Interactions on record — worth a quick check against your medications. Based on 7 of 15 ingredients. Check your meds →
Dietary supplement

Healthy Cholesterol Support Formula Ingredients & Drug Interactions

by Lee Swanson Signature Line

Softgel Capsule Category: Other Combinations
Most serious interaction: Moderate
The interaction bottom line Most serious interaction: Moderate

Healthy Cholesterol Support Formula is a dietary supplement by Lee Swanson Signature Line with 15 active ingredients. Its ingredients are commonly taken for general antioxidant support, skin and hair care, heart health.Based on those ingredients, 911 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Vitamin E, Policosanol, Krill Oil. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

Computed from our clinical databases

HelloPharmacist Scorecard of Healthy Cholesterol Support Formula by Lee Swanson Signature Line

Four independent checks of what is known — a summary of the available information, not a grade of the product itself.

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

The stated purpose hasn't been mapped to our evidence data yet.

Why this rating?
  • We haven't mapped this product's purpose to our evidence data yet — it'll be graded on the next content refresh.
Ingredient Transparency
Partial

Most active ingredients list an amount, but at least one is hidden in a blend or missing.

Why this rating?
  • The label discloses an exact amount for 16 of its 20 active ingredients.
  • “Krill Oil” is listed as a grouped ingredient — the label gives one combined amount (600 mg) without saying how much of each component you get.
  • “CardioAid-S Phytosterol Esters” is listed as a grouped ingredient — the label gives one combined amount (650 mg) without saying how much of each component you get.
  • “Cholesstrinol” is listed as a grouped ingredient — the label gives one combined amount (300 mg) without saying how much of each component you get.
Known Interaction Concern
Moderate identified

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

Why this rating?
  • 4 of the 6 matched ingredients can interact with medications — Policosanol, Octacosanol, Vitamin E, Astaxanthin.
  • The most serious interaction on file is rated Moderate.
  • Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs; immunosuppressants / transplant drugs; cancer treatments; diabetes medications; Parkinson's medications.
  • For scale: 912 individual medications appear in the full list. A big number alone doesn't make a product dangerous — what matters is whether YOUR medication is on it, so run yours through the interaction checker on this page.
Safety Information
Well characterized

Adverse-effect, pregnancy, and general safety data are on file for most of these ingredients.

Why this rating?
  • We hold adverse-effect (side-effect) data for 6 of the 6 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 6 of 6.
  • General safety write-ups exist for 6 of 6.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

HelloPharmacist summaryPartially disclosed formula with no assessable stated purpose. Moderate medication interactions have been identified, and safety information is well characterized.

Assessment coverage: 11 of 20 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Nov 20, 2017.

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

At a glance

General information

Key facts about Healthy Cholesterol Support Formula, straight from the product label.

Brand Lee Swanson Signature Line
Barcode (UPC) 087614200231
Net contents 120 Softgel(s)
Market status Off market
Date entered into DSLD Nov 20, 2017
DSLD ID 78266
Product type Other Combinations
Supplement form Softgel Capsule
Dietary claims / uses All Other, Structure/Function
Intended target group(s) Adult (18 - 50 Years)
From the label
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.

Supplement Facts

The label details for Healthy Cholesterol Support Formula by Lee Swanson Signature Line, sourced from the NIH Dietary Supplement Label Database.

Supplement Facts

Daily Value (DV) Target Group(s):
Adults and children 4 or more years of age
Minimum serving Sizes:
2 Softgel(s)
Maximum serving Sizes:
2 Softgel(s)
Servings per container
60
UPC/BARCODE
087614200231
IngredientAmount% DV
Calories10 Calorie(s)--
Vitamin E14 IU46%
Krill Oil600 mg--
Calories from Fat10 Calorie(s)--
Astaxanthin48 mcg--
Hexacosanol0.9 mg--
Campesterol170 mg--
Stigmasterol118 mg--
Brassicasterol20 mg--
Aspergillus oryzae0 NP--
natural Citrus Polymethoxylated Flavones0 NP--
Octacosanol9 mg--
Palm fruit Tocotrienols0 NP--
D-Gamma Tocotrienol13 mg--
D-Alpha-Tocotrienol10 mg--
D-Delta-Tocotrienol3.8 mg--
Beta-Sitosterol306 mg--
Sitostanol16 mg--
D-Beta Tocotrienol1.32 mg--
Triacontanol2.7 mg--
CardioAid-S Phytosterol Esters650 mg--
Campestanol12 mg--
Other Sterols12 mg--
Cholesstrinol300 mg--
Tocotrienols30 mg--
Policosanol20 mg--
Typical Aliphatic Alcohol Profile:0 NP--
Nattozimes Proprietary Blend65 mg--
Aspergillus melleus0 NP--

Other ingredients: Gelatin, Glycerin, Soybean Oil, purified Water, Sunflower Lecithin, Beeswax, Annatto

Tap any ingredient to jump to its full detail below.

