Interactions on record — worth a quick check against your medications. Based on 6 of 10 ingredients. Check your meds →
Dietary supplement

Female Flo Ingredients & Drug Interactions

by Professional Botanicals

Female Flo label
See full label image
Capsule Category: Other Combinations
Most serious interaction: Moderate
Clinical methodology reviewed by · Updated Sep 16, 2026 · Label data from the NIH DSLD
What is this page for?

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

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

The interaction bottom line Most serious interaction: Moderate

Female Flo is a dietary supplement by Professional Botanicals with 10 active ingredients. Its ingredients are commonly taken for skin irritation and inflammation, hemorrhoids, minor cuts and bruises.Based on those ingredients, 1,510 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Comfrey, Shepherd's Purse, Yarrow. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

Jump to a section

Check Your Meds Against Female Flo by Professional Botanicals

Ask about any prescription or over-the-counter medication and we check it for interactions with Female Flo by Professional Botanicals — and tell you which ingredient is responsible.

Pharmacist-reviewed data Checks every ingredient Answer in seconds
Prefer a human? Send your question to our licensed pharmacists — free, answered by email within 24 hours.

HelloPharmacist Scorecard of Female Flo by Professional Botanicals

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 11, 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 18 active ingredients.
  • “Proprietary Blend” is a proprietary blend — the label gives one combined amount (868 mg) without saying how much of each component you get.
  • “AdPT” is listed as a grouped ingredient — the label doesn't break down how much of each component you get.
  • “EDS” is listed as a grouped ingredient — the label doesn't break down how much of each component you get.

Female Flo contains 18 ingredients total, including several active botanical and enzyme components. The main botanical actives include ashwagandha, eleuthero, rhodiola, cordyceps, reishi mushroom, gynostemma (jiaogulan), witch hazel, and others such as yarrow, black haw, shepherd's purse, and comfrey.

The product also includes digestive enzymes—protease, lipase, and amylase—which help break down food. Three ingredients in this product (amylase, cellulase, and raspberry) cannot be fully evaluated from our data.

The product is formulated in a vegetable capsule and contains proprietary blends (labeled AdPT and EDS) whose exact proportions are not disclosed on the label.

Does it work?

Not established
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
Not established

The graded evidence we hold for these ingredients covers different conditions than the ones this product is marketed for, so there's no established rating for its stated use.

Why this rating?
  • The label markets this product for: support healthy menstruation.
  • We looked for evidence on: Dysmenorrhea, Fatigue, menstrual bleeding, menstrual discomfort, period support.
  • The closest evidence on file: Yarrow is rated "Insufficient Reliable Evidence To Rate" for Dysmenorrhea (Natural Medicines).
  • Also on file: Cordyceps is rated "Insufficient Reliable Evidence To Rate" for Fatigue.
  • Also on file: Rhodiola is rated "Insufficient Reliable Evidence To Rate" for Chronic fatigue syndrome (CFS), Fatigue.

Ashwagandha is possibly effective for insomnia, anxiety, stress, and generalized anxiety disorder. Eleuthero and cordyceps each show insufficient evidence for the conditions listed in our data.

Rhodiola, reishi mushroom, and witch hazel also lack established effectiveness ratings in our records for their intended uses. Gynostemma (jiaogulan) is possibly effective for diabetes.

Protease, lipase, and the other botanical ingredients either lack effectiveness ratings in our data or show insufficient evidence. No strong evidence supports this product's effectiveness for any single condition.

The evidence, ingredient by ingredient Witch Hazel Bayberry Yarrow Black Haw Shepherd's Purse Comfrey

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 13 of the 14 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 14 of 14.
  • General safety write-ups exist for 14 of 14.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

Ashwagandha is generally well tolerated short-term in healthy adults, but long-term safety data are limited. It should be avoided during pregnancy (risk of miscarriage) and while breastfeeding.

Eleuthero, rhodiola, cordyceps, and reishi are generally well tolerated short-term but should be avoided in pregnancy and breastfeeding due to insufficient safety data. Gynostemma (jiaogulan) is possibly unsafe in pregnancy and should be avoided.

Yarrow is likely unsafe in pregnancy and should not be used. Shepherd's purse may stimulate the uterus and is likely unsafe in pregnancy.

Comfrey is likely unsafe in all forms during pregnancy and breastfeeding due to liver toxicity risk. Common side effects from ashwagandha can include diarrhea, nausea, and gastrointestinal upset at high doses, though these are uncommon at typical doses.

Eleuthero may cause nervousness, slight anxiety, and headache. Rhodiola can cause dizziness and dry mouth.

Cordyceps, reishi, and gynostemma may cause diarrhea, nausea, and gastrointestinal upset. Rare but serious adverse effects include liver damage (ashwagandha, comfrey), kidney damage (witch hazel at high doses), and respiratory issues (comfrey).

Side effects, ingredient by ingredient Witch Hazel Bayberry Yarrow Black Haw Shepherd's Purse Comfrey

Meds to double-check

Moderate interaction found
Known Interaction Concern · database check
Moderate identified

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

Why this rating?
  • 9 of the 14 matched ingredients can interact with medications — Shepherd's Purse, Yarrow, Jiaogulan, Comfrey, Cordyceps, among others.
  • The most serious interaction on file is rated Moderate.
  • Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs; immunosuppressants / transplant drugs; diabetes medications; heart-rhythm medications; lithium.
  • For scale: 1,511 individual medications appear in the full list. A big number alone doesn't make a product dangerous — what matters is whether YOUR medication is on it, so run yours through the interaction checker on this page.

Before taking Female Flo, check your medications against these categories. Ashwagandha and eleuthero both interact with CNS depressants (sedatives, barbiturates, anxiolytics); ashwagandha also affects benzodiazepines.

Blood pressure medications (antihypertensives) interact with ashwagandha, eleuthero, rhodiola, and reishi. Blood thinners (anticoagulants and antiplatelets) interact with eleuthero, cordyceps, reishi, and gynostemma.

Antidiabetes drugs interact with ashwagandha, eleuthero, rhodiola, reishi, and gynostemma. Immunosuppressants interact with ashwagandha, eleuthero, rhodiola, cordyceps, and gyrostemma.

Thyroid hormones interact with ashwagandha, and shepherd's purse affects thyroid hormone therapy. Hepatotoxic drugs interact with ashwagandha and comfrey.

