Immunity Plus Ingredients & Drug Interactions
by Just Thrive
What is this page for?
First and foremost: checking Immunity Plus 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
Immunity Plus is a dietary supplement by Just Thrive with 5 active ingredients. Its ingredients are commonly taken for common cold, flu and respiratory infections, immune support.Based on those ingredients, 1,109 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Pomanox P30, Echinacea, Zinc Bisglycinate. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against Immunity Plus by Just Thrive
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AI summaries are generated from our interaction database for education only — always confirm with your pharmacist. How we use AI
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HelloPharmacist Scorecard of Immunity Plus by Just Thrive
Our pharmacy team’s full take, with four database checks built into the cards below — a summary of what is known, not a grade of the product itself.
What’s inside
Full disclosure
Immunity Plus contains five active ingredients: selenomethionine, echinacea, zinc bisglycinate, EPICOR, and Pomanox P30 (pomegranate extract). Echinacea is included for immune support, zinc plays a role in immune function and is effective for zinc deficiency, and pomegranate is a plant polyphenol antioxidant.
The supplement also contains cellulose and a vegetable capsule as inactive ingredients.
Does it work?
Moderate evidence
The data we hold shows that zinc is effective for zinc deficiency and likely effective for Wilson disease. For the other conditions echinacea and pomegranate are listed for — anxiety, athletic performance, ADHD, burns, chronic fatigue, migraine, hypertension, and diabetes — the evidence is either insufficient to rate or suggests the ingredient may be ineffective.
We don't have effectiveness information on file for selenomethionine or EPICOR.
How safe is it?
Well-documented data
Echinacea is generally well tolerated for short-term use but may cause stomach upset, rashes, nausea, or diarrhea; rare serious allergic reactions and hepatitis have been reported, especially in people sensitive to ragweed and related plants. Zinc is generally well tolerated at recommended doses (up to 40 mg daily for adults) but can cause nausea, diarrhea, metallic taste, and abdominal cramps at higher doses.
Pomegranate fruit and juice are generally well tolerated, though concentrated extracts can cause diarrhea, flatulence, or mild stomach upset in some people. For pregnancy, echinacea is rated possibly safe, zinc is likely safe, and pomegranate is possibly safe — but the data advises caution and limited safety information for echinacea, so talk with your doctor or pharmacist before taking this product if you're pregnant or breastfeeding.
Meds to double-check
Moderate interaction found
Before taking this product, check with your doctor or pharmacist if you take antihypertensive (blood pressure) drugs, warfarin or other blood thinners, immunosuppressant medications, antibiotics (especially quinolones, tetracyclines, or cephalexin), ACE inhibitors, drugs metabolized by CYP1A2 or CYP2D6 enzymes, HIV medications (ritonavir, integrase inhibitors, bictegravir-containing products), cancer drugs (etoposide, cisplatin), or carbamazepine. No interactions are documented for the ingredients we could not check.
The bottom line
Scorecard at a glanceFully disclosed formula with some supporting evidence for its stated purpose. Moderate medication interactions have been identified, and safety information is well characterized.
This product combines three ingredients with multiple medication interactions — echinacea affects how your body breaks down many drugs, zinc reduces absorption of several antibiotics and HIV medications, and pomegranate theoretically increases bleeding risk with warfarin and blood-pressure-lowering effects. If you take any prescription medications, especially blood thinners, antibiotics, blood pressure drugs, or HIV treatments, check with your doctor or pharmacist before starting Immunity Plus.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 3 of 5 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Aug 23, 2022.
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 Immunity Plus, straight from the product label.
| Brand | Just Thrive |
|---|---|
| Barcode (UPC) | 674306989699 |
| Net contents | 60 Capsule(s) |
| Market status | On market |
| Date entered into DSLD | Aug 23, 2022 |
| DSLD ID | 267939 |
| Product type | Other Combinations |
| Supplement form | Capsule |
| Dietary claims / uses | All Other, Structure/Function |
| Intended target group(s) | Children 4 or More Years of Age, Vegan, Vegetarian, Adult (18 - 50 Years), Gluten Free, Dairy 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 Immunity Plus by Just Thrive, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Selenomethionine | 200 mcg | -- |
| Echinacea | 250 mg | -- |
| Zinc Bisglycinate | 15 mg | -- |
| EPICOR | 500 mg | -- |
| Pomanox P30 | 200 mg | -- |
Other ingredients: Cellulose, Vegetable Capsule
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.
Formula
Just Thrive Immunity plus is your proactive immune formula, whether you're having an off day or just need a little lift. Our easy-to-take capsules contain key minerals, polyphenols, immune supporting herbs, and postbiotics that activate crucial immunity players to support optimal health during any season.
Key minerals, herbs, polyphenols
Suggested/Recommended/Usage/Directions
Directions: Ages 8+: Take 2 capsules daily with or without a meal, or as directed by your healthcare practitioner.
Precautions
Do not use if safety seal is broken.
Caution: If you are pregnant or nursing, taking any medication, or have a medical condition, consult with your doctor before using this product.
Keep out of reach of children.
FDA Disclaimer Statement
These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.
