Major interaction on record — check this product against your medications before combining. Based on 10 of 11 ingredients. Check your meds →
Dietary supplement

Fiber & More Ingredients & Drug Interactions

by MNP Michael's Naturopathic Programs

Fiber & More label
See full label image
Tablet Or Pill Category: Botanical With Nutrients
Most serious interaction: Major
Clinical methodology reviewed by · Updated Sep 23, 2026 · Label data from the NIH DSLD
What is this page for?

First and foremost: checking Fiber & More 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

Fiber & More is a dietary supplement by MNP Michael's Naturopathic Programs with 11 active ingredients. Its ingredients are commonly taken for constipation, diarrhea, high cholesterol.Based on those ingredients, 2,193 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are Marshmallow, Dietary Fiber, Garlic. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

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Check Your Meds Against Fiber & More by MNP Michael's Naturopathic Programs

Ask about any prescription or over-the-counter medication and we check it for interactions with Fiber & More by MNP Michael's Naturopathic Programs — and tell you which ingredient is responsible.

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HelloPharmacist Scorecard of Fiber & More by MNP Michael's Naturopathic Programs

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 1 of its 11 active ingredients.
  • “Proprietary Blend” is a proprietary blend — the label gives one combined amount (4.10 Gram(s)) without saying how much of each component you get.

Fiber & More contains 10 active ingredients. The product features a proprietary blend — meaning the exact amounts of each component aren't disclosed — plus individual amounts of rice bran, apple, pumpkin, marshmallow, okra, dandelion, butternut, garlic, and flax.

We could not verify the ingredient count for psyllium, as that component's data are not on file. These are primarily plant-based sources of fiber and traditional digestive support.

Rice bran contributes bran fiber; apple and pumpkin add both fiber and phytonutrients; marshmallow, okra, and flax all contain mucilage or soluble fiber; dandelion and garlic are included for broader wellness; and butternut acts as a stimulant laxative. The product also contains several inactive ingredients — dicalcium phosphate, microcrystalline cellulose, stearic acid, modified cellulose gum, vegetable magnesium stearate, silicon dioxide, and pharmaceutical glaze — which serve as binders, fillers, and capsule material.

Does it work?

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

This product doesn't appear to be marketed for a specific use, so we graded its ingredients' overall clinical evidence instead.

Strong

Strong clinical evidence supports its ingredients for:

Why this rating?
  • We looked at the product name, claims, and label statements and couldn't find a stated purpose to grade.
  • Since the label doesn't commit to one use, we graded the ingredients' overall clinical evidence instead.
  • On file: Constipation — rated "Effective" (Black Psyllium) (Natural Medicines).
  • On file: Coronary heart disease (CHD) — rated "Likely Effective" (Black Psyllium) (Natural Medicines).
  • On file: Atherosclerosis — rated "Possibly Effective" (Garlic) (Natural Medicines).
  • On file: Benign prostatic hyperplasia (BPH) — rated "Possibly Effective" (Pumpkin) (Natural Medicines).
  • On file: Nonalcoholic fatty liver disease (NAFLD) — rated "Possibly Effective" (Garlic) (Natural Medicines).

The evidence for this product's ingredients is mixed and often limited. Rice bran is possibly effective for dyslipidemia (abnormal blood fat levels) but possibly ineffective for colorectal cancer prevention; the other conditions rice bran was studied for lack reliable evidence.

Apple, pumpkin, marshmallow, okra, dandelion, and butternut have insufficient reliable evidence for the conditions they were tested against — meaning the research is too sparse or weak to draw conclusions. Garlic shows possibly effective evidence for periodontitis (gum disease), nonalcoholic fatty liver disease, diabetes, hypertension, and atherosclerosis (plaque buildup in arteries).

Flax is possibly effective for high cholesterol, diabetes, breast pain, high blood pressure, and constipation. Psyllium's effectiveness was not included in our data.

In short, garlic and flax carry the strongest evidence, while most of the other ingredients lack solid proof of benefit for specific conditions. If you're considering this product for a particular health goal, talk with your doctor or pharmacist about what the research actually supports.

The evidence, ingredient by ingredient Black Psyllium Rice Bran Apple Pumpkin Marshmallow Ambrette Dandelion Butternut

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.

Overall, these ingredients are generally well tolerated when taken as food, but concentrated supplements often have less safety data. Rice bran may cause temporary abdominal discomfort, flatulence, or irregular bowel habits when you first increase bran intake; rarely, it can trigger allergic reactions including anaphylaxis.

Apple and pumpkin are generally well tolerated but can cause bloating, flatulence, and digestive upset; apple seeds contain cyanide and are unsafe in large amounts. Marshmallow is generally well tolerated for short-term use but has limited human safety data.

Okra (listed as ambrette in our data) has very limited safety information. Dandelion, garlic, and flax may cause stomach upset, heartburn, or diarrhea; garlic can cause breath odor and flatulence.

Butternut acts as a stimulant laxative and can cause diarrhea and gastrointestinal irritation. For pregnancy: rice bran is likely safe; apple is safe as food but concentrated extracts are not well studied; pumpkin and okra lack enough data — avoid concentrated supplements unless your doctor approves; marshmallow and butternut should be avoided; dandelion has limited data; garlic is likely safe as food but avoid high-dose supplements; flax may not be safe at supplement doses.

For breastfeeding: rice bran and garlic are likely safe as food; apple, pumpkin, marshmallow, okra, dandelion, and flax all lack reliable safety information at supplement doses — use caution or avoid unless your doctor says otherwise.

Side effects, ingredient by ingredient Black Psyllium Rice Bran Apple Pumpkin Marshmallow Ambrette Dandelion Butternut

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?
  • 9 of the 10 matched ingredients can interact with medications — Ambrette, Black Psyllium, Apple, Garlic, Dandelion, 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: 2,194 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 Fiber & More, double-check with your doctor or pharmacist if you take any of the following: blood pressure medications (especially atenolol and aliskiren), blood thinners or antiplatelet drugs (including warfarin), diabetes medications, lithium, heart medications like digoxin, corticosteroids, diuretics, antibiotics, or hormone-based drugs like estrogens. Apple carries the most serious interaction (Major), blocking absorption of certain blood pressure and allergy medications.

No interactions were documented for psyllium, though we could not verify that ingredient.

Check your own medication Run your meds through the checker above

The bottom line

Scorecard at a glanceFormula with limited ingredient disclosure with strong clinical evidence behind its ingredients' uses. Major medication interactions have been identified, and safety information is well characterized.

