FV Ingredients & Drug Interactions
What is this page for?
First and foremost: checking FV 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
FV is a dietary supplement by Nature's Sunshine with 4 active ingredients. Its ingredients are commonly taken for sore throat and cough, heartburn and stomach upset, mouth ulcers and digestive complaints.Based on those ingredients, 1,291 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Goldenseal Root Extract, Licorice, Ginger. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against FV by Nature's Sunshine
Ask about any prescription or over-the-counter medication and we check it for interactions with FV by Nature's Sunshine — 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 FV by Nature's Sunshine
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
FV contains four active ingredients in a proprietary blend: licorice, goldenseal root extract, ginger, and capsicum. Licorice is traditionally used for its anti-inflammatory properties and has been studied for conditions like eczema and canker sores.
Goldenseal root extract contains berberine and is included for its antimicrobial and immune-supporting properties. Ginger is recognized for reducing nausea and supporting joint comfort, while capsicum (the compound in hot peppers) is valued for its pain-relieving effects and support for nerve-related discomfort.
The capsule itself is an inactive ingredient—simply the container holding the formula.
Does it work?
Not established
Among this product's ingredients, ginger has the strongest evidence: it's possibly effective for pregnancy-related nausea and vomiting, period cramps (dysmenorrhea), and osteoarthritis pain. Capsicum is likely effective for nerve pain from shingles (postherpetic neuralgia) and diabetic neuropathy, and possibly effective for cluster headaches and back pain.
Licorice is possibly effective for eczema (atopic dermatitis) and canker sores. Goldenseal's evidence is less established—the data we hold rates it insufficient for the conditions studied, and it may be ineffective for masking urine drug tests despite that popular claim.
If you're considering this product for a specific health concern, check which ingredient targets it and what the evidence actually shows.
How safe is it?
Well-documented data
Ginger is generally well tolerated in supplement amounts for most healthy adults, though higher doses (above 5 grams daily) raise the risk of side effects like heartburn, diarrhea, and abdominal discomfort. Licorice is fine in small food amounts but can cause serious problems—particularly high blood pressure, low potassium, and water retention—with high doses or long-term use; its active compound glycyrrhizin is the culprit.
Goldenseal has limited safety data beyond short-term use in healthy people. Capsicum is generally safe as food but can cause burning sensations in the mouth and digestive tract.
During pregnancy, licorice is unsafe due to links to harmful fetal effects, and goldenseal is likely unsafe because its berberine may harm the fetus and trigger contractions; ginger is likely safe and capsicum is likely safe. While breastfeeding, licorice and goldenseal should be avoided—neither has enough reliable safety information.
Ginger and capsicum are likely safe in food amounts, though concentrated supplement safety during breastfeeding is not well established.
Meds to double-check
Moderate interaction found
Before taking FV, check with your doctor or pharmacist if you use any blood thinners or antiplatelet drugs (warfarin, aspirin, clopidogrel), heart medications including digoxin and calcium channel blockers like nifedipine, diabetes drugs, or any cancer medications. Additionally, avoid it if you take midazolam or other sedatives, theophylline, ciprofloxacin, or any medication metabolized by CYP enzymes (CYP2B6, CYP2C9, CYP2C19, CYP2D6, CYP3A4), as licorice, goldenseal, and ginger all affect how your body processes these drugs.
No interactions are documented for the ingredients we could not access data for, though that is not a guarantee none exist.
The bottom line
Scorecard at a glanceFormula with limited ingredient disclosure with no established evidence rating for its marketed use. Moderate medication interactions have been identified, and safety information is well characterized.
FV may appeal to people looking for traditional herbal support for joint comfort, nausea, or nerve-related pain—especially ginger and capsicum, which have stronger evidence. However, if you take any blood thinners, heart medications, diabetes drugs, or medications cleared by liver enzymes, this product demands careful review with your pharmacist or doctor first, because licorice, goldenseal, ginger, and capsicum all interact significantly with those categories.
Pregnant people and anyone breastfeeding should avoid it entirely due to safety concerns with licorice and goldenseal. Talk with your own doctor or pharmacist before starting, especially if you're on any prescription medications.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 4 of 4 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Aug 23, 2019.
This Scorecard evaluates available label information, ingredient evidence, and known medication-safety considerations. It does not independently verify product identity, purity, potency, contamination, or manufacturing quality. How these ratings are computed
General information
Key facts about FV, straight from the product label.
| Brand | Nature's Sunshine |
|---|---|
| Barcode (UPC) | 099904009004 |
| Net contents | 100 Capsule(s) |
| Market status | On market |
| Date entered into DSLD | Aug 23, 2019 |
| DSLD ID | 205861 |
| Product type | Botanical |
| Supplement form | Capsule |
| Dietary claims / uses | All Other, Structure/Function |
| Intended target group(s) | Adult (18 - 50 Years), Kosher |
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 FV by Nature's Sunshine, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Proprietary Blend | 1405 mg | -- |
| Licorice | 0 NP | -- |
| Goldenseal Root Extract | 0 NP | -- |
| Ginger | 0 NP | -- |
| Capsicum | 0 NP | -- |
Other ingredients: Capsule
Tap any ingredient to jump to its full detail below.