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

Genetic designed nutrition

BioCosanol is a registered trademark of Cyvex Nutrition, Inc., d/b/a Nutegrity. CardioAid-S and the Cardio-Aid logo are trademarks of Archer Daniels Midland Co. Nattozimes is a registered trademark of National Enzyme Company. Cholesstrinol is a trademark of SourceOne and is protected under U.S. Patents #6,239,114; #6,251,400; and #6,987,125.

FDA Statement of Identity

Dietary Supplement

General Statements

Supports healthy cholesterol levels already within the normal range.

To reorder, call toll free 1-800-437-4148 or visit our website at www.swansonvitamins.com

Seals/Symbols

Guaranteed purity & potency

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

Do not use if seal is broken.

Keep out of reach of children.

Warning: Do not use this product if you have a blood coagulation disorder and/or are taking any drug that affects blood coagulation such as prescription vitamin K, heparin or warfarin (coumadin). Do not take this product if you are pregnant or nursing. Consult with your healthcare provider before use if you are taking other medications, especially cholesterol lowering medication.

Discontinue use if cholesterol levels drop below 150–180 mg/DL.

Storage

Store in a cool, dry place. Do not refrigerate.

Suggested/Recommended/Usage/Directions

Suggested Use: As a dietary supplement, take two softgels per day with food and water. For maximum benefit, take four softgels per day.

General

SWL023

See for yourself

Healthy Cholesterol Support Formula by Lee Swanson Signature Line label

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

What’s inside

The Ingredients in Healthy Cholesterol Support Formula by Lee Swanson Signature Line

These are the 15 active ingredients this product is made of. Select any to open its full monograph.

Serving size2 Softgel(s) Dosage formSoftgel Capsule 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.

Vitamin E

Interacts with
764 drugs
14 IU per serving Form: D-Alpha-Tocopherol

Vitamin E is an essential fat-soluble vitamin and antioxidant that most people get in adequate amounts from a normal diet. Supplements can help correc...

Vitamin E monograph & interactions

Krill Oil

Interacts with
208 drugs
600 mg per serving

Krill oil is a source of omega-3 fatty acids (EPA and DHA) bound to phospholipids, which may help absorption. It is most studied for lowering triglyce...

Krill Oil monograph & interactions

CardioAid-S Phytosterol Esters

650 mg per serving

Cholesstrinol

300 mg per serving
  • › Natural Citrus Polymethoxylated Flavones
  • › Palm fruit Tocotrienols

Tocotrienols

Interacts with
122 drugs
30 mg per serving Form: Palm

Tocotrienols are a less common form of vitamin E with strong antioxidant activity studied mostly for cholesterol, liver, and heart health. Early resea...

Tocotrienols monograph & interactions

Policosanol

Interacts with
242 drugs
20 mg per serving Form: 100% natural Sugar Cane, BioCosanol

Policosanol is a mix of waxy alcohols (mostly octacosanol) made from sugar cane or other plant waxes, and it is often marketed as a natural way to low...

Policosanol monograph & interactions
  • › Typical Aliphatic Alcohol Profile:

Nattozimes Proprietary Blend

65 mg per serving
  • › Aspergillus oryzae
  • › Aspergillus melleus

Other (inactive) ingredients: Gelatin, Glycerin, Soybean Oil, Purified Water, Sunflower Lecithin, Beeswax, Annatto. These complete the product’s ingredient list but are not active constituents.

Interaction report

Healthy Cholesterol Support Formula by Lee Swanson Signature Line Drug Interactions

Healthy Cholesterol Support Formula contains 15 ingredients, and 4 of them have known drug interactions. Altogether they interact with 911 medications. Here’s the picture, then you can look up your own drug.

Want to check YOUR meds against Healthy Cholesterol Support Formula?

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

Go to the checker
911Drugs
910 Moderate 1 Minor

Ingredients driving the most interactions

Vitamin E 764
Krill Oil 208

Each ingredient & the kinds of drugs it affects

For each ingredient in Healthy Cholesterol Support Formula 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.

Vitamin E8 drug types · 764 drugs

Alkylating Agents

Theoretically, antioxidant effects of vitamin E might reduce the effectiveness of alkylating agents.
There's concern that antioxidants could reduce the activity of chemotherapy drugs which generate free radicals, such as cyclophosphamide, chlorambucil, carmustine, busulfan, and thiotepa. However, some researchers theorize that antioxidants might make chemotherapy more effective by reducing oxidative stress that might interfere with apoptosis (cell death) of cancer cells. More evidence is needed to determine what effect, if any, antioxidants such as vitamin E have on chemotherapy. Advise patients to consult their oncologist before using vitamin E supplements, especially in high doses.