Fiber & More may appeal to people seeking plant-based digestive support, especially those interested in garlic and flax for their possibly effective roles in heart health and blood sugar management. However, if you take any blood pressure medications (especially atenolol or aliskiren), blood thinners, diabetes drugs, lithium, heart medications, or antibiotics, you should check your specific medications before starting, because this product carries multiple Moderate interactions and one Major interaction.

The laxative effect from butternut and the fiber content may also cause digestive upset, especially at first. Talk with your doctor or pharmacist before adding this to your routine, particularly if you're pregnant, breastfeeding, or managing a chronic condition.

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

Assessment coverage: 10 of 11 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated May 22, 2020.

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 Fiber & More, straight from the product label.

Brand MNP Michael's Naturopathic Programs
Barcode (UPC) 755929010509
Net contents 90 Vegetarian Tablet(s)
Market status On market
Date entered into DSLD May 22, 2020
DSLD ID 220118
Product type Botanical With Nutrients
Supplement form Tablet Or Pill
Dietary claims / uses Nutrient, All Other, Structure/Function
Intended target group(s) Adult (18 - 50 Years), Kosher
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 Fiber & More by MNP Michael's Naturopathic Programs, 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:
6 Tablet(s)
Maximum serving Sizes:
6 Tablet(s)
Servings per container
15
UPC/BARCODE
755929010509
IngredientAmount% DV
Dietary Fiber2.68 Gram(s)10%
Proprietary Blend4.1 Gram(s)--
Rice Bran0 NP--
Psyllium0 NP--
Apple0 NP--
Pumpkin0 NP--
Marshmallow0 NP--
Okra0 NP--
Dandelion0 NP--
Butternut0 NP--
Garlic0 NP--
Flax0 NP--

Other ingredients: Dicalcium Phosphate, Microcrystalline Cellulose, Stearic Acid, modified Cellulose Gum, Vegetable Magnesium Stearate, Silicon Dioxide, Pharmaceutical Glaze

Tap any ingredient to jump to its full detail below.

Label statements
These statements are the manufacturer’s wording, reproduced from the product label — the label is saying it, not HelloPharmacist. We don’t verify or endorse them.
Suggested/Recommended/Usage/Directions

Directions: As a dietary supplement, take six (6) tablets before bed with eight ounces of water. Dosage may be increased as directed by a healthcare practitioner.

General Statements

Our products contain organically grown herbs, when available.

Family owned and operated.

Healthcare solutions since 1984 Created by Naturopathic doctor Michael Schwartz, N.M.D.

Synergistically complete

Eco-friendly material

Precautions

Double-sealed for your protection. Do not use if outer seal is broken or missing.

Warning: Keep out of reach of children.

Warning: Consuming this product can expose you to chemicals including lead, which is known to the State of California to cause birth defects or other reproductive harm. For more information, go to www.P65Warnings.ca.gov.

Made in a GMP facility that processes egg, fish, milk, shellfish, soy, tree nut and wheat products.

Contains tree nut (butternut).

Formula

Certified Kosher.

Comprehensive fiber formula

Seals/Symbols

Star K "Parve" (Kosher)

Formulation

Made in the U.S.A.

Comprehensive intestinal support

FDA Disclaimer Statement

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

FDA Statement of Identity

Dietary Supplement

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

See for yourself

Fiber & More by MNP Michael's Naturopathic Programs label

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

Fiber & More 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 Fiber & More by MNP Michael's Naturopathic Programs

These are the 11 active ingredients this product is made of. Select any to open its full monograph.

Serving size6 Tablet(s) Dosage formTablet Or Pill Servings per container15 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.

Dietary Fiber

Interacts with
2,025 drugs
2.68 Gram(s) per serving

Black psyllium is a soluble-fiber supplement made from the seeds of a Plantago plant, used mostly to ease constipation and support digestive health. I...

Dietary Fiber monograph & interactions

Proprietary Blend

4.1 Gram(s) per serving

Other (inactive) ingredients: Dicalcium Phosphate, Microcrystalline Cellulose, Stearic Acid, Modified Cellulose Gum, Vegetable Magnesium Stearate, Silicon Dioxide, Pharmaceutical Glaze. These complete the product’s ingredient list but are not active constituents.

Interaction report

Fiber & More by MNP Michael's Naturopathic Programs Drug Interactions

Want to check YOUR meds against Fiber & More?

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
2,193Drugs
47 Major 1,213 Moderate 933 Minor

Ingredients driving the most interactions

Marshmallow 2,040
Dietary Fiber 2,025
Garlic 989
Flax 597
Dandelion 457

Individual Drug Interactions

The ingredients in Fiber & More interact with 2,193 drugs. Click any drug to see the details.

9 of the 11 ingredients in Fiber & More interact with drugs. Each result below shows which ingredient is responsible. Marshmallow Dietary Fiber Garlic Flax Dandelion Apple Butternut Okra Pumpkin

Each ingredient & the kinds of drugs it affects

For each ingredient in Fiber & More 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

Dietary Fiber7 drug types · 2,025 drugs

Carbamazepine (Tegretol)

Theoretically, black psyllium might reduce the effects of carbamazepine and increase the risk for convulsions.
Theoretically, black psyllium might reduce carbamazepine absorption. A preliminary study using blond psyllium reported decreased carbamazepine bioavailability due to binding of the drug to psyllium, as well as reduction of available fluid in the gut for dissolution of the drug. This interaction may also occur with black psyllium.

Likelihood Probable Evidence D
Lithium

Theoretically, taking black psyllium at the same time as lithium might reduce lithium absorption.
The fiber in black psyllium might reduce lithium absorption and plasma levels. Some case reports describe a reduction in plasma lithium levels with concomitant administration of blond psyllium. This was reversed when psyllium was stopped. This interaction may also occur with black psyllium.

Likelihood Probable Evidence D
Metformin (Glucophage)

Theoretically, black psyllium might increase the therapeutic and adverse effects of metformin.
Animal research shows that concurrent consumption of blond psyllium with metformin slows and increases the absorption of metformin. This interaction may also occur with black psyllium. To avoid changes in absorption, take psyllium 30-60 minutes after metformin.

Likelihood Possible Evidence D
Olanzapine (Zyprexa)

Theoretically, taking black psyllium at the same time as olanzapine might reduce olanzapine absorption.
The fiber in black psyllium might decrease the absorption of olanzapine. A single case report describes a reduction in the effectiveness of olanzapine when it was concomitantly administered with an unspecified type of psyllium 3 grams orally twice daily. This effect was reversed when psyllium was stopped.

Likelihood Possible Evidence D
Digoxin (Lanoxin)

Theoretically, taking black psyllium at the same time as digoxin might reduce digoxin absorption and decrease digoxin levels.
Psyllium might bind digoxin in the gut. However, some clinical evidence suggests that psyllium does not impact digoxin absorption.

