Garlic Extract Ingredients & Drug Interactions
by 21st Century
What is this page for?
First and foremost: checking Garlic Extract 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
Garlic Extract is a dietary supplement by 21st Century with 2 active ingredients. Its ingredients are commonly taken for bone health and osteoporosis prevention, dietary calcium deficiency, heartburn relief (calcium carbonate antacids).Based on those ingredients, 1,065 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are Garlic extract, Calcium. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against Garlic Extract by 21st Century
Ask about any prescription or over-the-counter medication and we check it for interactions with Garlic Extract by 21st Century — 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 Garlic Extract by 21st Century
Our pharmacy team’s full take, with four database checks built into the cards below — a summary of what is known, not a grade of the product itself.
What’s inside
Full disclosure
This product contains 2 active ingredients. Calcium is a mineral essential for bone health, muscle function, and many other body processes — the product lists it for conditions including kidney failure, indigestion (dyspepsia), low blood calcium (hypocalcemia), high potassium (hyperkalemia), and weak bones (osteoporosis).
Garlic extract is the other active ingredient; we hold no separate interaction or effectiveness data for it on file. The product also contains inactive ingredients like cellulose and stearic acid, which are common binders and fillers in tablets.
Does it work?
Strong evidence
How safe is it?
Well-documented data
Calcium is generally well tolerated when taken at recommended doses, though high amounts can cause problems. The most common side effects when taken by mouth are belching, constipation, diarrhea, gas, and stomach upset.
Serious effects are rare but case reports have noted concerns about calciphylaxis and kidney stones. There is also ongoing research into whether very high calcium intake (over 1500–2000 mg/day from all sources) might raise the risk of advanced prostate cancer and cardiovascular disease; the evidence is mixed and some studies have been criticized for their design.
For pregnancy and breastfeeding: adequate calcium is important during both; the safety data supports staying within recommended amounts unless your doctor advises otherwise.
Meds to double-check
Major interaction found
Before starting this product, double-check any HIV integrase inhibitors (dolutegravir, elvitegravir), intravenous antibiotics like ceftriaxone, thyroid hormones (levothyroxine), heart or blood pressure medications (sotalol, diltiazem), or psoriasis treatments (calcipotriene). Altogether, these interactions span 167 individual medications.
The bottom line
Scorecard at a glanceFully disclosed formula with strong clinical evidence behind its ingredients' uses. Major medication interactions have been identified, and safety information is well characterized.
If you take dolutegravir, elvitegravir, or intravenous ceftriaxone, you'll need to carefully time doses of this product — talk to your pharmacist first. The same goes for levothyroxine, sotalol, raltegravir, calcipotriene, or diltiazem.
If you're on any other medications, use the checker below to be sure.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 1 of 2 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 Garlic Extract, straight from the product label.
| Brand | 21st Century |
|---|---|
| Barcode (UPC) | 740985218402 |
| Net contents | 60 Enteric Coated Tablet(s) |
| Market status | On market |
| Date entered into DSLD | Aug 23, 2019 |
| DSLD ID | 205834 |
| Product type | Botanical With Nutrients |
| Supplement form | Tablet Or Pill |
| Dietary claims / uses | All Other, Structure/Function |
| Intended target group(s) | Vegetarian, Adult (18 - 50 Years), Gluten Free |
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.
Supplement Facts
The label details for Garlic Extract by 21st Century, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Calcium | 30 mg | 2% |
| Garlic extract | 400 mg | -- |
| Allicin | 4000 mcg | -- |
Other ingredients: Cellulose, Stearic Acid, Contains <2% of
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.
Suggested/Recommended/Usage/Directions
Directions: As a herbal supplement, adults take one (1) tablet with any meal, up to three times daily or as directed by a healthcare provider. Do not exceed recommended dosage.
Precautions
Do not exceed recommended dosage.
Warning: Consult a healthcare provider prior to use if pregnant, nursing, on medications, have a medical condition or are planning a medical procedure.
Stop use and contact a physician if adverse reactions occur.
Keep out of reach of children.
Do not use if product appears to be tampered with or seal is broken.
General Statements
Individual results may vary.
Standardized Heart & Circulatory Function Support
Enteric coated tablets help reduce the unpleasant taste of garlic for those that are garlic sensitive.
500489-0217N
Storage
Store at room temperature.
Formulation
No added Sugar, Yeast, Preservatives, Artificial Flavors or Colors.
100% Vegetarian.
Gluten free
FDA Disclaimer Statement
These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.
FDA Statement of Identity
Herbal Supplement
Seals/Symbols
Gluten free
Guaranteed quality Laboratory tested
Formula
Garlic Extract provides a high concentration of allicin, thought to be responsible for supporting heart and circulatory health.
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Garlic Extract by 21st Century 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 Garlic Extract by 21st Century
These are the 2 active ingredients this product is made of. Select any to open its full monograph.
Serving size1 Tablet(s) Dosage formTablet Or Pill 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.