Digoxin interacts with eleuthero. Lithium interacts with yarrow.

Several ingredients also affect liver-metabolized drugs through CYP450 enzymes and P-glycoprotein transporters—your pharmacist can help you identify these.

Check your own medication Run your meds through the checker above

The bottom line

Scorecard at a glanceFormula with limited ingredient disclosure with no established evidence rating for its marketed use. Moderate medication interactions have been identified, and safety information is well characterized.

Female Flo is designed for women's health with multiple botanical actives and digestive enzymes, but the evidence base for its effectiveness is mixed and often insufficient. If you take any blood pressure medications, blood thinners, diabetes drugs, thyroid hormones, sedatives, benzodiazepines, immunosuppressants, or lithium, you need to check your specific medications with the tool below before taking this product.

Avoid use during pregnancy or breastfeeding unless your doctor advises otherwise.

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

Assessment coverage: 14 of 18 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Feb 25, 2019.

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 Female Flo, straight from the product label.

Brand Professional Botanicals
Barcode (UPC) 898175001393
Net contents 60 Capsule(s)
Market status On market
Date entered into DSLD Feb 25, 2019
DSLD ID 193268
Product type Other Combinations
Supplement form Capsule
Dietary claims / uses All Other, Structure/Function
Intended target group(s) Adult Female (18 - 50 Years), Gluten Free
From the label
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.

Supplement Facts

The label details for Female Flo by Professional Botanicals, sourced from the NIH Dietary Supplement Label Database.

Supplement Facts

Daily Value (DV) Target Group(s):
Adults and children 4 or more years of age
Minimum serving Sizes:
1 Capsule(s)
Maximum serving Sizes:
2 Capsule(s)
Servings per container
30
UPC/BARCODE
898175001393
IngredientAmount% DV
Proprietary Blend868 mg--
Ashwagandha0 NP--
Amylase0 NP--
Protease0 NP--
Lipase0 NP--
Cellulase0 NP--
Witch Hazel0 NP--
Eleuthero0 NP--
Rhodiola0 NP--
AdPT0 NP--
Cordyceps0 NP--
Reishi0 NP--
Gynostemma0 NP--
EDS0 NP--
Raspberry0 NP--
Bayberry0 NP--
Yarrow0 NP--
Black Haw0 NP--
Cranesbill0 NP--
Shepherd's Purse0 NP--
Comfrey0 NP--

Other ingredients: Vegetable Capsule

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.
Formula

Design to support a healthy menstruation.

Suggested/Recommended/Usage/Directions

Dosage: One to two capsules three times a day, or as directed.

Brand IP Statement(s)

EDS: Added enzymes for better absorption & breakdown. AdPT: Adaptogenic herbs for energy production & adaption.

Seals/Symbols

Gluten free Non GMO

Made in USA

Formulation

Gluten free Non GMO No fillers 3x tested

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

Please recycle

Premium quality

Est. 1980

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

See for yourself

Female Flo by Professional Botanicals label

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

Female Flo 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 Female Flo by Professional Botanicals

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

Serving size1 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.

Proprietary Blend

868 mg per serving

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

Interaction report

Female Flo by Professional Botanicals Drug Interactions

Want to check YOUR meds against Female Flo?

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
1,510Drugs
1,200 Moderate 310 Minor

Ingredients driving the most interactions

Comfrey 438
Shepherd's Purse 264
Yarrow 1

Individual Drug Interactions

The ingredients in Female Flo interact with 1,510 drugs. Click any drug to see the details.

3 of the 10 ingredients in Female Flo interact with drugs. Each result below shows which ingredient is responsible. Comfrey Shepherd's Purse Yarrow

Each ingredient & the kinds of drugs it affects

For each ingredient in Female Flo 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.

Comfrey2 drug types · 438 drugs

Cytochrome P450 3A4 (Cyp3A4) Inducers

Theoretically, CYP3A4 inducers might increase the risk of adverse effects from the pyrrolizidine alkaloid constituents in comfrey.
CYP3A4 enzymes convert pyrrolizidine alkaloids, constituents of comfrey, to toxic metabolites. Some case reports show that enzyme inducers, such as phenobarbital, seem to enhance the toxicity of comfrey.

Likelihood Possible Evidence D
Hepatotoxic Drugs

Theoretically, comfrey might have additive adverse effects on the liver when used with hepatotoxic drugs.
Due to its pyrrolizidine alkaloid constituents, comfrey can cause hepatotoxic effects, including ascites, cirrhosis, hepatic fibrosis, hepatomegaly, and sinusoidal obstruction syndrome.

Likelihood Possible Evidence D
Comfrey full monograph & interactions

Shepherd's Purse2 drug types · 264 drugs

Cns Depressants

Theoretically, concomitant use with drugs with sedative properties may cause additive effects and side effects.

Likelihood Possible Evidence D
Thyroid Hormone

Theoretically, concomitant use may interfere with thyroid dysfunction therapy.

Likelihood Possible Evidence D
Shepherd's Purse full monograph & interactions

Yarrow1 drug type · 1 drug

Lithium

Theoretically, taking yarrow with lithium might increase the levels and adverse effects of lithium.
Animal research shows that yarrow has diuretic activity. Theoretically, due to these potential diuretic effects, yarrow might reduce excretion and increase levels of lithium. The dose of lithium might need to be decreased.

Likelihood Probable Evidence D
Yarrow full monograph & interactions
The maker

Brand information

Manufacturer and brand details for Female Flo, from the product label.

