Heart Strong Ingredients & Drug Interactions
What is this page for?
First and foremost: checking Heart Strong 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 Strong is a dietary supplement by Redd Remedies with 6 active ingredients. Its ingredients are commonly taken for heart health, statin-related muscle aches, migraine prevention.Based on those ingredients, 1,447 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are White Panax Ginseng (Panax ginseng) root extract, Arjuna (Terminalia arguna) bark extract, Magnesium. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against Heart Strong by Redd Remedies
Ask about any prescription or over-the-counter medication and we check it for interactions with Heart Strong by Redd Remedies — 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 Heart Strong by Redd Remedies
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
Partial disclosure
Heart Strong contains six active ingredients. Coenzyme Q10 is an antioxidant made naturally by your body and found in food; it supports cellular energy production.
Acetyl L-carnitine is a compound that helps move fatty acids into mitochondria (your cells' energy factories) to fuel energy production. Magnesium is a mineral involved in muscle and nerve function, bone health, and energy metabolism.
Hawthorn berry, leaf, and flower extract comes from a plant traditionally used to support heart health. Arjuna bark extract is an herb from Ayurvedic medicine thought to support cardiovascular function.
White Panax ginseng root extract is a traditional herbal adaptogen used in Chinese medicine for stamina and vitality. The product also contains inactive ingredients—stearic acid, microcrystalline cellulose, modified cellulose gum, magnesium stearate, and silicon dioxide—which serve as binders, fillers, and capsule material.
Does it work?
Strong evidence
Our data shows limited evidence for most of what this blend is intended to do. Coenzyme Q10 is likely effective for coenzyme Q10 deficiency, and possibly effective for fibromyalgia, migraine, congestive heart failure, and diabetic nerve pain.
Acetyl L-carnitine is possibly effective for age-related mental decline, Alzheimer disease, alcohol use disorder, diabetic nerve pain, and depression. Magnesium is effective for indigestion and constipation, and effective for low blood magnesium (hypomagnesemia) and pre-eclampsia in pregnancy.
For the other three ingredients—hawthorn, arjuna, and panax ginseng—the evidence in our data is rated insufficient to reliably establish how well they work for heart conditions, high cholesterol, high blood pressure, or angina. Panax ginseng is possibly effective for erectile dysfunction, sexual arousal, influenza, mental focus, and multiple sclerosis-related fatigue.
Because the product combines these ingredients, we cannot estimate an overall effectiveness rating; each ingredient's actual benefit depends on your individual situation and the dose you're taking.
How safe is it?
Well-documented data
Coenzyme Q10 is generally well tolerated; gastrointestinal side effects like nausea, diarrhea, and heartburn occur in fewer than 1% of users. Rarely, headache, dizziness, insomnia, or skin itching have been reported.
Acetyl L-carnitine is generally well tolerated short-term, though long-term safety isn't fully established. Common side effects include agitation, dry mouth, headache, insomnia, and reduced appetite; some users report a fishy odor to urine, breath, or sweat.
Magnesium is generally well tolerated; the most common effect is diarrhea and mild gastrointestinal upset. For pregnancy: coenzyme Q10 lacks enough safety data—talk with your doctor before using.
Acetyl L-carnitine should be avoided in pregnancy; safety while breastfeeding is unknown. Magnesium is needed during pregnancy but should be used only under your doctor's guidance; normal dietary amounts are fine while breastfeeding, though check with your doctor before supplementing.
Hawthorn, arjuna, and panax ginseng all lack sufficient safety data in pregnancy and breastfeeding—the safety notes advise against use unless your doctor advises otherwise.
Meds to double-check
Major interaction found
Before you take Heart Strong, double-check the following medication types with your own doctor or pharmacist: Parkinson's drugs (levodopa/carbidopa), particularly important because magnesium can cut absorption by over one-third; blood thinners (warfarin, acenocoumarol) and anticoagulant/antiplatelet drugs, which several ingredients may affect; blood pressure drugs including calcium channel blockers, beta-blockers, and nitrates; diabetes medications and insulin; antidepressants and serotonergic drugs; thyroid hormone replacement; skeletal muscle relaxants; and any drug metabolized by the liver enzymes CYP2D6, CYP2C9, or CYP3A4—a category that includes hundreds of medications. No interactions are documented for any ingredient we could not check.
Use the interaction search tool on this page to verify your specific prescriptions.
The bottom line
Scorecard at a glancePartially disclosed formula with clinical evidence supporting its stated purpose. Major medication interactions have been identified, and safety information is well characterized.
Heart Strong combines ingredients with a long history in traditional and herbal medicine, though the evidence for most heart-health claims is not yet established in our data. If you take any prescription medications—especially blood thinners, diabetes drugs, blood pressure medications, Parkinson drugs, antidepressants, or any sedatives—you need to check your exact medications before starting this product, because the interactions are numerous and some are serious.
Talk with your doctor or pharmacist about whether this supplement makes sense for you and your current medications.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 6 of 6 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Jan 25, 2016.
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 Strong, straight from the product label.
| Brand | Redd Remedies |
|---|---|
| Barcode (UPC) | 855735001293 |
| Net contents | 60 Tablet(s) |
| Market status | On market |
| Date entered into DSLD | Jan 25, 2016 |
| DSLD ID | 56118 |
| Product type | Other Combinations |
| Supplement form | Tablet Or Pill |
| Dietary claims / uses | All Other, Structure/Function |
| Intended target group(s) | Vegetarian, Adult (18 - 50 Years), Gluten Free, Dairy Free, Sugar 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 Heart Strong by Redd Remedies, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Coenzyme Q10 | 50 mg | -- |
| Acetyl L-Carnitine | 200 mg | -- |
| Magnesium | 150 mg | 38% |
| Hawthorn (Crataegus sp.) berry, leaf & flower extract | 0 NP | -- |
| Arjuna (Terminalia arguna) bark extract | 0 NP | -- |
| White Panax Ginseng (Panax ginseng) root extract | 0 NP | -- |
| Heart Strong Blend | 400 mg | -- |
Other ingredients: Stearic Acid, Microcrystalline Cellulose, modified Cellulose Gum, Magnesium Stearate, Silicon Dioxide
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)
Putting Health In Order
HEART Strong is designed to provide targeted nutrients to support energy creation within the heart muscle; support overall heart muscle and cardiovascular function and defend the cardiovascular system against stress.
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.
General Statements
{tablet} Actual Size
reddremedies.com
Cardiovascular Foundation
~ Supports healthy heart muscle energy and function ~ Promotes cardiovascular health
Seals/Symbols
REDD REMEDIES
Vegetarian
Quality & Purity Guaranteed Laboratory Tested
FDA Statement of Identity
Dietary Supplement
Formulation
Gluten Free
CONTAINS NO: soy, sugar, yeast, wheat, gluten, corn, dairy products, artificial flavoring or coloring, preservatives or animal ingredients.
Precautions
WARNING: If pregnant, nursing, or taking prescription drugs, discuss all products used with a healthcare practitioner.
Suggested/Recommended/Usage/Directions
Suggested Use: 2 tablets daily with meals. Best taken in divided doses.
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Heart Strong by Redd Remedies 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 Strong by Redd Remedies
These are the 6 active ingredients this product is made of. Select any to open its full monograph.
Serving size2 Tablet(s) Dosage formTablet Or Pill 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.
Coenzyme Q10
Interacts with198 drugs
CoQ10 is a vitamin-like substance your body makes naturally that helps cells produce energy and acts as an antioxidant. It is generally well tolerated...
Coenzyme Q10 monograph & interactionsAcetyl L-Carnitine
Interacts with203 drugs
Acetyl-L-carnitine is a form of the amino acid carnitine that the body uses to help produce energy in cells. It is most studied for nerve pain and mem...
Acetyl L-Carnitine monograph & interactionsMagnesium
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 & interactionsOther (inactive) ingredients: Stearic Acid, Microcrystalline Cellulose, Modified Cellulose Gum, Magnesium Stearate, Silicon Dioxide. These complete the product’s ingredient list but are not active constituents.
Heart Strong by Redd Remedies Drug Interactions
HelloPharmacist Interaction Report
Heart Strong by Redd Remedies contains six active ingredients, and through its coenzyme Q10, acetyl L-carnitine, magnesium, hawthorn, arjuna, and panax ginseng content, it interacts with a substantial number of medications.
The most serious interaction is magnesium with levodopa/carbidopa (Sinemet), a Major-severity combination: magnesium reduces levodopa absorption by about 35%, which can significantly worsen Parkinson symptoms and treatment effectiveness.
Read the full breakdown — every affected drug type, severity by severity
Hawthorn and magnesium also carry Major-severity interactions. Hawthorn combined with nitrates (like nitroglycerin) or phosphodiesterase-5 inhibitors (ED drugs such as sildenafil/Viagra) risks excessive blood vessel relaxation and dangerous drops in blood pressure.
Magnesium affects skeletal muscle relaxants (heightening their strength and duration), potassium-sparing water pills, calcium channel blockers (blood pressure drugs), antacids, sulfonylureas (diabetes drugs), quinolone antibiotics, and bisphosphonates (bone drugs)—all rated Moderate. Coenzyme Q10 and acetyl L-carnitine each interact with blood thinners (warfarin/Coumadin) at Moderate severity, potentially reducing warfarin's protective effect.
Acetyl L-carnitine also affects serotonergic drugs (antidepressants, migraine treatments) and thyroid hormone replacement, both Moderate.
Arjuna can inhibit three major drug-metabolizing enzyme systems (CYP2D6, CYP2C9, CYP3A4), which theoretically increases levels and effects of hundreds of medications metabolized by these pathways—all rated Moderate. It also interacts with anticoagulants/antiplatelet drugs, diabetes medications, and two specific drugs: chlorzoxazone (a muscle relaxer) and omeprazole (a stomach acid reducer).
Panax ginseng affects midazolam (a sedative), CYP2D6 substrates, furosemide (a water pill), monoamine oxidase inhibitors (older antidepressants), selegiline (a Parkinson drug), insulin, raltegravir (an HIV drug), and warfarin—all Moderate severity. Coenzyme Q10 also carries a Minor interaction with blood pressure–lowering drugs, as it may amplify their effects.
Altogether, these interactions span 1,448 individual medications. Use the interaction checker below to search your exact prescriptions before starting this product, and discuss any potential overlaps with your doctor or pharmacist.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against Heart Strong?
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 Strong interact with 1,447 drugs. Click any drug to see the details.
6 of the 6 ingredients in Heart Strong interact with drugs. Each result below shows which ingredient is responsible. White Panax Ginseng (Panax ginseng) root extract Arjuna (Terminalia arguna) bark extract Magnesium Acetyl L-Carnitine Coenzyme Q10 Hawthorn (Crataegus sp.) berry, leaf & flower extract
AvanafilStendra
How Avanafil interacts with Heart Strong — through 3 ingredients. Tap an ingredient for the detail:
Hawthorn (crataegus Sp.) Berry, Leaf & Flower ExtractPhosphodiesterase-5 Inhibitors Major
Interaction Summary
Theoretically, concomitant use might result in additive vasodilation and hypotension.
Read the full Hawthorn (crataegus Sp.) Berry, Leaf & Flower Extract + Avanafil interactionArjuna (terminalia Arguna) Bark ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, use of Terminalia arjuna may increase the levels and clinical effects of CYP3A4 substrates.
Read the full Arjuna (terminalia Arguna) Bark Extract + Avanafil interactionWhite Panax Ginseng (panax Ginseng) Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, Panax ginseng might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full White Panax Ginseng (panax Ginseng) Root Extract + Avanafil interactionBenserazide, LevodopaMadopar, Prolopa
How Benserazide, Levodopa interacts with Heart Strong — 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 Strong — 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 Strong — 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 Strong — 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 Strong — through 3 ingredients. Tap an ingredient for the detail:
Hawthorn (crataegus Sp.) Berry, Leaf & Flower ExtractPhosphodiesterase-5 Inhibitors Major
Interaction Summary
Theoretically, concomitant use might result in additive vasodilation and hypotension.