Calcium
Interacts with168 drugs
Calcium is an essential mineral your body needs for strong bones, nerve signaling, and muscle function, and supplements can help fill gaps when diet f...
Calcium monograph & interactionsGarlic extract
Interacts with989 drugs
Garlic is a common food and supplement that may modestly help with blood pressure and cholesterol, though the evidence is mixed and effects are usuall...
Garlic extract monograph & interactions- › Allicin
Other (inactive) ingredients: Cellulose, Stearic Acid, Contains <2% of. These complete the product’s ingredient list but are not active constituents.
Garlic Extract by 21st Century Drug Interactions
HelloPharmacist Interaction Report
Garlic Extract by 21st Century contains calcium, which has documented interactions with a number of medications.
The most serious concern is with HIV integrase inhibitors — dolutegravir (Tivicay) and elvitegravir (Vitekta) — where calcium can lower drug levels by a significant amount (up to 40% in some cases). If you take either of these, you'll need to space your doses: take the HIV medication 2 hours before or 6 hours after calcium for dolutegravir, or 2 hours before or after for elvitegravir.
There's also a Major-level interaction with the antibiotic ceftriaxone (Rocephin) when given intravenously — calcium can cause a dangerous precipitate in the lungs and kidneys, so intravenous calcium should be avoided within 48 hours of intravenous ceftriaxone.
Read the full breakdown — every affected drug type, severity by severity
Calcium also interacts at Moderate severity with several other drug types: the HIV medication raltegravir (Isentress), the thyroid hormone levothyroxine (Synthroid and others), the blood pressure medicine sotalol (Betapace), the psoriasis medication calcipotriene (Dovonex), and the heart medication diltiazem (Cardizem and others). With levothyroxine, separate doses by at least 4 hours; with sotalol, space them 2 hours before or 4–6 hours after calcium.
We were unable to check garlic extract itself or allicin (one of garlic's active compounds) — we hold no interaction data for those ingredients. Use the medication checker on this page to search your exact prescriptions before you start.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against Garlic Extract?
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 Garlic Extract interact with 1,065 drugs. Click any drug to see the details.
2 of the 2 ingredients in Garlic Extract interact with drugs. Each result below shows which ingredient is responsible. Garlic extract Calcium
Acetaminophen, Caffeine, IsomethepteneMigralam
How Acetaminophen, Caffeine, Isometheptene interacts with Garlic Extract — through 1 ingredient. Tap an ingredient for the detail:
Garlic ExtractCytochrome P450 2e1 (cyp2e1) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Garlic might increase levels of drugs metabolized by CYP2E1.
Read the full Garlic Extract + Acetaminophen, Caffeine, Isometheptene interactionAcetaminophen, Caffeine, PyrilamineMidol Max Strength Menstrual
How Acetaminophen, Caffeine, Pyrilamine interacts with Garlic Extract — through 1 ingredient. Tap an ingredient for the detail:
Garlic ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 2e1 (cyp2e1) Substrates Moderate
Interaction Summary
Theoretically, garlic products containing allicin might induce intestinal CYP3A4 and inhibit hepatic CYP3A4.
Read the full Garlic Extract + Acetaminophen, Caffeine, Pyrilamine interactionAcetaminophen, Chlorpheniramine Maleate, Dextromethorphan HbrVicks Formula 44M Cough, Cold & Flu Relief
How Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interacts with Garlic Extract — through 1 ingredient. Tap an ingredient for the detail:
Garlic ExtractCytochrome P450 2e1 (cyp2e1) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Garlic might increase levels of drugs metabolized by CYP2E1.
Read the full Garlic Extract + Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interactionAcetaminophen, Chlorpheniramine, Codeine, PhenylephrineColrex
How Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interacts with Garlic Extract — through 1 ingredient. Tap an ingredient for the detail:
Garlic ExtractCytochrome P450 2e1 (cyp2e1) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Garlic might increase levels of drugs metabolized by CYP2E1.
Read the full Garlic Extract + Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interactionAcetaminophen, Chlorpheniramine, DextromethorphanCoricidin II Extra Strength Cold and Flu
How Acetaminophen, Chlorpheniramine, Dextromethorphan interacts with Garlic Extract — through 1 ingredient. Tap an ingredient for the detail:
Garlic ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 2e1 (cyp2e1) Substrates Moderate
Interaction Summary
Theoretically, garlic products containing allicin might induce intestinal CYP3A4 and inhibit hepatic CYP3A4.
Read the full Garlic Extract + Acetaminophen, Chlorpheniramine, Dextromethorphan interactionAcetaminophen, Chlorpheniramine, Dextromethorphan HydrobromideCoricidin HBP Maximum Strength Flu
How Acetaminophen, Chlorpheniramine, Dextromethorphan Hydrobromide interacts with Garlic Extract — through 1 ingredient. Tap an ingredient for the detail:
Garlic ExtractCytochrome P450 2e1 (cyp2e1) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Garlic might increase levels of drugs metabolized by CYP2E1.