Professional Botanicals

See all Professional Botanicals products
Name
Professional Botanicals
City
Ogden
State
UT
ZipCode
84404
Phone Number
877-745-0850
Web Address
ProfessionalBotanicals.com
Pharmacist Counseling Corner

Female Flo by Professional Botanicals: Common Questions

Does Female Flo by Professional Botanicals interact with any medications?
Yes. Based on its ingredients, Female Flo has a known interaction with 1,510 medications. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Female Flo 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.
Can I take Female Flo if I'm pregnant or breastfeeding?
No, you should avoid this product during pregnancy. Ashwagandha is traditionally thought to risk miscarriage, yarrow is likely unsafe, gynostemma and shepherd's purse are possibly or likely unsafe, and comfrey is likely unsafe. While breastfeeding, there isn't enough safety data on most ingredients, so it's best avoided. Talk with your doctor or pharmacist before using it.
What are the digestive enzymes in this product for?
The product contains protease, lipase, and amylase—enzymes that help break down proteins, fats, and carbohydrates in food to aid digestion. The effectiveness of supplemental enzymes for digestive health has insufficient evidence in our data.
Is ashwagandha in this product safe if I take anxiety or sleep medication?
Ashwagandha may increase the sedative effects of anxiety medications like benzodiazepines (Valium, Klonopin) and other CNS depressants, which could cause too much drowsiness or dizziness. You need to check with your pharmacist before combining them, as your medication dose may need adjustment.
What's the difference between the herbs in this product—ashwagandha, eleuthero, and rhodiola?
All three are plant-based adaptogens traditionally used for stress and energy, but they work differently. Ashwagandha is possibly effective for anxiety and insomnia. Eleuthero and rhodiola lack established effectiveness ratings in our data, though eleuthero has been studied for herpes and rhodiola for altitude sickness. All three can interact with multiple medications.
Are there any side effects I should watch for?
Most common side effects are gastrointestinal—diarrhea, nausea, or stomach upset, especially at higher doses. Ashwagandha and eleuthero may cause drowsiness or nervousness. Rare but serious risks include liver damage (ashwagandha, comfrey) and high blood pressure (eleuthero in some people). Stop and contact your doctor if you develop jaundice, severe abdominal pain, or unusual bruising.
Why does this product have so many ingredients?
Female Flo combines multiple botanical actives and digestive enzymes in proprietary blends. The exact amounts of each ingredient are not disclosed on the label, so you can't tell which one is responsible if a side effect occurs. If you're sensitive to any single herb, you won't know which to avoid in the future.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Not sure if Female Flo is safe with your meds?

Our pharmacists answer your medication & supplement questions — free.

Ask a pharmacist

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.

Female Flo label
Go deeper

The Full Monographs Behind Female Flo’s Ingredients

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

Herb & supplement monograph

Witch Hazel

Witch hazel is a plant-based astringent used mostly on the skin for minor irritation, hemorrhoids, and oily skin. It is generally well tolerated as a topical product for short-term use, but...

Read the full Witch Hazel monograph → Herb & supplement monograph

Bayberry

Bayberry is a traditional herb used mainly as an astringent for diarrhea, sore throats, and minor skin or gum problems, but there is very little modern human research to confirm it works. It...

Read the full Bayberry monograph → Herb & supplement monograph

Yarrow

Interacts with 1 drug

Yarrow is a traditional herb long used for wounds, digestive complaints, and colds, but high-quality human studies are very limited, so its benefits are not well proven. It is generally used...

Read the full Yarrow monograph → Herb & supplement monograph

Black Haw

Black Haw is a traditional herbal bark long used to ease menstrual cramps and uterine spasms, but modern human studies are very limited. It contains compounds that may relax smooth muscle, b...

Read the full Black Haw monograph → Herb & supplement monograph

Shepherd's Purse

Interacts with 264 drugs

Shepherd's purse is a traditional herb most often used to help slow heavy menstrual bleeding and other minor bleeding, but solid human research is very limited. Because it may affect blood c...

Read the full Shepherd's Purse monograph → Herb & supplement monograph

Comfrey

Interacts with 438 drugs

Comfrey is a traditional herb used mainly on the skin for bruises, sprains, and joint pain, and some topical products show modest benefit for these uses. However, comfrey contains compounds...

Read the full Comfrey monograph →
Sources

Sources & How We Checked

Female Flo'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 148 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.