Read the full Hawthorn (crataegus Sp.) Berry, Leaf & Flower Extract + Finasteride, Tadalafil interactionArjuna (terminalia Arguna) Bark ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, use of Terminalia arjuna may increase the levels and clinical effects of CYP3A4 substrates.
Read the full Arjuna (terminalia Arguna) Bark Extract + Finasteride, Tadalafil interactionWhite Panax Ginseng (panax Ginseng) Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, Panax ginseng might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full White Panax Ginseng (panax Ginseng) Root Extract + Finasteride, Tadalafil interactionGlyceryl TrinitrateNitronal
How Glyceryl Trinitrate interacts with Heart Strong — through 1 ingredient. Tap an ingredient for the detail:
Hawthorn (crataegus Sp.) Berry, Leaf & Flower ExtractNitrates Major
Interaction Summary
Theoretically, concomitant use might cause additive coronary vasodilatory effects.
Read the full Hawthorn (crataegus Sp.) Berry, Leaf & Flower Extract + Glyceryl Trinitrate interactionIsosorbide DinitrateAngitak, Cedocard Retard, Isoket, Isoket Retard, Isordil
How Isosorbide Dinitrate interacts with Heart Strong — through 1 ingredient. Tap an ingredient for the detail:
Hawthorn (crataegus Sp.) Berry, Leaf & Flower ExtractNitrates Major
Interaction Summary
Theoretically, concomitant use might cause additive coronary vasodilatory effects.
Read the full Hawthorn (crataegus Sp.) Berry, Leaf & Flower Extract + Isosorbide Dinitrate interactionIsosorbide Dinitrate, HydralazineBiDil
How Isosorbide Dinitrate, Hydralazine interacts with Heart Strong — through 2 ingredients. Tap an ingredient for the detail:
Hawthorn (crataegus Sp.) Berry, Leaf & Flower ExtractNitrates Major
Interaction Summary
Theoretically, concomitant use might cause additive coronary vasodilatory effects.
Read the full Hawthorn (crataegus Sp.) Berry, Leaf & Flower Extract + Isosorbide Dinitrate, Hydralazine interactionCoenzyme Q10Antihypertensive Drugs Minor
Interaction Summary
Theoretically, coenzyme Q10 might have additive effects with antihypertensive drugs.
Read the full Coenzyme Q10 + Isosorbide Dinitrate, Hydralazine interactionIsosorbide MononitrateAngeze, Angeze SR, Chemydur 60XL, Dynamin, Elantan, Elantan LA +13 more
How Isosorbide Mononitrate interacts with Heart Strong — through 1 ingredient. Tap an ingredient for the detail:
Hawthorn (crataegus Sp.) Berry, Leaf & Flower ExtractNitrates Major
Interaction Summary
Theoretically, concomitant use might cause additive coronary vasodilatory effects.
Read the full Hawthorn (crataegus Sp.) Berry, Leaf & Flower Extract + Isosorbide Mononitrate interactionLevodopaInbrija, Larodopa
How Levodopa interacts with Heart Strong — 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 Strong — 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 Strong — through 4 ingredients. Tap an ingredient for the detail:
Hawthorn (crataegus Sp.) Berry, Leaf & Flower ExtractPhosphodiesterase-5 Inhibitors Major
Interaction Summary
Theoretically, concomitant use might result in additive vasodilation and hypotension.
Read the full Hawthorn (crataegus Sp.) Berry, Leaf & Flower Extract + Macitentan, Tadalafil interactionWhite Panax Ginseng (panax Ginseng) Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, Panax ginseng might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full White Panax Ginseng (panax Ginseng) Root Extract + Macitentan, Tadalafil interactionArjuna (terminalia Arguna) Bark ExtractCytochrome P450 2c9 (cyp2c9) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, use of Terminalia arjuna may increase the levels and clinical effects of CYP2C9 substrates.
Read the full Arjuna (terminalia Arguna) Bark Extract + Macitentan, Tadalafil interactionCoenzyme Q10Antihypertensive Drugs Minor
Interaction Summary
Theoretically, coenzyme Q10 might have additive effects with antihypertensive drugs.
Read the full Coenzyme Q10 + Macitentan, Tadalafil interactionNicorandilAprior, Dancor, Ikorel, Sigmart, Zynicor
How Nicorandil interacts with Heart Strong — through 1 ingredient. Tap an ingredient for the detail:
Hawthorn (crataegus Sp.) Berry, Leaf & Flower ExtractNitrates Major
Interaction Summary
Theoretically, concomitant use might cause additive coronary vasodilatory effects.
Read the full Hawthorn (crataegus Sp.) Berry, Leaf & Flower Extract + Nicorandil interactionNitroglycerinGonitro, Nitro Time, Nitro-Bid, Nitrocine Timecaps, Nitrogard, Nitrogard SR +7 more
How Nitroglycerin interacts with Heart Strong — through 1 ingredient. Tap an ingredient for the detail:
Hawthorn (crataegus Sp.) Berry, Leaf & Flower ExtractNitrates Major
Interaction Summary
Theoretically, concomitant use might cause additive coronary vasodilatory effects.
Read the full Hawthorn (crataegus Sp.) Berry, Leaf & Flower Extract + Nitroglycerin interactionPentaerythritol TetranitratePeritrate, Peritrate SA
How Pentaerythritol Tetranitrate interacts with Heart Strong — through 1 ingredient. Tap an ingredient for the detail:
Hawthorn (crataegus Sp.) Berry, Leaf & Flower ExtractNitrates Major
Interaction Summary
Theoretically, concomitant use might cause additive coronary vasodilatory effects.
Read the full Hawthorn (crataegus Sp.) Berry, Leaf & Flower Extract + Pentaerythritol Tetranitrate interactionSildenafilRevatio
How Sildenafil interacts with Heart Strong — through 3 ingredients. Tap an ingredient for the detail:
Hawthorn (crataegus Sp.) Berry, Leaf & Flower ExtractPhosphodiesterase-5 Inhibitors Major
Interaction Summary
Theoretically, concomitant use might result in additive vasodilation and hypotension.
Read the full Hawthorn (crataegus Sp.) Berry, Leaf & Flower Extract + Sildenafil interactionArjuna (terminalia Arguna) Bark ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 2c9 (cyp2c9) Substrates Moderate
Interaction Summary
Theoretically, use of Terminalia arjuna may increase the levels and clinical effects of CYP3A4 substrates.
Read the full Arjuna (terminalia Arguna) Bark Extract + Sildenafil interactionWhite Panax Ginseng (panax Ginseng) Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, Panax ginseng might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full White Panax Ginseng (panax Ginseng) Root Extract + Sildenafil interactionSildenafil CitrateViagra
How Sildenafil Citrate interacts with Heart Strong — through 3 ingredients. Tap an ingredient for the detail:
Hawthorn (crataegus Sp.) Berry, Leaf & Flower ExtractPhosphodiesterase-5 Inhibitors Major
Interaction Summary
Theoretically, concomitant use might result in additive vasodilation and hypotension.
Read the full Hawthorn (crataegus Sp.) Berry, Leaf & Flower Extract + Sildenafil Citrate interactionWhite Panax Ginseng (panax Ginseng) Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, Panax ginseng might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full White Panax Ginseng (panax Ginseng) Root Extract + Sildenafil Citrate interactionArjuna (terminalia Arguna) Bark ExtractCytochrome P450 2c9 (cyp2c9) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, use of Terminalia arjuna may increase the levels and clinical effects of CYP2C9 substrates.
Read the full Arjuna (terminalia Arguna) Bark Extract + Sildenafil Citrate interactionTadalafilCialis, Tadliq
How Tadalafil interacts with Heart Strong — through 3 ingredients. Tap an ingredient for the detail:
Hawthorn (crataegus Sp.) Berry, Leaf & Flower ExtractPhosphodiesterase-5 Inhibitors Major
Interaction Summary
Theoretically, concomitant use might result in additive vasodilation and hypotension.
Read the full Hawthorn (crataegus Sp.) Berry, Leaf & Flower Extract + Tadalafil interactionWhite Panax Ginseng (panax Ginseng) Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, Panax ginseng might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full White Panax Ginseng (panax Ginseng) Root Extract + Tadalafil interactionArjuna (terminalia Arguna) Bark ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, use of Terminalia arjuna may increase the levels and clinical effects of CYP3A4 substrates.
Read the full Arjuna (terminalia Arguna) Bark Extract + Tadalafil interactionVardenafilLevitra, Staxyn
How Vardenafil interacts with Heart Strong — through 3 ingredients. Tap an ingredient for the detail:
Hawthorn (crataegus Sp.) Berry, Leaf & Flower ExtractPhosphodiesterase-5 Inhibitors Major
Interaction Summary
Theoretically, concomitant use might result in additive vasodilation and hypotension.
Read the full Hawthorn (crataegus Sp.) Berry, Leaf & Flower Extract + Vardenafil interactionArjuna (terminalia Arguna) Bark ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, use of Terminalia arjuna may increase the levels and clinical effects of CYP3A4 substrates.
Read the full Arjuna (terminalia Arguna) Bark Extract + Vardenafil interactionWhite Panax Ginseng (panax Ginseng) Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, Panax ginseng might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full White Panax Ginseng (panax Ginseng) Root Extract + Vardenafil interaction6-mercaptopurinePurinethol
How 6-mercaptopurine interacts with Heart Strong — through 1 ingredient. Tap an ingredient for the detail:
White Panax Ginseng (panax Ginseng) Root ExtractImmunosuppressants Moderate
Interaction Summary
Theoretically, Panax ginseng use might interfere with immunosuppressive therapy.
Read the full White Panax Ginseng (panax Ginseng) Root Extract + 6-mercaptopurine interactionAdo-trastuzumab EmtansineKadcyla
How Ado-trastuzumab Emtansine interacts with Heart Strong — through 2 ingredients. Tap an ingredient for the detail:
White Panax Ginseng (panax Ginseng) Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, Panax ginseng might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full White Panax Ginseng (panax Ginseng) Root Extract + Ado-trastuzumab Emtansine interactionArjuna (terminalia Arguna) Bark ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, use of Terminalia arjuna may increase the levels and clinical effects of CYP3A4 substrates.
Read the full Arjuna (terminalia Arguna) Bark Extract + Ado-trastuzumab Emtansine interactionAbciximabReoPro
How Abciximab interacts with Heart Strong — through 4 ingredients. Tap an ingredient for the detail:
White Panax Ginseng (panax Ginseng) Root ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Although Panax ginseng has shown antiplatelet effects in the laboratory, it is unlikely to increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full White Panax Ginseng (panax Ginseng) Root Extract + Abciximab interactionArjuna (terminalia Arguna) Bark ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, concomitant use of Terminalia arjuna with anticoagulant or antiplatelet drugs may increase the risk of bleeding in some patients.
Read the full Arjuna (terminalia Arguna) Bark Extract + Abciximab interactionHawthorn (crataegus Sp.) Berry, Leaf & Flower ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, hawthorn may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Hawthorn (crataegus Sp.) Berry, Leaf & Flower 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 Strong — through 2 ingredients. Tap an ingredient for the detail:
Arjuna (terminalia Arguna) Bark ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, use of Terminalia arjuna may increase the levels and clinical effects of CYP3A4 substrates.
Read the full Arjuna (terminalia Arguna) Bark Extract + Abemaciclib interactionWhite Panax Ginseng (panax Ginseng) Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, Panax ginseng might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full White Panax Ginseng (panax Ginseng) Root Extract + Abemaciclib interactionAbiraterone
How Abiraterone interacts with Heart Strong — through 2 ingredients. Tap an ingredient for the detail:
White Panax Ginseng (panax Ginseng) Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, Panax ginseng might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full White Panax Ginseng (panax Ginseng) Root Extract + Abiraterone interactionArjuna (terminalia Arguna) Bark ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, use of Terminalia arjuna may increase the levels and clinical effects of CYP3A4 substrates.
