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Dietary supplement

FCS II Ingredients & Drug Interactions

by Nature's Sunshine

FCS II label
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Capsule Category: Botanical
Most serious interaction: Major
Clinical methodology reviewed by · Updated Sep 16, 2026 · Label data from the NIH DSLD
What is this page for?

First and foremost: checking FCS II against your medications. The heart of this page is the interaction checker and the full interaction report — how this product’s ingredients may interact with prescription and over-the-counter medicines you may be taking.

Around that, we add a pharmacist’s high-level view of the product as a whole — what’s inside, the evidence for its stated use, how transparent the label is, and what safety data exists — so you can see the full picture in one place. It’s educational information from our licensed clinical databases and the clinical staff at HelloPharmacist — not medical advice — and we don’t sell or endorse products. Our editorial policy

The interaction bottom line Most serious interaction: Major

FCS II is a dietary supplement by Nature's Sunshine with 10 active ingredients. Its ingredients are commonly taken for cough and sore throat, dry mouth and throat irritation, digestive upset and heartburn.Based on those ingredients, 2,206 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are Marshmallow, Goldenseal root extract, Ginger. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

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Check Your Meds Against FCS II by Nature's Sunshine

Ask about any prescription or over-the-counter medication and we check it for interactions with FCS II by Nature's Sunshine — and tell you which ingredient is responsible.

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HelloPharmacist Scorecard of FCS II by Nature's Sunshine

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

From our pharmacy team — supplement deep dive

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

What’s inside

Low disclosure
Ingredient Transparency · database check
Low

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

Why this rating?
  • The label discloses an exact amount for 0 of its 10 active ingredients.
  • “Proprietary Blend” is a proprietary blend — the label gives one combined amount (880 mg) without saying how much of each component you get.

FCS II contains 10 ingredients. The active ones are marshmallow, lobelia, capsicum, ginger, blessed thistle, goldenseal root extract, dong quai, red raspberry leaf, and black cohosh rhizome and root extract.

These herbs are traditional women's support ingredients; the product also contains gelatin and water as inactive ingredients.

Does it work?

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

Some clinical evidence supports this product's ingredients for its stated purpose, but it isn't conclusive.

Why this rating?
  • The label markets this product for: Female glandular support.
  • We looked for evidence on: Menopause symptoms, Menstrual health, Hormonal balance, Women's wellness.
  • The strongest evidence on file: Black Cohosh is rated "Possibly Effective" for Menopausal symptoms (Natural Medicines).
  • Also on file: Dong Quai is rated "Insufficient Reliable Evidence To Rate" for Menopausal symptoms.
  • Also on file: Ginger is rated "Insufficient Reliable Evidence To Rate" for Menopausal symptoms.

The evidence on FCS II's active ingredients is sparse. Capsicum is likely effective for nerve pain after shingles (postherpetic neuralgia) and diabetic nerve damage, and possibly effective for cluster headaches, back pain, and nausea after surgery.

Ginger is possibly effective for pregnancy-related nausea, period cramps, and osteoarthritis. Black cohosh is possibly effective for hot flashes and menopausal symptoms.

The remaining ingredients—marshmallow, lobelia, blessed thistle, goldenseal, dong quai, and red raspberry—lack sufficient evidence to establish whether they work for their traditional uses.

The evidence, ingredient by ingredient Marshmallow Lobelia Capsicum Ginger Blessed Thistle Goldenseal Dong Quai Red Raspberry

How safe is it?

Well-documented data
Safety Information · database check
Well characterized

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

Why this rating?
  • We hold adverse-effect (side-effect) data for 9 of the 10 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 10 of 10.
  • General safety write-ups exist for 10 of 10.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

FCS II contains ingredients with significant safety caveats. Lobelia is toxic at higher doses (600 mg or more) and can cause serious effects like rapid heart rate, low blood pressure, and even death at toxic levels; nausea, vomiting, and throat irritation occur at doses as low as 50 mg.

Goldenseal and dong quai should be avoided in pregnancy. Marshmallow, blessed thistle, and black cohosh lack enough pregnancy safety data and are best avoided.

Red raspberry leaf is often used late in pregnancy but only with provider guidance. Capsicum in food amounts is generally fine, but concentrated supplements are not well studied.

Ginger is generally well tolerated in moderate amounts, though doses above 5 grams daily increase side-effect risk. Most common side effects across these herbs include nausea, vomiting, diarrhea, and abdominal discomfort.

Side effects, ingredient by ingredient Marshmallow Lobelia Capsicum Ginger Blessed Thistle Goldenseal Dong Quai Red Raspberry

Meds to double-check

Major interaction found
Known Interaction Concern · database check
Major identified

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

Why this rating?
  • 10 of the 10 matched ingredients can interact with medications — Blessed Thistle, Meadowsweet, Lobelia, Red Raspberry, Marshmallow, among others.
  • The most serious interaction on file is rated Major.
  • Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs; immunosuppressants / transplant drugs; diabetes medications; heart-rhythm medications; lithium.
  • For scale: 2,207 individual medications appear in the full list. A big number alone doesn't make a product dangerous — what matters is whether YOUR medication is on it, so run yours through the interaction checker on this page.

Check with your doctor or pharmacist before taking FCS II if you use blood thinners like warfarin or antiplatelet drugs, diabetes medications, heart and blood-pressure drugs (especially nifedipine and losartan), theophylline for asthma, aspirin, ciprofloxacin (Cipro), lithium for mood disorders, or any medication broken down by your liver (ask your pharmacist if you're unsure). The product also may reduce effectiveness of acid-reducing drugs.

Check your own medication Run your meds through the checker above

The bottom line

Scorecard at a glanceFormula with limited ingredient disclosure with some supporting evidence for its stated purpose. Major medication interactions have been identified, and safety information is well characterized.

FCS II is a multi-ingredient herbal supplement with established interactions across blood thinners, diabetes drugs, and several other medication classes—some serious. If you take any prescription medications, use the interaction checker on this page before starting.

Anyone on warfarin or similar anticoagulants should talk with their doctor or pharmacist first. The supplement is not recommended in pregnancy or while breastfeeding.

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

Assessment coverage: 10 of 10 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Oct 24, 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

At a glance

General information

Key facts about FCS II, straight from the product label.

Brand Nature's Sunshine
Barcode (UPC) 099904008786
Net contents 100 Capsule(s)
Market status On market
Date entered into DSLD Oct 24, 2022
DSLD ID 278080
Product type Botanical
Supplement form Capsule
Dietary claims / uses All Other, Structure/Function
Intended target group(s) Kosher, Adult Female (18 - 50 Years)
From the label
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.

