IMS-W Ingredients & Drug Interactions
by Pure Herbs
What is this page for?
First and foremost: checking IMS-W 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
IMS-W is a dietary supplement by Pure Herbs with 8 active ingredients. Its ingredients are commonly taken for water retention (diuretic), digestive upset and bloating, urinary tract support.Based on those ingredients, 2,209 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Marshmallow Root Extract, Calamus Root Extract, Black Cohosh Root Extract. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against IMS-W by Pure Herbs
Ask about any prescription or over-the-counter medication and we check it for interactions with IMS-W by Pure Herbs — 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 IMS-W by Pure Herbs
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
Pure Herbs IMS-W contains 8 ingredients in a proprietary herbal blend. The active plant extracts are juniper fruit, mullein leaf, marshmallow root, black cohosh root, sarsaparilla root, pau d'arco bark, figwort aerial parts, and calamus root.
These are traditional herbal ingredients; the product contains no other inactive ingredients listed.
Does it work?
Not established
The evidence on this blend's ingredients is limited. Black cohosh root extract is rated possibly effective for menopausal symptoms.
The other six active ingredients—juniper, mullein, marshmallow, sarsaparilla, pau d'arco, figwort, and calamus—do not have reliable evidence established in our data for any of the conditions they're traditionally used for. If you're considering this product for a specific health concern, talk with your doctor or pharmacist about what the science actually supports.
How safe is it?
Well-documented data
Most of these ingredients are generally well tolerated in short-term use, but some carry real cautions. Calamus root is flagged as likely unsafe—it may contain beta-asarone, a possible carcinogen that the FDA has banned from food, and may cause nausea, vomiting, or intestinal paralysis.
Juniper should not be used long-term because it can irritate the kidneys. Black cohosh is generally well tolerated short-term but has rare concerns about liver damage; cases of liver failure have been reported.
Pau d'arco at high doses (above 1.5 grams daily) may cause anemia and bleeding risk. For pregnancy: juniper is unsafe, black cohosh and pau d'arco are possibly unsafe, and mullein, marshmallow, sarsaparilla, figwort, and calamus lack enough data—avoid them during pregnancy.
For breastfeeding, safety data are insufficient or absent for all ingredients; it's best avoided.
Meds to double-check
Moderate interaction found
Check with your doctor or pharmacist before using this product if you take any of the following: CNS depressants or sedatives (calamus), antihypertensive/blood pressure drugs (calamus), antidepressants or serotonergic drugs (black cohosh, calamus), blood thinners or anticoagulants (pau d'arco, marshmallow, mullein), diabetes medications (juniper), lithium (juniper, marshmallow, sarsaparilla, figwort), diuretics (juniper, figwort), or liver-metabolized drugs (black cohosh, calamus). Because calamus interacts with so many drug classes, this product warrants careful review of your complete medication list.
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.
This product combines eight herbal ingredients with limited clinical evidence and multiple medication interactions—especially with blood pressure drugs, antidepressants, blood thinners, and diabetes medications. The inclusion of calamus root, which may contain a possible carcinogen, is a particular concern.
If you take any regular medications, especially those listed above, talk with your doctor or pharmacist before starting this product. It's not recommended during pregnancy or breastfeeding.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 8 of 8 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Jan 23, 2023.
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 IMS-W, straight from the product label.
| Brand | Pure Herbs |
|---|---|
| Net contents | 4 Fluid Ounce(s); 120 mL |
| Market status | On market |
| Date entered into DSLD | Jan 23, 2023 |
| DSLD ID | 281352 |
| Product type | Botanical |
| Supplement form | Liquid |
| Dietary claims / uses | All Other, Structure/Function |
| Intended target group(s) | Adult (18 - 50 Years), Women (not pregnant or lactating) |
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 IMS-W by Pure Herbs, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Proprietary Blend | 1884 mg | -- |
| Juniper Fruit Extract | 0 NP | -- |
| Mullein Leaf Extract | 0 NP | -- |
| Marshmallow Root Extract | 0 NP | -- |
| Black Cohosh Root Extract | 0 NP | -- |
| Sarsaparilla Root Extract | 0 NP | -- |
| Pau d'Arco Bark Extract | 0 NP | -- |
| Figwort Aerial Parts Extract | 0 NP | -- |
| Calamus Root Extract | 0 NP | -- |
Other ingredients: None
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.
Suggested/Recommended/Usage/Directions
Directions: For adults, mix 2 mL (abt. 1/2 tsp) of extract in 2 fl. oz (60 mL) water one time daily preferably with a meal.
Shake well before use
Formulation
Helps to support a healthy immune system.
FDA Disclaimer Statement
This statement has not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.
Precautions
Warning: Discontinue use and consult a healthcare practitioner if you have a liver disorder or develop symptoms of liver trouble, such as abdominal pain, dark urine, or jaundice.
Not intended for use by pregnant or nursing women. If you have a medical condition or are taking medication, consult your doctor prior to use.
Keep out of reach of children
Brand IP Statement(s)
Pure Herbs, LTD. Natural Herbal Extracts
FDA Statement of Identity
Dietary Supplement
General Statements
"No expense has been spared to provide the finest nature has to offer."
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
IMS-W by Pure Herbs 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 IMS-W by Pure Herbs
These are the 8 active ingredients this product is made of. Select any to open its full monograph.
Serving size2 mL 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.
Other (inactive) ingredients: None. These complete the product’s ingredient list but are not active constituents.
IMS-W by Pure Herbs Drug Interactions
HelloPharmacist Interaction Report
Pure Herbs IMS-W is a liquid herbal blend with several ingredients that interact with medications.
The most serious concern involves calamus root extract, which has Moderate-severity interactions with CNS depressants (sedatives, sleep aids, anxiety medications) and can add to their sedative effects. Additionally, calamus interacts with antihypertensive drugs (blood pressure medications), CYP2D6 and CYP3A4 substrates (a broad class of drugs your liver breaks down), anticholinergic drugs, cholinergic drugs, and MAOIs (a type of antidepressant).
