Fortify Ingredients & Drug Interactions
by Iso-Sport
What is this page for?
First and foremost: checking Fortify 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
Fortify is a dietary supplement by Iso-Sport with 6 active ingredients. Its ingredients are commonly taken for memory and cognitive support, age-related mental decline, circulation problems.Based on those ingredients, 1,624 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are Ginkgo biloba, Polygonum multiflorum, Eleutherococcus senticosus. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against Fortify by Iso-Sport
Ask about any prescription or over-the-counter medication and we check it for interactions with Fortify by Iso-Sport — 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 Fortify by Iso-Sport
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
Fortify contains 6 active ingredients: ginkgo biloba leaf extract, a proprietary herbal blend, turmeric extract, fo-ti (Polygonum multiflorum), CBD, and gotu kola (Centella asiatica). The herbal blend itself contains component ingredients, which are listed separately in our full breakdown.
These botanicals are delivered in a liquid form with inactive ingredients including glycerin, medium-chain triglycerides (a coconut-derived oil), sunflower lecithin, and vanilla oil.
Does it work?
Not established
The evidence for Fortify's ingredients is mixed and modest. Ginkgo biloba is possibly effective for hearing loss, stroke recovery, schizophrenia, premenstrual syndrome, dementia, and anxiety.
Turmeric extract is possibly effective for depression, high cholesterol, hay fever, and indigestion. Gotu kola is possibly effective for venous insufficiency and wound healing, though it showed no clear benefit for cognitive function or Alzheimer's disease in the data we hold.
Fo-ti and eleuthero have insufficient evidence to rate for most of their traditional uses—meaning the research is too thin to say whether they work. We hold no effectiveness data for CBD.
How safe is it?
Well-documented data
Ginkgo is generally well tolerated but increases bleeding risk, particularly over time or at higher doses; it also has rare reports of heart rhythm problems (162 cases internationally, with some serious outcomes). Turmeric is well tolerated at food amounts, but concentrated supplements have caused liver damage in at least 70 reported cases, usually after 2+ weeks of use; most cases resolved after stopping.
Fo-ti carries significant liver injury risk—around 450 cases documented—and can cause diarrhea, nausea, and vomiting, especially the raw form. Gotu kola is generally well tolerated short-term but has four reported cases of liver damage, and quality long-term safety data is limited.
Eleuthero is usually well tolerated short-term but may cause nervousness (reported in about 7% of users), anxiety, headache, or elevated blood pressure, especially at higher doses. For pregnancy: ginkgo is possibly unsafe and should be avoided; turmeric is likely safe at food doses but possibly unsafe at medicinal doses; fo-ti is possibly unsafe and should be avoided; gotu kola is possibly safe but traditionally avoided; and eleuthero should be avoided due to insufficient data.
For breastfeeding: ginkgo, fo-ti, and eleuthero should all be avoided, turmeric is likely safe, and gotu kola's safety is unknown so it's best avoided. Talk with your doctor or pharmacist about whether Fortify is appropriate if you're pregnant or nursing.
Meds to double-check
Major interaction found
Before taking Fortify, double-check with your doctor or pharmacist if you take talinolol or any beta-blockers, blood thinners or antiplatelet drugs (especially warfarin), anxiety or sleep medications, cholesterol drugs, cancer chemotherapy, immunosuppressants like tacrolimus, heart medication digoxin, diabetes drugs, or pain relievers like tramadol. These represent the main medication categories documented to interact with one or more ingredients in this product.
The bottom line
Scorecard at a glanceFormula with limited ingredient disclosure with no established evidence rating for its marketed use. Major medication interactions have been identified, and safety information is well characterized.
Fortify may appeal to you if you're interested in herbal support for brain health, circulation, or mood and you take no regular medications—but this product carries substantial interaction risks and liver-safety concerns that warrant a careful review with your own doctor or pharmacist. If you take any prescription drugs, especially blood thinners, heart medications, diabetes treatments, or chemotherapy, you should verify your specific medications against the checker on this page before taking it.
Those who are pregnant, breastfeeding, or have liver disease should avoid it unless advised otherwise by their healthcare provider.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 5 of 6 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Jun 23, 2021.
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 Fortify, straight from the product label.
| Brand | Iso-Sport |
|---|---|
| Barcode (UPC) | 800001473330 |
| Net contents | 2 Fluid Ounce(s); 60 mL |
| Market status | On market |
| Date entered into DSLD | Jun 23, 2021 |
| DSLD ID | 247224 |
| Product type | Other Combinations |
| Supplement form | Liquid |
| Dietary claims / uses | All Other, Structure/Function |
| Intended target group(s) | Adult (18 - 50 Years) |
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 Fortify by Iso-Sport, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Ginkgo biloba | 0 NP | -- |
| Proprietary Herbal Blend | 133 mg | -- |
| Turmeric extract | 200 mg | -- |
| Polygonum multiflorum | 0 NP | -- |
| CBD | 8.33 mg | -- |
| Centella asiatica | 0 NP | -- |
| Eleutherococcus senticosus | 0 NP | -- |
Other ingredients: Glycerin, Medium Chain Triglycerides, Sunflower Lecithin, Vanilla Oil
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.
Formulation
ISO-SPORT FORTIFY is formulated to help raise energy levels, lift away brain fog and may help reduce inflammation with a naturally-balancing blend of powerful adaptogens.
THC free
Pre-workout
Precautions
Caution: Consult with a doctor before consuming any dietary supplement or if you are pregnant, nursing, or taking any other medication.
Keep out of reach of children.
Do not use if safety seal is damaged or missing.
Always check with your physician before starting a new dietary supplement.
FDA Disclaimer Statement
These statements have not been evaluated by the FDA and are not intended to diagnose, treat, or cure any disease.
General Statements
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Formula
500 mg CBD per bottle Turmeric Ginkgo biloba
FDA Statement of Identity
Dietary Supplement
Suggested/Recommended/Usage/Directions
Suggested Use: Shake well before use. Consume 1 dropper orally once or twice daily.
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Fortify by Iso-Sport 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 Fortify by Iso-Sport
These are the 6 active ingredients this product is made of. Select any to open its full monograph.
Serving size1 mL Dosage formLiquid 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.
Proprietary Herbal Blend
Turmeric extract
Interacts with1,133 drugs
Turmeric is a popular spice whose main active compounds, curcuminoids, are studied mostly for inflammation and joint pain. Some research is promising,...
Turmeric extract monograph & interactionsCBD
Other (inactive) ingredients: Glycerin, Medium Chain Triglycerides, Sunflower Lecithin, Vanilla Oil. These complete the product’s ingredient list but are not active constituents.
Fortify by Iso-Sport Drug Interactions
HelloPharmacist Interaction Report
Iso-Sport Fortify interacts with medications through its ginkgo biloba, turmeric extract, fo-ti, gotu kola, and eleuthero content.
The most serious interaction is ginkgo's effect on talinolol (a beta-blocker), which is a Major-severity interaction: regular ginkgo use can raise talinolol levels by about 36%, potentially increasing side effects like low heart rate or dizziness.
Read the full breakdown — every affected drug type, severity by severity
Ginkgo also carries Moderate-severity risks with blood thinners like warfarin by increasing bleeding risk, and with anxiety medications like alprazolam and some cholesterol drugs like simvastatin by lowering their levels in your blood. Turmeric extract poses Moderate concerns with cancer chemotherapy drugs (both topoisomerase inhibitors and antitumor antibiotics), the immunosuppressant tacrolimus, tamoxifen for breast cancer, sulfasalazine for inflammatory bowel disease, methotrexate, and tramadol pain relief.
Fo-ti carries Moderate-severity interactions with blood thinners and antiplatelet drugs, heart medication digoxin, and several drug-metabolizing pathways. Gotu kola theoretically raises the sedative effects of CNS depressants and shares concerns about liver toxicity with certain medications.
Eleuthero interacts Moderately with multiple drug classes including blood thinners, immunosuppressants, diabetes medications, and digoxin—with a Minor interaction affecting drugs broken down by a liver enzyme called CYP2D6.
We could not check CBD, as we hold no interaction data for it. Altogether, these interactions span 1,625 individual medications.
Before starting Fortify, use the medication checker on this page to verify your exact prescriptions, and talk with your doctor or pharmacist about whether this product is right for you.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against Fortify?
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 Fortify interact with 1,624 drugs. Click any drug to see the details.
5 of the 6 ingredients in Fortify interact with drugs. Each result below shows which ingredient is responsible. Ginkgo biloba Polygonum multiflorum Eleutherococcus senticosus Turmeric extract Centella asiatica
Aerosphere Budesonide, Formoterol Fumarate, GlycopyrrolateBreztri
How Aerosphere Budesonide, Formoterol Fumarate, Glycopyrrolate interacts with Fortify — through 3 ingredients. Tap an ingredient for the detail:
Polygonum MultiflorumCytochrome P450 2c9 (cyp2c9) Substrates, Cytochrome P450 2d6 (cyp2d6) Substrates +1 Moderate
Interaction Summary
Theoretically, fo-ti may increase the levels and clinical effects of drugs metabolized by CYP2C9.
Read the full Polygonum Multiflorum + Aerosphere Budesonide, Formoterol Fumarate, Glycopyrrolate interactionEleutherococcus SenticosusCytochrome P450 2c9 (cyp2c9) Substrates, Cytochrome P450 2d6 (cyp2d6) Substrates Moderate
Interaction Summary
Theoretically, eleuthero might increase levels of drugs metabolized by CYP2C9.
Read the full Eleutherococcus Senticosus + Aerosphere Budesonide, Formoterol Fumarate, Glycopyrrolate interactionGinkgo BilobaCytochrome P450 2c19 (cyp2c19) Substrates, Cytochrome P450 2c9 (cyp2c9) Substrates Moderate
Interaction Summary
Theoretically, ginkgo might decrease levels of drugs metabolized by CYP2C19.
Read the full Ginkgo Biloba + Aerosphere Budesonide, Formoterol Fumarate, Glycopyrrolate interactionAfatinib DimaleateGilotrif
How Afatinib Dimaleate interacts with Fortify — through 3 ingredients. Tap an ingredient for the detail:
Ginkgo BilobaP-glycoprotein Substrates Moderate
Interaction Summary
Theoretically, taking ginkgo with P-glycoprotein substrates might increase the levels and adverse effects of these substrates.
