Substrates, Hepatotoxic Drugs +1 Moderate
Interaction Summary
Turmeric might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full Turmipure(r) + Acetaminophen, Caffeine, Isometheptene interactionPerluxan(r) Hops ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Hops extract does not seem to affect the metabolism of CYP1A2 substrates.
Read the full Perluxan(r) Hops Extract + Acetaminophen, Caffeine, Isometheptene interactionAcetaminophen, Caffeine, PyrilamineMidol Max Strength Menstrual
How Acetaminophen, Caffeine, Pyrilamine interacts with Extreme Flex — through 2 ingredients. Tap an ingredient for the detail:
Turmipure(r)Cytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Moderate
Interaction Summary
Theoretically, turmeric might increase levels of drugs metabolized by CYP1A2.
Read the full Turmipure(r) + Acetaminophen, Caffeine, Pyrilamine interactionPerluxan(r) Hops ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, hops extract might alter metabolism of CYP3A4 substrates; however, this effect may not be clinically significant.
Read the full Perluxan(r) Hops Extract + Acetaminophen, Caffeine, Pyrilamine interactionAcetaminophen, Chlorpheniramine Maleate, Dextromethorphan HbrVicks Formula 44M Cough, Cold & Flu Relief
How Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interacts with Extreme Flex — through 2 ingredients. Tap an ingredient for the detail:
Turmipure(r)Hepatotoxic Drugs, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Moderate
Interaction Summary
Theoretically, turmeric might increase the risk of liver damage when taken with hepatotoxic drugs.
Read the full Turmipure(r) + Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interactionPerluxan(r) Hops ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Hops extract does not seem to affect the metabolism of CYP1A2 substrates.
Read the full Perluxan(r) Hops Extract + Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interactionEach ingredient & the kinds of drugs it affects
For each ingredient in Extreme Flex 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.
Turmipure(R)
Alkylating Agents
Turmeric has antioxidant effects. Theoretically, this may reduce the activity of chemotherapy drugs that generate free radicals. However, research is conflicting.
In vitro research suggests that curcumin, a constituent of turmeric, inhibits mechlorethamine-induced apoptosis of breast cancer cells by up to 70%. Also, animal research shows that curcumin inhibits cyclophosphamide-induced tumor regression. However, some in vitro research shows that curcumin does not affect the apoptosis capacity of etoposide. Also, other laboratory research suggests that curcumin might augment the cytotoxic effects of alkylating agents. Reasons for the discrepancies may relate to the dose of curcumin and the specific chemotherapeutic agent. Lower doses of curcumin might have antioxidant effects while higher doses might have pro-oxidant effects. More evidence is needed to determine what effect, if any, turmeric might have on alkylating agents.
Amlodipine (Norvasc)
Taking turmeric with amlodipine may increase levels of amlodipine.
Animal research shows that giving amlodipine 1 mg/kg as a single dose following the use of turmeric extract 200 mg/kg daily for 2 weeks increases the maximum concentration and area under the curve by 53% and 56%, respectively, when compared with amlodipine alone. Additional animal research shows that taking amlodipine 1 mg/kg with a curcumin 2 mg/kg pretreatment for 10 days increases the maximum concentration and area under the curve by about 2-fold when compared with amlodipine alone.
Anticoagulant/Antiplatelet Drugs
Turmeric may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs. However, research is conflicting.
Curcumin, a constituent of turmeric, has demonstrated antiplatelet effects in vitro. Furthermore, two case reports have found that taking turmeric along with warfarin or fluindione was associated with an increased international normalized ratio (INR). However, one clinical study in healthy volunteers shows that taking curcumin 500 mg daily for 3 weeks, alone or with aspirin 100 mg, does not increase antiplatelet effects or bleeding risk. It is possible that the dose of turmeric used in this study was too low to produce a notable effect.
Antidiabetes Drugs
Theoretically, taking turmeric with antidiabetes drugs might increase the risk of hypoglycemia.
Animal research and case reports suggest that curcumin, a turmeric constituent, can reduce blood glucose levels in patients with diabetes. Furthermore, clinical research in adults with type 2 diabetes shows that taking curcumin 475 mg daily for 10 days prior to taking glyburide 5 mg decreased postprandial glucose levels for up to 24 hours when compared with glyburide alone, despite the lack of a significant pharmacokinetic interaction. Other clinical studies in patients with diabetes show that taking curcumin daily can reduce blood glucose levels when compared with placebo.
