Heart Guard Ingredients & Drug Interactions
by KaraMD
What is this page for?
First and foremost: checking Heart Guard 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
Heart Guard is a dietary supplement by KaraMD with 4 active ingredients. Its ingredients are commonly taken for preventing or treating magnesium deficiency, constipation, muscle cramps.Based on those ingredients, 1,148 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are Grapeseed extract, Magnesium, Nattokinase. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
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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 Heart Guard by KaraMD
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
Heart Guard contains four active ingredients. Magnesium is an essential mineral used here to support heart and bone health.
Grapeseed extract comes from grape seeds and is studied for circulatory support. Nattokinase is an enzyme derived from fermented soybeans with potential effects on blood flow.
Hawthorn extract, made from the hawthorn plant, has a long history in heart health formulations. The capsule itself is made from vegetable cellulose, a plant-based material.
Does it work?
Moderate evidence
The evidence for these ingredients varies. Magnesium is effective for indigestion and constipation, and appears effective for low magnesium levels and pre-eclampsia in pregnancy when used under medical supervision.
Grapeseed extract shows only possibly effective evidence for chronic venous insufficiency (a circulation condition), and possibly ineffective evidence for nausea from chemotherapy, hay fever, and weight loss. Nattokinase and hawthorn extract both carry insufficient evidence to rate their effectiveness for the conditions studied, including heart disease and angina.
Because the evidence for most of these ingredients as a heart support product is limited or not established, talk with your doctor about whether this product makes sense for your specific goals.
How safe is it?
Well-documented data
Magnesium is generally well tolerated at recommended doses, though it can cause diarrhea, nausea, vomiting, or upset stomach in some people. Grapeseed extract also appears well tolerated and is safe as whole grapes in food.
Nattokinase has been generally tolerated in short-term use but carries a risk of bleeding due to its blood-thinning effects; it is not enough data to use in pregnancy or while breastfeeding. Hawthorn extract is generally well tolerated in studies, though it requires medical supervision if you have a heart condition; it is also not recommended in pregnancy or while breastfeeding due to lack of safety data.
Magnesium is needed during pregnancy but supplements should only be used under your doctor's guidance. There is not enough information on concentrated grape supplements, nattokinase, or hawthorn during breastfeeding.
Meds to double-check
Major interaction found
Before taking this product, check with your doctor or pharmacist if you take nitrates or phosphodiesterase-5 inhibitors (like sildenafil), as hawthorn may cause a dangerous drop in blood pressure. You should also verify any blood pressure medications, blood thinners or antiplatelet drugs (including aspirin), Parkinson's medication (levodopa/carbidopa), skeletal muscle relaxants, diabetes drugs, antibiotics (especially quinolone antibiotics), bone-strengthening drugs, or any other medications your liver processes—each of the four ingredients can affect different drug types.
The bottom line
Scorecard at a glanceFully disclosed formula with some supporting evidence for its stated purpose. Major medication interactions have been identified, and safety information is well characterized.
Heart Guard combines four ingredients with varying evidence and real interaction risks, especially if you take blood pressure medications, blood thinners, or heart drugs. Because the product's effectiveness for heart health is not well established and the interaction list is long, this is not a take-it-and-see situation.
Talk with your doctor or pharmacist before starting, especially if you have a heart condition or take 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 Feb 25, 2021.
This Scorecard evaluates available label information, ingredient evidence, and known medication-safety considerations. It does not independently verify product identity, purity, potency, contamination, or manufacturing quality. How these ratings are computed
General information
Key facts about Heart Guard, straight from the product label.
| Brand | KaraMD |
|---|---|
| Barcode (UPC) | X002ED18CB |
| Net contents | 60 Veggie Capsule(s) |
| Market status | On market |
| Date entered into DSLD | Feb 25, 2021 |
| DSLD ID | 243872 |
| Product type | Other Combinations |
| Supplement form | Capsule |
| Dietary claims / uses | All Other, Structure/Function |
| Intended target group(s) | Vegan, Vegetarian, Adult (18 - 50 Years) |
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.
Supplement Facts
The label details for Heart Guard by KaraMD, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Magnesium | 200 mg | -- |
| Grapeseed extract | 150 mg | -- |
| Nattokinase | 50 mg | -- |
| Hawthorne extract | 400 mg | -- |
Other ingredients: Vegetable Cellulose
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.
Brand IP Statement(s)
Copyright 2019
Suggested/Recommended/Usage/Directions
Suggested Use: Take 2 Heart Guard veggie capsules once a day with 8 fl oz of water.
Formulation
Heart Guard is made in the USA in our FDA Registered Facility using natural ingredients.
Helps protect essential heart functions
Non GMO
Vegan
Precautions
Consult your physician if you have any medical condition, you're pregnant/lactating or under 18, or if you're taking any medications.
Consult your physician if you have any medical condition, you're pregnant/lactating or under 18, or if you're taking any medications.
Do not use if safety seal is damaged or missing.
Keep out of reach of children.