Likelihood Possible Evidence D
Anticoagulant/Antiplatelet Drugs

Concomitant use of vitamin E and anticoagulant or antiplatelet agents might increase the risk of bleeding.
Vitamin E seems to inhibit of platelet aggregation and antagonize the effects of vitamin K-dependent clotting factors. These effects appear to be dose-dependent, and are probably only likely to be clinically significant with doses of at least 800 units daily. Mixed tocopherols, such as those found in food, might have a greater antiplatelet effect than alpha-tocopherol. RRR alpha-tocopherol (natural vitamin E) 1000 IU daily antagonizes vitamin K-dependent clotting factors. Advise patients to avoid high doses of vitamin E, especially in people with low vitamin K intake or other risk factors for bleeding.

Likelihood Possible Evidence B
Antitumor Antibiotics

Theoretically, antioxidant effects of vitamin E might reduce the effectiveness of antitumor antibiotics.
There's concern that antioxidants could reduce the activity of antitumor antibiotic drugs such as doxorubicin, which generate free radicals. However, some researchers theorize that antioxidants might make chemotherapy more effective by reducing oxidative stress that might interfere with apoptosis (cell death) of cancer cells. More evidence is needed to determine what effect, if any, antioxidants such as vitamin E have on chemotherapy involving antitumor antibiotics. Advise patients to consult their oncologist before using vitamin E supplements, especially in high doses.

Likelihood Possible Evidence D
Cyclosporine (Neoral, Sandimmune)

A specific form of vitamin E might increase absorption and levels of cyclosporine.
There is some evidence that one specific formulation of vitamin E (D-alpha-tocopheryl-polyethylene glycol-1000 succinate, TPGS, tocophersolan, Liqui-E) might increase absorption of cyclosporine. This vitamin E formulation forms micelles which seems to increase absorption of cyclosporine by 40% to 72% in some patients. However, this interaction is unlikely to occur with the usual forms of vitamin E.

Likelihood Unlikely Evidence B
Cytochrome P450 3A4 (Cyp3A4) Substrates

Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Vitamin E appears to bind with the nuclear receptor, pregnane X receptor (PXR), which results in increased expression of CYP3A4. Although the clinical significance of this is not known, use caution when considering concomitant use of vitamin E and other drugs affected by these enzymes.

Likelihood Possible Evidence D
Selumetinib (Koselugo)

Taking selumetinib with vitamin E can result in a total daily dose of vitamin E that exceeds safe limits and therefore might increase the risk of bleeding.
Selumetinib contains 48-54 IU vitamin E per capsule. The increased risk of bleeding with vitamin E appears to be dose-dependent. Be cautious when using selumetinib in combination with supplemental vitamin E, especially in patients at higher risk of bleed, such as those with chronic conditions and those taking antiplatelet drugs.

Likelihood Possible Evidence D
Warfarin (Coumadin)

Using vitamin E with warfarin might increase the risk of bleeding.
Due to interference with production of vitamin K-dependent clotting factors, use of more than 400 IU of vitamin E daily with warfarin might increase prothrombin time (PT), INR, and the risk of bleeding,. At a dose of 1000 IU per day, vitamin E can antagonize vitamin K-dependent clotting factors even in people not taking warfarin. Limited clinical evidence suggests that doses up to 1200 IU daily may be used safely by patients taking warfarin, but this may not be applicable in all patient populations.

Likelihood Possible Evidence B
Niacin

Vitamin E might decrease the beneficial effects of niacin on high-density lipoprotein (HDL) cholesterol levels.
A combination of niacin and simvastatin (Zocor) effectively raises high-density lipoprotein (HDL) cholesterol levels in people with coronary disease and low HDL levels. Clinical research shows that taking a combination of antioxidants (vitamin C, vitamin E, beta-carotene, and selenium) along with niacin and simvastatin (Zocor) attenuates this rise in HDL, specifically the HDL-2 and apolipoprotein A1 fractions, by more than 50%. Vitamin E alone combined with a statin does not seem to decrease HDL levels. It is not known whether the adverse effect on HDL is due to one of the other antioxidants or to the combination. It also is not known whether it will occur in other patient populations.

Likelihood Possible Evidence A

Policosanol6 drug types · 242 drugs

Anticoagulant/Antiplatelet Drugs

Theoretically, taking policosanol with other antiplatelet or anticoagulant drugs might increase the risk of bruising and bleeding.
Some clinical research shows that taking policosanol 10-50 mg daily for 7-15 days can inhibit platelet aggregation in healthy patients. Although, one clinical trial shows that taking policosanol 10 mg twice daily for 2 weeks prior to warfarin dosing does not affect warfarin pharmacokinetics or warfarin response. Furthermore, a study in patients undergoing percutaneous coronary intervention with a drug-eluting stent found that taking policosanol 40 mg plus clopidogrel and aspirin daily for 30 days modestly reduced the risk for minor bleeding events when compared with taking clopidogrel and aspirin alone. Until more is known, use with caution.

Likelihood Possible Evidence B
Antidiabetes Drugs

Theoretically, policosanol might have additive effects with antidiabetes drugs and increase the risk of hypoglycemia.
Clinical research shows that policosanol can lower blood glucose levels.

