FishSmart Ultra Ingredients & Drug Interactions
by Renew Life
What is this page for?
First and foremost: checking FishSmart Ultra 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
FishSmart Ultra is a dietary supplement by Renew Life with 3 active ingredients. Its ingredients are commonly taken for digestive support, bloating and gas, fat digestion.Based on those ingredients, 1,054 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Peppermint Oil, Omega-3 Fatty Acids. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against FishSmart Ultra by Renew Life
Ask about any prescription or over-the-counter medication and we check it for interactions with FishSmart Ultra by Renew Life — and tell you which ingredient is responsible.
AI summaries are generated from our interaction database for education only — always confirm with your pharmacist. How we use AI
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HelloPharmacist Scorecard of FishSmart Ultra by Renew Life
Our pharmacy team’s full take, with four database checks built into the cards below — a summary of what is known, not a grade of the product itself.
What’s inside
Full disclosure
FishSmart Ultra contains five active ingredients: two omega-3 fatty acids (eicosapentaenoic acid and docosahexaenoic acid), other omega-3 fatty acids, lipase (a digestive enzyme), and peppermint oil. The product is delivered in a softgel capsule with inactive ingredients including gelatin, glycerin, beeswax, lecithin, purified water, natural caramel color, and an enteric coating — a delayed-release shell designed to help the contents reach your intestines rather than break down in your stomach.
Does it work?
Strong evidence
Peppermint oil in this product is likely effective for irritable bowel syndrome (IBS) and possibly effective for indigestion (dyspepsia), nausea from chemotherapy, spasm during barium enema procedures, and side effects from endoscopy. The evidence for lipase on digestive issues and premature infant health is currently insufficient to rate.
We hold no effectiveness data on the omega-3 fatty acids in this product.
How safe is it?
Well-documented data
Peppermint oil is generally well tolerated when taken by mouth, though some people report abdominal pain, anal burning, belching, diarrhea, dry mouth, heartburn, nausea, or vomiting. Rare allergic reactions including anaphylaxis have been reported.
Lipase has no reported adverse effects in adults, though safety data is limited and it should be used only under medical guidance in people with serious digestive conditions. For pregnancy and breastfeeding: peppermint oil is likely safe, but there is little safety data on supplemental lipase in pregnancy or while breastfeeding — talk with your doctor or pharmacist before use in either case.
Meds to double-check
Moderate interaction found
Before taking FishSmart Ultra, check with your doctor or pharmacist if you take medications broken down by liver enzymes CYP3A4, CYP2C9, or CYP2C19 (including blood pressure drugs and many others), cyclosporine, or drugs processed by the CYP1A2 enzyme. Peppermint oil can theoretically raise their blood levels, though most interactions are not yet proven in humans.
The bottom line
Scorecard at a glanceFully disclosed formula with clinical evidence supporting its stated purpose. Moderate medication interactions have been identified, and safety information is well characterized.
FishSmart Ultra's omega-3s and enzymes may help with digestion and IBS-related symptoms, but the peppermint oil interacts with liver enzymes that metabolize many common medications. Before you start, check your exact prescriptions against the medication checker on this page, and talk with your doctor or pharmacist — especially if you take blood pressure drugs, immunosuppressants, or any medication metabolized by your liver.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 2 of 5 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Mar 24, 2017.
This Scorecard evaluates available label information, ingredient evidence, and known medication-safety considerations. It does not independently verify product identity, purity, potency, contamination, or manufacturing quality. How these ratings are computed
General information
Key facts about FishSmart Ultra, straight from the product label.
| Brand | Renew Life |
|---|---|
| Barcode (UPC) | 631257535054 |
| Net contents | 45 Enteric Coated Softgel(s) |
| Market status | On market |
| Date entered into DSLD | Mar 24, 2017 |
| DSLD ID | 71503 |
| Product type | Other Combinations |
| Supplement form | Softgel Capsule |
| Dietary claims / uses | Nutrient, All Other, Structure/Function |
| Intended target group(s) | Adult (18 - 50 Years), Gluten Free, Dairy Free, Sugar Free |
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.
Supplement Facts
The label details for FishSmart Ultra by Renew Life, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Calories | 11 Calorie(s), 33 Calorie(s) | -- |
| Calories from Fat | 9 Calorie(s), 27 Calorie(s) | -- |
| Eicosapentaenoic Acid | 300 mg, 900 mg | -- |
| Docosahexaenoic Acid | 200 mg, 600 mg | -- |
| Saturated Fat | 0.1 Gram(s), 0.3 Gram(s) | 2% |
| Trans Fat | 0 Gram(s), 0 Gram(s) | -- |
| Total Fat | 1 Gram(s), 3 Gram(s) | 5% |
| Lipase | 24 mg, 72 mg | -- |
| Other Omega-3 Fatty Acids | 150 mg, 450 mg | -- |
| Peppermint Oil | 22 mg, 66 mg | -- |
| Omega-3 Fatty Acids | 650 mg, 1950 mg | -- |
Other ingredients: Gelatin, Glycerin, Beeswax, Lecithin, purified Water, natural Caramel color, Enteric Coating
Tap any ingredient to jump to its full detail below.
These statements are the manufacturer’s wording, reproduced from the product label — the label is saying it, not HelloPharmacist. We don’t verify or endorse them.
General Statements
FishSmart Ultra is an ultra-concentrated daily fish oil supplement ideal for those with difficult digestion.
Purified and third-party tested to exceed all published U.S. and international standards for PCBs, pesticides, heavy metals and dioxins.