Storage
Store in a cool, dry place
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.
FDA Statement of Identity
Heart Health Supplement
Seals/Symbols
Made in the USA
General Statements
90 Day Money Back Guarantee
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Heart Guard by KaraMD 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 Heart Guard by KaraMD
These are the 4 active ingredients this product is made of. Select any to open its full monograph.
Serving size2 Veggie Capsule(s) Dosage formCapsule Servings per container30 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.
Magnesium
Interacts with295 drugs
Magnesium is an essential mineral your body needs for muscles, nerves, blood pressure, and many other functions, and supplements are useful for preven...
Magnesium monograph & interactionsGrapeseed extract
Interacts with910 drugs
Grapes and grape products like grape seed extract contain antioxidant compounds such as resveratrol and proanthocyanidins that may support heart and b...
Grapeseed extract monograph & interactionsNattokinase
Interacts with289 drugs
Nattokinase is an enzyme from the fermented soybean food natto that may have mild blood-thinning and blood-flow effects. Some small studies hint at be...
Nattokinase monograph & interactionsHawthorne extract
Interacts with191 drugs
Hawthorn is a plant traditionally used for heart-related complaints, and some studies suggest it may modestly help symptoms of mild heart failure when...
Hawthorne extract monograph & interactionsOther (inactive) ingredients: Vegetable Cellulose. These complete the product’s ingredient list but are not active constituents.
Heart Guard by KaraMD Drug Interactions
HelloPharmacist Interaction Report
Heart Guard by KaraMD contains four active ingredients—magnesium, grapeseed extract, nattokinase, and hawthorn extract—that together have documented interactions with medications.
The most serious concern is hawthorn extract with nitrates or phosphodiesterase-5 inhibitors (like sildenafil for erectile dysfunction), which could cause dangerous drops in blood pressure through additive vasodilation effects.
Read the full breakdown — every affected drug type, severity by severity
Magnesium interacts with multiple drug types, most critically with levodopa/carbidopa (a Parkinson's medication), which it can reduce by up to 35%, potentially weakening symptom control. It also affects skeletal muscle relaxants by increasing their strength and speed of action, potassium-sparing water pills by raising magnesium levels, blood pressure medications (calcium channel blockers), stomach acid reducers, diabetes drugs (sulfonylureas), antibiotics (quinolones), and bone-strengthening drugs (bisphosphonates).
Grapeseed extract may interact with several types of medications that your liver processes, including some blood thinners and the sedative midazolam. Nattokinase similarly carries a bleeding risk if combined with blood thinners or aspirin, and may lower blood pressure further when used with blood pressure medications.
Hawthorn extract adds to these concerns, potentially increasing bleeding risk with anticoagulants and amplifying the effects of beta-blockers, calcium channel blockers, and the heart medication digoxin.
Altogether, these interactions span 1,149 individual medications. Use the medication checker on this page to search your exact prescriptions before starting this product.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against Heart Guard?
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 Heart Guard interact with 1,148 drugs. Click any drug to see the details.
4 of the 4 ingredients in Heart Guard interact with drugs. Each result below shows which ingredient is responsible. Grapeseed extract Magnesium Nattokinase Hawthorne extract
AvanafilStendra
How Avanafil interacts with Heart Guard — through 2 ingredients. Tap an ingredient for the detail:
Hawthorne ExtractPhosphodiesterase-5 Inhibitors Major
Interaction Summary
Theoretically, concomitant use might result in additive vasodilation and hypotension.
Read the full Hawthorne Extract + Avanafil interactionGrapeseed ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
It is unclear if grape seed extract inhibits or induces CYP3A4; research is conflicting.
Read the full Grapeseed Extract + Avanafil interactionBenserazide, LevodopaMadopar, Prolopa
How Benserazide, Levodopa interacts with Heart Guard — through 1 ingredient. Tap an ingredient for the detail:
MagnesiumLevodopa/carbidopa (sinemet) Major
Interaction Summary
Magnesium can reduce the bioavailability of levodopa/carbidopa.
Read the full Magnesium + Benserazide, Levodopa interactionCarbidopaLodosyn
How Carbidopa interacts with Heart Guard — through 1 ingredient. Tap an ingredient for the detail:
MagnesiumLevodopa/carbidopa (sinemet) Major
Interaction Summary
Magnesium can reduce the bioavailability of levodopa/carbidopa.
Read the full Magnesium + Carbidopa interactionCarbidopa, LevodopaDhivy, Rytary, Sinemet, Sinemet CR
How Carbidopa, Levodopa interacts with Heart Guard — through 1 ingredient. Tap an ingredient for the detail:
MagnesiumLevodopa/carbidopa (sinemet) Major
Interaction Summary
Magnesium can reduce the bioavailability of levodopa/carbidopa.
Read the full Magnesium + Carbidopa, Levodopa interactionCarbidopa, Levodopa, EntacaponeStalevo
How Carbidopa, Levodopa, Entacapone interacts with Heart Guard — through 1 ingredient. Tap an ingredient for the detail:
MagnesiumLevodopa/carbidopa (sinemet) Major
Interaction Summary
Magnesium can reduce the bioavailability of levodopa/carbidopa.
