Forever Nature's 18 Ingredients & Drug Interactions
by Forever
What is this page for?
First and foremost: checking Forever Nature's 18 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
Forever Nature's 18 is a dietary supplement by Forever with 22 active ingredients. Its ingredients are commonly taken for common cold and immune support, antioxidant support, skin health and collagen formation.Based on those ingredients, 1,390 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are Grape, Lime, Cranberry Whole Fruit Extract. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against Forever Nature's 18 by Forever
Ask about any prescription or over-the-counter medication and we check it for interactions with Forever Nature's 18 by Forever — 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 Forever Nature's 18 by Forever
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
Low disclosure
Forever Nature's 18 is a tablet containing 21 active ingredient sources: vitamin C, rutin, and whole-fruit extracts of cranberry, prune, carrot, blueberry, and elderberry, along with extracts of grape and raspberry, plus individual vegetables and fruits including cabbage, cauliflower, celery, green bean, kiwi, lime, parsley, red bell pepper, banana, and apple. These ingredients are combined in a proprietary blend, meaning their individual amounts are not disclosed separately.
The product also contains inactive ingredients — dextrose, malic acid, stearic acid, and silicon dioxide — which are excipients used to form and stabilize the tablet.
Does it work?
Strong evidence
The evidence for this product's ingredients is mixed. Vitamin C is effective for vitamin C deficiency and possibly effective for several conditions including anemia of chronic disease, atrial fibrillation, cataracts, and exercise-induced respiratory infections.
Cranberry is possibly effective for urinary tract infections. Red bell pepper (capsicum) is likely effective for postherpetic neuralgia and diabetic neuropathy, and possibly effective for cluster headache, back pain, and postoperative nausea.
Prune is possibly effective for constipation, and banana is possibly effective for diarrhea. For most other ingredients in this product — rutin, blueberry, elderberry, carrot, grape, apple, kiwi, lime, parsley, celery, cauliflower, cabbage, green bean, and zucchini — the evidence we hold is rated insufficient to establish effectiveness for the conditions they are claimed to address.
This means the research is too limited or conflicting to draw firm conclusions.
How safe is it?
Well-documented data
Vitamin C is generally well tolerated at normal dietary and supplement doses, though very high doses can cause abdominal cramps, heartburn, diarrhea, headache, nausea, and kidney stones in those prone to them. Adverse effects are more likely above 2 grams daily.
Rutin is generally well tolerated in food and short-term supplement use, though long-term safety data are limited, and it may cause headache, flushing, or rash in some people. Cranberry is well tolerated as food or supplement, with gastrointestinal upset and diarrhea the main adverse effects at high doses.
Blueberry is generally well tolerated, though freeze-dried forms can cause constipation, diarrhea, nausea, or vomiting. Prune is well tolerated and generally causes only gastrointestinal effects like gas and diarrhea.
Most other ingredients—carrot, grape, apple, banana, kiwi, and cabbage—are well tolerated as foods; concentrated supplements are less studied. Red bell pepper commonly causes burning and irritation orally and topically.
Elderberry extracts prepared from ripe fruit are well tolerated, but raw or unripe berries and plant parts contain cyanogenic glycosides and are toxic. Celery may cause photosensitivity and allergic reactions including oral allergy syndrome and, rarely, anaphylaxis.
Parsley at large doses carries risk of serious effects and should be used cautiously. Pregnancy and lactation data vary by ingredient: vitamin C is rated likely safe in normal amounts but avoid high-dose supplements in pregnancy; rutin is likely safe in pregnancy but safety during breastfeeding is unknown; cranberry, carrot, grape, blueberry, and kiwi are likely safe in food amounts during pregnancy and lactation, though concentrated supplements are not well studied; elderberry, celery, and parsley lack sufficient safety data and should be avoided in medicinal amounts during pregnancy and breastfeeding; red bell pepper is likely to possibly safe in pregnancy and likely safe during lactation.
Meds to double-check
Major interaction found
Before taking Forever Nature's 18, double-check your medications against these drug types: OATP substrates and fexofenadine, atenolol, or aliskiren (Major severity via apple); estrogens and oral contraceptives, blood thinners (warfarin and anticoagulants/antiplatelets), antidiabetes drugs, chemotherapy drugs (alkylating agents and antitumor antibiotics), ACE inhibitors, and multiple enzyme-metabolized drug families (CYP3A4, CYP2D6, CYP2C9, CYP1A2, CYP2E1 substrates) — all moderate severity. Immunosuppressants, levothyroxine, indinavir, theophylline, aspirin, and several others are also affected.
Ask your doctor or pharmacist to verify your specific medications before you start.
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.
This product is a multi-ingredient supplement with mixed evidence—some ingredients like vitamin C and cranberry have established uses, while most others lack strong research backing. The real concern here is medication interactions: the product interacts with over 1,300 individual medications across major drug classes (blood thinners, heart drugs, diabetes medications, chemotherapy, and hormone therapies), with some interactions being serious.
If you take any prescription or over-the-counter medication, check it against the product using the tool on this page before taking Forever Nature's 18, and discuss the results with your own doctor or pharmacist to be sure it's safe for your situation.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 18 of 21 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Dec 22, 2019.
This Scorecard evaluates available label information, ingredient evidence, and known medication-safety considerations. It does not independently verify product identity, purity, potency, contamination, or manufacturing quality. How these ratings are computed
General information
Key facts about Forever Nature's 18, straight from the product 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 Forever Nature's 18 by Forever, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Calories | 10 Calorie(s) | -- |
| Total Carbohydrates | 2 Gram(s) | 1% |
| Sugar | 2 Gram(s) | -- |
| Vitamin C | 20 mg | 33% |
| Rutin | 0 NP | -- |
| Proprietary Blend | 1004 mg | -- |
| Cranberry Whole Fruit Extract | 0 NP | -- |
| Prune | 0 NP | -- |
| Carrot | 0 NP | -- |
| Grape | 0 NP | -- |
| Apple | 0 NP | -- |
| Blueberry extract | 0 NP | -- |
| Elderberry extract | 0 NP | -- |
| Banana | 0 NP | -- |
| Grape extract | 0 NP | -- |
| Raspberry extract | 0 NP | -- |
| Cabbage | 0 NP | -- |
| Cauliflower | 0 NP | -- |
| Celery | 0 NP | -- |
| Green Bean | 0 NP | -- |
| Kiwi | 0 NP | -- |
| Lime | 0 NP | -- |
| Parsley | 0 NP | -- |
| Red Bell Pepper | 0 NP | -- |
| Zucchini | 0 NP | -- |
Other ingredients: Dextrose, Malic Acid, Stearic Acid, Silicon Dioxide
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.
FDA Statement of Identity
Fruit and Vegetable Supplement
General Statements
Contents 120 tablets (30 day supply)
Product #271 Version 7
Suggested/Recommended/Usage/Directions
Suggested Use Chew two tablets twice daily
FDA Disclaimer Statement
The statements contained herein have not been evaluated by the FDA. The products discussed are not intended to diagnose, mitigate, treat, cure or prevent a specific disease or class of diseases.
Precautions
You should consult your family physician if you are experiencing a medical problem.
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Forever Nature's 18 by Forever 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 Forever Nature's 18 by Forever
These are the 22 active ingredients this product is made of. Select any to open its full monograph.
Serving size2 Tablet(s) Dosage formTablet Or Pill Servings per container60 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.
Sugar
Vitamin C
Interacts with207 drugs
Vitamin C (ascorbic acid) is an essential nutrient your body needs but cannot make, so you must get it from food or supplements. It's important for im...
Vitamin C monograph & interactionsProprietary Blend
- › Rutin
- › Cranberry Whole Fruit Extract
- › Prune
- › Carrot
- › Grape
- › Apple
- › Blueberry extract
- › Elderberry extract
- › Banana
- › Grape extract
- › Raspberry extract
- › Cabbage
- › Cauliflower
- › Celery
- › Green Bean
- › Kiwi
- › Lime
- › Parsley
- › Red Bell Pepper
- › Zucchini
Other (inactive) ingredients: Dextrose, Malic Acid, Stearic Acid, Silicon Dioxide. These complete the product’s ingredient list but are not active constituents.
Forever Nature's 18 by Forever Drug Interactions
HelloPharmacist Interaction Report
Forever Nature's 18 contains 21 ingredients, several of which interact with medications.
The most serious interaction is through apple content, which can significantly reduce absorption of OATP substrates (a Major severity interaction). This affects drugs like fexofenadine, atenolol, and aliskiren — sometimes cutting blood levels in half or more.
Through its vitamin C, rutin, cranberry, prune, grape, and grape extract, the product also interacts with multiple moderate-severity drug types: estrogens and hormone therapies may see higher blood levels; chemotherapy drugs (alkylating agents and antitumor antibiotics) might lose effectiveness; blood thinners like warfarin face conflicting evidence of reduced effect; and several heart and antidiabetes medications could be affected.
Read the full breakdown — every affected drug type, severity by severity
Additionally, vitamin C may interfere with levothyroxine absorption and reduce indinavir levels. Cranberry, grape, and grape extract all affect how your liver metabolizes drugs through several enzyme systems (CYP3A4, CYP2D6, CYP2C9, CYP1A2, and CYP2E1 substrates), with potential to raise or lower drug levels unpredictably.
Cabbage, celery, parsley, and kiwi each bring their own moderate interactions with blood thinners, blood pressure drugs, and diabetes medications. Red bell pepper (capsicum) interacts moderately with anticoagulants, diabetes drugs, theophylline, and aspirin.
Elderberry may interfere with immunosuppressants and has a case report involving pazopanib.
Several ingredients — raspberry extract, green bean, and zucchini — we could not check for interactions because we hold no interaction data for them. Carrot, cauliflower, lime, and banana each have documented interactions as well, though carrot and cauliflower data show limited or no documented interactions in our files.