These statements are the manufacturer’s wording, reproduced from the product label — the label is saying it, not HelloPharmacist. We don’t verify or endorse them.
General Statements
010009001116 Immune system support Guaranteed pure
Nature's Sunshine uses natural source materials that are subject to color variation. Product of U.S.A. Since 1972 Quality, service, integrity
Suggested/Recommended/Usage/Directions
Recommendation Take three capsules with a meal twice daily.
FDA Disclaimer Statement
This statement has not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.
Precautions
This bottle was sealed for your protection. Do not use if inner seal is missing or damaged.
FDA Statement of Identity
Herbal Dietary Supplement
Seals/Symbols
Ko Pareve
Formula
Ko Pareve
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
FV by Nature's Sunshine 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 FV by Nature's Sunshine
These are the 4 active ingredients this product is made of. Select any to open its full monograph.
Serving size3 Capsule(s) Dosage formCapsule Servings per container33 Amounts shown are per serving.
Most supplement products combine several ingredients, and a medication can interact with the product through any one of them. Each ingredient below shows whether it has known drug interactions.
Proprietary Blend
Other (inactive) ingredients: Capsule. These complete the product’s ingredient list but are not active constituents.
FV by Nature's Sunshine Drug Interactions
HelloPharmacist Interaction Report
FV by Nature's Sunshine contains four ingredients—licorice, goldenseal root extract, ginger, and capsicum—that together interact with a substantial number of medications.
The most serious documented interaction is moderate in severity: licorice may theoretically increase the risk of cardiac toxicity when used with digoxin (Lanoxin), a heart medication, especially if licorice causes potassium loss.
Read the full breakdown — every affected drug type, severity by severity
Licorice interacts with blood thinners like warfarin (Coumadin), where it may decrease their effectiveness by speeding up how your body processes them. It also affects heart rhythm medications and cancer drugs like cisplatin and paclitaxel, as well as several enzyme systems (CYP2B6, CYP2C19, CYP3A4 substrates) that clear many other drugs from your body.
Goldenseal root extract and ginger each affect blood thinners and diabetes medications, while goldenseal also inhibits enzymes (CYP2D6, CYP2C9, CYP3A4) that metabolize many prescriptions. Ginger may additionally increase blood levels of certain cancer medications and P-glycoprotein substrates.
Capsicum interacts with blood thinners, diabetes drugs, and theophylline (an asthma and breathing medication), plus aspirin and the antibiotic ciprofloxacin.
Altogether, these interactions span 1,292 individual medications. To see whether any of your specific prescriptions are affected, use the medication checker on this page before starting FV.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against FV?
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 FV interact with 1,291 drugs. Click any drug to see the details.
4 of the 4 ingredients in FV interact with drugs. Each result below shows which ingredient is responsible. Goldenseal Root Extract Licorice Ginger Capsicum
AsenapineSaphris, Secuado
How Asenapine interacts with FV — through 2 ingredients. Tap an ingredient for the detail:
GingerCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, ginger might increase the levels of CYP1A2 substrates.
Read the full Ginger + Asenapine interactionLicoriceCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, licorice might decrease the levels and clinical effects of CYP1A2 substrates.
Read the full Licorice + Asenapine interactionBendamustineBelrapzo, Treanda, Vivimusta
How Bendamustine interacts with FV — through 2 ingredients. Tap an ingredient for the detail:
GingerCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, ginger might increase the levels of CYP1A2 substrates.
Read the full Ginger + Bendamustine interactionLicoriceCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, licorice might decrease the levels and clinical effects of CYP1A2 substrates.
Read the full Licorice + Bendamustine interactionBendamustine HydrochlorideBendeka
How Bendamustine Hydrochloride interacts with FV — through 2 ingredients. Tap an ingredient for the detail:
LicoriceCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, licorice might decrease the levels and clinical effects of CYP1A2 substrates.
Read the full Licorice + Bendamustine Hydrochloride interactionGingerCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, ginger might increase the levels of CYP1A2 substrates.
Read the full Ginger + Bendamustine Hydrochloride interactionBismuth Subsalicylate, Metronidazole, TetracyclineHelidac
How Bismuth Subsalicylate, Metronidazole, Tetracycline interacts with FV — through 1 ingredient. Tap an ingredient for the detail:
GingerMetronidazole (flagyl) Minor
Interaction Summary
Theoretically, ginger might increase levels of metronidazole.