Read the full Magnesium + Carbidopa, Levodopa, Entacapone interactionFinasteride, TadalafilEntadfi
How Finasteride, Tadalafil interacts with Heart Guard — through 2 ingredients. Tap an ingredient for the detail:
Hawthorne ExtractPhosphodiesterase-5 Inhibitors Major
Interaction Summary
Theoretically, concomitant use might result in additive vasodilation and hypotension.
Read the full Hawthorne Extract + Finasteride, Tadalafil interactionGrapeseed ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
It is unclear if grape seed extract inhibits or induces CYP3A4; research is conflicting.
Read the full Grapeseed Extract + Finasteride, Tadalafil interactionGlyceryl TrinitrateNitronal
How Glyceryl Trinitrate interacts with Heart Guard — through 1 ingredient. Tap an ingredient for the detail:
Hawthorne ExtractNitrates Major
Interaction Summary
Theoretically, concomitant use might cause additive coronary vasodilatory effects.
Read the full Hawthorne Extract + Glyceryl Trinitrate interactionIsosorbide DinitrateAngitak, Cedocard Retard, Isoket, Isoket Retard, Isordil
How Isosorbide Dinitrate interacts with Heart Guard — through 1 ingredient. Tap an ingredient for the detail:
Hawthorne ExtractNitrates Major
Interaction Summary
Theoretically, concomitant use might cause additive coronary vasodilatory effects.
Read the full Hawthorne Extract + Isosorbide Dinitrate interactionIsosorbide Dinitrate, HydralazineBiDil
How Isosorbide Dinitrate, Hydralazine interacts with Heart Guard — through 2 ingredients. Tap an ingredient for the detail:
Hawthorne ExtractNitrates Major
Interaction Summary
Theoretically, concomitant use might cause additive coronary vasodilatory effects.
Read the full Hawthorne Extract + Isosorbide Dinitrate, Hydralazine interactionNattokinaseAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, nattokinase might increase the risk of hypotension when used with antihypertensive drugs.
Read the full Nattokinase + Isosorbide Dinitrate, Hydralazine interactionIsosorbide MononitrateAngeze, Angeze SR, Chemydur 60XL, Dynamin, Elantan, Elantan LA +13 more
How Isosorbide Mononitrate interacts with Heart Guard — through 1 ingredient. Tap an ingredient for the detail:
Hawthorne ExtractNitrates Major
Interaction Summary
Theoretically, concomitant use might cause additive coronary vasodilatory effects.
Read the full Hawthorne Extract + Isosorbide Mononitrate interactionLevodopaInbrija, Larodopa
How Levodopa interacts with Heart Guard — through 1 ingredient. Tap an ingredient for the detail:
MagnesiumLevodopa/carbidopa (sinemet) Major
Interaction Summary
Magnesium can reduce the bioavailability of levodopa/carbidopa.
Read the full Magnesium + Levodopa interactionLevodopa, CarbidopaDuodopa
How Levodopa, Carbidopa interacts with Heart Guard — through 1 ingredient. Tap an ingredient for the detail:
MagnesiumLevodopa/carbidopa (sinemet) Major
Interaction Summary
Magnesium can reduce the bioavailability of levodopa/carbidopa.
Read the full Magnesium + Levodopa, Carbidopa interactionMacitentan, TadalafilOpsynvi
How Macitentan, Tadalafil interacts with Heart Guard — through 3 ingredients. Tap an ingredient for the detail:
Hawthorne ExtractPhosphodiesterase-5 Inhibitors Major
Interaction Summary
Theoretically, concomitant use might result in additive vasodilation and hypotension.
Read the full Hawthorne Extract + Macitentan, Tadalafil interactionNattokinaseAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, nattokinase might increase the risk of hypotension when used with antihypertensive drugs.
Read the full Nattokinase + Macitentan, Tadalafil interactionGrapeseed ExtractCytochrome P450 2c9 (cyp2c9) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
It is unclear if grape juice or grape seed extract inhibits CYP2C9; research is conflicting.
Read the full Grapeseed Extract + Macitentan, Tadalafil interactionNicorandilAprior, Dancor, Ikorel, Sigmart, Zynicor
How Nicorandil interacts with Heart Guard — through 1 ingredient. Tap an ingredient for the detail:
Hawthorne ExtractNitrates Major
Interaction Summary
Theoretically, concomitant use might cause additive coronary vasodilatory effects.
Read the full Hawthorne Extract + Nicorandil interactionNitroglycerinGonitro, Nitro Time, Nitro-Bid, Nitrocine Timecaps, Nitrogard, Nitrogard SR +7 more
How Nitroglycerin interacts with Heart Guard — through 1 ingredient. Tap an ingredient for the detail:
Hawthorne ExtractNitrates Major
Interaction Summary
Theoretically, concomitant use might cause additive coronary vasodilatory effects.