Read the full breakdown — every affected drug type, severity by severity
Black cohosh root extract also carries Moderate interactions with CYP2D6 substrates, hepatotoxic drugs (medications that stress the liver), atorvastatin, cisplatin, estrogens, and serotonergic drugs (antidepressants and related medications). Juniper fruit extract has Moderate interactions with antidiabetes drugs and can theoretically lower blood sugar further.
Pau d'arco bark, sarsaparilla root, and figwort aerial parts also interact with anticoagulant/antiplatelet drugs (blood thinners), lithium, and diuretics, respectively.
Marshmallow root extract has a Minor interaction with oral drugs generally—its mucilage may interfere with how your body absorbs them. Mullein leaf extract has a Minor interaction with blood thinners.
Several other ingredient interactions span Minor severity with lithium, diuretic drugs, H2-blockers, and OATP substrates.
Altogether, these interactions span 2,210 individual medications. Before taking this product, check with your doctor or pharmacist about any prescriptions or over-the-counter medications you're on—especially blood pressure drugs, antidepressants, blood thinners, diabetes medications, and liver-metabolized drugs.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against IMS-W?
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 IMS-W interact with 2,209 drugs. Click any drug to see the details.
8 of the 8 ingredients in IMS-W interact with drugs. Each result below shows which ingredient is responsible. Marshmallow Root Extract Calamus Root Extract Black Cohosh Root Extract Juniper Fruit Extract Mullein Leaf Extract Pau d'Arco Bark Extract Figwort Aerial Parts Extract Sarsaparilla Root Extract
6-mercaptopurinePurinethol
How 6-mercaptopurine interacts with IMS-W — through 2 ingredients. Tap an ingredient for the detail:
Black Cohosh Root ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
Read the full Black Cohosh Root Extract + 6-mercaptopurine interactionMarshmallow Root ExtractOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow Root Extract + 6-mercaptopurine interactionAdo-trastuzumab EmtansineKadcyla
How Ado-trastuzumab Emtansine interacts with IMS-W — through 1 ingredient. Tap an ingredient for the detail:
Calamus Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, taking calamus with drugs metabolized by CYP3A4 might increase drug levels and potentially increase the risk of adverse effects.
Read the full Calamus Root Extract + Ado-trastuzumab Emtansine interactionAbacavir Sulfate, Dolutegravir, LamivudineTriumeq
How Abacavir Sulfate, Dolutegravir, Lamivudine interacts with IMS-W — through 2 ingredients. Tap an ingredient for the detail:
Black Cohosh Root ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
Read the full Black Cohosh Root Extract + Abacavir Sulfate, Dolutegravir, Lamivudine interactionMarshmallow Root ExtractOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow Root Extract + Abacavir Sulfate, Dolutegravir, Lamivudine interactionAbacavir, LamivudineEpzicom
How Abacavir, Lamivudine interacts with IMS-W — through 2 ingredients. Tap an ingredient for the detail:
Black Cohosh Root ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
Read the full Black Cohosh Root Extract + Abacavir, Lamivudine interactionMarshmallow Root ExtractOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow Root Extract + Abacavir, Lamivudine interactionAbciximabReoPro
How Abciximab interacts with IMS-W — through 3 ingredients. Tap an ingredient for the detail:
Pau D'arco Bark ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, pau d'arco might increase the risk of bleeding when taken with anticoagulant or antiplatelet drugs.
Read the full Pau D'arco Bark Extract + Abciximab interactionMarshmallow Root ExtractAnticoagulant/antiplatelet Drugs, Oral Drugs Minor
Interaction Summary
Theoretically, marshmallow flower might have antiplatelet effects.
Read the full Marshmallow Root Extract + Abciximab interactionMullein Leaf ExtractAnticoagulant/antiplatelet Drugs Minor
Interaction Summary
Lab tests on extracts from different parts of common and dense-flowered mullein plants show that they do have some blood-thinning effects, as they increase the time it takes for blood to clot.
Read the full Mullein Leaf Extract + Abciximab interactionAbemaciclibVerzenio
How Abemaciclib interacts with IMS-W — through 2 ingredients. Tap an ingredient for the detail:
Calamus Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, taking calamus with drugs metabolized by CYP3A4 might increase drug levels and potentially increase the risk of adverse effects.
Read the full Calamus Root Extract + Abemaciclib interactionMarshmallow Root ExtractOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow Root Extract + Abemaciclib interactionAbiraterone
How Abiraterone interacts with IMS-W — through 3 ingredients. Tap an ingredient for the detail:
Calamus Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, taking calamus with drugs metabolized by CYP3A4 might increase drug levels and potentially increase the risk of adverse effects.
Read the full Calamus Root Extract + Abiraterone interactionBlack Cohosh Root ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
Read the full Black Cohosh Root Extract + Abiraterone interactionMarshmallow Root ExtractOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow Root Extract + Abiraterone interactionAbiraterone AcetateYonsa, Zytiga
How Abiraterone Acetate interacts with IMS-W — through 3 ingredients. Tap an ingredient for the detail:
Black Cohosh Root ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
Read the full Black Cohosh Root Extract + Abiraterone Acetate interactionCalamus Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, taking calamus with drugs metabolized by CYP3A4 might increase drug levels and potentially increase the risk of adverse effects.
Read the full Calamus Root Extract + Abiraterone Acetate interactionMarshmallow Root ExtractOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow Root Extract + Abiraterone Acetate interactionAbrocitinibCibinqo
How Abrocitinib interacts with IMS-W — through 3 ingredients. Tap an ingredient for the detail:
Pau D'arco Bark ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, pau d'arco might increase the risk of bleeding when taken with anticoagulant or antiplatelet drugs.
Read the full Pau D'arco Bark Extract + Abrocitinib interactionMullein Leaf ExtractAnticoagulant/antiplatelet Drugs Minor
Interaction Summary
Lab tests on extracts from different parts of common and dense-flowered mullein plants show that they do have some blood-thinning effects, as they increase the time it takes for blood to clot.
Read the full Mullein Leaf Extract + Abrocitinib interactionMarshmallow Root ExtractOral Drugs, Anticoagulant/antiplatelet Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow Root Extract + Abrocitinib interactionAcalabrutinibCalquence
How Acalabrutinib interacts with IMS-W — through 2 ingredients. Tap an ingredient for the detail:
Calamus Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, taking calamus with drugs metabolized by CYP3A4 might increase drug levels and potentially increase the risk of adverse effects.