Read the full Garlic Extract + Acetaminophen, Chlorpheniramine, Dextromethorphan Hydrobromide interactionAcetaminophen, Chlorpheniramine, Dextromethorphan, PhenylpropanolamineMulti Symptom Cold Relief
How Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylpropanolamine interacts with Garlic Extract — through 1 ingredient. Tap an ingredient for the detail:
Garlic ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 2e1 (cyp2e1) Substrates Moderate
Interaction Summary
Theoretically, garlic products containing allicin might induce intestinal CYP3A4 and inhibit hepatic CYP3A4.
Read the full Garlic Extract + Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylpropanolamine interactionAcetaminophen, Chlorpheniramine, Dextromethorphan, PseudoephedrineChildren's Tylenol Cold Plus Cough, Tylenol Cold Ex Strength
How Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine interacts with Garlic Extract — through 1 ingredient. Tap an ingredient for the detail:
Garlic ExtractCytochrome P450 2e1 (cyp2e1) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Garlic might increase levels of drugs metabolized by CYP2E1.
Read the full Garlic Extract + Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine interactionAcetaminophen, Chlorpheniramine, Guaifenesin, Phenylephrine, SalicylamideRhinogesic GG
How Acetaminophen, Chlorpheniramine, Guaifenesin, Phenylephrine, Salicylamide interacts with Garlic Extract — through 1 ingredient. Tap an ingredient for the detail:
Garlic ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 2e1 (cyp2e1) Substrates Moderate
Interaction Summary
Theoretically, garlic products containing allicin might induce intestinal CYP3A4 and inhibit hepatic CYP3A4.
Read the full Garlic Extract + Acetaminophen, Chlorpheniramine, Guaifenesin, Phenylephrine, Salicylamide interactionAcetaminophen, Chlorpheniramine, PhenylephrineAlka-Seltzer PLUS, Histex SR, Protid
How Acetaminophen, Chlorpheniramine, Phenylephrine interacts with Garlic Extract — through 1 ingredient. Tap an ingredient for the detail:
Garlic ExtractCytochrome P450 2e1 (cyp2e1) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Garlic might increase levels of drugs metabolized by CYP2E1.
Read the full Garlic Extract + Acetaminophen, Chlorpheniramine, Phenylephrine interactionAcetaminophen, Chlorpheniramine, Phenylephrine, SalicylamideRhinogesic, Rhinogesic JR
How Acetaminophen, Chlorpheniramine, Phenylephrine, Salicylamide interacts with Garlic Extract — through 1 ingredient. Tap an ingredient for the detail:
Garlic ExtractCytochrome P450 2e1 (cyp2e1) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Garlic might increase levels of drugs metabolized by CYP2E1.
Read the full Garlic Extract + Acetaminophen, Chlorpheniramine, Phenylephrine, Salicylamide interactionAcetaminophen, Chlorpheniramine, PhenylpropanolamineAlumadrine, Conex, Sinadrin Max Strength, Sinulin
How Acetaminophen, Chlorpheniramine, Phenylpropanolamine interacts with Garlic Extract — through 1 ingredient. Tap an ingredient for the detail:
Garlic ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 2e1 (cyp2e1) Substrates Moderate
Interaction Summary
Theoretically, garlic products containing allicin might induce intestinal CYP3A4 and inhibit hepatic CYP3A4.
Read the full Garlic Extract + Acetaminophen, Chlorpheniramine, Phenylpropanolamine interactionAcetaminophen, Chlorpheniramine, Phenylpropanolamine, OpiumHista-Derfule
How Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium interacts with Garlic Extract — through 1 ingredient. Tap an ingredient for the detail:
Garlic ExtractCytochrome P450 2e1 (cyp2e1) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Garlic might increase levels of drugs metabolized by CYP2E1.
Read the full Garlic Extract + Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium interactionAcetaminophen, Chlorpheniramine, Phenylpropanolamine, PhenyltoloxamineNorel Plus
How Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Phenyltoloxamine interacts with Garlic Extract — through 1 ingredient. Tap an ingredient for the detail:
Garlic ExtractCytochrome P450 2e1 (cyp2e1) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Garlic might increase levels of drugs metabolized by CYP2E1.
Read the full Garlic Extract + Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Phenyltoloxamine interactionAcetaminophen, Chlorpheniramine, PseudoephedrineAlka-Seltzer PLUS Liquid Gels, Children's Tylenol Cold, Codimal, Comtrex, Extra Strength Tylenol Allergy Sinus, Lorsin +3 more
How Acetaminophen, Chlorpheniramine, Pseudoephedrine interacts with Garlic Extract — through 1 ingredient. Tap an ingredient for the detail:
Garlic ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 2e1 (cyp2e1) Substrates Moderate
Interaction Summary
Theoretically, garlic products containing allicin might induce intestinal CYP3A4 and inhibit hepatic CYP3A4.