Altogether, these interactions span 1,391 individual medications. Before starting this product, use the medication checker on this page with all your current prescriptions, and confirm the results with your own doctor or pharmacist.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against Forever Nature's 18?
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 Forever Nature's 18 interact with 1,390 drugs. Click any drug to see the details.
16 of the 22 ingredients in Forever Nature's 18 interact with drugs. Each result below shows which ingredient is responsible. Grape Lime Cranberry Whole Fruit Extract Celery Parsley Cabbage Apple Kiwi Red Bell Pepper Vitamin C Cauliflower Prune Elderberry extract Blueberry extract Rutin Banana
AtorvastatinAtorvaliq
How Atorvastatin interacts with Forever Nature's 18 — through 5 ingredients. Tap an ingredient for the detail:
AppleOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple + Atorvastatin interactionCabbageGlucuronidated Drugs Moderate
Interaction Summary
Theoretically, cabbage might increase clearance and decrease the effects of drugs metabolized through glucuronide conjugation.
Read the full Cabbage + Atorvastatin interactionCranberry Whole Fruit ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Atorvastatin (lipitor) Moderate
Interaction Summary
Theoretically, cranberry might increase the levels and adverse effects of CYP3A4 substrates.
Read the full Cranberry Whole Fruit Extract + Atorvastatin interactionGrape ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
It is unclear if grape seed extract inhibits or induces CYP3A4; research is conflicting.
Read the full Grape Extract + Atorvastatin interactionLimeCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Animal research shows that phenolics in lime juice inhibit cytochrome P450 3A4.
Read the full Lime + Atorvastatin interactionAtorvastatin CalciumLipitor
How Atorvastatin Calcium interacts with Forever Nature's 18 — through 5 ingredients. Tap an ingredient for the detail:
AppleOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple + Atorvastatin Calcium interactionCranberry Whole Fruit ExtractAtorvastatin (lipitor), Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, cranberry might increase levels and adverse effects of atorvastatin.
Read the full Cranberry Whole Fruit Extract + Atorvastatin Calcium interactionCabbageGlucuronidated Drugs Moderate
Interaction Summary
Theoretically, cabbage might increase clearance and decrease the effects of drugs metabolized through glucuronide conjugation.
Read the full Cabbage + Atorvastatin Calcium interactionGrape ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
It is unclear if grape seed extract inhibits or induces CYP3A4; research is conflicting.
Read the full Grape Extract + Atorvastatin Calcium interactionLimeCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Animal research shows that phenolics in lime juice inhibit cytochrome P450 3A4.
Read the full Lime + Atorvastatin Calcium interactionBosentanTracleer
How Bosentan interacts with Forever Nature's 18 — through 6 ingredients. Tap an ingredient for the detail:
AppleAntihypertensive Drugs, Organic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Consuming apple juice with antihypertensive drugs might interfere with blood pressure control.
Read the full Apple + Bosentan interactionLimeCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Animal research shows that phenolics in lime juice inhibit cytochrome P450 3A4.
Read the full Lime + Bosentan interactionGrape ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 2c9 (cyp2c9) Substrates Moderate
Interaction Summary
It is unclear if grape seed extract inhibits or induces CYP3A4; research is conflicting.
Read the full Grape Extract + Bosentan interactionCranberry Whole Fruit ExtractCytochrome P450 2c9 (cyp2c9) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, cranberry might increase the levels and adverse effects of CYP2C9 substrates.
Read the full Cranberry Whole Fruit Extract + Bosentan interactionKiwiAntihypertensive Drugs Moderate
Interaction Summary
Clinical research suggests that consuming kiwi reduces systolic and diastolic blood pressure in hypertensive individuals.
Read the full Kiwi + Bosentan interactionCeleryAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, celery seed extract might have additive effects with antihypertensive drugs.
Read the full Celery + Bosentan interactionBrincidofovirTembexa
How Brincidofovir interacts with Forever Nature's 18 — through 1 ingredient. Tap an ingredient for the detail:
AppleOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple + Brincidofovir interactionCeliprololCelicard
How Celiprolol interacts with Forever Nature's 18 — through 3 ingredients. Tap an ingredient for the detail:
AppleAntihypertensive Drugs, Organic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Consuming apple juice with antihypertensive drugs might interfere with blood pressure control.
Read the full Apple + Celiprolol interactionCeleryAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, celery seed extract might have additive effects with antihypertensive drugs.
Read the full Celery + Celiprolol interactionKiwiAntihypertensive Drugs Moderate
Interaction Summary
Clinical research suggests that consuming kiwi reduces systolic and diastolic blood pressure in hypertensive individuals.
Read the full Kiwi + Celiprolol interactionCerivastatin SodiumBaycol
How Cerivastatin Sodium interacts with Forever Nature's 18 — through 1 ingredient. Tap an ingredient for the detail:
AppleOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple + Cerivastatin Sodium interactionCinoxacinCinobac
How Cinoxacin interacts with Forever Nature's 18 — through 3 ingredients. Tap an ingredient for the detail:
AppleOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple + Cinoxacin interactionLimePhotosensitizing Drugs Moderate
Interaction Summary
Theoretically, concomitant use of lime oil with photosensitizing drugs may increase the risk of phototoxicity.
Read the full Lime + Cinoxacin interactionCeleryPhotosensitizing Drugs Minor
Interaction Summary
Theoretically, celery might increase the risk of photosensitivity reactions when taken with photosensitizing drugs.
Read the full Celery + Cinoxacin interactionCiprofloxacinCiloxan, Cipro, Cipro IV, Cipro XR, Ciprobay, Otiprio
How Ciprofloxacin interacts with Forever Nature's 18 — through 4 ingredients. Tap an ingredient for the detail:
AppleOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple + Ciprofloxacin interactionLimePhotosensitizing Drugs Moderate
Interaction Summary
Theoretically, concomitant use of lime oil with photosensitizing drugs may increase the risk of phototoxicity.
Read the full Lime + Ciprofloxacin interactionCeleryPhotosensitizing Drugs Minor
Interaction Summary
Theoretically, celery might increase the risk of photosensitivity reactions when taken with photosensitizing drugs.
Read the full Celery + Ciprofloxacin interactionRed Bell PepperCiprofloxacin (cipro) Minor
Interaction Summary
Theoretically, taking capsicum with ciprofloxacin might increase levels and adverse effects of ciprofloxacin.
Read the full Red Bell Pepper + Ciprofloxacin interactionCiprofloxacin, HydrocortisoneCipro HC Otic
How Ciprofloxacin, Hydrocortisone interacts with Forever Nature's 18 — through 1 ingredient. Tap an ingredient for the detail:
AppleOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple + Ciprofloxacin, Hydrocortisone interactionClinafloxacinClinafloxacin
How Clinafloxacin interacts with Forever Nature's 18 — through 1 ingredient. Tap an ingredient for the detail:
AppleOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple + Clinafloxacin interactionEnoxacinPenetrex
How Enoxacin interacts with Forever Nature's 18 — through 3 ingredients. Tap an ingredient for the detail:
AppleOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple + Enoxacin interactionLimePhotosensitizing Drugs Moderate
Interaction Summary
Theoretically, concomitant use of lime oil with photosensitizing drugs may increase the risk of phototoxicity.
Read the full Lime + Enoxacin interactionCeleryPhotosensitizing Drugs Minor
Interaction Summary
Theoretically, celery might increase the risk of photosensitivity reactions when taken with photosensitizing drugs.
Read the full Celery + Enoxacin interactionEtoposideEtopophos, VePesid, VP16
How Etoposide interacts with Forever Nature's 18 — through 4 ingredients. Tap an ingredient for the detail:
AppleOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple + Etoposide interactionGrape ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
It is unclear if grape seed extract inhibits or induces CYP3A4; research is conflicting.
Read the full Grape Extract + Etoposide interactionCranberry Whole Fruit ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, cranberry might increase the levels and adverse effects of CYP3A4 substrates.
Read the full Cranberry Whole Fruit Extract + Etoposide interactionLimeCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Animal research shows that phenolics in lime juice inhibit cytochrome P450 3A4.
Read the full Lime + Etoposide interactionEzetimibe, AtorvastatinLiptruzet
How Ezetimibe, Atorvastatin interacts with Forever Nature's 18 — through 5 ingredients. Tap an ingredient for the detail:
AppleOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple + Ezetimibe, Atorvastatin interactionCranberry Whole Fruit ExtractAtorvastatin (lipitor), Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, cranberry might increase levels and adverse effects of atorvastatin.
Read the full Cranberry Whole Fruit Extract + Ezetimibe, Atorvastatin interactionCabbageGlucuronidated Drugs Moderate
Interaction Summary
Theoretically, cabbage might increase clearance and decrease the effects of drugs metabolized through glucuronide conjugation.
Read the full Cabbage + Ezetimibe, Atorvastatin interactionGrape ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
It is unclear if grape seed extract inhibits or induces CYP3A4; research is conflicting.
Read the full Grape Extract + Ezetimibe, Atorvastatin interactionLimeCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Animal research shows that phenolics in lime juice inhibit cytochrome P450 3A4.
Read the full Lime + Ezetimibe, Atorvastatin interactionFexofenadineAllegra
How Fexofenadine interacts with Forever Nature's 18 — through 4 ingredients. Tap an ingredient for the detail:
AppleOrganic Anion-transporting Polypeptide Substrates (oatp), Fexofenadine (allegra) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple + Fexofenadine interactionCranberry Whole Fruit ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, cranberry might increase the levels and adverse effects of CYP3A4 substrates.
Read the full Cranberry Whole Fruit Extract + Fexofenadine interactionLimeCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Animal research shows that phenolics in lime juice inhibit cytochrome P450 3A4.