Read the full Calamus Root Extract + Acalabrutinib interactionMarshmallow Root ExtractOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow Root Extract + Acalabrutinib interactionAcarboseGlucobay, Prandase, Precose
How Acarbose interacts with IMS-W — through 3 ingredients. Tap an ingredient for the detail:
Black Cohosh Root ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
Read the full Black Cohosh Root Extract + Acarbose interactionJuniper Fruit ExtractAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, taking juniper berry with antidiabetes medications might cause additive hypoglycemia.
Read the full Juniper Fruit Extract + Acarbose interactionMarshmallow Root ExtractOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow Root Extract + Acarbose interactionAcebutololRhotral, Sectral
How Acebutolol interacts with IMS-W — through 3 ingredients. Tap an ingredient for the detail:
Calamus Root ExtractAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, taking calamus with other antihypertensive medications might increase the risk of hypotension.
Read the full Calamus Root Extract + Acebutolol interactionBlack Cohosh Root ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
Read the full Black Cohosh Root Extract + Acebutolol interactionMarshmallow Root ExtractOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow Root Extract + Acebutolol interactionAcenocoumarolSintrom
How Acenocoumarol interacts with IMS-W — through 3 ingredients. Tap an ingredient for the detail:
Pau D'arco Bark ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, pau d'arco might increase the risk of bleeding when taken with anticoagulant or antiplatelet drugs.
Read the full Pau D'arco Bark Extract + Acenocoumarol interactionMullein Leaf ExtractAnticoagulant/antiplatelet Drugs Minor
Interaction Summary
Lab tests on extracts from different parts of common and dense-flowered mullein plants show that they do have some blood-thinning effects, as they increase the time it takes for blood to clot.
Read the full Mullein Leaf Extract + Acenocoumarol interactionMarshmallow Root ExtractAnticoagulant/antiplatelet Drugs, Oral Drugs Minor
Interaction Summary
Theoretically, marshmallow flower might have antiplatelet effects.
Read the full Marshmallow Root Extract + Acenocoumarol interactionAcepromazineAtravet
How Acepromazine interacts with IMS-W — through 2 ingredients. Tap an ingredient for the detail:
Calamus Root ExtractCns Depressants, Anticholinergic Drugs Moderate
Interaction Summary
Theoretically, concurrent use of CNS depressants and calamus might have an additive effect and increase the risk of sedative effects.
Read the full Calamus Root Extract + Acepromazine interactionMarshmallow Root ExtractOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow Root Extract + Acepromazine interactionAcetaminophenChildren's Tylenol, Children's Tylenol Meltaways, Tylenol, Tylenol Ex Strength
How Acetaminophen interacts with IMS-W — through 2 ingredients. Tap an ingredient for the detail:
Black Cohosh Root ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
Read the full Black Cohosh Root Extract + Acetaminophen interactionMarshmallow Root ExtractOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow Root Extract + Acetaminophen interactionAcetaminophen, AspirinGemnisyn
How Acetaminophen, Aspirin interacts with IMS-W — through 4 ingredients. Tap an ingredient for the detail:
Black Cohosh Root ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
Read the full Black Cohosh Root Extract + Acetaminophen, Aspirin interactionPau D'arco Bark ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, pau d'arco might increase the risk of bleeding when taken with anticoagulant or antiplatelet drugs.
Read the full Pau D'arco Bark Extract + Acetaminophen, Aspirin interactionMarshmallow Root ExtractAnticoagulant/antiplatelet Drugs, Oral Drugs Minor
Interaction Summary
Theoretically, marshmallow flower might have antiplatelet effects.
Read the full Marshmallow Root Extract + Acetaminophen, Aspirin interactionMullein Leaf ExtractAnticoagulant/antiplatelet Drugs Minor
Interaction Summary
Lab tests on extracts from different parts of common and dense-flowered mullein plants show that they do have some blood-thinning effects, as they increase the time it takes for blood to clot.
Read the full Mullein Leaf Extract + Acetaminophen, Aspirin interactionAcetaminophen, Aspirin, CaffeineExcedrin, Excedrin Extra Strength, Excedrin Migraine
How Acetaminophen, Aspirin, Caffeine interacts with IMS-W — through 5 ingredients. Tap an ingredient for the detail:
Pau D'arco Bark ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, pau d'arco might increase the risk of bleeding when taken with anticoagulant or antiplatelet drugs.
Read the full Pau D'arco Bark Extract + Acetaminophen, Aspirin, Caffeine interactionBlack Cohosh Root ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
Read the full Black Cohosh Root Extract + Acetaminophen, Aspirin, Caffeine interactionCalamus Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, taking calamus with drugs metabolized by CYP3A4 might increase drug levels and potentially increase the risk of adverse effects.
Read the full Calamus Root Extract + Acetaminophen, Aspirin, Caffeine interactionMullein Leaf ExtractAnticoagulant/antiplatelet Drugs Minor
Interaction Summary
Lab tests on extracts from different parts of common and dense-flowered mullein plants show that they do have some blood-thinning effects, as they increase the time it takes for blood to clot.
Read the full Mullein Leaf Extract + Acetaminophen, Aspirin, Caffeine interactionMarshmallow Root ExtractOral Drugs, Anticoagulant/antiplatelet Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow Root Extract + Acetaminophen, Aspirin, Caffeine interactionAcetaminophen, Brompheniramine, PhenylpropanolamineDimetapp Cold and Flu
How Acetaminophen, Brompheniramine, Phenylpropanolamine interacts with IMS-W — through 2 ingredients. Tap an ingredient for the detail:
Black Cohosh Root ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
Read the full Black Cohosh Root Extract + Acetaminophen, Brompheniramine, Phenylpropanolamine interactionMarshmallow Root ExtractOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow Root Extract + Acetaminophen, Brompheniramine, Phenylpropanolamine interactionAcetaminophen, ButalbitalAxocet, Bancap, Bucet, Butex Forte, Esgic CF, Orbivan CF +5 more
How Acetaminophen, Butalbital interacts with IMS-W — through 2 ingredients. Tap an ingredient for the detail:
Black Cohosh Root ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
Read the full Black Cohosh Root Extract + Acetaminophen, Butalbital interactionMarshmallow Root ExtractOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow Root Extract + Acetaminophen, Butalbital interactionAcetaminophen, Butalbital, CaffeineEsgic, Esgic Plus, Fiogesic, Fioricet, Repan, Tecnal +1 more
How Acetaminophen, Butalbital, Caffeine interacts with IMS-W — through 3 ingredients. Tap an ingredient for the detail:
Black Cohosh Root ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
Read the full Black Cohosh Root Extract + Acetaminophen, Butalbital, Caffeine interactionCalamus Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, taking calamus with drugs metabolized by CYP3A4 might increase drug levels and potentially increase the risk of adverse effects.
