Herbal Defense Ingredients & Drug Interactions
What is this page for?
First and foremost: checking Herbal Defense 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
Herbal Defense is a dietary supplement by Herbally Grounded with 3 active ingredients. Its ingredients are commonly taken for irritable bowel syndrome (ibs), indigestion and gas, nausea.Based on those ingredients, 959 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Echinacea angustifolia, Peppermint, Myrrh. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against Herbal Defense by Herbally Grounded
Ask about any prescription or over-the-counter medication and we check it for interactions with Herbal Defense by Herbally Grounded — 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 Herbal Defense by Herbally Grounded
Our pharmacy team’s full take, with four database checks built into the cards below — a summary of what is known, not a grade of the product itself.
What’s inside
Low disclosure
Herbal Defense is a liquid supplement containing 3 active ingredients: peppermint, myrrh, and echinacea angustifolia, blended together. These are mixed with vegetable glycerine and distilled water as inactive ingredients.
Peppermint is included for its effects on digestion and gastrointestinal comfort. Myrrh and echinacea are traditional herbs commonly used to support immune and general wellness function, though the evidence for most of their uses is limited or not well established.
Does it work?
Not established
Peppermint has the most established evidence in this product: it's rated Likely Effective for irritable bowel syndrome (IBS) and Possibly Effective for indigestion, nausea from chemotherapy, and reducing colon spasm during certain medical procedures. Myrrh and echinacea have insufficient reliable evidence to support their use for most conditions in our data.
Myrrh is rated Likely Ineffective for schistosomiasis (a parasitic infection) and shows insufficient evidence for back pain, cancer, colds, dental implant infections, and Crohn disease. Echinacea shows insufficient evidence for anxiety, athletic performance, ADHD, burns, chronic fatigue, and migraines.
If you're considering this product for a specific health goal, talk with your doctor or pharmacist about whether the evidence supports that use.
How safe is it?
Well-documented data
Peppermint is generally well tolerated when used orally; the most common side effects are abdominal pain, belching, dry mouth, diarrhea, heartburn, nausea, and vomiting. Rare allergic reactions including anaphylaxis have been reported, especially in people with peppermint sensitivity.
Concentrated peppermint oil should be used with caution because large amounts can cause burns in the mouth and throat. Myrrh is likely safe for short-term topical or mouth-rinse use, but oral safety is not well studied.
Orally, it may cause diarrhea at higher doses and has traditionally been said to stimulate the uterus, so it should be avoided in pregnancy. Echinacea is generally well tolerated short-term but may cause allergic reactions, especially in people sensitive to ragweed and related plants (ragweed family).
Rare cases of liver inflammation have been reported. Since safety information is limited, check with your doctor or pharmacist before starting, especially if you have allergies or sensitivities.
Meds to double-check
Moderate interaction found
Before taking Herbal Defense, double-check with your doctor or pharmacist if you take blood thinners like warfarin, immunosuppressants such as cyclosporine, antidiabetes medications, heart drugs metabolized by your liver (including certain calcium-channel blockers), cancer medications like etoposide, or any drug that depends on liver enzymes (CYP1A2, CYP2C9, CYP2C19, or CYP3A4) to be broken down. These Moderate-severity interactions are the most serious documented for this product's ingredients.
The bottom line
Scorecard at a glanceFormula with limited ingredient disclosure with no established evidence rating for its marketed use. Moderate medication interactions have been identified, and safety information is well characterized.
Herbal Defense may appeal to you if you're looking for peppermint's established benefit for IBS and indigestion. However, the myrrh and echinacea components have limited evidence for most uses.
More importantly, this product has documented interactions with a substantial number of medications—especially blood thinners, immunosuppressants, diabetes drugs, and certain cancer or heart medications. Before you start it, check your exact prescriptions with your own doctor or pharmacist using the tool on this page.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 3 of 3 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Dec 26, 2020.
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 Herbal Defense, straight from the product label.
| Brand | Herbally Grounded |
|---|---|
| Net contents | 4 Fluid Ounce(s) |
| Market status | On market |
| Date entered into DSLD | Dec 26, 2020 |
| DSLD ID | 239711 |
| Product type | Botanical |
| Supplement form | Liquid |
| Dietary claims / uses | All Other |
| Intended target group(s) | Children 4 or More Years of Age, Vegetarian, Adult (18 - 50 Years) |
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.
Supplement Facts
The label details for Herbal Defense by Herbally Grounded, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Proprietary Blend | 500 mg | -- |
| Peppermint | 0 NP | -- |
| Myrrh | 0 NP | -- |
| Echinacea angustifolia | 0 NP | -- |
Other ingredients: Vegetable Glycerine, distilled Water
Tap any ingredient to jump to its full detail below.
These statements are the manufacturer’s wording, reproduced from the product label — the label is saying it, not HelloPharmacist. We don’t verify or endorse them.
General Statements
Herbal Defense (Formerly Kid Viral)
Formulation
This combination of herbs assists the body in gently healing infections, making Herbal Defense ideal for adults and children alike. the herbs have also been known to assist the body in increasing white blood cell activity, antibody protection, and help to reduce the risk of the spread of illness.
100% Vegetarian formula
Suggested/Recommended/Usage/Directions
Recommended Use: Take 3 squirts once or twice a day. Increase as needed.
Formula
Proprietary Blend: Myrrh, Echinacea angustifolia root, Peppermint leaf, Kosher vegetable Glycerine, distilled Water
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Herbal Defense by Herbally Grounded 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 Herbal Defense by Herbally Grounded
These are the 3 active ingredients this product is made of. Select any to open its full monograph.
Serving size3 Squirt(s) Dosage formLiquid Servings per container60 Amounts shown are per serving.
Most supplement products combine several ingredients, and a medication can interact with the product through any one of them. Each ingredient below shows whether it has known drug interactions.