Read the full Arjuna (terminalia Arguna) Bark Extract + Abiraterone interactionAbiraterone AcetateYonsa, Zytiga
How Abiraterone Acetate interacts with Heart Strong — through 2 ingredients. Tap an ingredient for the detail:
Arjuna (terminalia Arguna) Bark ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, use of Terminalia arjuna may increase the levels and clinical effects of CYP3A4 substrates.
Read the full Arjuna (terminalia Arguna) Bark Extract + Abiraterone Acetate interactionWhite Panax Ginseng (panax Ginseng) Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, Panax ginseng might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full White Panax Ginseng (panax Ginseng) Root Extract + Abiraterone Acetate interactionAbrocitinibCibinqo
How Abrocitinib interacts with Heart Strong — through 4 ingredients. Tap an ingredient for the detail:
White Panax Ginseng (panax Ginseng) Root ExtractAnticoagulant/antiplatelet Drugs, Immunosuppressants Moderate
Interaction Summary
Although Panax ginseng has shown antiplatelet effects in the laboratory, it is unlikely to increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full White Panax Ginseng (panax Ginseng) Root Extract + Abrocitinib interactionHawthorn (crataegus Sp.) Berry, Leaf & Flower ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, hawthorn may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Hawthorn (crataegus Sp.) Berry, Leaf & Flower Extract + Abrocitinib interactionArjuna (terminalia Arguna) Bark ExtractAnticoagulant/antiplatelet Drugs, Cytochrome P450 2c9 (cyp2c9) Substrates Moderate
Interaction Summary
Theoretically, concomitant use of Terminalia arjuna with anticoagulant or antiplatelet drugs may increase the risk of bleeding in some patients.
Read the full Arjuna (terminalia Arguna) Bark 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 Strong — through 2 ingredients. Tap an ingredient for the detail:
Arjuna (terminalia Arguna) Bark ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, use of Terminalia arjuna may increase the levels and clinical effects of CYP3A4 substrates.
Read the full Arjuna (terminalia Arguna) Bark Extract + Acalabrutinib interactionWhite Panax Ginseng (panax Ginseng) Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, Panax ginseng might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full White Panax Ginseng (panax Ginseng) Root Extract + Acalabrutinib interactionAcarboseGlucobay, Prandase, Precose
How Acarbose interacts with Heart Strong — through 2 ingredients. Tap an ingredient for the detail:
White Panax Ginseng (panax Ginseng) Root ExtractAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, taking Panax ginseng with antidiabetes drugs might increase the risk of hypoglycemia.
Read the full White Panax Ginseng (panax Ginseng) Root Extract + Acarbose interactionArjuna (terminalia Arguna) Bark ExtractAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, concomitant use of Terminalia bellirica or Terminalia chebula with antidiabetes drugs could affect blood sugar control and increase the risk of hypoglycemia.
Read the full Arjuna (terminalia Arguna) Bark Extract + Acarbose interactionAcebutololRhotral, Sectral
How Acebutolol interacts with Heart Strong — through 2 ingredients. Tap an ingredient for the detail:
Hawthorn (crataegus Sp.) Berry, Leaf & Flower ExtractBeta-blockers Moderate
Interaction Summary
Theoretically, concomitant use might cause additive effects on blood pressure and heart rate.
Read the full Hawthorn (crataegus Sp.) Berry, Leaf & Flower Extract + Acebutolol interactionCoenzyme Q10Antihypertensive Drugs Minor
Interaction Summary
Theoretically, coenzyme Q10 might have additive effects with antihypertensive drugs.
Read the full Coenzyme Q10 + Acebutolol interactionEach ingredient & the kinds of drugs it affects
For each ingredient in Heart Strong 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.
White Panax Ginseng (Panax ginseng) root extract
Anticoagulant/Antiplatelet Drugs
Although Panax ginseng has shown antiplatelet effects in the laboratory, it is unlikely to increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
In vitro evidence suggests that ginsenoside constituents in Panax ginseng might decrease platelet aggregation. However, research in humans suggests that ginseng does not affect platelet aggregation. Animal research indicates low oral bioavailability of Rb1 and rapid elimination of Rg1, which might explain the discrepancy between in vitro and human research. Until more is known, use with caution in patients concurrently taking anticoagulant or antiplatelet drugs.
Antidiabetes Drugs
Theoretically, taking Panax ginseng with antidiabetes drugs might increase the risk of hypoglycemia.
Clinical research suggests that Panax ginseng might decrease blood glucose levels. Monitor blood glucose levels closely.
Caffeine
Theoretically, taking Panax ginseng with caffeine might increase the risk of adverse stimulant effects.
Panax ginseng has been shown to have stimulant effects. Theoretically, caffeine might have an additive effect on the stimulant effects of Panax ginseng.
Cytochrome P450 2D6 (Cyp2D6) Substrates
Theoretically, Panax ginseng might increase levels of drugs metabolized by CYP2D6. However, research is conflicting.
There is some evidence that Panax ginseng can inhibit the CYP2D6 enzyme by approximately 6%. In addition, in animal research, Panax ginseng inhibits the metabolism of dextromethorphan, a drug metabolized by CYP2D6, by a small amount. However, contradictory research suggests Panax ginseng might not inhibit CYP2D6. Until more is known, use Panax ginseng cautiously in patients taking drugs metabolized by these enzymes.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, Panax ginseng might increase or decrease levels of drugs metabolized by CYP3A4.
Panax ginseng may affect the clearance of drugs metabolized by CYP3A4. One such drug is imatinib. Inhibition of CYP3A4 was believed to be responsible for a case of imatinib-induced hepatotoxicity. In contrast, Panax ginseng has been shown to increase the clearance of midazolam, another drug metabolized by CYP3A4. Clinical research shows that Panax ginseng can reduce midazolam area under the curve by 44%, maximum plasma concentration by 26%, and time to reach maximum plasma concentration by 29%. Midazolam metabolism was also increased in animals given Panax ginseng. Until more is known, use Panax ginseng cautiously in combination with CYP3A4 substrates.
Estrogens
Theoretically, concomitant use of large amounts of Panax ginseng might interfere with hormone replacement therapy.
Laboratory research and some case reports suggest that Panax ginseng can have estrogenic effects due to competition for estrogen receptors. The estrogenic activity is attributed to the ginsenoside constituents of Panax ginseng.
Furosemide (Lasix)
Theoretically, Panax ginseng might reduce the effects of furosemide.
There is some concern that Panax ginseng might contribute to furosemide resistance. There is one case of resistance to furosemide diuresis in a patient taking a germanium-containing ginseng product.
Imatinib (Gleevec)
Theoretically, Panax ginseng might increase the effects and adverse effects of imatinib.
A case of imatinib-induced hepatotoxicity has been reported for a 26-year-old male with chronic myelogenous leukemia stabilized on imatinib for 7 years. The patient took imatinib 400 mg along with a Panax ginseng-containing energy drink daily for 3 months. Since imatinib-associated hepatotoxicity typically occurs within 2 years of initiating therapy, it is believed that Panax ginseng affected imatinib toxicity though inhibition of cytochrome P450 3A4. CYP3A4 is the primary enzyme involved in imatinib metabolism.
Immunosuppressants
Theoretically, Panax ginseng use might interfere with immunosuppressive therapy.
Panax ginseng might have immune system stimulating properties.
Insulin
Theoretically, taking Panax ginseng with insulin might increase the risk of hypoglycemia.
Clinical research suggests that Panax ginseng might decrease blood glucose levels. Insulin dose adjustments might be necessary in patients taking Panax ginseng; use with caution.
Midazolam (Versed)
Theoretically, Panax ginseng may increase the clearance of midazolam.
Midazolam is metabolized by cytochrome P450 3A4 (CYP3A4). Clinical research suggests that Panax ginseng can reduce midazolam area under the curve by 44%, maximum plasma concentration by 26%, and time to reach maximum plasma concentration by 29%. Midazolam metabolism was also increased in animals given Panax ginseng.
Monoamine Oxidase Inhibitors (Maois)
Theoretically, Panax ginseng can interfere with MAOI therapy.
Concomitant use of Panax ginseng with phenelzine (Nardil) is associated with insomnia, headache, tremors, and hypomania.
Nifedipine (Procardia)
Theoretically, taking Panax ginseng with nifedipine might increase serum levels of nifedipine and the risk of hypotension.
Preliminary clinical research shows that concomitant use can increase serum levels of nifedipine in healthy volunteers. This might cause the blood pressure lowering effects of nifedipine to be increased when taken concomitantly with Panax ginseng.
Qt Interval-Prolonging Drugs
Theoretically, Panax ginseng has an additive effect with drugs that prolong the QT interval and potentially increase the risk of ventricular arrhythmias. However, research is conflicting.
Clinical research shows that short-term use of Panax ginseng can increase the QT interval. However, no changes in QT interval have been identified with prolonged use.
Raltegravir (Isentress)
Theoretically, taking Panax ginseng with raltegravir might increase the risk of liver toxicity.
A case report suggests that concomitant use of Panax ginseng with raltegravir can increase serum levels of raltegravir, resulting in elevated liver enzymes levels.
Selegiline (Eldepryl)
Theoretically, Panax ginseng might increase or decrease levels of selegiline, possibly altering the effects and side effects of selegiline.
Animal research shows that taking selegiline with a low dose of Panax ginseng extract (1 gram/kg) reduces selegiline bioavailability, while taking a high dose of Panax ginseng extract (3 grams/kg) increases selegiline bioavailability. More research is needed to confirm these effects.
Stimulant Drugs
Theoretically, taking Panax ginseng with stimulant drugs might increase the risk of adverse stimulant effects.
Panax ginseng has been shown to have stimulant effects.
Warfarin (Coumadin)
Panax ginseng might affect the clearance of warfarin. However, this interaction appears to be unlikely.
There has been a single case report of decreased effectiveness of warfarin in a patient who also took Panax ginseng. However, it is questionable whether Panax ginseng was the cause of this decrease in warfarin effectiveness. Some research in humans and animals suggests that Panax ginseng does not affect the pharmacokinetics of warfarin. However, other research in humans suggests that Panax ginseng might modestly increase the clearance of the S-warfarin isomer. More evidence is needed to determine whether Panax ginseng causes a significant interaction with warfarin.
Fexofenadine (Allegra)
Theoretically, Panax ginseng might decrease blood levels of oral or intravenous fexofenadine.
Animal research suggests that taking Panax ginseng in combination with oral or intravenous fexofenadine may reduce the bioavailability of fexofenadine. Some scientists have attributed this effect to the ability of Panax ginseng to increase the expression of P-glycoprotein.
Lopinavir/Ritonavir (Kaletra)
Although Panax ginseng has demonstrated variable effects on cytochrome P450 3A4 (CYP3A4), which metabolizes lopinavir, Panax ginseng is unlikely to alter levels of lopinavir/ritonavir.
Lopinavir is metabolized by CYP3A4 and is administered with the CYP3A4 inhibitor ritonavir to increase its plasma concentrations. Panax ginseng has shown variable effects on CYP3A4 activity in humans. However, taking Panax ginseng (Vitamer Laboratories) 500 mg twice daily for 14 days did not alter the pharmacokinetics of lopinavir/ritonavir in 12 healthy volunteers.
Arjuna (Terminalia arguna) bark extract
Anticoagulant/Antiplatelet Drugs
Theoretically, concomitant use of Terminalia arjuna with anticoagulant or antiplatelet drugs may increase the risk of bleeding in some patients.
In vitro, Terminalia arjuna bark extract inhibits platelet aggregation, decreases platelet activation, and shows antithrombotic properties.
Antidiabetes Drugs
Theoretically, concomitant use of Terminalia bellirica or Terminalia chebula with antidiabetes drugs could affect blood sugar control and increase the risk of hypoglycemia.
Animal and in vitro research shows that Terminalia bellirica and Terminalia chebula fruit and seed extract have hypoglycemic effects.
Chlorzoxazone (Parafon Forte, Paraflex)
Theoretically, use of Terminalia chebula may increase the risk of adverse effects from chlorzoxazone.