Supplement Facts

The label details for FCS II by Nature's Sunshine, sourced from the NIH Dietary Supplement Label Database.

Supplement Facts

Daily Value (DV) Target Group(s):
Adults and children 4 or more years of age
Minimum serving Sizes:
2 Capsule(s)
Maximum serving Sizes:
2 Capsule(s)
Servings per container
50
UPC/BARCODE
099904008786
IngredientAmount% DV
Proprietary Blend880 mg--
Marshmallow0 NP--
Lobelia0 NP--
Capsicum0 NP--
Ginger0 NP--
Blessed Thistle0 NP--
Goldenseal root extract0 NP--
Dong Quai0 NP--
Red Raspberry0 NP--
Black Cohosh rhizome & root extract0 NP--
Queen of the Meadow0 NP--

Other ingredients: Gelatin, Water

Tap any ingredient to jump to its full detail below.

Label statements
These statements are the manufacturer’s wording, reproduced from the product label — the label is saying it, not HelloPharmacist. We don’t verify or endorse them.
FDA Disclaimer Statement

These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.

General Statements

Bottle made from 100% post consumer recycled material. We are committed to you and our planet. Scan to learn more.

We source the world's purest ingredients, no matter where they are grown, to ensure the active nutrients are delivered just as nature intended.

New look! Same great product

Precautions

Pregnant or lactating women should consult their health care professional prior to taking this supplement.

Do not use if inner seal is missing or damaged.

Seals/Symbols

Ko Pareve (Kosher)

Formula

Ko Pareve (Kosher)

Female glandular support

With herbal extracts

Formulation

Traditionally used to support the female glandular system

Guaranteed pure

FDA Statement of Identity

Dietary supplement

Brand IP Statement(s)

Natures Sunshine Herbal experts since 1972

Suggested/Recommended/Usage/Directions

Recommended Use: Take 2 capsules with a meal three times daily.

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

See for yourself

FCS II by Nature's Sunshine label

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

FCS II label

Label images are published by the NIH Dietary Supplement Label Database for the version of this product on file. Always read your actual product label.

View the full label (PDF)
What’s inside

The Ingredients in FCS II by Nature's Sunshine

These are the 10 active ingredients this product is made of. Select any to open its full monograph.

Serving size2 Capsule(s) Dosage formCapsule Servings per container50 Amounts shown are per serving.

Most supplement products combine several ingredients, and a medication can interact with the product through any one of them. Each ingredient below shows whether it has known drug interactions.

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

Interaction report

FCS II by Nature's Sunshine Drug Interactions

Want to check YOUR meds against FCS II?

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

 Go to the checker
2,206Drugs
2 Major 1,412 Moderate 792 Minor

Ingredients driving the most interactions

Marshmallow 2,040
Goldenseal root extract 1,237
Ginger 1,007
Black Cohosh rhizome & root extract 652
Capsicum 239

Individual Drug Interactions

The ingredients in FCS II interact with 2,206 drugs. Click any drug to see the details.

10 of the 10 ingredients in FCS II interact with drugs. Each result below shows which ingredient is responsible. Marshmallow Goldenseal root extract Ginger Black Cohosh rhizome & root extract Capsicum Dong Quai Red Raspberry Queen of the Meadow Blessed Thistle Lobelia

Each ingredient & the kinds of drugs it affects

For each ingredient in FCS II 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.

Marshmallow3 drug types · 2,040 drugs

Lithium

Theoretically, due to potential diuretic effects, marshmallow might reduce excretion and increase levels of lithium.
Marshmallow is thought to have diuretic properties. To avoid lithium toxicity, the dose of lithium might need to be decreased when used with marshmallow.

Likelihood Probable Evidence D
Anticoagulant/Antiplatelet Drugs

Theoretically, marshmallow flower might have antiplatelet effects.
Animal research suggests that marshmallow flower extract has antiplatelet effects. However, the root and leaf of marshmallow, not the flower, are the plant parts most commonly found in dietary supplements. Theoretically, use of marshmallow flower with anticoagulant/antiplatelet drugs can have additive effects, and might increase the risk for bleeding in some patients.

Likelihood Unlikely Evidence D
Oral Drugs

Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Marshmallow contains mucilage which can affect oral drug absorption. To avoid changes in absorption, take marshmallow 30-60 minutes after oral medications.

Likelihood Possible Evidence D
Marshmallow full monograph & interactions

Goldenseal root extract16 drug types · 1,237 drugs

Anticoagulant/Antiplatelet Drugs

Theoretically, goldenseal might increase the risk of bleeding when used with anticoagulant or antiplatelet drugs.
Goldenseal contains berberine. In vitro and animal research shows that berberine can inhibit platelet aggregation. However, this effect has not been reported in humans.

Likelihood Possible Evidence D
Antidiabetes Drugs

Theoretically, goldenseal might increase the risk of hypoglycemia when used with antidiabetes drugs.
Goldenseal contains berberine. Clinical research shows that berberine can lower blood glucose levels. However, this effect has not been reported with goldenseal.

Likelihood Possible Evidence D
Antihypertensive Drugs

Theoretically, goldenseal might increase the risk of hypotension when taken with antihypertensive drugs.
Goldenseal contains berberine. Animal research shows that berberine can have hypotensive effects. Also, an analysis of clinical research shows that taking berberine in combination with amlodipine can lower systolic and diastolic blood pressure when compared with amlodipine alone. However, this effect has not been reported with goldenseal.

Likelihood Possible Evidence D
Cns Depressants

Theoretically, goldenseal might increase the sedative effects of CNS depressants.
Goldenseal contains berberine. Animal research shows that berberine can have sedative effects. However, this effect has not been reported in humans.

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

Theoretically, goldenseal might increase serum levels of drugs metabolized by CYP2C9.
In vitro research shows that goldenseal root extract can modestly inhibit CYP2C9. This effect may be due to its alkaloid constituents, hydrastine and berberine. However, this effect has not been reported in humans.

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

Goldenseal might increase serum levels of drugs metabolized by CYP2D6.
Clinical and in vitro research shows that goldenseal can significantly inhibit CYP2D6 enzymes, potentially increasing levels of drugs metabolized by CYP2D6.

Likelihood Probable Evidence B
Cytochrome P450 2E1 (Cyp2E1) Substrates

Theoretically, goldenseal might increase serum levels of drugs metabolized by CYP2E1.
In vitro research shows that goldenseal root extract can inhibit the activity of CYP2E1. However, this effect has not been reported in humans.