Read the full Hawthorne Extract + Nitroglycerin interactionPentaerythritol TetranitratePeritrate, Peritrate SA
How Pentaerythritol Tetranitrate interacts with Heart Guard — through 1 ingredient. Tap an ingredient for the detail:
Hawthorne ExtractNitrates Major
Interaction Summary
Theoretically, concomitant use might cause additive coronary vasodilatory effects.
Read the full Hawthorne Extract + Pentaerythritol Tetranitrate interactionSildenafilRevatio
How Sildenafil interacts with Heart Guard — through 2 ingredients. Tap an ingredient for the detail:
Hawthorne ExtractPhosphodiesterase-5 Inhibitors Major
Interaction Summary
Theoretically, concomitant use might result in additive vasodilation and hypotension.
Read the full Hawthorne Extract + Sildenafil interactionGrapeseed ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 2c9 (cyp2c9) Substrates Moderate
Interaction Summary
It is unclear if grape seed extract inhibits or induces CYP3A4; research is conflicting.
Read the full Grapeseed Extract + Sildenafil interactionSildenafil CitrateViagra
How Sildenafil Citrate interacts with Heart Guard — through 2 ingredients. Tap an ingredient for the detail:
Hawthorne ExtractPhosphodiesterase-5 Inhibitors Major
Interaction Summary
Theoretically, concomitant use might result in additive vasodilation and hypotension.
Read the full Hawthorne Extract + Sildenafil Citrate interactionGrapeseed ExtractCytochrome P450 2c9 (cyp2c9) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
It is unclear if grape juice or grape seed extract inhibits CYP2C9; research is conflicting.
Read the full Grapeseed Extract + Sildenafil Citrate interactionTadalafilCialis, Tadliq
How Tadalafil interacts with Heart Guard — through 2 ingredients. Tap an ingredient for the detail:
Hawthorne ExtractPhosphodiesterase-5 Inhibitors Major
Interaction Summary
Theoretically, concomitant use might result in additive vasodilation and hypotension.
Read the full Hawthorne Extract + Tadalafil interactionGrapeseed ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
It is unclear if grape seed extract inhibits or induces CYP3A4; research is conflicting.
Read the full Grapeseed Extract + Tadalafil interactionVardenafilLevitra, Staxyn
How Vardenafil interacts with Heart Guard — through 2 ingredients. Tap an ingredient for the detail:
Hawthorne ExtractPhosphodiesterase-5 Inhibitors Major
Interaction Summary
Theoretically, concomitant use might result in additive vasodilation and hypotension.
Read the full Hawthorne Extract + Vardenafil interactionGrapeseed ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
It is unclear if grape seed extract inhibits or induces CYP3A4; research is conflicting.
Read the full Grapeseed Extract + Vardenafil interactionAdo-trastuzumab EmtansineKadcyla
How Ado-trastuzumab Emtansine interacts with Heart Guard — through 1 ingredient. Tap an ingredient for the detail:
Grapeseed ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
It is unclear if grape seed extract inhibits or induces CYP3A4; research is conflicting.
Read the full Grapeseed Extract + Ado-trastuzumab Emtansine interactionAbciximabReoPro
How Abciximab interacts with Heart Guard — through 4 ingredients. Tap an ingredient for the detail:
NattokinaseAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Nattokinase might increase the risk of bleeding when used with anticoagulant/antiplatelet drugs.
Read the full Nattokinase + Abciximab interactionHawthorne ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, hawthorn may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Hawthorne Extract + Abciximab interactionGrapeseed ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, grape extracts may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Grapeseed Extract + Abciximab interactionMagnesiumAnticoagulant/antiplatelet Drugs Minor
Interaction Summary
Theoretically, magnesium may have antiplatelet effects, but the evidence is conflicting.
Read the full Magnesium + Abciximab interactionAbemaciclibVerzenio
How Abemaciclib interacts with Heart Guard — through 1 ingredient. Tap an ingredient for the detail:
Grapeseed ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
It is unclear if grape seed extract inhibits or induces CYP3A4; research is conflicting.
Read the full Grapeseed Extract + Abemaciclib interactionAbiraterone
How Abiraterone interacts with Heart Guard — through 1 ingredient. Tap an ingredient for the detail:
Grapeseed ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
It is unclear if grape seed extract inhibits or induces CYP3A4; research is conflicting.
Read the full Grapeseed Extract + Abiraterone interactionAbiraterone AcetateYonsa, Zytiga
How Abiraterone Acetate interacts with Heart Guard — through 1 ingredient. Tap an ingredient for the detail:
Grapeseed ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
It is unclear if grape seed extract inhibits or induces CYP3A4; research is conflicting.
Read the full Grapeseed Extract + Abiraterone Acetate interactionAbrocitinibCibinqo
How Abrocitinib interacts with Heart Guard — through 4 ingredients. Tap an ingredient for the detail:
Grapeseed ExtractCytochrome P450 2c9 (cyp2c9) Substrates, Anticoagulant/antiplatelet Drugs Moderate
Interaction Summary
It is unclear if grape juice or grape seed extract inhibits CYP2C9; research is conflicting.
