Interactions on record — worth a quick check against your medications. Based on 3 of 5 ingredients. Check your meds →
Dietary supplement

Flex Ingredients & Drug Interactions

by New Earth

Flex label
See full label image
Capsule Category: Other Combinations
Most serious interaction: Moderate
Clinical methodology reviewed by · Updated Sep 23, 2026 · Label data from the NIH DSLD
What is this page for?

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

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

The interaction bottom line Most serious interaction: Moderate

Flex is a dietary supplement by New Earth with 5 active ingredients. Its ingredients are commonly taken for osteoarthritis joint pain, joint stiffness, cartilage support.Based on those ingredients, 1,079 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Boswellia serrata extract, organic Microalgae, Chondroitin Sulfate. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

Jump to a section

Check Your Meds Against Flex by New Earth

Ask about any prescription or over-the-counter medication and we check it for interactions with Flex by New Earth — and tell you which ingredient is responsible.

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HelloPharmacist Scorecard of Flex by New Earth

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 5 active ingredients.
  • “Proprietary Blend” is a proprietary blend — the label gives one combined amount (1.70 Gram(s)) without saying how much of each component you get.
  • “standardized Chicken Cartilage” is listed as a grouped ingredient — the label gives one combined amount (40 mg) without saying how much of each component you get.

Flex contains five active ingredients. Vegetable glucosamine HCl and chondroitin sulfate are both joint-support compounds.

The product also includes organic microalgae (spirulina), Boswellia serrata extract (a plant resin used for inflammation), standardized chicken cartilage, and total collagen. These are paired with inactive ingredients: plant fiber and shark cartilage.

Does it work?

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

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

Why this rating?
  • The label markets this product for: Joint support and healthy cartilage.
  • We looked for evidence on: Osteoarthritis, Rheumatoid arthritis (RA), Knee pain, Exercise-induced muscle soreness, Joint flexibility, Joint stiffness — and 1 related terms.
  • The strongest evidence on file: Boswellia Serrata is rated "Possibly Effective" for Osteoarthritis (Natural Medicines).
  • Also on file: Chondroitin Sulfate is rated "Possibly Effective" for Osteoarthritis.
  • Also on file: Boswellia Serrata is rated "Insufficient Reliable Evidence To Rate" for Exercise-induced muscle soreness, Rheumatoid arthritis (RA), Knee pain.

Chondroitin is possibly effective for cataracts and osteoarthritis, though evidence is uncertain and quality varies. The microalgae (spirulina) is possibly effective for high blood pressure.

Boswellia serrata extract is possibly effective for osteoarthritis. The data on file doesn't establish effectiveness for the other suggested uses—aging skin, osteoporosis, high cholesterol, colorectal polyps, acne, hay fever, anemia, arsenic poisoning, Alzheimer disease, asthma, or cluster headaches.

The evidence, ingredient by ingredient Chondroitin Sulfate Blue-green Algae Boswellia Serrata

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 3 of the 3 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 3 of 3.
  • General safety write-ups exist for 3 of 3.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

Chondroitin is generally well tolerated short-term when taken by mouth, though quality and benefit are uncertain. Common side effects include stomach pain, bloating, constipation, diarrhea, heartburn, and nausea.

Rare serious effects include liver damage. Skin reactions—swelling, hair loss, rash, hives—have been reported, sometimes in combination products with glucosamine.

One case of asthma worsening was reported. Do not use during pregnancy or breastfeeding; there isn't enough safety data.

Organic microalgae is generally well tolerated but quality varies and some products can be contaminated with toxins or heavy metals. Avoid during pregnancy and breastfeeding due to contamination risk and unknown safety.

Common side effects include stomach cramps, bloating, diarrhea, dizziness, fatigue, gas, headache, nausea, and vomiting. Allergic reactions, including rare anaphylaxis, and mild bleeding or bruising have been reported.

Boswellia serrata is generally well tolerated short-term. Common side effects include stomach pain, diarrhea, headache, heartburn, itching, and nausea.

Dizziness, vertigo, and headache occur in some users. Avoid during pregnancy and breastfeeding; safety data is lacking.