Proprietary Blend
Other (inactive) ingredients: Vegetable Glycerine, Distilled Water. These complete the product’s ingredient list but are not active constituents.
Herbal Defense by Herbally Grounded Drug Interactions
HelloPharmacist Interaction Report
Herbal Defense by Herbally Grounded contains three active ingredients—peppermint, myrrh, and echinacea angustifolia—and they interact with medications across multiple drug types.
The most serious documented interaction involves myrrh and warfarin (a blood thinner), where myrrh theoretically may decrease warfarin's effectiveness and cause a significant drop in its blood-thinning action.
Read the full breakdown — every affected drug type, severity by severity
Peppermint interacts with several drug-metabolizing enzymes in your liver (CYP2C19, CYP2C9, and CYP3A4 substrates), potentially raising the levels of these medications. It also has a documented Moderate interaction with cyclosporine (an immunosuppressant), where it may increase cyclosporine levels and side effects.
A single dose of peppermint oil 600 mg has been shown in clinical research to inhibit CYP3A4 and increase blood levels of felodipine, a heart medication. Additionally, peppermint carries a Minor interaction with CYP1A2 substrates, though clinical evidence of harm is limited.
Myrrh carries a Moderate interaction with antidiabetes drugs, where it may theoretically increase the risk of low blood sugar (hypoglycemia). Echinacea interacts with CYP1A2 and CYP3A4 substrates, and has documented Moderate interactions with caffeine (raising its levels by around 30%), immunosuppressants, and the cancer drug etoposide.
It carries Minor interactions with warfarin and certain HIV and anesthesia medications.
Altogether, these interactions span 960 individual medications. Use the medication checker on this page to search your exact prescriptions before starting this product, and confirm with your own doctor or pharmacist that it's safe to combine.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against Herbal Defense?
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 Herbal Defense interact with 959 drugs. Click any drug to see the details.
3 of the 3 ingredients in Herbal Defense interact with drugs. Each result below shows which ingredient is responsible. Echinacea angustifolia Peppermint Myrrh
6-mercaptopurinePurinethol
How 6-mercaptopurine interacts with Herbal Defense — through 1 ingredient. Tap an ingredient for the detail:
Echinacea AngustifoliaImmunosuppressants Moderate
Interaction Summary
Echinacea has immunostimulant activity which may interfere with immunosuppressant therapy.
Read the full Echinacea Angustifolia + 6-mercaptopurine interactionAdo-trastuzumab EmtansineKadcyla
How Ado-trastuzumab Emtansine interacts with Herbal Defense — through 2 ingredients. Tap an ingredient for the detail:
PeppermintCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, peppermint might increase the levels of CYP3A4 substrates.
Read the full Peppermint + Ado-trastuzumab Emtansine interactionEchinacea AngustifoliaCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea Angustifolia + Ado-trastuzumab Emtansine interactionAbemaciclibVerzenio
How Abemaciclib interacts with Herbal Defense — through 2 ingredients. Tap an ingredient for the detail:
Echinacea AngustifoliaCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea Angustifolia + Abemaciclib interactionPeppermintCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, peppermint might increase the levels of CYP3A4 substrates.
Read the full Peppermint + Abemaciclib interactionAbiraterone
How Abiraterone interacts with Herbal Defense — through 2 ingredients. Tap an ingredient for the detail:
PeppermintCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, peppermint might increase the levels of CYP3A4 substrates.
Read the full Peppermint + Abiraterone interactionEchinacea AngustifoliaCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea Angustifolia + Abiraterone interactionAbiraterone AcetateYonsa, Zytiga
How Abiraterone Acetate interacts with Herbal Defense — through 2 ingredients. Tap an ingredient for the detail:
PeppermintCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, peppermint might increase the levels of CYP3A4 substrates.
Read the full Peppermint + Abiraterone Acetate interactionEchinacea AngustifoliaCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea Angustifolia + Abiraterone Acetate interactionAbrocitinibCibinqo
How Abrocitinib interacts with Herbal Defense — through 2 ingredients. Tap an ingredient for the detail:
PeppermintCytochrome P450 2c9 (cyp2c9) Substrates, Cytochrome P450 2c19 (cyp2c19) Substrates Moderate
Interaction Summary
Theoretically, peppermint might increase the levels of CYP2C9 substrates.
Read the full Peppermint + Abrocitinib interactionEchinacea AngustifoliaImmunosuppressants Moderate
Interaction Summary
Echinacea has immunostimulant activity which may interfere with immunosuppressant therapy.
Read the full Echinacea Angustifolia + Abrocitinib interactionAcalabrutinibCalquence
How Acalabrutinib interacts with Herbal Defense — through 2 ingredients. Tap an ingredient for the detail:
PeppermintCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, peppermint might increase the levels of CYP3A4 substrates.
Read the full Peppermint + Acalabrutinib interactionEchinacea AngustifoliaCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea Angustifolia + Acalabrutinib interactionAcarboseGlucobay, Prandase, Precose
How Acarbose interacts with Herbal Defense — through 1 ingredient. Tap an ingredient for the detail:
MyrrhAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, myrrh might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Read the full Myrrh + Acarbose interactionAcetaminophenChildren's Tylenol, Children's Tylenol Meltaways, Tylenol, Tylenol Ex Strength
How Acetaminophen interacts with Herbal Defense — through 2 ingredients. Tap an ingredient for the detail:
Echinacea AngustifoliaCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea Angustifolia + Acetaminophen interactionPeppermintCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, peppermint might increase the levels of CYP1A2 substrates.
Read the full Peppermint + Acetaminophen interactionAcetaminophen, AspirinGemnisyn
How Acetaminophen, Aspirin interacts with Herbal Defense — through 2 ingredients. Tap an ingredient for the detail:
Echinacea AngustifoliaCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea Angustifolia + Acetaminophen, Aspirin interactionPeppermintCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, peppermint might increase the levels of CYP1A2 substrates.