Read the full Ginkgo Biloba + Afatinib Dimaleate interactionEleutherococcus SenticosusP-glycoprotein Substrates Moderate
Interaction Summary
Theoretically, eleuthero might increase levels of P-glycoprotein substrates.
Read the full Eleutherococcus Senticosus + Afatinib Dimaleate interactionTurmeric ExtractP-glycoprotein Substrates Minor
Interaction Summary
Theoretically, turmeric might increase the absorption of P-glycoprotein substrates.
Read the full Turmeric Extract + Afatinib Dimaleate interactionAgomelatineValdoxan
How Agomelatine interacts with Fortify — through 4 ingredients. Tap an ingredient for the detail:
Polygonum MultiflorumCytochrome P450 2c19 (cyp2c19) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Moderate
Interaction Summary
Theoretically, fo-ti may increase the levels and clinical effects of drugs metabolized by CYP2C19.
Read the full Polygonum Multiflorum + Agomelatine interactionGinkgo BilobaCytochrome P450 2c19 (cyp2c19) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Moderate
Interaction Summary
Theoretically, ginkgo might decrease levels of drugs metabolized by CYP2C19.
Read the full Ginkgo Biloba + Agomelatine interactionEleutherococcus SenticosusCytochrome P450 2c9 (cyp2c9) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, eleuthero might increase levels of drugs metabolized by CYP2C9.
Read the full Eleutherococcus Senticosus + Agomelatine interactionTurmeric ExtractCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, turmeric might increase levels of drugs metabolized by CYP1A2.
Read the full Turmeric Extract + Agomelatine interactionAlbiglutideTanzeum
How Albiglutide interacts with Fortify — through 4 ingredients. Tap an ingredient for the detail:
Eleutherococcus SenticosusAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, eleuthero might have additive effects when used with antidiabetes drugs.
Read the full Eleutherococcus Senticosus + Albiglutide interactionGinkgo BilobaAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, taking ginkgo with antidiabetes drugs might alter the response to antidiabetes drugs.
Read the full Ginkgo Biloba + Albiglutide interactionTurmeric ExtractAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, taking turmeric with antidiabetes drugs might increase the risk of hypoglycemia.
Read the full Turmeric Extract + Albiglutide interactionPolygonum MultiflorumAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, fo-ti might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Read the full Polygonum Multiflorum + Albiglutide interactionAldesleukinProleukin
How Aldesleukin interacts with Fortify — through 3 ingredients. Tap an ingredient for the detail:
Polygonum MultiflorumHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, fo-ti might increase the risk of liver damage when taken with hepatotoxic drugs.
Read the full Polygonum Multiflorum + Aldesleukin interactionTurmeric ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, turmeric might increase the risk of liver damage when taken with hepatotoxic drugs.
Read the full Turmeric Extract + Aldesleukin interactionCentella AsiaticaHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking gotu kola with hepatotoxic drugs might have additive adverse effects.
Read the full Centella Asiatica + Aldesleukin interactionAlectinib HydrochlorideAlecensa
How Alectinib Hydrochloride interacts with Fortify — through 3 ingredients. Tap an ingredient for the detail:
Centella AsiaticaHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking gotu kola with hepatotoxic drugs might have additive adverse effects.
Read the full Centella Asiatica + Alectinib Hydrochloride interactionPolygonum MultiflorumHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, fo-ti might increase the risk of liver damage when taken with hepatotoxic drugs.
Read the full Polygonum Multiflorum + Alectinib Hydrochloride interactionTurmeric ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, turmeric might increase the risk of liver damage when taken with hepatotoxic drugs.
Read the full Turmeric Extract + Alectinib Hydrochloride interactionAlefaceptAmevive
How Alefacept interacts with Fortify — through 1 ingredient. Tap an ingredient for the detail:
Eleutherococcus SenticosusImmunosuppressants Moderate
Interaction Summary
Theoretically, eleuthero might interfere with immunosuppressive drugs because of its immunostimulant activity.
Read the full Eleutherococcus Senticosus + Alefacept interactionAlemtuzumabCampath
How Alemtuzumab interacts with Fortify — through 1 ingredient. Tap an ingredient for the detail:
Eleutherococcus SenticosusImmunosuppressants Moderate
Interaction Summary
Theoretically, eleuthero might interfere with immunosuppressive drugs because of its immunostimulant activity.
Read the full Eleutherococcus Senticosus + Alemtuzumab interactionAlfentanilAlfenta
How Alfentanil interacts with Fortify — through 5 ingredients. Tap an ingredient for the detail:
Turmeric ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Turmeric might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full Turmeric Extract + Alfentanil interactionCentella AsiaticaCns Depressants Moderate
Interaction Summary
Theoretically, taking gotu kola might increase the sedative effects of CNS depressants.
Read the full Centella Asiatica + Alfentanil interactionGinkgo BilobaSeizure Threshold Lowering Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, taking ginkgo with drugs that lower the seizure threshold might increase the risk for convulsions.
Read the full Ginkgo Biloba + Alfentanil interactionPolygonum MultiflorumCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, fo-ti might increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Polygonum Multiflorum + Alfentanil interactionEleutherococcus SenticosusCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, eleuthero might increase levels of drugs metabolized by CYP3A4.
Read the full Eleutherococcus Senticosus + Alfentanil interactionAlfuzosinUroxatral
How Alfuzosin interacts with Fortify — through 4 ingredients. Tap an ingredient for the detail:
Polygonum MultiflorumCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, fo-ti might increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Polygonum Multiflorum + Alfuzosin interactionTurmeric ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Turmeric might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full Turmeric Extract + Alfuzosin interactionGinkgo BilobaCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, ginkgo might decrease levels of drugs metabolized by CYP3A4.
Read the full Ginkgo Biloba + Alfuzosin interactionEleutherococcus SenticosusCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, eleuthero might increase levels of drugs metabolized by CYP3A4.
Read the full Eleutherococcus Senticosus + Alfuzosin interactionAliskirenTekturna
How Aliskiren interacts with Fortify — through 4 ingredients. Tap an ingredient for the detail:
Ginkgo BilobaCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, ginkgo might decrease levels of drugs metabolized by CYP3A4.
Read the full Ginkgo Biloba + Aliskiren interactionPolygonum MultiflorumCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, fo-ti might increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Polygonum Multiflorum + Aliskiren interactionTurmeric ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Turmeric might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full Turmeric Extract + Aliskiren interactionEleutherococcus SenticosusCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, eleuthero might increase levels of drugs metabolized by CYP3A4.
Read the full Eleutherococcus Senticosus + Aliskiren interactionAllopurinolCaplenal, Cosuric, Rimapurinol, Zyloprim, Zyloric
How Allopurinol interacts with Fortify — through 3 ingredients. Tap an ingredient for the detail:
Turmeric ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, turmeric might increase the risk of liver damage when taken with hepatotoxic drugs.
Read the full Turmeric Extract + Allopurinol interactionCentella AsiaticaHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking gotu kola with hepatotoxic drugs might have additive adverse effects.
Read the full Centella Asiatica + Allopurinol interactionPolygonum MultiflorumHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, fo-ti might increase the risk of liver damage when taken with hepatotoxic drugs.
Read the full Polygonum Multiflorum + Allopurinol interactionAlmotriptanAlmogran, Axert
How Almotriptan interacts with Fortify — through 4 ingredients. Tap an ingredient for the detail:
Polygonum MultiflorumCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, fo-ti might increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Polygonum Multiflorum + Almotriptan interactionTurmeric ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Turmeric might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full Turmeric Extract + Almotriptan interactionGinkgo BilobaCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, ginkgo might decrease levels of drugs metabolized by CYP3A4.
Read the full Ginkgo Biloba + Almotriptan interactionEleutherococcus SenticosusCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, eleuthero might increase levels of drugs metabolized by CYP3A4.
Read the full Eleutherococcus Senticosus + Almotriptan interactionAlogliptinNesina
How Alogliptin interacts with Fortify — through 5 ingredients. Tap an ingredient for the detail:
Ginkgo BilobaCytochrome P450 3a4 (cyp3a4) Substrates, Antidiabetes Drugs Moderate
Interaction Summary
Theoretically, ginkgo might decrease levels of drugs metabolized by CYP3A4.
Read the full Ginkgo Biloba + Alogliptin interactionEleutherococcus SenticosusCytochrome P450 3a4 (cyp3a4) Substrates, Antidiabetes Drugs Moderate
Interaction Summary
Theoretically, eleuthero might increase levels of drugs metabolized by CYP3A4.
Read the full Eleutherococcus Senticosus + Alogliptin interactionPolygonum MultiflorumHepatotoxic Drugs, Antidiabetes Drugs +2 Moderate
Interaction Summary
Theoretically, fo-ti might increase the risk of liver damage when taken with hepatotoxic drugs.
Read the full Polygonum Multiflorum + Alogliptin interactionTurmeric ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Hepatotoxic Drugs +1 Moderate
Interaction Summary
Turmeric might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full Turmeric Extract + Alogliptin interactionCentella AsiaticaHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking gotu kola with hepatotoxic drugs might have additive adverse effects.
Read the full Centella Asiatica + Alogliptin interactionAlogliptin, MetforminKazano
How Alogliptin, Metformin interacts with Fortify — through 4 ingredients. Tap an ingredient for the detail:
Turmeric ExtractAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, taking turmeric with antidiabetes drugs might increase the risk of hypoglycemia.
Read the full Turmeric Extract + Alogliptin, Metformin interactionPolygonum MultiflorumAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, fo-ti might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Read the full Polygonum Multiflorum + Alogliptin, Metformin interactionEleutherococcus SenticosusAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, eleuthero might have additive effects when used with antidiabetes drugs.
Read the full Eleutherococcus Senticosus + Alogliptin, Metformin interactionGinkgo BilobaAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, taking ginkgo with antidiabetes drugs might alter the response to antidiabetes drugs.
Read the full Ginkgo Biloba + Alogliptin, Metformin interactionAlogliptin, PioglitazoneOseni
How Alogliptin, Pioglitazone interacts with Fortify — through 5 ingredients. Tap an ingredient for the detail:
Ginkgo BilobaAntidiabetes Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, taking ginkgo with antidiabetes drugs might alter the response to antidiabetes drugs.