Likelihood Unlikely Evidence B
Ethinyl Estradiol

Theoretically, taking black psyllium at the same time as ethinyl estradiol might alter levels of estradiol.
Concurrent use of blond psyllium with ethinyl estradiol results in a slight increase in the extent of ethinyl estradiol absorption and a slower rate of absorption. This is unlikely to be clinically significant.

Likelihood Unlikely Evidence D
Oral Drugs

Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Psyllium seems to have variable effects on drug absorption. To avoid changes in absorption, take psyllium 30-60 minutes after oral medications. Animal research shows that blond psyllium delays and increases the absorption of metformin and ethinyl estradiol. Case reports and animal research suggest that blond psyllium might reduce absorption of lithium, digoxin, olanzapine, and carbamazepine. Finally, some pharmacokinetic studies show that psyllium does not affect the absorption of levothyroxine or warfarin. Although many of these studies evaluated blond psyllium, the fiber content in black psyllium may have similar effects.

Likelihood Possible Evidence B
Dietary Fiber full monograph & interactions

Garlic12 drug types · 989 drugs

Anticoagulant/Antiplatelet Drugs

Garlic may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Raw garlic and a variety of garlic extracts have antiplatelet activity and can increase prothrombin time.

Likelihood Possible Evidence D
Antidiabetes Drugs

Theoretically, taking garlic with antidiabetes drugs might increase the risk of hypoglycemia.
Clinical research suggests that garlic and garlic extract lower blood glucose levels in healthy and diabetic individuals.

Likelihood Possible Evidence B
Antihypertensive Drugs

Theoretically, taking garlic with antihypertensive drugs might increase the risk of hypotension.
In human research, both garlic and garlic extracts have blood pressure-lowering effects.

Likelihood Possible Evidence D
Atazanavir (Reyataz)

Theoretically, garlic might decrease levels and effects of atazanavir.
In a case report, a patient consuming six stir-fried garlic cloves three times weekly developed suboptimal atazanavir levels and increases in HIV viral load. While the exact cause of this interaction is unclear, there is speculation that garlic might decrease the intestinal absorption of atazanavir or increase its metabolism by inducing cytochrome P450 3A4 (CYP3A4). Until more is known, advise patients not to consume large amounts of garlic while taking atazanavir.

Likelihood Possible Evidence D
Cytochrome P450 2E1 (Cyp2E1) Substrates

Garlic might increase levels of drugs metabolized by CYP2E1.
Clinical research suggests garlic oil can inhibit the activity of CYP2E1 by 39%. Use garlic oil cautiously in patients taking drugs metabolized by these enzymes.

Likelihood Probable Evidence B
Cytochrome P450 3A4 (Cyp3A4) Substrates

Theoretically, garlic products containing allicin might induce intestinal CYP3A4 and inhibit hepatic CYP3A4. This may increase or decrease levels of drugs metabolized by CYP3A4.
Some human research suggests that garlic may induce INTESTINAL CYP3A4, reducing levels of drugs metabolized by this enzyme. This is primarily based on a study showing that taking a specific allicin-containing garlic product (GarliPure Maximum Allicin Formula, Natrol Inc.) twice daily for 3 days reduces saquinavir levels by approximately 50%. It is speculated that the allicin constituent induced CYP3A4 in the gut mucosa. Another study shows that giving docetaxel intravenously, bypassing the CYP3A4 enzymes in the gut mucosa, along with the same specific garlic product for 12 consecutive days, does not affect docetaxel levels. Conversely, there is concern that garlic may inhibit HEPATIC CYP3A4. In a single case report, increased tacrolimus levels and liver injury occurred in a liver transplant patient after taking a specific garlic supplement (Garlicin Cardio, Nature's Way) at up to three times the manufacturer recommended dose for 7 days. Several other studies have evaluated the impact of other garlic formulations on CYP3A4 substrates and have found no effect. Most of the products in these studies provided little or no allicin.

Likelihood Possible Evidence B
Isoniazid

Theoretically, garlic might decrease levels of isoniazid.
Animal research suggests that an aqueous extract of garlic reduces isoniazid levels by about 65%. Garlic reduced the maximum concentration (Cmax) and area under the curve (AUC), but not the half-life, of isoniazid. This suggests that garlic extract might inhibit isoniazid absorption across the intestinal mucosa; however, the exact mechanism of this potential interaction is not known.

Likelihood Possible Evidence D
Protease Inhibitors (Pis)

Theoretically, garlic products containing allicin might decrease levels of PIs.
Protease inhibitors are metabolized by cytochrome P450 3A4 (CYP3A4) isoenzymes. There is concern that garlic products containing allicin might induce intestinal CYP3A4, reducing plasma levels of protease inhibitors. This is primarily based on a study showing that taking a specific garlic product (GarliPure Maximum Allicin Formula, Natrol Inc.) twice daily for 3 days reduces levels of saquinavir, a PI, by approximately 50%. It is speculated that the allicin constituent induce CYP3A4 in the gut mucosa. Several studies have evaluated the impact of other garlic formulations on CYP3A4 substrates and have found no effect. Most of the products in these studies provided little or no allicin.

Likelihood Possible Evidence B
Saquinavir (Fortovase, Invirase)

Theoretically, garlic containing allicin might decrease levels of saquinavir.
Saquinavir is a substrate of cytochrome P450 3A4 (CYP3A4) isoenzymes. There is concern that garlic products containing allicin might induce intestinal CYP3A4 and cause subtherapeutic levels of saquinavir. This is primarily based on a pharmacokinetic study showing that taking a specific garlic product (GarliPure Maximum Allicin Formula, Natrol Inc.) twice daily for 3 days reduces saquinavir levels by approximately 50%. It is speculated that the allicin constituent induces CYP3A4 in the gut mucosa. Several pharmacokinetic studies have evaluated the impact of other garlic formulations on CYP3A4 substrates and have found no effect. Most of the products in these studies provided little or no allicin. Until more is known about this potential interaction, use garlic containing allicin cautiously in patients taking saquinavir.

Likelihood Possible Evidence B
Sofosbuvir (Sovaldi)

Theoretically, taking garlic with sofosbuvir might decrease its effectiveness.
Animal research in rats shows that giving aged garlic extract 120 mg/kg orally daily for 14 days decreases the area under the concentration time curve (AUC) after a single sofosbuvir dose of 40 mg/kg by 36%, increases the clearance by 63%, and decreases the plasma concentrations at 1 and 8 hours by 35% and 58%, respectively. This interaction is hypothesized to be due to induction of intestinal P-glycoprotein expression by garlic.