Antitumor Antibiotics
Turmeric has antioxidant effects. Theoretically, this may reduce the activity of chemotherapy drugs that generate free radicals. However, research is conflicting.
In vitro and animal research shows that curcumin, a constituent of turmeric, inhibits doxorubicin-induced apoptosis of breast cancer cells by up to 65%. However, curcumin does not seem to affect the apoptosis capacity of daunorubicin. In fact, some research shows that curcumin might augment the cytotoxic effects of antitumor antibiotics, increasing their effectiveness. Reasons for the discrepancies may relate to the dose of curcumin and the chemotherapeutic agent. Lower doses of curcumin might have antioxidant effects while higher doses might have pro-oxidant effects. More evidence is needed to determine what effects, if any, antioxidants such as turmeric have on antitumor antibiotics.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Turmeric might increase or decrease levels of drugs metabolized by CYP3A4.
In vitro and animal research show that turmeric and its constituents curcumin and curcuminoids inhibit CYP3A4. Also, 8 case reports from the World Health Organization (WHO) adverse drug reaction database describe increased toxicity in patients taking turmeric and cancer medications that are CYP3A4 substrates, including everolimus, ruxolitinib, ibrutinib, and palbociclib, and bortezomib. In another case report, a transplant patient presented with acute nephrotoxicity and elevated tacrolimus levels after consuming turmeric powder at a dose of 15 or more spoonfuls daily for ten days prior. It was thought that turmeric increased levels of tacrolimus due to CYP3A4 inhibition.
Conversely, other in vitro research suggests that turmeric induces CYP3A4 activity, leading to reduced levels of CYP3A4 substrates. An animal model suggests that induction of CYP3A4 occurs after daily curcumin use for 1 week. However, the induction of CYP3A4 by turmeric has not been reported in humans.
Hepatotoxic Drugs
Theoretically, turmeric might increase the risk of liver damage when taken with hepatotoxic drugs.
There is concern that turmeric might cause hepatotoxicity, especially when highly bioavailable formulations are used in high doses.
Methotrexate (Trexall, Others)
Theoretically, turmeric might have additive effects when used with hepatotoxic drugs such as methotrexate.
In one case report, a 39-year-old female taking methotrexate, turmeric, and linseed oil developed hepatotoxicity.
Organic Anion-Transporting Polypeptide Substrates (Oatp)
Theoretically, turmeric might increase blood levels of OATP4C1 substrates.
In vitro research shows that the turmeric constituent curcumin competitively inhibits OATP4C1 transport. This transporter is expressed in the kidney and facilitates the renal excretion of certain drugs. Theoretically, taking turmeric might decrease renal excretion of OATP substrates.
Sulfasalazine (Azulfidine)
Turmeric might increase the effects and adverse effects of sulfasalazine.
Clinical research shows that taking the turmeric constituent, curcumin, can increase blood levels of sulfasalazine by 3.2-fold.
Tacrolimus (Prograf)
Turmeric might increase the effects and adverse effects of tacrolimus.
In one case report, a transplant patient presented with acute nephrotoxicity and elevated tacrolimus levels of 29 ng/mL. The patient previously had tacrolimus levels within the therapeutic range at 9.7 ng/mL. Ten days prior to presenting at the emergency room the patient started consumption of turmeric powder at a dose of 15 or more spoonfuls daily. It was thought that turmeric increased levels of tacrolimus due to cytochrome P450 3A4 (CYP3A4) inhibition. In vitro and animal research show that turmeric and its constituent curcumin inhibit CYP3A4.
Talinolol
Turmeric may reduce the absorption of talinolol in some situations.
Clinical research shows that taking curcumin for 6 days decreases the bioavailability of talinolol when taken together on the seventh day. The clinical significance of this effect is unclear.
Tamoxifen (Nolvadex)
Theoretically, turmeric might reduce the levels and clinical effects of tamoxifen.
In a small clinical trial in patients with breast cancer taking tamoxifen 20-30 mg daily, adding curcumin 1200 mg plus piperine 10 mg three times daily reduces the 24-hour area under the curve of tamoxifen and the active metabolite endoxifen by 12.8% and 12.4%, respectively, as well as the maximum concentrations of tamoxifen, when compared with tamoxifen alone. However, in the absence of piperine, the area under the curve for endoxifen and the maximum concentration of tamoxifen were not significantly reduced. Effects were most pronounced in patients who were extensive cytochrome P450 (CYP) 2D6 metabolizers.
Topoisomerase I Inhibitors
Turmeric has antioxidant effects. There is some concern that this may reduce the activity of chemotherapy drugs that generate free radicals. However, research is conflicting.