Read the full Calamus Root Extract + Acetaminophen, Butalbital, Caffeine interactionMarshmallow Root ExtractOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow Root Extract + Acetaminophen, Butalbital, Caffeine interactionAcetaminophen, Butalbital, Caffeine, CodeineEsgic with Codeine, Fioricet w/ Codeine
How Acetaminophen, Butalbital, Caffeine, Codeine interacts with IMS-W — through 3 ingredients. Tap an ingredient for the detail:
Calamus Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cns Depressants +1 Moderate
Interaction Summary
Theoretically, taking calamus with drugs metabolized by CYP3A4 might increase drug levels and potentially increase the risk of adverse effects.
Read the full Calamus Root Extract + Acetaminophen, Butalbital, Caffeine, Codeine interactionBlack Cohosh Root ExtractCytochrome P450 2d6 (cyp2d6) Substrates, Hepatotoxic Drugs Moderate
Interaction Summary
Some research suggests that black cohosh might inhibit CYP2D6, but there is conflicting evidence.
Read the full Black Cohosh Root Extract + Acetaminophen, Butalbital, Caffeine, Codeine interactionMarshmallow Root ExtractOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow Root Extract + Acetaminophen, Butalbital, Caffeine, Codeine interactionAcetaminophen, Butalbital, CodeineBancap w/ Codeine
How Acetaminophen, Butalbital, Codeine interacts with IMS-W — through 3 ingredients. Tap an ingredient for the detail:
Black Cohosh Root ExtractHepatotoxic Drugs, Cytochrome P450 2d6 (cyp2d6) Substrates Moderate
Interaction Summary
Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
Read the full Black Cohosh Root Extract + Acetaminophen, Butalbital, Codeine interactionCalamus Root ExtractCytochrome P450 2d6 (cyp2d6) Substrates, Cns Depressants Moderate
Interaction Summary
Theoretically, taking calamus with drugs metabolized by CYP2D6 might increase drug levels and potentially increase the risk of adverse effects.
Read the full Calamus Root Extract + Acetaminophen, Butalbital, Codeine interactionMarshmallow Root ExtractOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow Root Extract + Acetaminophen, Butalbital, Codeine interactionAcetaminophen, Butalbital, Codeine PhosphatePhrenilin #3
How Acetaminophen, Butalbital, Codeine Phosphate interacts with IMS-W — through 3 ingredients. Tap an ingredient for the detail:
Calamus Root ExtractCns Depressants, Cytochrome P450 2d6 (cyp2d6) Substrates Moderate
Interaction Summary
Theoretically, concurrent use of CNS depressants and calamus might have an additive effect and increase the risk of sedative effects.
Read the full Calamus Root Extract + Acetaminophen, Butalbital, Codeine Phosphate interactionBlack Cohosh Root ExtractCytochrome P450 2d6 (cyp2d6) Substrates, Hepatotoxic Drugs Moderate
Interaction Summary
Some research suggests that black cohosh might inhibit CYP2D6, but there is conflicting evidence.
Read the full Black Cohosh Root Extract + Acetaminophen, Butalbital, Codeine Phosphate interactionMarshmallow Root ExtractOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow Root Extract + Acetaminophen, Butalbital, Codeine Phosphate interactionAcetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, PhenylephrineHycomine Compound
How Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interacts with IMS-W — through 3 ingredients. Tap an ingredient for the detail:
Black Cohosh Root ExtractHepatotoxic Drugs, Cytochrome P450 2d6 (cyp2d6) Substrates Moderate
Interaction Summary
Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
Read the full Black Cohosh Root Extract + Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interactionCalamus Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Anticholinergic Drugs +2 Moderate
Interaction Summary
Theoretically, taking calamus with drugs metabolized by CYP3A4 might increase drug levels and potentially increase the risk of adverse effects.
Read the full Calamus Root Extract + Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interactionMarshmallow Root ExtractOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow Root Extract + 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 IMS-W — through 3 ingredients. Tap an ingredient for the detail:
Black Cohosh Root ExtractCytochrome P450 2d6 (cyp2d6) Substrates, Hepatotoxic Drugs Moderate
Interaction Summary
Some research suggests that black cohosh might inhibit CYP2D6, but there is conflicting evidence.
Read the full Black Cohosh Root Extract + Acetaminophen, Caffeine, Codeine interactionCalamus Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cns Depressants +1 Moderate
Interaction Summary
Theoretically, taking calamus with drugs metabolized by CYP3A4 might increase drug levels and potentially increase the risk of adverse effects.
Read the full Calamus Root Extract + Acetaminophen, Caffeine, Codeine interactionMarshmallow Root ExtractOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow Root Extract + Acetaminophen, Caffeine, Codeine interactionAcetaminophen, Caffeine, Codeine, SalicylamideCodalan No.1, Codalan No.2, Codalan No.3
How Acetaminophen, Caffeine, Codeine, Salicylamide interacts with IMS-W — through 3 ingredients. Tap an ingredient for the detail:
Calamus Root ExtractCytochrome P450 2d6 (cyp2d6) Substrates, Cns Depressants +1 Moderate
Interaction Summary
Theoretically, taking calamus with drugs metabolized by CYP2D6 might increase drug levels and potentially increase the risk of adverse effects.