Read the full Garlic Extract + Acetaminophen, Chlorpheniramine, Pseudoephedrine interactionAcetaminophen, ChlorzoxazoneAcetazone Forte, Extra Strength Tylenol Aches & Strains, Parafon Forte
How Acetaminophen, Chlorzoxazone interacts with Garlic Extract — through 1 ingredient. Tap an ingredient for the detail:
Garlic ExtractCytochrome P450 2e1 (cyp2e1) Substrates Moderate
Interaction Summary
Garlic might increase levels of drugs metabolized by CYP2E1.
Read the full Garlic Extract + Acetaminophen, Chlorzoxazone interactionAcetaminophen, Chlorzoxazone, CodeineAcetazone Forte C8, Parafon Forte C8
How Acetaminophen, Chlorzoxazone, Codeine interacts with Garlic Extract — through 1 ingredient. Tap an ingredient for the detail:
Garlic ExtractCytochrome P450 2e1 (cyp2e1) Substrates Moderate
Interaction Summary
Garlic might increase levels of drugs metabolized by CYP2E1.
Read the full Garlic Extract + Acetaminophen, Chlorzoxazone, Codeine interactionAcetaminophen, CodeineTylenol No.3, Tylenol w/ Codeine
How Acetaminophen, Codeine interacts with Garlic Extract — through 1 ingredient. Tap an ingredient for the detail:
Garlic ExtractCytochrome P450 2e1 (cyp2e1) Substrates Moderate
Interaction Summary
Garlic might increase levels of drugs metabolized by CYP2E1.
Read the full Garlic Extract + Acetaminophen, Codeine interactionAcetaminophen, Codeine, DoxylamineMersyndol
How Acetaminophen, Codeine, Doxylamine interacts with Garlic Extract — through 1 ingredient. Tap an ingredient for the detail:
Garlic ExtractCytochrome P450 2e1 (cyp2e1) Substrates Moderate
Interaction Summary
Garlic might increase levels of drugs metabolized by CYP2E1.
Read the full Garlic Extract + Acetaminophen, Codeine, Doxylamine interactionAcetaminophen, Codeine, MethocarbamolAcetaminophen, Codeine, Methocarbamol, Robaxacet 8
How Acetaminophen, Codeine, Methocarbamol interacts with Garlic Extract — through 1 ingredient. Tap an ingredient for the detail:
Garlic ExtractCytochrome P450 2e1 (cyp2e1) Substrates Moderate
Interaction Summary
Garlic might increase levels of drugs metabolized by CYP2E1.
Read the full Garlic Extract + Acetaminophen, Codeine, Methocarbamol interactionAcetaminophen, Dexbrompheniramine, PseudoephedrineSinadrin Plus
How Acetaminophen, Dexbrompheniramine, Pseudoephedrine interacts with Garlic Extract — through 1 ingredient. Tap an ingredient for the detail:
Garlic ExtractCytochrome P450 2e1 (cyp2e1) Substrates Moderate
Interaction Summary
Garlic might increase levels of drugs metabolized by CYP2E1.
Read the full Garlic Extract + Acetaminophen, Dexbrompheniramine, Pseudoephedrine interactionAcetaminophen, DextromethorphanTylenol Cough Ex Strength
How Acetaminophen, Dextromethorphan interacts with Garlic Extract — through 1 ingredient. Tap an ingredient for the detail:
Garlic ExtractCytochrome P450 2e1 (cyp2e1) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Garlic might increase levels of drugs metabolized by CYP2E1.
Read the full Garlic Extract + Acetaminophen, Dextromethorphan interactionAcetaminophen, Dextromethorphan, Doxylamine, PseudoephedrineVicks NyQuil
How Acetaminophen, Dextromethorphan, Doxylamine, Pseudoephedrine interacts with Garlic Extract — through 1 ingredient. Tap an ingredient for the detail:
Garlic ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 2e1 (cyp2e1) Substrates Moderate
Interaction Summary
Theoretically, garlic products containing allicin might induce intestinal CYP3A4 and inhibit hepatic CYP3A4.
Read the full Garlic Extract + Acetaminophen, Dextromethorphan, Doxylamine, Pseudoephedrine interactionAcetaminophen, Dextromethorphan, Guaifenesin, PhenylephrineConar-A
How Acetaminophen, Dextromethorphan, Guaifenesin, Phenylephrine interacts with Garlic Extract — through 1 ingredient. Tap an ingredient for the detail:
Garlic ExtractCytochrome P450 2e1 (cyp2e1) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Garlic might increase levels of drugs metabolized by CYP2E1.