Side effects, ingredient by ingredient Chondroitin Sulfate Blue-green Algae Boswellia Serrata

Meds to double-check

Moderate interaction found
Known Interaction Concern · database check
Moderate identified

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

Why this rating?
  • 3 of the 3 matched ingredients can interact with medications — Boswellia Serrata, Chondroitin Sulfate, Blue-green Algae.
  • The most serious interaction on file is rated Moderate.
  • Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs; immunosuppressants / transplant drugs; diabetes medications.
  • For scale: 1,080 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 Flex, double-check with your pharmacist or doctor if you take warfarin or other blood thinners (anticoagulants or antiplatelet agents)—chondroitin and microalgae may increase bleeding risk. Also confirm it's safe if you're on antidiabetes drugs, immunosuppressants, or medications processed by your liver's CYP2D6, CYP2C19, CYP1A2, CYP2C9, or CYP3A4 pathways, as Boswellia may alter their levels.

Check your own medication Run your meds through the checker above

The bottom line

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

Flex targets joint and cartilage support through glucosamine, chondroitin, and Boswellia—ingredients with some evidence for osteoarthritis and related conditions, though results are mixed. The big catch: if you take blood thinners, drugs for diabetes, immunosuppressants, or medications metabolized by your liver, you need to check with your doctor or pharmacist before starting this product.

Quality varies across these supplement ingredients, and some carry contamination risk.

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

Assessment coverage: 3 of 5 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Aug 23, 2022.

This Scorecard evaluates available label information, ingredient evidence, and known medication-safety considerations. It does not independently verify product identity, purity, potency, contamination, or manufacturing quality. How these ratings are computed

At a glance

General information

Key facts about Flex, straight from the product label.

Brand New Earth
Net contents 90 Capsule(s)
Market status On market
Date entered into DSLD Aug 23, 2022
DSLD ID 271446
Product type Other Combinations
Supplement form Capsule
Dietary claims / uses Nutrient, All Other, Structure/Function
Intended target group(s) Adult (18 - 50 Years)
From the label
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.

Supplement Facts

The label details for Flex by New Earth, 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:
3 Capsule(s)
Maximum serving Sizes:
3 Capsule(s)
Servings per container
30
IngredientAmount% DV
Vegetable Glucosamine HCl0 NP--
Chondroitin Sulfate0 NP--
organic Microalgae0 NP--
Proprietary Blend1.7 Gram(s)--
Calories5 Calorie(s)--
Total Carbohydrate1 Gram(s)1%
Total Collagen10 mg--
Boswellia serrata extract0 NP--
standardized Chicken Cartilage40 mg--

Other ingredients: Plant Fiber, Shark Cartilage

Tap any ingredient to jump to its full detail below.

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

Joint Support Maintaining healthy, flexible, and strong joints and supporting cartilage is a significant factor in an active lifestyle. Meet Flex, our scientifically designed proprietary blend of UC-II with undenatured type II collagen, ApresFLEX boswellia extract, vegetable-based glucosamine, chondroitin, and our organic Wild Microalgae. Give yourself the gift of maximum flexibility with Flex.

Suggested/Recommended/Usage/Directions

Suggested Use: 3 capsules once a day or as needed. Ideal after a workout.

Storage

Keep in a cool, dry place.

FDA Disclaimer Statement

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

FDA Statement of Identity

Dietary Supplement

Brand IP Statement(s)

ApresFlex is a registered trademark of Laila Nutraceuticals exclusively licensed to PL Thomas - Laila Nutra LC. U.S. Patent # 8,551,496 and other patents pending. UC-II is a Lonza trademark

Formulation

Product of USA

Meet Flex, our scientifically designed proprietary blend of UC-II with undenatured type II collagen, ApresFLEX boswellia extract, vegetable-based glucosamine, chondroitin, and our organic Wild Microalgae.

Helps maintain joint flexibility Supports joint and cartilage strength Supports greater range of motion

General Statements

Please Recycle

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

See for yourself

Flex by New Earth label

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

Flex 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 Flex by New Earth

These are the 5 active ingredients this product is made of. Select any to open its full monograph.

Serving size3 Capsule(s) Dosage formCapsule Servings per container30 Amounts shown are per serving.

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

Proprietary Blend

1.7 Gram(s) per serving

Other (inactive) ingredients: Plant Fiber, Shark Cartilage. These complete the product’s ingredient list but are not active constituents.

Interaction report

Flex by New Earth Drug Interactions

Want to check YOUR meds against Flex?