Read the full Calamus Root Extract + Acetaminophen, Caffeine, Codeine, Salicylamide interactionBlack Cohosh Root ExtractHepatotoxic Drugs, Cytochrome P450 2d6 (cyp2d6) Substrates Moderate
Interaction Summary
Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
Read the full Black Cohosh Root Extract + Acetaminophen, Caffeine, Codeine, Salicylamide interactionMarshmallow Root ExtractOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow Root Extract + Acetaminophen, Caffeine, Codeine, Salicylamide interactionAcetaminophen, Caffeine, DihydrocodeineDHC Plus, Panlor DC, Panlor SS
How Acetaminophen, Caffeine, Dihydrocodeine interacts with IMS-W — through 3 ingredients. Tap an ingredient for the detail:
Black Cohosh Root ExtractCytochrome P450 2d6 (cyp2d6) Substrates, Hepatotoxic Drugs Moderate
Interaction Summary
Some research suggests that black cohosh might inhibit CYP2D6, but there is conflicting evidence.
Read the full Black Cohosh Root Extract + Acetaminophen, Caffeine, Dihydrocodeine interactionCalamus Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cns Depressants +1 Moderate
Interaction Summary
Theoretically, taking calamus with drugs metabolized by CYP3A4 might increase drug levels and potentially increase the risk of adverse effects.
Read the full Calamus Root Extract + Acetaminophen, Caffeine, Dihydrocodeine interactionMarshmallow Root ExtractOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow Root Extract + Acetaminophen, Caffeine, Dihydrocodeine interactionAcetaminophen, Caffeine, IsomethepteneMigralam
How Acetaminophen, Caffeine, Isometheptene interacts with IMS-W — through 3 ingredients. Tap an ingredient for the detail:
Black Cohosh Root ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
Read the full Black Cohosh Root Extract + Acetaminophen, Caffeine, Isometheptene interactionCalamus Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, taking calamus with drugs metabolized by CYP3A4 might increase drug levels and potentially increase the risk of adverse effects.
Read the full Calamus Root Extract + Acetaminophen, Caffeine, Isometheptene interactionMarshmallow Root ExtractOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow Root Extract + Acetaminophen, Caffeine, Isometheptene interactionAcetaminophen, Caffeine, PyrilamineMidol Max Strength Menstrual
How Acetaminophen, Caffeine, Pyrilamine interacts with IMS-W — through 5 ingredients. Tap an ingredient for the detail:
Calamus Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Anticholinergic Drugs Moderate
Interaction Summary
Theoretically, taking calamus with drugs metabolized by CYP3A4 might increase drug levels and potentially increase the risk of adverse effects.
Read the full Calamus Root Extract + Acetaminophen, Caffeine, Pyrilamine interactionBlack Cohosh Root ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
Read the full Black Cohosh Root Extract + Acetaminophen, Caffeine, Pyrilamine interactionFigwort Aerial Parts ExtractDiuretic Drugs Moderate
Interaction Summary
Theoretically, overuse of figwort might compound diuretic-induced potassium loss.
Read the full Figwort Aerial Parts Extract + Acetaminophen, Caffeine, Pyrilamine interactionMarshmallow Root ExtractOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow Root Extract + Acetaminophen, Caffeine, Pyrilamine interactionJuniper Fruit ExtractDiuretic Drugs Minor
Interaction Summary
Theoretically, juniper berry might increase the risk of adverse effects from diuretic drugs.
Read the full Juniper Fruit Extract + Acetaminophen, Caffeine, Pyrilamine interactionAcetaminophen, Chlorpheniramine Maleate, Dextromethorphan HbrVicks Formula 44M Cough, Cold & Flu Relief
How Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interacts with IMS-W — through 3 ingredients. Tap an ingredient for the detail:
Calamus Root ExtractAnticholinergic Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Moderate
Interaction Summary
Theoretically, concurrent use of anticholinergic drugs and calamus might decrease the effectiveness of the anticholinergic drug.
Read the full Calamus Root Extract + Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interactionBlack Cohosh Root ExtractSerotonergic Drugs, Cytochrome P450 2d6 (cyp2d6) Substrates +1 Moderate
Interaction Summary
Combining serotonergic drugs with black cohosh might cause additive serotonergic effects.
Read the full Black Cohosh Root Extract + Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interactionMarshmallow Root ExtractOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow Root Extract + Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interactionEach ingredient & the kinds of drugs it affects
For each ingredient in IMS-W 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.
Marshmallow Root Extract
Lithium
Theoretically, due to potential diuretic effects, marshmallow might reduce excretion and increase levels of lithium.
Marshmallow is thought to have diuretic properties. To avoid lithium toxicity, the dose of lithium might need to be decreased when used with marshmallow.
Anticoagulant/Antiplatelet Drugs
Theoretically, marshmallow flower might have antiplatelet effects.
Animal research suggests that marshmallow flower extract has antiplatelet effects. However, the root and leaf of marshmallow, not the flower, are the plant parts most commonly found in dietary supplements. Theoretically, use of marshmallow flower with anticoagulant/antiplatelet drugs can have additive effects, and might increase the risk for bleeding in some patients.
Oral Drugs
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Marshmallow contains mucilage which can affect oral drug absorption. To avoid changes in absorption, take marshmallow 30-60 minutes after oral medications.
Calamus Root Extract
Anticholinergic Drugs
Theoretically, concurrent use of anticholinergic drugs and calamus might decrease the effectiveness of the anticholinergic drug.
In vitro evidence shows that calamus can inhibit acetylcholinesterase (AChE).
Antihypertensive Drugs
Theoretically, taking calamus with other antihypertensive medications might increase the risk of hypotension.
Animal research shows that calamus decreases the rate and strength of the heartbeat, which might lower blood pressure. use with caution.
Cholinergic Drugs
Theoretically, concurrent use of cholinergic drugs and calamus might have an additive effect and increase the risk of cholinergic effects.
In vitro evidence shows that calamus can inhibit acetylcholinesterase (AChE).
Cns Depressants
Theoretically, concurrent use of CNS depressants and calamus might have an additive effect and increase the risk of sedative effects.
Animal research shows that calamus is a CNS depressant and increases gamma-aminobutyric acid levels.