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

Goldenseal might increase serum levels of drugs metabolized by CYP3A4.
Most clinical and in vitro research shows that goldenseal inhibits CYP3A4 enzyme activity and increases serum levels of CYP3A4 substrates, such as midazolam. However, in one small clinical study, goldenseal did not affect the levels of indinavir, a CYP3A4 substrate, in healthy volunteers. This is likely due to the fact that indinavir has a high oral bioavailability, making it an inadequate probe for CYP3A4 interactions and/or that it is primarily metabolized by hepatic CYP3A, while goldenseal has more potential to inhibit intestinal CYP3A enzyme activity. Both goldenseal extract and its isolated constituents berberine and hydrastine inhibit CYP3A, with hydrastine possibly having more inhibitory potential than berberine.

Likelihood Possible Evidence B
Dextromethorphan (Robitussin Dm, Others)

Theoretically, goldenseal might increase serum levels of dextromethorphan.
Goldenseal contains berberine. A small clinical study shows that berberine can inhibit cytochrome P450 2D6 (CYP2D6) activity and reduce the metabolism of dextromethorphan.

Likelihood Possible Evidence D
Digoxin (Lanoxin)

Goldenseal might increase serum levels of digoxin, although this effect is unlikely to be clinically significant.
Clinical research shows that goldenseal modestly increases digoxin peak levels by about 14% in healthy volunteers. However, goldenseal does not seem to affect other pharmacokinetic parameters such as area under the curve (AUC). This suggests that goldenseal does not cause a clinically significant interaction with digoxin. Digoxin is a P-glycoprotein substrate. Some evidence suggests that goldenseal constituents might affect P-glycoprotein; however, it is unclear whether these constituents inhibit or induce P-glycoprotein.

Likelihood Probable Evidence B
Losartan (Cozaar)

Theoretically, goldenseal might decrease the conversion of losartan to its active form.
Goldenseal contains berberine. A small clinical study shows that berberine inhibits cytochrome P450 2C9 (CYP2C9) activity and reduces the metabolism of losartan. However, this effect has not been reported with goldenseal.

Likelihood Possible Evidence D
Metformin (Glucophage)

Theoretically, goldenseal might reduce blood levels of metformin.
In vitro research shows that goldenseal extract decreases the bioavailability of metformin, likely by interfering with transport, intestinal permeability, or other processes involved in metformin absorption. It is unclear which, if any, of metformin's transporters are inhibited by goldenseal. Goldenseal does not appear to alter the clearance or half-life of metformin.

Likelihood Possible Evidence D
P-Glycoprotein Substrates

Theoretically, goldenseal might increase or decrease serum levels of P-glycoprotein (P-gp) substrates.
There is conflicting evidence about the effect of goldenseal on P-gp. In vitro research suggests that berberine, a constituent of goldenseal, modestly inhibits P-gp efflux. Other evidence suggests that berberine induces P-gp. In healthy volunteers, goldenseal modestly increases peak levels of the P-gp substrate digoxin by about 14%. However, it does not seem to affect other pharmacokinetic parameters such as area under the curve (AUC). This suggests that goldenseal is not a potent inhibitor of P-gp-mediated drug efflux. Until more is known, goldenseal should be used cautiously with P-gp substrates.

Likelihood Probable Evidence B
Pentobarbital (Nembutal)

Theoretically, goldenseal might increase the sedative effects of pentobarbital.
Animal research shows that berberine, a constituent of goldenseal, can prolong pentobarbital-induced sleeping time. However, this effect has not been reported with goldenseal.

Likelihood Possible Evidence D
Tacrolimus (Prograf)

Theoretically, goldenseal might increase serum levels of tacrolimus.
Goldenseal contains berberine. In a 16-year-old patient with idiopathic nephrotic syndrome who was being treated with tacrolimus 6.5 mg twice daily, intake of berberine 200 mg three times daily increased the blood concentration of tacrolimus from 8 to 22 ng/mL. Following a reduction of tacrolimus dosing to 3 mg daily, blood levels of tacrolimus decreased to 12 ng/mL.

Likelihood Possible Evidence D
Oseltamivir (Tamiflu)

Theoretically, goldenseal might reduce the therapeutic effects of oseltamivir by decreasing its conversion to its active form.
In vitro evidence suggests that goldenseal reduces the formation of the active compound from the prodrug oseltamivir. The mechanism of action and clinical relevance is unclear.

Likelihood Possible Evidence D
Goldenseal root extract full monograph & interactions

Ginger14 drug types · 1,007 drugs

Anticoagulant/Antiplatelet Drugs

Ginger may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs. However, research is conflicting.
Laboratory research suggests that ginger inhibits thromboxane synthetase and decreases platelet aggregation. However, this has not been demonstrated unequivocally in humans, with mixed results from clinical trials. Theoretically, excessive amounts of ginger might increase the risk of bleeding when used with anticoagulant/antiplatelet drugs.

Likelihood Possible Evidence B
Antidiabetes Drugs

Theoretically, taking ginger with antidiabetes drugs might increase the risk of hypoglycemia.
Animal and human research suggests that ginger might increase insulin levels and/or decrease blood glucose levels.

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

Ginger might increase or decrease the levels of CYP3A4 substrates.
In vitro research and some case reports suggest that ginger inhibits CYP3A4 activity. Three case reports from the World Health Organization (WHO) adverse drug reaction database describe increased toxicity in patients taking ginger and cancer medications that are CYP3A4 substrates (imatinib, dabrafenib, and crizotinib). However, the causality of this interaction is unclear due to the presence of multiple interacting drugs and routes of administration.
Conversely, other in vitro research suggests that ginger induces CYP3A4 activity, leading to reduced levels of CYP3A4 substrates. However, this interaction has not been reported in humans.

Likelihood Possible Evidence D
Losartan (Cozaar)

Theoretically, ginger might increase levels of losartan and the risk of hypotension.
In animal research, ginger increased the levels and hypotensive effects of a single dose of losartan. It is not clear if ginger alters the concentration or effects of losartan when taken continuously. Additionally, this interaction has not been shown in humans.

Likelihood Possible Evidence D
Nifedipine (Procardia)

Ginger may have antiplatelet effects and increase the risk of bleeding if used with nifedipine.
Clinical research shows that combined treatment with ginger 1 gram plus nifedipine 10 mg significantly inhibits platelet aggregation when compared to nifedipine or ginger alone.

Likelihood Possible Evidence B
P-Glycoprotein Substrates

Ginger might increase the absorption and blood levels of P-glycoprotein (P-gp) substrates.
In vitro research and case reports suggest that ginger inhibits drug efflux by P-gp, potentially increasing absorption and serum levels of P-gp substrates. Two case reports from the World Health Organization (WHO) adverse drug reaction database describe increased toxicity in patients taking ginger and cancer medications that are P-gp substrates (trametinib, crizotinib). However, the causality of this interaction is unclear due to the presence of multiple interacting drugs and routes of administration.