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

 Go to the checker
1,079Drugs
1,079 Moderate

Ingredients driving the most interactions

Boswellia serrata extract 952
organic Microalgae 327
Chondroitin Sulfate 2

Individual Drug Interactions

The ingredients in Flex interact with 1,079 drugs. Click any drug to see the details.

3 of the 5 ingredients in Flex interact with drugs. Each result below shows which ingredient is responsible. Boswellia serrata extract organic Microalgae Chondroitin Sulfate

Each ingredient & the kinds of drugs it affects

For each ingredient in Flex with known interactions, here are the types of medications they can affect. Open any type for the detail — or search your exact drug in the checker above.

Boswellia serrata extract6 drug types · 952 drugs

Cytochrome P450 1A2 (Cyp1A2) Substrates

Theoretically, Boswellia serrata might increase the levels of CYP1A2 substrates.
In vitro research shows that Boswellia serrata gum resin inhibits CYP1A2 enzymes.

Likelihood Possible Evidence D
Cytochrome P450 2C19 (Cyp2C19) Substrates

Theoretically, Boswellia serrata might increase the levels of CYP2C19 substrates.
In vitro research shows that Boswellia serrata gum resin inhibits CYP2C19 enzymes.

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

Theoretically, Boswellia serrata might increase the levels of CYP2C9 substrates.
In vitro research shows that Boswellia serrata gum resin inhibits CYP2C9 enzymes.

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

Theoretically, Boswellia serrata might increase the levels of CYP2D6 substrates.
In vitro research shows that Boswellia serrata gum resin inhibits CYP2D6 enzymes.

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

Theoretically, Boswellia serrata might increase or decrease the levels and clinical effects of CYP3A4 substrates.
In vitro research shows that Boswellia serrata gum resin inhibits CYP3A4 enzymes. Other in vitro research shows that Boswellia serrata extract inhibits CYP3A4 enzymes at most concentrations, although it may modestly induce enzyme activity at low concentrations.

Likelihood Possible Evidence D
Immunosuppressants

Theoretically, Boswellia serrata might alter the effects of immunosuppressive drugs.
Some in vitro research suggests that Boswellia serrata extracts might inhibit mediators of autoimmune disorders such as leukotrienes and reduce production of antibodies and cell-mediated immunity. However, other in vitro research suggests that, when coupled with calcium ions, boswellic acids containing the keto group have immunostimulant properties within specific cell signaling pathways.

Likelihood Possible Evidence D
Boswellia serrata extract full monograph & interactions

organic Microalgae3 drug types · 327 drugs

Anticoagulant/Antiplatelet Drugs

Theoretically, spirulina blue-green algae might increase the risk of bleeding if used with other anticoagulant or antiplatelet drugs. However, this is unlikely.
Spirulina blue-green algae have shown antiplatelet and anticoagulant effects in vitro. However, one preliminary study in 24 patients receiving spirulina blue-green algae 2.3 grams daily for 2 weeks showed no effect on platelet activation or measures of clotting time.

Likelihood Unlikely Evidence D
Antidiabetes Drugs

Theoretically, taking blue-green algae with antidiabetes drugs might increase the risk of hypoglycemia.
Human research shows that spirulina blue-green algae can have hypoglycemic effects in patients with diabetes, at least some of whom were using antidiabetes drugs. However, blue-green algae does not seem to improve glycated hemoglobin (HbA1c) levels in patients with diabetes. A meta-analysis of animal studies also suggests that spirulina blue-green algae have hypoglycemic effects.

Likelihood Possible Evidence B
Immunosuppressants

Theoretically, concurrent use of blue-green algae might interfere with immunosuppressive therapy.
Blue-green algae have been shown to stimulate the immune system.

Likelihood Possible Evidence D
organic Microalgae full monograph & interactions

Chondroitin Sulfate1 drug type · 2 drugs

Warfarin (Coumadin)

Taking chondroitin in combination with glucosamine might increase the anticoagulant effects of warfarin. However, the effect of chondroitin alone is unclear.
There have been multiple reports of increased international normalized ratio (INR) in patients taking warfarin with glucosamine, with or without chondroitin. The lack of reports with chondroitin alone seem to suggest that the interactions occurring in these reports may have been due to glucosamine. In two individual case reports, glucosamine/chondroitin combinations were associated with a significant increase in INR in patients previously stabilized on warfarin. Additionally, 20 voluntary case reports to the US Food & Drug Administration (FDA) have linked glucosamine plus chondroitin with increased INR, bruising, and bleeding in patients who were also taking warfarin. There have also been 20 additional case reports to the World Health Organization (WHO) that link glucosamine alone, without chondroitin, to increased INR in patients taking warfarin.