Quality and purity guaranteed
Manufactured in a GMP facility
3X more omega-3 absorption Relieves digestive discomfort Supports heart & joint health
Serving size: 1 to 3 softgels Servings per container: 15 to 45
1,000 mg
Made in USA
Enteric-coated controlled release
FishSMART Ultra: ~ Targeted release ~ No aftertaste ~ Lipase aids digestion Typical uncoated fish oils: ~ Poor breakdown ~ Gastrointestinal discomfort ~ Fishy “repeat” Non-coated capsule dissolves in stomach causing fishy after-taste and poor absorption Lipase Fat-splitting Enzyme Enhances the digestion and absorption of Omega-3 oils FishSMART Ultra: Oil droplets in bile 3 minutes after adding lipase enzyme 1 enteric-coated softgel = 3 uncoated softgels
Enteric-coated Less burping
The total-body benefits of omega-3s Clinical studies indicate that a diet rich in Omega-3 oils provides numerous health benets for the whole body. Fish-derived Omega-3s have been shown to support heart health and immunity, as well as healthy skin and joints and improved mood.
Peppermint oil for enhanced digestion Peppermint oil is a powerful natural digestive aid ideal for those with digestive issues.
Its soothing properties help relax the muscles of the stomach and colon and may help relieve occasional irritable bowel, diarrhea, abdominal cramping and flatulence.
Ultimate purity and potency
Sourced from smaller species of wild, cold-water fish, the omega oils in FishSMART Ultra undergo a minimum of three purification steps to ensure high concentration and freedom from any contaminants.
How does FishSMART Ultra deliver 3x better absorption?
#15543 0511
Formula
Enteric-coated softgels and lipase guarantee 3X more Omega-3 absorption, and added peppermint oil stimulates digestion and helps relieve intestinal discomfort.*
The omega-3 oil for digestive issues
Fish oil with peppermint oil Ultra-concentrated omega-3
Contains: Non-GMO soy
FishSMART Ultra enteric-coated capsules contain peppermint oil and lipase, which aid in digestion and also help reduce fishy aftertaste.
Lipase-enhanced digestion FishSMART Ultra is enhanced with plant-derived lipase, the fat-splitting enzyme, to aid in omega-3 digestion and absorption. Lipase helps break down the fats and prevent fishy burps or aftertaste.
The peppermint oil in FishSMART Ultra stimulates the flow of digestive fluids and helps relieve occasional gas, bloating, nausea and indigestion.
FishSMART Ultra provides superior-quality, purified fish oil rich in Omega-3 DHA and EPA.
Formulation
Contains no GMOs, gluten, yeast, sugar, salt, dairy, eggs, nuts, wheat, corn, binders, preservatives or artificial ingredients.
Storage
Store in a dry place at 59-86(0)F (15-30(0)C).
Precautions
Keep out of reach of children.
Warning: Consult your physician before using this or any product if you are pregnant, nursing, trying to conceive, taking medication or have a medical condition.
Tamper Evident: Do not use if safety seal is broken or missing.
Contains: Non-GMO soy
General
0511
FDA Disclaimer Statement
This statement has not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.
Seals/Symbols
Purity Potency Guaranteed
Suggested/Recommended/Usage/Directions
Once-daily potency
Directions: Take 1 softgel daily. To maximize your intake of Omega-3, take 3 softgels daily.
Once-daily convenience FishSMART Ultra is more concentrated than other fish oil blends, which means you get all the benefits of the 1,000 mg powerful omega-3 formula in just one daily softgel.
FDA Statement of Identity
Dietary Supplement
Brand IP Statement(s)
Renew Life The digestive care company
Ultragest Technology
Our Ultragest enteric coating means more omega-3 oils are delivered directly to the intestines. This targeted release ensures superior absorption with less of the fishy repeat, aftertaste or odor typical with uncoated fish oils.
Ultragest Enteric Coating Oils are delivered directly to the intestines for superior absorption
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
FishSmart Ultra by Renew Life label
The label scan from the NIH Dietary Supplement Label Database. Tap to enlarge.
Label images are published by the NIH Dietary Supplement Label Database for the version of this product on file. Always read your actual product label.
View the full label (PDF)The Ingredients in FishSmart Ultra by Renew Life
These are the 3 active ingredients this product is made of. Select any to open its full monograph.
Serving size1 Softgel(s) Dosage formSoftgel Capsule Servings per container45 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.
Lipase
No knowninteractions
Lipase is a digestive enzyme that helps your body break down dietary fats. It is well established as part of prescription pancreatic enzyme therapy fo...
Lipase monograph & interactionsPeppermint Oil
Interacts with796 drugs
Peppermint is a popular herb with the best evidence supporting enteric-coated peppermint oil for easing IBS symptoms. It is generally well tolerated f...
Peppermint Oil monograph & interactionsOmega-3 Fatty Acids
Interacts with375 drugs
DHA is an omega-3 fatty acid found in fatty fish and algae that is a building block for the brain, nervous system, and eyes. It is widely used and gen...
Omega-3 Fatty Acids monograph & interactions- › Eicosapentaenoic Acid
- › Docosahexaenoic Acid
- › Other Omega-3 Fatty Acids
Other (inactive) ingredients: Gelatin, Glycerin, Beeswax, Lecithin, Purified Water, Natural Caramel color, Enteric Coating. These complete the product’s ingredient list but are not active constituents.
FishSmart Ultra by Renew Life Drug Interactions
HelloPharmacist Interaction Report
FishSmart Ultra by Renew Life contains peppermint oil, which interacts with a wide range of medications through its effects on liver enzymes that break down drugs.