General Statements
Vitamin angels Proud supporter Your purchase helps support the health of a child for an entire year.
Formulation
Gluten Free Dairy Free Non GMO Soy Free
Vegan Friendly
Proactive Immune Support Optimal Immune Health Complex
FDA Statement of Identity
Dietary Supplement
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Immunity Plus by Just Thrive 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 Immunity Plus by Just Thrive
These are the 5 active ingredients this product is made of. Select any to open its full monograph.
Serving size2 Capsule(s) Dosage formCapsule Servings per container30 Amounts shown are per serving.
Most supplement products combine several ingredients, and a medication can interact with the product through any one of them. Each ingredient below shows whether it has known drug interactions.
Selenomethionine
Echinacea
Interacts with816 drugs
Echinacea 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 bes...
Echinacea monograph & interactionsZinc Bisglycinate
Interacts with67 drugs
Zinc is an essential mineral that your body needs for immune function, wound healing, taste, and smell. Most people get enough from food, but suppleme...
Zinc Bisglycinate monograph & interactionsEPICOR
Pomanox P30
Interacts with922 drugs
Pomegranate is a nutrient-rich fruit that is high in antioxidants and is widely enjoyed as food and juice. Early research suggests it may support hear...
Pomanox P30 monograph & interactionsOther (inactive) ingredients: Cellulose, Vegetable Capsule. These complete the product’s ingredient list but are not active constituents.
Immunity Plus by Just Thrive Drug Interactions
HelloPharmacist Interaction Report
Immunity Plus by Just Thrive has documented interactions with multiple medications, primarily through its echinacea, zinc, and pomegranate content.
The most serious interaction is echinacea's moderate effect on drugs metabolized by cytochrome P450 enzymes (CYP1A2 and CYP3A4 substrates), which can increase or decrease drug levels unpredictably — including a specific risk of increased etoposide levels and more severe side effects. Echinacea also has moderate interactions with immunosuppressant drugs, caffeine, and several antibiotic classes.
Read the full breakdown — every affected drug type, severity by severity
Zinc in this product interacts moderately with quinolone antibiotics, tetracycline antibiotics, cephalexin, penicillamine, and several HIV and cancer medications (ritonavir, integrase inhibitors, bictegravir-containing drugs, and cisplatin) by reducing their absorption or effectiveness. Pomegranate adds moderate interactions with blood pressure medications, ACE inhibitors, warfarin, and drugs metabolized by CYP2D6 — theoretically increasing bleeding risk with warfarin and risking dangerously low blood pressure when combined with antihypertensive drugs.
Zinc also carries minor interactions with drugs broken down by CYP2C9, and pomegranate has minor interactions with CYP3A4 substrates and carbamazepine. Altogether, these interactions span 1,110 individual medications.
We could not check selenomethionine or EPICOR for interactions. Run your exact medications through the search tool on this page before you start.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against Immunity Plus?
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 Immunity Plus interact with 1,109 drugs. Click any drug to see the details.
3 of the 5 ingredients in Immunity Plus interact with drugs. Each result below shows which ingredient is responsible. Pomanox P30 Echinacea Zinc Bisglycinate
AlpelisibPiqray
How Alpelisib interacts with Immunity Plus — through 2 ingredients. Tap an ingredient for the detail:
EchinaceaCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea + Alpelisib interactionPomanox P30Cytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, pomegranate might increase levels of drugs metabolized by CYP3A4, but most research suggests this interaction is unlikely to be clinically significant.
Read the full Pomanox P30 + Alpelisib interactionAlprazolamNiravam, Xanax
How Alprazolam interacts with Immunity Plus — through 2 ingredients. Tap an ingredient for the detail:
EchinaceaCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea + Alprazolam interactionPomanox P30Cytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, pomegranate might increase levels of drugs metabolized by CYP3A4, but most research suggests this interaction is unlikely to be clinically significant.
Read the full Pomanox P30 + Alprazolam interactionAluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium HydroxideAscriptin Codeine #2
How Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide interacts with Immunity Plus — through 1 ingredient. Tap an ingredient for the detail:
Pomanox P30Cytochrome P450 2d6 (cyp2d6) Substrates Moderate
Interaction Summary
Theoretically, pomegranate might increase levels of drugs metabolized by CYP2D6.
Read the full Pomanox P30 + Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide interactionAmbrisentanLetairis, Volibris
How Ambrisentan interacts with Immunity Plus — through 2 ingredients. Tap an ingredient for the detail:
Pomanox P30Antihypertensive Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, taking pomegranate with antihypertensive drugs might increase the risk of hypotension.
Read the full Pomanox P30 + Ambrisentan interactionEchinaceaCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea + Ambrisentan interactionAmilorideAmilamont, Midamor
How Amiloride interacts with Immunity Plus — through 2 ingredients. Tap an ingredient for the detail:
Pomanox P30Antihypertensive Drugs Moderate
Interaction Summary
Theoretically, taking pomegranate with antihypertensive drugs might increase the risk of hypotension.