Likelihood Unlikely Evidence D
Chondroitin Sulfate full monograph & interactions
The maker

Brand information

Manufacturer and brand details for Flex, from the product label.

New Earth

See all New Earth products
Name
New Earth Life Sciences, Inc.
Street Address
565 Century Court
City
Klamath Falls
State
OR
ZipCode
97601
Phone Number
800.800.1300
Web Address
www.NewEarth.com
Pharmacist Counseling Corner

Flex by New Earth: Common Questions

Does Flex by New Earth interact with any medications?
Yes. Based on its ingredients, Flex has a known interaction with 1,079 medications. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Flex contains 5 active ingredients, and an interaction can come from any of them. We check every ingredient, combine the results into one list per medication, and show which ingredient and mechanism is responsible.
Where does this information come from?
The product label data comes from the NIH Dietary Supplement Label Database (DSLD); the interaction data is built on the Natural Medicines database and reviewed by HelloPharmacist pharmacists.
Is it safe to take Flex while pregnant or breastfeeding?
Safety data isn't established for the chondroitin, microalgae, or Boswellia in this product during pregnancy or breastfeeding. The facts advise against use in both. Talk with your doctor or pharmacist about whether it's right for your situation.
What side effects might I notice?
The most common are digestive: stomach pain, bloating, constipation, diarrhea, heartburn, nausea, and gas. Headache, dizziness, and fatigue are possible. Skin reactions—rash, swelling, hives—have been reported. Stop and contact your healthcare provider if you have an allergic reaction or unusual bleeding.
Does Flex actually work for joint pain?
Chondroitin and Boswellia serrata are possibly effective for osteoarthritis based on the evidence we hold, but results vary and benefit is uncertain. Quality also differs between products. Your own results will depend on your situation—talk it over with your doctor.
What is the organic microalgae in this product?
It's spirulina, a blue-green algae sometimes used for blood pressure support and other conditions. Quality can vary and some batches carry contamination risk, so the ingredient is flagged for caution.
What does Boswellia serrata do?
It's a plant resin extract that may help with inflammation and osteoarthritis. It's possibly effective for joint support, though evidence is mixed and quality varies across products.
Can I take this with my other supplements or medications?
Not safely without checking first. Use the medication search tool on this page to look up your exact drugs, or ask your pharmacist or doctor before starting—especially if you take blood thinners, diabetes meds, or any drug your liver metabolizes.

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

Not sure if Flex is safe with your meds?

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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.

Flex label
Go deeper

The Full Monographs Behind Flex’s Ingredients

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

Herb & supplement monograph

Chondroitin Sulfate

Interacts with 2 drugs

Chondroitin sulfate is a naturally occurring building block of cartilage that is widely taken, often with glucosamine, for osteoarthritis joint pain. The evidence is mixed—some people report...

Read the full Chondroitin Sulfate monograph → Herb & supplement monograph

Blue-green Algae

Interacts with 327 drugs

Blue-green algae are nutrient-rich aquatic microorganisms (such as spirulina and Klamath Lake algae) taken as a supplement for energy, nutrition, and general wellness. Evidence for most heal...

Read the full Blue-green Algae monograph → Herb & supplement monograph

Boswellia Serrata

Interacts with 952 drugs

Boswellia serrata is a tree resin used in traditional medicine, mainly for joint pain and inflammation. Some studies suggest it may help with osteoarthritis symptoms, but the overall evidenc...

Read the full Boswellia Serrata monograph →
Sources

Sources & How We Checked

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

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 60 references behind this product’s interaction data

Every citation that drives the interaction findings for this product’s ingredients, from the evidence-graded Natural Medicines (TRC Healthcare) database. Open an ingredient to browse its citations — links open the study on PubMed or the publisher’s site.