Read the full Garlic Extract + Acetaminophen, Dextromethorphan, Guaifenesin, Phenylephrine interactionAcetaminophen, Dextromethorphan, Guaifenesin, PhenylpropanolamineAnatuss
How Acetaminophen, Dextromethorphan, Guaifenesin, Phenylpropanolamine interacts with Garlic Extract — through 1 ingredient. Tap an ingredient for the detail:
Garlic ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 2e1 (cyp2e1) Substrates Moderate
Interaction Summary
Theoretically, garlic products containing allicin might induce intestinal CYP3A4 and inhibit hepatic CYP3A4.
Read the full Garlic Extract + Acetaminophen, Dextromethorphan, Guaifenesin, Phenylpropanolamine interactionAcetaminophen, Dextromethorphan, Guaifenesin, PseudoephedrineRobitussin Cold, Severe Cold, Suphedrine Cold/Cough
How Acetaminophen, Dextromethorphan, Guaifenesin, Pseudoephedrine interacts with Garlic Extract — through 1 ingredient. Tap an ingredient for the detail:
Garlic ExtractCytochrome P450 2e1 (cyp2e1) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Garlic might increase levels of drugs metabolized by CYP2E1.
Read the full Garlic Extract + Acetaminophen, Dextromethorphan, Guaifenesin, Pseudoephedrine interactionAcetaminophen, Dextromethorphan, Phenylpropanolamine, PyrilamineTheracaps
How Acetaminophen, Dextromethorphan, Phenylpropanolamine, Pyrilamine interacts with Garlic Extract — through 1 ingredient. Tap an ingredient for the detail:
Garlic ExtractCytochrome P450 2e1 (cyp2e1) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Garlic might increase levels of drugs metabolized by CYP2E1.
Read the full Garlic Extract + Acetaminophen, Dextromethorphan, Phenylpropanolamine, Pyrilamine interactionAcetaminophen, Dextromethorphan, PseudoephedrineAlka-Seltzer PLUS Flu Liquid Gels, Non Aspirin Cold Caps, Tylenol Cold, Tylenol Flu Daytime Ex Strength, Tylenol Flu Ex Strength
How Acetaminophen, Dextromethorphan, Pseudoephedrine interacts with Garlic Extract — through 1 ingredient. Tap an ingredient for the detail:
Garlic ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 2e1 (cyp2e1) Substrates Moderate
Interaction Summary
Theoretically, garlic products containing allicin might induce intestinal CYP3A4 and inhibit hepatic CYP3A4.
Read the full Garlic Extract + Acetaminophen, Dextromethorphan, Pseudoephedrine interactionAcetaminophen, Dichloralantipyrine, IsomethepteneAmidrine, Midchlor, Migquin, Migratine
How Acetaminophen, Dichloralantipyrine, Isometheptene interacts with Garlic Extract — through 1 ingredient. Tap an ingredient for the detail:
Garlic ExtractCytochrome P450 2e1 (cyp2e1) Substrates Moderate
Interaction Summary
Garlic might increase levels of drugs metabolized by CYP2E1.
Read the full Garlic Extract + Acetaminophen, Dichloralantipyrine, Isometheptene interactionAcetaminophen, Dichloralphenazone, IsomethepteneMidrin
How Acetaminophen, Dichloralphenazone, Isometheptene interacts with Garlic Extract — through 1 ingredient. Tap an ingredient for the detail:
Garlic ExtractCytochrome P450 2e1 (cyp2e1) Substrates Moderate
Interaction Summary
Garlic might increase levels of drugs metabolized by CYP2E1.
Read the full Garlic Extract + Acetaminophen, Dichloralphenazone, Isometheptene interactionEach ingredient & the kinds of drugs it affects
For each ingredient in Garlic Extract 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.
Garlic extract
Anticoagulant/Antiplatelet Drugs
Garlic may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Raw garlic and a variety of garlic extracts have antiplatelet activity and can increase prothrombin time.
Antidiabetes Drugs
Theoretically, taking garlic with antidiabetes drugs might increase the risk of hypoglycemia.
Clinical research suggests that garlic and garlic extract lower blood glucose levels in healthy and diabetic individuals.
Antihypertensive Drugs
Theoretically, taking garlic with antihypertensive drugs might increase the risk of hypotension.
In human research, both garlic and garlic extracts have blood pressure-lowering effects.
Atazanavir (Reyataz)
Theoretically, garlic might decrease levels and effects of atazanavir.
In a case report, a patient consuming six stir-fried garlic cloves three times weekly developed suboptimal atazanavir levels and increases in HIV viral load. While the exact cause of this interaction is unclear, there is speculation that garlic might decrease the intestinal absorption of atazanavir or increase its metabolism by inducing cytochrome P450 3A4 (CYP3A4). Until more is known, advise patients not to consume large amounts of garlic while taking atazanavir.
Cytochrome P450 2E1 (Cyp2E1) Substrates
Garlic might increase levels of drugs metabolized by CYP2E1.
Clinical research suggests garlic oil can inhibit the activity of CYP2E1 by 39%. Use garlic oil cautiously in patients taking drugs metabolized by these enzymes.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, garlic products containing allicin might induce intestinal CYP3A4 and inhibit hepatic CYP3A4. This may increase or decrease levels of drugs metabolized by CYP3A4.