The most serious documented interaction is with cyclosporine (an immunosuppressant), where peppermint may raise its levels and increase side effects.
Read the full breakdown — every affected drug type, severity by severity
Peppermint oil can theoretically increase blood levels of medications metabolized by three major liver enzyme systems (CYP3A4, CYP2C9, and CYP2C19 substrates). This includes many common drugs, though most interactions have only been observed in lab or animal studies so far — one clinical study did show peppermint raising levels of felodipine, a blood pressure medication.
Peppermint may also affect CYP1A2 substrates, though evidence from human use is weak.
We could not check eicosapentaenoic acid, docosahexaenoic acid, other omega-3 fatty acids, or lipase for interactions — we hold no data on these ingredients. Use the medication checker on this page to look up your specific drugs before you start.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against FishSmart Ultra?
Ask about interactions with your drugs in plain English — “Can I take it with lisinopril?” — and we find you the answer in seconds, ingredient by ingredient.
Go to the checkerIngredients driving the most interactions
Individual Drug Interactions
The ingredients in FishSmart Ultra interact with 1,054 drugs. Click any drug to see the details.
2 of the 3 ingredients in FishSmart Ultra interact with drugs. Each result below shows which ingredient is responsible. Peppermint Oil Omega-3 Fatty Acids
Acetaminophen, Chlorpheniramine, Phenylpropanolamine, OpiumHista-Derfule
How Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium interacts with FishSmart Ultra — through 1 ingredient. Tap an ingredient for the detail:
Peppermint OilCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, peppermint might increase the levels of CYP3A4 substrates.
Read the full Peppermint Oil + Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium interactionAcetaminophen, Chlorpheniramine, Phenylpropanolamine, PhenyltoloxamineNorel Plus
How Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Phenyltoloxamine interacts with FishSmart Ultra — through 1 ingredient. Tap an ingredient for the detail:
Peppermint OilCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, peppermint might increase the levels of CYP1A2 substrates.
Read the full Peppermint Oil + Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Phenyltoloxamine interactionAcetaminophen, Chlorpheniramine, PseudoephedrineAlka-Seltzer PLUS Liquid Gels, Children's Tylenol Cold, Codimal, Comtrex, Extra Strength Tylenol Allergy Sinus, Lorsin +3 more
How Acetaminophen, Chlorpheniramine, Pseudoephedrine interacts with FishSmart Ultra — through 1 ingredient. Tap an ingredient for the detail:
Peppermint OilCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, peppermint might increase the levels of CYP3A4 substrates.
Read the full Peppermint Oil + Acetaminophen, Chlorpheniramine, Pseudoephedrine interactionAcetaminophen, DextromethorphanTylenol Cough Ex Strength
How Acetaminophen, Dextromethorphan interacts with FishSmart Ultra — through 1 ingredient. Tap an ingredient for the detail:
Peppermint OilCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, peppermint might increase the levels of CYP1A2 substrates.
Read the full Peppermint Oil + Acetaminophen, Dextromethorphan interactionAcetaminophen, Dextromethorphan, Doxylamine, PseudoephedrineVicks NyQuil
How Acetaminophen, Dextromethorphan, Doxylamine, Pseudoephedrine interacts with FishSmart Ultra — through 1 ingredient. Tap an ingredient for the detail:
Peppermint OilCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, peppermint might increase the levels of CYP1A2 substrates.
Read the full Peppermint Oil + Acetaminophen, Dextromethorphan, Doxylamine, Pseudoephedrine interactionAcetaminophen, Dextromethorphan, Guaifenesin, PhenylephrineConar-A
How Acetaminophen, Dextromethorphan, Guaifenesin, Phenylephrine interacts with FishSmart Ultra — through 1 ingredient. Tap an ingredient for the detail:
Peppermint OilCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, peppermint might increase the levels of CYP3A4 substrates.
Read the full Peppermint Oil + Acetaminophen, Dextromethorphan, Guaifenesin, Phenylephrine interactionAcetaminophen, Dextromethorphan, Guaifenesin, PhenylpropanolamineAnatuss
How Acetaminophen, Dextromethorphan, Guaifenesin, Phenylpropanolamine interacts with FishSmart Ultra — through 1 ingredient. Tap an ingredient for the detail:
Peppermint OilCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, peppermint might increase the levels of CYP1A2 substrates.
Read the full Peppermint Oil + Acetaminophen, Dextromethorphan, Guaifenesin, Phenylpropanolamine interactionAcetaminophen, Dextromethorphan, Guaifenesin, PseudoephedrineRobitussin Cold, Severe Cold, Suphedrine Cold/Cough
How Acetaminophen, Dextromethorphan, Guaifenesin, Pseudoephedrine interacts with FishSmart Ultra — through 1 ingredient. Tap an ingredient for the detail:
Peppermint OilCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, peppermint might increase the levels of CYP1A2 substrates.
Read the full Peppermint Oil + Acetaminophen, Dextromethorphan, Guaifenesin, Pseudoephedrine interactionAcetaminophen, Dextromethorphan, Phenylpropanolamine, PyrilamineTheracaps
How Acetaminophen, Dextromethorphan, Phenylpropanolamine, Pyrilamine interacts with FishSmart Ultra — through 1 ingredient. Tap an ingredient for the detail:
Peppermint OilCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, peppermint might increase the levels of CYP3A4 substrates.