Read the full Lime + Fexofenadine interactionGrape ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
It is unclear if grape seed extract inhibits or induces CYP3A4; research is conflicting.
Read the full Grape Extract + Fexofenadine interactionFexofenadine, PseudoephedrineAllegra D
How Fexofenadine, Pseudoephedrine interacts with Forever Nature's 18 — through 4 ingredients. Tap an ingredient for the detail:
AppleOrganic Anion-transporting Polypeptide Substrates (oatp), Fexofenadine (allegra) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple + Fexofenadine, Pseudoephedrine interactionGrape ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
It is unclear if grape seed extract inhibits or induces CYP3A4; research is conflicting.
Read the full Grape Extract + Fexofenadine, Pseudoephedrine interactionLimeCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Animal research shows that phenolics in lime juice inhibit cytochrome P450 3A4.
Read the full Lime + Fexofenadine, Pseudoephedrine interactionCranberry Whole Fruit ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, cranberry might increase the levels and adverse effects of CYP3A4 substrates.
Read the full Cranberry Whole Fruit Extract + Fexofenadine, Pseudoephedrine interactionFluvastatinLescol, Lescol XL
How Fluvastatin interacts with Forever Nature's 18 — through 3 ingredients. Tap an ingredient for the detail:
AppleOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple + Fluvastatin interactionCranberry Whole Fruit ExtractCytochrome P450 2c9 (cyp2c9) Substrates Minor
Interaction Summary
Theoretically, cranberry might increase the levels and adverse effects of CYP2C9 substrates.
Read the full Cranberry Whole Fruit Extract + Fluvastatin interactionGrape ExtractCytochrome P450 2c9 (cyp2c9) Substrates Minor
Interaction Summary
It is unclear if grape juice or grape seed extract inhibits CYP2C9; research is conflicting.
Read the full Grape Extract + Fluvastatin interactionGatifloxacinTequin, Tequin Injection
How Gatifloxacin interacts with Forever Nature's 18 — through 3 ingredients. Tap an ingredient for the detail:
AppleOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple + Gatifloxacin interactionLimePhotosensitizing Drugs Moderate
Interaction Summary
Theoretically, concomitant use of lime oil with photosensitizing drugs may increase the risk of phototoxicity.
Read the full Lime + Gatifloxacin interactionCeleryPhotosensitizing Drugs Minor
Interaction Summary
Theoretically, celery might increase the risk of photosensitivity reactions when taken with photosensitizing drugs.
Read the full Celery + Gatifloxacin interactionGemifloxacinFactive
How Gemifloxacin interacts with Forever Nature's 18 — through 1 ingredient. Tap an ingredient for the detail:
AppleOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple + Gemifloxacin interactionGlyburideAlbert Glyburide, Diabeta, Glycron, Glynase, Glynase PresTab, Micronase +1 more
How Glyburide interacts with Forever Nature's 18 — through 10 ingredients. Tap an ingredient for the detail:
AppleAntidiabetes Drugs, Organic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Theoretically, consuming apple juice with antidiabetes drugs might interfere with blood glucose control.
Read the full Apple + Glyburide interactionRed Bell PepperAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, taking capsicum with antidiabetes drugs might increase the risk of hypoglycemia.
Read the full Red Bell Pepper + Glyburide interactionParsleyAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, parsley might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Read the full Parsley + Glyburide interactionLimePhotosensitizing Drugs Moderate
Interaction Summary
Theoretically, concomitant use of lime oil with photosensitizing drugs may increase the risk of phototoxicity.
Read the full Lime + Glyburide interactionRutinAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, taking rutin with antidiabetes drugs might increase the risk of hypoglycemia.
Read the full Rutin + Glyburide interactionCabbageAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, cabbage might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Read the full Cabbage + Glyburide interactionCranberry Whole Fruit ExtractCytochrome P450 2c9 (cyp2c9) Substrates Minor
Interaction Summary
Theoretically, cranberry might increase the levels and adverse effects of CYP2C9 substrates.
Read the full Cranberry Whole Fruit Extract + Glyburide interactionBlueberry ExtractAntidiabetes Drugs Minor
Interaction Summary
Theoretically, blueberries or blueberry leaf extracts might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Read the full Blueberry Extract + Glyburide interactionCeleryPhotosensitizing Drugs Minor
Interaction Summary
Theoretically, celery might increase the risk of photosensitivity reactions when taken with photosensitizing drugs.
Read the full Celery + Glyburide interactionGrape ExtractCytochrome P450 2c9 (cyp2c9) Substrates Minor
Interaction Summary
It is unclear if grape juice or grape seed extract inhibits CYP2C9; research is conflicting.
Read the full Grape Extract + Glyburide interactionGlyburide, MetforminGlucovance
How Glyburide, Metformin interacts with Forever Nature's 18 — through 10 ingredients. Tap an ingredient for the detail:
AppleAntidiabetes Drugs, Organic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Theoretically, consuming apple juice with antidiabetes drugs might interfere with blood glucose control.
Read the full Apple + Glyburide, Metformin interactionCabbageAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, cabbage might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Read the full Cabbage + Glyburide, Metformin interactionRutinAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, taking rutin with antidiabetes drugs might increase the risk of hypoglycemia.
Read the full Rutin + Glyburide, Metformin interactionParsleyAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, parsley might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Read the full Parsley + Glyburide, Metformin interactionRed Bell PepperAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, taking capsicum with antidiabetes drugs might increase the risk of hypoglycemia.
Read the full Red Bell Pepper + Glyburide, Metformin interactionLimePhotosensitizing Drugs Moderate
Interaction Summary
Theoretically, concomitant use of lime oil with photosensitizing drugs may increase the risk of phototoxicity.
Read the full Lime + Glyburide, Metformin interactionGrape ExtractCytochrome P450 2c9 (cyp2c9) Substrates Minor
Interaction Summary
It is unclear if grape juice or grape seed extract inhibits CYP2C9; research is conflicting.
Read the full Grape Extract + Glyburide, Metformin interactionCeleryPhotosensitizing Drugs Minor
Interaction Summary
Theoretically, celery might increase the risk of photosensitivity reactions when taken with photosensitizing drugs.
Read the full Celery + Glyburide, Metformin interactionBlueberry ExtractAntidiabetes Drugs Minor
Interaction Summary
Theoretically, blueberries or blueberry leaf extracts might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Read the full Blueberry Extract + Glyburide, Metformin interactionCranberry Whole Fruit ExtractCytochrome P450 2c9 (cyp2c9) Substrates Minor
Interaction Summary
Theoretically, cranberry might increase the levels and adverse effects of CYP2C9 substrates.
Read the full Cranberry Whole Fruit Extract + Glyburide, Metformin interactionGrepafloxacinRaxar
How Grepafloxacin interacts with Forever Nature's 18 — through 6 ingredients. Tap an ingredient for the detail:
AppleOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple + Grepafloxacin interactionGrape ExtractCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, grape juice might reduce the levels of CYP1A2 substrates.
Read the full Grape Extract + Grepafloxacin interactionCabbageCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, cabbage might decrease levels of drugs metabolized by CYP1A2.
Read the full Cabbage + Grepafloxacin interactionCauliflowerCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Preliminary clinical evidence suggests that eating cruciferous vegetables, including broccoli, cauliflower, daikon radish sprouts, and cabbage, can increase cytochrome P450 1A2 (CYP1A2) activity by 14% to 27%.
Read the full Cauliflower + Grepafloxacin interactionParsleyCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, parsley might increase serum levels of CYP1A2 substrates.
Read the full Parsley + Grepafloxacin interactionCeleryCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, celery might increase levels of drugs metabolized by CYP1A2.
Read the full Celery + Grepafloxacin interactionIrinotecanCamptosar, Onivyde
How Irinotecan interacts with Forever Nature's 18 — through 5 ingredients. Tap an ingredient for the detail:
AppleOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple + Irinotecan interactionCranberry Whole Fruit ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, cranberry might increase the levels and adverse effects of CYP3A4 substrates.
Read the full Cranberry Whole Fruit Extract + Irinotecan interactionLimeCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Animal research shows that phenolics in lime juice inhibit cytochrome P450 3A4.
Read the full Lime + Irinotecan interactionCabbageGlucuronidated Drugs Moderate
Interaction Summary
Theoretically, cabbage might increase clearance and decrease the effects of drugs metabolized through glucuronide conjugation.
Read the full Cabbage + Irinotecan interactionGrape ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
It is unclear if grape seed extract inhibits or induces CYP3A4; research is conflicting.
Read the full Grape Extract + Irinotecan interactionIrinotecan Hydrochloride
How Irinotecan Hydrochloride interacts with Forever Nature's 18 — through 5 ingredients. Tap an ingredient for the detail:
AppleOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple + Irinotecan Hydrochloride interactionGrape ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
It is unclear if grape seed extract inhibits or induces CYP3A4; research is conflicting.
Read the full Grape Extract + Irinotecan Hydrochloride interactionLimeCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Animal research shows that phenolics in lime juice inhibit cytochrome P450 3A4.
Read the full Lime + Irinotecan Hydrochloride interactionCranberry Whole Fruit ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, cranberry might increase the levels and adverse effects of CYP3A4 substrates.
Read the full Cranberry Whole Fruit Extract + Irinotecan Hydrochloride interactionCabbageGlucuronidated Drugs Moderate
Interaction Summary
Theoretically, cabbage might increase clearance and decrease the effects of drugs metabolized through glucuronide conjugation.
Read the full Cabbage + Irinotecan Hydrochloride interactionIsoniazid, Pyrazinamide, RifampinRifater
How Isoniazid, Pyrazinamide, Rifampin interacts with Forever Nature's 18 — through 3 ingredients. Tap an ingredient for the detail:
AppleOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple + Isoniazid, Pyrazinamide, Rifampin interactionLimePhotosensitizing Drugs Moderate
Interaction Summary
Theoretically, concomitant use of lime oil with photosensitizing drugs may increase the risk of phototoxicity.