Ashwagandha 32 references
  1. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
  2. Upton R, ed. Ashwagandha Root (Withania somnifera): Analytical, quality control, and therapuetic monograph. Santa Cruz, CA: American Herbal Pharmacopoeia 2000:1-25.
  3. Davis L, Kuttan G. Effect of Withania somnifera on cyclophosphamide-induced urotoxicity. Cancer Lett 2000;148:9-17. PubMed
  4. Davis L, Kuttan G. Suppressive effect of cyclophosphamide-induced toxicity by Withania somnifera extract in mice. J Ethnopharmacol 1998;62:209-14. PubMed
  5. Mishra LC, Singh BB, Dagenais S. Scientific basis for the therapeutic use of Withania somnifera (ashwagandha): a review. Altern Med Rev 2000;5:334-46. DOI
  6. Andallu B, Radhika B. Hypoglycemic, diuretic and hypocholesterolemic effect of winter cherry (Withania somnifera, Dunal) root. Indian J Exp Biol 2000;38:607-9.
  7. Kulkarni RR, Patki PS, Jog VP, et al. Treatment of osteoarthritis with a herbomineral formulation: a double-blind, placebo-controlled, cross-over study. J Ethnopharmacol 1991;33:91-5. PubMed
  8. Ahumada F, Aspee F, Wikman G, Hancke J. Withania somnifera exract. Its effects on arterial blood pressure in anaesthetized dogs. Phytother Res 1991;5:111-14.
  9. Panda S, Kar A. Withania somnifera and Bauhinia purpurea in the regulation of circulating thyroid hormone concentrations in female mice. J Ethnopharmacol 1999;67:233-39. PubMed
  10. Panda S, Kar A. Changes in thyroid hormone concentrations after administration of ashwagandha root extract to adult male mice. J Pharm Pharmacol 1998;50:1065-68. PubMed
  11. Sehgal, V. N., Verma, P., and Bhattacharya, S. N. Fixed-drug eruption caused by ashwagandha (Withania somnifera): a widely used Ayurvedic drug. Skinmed. 2012;10(1):48-49.
  12. Agnihotri AP, Sontakke SD, Thawani VR, Saoji A, Goswami VS. Effects of Withania somnifera in patients of schizophrenia: a randomized, double blind, placebo controlled pilot trial study. Indian J Pharmacol. 2013;45(4):417-8. PubMed
  13. Biswal BM, Sulaiman SA, Ismail HC, Zakaria H, Musa KI. Effect of Withania somnifera (Ashwagandha) on the development of chemotherapy-induced fatigue and quality of life in breast cancer patients. Integr Cancer Ther. 2013;12(4):312-22.
  14. Sharma AK, Basu I, Singh S. Efficacy and safety of Ashwagandha root extract in subclinical hypothyroid patients: a double-blind, randomized placebo-controlled trial. J Altern Complement Med. 2018 Mar;24(3):243-248. PubMed
  15. Durg S, Bavage S, Shivaram SB. Withania somnifera (Indian ginseng) in diabetes mellitus: A systematic review and meta-analysis of scientific evidence from experimental research to clinical application. Phytother Res. 2020;34(5):1041-1059.
  16. Björnsson HK, Björnsson ES, Avula B, et al. Ashwagandha-induced liver injury: A case series from Iceland and the US Drug-Induced Liver Injury Network. Liver Int. 2020;40(4):825-829. PubMed
  17. Tharakan A, Shukla H, Benny IR, Tharakan M, George L, Koshy S. Immunomodulatory Effect of Withania somnifera (Ashwagandha) Extract-A Randomized, Double-Blind, Placebo Controlled Trial with an Open Label Extension on Healthy Participants. J Clin Med 2021;1 PubMed
  18. Ireland PJ, Hardy T, Burt AD, Donnelly MC. Drug-induced hepatocellular injury due to herbal supplement ashwagandha. J R Coll Physicians Edinb. 2021;51(4):363-365. PubMed
  19. Kamal HI, Patel K, Brdak A, Heffernan J, Ahmad N. Ashwagandha as a unique cause of thyrotoxicosis presenting with supraventricular tachycardia. Cureus. 2022 Mar 25;14(3):e23494. PubMed
  20. Suryawanshi G, Abdallah M, Thomson M, Desai N, Chauhan A, Lim N. Ashwagandha-Associated Acute Liver Failure Requiring Liver Transplantation. Am J Ther 2023;30(1):e80-e83. PubMed
  21. Pusec CM, Wolsky R, Llerena C, Sura P. A Case of Supplement-Induced Hepatitis. Cureus 2022;14(10):e30433. PubMed
  22. Ajgaonkar A, Jain M, Debnath K. Efficacy and Safety of Ashwagandha (Withania somnifera) Root Extract for Improvement of Sexual Health in Healthy Women: A Prospective, Randomized, Placebo-Controlled Study. Cureus 2022;14(10):e30787. PubMed
  23. Haron MH, Dale O, Martin K, et al. Evaluation of the Herb-Drug Interaction Potential of Commonly Used Botanicals on the US Market with Regard to PXR- and AhR-Mediated Influences on CYP3A4 and CYP1A2. J Diet Suppl 2022. PubMed
  24. Lubarska M, Halasinski P, Hryhorowicz S, et al. Liver Dangers of Herbal Products: A Case Report of Ashwagandha-Induced Liver Injury. Int J Environ Res Public Health 2023;20(5):3921. PubMed
  25. Tóth M, Benedek AE, Longerich T, Seitz HK. Ashwagandha-induced acute liver injury: A case report. Clin Case Rep 2023;11(3):e7078.
  26. Bokan G, Glamocanin T, Mavija Z, et al. Herb-Induced Liver Injury by Ayurvedic Ashwagandha as Assessed for Causality by the Updated RUCAM: An Emerging Cause. Pharmaceuticals (Basel) 2023;16(8):1129. PubMed
  27. Patel PA, Sanborn E, Then R, Williams DM. Recurrent Reversible Cerebral Vasoconstriction Syndrome: A Report of Two Cases. Cureus 2023;15(8):e42992. PubMed
  28. Majeed M, Nagabhushanam K, Murali A, Vishwanathan DT, Mamidala RV, Mundkur L. A Standardized Withania somniferra (Linn.) Root Extract with Piperine Alleviates the Symptoms of Anxiety and Depression by Increasing Serotonin Levels: A Double-Blind, Randomize
  29. Philips CA, Valsan A, Theruvath AH, et al. Ashwagandha-induced liver injury-A case series from India and literature review. Hepatol Commun 2023;7(10):e0270. PubMed
  30. Hayashi M, Hamada H, Azuma SI, Hayashi K. Painless Thyroiditis by Withania somnifera (Ashwagandha). Cureus 2024;16(3):e55352. PubMed
  31. Vazirani S, Kothari A, Fujimoto J, Gomez M. Supplements Are Not a Synonym for Safe: Suspected Liver Injury From Ashwagandha. Fed Pract 2023;40(9):315-319. PubMed
  32. Patel M, Newell R, Hillier M, Ramalingam R. Herbal remedies as a potential cause of hypoadrenalism. Br J Hosp Med (Lond) 2024;85(6):1-4. PubMed

See these in context on the Ashwagandha monograph →

Proteolytic Enzymes (proteases) 3 references
  1. Weeks JA, Harper RA, Simon RA, Burdick JD. Assessment of sensitization risk of a laundry pre-spotter containing protease. Cutan Ocul Toxicol. 2011;30(4):272-9. PubMed
  2. Marquès LI, Lara S, Abós T, Bartolomé B. Occupational rhinitis due to pepsin. J Investig Allergol Clin Immunol. 2006;16(2):136-7. DOI
  3. Cartier A, Malo JL, Pineau L, Dolovich J. Occupational asthma due to pepsin. J Allergy Clin Immunol. 1984;73(5 Pt 1):574-7. PubMed

See these in context on the Proteolytic Enzymes (proteases) monograph →

Lipase 1 reference
  1. Casper C, Hascoet JM, Ertl T, et al. Recombinant bile salt-stimulated lipase in preterm infant feeding: A randomized phase 3 study. PLoS One. 2016;11(5):e0156071. PubMed

See these in context on the Lipase monograph →

Witch Hazel 7 references
  1. The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999.
  2. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
  3. Robbers JE, Tyler VE. Tyler's Herbs of Choice: The Therapeutic Use of Phytomedicinals. New York, NY: The Haworth Herbal Press, 1999.
  4. Hormann HP, Korting HC. Evidence for the efficacy and safety of topical herbal drugs in dermatology: part I: anti-inflammatory agents. Phytomedicine 1994;1:161-71. PubMed
  5. Wolff, H. H. and Kieser, M. Hamamelis in children with skin disorders and skin injuries: results of an observational study. Eur.J.Pediatr. 2007;166(9):943-948. PubMed
  6. Khanna, N. and Datta, Gupta S. Rejuvenating facial massage--a bane or boon? Int J Dermatol. 2002;41(7):407-410. PubMed
  7. Theisen LL, Erdelmeier CA, Spoden GA, Boukhallouk F, Sausy A, Florin L, Muller CP. Tannins from Hamamelis virginiana bark extract: characterization and improvement of the antiviral efficacy against influenza A virus and human papillomavirus. PLoS One. 201 PubMed