Read the full Peppermint + Acetaminophen, Aspirin interactionAcetaminophen, Aspirin, CaffeineExcedrin, Excedrin Extra Strength, Excedrin Migraine
How Acetaminophen, Aspirin, Caffeine interacts with Herbal Defense — through 2 ingredients. Tap an ingredient for the detail:
Echinacea AngustifoliaCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea Angustifolia + Acetaminophen, Aspirin, Caffeine interactionPeppermintCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, peppermint might increase the levels of CYP3A4 substrates.
Read the full Peppermint + Acetaminophen, Aspirin, Caffeine interactionAcetaminophen, Brompheniramine, PhenylpropanolamineDimetapp Cold and Flu
How Acetaminophen, Brompheniramine, Phenylpropanolamine interacts with Herbal Defense — through 2 ingredients. Tap an ingredient for the detail:
Echinacea AngustifoliaCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea Angustifolia + Acetaminophen, Brompheniramine, Phenylpropanolamine interactionPeppermintCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, peppermint might increase the levels of CYP1A2 substrates.
Read the full Peppermint + Acetaminophen, Brompheniramine, Phenylpropanolamine interactionAcetaminophen, ButalbitalAxocet, Bancap, Bucet, Butex Forte, Esgic CF, Orbivan CF +5 more
How Acetaminophen, Butalbital interacts with Herbal Defense — through 2 ingredients. Tap an ingredient for the detail:
Echinacea AngustifoliaCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea Angustifolia + Acetaminophen, Butalbital interactionPeppermintCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, peppermint might increase the levels of CYP1A2 substrates.
Read the full Peppermint + Acetaminophen, Butalbital interactionAcetaminophen, Butalbital, CaffeineEsgic, Esgic Plus, Fiogesic, Fioricet, Repan, Tecnal +1 more
How Acetaminophen, Butalbital, Caffeine interacts with Herbal Defense — through 2 ingredients. Tap an ingredient for the detail:
PeppermintCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, peppermint might increase the levels of CYP1A2 substrates.
Read the full Peppermint + Acetaminophen, Butalbital, Caffeine interactionEchinacea AngustifoliaCaffeine, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Moderate
Interaction Summary
Echinacea can increase plasma levels of caffeine by inhibiting its metabolism.
Read the full Echinacea Angustifolia + Acetaminophen, Butalbital, Caffeine interactionAcetaminophen, Butalbital, Caffeine, CodeineEsgic with Codeine, Fioricet w/ Codeine
How Acetaminophen, Butalbital, Caffeine, Codeine interacts with Herbal Defense — through 2 ingredients. Tap an ingredient for the detail:
PeppermintCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, peppermint might increase the levels of CYP3A4 substrates.
Read the full Peppermint + Acetaminophen, Butalbital, Caffeine, Codeine interactionEchinacea AngustifoliaCytochrome P450 1a2 (cyp1a2) Substrates, Caffeine +1 Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea Angustifolia + Acetaminophen, Butalbital, Caffeine, Codeine interactionAcetaminophen, Butalbital, CodeineBancap w/ Codeine
How Acetaminophen, Butalbital, Codeine interacts with Herbal Defense — through 2 ingredients. Tap an ingredient for the detail:
Echinacea AngustifoliaCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea Angustifolia + Acetaminophen, Butalbital, Codeine interactionPeppermintCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, peppermint might increase the levels of CYP1A2 substrates.
Read the full Peppermint + Acetaminophen, Butalbital, Codeine interactionAcetaminophen, Butalbital, Codeine PhosphatePhrenilin #3
How Acetaminophen, Butalbital, Codeine Phosphate interacts with Herbal Defense — through 2 ingredients. Tap an ingredient for the detail:
Echinacea AngustifoliaCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea Angustifolia + Acetaminophen, Butalbital, Codeine Phosphate interactionPeppermintCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, peppermint might increase the levels of CYP1A2 substrates.
Read the full Peppermint + Acetaminophen, Butalbital, Codeine Phosphate interactionAcetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, PhenylephrineHycomine Compound
How Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interacts with Herbal Defense — through 2 ingredients. Tap an ingredient for the detail:
PeppermintCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, peppermint might increase the levels of CYP3A4 substrates.
Read the full Peppermint + Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interactionEchinacea AngustifoliaCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea Angustifolia + Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interactionAcetaminophen, Caffeine, CodeineGesic C15, Gesic C30, Gesic C8, Lenoltec 1, Lenoltec 2, Lenoltec 3 +1 more
How Acetaminophen, Caffeine, Codeine interacts with Herbal Defense — through 2 ingredients. Tap an ingredient for the detail:
Echinacea AngustifoliaCaffeine, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Moderate
Interaction Summary
Echinacea can increase plasma levels of caffeine by inhibiting its metabolism.
Read the full Echinacea Angustifolia + Acetaminophen, Caffeine, Codeine interactionPeppermintCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, peppermint might increase the levels of CYP1A2 substrates.
Read the full Peppermint + Acetaminophen, Caffeine, Codeine interactionAcetaminophen, Caffeine, Codeine, SalicylamideCodalan No.1, Codalan No.2, Codalan No.3
How Acetaminophen, Caffeine, Codeine, Salicylamide interacts with Herbal Defense — through 2 ingredients. Tap an ingredient for the detail:
Echinacea AngustifoliaCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea Angustifolia + Acetaminophen, Caffeine, Codeine, Salicylamide interactionPeppermintCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, peppermint might increase the levels of CYP1A2 substrates.
Read the full Peppermint + Acetaminophen, Caffeine, Codeine, Salicylamide interactionAcetaminophen, Caffeine, DihydrocodeineDHC Plus, Panlor DC, Panlor SS
How Acetaminophen, Caffeine, Dihydrocodeine interacts with Herbal Defense — through 2 ingredients. Tap an ingredient for the detail:
Echinacea AngustifoliaCaffeine, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Moderate
Interaction Summary
Echinacea can increase plasma levels of caffeine by inhibiting its metabolism.