Read the full Ginkgo Biloba + Alogliptin, Pioglitazone interactionTurmeric ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Hepatotoxic Drugs +1 Moderate
Interaction Summary
Turmeric might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full Turmeric Extract + Alogliptin, Pioglitazone interactionPolygonum MultiflorumAntidiabetes Drugs, Cytochrome P450 2c8 (cyp2c8) Substrates +2 Moderate
Interaction Summary
Theoretically, fo-ti might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Read the full Polygonum Multiflorum + Alogliptin, Pioglitazone interactionCentella AsiaticaHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking gotu kola with hepatotoxic drugs might have additive adverse effects.
Read the full Centella Asiatica + Alogliptin, Pioglitazone interactionEleutherococcus SenticosusAntidiabetes Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, eleuthero might have additive effects when used with antidiabetes drugs.
Read the full Eleutherococcus Senticosus + Alogliptin, Pioglitazone interactionAlpelisibPiqray
How Alpelisib interacts with Fortify — through 4 ingredients. Tap an ingredient for the detail:
Ginkgo BilobaCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, ginkgo might decrease levels of drugs metabolized by CYP3A4.
Read the full Ginkgo Biloba + Alpelisib interactionTurmeric ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Turmeric might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full Turmeric Extract + Alpelisib interactionPolygonum MultiflorumCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, fo-ti might increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Polygonum Multiflorum + Alpelisib interactionEleutherococcus SenticosusCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, eleuthero might increase levels of drugs metabolized by CYP3A4.
Read the full Eleutherococcus Senticosus + Alpelisib interactionAlprazolamNiravam, Xanax
How Alprazolam interacts with Fortify — through 5 ingredients. Tap an ingredient for the detail:
Polygonum MultiflorumCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, fo-ti might increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Polygonum Multiflorum + Alprazolam interactionGinkgo BilobaAlprazolam (xanax), Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, ginkgo might decrease the levels and clinical effects of alprazolam.
Read the full Ginkgo Biloba + Alprazolam interactionTurmeric ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Turmeric might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full Turmeric Extract + Alprazolam interactionCentella AsiaticaCns Depressants Moderate
Interaction Summary
Theoretically, taking gotu kola might increase the sedative effects of CNS depressants.
Read the full Centella Asiatica + Alprazolam interactionEleutherococcus SenticosusCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, eleuthero might increase levels of drugs metabolized by CYP3A4.
Read the full Eleutherococcus Senticosus + Alprazolam interactionAlteplase, TpaActilyse, Activase
How Alteplase, Tpa interacts with Fortify — through 4 ingredients. Tap an ingredient for the detail:
Turmeric ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Turmeric may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Turmeric Extract + Alteplase, Tpa interactionEleutherococcus SenticosusAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, eleuthero may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Eleutherococcus Senticosus + Alteplase, Tpa interactionPolygonum MultiflorumAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Fo-ti has been linked to cases of acute liver failure which can decrease clotting factor production and increase the effects of anticoagulants.
Read the full Polygonum Multiflorum + Alteplase, Tpa interactionGinkgo BilobaAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Ginkgo has been shown to increase the risk of bleeding in some people when taken with warfarin.
Read the full Ginkgo Biloba + Alteplase, Tpa interactionAltretamineHexalen
How Altretamine interacts with Fortify — through 1 ingredient. Tap an ingredient for the detail:
Turmeric ExtractAlkylating Agents Moderate
Interaction Summary
Turmeric has antioxidant effects.
Read the full Turmeric Extract + Altretamine interactionAluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium HydroxideAscriptin Codeine #2
How Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide interacts with Fortify — through 5 ingredients. Tap an ingredient for the detail:
Turmeric ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Turmeric may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Turmeric Extract + Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide interactionCentella AsiaticaCns Depressants Moderate
Interaction Summary
Theoretically, taking gotu kola might increase the sedative effects of CNS depressants.
Read the full Centella Asiatica + Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide interactionPolygonum MultiflorumCytochrome P450 2d6 (cyp2d6) Substrates, Anticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, fo-ti may increase the levels and clinical effects of drugs metabolized by CYP2D6.
Read the full Polygonum Multiflorum + Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide interactionGinkgo BilobaAnticoagulant/antiplatelet Drugs, Seizure Threshold Lowering Drugs Moderate
Interaction Summary
Ginkgo has been shown to increase the risk of bleeding in some people when taken with warfarin.
Read the full Ginkgo Biloba + Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide interactionEleutherococcus SenticosusAnticoagulant/antiplatelet Drugs, Cytochrome P450 2d6 (cyp2d6) Substrates Moderate
Interaction Summary
Theoretically, eleuthero may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Eleutherococcus Senticosus + Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide interactionAluminum Hydroxide, Aspirin, Magnesium HydroxideAscriptin
How Aluminum Hydroxide, Aspirin, Magnesium Hydroxide interacts with Fortify — through 4 ingredients. Tap an ingredient for the detail:
Polygonum MultiflorumAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Fo-ti has been linked to cases of acute liver failure which can decrease clotting factor production and increase the effects of anticoagulants.
Read the full Polygonum Multiflorum + Aluminum Hydroxide, Aspirin, Magnesium Hydroxide interactionTurmeric ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Turmeric may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Turmeric Extract + Aluminum Hydroxide, Aspirin, Magnesium Hydroxide interactionGinkgo BilobaAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Ginkgo has been shown to increase the risk of bleeding in some people when taken with warfarin.
Read the full Ginkgo Biloba + Aluminum Hydroxide, Aspirin, Magnesium Hydroxide interactionEleutherococcus SenticosusAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, eleuthero may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Eleutherococcus Senticosus + Aluminum Hydroxide, Aspirin, Magnesium Hydroxide interactionAlvimopanEntereg
How Alvimopan interacts with Fortify — through 3 ingredients. Tap an ingredient for the detail:
Eleutherococcus SenticosusP-glycoprotein Substrates Moderate
Interaction Summary
Theoretically, eleuthero might increase levels of P-glycoprotein substrates.
Read the full Eleutherococcus Senticosus + Alvimopan interactionGinkgo BilobaP-glycoprotein Substrates Moderate
Interaction Summary
Theoretically, taking ginkgo with P-glycoprotein substrates might increase the levels and adverse effects of these substrates.
Read the full Ginkgo Biloba + Alvimopan interactionTurmeric ExtractP-glycoprotein Substrates Minor
Interaction Summary
Theoretically, turmeric might increase the absorption of P-glycoprotein substrates.
Read the full Turmeric Extract + Alvimopan interactionAmbrisentanLetairis, Volibris
How Ambrisentan interacts with Fortify — through 5 ingredients. Tap an ingredient for the detail:
Ginkgo BilobaP-glycoprotein Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, taking ginkgo with P-glycoprotein substrates might increase the levels and adverse effects of these substrates.
Read the full Ginkgo Biloba + Ambrisentan interactionTurmeric ExtractP-glycoprotein Substrates, Hepatotoxic Drugs +1 Moderate
Interaction Summary
Theoretically, turmeric might increase the absorption of P-glycoprotein substrates.
Read the full Turmeric Extract + Ambrisentan interactionCentella AsiaticaHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking gotu kola with hepatotoxic drugs might have additive adverse effects.
Read the full Centella Asiatica + Ambrisentan interactionEleutherococcus SenticosusP-glycoprotein Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, eleuthero might increase levels of P-glycoprotein substrates.
Read the full Eleutherococcus Senticosus + Ambrisentan interactionPolygonum MultiflorumCytochrome P450 3a4 (cyp3a4) Substrates, Hepatotoxic Drugs Moderate
Interaction Summary
Theoretically, fo-ti might increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Polygonum Multiflorum + Ambrisentan interactionAmifampridineRuzurgi
How Amifampridine interacts with Fortify — through 1 ingredient. Tap an ingredient for the detail:
Ginkgo BilobaSeizure Threshold Lowering Drugs Moderate
Interaction Summary
Theoretically, taking ginkgo with drugs that lower the seizure threshold might increase the risk for convulsions.
Read the full Ginkgo Biloba + Amifampridine interactionAmifampridine PhosphateFirdapse
How Amifampridine Phosphate interacts with Fortify — through 1 ingredient. Tap an ingredient for the detail:
Ginkgo BilobaSeizure Threshold Lowering Drugs Moderate
Interaction Summary
Theoretically, taking ginkgo with drugs that lower the seizure threshold might increase the risk for convulsions.
Read the full Ginkgo Biloba + Amifampridine Phosphate interactionAmiloride, HydrochlorothiazideAmil-Co, Amilzide, Moduret 25, Moduretic
How Amiloride, Hydrochlorothiazide interacts with Fortify — through 1 ingredient. Tap an ingredient for the detail:
Polygonum MultiflorumDiuretic Drugs Moderate
Interaction Summary
Theoretically, fo-ti, particularly raw fo-ti root, might increase the risk of hypokalemia when taken with diuretic drugs.
Read the full Polygonum Multiflorum + Amiloride, Hydrochlorothiazide interactionAminoglutethimideCytadren
How Aminoglutethimide interacts with Fortify — through 1 ingredient. Tap an ingredient for the detail:
Centella AsiaticaCns Depressants Moderate
Interaction Summary
Theoretically, taking gotu kola might increase the sedative effects of CNS depressants.
Read the full Centella Asiatica + Aminoglutethimide interactionAminophylline, Amobarbital, EphedrineAmesec
How Aminophylline, Amobarbital, Ephedrine interacts with Fortify — through 2 ingredients. Tap an ingredient for the detail:
Centella AsiaticaCns Depressants Moderate
Interaction Summary
Theoretically, taking gotu kola might increase the sedative effects of CNS depressants.
Read the full Centella Asiatica + Aminophylline, Amobarbital, Ephedrine interactionGinkgo BilobaAnticonvulsants Moderate
Interaction Summary
Theoretically, ginkgo might reduce the effectiveness of anticonvulsants.
Read the full Ginkgo Biloba + Aminophylline, Amobarbital, Ephedrine interactionAminosalicylic AcidPaser
How Aminosalicylic Acid interacts with Fortify — through 3 ingredients. Tap an ingredient for the detail:
Turmeric ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, turmeric might increase the risk of liver damage when taken with hepatotoxic drugs.