Cytochrome P450 2D6 (Cyp2D6) Substrates
Theoretically, taking calamus with drugs metabolized by CYP2D6 might increase drug levels and potentially increase the risk of adverse effects.
In vitro research shows that calamus extract inhibits CYP2D6 enzyme.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, taking calamus with drugs metabolized by CYP3A4 might increase drug levels and potentially increase the risk of adverse effects.
In vitro research shows that calamus extract inhibits CYP3A4 enzyme.
Monoamine Oxidase Inhibitors (Maois)
Theoretically, calamus might potentiate the effects and adverse effects of MAOIs.
Some reports suggest that calamus increases the effects of MAOIs.
Antacids
Theoretically, taking calamus might reduce the effectiveness of antacids.
Some research suggests that calamus lowers gastric pH.
H2-Blockers
Theoretically, taking calamus might reduce the effectiveness of H2-blockers.
Some research suggests that calamus lowers gastric pH.
Proton Pump Inhibitors (Ppis)
Theoretically, taking calamus might reduce the effectiveness of PPIs.
Some research suggests that calamus lowers gastric pH.
Black Cohosh Root Extract
Atorvastatin (Lipitor)
Taking black cohosh with atorvastatin might increase the risk for elevated liver function tests.
In one case report, a patient taking atorvastatin (Lipitor) developed significantly elevated liver function enzymes after starting black cohosh 100 mg four times daily. Liver enzymes returned to normal when black cohosh was discontinued. It is unclear whether the elevated liver enzymes were due to black cohosh itself or an interaction between atorvastatin and black cohosh.
Cisplatin (Platinol-Aq)
Theoretically, black cohosh may reduce the clinical effects of cisplatin.
Animal research suggests that black cohosh might decrease the cytotoxic effect of cisplatin on breast cancer cells.
Cytochrome P450 2D6 (Cyp2D6) Substrates
Some research suggests that black cohosh might inhibit CYP2D6, but there is conflicting evidence.
Some clinical research suggests that black cohosh might modestly inhibit CYP2D6 and increase levels of drugs metabolized by this enzyme. However, contradictory clinical research shows a specific black cohosh product (Remifemin, Enzymatic Therapy) 40 mg twice daily does not significantly inhibit metabolism of a CYP2D6 substrate in healthy study volunteers. Until more is known, use black cohosh cautiously in patients taking drugs metabolized by CYP2D6.
Estrogens
Theoretically, black cohosh may alter the effects of estrogen therapy.
Some research suggests that black cohosh has estrogenic effects. This may enhance or inhibit the effects of estrogen therapy.
Hepatotoxic Drugs
Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
There is concern that black cohosh might be linked to cases of liver failure and autoimmune hepatitis.
Serotonergic Drugs
Combining serotonergic drugs with black cohosh might cause additive serotonergic effects.
Black cohosh might increase the risk of serotonin syndrome when combined with other serotonergic drugs. Black cohosh acts as an agonist at several serotonin receptor subtypes and might interact with other serotonergic medications. In one case, a 55-year-old female who had been on stable treatment with sertraline 50 mg and duloxetine 60 mg daily developed serotonin syndrome after taking black cohosh extract 40 mg daily for 3 days.
Organic Anion-Transporting Polypeptide Substrates (Oatp)
Black cohosh may inhibit one form of OATP, OATP2B1, which could reduce the bioavailability and clinical effects of OATP2B1 substrates.
In vitro research shows that black cohosh modestly inhibits OATP2B1. OATPs are expressed in the small intestine and liver and are responsible for the uptake of drugs and other compounds into the body. Inhibition of OATP may reduce the bioavailability of oral drugs that are substrates of OATP.
Juniper Fruit Extract
Antidiabetes Drugs
Theoretically, taking juniper berry with antidiabetes medications might cause additive hypoglycemia.
Animal research shows that juniper berry can lower blood glucose.
Diuretic Drugs
Theoretically, juniper berry might increase the risk of adverse effects from diuretic drugs.
Juniper berry is thought to have mild diuretic effects.
Lithium
Theoretically, juniper berry might reduce lithium excretion and increase serum levels of lithium.
Juniper berry is thought to have mild diuretic effects.
Mullein Leaf Extract
Anticoagulant/Antiplatelet Drugs
Lab tests on extracts from different parts of common and dense-flowered mullein plants show that they do have some blood-thinning effects, as they increase the time it takes for blood to clot. This is likely due to at least one of the known constituents of muellein, triterpenoid saponins. However, the effects appear to be mild and results have been inconsistent. Extracts from different plant parts have been show to have varying anticoagulant strengths, with water-based ones being more potent than alcohol-based extracts.
Pau d'Arco Bark Extract
Anticoagulant/Antiplatelet Drugs
Theoretically, pau d'arco might increase the risk of bleeding when taken with anticoagulant or antiplatelet drugs.
In vitro research shows that pau d'arco reduces platelet aggregation and may interfere with vitamin K. One clinical study shows that taking the lapachol constituent of pau d'arco in doses above 1.5 grams daily increases the risk of bleeding. The effects of whole pau d'arco or pau d'arco extract in humans are unclear.
Figwort Aerial Parts Extract
Diuretic Drugs
Theoretically, overuse of figwort might compound diuretic-induced potassium loss. There is some concern that people taking figwort along with potassium depleting diuretics might have an increased risk for hypokalemia. Initiation of potassium supplementation or an increase in potassium supplement dose may be necessary for some patients. Some diuretics that can deplete potassium include chlorothiazide (Diuril), chlorthalidone (Thalitone), furosemide (Lasix), hydrochlorothiazide (HCTZ, Hydrodiuril, Microzide), and others.
Lithium
Figwort is thought to have diuretic properties. Theoretically, due to these potential diuretic effects, figwort might reduce excretion and increase levels of lithium. The dose of lithium might need to be decreased.
Sarsaparilla Root Extract
Digoxin (Lanoxin)
Theoretically, concomitant use of sarsaparilla with digoxin might increase the risk of cardiac toxicity.
Sarsaparilla is thought to have diuretic properties, which could potentially cause potassium loss. Overuse or misuse of sarsaparilla with cardiac glycoside therapy might increase the risk of cardiac toxicity due to potassium loss.