Read the full Pomanox P30 + Amiloride interactionZinc BisglycinateAmiloride (midamor) Minor
Interaction Summary
Amiloride can modestly reduce zinc excretion and increase zinc levels.
Read the full Zinc Bisglycinate + Amiloride interactionAmiloride, HydrochlorothiazideAmil-Co, Amilzide, Moduret 25, Moduretic
How Amiloride, Hydrochlorothiazide interacts with Immunity Plus — through 2 ingredients. Tap an ingredient for the detail:
Pomanox P30Antihypertensive Drugs Moderate
Interaction Summary
Theoretically, taking pomegranate with antihypertensive drugs might increase the risk of hypotension.
Read the full Pomanox P30 + Amiloride, Hydrochlorothiazide interactionZinc BisglycinateAmiloride (midamor) Minor
Interaction Summary
Amiloride can modestly reduce zinc excretion and increase zinc levels.
Read the full Zinc Bisglycinate + Amiloride, Hydrochlorothiazide interactionAmiodaroneCordarone, Pacerone
How Amiodarone interacts with Immunity Plus — through 2 ingredients. Tap an ingredient for the detail:
EchinaceaCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea + Amiodarone interactionPomanox P30Cytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, pomegranate might increase levels of drugs metabolized by CYP3A4, but most research suggests this interaction is unlikely to be clinically significant.
Read the full Pomanox P30 + Amiodarone interactionAmitriptylineElavil
How Amitriptyline interacts with Immunity Plus — through 2 ingredients. Tap an ingredient for the detail:
Pomanox P30Cytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 2c9 (cyp2c9) Substrates +1 Moderate
Interaction Summary
Theoretically, pomegranate might increase levels of drugs metabolized by CYP3A4, but most research suggests this interaction is unlikely to be clinically significant.
Read the full Pomanox P30 + Amitriptyline interactionEchinaceaCytochrome 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 + Amitriptyline interactionAmitriptyline, ChlordiazepoxideLimbitrol DS
How Amitriptyline, Chlordiazepoxide interacts with Immunity Plus — through 2 ingredients. Tap an ingredient for the detail:
Pomanox P30Cytochrome P450 2d6 (cyp2d6) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Moderate
Interaction Summary
Theoretically, pomegranate might increase levels of drugs metabolized by CYP2D6.
Read the full Pomanox P30 + Amitriptyline, Chlordiazepoxide interactionEchinaceaCytochrome 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 + Amitriptyline, Chlordiazepoxide interactionAmitriptyline, PerphenazineEtrafon, Etrafon-A, Etrafon-Forte, Triavil
How Amitriptyline, Perphenazine interacts with Immunity Plus — through 2 ingredients. Tap an ingredient for the detail:
EchinaceaCytochrome 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 + Amitriptyline, Perphenazine interactionPomanox P30Cytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 2d6 (cyp2d6) Substrates +1 Moderate
Interaction Summary
Theoretically, pomegranate might increase levels of drugs metabolized by CYP3A4, but most research suggests this interaction is unlikely to be clinically significant.
Read the full Pomanox P30 + Amitriptyline, Perphenazine interactionAmlodipineNorliqva
How Amlodipine interacts with Immunity Plus — through 2 ingredients. Tap an ingredient for the detail:
EchinaceaCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea + Amlodipine interactionPomanox P30Cytochrome P450 3a4 (cyp3a4) Substrates, Antihypertensive Drugs Moderate
Interaction Summary
Theoretically, pomegranate might increase levels of drugs metabolized by CYP3A4, but most research suggests this interaction is unlikely to be clinically significant.
Read the full Pomanox P30 + Amlodipine interactionAmlodipine BenzoateKaterzia
How Amlodipine Benzoate interacts with Immunity Plus — through 2 ingredients. Tap an ingredient for the detail:
Pomanox P30Antihypertensive Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, taking pomegranate with antihypertensive drugs might increase the risk of hypotension.
Read the full Pomanox P30 + Amlodipine Benzoate interactionEchinaceaCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea + Amlodipine Benzoate interactionAmlodipine BesilateIstin
How Amlodipine Besilate interacts with Immunity Plus — through 2 ingredients. Tap an ingredient for the detail:
Pomanox P30Antihypertensive Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, taking pomegranate with antihypertensive drugs might increase the risk of hypotension.
Read the full Pomanox P30 + Amlodipine Besilate interactionEchinaceaCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea + Amlodipine Besilate interactionAmlodipine BesylateNorvasc
How Amlodipine Besylate interacts with Immunity Plus — through 2 ingredients. Tap an ingredient for the detail:
Pomanox P30Antihypertensive Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, taking pomegranate with antihypertensive drugs might increase the risk of hypotension.
Read the full Pomanox P30 + Amlodipine Besylate interactionEchinaceaCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea + Amlodipine Besylate interactionAmlodipine Besylate, BenazeprilLotrel
How Amlodipine Besylate, Benazepril interacts with Immunity Plus — through 2 ingredients. Tap an ingredient for the detail:
Pomanox P30Cytochrome P450 3a4 (cyp3a4) Substrates, Antihypertensive Drugs +1 Moderate
Interaction Summary
Theoretically, pomegranate might increase levels of drugs metabolized by CYP3A4, but most research suggests this interaction is unlikely to be clinically significant.