Read the full Turmeric Extract + Aminosalicylic Acid interactionCentella AsiaticaHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking gotu kola with hepatotoxic drugs might have additive adverse effects.
Read the full Centella Asiatica + Aminosalicylic Acid interactionPolygonum MultiflorumHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, fo-ti might increase the risk of liver damage when taken with hepatotoxic drugs.
Read the full Polygonum Multiflorum + Aminosalicylic Acid interactionEach ingredient & the kinds of drugs it affects
For each ingredient in Fortify 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.
Ginkgo biloba
Talinolol
Taking ginkgo with talinolol seems to increase blood levels of talinolol.
There is some evidence that using ginkgo leaf extract 120 mg orally three times daily for 14 days can increase levels of talinolol by 36% in healthy male individuals. However, single doses of ginkgo do not seem to affect talinolol pharmacokinetics.
Alprazolam (Xanax)
Theoretically, ginkgo might decrease the levels and clinical effects of alprazolam.
In clinical research, ginkgo extract (Ginkgold) 120 mg twice daily seems to decrease alprazolam levels by about 17%. However, ginkgo does not appear to decrease the elimination half-life of alprazolam. This suggests that ginkgo is more likely to decrease absorption of alprazolam rather than induce hepatic metabolism of alprazolam.
Anticoagulant/Antiplatelet Drugs
Ginkgo has been shown to increase the risk of bleeding in some people when taken with warfarin. Theoretically, ginkgo might increase the risk of bleeding if used with other anticoagulant or antiplatelet drugs.
Several pharmacodynamic studies suggest that ginkgo inhibits platelet aggregation. It is thought that the ginkgo constituent, ginkgolide B, displaces platelet-activating factor (PAF) from its binding sites, decreasing blood coagulation. Several case reports have documented serious bleeding events in patients taking ginkgo. However, population and clinical studies have produced mixed results. Some evidence shows that short-term use of ginkgo leaf does not significantly reduce platelet aggregation and blood clotting. A study in healthy males who took a specific ginkgo leaf extract (EGb 761) 160 mg twice daily for 7 days found no change in prothrombin time. An analysis of a large medical record database suggests that ginkgo increases the risk of a bleeding adverse event by 38% when taken concurrently with warfarin. It has been suggested that ginkgo has to be taken for at least 2-3 weeks to have a significant effect on platelet aggregation. However, a meta-analysis of 18 studies using standardized ginkgo extracts, 80-480 mg daily for up to 32 weeks, did not find a significant effect on platelet aggregation, fibrinogen concentration, or PT/aPTT. In addition, a single dose of ginkgo plus clopidogrel or ticlopidine does not seem to significantly increase bleeding time or platelet aggregation. Also, taking ginkgo leaf extract daily for 8 days in conjunction with rivaroxaban does not affect anti-factor Xa activity; however, this study did not evaluate bleeding time.
Anticonvulsants
Theoretically, ginkgo might reduce the effectiveness of anticonvulsants.
Ginkgo seeds contain ginkgotoxin. Large amounts of ginkgotoxin can cause neurotoxicity and seizure. Ginkgotoxin is present in much larger amounts in ginkgo seeds than leaves. Ginkgo leaf extract contains trace amounts of ginkgotoxin. The amount of ginkgotoxin in ginkgo leaf and leaf extract seems unlikely to cause toxicity. However, there are anecdotal reports of seizure occurring after use of ginkgo leaf both in patients without a history of seizure disorder and in those with previously well-controlled epilepsy.
Antidiabetes Drugs
Theoretically, taking ginkgo with antidiabetes drugs might alter the response to antidiabetes drugs.
Ginkgo leaf extract seems to alter insulin secretion and metabolism, and might affect blood glucose levels in people with type 2 diabetes. The effect of ginkgo seems to differ depending on the insulin and treatment status of the patient. In diet-controlled diabetes patients with hyperinsulinemia, taking ginkgo does not seem to significantly affect insulin or blood glucose levels. In patients with hyperinsulinemia who are treated with oral hypoglycemic agents, taking ginkgo seems to decrease insulin levels and increase blood glucose following an oral glucose tolerance test. Researchers speculate that this could be due to ginkgo-enhanced hepatic metabolism of insulin. In patients with pancreatic exhaustion, taking ginkgo seems to stimulate pancreatic beta-cells, resulting in increased insulin and C-peptide levels, but with no significant change in blood glucose levels in response to an oral glucose tolerance test.
Atorvastatin (Lipitor)
Theoretically, ginkgo might decrease the levels and clinical effects of atorvastatin.
In humans, intake of ginkgo extract appears to increase atorvastatin clearance, reducing the area under the curve of atorvastatin by 10% to 14% and the maximum concentration by 29%. However, this interaction does not appear to affect cholesterol synthesis and absorption. Further, a model in rats with hyperlipidemia suggests that administering ginkgo extract does not impact blood levels of atorvastatin and leads to lower total cholesterol, low-density lipoprotein cholesterol, and triglycerides when compared with rats given atorvastatin alone.
Cytochrome P450 1A2 (Cyp1A2) Substrates
Theoretically, ginkgo might increase levels of drugs metabolized by CYP1A2.
Laboratory research suggests that ginkgo leaf extract can mildly inhibit CYP1A2 enzymes. However, clinical research suggests ginkgo might not affect CYP1A2. Until more is known, use ginkgo cautiously in patients taking drugs metabolized by these enzymes.
Cytochrome P450 2C19 (Cyp2C19) Substrates
Theoretically, ginkgo might decrease levels of drugs metabolized by CYP2C19.
Some clinical research shows that a specific ginkgo leaf extract (Remembrance, Herbs Product LTD) 140 mg twice daily can induce CYP2C19 enzymes and potentially decrease levels of drugs metabolized by these enzymes. However, other clinical research shows that taking ginkgo 120 mg twice daily for 12 days has no effect on levels of drugs metabolized by CYP2C19.
Cytochrome P450 2C9 (Cyp2C9) Substrates
Theoretically, ginkgo might increase levels of drugs metabolized by CYP2C9.
In vitro, a specific standardized extract of ginkgo leaf (EGb 761) inhibits CYP2C9 activity . The terpenoid (ginkgolides) and flavonoid (quercetin, kaempferol, etc.) constituents seem to be responsible for this effect. Most ginkgo extracts contain some amount of these constituents. Therefore, other ginkgo leaf extracts might also inhibit the CYP2C9 enzyme. However, clinical research suggests that ginkgo might not have a significant effect on CYP2C9 in humans. Ginkgo does not seem to significantly affect the pharmacokinetics of CYP2C9 substrates diclofenac or tolbutamide.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, ginkgo might decrease levels of drugs metabolized by CYP3A4.
There is conflicting evidence about whether ginkgo induces or inhibits CYP3A4. Ginkgo does not appear to affect hepatic CYP3A4. However, it is not known if ginkgo affects intestinal CYP3A4. Preliminary clinical research suggests that taking ginkgo does not significantly affect levels of donepezil, lopinavir, or ritonavir, which are all CYP3A4 substrates. Other clinical research also suggests ginkgo does not significantly affect CYP3A4 activity. However, there are two case reports of decreased efavirenz concentrations and increased viral load in patients taking ginkgo. It is suspected that terpenoids from the ginkgo extract reduced drug levels by inducing cytochrome P450 3A4 (CYP3A4).
Efavirenz (Sustiva)
Theoretically, ginkgo might decrease the levels and clinical effects of efavirenz.
There are two case reports of decreased efavirenz concentrations and increased viral load in patients taking ginkgo. In one case, an HIV-positive male experienced over a 50% decrease in efavirenz levels over the course of 14 months while taking ginkgo extract. HIV-1 RNA copies also increased substantially, from less than 50 to more than 1500. It is suspected that terpenoids from the ginkgo extract reduced drug levels by inducing cytochrome P450 3A4 (CYP3A4). In another case report, a patient stable on antiviral therapy including efavirenz for 10 years, had an increase in viral load from <50 copies/mL to 1350 copies/mL after 2 months of taking a combination of supplements including ginkgo. After stopping ginkgo, the viral load was again controlled with the same antiviral therapy regimen.
Ibuprofen (Advil, Others)
Theoretically, ginkgo might increase the risk of bleeding when used with ibuprofen.
Ginkgo might have antiplatelet effects and has been associated with several case reports of spontaneous bleeding. In one case, a 71-year-old male had taken a specific ginkgo extract (Gingium, Biocur) 40 mg twice daily for 2.5 years. About 4 weeks after starting ibuprofen 600 mg daily he experienced a fatal intracerebral hemorrhage. However, the antiplatelet effects of ginkgo have been questioned. A meta-analysis and other studies have not found a significant antiplatelet effect with standardized ginkgo extracts, 80 mg to 480 mg taken daily for up to 32 weeks.
P-Glycoprotein Substrates
Theoretically, taking ginkgo with P-glycoprotein substrates might increase the levels and adverse effects of these substrates.
A small clinical study in healthy volunteers shows that using ginkgo leaf extract 120 mg orally three times daily for 14 days can increase levels of the P-glycoprotein substrate, talinolol, by 36% in healthy male individuals. However, single doses of ginkgo do not have the same effect.
Risperidone (Risperdal)
Theoretically, taking ginkgo with risperidone might increase the levels and adverse effects of risperidone.
A single case of priapism has been reported for a 26-year-old male with schizophrenia who used risperidone 3 mg daily along with ginkgo extract 160 mg daily. Risperidone is metabolized by cytochrome P450 (CYP) 2D6 and CYP3A4. CYP3A4 activity might be affected by ginkgo. Theoretically, ginkgo may inhibit the metabolism of risperidone and increase the risk of adverse effects.
Rosiglitazone (Avandia)
Theoretically, ginkgo might decrease the levels and clinical effects of rosiglitazone.
Animal research shows that ginkgo leaf extract orally 100 or 200 mg/kg daily for 10 days alters the pharmacodynamics of rosiglitazone in a dose-dependent manner. The 100 mg/kg and 200 mg/kg doses reduce the area under the concentration time curve (AUC) of rosiglitazone by 39% and 52%, respectively, and the half-life by 28% and 39%, respectively. It is hypothesized that these changes may be due to induction of cytochrome P450 2C8 by ginkgo.