Read the full Peppermint Oil + Acetaminophen, Dextromethorphan, Phenylpropanolamine, Pyrilamine interactionAcetaminophen, Dextromethorphan, PseudoephedrineAlka-Seltzer PLUS Flu Liquid Gels, Non Aspirin Cold Caps, Tylenol Cold, Tylenol Flu Daytime Ex Strength, Tylenol Flu Ex Strength
How Acetaminophen, Dextromethorphan, Pseudoephedrine interacts with FishSmart Ultra — through 1 ingredient. Tap an ingredient for the detail:
Peppermint OilCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, peppermint might increase the levels of CYP1A2 substrates.
Read the full Peppermint Oil + Acetaminophen, Dextromethorphan, Pseudoephedrine interactionAcetaminophen, HydrocodoneAnexsia, Anodynos DHC, Azdone, Co-Gesic, Doucet, Lorcet +9 more
How Acetaminophen, Hydrocodone interacts with FishSmart Ultra — through 1 ingredient. Tap an ingredient for the detail:
Peppermint OilCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, peppermint might increase the levels of CYP1A2 substrates.
Read the full Peppermint Oil + Acetaminophen, Hydrocodone interactionAcetaminophen, IbuprofenCombogesic
How Acetaminophen, Ibuprofen interacts with FishSmart Ultra — through 2 ingredients. Tap an ingredient for the detail:
Peppermint OilCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 2c9 (cyp2c9) Substrates Moderate
Interaction Summary
Theoretically, peppermint might increase the levels of CYP1A2 substrates.
Read the full Peppermint Oil + Acetaminophen, Ibuprofen interactionOmega-3 Fatty AcidsAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, DHA may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Omega-3 Fatty Acids + Acetaminophen, Ibuprofen interactionAcetaminophen, Phenylephrine, ChlorpheniramineSuper Cold Tabs
How Acetaminophen, Phenylephrine, Chlorpheniramine interacts with FishSmart Ultra — through 1 ingredient. Tap an ingredient for the detail:
Peppermint OilCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, peppermint might increase the levels of CYP1A2 substrates.
Read the full Peppermint Oil + Acetaminophen, Phenylephrine, Chlorpheniramine interactionAcetazolamideAk-Zol, Diamox
How Acetazolamide interacts with FishSmart Ultra — through 1 ingredient. Tap an ingredient for the detail:
Omega-3 Fatty AcidsAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, taking DHA with antihypertensive drugs might increase the risk of hypotension.
Read the full Omega-3 Fatty Acids + Acetazolamide interactionAcetohexamideDymelor
How Acetohexamide interacts with FishSmart Ultra — through 1 ingredient. Tap an ingredient for the detail:
Omega-3 Fatty AcidsAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, taking DHA with antidiabetes drugs might reduce the effects of these medications.
Read the full Omega-3 Fatty Acids + Acetohexamide interactionAcetylsalicylic AcidEntrophen
How Acetylsalicylic Acid interacts with FishSmart Ultra — through 1 ingredient. Tap an ingredient for the detail:
Omega-3 Fatty AcidsAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, DHA may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Omega-3 Fatty Acids + Acetylsalicylic Acid interactionAdagrasibKrazati
How Adagrasib interacts with FishSmart Ultra — through 1 ingredient. Tap an ingredient for the detail:
Peppermint OilCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, peppermint might increase the levels of CYP3A4 substrates.
Read the full Peppermint Oil + Adagrasib interactionAerosphere Budesonide, Formoterol Fumarate, GlycopyrrolateBreztri
How Aerosphere Budesonide, Formoterol Fumarate, Glycopyrrolate interacts with FishSmart Ultra — through 1 ingredient. Tap an ingredient for the detail:
Peppermint OilCytochrome P450 2c19 (cyp2c19) Substrates, Cytochrome P450 2c9 (cyp2c9) Substrates Moderate
Interaction Summary
Theoretically, peppermint might increase the levels of CYP2C19 substrates.
Read the full Peppermint Oil + Aerosphere Budesonide, Formoterol Fumarate, Glycopyrrolate interactionAgomelatineValdoxan
How Agomelatine interacts with FishSmart Ultra — through 1 ingredient. Tap an ingredient for the detail:
Peppermint OilCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 2c9 (cyp2c9) Substrates +1 Moderate
Interaction Summary
Theoretically, peppermint might increase the levels of CYP1A2 substrates.
Read the full Peppermint Oil + Agomelatine interactionAlbiglutideTanzeum
How Albiglutide interacts with FishSmart Ultra — through 1 ingredient. Tap an ingredient for the detail:
Omega-3 Fatty AcidsAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, taking DHA with antidiabetes drugs might reduce the effects of these medications.
Read the full Omega-3 Fatty Acids + Albiglutide interactionAlfentanilAlfenta
How Alfentanil interacts with FishSmart Ultra — through 1 ingredient. Tap an ingredient for the detail:
Peppermint OilCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, peppermint might increase the levels of CYP3A4 substrates.
Read the full Peppermint Oil + Alfentanil interactionAlfuzosinUroxatral
How Alfuzosin interacts with FishSmart Ultra — through 1 ingredient. Tap an ingredient for the detail:
Peppermint OilCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, peppermint might increase the levels of CYP3A4 substrates.
Read the full Peppermint Oil + Alfuzosin interactionAliskirenTekturna
How Aliskiren interacts with FishSmart Ultra — through 2 ingredients. Tap an ingredient for the detail:
Peppermint OilCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, peppermint might increase the levels of CYP3A4 substrates.
Read the full Peppermint Oil + Aliskiren interactionOmega-3 Fatty AcidsAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, taking DHA with antihypertensive drugs might increase the risk of hypotension.