Read the full Echinacea Angustifolia + Acetaminophen, Caffeine, Dihydrocodeine interactionPeppermintCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, peppermint might increase the levels of CYP3A4 substrates.
Read the full Peppermint + Acetaminophen, Caffeine, Dihydrocodeine interactionAcetaminophen, Caffeine, IsomethepteneMigralam
How Acetaminophen, Caffeine, Isometheptene interacts with Herbal Defense — through 2 ingredients. Tap an ingredient for the detail:
PeppermintCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, peppermint might increase the levels of CYP1A2 substrates.
Read the full Peppermint + Acetaminophen, Caffeine, Isometheptene interactionEchinacea AngustifoliaCaffeine, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Moderate
Interaction Summary
Echinacea can increase plasma levels of caffeine by inhibiting its metabolism.
Read the full Echinacea Angustifolia + Acetaminophen, Caffeine, Isometheptene interactionAcetaminophen, Caffeine, PyrilamineMidol Max Strength Menstrual
How Acetaminophen, Caffeine, Pyrilamine interacts with Herbal Defense — through 2 ingredients. Tap an ingredient for the detail:
Echinacea AngustifoliaCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea Angustifolia + Acetaminophen, Caffeine, Pyrilamine interactionPeppermintCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, peppermint might increase the levels of CYP1A2 substrates.
Read the full Peppermint + Acetaminophen, Caffeine, Pyrilamine interactionAcetaminophen, Chlorpheniramine Maleate, Dextromethorphan HbrVicks Formula 44M Cough, Cold & Flu Relief
How Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interacts with Herbal Defense — through 2 ingredients. Tap an ingredient for the detail:
Echinacea AngustifoliaCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea Angustifolia + Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interactionPeppermintCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, peppermint might increase the levels of CYP3A4 substrates.
Read the full Peppermint + Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interactionAcetaminophen, Chlorpheniramine, Codeine, PhenylephrineColrex
How Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interacts with Herbal Defense — through 2 ingredients. Tap an ingredient for the detail:
Echinacea AngustifoliaCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea Angustifolia + Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interactionPeppermintCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, peppermint might increase the levels of CYP3A4 substrates.
Read the full Peppermint + Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interactionAcetaminophen, Chlorpheniramine, DextromethorphanCoricidin II Extra Strength Cold and Flu
How Acetaminophen, Chlorpheniramine, Dextromethorphan interacts with Herbal Defense — through 2 ingredients. Tap an ingredient for the detail:
Echinacea AngustifoliaCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea Angustifolia + Acetaminophen, Chlorpheniramine, Dextromethorphan interactionPeppermintCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, peppermint might increase the levels of CYP1A2 substrates.
Read the full Peppermint + Acetaminophen, Chlorpheniramine, Dextromethorphan interactionAcetaminophen, Chlorpheniramine, Dextromethorphan HydrobromideCoricidin HBP Maximum Strength Flu
How Acetaminophen, Chlorpheniramine, Dextromethorphan Hydrobromide interacts with Herbal Defense — through 2 ingredients. Tap an ingredient for the detail:
Echinacea AngustifoliaCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea Angustifolia + Acetaminophen, Chlorpheniramine, Dextromethorphan Hydrobromide interactionPeppermintCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, peppermint might increase the levels of CYP1A2 substrates.
Read the full Peppermint + Acetaminophen, Chlorpheniramine, Dextromethorphan Hydrobromide interactionAcetaminophen, Chlorpheniramine, Dextromethorphan, PhenylpropanolamineMulti Symptom Cold Relief
How Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylpropanolamine interacts with Herbal Defense — through 2 ingredients. Tap an ingredient for the detail:
Echinacea AngustifoliaCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea Angustifolia + Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylpropanolamine interactionPeppermintCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, peppermint might increase the levels of CYP1A2 substrates.
Read the full Peppermint + Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylpropanolamine interactionAcetaminophen, Chlorpheniramine, Dextromethorphan, PseudoephedrineChildren's Tylenol Cold Plus Cough, Tylenol Cold Ex Strength
How Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine interacts with Herbal Defense — through 2 ingredients. Tap an ingredient for the detail:
PeppermintCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, peppermint might increase the levels of CYP3A4 substrates.
Read the full Peppermint + Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine interactionEchinacea AngustifoliaCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea Angustifolia + Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine interactionAcetaminophen, Chlorpheniramine, Guaifenesin, Phenylephrine, SalicylamideRhinogesic GG
How Acetaminophen, Chlorpheniramine, Guaifenesin, Phenylephrine, Salicylamide interacts with Herbal Defense — through 2 ingredients. Tap an ingredient for the detail:
PeppermintCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, peppermint might increase the levels of CYP3A4 substrates.
Read the full Peppermint + Acetaminophen, Chlorpheniramine, Guaifenesin, Phenylephrine, Salicylamide interactionEchinacea AngustifoliaCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea Angustifolia + Acetaminophen, Chlorpheniramine, Guaifenesin, Phenylephrine, Salicylamide interactionEach ingredient & the kinds of drugs it affects
For each ingredient in Herbal Defense 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.
Echinacea angustifolia
Caffeine
Echinacea can increase plasma levels of caffeine by inhibiting its metabolism.
Echinacea seems to increase plasma concentrations of caffeine by around 30%. This is likely due to inhibition of cytochrome P450 1A2 (CYP1A2) by echinacea.
Cytochrome P450 1A2 (Cyp1A2) Substrates
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Echinacea appears to inhibit CYP1A2 enzymes in humans. Additionally, echinacea seems to increase plasma concentrations of caffeine, a CYP1A2 substrate, by around 30%. Theoretically, echinacea might increase levels of other drugs metabolized by CYP1A2.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4. This may increase or decrease levels of drugs metabolized by CYP3A4.