Likelihood Possible Evidence D
Phenprocoumon (Marcoumar, Others)

Ginger might increase the risk of bleeding with phenprocoumon.
Phenprocoumon, a warfarin-related anticoagulant, might increase the international normalized ratio (INR) when taken with ginger. There is one case report of a 76-year-old woman with a stable INR on phenprocoumon that increased to greater than 10 when she began consuming dried ginger and ginger tea.

Likelihood Possible Evidence D
Warfarin (Coumadin)

Ginger might increase the risk of bleeding with warfarin.
Laboratory research suggests that ginger might inhibit thromboxane synthetase and decrease platelet aggregation. In one case report, ginger increased the INR when taken with phenprocoumon, which has similar pharmacological effects as warfarin. In another case report, ginger increased the INR when taken with a combination of warfarin, hydrochlorothiazide, and acetaminophen. A longitudinal analysis suggests that taking ginger increases the risk of bleeding in patients taking warfarin for at least 4 months. However, research in healthy people suggests that ginger has no effect on INR, or the pharmacokinetics or pharmacodynamics of warfarin. Until more is known, monitor INRs closely in patients taking large amounts of ginger.

Likelihood Possible Evidence B
Calcium Channel Blockers

Theoretically, taking ginger with calcium channel blockers might increase the risk of hypotension.
Some animal and in vitro research suggests that ginger has hypotensive and calcium channel-blocking effects. Another animal study shows that concomitant administration of ginger and the calcium channel blocker amlodipine leads to greater reductions in blood pressure when compared with amlodipine alone.

Likelihood Unlikely Evidence D
Cyclosporine (Neoral, Sandimmune)

Theoretically, when taken prior to cyclosporine, ginger might decrease cyclosporine levels.
In an animal model, ginger juice taken 2 hours prior to cyclosporine administration reduced the maximum concentration and area under the curve of cyclosporine by 51% and 40%, respectively. This effect was not observed when ginger juice and cyclosporine were administered at the same time.

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

Theoretically, ginger might increase the levels of CYP1A2 substrates.
In vitro research shows that ginger inhibits CYP1A2 activity. However, this interaction has not been reported in humans.

Likelihood Possible Evidence D
Cytochrome P450 2B6 (Cyp2B6) Substrates

Theoretically, ginger might increase the levels of CYP2B6 substrates.
In vitro research shows that ginger inhibits CYP2B6 activity. However, this interaction has not been reported in humans.

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

Theoretically, ginger might increase the levels of CYP2C9 substrates.
In vitro research shows that ginger inhibits CYP2C9 activity. However, this interaction has not been reported in humans.

Likelihood Possible Evidence D
Metronidazole (Flagyl)

Theoretically, ginger might increase levels of metronidazole.
In an animal model, ginger increased the absorption and plasma half-life of metronidazole. In addition, the elimination rate and clearance of metronidazole was significantly reduced.

Likelihood Possible Evidence D
Ginger full monograph & interactions

Black Cohosh rhizome & root extract7 drug types · 652 drugs

Atorvastatin (Lipitor)

Taking black cohosh with atorvastatin might increase the risk for elevated liver function tests.
In one case report, a patient taking atorvastatin (Lipitor) developed significantly elevated liver function enzymes after starting black cohosh 100 mg four times daily. Liver enzymes returned to normal when black cohosh was discontinued. It is unclear whether the elevated liver enzymes were due to black cohosh itself or an interaction between atorvastatin and black cohosh.

Likelihood Possible Evidence D
Cisplatin (Platinol-Aq)

Theoretically, black cohosh may reduce the clinical effects of cisplatin.
Animal research suggests that black cohosh might decrease the cytotoxic effect of cisplatin on breast cancer cells.

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

Some research suggests that black cohosh might inhibit CYP2D6, but there is conflicting evidence.
Some clinical research suggests that black cohosh might modestly inhibit CYP2D6 and increase levels of drugs metabolized by this enzyme. However, contradictory clinical research shows a specific black cohosh product (Remifemin, Enzymatic Therapy) 40 mg twice daily does not significantly inhibit metabolism of a CYP2D6 substrate in healthy study volunteers. Until more is known, use black cohosh cautiously in patients taking drugs metabolized by CYP2D6.

Likelihood Possible Evidence B
Estrogens

Theoretically, black cohosh may alter the effects of estrogen therapy.
Some research suggests that black cohosh has estrogenic effects. This may enhance or inhibit the effects of estrogen therapy.

Likelihood Possible Evidence D
Hepatotoxic Drugs

Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
There is concern that black cohosh might be linked to cases of liver failure and autoimmune hepatitis.

Likelihood Possible Evidence D
Serotonergic Drugs

Combining serotonergic drugs with black cohosh might cause additive serotonergic effects.
Black cohosh might increase the risk of serotonin syndrome when combined with other serotonergic drugs. Black cohosh acts as an agonist at several serotonin receptor subtypes and might interact with other serotonergic medications. In one case, a 55-year-old female who had been on stable treatment with sertraline 50 mg and duloxetine 60 mg daily developed serotonin syndrome after taking black cohosh extract 40 mg daily for 3 days.

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

Black cohosh may inhibit one form of OATP, OATP2B1, which could reduce the bioavailability and clinical effects of OATP2B1 substrates.
In vitro research shows that black cohosh modestly inhibits OATP2B1. OATPs are expressed in the small intestine and liver and are responsible for the uptake of drugs and other compounds into the body. Inhibition of OATP may reduce the bioavailability of oral drugs that are substrates of OATP.

Likelihood Possible Evidence D
Black Cohosh rhizome & root extract full monograph & interactions

Capsicum6 drug types · 239 drugs

Anticoagulant/Antiplatelet Drugs

Theoretically, capsicum may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
In vitro research shows that capsicum might increase the effects of antiplatelet drugs. Also, population research shows that capsicum is associated with an increased risk of self-reported bleeding in patients taking warfarin. However, clinical research shows that taking a single dose of capsaicin (Asian Herbex Ltd.), the active ingredient in capsicum, 400-800 mcg orally in combination with aspirin 500 mg does not decrease platelet aggregation when compared with taking aspirin 500 mg alone. Also, there was no notable effect on measures of platelet aggregation with capsaicin. It is unclear whether capsaicin must be used in more than a single dose to affect platelet aggregation.