Read the full Omega-3 Fatty Acids + Aliskiren interactionAlmotriptanAlmogran, Axert
How Almotriptan interacts with FishSmart Ultra — through 1 ingredient. Tap an ingredient for the detail:
Peppermint OilCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, peppermint might increase the levels of CYP3A4 substrates.
Read the full Peppermint Oil + Almotriptan interactionAlogliptinNesina
How Alogliptin interacts with FishSmart Ultra — through 2 ingredients. Tap an ingredient for the detail:
Omega-3 Fatty AcidsAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, taking DHA with antidiabetes drugs might reduce the effects of these medications.
Read the full Omega-3 Fatty Acids + Alogliptin interactionPeppermint OilCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, peppermint might increase the levels of CYP3A4 substrates.
Read the full Peppermint Oil + Alogliptin interactionAlogliptin, MetforminKazano
How Alogliptin, Metformin interacts with FishSmart Ultra — through 1 ingredient. Tap an ingredient for the detail:
Omega-3 Fatty AcidsAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, taking DHA with antidiabetes drugs might reduce the effects of these medications.
Read the full Omega-3 Fatty Acids + Alogliptin, Metformin interactionAlogliptin, PioglitazoneOseni
How Alogliptin, Pioglitazone interacts with FishSmart Ultra — through 2 ingredients. Tap an ingredient for the detail:
Omega-3 Fatty AcidsAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, taking DHA with antidiabetes drugs might reduce the effects of these medications.
Read the full Omega-3 Fatty Acids + Alogliptin, Pioglitazone interactionPeppermint OilCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, peppermint might increase the levels of CYP3A4 substrates.
Read the full Peppermint Oil + Alogliptin, Pioglitazone interactionAlpelisibPiqray
How Alpelisib interacts with FishSmart Ultra — through 1 ingredient. Tap an ingredient for the detail:
Peppermint OilCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, peppermint might increase the levels of CYP3A4 substrates.
Read the full Peppermint Oil + Alpelisib interactionAlprazolamNiravam, Xanax
How Alprazolam interacts with FishSmart Ultra — through 1 ingredient. Tap an ingredient for the detail:
Peppermint OilCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, peppermint might increase the levels of CYP3A4 substrates.
Read the full Peppermint Oil + Alprazolam interactionAlteplase, TpaActilyse, Activase
How Alteplase, Tpa interacts with FishSmart Ultra — through 1 ingredient. Tap an ingredient for the detail:
Omega-3 Fatty AcidsAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, DHA may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Omega-3 Fatty Acids + Alteplase, Tpa interactionEach ingredient & the kinds of drugs it affects
For each ingredient in FishSmart Ultra 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.
Peppermint Oil
Cyclosporine (Neoral, Sandimmune)
Theoretically, peppermint oil might increase the levels and adverse effects of cyclosporine.
In animal research, peppermint oil inhibits cyclosporine metabolism and increases cyclosporine levels. Inhibition of cytochrome P450 3A4 (CYP3A4) may be partially responsible for this interaction. An interaction between peppermint oil and cyclosporine has not been reported in humans.
Cytochrome P450 2C19 (Cyp2C19) Substrates
Theoretically, peppermint might increase the levels of CYP2C19 substrates.
In vitro research shows that peppermint oil inhibits CYP2C19. So far, this interaction has not been reported in humans.
Cytochrome P450 2C9 (Cyp2C9) Substrates
Theoretically, peppermint might increase the levels of CYP2C9 substrates.
In vitro research shows that peppermint oil inhibits CYP2C9. So far, this interaction has not been reported in humans.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, peppermint might increase the levels of CYP3A4 substrates.
Clinical research in healthy volunteers shows that a single dose of peppermint oil 600 mg inhibits CYP3A4 enzymes and increases the AUC of felodipine, a CYP3A4 substrate. However, in vitro research suggests that peppermint oil only inhibits CYP3A4 at very high concentrations.
Cytochrome P450 1A2 (Cyp1A2) Substrates
Theoretically, peppermint might increase the levels of CYP1A2 substrates.
In vitro and animal research shows that peppermint oil and peppermint leaf inhibit CYP1A2. However, in clinical research, peppermint tea did not significantly affect the metabolism of caffeine, a CYP1A2 substrate. It is possible that the 6-day duration of treatment may have been too short to identify a difference.
Omega-3 Fatty Acids
Anticoagulant/Antiplatelet Drugs
Theoretically, DHA may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Although some clinical evidence suggests that DHA might reduce collagen-stimulated platelet aggregation and thromboxane release, most clinical evidence suggests that DHA alone does not affect blood clotting. However, theoretically, when given in combination with EPA as fish oil, concomitant use with anticoagulant or antiplatelet drugs (including aspirin) might increase risk of bleeding.
Antidiabetes Drugs
Theoretically, taking DHA with antidiabetes drugs might reduce the effects of these medications.
In people with type 2 diabetes, including those taking oral hypoglycemic medications, DHA seems to increase fasting blood glucose levels.
Antihypertensive Drugs
Theoretically, taking DHA with antihypertensive drugs might increase the risk of hypotension.
Fish oils containing DHA can lower blood pressure and might have additive effects in patients treated with antihypertensives; use with caution.
Brand information
Manufacturer and brand details for FishSmart Ultra, from the product label.
Renew Life
- Name
- ReNew Life Formulas
- City
- Palm Harbor
- State
- FL
- ZipCode
- 34683
- Phone Number
- 1-800-830-1800
- Web Address
- www.renewlife.com
FishSmart Ultra by Renew Life: Common Questions
Does FishSmart Ultra by Renew Life interact with any medications?