Seizure Threshold Lowering Drugs
Theoretically, taking ginkgo with drugs that lower the seizure threshold might increase the risk for convulsions.
Ginkgo seeds contain ginkgotoxin. Large amounts of ginkgotoxin can cause neurotoxicity and seizure. Ginkgotoxin is present in much larger amounts in ginkgo seeds than leaves. Ginkgo leaf extract contains trace amounts of ginkgotoxin. The amount of ginkgotoxin in ginkgo leaf and leaf extract seems unlikely to cause toxicity. However, there are anecdotal reports of seizure occurring after use of ginkgo leaf both in patients without a history of seizure disorder and in those with previously well-controlled epilepsy.
Simvastatin (Zocor)
Theoretically, ginkgo might decrease the levels and clinical effects of simvastatin.
Clinical research shows that taking ginkgo extract can reduce the area under the curve and maximum concentration of simvastatin by 32% to 39%. However, ginkgo extract does not seem to affect the cholesterol-lowering ability of simvastatin.
Sofosbuvir (Sovaldi)
Theoretically, ginkgo might increase the levels and clinical effects of sofosbuvir.
Animal research in rats shows that giving a ginkgo extract 25 mg/kg orally daily for 14 days increases the area under the concentration time curve (AUC) after a single sofosbuvir dose of 40 mg/kg by 11%, increases the half-life by 60%, and increases the plasma concentration at 4 hours by 38%. This interaction appears to be related to the inhibition of intestinal P-glycoprotein by ginkgo.
Tacrolimus (Prograf)
Theoretically, ginkgo might increase the blood levels of tacrolimus.
In vitro evidence suggests that certain biflavonoids in ginkgo leaves (i.e. amentoflavone, ginkgetin, bilobetin) may inhibit the metabolism of tacrolimus by up to 50%. This interaction appears to be time-dependent and due to inhibition of cytochrome P450 (CYP) 3A4 by these bioflavonoids. In rats given tacrolimus 1 mg/kg orally, amentoflavone was shown to increase the area under the concentration time curve (AUC) of tacrolimus by 3.8-fold.
Trazodone (Desyrel)
Theoretically, ginkgo might increase the levels and clinical effects of trazodone.
In a case report, an Alzheimer patient taking trazodone 20 mg twice daily and ginkgo leaf extract 80 mg twice daily for four doses became comatose. The coma was reversed by administration of flumazenil (Romazicon). Coma might have been induced by excessive GABA-ergic activity. Ginkgo flavonoids are thought to have GABA-ergic activity and act directly on benzodiazepine receptors. Ginkgo might also increase metabolism of trazodone to active GABA-ergic metabolites, possibly by inducing cytochrome P450 3A4 (CYP3A4) metabolism.
Warfarin (Coumadin)
Ginkgo has been shown to increase the risk of bleeding in some people when taken with warfarin.
Several pharmacodynamic studies suggest that ginkgo inhibits platelet aggregation. It is thought that the ginkgo constituent, ginkgolide B, displaces platelet-activating factor (PAF) from its binding sites, decreasing blood coagulation. Several case reports have documented serious bleeding events in patients taking ginkgo. Information from a medical database suggests that when taken concurrently with warfarin, ginkgo increases the risk of a bleeding adverse event by 38%. There is also some evidence that ginkgo leaf extract can inhibit cytochrome P450 2C9, an enzyme that metabolizes warfarin. This could result in increased warfarin levels. However, population and clinical research has produced mixed results. Clinical research in healthy people suggests that ginkgo has no effect on INR, or the pharmacokinetics or pharmacodynamics of warfarin. A meta-analysis of 18 studies using standardized ginkgo extracts, 80 mg to 480 mg daily for up to 32 weeks, did not find a significant effect on platelet aggregation, fibrinogen concentration, or PT/aPTT. There is also some preliminary clinical research that suggests ginkgo might not significantly increase the effects of warfarin in patients that have a stable INR.
Nifedipine (Procardia)
Theoretically, taking ginkgo with oral, but not intravenous, nifedipine might increase levels and adverse effects of nifedipine.
Animal research and some clinical evidence suggests that taking ginkgo leaf extract orally in combination with oral nifedipine might increase nifedipine levels and cause increased side effects, such as headaches, dizziness, and hot flushes. However, taking ginkgo orally does not seem to affect the pharmacokinetics of intravenous nifedipine.
Omeprazole (Prilosec)
Theoretically, taking ginkgo with omeprazole might decrease the levels and clinical effects of omeprazole.
Clinical research shows that a specific ginkgo leaf extract (Remembrance, Herbs Product LTD) 140 mg twice daily can induce cytochrome P450 (CYP) 2C19 enzymes and decrease levels of omeprazole by about 27% to 42%.
Polygonum multiflorum
Anticoagulant/Antiplatelet Drugs
Fo-ti has been linked to cases of acute liver failure which can decrease clotting factor production and increase the effects of anticoagulants. In one case, a patient who had been stable on warfarin presented with acute hepatitis and an INR elevated to 14.98. The patient had been taking fo-ti for 90 days prior to admission. Discontinuation of warfarin and fo-ti lead to a decrease in the INR and full recovery. Theoretically, concomitant use of fo-ti with anticoagulant or antiplatelet drugs may increase the risk of bleeding in some patients. Until more is known, monitor patients taking fo-ti and drugs that affect bleeding.
Some of these drugs include aspirin, clopidogrel (Plavix), dalteparin (Fragmin), dipyridamole (Persantine), enoxaparin (Lovenox), heparin, ticlopidine (Ticlid), warfarin (Coumadin), and others.
Antidiabetes Drugs
Theoretically, fo-ti might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Fo-ti reportedly has hypoglycemic effects.
Contraceptive Drugs
Theoretically, taking large amounts of fo-ti might interfere with contraceptive drugs due to competition for estrogen receptors.
In vitro research suggests that fo-ti extract has estrogenic activity.
Cytochrome P450 1A2 (Cyp1A2) Substrates
Theoretically, fo-ti might increase or decrease the levels and clinical effects of drugs metabolized by CYP1A2.
In vitro research suggests that fo-ti might inhibit CYP1A2. Additionally, in vitro research suggests that the degree of CYP1A2 inhibition depends on the type of fo-ti extract (i.e., the raw plant leads to greater inhibition than extensively processed extracts). However, in an animal study, an aqueous extract of fo-ti inhibited CYP1A2 while an alcoholic extract of fo-ti induced CYP1A2. Induction or inhibition of CYP1A2 by fo-ti has not been reported in humans.
Cytochrome P450 2B6 (Cyp2B6) Substrates
Theoretically, fo-ti might increase the levels and clinical effects of drugs metabolized by CYP2B6.
Animal research suggests that fo-ti might inhibit CYP2B6. One in vitro study suggests that the degree of CYP2B6 inhibition may depend on the type of fo-ti extract (i.e., the raw plant leads to greater inhibition than extensively processed extracts). However, this interaction has not been reported in humans.
Cytochrome P450 2C19 (Cyp2C19) Substrates
Theoretically, fo-ti may increase the levels and clinical effects of drugs metabolized by CYP2C19.
Animal and in vitro research suggests that fo-ti may inhibit CYP2C19. An in vitro study suggests that the degree of CYP2C19 inhibition may depend on the type of fo-ti extract (i.e., the raw plant leads to greater inhibition than extensively processed extracts). However, this interaction has not been reported in humans.
Cytochrome P450 2C8 (Cyp2C8) Substrates
Theoretically, fo-ti might increase the levels and clinical effects of drugs metabolized by CYP2C8.
In vitro research suggests that fo-ti might inhibit CYP2C8. However, this interaction has not been reported in humans.
Cytochrome P450 2C9 (Cyp2C9) Substrates
Theoretically, fo-ti may increase the levels and clinical effects of drugs metabolized by CYP2C9.
Animal and in vitro research suggests that fo-ti may inhibit CYP2C9. However, this interaction has not been reported in humans.
Cytochrome P450 2D6 (Cyp2D6) Substrates
Theoretically, fo-ti may increase the levels and clinical effects of drugs metabolized by CYP2D6.
Animal research suggests that fo-ti might inhibit CYP2D6. Additionally, an in vitro study suggests that the degree of CYP2D6 inhibition may depend on the type of fo-ti extract (i.e., the raw plant leads to greater inhibition than extensively processed extracts). However, this interaction has not been reported in humans.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, fo-ti might increase the levels and clinical effects of drugs metabolized by CYP3A4.
In vitro research suggests that fo-ti might inhibit CYP3A4. One in vitro study suggests that the degree of CYP3A4 inhibition may depend on the type of fo-ti extract (i.e., the raw plant leads to greater inhibition than extensively processed extracts). However, this evidence conflicts with animal research suggesting that fo-ti does not inhibit CYP3A4. This interaction has not been reported in humans.
Digoxin (Lanoxin)
Theoretically, fo-ti, particularly raw fo-ti root, might increase the risk of hypokalemia and cardiotoxicity when taken with digoxin.
Raw fo-ti root contains anthraquinone derivatives, which might have stimulant laxative effects. In vitro research shows that fermented and processed fo-ti root have reduced laxative effects compared with raw fo-ti root.
Diuretic Drugs
Theoretically, fo-ti, particularly raw fo-ti root, might increase the risk of hypokalemia when taken with diuretic drugs.
Raw fo-ti root contains anthraquinone derivatives, which might have stimulant laxative effects and compound diuretic-induced potassium loss. In vitro research shows that fermented and processed fo-ti root have reduced laxative effects compared with raw fo-ti root.
Estrogens
Theoretically, taking large amounts of fo-ti might interfere with hormone replacement therapy through competition for estrogen receptors.
In vitro research suggests that fo-ti extract has estrogenic activity.
Hepatotoxic Drugs
Theoretically, fo-ti might increase the risk of liver damage when taken with hepatotoxic drugs.
Fo-ti has been linked to liver damage in many reports.
Stimulant Laxatives
Theoretically, fo-ti, particularly raw fo-ti root, might increase the risk of fluid and electrolyte depletion when taken with stimulant laxatives.
Raw fo-ti root contains anthraquinone derivatives, which might have stimulant laxative effects. However, in vitro research shows that fermented and processed fo-ti root have reduced laxative effects compared with raw fo-ti root.
Sulindac (Clinoril)
Theoretically, fo-ti might increase or decrease the levels and clinical effects of sulindac.