Read the full Ginger + Bismuth Subsalicylate, Metronidazole, Tetracycline interactionCiprofloxacinCiloxan, Cipro, Cipro IV, Cipro XR, Ciprobay, Otiprio
How Ciprofloxacin interacts with FV — through 1 ingredient. Tap an ingredient for the detail:
CapsicumCiprofloxacin (cipro) Minor
Interaction Summary
Theoretically, taking capsicum with ciprofloxacin might increase levels and adverse effects of ciprofloxacin.
Read the full Capsicum + Ciprofloxacin interactionFezolinetantVeozah
How Fezolinetant interacts with FV — through 2 ingredients. Tap an ingredient for the detail:
GingerCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, ginger might increase the levels of CYP1A2 substrates.
Read the full Ginger + Fezolinetant interactionLicoriceCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, licorice might decrease the levels and clinical effects of CYP1A2 substrates.
Read the full Licorice + Fezolinetant interactionGrepafloxacinRaxar
How Grepafloxacin interacts with FV — through 2 ingredients. Tap an ingredient for the detail:
GingerCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, ginger might increase the levels of CYP1A2 substrates.
Read the full Ginger + Grepafloxacin interactionLicoriceCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, licorice might decrease the levels and clinical effects of CYP1A2 substrates.
Read the full Licorice + Grepafloxacin interactionMethotrexateOtrexup, Rasuvo, Reditrex, Rheumatrex
How Methotrexate interacts with FV — through 1 ingredient. Tap an ingredient for the detail:
LicoriceMethotrexate (trexall, Others) Minor
Interaction Summary
Theoretically, licorice might increase levels of methotrexate.
Read the full Licorice + Methotrexate interactionMethotrexate SodiumXatmep
How Methotrexate Sodium interacts with FV — through 1 ingredient. Tap an ingredient for the detail:
LicoriceMethotrexate (trexall, Others) Minor
Interaction Summary
Theoretically, licorice might increase levels of methotrexate.
Read the full Licorice + Methotrexate Sodium interactionMetronidazoleAnabact, Flagyl, Flagyl IV, Flagyl IV RTU, Likmez, Metro IV +12 more
How Metronidazole interacts with FV — through 1 ingredient. Tap an ingredient for the detail:
GingerMetronidazole (flagyl) Minor
Interaction Summary
Theoretically, ginger might increase levels of metronidazole.
Read the full Ginger + Metronidazole interactionMetronidazole, Tetracyline, Bismuth Subcitrate PotassiumPylera
How Metronidazole, Tetracyline, Bismuth Subcitrate Potassium interacts with FV — through 1 ingredient. Tap an ingredient for the detail:
GingerMetronidazole (flagyl) Minor
Interaction Summary
Theoretically, ginger might increase levels of metronidazole.
Read the full Ginger + Metronidazole, Tetracyline, Bismuth Subcitrate Potassium interactionOseltamivir PhosphateTamiflu
How Oseltamivir Phosphate interacts with FV — through 1 ingredient. Tap an ingredient for the detail:
Goldenseal Root ExtractOseltamivir (tamiflu) Minor
Interaction Summary
Theoretically, goldenseal might reduce the therapeutic effects of oseltamivir by decreasing its conversion to its active form.
Read the full Goldenseal Root Extract + Oseltamivir Phosphate interactionPirfenidoneEsbriet
How Pirfenidone interacts with FV — through 2 ingredients. Tap an ingredient for the detail:
LicoriceCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, licorice might decrease the levels and clinical effects of CYP1A2 substrates.
Read the full Licorice + Pirfenidone interactionGingerCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, ginger might increase the levels of CYP1A2 substrates.
Read the full Ginger + Pirfenidone interactionRasagilineAzilect
How Rasagiline interacts with FV — through 2 ingredients. Tap an ingredient for the detail:
GingerCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, ginger might increase the levels of CYP1A2 substrates.
Read the full Ginger + Rasagiline interactionLicoriceCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, licorice might decrease the levels and clinical effects of CYP1A2 substrates.
Read the full Licorice + Rasagiline interactionRiluzoleExservan, Rilutek, Tiglutik
How Riluzole interacts with FV — through 2 ingredients. Tap an ingredient for the detail:
LicoriceCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, licorice might decrease the levels and clinical effects of CYP1A2 substrates.
Read the full Licorice + Riluzole interactionGingerCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, ginger might increase the levels of CYP1A2 substrates.
Read the full Ginger + Riluzole interactionRopiniroleAdartrel, Requip
How Ropinirole interacts with FV — through 2 ingredients. Tap an ingredient for the detail:
LicoriceCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, licorice might decrease the levels and clinical effects of CYP1A2 substrates.