Read the full Lime + Isoniazid, Pyrazinamide, Rifampin interactionCeleryPhotosensitizing Drugs Minor
Interaction Summary
Theoretically, celery might increase the risk of photosensitivity reactions when taken with photosensitizing drugs.
Read the full Celery + Isoniazid, Pyrazinamide, Rifampin interactionIsoniazid, RifampinRifamate
How Isoniazid, Rifampin interacts with Forever Nature's 18 — through 1 ingredient. Tap an ingredient for the detail:
AppleOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple + Isoniazid, Rifampin interactionLevofloxacinLeva-pak, Levaquin, Levaquin Injection
How Levofloxacin interacts with Forever Nature's 18 — through 3 ingredients. Tap an ingredient for the detail:
AppleOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple + Levofloxacin interactionLimePhotosensitizing Drugs Moderate
Interaction Summary
Theoretically, concomitant use of lime oil with photosensitizing drugs may increase the risk of phototoxicity.
Read the full Lime + Levofloxacin interactionCeleryPhotosensitizing Drugs Minor
Interaction Summary
Theoretically, celery might increase the risk of photosensitivity reactions when taken with photosensitizing drugs.
Read the full Celery + Levofloxacin interactionLevofloxacin (ophthalmic)Levofloxacin
How Levofloxacin (ophthalmic) interacts with Forever Nature's 18 — through 1 ingredient. Tap an ingredient for the detail:
AppleOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple + Levofloxacin (ophthalmic) interactionLomefloxacinMaxaquin
How Lomefloxacin interacts with Forever Nature's 18 — through 3 ingredients. Tap an ingredient for the detail:
AppleOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple + Lomefloxacin interactionLimePhotosensitizing Drugs Moderate
Interaction Summary
Theoretically, concomitant use of lime oil with photosensitizing drugs may increase the risk of phototoxicity.
Read the full Lime + Lomefloxacin interactionCeleryPhotosensitizing Drugs Minor
Interaction Summary
Theoretically, celery might increase the risk of photosensitivity reactions when taken with photosensitizing drugs.
Read the full Celery + Lomefloxacin interactionLovastatinAltocor, Mevacor
How Lovastatin interacts with Forever Nature's 18 — through 5 ingredients. Tap an ingredient for the detail:
AppleOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple + Lovastatin interactionLimeCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Animal research shows that phenolics in lime juice inhibit cytochrome P450 3A4.
Read the full Lime + Lovastatin interactionCranberry Whole Fruit ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, cranberry might increase the levels and adverse effects of CYP3A4 substrates.
Read the full Cranberry Whole Fruit Extract + Lovastatin interactionCabbageGlucuronidated Drugs Moderate
Interaction Summary
Theoretically, cabbage might increase clearance and decrease the effects of drugs metabolized through glucuronide conjugation.
Read the full Cabbage + Lovastatin interactionGrape ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
It is unclear if grape seed extract inhibits or induces CYP3A4; research is conflicting.
Read the full Grape Extract + Lovastatin interactionMethotrexateOtrexup, Rasuvo, Reditrex, Rheumatrex
How Methotrexate interacts with Forever Nature's 18 — through 1 ingredient. Tap an ingredient for the detail:
AppleOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple + Methotrexate interactionEach ingredient & the kinds of drugs it affects
For each ingredient in Forever Nature's 18 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.
Grape
Anticoagulant/Antiplatelet Drugs
Theoretically, grape extracts may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
In vitro evidence suggests that grape extracts might decrease platelet aggregation.
Cyclosporine (Neoral, Sandimmune)
Ingesting grape juice with cyclosporine can reduce cyclosporine absorption.
A small pharmacokinetic study in healthy young adults shows that intake of purple grape juice 200 mL along with cyclosporine can decrease the absorption of cyclosporine by up to 30% when compared with water. Separate doses of grape juice and cyclosporine by at least 2 hours to avoid this interaction.
Cytochrome P450 1A2 (Cyp1A2) Substrates
Theoretically, grape juice might reduce the levels of CYP1A2 substrates.
A small pharmacokinetic study in healthy adults shows that ingestion of 200 mL of grape juice decreases phenacetin plasma levels. This is thought to be due to induction of CYP1A2.
Cytochrome P450 2D6 (Cyp2D6) Substrates
Theoretically, grape seed extract may increase the levels of CYP2D6 substrates.
In vitro evidence suggests that grape seed extract might inhibit CYP2D6 enzymes. However, this interaction has not been reported in humans.
Cytochrome P450 2E1 (Cyp2E1) Substrates
Theoretically, grape seed extract might increase the levels of CYP2E1 substrates.
In vitro and animal research suggests that grape seed proanthocyanidin extract inhibits CYP2E1 enzymes. However, this interaction has not been reported in humans.
Cytochrome P450 3A4 (Cyp3A4) Substrates
It is unclear if grape seed extract inhibits or induces CYP3A4; research is conflicting.
In vitro evidence suggests that grape seed extract might inhibit CYP3A4 enzymes. However, evidence from animal research shows that grape seed extract may induce CYP3A4 in the liver. So far, these interactions have not been reported in humans.
Midazolam (Versed)
Theoretically, long-term intake of grape seed extract might decrease the effects of midazolam.
Animal research shows that subchronic ingestions of grape seed extract can increase the elimination of intravenous midazolam by increasing hepatic CYP3A4 activity. Single doses of grape seed extract do not appear to affect midazolam elimination.
Phenacetin
Grape juice might decrease phenacetin absorption.
A small pharmacokinetic study in healthy adults shows that ingestion of 200 mL of grape juice decreases phenacetin plasma levels. This is thought to be due to induction of cytochrome P450 1A2 (CYP1A2).
Cytochrome P450 2C9 (Cyp2C9) Substrates
It is unclear if grape juice or grape seed extract inhibits CYP2C9; research is conflicting.
In vitro evidence shows that grape seed extract or grape juice might inhibit CYP2C9 enzymes. However, a small pharmacokinetic study in healthy adults shows that drinking 8 ounces of grape juice once does not affect the clearance of flurbiprofen, a probe-drug for CYP2C9 metabolism. The effects of continued grape juice consumption are unclear.
Lime
Cytochrome P450 3A4 (Cyp3A4) Substrates
Animal research shows that phenolics in lime juice inhibit cytochrome P450 3A4. This has been demonstrated in rats treated with sildenafil, a CYP3A4 substrate, and high doses of lime juice.
Photosensitizing Drugs
Theoretically, concomitant use of lime oil with photosensitizing drugs may increase the risk of phototoxicity.
Cranberry Whole Fruit Extract
Atorvastatin (Lipitor)
Theoretically, cranberry might increase levels and adverse effects of atorvastatin.
In one case report, a patient taking atorvastatin experienced upper back pain, rhabdomyolysis, and abnormal liver function after drinking cranberry juice 16 ounces daily for 2 weeks. Theoretically, this may have been caused by inhibition of cytochrome P450 3A4 (CYP3A4) enzymes by cranberry juice, as atorvastatin is a CYP3A4 substrate. Creatinine kinase and liver enzymes normalized within 2 weeks of stopping cranberry juice. Patients taking atorvastatin should avoid large quantities of cranberry juice.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, cranberry might increase the levels and adverse effects of CYP3A4 substrates.
A case of upper back pain, rhabdomyolysis, and abnormal liver function has been reported for a patient taking atorvastatin, a CYP3A4 substrate, in combination with cranberry juice 16 ounces daily for 2 weeks. Creatinine kinase and liver enzymes normalized within 2 weeks of stopping cranberry juice. Also, animal research suggests that cranberry juice, administered intraduodenally 30 minutes prior to nifedipine, a CYP3A4 substrate, inhibits nifedipine metabolism and increases the area under the concentration-time curve by 1.6-fold compared to control.
Nifedipine (Procardia)
Theoretically, cranberry might increase the levels and adverse effects of nifedipine.
Animal research suggests that cranberry juice, administered intraduodenally 30 minutes prior to nifedipine treatment, inhibits nifedipine metabolism and increases the area under the concentration-time curve by 1.6-fold compared to control. This interaction has not been reported in humans.
Warfarin (Coumadin)
Theoretically, cranberry might increase the levels and adverse effects of warfarin. However, research is conflicting.
There is contradictory evidence about the effect of cranberry juice on warfarin. Case reports have linked cranberry juice consumption to increases in the international normalized ratio (INR) in patients taking warfarin, resulting in severe spontaneous bleeding and excessive postoperative bleeding. Daily consumption of cranberry sauce for one week has also been linked to an increase in INR in one case report. In a small study in healthy young males, taking a high dose of 3 grams of cranberry juice concentrate capsules, equivalent to 57 grams of fruit daily, for 2 weeks produced a 30% increase in the area under the INR-time curve after a single 25-mg dose of warfarin. However, 3 very small clinical studies in patients stabilized on warfarin reported that cranberry juice 250 mL once or twice daily for 7 days (27% cranberry juice or pure cranberry juice) or 240 mL once daily for 14 days does not significantly increase INR or affect plasma warfarin levels. The reasons for these discrepant findings are unclear. It is possible that the form and dose of cranberry may play a role, as cranberry extracts and juices contain different constituents. Additionally, an in vitro study evaluating 5 different cranberry juices found varying effects, with only a cranberry concentrate, and not diluted cranberry juices, inhibiting CYP2C9. However, this concentrate did not inhibit CYP2C9 activity in humans.
Cytochrome P450 2C9 (Cyp2C9) Substrates
Theoretically, cranberry might increase the levels and adverse effects of CYP2C9 substrates. However, research is conflicting.