Read the full Pomanox P30 + Amlodipine Besylate, Benazepril interactionEchinaceaCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea + Amlodipine Besylate, Benazepril interactionAmlodipine, CelecoxibConsensi
How Amlodipine, Celecoxib interacts with Immunity Plus — through 2 ingredients. Tap an ingredient for the detail:
Pomanox P30Cytochrome P450 2c9 (cyp2c9) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Moderate
Interaction Summary
Theoretically, pomegranate might increase levels of drugs metabolized by CYP2C9.
Read the full Pomanox P30 + Amlodipine, Celecoxib interactionEchinaceaCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea + Amlodipine, Celecoxib interactionAmmonium ChlorideAmmonium Chloride
How Ammonium Chloride interacts with Immunity Plus — through 1 ingredient. Tap an ingredient for the detail:
Pomanox P30Antihypertensive Drugs Moderate
Interaction Summary
Theoretically, taking pomegranate with antihypertensive drugs might increase the risk of hypotension.
Read the full Pomanox P30 + Ammonium Chloride interactionAmoxicillin, Omeprazole Magnesium, RifabutinTalicia
How Amoxicillin, Omeprazole Magnesium, Rifabutin interacts with Immunity Plus — through 2 ingredients. Tap an ingredient for the detail:
EchinaceaCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea + Amoxicillin, Omeprazole Magnesium, Rifabutin interactionPomanox P30Cytochrome P450 2c9 (cyp2c9) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, pomegranate might increase levels of drugs metabolized by CYP2C9.
Read the full Pomanox P30 + Amoxicillin, Omeprazole Magnesium, Rifabutin interactionAmphetamineAdensys XR-ODT, Adzenys ER, Dyanavel XR, Mydayis
How Amphetamine interacts with Immunity Plus — through 1 ingredient. Tap an ingredient for the detail:
Pomanox P30Cytochrome P450 2d6 (cyp2d6) Substrates Moderate
Interaction Summary
Theoretically, pomegranate might increase levels of drugs metabolized by CYP2D6.
Read the full Pomanox P30 + Amphetamine interactionAmphetamine Aspartate, Amphetamine Sulfate, Dextroamphetamine Saccharate, Dextroamphetamine SulfateAdderall, Adderall XR
How Amphetamine Aspartate, Amphetamine Sulfate, Dextroamphetamine Saccharate, Dextroamphetamine Sulfate interacts with Immunity Plus — through 1 ingredient. Tap an ingredient for the detail:
Pomanox P30Cytochrome P450 2d6 (cyp2d6) Substrates Moderate
Interaction Summary
Theoretically, pomegranate might increase levels of drugs metabolized by CYP2D6.
Read the full Pomanox P30 + Amphetamine Aspartate, Amphetamine Sulfate, Dextroamphetamine Saccharate, Dextroamphetamine Sulfate interactionAmphetamine SulfateBenzedrine, Evekeo ODT
How Amphetamine Sulfate interacts with Immunity Plus — through 1 ingredient. Tap an ingredient for the detail:
Pomanox P30Cytochrome P450 2d6 (cyp2d6) Substrates Moderate
Interaction Summary
Theoretically, pomegranate might increase levels of drugs metabolized by CYP2D6.
Read the full Pomanox P30 + Amphetamine Sulfate interactionAmphotericin, TetracyclineMysteclin-F
How Amphotericin, Tetracycline interacts with Immunity Plus — through 1 ingredient. Tap an ingredient for the detail:
Zinc BisglycinateTetracycline Antibiotics Moderate
Interaction Summary
Zinc might reduce levels of tetracycline antibiotics.
Read the full Zinc Bisglycinate + Amphotericin, Tetracycline interactionAmprenavirAgenerase
How Amprenavir interacts with Immunity Plus — through 2 ingredients. Tap an ingredient for the detail:
EchinaceaCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea + Amprenavir interactionPomanox P30Cytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, pomegranate might increase levels of drugs metabolized by CYP3A4, but most research suggests this interaction is unlikely to be clinically significant.
Read the full Pomanox P30 + Amprenavir interactionAnagrelideAgrylin
How Anagrelide interacts with Immunity Plus — through 1 ingredient. Tap an ingredient for the detail:
EchinaceaCytochrome 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 + Anagrelide interactionAnifrolumab-fniaSaphnelo
How Anifrolumab-fnia interacts with Immunity Plus — through 1 ingredient. Tap an ingredient for the detail:
EchinaceaImmunosuppressants Moderate
Interaction Summary
Echinacea has immunostimulant activity which may interfere with immunosuppressant therapy.
Read the full Echinacea + Anifrolumab-fnia interactionAntithymocyte GlobulinThymoglobulin
How Antithymocyte Globulin interacts with Immunity Plus — through 1 ingredient. Tap an ingredient for the detail:
EchinaceaImmunosuppressants Moderate
Interaction Summary
Echinacea has immunostimulant activity which may interfere with immunosuppressant therapy.