Animal research shows that enteral administration of Terminalia chebula for 15 days prior to administration of chlorzoxazone increases blood levels of chlorzoxazone and decreases chlorzoxazone clearance. It is speculated that Terminalia chebula reduces the metabolism of chlorzoxazone by inhibiting cytochrome P450 2E1.
Cytochrome P450 2C9 (Cyp2C9) Substrates
Theoretically, use of Terminalia arjuna may increase the levels and clinical effects of CYP2C9 substrates.
In vitro research shows that Terminalia arjuna extract inhibits CYP2C9 enzymes and reduces CYP2C9 substrate metabolism.
Cytochrome P450 2D6 (Cyp2D6) Substrates
Theoretically, use of Terminalia arjuna may increase the levels and clinical effects of CYP2D6 substrates.
In vitro research shows that Terminalia arjuna extract inhibits CYP2D6 enzymes and reduces CYP2D6 substrate metabolism.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, use of Terminalia arjuna may increase the levels and clinical effects of CYP3A4 substrates.
In vitro research shows that Terminalia arjuna extract inhibits CYP3A4 enzymes and reduces CYP3A4 substrate metabolism.
Omeprazole (Prilosec)
Theoretically, use of Terminalia chebula may increase the risk of adverse effects from omeprazole.
Animal research shows that enteral administration of Terminalia chebula for 15 days prior to administration of omeprazole increases blood levels of omeprazole and decreases omeprazole clearance. It is speculated that Terminalia chebula reduces the metabolism of omeprazole by inhibiting cytochrome P450 2C19.
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.
Acetyl L-Carnitine
Acenocoumarol (Sintrom)
Theoretically, acetyl-L-carnitine might increase the anticoagulant effects of acenocoumarol.
L-carnitine, the parent compound of acetyl-L-carnitine, might enhance the anticoagulant effects of acenocoumarol, an oral anticoagulant that is similar to warfarin, but shorter-acting. There are at least two case reports of INR elevation when L-carnitine was taken with acenocoumarol. In one case, a 33-year-old male with a previously stable INR had an elevated INR of 4.65 after L-carnitine was started and continued for 10 weeks. INR normalized after discontinuation of the L-carnitine-containing product. It is unclear if such an interaction would also occur with acetyl-L-carnitine.
Serotonergic Drugs
Theoretically, acetyl-L-carnitine might increase the risk of serotonergic side effects, including serotonin syndrome and cerebral vasoconstrictive disorders, when taken with serotonergic drugs.
Animal research shows that acetyl-L-carnitine can increase levels of serotonin in the brain.
Thyroid Hormone
Theoretically, acetyl-L-carnitine might decrease the effectiveness of thyroid hormone replacement.
L-carnitine appears to act as a peripheral thyroid hormone antagonist by inhibiting entry of thyroid hormone into the nucleus of cells. Taking L-carnitine also seems to diminish some of the symptoms of hyperthyroidism. It is unclear if such an interaction would occur with acetyl-L-carnitine.
Warfarin (Coumadin)
Theoretically, acetyl-L-carnitine might increase the anticoagulant effects of warfarin.
L-carnitine, the parent compound of acetyl-L-carnitine, might increase the anticoagulant effects of acenocoumarol, a shorter-acting oral anticoagulant similar to warfarin. There is not enough information to know whether this interaction occurs with acetyl-L-carnitine and warfarin.
Coenzyme Q10
Alkylating Agents
Coenzyme Q10 has antioxidant effects. Theoretically, this may reduce the activity of chemotherapy drugs that generate free radicals.
Theoretically, antioxidants such as coenzyme Q10 might protect tumor cells from chemotherapeutic agents that work by inducing oxidative stress, such as alkylating agents (e.g., cyclophosphamide) and radiation therapy. The clinical importance of this interaction is unknown.
Warfarin (Coumadin)
Coenzyme Q10 is chemically similar to menaquinone and might have vitamin K-like procoagulant effects, which could decrease the effects of warfarin.
Concomitant use of coenzyme Q10 and warfarin might reduce the anticoagulant effects of warfarin. Four cases of decreased warfarin efficacy thought to be due to coenzyme Q10 have been reported. However, there is some preliminary clinical research that suggests coenzyme Q10 might not significantly decrease the effects of warfarin in patients who have a stable INR.
Antihypertensive Drugs
Theoretically, coenzyme Q10 might have additive effects with antihypertensive drugs.
Some clinical research shows that coenzyme Q10 can significantly lower blood pressure, although other studies have shown conflicting results.
Hawthorn (Crataegus sp.) berry, leaf & flower 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 Strong, from the product label.
Redd Remedies
See all Redd Remedies products- Name
- Redd Remedies
- City
- Bradley
- State
- IL
- ZipCode
- 60915
- Phone Number
- 888-453-5058
- Web Address
- www.reddremedies.com
Heart Strong by Redd Remedies: 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 Heart Strong’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Coenzyme Q10
Interacts with 198 drugsCoQ10 is a vitamin-like substance your body makes naturally that helps cells produce energy and acts as an antioxidant. It is generally well tolerated and is most studied for heart condition...
Read the full Coenzyme Q10 monograph → Herb & supplement monographAcetyl-l-carnitine
Interacts with 203 drugsAcetyl-L-carnitine is a form of the amino acid carnitine that the body uses to help produce energy in cells. It is most studied for nerve pain and memory-related conditions, though the evide...
Read the full Acetyl-l-carnitine monograph → Herb & supplement monographMagnesium
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 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 → Herb & supplement monographTerminalia
Interacts with 933 drugsTerminalia is a group of traditional Ayurvedic tree species (most notably Terminalia arjuna) used for heart, digestive, and general wellness purposes. Some small studies suggest possible ben...
Read the full Terminalia monograph → Herb & supplement monographPanax Ginseng
Interacts with 1,130 drugsPanax ginseng is a popular traditional herb used to boost energy, ease stress, and support overall wellness, though scientific evidence is mixed and mostly preliminary. It is generally well...
Read the full Panax Ginseng monograph →Sources & How We Checked
Heart Strong'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 244 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.
Coenzyme Q10 40 references
- Kamikawa T, Kobayashi A, Yamashita T, et al. Effects of coenzyme Q10 on exercise tolerance in chronic stable angina pectoris. Am J Cardiol 1985;56:247-51. PubMed
- Langsjoen P, Willis R, Folkers K. Treatment of essential hypertension with coenzyme Q10. Mol Aspects Med 1994;S265-72. PubMed
- Spigset O. Reduced effect of warfarin caused by ubidecarenone. Lancet 1994;334:1372-3. PubMed
- Singh RB, Niaz MA, Rastogi SS, et al. Effect of hydrosoluble coenzyme Q10 on blood pressures and insulin resistance in hypertensive patients with coronary artery disease. J Hum Hypertens 1999;13:203-8. PubMed
- Portakal O, Ozkaya O, Erden Inal M, et al. Coenzyme Q10 concentrations and antioxidant status in tissues of breast cancer patients. Clin Biochem 2000;33:279-84. PubMed
- Lund EL, Quistorff B, Spang-Thomsen M, Kristjansen PE. Effect of radiation therapy on small-cell lung cancer is reduced by ubiquinone intake. Folia Microbiol (Praha) 1998;43:505-6. PubMed
- Langsjoen PH, Langsjoen PH, Folkers K. Long-term efficacy and safety of coenzyme Q10 therapy for idiopathic dilated cardiomyopathy. Am J Cardiol 1990;65:521-3. PubMed
- Heck AM, DeWitt BA, Lukes AL. Potential interactions between alternative therapies and warfarin. Am J Health Syst Pharm 2000;57:1221-7. DOI
- Landbo C, Almdal TP. [Interaction between warfarin and coenzyme Q10]. Ugeskr Laeger 1998;160:3226-7.
- Baggio E, Gandini R, Plauncher AC, et al. Italian multicenter study on the safety and efficacy of coenzyme Q10 as adjunctive therapy in heart failure. CoQ10 Drug Surveillance Investigators. Mol Aspects Med 1994;15 Suppl:S287-94. PubMed
- Burke BE, Neuenschwander R, Olson RD. Randomized, double-blind, placebo-controlled trial of coenzyme Q10 in isolated systolic hypertension. South Med J 2001;94:1112-7. PubMed
- The Huntington Study Group. A randomized, placebo-controlled trial of coenzyme Q10 and remacemide in Huntington's disease. Neurology 2001;57:397-404.
- Hodgson JM, Watts GF, Playford DA, et al. Coenzyme Q10 improves blood pressure and glycaemic control: a controlled trial in subjects with type 2 diabetes. Eur J Clin Nutr 2002;56:1137-42. PubMed
- Singh RB, Neki NS, Kartikey K, et al. Effect of coenzyme Q10 on risk of atherosclerosis in patients with recent myocardial infarction. Mol Cell Biochem 2003;246:75-82. DOI
- Porterfield LM. Why did the response to warfarin change? RN 2000;63:107.
- Sandor PS, Di Clemente L, Coppola G, et al. Efficacy of coenzyme Q10 in migraine prophylaxis: A randomized controlled trial. Neurology 2005;64:713-5. PubMed
- Engelsen J, Nielsen JD, Winther K. Effect of coenzyme Q10 and Ginkgo biloba on warfarin dosage in stable, long-term warfarin treated outpatients. A randomised, double blind, placebo-crossover trial. Thromb Haemost 2002;87:1075-6. DOI
- Berman M, Erman A, Ben-Gal T, et al. Coenzyme Q10 in patients with end-stage heart failure awaiting cardiac transplantation: a randomized, placebo-controlled study. Clin Cardiol 2004;27:295–9. PubMed
- Storch A, Jost WH, Vieregge P, et al. Randomized, double-blind, placebo-controlled trial on symptomatic effects of coenzyme Q10 in Parkinson disease. Arch Neurol 2007;64:938-44. DOI
- Digiesi V, Cantini F, Oradei A, et al. Coenzyme Q10 in essential hypertension. Mol Aspects Med 1994;15 Suppl:s257-63. PubMed
- Yamagami T, Takagi M, Akagami H, et al. Effect of coenzyme Q10 on essential hypertension, a double blind controlled study. In: Folkers KA, Yamamura Y, eds. Biomedical and Clinical Aspects of Coenzyme Q, Vol. 5. Amsterdam: Elsevier Science Publications, 19
- Ho MJ, Bellusci A, Wright JM. Blood pressure lowering efficacy of coenzyme Q10 for primary hypertension (review). Cochrane Database Syst Rev 2009;(4):CD007435. PubMed
- Rosenfeldt, F. L., Haas, S. J., Krum, H., Hadj, A., Ng, K., Leong, J. Y., and Watts, G. F. Coenzyme Q10 in the treatment of hypertension: a meta-analysis of the clinical trials. J Hum.Hypertens. 2007;21(4):297-306. PubMed
- Stamelou, M., Reuss, A., Pilatus, U., Magerkurth, J., Niklowitz, P., Eggert, K. M., Krisp, A., Menke, T., Schade-Brittinger, C., Oertel, W. H., and Hoglinger, G. U. Short-term effects of coenzyme Q10 in progressive supranuclear palsy: a randomized, place DOI
- Keogh A, Fenton S, Leslie C, et al. Randomised double-blind, placebo-controlled trial of coenzyme Q, therapy in class II and III systolic heart failure. Heart Lung Circ. 2003;12:135-41.