See these in context on the Witch Hazel monograph →

Eleuthero 24 references
  1. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
  2. McRae S. Elevated serum digoxin levels in a patient taking digoxin and Siberian ginseng. CMAJ 1996;155:293-5.
  3. Awang DVC. Siberian ginseng toxicity may be case of mistaken identity (letter). CMAJ 1996;155:1237.
  4. Mills S, Bone K. Principles and Practice of Phytotherapy. London: Churchill Livingstone, 2000.
  5. Harkey MR, Henderson GL, Zhou L, et al. Effects of Siberian ginseng (Eleutherococcus senticosus) on c-DNA-expressed P450 drug metabolizing enzymes. Alt Ther 2001;7:S14.
  6. Hikino H, Takahashi M, Otake K, Konno C. Isolation and hypoglycemic activity of eleutherans A, B, C, D, E, F, and G: glycans of Eleutherococcus senticosus roots. J Nat Prod 1986;49:293-7. PubMed
  7. Yun-Choi HS, Kim JH, Lee JR. Potential inhibitors of platelet aggregation from plant sources, III. J Nat Prod 1987;50:1059-64. PubMed
  8. Donovan JL, DeVane CL, Chavin KD, et al. Siberian Ginseng (Eleutheroccus senticosus) Effects on CYP2D6 and CYP3A4 Activity in Normal Volunteers. Drug Metab Dispos 2003;31:519-22.. PubMed
  9. Hartz AJ, Bentler S, Noyes R et al. Randomized controlled trial of Siberian ginseng for chronic fatigue. Psychol Med 2004;34:51-61. PubMed
  10. Sievenpiper JL, Arnason JT, Leiter LA, Vuksan V. Decreasing, null and increasing effects of eight popular types of ginseng on acute postprandial glycemic indices in healthy humans: the role of ginsenosides. J Am Coll Nutr 2004;23:248-58. PubMed
  11. Dasgupta A, Wu S, Actor J, et al. Effect of Asian and Siberian ginseng on serum digoxin measurement by five digoxin immunoassays. Significant variation in digoxin-like immunoreactivity among commercial ginsengs. Am J Clin Pathol 2003;119:298-303. DOI
  12. Takahashi T, Kaku T, Sato T, et al. Effects of Acanthopanax senticosus HARMS extract on drug transport in human intestinal cell line Caco-2. J Nat Med. 2010;64(1):55-62. PubMed
  13. Fuchikami H, Satoh H, Tsujimoto M, Ohdo S, Ohtani H, Sawada Y. Effects of herbal extracts on the function of human organic anion-transporting polypeptide OATP-B. Drug Metab Dispos 2006;34:577-82. PubMed
  14. Friedman, J. A., Taylor, S. A., McDermott, W., and Alikhani, P. Multifocal and recurrent subarachnoid hemorrhage due to an herbal supplement containing natural coumarins. Neurocrit.Care 2007;7(1):76-80. PubMed
  15. Molokovskii, D. S., Davydov, V. V., and Tiulenev, V. V. [The action of adaptogenic plant preparations in experimental alloxan diabetes]. Probl.Endokrinol.(Mosk) 1989;35(6):82-87.
  16. Schmolz, M. W., Sacher, F., and Aicher, B. The synthesis of Rantes, G-CSF, IL-4, IL-5, IL-6, IL-12 and IL-13 in human whole-blood cultures is modulated by an extract from Eleutherococcus senticosus L. roots. Phytother.Res 2001;15(3):268-270.
  17. Huang, D. B., Ran, R. Z., and Yu, Z. F. [Effect of Acanthopanax senticosus injection on the activities of human tumor necrosis factor and natural killer cell in blood in the patients with lung cancer]. Zhongguo Zhong.Yao Za Zhi. 2005;30(8):621-624.
  18. Niu, H. S., Hsu, F. L., Liu, I. M., and Cheng, J. T. Increase of beta-endorphin secretion by syringin, an active principle of Eleutherococcus senticosus, to produce antihyperglycemic action in type 1-like diabetic rats. Horm.Metab Res 2007;39(12):894-898
  19. Watanabe, K., Kamata, K., Sato, J., and Takahashi, T. Fundamental studies on the inhibitory action of Acanthopanax senticosus Harms on glucose absorption. J Ethnopharmacol. 10-28-2010;132(1):193-199. PubMed
  20. Bazaz'ian, G. G., Liapina, L. A., Pastorova, V. E., and Zvereva, E. G. [Effect of Eleutherococcus on the functional status of the anticoagulation system in older animals]. Fiziol.Zh.SSSR Im I.M.Sechenova 1987;73(10):1390-1395.
  21. Kaloeva, Z. D. [Effect of the glycosides of Eleutherococcus senticosus on the hemodynamic indices of children with hypotensive states]. Farmakol.Toksikol. 1986;49(5):73.
  22. Martinez, B. and Staba, E. J. The physiological effects of Aralia, Panax and Eleutherococcus on exercised rats. Jpn J Pharmacol 1984;35(2):79-85. DOI
  23. Medon, P. J., Thompson, E. B., and Farnsworth, N. R. Hypoglycemic effect and toxicity of Eleutherococcus senticosus following acute and chronic administration in mice. Zhongguo Yao Li Xue.Bao. 1981;2(4):281-285.
  24. Freye E, GLeske J. Siberian ginseng results in beneficial effects on glucose metabolism in diabetes type 2 patients: a double blind placebo-controlled study in comparison to panax ginseng. Int J Clin Nutr. 2013;1(1):11-17.