Read the full Echinacea + Antithymocyte Globulin interactionApalutamideErleada
How Apalutamide interacts with Immunity Plus — through 2 ingredients. Tap an ingredient for the detail:
EchinaceaCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea + Apalutamide interactionPomanox P30Cytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, pomegranate might increase levels of drugs metabolized by CYP3A4, but most research suggests this interaction is unlikely to be clinically significant.
Read the full Pomanox P30 + Apalutamide interactionApixabanEliquis
How Apixaban interacts with Immunity Plus — through 2 ingredients. Tap an ingredient for the detail:
EchinaceaCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea + Apixaban interactionPomanox P30Cytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, pomegranate might increase levels of drugs metabolized by CYP3A4, but most research suggests this interaction is unlikely to be clinically significant.
Read the full Pomanox P30 + Apixaban interactionApremilastOtezla
How Apremilast interacts with Immunity Plus — through 2 ingredients. Tap an ingredient for the detail:
EchinaceaCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea + Apremilast interactionPomanox P30Cytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, pomegranate might increase levels of drugs metabolized by CYP3A4, but most research suggests this interaction is unlikely to be clinically significant.
Read the full Pomanox P30 + Apremilast interactionAprepitantCinvanti, Emend
How Aprepitant interacts with Immunity Plus — through 2 ingredients. Tap an ingredient for the detail:
EchinaceaCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea + Aprepitant interactionPomanox P30Cytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, pomegranate might increase levels of drugs metabolized by CYP3A4, but most research suggests this interaction is unlikely to be clinically significant.
Read the full Pomanox P30 + Aprepitant interactionEach ingredient & the kinds of drugs it affects
For each ingredient in Immunity Plus 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.
Pomanox P30
Ace Inhibitors (Aceis)
Theoretically, taking pomegranate with ACEIs might increase the risk of adverse effects.
Pomegranate juice is thought to have ACE inhibitor-like effects.
Antihypertensive Drugs
Theoretically, taking pomegranate with antihypertensive drugs might increase the risk of hypotension.
Consuming pomegranate juice can modestly lower blood pressure.
Cytochrome P450 2D6 (Cyp2D6) Substrates
Theoretically, pomegranate might increase levels of drugs metabolized by CYP2D6.
In vitro, pomegranate juice inhibits CYP2D6. However, the clinical significance of this potential interaction in humans is not known.
Rosuvastatin (Crestor)
Theoretically, taking pomegranate with rosuvastatin might increase the risk of adverse effects.
In one case, a patient taking rosuvastatin 5 mg every other day in combination with ezetimibe 10 mg daily developed rhabdomyolysis after drinking pomegranate juice 200 mL twice weekly for 3 weeks. This patient had a history of elevated creatine kinase levels while not receiving any statin treatment. This suggests a possible underlying myopathy and predisposition to rhabdomyolysis.
Warfarin (Coumadin)
Theoretically, pomegranate might increase warfarin levels and increase the risk of bleeding. Also, discontinuing regular consumption of pomegranate juice might decrease warfarin levels.
In one case report, a patient had a stable, therapeutic bleeding time, as measured by international normalized ratio (INR), while taking warfarin in combination with pomegranate juice 2-3 times per week. The patient became subtherapeutic within about 10 days after discontinuing pomegranate juice, which required a warfarin dose increase. In another case report, a patient with a stable INR for over one year presented with an INR of 14. The patient noted no changes to medications or diet but did report consuming around 3 liters of pomegranate juice over the previous week. The patient's INR stabilized upon moderation of pomegranate juice consumption. The mechanism of this potential interaction is unclear.
Carbamazepine (Tegretol)
Theoretically, taking pomegranate with carbamazepine might increase the risk of adverse effects, although research suggests this interaction is unlikely to be clinically significant.
Animal research shows that pomegranate juice may inhibit cytochrome P450 3A4 (CYP3A4) metabolism of carbamazepine and increase levels of carbamazepine by 1.5 times without prolonging the elimination half-life. This suggests that pomegranate juice inhibits intestinal CYP3A4, but might not inhibit hepatic CYP3A4. However, some human research suggests that pomegranate does not significantly inhibit CYP3A4 drug metabolism in humans.
Cytochrome P450 2C9 (Cyp2C9) Substrates
Theoretically, pomegranate might increase levels of drugs metabolized by CYP2C9.
Some animal and in vitro research shows that pomegranate juice inhibits intestinal, but not hepatic, CYP2C9 isoenzyme activity. However, clinical research shows that neither pomegranate juice nor pomegranate extract have a significant effect on CYP2C9 activity in humans.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, pomegranate might increase levels of drugs metabolized by CYP3A4, but most research suggests this interaction is unlikely to be clinically significant.