- Gane, E. J., Weilert, F., Orr, D. W., Keogh, G. F., Gibson, M., Lockhart, M. M., Frampton, C. M., Taylor, K. M., Smith, R. A., and Murphy, M. P. The mitochondria-targeted anti-oxidant mitoquinone decreases liver damage in a phase II study of hepatitis C
- Lynch, D. R., Perlman, S. L., and Meier, T. A phase 3, double-blind, placebo-controlled trial of idebenone in friedreich ataxia. Arch Neurol. 2010;67(8):941-947. PubMed
- Young, J. M., Florkowski, C. M., Molyneux, S. L., McEwan, R. G., Frampton, C. M., Nicholls, M. G., Scott, R. S., and George, P. M. A randomized, double-blind, placebo-controlled crossover study of coenzyme Q10 therapy in hypertensive patients with the me
- Ishiyama, T., Morita, Y., Toyama, S., Yamagami, T., and Tsukamoto, N. A clinical study of the effect of coenzyme Q on congestive heart failure. Jpn.Heart J 1976;17(1):32-42. PubMed
- Matthews, P. M., Ford, B., Dandurand, R. J., Eidelman, D. H., O'Connor, D., Sherwin, A., Karpati, G., Andermann, F., and Arnold, D. L. Coenzyme Q10 with multiple vitamins is generally ineffective in treatment of mitochondrial disease. Neurology 1993;43(5
- Malm, C., Svensson, M., Sjoberg, B., Ekblom, B., and Sjodin, B. Supplementation with ubiquinone-10 causes cellular damage during intense exercise. Acta Physiol Scand. 1996;157(4):511-512. PubMed
- Singh, R. B., Wander, G. S., Rastogi, A., Shukla, P. K., Mittal, A., Sharma, J. P., Mehrotra, S. K., Kapoor, R., and Chopra, R. K. Randomized, double-blind placebo-controlled trial of coenzyme Q10 in patients with acute myocardial infarction. Cardiovasc. PubMed
- Digiesi V, Cantini F, and Brodbeck B. Effect of coenzyme Q10 on essential arterial hypertension. Current Therapeutic Research 1990;47(5):841-845.
- Parkinson Study Group QE3 Investigators, Beal MF, Oakes D, et al. A randomized clinical trial of high-dosage coenzyme Q10 in early Parkinson disease: no evidence of benefit. JAMA Neurol. 2014;71(5):543-52.
- Alehagen U, Johansson P, Bjornstedt M, et al. Cardiovascular mortality and N-terminal-proBNP reduced after combined selenium and coenzyme Q10 supplementation: A 5-year prospective randomized double-blind placebo-controlled trial among elderly Swedish citi
- Ho MJ, Li EC, Wright JM. Blood pressure lowering efficacy of coenzyme Q10 for primary hypertension. Cochrane Database Syst Rev. 2016 Mar 3;3:CD007435. doi: 10.1002/14651858.CD007435.pub3. PubMed
- Tabrizi R, Akbari M, Sharifi N, Lankarani KB, Moosazadeh M, Kolahdooz F, et al. The effects of coenzyme Q10 supplementation on blood pressures among patients with metabolic diseases: a systematic review and meta-analysis of randomized controlled trials. PubMed
- Tsai IC, Hsu CW, Chang CH, Tseng PT, Chang KV. Effectiveness of coenzyme Q10 supplementation for reducing fatigue: A systematic review and meta-analysis of randomized controlled trials. Front Pharmacol 2022;13:883251. PubMed
- Yaghini O, Hoseini N, Ghazavi MR, et al. A comparative study on the efficacy of coenzyme Q10 and amitriptyline in the prophylactic treatment of migraine headaches in children: A randomized controlled trial. Adv Biomed Res 2022;11:43. PubMed
- Hansen KS, Mogensen TH, Agergaard J, et al. High-dose coenzyme Q10 therapy versus placebo in patients with post COVID-19 condition: A randomized, phase 2, crossover trial. Lancet Reg Health Eur 2022. PubMed
Acetyl-l-carnitine 22 references
- Thal LJ, Carta A, Clarke WR, et al. A 1-year multicenter placebo-controlled study of acetyl-L-carnitine in patients with Alzheimer's Disease. Neurology 1996;47:705-11. PubMed
- Sano M, Bell K, Cote L, et al. Double-blind parallel design pilot study of acetyl levocarnitine in patients with Alzheimer's Disease. Arch Neurol 1992;49:1137-41. PubMed
- Spagnoli A, Lucca U, Menasce G, et al. Long-term acetyl-L-carnitine treatment in Alzheimer's Disease. Neurology 1991;41:1726-32. PubMed
- Brooks JO 3rd, Yesavage JA, Carta A, Bravi D. Acetyl L-carnitine slows decline in younger patients with Alzheimer's disease: a reanalysis of a double-blind, placebo-controlled study using the trilinear approach. Int Psychoger 1998;10:193-203. PubMed
- Pettegrew JW, Klunk WE, Panchalingam K, et al. Clinical and neurochemical effects of acetyl-L-carnitine in Alzheimer's disease. Neurobiol Aging 1995;16:1-4. PubMed
- Rai G, Wright G, Scott L, et al. Double-blind, placebo controlled study of acetyl-l-carnitine in patients with Alzheimer's dementia. Curr Med Res Opin 1990;11:638-47. PubMed
- Benvenga S, Ruggeri RM, Russo A, et al. Usefulness of L-carnitine, a naturally occurring peripheral antagonist of thyroid hormone action, in iatrogenic hyperthyroidism: a randomized, double-blind, placebo-controlled clinical trial. J Clin Endocrinol Meta
- Montgomery SA, Thal LJ, Amrein R. Meta-analysis of double blind randomized controlled clinical trials of acetyl-L-carnitine versus placebo in the treatment of mild cognitive impairment and mild Alzheimer's disease. Int Clin Psychopharmacol 2003;18:61-71.. PubMed
- Martinez E, Domingo P, Roca-Cusachs A. Potentiation of acenocoumarol action by L-carnitine. J Intern Med 1993;233:94.
- Hudson S, Tabet N. Acetyl-L-carnitine for dementia. Cochrane Database Syst Rev 2003;2:CD003158.. PubMed
- Bachmann HU, Hoffmann A. Interaction of food supplement L-carnitine with oral anticoagulant acenocoumarol. Swiss Med Wkly 2004;134:385. PubMed
- De Grandis D, Minardi C. Acetyl-L-carnitine (levacecarnine) in the treatment of diabetic neuropathy. A long-term, randomised, double-blind, placebo-controlled study. Drugs R D 2002;3:223-31. PubMed
- 12761 Benvenga S, Amato A, Calvani M, Trimarchi F. Effects of carnitine on thyroid hormone action. Ann N Y Acad Sci 2004;1033:158-67. PubMed
- Sima AAF, Calvani M, Mehra M, et al. Acetyl-L-carnitine improves pain, nerve regeneration, and vibratory perception in patients with chronic diabetic neuropathy: An analysis of two randomized, placebo-controlled trials. Diabetes Care 2005;28:89-94.
- Youle, M. and Osio, M. A double-blind, parallel-group, placebo-controlled, multicentre study of acetyl L-carnitine in the symptomatic treatment of antiretroviral toxic neuropathy in patients with HIV-1 infection. HIV.Med. 2007;8(4):241-250.
- Brennan BP, Jensen JE, Hudson JI, Coit CE, Beaulieu A, Pope HG Jr, Renshaw PF, Cohen BM. A placebo-controlled trial of acetyl-L-carnitine and a-lipoic acid in the treatment of bipolar depression. J Clin Psychopharmacol. 2013 Oct;33(5):627-35.
- Ledinek AH, Sajko MC, Rot U. Evaluating the effects of amantadin, modafinil and acetyl-L-carnitine on fatigue in multiple sclerosis--result of a pilot randomized, blind study. Clin Neurol Neurosurg. 2013 Dec;115 Suppl 1:S86-9. PubMed
- Martinotti G, Andreoli S, Reina D, Di Nicola M, Ortolani I, Tedeschi D, Fanella F, Pozzi G, Iannoni E, D'Iddio S, Prof LJ. Acetyl-l-Carnitine in the treatment of anhedonia, melancholic and negative symptoms in alcohol dependent subjects. Prog Neuropsychop PubMed
- Baek SM, Zheng R, Seo EJ, Hwang DY, Kim BH. Pharmacokinetic comparisons of two acetyl-L-carnitine formulations in healthy Korean volunteers. Int J Clin Pharmacol Ther. 2015;53(11):980-6. PubMed
- Goodison G, Overeem K, de Monte V, Siskind D. Mania associated with self-prescribed acetyl-l-carnitine in a man with bipolar I disorder. Australas Psychiatry. 2017;25(1):13-4.
- Bruno A, Pandolfo G, Crucitti M, Lorusso S, Zoccali RA, Muscatello MR. Acetyl-L-Carnitine Augmentation of Clozapine in Partial-Responder Schizophrenia: A 12-Week, Open-Label Uncontrolled Preliminary Study. Clin Neuropharmacol. 2016;39(6):277-80. PubMed
- Veronese N, Stubbs B, Solmi M, Ajnakina O, Carvalho AF, Maggi S. Acetyl-L-Carnitine Supplementation and the Treatment of Depressive Symptoms: A Systematic Review and Meta-Analysis. Psychosom Med. 2018;80(2):154-9. PubMed
Magnesium 82 references
- Rodin SM, Johnson BF. Pharmacokinetic interactions with digoxin. Clin Pharmacokinet 1988;15:227-44.
- Covington TR, et al. Handbook of Nonprescription Drugs. 11th ed. Washington, DC: American Pharmaceutical Association, 1996.
- Dahle LO, Berg G, Hammar M, et al. The effect of oral magnesium substitution on pregnancy-induced leg cramps. Am J Obstet Gynecol 1995;173:175-80. PubMed
- Hansten PD, Horn JR. Drug Interactions Analysis and Management. Vancouver, WA: Applied Therapeutics Inc., 1997 and updates.
- Peikert A, Wilimzig C, Kohne-Volland R. Prophylaxis of migraine with oral magnesium: results from a prospective, multi-center, placebo-controlled and double-blind randomized study. Cephalalgia 1996;16:257-63. PubMed
- 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.
- Birrer RB, Shallash AJ, Totten V. Hypermagnesemia-induced fatality following epsom salt gargles. J Emerg Med 2002;22:185-8. PubMed
- Ryan MP. Diuretics and potassium/magnesium depletion. Directions for treatment. Am J Med 1987;82:38-47.. PubMed
- Hollifield JW. Magnesium depletion, diuretics, and arrhythmias. Am J Med 1987;82:30-7.. PubMed
- Heidenreich O. Mode of action of conventional and potassium-sparing diuretics--aspects with relevance to Mg-sparing effects. Magnesium 1984;3:248-56..
- Pfaffenrath V, Wessely P, Meyer C, et al. Magnesium in the prophylaxis of migraine--a double-blind placebo-controlled study. Cephalalgia 1996;16:436-40.. PubMed
- Wang F, Van Den Eeden SK, Ackerson LM, et al. Oral magnesium oxide prophylaxis of frequent migrainous headache in children: a randomized, double-blind, placebo-controlled trial. Headache 2003;43:601-10.. PubMed
- Sompolinsky D, Samra Z. Influence of magnesium and manganese on some biological and physical properties of tetracycline. J Bacteriol 1972;110:468-76.. PubMed
- Jeyabalan A, Caritis SN. Pharmacologic inhibition of preterm labor. Clin Obstet Gynecol 2002;45:99-113. PubMed
- Mittendorf R, Dambrosia J, Pryde PG, et al. Association between the use of antenatal magnesium sulfate in preterm labor and adverse health outcomes in infants. Am J Obstet Gynecol 2002;186:1111-8.. PubMed
- Witlin AG, Sibai BM. Magnesium sulfate therapy in preeclampsia and eclampsia. Obstet Gynecol 1998;92:883-9.. DOI
- Crowther CA, Hiller JE, Doyle LW. Magnesium sulphate for preventing preterm birth in threatened preterm labour. Cochrane Database Syst Rev 2002;4:CD001060. . PubMed
- Davey MJ, Teubner D. A randomized controlled trial of magnesium sulfate, in addition to usual care, for rate control in atrial fibrillation. Ann Emerg Med 2005;45:347-53.. PubMed
- L'Hommedieu CS, Nicholas D, Armes DA, et al. Potentiation of magnesium sulfate--induced neuromuscular weakness by gentamicin, tobramycin, and amikacin. J Pediatr 1983;102:629-31..
- Dunn CJ, Goa KL. Risedronate: a review of its pharmacological properties and clinical use in resorptive bone disease. Drugs 2001;61:685-712..