In vitro research shows that curcumin, a constituent of turmeric, inhibits camptothecin-induced apoptosis of breast cancer cells by up to 71%. However, other in vitro research shows that curcumin augments the cytotoxic effects of camptothecin. Reasons for the discrepancies may relate to the dose of curcumin and the chemotherapeutic agents. Lower doses of curcumin might have antioxidant effects while higher doses might have pro-oxidant effects. More evidence is needed to determine what effect, if any, turmeric might have.
Tramadol (Ultram)
Theoretically, turmeric might increase or decrease levels of tramadol.
Animal research suggests that a single dose of curcumin, a constituent of turmeric, may increase tramadol's maximum concentration (Cmax) by inhibiting metabolism, while continued daily use for 7 days may reduce the area under the curve (AUC) due to the induction of drug-metabolizing enzymes such as cytochrome P450 3A4 (CYP3A4). However, this interaction has not been reported in humans.
Warfarin (Coumadin)
Turmeric might increase the risk of bleeding with warfarin.
One case of increased international normalized ratio (INR) has been reported for a patient taking warfarin who began taking turmeric. Prior to taking turmeric, the patient had stable INR measurements. Within a few weeks of starting turmeric supplementation, the patient's INR increased to 10. Additionally, curcumin, the active constituent in turmeric, has demonstrated antiplatelet effects in vitro, which may produce additive effects when taken with warfarin.
Cytochrome P450 1A2 (Cyp1A2) Substrates
Theoretically, turmeric might increase levels of drugs metabolized by CYP1A2. However, research is conflicting.
In vitro and animal research show that the turmeric constituent, curcumin, inhibits CYP1A2. However, other in vitro research suggests that curcumin does not significantly affect CYP1A2.
Docetaxel (Taxotere)
Theoretically, turmeric might increase blood levels of oral docetaxel.
Animal research suggests that the turmeric constituent, curcumin, enhances the oral bioavailability of docetaxel. However, the significance of this interaction is unclear, as this drug is typically administered intravenously in clinical settings.
Estrogens
Theoretically, large amounts of turmeric might interfere with hormone replacement therapy through competition for estrogen receptors.
In vitro research shows that curcumin, a constituent of turmeric, displaces the binding of estrogen to its receptors.
Glyburide (Diabeta, Others)
Theoretically, taking turmeric and glyburide in combination might increase the risk of hypoglycemia.
Clinical research shows that taking curcumin 475 mg daily for 10 days prior to taking glyburide 5 mg increases blood levels of glyburide by 12% at 2 hours after the dose in patients with type 2 diabetes. While maximal blood concentrations of glyburide were not affected, turmeric modestly decreased postprandial glucose levels for up to 24 hours when compared to glyburide alone, possibly due to the hypoglycemic effect of turmeric demonstrated in animal research.
Losartan (Cozaar)
Theoretically, turmeric might increase the effects of losartan.
Research in hypertensive rats shows that taking turmeric can increase the hypotensive effects of losartan.
Norfloxacin (Noroxin)
Theoretically, turmeric might increase the effects and adverse effects of norfloxacin.
Animal research shows that taking curcumin, a turmeric constituent, can increase blood levels of orally administered norfloxacin.
P-Glycoprotein Substrates
Theoretically, turmeric might increase the absorption of P-glycoprotein substrates.
In vitro and animal research shows that curcuminoids and other constituents found in turmeric can inhibit P-glycoprotein expression and activity.
Paclitaxel (Abraxane, Onxol)
Theoretically, turmeric might alter blood levels of paclitaxel, although any effect may not be clinically relevant.
Clinical research in adults with breast cancer receiving intravenous paclitaxel suggests that taking turmeric may modestly alter paclitaxel pharmacokinetics. Patients received paclitaxel on day 1, followed by either no treatment or turmeric 2 grams daily from days 2-22. Pharmacokinetic modeling suggests that turmeric reduces the maximum concentration and area under the curve of paclitaxel by 12.1% and 7.7%, respectively. However, these changes are not likely to be considered clinically relevant. Conversely, animal research suggests that curcumin, a constituent of turmeric, enhances the oral bioavailability of paclitaxel. However, the significance of this interaction is unclear, as this drug is typically administered intravenously in clinical settings.
Perluxan(R) Hops extract
Cns Depressants
Theoretically, concomitant use of hops with sedative drugs might cause additive sedation.
Some animal research shows that hops has sedative effects.