There is contradictory evidence about the effect of cranberry on CYP2C9 enzymes. In vitro evidence suggests that flavonoids in cranberry inhibit CYP2C9 enzymes. However, clinical research shows that cranberry juice does not significantly affect the levels, metabolism, or elimination of the CYP2C9 substrates flurbiprofen or diclofenac. Also, in patients stabilized on warfarin, drinking cranberry juice 250 mL daily for 7 days does not significantly increase the anticoagulant activity of warfarin, a CYP2C9 substrate. Additional pharmacokinetic research shows that cranberry juice does not increase peak plasma concentrations or area under the concentration-time curve of warfarin.
Diclofenac (Voltaren, Others)
Theoretically, cranberry might modestly increase the levels and adverse effects of diclofenac.
In vitro evidence suggests that cranberry juice inhibits diclofenac metabolism by human liver microsomes. However, drinking cranberry juice does not seem to affect diclofenac metabolism in humans.
Celery
Anticoagulant/Antiplatelet Drugs
Theoretically, celery root might increase the risk of bleeding when taken with anticoagulant/antiplatelet drugs.
Celery root contains the constituents falcarinol and falcarindiol. Laboratory research suggests that these constituents can inhibit platelet aggregation. This effect has not been reported in humans.
Antihypertensive Drugs
Theoretically, celery seed extract might have additive effects with antihypertensive drugs.
Clinical research suggests that taking celery seed extract may reduce daytime systolic blood pressure by about 12 mmHg compared to less than 1 mmHg with placebo.
Cytochrome P450 1A2 (Cyp1A2) Substrates
Theoretically, celery might increase levels of drugs metabolized by CYP1A2.
In vitro and animal research suggests that constituents of celery can inhibit CYP1A2. This effect has not been reported in humans.
Levothyroxine (Synthroid, Others)
Theoretically, celery seed might decrease the effects of levothyroxine.
Several cases of hypothyroidism with low T4 levels have been reported in people who were previously stabilized on levothyroxine and then started taking celery seed tablets. They presented with symptoms such as lethargy, bloating, and dry skin, and recovered when celery seed was stopped. However, celery stem and leaf has been associated with case reports of hyperthyroidism in patients with no pre-existing thyroid disorders.
Lithium
Theoretically, celery might reduce excretion and increase levels of lithium due to potential diuretic effects.
Celery is thought to have diuretic properties. However, this effect has not been confirmed in humans.
Venlafaxine (Effexor)
Theoretically, celery root extract might increase blood levels of venlafaxine.
There is one case report of a patient who experienced medication-induced bipolar disorder after beginning to take celery root extract 1000 mg daily along with venlafaxine 75 mg and St. John's wort 600 mg daily. Symptoms included confusion, speech abnormalities, manic affect, and visual hallucinations. The plasma level of venlafaxine was 476.8 ng/mL (normal range 195-400 ng/mL). It is theorized that celery root increased venlafaxine levels by inhibiting cytochrome P450 2D6.
Acetaminophen (Tylenol, Others)
Theoretically, celery juice might increase the effects and side effects of acetaminophen.
Animal research suggests that concomitant use of celery juice plus acetaminophen prolongs the effects of acetaminophen. This effect has been attributed to a decrease in hepatic cytochrome P450 activity. However, other animal research shows that pretreatment with celery root extract protects against acetaminophen-induced acute liver failure. These effects have not been reported in humans.
Photosensitizing Drugs
Theoretically, celery might increase the risk of photosensitivity reactions when taken with photosensitizing drugs.
Laboratory research shows that celery contains photosensitizing agents such as phenols and psoralens.
Parsley
Anticoagulant/Antiplatelet Drugs
Theoretically, parsley might increase the risk of bleeding when taken with anticoagulant or antiplatelet drugs.
Animal research suggests that parsley has antiplatelet effects.
Antidiabetes Drugs
Theoretically, parsley might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Animal research suggests that parsley might decrease blood glucose. Monitor blood glucose levels closely. Dose adjustments might be necessary.
Cytochrome P450 1A2 (Cyp1A2) Substrates
Theoretically, parsley might increase serum levels of CYP1A2 substrates.
Laboratory research suggests that parsley can inhibit CYP1A2.
Diuretic Drugs
Theoretically, parsley might enhance or interfere with the effects of diuretic drugs.
Animal research suggests that parsley seed extract increases urine elimination. Parsley leaf and root might also interfere with diuretic therapy due their purported aquaretic effects.
Pentobarbital (Nembutal)
Theoretically, parsley might increase the duration of pentobarbital effects.
Animal research suggests that parsley juice prolongs the action of pentobarbital, perhaps by decreasing cytochrome P450 levels. It is not known if this occurs in humans or if this applies to other barbiturates or sedatives.
Sirolimus (Rapamune)
Theoretically, large quantities of parsley might increase sirolimus levels.
In one case report, an adult female with a history of kidney transplant presented with elevated blood sirolimus levels, approximately 4-7 times greater than previous measures, after daily consumption of a juice containing approximately 30 grams of parsley for 7 days. Sirolimus levels returned to normal a week after the parsley juice was discontinued.
Warfarin (Coumadin)
Theoretically, large amounts of parsley leaf and root might decrease the effects of warfarin.
Parlsey contains vitamin K.
Aspirin
Theoretically, aspirin might increase the severity of allergic reactions to parsley.
In one case, severe urticaria and swelling were reported after taking aspirin with parsley in an individual with a known mild parsley allergy.
Cabbage
Acetaminophen (Tylenol, Others)
Cabbage might increase clearance and reduce the effects of acetaminophen.
A small clinical study shows that daily consumption of cabbage and Brussels sprout decreases acetaminophen levels by as much as 16%, with some evidence suggesting that this effect is due to increased elimination through glucuronide conjugation.
Antidiabetes Drugs
Theoretically, cabbage might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Animal and in vivo research suggests that cabbage might have hypoglycemic effects.
Cytochrome P450 1A2 (Cyp1A2) Substrates
Theoretically, cabbage might decrease levels of drugs metabolized by CYP1A2.
Some animal research suggests that cabbage or its constituent indole-3-carbinol might increase drug metabolism and elimination by stimulating CYP1A2 activity.
Glucuronidated Drugs
Theoretically, cabbage might increase clearance and decrease the effects of drugs metabolized through glucuronide conjugation.
A small clinical study shows that daily consumption of cabbage and Brussels sprout decreases levels of some drugs metabolized through glucuronide conjugation.
Oxazepam (Serax)
Cabbage might increase clearance and reduce the effects of oxazepam.
A small clinical study shows that daily consumption of cabbage and brussels sprout decreases oxazepam levels by as much as 17%, with some evidence suggesting that this effect is due to increased elimination through glucuronide conjugation.
Warfarin (Coumadin)
Theoretically, cabbage might decrease the anticoagulant effects of warfarin.
Cabbage contains vitamin K. If consumed in large quantities, cabbage might decrease the anticoagulant effects of warfarin.
Apple
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.
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.
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.
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.
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.
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.
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.
Kiwi
Anticoagulant/Antiplatelet Drugs
Clinical research suggests that kiwi inhibits platelet aggregation. Theoretically, kiwi might increase the risk of bleeding when used with antiplatelet or anticoagulant drugs. Some anticoagulant or antiplatelet drugs include aspirin, clopidogrel (Plavix), dalteparin (Fragmin), enoxaparin (Lovenox), heparin, ticlopidine (Ticlid), warfarin (Coumadin), and others.
Antihypertensive Drugs
Clinical research suggests that consuming kiwi reduces systolic and diastolic blood pressure in hypertensive individuals. Theoretically, concomitant use of kiwi and antihypertensive drugs may increase the risk of hypotension when used in combination with drugs that lower blood pressure. These include captopril (Capoten), enalapril (Vasotec), losartan (Cozaar), valsartan (Diovan), diltiazem (Cardizem), amlodipine (Norvasc), hydrochlorothiazide (HydroDiuril), furosemide (Lasix), and many others.
Red Bell Pepper
Anticoagulant/Antiplatelet Drugs
Theoretically, capsicum may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
In vitro research shows that capsicum might increase the effects of antiplatelet drugs. Also, population research shows that capsicum is associated with an increased risk of self-reported bleeding in patients taking warfarin. However, clinical research shows that taking a single dose of capsaicin (Asian Herbex Ltd.), the active ingredient in capsicum, 400-800 mcg orally in combination with aspirin 500 mg does not decrease platelet aggregation when compared with taking aspirin 500 mg alone. Also, there was no notable effect on measures of platelet aggregation with capsaicin. It is unclear whether capsaicin must be used in more than a single dose to affect platelet aggregation.
Antidiabetes Drugs
Theoretically, taking capsicum with antidiabetes drugs might increase the risk of hypoglycemia.
Preliminary clinical research shows that consuming capsicum 5 grams along with a glucose drink attenuates the rise in plasma glucose after 30 minutes by 21%, decreases the 2-hour postprandial area under the curve of plasma glucose by 11%, and increases the 2-hour postprandial area under the curve of plasma insulin by 58% in healthy individuals when compared with placebo. Other clinical research shows that taking capsicum 5 mg daily for 28 days significantly reduces postprandial blood glucose and insulin levels, but not fasting blood glucose and insulin levels, in patients with gestational diabetes.
Aspirin
Theoretically, taking capsicum with aspirin might reduce the bioavailability of aspirin.
Animal research shows that acute or chronic intake of capsicum pepper reduces oral aspirin bioavailability. This has not been shown in humans.
Theophylline
Theoretically, taking capsicum with theophylline might increase the levels and adverse effects of theophylline.
In animal research, oral administration of capsicum reduced excretion of theophylline. However, capsicum does not seem to affect the pharmacokinetics of theophylline when administered intravenously.
Ace Inhibitors (Aceis)
Theoretically, using topical capsaicin may increase the risk of ACE inhibitor-induced cough.