- Kass L, Weekes J, Carpenter L. Effect of magnesium supplementation on blood pressure: a meta-analysis. Eur J Clin Nutr 2012;66:411-8. PubMed
- Koontz SL, Friedman SA, Schwartz ML. Symptomatic hypocalcemia after tocolytic therapy with magnesium sulfate and nifedipine. Am J Obstet Gynecol. 2004;190(6):1773-6. PubMed
- Snyder SW, Cardwell MS. Neuromuscular blockade with magnesium sulfate and nifedipine. Am J Obstet Gynecol. 1989;161(1):35-6. PubMed
- Waisman GD, Mayorga LM, Cámera MI, et al. Magnesium plus nifedipine: potentiation of hypotensive effect in preeclampsia? Am J Obstet Gynecol. 1988;159(2):308-9. PubMed
- Brown DD, Juhl RP. Decreased bioavailability of digoxin due to antacids and kaolin-pectin. N Engl J Med. 1976;295(19):1034-7. PubMed
- Allen MD, Greenblatt DJ, Harmatz JS, et al. Effect of magnesium--aluminum hydroxide and kaolin--pectin on absorption of digoxin from tablets and capsules. J Clin Pharmacol. 1981;21(1):26-30. PubMed
- Ravn HB, Vissinger H, Kristensen SD, et al. Magnesium inhibits platelet activity--an in vitro study. Thromb Haemost. 1996;76(1):88-93. DOI
- Ravn HB, Kristensen SD, Vissinger H, et al. Magnesium inhibits human platelets. Blood Coagul Fibrinolysis. 1996;7(2):241-4. PubMed
- Ravn HB, Vissinger H, Kristensen SD, et al. Magnesium inhibits platelet activity--an infusion study in healthy volunteers. Thromb Haemost. 1996;75(6):939-44. DOI
- Neuvonen PJ, Kivistö KT. The effects of magnesium hydroxide on the absorption and efficacy of two glibenclamide preparations. Br J Clin Pharmacol. 1991;32(2):215-20. PubMed
- Kivistö KT, Neuvonen PJ. Enhancement of absorption and effect of glipizide by magnesium hydroxide. Clin Pharmacol Ther. 1991;49(1):39-43. PubMed
- Neuvonen PJ, Kivistö KT. Enhancement of drug absorption by antacids. An unrecognised drug interaction. Clin Pharmacokinet. 1994;27(2):120-8. PubMed
- Shechter, M., Merz, C. N., Paul-Labrador, M., Meisel, S. R., Rude, R. K., Molloy, M. D., Dwyer, J. H., Shah, P. K., and Kaul, S. Beneficial antithrombotic effects of the association of pharmacological oral magnesium therapy with aspirin in coronary heart
- Ganzevoort, J. W., Hoogerwaard, E. M., and van der Post, J. A. [Hypocalcemic delirium due to magnesium sulphate therapy in a pregnant woman with pre-eclampsia]. Ned.Tijdschr.Geneeskd. 8-3-2002;146(31):1453-1456.
- Horner, S. M. Efficacy of intravenous magnesium in acute myocardial infarction in reducing arrhythmias and mortality. Meta-analysis of magnesium in acute myocardial infarction. Circulation 1992;86(3):774-779. PubMed
- Azria, E., Tsatsaris, V., Goffinet, F., Kayem, G., Mignon, A., and Cabrol, D. [Magnesium sulfate in obstetrics: current data]. J Gynecol.Obstet.Biol.Reprod.(Paris) 2004;33(6 Pt 1):510-517.
- Magee, L. A., Miremadi, S., Li, J., Cheng, C., Ensom, M. H., Carleton, B., Cote, A. M., and von Dadelszen, P. Therapy with both magnesium sulfate and nifedipine does not increase the risk of serious magnesium-related maternal side effects in women with p
- Henyan, N. N., Gillespie, E. L., White, C. M., Kluger, J., and Coleman, C. I. Impact of intravenous magnesium on post-cardiothoracic surgery atrial fibrillation and length of hospital stay: a meta-analysis. Ann.Thorac.Surg. 2005;80(6):2402-2406. PubMed
- Li, J., Zhang, Q., Zhang, M., and Egger, M. Intravenous magnesium for acute myocardial infarction. Cochrane.Database.Syst.Rev. 2007;(2):CD002755. PubMed
- Doyle, L. W., Crowther, C. A., Middleton, P., Marret, S., and Rouse, D. Magnesium sulphate for women at risk of preterm birth for neuroprotection of the fetus. Cochrane.Database.Syst.Rev. 2009;(1):CD004661. PubMed
- Han, S., Crowther, C. A., and Moore, V. Magnesium maintenance therapy for preventing preterm birth after threatened preterm labour. Cochrane.Database.Syst.Rev. 2010;(7):CD000940. PubMed
- Duley, L., Gulmezoglu, A. M., Henderson-Smart, D. J., and Chou, D. Magnesium sulphate and other anticonvulsants for women with pre-eclampsia. Cochrane.Database.Syst.Rev. 2010;(11):CD000025. PubMed
- Conde-Agudelo, A., Romero, R., and Kusanovic, J. P. Nifedipine in the management of preterm labor: a systematic review and metaanalysis. Am J Obstet.Gynecol. 2011;204(2):134-20. PubMed
- Wong, G. K., Boet, R., Poon, W. S., Chan, M. T., Gin, T., Ng, S. C., and Zee, B. C. Intravenous magnesium sulphate for aneurysmal subarachnoid hemorrhage: an updated systemic review and meta-analysis. Crit Care 2011;15(1):R52. PubMed
- Magee, L., Sawchuck, D., Synnes, A., and von, Dadelszen P. SOGC Clinical Practice Guideline. Magnesium sulphate for fetal neuroprotection. J Obstet.Gynaecol.Can. 2011;33(5):516-529.
- Doyle, L. W. Antenatal magnesium sulfate and neuroprotection. Curr Opin Pediatr 2012;24(2):154-159. PubMed
- McDonald, S. D., Lutsiv, O., Dzaja, N., and Duley, L. A systematic review of maternal and infant outcomes following magnesium sulfate for pre-eclampsia/eclampsia in real-world use. Int J Gynaecol.Obstet. 2012;118(2):90-96. PubMed
- Gordon, M., Naidoo, K., Akobeng, A. K., and Thomas, A. G. Osmotic and stimulant laxatives for the management of childhood constipation. Cochrane.Database.Syst.Rev. 2012;7:CD009118. PubMed
- Dodd, J. M., Crowther, C. A., and Middleton, P. Oral betamimetics for maintenance therapy after threatened preterm labour. Cochrane.Database.Syst.Rev. 2012;12:CD003927. PubMed
- Wu, X., Wang, C., Zhu, J., Zhang, C., Zhang, Y., and Gao, Y. Meta-analysis of randomized controlled trials on magnesium in addition to beta-blocker for prevention of postoperative atrial arrhythmias after coronary artery bypass grafting. BMC.Cardiovasc.D PubMed
- Thorp, J. M., Jr., Katz, V. L., Campbell, D., and Cefalo, R. C. Hypersensitivity to magnesium sulfate. Am.J.Obstet.Gynecol. 1989;161(4):889-890. PubMed
- Duley L and Gulmezoglu AM. Magnesium sulphate versus lytic cocktail for eclampsia. Cochrane Database of Systematic Reviews 2000;(3) PubMed
- Gibbins KJ, Browning KR, Lopes VV, Anderson BL, Rouse DJ. Evaluation of the clinical use of magnesium sulfate for cerebral palsy prevention. Obstet Gynecol 2013;121(2 Pt 1):235-40. PubMed
- Ji D. Oral magnesium sulfate causes perforation during bowel preparation for fiberoptic colonoscopy in patients with colorectal cancer. J Emerg Med 2012;43(4):716-7. PubMed
- Yagi T, Naito T, Mino Y, Umemura K, Kawakami J. Impact of concomitant antacid administration on gabapentin plasma exposure and oral bioavailability in healthy adult subjects. Drug Metab Pharmacokinet 2012;27(2):248-54. PubMed
- Yamasaki M, Funakoshi S, Matsuda S, Imazu T, Takeda Y, Murakami T, Maeda Y. Interaction of magnesium oxide with gastric acid secretion inhibitors in clinical pharmacotherapy. Eur J Clin Pharmacol 2014;70(8):921-4. PubMed
- Choi ES, Jeong WJ, Ahn SH, Oh AY, Jeon YT, Do SH. Magnesium sulfate accelerates the onset of low-dose rocuronium in patients undergoing laryngeal microsurgery. J Clin Anesth. 2017 Feb;36:102-106. PubMed
- Ikee R, Toyoyama T, Endo T, Tsunoda M, Hashimoto N. Impact of sevelamer hydrochloride on serum magnesium concentrations in hemodialysis patients. Magnes Res. 2016 Apr 1;29(4):184-90. PubMed
- Miller ES, Sakowicz A, Leger E. Lange E, Yee LM. The association between receipt of intrapartum magnesium and postpartum hemorrhage. Am J Obstet Gynecol 2018;218(1 Suppl):S165.
- Rodríguez-Rubio L, Solis Garcia Del Pozo J, Nava E, Jordán J. Interaction between magnesium sulfate and neuromuscular blockers during the perioperative period. A systematic review and meta-analysis. J Clin Anesth. 2016;34:524-34. PubMed
- Brown RS. Magnesium Sulfate: Another Cause of a Solute Diuresis. Am J Kidney Dis. 2017;69(4):550-551. PubMed
- Park H, Qin R, Smith TJ, et al. North Central Cancer Treatment Group N10C2 (Alliance): a double-blind placebo-controlled study of magnesium supplements to reduce menopausal hot flashes. Menopause. 2015;22(6):627-32. PubMed
- Sakanoue M, Sanada J, Kanekura T. Skin eruption elicited by magnesium oxide (Maglax). J Dermatol. 2016;43(2):221-2.
- Iwamuro M, Saito S, Yoshioka M, et al. A Magnesium Oxide Bezoar. Intern Med. 2018;57(21):3087-3091. PubMed
- Vilchez G, Dai J, Kumar K, Mundy D, Kontopoulos E, Sokol RJ. Racial/ethnic disparities in magnesium sulfate neuroprotection: a subgroup analysis of a multicenter randomized controlled trial. J Matern Fetal Neonatal Med. 2018;31(17):2304-2311. PubMed
- Drug Safety Communication: FDA Recommends Against Prolonged Use of Magnesium Sulfate to Stop Pre-term Labor Due to Bone Changes in Exposed Babies. U.S. Food and Drug Administration (FDA), May 30, 2013. https://www.fda.gov/downloads/Drugs/DrugSafety/UCM353
- Committee Opinion: Magnesium Sulfate Use in Obstetrics. The American College of Obstetricians and Gynecologists Committee on Obstetric Practice Society for Maternal-Fetal Medicine, Number 652, January 2016. https://www.acog.org/Clinical-Guidance-and-Publi
- Kashihara Y, Terao Y, Yoda K, et al. Effects of magnesium oxide on pharmacokinetics of L-dopa/carbidopa and assessment of pharmacodynamic changes by a model-based simulation. Eur J Clin Pharmacol. 2019;75(3):351-361. PubMed
- Shepherd E, Salam RA, Manhas D, et al. Antenatal magnesium sulphate and adverse neonatal outcomes: A systematic review and meta-analysis. PLoS Med. 2019;16(12):e1002988. PubMed
- Hong JY, Hong JY, Choi YS, et al. Antenatal magnesium sulfate treatment and risk of necrotizing enterocolitis in preterm infants born at less than 32 weeks of gestation. Sci Rep. 2020;10(1):12826. PubMed
- Schuh S, Sweeney J, Rumantir M, et al. Effect of nebulized magnesium vs placebo added to albuterol on hospitalization among children with refractory acute asthma treated in the emergency department: a randomized clinical trial. JAMA. 2020;324(20):2038-20 PubMed
- Almeida CED, Carvalho LR, Andrade CVC, Nascimento PD Jr, Barros GAM, Modolo NSP. Effects of magnesium sulphate on the onset time of rocuronium at different doses: a randomized clinical trial. Braz J Anesthesiol. 2021;71(5):482-8. PubMed
- Gochi Valdovinos A, Arriaga-Redondo M, Dejuan Bitriá E, Pérez Rodríguez I, Márquez Isidro E, Blanco Bravo D. Prenatal therapy with magnesium sulphate and intestinal obstruction due to meconium in preterm newborns. An Pediatr (Engl Ed). 2022 Feb;96(2):138- PubMed
- Iio K, Kondo E, Shibata E, et al. Long-term tocolysis with magnesium sulfate as a risk factor for low bone mass: a case series. J Med Cases. 2022 Feb;13(2):47-50. PubMed
- Eiraku K, Uozumi Y, Hieda M, Maruyama T, Nomura H. A senile case of heart failure associated with hypermagnesemia induced by magnesium-containing laxative agent. Geriatr Gerontol Int. 2022;22(10):897-899.