Pomegranate contains several polyphenols that have individually been shown to inhibit CYP3A4. However, there is contradictory evidence about the effect of whole pomegranate juice on CYP3A4 activity. In vitro, pomegranate juice significantly inhibits the CYP3A4 enzyme, with comparable inhibition to grapefruit juice. In an animal model, pomegranate juice inhibits CYP3A4 metabolism of carbamazepine and increases levels of carbamazepine by 1.5 times; however, in human volunteers, drinking a single glass of pomegranate juice 240 mL or taking 200 mL daily for 2 weeks does not significantly affect levels of the CYP3A4 substrate midazolam after oral or intravenous administration. Another study in healthy volunteers shows that consuming pomegranate juice 300 mL three times daily for three days also does not significantly affect levels of simvastatin, a CYP3A4 substrate This suggests that pomegranate is unlikely to significantly affect levels of CYP3A4 substrates in humans.
Tolbutamide (Orinase)
Theoretically, pomegranate might increase levels of tolbutamide, although research suggests this interaction is unlikely to be clinically significant.
Animal research shows that pomegranate juice inhibits the cytochrome P450 2C9 (CYP2C9) metabolism of tolbutamide. Pomegranate juice increased tolbutamide levels by 1.2 times without prolonging the elimination half-life. This suggests that pomegranate juice inhibits intestinal CYP2C9, but might not inhibit hepatic CYP2C9. Despite this evidence, clinical research shows that neither pomegranate juice nor pomegranate extract have a significant effect on CYP2C9 activity in humans. This interaction does not appear to be clinically significant in humans.
Echinacea
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.
Zinc Bisglycinate
Bictegravir/Emtricitabine/Tenofovir Alafenamide (Biktarvy)
Theoretically, zinc 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 zinc containing products.
Cephalexin (Keflex)
Zinc might decrease cephalexin levels by chelating with cephalexin in the gut and preventing its absorption.
A pharmacokinetic study shows that zinc sulfate 250 mg taken concomitantly with cephalexin 500 mg decreases peak levels of cephalexin by 31% and reduces the exposure to cephalexin by 27%. Also, taking zinc sulfate 3 hours before cephalexin decreases peak levels of cephalexin by 11% and reduces the exposure to cephalexin by 18%. By decreasing cephalexin levels, zinc might increase the risk of treatment failure. This effect does not occur when zinc is taken 3 hours after the cephalexin dose. To avoid an interaction, advise patients take zinc sulfate 3 hours after taking cephalexin.
Cisplatin (Platinol-Aq)
Theoretically, zinc might interfere with the therapeutic effects of cisplatin.
Animal research suggests that zinc stimulates tumor cell production of the protein metallothionein, which binds and inactivates cisplatin. It is not known whether zinc supplements or high dietary zinc intake can cause clinically significant interference with cisplatin therapy. Cisplatin might also increase zinc excretion.
Integrase Inhibitors
Theoretically, taking zinc along with integrase inhibitors might decrease the levels and clinical effects of these drugs.
Zinc is a divalent cation. Pharmacokinetic studies have shown that other divalent cations such as calcium and iron can decrease blood levels of the integrase inhibitor dolutegravir through chelation.
Penicillamine (Cuprimine, Depen)
Zinc might reduce the levels and clinical effects of penicillamine.
By forming an insoluble complex with penicillamine, zinc interferes with penicillamine absorption and activity. Zinc supplements reduce the efficacy of low-dose penicillamine (0.5-1 gram/day), but do not seem to affect higher doses (1-2.75 gram/day), provided dosing times are separated. Advise patients to take zinc and penicillamine at least 2 hours apart.
Quinolone Antibiotics
Zinc can decrease the levels and clinical effects of quinolones antibiotics.
Quinolones form complexes with zinc in the gastrointestinal tract, reducing absorption of both the quinolone and zinc if taken at the same time. Advise patients to take these drugs at least 2 hours before, or 4-6 hours after, zinc supplements.
Ritonavir (Norvir)
Zinc modestly reduces levels of ritonavir.
Clinical research shows that zinc might reduce serum ritonavir levels by chelating with ritonavir in the gut and preventing its absorption. In patients with HIV, ritonavir is taken with atazanavir to prevent the metabolism and increase the effects of atazanavir. A pharmacokinetic study shows that, in patients being treated with atazanavir/ritonavir, co-administration of zinc sulfate (Solvazinc tablets) 125 mg as a single dose or as multiple daily doses for 2 weeks reduces plasma levels of ritonavir by about 16%. However, atazanavir levels still remains high enough to prevent HIV virus replication. Therefore, the decrease in ritonavir levels is not likely to be clinically significant.
Tetracycline Antibiotics
Zinc might reduce levels of tetracycline antibiotics.
Tetracyclines form complexes with zinc in the gastrointestinal tract, which can reduce absorption of both the tetracycline and zinc when taken at the same time. Taking zinc sulfate 200 mg with tetracycline reduces absorption of the antibiotic by 30% to 40%. Demeclocycline and minocycline cause a similar interaction. However, doxycycline does not seem to interact significantly with zinc. Advise patients to take tetracyclines at least 2 hours before, or 4-6 hours after, zinc supplements to avoid any interactions.
Amiloride (Midamor)
Amiloride can modestly reduce zinc excretion and increase zinc levels.