There is one case report of a topically applied capsaicin cream contributing to the cough reflex in a patient using an ACEI. However, it is unclear if this interaction is clinically significant.
Ciprofloxacin (Cipro)
Theoretically, taking capsicum with ciprofloxacin might increase levels and adverse effects of ciprofloxacin.
Animal research shows that concomitant use of capsaicin, the active constituent of capsicum, and ciprofloxacin increases the bioavailability of ciprofloxacin by up to 70%.
Vitamin C
Alkylating Agents
Theoretically, antioxidant effects of vitamin C might reduce the effectiveness of alkylating agents.
The use of antioxidants like vitamin C during chemotherapy is controversial. There is concern that antioxidants could reduce the activity of chemotherapy drugs that generate free radicals, such as cyclophosphamide, chlorambucil, carmustine, busulfan, and thiotepa. In contrast, some researchers theorize that antioxidants might make chemotherapy more effective by reducing oxidative stress that could interfere with apoptosis (cell death) of cancer cells. More evidence is needed to determine what effect, if any, antioxidants such as vitamin C have on chemotherapy.
Aluminum
Vitamin C can increase the amount of aluminum absorbed from aluminum compounds.
Research in animals and humans shows that vitamin C increases aluminum absorption, theoretically by chelating aluminum and keeping it in solution where it is available for absorption. In people with normal renal function, urinary excretion of aluminum will likely increase, making aluminum retention and toxicity unlikely. Patients with renal failure who take aluminum-containing compounds such as phosphate binders should avoid vitamin C supplements in doses above the recommended dietary allowances.
Antitumor Antibiotics
Theoretically, the antioxidant effects of vitamin C might reduce the effectiveness of antitumor antibiotics.
The use of antioxidants like vitamin C during chemotherapy is controversial. There is concern that antioxidants could reduce the activity of chemotherapy drugs which generate free radicals, such as doxorubicin. In contrast, some researchers theorize that antioxidants might make chemotherapy more effective by reducing oxidative stress that could interfere with apoptosis (cell death) of cancer cells. More evidence is needed to determine what effects, if any, antioxidants such as vitamin C have on chemotherapy.
Estrogens
Vitamin C might increase blood levels of estrogens.
Increases in plasma estrogen levels of up to 55% occur under some circumstances when vitamin C is taken concurrently with oral contraceptives or hormone replacement therapy, including topical products. It is suggested that vitamin C prevents oxidation of estrogen in the tissues, regenerates oxidized estrogen, and reduces sulfate conjugation of estrogen in the gut wall. When tissue levels of vitamin C are high, these processes are already maximized and supplemental vitamin C does not have any effect on estrogen levels. Increases in plasma estrogen levels may occur when patients who are deficient in vitamin C take supplements. Monitor these patients for estrogen-related side effects.
Fluphenazine (Prolixin)
Theoretically, vitamin C might decrease levels of fluphenazine.
In one patient there was a clinically significant decrease in fluphenazine levels when vitamin C (500 mg twice daily) was started. The mechanism is not known, and there is no further data to confirm this interaction.
Indinavir (Crixivan)
Vitamin C can modestly reduce indinavir levels.
One pharmacokinetic study shows that taking vitamin C 1 gram orally once daily along with indinavir 800 mg orally three times daily reduces the area under the concentration-time curve of indinavir by 14%. The mechanism of this interaction is unknown, but it is unlikely to be clinically significant in most patients. The effect of higher doses of vitamin C on indinavir levels is unknown.
Levothyroxine (Synthroid, Others)
Vitamin C can increase levothyroxine absorption.
Two clinical studies in adults with poorly controlled hypothyroidism show that swallowing levothyroxine with a glass of water containing vitamin C 500-1000 mg in solution reduces thyroid stimulating hormone (TSH) levels and increases thyroxine (T4) levels when compared with taking levothyroxine alone. This suggests that vitamin C increases the oral absorption of levothyroxine, possibly due to a reduction in pH.
Warfarin (Coumadin)
High-dose vitamin C might reduce the levels and effectiveness of warfarin.
Vitamin C in high doses may cause diarrhea and possibly reduce warfarin absorption. There are reports of two people who took up to 16 grams daily of vitamin C and had a reduction in prothrombin time. Lower doses of 5-10 grams daily can also reduce warfarin absorption. In many cases, this does not seem to be clinically significant. However, a case of warfarin resistance has been reported for a patient who took vitamin C 500 mg twice daily. Cessation of vitamin C supplementation resulted in a rapid increase in international normalized ratio (INR). Tell patients taking warfarin to avoid taking vitamin C in excessively high doses (greater than 10 grams daily). Lower doses may be safe, but the anticoagulation activity of warfarin should be monitored. Patients who are stabilized on warfarin while taking vitamin C should avoid adjusting vitamin C dosage to prevent the possibility of warfarin resistance.
Acetaminophen (Tylenol, Others)
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
A small pharmacokinetic study in healthy volunteers shows that taking high-dose vitamin C (3 grams) 1.5 hours after taking acetaminophen 1 gram slightly increases the apparent half-life of acetaminophen from around 2.3 hours to 3.1 hours. Ascorbic acid competitively inhibits sulfate conjugation of acetaminophen. However, to compensate, elimination of acetaminophen glucuronide and unconjugated acetaminophen increases. This effect is not likely to be clinically significant.
Aspirin
Acidification of the urine by vitamin C might increase aspirin levels.
It has been suggested that acidification of the urine by vitamin C could increase reabsorption of salicylates by the renal tubules, and increase plasma salicylate levels. However, short-term use of up to 6 grams daily of vitamin C does not seem to affect urinary pH or salicylate excretion, suggesting this interaction is not clinically significant.
Choline Magnesium Trisalicylate (Trilisate)
Acidification of the urine by vitamin C might increase choline magnesium trisalicylate levels.
It has been suggested that acidification of the urine by vitamin C could increase reabsorption of salicylates by the renal tubules, and increase plasma salicylate levels. However, short-term use of up to 6 grams daily of vitamin C does not seem to affect urinary pH or salicylate excretion, suggesting this interaction probably is not clinically significant.
Niacin
Vitamin C might decrease the beneficial effects of niacin on high-density lipoprotein (HDL) cholesterol levels.
A combination of niacin and simvastatin (Zocor) effectively raises HDL cholesterol levels in patients with coronary disease and low HDL levels. Clinical research shows that taking a combination of antioxidants (vitamin C, vitamin E, beta-carotene, and selenium) along with niacin and simvastatin (Zocor) attenuates this rise in HDL, specifically the HDL-2 and apolipoprotein A1 fractions, by more than 50% in patients with coronary disease. It is not known whether this adverse effect is due to a single antioxidant such as vitamin C, or to the combination. It also is not known whether it will occur in other patient populations.
Salsalate (Disalcid)
Acidification of the urine by vitamin C might increase salsalate levels.
It has been suggested that acidification of the urine by vitamin C could increase reabsorption of salicylates by the renal tubules, and increase plasma salicylate levels. However, short-term use of up to 6 grams/day vitamin C does not seem to affect urinary pH or salicylate excretion, suggesting this interaction probably is not clinically significant.
Cauliflower
Cytochrome P450 1A2 (Cyp1A2) Substrates
Preliminary clinical evidence suggests that eating cruciferous vegetables, including broccoli, cauliflower, daikon radish sprouts, and cabbage, can increase cytochrome P450 1A2 (CYP1A2) activity by 14% to 27%. Theoretically, cauliflower might increase the clearance and decrease the effects of drugs metabolized by CYP1A2. Some drugs metabolized by CYP1A2 include clozapine (Clozaril), cyclobenzaprine (Flexeril), fluvoxamine (Luvox), haloperidol (Haldol), imipramine (Tofranil), mexiletine (Mexitil), olanzapine (Zyprexa), pentazocine (Talwin), propranolol (Inderal), tacrine (Cognex), theophylline, zileuton (Zyflo), zolmitriptan (Zomig), and others.
Prune
Anticoagulant/Antiplatelet Drugs
Theoretically, plum juice might have antiplatelet effects.
Consuming plum juice while taking anticoagulant or antiplatelet drugs might increase the risk of bruising and bleeding. In healthy volunteers, drinking plum juice 200 mL daily for 28 days prolonged clotting time and inhibited platelet aggregation.
Elderberry extract
Immunosuppressants
Theoretically, elderberry might interfere with immunosuppressant therapy due to its immunostimulant activity.
Elderberry has immunostimulant activity, increasing the production of cytokines, including interleukin and tumor necrosis factor.
Pazopanib (Votrient)
Theoretically, elderberry might interact with pazopanib, potentially increasing the risk of adverse effects.
Blueberry extract
Antidiabetes Drugs
Theoretically, blueberries or blueberry leaf extracts might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Animal and in vitro research suggests that blueberry and/or blueberry leaf extracts can lower blood glucose levels.
Buspirone (Buspar)
Theoretically, blueberry juice might increase blood levels of buspirone.
In vitro research shows that blueberry juice can inhibit the metabolism of buspirone, possibly by inhibiting cytochrome P450 3A (CYP3A) enzymes. However, pharmacokinetic research in humans shows that drinking 300 mL of blueberry juice 30 minutes before taking buspirone hydrochloride 10 mg does not significantly affect the concentration or clearance of buspirone.
Flurbiprofen (Ansaid, Others)
Theoretically, blueberry juice might increase blood levels of flurbiprofen.
In vitro research shows that blueberry juice can inhibit the metabolism of flurbiprofen, possibly by inhibiting cytochrome P450 2C9 (CYP2C9) enzymes. However, pharmacokinetic research in humans shows that drinking 300 mL of blueberry juice 30 minutes before taking flurbiprofen 100 mg does not significantly affect the concentration or clearance of flurbiprofen.
Rutin
Antidiabetes Drugs
Theoretically, taking rutin with antidiabetes drugs might increase the risk of hypoglycemia.