Several clinical trials have shown that taking echinacea for up to one month does not significantly affect the metabolism of various CYP3A4 substrates, including midazolam, docetaxel, etravirine, lopinavir-ritonavir, and darunavir-ritonavir. However, other clinical research shows that echinacea may increase the clearance of midazolam, suggesting that echinacea might induce CYP3A4. The discrepancy is thought to be due to differing effects of echinacea on intestinal versus hepatic CYP3A4 enzymes. Echinacea appears to induce hepatic CYP3A4 but inhibit intestinal CYP3A4. In some cases, these effects might cancel each other out, but in others, drug levels may be increased or decreased depending on the level of effect at hepatic and intestinal sites. The effect of echinacea on CYP3A4 activity may differ depending on the CYP3A4 substrate.
Etoposide (Vepesid)
Echinacea may increase levels of etoposide.
In one report, concomitant use of etoposide and echinacea was associated with more severe thrombocytopenia than the use of etoposide alone, suggesting inhibition of etoposide metabolism. Etoposide is a cytochrome P450 3A4 (CYP3A4) substrate. Echinacea has variable effects on CYP3A4, but some studies have reported inhibition of the enzyme.
Immunosuppressants
Echinacea has immunostimulant activity which may interfere with immunosuppressant therapy.
Theoretically, echinacea may interfere with immunosuppressant therapy because of its immunostimulant activity.
Darunavir (Prezista)
Theoretically, echinacea may interfere with the metabolism of darunavir; however, a small clinical study found no effect.
Darunavir is metabolized by cytochrome P450 3A4 (CYP3A4) and is administered with the CYP3A4 inhibitor ritonavir to increase its plasma concentrations. Echinacea has variable effects on CYP3A4, but administration of an E. purpurea root extract (Arkocapsulas Echinacea, Arkopharma) 500 mg four times daily for 14 days did not affect darunavir/ritonavir pharmacokinetics in 15 HIV-infected patients.
Dayquil Severe
Echinacea is reported to have varying effects on a number of Cytochrome P450 metabolizing enzymes in the liver, including CYP1A2 and CYP3A4, which play a role in acetaminophen and dextromethorphan metabolism (both contained in DayQuil Severe), respectively. Studies have reported both enzyme inhibition and induction, making it difficult to predict clinically significant drug interactions with reliability. Specific drug interaction studies reporting definitive results are rare, and potential drug interactions involving echinacea should likely be taken on a case-by-case basis. Based on what we know about how acetaminophen and dextromethorphan are metabolized, the risk of a clinically significant interaction between echinacea and DayQuil Severe is low.
Docetaxel (Taxotere)
Theoretically, echinacea may interfere with the metabolism of docetaxel; however, a small clinical study found no effect.
Docetaxel is metabolized by cytochrome P450 3A4 (CYP3A4). Echinacea has variable effects on CYP3A4, but taking E. purpurea whole plant extract (Echinaforce, A. Vogel Biopharma AG) 20 drops three times daily for 2 weeks did not alter the pharmacokinetics of docetaxel in one clinical study.
Etravirine (Intelence)
Theoretically, echinacea may interfere with the metabolism of etravirine; however, a small clinical study found no effect.
Etravirine is metabolized by cytochrome P450 3A4 (CYP3A4). Echinacea has variable effects on CYP3A4, but taking E. purpurea root extract (Arkocapsulas Echinacea, Arkopharma) 500 mg three times daily for 14 days did not alter the pharmacokinetics of etravirine in HIV-infected patients.
Lopinavir/Ritonavir (Kaletra)
Theoretically, echinacea may interfere with the metabolism of lopinavir; however, a small clinical study found no effect.
Lopinavir is metabolized by cytochrome P450 3A4 (CYP3A4) and is administered with the CYP3A4 inhibitor ritonavir to increase its plasma concentrations. Echinacea has variable effects on CYP3A4, but taking E. purpurea (Echinamide, Natural Factors Nutritional Products, Inc.) 500 mg three times daily for 14 days did not alter the pharmacokinetics of lopinavir/ritonavir in healthy volunteers.
Midazolam (Versed)
Theoretically, echinacea may increase the metabolism of intravenous midazolam.
Echinacea induces hepatic CYP3A4 and might decrease plasma levels of midazolam by about 20%, reducing the effectiveness of intravenous midazolam. Echinacea also appears to inhibit intestinal CYP3A4, which could theoretically increase the bioavailability of oral midazolam. This may cancel out the decrease in availability caused by induction of hepatic CYP3A4, such that overall plasma levels after oral administration of midazolam are not affected by echinacea.
Warfarin (Coumadin)
Echinacea seems to increase the clearance of warfarin, although the effect may not be clinically significant.
Preliminary clinical research in healthy male volunteers suggests that taking echinacea increases the clearance of the active S-isomer of warfarin after a single dose of warfarin, but there was not a clinically significant effect on the INR.
Peppermint
Cyclosporine (Neoral, Sandimmune)
Theoretically, peppermint oil might increase the levels and adverse effects of cyclosporine.
In animal research, peppermint oil inhibits cyclosporine metabolism and increases cyclosporine levels. Inhibition of cytochrome P450 3A4 (CYP3A4) may be partially responsible for this interaction. An interaction between peppermint oil and cyclosporine has not been reported in humans.
Cytochrome P450 2C19 (Cyp2C19) Substrates
Theoretically, peppermint might increase the levels of CYP2C19 substrates.
In vitro research shows that peppermint oil inhibits CYP2C19. So far, this interaction has not been reported in humans.
Cytochrome P450 2C9 (Cyp2C9) Substrates
Theoretically, peppermint might increase the levels of CYP2C9 substrates.