Read the full Licorice + Ropinirole interactionGingerCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, ginger might increase the levels of CYP1A2 substrates.
Read the full Ginger + Ropinirole interactionRopivacaineNaropin
How Ropivacaine interacts with FV — through 2 ingredients. Tap an ingredient for the detail:
GingerCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, ginger might increase the levels of CYP1A2 substrates.
Read the full Ginger + Ropivacaine interactionLicoriceCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, licorice might decrease the levels and clinical effects of CYP1A2 substrates.
Read the full Licorice + Ropivacaine interactionTacrineCognex
How Tacrine interacts with FV — through 2 ingredients. Tap an ingredient for the detail:
LicoriceCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, licorice might decrease the levels and clinical effects of CYP1A2 substrates.
Read the full Licorice + Tacrine interactionGingerCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, ginger might increase the levels of CYP1A2 substrates.
Read the full Ginger + Tacrine interactionTizanidineOntralfy, Zanaflex
How Tizanidine interacts with FV — through 2 ingredients. Tap an ingredient for the detail:
LicoriceCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, licorice might decrease the levels and clinical effects of CYP1A2 substrates.
Read the full Licorice + Tizanidine interactionGingerCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, ginger might increase the levels of CYP1A2 substrates.
Read the full Ginger + Tizanidine interactionTriclabendazoleEgaten
How Triclabendazole interacts with FV — through 2 ingredients. Tap an ingredient for the detail:
LicoriceCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, licorice might decrease the levels and clinical effects of CYP1A2 substrates.
Read the full Licorice + Triclabendazole interactionGingerCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, ginger might increase the levels of CYP1A2 substrates.
Read the full Ginger + Triclabendazole interactionEach ingredient & the kinds of drugs it affects
For each ingredient in FV 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.
Goldenseal Root Extract
Anticoagulant/Antiplatelet Drugs
Theoretically, goldenseal might increase the risk of bleeding when used with anticoagulant or antiplatelet drugs.
Goldenseal contains berberine. In vitro and animal research shows that berberine can inhibit platelet aggregation. However, this effect has not been reported in humans.
Antidiabetes Drugs
Theoretically, goldenseal might increase the risk of hypoglycemia when used with antidiabetes drugs.
Goldenseal contains berberine. Clinical research shows that berberine can lower blood glucose levels. However, this effect has not been reported with goldenseal.
Antihypertensive Drugs
Theoretically, goldenseal might increase the risk of hypotension when taken with antihypertensive drugs.
Goldenseal contains berberine. Animal research shows that berberine can have hypotensive effects. Also, an analysis of clinical research shows that taking berberine in combination with amlodipine can lower systolic and diastolic blood pressure when compared with amlodipine alone. However, this effect has not been reported with goldenseal.
Cns Depressants
Theoretically, goldenseal might increase the sedative effects of CNS depressants.
Goldenseal contains berberine. Animal research shows that berberine can have sedative effects. However, this effect has not been reported in humans.
Cytochrome P450 2C9 (Cyp2C9) Substrates
Theoretically, goldenseal might increase serum levels of drugs metabolized by CYP2C9.
In vitro research shows that goldenseal root extract can modestly inhibit CYP2C9. This effect may be due to its alkaloid constituents, hydrastine and berberine. However, this effect has not been reported in humans.
Cytochrome P450 2D6 (Cyp2D6) Substrates
Goldenseal might increase serum levels of drugs metabolized by CYP2D6.
Clinical and in vitro research shows that goldenseal can significantly inhibit CYP2D6 enzymes, potentially increasing levels of drugs metabolized by CYP2D6.
Cytochrome P450 2E1 (Cyp2E1) Substrates
Theoretically, goldenseal might increase serum levels of drugs metabolized by CYP2E1.
In vitro research shows that goldenseal root extract can inhibit the activity of CYP2E1. However, this effect has not been reported in humans.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Goldenseal might increase serum levels of drugs metabolized by CYP3A4.
Most clinical and in vitro research shows that goldenseal inhibits CYP3A4 enzyme activity and increases serum levels of CYP3A4 substrates, such as midazolam. However, in one small clinical study, goldenseal did not affect the levels of indinavir, a CYP3A4 substrate, in healthy volunteers. This is likely due to the fact that indinavir has a high oral bioavailability, making it an inadequate probe for CYP3A4 interactions and/or that it is primarily metabolized by hepatic CYP3A, while goldenseal has more potential to inhibit intestinal CYP3A enzyme activity. Both goldenseal extract and its isolated constituents berberine and hydrastine inhibit CYP3A, with hydrastine possibly having more inhibitory potential than berberine.
Dextromethorphan (Robitussin Dm, Others)
Theoretically, goldenseal might increase serum levels of dextromethorphan.