Likelihood Possible Evidence B
Beta-Blockers

Concomitant use of policosanol with beta-blockers can cause additive blood pressure-lowering effects.
Clinical research shows that policosanol 5 mg daily can have additive blood pressure-lowering effects in patients with hypertension who are taking beta-blockers. Also, animal research shows that policosanol can increase the blood-pressure lowering effects of propranolol.

Likelihood Probable Evidence A
Nitroprusside (Nitropress)

Theoretically, concomitant use of policosanol with nitroprusside might cause additive blood pressure-lowering effects.
Animal research shows that taking policosanol along with nitroprusside can increase the blood pressure-lowering effects of nitroprusside.

Likelihood Possible Evidence D
Propranolol (Inderal)

Animal research shows that taking policosanol along with propranolol can increase the blood pressure-lowering effects of propranolol.

Likelihood Possible Evidence D
Warfarin (Coumadin)

Theoretically, taking policosanol with warfarin might increase the risk of bruising and bleeding.
Some clinical research shows that taking policosanol 10-50 mg daily for 7-15 days can inhibit platelet aggregation in healthy patients. However, one clinical trial shows that taking policosanol 10 mg twice daily for 2 weeks prior to warfarin dosing does not affect warfarin pharmacokinetics or warfarin response.

Likelihood Possible Evidence B

Krill Oil2 drug types · 208 drugs

Anticoagulant/Antiplatelet Drugs

Theoretically, krill oil may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Taking high doses of omega-3 fatty acids from fish oil can modestly decrease platelet aggregation. Since krill oil also contains these fatty acids, taking high doses of krill oil might also inhibit platelet aggregation. Theoretically, taking high doses of krill oil with antiplatelet or anticoagulant drugs might increase the risk of bleeding. However, the omega-3 content of krill oil is much lower than that of fish oil.

Likelihood Possible Evidence D
Antidiabetes Drugs

Theoretically, taking krill oil with antidiabetes drugs might increase the risk of hypoglycemia.
Some research in animals and humans shows that krill oil might lower blood glucose levels. However, a small study shows that taking krill oil does not reduce blood glucose levels in patients with type 2 diabetes, most of whom were taking antidiabetes drugs.

Likelihood Possible Evidence B

Tocotrienols1 drug type · 122 drugs

Anticoagulant/Antiplatelet Drugs

Concomitant use of tocotrienols with anticoagulant or antiplatelet agents might increase the risk of bleeding. However, this has not been reported in humans.
Taking tocotrienols orally inhibits experimentally-induced platelet aggregation in humans. Theoretically tocotrienols might increase the risk of bleeding if taken with antiplatelet or anticoagulant drugs. However, tocotrienols 400-800 mg daily have been used with aspirin and/or clopidogrel for 1 year with no clear cumulative antiplatelet effects and no reports of bleeding.

Likelihood Unlikely Evidence B
The maker

Brand information

Manufacturer and brand details for Healthy Cholesterol Support Formula, from the product label.

Lee Swanson Signature Line

See all Lee Swanson Signature Line products
Name
Swanson Health Products
Street Address
PO BOX 2803
City
Fargo
State
ND
ZipCode
58108
Phone Number
1-800-437-4148
Web Address
www.swansonvitamins.com
Pharmacist Counseling Corner

Healthy Cholesterol Support Formula by Lee Swanson Signature Line: Common Questions

Does Healthy Cholesterol Support Formula by Lee Swanson Signature Line interact with any medications?
Yes. Based on its ingredients, Healthy Cholesterol Support Formula has a known interaction with 911 medications. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Healthy Cholesterol Support Formula contains 15 active ingredients, and an interaction can come from any of them. We check every ingredient, combine the results into one list per medication, and show which ingredient and mechanism is responsible.
Where does this information come from?
The product label data comes from the NIH Dietary Supplement Label Database (DSLD); the interaction data is built on the Natural Medicines database and reviewed by HelloPharmacist pharmacists.

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

Not sure if Healthy Cholesterol Support Formula is safe with your meds?

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Label information is sourced from the NIH Dietary Supplement Label Database and reflects the product version on file; always read your actual product label. This page is for education only and is not a substitute for professional medical advice. Confirm with your pharmacist or doctor before combining supplements and medications.

Healthy Cholesterol Support Formula label
Go deeper

The Full Monographs Behind Healthy Cholesterol Support Formula’s Ingredients

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

Herb & supplement monograph

Vitamin E

Interacts with 764 drugs

Vitamin E is an essential fat-soluble vitamin and antioxidant that most people get in adequate amounts from a normal diet. Supplements can help correct a true deficiency, but high-dose vitam...

Read the full Vitamin E monograph →
Herb & supplement monograph

Krill Oil

Interacts with 208 drugs

Krill oil is a source of omega-3 fatty acids (EPA and DHA) bound to phospholipids, which may help absorption. It is most studied for lowering triglycerides and supporting heart health, but t...

Read the full Krill Oil monograph →
Herb & supplement monograph

Astaxanthin

Interacts with 671 drugs

Astaxanthin is a reddish carotenoid pigment with strong antioxidant activity in the lab, and it is widely promoted for skin, eye, heart, and exercise benefits. Early human studies are promis...