Animal research suggests that the type of fo-ti extract might affect the levels of sulindac differently; the raw plant may increase levels, but processed parts may decrease levels. Induction or inhibition of CYP1A2 by fo-ti has not been reported in humans.
Warfarin (Coumadin)
Theoretically, fo-ti might increase the effects and adverse effects of warfarin.
Fo-ti may have stimulant laxative effects and cause diarrhea, especially when the raw or unprocessed fo-ti root is used. Diarrhea can increase the effects of warfarin, increase international normalized ratio (INR), and increase the risk of bleeding. Also, fo-ti has been linked to cases of acute liver failure which can decrease clotting factor production and increase the effects of warfarin. In one case, a patient who had been stable on warfarin presented with acute hepatitis and an INR elevated to 14.98. The patient had been taking fo-ti for 90 days prior to admission. Discontinuation of warfarin and fo-ti lead to a decrease in the INR and full recovery.
Eleutherococcus senticosus
Anticoagulant/Antiplatelet Drugs
Theoretically, eleuthero may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
In vitro and animal research shows that a constituent of eleuthero, dihydroxybenzoic acid, appears to inhibit platelet aggregation. Concomitant use with anticoagulant or antiplatelet drugs might increase the risk of bleeding. This effect has not been reported in humans.
Antidiabetes Drugs
Theoretically, eleuthero might have additive effects when used with antidiabetes drugs.
Animal research suggests that certain constituents of eleuthero have hypoglycemic activity in both healthy and diabetic animals. A small study in adults with type 2 diabetes also shows that taking eleuthero for 3 months can lower blood glucose levels. However, one very small study in healthy individuals shows that taking powdered eleuthero 3 grams, 40 minutes prior to a 75-gram oral glucose tolerance test, significantly increases postprandial blood glucose levels when compared with placebo. These contradictory findings might be due to patient-specific variability and variability in active ingredient ratios.
Cytochrome P450 1A2 (Cyp1A2) Substrates
Theoretically, eleuthero might increase levels of drugs metabolized by CYP1A2.
In vitro and animal research suggest that standardized extracts of eleuthero inhibit CYP1A2. This effect has not been reported in humans.
Cytochrome P450 2C9 (Cyp2C9) Substrates
Theoretically, eleuthero might increase levels of drugs metabolized by CYP2C9.
In vitro and animal research suggest that standardized extracts of eleuthero might inhibit CYP2C9. This effect has not been reported in humans.
Digoxin (Lanoxin)
Eleuthero might increase serum digoxin levels and increase the risk of side effects.
In one case report, a 74-year-old male who was stabilized on digoxin presented with an elevated serum digoxin level after starting an eleuthero supplement, without symptoms of toxicity. After stopping the supplement, serum digoxin levels returned to normal. It is not clear whether this was due to a pharmacokinetic interaction or to interference with the digoxin assay. Although the product was found to be free of digoxin and digitoxin, it was not tested for other contaminants.
Immunosuppressants
Theoretically, eleuthero might interfere with immunosuppressive drugs because of its immunostimulant activity.
Animal and in vitro research shows that eleuthero extracts have immunomodulatory effects, including increasing cellular and humoral activity.
P-Glycoprotein Substrates
Theoretically, eleuthero might increase levels of P-glycoprotein substrates.
In vitro research suggests that eleuthero can inhibit the multi-drug transporter protein, P-glycoprotein. However, it is too soon to tell if this is clinically important. This interaction has not been reported in humans.
Cytochrome P450 2D6 (Cyp2D6) Substrates
Theoretically, eleuthero might increase levels of drugs metabolized by CYP2D6.
In vitro and animal research suggest that standardized extracts of eleuthero might inhibit CYP2D6. However, research in healthy human volunteers has found that taking eleuthero 485 mg twice daily for 14 days does not inhibit CYP2D6 drug metabolism.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, eleuthero might increase levels of drugs metabolized by CYP3A4.
In vitro and animal research suggest that standardized extracts of eleuthero might inhibit CYP3A4. However, research in healthy human volunteers has found that taking eleuthero 485 mg twice daily for 14 days does not inhibit CYP3A4 drug metabolism.
Organic Anion-Transporting Polypeptide Substrates (Oatp)
Theoretically, eleuthero might decrease levels of drugs metabolized by OATP.
In vitro research suggests that eleuthero inhibits OATP2B1, which might reduce the bioavailability of oral drugs that are substrates of OATP2B1. Due to the weak inhibitory effect identified in this study, this interaction is not likely to be clinically significant.
Turmeric extract
Alkylating Agents
Turmeric has antioxidant effects. Theoretically, this may reduce the activity of chemotherapy drugs that generate free radicals. However, research is conflicting.
In vitro research suggests that curcumin, a constituent of turmeric, inhibits mechlorethamine-induced apoptosis of breast cancer cells by up to 70%. Also, animal research shows that curcumin inhibits cyclophosphamide-induced tumor regression. However, some in vitro research shows that curcumin does not affect the apoptosis capacity of etoposide. Also, other laboratory research suggests that curcumin might augment the cytotoxic effects of alkylating agents. Reasons for the discrepancies may relate to the dose of curcumin and the specific chemotherapeutic agent. Lower doses of curcumin might have antioxidant effects while higher doses might have pro-oxidant effects. More evidence is needed to determine what effect, if any, turmeric might have on alkylating agents.
Amlodipine (Norvasc)
Taking turmeric with amlodipine may increase levels of amlodipine.
Animal research shows that giving amlodipine 1 mg/kg as a single dose following the use of turmeric extract 200 mg/kg daily for 2 weeks increases the maximum concentration and area under the curve by 53% and 56%, respectively, when compared with amlodipine alone. Additional animal research shows that taking amlodipine 1 mg/kg with a curcumin 2 mg/kg pretreatment for 10 days increases the maximum concentration and area under the curve by about 2-fold when compared with amlodipine alone.
Anticoagulant/Antiplatelet Drugs
Turmeric may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs. However, research is conflicting.
Curcumin, a constituent of turmeric, has demonstrated antiplatelet effects in vitro. Furthermore, two case reports have found that taking turmeric along with warfarin or fluindione was associated with an increased international normalized ratio (INR). However, one clinical study in healthy volunteers shows that taking curcumin 500 mg daily for 3 weeks, alone or with aspirin 100 mg, does not increase antiplatelet effects or bleeding risk. It is possible that the dose of turmeric used in this study was too low to produce a notable effect.
Antidiabetes Drugs
Theoretically, taking turmeric with antidiabetes drugs might increase the risk of hypoglycemia.
Animal research and case reports suggest that curcumin, a turmeric constituent, can reduce blood glucose levels in patients with diabetes. Furthermore, clinical research in adults with type 2 diabetes shows that taking curcumin 475 mg daily for 10 days prior to taking glyburide 5 mg decreased postprandial glucose levels for up to 24 hours when compared with glyburide alone, despite the lack of a significant pharmacokinetic interaction. Other clinical studies in patients with diabetes show that taking curcumin daily can reduce blood glucose levels when compared with placebo.
Antitumor Antibiotics
Turmeric has antioxidant effects. Theoretically, this may reduce the activity of chemotherapy drugs that generate free radicals. However, research is conflicting.
In vitro and animal research shows that curcumin, a constituent of turmeric, inhibits doxorubicin-induced apoptosis of breast cancer cells by up to 65%. However, curcumin does not seem to affect the apoptosis capacity of daunorubicin. In fact, some research shows that curcumin might augment the cytotoxic effects of antitumor antibiotics, increasing their effectiveness. Reasons for the discrepancies may relate to the dose of curcumin and the chemotherapeutic agent. Lower doses of curcumin might have antioxidant effects while higher doses might have pro-oxidant effects. More evidence is needed to determine what effects, if any, antioxidants such as turmeric have on antitumor antibiotics.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Turmeric might increase or decrease levels of drugs metabolized by CYP3A4.
In vitro and animal research show that turmeric and its constituents curcumin and curcuminoids inhibit CYP3A4. Also, 8 case reports from the World Health Organization (WHO) adverse drug reaction database describe increased toxicity in patients taking turmeric and cancer medications that are CYP3A4 substrates, including everolimus, ruxolitinib, ibrutinib, and palbociclib, and bortezomib. In another case report, a transplant patient presented with acute nephrotoxicity and elevated tacrolimus levels after consuming turmeric powder at a dose of 15 or more spoonfuls daily for ten days prior. It was thought that turmeric increased levels of tacrolimus due to CYP3A4 inhibition.
Conversely, other in vitro research suggests that turmeric induces CYP3A4 activity, leading to reduced levels of CYP3A4 substrates. An animal model suggests that induction of CYP3A4 occurs after daily curcumin use for 1 week. However, the induction of CYP3A4 by turmeric has not been reported in humans.
Hepatotoxic Drugs
Theoretically, turmeric might increase the risk of liver damage when taken with hepatotoxic drugs.
There is concern that turmeric might cause hepatotoxicity, especially when highly bioavailable formulations are used in high doses.
Methotrexate (Trexall, Others)
Theoretically, turmeric might have additive effects when used with hepatotoxic drugs such as methotrexate.
In one case report, a 39-year-old female taking methotrexate, turmeric, and linseed oil developed hepatotoxicity.
Organic Anion-Transporting Polypeptide Substrates (Oatp)
Theoretically, turmeric might increase blood levels of OATP4C1 substrates.
In vitro research shows that the turmeric constituent curcumin competitively inhibits OATP4C1 transport. This transporter is expressed in the kidney and facilitates the renal excretion of certain drugs. Theoretically, taking turmeric might decrease renal excretion of OATP substrates.
Sulfasalazine (Azulfidine)
Turmeric might increase the effects and adverse effects of sulfasalazine.
Clinical research shows that taking the turmeric constituent, curcumin, can increase blood levels of sulfasalazine by 3.2-fold.
Tacrolimus (Prograf)
Turmeric might increase the effects and adverse effects of tacrolimus.
In one case report, a transplant patient presented with acute nephrotoxicity and elevated tacrolimus levels of 29 ng/mL. The patient previously had tacrolimus levels within the therapeutic range at 9.7 ng/mL. Ten days prior to presenting at the emergency room the patient started consumption of turmeric powder at a dose of 15 or more spoonfuls daily. It was thought that turmeric increased levels of tacrolimus due to cytochrome P450 3A4 (CYP3A4) inhibition. In vitro and animal research show that turmeric and its constituent curcumin inhibit CYP3A4.