Goldenseal contains berberine. A small clinical study shows that berberine can inhibit cytochrome P450 2D6 (CYP2D6) activity and reduce the metabolism of dextromethorphan.
Digoxin (Lanoxin)
Goldenseal might increase serum levels of digoxin, although this effect is unlikely to be clinically significant.
Clinical research shows that goldenseal modestly increases digoxin peak levels by about 14% in healthy volunteers. However, goldenseal does not seem to affect other pharmacokinetic parameters such as area under the curve (AUC). This suggests that goldenseal does not cause a clinically significant interaction with digoxin. Digoxin is a P-glycoprotein substrate. Some evidence suggests that goldenseal constituents might affect P-glycoprotein; however, it is unclear whether these constituents inhibit or induce P-glycoprotein.
Losartan (Cozaar)
Theoretically, goldenseal might decrease the conversion of losartan to its active form.
Goldenseal contains berberine. A small clinical study shows that berberine inhibits cytochrome P450 2C9 (CYP2C9) activity and reduces the metabolism of losartan. However, this effect has not been reported with goldenseal.
Metformin (Glucophage)
Theoretically, goldenseal might reduce blood levels of metformin.
In vitro research shows that goldenseal extract decreases the bioavailability of metformin, likely by interfering with transport, intestinal permeability, or other processes involved in metformin absorption. It is unclear which, if any, of metformin's transporters are inhibited by goldenseal. Goldenseal does not appear to alter the clearance or half-life of metformin.
P-Glycoprotein Substrates
Theoretically, goldenseal might increase or decrease serum levels of P-glycoprotein (P-gp) substrates.
There is conflicting evidence about the effect of goldenseal on P-gp. In vitro research suggests that berberine, a constituent of goldenseal, modestly inhibits P-gp efflux. Other evidence suggests that berberine induces P-gp. In healthy volunteers, goldenseal modestly increases peak levels of the P-gp substrate digoxin by about 14%. However, it does not seem to affect other pharmacokinetic parameters such as area under the curve (AUC). This suggests that goldenseal is not a potent inhibitor of P-gp-mediated drug efflux. Until more is known, goldenseal should be used cautiously with P-gp substrates.
Pentobarbital (Nembutal)
Theoretically, goldenseal might increase the sedative effects of pentobarbital.
Animal research shows that berberine, a constituent of goldenseal, can prolong pentobarbital-induced sleeping time. However, this effect has not been reported with goldenseal.
Tacrolimus (Prograf)
Theoretically, goldenseal might increase serum levels of tacrolimus.
Goldenseal contains berberine. In a 16-year-old patient with idiopathic nephrotic syndrome who was being treated with tacrolimus 6.5 mg twice daily, intake of berberine 200 mg three times daily increased the blood concentration of tacrolimus from 8 to 22 ng/mL. Following a reduction of tacrolimus dosing to 3 mg daily, blood levels of tacrolimus decreased to 12 ng/mL.
Oseltamivir (Tamiflu)
Theoretically, goldenseal might reduce the therapeutic effects of oseltamivir by decreasing its conversion to its active form.
In vitro evidence suggests that goldenseal reduces the formation of the active compound from the prodrug oseltamivir. The mechanism of action and clinical relevance is unclear.
Licorice
Antihypertensive Drugs
Theoretically, licorice might reduce the effects of antihypertensive drugs.
In human research, licorice increases blood pressure in a dose-dependent manner.
Cisplatin (Platinol-Aq)
Theoretically, licorice might reduce the effects of cisplatin.
In animal research, licorice diminished the therapeutic efficacy of cisplatin.
Corticosteroids
Theoretically, concomitant use of licorice and corticosteroids might increase the side effects of corticosteroids.
Case reports suggest that concomitant use of licorice and oral corticosteroids, such as hydrocortisone, can potentiate the duration of activity and increase blood levels of corticosteroids. Additionally, in one case report, a patient with neurogenic orthostatic hypertension stabilized on fludrocortisone 0.1 mg twice daily developed pseudohyperaldosteronism after recent consumption of large amounts of black licorice.
Cytochrome P450 2B6 (Cyp2B6) Substrates
Theoretically, licorice might increase levels of drugs metabolized by CYP2B6.
In vitro research shows that licorice extract and glabridin, a licorice constituent, inhibit CYP2B6 isoenzymes. Licorice extract from the species G. uralensis seems to inhibit CYP2B6 isoenzymes to a greater degree than G. glabra extract in vitro. Theoretically, these species of licorice might increase levels of drugs metabolized by CYP2B6; however, these interactions have not yet been reported in humans.
Cytochrome P450 2C19 (Cyp2C19) Substrates
Theoretically, licorice might increase levels of drugs metabolized by CYP2C19.