Read the full Astaxanthin monograph →
Herb & supplement monograph

Beta-sitosterol

Beta-sitosterol is a plant sterol that may modestly lower LDL ('bad') cholesterol and may help ease urinary symptoms from an enlarged prostate. Evidence is moderate for these uses and weaker...

Read the full Beta-sitosterol monograph →
Herb & supplement monograph

Sitostanol

Sitostanol is a plant stanol that can modestly lower LDL ("bad") cholesterol by blocking the absorption of cholesterol in the gut. It is best known when combined with related stanols and ste...

Read the full Sitostanol monograph →
Herb & supplement monograph

Tocotrienols

Interacts with 122 drugs

Tocotrienols are a less common form of vitamin E with strong antioxidant activity studied mostly for cholesterol, liver, and heart health. Early research is interesting but far from conclusi...

Read the full Tocotrienols monograph →
Herb & supplement monograph

Policosanol

Interacts with 242 drugs

Policosanol is a mix of waxy alcohols (mostly octacosanol) made from sugar cane or other plant waxes, and it is often marketed as a natural way to lower cholesterol. Early studies from Cuba...

Read the full Policosanol monograph →
Sources

Sources & How We Checked

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

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

The 148 references behind this product’s interaction data

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

Vitamin E 64 references
  1. Kim JM, White RH. Effect of vitamin E on the anticoagulant response to warfarin. Am J Cardiol 1996;77:545-6. PubMed
  2. Corrigan JJ Jr. The effect of vitamin E on warfarin-induced vitamin K deficiency. Ann N Y Acad Sci 1982;393:361-8. PubMed
  3. Corrigan JJ Jr. Coagulation problems relating to vitamin E. Am J Pediatr Hematol Oncol 1979;1:169-73.
  4. Corrigan JJ Jr, Marcus FI. Coagulopathy associated with vitamin E ingestion. JAMA 1974;230:1300-1. DOI
  5. Labriola D, Livingston R. Possible interactions between dietary antioxidants and chemotherapy. Oncology 1999;13:1003-8.
  6. Chang T, Benet LZ, Hebert MF. The effect of water-soluble vitamin E on cyclosporine pharmacokinetics in healthy volunteers. Clin Pharmacol Ther 1996;59:297-303. PubMed
  7. Pan SH, Lopez RR Jr, Sher LS, et al. Enhanced oral cyclosporine absorption with water-soluble vitamin E early after liver transplantation. Pharmacother 1996;16:59-65. DOI
  8. Anon. Dietary supplementation with n-3 polyunsaturated fatty acids and vitamin E after myocardial infarction: results of the GISSI-Prevenzione trial. Gruppo Italiano per lo Studio della Soprawivenza nell'Infarto miocardico. Lancet 1999;354:447-55. DOI
  9. Chappell LC, Seed PT, Briley AL, et al. Effect of antioxidants on the occurrence of pre-eclampsia in women at increased risk: a randomised trial. Lancet 1999;354:810-6. DOI
  10. Yusuf S, Dagenais G, Pogue J, et al. Vitamin E supplementation and cardiovascular events in high-risk patients. The heart outcomes prevention evaluation study investigators. N Engl J Med 2000;342:154-60. PubMed
  11. Stephens NG, Parsons A, Schofield PM, et al. Randomised controlled trial of vitamin E in patients with coronary disease: Cambridge Heart Antioxidant Study. Lancet 1996;347:781-6.
  12. The Alpha-Tocopherol, Beta Carotene Cancer Prevention Study Group. The effect of vitamin E and beta carotene on the incidence of lung cancer and other cancers in male smokers. N Engl J Med 1994;330:1029-35. PubMed
  13. Takahashi O. Haemorrhagic toxicity of a large dose of alpha-, beta-, gamma- and delta-tocopherols, ubiquinone, beta-carotene, retinol acetate and L-ascorbic acid in the rat. Food Chem Toxicol 1995;33:121-8.
  14. Briggs GB, Freeman RK, Yaffe SJ. Drugs in Pregnancy and Lactation. 5th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 1998.
  15. Sano M, Ernesto C, Thomas RG, et al. A controlled trial of selegiline, alpha-tocopherol, or both as treatment for Alzheimer's disease. The Alzheimer's Disease Cooperative Study. N Engl J Med 1997;336:1216-22. PubMed
  16. Liede KE, Haukka JK, Saxen LM, Heinonen OP. Increased tendency towards gingival bleeding caused by joint effect of alpha-tocopherol supplementation and acetylsalicylic acid. Ann Med 1998;30:542-6.
  17. Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes for Vitamin C, Vitamin E, Selenium, and Carotenoids. Washington, DC: National Academy Press, 2000. Available at: http://www.nap.edu/books/0309069351/html/.