Estrogens
Theoretically, concomitant use of large amounts of hops might interfere with hormone replacement therapy due to competition for estrogen receptors.
In vitro research suggests that certain hops constituents can competitively bind to estrogen receptors. However, most hops extracts contain very small amounts of these constituents.
Cytochrome P450 1A2 (Cyp1A2) Substrates
Hops extract does not seem to affect the metabolism of CYP1A2 substrates.
In vitro research suggests that flavonoid constituents of hops inhibit CYP1A2 enzyme activity. However, a pharmacokinetic study in healthy postmenopausal patients shows that taking a standardized extract of spent hops containing prenylated phenols, as 59.5 mg twice daily for 2 weeks, does not affect levels of caffeine, a CYP1A2 probe substrate.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, hops extract might alter metabolism of CYP3A4 substrates; however, this effect may not be clinically significant.
Animal research suggests that specific constituents of hops, called lupulones, can induce hepatic CYP3A4 enzyme activity. However, a pharmacokinetic study in healthy postmenopausal patients with normal metabolism shows that taking a standardized extract of spent hops containing prenylated phenols, as 59.5 mg twice daily for 2 weeks, decreases the concentration of alprazolam, a CYP3A4 probe substrate, by 7.6%. This reduction is unlikely to be clinically relevant.
Chondroitin Sulfate
Warfarin (Coumadin)
Taking chondroitin in combination with glucosamine might increase the anticoagulant effects of warfarin. However, the effect of chondroitin alone is unclear.
There have been multiple reports of increased international normalized ratio (INR) in patients taking warfarin with glucosamine, with or without chondroitin. The lack of reports with chondroitin alone seem to suggest that the interactions occurring in these reports may have been due to glucosamine. In two individual case reports, glucosamine/chondroitin combinations were associated with a significant increase in INR in patients previously stabilized on warfarin. Additionally, 20 voluntary case reports to the US Food & Drug Administration (FDA) have linked glucosamine plus chondroitin with increased INR, bruising, and bleeding in patients who were also taking warfarin. There have also been 20 additional case reports to the World Health Organization (WHO) that link glucosamine alone, without chondroitin, to increased INR in patients taking warfarin.
Brand information
Manufacturer and brand details for Extreme Flex, from the product label.
KingFisher Media
See all KingFisher Media products- Name
- KingFisher Media, LLC
- Phone Number
- 1-877-902-7743
- Web Address
- www.ExtremeFlex.com
Extreme Flex by KingFisher Media: Common Questions
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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.
The Full Monographs Behind Extreme Flex’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Hops
Interacts with 863 drugsHops are most often used for sleep and mild anxiety, frequently combined with valerian, but the human evidence is limited and not very strong. They are generally well tolerated when used sho...
Read the full Hops monograph → Herb & supplement monographChondroitin Sulfate
Interacts with 2 drugsChondroitin sulfate is a naturally occurring building block of cartilage that is widely taken, often with glucosamine, for osteoarthritis joint pain. The evidence is mixed—some people report...
Read the full Chondroitin Sulfate monograph → Herb & supplement monographHyaluronic Acid
Hyaluronic acid is a natural substance in the body that helps hold water in the skin, joints, and eyes. Oral and topical products are popular for skin moisture and joint comfort, and the evi...
Read the full Hyaluronic Acid monograph → Herb & supplement monographTurmeric
Interacts with 1,133 drugsTurmeric is a popular spice whose main active compounds, curcuminoids, are studied mostly for inflammation and joint pain. Some research is promising, but quality is mixed and curcumin is po...
Read the full Turmeric monograph →Sources & How We Checked
Extreme Flex'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 143 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.
Chondroitin Sulfate 22 references
- Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. Washington, DC: National Academy Press, 2002.
- Tallia AF, Cardone DA. Asthma exacerbation associated with glucosamine-chondroitin supplement. J Am Board Fam Pract 2002;15:481-4..