In vitro research shows that peppermint oil inhibits CYP2C9. So far, this interaction has not been reported in humans.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, peppermint might increase the levels of CYP3A4 substrates.
Clinical research in healthy volunteers shows that a single dose of peppermint oil 600 mg inhibits CYP3A4 enzymes and increases the AUC of felodipine, a CYP3A4 substrate. However, in vitro research suggests that peppermint oil only inhibits CYP3A4 at very high concentrations.
Cytochrome P450 1A2 (Cyp1A2) Substrates
Theoretically, peppermint might increase the levels of CYP1A2 substrates.
In vitro and animal research shows that peppermint oil and peppermint leaf inhibit CYP1A2. However, in clinical research, peppermint tea did not significantly affect the metabolism of caffeine, a CYP1A2 substrate. It is possible that the 6-day duration of treatment may have been too short to identify a difference.
Myrrh
Antidiabetes Drugs
Theoretically, myrrh might increase the risk of hypoglycemia when taken with antidiabetes drugs.
In vitro and animal research suggests that myrrh has hypoglycemic effects.
Warfarin (Coumadin)
Theoretically, myrrh might decrease the effectiveness of warfarin.
In one case, a patient who was previously stable on warfarin had a significant decline in international normalized ratio (INR) following consumption of an aqueous extract of myrrh.
Brand information
Manufacturer and brand details for Herbal Defense, from the product label.
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The Full Monographs Behind Herbal Defense’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Peppermint
Interacts with 796 drugsPeppermint is a popular herb with the best evidence supporting enteric-coated peppermint oil for easing IBS symptoms. It is generally well tolerated for most adults, but it can cause heartbu...
Read the full Peppermint monograph → Herb & supplement monographMyrrh
Interacts with 88 drugsMyrrh is a fragrant gum resin from Commiphora trees that has long been used in mouthwashes, throat remedies, and skin care. Modern evidence for most of its uses is limited and comes mostly f...
Read the full Myrrh monograph → Herb & supplement monographEchinacea
Interacts with 816 drugsEchinacea is a popular herb taken to help prevent or shorten the common cold, but study results are mixed and the overall benefit appears small at best. It is generally well tolerated for sh...
Read the full Echinacea monograph →Sources & How We Checked
Herbal Defense'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 100 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.
Peppermint 41 references
- Liu JH, Chen GH, Yeh HZ, et al. Enteric-coated peppermint-oil capsules in the treatment of irritable bowel syndrome: a prospective, randomized trial. J Gastroenterol 1997;32:765-8. PubMed
- Pittler MH, Ernst E. Peppermint oil for irritable bowel syndrome: a critical review and metaanalysis. Am J Gastroenterol 1998;93:1131-5. PubMed
- Kline RM, Kline JJ, Di Palma J, Barbero GJ. Enteric-coated, pH-dependent peppermint oil capsules for the treatment of irritable bowel syndrome in children. J Pediatr 2001;138:125-8. PubMed
- Madisch A, Heydenreich CJ, Wieland V, et al. Treatment of functional dyspepsia with a fixed peppermint oil and caraway oil combination preparation as compared to cisapride. A multicenter, reference-controlled, double-blind equivalence study. Arzneimittel
- May B, Kuntz HD, Kieser M, Kohler S. Efficacy of a fixed peppermint oil/caraway oil combination in non-ulcer dyspepsia. Arzneimittelforschung 1996;46:1149-53.
- Micklefield GH, Greving I, May B. Effects of peppermint oil and caraway oil on gastroduodenal motility. Phytother Res 2000;14:20-3. DOI
- Morton CA, Garioch J, Todd P, et al. Contact sensitivity to menthol and peppermint in patients with intra-oral symptoms. Contact Dermatitis 1995;32:281-4. PubMed
- May B, Kohler S, Schneider B. Efficacy and tolerability of a fixed combination of peppermint oil and caraway oil in patients suffering from functional dyspepsia. Aliment Pharmacol Ther 2000;14:1671-7. PubMed
- Nash P, Gould SR, Bernardo DE. Peppermint oil does not relieve the pain of irritable bowel syndrome. Br J Clin Pract 1986;40:292-3. DOI
- Rees WD, Evans BK, Rhodes J. Treating irritable bowel syndrome with peppermint oil. Br Med J 1979;2:835-6. PubMed
- Davies SJ, Harding LM, Baranowski AP. A novel treatment of postherpetic neuralgia using peppermint oil. Clin J Pain 2002;18:200-2. PubMed
- Weston CF. Anal burning and peppermint oil. Postgrad Med J 1987;63:717. PubMed
- Dresser GK, Wacher V, Wong S, et al. Evaluation of peppermint oil and ascorbyl palmitate as inhibitors of cytochrome P4503A4 activity in vitro and in vivo. Clin Pharmacol Ther 2002;72:247-55. PubMed
- Wacher VJ, Wong S, Wong HT. Peppermint oil enhances cyclosporine oral bioavailability in rats: comparison with D-alpha-tocopheryl poly(ethylene glycol 1000) succinate (TPGS) and ketoconazole. J Pharm Sci 2002;91:77-90.
- Lawson MJ, Knight RE, Tran K, et al. Failure of enteric-coated peppermint oil in the irritable bowel syndrome: a randomized double-blind crossover study. J Gastroenterol Hepatol 1988;3:235-8. DOI
- Unger M, Frank A. Simultaneous determination of the inhibitory potency of herbal extracts on the activity of six major cytochrome P450 enzymes using liquid chromatography/mass spectrometry and automated online extraction. Rapid Commun Mass Spectrom 2004;1 PubMed
- Maliakal PP, Wanwimolruk S. Effect of herbal teas on hepatic drug metabolizing enzymes in rats. J Pharm Pharmacol 2001;53:1323-9. PubMed
- Rogers SN, Pahor AL. A form of stomatitis induced by excessive peppermint consumption. Dent Update 1995;22:36-7.