See these in context on the Eleuthero monograph →

Rhodiola 13 references
  1. Kim SH, Hyun SH, Choung SY. Antioxidative effects of Cinnamomi cassiae and Rhodiola rosea extracts in liver of diabetic mice. Biofactors 2006;26:209-19.
  2. Kwon YI, Jang HD, Shetty K. Evaluation of Rhodiola crenulata and Rhodiola rosea for management of type II diabetes and hypertension. Asia Pac J Clin Nutr 2006;15:425-32.
  3. Bystritsky A, Kerwin L, Feusner JD. A pilot study of Rhodiola rosea (Rhodax) for generalized anxiety disorder (GAD). J Altern Complement Med 2008;14:175-80.
  4. Shevtsov VA, Zholus BI, Shervarly VI, et al. A randomized trial of two different doses of a SHR-5 Rhodiola rosea extract versus placebo and control of capacity for mental work. Phytomedicine 2003;10:95-105. PubMed
  5. Apostolidis E, Kwon YI, Shetty K. Potential of cranberry-based herbal synergies for diabetes and hypertension management. Asia Pac J Clin Nutr 2006;15:433-41.
  6. Hellum BH, Tosse A, Hoybakk K, et al. Potent in vitro inhibition of CYP3A4 and P-glycoprotein by Rhodiola rosea. Planta Med 2010;76:331-8.
  7. Skopriska-Rozewska E, Wojcik R, Siwicki AK, et al. The effect of Rhodiola quadrifida extracts on cellular immunity in mice and rats. Pol J Vet Sci 2008;11:105-11.
  8. Mishra KP, Chanda S, Shukla K, Ganju L. Adjuvant effect of aqueous extract of Rhodiola imbricate rhizome on the immune responses to tetanus toxoid and ovalbumin in rats. Immunopharmacol Immunotoxicol 2010;32:141-6.
  9. Li HX, Sze SC, Tong Y, Ng TB. Production of Th1- and Th2-dependent cytokines induced by the Chinese medicine herb, Rhodiola algida, on human peripheral blood monocytes. J Ethnopharmacol 2009;123:257-66. PubMed
  10. Mishra KP, Ganju L, Chanda S, et al. Aqueous extract of Rhodiola imbricate rhizome stimulates Toll-like receptor 4, granzyme-B and Th1 cytokines in vitro. Immunobiology 2009;214:27-31.
  11. Thu OK, Nilsen OG, Hellum B. In vitro inhibition of cytochrome P-450 activities and quantification of constituents in a selection of commercial Rhodiola rosea products. Pharm Bio. 2016 Dec;54(12):3249-3256.
  12. Thu OK, Spigset O, Nilsen OG, Hellum B. Effect of commercial Rhodiola rosea on CYP enzyme activity in humans. Eur J Clin Pharmacol. 2016 Mar;72(3):295-300. PubMed
  13. Woron J, Siwek M. Unwanted effects of psychotropic drug interactions with medicinal products and diet supplements containing plant extracts. Psychiatr Pol 2018;52(6):983-96. PubMed

See these in context on the Rhodiola monograph →

Cordyceps 14 references
  1. Zhu JS, Halpern GM, Jones K. The scientific rediscovery of an ancient Chinese herbal medicine: Cordyceps sinensis: part I. J Altern Complement Med 1998;4:289-303.
  2. Zhu JS, Halpern GM, Jones K. The scientific rediscovery of a precious ancient Chinese herbal regimen: Cordyceps sinensis: part II. J Altern Complement Med 1998;4:429-57.
  3. Chen YJ, Shiao MS, Lee SS, Wang SY. Effect of Cordyceps sinensis on the proliferation and differentiation of human leukemic U937 cells. Life Sci 1997;60:2349-59. PubMed
  4. Zhao Y. [Inhibitory effects of alcoholic extract of Cordyceps sinensis on abdominal aortic thrombus formation in rabbits]. Chung Hua I Hsueh Tsa Chih (Taipei) 1991;71:612-5, 42.
  5. Chen GZ, Chen GL, Sun T, et al. Effects of Cordyceps sinensis on murine T lymphocyte subsets. Chin Med J (English) 1991;104:4-8.
  6. Zhu XY, Yu HY. [Immunosuppressive effect of cultured Cordyceps sinensis on cellular immune response]. Chung Hsi I Chieh Ho Tsa Chih 1990;10:485-7, 454.
  7. Hsu, C. C., Huang, Y. L., Tsai, S. J., Sheu, C. C., and Huang, B. M. In vivo and in vitro stimulatory effects of Cordyceps sinensis on testosterone production in mouse Leydig cells. Life Sci 9-5-2003;73(16):2127-2136. PubMed
  8. Ikumoto, T., Sasaki, S., Namba, H., Toyama, R., Moritoki, H., and Mouri, T. [Physiologically active compounds in the extracts from tochukaso and cultured mycelia of Cordyceps and Isaria]. Yakugaku Zasshi 1991;111(9):504-509. PubMed
  9. Wu, T. N., Yang, K. C., Wang, C. M., Lai, J. S., Ko, K. N., Chang, P. Y., and Liou, S. H. Lead poisoning caused by contaminated Cordyceps, a Chinese herbal medicine: two case reports. Sci.Total Environ. 4-5-1996;182(1-3):193-195. PubMed
  10. Hong T, Zhang M, Fan J. Cordyceps sinensis (a traditional Chinese medicine) for kidney transplant recipients (Review). Cochrane Database Syst Rev. 2015;(10):CD009698. doi: 10.1002/14651858.CD009698.pub2.
  11. Zhang HW, Lin ZX, Tung YS, Kwan TH, Mok CK, Leung C, Chan LS. Cordyceps sinensis (a traditional Chinese medicine) for treating chronic kidney disease (Review). Cochrane Database Syst Rev. 2014;(12):CD008353. doi: 10.1002/14651858.CD008353.pub2. PubMed
  12. Bee Yean O, Zoriah A. Efficacy of Cordyceps sinensis as an adjunctive treatment in hemodialysis patients: a systematic review and Meta-analysis. J Tradit Chin Med. 2019;39(1):1-14.
  13. Thurian D, Montani M, Stickel F. Drug-induced, mixed-type hepatitis following ingestion of Cordyceps sinensis. Int J Clin Pharmacol Ther 2022;60(2):115-120. PubMed
  14. Yu X, Mao Y, Shergis JL, et al. Effectiveness and safety of oral Cordyceps sinensis on stable COPD of GOLD stages 2-3: Systematic review and meta-analysis. Evid Based Complement Alternat Med. 2019;2019:4903671.