- Danao-Camara T. Potential side effects of treatment with glucosamine and chondroitin. Arthritis Rheum 2000;43:2853. PubMed
- Rozenfeld V, Crain JL, Callahan AK. Possible augmentation of warfarin effect by glucosamine-chondroitin. Am J Health Syst Pharm 2004;61:306-307. PubMed
- Clegg DO, Reda DJ, Harris CL, et al. Glucosamine, chondroitin sulfate, and the two in combination for painful knee osteoarthritis. N Engl J Med 2006;354:795-808. DOI
- Knudsen J, Sokol GH. Potential glucosamine-warfarin interaction resulting in increased international normalized ratio: Case report and review of the literature and MedWatch database. Pharmacotherapy 2008;28:540-8. PubMed
- Yue QY, Strandell J, Myrberg O. Concomitant use of glucosamine potentiates the effect of warfarin. Jan 2006. Drug Safety 29(10):911-1010. DOI
- Nordling, J. and van, Ophoven A. Intravesical glycosaminoglycan replenishment with chondroitin sulphate in chronic forms of cystitis. A multi-national, multi-centre, prospective observational clinical trial. Arzneimittelforschung. 2008;58(7):328-335. PubMed
- Nickel, J. C., Egerdie, B., Downey, J., Singh, R., Skehan, A., Carr, L., and Irvine-Bird, K. A real-life multicentre clinical practice study to evaluate the efficacy and safety of intravesical chondroitin sulphate for the treatment of interstitial cystit
- Oliviero, U., Sorrentino, G. P., De Paola, P., Tranfaglia, E., D'Alessandro, A., Carifi, S., Porfido, F. A., Cerio, R., Grasso, A. M., Policicchio, D., and . Effects of the treatment with matrix on elderly people with chronic articular degeneration. Drug
- Crowley, D. C., Lau, F. C., Sharma, P., Evans, M., Guthrie, N., Bagchi, M., Bagchi, D., Dey, D. K., and Raychaudhuri, S. P. Safety and efficacy of undenatured type II collagen in the treatment of osteoarthritis of the knee: a clinical trial. Int.J.Med.Sc PubMed
- Nickel, J. C., Egerdie, R. B., Steinhoff, G., Palmer, B., and Hanno, P. A multicenter, randomized, double-blind, parallel group pilot evaluation of the efficacy and safety of intravesical sodium chondroitin sulfate versus vehicle control in patients with
- Sawitzke, A. D., Shi, H., Finco, M. F., Dunlop, D. D., Harris, C. L., Singer, N. G., Bradley, J. D., Silver, D., Jackson, C. G., Lane, N. E., Oddis, C. V., Wolfe, F., Lisse, J., Furst, D. E., Bingham, C. O., Reda, D. J., Moskowitz, R. W., Williams, H. J.
- Wildi, L. M., Raynauld, J. P., Martel-Pelletier, J., Beaulieu, A., Bessette, L., Morin, F., Abram, F., Dorais, M., and Pelletier, J. P. Chondroitin sulphate reduces both cartilage volume loss and bone marrow lesions in knee osteoarthritis patients starti
- Pavelka and et al. Double-blind, dose effect study of oral cs 4 & 6 1200mg, 800mg, 200mg against placebo in the treatment of femorotibial osteoarthritis. Wular Rheumatol Liter 1998;27(suppl 2):63.
- Cerda C, Bruguera M, Parés A. Hepatotoxicity associated with glucosamine and chondroitin sulfate in patients with chronic liver disease. World J Gastroenterol 2013;19(32):5381-4. PubMed
- von Felden J, Montani M, Kessebohm K, Stickel F. Drug-induced acute liver injury mimicking autoimmune hepatitis after intake of dietary supplements containing glucosamine and chondroitin sulfate. Int J Clin Pharmacol Ther 2013;51(3):219-23. PubMed
- Provenza JR, Shinjo SK, Silva JM, Peron CR, Rocha FA. Combined glucosamine and chondroitin sulfate, once or three times daily, provides clinically relevant analgesia in knee osteoarthritis. Clin Rheumatol 2015;34:1455-62. PubMed
- Ossendza RA, Grandval P, Chinoune F, Rocher F, Chapel F, Bernardini D. [Acute cholestatic hepatitis due to glucosamine forte]. Gastroenterol Clin Biol. 2007 Apr;31(4):449-50.