How can one product interact with so many drugs?
Where does this information come from?
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Can I take this if I have a sensitive stomach?
What's the enteric coating for?
Is this safe while breastfeeding?
Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
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Label information is sourced from the NIH Dietary Supplement Label Database and reflects the product version on file; always read your actual product label. This page is for education only and is not a substitute for professional medical advice. Confirm with your pharmacist or doctor before combining supplements and medications.
The Full Monographs Behind FishSmart Ultra’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Lipase
Lipase is a digestive enzyme that helps your body break down dietary fats. It is well established as part of prescription pancreatic enzyme therapy for people who cannot make enough of their...
Read the full Lipase monograph → Herb & supplement monographPeppermint
Interacts with 796 drugsPeppermint is a popular herb with the best evidence supporting enteric-coated peppermint oil for easing IBS symptoms. It is generally well tolerated for most adults, but it can cause heartbu...
Read the full Peppermint monograph → Herb & supplement monographDocosahexaenoic Acid (dha)
Interacts with 375 drugsDHA is an omega-3 fatty acid found in fatty fish and algae that is a building block for the brain, nervous system, and eyes. It is widely used and generally well tolerated, with the stronges...
Read the full Docosahexaenoic Acid (dha) monograph →Sources & How We Checked
FishSmart Ultra's label data comes from the NIH Dietary Supplement Label Database; the ingredient interaction data is from the Natural Medicines database, reviewed by our pharmacists.
- NIH Dietary Supplement Label Database (DSLD) — The official product label on file for this supplement.
- Natural Medicines (Therapeutic Research Center) — Evidence-graded clinical reference behind the ingredient interaction data.
Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.
The 91 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.
Lipase 1 reference
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Peppermint 41 references
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- Pittler MH, Ernst E. Peppermint oil for irritable bowel syndrome: a critical review and metaanalysis. Am J Gastroenterol 1998;93:1131-5. PubMed
- Kline RM, Kline JJ, Di Palma J, Barbero GJ. Enteric-coated, pH-dependent peppermint oil capsules for the treatment of irritable bowel syndrome in children. J Pediatr 2001;138:125-8. PubMed
- Madisch A, Heydenreich CJ, Wieland V, et al. Treatment of functional dyspepsia with a fixed peppermint oil and caraway oil combination preparation as compared to cisapride. A multicenter, reference-controlled, double-blind equivalence study. Arzneimittel
- May B, Kuntz HD, Kieser M, Kohler S. Efficacy of a fixed peppermint oil/caraway oil combination in non-ulcer dyspepsia. Arzneimittelforschung 1996;46:1149-53.
- Micklefield GH, Greving I, May B. Effects of peppermint oil and caraway oil on gastroduodenal motility. Phytother Res 2000;14:20-3. DOI
- Morton CA, Garioch J, Todd P, et al. Contact sensitivity to menthol and peppermint in patients with intra-oral symptoms. Contact Dermatitis 1995;32:281-4. PubMed
- May B, Kohler S, Schneider B. Efficacy and tolerability of a fixed combination of peppermint oil and caraway oil in patients suffering from functional dyspepsia. Aliment Pharmacol Ther 2000;14:1671-7. PubMed
- Nash P, Gould SR, Bernardo DE. Peppermint oil does not relieve the pain of irritable bowel syndrome. Br J Clin Pract 1986;40:292-3. DOI
- Rees WD, Evans BK, Rhodes J. Treating irritable bowel syndrome with peppermint oil. Br Med J 1979;2:835-6. PubMed
- Davies SJ, Harding LM, Baranowski AP. A novel treatment of postherpetic neuralgia using peppermint oil. Clin J Pain 2002;18:200-2. PubMed
- Weston CF. Anal burning and peppermint oil. Postgrad Med J 1987;63:717. PubMed
- Dresser GK, Wacher V, Wong S, et al. Evaluation of peppermint oil and ascorbyl palmitate as inhibitors of cytochrome P4503A4 activity in vitro and in vivo. Clin Pharmacol Ther 2002;72:247-55. PubMed
- Wacher VJ, Wong S, Wong HT. Peppermint oil enhances cyclosporine oral bioavailability in rats: comparison with D-alpha-tocopheryl poly(ethylene glycol 1000) succinate (TPGS) and ketoconazole. J Pharm Sci 2002;91:77-90.
- Lawson MJ, Knight RE, Tran K, et al. Failure of enteric-coated peppermint oil in the irritable bowel syndrome: a randomized double-blind crossover study. J Gastroenterol Hepatol 1988;3:235-8. DOI
- Unger M, Frank A. Simultaneous determination of the inhibitory potency of herbal extracts on the activity of six major cytochrome P450 enzymes using liquid chromatography/mass spectrometry and automated online extraction. Rapid Commun Mass Spectrom 2004;1 PubMed
- Maliakal PP, Wanwimolruk S. Effect of herbal teas on hepatic drug metabolizing enzymes in rats. J Pharm Pharmacol 2001;53:1323-9. PubMed
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- Cappello G, Spezzaferro M, Grossi L, et al. Peppermint oil (Mintoil) in the treatment of irritable bowel syndrome: a prospective double blind placebo-controlled randomized trial. Dig Liver Dis 2007;39:530-6. PubMed
- Moghadam BK, Gier R, and Thurlow T. Extensive oral mucosal ulcerations caused by misuse of a commercial mouthwash. Cutis 1999;64:131-134.