In vitro, licorice extracts from the species G. glabra and G. uralensis inhibit CYP2C19 isoenzymes in vitro. Theoretically, these species of licorice might increase levels of drugs metabolized by CYP2C19; however, this interaction has not yet been reported in humans.
Cytochrome P450 2C8 (Cyp2C8) Substrates
Theoretically, licorice might increase levels of drugs metabolized by CYP2C8.
In vitro, licorice extract from the species G. glabra and G. uralensis inhibits CYP2C8 isoenzymes. Theoretically, these species of licorice might increase levels of drugs metabolized by CYP2C8; however, this interaction has not yet been reported in humans.
Cytochrome P450 2C9 (Cyp2C9) Substrates
Theoretically, licorice might increase or decrease levels of drugs metabolized by CYP2C9.
There is conflicting evidence about the effect of licorice on CYP2C9 enzyme activity. In vitro research shows that extracts from the licorice species G. glabra and G. uralensis moderately inhibit CYP2C9 isoenzymes. However, evidence from an animal model shows that licorice extract from the species G. uralensis can induce hepatic CYP2C9 activity. Until more is known, licorice should be used cautiously in people taking CYP2C9 substrates.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, licorice might increase or decrease levels of drugs metabolized by CYP3A4.
Pharmacokinetic research shows that the licorice constituent glycyrrhizin, taken in a dosage of 150 mg orally twice daily for 14 days, modestly decreases the area under the concentration-time curve of midazolam by about 20%. Midazolam is a substrate of CYP3A4, suggesting that glycyrrhizin modestly induces CYP3A4 activity. Animal research also shows that licorice extract from the species G. uralensis induces CYP3A4 activity. However, licorice extract from G. glabra species appear to inhibit CYP3A4-induced metabolism of testosterone in vitro. It is thought that the G. glabra inhibits CYP3A4 due to its constituent glabridin, which is a moderate CYP3A4 inhibitor in vitro and not present in other licorice species. Until more is known, licorice should be used cautiously in people taking CYP3A4 substrates.
Digoxin (Lanoxin)
Theoretically, concomitant use of licorice with digoxin might increase the risk of cardiac toxicity.
Overuse or misuse of licorice with cardiac glycoside therapy might increase the risk of cardiac toxicity due to potassium loss.
Diuretic Drugs
Theoretically, concomitant use of licorice with diuretic drugs might increase the risk of hypokalemia.
Overuse of licorice might compound diuretic-induced potassium loss. In one case report, a 72-year-old male with a past medical history of hypertension, type 2 diabetes, hyperlipidemia, arrhythmia, stroke, and hepatic dysfunction was hospitalized with severe hypokalemia and uncontrolled hypertension due to pseudohyperaldosteronism. This was thought to be provoked by concomitant daily consumption of a product containing 225 mg of glycyrrhizin, a constituent of licorice, and hydrochlorothiazide 12.5 mg for 1 month.
Estrogens
Theoretically, licorice might increase or decrease the effects of estrogen therapy.
Theoretically, licorice might interfere with estrogen therapy due to estrogenic and anti-estrogenic effects.
Loop Diuretics
Theoretically, loop diuretics might increase the mineralocorticoid effects of licorice.
Theoretically, loop diuretics might enhance the mineralocorticoid effects of licorice by inhibiting the enzyme that converts cortisol to cortisone; however, bumetanide (Bumex) does not appear to have this effect.
Midazolam (Versed)
Theoretically, licorice might decrease levels of midazolam.
In humans, the licorice constituent glycyrrhizin appears to moderately induce the metabolism of midazolam. This is likely due to induction of cytochrome P450 3A4 by licorice. Until more is known, licorice should be used cautiously in people taking midazolam.
P-Glycoprotein Substrates
Theoretically, licorice might decrease the absorption of P-glycoprotein substrates.
In vitro research shows that licorice can increase P-glycoprotein activity.
Paclitaxel (Abraxane, Onxol)
Theoretically, licorice might decrease plasma levels and clinical effects of paclitaxel.
Multiple doses of licorice taken concomitantly with paclitaxel might reduce the effectiveness of paclitaxel. Animal research shows that licorice 3 grams/kg given orally for 14 days before intravenous administration of paclitaxel decreases the exposure to paclitaxel and increases its clearance. Theoretically, this occurs because licorice induces cytochrome P450 3A4 enzymes, which metabolize paclitaxel. Notably, a single dose of licorice did not affect exposure or clearance of paclitaxel.
Warfarin (Coumadin)
Theoretically, licorice might decrease plasma levels and clinical effects of warfarin.
Licorice seems to increase metabolism and decrease levels of warfarin in animal models. This is likely due to induction of cytochrome P450 2C9 (CYP2C9) metabolism by licorice. Advise patients taking warfarin to avoid taking licorice.
Cytochrome P450 1A2 (Cyp1A2) Substrates
Theoretically, licorice might decrease the levels and clinical effects of CYP1A2 substrates.