- Greenlee H, Crew KD, Shao T, Kranwinkel G, Kalinsky K, Maurer M, Brafman L, Insel B, Tsai WY, Hershman DL. Phase II study of glucosamine with chondroitin on aromatase inhibitor-associated joint symptoms in women with breast cancer. Support Care Cancer 201 PubMed
- Chu EC, Huang KHK, Cheung G, Ng G, Lin A. Delayed Skin Allergy to Glucosamine Chondroitin Supplement. Cureus 2023;15(3):e36310. PubMed
- Lila AM, Alekseeva LI, Baranov AA, et al. Chondroitin sulfate and glucosamine combination in patients with knee and hip osteoarthritis: A long-term observational study in Russia. World J Orthop 2023;14(6):443-457. PubMed
Hyaluronic Acid 4 references
- Park Y, Song JS, Choi CY, Yoon KC, Lee HK, Kim HS. A randomized multicenter study comparing 0.1%, 0.15%, and 0.3% sodium hyaluronate with 0.05% cyclosporine in the treatment of dry eye. J Ocul Pharmacol Ther. 2017;33(2):66-72. PubMed
- U.S. Food and Drug Administration. Do Not Use Needle-Free Devices for Injection of Dermal Fillers - FDA Safety Communication. October 8, 2021. Available at: https://www.fda.gov/medical-devices/safety-communications/do-not-use-needle-free-devices-injection
- Disphanurat W, Srisantithum B. Efficacy and safety of 0.15% isobutylamido thiazolyl resorcinol combined with hyaluronic acid vs 0.15% isobutylamido thiazolyl resorcinol or hyaluronic acid alone in melasma treatment: A randomized evaluator-blind trial. J C PubMed
- Humbert P, Mikosinki J, Benchikhi H, Allaert FA. Efficacy and safety of a gauze pad containing hyaluronic acid in treatment of leg ulcers of venous or mixed origin: a double-blind, randomised, controlled trial. Int Wound J 2013;10(2):159-66. PubMed
Hops 15 references
- Newall CA, Anderson LA, Philpson JD. Herbal Medicine: A Guide for Healthcare Professionals. London, UK: The Pharmaceutical Press, 1996.
- McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
- Zava DT, Dollbaum CM, Blen M. Estrogen and progestin bioactivity of foods, herbs, and spices. Proc Soc Exp Biol Med 1998;217:369-78. PubMed
- Milligan SR, Kalita JC, Heyerick A, et al. Identification of a potent phytoestrogen in hops (Humulus lupulus L.) and beer. J Clin Endocrinol Metab 1999;84:2249-52.. PubMed
- Milligan SR, Kalita JC, Pocock V, et al. The endocrine activities of 8-prenylnaringenin and related hop (Humulus lupulus L.) flavonoids. J Clin Endocrinol Metab 2000;85:4912-5.. DOI
- Henderson MC, Miranda CL, Stevens JF, et al. In vitro inhibition of human P450 enzymes by prenylated flavonoids from hops, Humulus lupulus. Xenobiotica 2000;30:235-51.. PubMed
- Mannering, G. J., Shoeman, J. A., and Deloria, L. B. Identification of the antibiotic hops component, colupulone, as an inducer of hepatic cytochrome P-4503A in the mouse. Drug Metab Dispos 1992;20(2):142-147. DOI
- Skorska, C., Mackiewicz, B., Gora, A., Golec, M., and Dutkiewicz, J. Health effects of inhalation exposure to organic dust in hops farmers. Ann.Univ Mariae.Curie Sklodowska [Med] 2003;58(1):459-465.
- Schiller, H., Forster, A., Vonhoff, C., Hegger, M., Biller, A., and Winterhoff, H. Sedating effects of Humulus lupulus L. extracts. Phytomedicine. 2006;13(8):535-541. PubMed
- van Hunsel, F. P. and Kampschoer, P. [Postmenopausal bleeding and dietary supplements: a possible causal relationship with hop- and soy-containing preparations]. Ned.Tijdschr.Geneeskd. 2012;156(41):A5095.
- Fenselau, C. and Talalay, P. Is oestrogenic activity present in hops? Food Cosmet.Toxicol. 1973;11(4):597-602. PubMed
- Godnic-Cvar, J., Zuskin, E., Mustajbegovic, J., Schachter, E. N., Kanceljak, B., Macan, J., Ilic, Z., and Ebling, Z. Respiratory and immunological findings in brewery workers. Am J Ind Med 1999;35(1):68-75. DOI
- Lee KM, Jung JS, Song DK, and et al. Effects of Humulus lupulus extract on the central nervous system in mice. Planta Med 1993;59(Suppl):A691.
- Assessment report on Humulus lupulus L., flos. European Medicines Agency, 2014. Available at: https://www.ema.europa.eu/en/documents/herbal-report/final-assessment-report-humulus-lupulus-l-flos_en.pdf. Accessed September 29, 2021.
- van Breemen RB, Chen L, Tonsing-Carter A, et al. Pharmacokinetic Interactions of a Hop Dietary Supplement with Drug Metabolism in Perimenopausal and Postmenopausal Women. J Agric Food Chem. 2020;68(18):5212-5220. PubMed
Turmeric 102 references
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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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