Talinolol
Turmeric may reduce the absorption of talinolol in some situations.
Clinical research shows that taking curcumin for 6 days decreases the bioavailability of talinolol when taken together on the seventh day. The clinical significance of this effect is unclear.
Tamoxifen (Nolvadex)
Theoretically, turmeric might reduce the levels and clinical effects of tamoxifen.
In a small clinical trial in patients with breast cancer taking tamoxifen 20-30 mg daily, adding curcumin 1200 mg plus piperine 10 mg three times daily reduces the 24-hour area under the curve of tamoxifen and the active metabolite endoxifen by 12.8% and 12.4%, respectively, as well as the maximum concentrations of tamoxifen, when compared with tamoxifen alone. However, in the absence of piperine, the area under the curve for endoxifen and the maximum concentration of tamoxifen were not significantly reduced. Effects were most pronounced in patients who were extensive cytochrome P450 (CYP) 2D6 metabolizers.
Topoisomerase I Inhibitors
Turmeric has antioxidant effects. There is some concern that this may reduce the activity of chemotherapy drugs that generate free radicals. However, research is conflicting.
In vitro research shows that curcumin, a constituent of turmeric, inhibits camptothecin-induced apoptosis of breast cancer cells by up to 71%. However, other in vitro research shows that curcumin augments the cytotoxic effects of camptothecin. Reasons for the discrepancies may relate to the dose of curcumin and the chemotherapeutic agents. Lower doses of curcumin might have antioxidant effects while higher doses might have pro-oxidant effects. More evidence is needed to determine what effect, if any, turmeric might have.
Tramadol (Ultram)
Theoretically, turmeric might increase or decrease levels of tramadol.
Animal research suggests that a single dose of curcumin, a constituent of turmeric, may increase tramadol's maximum concentration (Cmax) by inhibiting metabolism, while continued daily use for 7 days may reduce the area under the curve (AUC) due to the induction of drug-metabolizing enzymes such as cytochrome P450 3A4 (CYP3A4). However, this interaction has not been reported in humans.
Warfarin (Coumadin)
Turmeric might increase the risk of bleeding with warfarin.
One case of increased international normalized ratio (INR) has been reported for a patient taking warfarin who began taking turmeric. Prior to taking turmeric, the patient had stable INR measurements. Within a few weeks of starting turmeric supplementation, the patient's INR increased to 10. Additionally, curcumin, the active constituent in turmeric, has demonstrated antiplatelet effects in vitro, which may produce additive effects when taken with warfarin.
Cytochrome P450 1A2 (Cyp1A2) Substrates
Theoretically, turmeric might increase levels of drugs metabolized by CYP1A2. However, research is conflicting.
In vitro and animal research show that the turmeric constituent, curcumin, inhibits CYP1A2. However, other in vitro research suggests that curcumin does not significantly affect CYP1A2.
Docetaxel (Taxotere)
Theoretically, turmeric might increase blood levels of oral docetaxel.
Animal research suggests that the turmeric constituent, curcumin, enhances the oral bioavailability of docetaxel. However, the significance of this interaction is unclear, as this drug is typically administered intravenously in clinical settings.
Estrogens
Theoretically, large amounts of turmeric might interfere with hormone replacement therapy through competition for estrogen receptors.
In vitro research shows that curcumin, a constituent of turmeric, displaces the binding of estrogen to its receptors.
Glyburide (Diabeta, Others)
Theoretically, taking turmeric and glyburide in combination might increase the risk of hypoglycemia.
Clinical research shows that taking curcumin 475 mg daily for 10 days prior to taking glyburide 5 mg increases blood levels of glyburide by 12% at 2 hours after the dose in patients with type 2 diabetes. While maximal blood concentrations of glyburide were not affected, turmeric modestly decreased postprandial glucose levels for up to 24 hours when compared to glyburide alone, possibly due to the hypoglycemic effect of turmeric demonstrated in animal research.
Losartan (Cozaar)
Theoretically, turmeric might increase the effects of losartan.
Research in hypertensive rats shows that taking turmeric can increase the hypotensive effects of losartan.
Norfloxacin (Noroxin)
Theoretically, turmeric might increase the effects and adverse effects of norfloxacin.
Animal research shows that taking curcumin, a turmeric constituent, can increase blood levels of orally administered norfloxacin.
P-Glycoprotein Substrates
Theoretically, turmeric might increase the absorption of P-glycoprotein substrates.
In vitro and animal research shows that curcuminoids and other constituents found in turmeric can inhibit P-glycoprotein expression and activity.
Paclitaxel (Abraxane, Onxol)
Theoretically, turmeric might alter blood levels of paclitaxel, although any effect may not be clinically relevant.
Clinical research in adults with breast cancer receiving intravenous paclitaxel suggests that taking turmeric may modestly alter paclitaxel pharmacokinetics. Patients received paclitaxel on day 1, followed by either no treatment or turmeric 2 grams daily from days 2-22. Pharmacokinetic modeling suggests that turmeric reduces the maximum concentration and area under the curve of paclitaxel by 12.1% and 7.7%, respectively. However, these changes are not likely to be considered clinically relevant. Conversely, animal research suggests that curcumin, a constituent of turmeric, enhances the oral bioavailability of paclitaxel. However, the significance of this interaction is unclear, as this drug is typically administered intravenously in clinical settings.
Centella asiatica
Cns Depressants
Theoretically, taking gotu kola might increase the sedative effects of CNS depressants.
In vitro research suggests that gotu kola may have sedative effects via binding of GABA receptors.
Hepatotoxic Drugs
Theoretically, taking gotu kola with hepatotoxic drugs might have additive adverse effects.
There are at least four case reports of hepatotoxicity associated with the use of gotu kola. However, more information is needed to determine if gotu kola was the causative factor in these cases.
Brand information
Manufacturer and brand details for Fortify, from the product label.
Iso-Sport
See all Iso-Sport products- Name
- ISO International, LLC
- City
- Gilbert
- State
- AZ
- ZipCode
- 85233
- Phone Number
- 1-888-503-8505
- Web Address
- iso-sport.com
Fortify by Iso-Sport: 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 Fortify’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Ginkgo
Interacts with 1,266 drugsGinkgo is one of the world's most popular herbal supplements, mostly taken to support memory and circulation. The evidence for these uses is mixed and generally weak, and it is not proven to...
Read the full Ginkgo monograph → Herb & supplement monographFo-ti
Interacts with 1,257 drugsFo-ti (He Shou Wu) is a root used in traditional Chinese medicine, often promoted for healthy aging and hair. High-quality human evidence for these benefits is limited, and processed Fo-ti h...
Read the full Fo-ti monograph → Herb & supplement monographGotu Kola
Interacts with 579 drugsGotu kola is a traditional Ayurvedic and Asian herb that people use for wound healing, circulation, skin problems, and as a calming or memory-supporting herb. Some early studies suggest poss...
Read the full Gotu Kola monograph → Herb & supplement monographEleuthero
Interacts with 1,140 drugsEleuthero is an herb traditionally used as an 'adaptogen' to fight fatigue, boost energy, and help the body handle stress. The scientific evidence behind these uses is limited and mixed, so...
Read the full Eleuthero monograph → Herb & supplement monographTurmeric
Interacts with 1,133 drugsTurmeric is a popular spice whose main active compounds, curcuminoids, are studied mostly for inflammation and joint pain. Some research is promising, but quality is mixed and curcumin is po...
Read the full Turmeric monograph →Sources & How We Checked
Fortify'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 269 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.
Ginkgo 97 references
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- Benjamin J, Muir T, Briggs K, Pentland B. A case of cerebral haemorrhage-can Ginkgo biloba be implicated? Postgrad Med J 2001;77:112-3.
- Matthews, MK. Association of Ginkgo biloba with intracerebral hemorrhage. Neurology 1998;50:1934.
- Rowin J, Lewis SL. Spontaneous bilateral subdural hemotomas with chronic Ginkgo biloba ingestion. Neurology 1996;46:1775-6.
- Rosenblatt M, Mindel T. Spontaneous hyphema associated with ingestion of Ginkgo biloba extract. N Engl J Med 1997;336:1108.
- Fessenden JM, Wittenborn W, Clarke L. Gingko biloba: a case report of herbal medicine and bleeding postoperatively from a laparoscopic cholecystectomy. Am Surg 2001;67:33-5. DOI
- Gurley BJ, Gardner SF, Hubbard MA. Clinical assessment of potential cytochrome P450-mediated herb-drug interactions. AAPS Ann Mtg & Expo Indianapolis, IN: 2000; Oct 29 - Nov 2:presentation #3460.
- Cohen AJ, Bartlik B. Ginkgo biloba for antidepressant-induced sexual dysfunction. J Sex Marital Ther 1998;24:139-43. PubMed
- Kudolo GB. The effect of 3-month ingestion of Ginkgo biloba extract on pancreatic beta-cell function in response to glucose loading in normal glucose tolerant individuals. J Clin Pharmacol 2000;40:647-54.
- Heck AM, DeWitt BA, Lukes AL. Potential interactions between alternative therapies and warfarin. Am J Health Syst Pharm 2000;57:1221-7. DOI
- Cesarani A, Meloni F, Alpini D, et al. Ginkgo biloba (EGb 761) in the treatment of equilibrium disorders. Adv Ther 1998;15:291-304.
- Galluzzi S, Zanetti O, Binetti G, et al. Coma in a patient with Alzheimer's disease taking low dose trazodone and Ginkgo biloba. J Neurol Neurosurg Psychiatry 2000;68:679-80. DOI
- Budzinski JW, Foster BC, Vandenhoek S, Arnason JT. An in vitro evaluation of human cytochrome P450 3A4 inhibition by selected commercial herbal extracts and tinctures. Phytomedicine 2000;7:273-82. PubMed
- Gregory PJ. Seizure associated with Ginkgo biloba? Ann Intern Med 2001;134:344.