In vitro research shows that licorice induces CYP1A2 enzymes.
Methotrexate (Trexall, Others)
Theoretically, licorice might increase levels of methotrexate.
Animal research suggests that intravenous administration of glycyrrhizin, a licorice constituent, and high-dose methotrexate may delay methotrexate excretion and increase systemic exposure, leading to transient elevations in liver enzymes and total bilirubin. This interaction has not yet been reported in humans.
Ginger
Anticoagulant/Antiplatelet Drugs
Ginger may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs. However, research is conflicting.
Laboratory research suggests that ginger inhibits thromboxane synthetase and decreases platelet aggregation. However, this has not been demonstrated unequivocally in humans, with mixed results from clinical trials. Theoretically, excessive amounts of ginger might increase the risk of bleeding when used with anticoagulant/antiplatelet drugs.
Antidiabetes Drugs
Theoretically, taking ginger with antidiabetes drugs might increase the risk of hypoglycemia.
Animal and human research suggests that ginger might increase insulin levels and/or decrease blood glucose levels.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Ginger might increase or decrease the levels of CYP3A4 substrates.
In vitro research and some case reports suggest that ginger inhibits CYP3A4 activity. Three case reports from the World Health Organization (WHO) adverse drug reaction database describe increased toxicity in patients taking ginger and cancer medications that are CYP3A4 substrates (imatinib, dabrafenib, and crizotinib). However, the causality of this interaction is unclear due to the presence of multiple interacting drugs and routes of administration.
Conversely, other in vitro research suggests that ginger induces CYP3A4 activity, leading to reduced levels of CYP3A4 substrates. However, this interaction has not been reported in humans.
Losartan (Cozaar)
Theoretically, ginger might increase levels of losartan and the risk of hypotension.
In animal research, ginger increased the levels and hypotensive effects of a single dose of losartan. It is not clear if ginger alters the concentration or effects of losartan when taken continuously. Additionally, this interaction has not been shown in humans.
Nifedipine (Procardia)
Ginger may have antiplatelet effects and increase the risk of bleeding if used with nifedipine.
Clinical research shows that combined treatment with ginger 1 gram plus nifedipine 10 mg significantly inhibits platelet aggregation when compared to nifedipine or ginger alone.
P-Glycoprotein Substrates
Ginger might increase the absorption and blood levels of P-glycoprotein (P-gp) substrates.
In vitro research and case reports suggest that ginger inhibits drug efflux by P-gp, potentially increasing absorption and serum levels of P-gp substrates. Two case reports from the World Health Organization (WHO) adverse drug reaction database describe increased toxicity in patients taking ginger and cancer medications that are P-gp substrates (trametinib, crizotinib). However, the causality of this interaction is unclear due to the presence of multiple interacting drugs and routes of administration.
Phenprocoumon (Marcoumar, Others)
Ginger might increase the risk of bleeding with phenprocoumon.
Phenprocoumon, a warfarin-related anticoagulant, might increase the international normalized ratio (INR) when taken with ginger. There is one case report of a 76-year-old woman with a stable INR on phenprocoumon that increased to greater than 10 when she began consuming dried ginger and ginger tea.
Warfarin (Coumadin)
Ginger might increase the risk of bleeding with warfarin.
Laboratory research suggests that ginger might inhibit thromboxane synthetase and decrease platelet aggregation. In one case report, ginger increased the INR when taken with phenprocoumon, which has similar pharmacological effects as warfarin. In another case report, ginger increased the INR when taken with a combination of warfarin, hydrochlorothiazide, and acetaminophen. A longitudinal analysis suggests that taking ginger increases the risk of bleeding in patients taking warfarin for at least 4 months. However, research in healthy people suggests that ginger has no effect on INR, or the pharmacokinetics or pharmacodynamics of warfarin. Until more is known, monitor INRs closely in patients taking large amounts of ginger.
Calcium Channel Blockers
Theoretically, taking ginger with calcium channel blockers might increase the risk of hypotension.
Some animal and in vitro research suggests that ginger has hypotensive and calcium channel-blocking effects. Another animal study shows that concomitant administration of ginger and the calcium channel blocker amlodipine leads to greater reductions in blood pressure when compared with amlodipine alone.
Cyclosporine (Neoral, Sandimmune)
Theoretically, when taken prior to cyclosporine, ginger might decrease cyclosporine levels.
In an animal model, ginger juice taken 2 hours prior to cyclosporine administration reduced the maximum concentration and area under the curve of cyclosporine by 51% and 40%, respectively. This effect was not observed when ginger juice and cyclosporine were administered at the same time.
Cytochrome P450 1A2 (Cyp1A2) Substrates
Theoretically, ginger might increase the levels of CYP1A2 substrates.