- 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
- Darmawan D, Rengganis I, Rumende CM, et al. Effectiveness and Safety of Nebulized Magnesium as Last Line Treatment in Adults with Acute Asthma Attack: A Systematic Review and Meta-Analysis. Acta Med Indones 2024;56(1):3-12.
- 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.
Hawthorn 25 references
- Tauchert M. Efficacy and safety of crataegus extract WS 1442 in comparison with placebo in patients with chronic stable New York Heart Association class-III heart failure. Am Heart J 2002;143:910-5. PubMed
- Pittler MH, Schmidt K, Ernst E. Hawthorn extract for treating chronic heart failure: meta-analysis of randomized trials. Am J Med 2003;114:665-74.. PubMed
- Chang Q, Zuo Z, Harrison F, Chow MS. Hawthorn. J Clin Pharmacol 2002;42:605-12.
- Holubarsch CJ, Colucci WS, Meinertz T, et al. The efficacy and safety of Crataegus extract WS 1442 in patients with heart failure: the SPICE trial. Eur J Heart Fail 2008;10:1255-63. PubMed
- Pittler MH, Guo R, and Ernst E. Hawthorn extract for treating chronic heart failure. Cochrane.Database.Syst Rev 2008:CD005312. PubMed
- Zick SM, Vautaw BM, Gillespie B, Aaronson KD. Hawthorn Extract Randomized Blinded Chronic Heart Failure (HERB CHF) trial. Eur J Heart Fail. 2009;11:990-99. PubMed
- Werner NS, Duschek S, and Schandry R. D-camphor-crataegus berry extract combination increases blood pressure and cognitive functioning in the elderly - a randomized, placebo controlled double blind study. Phytomedicine. 2009;16:1077-82. PubMed
- Dalli E, Colomer E, Tormos MC, et al. Crataegus laevigata decreases neutrophil elastase and has hypolipidemic effect: a randomized, double-blind, placebo-controlled trial. Phytomedicine. 6-15-2011;18:769-75. PubMed
- Maek-a-nantawat W, Phonrat B, Dhitavat J, et al. Safety and efficacy of CKBM-A01, a Chinese herbal medicine, among asymptomatic HIV patients. Southeast Asian J Trop.Med Public Health 2009;40:494-501.
- Asher GN, Viera AJ, Weaver MA, et al. Effect of hawthorn standardized extract on flow mediated dilation in prehypertensive and mildly hypertensive adults: a randomized, controlled cross-over trial. BMC.Complement Altern.Med 2012;12:26. PubMed
- Walker AF, Marakis G, Simpson E, et al. Hypotensive effects of hawthorn for patients with diabetes taking prescription drugs: a randomised controlled trial. Br J Gen.Pract 2006;56:437-43.
- Daniele C, Mazzanti G, Pittler MH, et al. Adverse-event profile of Crataegus spp.: a systematic review. Drug Saf 2006;29:523-35. PubMed
- Tankanow R, Tamer HR, Streetman DS, et al. Interaction study between digoxin and a preparation of hawthorn (Crataegus oxyacantha). J.Clin.Pharmacol. 2003;43:637-42. DOI
- Tauchert, M., Gildor, A., and Lipinski, J. [High-dose Crataegus extract WS 1442 in the treatment of NYHA stage II heart failure]. Herz 1999;24(6):465-474.
- Horoz, M., Gok, E., Genctoy, G., Ozcan, T., Olmaz, R., Akca, M., Kiykim, A., and Gurses, I. Crataegus orientalis associated multiorgan hypersensitivity reaction and acute renal failure. Intern.Med 2008;47(23):2039-2042. PubMed
- Dalli, E., Valles, J., Cosin-Sales, J., Santos, M. T., Moscardo, A., Milara, J., and Sotillo, J. F. Effects of hawthorn (Crataegus laevigata) on platelet aggregation in healthy volunteers. Thromb.Res 2011;128(4):398-400. PubMed
- Rogov VD. [Toxiderma due to the fruits of the hawthorn]. Vestn Dermatol Venerol 1984;7(7):46-47.
- Loew D, Albrecht M, and Podzuweit H. Efficacy and tolerability of a Hawthorn preparation in patients with heart failure Stage I and II according to NYHA - a surveillance study. Phytomedicine 1996;3(Suppl 1):92.
- Rababa'h AM, Altarabsheh SE, Haddad O, Deo SV, Obeidat Y, Al-Azzam S. Hawthorn Herb Increases the Risk of Bleeding after Cardiac Surgery: An Evidence-Based Approach. Heart Surg Forum 2016;19(4):E175-9. PubMed
- Shatoor AS, Soliman H, Al-Hashem F, Gamal BE, Othman A, El-Menshaw N. Effect of hawthorn (Crataegus aronia syn. Azarolus (L)) on platelet function in albino wistar rats. Thromb Res 2012;130(1):75-80. PubMed
- Vibes J, Lasserre B, Gleye J, Declume C. Inhibition of thromboxane A2 biosynthesis in vitro by the main components of Crataegus oxyacantha (hawthorn) flower heads. Prostaglandins Leukot Essent Fatty Acids 1994;50(4):173-5. PubMed
- Rogers KL, Grice ID, Griffiths LR. Inhibition of platelet aggregation and 5-HT release by extracts of Australian plants used traditionally as headache treatments. Eur J Pharm Sci 2000;9(4):355-63. PubMed
- Zhou CC, Huang XX, Gao PY, et al. Two new compounds from Crataegus pinnatifida and their antithrombotic activities. J Asian Nat Prod Res 2014;16(2):169-74.
- Palmer KG, Lebin JA, Cronin MT, Mazor SS, Burns RA. Crataegus mexicana (Tejocote) Exposure Associated with Cardiotoxicity and a Falsely Elevated Digoxin Level. J Med Toxicol. 2019;15(4):295-298. PubMed
- Espinosa J, Bassett R, Lucerna A, Finn D. Hawthorne root (Crataegus mexicana) toxicity. Am J Emerg Med. 2024;78:242.e5-242.e6. PubMed
Terminalia 9 references
- Sabu, M. C. and Kuttan, R. Anti-diabetic activity of medicinal plants and its relationship with their antioxidant property. J Ethnopharmacol. 2002;81(2):155-160. PubMed
- Rao, N. K. and Nammi, S. Antidiabetic and renoprotective effects of the chloroform extract of Terminalia chebula Retz. seeds in streptozotocin-induced diabetic rats. BMC.Complement Altern.Med 2006;6:17. PubMed
- Murali, Y. K., Anand, P., Tandon, V., Singh, R., Chandra, R., and Murthy, P. S. Long-term effects of Terminalia chebula Retz. on hyperglycemia and associated hyperlipidemia, tissue glycogen content and in vitro release of insulin in streptozotocin induced
- Senthilkumar, G. P. and Subramanian, S. Evaluation of antioxidant potential of Terminalia chebula fruits studies in streptozotocin-induced diabetic rats. Pharmaceutical Biology (Netherlands) 2007;45:511-518.
- Malik N, Dhawan V, Bahl A, Kaul D. Inihbitory effects of Terminalia arjuna on platelet activation in vitro in healthy subjects and patients with coronary artery disease. Platelets. 2009;20(3):183-1190.
- Varghese A, Savai J, Pandita N, Gaud RS. In vitro modulatory effects of Terminalia arjuna, arjunic acid, arjunetin, and arjungenin on CYP3A4, CYP2D6, and CYP2C9 enzyme activity in human liver microsomes. Toxicology Reports. 2015(2):806-16. PubMed
- Wu G, Dong Z, Dong J, et al. Effects of mongolian medicine Terminalia chebula Retz. on 6 CYP450 enzymes in rats. Int J Clin Exp Pathol 2020;13(12):3128-3138.
- Das A, Naveen J, Sreerama YN, Gnanesh Kumar BS, Baskaran V. Low-glycemic foods with wheat, barley and herbs (Terminalia chebula, Terminalia bellerica and Emblica officinalis) inhibit a-amylase, a-glucosidase and DPP-IV activity in high fat and low dose st
- Eltimamy M, Elshamarka M, Aboelsaad M, Sayed M, Moawad H. Effects of alcoholic extract of Terminalia Chebula dried fruit on blood biochemical profile in diabetic rats. J Diabetes Metab Disord 2022;21(1):159-170. PubMed
Panax Ginseng 66 references
- Scaglione F, Cattaneo G, Alessandria M, Cogo R. Efficacy and safety of the standardized Ginseng extract G115 for potentiating vaccination against the influenza syndrome and protection against the common cold. Drugs Exp Clin Res 1996;22:65-72.
- Palmer BV, Montgomery AC, Monteiro JC, et al. Gin Seng and mastalgia [letter]. BMJ 1978;1:1284. PubMed
- Hopkins MP, Androff L, Benninghoff AS. Ginseng face cream and unexplained vaginal bleeding. Am J Obstet Gynecol 1988;159:1121-2. PubMed
- Greenspan EM. Ginseng and vaginal bleeding [letter]. JAMA 1983;249:2018.
- Gonzalez-Seijo JC, Ramos YM, Lastra I. Manic episode and ginseng: Report of a possible case. J Clin Psychopharmacol 1995;15:447-8.
- Dega H, Laporte JL, Frances C, et al. Ginseng as a cause of Stevens-Johnson syndrome. Lancet 1996;347:1344.
- Hamid S, Rojter S, Vierling J. Protracted cholestatic hepatitis after the use of Prostata. Ann Intern Med 1997;127:169-70.
- Shader RI, Greenblatt DJ. Phenelzine and the dream machine-ramblings and reflections. J Clin Psychopharmacol 1985;5:65. PubMed
- Jones BD, Runikis AM. Interaction of ginseng with phenelzine. J Clin Psychopharmacol 1987;7:201-2. PubMed
- Janetzky K, Morreale AP. Probable interaction between warfarin and ginseng. Am J Health Syst Pharm 1997;54:692-3. PubMed
- Becker BN. Ginseng-induced diuretic resistance. JAMA 1996;276:606-7. PubMed
- Gurley BJ, Gardner SF, Hubbard MA. Clinical assessment of potential cytochrome P450-mediated herb-drug interactions. AAPS Ann Mtg & Expo Indianapolis, IN: 2000; Oct 29 - Nov 2:presentation #3460.
- Park HJ, Lee JH, Song YB, Park KH. Effects of dietary supplementation of lipophilic fraction from Panax ginseng on cGMP and cAMP in rat platelets and on blood coagulation. Biol Pharm Bull 1996;19:1434-9. PubMed
- Zhu M, Chan KW, Ng LS, et al. Possible influences of ginseng on the pharmacodynamics of warfarin in rats. J Pharm Pharmacol 1999;51:175-80.