Lithium
Theoretically, sarsaparilla might increase the effects and adverse effects of lithium.
Sarsaparilla is thought to have diuretic properties. Due to these effects, sarsaparilla might reduce excretion and increase levels of lithium. The dose of lithium might need to be decreased.
Brand information
Manufacturer and brand details for IMS-W, from the product label.
Pure Herbs
See all Pure Herbs products- Name
- Pure Herbs, Ltd.
- City
- Sterling Heights
- State
- MI
- Phone Number
- (800) 860-4372
- Web Address
- www.pureherbs.com
IMS-W by Pure Herbs: Common Questions
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How can one product interact with so many drugs?
Where does this information come from?
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Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
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Label information is sourced from the NIH Dietary Supplement Label Database and reflects the product version on file; always read your actual product label. This page is for education only and is not a substitute for professional medical advice. Confirm with your pharmacist or doctor before combining supplements and medications.
The Full Monographs Behind IMS-W’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Juniper
Interacts with 162 drugsJuniper berry is a traditional herb best known for flavoring gin and for its folk use as a diuretic and digestive aid. Solid human evidence for its health benefits is limited, and it can irr...
Read the full Juniper monograph → Herb & supplement monographMullein
Interacts with 122 drugsMullein is a traditional herbal remedy most often used as a tea or syrup to soothe coughs, sore throats, and respiratory irritation. High-quality human studies are lacking, so its benefits a...
Read the full Mullein monograph → Herb & supplement monographMarshmallow
Interacts with 2,040 drugsMarshmallow root is a traditional herb rich in soothing, gel-like fibers called mucilage, which is why it has long been used for coughs, sore throats, and stomach irritation. Evidence for th...
Read the full Marshmallow monograph → Herb & supplement monographBlack Cohosh
Interacts with 652 drugsBlack cohosh is a North American plant most often used to ease menopause symptoms like hot flashes, but the research is mixed and far from settled. It is generally well tolerated for short-t...
Read the full Black Cohosh monograph → Herb & supplement monographSarsaparilla
Interacts with 2 drugsSarsaparilla is a traditional root used in teas, tonics, and old-fashioned root beer flavoring. Modern evidence for its health claims is very limited and comes mostly from lab studies, so it...
Read the full Sarsaparilla monograph → Herb & supplement monographPau D'arco
Interacts with 122 drugsPau d'arco is a South American tree bark traditionally used for infections and inflammation, and it contains compounds like lapachol that show activity in lab studies. However, strong human...
Read the full Pau D'arco monograph → Herb & supplement monographFigwort
Interacts with 76 drugsFigwort is a traditional herb used mainly for skin problems and minor swelling, but solid human studies are lacking, so its benefits remain unproven. It is generally used short-term and topi...
Read the full Figwort monograph → Herb & supplement monographCalamus
Interacts with 1,117 drugsCalamus is a swamp plant with a long history in Ayurvedic and traditional Chinese medicine, mostly for digestive and nervous-system complaints. However, it contains beta-asarone, a compound...
Read the full Calamus monograph →Sources & How We Checked
IMS-W'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 105 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.
Juniper 7 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.
- Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
- Robbers JE, Tyler VE. Tyler's Herbs of Choice: The Therapeutic Use of Phytomedicinals. New York, NY: The Haworth Herbal Press, 1999.
- Sanchez de Medina F, Gamez MJ, Jimenez I, et al. Hypoglycemic activity of juniper "berries." Planta Med 1994;60:197-200. PubMed
- Swanston-Flatt SK, Day C, Bailey CJ, Flatt PR. Traditional plant treatments for diabetes. Studies in normal and streptozotocin diabetic mice. Diabetologia 1990;33:462-4. PubMed
- Tammaro A, Adebanjo GAR, Chello C, et al. Bullous dermatitis caused by common juniper. Contact Dermatitis. 2020. PubMed
Mullein 2 references
- Castro AI, Carmona JB, Gonzales FG, Nestar OB. Occupational airborne dermatitis from gordolobo (Verbascum densiflorum). Contact Dermatitis 2006;55(5):301.
- Flores Echaiz C, Al Ali A, Cao AQ, Sasseville D. Simultaneous contact dermatitis caused by Asteraceae and Verbascum thapsus. Contact Dermatitis 2017;76(5):316-8.
Marshmallow 5 references
- Monographs on the medicinal uses of plant drugs. Exeter, UK: European Scientific Co-op Phytother, 1997.
- Leung AY, Foster S. Encyclopedia of Common Natural Ingredients Used in Food, Drugs and Cosmetics. 2nd ed. New York, NY: John Wiley & Sons, 1996.
- 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.
- Hage-Sleiman R, Mroueh M, Daher CF. Pharmacological evaluation of aqueous extract of Althaea officinalis flower grown in Lebanon. Pharm Biol 2011;49(3):327-33.
Black Cohosh 68 references
- McFarlin BL, Gibson MH, O'Rear J, Harman P. A national survey of herbal preparation use by nurse-midwives for labor stimulation. Review of the literature and recommendations for practice. J Nurse Midwifery 1999;44:205-16. PubMed
- Whiting PW, Clouston A, Kerlin P. Black cohosh and other herbal remedies associated with acute hepatitis. Med J Aust 2002;177:440-3. PubMed
- Pepping J. Black cohosh: Cimicifuga racemosa. Am J Health Syst Pharm 1999;56:1400-2. PubMed
- Liske E. Therapeutic efficacy and safety of Cimicifuga racemosa for gynecologic disorders. Adv Ther 1998;15:45-53.
- Kruse SO, Lohning A, Pauli GF, et al. Fukiic and piscidic acid esters from the rhizome of Cimicifuga racemosa and the in vitro estrogenic activity of fukinolic acid. Planta Med 1999;65:763-4.
- Jacobson JS, Troxel AB, Evans J, et al. Randomized trial of black cohosh for the treatment of hot flashes among women with a history of breast cancer. J Clin Oncol 2001;19:2739-45. PubMed
- Gunn TR, Wright IM. The use of black and blue cohosh in labour. N Z Med J 1996;109:410-1.