Chondroitin Sulfate 22 references
  1. Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. Washington, DC: National Academy Press, 2002.
  2. Tallia AF, Cardone DA. Asthma exacerbation associated with glucosamine-chondroitin supplement. J Am Board Fam Pract 2002;15:481-4..
  3. Danao-Camara T. Potential side effects of treatment with glucosamine and chondroitin. Arthritis Rheum 2000;43:2853. PubMed
  4. Rozenfeld V, Crain JL, Callahan AK. Possible augmentation of warfarin effect by glucosamine-chondroitin. Am J Health Syst Pharm 2004;61:306-307. PubMed
  5. Clegg DO, Reda DJ, Harris CL, et al. Glucosamine, chondroitin sulfate, and the two in combination for painful knee osteoarthritis. N Engl J Med 2006;354:795-808. DOI
  6. Knudsen J, Sokol GH. Potential glucosamine-warfarin interaction resulting in increased international normalized ratio: Case report and review of the literature and MedWatch database. Pharmacotherapy 2008;28:540-8. PubMed
  7. Yue QY, Strandell J, Myrberg O. Concomitant use of glucosamine potentiates the effect of warfarin. Jan 2006. Drug Safety 29(10):911-1010. DOI
  8. Nordling, J. and van, Ophoven A. Intravesical glycosaminoglycan replenishment with chondroitin sulphate in chronic forms of cystitis. A multi-national, multi-centre, prospective observational clinical trial. Arzneimittelforschung. 2008;58(7):328-335. PubMed
  9. Nickel, J. C., Egerdie, B., Downey, J., Singh, R., Skehan, A., Carr, L., and Irvine-Bird, K. A real-life multicentre clinical practice study to evaluate the efficacy and safety of intravesical chondroitin sulphate for the treatment of interstitial cystit
  10. Oliviero, U., Sorrentino, G. P., De Paola, P., Tranfaglia, E., D'Alessandro, A., Carifi, S., Porfido, F. A., Cerio, R., Grasso, A. M., Policicchio, D., and . Effects of the treatment with matrix on elderly people with chronic articular degeneration. Drug
  11. Crowley, D. C., Lau, F. C., Sharma, P., Evans, M., Guthrie, N., Bagchi, M., Bagchi, D., Dey, D. K., and Raychaudhuri, S. P. Safety and efficacy of undenatured type II collagen in the treatment of osteoarthritis of the knee: a clinical trial. Int.J.Med.Sc PubMed
  12. Nickel, J. C., Egerdie, R. B., Steinhoff, G., Palmer, B., and Hanno, P. A multicenter, randomized, double-blind, parallel group pilot evaluation of the efficacy and safety of intravesical sodium chondroitin sulfate versus vehicle control in patients with
  13. Sawitzke, A. D., Shi, H., Finco, M. F., Dunlop, D. D., Harris, C. L., Singer, N. G., Bradley, J. D., Silver, D., Jackson, C. G., Lane, N. E., Oddis, C. V., Wolfe, F., Lisse, J., Furst, D. E., Bingham, C. O., Reda, D. J., Moskowitz, R. W., Williams, H. J.
  14. Wildi, L. M., Raynauld, J. P., Martel-Pelletier, J., Beaulieu, A., Bessette, L., Morin, F., Abram, F., Dorais, M., and Pelletier, J. P. Chondroitin sulphate reduces both cartilage volume loss and bone marrow lesions in knee osteoarthritis patients starti
  15. Pavelka and et al. Double-blind, dose effect study of oral cs 4 & 6 1200mg, 800mg, 200mg against placebo in the treatment of femorotibial osteoarthritis. Wular Rheumatol Liter 1998;27(suppl 2):63.
  16. Cerda C, Bruguera M, Parés A. Hepatotoxicity associated with glucosamine and chondroitin sulfate in patients with chronic liver disease. World J Gastroenterol 2013;19(32):5381-4. PubMed
  17. von Felden J, Montani M, Kessebohm K, Stickel F. Drug-induced acute liver injury mimicking autoimmune hepatitis after intake of dietary supplements containing glucosamine and chondroitin sulfate. Int J Clin Pharmacol Ther 2013;51(3):219-23. PubMed
  18. Provenza JR, Shinjo SK, Silva JM, Peron CR, Rocha FA. Combined glucosamine and chondroitin sulfate, once or three times daily, provides clinically relevant analgesia in knee osteoarthritis. Clin Rheumatol 2015;34:1455-62. PubMed
  19. Ossendza RA, Grandval P, Chinoune F, Rocher F, Chapel F, Bernardini D. [Acute cholestatic hepatitis due to glucosamine forte]. Gastroenterol Clin Biol. 2007 Apr;31(4):449-50.
  20. Greenlee H, Crew KD, Shao T, Kranwinkel G, Kalinsky K, Maurer M, Brafman L, Insel B, Tsai WY, Hershman DL. Phase II study of glucosamine with chondroitin on aromatase inhibitor-associated joint symptoms in women with breast cancer. Support Care Cancer 201 PubMed
  21. Chu EC, Huang KHK, Cheung G, Ng G, Lin A. Delayed Skin Allergy to Glucosamine Chondroitin Supplement. Cureus 2023;15(3):e36310. PubMed
  22. Lila AM, Alekseeva LI, Baranov AA, et al. Chondroitin sulfate and glucosamine combination in patients with knee and hip osteoarthritis: A long-term observational study in Russia. World J Orthop 2023;14(6):443-457. PubMed