Read the full Grapeseed Extract + Abrocitinib interactionNattokinaseAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Nattokinase might increase the risk of bleeding when used with anticoagulant/antiplatelet drugs.
Read the full Nattokinase + Abrocitinib interactionHawthorne ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, hawthorn may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Hawthorne Extract + Abrocitinib interactionMagnesiumAnticoagulant/antiplatelet Drugs Minor
Interaction Summary
Theoretically, magnesium may have antiplatelet effects, but the evidence is conflicting.
Read the full Magnesium + Abrocitinib interactionAcalabrutinibCalquence
How Acalabrutinib interacts with Heart Guard — through 1 ingredient. Tap an ingredient for the detail:
Grapeseed ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
It is unclear if grape seed extract inhibits or induces CYP3A4; research is conflicting.
Read the full Grapeseed Extract + Acalabrutinib interactionAcebutololRhotral, Sectral
How Acebutolol interacts with Heart Guard — through 2 ingredients. Tap an ingredient for the detail:
NattokinaseAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, nattokinase might increase the risk of hypotension when used with antihypertensive drugs.
Read the full Nattokinase + Acebutolol interactionHawthorne ExtractBeta-blockers Moderate
Interaction Summary
Theoretically, concomitant use might cause additive effects on blood pressure and heart rate.
Read the full Hawthorne Extract + Acebutolol interactionAcenocoumarolSintrom
How Acenocoumarol interacts with Heart Guard — through 4 ingredients. Tap an ingredient for the detail:
Grapeseed ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, grape extracts may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Grapeseed Extract + Acenocoumarol interactionHawthorne ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, hawthorn may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Hawthorne Extract + Acenocoumarol interactionNattokinaseAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Nattokinase might increase the risk of bleeding when used with anticoagulant/antiplatelet drugs.
Read the full Nattokinase + Acenocoumarol interactionMagnesiumAnticoagulant/antiplatelet Drugs Minor
Interaction Summary
Theoretically, magnesium may have antiplatelet effects, but the evidence is conflicting.
Read the full Magnesium + Acenocoumarol interactionAcetaminophenChildren's Tylenol, Children's Tylenol Meltaways, Tylenol, Tylenol Ex Strength
How Acetaminophen interacts with Heart Guard — through 1 ingredient. Tap an ingredient for the detail:
Grapeseed ExtractCytochrome P450 2e1 (cyp2e1) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, grape seed extract might increase the levels of CYP2E1 substrates.
Read the full Grapeseed Extract + Acetaminophen interactionEach ingredient & the kinds of drugs it affects
For each ingredient in Heart Guard 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.
Grapeseed extract
Anticoagulant/Antiplatelet Drugs
Theoretically, grape extracts may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
In vitro evidence suggests that grape extracts might decrease platelet aggregation.
Cyclosporine (Neoral, Sandimmune)
Ingesting grape juice with cyclosporine can reduce cyclosporine absorption.
A small pharmacokinetic study in healthy young adults shows that intake of purple grape juice 200 mL along with cyclosporine can decrease the absorption of cyclosporine by up to 30% when compared with water. Separate doses of grape juice and cyclosporine by at least 2 hours to avoid this interaction.
Cytochrome P450 1A2 (Cyp1A2) Substrates
Theoretically, grape juice might reduce the levels of CYP1A2 substrates.
A small pharmacokinetic study in healthy adults shows that ingestion of 200 mL of grape juice decreases phenacetin plasma levels. This is thought to be due to induction of CYP1A2.
Cytochrome P450 2D6 (Cyp2D6) Substrates
Theoretically, grape seed extract may increase the levels of CYP2D6 substrates.
In vitro evidence suggests that grape seed extract might inhibit CYP2D6 enzymes. However, this interaction has not been reported in humans.
Cytochrome P450 2E1 (Cyp2E1) Substrates
Theoretically, grape seed extract might increase the levels of CYP2E1 substrates.
In vitro and animal research suggests that grape seed proanthocyanidin extract inhibits CYP2E1 enzymes. However, this interaction has not been reported in humans.
Cytochrome P450 3A4 (Cyp3A4) Substrates
It is unclear if grape seed extract inhibits or induces CYP3A4; research is conflicting.
In vitro evidence suggests that grape seed extract might inhibit CYP3A4 enzymes. However, evidence from animal research shows that grape seed extract may induce CYP3A4 in the liver. So far, these interactions have not been reported in humans.
Midazolam (Versed)
Theoretically, long-term intake of grape seed extract might decrease the effects of midazolam.
Animal research shows that subchronic ingestions of grape seed extract can increase the elimination of intravenous midazolam by increasing hepatic CYP3A4 activity. Single doses of grape seed extract do not appear to affect midazolam elimination.