- Cappello G, Spezzaferro M, Grossi L, et al. Peppermint oil (Mintoil) in the treatment of irritable bowel syndrome: a prospective double blind placebo-controlled randomized trial. Dig Liver Dis 2007;39:530-6. PubMed
- Moghadam BK, Gier R, and Thurlow T. Extensive oral mucosal ulcerations caused by misuse of a commercial mouthwash. Cutis 1999;64:131-134.
- Andersen, K. E. Contact allergy to toothpaste flavors. Contact Dermatitis 1978;4(4):195-198. PubMed
- Barnard, D. R. Repellency of essential oils to mosquitoes (Diptera: Culicidae). J Med Entomol. 1999;36(5):625-629. PubMed
- Tamir, S., Davidovich, Z., Attal, P., and Eliashar, R. Peppermint oil chemical burn. Otolaryngol.Head Neck Surg. 2005;133(5):801-802. PubMed
- Kalavala, M., Hughes, T. M., Goodwin, R. G., Anstey, A. V., and Stone, N. M. Allergic contact dermatitis to peppermint foot spray. Contact Dermatitis 2007;57(1):57-58. PubMed
- Vermaat, H., van Meurs, T., Rustemeyer, T., Bruynzeel, D. P., and Kirtschig, G. Vulval allergic contact dermatitis due to peppermint oil in herbal tea. Contact Dermatitis 2008;58(6):364-365. PubMed
- Merat, S., Khalili, S., Mostajabi, P., Ghorbani, A., Ansari, R., and Malekzadeh, R. The effect of enteric-coated, delayed-release peppermint oil on irritable bowel syndrome. Dig.Dis.Sci. 2010;55(5):1385-1390. PubMed
- Tran, A., Pratt, M., and DeKoven, J. Acute allergic contact dermatitis of the lips from peppermint oil in a lip balm. Dermatitis 2010;21(2):111-115. DOI
- Hitz, Lindenmuller, I and Lambrecht, J. T. Oral care. Curr Probl.Dermatol 2011;40:107-115.
- Shavakhi, A., Ardestani, S. K., Taki, M., Goli, M., and Keshteli, A. H. Premedication with peppermint oil capsules in colonoscopy: a double blind placebo-controlled randomized trial study. Acta Gastroenterol Belg 2012;75(3):349-353.
- Lech, Y., Olesen, K. M., Hey, H., Rask-Pedersen, E., Vilien, M., and Ostergaard, O. [Treatment of irritable bowel syndrome with peppermint oil. A double- blind study with a placebo]. Ugeskr.Laeger 10-3-1988;150(40):2388-2389.
- Parys, B. T. Chemical burns resulting from contact with peppermint oil mar: a case report. Burns Incl.Therm.Inj. 1983;9(5):374-375. PubMed
- Bayat R, Borici-Mazi R. A case of anaphylaxis to peppermint. Allergy Asthma Clin Immunol. 2014;10(1):6. PubMed
- Rich G, Shah A, Koloski N, et al. A randomized placebo-controlled trial on the effects of Menthacarin, a proprietary peppermint- and caraway-oil-preparation, on symptoms and quality of life in patients with functional dyspepsia. Neurogastroenterol Motil 2 PubMed
- Douros A, Bronder E, Andersohn F, et al. Herb-Induced Liver Injury in the Berlin Case-Control Surveillance Study. Int J Mol Sci 2016;17(1). PubMed
- Begas E, Tsioutsiouliti A, Kouvaras E, et al. Effects of peppermint tea consumption on the activities of CYP1A2, CYP2A6, Xanthine Oxidase, N-acetyltranferase-2 and UDP-glucuronosyltransferases-1A1/1A6 in healthy volunteers. Food Chem Toxicol 2017;100:80-9 PubMed
- Cash BD, Epstein MS, Shah SM. A Novel Delivery System of Peppermint Oil Is an Effective Therapy for Irritable Bowel Syndrome Symptoms. Dig Dis Sci 2016;61(2):560-71. PubMed
- Elsaie LT, El Mohsen AM, Ibrahim IM, Mohey-Eddin MH, Elsaie ML. Effectiveness of topical peppermint oil on symptomatic treatment of chronic pruritus. Clin Cosmet Investig Dermatol 2016;9:333-8. PubMed
- Wu J, Xu R, Zhan R, et al. Effective symptomatic treatment for severe and intractable pruritus associated with severe burn-induced hypertrophic scars: A prospective, multicenter, controlled trial. Burns 2016;42(5):1059-66. PubMed
- Weerts ZZRM, Masclee AAM, Witteman BJM, et al. Efficacy and safety of peppermint oil in a randomized, double-blind trial of patients with irritable bowel syndrome. Gastroenterology. 2020;158(1):123-136. PubMed
- Nee J, Ballou S, Kelley JM, et al. Peppermint Oil Treatment for Irritable Bowel Syndrome: A Randomized Placebo-Controlled Trial. Am J Gastroenterol 2021;116(11):2279-2285. PubMed
- Ingrosso MR, Ianiro G, Nee J, et al. Systematic review and meta-analysis: efficacy of peppermint oil in irritable bowel syndrome. Aliment Pharmacol Ther 2022;56(6):932-41. PubMed
Myrrh 8 references
- Newall CA, Anderson LA, Philpson JD. Herbal Medicine: A Guide for Healthcare Professionals. London, UK: The Pharmaceutical Press, 1996.
- The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999.
- McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
- Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
- Al Faraj S. Antagonism of the anticoagulant effect of warfarin caused by the use of Commiphora molmol as a herbal medication: a case report. Ann Trop Med Parasitol 2005;99:219-20.
- Al-Jaroudi D, Kaddour O, Al-Amin N. Risks of myrrh use in pregnancy. JBRA Assist Reprod 2016;20(4):257-8.