Clinical research shows that amiloride can reduce urinary zinc excretion, especially at doses of 10 mg per day or more. This zinc-sparing effect can help to counteract zinc losses caused by thiazide diuretics, but it is unlikely to cause zinc toxicity at usual amiloride doses. The other potassium-sparing diuretics, spironolactone (Aldactone) and triamterene (Dyrenium), do not seem to have a zinc-sparing effect.
Atazanavir (Reyataz)
Zinc modestly reduces levels of atazanavir, although this effect does not seem to be clinically significant.
Clinical research shows that zinc might decrease serum atazanavir levels by chelating with atazanavir in the gut and preventing its absorption. Although a single dose of zinc sulfate (Solvazinc tablets) 125 mg orally does not affect atazanavir concentrations in patients being treated with atazanavir/ritonavir, co-administration of zinc sulfate 125 mg daily for 2 weeks reduces plasma levels of atazanavir by about 22% in these patients. However, despite this decrease, atazanavir levels still remain at high enough concentrations for the prevention of HIV virus replication.
Brand information
Manufacturer and brand details for Immunity Plus, from the product label.
Just Thrive
See all Just Thrive products- Name
- DMS Natural Health, LLC
- Street Address
- 810 Busse Highway
- City
- Park Ridge
- State
- IL
- ZipCode
- 60069
- Phone Number
- 800.455.8939
- Web Address
- justthrivehealth.com
Immunity Plus by Just Thrive: 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 Immunity Plus’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Echinacea
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 → Herb & supplement monographZinc
Interacts with 67 drugsZinc is an essential mineral that your body needs for immune function, wound healing, taste, and smell. Most people get enough from food, but supplements can help correct or prevent a defici...
Read the full Zinc monograph → Herb & supplement monographPomegranate
Interacts with 922 drugsPomegranate is a nutrient-rich fruit that is high in antioxidants and is widely enjoyed as food and juice. Early research suggests it may support heart health and blood pressure, but the evi...
Read the full Pomegranate monograph →Sources & How We Checked
Immunity Plus'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 166 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.
Echinacea 51 references
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- 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
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- 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.
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- 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
- Haller J, Freund, TF, Pelczer, KG, et al. The anxiolytic potential and psychotropic side effects of an echinacea preparation in laboratory animals and healthy volunteers. Phytother.Res. 2013;27:54-61.
- Grbic J, Wexler I, Celenti R, et al. A phase II trial of a transmucosal herbal patch for the treatment of gingivitis. J Am Dent.Assoc. 2011;142:1168-75. PubMed
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- Bossaer JB and Odle BL. Probable etoposide interaction with Echinacea. J.Diet.Suppl 2012;9:90-5.
- Abdul MI, Jiang X, Williams KM, et al. Pharmacokinetic and pharmacodynamic interactions of echinacea and policosanol with warfarin in healthy subjects. Br J Clin.Pharmacol. 2010;69:508-15. PubMed
- Kemp, D. E. and Franco, K. N. Possible leukopenia associated with long-term use of echinacea. J Am Board Fam.Pract. 2002;15(5):417-419.
- Liatsos, G., Elefsiniotis, I., Todorova, R., and Moulakakis, A. Severe thrombotic thrombocytopenic purpura (TTP) induced or exacerbated by the immunostimulatory herb Echinacea. Am J Hematol. 2006;81(3):224.
- Penzak, S. R., Robertson, S. M., Hunt, J. D., Chairez, C., Malati, C. Y., Alfaro, R. M., Stevenson, J. M., and Kovacs, J. A. Echinacea purpurea significantly induces cytochrome P450 3A activity but does not alter lopinavir-ritonavir exposure in healthy s
- Maskatia, Z. K. and Baker, K. Hypereosinophilia associated with echinacea use. South.Med J 2010;103(11):1173-1174. PubMed
- Parnham MJ. Benefit-risk assessment of the squeezed sap of the purple coneflower (Echinacea purpurea) for long-term oral immunostimulation. Phytomed 1996;3:95-102. PubMed
- Schroder-Aasen T, Molden G, Nilsen OG. In vitro inhibition of CYP3A4 by the multiherbal commercial product Sambucus Force and its main constituents Echinacea purpurea and Sambucus nigra. Phytother Res 2012;26(11):1606-13.
- Moltó J, Valle M, Miranda C, et al. Herb-drug interaction between Echinacea purpurea and darunavir-ritonavir in HIV-infected patients. Antimicrob Agents Chemother 2011;55(1):326-30.
- Goey AK, Meijerman I, Rosing H, et al. The effect of Echinacea purpurea on the pharmacokinetics of docetaxel. Br J Clin Pharmacol 2013;76(3):467-74.
- Moltó J, Valle M, Miranda C, et al. Herb-drug interaction between Echinacea purpurea and etravirine in HIV-infected patients. Antimicrob Agents Chemother 2012;56(10):5328-31. PubMed
- Lawrenson JA, Walls T, Day AS. Echinacea-induced acute liver failure in a child. J Paediatr Child Health 2014;50(10):841.
- Hansen TS, Nilsen OG. In vitro CYP3A4 metabolism: inhibition by Echinacea purpurea and choice of substrate for the evaluation of herbal inhibition. Basic Clin Pharmacol Toxicol 2008;103:445-9.