Animal research suggests that rutin has hypoglycemic effects.
Banana
Levodopa
Taking banana may reduce the effectiveness of levodopa.
A case report describes apparent wearing off in a patient with Parkinson disease after eating a banana every day. The wearing off subsided after removing dietary bananas.
Brand information
Manufacturer and brand details for Forever Nature's 18, from the product label.
Forever Nature's 18 by Forever: Common Questions
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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 Forever Nature's 18’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Vitamin C
Interacts with 207 drugsVitamin C (ascorbic acid) is an essential nutrient your body needs but cannot make, so you must get it from food or supplements. It's important for immune function, collagen, and acts as an...
Read the full Vitamin C monograph → Herb & supplement monographRutin
Interacts with 86 drugsRutin is a plant flavonoid (often taken from buckwheat or citrus) that people use mainly for blood vessel and circulation problems like varicose veins and hemorrhoids. The evidence is limite...
Read the full Rutin monograph → Herb & supplement monographCranberry
Interacts with 712 drugsCranberry is best known for helping to prevent repeated urinary tract infections (UTIs) in some people, and the evidence here is moderate but mixed. It is not a reliable treatment for an act...
Read the full Cranberry monograph → Herb & supplement monographPlum
Interacts with 122 drugsPlums and their dried form (prunes) are common, nutritious foods that are best known for helping relieve constipation thanks to their fiber and sorbitol content. They are generally safe as f...
Read the full Plum monograph → Herb & supplement monographCarrot
Carrot is a common food vegetable that is a rich source of beta-carotene (which the body turns into vitamin A) and other nutrients. Eating carrots is safe and nutritious for most people, but...
Read the full Carrot monograph → Herb & supplement monographGrape
Interacts with 910 drugsGrapes and grape products like grape seed extract contain antioxidant compounds such as resveratrol and proanthocyanidins that may support heart and blood vessel health. While the food is he...
Read the full Grape monograph → Herb & supplement monographApple
Interacts with 300 drugsApples 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 monographBlueberry
Interacts with 88 drugsBlueberries are a nutritious fruit rich in antioxidants called anthocyanins, and eating them as part of a balanced diet is healthy and safe for most people. Concentrated supplements are mark...
Read the full Blueberry monograph → Herb & supplement monographElderberry
Interacts with 121 drugsElderberry is a popular herbal supplement, mainly taken to help with colds and flu. Some small studies suggest it may modestly shorten cold or flu symptoms, but the evidence is limited and n...
Read the full Elderberry monograph → Herb & supplement monographBanana
Interacts with 5 drugsBananas are a nutritious, widely eaten fruit that provide potassium, fiber, vitamin B6, and quick energy, and they are part of a healthy diet. While some traditional uses (like easing diarrh...
Read the full Banana monograph → Herb & supplement monographCabbage
Interacts with 325 drugsCabbage is a nutritious, low-calorie vegetable that is safe to eat as food and is sometimes applied to the skin as a leaf wrap for breast engorgement or sore joints. Most medicinal claims ar...
Read the full Cabbage monograph → Herb & supplement monographCauliflower
Interacts with 186 drugsCauliflower is a nutritious cruciferous vegetable that provides vitamin C, fiber, and plant compounds called glucosinolates. As a food it is healthy and safe for most people, but there is no...
Read the full Cauliflower monograph → Herb & supplement monographCelery
Interacts with 651 drugsCelery is a common vegetable that is also taken as a seed extract or oil supplement, mainly for blood pressure, fluid retention, and joint discomfort. Human evidence for these supplement use...
Read the full Celery monograph → Herb & supplement monographKiwi
Interacts with 289 drugsKiwi is a nutritious fruit that is rich in vitamin C, fiber, and antioxidants, and it is generally safe to eat as a food. The strongest evidence is for helping with constipation and overall...
Read the full Kiwi monograph → Herb & supplement monographLime
Interacts with 886 drugsLime is a common citrus fruit and a good natural source of vitamin C and plant antioxidants. As a food it is generally safe and enjoyed by most people, but evidence that lime treats any spec...
Read the full Lime monograph → Herb & supplement monographParsley
Interacts with 443 drugsParsley is a popular culinary herb that is safe to eat in normal food amounts and is a good source of vitamins K and C. It is traditionally used as a diuretic and for digestion, but solid hu...
Read the full Parsley monograph → Herb & supplement monographCapsicum
Interacts with 239 drugsCapsicum (chili pepper) contains capsaicin, which is best known and best studied as a topical treatment for certain types of pain. Topical capsaicin products are supported by reasonable evid...
Read the full Capsicum monograph →Sources & How We Checked
Forever Nature's 18'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 418 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.
Vitamin C 51 references
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- Morris JC, Beeley L, Ballantine N. Interaction of ethinyloestradiol with ascorbic acid in man [letter]. Br Med J (Clin Res Ed) 1981;283:503.
- Labriola D, Livingston R. Possible interactions between dietary antioxidants and chemotherapy. Oncology 1999;13:1003-8.
- Dwyer JH, Merz NB, Shirocre AM, et al. Progression of early atherosclerosis and intake of vitamin C and vitamin E from supplements and food. The Los Angeles Atherosclerosis Study. 41st Annual Conference on Cardiovascular Disease Epidemiology and Prevent
- Levine M, Rumsey SC, Daruwala R, et al. Criteria and recommendations for vitamin C intake. JAMA 1999;281:1415-23. PubMed
- Hansten PD, Horn JR. Drug Interactions Analysis and Management. Vancouver, WA: Applied Therapeutics Inc., 1997 and updates.
- Segal S, Kaminski S. Drug-nutrient interactions. American Druggist 1996 Jul;42-8.
- Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes for Vitamin C, Vitamin E, Selenium, and Carotenoids. Washington, DC: National Academy Press, 2000. Available at: http://www.nap.edu/books/0309069351/html/.
- Houston JB, Levy G. Drug biotransformation interactions in man VI: Acetaminophen and ascorbic acid. J Pharm Sci 1976;65:1218-21. PubMed
- Brown BG, Zhao XQ, Chait A, et al. Simvastatin and niacin, antioxidant vitamins, or the combination for the prevention of coronary disease. N Engl J Med 2001;345:1583-93. DOI
- Rosenthal G. Interaction of ascorbic acid and warfarin. JAMA 1971;215:1671. DOI
- Hume R, Johnstone JM, Weyers E. Interaction of ascorbic acid and warfarin. JAMA 1972;219:1479. DOI
- Smith EC, Skalski RJ, Johnson GC, Rossi GV. Interaction of ascorbic acid and warfarin. JAMA 1972;221:1166. DOI
- Traxer O, Huet B, Poindexter J, et al. Effect of ascorbic acid consumption on urinary stone risk factors. J Urol 2003;170:397-401.. PubMed
- Domingo JL, Gomez M, Llobet JM, Richart C. Effect of ascorbic acid on gastrointestinal aluminum absorption (letter). Lancet 1991;338:1467.
- Domingo JL, Gomez M, Llobet JM, Corbella J. Influence of some dietary constituents on aluminum absorption and retention in rats. Kidney Int 1991;39:598-601. PubMed
- Partridge NA, Regnier FE, White JL, Hem SL. Influence of dietary constituents on intestinal absorption of aluminum. Kidney Int 1989;35:1413-7. PubMed
- Mc Leod DC, Nahata MC. Inefficacy of ascorbic acid as a urinary acidifier (letter). N Engl J Med 1977;296:1413. DOI
- Hansten PD, Hayton WL. Effect of antacid and ascorbic acid on serum salicylate concentration. J Clin Pharmacol 1980;20:326-31. PubMed
- Dysken MW, Cumming RJ, Channon RA, Davis JM. Drug interaction between ascorbic acid and fluphenazine. JAMA 1979;241:2008. DOI
- Vihtamaki T, Parantainen J, Koivisto AM, et al. Oral ascorbic acid increases plasma oestradiol during postmenopausal hormone replacement therapy. Maturitas 2002;42:129-35. PubMed
- Slain D, Amsden JR, Khakoo RA, et al. Effect of high-dose vitamin C on the steady-state pharmacokinetics of the protease inhibitor indinavir in healthy volunteers. Pharmacotherapy 2005;25:165-70. PubMed
- Cheung MC, Zhao XQ, Chait A, et al. Antioxidant supplements block the response of HDL to simvastatin-niacin therapy in patients with coronary artery disease and low HDL. Arterioscler Thromb Vasc Biol 2001;21:1320-6. PubMed
- Feetam CL, Leach RH, Meynell MJ. Lack of a clinically important interaction between warfarin and ascorbic acid. Toxicol Appl Pharmacol 1975;31:544-7. PubMed
- Weintraub M, Griner PF. Warfarin and ascorbic acid: lack of evidence for a drug interaction. Toxicol Appl Pharmacol 1974;28:53-6. PubMed
- Lee DH, Folsom AR, Harnack L, et al. Does supplemental vitamin C increase cardiovascular disease risk in women with diabetes? Am J Clin Nutr 2004;80:1194-200. PubMed
- Taylor EN, Stampfer MJ, Curhan GC. Dietary factors and the risk of incident kidney stones in men: new insights after 14 years of follow-up. J Am Soc Nephrol 2004;15:3225-32. PubMed
- Ward NC, Hodgson JM, Croft KD, et al. The combination of vitamin C and grape-seed polyphenols increases blood pressure: a randomized, double-blind, placebo-controlled trial. J Hypertens 2005;23:427-34.. PubMed
- Prasad KN. Rationale for using high-dose multiple dietary antioxidants as an adjunct to radiation therapy and chemotherapy. J Nutr 2004;134:3182S-3S. PubMed
- Conklin KA. Cancer chemotherapy and antioxidants. J Nutr 2004;134:3201S-3204S. PubMed
- Fairweather-Tait S, Hickson K, McGaw B, et al. Orange juice enhances aluminium absorption from antacid preparation. Eur J Clin Nutr. 1994;48(1):71-3.