- Xu YY, Li L, Xuan L, Guan K. Patch test diagnosis of non-immediate cutaneous reaction to myrrh following oral intake of a traditional Chinese medicine decoction. Contact Dermatitis. 2019;80(2):135-136. PubMed
- Al-Romaiyan A, Huang GC, Jones P, Persaud S. Commiphora myrrha stimulates insulin secretion from mouse and human islets of Langerhans. J Ethnopharmacol. 2021 Jan 10;264:113075. PubMed
Echinacea 51 references
- Mullins RJ. Echinacea-associated anaphylaxis. Med J Aust 1998;168:170-1. PubMed
- Mullins RJ. Allergic reactions to Echinacea. J Allergy Clin Immunol 2000;104:S340-341 (Abstract 1003).
- Chavez ML, Chavez PI. Echinacea. Hosp Pharm 1998;33:180-8.
- Grimm W, Muller HH. A randomized controlled trial of the effect of fluid extract of Echinacea purpurea on the incidence and severity of colds and respiratory infections. Am J Med 1999;106:138-43. PubMed
- Taylor JA, Weber W, Standish L, et al. Efficacy and safety of echinacea in treating upper respiratory tract infections in children: a randomized controlled trial. JAMA 2003;290:2824-30.. PubMed
- Luettig B, Steinmuller C, Gifford GE, et al. Macrophage activation by the polysaccharide arabinogalactan isolated from plant cell cultures of Echinacea purpurea. J Natl Cancer Inst 1989;81:669-75. PubMed
- Stimpel M, Proksch A, Wagner H, et al. Macrophage activation and induction of macrophage cytotoxicity by purified polysaccharide fractions from the plant Echinacea purpurea. Infect Immun 1984;46:845-9. PubMed
- Budzinski JW, Foster BC, Vandenhoek S, Arnason JT. An in vitro evaluation of human cytochrome P450 3A4 inhibition by selected commercial herbal extracts and tinctures. Phytomedicine 2000;7:273-82. PubMed
- Gallo M, Sarkar M, Au W, et al. Pregnancy outcome following gestational exposure to echinacea: A prospective controlled study. Arch Intern Med 2000;160:3141-3. PubMed
- Soon SL, Crawford RI. Recurrent erythema nodosum associated with echinacea herbal therapy. J Am Acad Dermatol 2001;44:298-9. PubMed
- Mullins RJ, Heddle R. Adverse reactions associated with echinacea: the Australian experience. Ann Allergy Asthma Immunol 2002;88:42-51. PubMed
- Logan JL, Ahmed J. Critical hypokalemic renal tubular acidosis due to Sjogren's syndrome: association with the purported immune stimulant echinacea. Clin Rheumatol 2003;22:158-9.
- Schulten B, Bulitta M, Ballering-Bruhl B, et al. Efficacy of Echinacea purpurea in patients with a common cold. A placebo-controlled, randomised, double-blind clinical trial. Arzneimittelforschung 2001;51:563-8.. PubMed
- Yale SH, Glurich I. Analysis of the inhibitory potential of Ginkgo biloba, Echinacea purpurea, and Serenoa repens on the metabolic activity of cytochrome P450 3A4, 2D6, and 2C9. J Altern Complement Med 2005;11:433-9.
- Yale SH, Liu K. Echinacea purpurea therapy for the treatment of the common cold: a randomized, double-blind, placebo-controlled clinical trial. Arch Intern Med 2004;164:1237-41. PubMed
- Gorski JC, Huang S, Zaheer NA, et al. The effect of echinacea (Echinacea purpurea root) on cytochrome P450 activity in vivo.Clin Pharmacol Ther 2003;73 (Abstract PDII-A-8):P94. PubMed
- Lee AN, Werth VP. Activation of autoimmunity following use of immunostimulatory herbal supplements. Arch Dermatol 2004;140:723-7. PubMed
- Goel V, Lovlin R, Barton R, et al. Efficacy of a standardized echinacea preparation (Echinilin) for the treatment of the common cold: a randomized, double-blind, placebo-controlled trial. J Clin Pharm Ther 2004;29:75-83.
- Barrett B. Medicinal properties of Echinacea: a critical review. Phytomedicine 2003;10:66-86. PubMed
- Huntley AL, Thompson Coon J, Ernst E. The safety of herbal medicinal products derived from Echinacea species: a systematic review. Drug Saf 2005;28:387-400. PubMed
- Turner RB, Bauer R, Woelkart K, et al. An evaluation of Echinacea angustifolia in experimental rhinovirus infections. N Engl J Med 2005;353:341-8.
- Gurley BJ, Gardner SF, Hubbard MA, et al. In vivo assessment of botanical supplementation on human cytochrome P450 phenotypes: Citrus aurantium, Echinacea purpurea, milk thistle, and saw palmetto. Clin Pharmacol Ther 2004;76:428-40. .
- Perri D, Dugoua JJ, Mills E, Koren G. Safety and efficacy of echinacea (Echinacea augustafolia, e. purpurea and e. pallida) during pregnancy and lactation. Can J Clin Pharmacol 2006;13:e262-7.
- Kocaman O, Hulagu S, Senturk O. Echinacea-induced severe acute hepatitis with features of cholestatic autoimmune hepatitis. Eur J Intern Med 2008;19:148. PubMed
- Barrett B, Brown R, Rakel D. et al. Echinacea for treating the common cold: a randomized trial. Ann Intern Med 2010;153:769-77. PubMed
- Press Release: Echinacea herbal products should not be used in children under 12 years old. Medicines and Healthcare Products Regulatory Agency (UK). August 20, 2012. Available at: www.mhra.gov.uk/NewsCentre/Pressreleases/CON180627. (Accessed 21 October
- Barrett B, Brown R, Rakel D, Rabago D, et al. Placebo effects and the common cold: a randomized controlled trial. Ann.Fam.Med 2011;9:312-22. 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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