Likelihood Possible Evidence B
Antidiabetes Drugs

Theoretically, taking capsicum with antidiabetes drugs might increase the risk of hypoglycemia.
Preliminary clinical research shows that consuming capsicum 5 grams along with a glucose drink attenuates the rise in plasma glucose after 30 minutes by 21%, decreases the 2-hour postprandial area under the curve of plasma glucose by 11%, and increases the 2-hour postprandial area under the curve of plasma insulin by 58% in healthy individuals when compared with placebo. Other clinical research shows that taking capsicum 5 mg daily for 28 days significantly reduces postprandial blood glucose and insulin levels, but not fasting blood glucose and insulin levels, in patients with gestational diabetes.

Likelihood Possible Evidence B
Aspirin

Theoretically, taking capsicum with aspirin might reduce the bioavailability of aspirin.
Animal research shows that acute or chronic intake of capsicum pepper reduces oral aspirin bioavailability. This has not been shown in humans.

Likelihood Possible Evidence D
Theophylline

Theoretically, taking capsicum with theophylline might increase the levels and adverse effects of theophylline.
In animal research, oral administration of capsicum reduced excretion of theophylline. However, capsicum does not seem to affect the pharmacokinetics of theophylline when administered intravenously.

Likelihood Possible Evidence D
Ace Inhibitors (Aceis)

Theoretically, using topical capsaicin may increase the risk of ACE inhibitor-induced cough.
There is one case report of a topically applied capsaicin cream contributing to the cough reflex in a patient using an ACEI. However, it is unclear if this interaction is clinically significant.

Likelihood Unlikely Evidence D
Ciprofloxacin (Cipro)

Theoretically, taking capsicum with ciprofloxacin might increase levels and adverse effects of ciprofloxacin.
Animal research shows that concomitant use of capsaicin, the active constituent of capsicum, and ciprofloxacin increases the bioavailability of ciprofloxacin by up to 70%.

Likelihood Possible Evidence D
Capsicum full monograph & interactions

Dong Quai3 drug types · 163 drugs

Warfarin (Coumadin)

Dong quai may increase the risk of bleeding when used with warfarin.
Case reports suggest that concomitant use of dong quai with warfarin can increase the anticoagulant effects of warfarin and increase the risk of bleeding. In one case, after 4 weeks of taking dong quai 565 mg once or twice daily, the international normalized ratio (INR) increased to 4.9. The INR normalized 4 weeks after discontinuation of dong quai.

Likelihood Probable Evidence D
Anticoagulant/Antiplatelet Drugs

Theoretically, dong quai may increase the risk of bleeding when used with anticoagulant or antiplatelet drugs; however, research is conflicting.
Animal studies suggest that dong quai has antithrombin activity and inhibits platelet aggregation due to its coumarin components. Additionally, some case reports in humans suggest that dong quai can increase the anticoagulant effects of warfarin. However, clinical research in healthy adults shows that taking 1 gram of dong quai root daily for 3 weeks does not significantly inhibit platelet aggregation or cause bleeding. Until more is known, use dong quai with caution in patients taking antiplatelet/anticoagulant drugs.

Likelihood Possible Evidence D
Estrogens

Theoretically, dong quai may reduce the effects of estrogens.
Dong quai has estrogenic effects. Theoretically, concomitant use of large amounts of dong quai might interfere with hormone replacement therapy due to competition for estrogen receptors.

Likelihood Possible Evidence D
Dong Quai full monograph & interactions

Red Raspberry2 drug types · 135 drugs

Anticoagulant/Antiplatelet Drugs

Theoretically, taking red raspberry leaf with anticoagulant/antiplatelet drugs might increase the risk of bleeding.
In vitro research suggests that red raspberry leaf extract has antiplatelet activity and enhances the in vitro effects of the antiplatelet medication cangrelor. This interaction has not been reported in humans.

Likelihood Possible Evidence D
Insulin

Red raspberry leaf might reduce glucose levels in patients being treated with insulin.
In one case report, a 38-year-old patient with gestational diabetes, whose blood glucose was being controlled with medical nutrition therapy and insulin, developed hypoglycemia after consuming two servings of raspberry leaf tea daily for 3 days beginning at 32 weeks' gestation. The patient required an insulin dose reduction. The hypoglycemia was considered to be probably related to use of red raspberry leaf tea.

Likelihood Possible Evidence D
Red Raspberry full monograph & interactions

Queen of the Meadow3 drug types · 39 drugs

Aspirin

Theoretically, meadowsweet might have an additive effect with other salicylate-containing drugs, such as aspirin.
Meadowsweet contains salicin, a plant salicylate; however, salicin doesn't seem to have the antiplatelet effects of aspirin.

Likelihood Possible Evidence D
Choline Magnesium Trisalicylate (Trilisate)

Theoretically, meadowsweet might have an additive effect with other salicylate-containing drugs, such as choline magnesium trisalicylate.
Meadowsweet contains salicin, a plant salicylate.

Likelihood Possible Evidence D
Salsalate (Disalcid)

Theoretically, meadowsweet might have an additive effect with other salicylate-containing drugs such as salsalate.
Meadowsweet contains salicin, a plant salicylate.

Likelihood Possible Evidence D
Queen of the Meadow full monograph & interactions

Blessed Thistle3 drug types · 36 drugs

Antacids

Theoretically, blessed thistle might decrease the effectiveness of antacids.
There are reports that blessed thistle increases stomach acid.

Likelihood Possible Evidence D
H2-Blockers

Theoretically, blessed thistle might decrease the effectiveness of H2-blockers.
There are reports that blessed thistle increases stomach acid.

Likelihood Possible Evidence D
Proton Pump Inhibitors (Ppis)

Theoretically, blessed thistle might decrease the effectiveness of PPIs.
There are reports that blessed thistle increases stomach acid.

Likelihood Possible Evidence D
Blessed Thistle full monograph & interactions

Lobelia1 drug type · 1 drug

Lithium

Lobelia is thought to have diuretic properties. Theoretically, due to these potential diuretic effects, lobelia might reduce excretion and increase levels of lithium. The dose of lithium might need to be decreased.

Likelihood Probable Evidence D
Lobelia full monograph & interactions
The maker

Brand information

Manufacturer and brand details for FCS II, from the product label.