- Gruenwald, J., Graubaum, H. J., Busch, R., and Bentley, C. Safety and tolerance of ester-C compared with regular ascorbic acid. Adv.Ther. 2006;23(1):171-178.
- Rahimi, R., Nikfar, S., Rezaie, A., and Abdollahi, M. A meta-analysis on the efficacy and safety of combined vitamin C and E supplementation in preeclamptic women. Hypertens.Pregnancy. 2009;28(4):417-434. PubMed
- Einerson, B., Nathorn, C., Kitiyakara, C., Sirada, M., and Thamlikitkul, V. The efficacy of ascorbic acid in suboptimal responsive anemic hemodialysis patients receiving erythropoietin: a meta-analysis. J Med.Assoc.Thai. 2011;94 Suppl 1:S134-S146.
- Li, G., Li, L., Yu, C., and Chen, L. Effect of vitamins C and E supplementation on Helicobacter pylori eradication: a meta-analysis. Br.J Nutr 2011;106(11):1632-1637.
- Chen X, Shen L, Gu X, et al. High-dose supplementation with vitamin C--induced pediatric urolithiasis: the first case report in a child and literature review. Urology. 2014;84(4):922-4. PubMed
- Sattar A, Willman JE, Kolluri R. Possible warfarin resistance due to interaction with ascorbic acid: case report and literature review. Am J Health Syst Pharm. 2013;70(9):782-6. PubMed
- Yaich S, Chaabouni Y, Charfeddine K, et al. Secondary oxalosis due to excess vitamin C intake: a cause of graft loss in a renal transplant recipient. Saudi J Kidney Dis Transpl. 2014;25(1):113-6. PubMed
- Jalloh MA, Gregory PJ, Hein D, et al. Dietary supplement interactions with antiretrovirals: a systematic review. Int J STD AIDS. 2017 Jan;28(1):4-15. PubMed
- Rumbold A, Ota E, Nagata C, Shahrook S, Crowther CA. Vitamin C supplementation in pregnancy. Cochrane Database Syst Rev. 2015;(9):CD004072. PubMed
- Seo MS, Kim JK, Shim JY. High-dose vitamin C promotes regression of multiple pulmonary metastases originating from hepatocellular carcinoma. Yonsei Med J. 2015;56(5):1449-52. PubMed
- Skelin M, Lucijanic T, Amidzic Klaric D, et al. Factors Affecting Gastrointestinal Absorption of Levothyroxine: A Review. Clin Ther. 2017 Feb;39(2):378-403. PubMed
- Jiang K, Tang K, Liu H, Xu H, Ye Z, Chen Z. Ascorbic acid supplements and kidney stones incidence among men and women: a systematic review and meta-analysis. Urol J. 2019;16(2):115-120.
- Thomas S, Patel D, Bittel B, et al. Effect of High-Dose Zinc and Ascorbic Acid Supplementation vs Usual Care on Symptom Length and Reduction Among Ambulatory Patients With SARS-CoV-2 Infection: The COVID A to Z Randomized Clinical Trial. JAMA Netw Open. 2 PubMed
- Giffen MA, McLemore JL. Hyperoxalosis Secondary to Intravenous Vitamin C Administration as a Non-Allopathic Treatment for Cancer. Acad Forensic Pathol 2019;9(1-2):118-126. PubMed
- Maike A, Sturgill D, Gallan A. Oxalate Nephropathy in a Renal Transplant Recipient After Receiving High Dose Ascorbic Acid. Am J Med Sci 2021. PubMed
- Shen ZY, Chen YR, Wang MC, Chang SS. High-dose vitamin C-induced acute oxalate nephropathy in a renal transplant recipient: a case report and literature review. Asian J Surg 2022. PubMed
- Yanase F, Spano S, Maeda A, et al. Mega-dose sodium ascorbate: a pilot, single-dose, physiological effect, double-blind, randomized, controlled trial. Crit Care 2023;27(1):371. PubMed
- Sharma Y, Sumanadasa S, Shahi R, et al. Efficacy and safety of vitamin C supplementation in the treatment of community-acquired pneumonia: a systematic review and meta-analysis with trial sequential analysis. Sci Rep 2024;14(1):11846. PubMed
- Pejcic AV, Petrovic NZ, Djordjic MD, Milosavljevic MN. Vitamin C Levels in Pregnant Women and the Efficacy of Vitamin C Supplements in Preventing Premature Rupture of Membranes: A Systematic Review and Meta-Analysis. Balkan Med J 2024;41(4):248-260. PubMed
Rutin 2 references
- Mehta DK (Ex Ed). British National Formulary, Number 37. British Medical Association and Royal Pharmaceutical Society of Great Britain: London, England, March 1999.
- Sun C, Wang L, Sun J, Wang Z, Tang Z. Hypoglycemic and hypolipidemic effects of rutin on hyperglycemic rats. J Tradit Chin Med. 2020;40(4):640-645.
Cranberry 33 references
- Anon. Possible interaction between warfarin and cranberry juice. Current Problems in Pharmacovigilance 2003;29:8. PubMed
- Greenblatt DJ, von Moltke LL, Perloff ES, et al. Interaction of flurbiprofen with cranberry juice, grape juice, tea, and fluconazole: in vitro and clinical studies. Clin Pharmacol Ther 2006;79:125-33. PubMed
- Hodek P, Trefil P, Stiborova M. Flavonoids-potent and versatile biologically active compounds interacting with cytochromes P450. Chem Biol Interact 2002;139:1-21.. PubMed
- Grant P. Warfarin and cranberry juice: An interaction? J Heart Valve Dis 2004;13:25-6.
- Suvarna R, Pirmohamed M, Henderson L. Possible interaction between warfarin and cranberry juice. BMJ 2003;327:1454. PubMed
- Li Z, Seeram NP, Carpenter CL, et al. Cranberry does not affect prothrombin time in male subjects on warfarin. J Am Diet Assoc 2006;106:2057-61. PubMed
- Lilja JJ, Backman JT, Neuvonen PJ. Effects of daily ingestion of cranberry juice on the pharmacokinetics of warfarin, tizanidine, and midazolam - probes of CYP2C9, CYP1A2 and CYP3A4. Clin Pharmacol The 2007:81:833-9. PubMed
- Wing DA, Rumney PJ, Preslicka CW, Chung JH. Daily cranberry juice for the prevention of asymptomatic bacteriuria in pregnancy: a randomized, controlled pilot study. J Urol 2008;180:1367-72. PubMed
- Mohammed Abdul MI, Jiang X, Williams KM, et al. Pharmacodynamic interaction of warfarin with cranberry but not with garlic in healthy subjects. Br J Pharmacol 2008;154:1691-700. PubMed
- McMurdo MET, Argo I, Phillips G, et al. Cranberry or trimethoprim for the prevention of recurrently urinary tract infections? A randomized controlled trial in older women. J Antimicrob Chemother 2009;63:389-95.
- Mergenhagen KA, Sherman O. Elevated International Normalized Ratio after concurrent ingestion of cranberry sauce and warfarin. Am J Health-Syst Pharm 2008;65:2113-6. PubMed
- Ansell J, McDonough M, Zhao Y, et al. The absence of an interaction between warfarin and cranberry juice: a randomized, double-blind trial. J Clin Pharmacol 2009;49:824-30. PubMed
- Haber SL, Cauthon KA, Raney EC. Cranberry and warfarin interaction: a case report and review of the literature. Consult Pharm 2012;27:58-65. PubMed
- Hamann GL, Campbell JD, George CM. Warfarin-cranberry juice interaction. Ann Pharmacother 2011;45:e17. PubMed
- Roberts D, Flanagan P. Case report: Cranberry juice and warfarin. Home Healthc Nurse 2011;29:92-7.
- Garcia-Calatayud, S., Larreina Cordoba, J. J., and Lozano De La Torre MJ. [Severe cranberry juice poisoning]. An.Esp.Pediatr. 2002;56(1):72-73.
- Patel, D. A., Gillespie, B., Sobel, J. D., Leaman, D., Nyirjesy, P., Weitz, M. V., and Foxman, B. Risk factors for recurrent vulvovaginal candidiasis in women receiving maintenance antifungal therapy: results of a prospective cohort study. Am J Obstet.Gy PubMed
- Isele, H. [Fatal bleeding under warfarin plus cranberry juice. Is it due to salicylic acid?]. MMW.Fortschr.Med 3-11-2004;146(11):13.
- Linsenmeyer, T. A., Harrison, B., Oakley, A., Kirshblum, S., Stock, J. A., and Millis, S. R. Evaluation of cranberry supplement for reduction of urinary tract infections in individuals with neurogenic bladders secondary to spinal cord injury. A prospecti
- McMurdo, M. E., Bissett, L. Y., Price, R. J., Phillips, G., and Crombie, I. K. Does ingestion of cranberry juice reduce symptomatic urinary tract infections in older people in hospital? A double-blind, placebo-controlled trial. Age Ageing 2005;34(3):256- PubMed
- Sylvan, L. and Justice, N. P. Possible interaction between warfarin and cranberry juice. Am Fam.Physician 9-15-2005;72(6):1000.
- Niklasson, A. and Andren, L. [Interaction between Waran and cranberry juice]. Lakartidningen 3-15-2006;103(11):853-854.
- Rindone, J. P. and Murphy, T. W. Warfarin-cranberry juice interaction resulting in profound hypoprothrombinemia and bleeding. Am J Ther 2006;13(3):283-284. PubMed
- Uesawa, Y. and Mohri, K. Effects of cranberry juice on nifedipine pharmacokinetics in rats. J Pharm Pharmacol 2006;58(8):1067-1072. PubMed
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