  18. Brown BG, Zhao XQ, Chait A, et al. Simvastatin and niacin, antioxidant vitamins, or the combination for the prevention of coronary disease. N Engl J Med 2001;345:1583-93. DOI
  19. Liu M, Wallmon A, Olsson-Mortlock C, et al. Mixed tocopherols inhibit platelet aggregation in humans: potential mechanisms. Am J Clin Nutr 2003;77:700-6. PubMed
  20. Sokol RJ, Johnson KE, Karrer FM, et al. Improvement of cyclosporin absorption in children after liver transplantation by means of water-soluble vitamin E. Lancet 1991;338:212-4.. PubMed
  21. Stein JH, Carlsson CM, Papcke-Benson K, et al. The effects of lipid-lowering and antioxidant vitamin therapies on flow-mediated vasodilation of the brachial artery in older adults with hypercholesterolemia. J Am Coll Cardiol 2001;38:1806-13.. PubMed
  22. Carlsson CM, Papcke-Benson K, Carnes M, et al. Health-related quality of life and long-term therapy with pravastatin and tocopherol (vitamin E) in older adults. Drugs Aging 2002;19:793-805. . PubMed
  23. Cheung MC, Zhao XQ, Chait A, et al. Antioxidant supplements block the response of HDL to simvastatin-niacin therapy in patients with coronary artery disease and low HDL. Arterioscler Thromb Vasc Biol 2001;21:1320-6. PubMed
  24. Schrogie JJ. Coagulopathy and fat-soluble vitamins (letter). JAMA 1975;232:19. DOI
  25. Celestini A, Pulcinelli FM, Pignatelli P, et al. Vitamin E potentiates the antiplatelet activity of aspirin in collagen-stimulated platelets. Haematologica 2002;87:420-6.
  26. Stampfer MJ, Jakubowski JA, Faigel D, et al. Vitamin E supplementation effect on human platelet function, arachidonic acid metabolism, and plasma prostacyclin levels. Am J Clin Nutr 1988;47:700-6. PubMed
  27. Jandak J, Steiner M, Richardson PD. Alpha-tocopherol, an effective inhibitor of platelet adhesion. Blood 1989;73:141-9. DOI
  28. Freedman JE, Farhat JH, Loscalzo J, Keaney JF. Alpha-tocopherol inhibits aggregation of human platelets by a protein kinase C-dependent mechanism. Circulation 1996;94:2434-40. PubMed
  29. Steiner M. Vitamin E, a modifier of platelet function: rationale and use in cardiovascular and cerebrovascular disease. Nutr Rev 1999;57:306-9. PubMed
  30. Brodkin RH, Bleiberg J. Sensitivity to topically applied vitamin E. Arch Dermatol 1965;92:76-7. DOI
  31. Booth SL, Golly I, Sacheck JM, et al. Effect of vitamin E supplementation on vitamin K status in adults with normal coagulation status. Am J Clin Nutr 2004;80:143-8. PubMed
  32. Miller ER 3rd, Pastor-Barriuso R, Dalal D, et al. Meta-analysis: High-dosage vitamin E supplementation may increase all-cause mortality. Ann Intern Med 2005;142:60520-53. PubMed
  33. Lonn E, Bosch J, Yusuf S, et al. HOPE and HOPE-TOO Trial Investigators. Effects of long-term vitamin E supplementation on cardiovascular events and cancer: a randomized controlled trial. JAMA 2005;293:1338-47. PubMed
  34. Landes N, Pfluger P, Kluth D, et al. Vitamin E activates gene expression via the pregnane X receptor. Biochem Pharmacol 2003;65:269-73. . PubMed
  35. Brigelius-Flohe R. Vitamin E and drug metabolism. Biochem Biophys Res Commun 2003;305:737-40. PubMed
  36. Prasad KN. Rationale for using high-dose multiple dietary antioxidants as an adjunct to radiation therapy and chemotherapy. J Nutr 2004;134:3182S-3S. PubMed
  37. Conklin KA. Cancer chemotherapy and antioxidants. J Nutr 2004;134:3201S-3204S. PubMed
  38. Schurks M, Glynn RJ, Rist PM, et al. Effects of vitamin E on stroke subtypes: meta-analysis of randomized controlled trials. BMJ 2010;341: c5702. doi: 10.1136/bmj.c5702.
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Krill Oil 13 references
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  11. Lobraico JM, DiLello LC, Butler AD, Cordisco ME, Petrini JR, Ahmadi R. Effects of krill oil on endothelial function and other cardiovascular risk factors in participants with type 2 diabetes, a randomized controlled trial. BMJ Open Diabetes Res Care. 2015 PubMed
  12. van der Wurff ISM, von Schacky C, Bergeland T, Zeegers MP, Kirschner PA, de Groot RHM. Krill oil supplementation's effect on school grades in typically developing adolescents. Prostaglandins Leukot Essent Fatty Acids 2023;191:102553. PubMed
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Astaxanthin 3 references
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  3. Choi HD, Youn YK, Shin WG. Positive effects of astaxanthin on lipid profiles and oxidative stress in overweight subjects. Plant Foods Hum Nutr. 2011;66:363-369. PubMed