Likelihood Possible Evidence D
Tacrolimus (Prograf)

Theoretically, garlic might increase levels of tacrolimus.
In one case report, a liver transplant patient taking tacrolimus experienced increased tacrolimus levels and liver injury after taking a specific garlic supplement (Garlicin Cardio, Nature's Way) at up to three times the manufacturer recommended dose for 7 days. It is speculated that garlic inhibited hepatic cytochrome P450 3A4 (CYP3A4), which increased plasma levels of tacrolimus.

Likelihood Possible Evidence B
Warfarin (Coumadin)

Theoretically, garlic might increase the risk of bleeding with warfarin.
Raw garlic and a variety of garlic extracts have antiplatelet activity and can increase prothrombin time. In addition, there is a report of two patients who experienced an increase in a previously stabilized international normalized ratio (INR) with concomitant garlic and warfarin use. However, this report has been subsequently debated due to limited clinical information. Other clinical studies have not identified an effect of garlic on INR, warfarin pharmacokinetics, or bleeding risk. More evidence is needed to determine the safety of using garlic with warfarin.

Likelihood Possible Evidence D
Garlic full monograph & interactions

Flax5 drug types · 597 drugs

Antibiotic Drugs

Theoretically, antibiotics might interfere with the metabolism of flaxseed constituents, which could potentially alter the effects of flaxseed.
Some potential benefits of flaxseed are thought to be due to its lignan content. Secoisolariciresinol diglucoside (SDG), a major lignan precursor, is found in high concentrations in flaxseed. SDG is converted by bacteria in the colon to the lignans enterolactone and enterodiol. Antibiotics alter the flora of the colon, which could theoretically alter the metabolism of flaxseed.

Likelihood Possible Evidence D
Anticoagulant/Antiplatelet Drugs

Theoretically, using flaxseed in combination with anticoagulant or antiplatelet drugs might have additive effects and increase the risk of bleeding.
Some clinical evidence suggests that the oil contained in flaxseed can decrease platelet aggregation.

Likelihood Possible Evidence B
Antidiabetes Drugs

Theoretically, flaxseed might have additive effects when used with antidiabetes drugs and increase the risk for hypoglycemia.
Some clinical research suggests that flaxseed can lower blood glucose levels.

Likelihood Probable Evidence B
Antihypertensive Drugs

Theoretically, flaxseed might have additive effects when used with antihypertensive drugs and increase the risk of hypotension.
Clinical research shows that daily flaxseed consumption, especially for longer than 12 weeks, modestly reduces blood pressure.

Likelihood Possible Evidence D
Estrogens

Theoretically, taking flaxseed might decrease the effects of estrogens.
Flaxseed contains lignans with mild estrogenic and possible antiestrogenic effects. The lignans seem to compete with circulating endogenous estrogen and might reduce estrogen binding to estrogen receptors, resulting in an anti-estrogen effect. It is unclear if this effect transfers to exogenously administered estrogens.

Likelihood Possible Evidence D
Flax full monograph & interactions

Dandelion7 drug types · 457 drugs

Anticoagulant/Antiplatelet Drugs

Theoretically, taking dandelion root along with anticoagulant or antiplatelet drugs might increase the risk of bruising and bleeding.
In vitro research suggests that dandelion root inhibits platelet aggregation.

Likelihood Possible Evidence D
Antidiabetes Drugs

Theoretically, dandelion might increase the risk for hypoglycemia when used with antidiabetes drugs.
Laboratory research suggests that dandelion extract may have moderate alpha-glucosidase inhibitor activity and might also increase insulin secretion. Also, in a case report, a 58-year-old woman with type 2 diabetes who was being treated with insulin developed hypoglycemia 2 weeks after beginning to eat salads containing dandelion.

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

Theoretically, dandelion might increase levels of drugs metabolized by CYP1A2.
Laboratory research suggests that dandelion might inhibit CYP1A2. So far, this interaction has not been reported in humans. However, until more is known, watch for an increase in the levels of drugs metabolized by CYP1A2 in patients taking dandelion.

Likelihood Possible Evidence D
Glucuronidated Drugs

Theoretically, dandelion might increase the clearance of drugs that are UDP-glucuronosyltransferase substrates.
There is some preliminary evidence that dandelion might induce UDP-glucuronosyltransferase, a phase II enzyme.

Likelihood Possible Evidence D
Lithium

Theoretically, through diuretic effects, dandelion might reduce excretion and increase levels of lithium.
Animal research suggests that dandelion has diuretic properties. As diuretics can increase serum lithium levels, the dose of lithium might need to be decreased when taken with dandelion.

Likelihood Probable Evidence D
Potassium-Sparing Diuretics

Theoretically, dandelion might increase the risk of hyperkalemia when taken with potassium-sparing diuretics.
Dandelion contains significant amounts of potassium.

Likelihood Possible Evidence D
Quinolone Antibiotics

Theoretically, dandelion might lower fluoroquinolone levels.
Animal research shows that dandelion reduces absorption of ciprofloxacin and can lower levels by 73%. However, this effect has not been reported in humans.

Likelihood Possible Evidence D
Dandelion full monograph & interactions

Apple7 drug types · 300 drugs

Organic Anion-Transporting Polypeptide Substrates (Oatp)

Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Research shows that consuming apple juice inhibits OATP, which reduces bioavailability of oral drugs that are substrates of OATP. Fexofenadine, atenolol, and aliskiren are substrates of OATP. Clinical research shows that coadministration of apple juice decreases bioavailability of fexofenadine by up to 78%, aliskiren by 63%, and atenolol by up to 82%. These effects appear to increase with larger quantities of apple juice. It is thought that apple juice might affect OATP for only a short time. Therefore, separating drug administration and consumption of apple juice by at least 4 hours might avoid this interaction.

Likelihood Likely Evidence B
Aliskiren (Tekturna, Rasilez)

Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of aliskiren.
Pharmacokinetic research shows that coadministration of apple juice 200 mL along with aliskiren 150 mg decreases the bioavailability of aliskiren by 63%. Apple juice seems to inhibit organic anion transporting polypeptide (OATP), which is involved in drug uptake in the gut, liver, and kidney. It is thought that apple juice might affect OATP for only a short time. Therefore, separating drug administration and consumption of apple juice by at least 4 hours might avoid this interaction.

Likelihood Probable Evidence B
Antidiabetes Drugs

Theoretically, consuming apple juice with antidiabetes drugs might interfere with blood glucose control.
Clinical research suggests that consuming apples or drinking apple juice can raise blood glucose levels, with the effects of drinking apple juice being more significant than consuming apples.

Likelihood Possible Evidence D
Antihypertensive Drugs

Consuming apple juice with antihypertensive drugs might interfere with blood pressure control.
Some clinical evidence suggests that consuming apple and cherry juice can increase blood pressure in elderly patients.