Nature's Sunshine

See all Nature's Sunshine products
Name
Nature's Sunshine Products, Inc.
City
Spanish Fork
State
UT
ZipCode
84660
Phone Number
1-800-223-8225
Web Address
www.naturessunshine.com
Pharmacist Counseling Corner

FCS II by Nature's Sunshine: Common Questions

Does FCS II by Nature's Sunshine interact with any medications?
Yes. Based on its ingredients, FCS II has a known interaction with 2,206 medications, including 2 rated major. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
FCS II contains 10 active ingredients, and an interaction can come from any of them. We check every ingredient, combine the results into one list per medication, and show which ingredient and mechanism is responsible.
Where does this information come from?
The product label data comes from the NIH Dietary Supplement Label Database (DSLD); the interaction data is built on the Natural Medicines database and reviewed by HelloPharmacist pharmacists.
Is FCS II safe to take during pregnancy?
No. Lobelia is likely unsafe in pregnancy due to toxicity. Goldenseal, dong quai, blessed thistle, and black cohosh all lack enough safety data and carry concerns about effects on the uterus, so they're best avoided. Red raspberry leaf is sometimes used late in pregnancy, but only under provider guidance. Talk with your doctor or pharmacist before considering any use.
What does lobelia do in this product, and why does it carry a strong caution?
Lobelia is a traditional herb, but it's toxic and can cause serious effects at higher doses. Even doses as low as 50 mg can trigger nausea, vomiting, diarrhea, and throat irritation. At 600 mg or above, it can cause rapid heart rate, low blood pressure, and life-threatening symptoms. That's why we caution strongly against this ingredient.
Can I take FCS II with my blood thinner?
Not safely without checking first. Dong quai, ginger, capsicum, and other ingredients in this product may increase bleeding risk or change how your blood thinner works—in one case, dong quai significantly raised warfarin levels. Talk with your doctor or pharmacist before combining them.
Does FCS II actually work?
Evidence varies by ingredient. Capsicum is proven effective for certain nerve pain; ginger shows promise for nausea and joint pain. Most of the others—marshmallow, lobelia, blessed thistle, goldenseal, dong quai, and red raspberry—lack enough research to know if they deliver real benefits.
What are the most common side effects?
Nausea, vomiting, diarrhea, and abdominal discomfort are the main ones reported across these herbs. Ginger at higher doses increases the risk of side effects. Capsicum commonly causes burning and irritation in your mouth and stomach.

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.

FCS II label
Go deeper

The Full Monographs Behind FCS II’s Ingredients

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

Herb & supplement monograph

Marshmallow

Interacts with 2,040 drugs

Marshmallow root is a traditional herb rich in soothing, gel-like fibers called mucilage, which is why it has long been used for coughs, sore throats, and stomach irritation. Evidence for th...

Read the full Marshmallow monograph → Herb & supplement monograph

Lobelia

Interacts with 1 drug

Lobelia is a traditional herb once used for breathing problems and to help people quit smoking, but reliable evidence supporting these uses is lacking. It can be toxic in higher amounts, cau...

Read the full Lobelia monograph → Herb & supplement monograph

Capsicum

Interacts with 239 drugs

Capsicum (chili pepper) contains capsaicin, which is best known and best studied as a topical treatment for certain types of pain. Topical capsaicin products are supported by reasonable evid...

Read the full Capsicum monograph → Herb & supplement monograph

Ginger

Interacts with 1,007 drugs

Ginger is a widely used culinary spice with a long history in traditional medicine, and it has the strongest evidence for helping with nausea and vomiting, including from motion sickness, pr...

Read the full Ginger monograph → Herb & supplement monograph

Blessed Thistle

Interacts with 36 drugs

Blessed thistle is a bitter herb traditionally used to stimulate appetite and ease mild digestive complaints. High-quality human studies are lacking, so its benefits are not well proven. It...

Read the full Blessed Thistle monograph → Herb & supplement monograph

Goldenseal

Interacts with 1,237 drugs

Goldenseal is a popular North American herb that contains berberine, a compound studied for antimicrobial effects. However, strong human evidence for its many traditional uses is largely lac...

Read the full Goldenseal monograph → Herb & supplement monograph

Dong Quai

Interacts with 163 drugs

Dong Quai is a traditional Chinese herb often called "female ginseng" and is mostly used for menstrual and menopausal complaints. High-quality scientific evidence that it works for these use...

Read the full Dong Quai monograph → Herb & supplement monograph

Red Raspberry

Interacts with 135 drugs

Red raspberry leaf is a traditional herbal remedy most often used as a tea in late pregnancy and for menstrual discomfort, but solid scientific evidence for these uses is limited. It is gene...

Read the full Red Raspberry monograph → Herb & supplement monograph

Black Cohosh

Interacts with 652 drugs

Black cohosh is a North American plant most often used to ease menopause symptoms like hot flashes, but the research is mixed and far from settled. It is generally well tolerated for short-t...

Read the full Black Cohosh monograph → Herb & supplement monograph

Meadowsweet

Interacts with 39 drugs

Meadowsweet is a traditional European herb that contains natural salicylates (aspirin-like compounds) and is used mainly for digestive upset, colds, and minor aches. High-quality human studi...

Read the full Meadowsweet monograph →
Sources

Sources & How We Checked

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

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

The 298 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.

Marshmallow 5 references
  1. Monographs on the medicinal uses of plant drugs. Exeter, UK: European Scientific Co-op Phytother, 1997.
  2. Leung AY, Foster S. Encyclopedia of Common Natural Ingredients Used in Food, Drugs and Cosmetics. 2nd ed. New York, NY: John Wiley & Sons, 1996.
  3. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
  4. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
  5. Hage-Sleiman R, Mroueh M, Daher CF. Pharmacological evaluation of aqueous extract of Althaea officinalis flower grown in Lebanon. Pharm Biol 2011;49(3):327-33.

See these in context on the Marshmallow monograph →

Lobelia 6 references
  1. Newall CA, Anderson LA, Philpson JD. Herbal Medicine: A Guide for Healthcare Professionals. London, UK: The Pharmaceutical Press, 1996.
  2. Leung AY, Foster S. Encyclopedia of Common Natural Ingredients Used in Food, Drugs and Cosmetics. 2nd ed. New York, NY: John Wiley & Sons, 1996.
  3. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
  4. McChargue DE, Collins FL Jr, Cohen LM. Effect of non-nicotinic moist snuff replacement and lobeline on withdrawal symptoms during 48-h smokeless tobacco deprivation. Nicotine Tob Res 2002;4:195-200. PubMed
  5. Stead LF, Hughes JR. Lobeline for smoking cessation. Cochrane Database Syst Rev 2000;2:CD000124. PubMed
  6. Plakun, A. L., Ambrus, J., Bross, I., Graham, S., Levin, M. L., and Ross, C. A. Clinical factors in smoking withdrawal: preliminary report. Am J Public Health Nations.Health 1966;56(3):434-441. PubMed