Phenacetin
Grape juice might decrease phenacetin absorption.
A small pharmacokinetic study in healthy adults shows that ingestion of 200 mL of grape juice decreases phenacetin plasma levels. This is thought to be due to induction of cytochrome P450 1A2 (CYP1A2).
Cytochrome P450 2C9 (Cyp2C9) Substrates
It is unclear if grape juice or grape seed extract inhibits CYP2C9; research is conflicting.
In vitro evidence shows that grape seed extract or grape juice might inhibit CYP2C9 enzymes. However, a small pharmacokinetic study in healthy adults shows that drinking 8 ounces of grape juice once does not affect the clearance of flurbiprofen, a probe-drug for CYP2C9 metabolism. The effects of continued grape juice consumption are unclear.
Magnesium
Levodopa/Carbidopa (Sinemet)
Magnesium can reduce the bioavailability of levodopa/carbidopa.
Clinical research in healthy volunteers shows that taking magnesium oxide 1000 mg with levodopa 100 mg/carbidopa 10 mg reduces the area under the curve (AUC) of levodopa by 35% and of carbidopa by 81%. In vitro and animal research shows that magnesium produces an alkaline environment in the digestive tract, which might lead to degradation and reduced bioavailability of levodopa/carbidopa.
Aminoglycoside Antibiotics
Concomitant use of aminoglycoside antibiotics and magnesium can increase the risk for neuromuscular weakness.
Both aminoglycosides and magnesium reduce presynaptic acetylcholine release, which can lead to neuromuscular blockade and possible paralysis. This is most likely to occur with high doses of magnesium given intravenously.
Antacids
Use of acid reducers may reduce the laxative effect of magnesium oxide.
A retrospective analysis shows that, in the presence of H2 receptor antagonists (H2RAs) or proton pump inhibitors (PPIs), a higher dose of magnesium oxide is needed for a laxative effect. This may also occur with antacids. Under acidic conditions, magnesium oxide is converted to magnesium chloride and then to magnesium bicarbonate, which has an osmotic laxative effect. By reducing acidity, antacids may reduce the conversion of magnesium oxide to the active bicarbonate salt.
Bictegravir/Emtricitabine/Tenofovir Alafenamide (Biktarvy)
Magnesium might decrease levels of bictegravir/emtricitabine/tenofovir alafenamide by reducing its absorption.
Advise patients that bictegravir/emtricitabine/tenofovir alafenamide should be taken at least 2 hours before or 6 hours after magnesium containing products.
Bisphosphonates
Magnesium can decrease absorption of bisphosphonates.
Cations, including magnesium, can decrease bisphosphonate absorption. Advise patients to separate doses of magnesium and these drugs by at least 2 hours.
Calcium Channel Blockers
Magnesium can have additive effects with calcium channel blockers, although evidence is conflicting.
Magnesium inhibits calcium entry into smooth muscle cells and may therefore have additive effects with calcium channel blockers. Severe hypotension and neuromuscular blockades may occur when nifedipine is used with intravenous magnesium, although some contradictory evidence suggests that concurrent use of magnesium with nifedipine does not increase the risk of neuromuscular weakness. High doses of magnesium could theoretically have additive effects with other calcium channel blockers.
Digoxin
Magnesium salts may reduce absorption of digoxin.
Clinical evidence suggests that treatment with oral magnesium hydroxide or magnesium trisilicate reduces absorption of digoxin from the intestines. This may reduce the blood levels of digoxin and decrease its therapeutic effects.
Potassium-Sparing Diuretics
Potassium-sparing diuretics decrease excretion of magnesium, possibly increasing magnesium levels.
Potassium-sparing diuretics also have magnesium-sparing properties, which can counteract the magnesium losses associated with loop and thiazide diuretics. Theoretically, increased magnesium levels could result from concomitant use of potassium-sparing diuretics and magnesium supplements.
Quinolone Antibiotics
Magnesium decreases absorption of quinolones.
Magnesium can form insoluble complexes with quinolones and decrease their absorption. Advise patients to take these drugs at least 2 hours before, or 4 to 6 hours after, magnesium supplements.
Skeletal Muscle Relaxants
Parenteral magnesium alters the pharmacokinetics of skeletal muscle relaxants, increasing their effects and accelerating the onset of effect.
Parenteral magnesium shortens the time to onset of skeletal muscle relaxants by about 1 minute and prolongs the duration of action by about 2 minutes. Magnesium potentiates the effects of skeletal muscle relaxants by decreasing calcium-mediated release of acetylcholine from presynaptic nerve terminals, reducing postsynaptic sensitivity to acetylcholine, and having a direct effect on the membrane potential of myocytes. Magnesium also has vasodilatory actions and increases cardiac output, allowing a greater amount of muscle relaxant to reach the motor end plate. A clinical study found that low-dose rocuronium (0.45 mg/kg), when given after administration of magnesium 30 mg/kg over 10 minutes, has an accelerated onset of effect, which matches the onset of effect seen with a full-dose rocuronium regimen (0.6 mg/kg). In another clinical study, onset times for rocuronium doses of 0.3, 0.6, and 1.2 mg/kg were 86, 76, and 50 seconds, respectively, when given alone, but were reduced to 66, 44, and 38 seconds, respectively, when the doses were given after a 15-minute infusion of magnesium sulfate 60 mg/kg. Giving intraoperative intravenous magnesium sulfate, 50 mg/kg loading dose followed by 15 mg/kg/hour, reduces the onset time of rocuronium, enhances its clinical effects, reduces the dose of intraoperative opiates, and prolongs the spontaneous recovery time. It does not affect the activity of subsequently administered neostigmine.