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Policosanol 15 references
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  2. Arruzazabala ML, Valdes S, Mas R, et al. Comparative study of policosanol, aspirin and the combination therapy policosanol-aspirin on platelet aggregation in healthy volunteers. Pharmacol Res 1997;36:293-7. PubMed
  3. Valdes S, Arruzazabala ML, Fernandez L. Effect of policosanol on platelet aggregation in healthy volunteers. Int J Clin Pharmacol Res 1996;16:67-72.
  4. Greyling A, De Witt C, Oosthuizen W, Jerling JC. Effects of a policosanol supplement on serum lipid concentrations in hypercholesterolaemic and heterozygous familial hypercholesterolaemic subjects. Br J Nutr 2006;95:968-75. PubMed
  5. Abdul MI, Jiang X, Williams KM, et al. Pharmacokinetic and pharmacodynamic interactions of echinacea and policosanol with warfarin in healthy subjects. Br J Clin.Pharmacol. 2010;69:508-15. PubMed
  6. Molina, Cuevas, V, Arruzazabala, M. L., Carbajal, Quintana D., Mas, Ferreiro R., and Valdes, Garcia S. Effect of policosanol on arterial blood pressure in rats. Study of the pharmacological interaction with nifedipine and propranolol. Arch Med Res 1998;29
  7. Castano G, Fernandez L, Mas R, et al. Comparison of the efficacy, safety and tolerability of original policosanol versus other mixtures of higher aliphatic primary alcohols in patients with type II hypercholesterolemia. Int.J.Clin.Pharmacol.Res. 2002;22:5
  8. Arruzazabala, M. L., Carbajal, D., Mas, R., Valdes, S., and Molina, V. Pharmacological Interaction Between Policosanol and Nitroprusside in Rats. J Med Food 2001;4(2):67-70. PubMed
  9. Castano G, Mas R, Gamez R, et al. Concomitant use of policosanol and beta-blockers in older patients. Int J Clin Pharmacol.Res 2004;24:65-77.
  10. Francini-Pesenti F, Brocadello F, Beltramolli D, et al. Sugar cane policosanol failed to lower plasma cholesterol in primitive, diet-resistant hypercholesterolaemia: A double blind, controlled study. Complement Ther Med 2008;16:61-65. PubMed
  11. Castaño G, Fernández L, Mas R, Illnait J, Mesa M, Fernández JC. Comparison of the effects of policosanol and atorvastatin on lipid profile and platelet aggregation in patients with dyslipidaemia and type 2 diabetes mellitus. Clin Drug Investig. 2003;23(10 PubMed
  12. Fernandez L, Mas R, Illnait J, Fernandez JC. Policosanol: results of a postmarketing surveillance study of 27,879 patients. Curr Ther Res 1998;59(10):717-22. DOI
  13. Wang HY, Jiao QP, Chen SY, et al. Efficacy and safety of policosanol plus fenofibrate combination therapy in elderly patients with mixed dyslipidemia: A randomized, controlled clinical study. Am J Med Sci. 2018;356(3):254-261. PubMed
  14. Xu K, Liu X, Li Y, Wang Y, Zang H, Guo L, et al. Safety and efficacy of policosanol in patients with high on-treatment platelet reactivity after drug-eluting stent implantation: two-year follow-up results. Cardiovasc Ther. 2016 Oct;34(5):337-42. doi: 10.1 PubMed
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See these in context on the Policosanol monograph →