See these in context on the Cordyceps monograph →

Reishi Mushroom 17 references
  1. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
  2. Tao J, Feng KY. Experimental and clinical studies on inhibitory effect of ganoderma lucidum on platelet aggregation. J Tongji Med Univ 1990;10:240-3. PubMed
  3. Singh AB, Gupta SK, Pereira BM, Prakash D. Sensitization to Ganoderma lucidum in patients with respiratory allergy in India. Clin Exp Allergy 1995;25:440-7.
  4. Lee SY, Rhee HM. Cardiovascular effects of mycelium extract of Ganoderma lucidum: inhibition of sympathetic outflow as a mechanism of its hypotensive action. Chem Pharm Bull (Tokyo) 1990;38:1359-64. PubMed
  5. Kwok Y, Ng KFJ, Li, CCF, et al. A prospective, randomized, double-blind, placebo-controlled study of the platelet and global hemostatic effects of Ganoderma lucidum (Ling-Zhi) in healthy volunteers. Anesth Analg 2005;101:423-6. PubMed
  6. Wanmuang, H., Leopairut, J., Kositchaiwat, C., Wananukul, W., and Bunyaratvej, S. Fatal fulminant hepatitis associated with Ganoderma lucidum (Lingzhi) mushroom powder. J Med Assoc Thai. 2007;90(1):179-181.
  7. Seto, S. W., Lam, T. Y., Tam, H. L., Au, A. L., Chan, S. W., Wu, J. H., Yu, P. H., Leung, G. P., Ngai, S. M., Yeung, J. H., Leung, P. S., Lee, S. M., and Kwan, Y. W. Novel hypoglycemic effects of Ganoderma lucidum water-extract in obese/diabetic (+db/+db
  8. Chu, T. T., Benzie, I. F., Lam, C. W., Fok, B. S., Lee, K. K., and Tomlinson, B. Study of potential cardioprotective effects of Ganoderma lucidum (Lingzhi): results of a controlled human intervention trial. Br.J.Nutr. 2012;107(7):1017-1027.
  9. Jin, X., Ruiz, Beguerie J., Sze, D. M., and Chan, G. C. Ganoderma lucidum (Reishi mushroom) for cancer treatment. Cochrane.Database.Syst.Rev. 2012;6:CD007731.
  10. Kabir, Y., Kimura, S., and Tamura, T. Dietary effect of Ganoderma lucidum mushroom on blood pressure and lipid levels in spontaneously hypertensive rats (SHR). J Nutr Sci Vitaminol.(Tokyo) 1988;34(4):433-438. PubMed
  11. Kanmatsuse, K., Kajiwara, N., Hayashi, K., Shimogaichi, S., Fukinbara, I., Ishikawa, H., and Tamura, T. [Studies on Ganoderma lucidum. I. Efficacy against hypertension and side effects]. Yakugaku Zasshi 1985;105(10):942-947. PubMed
  12. Gao, Y., Lan, J., Dai, X., Ye, J., and Zhou, S. A Phase I/II Study of Ling Zhi Mushroom Ganoderma lucidum(W.Curt: Fr.) Lloyd (Aphyllophoromycetideae) Extract in Patients with Type II Diabetes Mellitus. International Journal of Medicinal Mushrooms 2004;6. DOI
  13. Jin H, Zhang G, Cao X, and et al. Treatment of hypertension by linzhi combined with hypotensor and its effects on arterial, arteriolar and capillary pressure and microcirculation. In: Niimi H, Xiu RJ, Sawada T, and et al. Microcirculatory Approach to Asi
  14. Klupp NL, Chang D, Hawke F, Kiat H, Cao H, Grant SJ, Bensoussan A. Ganoderma lucidum mushroom for the treatment of cardiovascular risk factors. Cochrane Database Syst Rev. 2015 Feb 17;2:CD007259. PubMed
  15. Zhao H, Zhang Q, Zhao L, Huang X, Wang J, Kang X. Spore Powder of Ganoderma lucidum Improves Cancer-Related Fatigue in Breast Cancer Patients Undergoing Endocrine Therapy: A Pilot Clinical Trial. Evid Based Complement Alternat Med. 2012;2012:809614.
  16. Pazzi F, Adsuar JC, Domínguez-Muñoz FJ, García-Gordillo MA, Gusi N, Collado-Mateo D. Ganoderma lucidum effects on mood and health-related quality of life in women with fibromyalgia. Healthcare (Basel) 2020;8(4):520. PubMed
  17. Kogure T, Koiwai A, Fukushi D, et al. Hypereosinophilia with hepatic nodule formation caused by Ganoderma lucidum. Intern Med 2021;60(24):3897-3903.

See these in context on the Reishi Mushroom monograph →

Jiaogulan 8 references
  1. The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999.
  2. Tan H, Liu ZL, Liu MJ. [Antithrombotic effect of Gynostemma pentaphyllum]. Zhingguo Zhong Xi Yi Jie He Za Zhi 1993;13:278-80.
  3. Chan LY, Chiu PY, Lau TK. An in-vitro study of ginsenoside Rb(1)-induced teratogenicity using a whole rat embryo culture model. Hum Reprod 2003;18:2166-8..
  4. Huyen VT, Phan DV, Thang P, Hoa NK, Ostenson CG. Gynostemma pentaphyllum Tea Improves Insulin Sensitivity in Type 2 Diabetic Patients. J Nutr Metab. 2013;2013:765383. doi: 10.1155/2013/765383.
  5. Li Y, Lin W, Huang J, Xie Y, Ma W. Anti-cancer effects of Gynostemma pentaphyllum (Thunb.) Makino (Jiaogulan). Chin Med. 2016 Sep 27;11:43. Review. PubMed
  6. Huyen VT, Phan DV, Thang P, Ky PT, Hoa NK, Ostenson CG. Antidiabetic effect of add-on Gynostemma pentaphyllum extract therapy with sulfonylureas in type 2 diabetic patients. Evid Based Complement Alternat Med 2012; 452313.
  7. Huyen VT, Phan DV, Thang P, Hoa NK, Ostenson CG. Antidiabetic effect of Gynostemma pentaphyllum tea in randomly assigned type 2 diabetic patients. Horm Metab Res. 2010;42(5):353-7.
  8. Rao A, Clayton P, Briskey D. The effect of an orally-dosed Gynostemma pentaphyllum extract (ActivAMP®) on body composition in overweight, adult men and women: a double-blind, randomised, placebo-controlled study. J Hum Nutr Diet 2021.

See these in context on the Jiaogulan monograph →

Bayberry 3 references
  1. Newall CA, Anderson LA, Philpson JD. Herbal Medicine: A Guide for Healthcare Professionals. London, UK: The Pharmaceutical Press, 1996.
  2. Foster S, Tyler VE. Tyler's Honest Herbal: A Sensible Guide to the Use of Herbs and Related Remedies. 3rd ed., Binghamton, NY: Haworth Herbal Press, 1993.
  3. The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999.