- Granger AS. Ginkgo biloba precipitating epileptic seizures. Age Ageing 2001;30:523-5. PubMed
- Kajiyama Y, Fujii K, Takeuchi H, Manabe Y. Ginkgo seed poisoning. Pediatrics 2002;109:325-7. PubMed
- Miwa H, Iijima M, Tanaka S, Mizuno Y. Generalized convulsions after consuming a large amount of gingko nuts. Epilepsia 2001;42:280-1. DOI
- Burschka MA, Hassan HA, Reineke T, et al. Effect of treatment with Ginkgo biloba extract EGb 761 (oral) on unilateral idiopathic sudden hearing loss in a prospective randomized double-blind study of 106 outpatients. Eur Arch Otorhinolaryngol 2001;258:213- PubMed
- Miller LG, Freeman B. Possible subdural hematoma associated with Ginkgo biloba. J Herb Pharmacother 2002;2:57-63.
- Kudolo GB, Dorsey S, Blodgett J. Effect of the ingestion of Ginkgo biloba extract on platelet aggregation and urinary prostanoid excretion in healthy and Type 2 diabetic subjects. Thromb Res 2002;108:151-60.. PubMed
- Fong KC, Kinnear PE. Retrobulbar haemorrhage associated with chronic Ginkgo biloba ingestion. Postgrad Med J 2003;79:531-2..
- Gurley BJ, Gardner SF, Hubbard MA, et al. Cytochrome P450 phenotypic ratios for predicting herb-drug interactions in humans. Clin Pharmacol Ther 2002;72:276-87.. PubMed
- Kang BJ, Lee SJ, Kim MD, Cho MJ. A placebo-controlled, double-blind trial of Ginkgo biloba for antidepressant-induced sexual dysfunction. Hum Psychopharmacol 2002;17:279-84.
- Yale SH, Glurich I. Analysis of the inhibitory potential of Ginkgo biloba, Echinacea purpurea, and Serenoa repens on the metabolic activity of cytochrome P450 3A4, 2D6, and 2C9. J Altern Complement Med 2005;11:433-9.
- Yasui-Furukori N, Furukori H, Kaneda A, et al. The effects of Ginkgo biloba extracts on the pharmacokinetics and pharmacodynamics of donepezil. J Clin Pharmacol 2004;44:538-42.
- Markowitz JS, Donovan JL, Lindsay DeVane C, et al. Multiple-dose administration of Ginkgo biloba did not affect cytochrome P-450 2D6 or 3A4 activity in normal volunteers. J Clin Psychopharmacol 2003;23:576-81. PubMed
- Arenz A, Kelin M, Flehe K, et al. Occurrence of neurotoxic 4'-O-methylpyridoxine in ginkgo biloba leaves, ginkgo medications and Japanese ginkgo food. Planta Med 1996;62:548-51.
- Engelsen J, Nielsen JD, Winther K. Effect of coenzyme Q10 and Ginkgo biloba on warfarin dosage in stable, long-term warfarin treated outpatients. A randomised, double blind, placebo-crossover trial. Thromb Haemost 2002;87:1075-6. DOI
- Gaudineau C, Beckerman R, Welbourn S, Auclair K. Inhibition of human P450 enzymes by multiple constituents of the Ginkgo biloba extract. Biochem Biophys Res Comm 2004;318:1072–8. PubMed
- Kohler S, Funk P, Kieser M. Influence of a 7-day treatment with Ginkgo biloba special extract EGb 761 on bleeding time and coagulation: a randomized, placebo-controlled, double-blind study in healthy volunteers. Blood Coagul Fibrinolysis 2004;15:303–9. PubMed
- Jiang X, Williams KM, Liauw WS, et al. Effect of ginkgo and ginger on the pharmacokinetics and pharmacodynamics of warfarin in healthy subjects. Br J Clin Pharmacol 2005;59:425-32. PubMed
- Destro MW, Speranzini MB, Cavalheiro Filho C, et al. Bilateral haematoma after rhytidoplasty and blepharoplasty following chronic use of Ginkgo biloba. Br J Plast Surg 2005;58:100-1. PubMed
- Yin OQ, Tomlinson B, Waye MM, et al. Pharmacogenetics and herb-drug interactions: experience with Ginkgo biloba and omeprazole. Pharmacogenetics 2004;14:841-50. PubMed
- Bent S, Goldberg H, Padula A, Avins AL. Spontaneous bleeding associated with Ginkgo biloba: a case report and systematic review of the literature. J Gen Intern Med 2005;20;657-61. DOI
- Meisel C, Johne A, Roots I. Fatal intracerebral mass bleeding associated with Ginkgo biloba and ibuprofen. Atherosclerosis 2003;167:367. PubMed
- Bebbington A, Kulkarni R, Roberts P. Ginkgo biloba: Persistent bleeding after total hip arthroplasty caused by herbal self-medication. J Arthroplasty 2005;20:125-6. .
- Kupiec T, Raj V. Fatal seizures due to potential herb-drug interactions with Ginkgo biloba. J Anal Toxicol 2005:755-8. PubMed
- Hauser D, Gayowski T, Singh N. Bleeding complications precipitated by unrecognized Gingko biloba use after liver transplantation. Transpl Int 2002;15:377-9. DOI
- Mohutsky MA, Anderson GD, Miller JW, Elmer GW. Ginkgo biloba: evaluation of CYP2C9 drug interactions in vitro and in vivo. Am J Ther 2006;13:24-31. PubMed
- Kudolo GB. The effect of 3-month ingestion of Ginkgo biloba extract (EGb 761) on pancreatic beta-cell function in response to glucose loading in individuals with non-insulin-dependent diabetes mellitus. J Clin Pharmacol 2001;41:600-11.
- Pennisi RS. Acute generalised exanthematous pustulosis induced by the herbal remedy Ginkgo biloba. Med J Aust 2006;184:583-4. PubMed
- Yagmur E, Piatkowski A, Groger A, et al. Bleeding complication under Gingko biloba medication. Am J Hematol 2005;79:343-4. PubMed
- Vale S. Subarachnoid haemorrhage associated with Ginkgo biloba. Lancet 1998;352:36. PubMed
- Aruna D, Naidu MU. Pharmacodynamic interaction studies of Ginkgo biloba with cilostazol and clopidogrel in healthy human subjects. Br J Clin Pharmacol 2007;63:333-8.
- Dugoua JJ, Mills E, Perri D, Koren G. Safety and efficacy of ginkgo (Ginkgo biloba) during pregnancy and lactation. Can J Clin Pharmacol 2006;13:e277-84.
- Jiang X, Blair EY, McLachlan AJ. Investigation of the effects of herbal medicines on warfarin response in healthy subjects: a population pharmacokinetic-pharmacodynamic modeling approach. J Clin Pharmacol 2006;46:1370-8. PubMed
- Woelk H, Arnoldt KH, Kieser M, Hoerr R. Ginkgo biloba special extract EGb 761 in generalized anxiety disorder and adjustment disorder with anxious mood: a randomized, double-blind, placebo-controlled trial. J Psychiatr Res 2007;41:472-80. PubMed
- DeKosky ST, Williamson JD, Fitzpatrick AL, et al. Ginkgo biloba for prevention of dementia. JAMA 2008;300:2253-62.
- Dodge HH, Zitzelberger T, Oken BS, et al. A randomized placebo-controlled trial of ginkgo biloba for the prevention of cognitive decline. Neurology 2008;70(19 Pt 2):1809-17. PubMed
- Wiegman DJ, Brinkman K, Franssen EJ. Interaction of Ginkgo biloba with efavirenz. AIDS 2009;23:1184-5. PubMed
- Kim BH, Kim KP, Lim KS, et al. Influence of Ginkgo biloba extract on the pharmacodynamic effects and pharmacokinetic properties of ticlopidine: An open-label, randomized, two-period, two-treatment, two-sequence, single-dose crossover study in healthy Kor
- Salehi B, Imani R, Mohammadi MR, et al. Ginkgo biloba for attention-deficit/hyperactivity disorder in children and adolescents: a double blind, randomized controlled trial. Prog Neuropsychopharmacol Biol Psychiatry 2010;34:76-80. PubMed
- Kellermann AJ, Kloft C. Is there a risk of bleeding associated with standardized ginkgo biloba extract therapy? A systematic review and meta-analysis. Pharmacotherapy 2011;31:490-502.
- Kuller LH, Ives DG, Fitzpatrick AL, et al. Does Ginkgo biloba reduce the risk of cardiovascular events? Circ Cardiovasc Qual Outcomes 2010;3:41-7.
- Naccarato M, Yoong D, Gough K. A potential drug-herbal interaction between Ginkgo biloba and efavirenz. J Int Assoc Physicians AIDS Care (Chic). 2012;11(2):98-100. doi: 10.1177/1545109711435364. Epub 2012 Feb 9.
- Engelsen, J., Nielsen, J. D., and Hansen, K. F. [Effect of Coenzyme Q10 and Ginkgo biloba on warfarin dosage in patients on long-term warfarin treatment. A randomized, double-blind, placebo-controlled cross-over trial]. Ugeskr.Laeger 4-28-2003;165(18):18
- Parsad, D., Pandhi, R., and Juneja, A. Effectiveness of oral Ginkgo biloba in treating limited, slowly spreading vitiligo. Clin Exp.Dermatol. 2003;28(3):285-287.
- Bal Dit, Sollier C., Caplain, H., and Drouet, L. No alteration in platelet function or coagulation induced by EGb761 in a controlled study. Clin Lab Haematol. 2003;25(4):251-253. PubMed
- Yoshioka, M., Ohnishi, N., Koishi, T., Obata, Y., Nakagawa, M., Matsumoto, T., Tagagi, K., Takara, K., Ohkuni, T., Yokoyama, T., and Kuroda, K. Studies on interactions between functional foods or dietary supplements and medicines. IV. Effects of ginkgo b
- Yoshioka, M., Ohnishi, N., Sone, N., Egami, S., Takara, K., Yokoyama, T., and Kuroda, K. Studies on interactions between functional foods or dietary supplements and medicines. III. Effects of ginkgo biloba leaf extract on the pharmacokinetics of nifedipi
- Lovera, J., Bagert, B., Smoot, K., Morris, C. D., Frank, R., Bogardus, K., Wild, K., Oken, B., Whitham, R., and Bourdette, D. Ginkgo biloba for the improvement of cognitive performance in multiple sclerosis: a randomized, placebo-controlled trial. Mult.S PubMed
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