- Andersen, K. E. Contact allergy to toothpaste flavors. Contact Dermatitis 1978;4(4):195-198. PubMed
- Barnard, D. R. Repellency of essential oils to mosquitoes (Diptera: Culicidae). J Med Entomol. 1999;36(5):625-629. PubMed
- Tamir, S., Davidovich, Z., Attal, P., and Eliashar, R. Peppermint oil chemical burn. Otolaryngol.Head Neck Surg. 2005;133(5):801-802. PubMed
- Kalavala, M., Hughes, T. M., Goodwin, R. G., Anstey, A. V., and Stone, N. M. Allergic contact dermatitis to peppermint foot spray. Contact Dermatitis 2007;57(1):57-58. PubMed
- Vermaat, H., van Meurs, T., Rustemeyer, T., Bruynzeel, D. P., and Kirtschig, G. Vulval allergic contact dermatitis due to peppermint oil in herbal tea. Contact Dermatitis 2008;58(6):364-365. PubMed
- Merat, S., Khalili, S., Mostajabi, P., Ghorbani, A., Ansari, R., and Malekzadeh, R. The effect of enteric-coated, delayed-release peppermint oil on irritable bowel syndrome. Dig.Dis.Sci. 2010;55(5):1385-1390. PubMed
- Tran, A., Pratt, M., and DeKoven, J. Acute allergic contact dermatitis of the lips from peppermint oil in a lip balm. Dermatitis 2010;21(2):111-115. DOI
- Hitz, Lindenmuller, I and Lambrecht, J. T. Oral care. Curr Probl.Dermatol 2011;40:107-115.
- Shavakhi, A., Ardestani, S. K., Taki, M., Goli, M., and Keshteli, A. H. Premedication with peppermint oil capsules in colonoscopy: a double blind placebo-controlled randomized trial study. Acta Gastroenterol Belg 2012;75(3):349-353.
- Lech, Y., Olesen, K. M., Hey, H., Rask-Pedersen, E., Vilien, M., and Ostergaard, O. [Treatment of irritable bowel syndrome with peppermint oil. A double- blind study with a placebo]. Ugeskr.Laeger 10-3-1988;150(40):2388-2389.
- Parys, B. T. Chemical burns resulting from contact with peppermint oil mar: a case report. Burns Incl.Therm.Inj. 1983;9(5):374-375. PubMed
- Bayat R, Borici-Mazi R. A case of anaphylaxis to peppermint. Allergy Asthma Clin Immunol. 2014;10(1):6. PubMed
- Rich G, Shah A, Koloski N, et al. A randomized placebo-controlled trial on the effects of Menthacarin, a proprietary peppermint- and caraway-oil-preparation, on symptoms and quality of life in patients with functional dyspepsia. Neurogastroenterol Motil 2 PubMed
- Douros A, Bronder E, Andersohn F, et al. Herb-Induced Liver Injury in the Berlin Case-Control Surveillance Study. Int J Mol Sci 2016;17(1). PubMed
- Begas E, Tsioutsiouliti A, Kouvaras E, et al. Effects of peppermint tea consumption on the activities of CYP1A2, CYP2A6, Xanthine Oxidase, N-acetyltranferase-2 and UDP-glucuronosyltransferases-1A1/1A6 in healthy volunteers. Food Chem Toxicol 2017;100:80-9 PubMed
- Cash BD, Epstein MS, Shah SM. A Novel Delivery System of Peppermint Oil Is an Effective Therapy for Irritable Bowel Syndrome Symptoms. Dig Dis Sci 2016;61(2):560-71. PubMed
- Elsaie LT, El Mohsen AM, Ibrahim IM, Mohey-Eddin MH, Elsaie ML. Effectiveness of topical peppermint oil on symptomatic treatment of chronic pruritus. Clin Cosmet Investig Dermatol 2016;9:333-8. PubMed
- Wu J, Xu R, Zhan R, et al. Effective symptomatic treatment for severe and intractable pruritus associated with severe burn-induced hypertrophic scars: A prospective, multicenter, controlled trial. Burns 2016;42(5):1059-66. PubMed
- Weerts ZZRM, Masclee AAM, Witteman BJM, et al. Efficacy and safety of peppermint oil in a randomized, double-blind trial of patients with irritable bowel syndrome. Gastroenterology. 2020;158(1):123-136. PubMed
- Nee J, Ballou S, Kelley JM, et al. Peppermint Oil Treatment for Irritable Bowel Syndrome: A Randomized Placebo-Controlled Trial. Am J Gastroenterol 2021;116(11):2279-2285. PubMed
- Ingrosso MR, Ianiro G, Nee J, et al. Systematic review and meta-analysis: efficacy of peppermint oil in irritable bowel syndrome. Aliment Pharmacol Ther 2022;56(6):932-41. PubMed
Docosahexaenoic Acid (dha) 49 references
- Akedo I, Ishikawa H, Nakamura T, et al. Three cases with familial adenomatous polyposis diagnosed as having malignant lesions in the course of a long-term trial using docosahexanoic acid (DHA)-concentrated fish oil capsules (abstract). Jpn J Clin Oncol PubMed
- Prisco D, Paniccia R, Bandinelli B, et al. Effect of medium-term supplementation with a moderate dose of n-3 polyunsaturated fatty acids on blood pressure in mild hypertensive patients. Thromb Res 1998;1:105-12.