Likelihood Probable Evidence B
Atenolol (Tenormin)

Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of atenolol.
Pharmacokinetic research shows that coadministration of apple juice 600-1200 mL decreases levels of atenolol by 58% to 82% in a dose-dependent manner. Apple juice seems to inhibit organic anion transporting polypeptide (OATP), which is involved in drug uptake in the gut, liver, and kidney. It is thought that apple juice might affect OATP for only a short time. Therefore, separating drug administration and consumption of apple juice by at least 4 hours might avoid this interaction.

Likelihood Probable Evidence B
Fexofenadine (Allegra)

Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of fexofenadine.
Pharmacokinetic research shows that coadministration of apple juice 400-1200 mL along with fexofenadine 60-120 mg decreases bioavailability of fexofenadine by up to 78%. Coadministration with smaller quantities of apple juice (150 mL or less) does not appear to affect the bioavailability of fexofenadine. Apple juice seems to inhibit organic anion transporting polypeptide (OATP), which is involved in drug uptake in the gut, liver, and kidney. It is thought that apple juice might affect OATP for only a short time. Therefore, separating drug administration and consumption of apple juice by at least 4 hours might avoid this interaction.

Likelihood Likely Evidence B
Lithium

There is some concern that concomitant consumption of apple juice might decrease oral absorption and blood levels of lithium.
In one case report, a patient had an undetectable serum lithium level when lithium citrate was administered with apple juice. When lithium was administered with an alternative beverage, the lithium level became detectable and the patient demonstrated clinical improvement.

Likelihood Possible Evidence D
Apple full monograph & interactions

Butternut5 drug types · 122 drugs

Corticosteroids

Butternut has stimulant laxative effects. Theoretically, concomitant use of corticosteroids with butternut can increase the risk of potassium depletion.

Likelihood Possible Evidence D
Digoxin (Lanoxin)

Butternut has stimulant laxative effects. Theoretically, potassium depletion associated with butternut might increase the risk of digoxin toxicity.

Likelihood Possible Evidence D
Diuretic Drugs

Butternut has stimulant laxative effects. Theoretically, overuse of butternut might compound diuretic-induced potassium loss. There is some concern that people receiving butternut along with potassium-depleting diuretics might be at an increased risk for hypokalemia.
Some diuretics that can deplete potassium include chlorothiazide (Diuril), chlorthalidone (Thalitone), furosemide (Lasix), hydrochlorothiazide (HCTZ, Hydrodiuril, Microzide), and others.

Likelihood Possible Evidence D
Stimulant Laxatives

Butternut has stimulant laxative effects. Concomitant use with stimulant laxative medications might compound fluid and electrolyte loss.

Likelihood Possible Evidence D
Warfarin (Coumadin)

Butternut has stimulant laxative effects. In some people butternut can cause diarrhea. Diarrhea can increase the effects of warfarin, increase international normalized ratio (INR), and increase the risk of bleeding. Advise patients who take warfarin not to take excessive amounts of butternut.

Likelihood Possible Evidence D
Butternut full monograph & interactions

Okra1 drug type · 86 drugs

Antidiabetes Drugs

Theoretically, concomitant use of ambrette with antidiabetes drugs might increase the risk of hypoglycemia.
Animal research shows that myricetin, a constituent of ambrette, can lower blood glucose levels.

Likelihood Possible Evidence D
Okra full monograph & interactions

Pumpkin1 drug type · 1 drug

Lithium

Pumpkin might reduce excretion and increase levels of lithium.
Pumpkin is thought to have diuretic properties. Theoretically, this might reduce excretion and increase levels of lithium. The dose of lithium might need to be decreased.

Likelihood Probable Evidence D
Pumpkin full monograph & interactions
The maker

Brand information

Manufacturer and brand details for Fiber & More, from the product label.

MNP Michael's Naturopathic Programs

See all MNP Michael's Naturopathic Programs products
Name
Michael's Naturopathic Programs
Street Address
6003 Randolph Blvd
City
San Antonio
State
Texas
ZipCode
78233
Phone Number
800-845-2730
Web Address
www.michaelshealth.com
Pharmacist Counseling Corner

Fiber & More by MNP Michael's Naturopathic Programs: Common Questions

Does Fiber & More by MNP Michael's Naturopathic Programs interact with any medications?
Yes. Based on its ingredients, Fiber & More has a known interaction with 2,193 medications, including 47 rated major. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Fiber & More contains 11 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.
Will Fiber & More help with my cholesterol or blood pressure?
Garlic and flax in this product are possibly effective for high cholesterol and high blood pressure based on clinical research. However, if you're already taking blood pressure or cholesterol medications, the apple and garlic in this product could interfere with how they work. Check with your doctor or pharmacist before taking it alongside your current medications.
Is it safe to take this if I'm pregnant or breastfeeding?
It depends on the ingredient. Rice bran and garlic are likely or probably safe as food during pregnancy; however, butternut and marshmallow should be avoided, and several other ingredients lack enough safety data. At supplement doses, even "probably safe" ingredients may not be well studied. Talk with your doctor or pharmacist for personalized advice.
What's the difference between this product and just eating apples or garlic?
This product contains concentrated supplement amounts of multiple plant ingredients, not just food portions. Concentrated supplements have less safety data than the same ingredients eaten as whole foods. Additionally, some interactions (like apple juice blocking certain blood pressure medications) are stronger with juice or supplements than with whole fruit.
Will Fiber & More cause digestive side effects?
Yes, digestive upset is common when you first increase fiber intake. Rice bran, pumpkin, and flax can cause bloating, flatulence, abdominal discomfort, and irregular bowel habits, especially if you start with a large dose. Butternut acts as a laxative, so it may cause diarrhea. Start with a smaller amount and drink plenty of water to reduce these effects.
Is there a risk of allergic reaction?
Rare but serious allergic reactions including anaphylaxis have been reported with rice bran, apple, pumpkin, dandelion, and flax. If you have a known allergy to any plant in the Rosaceae family (apples, pears, peaches, strawberries, almonds) or the Asteraceae family (ragweed, chrysanthemums, daisies), talk with your pharmacist before taking this product.
Why do I need to space this out from my other medications?
Marshmallow contains mucilage, a thick substance that can coat your digestive tract and slow absorption of oral medications. To avoid this, take marshmallow 30 to 60 minutes after taking any other oral drugs. Some ingredients (like apple) also directly inhibit how certain medications are absorbed, which is why checking your specific drugs is important.

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

Not sure if Fiber & More 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.

Fiber & More label
Go deeper

The Full Monographs Behind Fiber & More’s Ingredients

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

Herb & supplement monograph

Black Psyllium

Interacts with 2,025 drugs

Black psyllium is a soluble-fiber supplement made from the seeds of a Plantago plant, used mostly to ease constipation and support digestive health. It is best known and most studied for rel...