See these in context on the Lobelia monograph →

Capsicum 89 references
  1. Covington TR, et al. Handbook of Nonprescription Drugs. 11th ed. Washington, DC: American Pharmaceutical Association, 1996.
  2. Cooper RL, Cooper MM. Red pepper-induced dermatitis in breast-fed infants. Dermatol 1996;93:61-2. PubMed
  3. Millqvist E. Cough provocation with capsaicin is an objective way to test sensory hyperreactivity in patients with asthma-like symptoms. Allergy 2000;55:546-50. DOI
  4. Locock RA. Capsicum. Can Pharm J 1985;118:517-9.
  5. Mason L, Moore RA, Derry S, et al. Systematic review of topical capsaicin for the treatment of chronic pain. BMJ 2004;328:991. PubMed
  6. Schmulson MJ, Valdovinos MA, Milke P. Chili pepper and rectal hyperalgesia in irritable bowel syndrome. Am J Gastroenterol 2003;98:1214-5. PubMed
  7. Surh YJ, Lee SS. Capsaicin in hot chili pepper: carcinogen, co-carcinogen or anticarcinogen? Food Chem Toxicol 1996;34:313-6. PubMed
  8. Bouraoui A, Brazier JL, Zouaghi H, Rousseau M. Theophylline pharmacokinetics and metabolism in rabbits following single and repeated administration of Capsicum fruit. Eur J Drug Metab Pharmacokinet 1995;20:173-8.
  9. Hogaboam CM, Wallace JL. Inhibition of platelet aggregation by capsaicin. An effect unrelated to actions on sensory afferent neurons. Eur J Pharmacol 1991;202:129-31. PubMed
  10. Wang JP, Hsu MF, Teng CM. Antiplatelet effect of capsaicin. Thromb Res 1984;36:497-507. PubMed
  11. Williams SR, Clark RF, Dunford JV. Contact dermatitis associated with capsaicin: Hunan hand syndrome. Ann Emerg Med 1995;25:713-5. PubMed
  12. Zollman TM, Bragg RM, Harrison DA. Clinical effects of oleoresin capsicum (pepper spray) on the human cornea and conjunctiva. Ophthalmology 2000;107:2186-9. PubMed
  13. Bortolotti M, Coccia G, Grossi G, Miglioli M. The treatment of functional dyspepsia with red pepper. Aliment Pharmacol Ther 2002;16:1075-82. PubMed
  14. Hakas JF Jr. Topical capsaicin induces cough in patient receiving ACE inhibitor. Ann Allergy 1990;65:322-3.
  15. Rapoport AM, Bigal ME, Tepper SJ, Sheftell FD. Intranasal medications for the treatment of migraine and cluster headache. CNS Drugs 2004;18:671-85. PubMed
  16. Stjarne P, Rinder J, Heden-Blomquist E, et al. Capsaicin desensitization of the nasal mucosa reduces symptoms upon allergen challenge in patients with allergic rhinitis. Acta Otolaryngol 1998;118:235-9. PubMed
  17. Levy RL. Intranasal capsaicin for acute abortive treatment of migraine without aura. Headache 1995;35:277.
  18. Fusco BM, Marabini S, Maggi CA, et al. Preventative effect of repeated nasal applications of capsaicin in cluster headache. Pain 1994;59:321-5. PubMed
  19. Sicuteri F, Fusco BM, Marabini S, et al. Beneficial effect of capsaicin application to the nasal mucosa in cluster headache. Clin J Pain 1989;5:49-53. PubMed
  20. Marabini S, Ciabatti PG, Polli G, et al. Beneficial effects of intranasal applications of capsaicin in patients with vasomotor rhinitis. Eur Arch Otorhinolaryngol 1991;248:191-4. PubMed
  21. Frerick H, Keitel W, Kuhn U, et al. Topical treatment of chronic low back pain with a capsicum plaster. Pain 2003;106:59-64. PubMed
  22. Keitel W, Frerick H, Kuhn U, et al. Capsicum pain plaster in chronic non-specific low back pain. Arzneimittelforschung 2001;51:896-903. PubMed
  23. Shalansky S, Lynd L, Richardson K, et al. Risk of warfarin-related bleeding events and supratherapeutic international normalized ratios associated with complementary and alternative medicine: a longitudinal analysis. Pharmacotherapy. 2007;27:1237-47. PubMed
  24. Sumano-López H, Gutiérrez-Olvera L, Aguilera-Jiménez R, et al. Administration of ciprofloxacin and capsaicin in rats to achieve higher maximal serum concentrations. Arzneimittelforschung. 2007;57(5):286-90. PubMed
  25. Wanwimolruk S, Nyika S, Kepple M, et al. Effects of capsaicin on the pharmacokinetics of antipyrine, theophylline and quinine in rats. J Pharm Pharmacol. 1993;45(7):618-21. PubMed
  26. Cruz L, Castañeda-Hernández G, Navarrete A. Ingestion of chilli pepper (Capsicum annuum) reduces salicylate bioavailability after oral asprin administration in the rat. Can J Physiol Pharmacol.
  27. Rodriguez-Stanley, S., Collings, K. L., Robinson, M., Owen, W., and Miner, P. B., Jr. The effects of capsaicin on reflux, gastric emptying and dyspepsia. Aliment.Pharmacol.Ther. 2000;14(1):129-134. PubMed
  28. Brown, L., Takeuchi, D., and Challoner, K. Corneal abrasions associated with pepper spray exposure. Am.J.Emerg.Med. 2000;18(3):271-272. PubMed
  29. Vesaluoma, M., Muller, L., Gallar, J., Lambiase, A., Moilanen, J., Hack, T., Belmonte, C., and Tervo, T. Effects of oleoresin capsicum pepper spray on human corneal morphology and sensitivity. Invest Ophthalmol.Vis.Sci. 2000;41(8):2138-2147.
  30. Stam, C., Bonnet, M. S., and van Haselen, R. A. The efficacy and safety of a homeopathic gel in the treatment of acute low back pain: a multi-centre, randomised, double-blind comparative clinical trial. Br Homeopath J 2001;90(1):21-28. PubMed
  31. Olajos, E. J. and Salem, H. Riot control agents: pharmacology, toxicology, biochemistry and chemistry. J.Appl.Toxicol. 2001;21(5):355-391. PubMed
  32. Fett, D. D. Botanical briefs: Capsicum peppers. Cutis 2003;72(1):21-23.
  33. McCarthy, G. M. and McCarty, D. J. Effect of topical capsaicin in the therapy of painful osteoarthritis of the hands. J.Rheumatol. 1992;19(4):604-607.
  34. Chaiyata, P., Puttadechakum, S., and Komindr, S. Effect of chili pepper (Capsicum frutescens) ingestion on plasma glucose response and metabolic rate in Thai women. J.Med.Assoc.Thai. 2003;86(9):854-860.
  35. Petruzzi, M., Lauritano, D., De Benedittis, M., Baldoni, M., and Serpico, R. Systemic capsaicin for burning mouth syndrome: short-term results of a pilot study. J.Oral Pathol.Med. 2004;33(2):111-114. PubMed