- Grimsgaard S, Bonaa KH, Hansen JB, Nordoy A. Highly purified eicosapentaenoic acid and docosahexaenoic acid in humans have similar triacylglycerol-lowering effects but divergent effects on serum fatty acids. Am J Clin Nutr 1997;66:649-59.
- Toft I, Bonaa KH, Ingebretsen OC, et al. Effects of n-3 polyunsaturated fatty acids on glucose homeostasis and blood pressure in essential hypertension. A randomized, controlled trial. Ann Intern Med 1995;123:911-8.
- Sacks FM, Hebert P, Appel LJ, et al. Short report: the effect of fish oil on blood pressure and high-density lipoprotein-cholesterol levels in phase I of the trials of hypertension prevention. J Hypertens 1994;12:209-13.
- Vandongen R, Mori TA, Burke V, et al. Effects on blood pressure of omega 3 fats in subjects at increased risk of cardiovascular disease. Hypertension 1993;22:371-9. PubMed
- FDA. Center for Food Safety and Applied Nutrition. Letter regarding dietary supplement health claim for omega-3 fatty acids and coronary heart disease. Available at: http://www.fda.gov/ohrms/dockets/dockets/95s0316/95s-0316-Rpt0272-38-Appendix-D-Reference
- Pedersen HS, Mulvad G, Seidelin KN, et al. N-3 fatty acids as a risk factor for haemorrhagic stroke. Lancet 1999;353:812-3. PubMed
- Ito Y, Suzuki K, Imai H, et al. Effects of polyunsaturated fatty acids on atrophic gastritis in a Japanese population. Cancer Lett 2001;163:171-8. PubMed
- Kris-Ehterton PM, Harris WS, Appel LJ, et al. Fish consumption, fish oil, omega-3 fatty acids, and cardiovascular disease. Circulation 2002;106:2747-57. PubMed
- Woodman RJ, Mori TA, Burke V, et al. Effects of purified eicosapentaenoic and docosahexaenoic acids on glycemic control, blood pressure, and serum lipids in type 2 diabetic patients with treated hypertension. Am J Clin Nutr 2002;76:1007-15.. PubMed
- Marangell LB, Martinez JM, Zboyan HA, et al. A double-blind, placebo-controlled study of the omega-3 fatty acid docosahexaenoic acid in the treatment of major depression. Am J Psychiatry 2003;160:996-8.. PubMed
- Leng GC, Smith FB, Fowkes FG, et al. Relationship between plasma essential fatty acids and smoking, serum lipids, blood pressure and haemostatic and rheological factors. Prostaglandins Leukot Essent Fatty Acids 1994;51:101-8. PubMed
- Nelson GJ, Schmidt PS, Bartolini GL, et al. The effect of dietary docosahexaenoic acid on platelet function, platelet fatty acid composition, and blood coagulation in humans. Lipids 1997;32:1129-36. PubMed
- Wheaton DH, Hoffman DR, Locke KG, et al. Biological safety assessment of docosahexaenoic acid supplementation in a randomized clinical trial for X-linked retinitis pigmentosa. Arch Ophthalmol 2003;121:1269-78. PubMed
- Malcolm CA, McCulloch DL, Montgomery C, et al. Maternal docosahexaenoic acid supplementation during pregnancy and visual evoked potential development in term infants: a double blind, prospective, randomised trial. Arch Dis Child Fetal Neonatal Ed 2003;88: DOI
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- Montgomery C, Speake BK, Cameron A, et al. Maternal docosahexaenoic acid supplementation and fetal accretion. Br J Nutr 2003;90:135-45. DOI
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- Hawkes JS, Bryan DL, Makrides M, et al. A randomized trial of supplementation with docosahexaenoic acid-rich tuna oil and its effects on the human milk cytokines interleukin 1 beta, interleukin 6, and tumor necrosis factor alpha. Am J Clin Nutr 2002;75:75
- Uauy R, Hoffman DR, Mena P, et al. Term infant studies of DHA and ARA supplementation on neurodevelopment: Results of randomized controlled trials. J Pediatr 2003;143:S17-25. PubMed
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- Mori, T. A., Bao, D. Q., Burke, V., Puddey, I. B., and Beilin, L. J. Docosahexaenoic acid but not eicosapentaenoic acid lowers ambulatory blood pressure and heart rate in humans. Hypertension 1999;34(2):253-260. PubMed
- Otto, S. J., van Houwelingen, A. C., and Hornstra, G. The effect of supplementation with docosahexaenoic and arachidonic acid derived from single cell oils on plasma and erythrocyte fatty acids of pregnant women in the second trimester. Prostaglandins Le PubMed
- Helland, I. B., Saugstad, O. D., Smith, L., Saarem, K., Solvoll, K., Ganes, T., and Drevon, C. A. Similar effects on infants of n-3 and n-6 fatty acids supplementation to pregnant and lactating women. Pediatrics 2001;108(5):E82. PubMed
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- Fougère H, Bilodeau JF, Lavoie PM, et al. Docosahexaenoic acid-rich algae oil supplementation on breast milk fatty acid profile of mothers who delivered prematurely: a randomized clinical trial. Sci Rep 2021;11(1):21492. PubMed
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- Christifano DN, Gustafson KM, Carlson SE, et al. Maternal docosahexaenoic acid exposure needed to achieve maternal-newborn EQ. Nutrients 2022;14(16):3300. PubMed
- Vizzari G, Morniroli D, Alessandretti F, et al. Comparative analysis of docosahexaenoic acid (DHA) content in mother's milk of term and preterm mothers. Nutrients 2022;14(21):4595. PubMed
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See these in context on the Docosahexaenoic Acid (dha) 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