- Gabranis I, Koufakis T1, Papakrivos I, Batala S. Echinacea-associated acute cholestatic hepatitis. J Postgrad Med. 2015;61(3):211-2. PubMed
- 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
- Karsch-Völk M, Barrett B, Kiefer D, Bauer R, Ardjomand-Woelkart K, Linde K. Echinacea for preventing and treating the common cold. Cochrane Database Syst Rev.2014;(2):CD000530. doi: 10.1002/14651858.CD000530.pub3. PubMed
- Hoban CL, Byard RW, Musgrave IF. Analysis of spontaneous adverse drug reactions to echinacea, valerian, black cohosh and ginkgo in Australia from 2000 to 2015. J Integr Med. 2019;17(5):338-343. PubMed
- Ogal M, Johnston SL, Klein P, Schoop R. Echinacea reduces antibiotic usage in children through respiratory tract infection prevention: a randomized, blinded, controlled clinical trial. Eur J Med Res. 2021 Apr 8;26(1):33. PubMed
- Lopresti AL, Smith SJ. An investigation into the anxiety-relieving and mood-enhancing effects of Echinacea angustifolia (EP107 ™): A randomised, double-blind, placebo-controlled study. J Affect Disord 2021;293:229-237.
- Weishaupt R, Buchkov A, Kolev E, Klein P, Schoop R. Reduction of viral load in patients with acute sore throats: Results from an observational clinical trial with Echinacea / Salvia lozenges [published online ahead of print, 2023 Mar 8]. Complement Med Re
- Sumer J, Keckeis K, Scanferla G, et al. Novel Echinacea formulations for the treatment of acute respiratory tract infections in adults-A randomized blinded controlled trial. Front Med (Lausanne) 2023;10:948787. PubMed
Zinc 88 references
- Barceloux DG. Zinc. J Toxicol Clin Toxicol 1999;37:279-92.
- Eby GA, Davis DR, Halcomb WW. Reduction in duration of common colds by zinc gluconate lozenges in a double-blind study. Antimicrob Agents Chemother 1984;25:20-4. DOI
- Smith DS, Helzner EC, Nuttall CE Jr, et al. Failure of zinc gluconate in treatment of acute upper respiratory tract infections. Antimicrob Agents Chemother 1989;33:646-8. PubMed
- Blondeau JM. Expanded activity and utility of the new fluoroquinolones: a review. Clin Ther 1999;21:3-40. PubMed
- Reyes AJ, Olhaberry JV, Leary WP, et al. Urinary zinc excretion, diuretics, zinc deficiency and some side-effects of diuretics. S Afr Med J 1983;64:936-41.
- Kugelmas M. Preliminary observation: oral zinc sulfate replacement is effective in treating muscle cramps in cirrhotic patients. J Am Coll Nutr 2000;19:13-5. PubMed
- Hebel SK, ed. Drug Facts and Comparisons. 52nd ed. St. Louis: Facts and Comparisons, 1998.
- Chan S, Gerson B, Subramaniam S. The role of copper, molybdenum, selenium, and zinc in nutrition and health. Clin Lab Med 1998;18:673-85. DOI
- Brewer GJ, Yuzbasiyan-Gurkan V, Johnson V, et al. Treatment of Wilson's disease with zinc: XI. Interaction with other anticopper agents. J Am Coll Nutr 1993;12:26-30. PubMed
- Fosmire GJ. Zinc toxicity. Am J Clin Nutr 1990;51:225-7.
- Lomaestro BM, Bailie GR. Absorption interactions with fluoroquinolones. 1995 update. Drug Saf 1995;12:314-33. PubMed
- Hansten PD, Horn JR. Drug Interactions Analysis and Management. Vancouver, WA: Applied Therapeutics Inc., 1997 and updates.
- Seelig MS. Auto-immune complications of D-penicillamine - A possible result of zinc and magnesium depletion and of pyridoxine inactivation. J Am Coll Nutr 1982;1:207-14. PubMed
- Neuvonen PJ. Interactions with the absorption of tetracyclines. Drugs 1976;11:45-54.. PubMed
- Hirt M, Nobel S, Barron E. Zinc nasal gel for the treatment of common cold symptoms: A double-blind, placebo-controlled trial. Ear Nose Throat J 2000;79:778-82.. DOI
- Simkin PA. Oral zinc sulphate in rheumatoid arthritis. Lancet 1976;2:539-42. PubMed
- Wray D. A double-blind trial of systemic zinc sulfate in recurrent aphthous stomatitis. Oral Surg Oral Med Oral Pathol 1982;53:469-72. PubMed
- Douglas RM, Miles HB, Moore BW, et al. Failure of effervescent zinc acetate lozenges to alter the course of upper respiratory tract infections in Australian adults. Antimicrob Agents Chemother 1987;31:1263-5. PubMed
- Lagiou P, Wuu J, Trichopoulou A, et al. Diet and benign prostatic hyperplasia: a study in Greece. Urology 1999;54:284-90. PubMed
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