Some human research suggests that garlic may induce INTESTINAL CYP3A4, reducing levels of drugs metabolized by this enzyme. This is primarily based on a study showing that taking a specific allicin-containing garlic product (GarliPure Maximum Allicin Formula, Natrol Inc.) twice daily for 3 days reduces saquinavir levels by approximately 50%. It is speculated that the allicin constituent induced CYP3A4 in the gut mucosa. Another study shows that giving docetaxel intravenously, bypassing the CYP3A4 enzymes in the gut mucosa, along with the same specific garlic product for 12 consecutive days, does not affect docetaxel levels. Conversely, there is concern that garlic may inhibit HEPATIC CYP3A4. In a single case report, increased tacrolimus levels and liver injury occurred in a liver transplant patient after taking a specific garlic supplement (Garlicin Cardio, Nature's Way) at up to three times the manufacturer recommended dose for 7 days. Several other studies have evaluated the impact of other garlic formulations on CYP3A4 substrates and have found no effect. Most of the products in these studies provided little or no allicin.
Isoniazid
Theoretically, garlic might decrease levels of isoniazid.
Animal research suggests that an aqueous extract of garlic reduces isoniazid levels by about 65%. Garlic reduced the maximum concentration (Cmax) and area under the curve (AUC), but not the half-life, of isoniazid. This suggests that garlic extract might inhibit isoniazid absorption across the intestinal mucosa; however, the exact mechanism of this potential interaction is not known.
Protease Inhibitors (Pis)
Theoretically, garlic products containing allicin might decrease levels of PIs.
Protease inhibitors are metabolized by cytochrome P450 3A4 (CYP3A4) isoenzymes. There is concern that garlic products containing allicin might induce intestinal CYP3A4, reducing plasma levels of protease inhibitors. This is primarily based on a study showing that taking a specific garlic product (GarliPure Maximum Allicin Formula, Natrol Inc.) twice daily for 3 days reduces levels of saquinavir, a PI, by approximately 50%. It is speculated that the allicin constituent induce CYP3A4 in the gut mucosa. Several studies have evaluated the impact of other garlic formulations on CYP3A4 substrates and have found no effect. Most of the products in these studies provided little or no allicin.
Saquinavir (Fortovase, Invirase)
Theoretically, garlic containing allicin might decrease levels of saquinavir.
Saquinavir is a substrate of cytochrome P450 3A4 (CYP3A4) isoenzymes. There is concern that garlic products containing allicin might induce intestinal CYP3A4 and cause subtherapeutic levels of saquinavir. This is primarily based on a pharmacokinetic study showing that taking a specific garlic product (GarliPure Maximum Allicin Formula, Natrol Inc.) twice daily for 3 days reduces saquinavir levels by approximately 50%. It is speculated that the allicin constituent induces CYP3A4 in the gut mucosa. Several pharmacokinetic studies have evaluated the impact of other garlic formulations on CYP3A4 substrates and have found no effect. Most of the products in these studies provided little or no allicin. Until more is known about this potential interaction, use garlic containing allicin cautiously in patients taking saquinavir.
Sofosbuvir (Sovaldi)
Theoretically, taking garlic with sofosbuvir might decrease its effectiveness.
Animal research in rats shows that giving aged garlic extract 120 mg/kg orally daily for 14 days decreases the area under the concentration time curve (AUC) after a single sofosbuvir dose of 40 mg/kg by 36%, increases the clearance by 63%, and decreases the plasma concentrations at 1 and 8 hours by 35% and 58%, respectively. This interaction is hypothesized to be due to induction of intestinal P-glycoprotein expression by garlic.
Tacrolimus (Prograf)
Theoretically, garlic might increase levels of tacrolimus.
In one case report, a liver transplant patient taking tacrolimus experienced increased tacrolimus levels and liver injury after taking a specific garlic supplement (Garlicin Cardio, Nature's Way) at up to three times the manufacturer recommended dose for 7 days. It is speculated that garlic inhibited hepatic cytochrome P450 3A4 (CYP3A4), which increased plasma levels of tacrolimus.
Warfarin (Coumadin)
Theoretically, garlic might increase the risk of bleeding with warfarin.
Raw garlic and a variety of garlic extracts have antiplatelet activity and can increase prothrombin time. In addition, there is a report of two patients who experienced an increase in a previously stabilized international normalized ratio (INR) with concomitant garlic and warfarin use. However, this report has been subsequently debated due to limited clinical information. Other clinical studies have not identified an effect of garlic on INR, warfarin pharmacokinetics, or bleeding risk. More evidence is needed to determine the safety of using garlic with warfarin.
Calcium
Ceftriaxone (Rocephin)
Co-administration of intravenous calcium and ceftriaxone can result in precipitation of a ceftriaxone-calcium salt in the lungs and kidneys.