Read the full Black Psyllium monograph → Herb & supplement monograph

Rice Bran

Rice bran is the nutrient-rich outer layer of the rice grain and is a good source of fiber, healthy fats, and plant compounds. It is most studied for helping lower cholesterol, but for most...

Read the full Rice Bran monograph → Herb & supplement monograph

Apple

Interacts with 300 drugs

Apples are a nutritious whole food that provides fiber, vitamins, and antioxidant plant compounds, and eating them regularly fits well into a healthy diet. While research suggests apples may...

Read the full Apple monograph → Herb & supplement monograph

Pumpkin

Interacts with 1 drug

Pumpkin is a nutritious squash, and its seeds and seed oil are the parts most often used as supplements, mainly for urinary and prostate symptoms. The evidence for these uses is limited and...

Read the full Pumpkin monograph → 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

Ambrette

Interacts with 86 drugs

Ambrette (Abelmoschus moschatus) is a fragrant plant best known for its musky seed oil used in perfumes and food flavoring. It has a long history in traditional medicine for digestion, breat...

Read the full Ambrette monograph → Herb & supplement monograph

Dandelion

Interacts with 457 drugs

Dandelion is a common plant used in food and traditional medicine, often promoted as a natural 'water pill' and digestive aid. Human evidence for these uses is very limited, so its benefits...

Read the full Dandelion monograph → Herb & supplement monograph

Butternut

Interacts with 122 drugs

Butternut (Juglans cinerea) is a North American tree whose inner bark was traditionally used as a mild laxative and folk remedy. Modern scientific evidence supporting any of its uses is very...

Read the full Butternut monograph → Herb & supplement monograph

Garlic

Interacts with 989 drugs

Garlic is a common food and supplement that may modestly help with blood pressure and cholesterol, though the evidence is mixed and effects are usually small. It is generally safe in food am...

Read the full Garlic monograph → Herb & supplement monograph

Flaxseed

Interacts with 597 drugs

Flaxseed is a nutritious food rich in fiber, omega-3 fats (ALA), and plant compounds called lignans. It is most reliably helpful for constipation and may modestly lower cholesterol, but evid...

Read the full Flaxseed monograph →
Sources

Sources & How We Checked

Fiber & More'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 278 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.

Black Psyllium 18 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. Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.
  3. Covington TR, et al. Handbook of Nonprescription Drugs. 11th ed. Washington, DC: American Pharmaceutical Association, 1996.
  4. Etman M. Effect of a bulk forming laxative on the bioavailablility of carbamazepine in man. Drug Dev Ind Pharm 1995;21:1901-6.
  5. Perlman BB. Interaction between lithium salts and ispaghula husk. Lancet 1990;335:416.
  6. Vaswani SK, Hamilton RG, Valentine MD, Adkinson NF. Psyllium laxative-induced anaphylaxis, asthma, and rhinitis. Allergy 1996;51:266-8. PubMed
  7. Lantner RR, Espiritu BR, Zumerchik P, Tobin MC. Anaphylaxis following ingestion of a psyllium-containing cereal. JAMA 1990;264:2534-6. DOI
  8. Kaplan MJ. Anaphylactic reaction to "Heartwise." N Engl J Med 1990;323:1072-3. DOI
  9. Nordstrom M, Melander A, Robertsson E, Steen B. Influence of wheat bran and of a bulk-forming ispaghula cathartic on the bioavailability of digoxin in geriatric in-patients. Drug Nutr Interact 1987;5:67-9..
  10. Robinson DS, Benjamin DM, McCormack JJ. Interaction of warfarin and nonsystemic gastrointestinal drugs. Clin Pharmacol Ther 1971;12:491-5. PubMed
  11. Garcia JJ, Fernandez N, Diez MJ, et al. Influence of two dietary fibers in the oral bioavailability and other pharmacokinetic parameters of ethinyloestradiol. Contraception 2000;62:253-7. PubMed
  12. Fernandez N, Lopez C, Díez R, et al. Drug interactions with the dietary fiber Plantago ovata husk. Expert Opin Drug Metab Toxicol 2012;8(11):1377-86.
  13. Semen plantaginis in: WHO Monographs on Selected Medicinal Plants, volume 1. World Health Organization, Geneva, 1999. Available at http://apps.who.int/medicinedocs/en/d/Js2200e/. Accessed November 26, 1026.
  14. Code of Federal Regulations, Title 21 (21CFR 101.17). Food labeling warning, notice, and safe handling statements. Available at www.ecfr.gov/cgi-bin/text-idx?SID=20f647d3b74161501f46564b915b4048&mc=true&node=se21.2.101_117&rgn=div8. Accessed December 3, 2
  15. Code of Federal Regulations, Title 21 (21CFR 201.319). Specific labeling requirements - water-soluble gums, hydrophilic gums, and hydrophilic mucilloids. Available at www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?fr=201.319. Accessed Dece
  16. Diez R, Garcia JJ, Diez MJ, Sierra M, Sahagun AM, Fernandez N. Influence of Plantago ovata husk (dietary fiber) on the bioavailability and other pharmacokinetic parameters of metformin in diabetic rabbits. BMC Complement Altern Med. 2017 Jun 7;17(1):298. PubMed
  17. Chiu AC, Sherman SI. Effects of pharmacological fiber supplements on levothyroxine absorption. Thyroid. 1998;8(8):667-71. PubMed
  18. Merrick C, Madden CA, Capurso NA. A Case of Blunted Orally Disintegrating Olanzapine Effect Due to Coadministered Psyllium. J Clin Psychiatry 2021;82(2):20cr13633. PubMed

See these in context on the Black Psyllium monograph →

Rice Bran 7 references
  1. Covington TR, et al. Handbook of Nonprescription Drugs. 11th ed. Washington, DC: American Pharmaceutical Association, 1996.
  2. Fujiwaki T, Furusho K. The effects of rice bran broth bathing in patients with atopic dermatitis. Acta Paediatr Jpn 1992;34:505-10.
  3. Uenotsuchi T, Satoh E, Kiryu H, Yano Y. Pyemotes dermatitis caused by indirect contact with husk rice. Br J Dermatol 2000;143:680-2. DOI
  4. Satoh R, Tsuge I, Tokuda R, Teshima R. Analysis of the distribution of rice allergens in brown rice grains and of the allergenicity of products containing rice bran. Food Chem. 2019;276:761-767. PubMed
  5. Togashi Y, Inomata N, Suzuki A, Hakuta A, Aihara M. Pediatric case with rice bran allergy induced by epicutaneous sensitization in a family rice shop. Allergol Int. 2019;68(1):117-118. PubMed
  6. So WKW, Chan JYW, Law BMH, et al. Effects of a Rice Bran Dietary Intervention on the Composition of the Intestinal Microbiota of Adults with a High Risk of Colorectal Cancer: A Pilot Randomised-Controlled Trial. Nutrients 2021;13(2):526. PubMed
  7. Haneda Y, Kadowaki S, Furui M, Taketani T. A pediatric case of food-dependent exercise-induced anaphylaxis due to rice bran. Asia Pac Allergy 2021;11(1):e4. PubMed