See these in context on the Bayberry monograph →

Yarrow 8 references
  1. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
  2. Uter, W., Nohle, M., Randerath, B., and Schwanitz, H. J. Occupational contact urticaria and late-phase bronchial asthma caused by compositae pollen in a florist. Am J Contact Dermat. 2001;12(3):182-184. DOI
  3. Schempp, C. M., Schopf, E., and Simon, J. C. [Plant-induced toxic and allergic dermatitis (phytodermatitis)]. Hautarzt 2002;53(2):93-97.
  4. Jovanovic, M., Poljacki, M., Duran, V., Vujanovic, L., Sente, R., and Stojanovic, S. Contact allergy to Compositae plants in patients with atopic dermatitis. Med Pregl. 2004;57(5-6):209-218. PubMed
  5. Becker LC, Bergfeld WF, Belsito DV, et al. Safety assessment of Achillea millefolium as used in cosmetics. Int J Toxicol. 2016;35(3 suppl):5S-15S.
  6. Zakeri S, Esmaeilzadeh S, Gorji N, Memariani Z, Moeini R, Bijani A. The effect of Achillea millefolium L. on vulvovaginal candidiasis compared with clotrimazole: A randomized controlled trial. Complement Ther Med. 2020;52:102483. PubMed
  7. de Souza P, Crestani S, da Silva Rde C, et al. Involvement of bradykinin and prostaglandins in the diuretic effects of Achillea millefolium L. (Asteraceae). J Ethnopharmacol. 2013 Aug 26;149(1):157-61. PubMed
  8. Miranzadeh S, Adib-Hajbaghery M, Soleymanpoor L, Ehsani M. Effect of adding the herb Achillea millefolium on mouthwash on chemotherapy induced oral mucositis in cancer patients: A double-blind randomized controlled trial. Eur J Oncol Nurs. 2015;19(3):207- PubMed

See these in context on the Yarrow monograph →

Black Haw 1 reference
  1. Leung AY, Foster S. Encyclopedia of Common Natural Ingredients Used in Food, Drugs and Cosmetics. 2nd ed. New York, NY: John Wiley & Sons, 1996.

See these in context on the Black Haw monograph →

Shepherd's Purse 4 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.
  3. Naafe M, Kariman N, Keshavarz Z, et al. Effect of hydroalcoholic extracts of Capsella bursa-pastoris on heavy menstrual bleeding: A randomized clinical trial. J Altern Complement Med. 2018;24(7):694-700. PubMed
  4. Ghalandari S, Kariman N, Sheikhan Z, et al. Effect of hydroalcoholic extract of Capsella bursa pastoris on early postpartum hemorrhage: A clinical trial study. J Altern Complement Med. 2017;23(10):794-799.

See these in context on the Shepherd's Purse monograph →

Comfrey 13 references
  1. Stewart MJ, Steenkamp V. Pyrrolizidine poisoning: a neglected area in human toxicology. Ther Drug Monit 2001;23:698-708. PubMed
  2. Food and Drug Administration. FDA Advises Dietary Supplement Manufacturers to Remove Comfrey Products From the Market. July 6, 2001. Available at: http://www.cfsan.fda.gov/~dms/dspltr06.html.
  3. Stickel F, Seitz HK. The efficacy and safety of comfrey. Public Health Nutr 2000;3:501-8. PubMed
  4. Chojkier M. Hepatic sinusoidal-obstruction syndrome: toxicity of pyrrolizidine alkaloids. J Hepatol 2003;39:437-46. PubMed
  5. Wang YP, Yan J, Fu PP, Chou MW. Human liver microsomal reduction of pyrrolizidine alkaloid N-oxides to form the corresponding carcinogenic parent alkaloid. Toxicol Lett 2005;155:411-20. PubMed
  6. Predel, H. G., Giannetti, B., Koll, R., Bulitta, M., and Staiger, C. Efficacy of a comfrey root extract ointment in comparison to a diclofenac gel in the treatment of ankle distortions: results of an observer-blind, randomized, multicenter study. Phytome
  7. Gyorik, S. and Stricker, H. Severe pulmonary hypertension possibly due to pyrrolizidine alkaloids in polyphytotherapy. Swiss.Med.Wkly. 4-4-2009;139(13-14):210-211.
  8. Giannetti, B. M., Staiger, C., Bulitta, M., and Predel, H. G. Efficacy and safety of comfrey root extract ointment in the treatment of acute upper or lower back pain: results of a double-blind, randomised, placebo controlled, multicentre trial. Br.J Spor PubMed
  9. Tanret, I. and Duh, D. [Pharmaceutical sheet. Symphytum officinale L., dermal use (Flexagile cream)]. J Pharm.Belg. 2012;(1):41-42.
  10. Laslett, L. L., Quinn, S. J., Darian-Smith, E., Kwok, M., Fedorova, T., Korner, H., Steels, E., March, L., and Jones, G. Treatment with 4Jointz reduces knee pain over 12 weeks of treatment in patients with clinical knee osteoarthritis: a randomised contr
  11. Frost R, Macpherson H, O'meara S. A critical scoping review of external uses of comfrey (Symphytum spp.). Complement Ther Med. 2013;21(6):724-45. PubMed
  12. Pabst H, Schaefer A, Staiger C, Junker-samek M, Predel HG. Combination of comfrey root extract plus methyl nicotinate in patients with conditions of acute upper or low back pain: a multicentre randomised controlled trial. Phytother Res. 2013;27(6):811-7. PubMed
  13. Smith DB, Jacobson BH. Effect of a blend of comfrey root extract (Symphytum officinale L.) and tannic acid creams in the treatment of osteoarthritis of the knee: randomized, placebo-controlled, double-blind, multiclinical trials. J Chiropr Med. 2011;10(3) PubMed

See these in context on the Comfrey monograph →

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

Keep exploring
Supplement interaction checker › Check any supplement or product against your medications Drug–drug interactions › Check two or more of your medications against each other Browse medications A–Z › Every drug we've checked against herbs & supplements NDC & pricing lookup › Find a drug’s NDCs, packaging and costs Ask a pharmacist › Free, personal answer from our licensed team