Avoid administering intravenous calcium in any form, such as parenteral nutrition or Lactated Ringers, within 48 hours of intravenous ceftriaxone. Case reports in neonates show that administering intravenous ceftriaxone and calcium can result in precipitation of a ceftriaxone-calcium salt in the lungs and kidneys. In several cases, neonates have died as a result of this interaction. So far there are no reports in adults; however, there is still concern that this interaction might occur in adults.
Dolutegravir (Tivicay)
Calcium seems to reduce levels of dolutegravir.
Advise patients to take dolutegravir either 2 hours before or 6 hours after taking calcium supplements. Pharmacokinetic research suggests that taking calcium carbonate 1200 mg concomitantly with dolutegravir 50 mg reduces plasma levels of dolutegravir by almost 40%. Calcium appears to decrease levels of dolutegravir through chelation.
Elvitegravir (Vitekta)
Calcium seems to reduce levels of elvitegravir.
Advise patients to take elvitegravir either 2 hours before or 2 hours after taking calcium supplements. Pharmacokinetic research suggests that taking calcium along with elvitegravir can reduce blood levels of elvitegravir through chelation.
Aluminum
Calcium citrate might increase aluminum absorption and toxicity. Other types of calcium do not increase aluminum absorption.
Calcium citrate can increase the absorption of aluminum when taken with aluminum hydroxide. The increase in aluminum levels may become toxic, particularly in individuals with kidney disease. However, the effect of calcium citrate on aluminum absorption is due to the citrate anion rather than calcium cation. Calcium acetate does not appear to increase aluminum absorption.
Bictegravir/Emtricitabine/Tenofovir Alafenamide (Biktarvy)
Calcium might decrease levels of bictegravir/emtricitabine/tenofovir alafenamide by reducing its absorption when taken in a fasting state.
Advise patients that bictegravir/emtricitabine/tenofovir alafenamide and calcium can be taken together if taken with food. However, if taken on an empty stomach, bictegravir/emtricitabine/tenofovir alafenamide should not be taken with, or 2 hours after, calcium containing products.
Bisphosphonates
Calcium reduces the absorption of bisphosphonates.
Advise patients to take bisphosphonates at least 30 minutes before calcium, but preferably at a different time of day. Calcium supplements decrease absorption of bisphosphonates.
Calcipotriene (Dovonex)
Taking calcipotriene with calcium might increase the risk for hypercalcemia.
Calcipotriene is a vitamin D analog used topically for psoriasis. It can be absorbed in sufficient amounts to cause systemic effects, including hypercalcemia. Theoretically, combining calcipotriene with calcium supplements might increase the risk of hypercalcemia.
Digoxin (Lanoxin)
Using intravenous calcium with digoxin might increase the risk of fatal cardiac arrhythmias.
Hypercalcemia increases the risk of fatal cardiac arrhythmias with digoxin. However, one retrospective analysis of clinical data suggests that intravenous calcium does not increase the risk of dysrhythmias or mortality in patients receiving digoxin.
Diltiazem (Cardizem, Others)
Theoretically, calcium may reduce the therapeutic effects of diltiazem.
Hypercalcemia can reduce the effectiveness of verapamil in atrial fibrillation. Theoretically, calcium might increase this risk of hypercalcemia and reduce the effectiveness of diltiazem.
Levothyroxine (Synthroid, Others)
Calcium seems to reduce the absorption and effectiveness of levothyroxine.
Advise patients to take levothyroxine and calcium supplements at least 4 hours apart. Calcium reduces levothyroxine absorption, probably by forming insoluble complexes. Calcium carbonate supplements reduce effectiveness of levothyroxine in patients with hypothyroidism.
Lithium
Theoretically, concomitant use of calcium and lithium may increase this risk of hypercalcemia.
Clinical research suggests that long-term use of lithium may cause hypercalcemia in 10% to 60% of patients. Theoretically, concomitant use of lithium and calcium supplements may further increase this risk.
Quinolone Antibiotics
Calcium seems to reduce the absorption of quinolone antibiotics.
Advise patients to take oral quinolones at least 2 hours before or 4-6 hours after calcium supplements or calcium-fortified foods. Taking calcium at the same time as oral quinolones can reduce quinolone absorption. Calcium binds to quinolones in the gut.
Raltegravir (Isentress)
Calcium may reduce levels of raltegravir.
Pharmacokinetic research shows that taking a single dose of calcium carbonate 3000 mg along with raltegravir 400 mg twice daily modestly decreases the mean area under the curve of raltegravir, but the decrease does not necessitate a dose adjustment of raltegravir. However, a case of elevated HIV-1 RNA levels and documented resistance to raltegravir has been reported for a patient taking calcium carbonate 1 gram three times daily plus vitamin D3 (cholecalciferol) 400 IU three times daily in combination with raltegravir 400 mg twice daily for 11 months. It is thought that calcium reduced raltegravir levels by chelation, leading to treatment failure.