  36. Misra, M. N., Pullani, A. J., and Mohamed, Z. U. Prevention of PONV by acustimulation with capsicum plaster is comparable to ondansetron after middle ear surgery: [La prevention des NVPO par acustimulation avec un emplatre de Capsicum est comparable a ce PubMed
  37. Milke, P., Diaz, A., Valdovinos, M. A., and Moran, S. Gastroesophageal reflux in healthy subjects induced by two different species of chilli (Capsicum annum). Dig.Dis. 2006;24(1-2):184-188.
  38. de Jong, N. W., van der Steen, J. J., Smeekens, C. C., Blacquiere, T., Mulder, P. G., van Wijk, R. G., and de Groot, H. Honeybee interference as a novel aid to reduce pollen exposure and nasal symptoms among greenhouse workers allergic to sweet bell pepp
  39. Final report on the safety assessment of capsicum annuum extract, capsicum annuum fruit extract, capsicum annuum resin, capsicum annuum fruit powder, capsicum frutescens fruit, capsicum frutescens fruit extract, capsicum frutescens resin, and capsaicin.
  40. Tandan, R., Lewis, G. A., Krusinski, P. B., Badger, G. B., and Fries, T. J. Topical capsaicin in painful diabetic neuropathy. Controlled study with long-term follow-up. Diabetes Care 1992;15(1):8-14. PubMed
  41. Gupta, P. J. Red hot chilli consumption is harmful in patients operated for anal fissure - a randomized, double-blind, controlled study. Dig.Surg. 2007;24(5):354-357. PubMed
  42. Patane, S., Marte, F., Di Bella, G., Cerrito, M., and Coglitore, S. Capsaicin, arterial hypertensive crisis and acute myocardial infarction associated with high levels of thyroid stimulating hormone. Int.J Cardiol. 5-1-2009;134(1):130-132. PubMed
  43. Gupta, P. J. Consumption of red-hot chili pepper increases symptoms in patients with acute anal fissures. A prospective, randomized, placebo-controlled, double blind, crossover trial. Arq Gastroenterol. 2008;45(2):124-127. PubMed
  44. Gupta, P. J. Consumption of red-hot chili pepper increases symptoms in patients with acute anal fissures. Ann.Ital.Chir 2008;79(5):347-351.
  45. Patane, S., Marte, F., La Rosa, F. C., and La, Rocca R. Capsaicin and arterial hypertensive crisis. Int J Cardiol. 10-8-2010;144(2):e26-e27. PubMed
  46. Chaiyasit, K., Khovidhunkit, W., and Wittayalertpanya, S. Pharmacokinetic and the effect of capsaicin in Capsicum frutescens on decreasing plasma glucose level. J Med.Assoc.Thai. 2009;92(1):108-113.
  47. Blanc, P., Liu, D., Juarez, C., and Boushey, H. A. Cough in hot pepper workers. Chest 1991;99(1):27-32. PubMed
  48. Akcay, A. B., Ozcan, T., Seyis, S., and Acele, A. Coronary vasospasm and acute myocardial infarction induced by a topical capsaicin patch. Turk.Kardiyol.Dern.Ars 2009;37(7):497-500.
  49. van Boxel, O. S., ter Linde, J. J., Siersema, P. D., and Smout, A. J. Role of chemical stimulation of the duodenum in dyspeptic symptom generation. Am J Gastroenterol. 2010;105(4):803-811. PubMed
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  52. McCormack, P. L. Capsaicin dermal patch: in non-diabetic peripheral neuropathic pain. Drugs 10-1-2010;70(14):1831-1842. PubMed
  53. Bortolotti, M. and Porta, S. Effect of red pepper on symptoms of irritable bowel syndrome: preliminary study. Dig.Dis.Sci 2011;56(11):3288-3295. PubMed
  54. Webster, L. R., Peppin, J. F., Murphy, F. T., Lu, B., Tobias, J. K., and Vanhove, G. F. Efficacy, safety, and tolerability of NGX-4010, capsaicin 8% patch, in an open-label study of patients with peripheral neuropathic pain. Diabetes Res Clin Pract. 2011 PubMed
  55. Gerber, S., Frueh, B. E., and Tappeiner, C. Conjunctival proliferation after a mild pepper spray injury in a young child. Cornea 2011;30(9):1042-1044. PubMed
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  73. Kim DH, Yoon KB, Park S, et al. Comparison of NSAID patch given as monotherapy and NSAID patch in combination with transcutaneous electric nerve stimulation, a heating pad, or topical capsaicin in the treatment of patients with myofascial pain syndrome o
  74. Kulkantrakorn K, Lorsuwansiri C, Meesawatsom P. 0.025% capsaicin gel for the treatment of painful diabetic neuropathy: a randomized, double-blind, crossover, placebo-controlled trial. Pain Pract. 2013;13(6):497-503. PubMed
  75. Pabalan N, Jarjanazi H, Ozcelik H. The impact of capsaicin intake on risk of developing gastric cancers: a meta-analysis. J Gastrointest Cancer. 2014;45(3):334-41. PubMed
  76. Sandor B, Papp J, Mozsik G, et al. Orally given gastroprotective capsaicin does not modify aspirin-induced platelet aggregation in healthy male volunteers (human phase I examination). Acta Physiol Hung. 2014 Dec;101(4):429-37. PubMed
  77. Van Nooten F, Treur M, Pantiri K, Stoker M, Charokopou M. Capsaicin 8% patch versus oral neuropathic pain medications for the treatment of painful diabetic peripheral neuropathy: a systematic literature review and network meta-analysis. Clin Ther. 2017 Ap PubMed
  78. Simpson DM, Robinson-Papp J, Van J, et al. Capsaicin 8% patch in painful diabetic peripheral neuropathy: a randomized, double-blind, placebo-controlled study. J Pain. 2017 Jan;18(1):42-53. PubMed
  79. Campbell CM, Diamond E, Schmidt WK, et al. A randomized, double-blind, placebo-controlled trial of injected capsaicin for pain in Morton's neuroma. Pain. 2016 Jun;157(6):1297-304. PubMed
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Ginger 64 references
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Red Raspberry 8 references
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Black Cohosh 68 references
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Meadowsweet 3 references
  1. Newall CA, Anderson LA, Philpson JD. Herbal Medicine: A Guide for Healthcare Professionals. London, UK: The Pharmaceutical Press, 1996.
  2. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
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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.

© 2021 Therapeutic Research Center, LLC

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