See these in context on the Rice Bran monograph →

Apple 16 references
  1. The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999.
  2. Bailey DG, Dresser GK, Munoz C, et al. Reduction of fexofenadine bioavailability by fruit juices. Clin Pharmacol Ther 2001;69:P21.
  3. Rodriguez J, Crespo JF, Lopez-Rubio A, et al. Clinical cross-reactivity among foods of the Rosaceae family. J Allergy Clin Immunol 2000;106:183-189. PubMed
  4. Greenblatt DJ. Analysis of drug interactions involving fruit beverages and organic anion-transporting polypeptides. J Clin Pharmacol 2009;49:1403-7. PubMed
  5. Bailey DG. Fruit juice inhibition of uptake transport: a new type of food-drug interaction. Br J Clin Pharmacol 2010;70:645-55. PubMed
  6. Kamath AV, Yao M, Zhang Y, Chong S. Effect of fruit juices on the oral bioavailability of fexofenadine in rats. J Pharm Sci 2005;94:233-9. PubMed
  7. Tapaninen T, Neuvonen PJ, Niemi M. Orange and apple juice greatly reduce the plasma concentrations of the OATP2B1 substrate aliskiren. Br J Clin Pharmacol 2011;71:718-26. PubMed
  8. Jeon H, Jang IJ, Lee S, et al. Apple juice greatly reduces systemic exposure to atenolol. Br J Clin Pharmacol 2012 May 11. doi: 10.1111/j.1365-2125.2012.04324.x. [Epub ahead of print]. PubMed
  9. Visvanathan, R., Chen, R., Horowitz, M., and Chapman, I. Blood pressure responses in healthy older people to 50 g carbohydrate drinks with differing glycaemic effects. Br J Nutr 2004;92(2):335-340. PubMed
  10. Asp, N. G., Agardh, C. D., Ahren, B., Dencker, I., Johansson, C. G., Lundquist, I., Nyman, M., Sartor, G., and Schersten, B. Dietary fibre in type II diabetes. Acta Med Scand Suppl 1981;656:47-50. PubMed
  11. Akamine Y, Miura M, Komori H, et al. Effects of one-time apple juice ingestion on the pharmacokinetics of fexofenadine enantiomers. Eur J Clin Pharmacol. 2014 Sep;70(9):1087-95. PubMed
  12. Luo J, Imai H, Ohyama T, et al. The Pharmacokinetic Exposure to Fexofenadine is Volume-Dependently Reduced in Healthy Subjects Following Oral Administration With Apple Juice. Clin Transl Sci. 2016 Aug;9(4):201-6. PubMed
  13. Tsiougkos N, Vovolis V. Repeated anaphylactic episodes to orange and apple. Eur Ann Allergy Clin Immunol. 2013 May;45(3):113-5.
  14. Rubido S, García-Caballero L, Abeleira MT, Limeres J, García M, Diz P. Effect of chewing an apple on dental plaque removal and on salivary bacterial viability. PLoS One. 2018;13(7):e0199812. PubMed
  15. Krishnasamy S, Lomer MCE, Marciani L, et al. Processing apples to puree or juice speeds gastric emptying and reduces postprandial intestinal volumes and satiety in healthy adults. J Nutr 2020;150(11):2890-9. PubMed
  16. Awan S, Abelleira A, Khehra L, Hieber R. Undetectable serum lithium concentrations after coadministration of liquid lithium citrate and apple juice: A case report. Ment Health Clin. 2021;11(1):27-30. PubMed

See these in context on the Apple monograph →

Pumpkin 5 references
  1. Marks L, Partin AW, Epstein JI, et al. Effects of a saw palmetto herbal blend in men with symptomatic benign prostatic hyperplasia. J Urol 2000;163:1451-6. DOI
  2. Cho YH, Lee SY, Jeong DW, et al. Effect of pumpkin seed oil on hair growth in men with androgenetic alopecia: a randomized, double-blind, placebo-controlled trial. Evid Based Complement Alternat Med 2014;2014:549721. PubMed
  3. Vahlensieck W, Theurer C, Pfitzer E, Patz B, Banik N, Engelmann U. Effects of pumpkin seed in men with lower urinary tract symptoms due to benign prostatic hyperplasia in the one-year, randomized, placebo-controlled GRANU study. Urol Int 2015;94(3):286-95 PubMed
  4. Assouly P. Hair loss associated with cucurbit poisoning. JAMA Dermatol. 2018 May 1;154(5):617-618. PubMed
  5. Gawryjolek J, Ludwig H, Zbikowska-Götz M, Bartuzi Z, Krogulska A. Anaphylaxis after consumption of pumpkin seeds in a 2-y-old child tolerant to its pulp: A case study. Nutrition 2021;89:111272. PubMed

See these in context on the Pumpkin monograph →

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 →

Ambrette 6 references
  1. The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999.
  2. Liu, I. M., Liou, S. S., Lan, T. W., Hsu, F. L., and Cheng, J. T. Myricetin as the active principle of Abelmoschus moschatus to lower plasma glucose in streptozotocin-induced diabetic rats. Planta Med. 2005;71(7):617-621.
  3. Liu, I. M., Liou, S. S., and Cheng, J. T. Mediation of beta-endorphin by myricetin to lower plasma glucose in streptozotocin-induced diabetic rats. J.Ethnopharmacol. 3-8-2006;104(1-2):199-206.
  4. Liu, I. M., Tzeng, T. F., Liou, S. S., and Lan, T. W. Improvement of insulin sensitivity in obese Zucker rats by myricetin extracted from Abelmoschus moschatus. Planta Med. 2007;73(10):1054-1060.
  5. Wojnarowska, F. and Calnan, C. D. Contact and photocontact allergy to musk ambrette. Br.J.Dermatol. 1986;114(6):667-675. PubMed
  6. Liu IM, Tzeng TF, Liou SS. Abelmoschus moschatus (Malvaceae), an aromatic plant, suitable for medical or food uses to improve insulin sensitivity. Phytother Res 2010;24(2):233-9.