Sulfonylureas
Magnesium increases the systemic absorption of sulfonylureas, increasing their effects and side effects.
Clinical research shows that administration of magnesium hydroxide with glyburide increases glyburide absorption, increases maximal insulin response by 35-fold, and increases the risk of hypoglycemia, when compared with glyburide alone. A similar interaction occurs between magnesium hydroxide and glipizide. The mechanism of this effect appears to be related to the elevation of gastrointestinal pH by magnesium-based antacids, increasing solubility and enhancing absorption of sulfonylureas.
Tetracycline Antibiotics
Magnesium decreases absorption of tetracyclines.
Magnesium can form insoluble complexes with tetracyclines in the gut and decrease their absorption and antibacterial activity. Advise patients to take these drugs 1 hour before or 2 hours after magnesium supplements.
Anticoagulant/Antiplatelet Drugs
Theoretically, magnesium may have antiplatelet effects, but the evidence is conflicting.
In vitro evidence shows that magnesium sulfate inhibits platelet aggregation, even at low concentrations. Some preliminary clinical evidence shows that infusion of magnesium sulfate increases bleeding time by 48% and reduces platelet activity. However, other clinical research shows that magnesium does not affect platelet aggregation, although inhibition of platelet-dependent thrombosis can occur.
Gabapentin (Neurontin)
Gabapentin absorption can be decreased by magnesium.
Clinical research shows that giving magnesium oxide orally along with gabapentin decreases the maximum plasma concentration of gabapentin by 33%, time to maximum concentration by 36%, and area under the curve by 43%. Advise patients to take gabapentin at least 2 hours before, or 4 to 6 hours after, magnesium supplements.
Sevelamer (Renagel, Renvela)
Sevelamer may increase serum magnesium levels.
In patients on hemodialysis, sevelamer use was associated with a 0.28 mg/dL increase in serum magnesium. The mechanism of this interaction remains unclear.
Nattokinase
Anticoagulant/Antiplatelet Drugs
Nattokinase might increase the risk of bleeding when used with anticoagulant/antiplatelet drugs.
Nattokinase has thrombolytic and anticoagulant effects. There is a case report of intracranial hemorrhage in a patient who added nattokinase to aspirin therapy.
Antihypertensive Drugs
Theoretically, nattokinase might increase the risk of hypotension when used with antihypertensive drugs.
Some clinical research suggests that nattokinase may reduce systolic and diastolic blood pressure.
Hawthorne extract
Nitrates
Theoretically, concomitant use might cause additive coronary vasodilatory effects.
Some evidence shows that hawthorn might lower blood pressure due to vasodilatory effects.
Phosphodiesterase-5 Inhibitors
Theoretically, concomitant use might result in additive vasodilation and hypotension.
Hawthorn might inhibit PDE-5 and cause vasodilation.
Anticoagulant/Antiplatelet Drugs
Theoretically, hawthorn may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
In vitro and animal research shows that hawthorn can inhibit platelet aggregation. However, its effect in humans is unclear. One observational study shows that patients taking hawthorn shortly before undergoing coronary artery bypass graft (CABG) surgery or valve replacement surgery have a 10% incidence of postoperative bleeding, compared with 1% in those who never consumed hawthorn extract. However, clinical research shows that taking a specific preparation of dried hawthorn leaves and flowers (Crataesor, Soria Natural Lab) 800 mg three times daily for 15 days does not affect platelet aggregation or levels of thromboxane B2, the metabolite of thromboxane A2, in healthy humans.
Beta-Blockers
Theoretically, concomitant use might cause additive effects on blood pressure and heart rate.
Some evidence shows that hawthorn might lower blood pressure and heart rate.
Calcium Channel Blockers
Theoretically, concomitant use might cause additive coronary vasodilation and hypotensive effects.
Some evidence shows that hawthorn might lower blood pressure due to vasodilatory effects.
Digoxin (Lanoxin)
Theoretically, hawthorn might potentiate the effects and adverse effects of digoxin.
Hawthorn appears to improve cardiac output; however, hawthorn does not appear to affect digoxin pharmacokinetics. Case reports suggest that at least one species of hawthorn root extract (Crataegus mexicana) may produce adverse effects similar to digoxin and can cross-react with digoxin assays, leading to falsely elevated plasma digoxin levels.