Octacosanol 16 references
  1. Carbajal D, Arruzazabala ML, Valdes S, Mas R. Effect of policosanol on platelet aggregation and serum levels of arachidonic acid metabolites in healthy volunteers. Prostaglandins Leukot Essent Fatty Acids 1998;58:61-4.
  2. Arruzazabala ML, Valdes S, Mas R, et al. Comparative study of policosanol, aspirin and the combination therapy policosanol-aspirin on platelet aggregation in healthy volunteers. Pharmacol Res 1997;36:293-7. PubMed
  3. Valdes S, Arruzazabala ML, Fernandez L. Effect of policosanol on platelet aggregation in healthy volunteers. Int J Clin Pharmacol Res 1996;16:67-72.
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  5. Greyling A, De Witt C, Oosthuizen W, Jerling JC. Effects of a policosanol supplement on serum lipid concentrations in hypercholesterolaemic and heterozygous familial hypercholesterolaemic subjects. Br J Nutr 2006;95:968-75. PubMed
  6. Abdul MI, Jiang X, Williams KM, et al. Pharmacokinetic and pharmacodynamic interactions of echinacea and policosanol with warfarin in healthy subjects. Br J Clin.Pharmacol. 2010;69:508-15. PubMed
  7. Molina, Cuevas, V, Arruzazabala, M. L., Carbajal, Quintana D., Mas, Ferreiro R., and Valdes, Garcia S. Effect of policosanol on arterial blood pressure in rats. Study of the pharmacological interaction with nifedipine and propranolol. Arch Med Res 1998;29
  8. Menendez, R., Mas, R., Amor, A. M., Gonzalez, R. M., Fernandez, J. C., Rodeiro, I., Zayas, M., and Jimenez, S. Effects of policosanol treatment on the susceptibility of low density lipoprotein (LDL) isolated from healthy volunteers to oxidative modificat
  9. Castano G, Fernandez L, Mas R, et al. Comparison of the efficacy, safety and tolerability of original policosanol versus other mixtures of higher aliphatic primary alcohols in patients with type II hypercholesterolemia. Int.J.Clin.Pharmacol.Res. 2002;22:5
  10. Arruzazabala, M. L., Carbajal, D., Mas, R., Valdes, S., and Molina, V. Pharmacological Interaction Between Policosanol and Nitroprusside in Rats. J Med Food 2001;4(2):67-70. PubMed
  11. Castano G, Mas R, Gamez R, et al. Concomitant use of policosanol and beta-blockers in older patients. Int J Clin Pharmacol.Res 2004;24:65-77.
  12. Francini-Pesenti F, Brocadello F, Beltramolli D, et al. Sugar cane policosanol failed to lower plasma cholesterol in primitive, diet-resistant hypercholesterolaemia: A double blind, controlled study. Complement Ther Med 2008;16:61-65. PubMed
  13. Castaño G, Fernández L, Mas R, Illnait J, Mesa M, Fernández JC. Comparison of the effects of policosanol and atorvastatin on lipid profile and platelet aggregation in patients with dyslipidaemia and type 2 diabetes mellitus. Clin Drug Investig. 2003;23(10 PubMed
  14. Wang HY, Jiao QP, Chen SY, et al. Efficacy and safety of policosanol plus fenofibrate combination therapy in elderly patients with mixed dyslipidemia: A randomized, controlled clinical study. Am J Med Sci. 2018;356(3):254-261. PubMed
  15. Xu K, Liu X, Li Y, Wang Y, Zang H, Guo L, et al. Safety and efficacy of policosanol in patients with high on-treatment platelet reactivity after drug-eluting stent implantation: two-year follow-up results. Cardiovasc Ther. 2016 Oct;34(5):337-42. doi: 10.1 PubMed
  16. Li C, Ding Y, Si Q, Li K, Xu K. Multiple functions of policosanol in elderly patients with dyslipidemia. J Int Med Res. 2020;48(7):300060520936082. PubMed

See these in context on the Octacosanol monograph →

Beta-sitosterol 7 references
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Sitostanol 26 references
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  8. Gylling H, Miettinen TA. Effects of inhibiting cholesterol absorption and synthesis on cholesterol and lipoprotein metabolism in hypercholesterolemic non-insulin-dependent diabetic men. J Lipid Res 1996;37:1776-85. DOI
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  10. Hallikainen MA, Uusitupa MI. Effects of 2 low-fat stanol ester-containing margarines on serum cholesterol concentrations as part of a low-fat diet in hypercholesterolemic subjects. Am J Clin Nutr 1999;69:403-10. PubMed
  11. Heinemann T, Kullak-Ublick GA, Pietruck B, von Bergmann K. Mechanisms of action of plant sterols on inhibition of cholesterol absorption. Comparison of sitosterol and sitostanol. Eur J Clin Pharmacol 1991;40 Suppl 1:S59-63. DOI
  12. Jones PJ, Ntanios FY, Raeini-Sarjaz M, et al. Cholesterol-lowering efficacy of a sitostanol-containing phytosterol mixture with a prudent diet in hyperlipidemic men. Am J Clin Nutr 1999;69:1144-50. PubMed
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  14. Miettinen TA, Puska P, Gylling H, et al. Reduction of serum cholesterol with sitostanol-ester margarine in a mildly hypercholesterolemic population. N Engl J Med 1995;333(20):1308-12. PubMed
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  19. Williams CL, Bollella MC, Strobino BA, et al. Plant stanol ester and bran fiber in childhood: effects on lipids, stool weight and stool frequency in preschool children. J Am Coll Nutr 1999;18:572-81. PubMed
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  23. Malhotra A, Shafiq N, Arora A, Singh M, Kumar R, Malhotra S. Dietary interventions (plant sterols, stanols, omega-3 fatty acids, soy protein and dietary fibers) for familial hypercholesterolaemia. Cochrane Database Syst Rev. 2014 Jun 10;6:CD001918. PubMed
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Tocotrienols 4 references
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  2. Baumann LS, Spencer JS. The effects of topical vitamin E on the cosmetic appearance of scars. Dermatol Surg 1999;25:311-5. PubMed
  3. Khoo TL, Halim AS, Zakaria Z, Mat Saad AZ, Wu LY, Lau HY. A prospective, randomised, double-blinded trial to study the efficacy of topical tocotrienol in the prevention of hypertrophic scars. J Plast Reconstr Aesthet Surg. 2011 Jun;64(6):e137-45. Epub 201 PubMed
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DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

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