See these in context on the Ambrette monograph →

Dandelion 27 references
  1. Maliakal PP, Wanwimolruk S. Effect of herbal teas on hepatic drug metabolizing enzymes in rats. J Pharm Pharmacol 2001;53:1323-9. PubMed
  2. Williams CA, Goldstone F, Greenham J. Flavonoids, cinnamic acids and coumarins from the different tissues and medicinal preparations of Taraxacum officinale. Phytochemistry 1996;42:121-7. PubMed
  3. Hussain Z, Waheed A, Qureshi RA, et al. The effect of medicinal plants of Islamabad and Murree region of Pakistan on insulin secretion from INS-1 cells. Phytother Res 2004;18:73-7. PubMed
  4. Racz-Kotilla E, Racz G, Solomon A. The action of Taraxacum officinale extracts on the body weight and diuresis of laboratory animals. Planta Med 1974;26:212-7. PubMed
  5. Zhu M, Wong PY, Li RC. Effects of taraxacum mongolicum on the bioavailability and disposition of ciprofloxacin in rats. J Pharm Sci 1999;88:632-4. PubMed
  6. Jovanovic M, Mimica-Dukic N, Poljacki M, Boza P. Erythema multiforme due to contact with weeds: a recurrence after patch testing. Contact Dermatitis 2003;48:17-25. PubMed
  7. Chivato T, Juan F, Montoro A, Laguna R. Anaphylaxis induced by ingestion of a pollen compound. J Investig Allergol Clin Immunol 1996;6:208-9.
  8. Cohen SH, Yunginger JW, Rosenberg N, Fink JN. Acute allergic reaction after composite pollen ingestion. J Allergy Clin Immunol 1979;64:270-4. PubMed
  9. Lovell CR, Rowan M. Dandelion dermatitis. Contact Dermatitis 1991;25:185-8. PubMed
  10. Agarwal SC, Crook JR, Pepper CB. Herbal remedies -- how safe are they? A case report of polymorphic ventricular tachycardia/ventricular fibrillation induced by herbal medication used for obesity. Int J Cardiol 2006;106:260-1. PubMed
  11. Martín-Muñoz MF, Bartolome B, Caminoa M, et al. Bee pollen: a dangerous food for allergic children. Identification of responsible allergens. Allergol Immunopathol (Madr) 2010;38:263-5. PubMed
  12. Neef H, Cilli F, Declerck PJ, et al. Platelet anti-aggregating activity of Taraxacum officinale Weber. Phytotherapy Research 1996;10:s138-s140.
  13. Cuzzolin L, Zaffani S, and Benoni G. Safety implications regarding use of phytomedicines. Eur.J Clin Pharmacol. 2006;62:37-42. PubMed
  14. Posadzki, P., Watson, L. K., and Ernst, E. Adverse effects of herbal medicines: an overview of systematic reviews. Clin Med 2013;13(1):7-12. PubMed
  15. Wakelin, S. H., Marren, P., Young, E., and Shaw, S. Compositae sensitivity and chronic hand dermatitis in a seven-year-old boy. Br J Dermatol 1997;137(2):289-291. PubMed
  16. Ingber, A. Seasonal allergic contact dermatitis from Taraxacum officinale (dandelion) in an Israeli florist. Contact Dermatitis 2000;43(1):49.
  17. Rodriguez, B., Rodriguez, A., de Barrio, M., Tornero, P., and Baeza, M. L. Asthma induced by canary food mix. Allergy Asthma Proc. 2003;24(4):265-268.
  18. Syhaieva, I. A. [Efficiency of specific immunotherapy in treatment of patients with seasonal allergic rhinitis]. Lik.Sprava. 2006;(1-2):51-53.
  19. Catania, M. A., Oteri, A., Caiello, P., Russo, A., Salvo, F., Giustini, E. S., Caputi, A. P., and Polimeni, G. Hemorrhagic cystitis induced by an herbal mixture. South.Med.J. 2010;103(1):90-92. PubMed
  20. Goksu, E., Eken, C., Karadeniz, O., and Kucukyilmaz, O. First report of hypoglycemia secondary to dandelion (Taraxacum officinale) ingestion. Am J Emerg.Med 2010;28(1):111-112. PubMed
  21. Fernandez-Gonzalez, D., Gonzalez-Parrado, Z., Vega-Maray, A. M., Valencia-Barrera, R. M., Camazon-Izquierdo, B., De, Nuntiis P., and Mandrioli, P. Platanus pollen allergen, Pla a 1: quantification in the atmosphere and influence on a sensitizing populati
  22. Liang, K. L., Su, M. C., Shiao, J. Y., Wu, S. H., Li, Y. H., and Jiang, R. S. Role of pollen allergy in Taiwanese patients with allergic rhinitis. J Formos.Med Assoc. 2010;109(12):879-885. PubMed
  23. Yang, Y., Zhao, Y., Wang, C. S., Wang, X. D., and Zhang, L. [Prevalence of sensitization to aeroallergens in 10 030 patients with allergic rhinitis]. Zhonghua Er.Bi Yan.Hou Tou.Jing.Wai Ke Za Zhi 2011;46(11):914-920.
  24. Davies, M. G. and Kersey, P. J. Contact allergy to yarrow and dandelion. Contact Dermatitis 1986;14(4):256-257. PubMed
  25. Collins JM and Miller DR. Dandelion green bezoar following antrectomy and vagotomy - case report. J Kansas Med Soc 1966;67(6):303-304.
  26. Moriarty B, Pinney JH, Owen-Casey MP, Rustin MH, Deroide F, Laing C, Davenport A. Digital necrosis from dandelion tea. Br J Dermatol. 2013 Jul;169(1):227-30. PubMed
  27. Onal S, Timur S, Okutucu B, Zihnioglu F. Inhibition of alphaglucosidase by aqueous extracts of some potent antidiabetic medicinal herbs. Prep Biochem Biotechnol 2005;35:29-36.

See these in context on the Dandelion monograph →

Butternut 3 references
  1. Blumenthal M, ed. The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. Trans. S. Klein. Boston, MA: American Botanical Council, 1998.
  2. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
  3. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.

See these in context on the Butternut monograph →

Garlic 154 references
  1. Silagy CA, Neil HA. A meta-analysis of the effect of garlic on blood pressure. J Hypertens 1994;12:463-8. DOI
  2. McMahon FG, Vargas R. Can garlic lower blood pressure? A pilot study. Pharmacotherapy 1993;13:406-7. DOI
  3. Auer W, Eiber A, Hertkorn E, et al. Hypertension and hyperlipidaemia: garlic helps in mild cases. Br J Clin Pract Suppl 1990;69:3-6.
  4. Garty BZ. Garlic burns. Pediatrics 1993;91:658-9.
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Flaxseed 37 references
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DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

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