See these in context on the Chondroitin Sulfate monograph →

Blue-green Algae 22 references
  1. Jensen GS, Ginsberg DJ, Huerta P, et al. Consumption of Aphanizomenon flos-aquae has rapid effects on the circulation and function of immune cells in humans. A novel approach to nutritional mobilization of the immune system. JANA 2000;2:50-6.
  2. Iwasa M, Yamamoto M, Tanaka Y, et al. Spirulina-associated hepatotoxicity. Am J Gastroenterol 2002;97:3212-13. PubMed
  3. Hayashi O, Katoh T, Okuwaki Y. Enhancement of antibody production in mice by dietary Spirulina platensis. J Nutr Sci Vitaminol (Tokyo) 1994;40:431-41.. PubMed
  4. Vitale S, Miller NR, Mejico LJ, et al. A randomized, placebo-controlled, crossover clinical trial of super blue-green algae in patients with essential blepharospasm or Meige syndrome. Am J Ophthalmol 2004;138:18-32. PubMed
  5. Mani UV, Desai S, Iyer U. Studies on the long-term effect of spirulina supplementation on serum lipid profile and glycated proteins in NIDDM patients. J Nutraceut 2000;2(3):25-32. DOI
  6. Chiu HF, Yang SP, Kuo YL, et al. Mechanisms involved in the antiplatelet effect of C-phycocyanin. Br J Nutr 2006;95:435-40. PubMed
  7. Hsiao G, Chou PH, Shen MY, et al. C-phycocyanin, a very potent and novel platelet aggregation inhibitor from Spirulina platensis. J Agric Food Chem 2005;53:7734-40.
  8. Katz M, Levine AA, Kol-Degani H, Kav-Venaki L. A compound herbal preparation (CHP) in the treatment of children with ADHD: a randomized controlled trial. J Atten Disord 2010;14:281-91. PubMed
  9. Madhyastha, H. K., Radha, K. S., Sugiki, M., Omura, S., and Maruyama, M. Purification of c-phycocyanin from Spirulina fusiformis and its effect on the induction of urokinase-type plasminogen activator from calf pulmonary endothelial cells. Phytomedicine PubMed
  10. Mazokopakis, E. E., Karefilakis, C. M., Tsartsalis, A. N., Milkas, A. N., and Ganotakis, E. S. Acute rhabdomyolysis caused by Spirulina (Arthrospira platensis). Phytomedicine. 2008;15(6-7):525-527. PubMed
  11. Halidou, Doudou M., Degbey, H., Daouda, H., Leveque, A., Donnen, P., Hennart, P., and Dramaix-Wilmet, M. [The effect of spiruline during nutritional rehabilitation: systematic review]. Rev.Epidemiol.Sante Publique 2008;56(6):425-431.
  12. Konno, T., Umeda, Y., Umeda, M., Kawachi, I., Oyake, M., and Fujita, N. [A case of inflammatory myopathy with widely skin rash following use of supplements containing Spirulina]. Rinsho Shinkeigaku 2011;51(5):330-333. PubMed
  13. Le TM, Knulst AC, Röckmann H. Anaphylaxis to Spirulina confirmed by skin prick test with ingredients of Spirulina tablets. Food Chem Toxicol 2014;74:309-10. PubMed
  14. Rzymski P, Niedzielski P, Kaczmarek N, Jurczak T, Klimaszyk P. The multidisciplinary approach to safety and toxicity assessment of microalgae-based food supplements following clinical cases of poisoning. Harmful Algae 2015;46:34-42. DOI
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See these in context on the Blue-green Algae monograph →

Boswellia Serrata 16 references
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See these in context on the Boswellia Serrata monograph →

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

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