- Choi HK, Jung GW, Moon KH, et al. Clinical study of SS-Cream in patients with lifelong premature ejaculation. Urology 2000;55:257-61. PubMed
- Shin HR, Kim JY, Yun TK, et al. The cancer-preventive potential of Panax ginseng: a review of human and experimental evidence. Cancer Causes Control 2000;11:565-76. PubMed
- Siegel RK. Ginseng Abuse Syndrome. JAMA 1979;241:1614-5. DOI
- Palop-Larrea V, Gonzalvez-Perales JL, Catalan-Oliver C, et al. Metrorrhagia and ginseng. Ann Pharmacother 2000;34:1347-8. PubMed
- Caron MF, Hotsko AL, Robertson S, et al. Electrocardiographic and hemodynamic effects of Panax ginseng. Ann Pharmacother 2002;36:758-63..
- Eagon PK, Elm MS, Hunter DS, et al. Medicinal herbs: modulation of estrogen action. Era of Hope Mtg, Dept Defense; Breast Cancer Res Prog, Atlanta, GA 2000;Jun 8-11.
- Chan LY, Chiu PY, Lau TK. An in-vitro study of ginsenoside Rb(1)-induced teratogenicity using a whole rat embryo culture model. Hum Reprod 2003;18:2166-8..
- Gurley BJ, Gardner SF, Hubbard MA, et al. Cytochrome P450 phenotypic ratios for predicting herb-drug interactions in humans. Clin Pharmacol Ther 2002;72:276-87.. PubMed
- Wiklund IK, Mattsson LA, Lindgren R, et al. Effects of a standardized ginseng extract on quality of life and physiological parameters in symptomatic postmenopausal women: a double-blind, placebo-controlled trial. Int J Clin Pharmacol Res 1999;19:89-99..
- Hammond TG, Whitworth JA. Adverse reactions to ginseng [letter]. Med J Aust 1981;1:492.. PubMed
- Punnonen R, Lukola A. Oestrogen-like effect of ginseng. Br Med J 1980;281:1110.. PubMed
- Lee YJ, Jin YR, Lim WC, et al. Ginsenoside-Rb1 acts as a weak phytoestrogen in MCF-7 human breast cancer cells. Arch Pharm Res 2003;26:58-63.. PubMed
- Xu QF, Fang XL, Chen DF. Pharmacokinetics and bioavailability of ginsenoside Rb1 and Rg1 from Panax notoginseng in rats. J Ethnopharmacol 2003;84:187-92. PubMed
- Jiang X, Williams KM, Liauw WS, et al. Effect of St John's wort and ginseng on the pharmacokinetics and pharmacodynamics of warfarin in healthy subjects. Br J Clin Pharmacol 2004;57:592-9. PubMed
- Yun YP, Do JH, Ko SR, et al. Effects of Korean red ginseng and its mixed prescription on the high molecular weight dextran-induced blood stasis in rats and human platelet aggregation. J Ethnopharmacol 2001;77:259-64. PubMed
- Wiwanikit V, Taungjarwinai W. A case report of suspected ginseng allergy. Medscape General Medicine 6 (3), 2004. Available at: www.medscape.com/viewarticle/482833 (Accessed 17 September 2004).
- Kabalak AA, Soyal OB, Urfalioglu A, et al. Menometrorrhagia and tachyarrhythmia after using oral and topical ginseng. J Womens Health (Larchmt) 2004;13:830-3. PubMed
- Jiang X, Blair EY, McLachlan AJ. Investigation of the effects of herbal medicines on warfarin response in healthy subjects: a population pharmacokinetic-pharmacodynamic modeling approach. J Clin Pharmacol 2006;46:1370-8. PubMed
- Lee SH, Ahn YM, Ahn SY, et al. Interaction between warfarin and Panax ginseng in ischemic stroke patients. J Altern Complement Med 2008;14:715-721.
- Smith M, Lin KM, and Zheng YP. PIII-89 an open trial of nifedipine-herb interactions: Nifedipine with St. John's wort, ginseng or ginkgo biloba. Clin Pharm Ther 2001;69:P86.
- Mateo-Carrasco, H., Galvez-Contreras, M. C., Fernandez-Gines, F. D., and Nguyen, T. V. Elevated liver enzymes resulting from an interaction between Raltegravir and Panax ginseng: a case report and brief review. Drug Metabol.Drug Interact. 2012;27(3):171-1
- Oh, K. J., Chae, M. J., Lee, H. S., Hong, H. D., and Park, K. Effects of Korean red ginseng on sexual arousal in menopausal women: placebo-controlled, double-blind crossover clinical study. J Sex Med 2010;7(4 Pt 1):1469-1477. PubMed
- Kim, T. H., Jeon, S. H., Hahn, E. J., Paek, K. Y., Park, J. K., Youn, N. Y., and Lee, H. L. Effects of tissue-cultured mountain ginseng (Panax ginseng CA Meyer) extract on male patients with erectile dysfunction. Asian J Androl 2009;11(3):356-361. PubMed
- Hu, Z., Yang, X., Ho, P. C., Chan, S. Y., Heng, P. W., Chan, E., Duan, W., Koh, H. L., and Zhou, S. Herb-drug interactions: a literature review. Drugs 2005;65(9):1239-1282. PubMed
- Zhang, R., Jie, J., Zhou, Y., Cao, Z., and Li, W. Long-term effects of Panax ginseng on disposition of fexofenadine in rats in vivo. Am J Chin Med 2009;37(4):657-667.
- Lee, Y. H., Lee, B. K., Choi, Y. J., Yoon, I. K., Chang, B. C., and Gwak, H. S. Interaction between warfarin and Korean red ginseng in patients with cardiac valve replacement. Int J Cardiol. 11-19-2010;145(2):275-276. PubMed
- Liu, P., Yin, H., Xu, Y., Zhang, Z., Chen, K., and Li, Y. Effects of ginsenoside Rg1 on postimplantation rat and mouse embryos cultured in vitro. Toxicol In Vitro 2006;20(2):234-238. PubMed
- Liu, P., Xu, Y., Yin, H., Wang, J., Chen, K., and Li, Y. Developmental toxicity research of ginsenoside Rb1 using a whole mouse embryo culture model. Birth Defects Res B Dev Reprod Toxicol 2005;74(2):207-209. PubMed
- Gurley, B. J., Gardner, S. F., Hubbard, M. A., Williams, D. K., Gentry, W. B., Cui, Y., and Ang, C. Y. Clinical assessment of effects of botanical supplementation on cytochrome P450 phenotypes in the elderly: St John's wort, garlic oil, Panax ginseng and DOI
- Wesnes KA, Faleni RA, Hefting NR, and et al. The cognitive, subjective, and physical effects of a Ginkgo biloba/Panax ginseng combination in healthy volunteers with neurasthenic complaints. Psychopharmacol Bull 1997;33(4):677-683.
- Martínez-Mir I, Rubio E, Morales-Olivas FJ, Palop-Larrea V. Transient ischemic attack secondary to hypertensive crisis related to Panax ginseng. Ann Pharmacother 2004;38(11):1970.
- Kakisaka Y, Ohara T, Tozawa H, Sato S, Katayama S, Suzuki T, Hino-Fukuyo N, Kure S. Panax ginseng: a newly identified cause of gynecomastia. Tohoku J Exp Med 2012;228(2):143-5. PubMed
- Malati CY, Robertson SM, Hunt JD, Chairez C, Alfaro RM, Kovacs JA, Penzak SR. Influence of Panax ginseng on cytochrome P450 (CYP)3A and P-glycoprotein (P-gp) activity in healthy participants. J Clin Pharmacol 2012;52(6):932-9.
- Sen A. Orobuccolingual dyskinesia after long-term use of black cohosh and ginseng. J Neuropsychiatry Clin Neurosci 2013 Fall;25(4):E50. PubMed
- Oh MR, Park SH, Kim SY, Back HI, Kim MG, Jeon JY, Ha KC, Na WT, Cha YS, Park BH, Park TS, Chae SW. Postprandial glucose-lowering effects of fermented red ginseng in subjects with impaired fasting glucose or type 2 diabetes: a randomized, double-blind, pla
- Kim HG, Cho JH, Yoo SR, Lee JS, Han JM, Lee NH, Ahn YC, Son CG. Antifatigue effects of Panax ginseng C.A. Meyer: a randomised, double-blind, placebo-controlled trial. PLoS One 2013;8(4):e61271. PubMed
- Rhee MY, Kim YS, Bae JH, Nah DY, Kim YK, Lee MM, Kim HY. Effect of Korean red ginseng on arterial stiffness in subjects with hypertension. J Altern Complement Med 2011;17(1):45-9.
- Bilgi N, Bell K, Ananthakrishnan AN, Atallah E. Imatinib and Panax ginseng: a potential interaction resulting in liver toxicity. Ann Pharmacother 2010;44(5):926-8.
- Jalloh MA, Gregory PJ, Hein D, et al. Dietary supplement interactions with antiretrovirals: a systematic review. Int J STD AIDS. 2017 Jan;28(1):4-15. PubMed
- Shah SA, Occiano A, Nguyen TA, et al. Electrocardiographic and blood pressure effects of energy drinks and panax ginseng in healthy volunteers: a randomized clinical trial. Int J Cardiol. 2016 Sep 1;218:318-23. PubMed
- Yang L, Li CL, Tsai TH. Preclinical Herb-Drug Pharmacokinetic Interaction of Panax ginseng Extract and Selegiline in Freely Moving Rats. ACS Omega. 2020;5(9):4682-4688.
- Shen L, Gwak SR, Joo JC, et al. Effectiveness and safety of Panax ginseng extract on hepatic dysfunction: A randomized, double-blind, placebo-controlled clinical trial. Evid Based Complement Alternat Med. 2020;2020:2689565.
- Kim Y, Jo JJ, Cho P, et al. Characterization of red ginseng-drug interaction by CYP3A activity increased in high dose administration in mice. Biopharm Drug Dispos. 2020;41(7):295-306. PubMed
- Bessell E, Fuller NR, Markovic TP, et al. Effects of a-cyclodextrin on cholesterol control and hydrolyzed ginseng extract on glycemic control in people with prediabetes: a randomized clinical trial. JAMA Netw Open 2020 Nov 2;3(11):e2023491.
- Lee SR, Hur K, Cho S. Subcorneal pustular dermatosis as a cause of pityriasis amiantacea in a young child. JAAD Case Rep 2021;18:40-44. PubMed
- Liu J, Chang D, Cordato D, et al. A pilot randomized controlled trial of WeiNaoKang (SaiLuoTong) in treating vascular dementia. Aging Med (Milton). 2022;5(4):246-256. PubMed
- Shin D, Yoon BI, Bang S, et al. Safety and Efficacy Assessment of Red Ginseng Oil (RXGIN) in Men with Lower Urinary Tract Symptoms in a Randomized, Double-Blind, Placebo-Controlled Trial. World J Mens Health 2023. PubMed
- Shin MB, Kim SA, Lee S, et al. Pharmacokinetic Comparison of Ginsenosides between Fermented and Non-Fermented Red Ginseng in Healthy Volunteers. Pharmaceutics 2022;14(12):2807. PubMed
- Gao J, Shi J, Ma X, et al. Effects of ginseng berry saponins from panax ginseng on glucose metabolism of patients with prediabetes: A randomized, double-blinded, placebo-controlled, crossover trial. Phytomedicine 2024;132:155842. PubMed
- Cho SK, Song YJ, Han JY, Kim HW, Nam E, Sung YK. Effectiveness of Korean Red Ginseng on fatigue in patients with rheumatic diseases: a randomized, double-blind, placebo-controlled study. Korean J Intern Med 2024;39(4):680-690. PubMed
- Arabi SM, Shahraki-Jazinaki M, Nayyerabadi M, et al. The Effect of Ginseng Supplementation on Lipid Profile: GRADE-assessed Systematic Review and Dose-response Meta-analysis of Randomized Controlled Trials. Curr Pharm Des 2024;30(26):2047-205. PubMed
- Zeng X, Zhou X, Zhang A, et al. Pityriasis Rosea-Like Eruption following anti-fatigue traditional herbs: Aconitum carmichaelii Debx and Panax Ginseng suspected. BMC Complement Med Ther 2024;24(1):248. 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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