Brand information
Manufacturer and brand details for Heart Guard, from the product label.
KaraMD
See all KaraMD products- Name
- KaraMD, Inc
- Street Address
- 3100 East 45th Street Suite 234 #109
- City
- Cleveland
- State
- OH
- ZipCode
- 44127
- Phone Number
- (800) 991-4518
- Web Address
- KaraMD.com
Heart Guard by KaraMD: Common Questions
Does Heart Guard by KaraMD interact with any medications?
How can one product interact with so many drugs?
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Can I take this while pregnant or breastfeeding?
What is nattokinase and why is it in this product?
Does magnesium in this product help lower blood pressure?
Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
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Label information is sourced from the NIH Dietary Supplement Label Database and reflects the product version on file; always read your actual product label. This page is for education only and is not a substitute for professional medical advice. Confirm with your pharmacist or doctor before combining supplements and medications.
The Full Monographs Behind Heart Guard’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Magnesium
Interacts with 295 drugsMagnesium is an essential mineral your body needs for muscles, nerves, blood pressure, and many other functions, and supplements are useful for preventing or correcting deficiency. Some othe...
Read the full Magnesium monograph → Herb & supplement monographGrape
Interacts with 910 drugsGrapes and grape products like grape seed extract contain antioxidant compounds such as resveratrol and proanthocyanidins that may support heart and blood vessel health. While the food is he...
Read the full Grape monograph → Herb & supplement monographNattokinase
Interacts with 289 drugsNattokinase is an enzyme from the fermented soybean food natto that may have mild blood-thinning and blood-flow effects. Some small studies hint at benefits for blood pressure and circulatio...
Read the full Nattokinase monograph → Herb & supplement monographHawthorn
Interacts with 191 drugsHawthorn is a plant traditionally used for heart-related complaints, and some studies suggest it may modestly help symptoms of mild heart failure when added to standard care. However, the ev...
Read the full Hawthorn monograph →Sources & How We Checked
Heart Guard'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 150 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.
Magnesium 82 references
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- Hansten PD, Horn JR. Drug Interactions Analysis and Management. Vancouver, WA: Applied Therapeutics Inc., 1997 and updates.
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- Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride. Washington, DC: National Academy Press, 1999. Available at: http://books.nap.edu/books/0309063507/html/index.html.
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- Neuvonen PJ, Kivistö KT. Enhancement of drug absorption by antacids. An unrecognised drug interaction. Clin Pharmacokinet. 1994;27(2):120-8. PubMed
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- Enayati A, Gin JH, Sajeev JK, et al. Efficacy of intravenous magnesium for the management of non-post operative atrial fibrillation with rapid ventricular response: A systematic review and meta-analysis. J Cardiovasc Electrophysiol 2023;34(5):1286-1295. PubMed
- Su YH, Luo DC, Pang Y. Effects of intraoperative Magnesium sulfate infusion on emergency agitation during general anesthesia in patients undergoing radical mastectomy: a randomized controlled study. BMC Anesthesiol 2023;23(1):326. PubMed
- Han J, Park HY, Shin HJ, Chung SH, Do SH. Effects of magnesium sulphate on neostigmine-induced recovery from moderate neuromuscular blockade with rocuronium: a randomized controlled trial. Magnes Res 2023;36(2):31-39. PubMed
- Lee AT, Cordova JC, Jamplis RP, Pomicter GR. Posterior Reversible Encephalopathy Syndrome and Eclampsia in the Setting of Magnesium Toxicity: A Case Report. A A Pract 2023;17(11):e01726. PubMed
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- Shepherd ES, Goldsmith S, Doyle LW, et al. Magnesium sulphate for women at risk of preterm birth for neuroprotection of the fetus. Cochrane Database Syst Rev 2024;5(5):CD004661. PubMed
- US Food and Drug Administration (FDA). Biktarvy Prescribing Information. October 2024. Available at: https://www.accessdata.fda.gov/drugsatfda_docs/label/2024/210251Orig1s020lbl.pdf. Accessed July 16, 2025.
Grape 34 references
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- Xiao Dong S, Zhi Ping Z, Zhong Xiao W, et al. Possible enhancement of the first-pass metabolism of phenacetin by ingestion of grape juice in Chinese subjects. Br J Clin Pharmacol 1999;48:638-40. PubMed
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- Chevallier A. The Encyclopedia of Medicinal Plants. London, UK: Dorling Kindersley, Ltd., 1996.
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- Greenblatt DJ, von Moltke LL, Perloff ES, et al. Interaction of flurbiprofen with cranberry juice, grape juice, tea, and fluconazole: in vitro and clinical studies. Clin Pharmacol Ther 2006;79:125-33. PubMed
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- Ray, S. D., Parikh, H., Hickey, E., Bagchi, M., and Bagchi, D. Differential effects of IH636 grape seed proanthocyanidin extract and a DNA repair modulator 4-aminobenzamide on liver microsomal cytochrome 4502E1-dependent aniline hydroxylation. Mol Cell B PubMed
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