Sotalol (Betapace)
Calcium seems to reduce the absorption of sotalol.
Advise patients to separate doses by at least 2 hours before or 4-6 hours after calcium. Calcium appears to reduce the absorption of sotalol, probably by forming insoluble complexes.
Tetracycline Antibiotics
Calcium seems to reduce the absorption of tetracycline antibiotics.
Advise patients to take oral tetracyclines at least 2 hours before, or 4-6 hours after calcium supplements. Taking calcium at the same time as oral tetracyclines can reduce tetracycline absorption. Calcium binds to tetracyclines in the gut.
Thiazide Diuretics
Taking calcium along with thiazides might increase the risk of hypercalcemia and renal failure.
Thiazides reduce calcium excretion by the kidneys. Using thiazides along with moderately large amounts of calcium carbonate increases the risk of milk-alkali syndrome (hypercalcemia, metabolic alkalosis, renal failure). Patients may need to have their serum calcium levels and/or parathyroid function monitored regularly.
Verapamil (Calan, Others)
Theoretically, calcium may reduce the therapeutic effects of verapamil.
Hypercalcemia can reduce the effectiveness of verapamil in atrial fibrillation. Theoretically, use of calcium supplements may increase this risk of hypercalcemia and reduce the effectiveness of verapamil.
Calcium Channel Blockers
Intravenous calcium may decrease the effects of calcium channel blockers; oral calcium is unlikely to have this effect.
Intravenous calcium is used to decrease the effects of calcium channel blockers in the management of overdose. Intravenous calcium gluconate has been used before intravenous verapamil (Isoptin) to prevent or reduce the hypotensive effects without affecting the antiarrhythmic effects. But there is no evidence that dietary or supplemental calcium when taken orally interacts with calcium channel blockers.
Brand information
Manufacturer and brand details for Garlic Extract, from the product label.
21st Century
See all 21st Century products- Name
- 21st Century HealthCare, Inc.
- Street Address
- 2119 S. Wilson St.
- City
- Tempe
- State
- AZ
- ZipCode
- 85282
- Web Address
- www.21stcenturyvitamins.com
Garlic Extract by 21st Century: 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 Garlic Extract’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Calcium
Interacts with 168 drugsCalcium is an essential mineral your body needs for strong bones, nerve signaling, and muscle function, and supplements can help fill gaps when diet falls short. Most people do best getting...
Read the full Calcium monograph → Herb & supplement monographGarlic
Interacts with 989 drugsGarlic is a common food and supplement that may modestly help with blood pressure and cholesterol, though the evidence is mixed and effects are usually small. It is generally safe in food am...
Read the full Garlic monograph →Sources & How We Checked
Garlic Extract'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 216 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.
Calcium 62 references
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- Neuhofel, A. L., Wilton, J. H., Victory, J. M., Hejmanowsk, L. G., and Amsden, G. W. Lack of bioequivalence of ciprofloxacin when administered with calcium-fortified orange juice: a new twist on an old interaction. J Clin Pharmacol. 2002;42(4):461-466. DOI
- Dickinson, H. O., Nicolson, D. J., Cook, J. V., Campbell, F., Beyer, F. R., Ford, G. A., and Mason, J. Calcium supplementation for the management of primary hypertension in adults. Cochrane.Database.Syst.Rev. 2006;(2):CD004639. PubMed
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- Levine, M., Nikkanen, H., and Pallin, D. J. The effects of intravenous calcium in patients with digoxin toxicity. J Emerg.Med. 2011;40(1):41-46. PubMed
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- Li K, Kaaks R, Linseisen J, Rohrmann S. Associations of dietary calcium intake and calcium supplementation with myocardial infarction and stroke risk and overall cardiovascular mortality in the Heidelberg cohort of the European Prospective Investigation i
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- Insentress [package insert]. Whitehouse Station, NJ: Merck Sharp & Dohme Corp.; 2014.
- Roberts JL, Kiser JJ, Hindman JT, Meditz AL. Virologic failure with a raltegravir-containing antiretroviral regimen and concomitant calcium administration. Pharmacotherapy 2011;31(10):298e-302e. DOI
- Vitekta [package insert]. Foster City, CA: Gilead Sciences, Inc.; 2014.
- Storan ER, O'Gorman SM, Murphy A, Laing M. Case Report of Calciphylaxis Secondary to Calcium and Vitamin D<sub>3</sub> Supplementation. J Cutan Med Surg. 2017;21(2):162-163. DOI
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Garlic 154 references
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- Garty BZ. Garlic burns. Pediatrics 1993;91:658-9.
- Rose KD, Croissant PD, Parliament CF, Levin MB. Spontaneous spinal epidural hematoma with associated platelet dysfunction from excessive garlic ingestion: a case report. Neurosurg 1990;26:880-2. PubMed
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- Sunter WH. Warfarin and garlic. Pharm J 1991;246:722.
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