In vitro research shows that ginger inhibits CYP1A2 activity. However, this interaction has not been reported in humans.
Cytochrome P450 2B6 (Cyp2B6) Substrates
Theoretically, ginger might increase the levels of CYP2B6 substrates.
In vitro research shows that ginger inhibits CYP2B6 activity. However, this interaction has not been reported in humans.
Cytochrome P450 2C9 (Cyp2C9) Substrates
Theoretically, ginger might increase the levels of CYP2C9 substrates.
In vitro research shows that ginger inhibits CYP2C9 activity. However, this interaction has not been reported in humans.
Metronidazole (Flagyl)
Theoretically, ginger might increase levels of metronidazole.
In an animal model, ginger increased the absorption and plasma half-life of metronidazole. In addition, the elimination rate and clearance of metronidazole was significantly reduced.
Capsicum
Anticoagulant/Antiplatelet Drugs
Theoretically, capsicum may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
In vitro research shows that capsicum might increase the effects of antiplatelet drugs. Also, population research shows that capsicum is associated with an increased risk of self-reported bleeding in patients taking warfarin. However, clinical research shows that taking a single dose of capsaicin (Asian Herbex Ltd.), the active ingredient in capsicum, 400-800 mcg orally in combination with aspirin 500 mg does not decrease platelet aggregation when compared with taking aspirin 500 mg alone. Also, there was no notable effect on measures of platelet aggregation with capsaicin. It is unclear whether capsaicin must be used in more than a single dose to affect platelet aggregation.
Antidiabetes Drugs
Theoretically, taking capsicum with antidiabetes drugs might increase the risk of hypoglycemia.
Preliminary clinical research shows that consuming capsicum 5 grams along with a glucose drink attenuates the rise in plasma glucose after 30 minutes by 21%, decreases the 2-hour postprandial area under the curve of plasma glucose by 11%, and increases the 2-hour postprandial area under the curve of plasma insulin by 58% in healthy individuals when compared with placebo. Other clinical research shows that taking capsicum 5 mg daily for 28 days significantly reduces postprandial blood glucose and insulin levels, but not fasting blood glucose and insulin levels, in patients with gestational diabetes.
Aspirin
Theoretically, taking capsicum with aspirin might reduce the bioavailability of aspirin.
Animal research shows that acute or chronic intake of capsicum pepper reduces oral aspirin bioavailability. This has not been shown in humans.
Theophylline
Theoretically, taking capsicum with theophylline might increase the levels and adverse effects of theophylline.
In animal research, oral administration of capsicum reduced excretion of theophylline. However, capsicum does not seem to affect the pharmacokinetics of theophylline when administered intravenously.
Ace Inhibitors (Aceis)
Theoretically, using topical capsaicin may increase the risk of ACE inhibitor-induced cough.
There is one case report of a topically applied capsaicin cream contributing to the cough reflex in a patient using an ACEI. However, it is unclear if this interaction is clinically significant.
Ciprofloxacin (Cipro)
Theoretically, taking capsicum with ciprofloxacin might increase levels and adverse effects of ciprofloxacin.
Animal research shows that concomitant use of capsaicin, the active constituent of capsicum, and ciprofloxacin increases the bioavailability of ciprofloxacin by up to 70%.
Brand information
Manufacturer and brand details for FV, from the product label.
Nature's Sunshine
See all Nature's Sunshine products- Name
- Nature's Sunshine Products, Inc.
- City
- Spanish Fork
- State
- Utah
- ZipCode
- 84660
- Phone Number
- 1-800-223-8225
- Web Address
- www.naturessunshine.com
FV by Nature's Sunshine: Common Questions
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Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
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The Full Monographs Behind FV’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Licorice
Interacts with 1,040 drugsLicorice root is a traditional remedy used for sore throats, coughs, and digestive complaints, but solid human evidence is limited for most uses. Regular licorice contains glycyrrhizin, whic...
Read the full Licorice monograph → Herb & supplement monographGoldenseal
Interacts with 1,237 drugsGoldenseal is a popular North American herb that contains berberine, a compound studied for antimicrobial effects. However, strong human evidence for its many traditional uses is largely lac...
Read the full Goldenseal monograph → Herb & supplement monographGinger
Interacts with 1,007 drugsGinger is a widely used culinary spice with a long history in traditional medicine, and it has the strongest evidence for helping with nausea and vomiting, including from motion sickness, pr...
Read the full Ginger monograph → Herb & supplement monographCapsicum
Interacts with 239 drugsCapsicum (chili pepper) contains capsaicin, which is best known and best studied as a topical treatment for certain types of pain. Topical capsaicin products are supported by reasonable evid...
Read the full Capsicum monograph →Sources & How We Checked
FV'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 279 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.
Licorice 92 references
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