- Baillie N, Rasmussen P. Black and blue cohosh in labour. N Z Med J 1997;110:20-1.
- Lontos S, Jones RM, Angus PW, Gow PJ. Acute liver failure associated with the use of herbal preparations containing black cohosh. Med J Aust 2003;179:390-1.. DOI
- Wuttke W, Seidlova-Wuttke D, Gorkow C. The Cimicifuga preparation BNO 1055 vs. conjugated estrogens in a double-blind placebo-controlled study: effects on menopause symptoms and bone markers. Maturitas 2003;44:S67-77. PubMed
- Huntley A, Ernst E. A systematic review of the safety of black cohosh. Menopause 2003;10:58-64.. DOI
- Cohen SM, O'Connor AM, Hart J, et al. Autoimmune hepatitis associated with the use of black cohosh: a case study. Menopause 2004;11:575-7. PubMed
- Vitetta L, Thomsen M, Sali A. Black cohosh and other herbal remedies associated with acute hepatitis. Med J Aust 2003;178:411-2.. PubMed
- Thomsen M, Vitetta L, Schmidt M, Sali A. Acute liver failure associated with the use of herbal preparations containing black cohosh. Med J Aust 2004;180:598-600.. DOI
- Cohen B, Schardt D. Center for Science in the Public Interest. Letter to Food and Drug Administration. Commissioner Mark McClellan, MD, PhD. March 4, 2004.
- Seidlova-Wuttke D, Hesse O, Jarry H, et al. Evidence for selective estrogen receptor modulator activity in a black cohosh (Cimicifuga racemosa) extract: comparison with estradiol-17beta. Eur J Endocrinol 2003;149:351-62. PubMed
- Rockwell S, Liu Y, Higgins SA. Alteration of the effects of cancer therapy agents on breast cancer cells by the herbal medicine black cohosh. Breast Cancer Res Treat 2005;90:233-9. PubMed
- Levitsky J, Alli TA, Wisecarver J, Sorrell MF. Fulminant liver failure associated with the use of black cohosh. Dig Dis Sci 2005;50:538-9. PubMed
- Cheong JL, Bucknall R. Retinal vein thrombosis associated with a herbal phytoestrogen preparation in a susceptible patient. Postgrad Med J 2005;81:266-7.. PubMed
- Nappi RE, Malavasi B, Brundu B, Facchinetti F. Efficacy of Cimicifuga racemosa on climacteric complaints: a randomized study versus low-dose transdermal estradiol. Gynecol Endocrinol 2005;20:30-5.
- Gurley BJ, Gardner SF, Hubbard MA, et al. In vivo effects of goldenseal, kava kava, black cohosh, and valerian on human cytochrome P450 1A2, 2D6, 2E1, and 3A4/5 phenotypes. Clin Pharmacol Ther 2005;77:415-26. PubMed
- Minciullo PL, Saija A, Patafi M, et al. Muscle damage induced by black cohosh (Cimicifuga racemosa). Phytomedicine 2006;13:115-8. PubMed
- Wuttke W, Gorkow C, Seidlova-Wuttke D. Effects of black cohosh (Cimicifuga racemosa) on bone turnover, vaginal mucosa, and various blood parameters in postmenopausal women: a double-blind, placebo-controlled, and conjugated estrogens-controlled study. Men PubMed
- MHRA. Black cohosh (Cimicifuga racemosa) - risk of liver problems. Herbal Safety News July 2006. Available at: http://www.mhra.gov.uk/home/idcplg?IdcService=SS_GET_PAGE&useSecondary= true&ssDocName=CON2024131&ssTargetNodeId=663.
- Dugoua JJ, Seely D, Perri D, et al. Safety and efficacy of black cohosh (cimicifuga racemosa) during pregnancy and lactation. Can J Clin Pharmacol 2006;13:e257-61.
- Raus K, Brucker C, Gorkow C, Wuttke W. First-time proof of endometrial safety of the special black cohosh extract (Actaea or Cimicifuga racemosa extract) CR BNO 1055. Menopause 2006;13:678-91. PubMed
- Lynch CR, Folkers ME, Hutson WR. Fulminant hepatic failure associated with the use of black cohosh: a case report. Liver Transpl 2006;12:989-92. PubMed
- Bai W, Henneicke-von Zepelin HH, Wang S, et al. Efficacy and tolerability of a medicinal product containing an isopropanolic black cohosh extract in Chinese women with menopausal symptoms: A randomized, double blind, parallel-controlled study versus tibol
- Meyer S, Vogt T, Obermann EC, et al. Cutaneous pseudolymphoma induced by Cimicifuga racemosa. Dermatology 2007;214:94-6.
- Gori L, Firenzuoli F. Is black cohosh a hepatotoxic medicinal herb? Forsch Komplementarmed 2007;14:109-10. PubMed
- Assessment of case reports connected to herbal medicinal products containing cimicifugae racemosa rhizoma (black cohosh, root). Doc. Ref. EMEA/269259/2006. Available at: www.emea.eu.int/pdfs/human/hmpc/26925806en.pdf (Accessed 30 November 2007).
- Chung DJ, Kim HY, Park KH, et al. Black cohosh and St. John's wort (GYNO-Plus) for climacteric symptoms. Yonsei Med J 2007;48:289-94. PubMed
- Chow ECY, Teo M, Ring JA, Chen JW. Liver failure associated with the use of black cohosh for menopausal symptoms. Med J Aust 2008;188:420-2. PubMed
- Mahady GB, Low Dog T, Barrett ML, et al. United States Pharmacopeia review of the black cohosh case reports of hepatotoxicity. Menopause 2008;15:628-38. PubMed
- Hepatotoxicity with black cohosh. Australian Adv Drug Reactions Bull 2006;25:6. Available at: www.tga.gov.au/adr/aadrb/aadr0604.htm#a1.
- Dunbar K, Solga SF. Black cohosh, safety, and public awareness. Liver Int 2007;27:1017. PubMed
- Patel NM, Derkits RM. Possible increase in liver enzymes secondary to atorvastatin and black cohosh administration. J Pharm Pract 2007;20:341-6. DOI
- Joy D, Joy J, Duane P. Black cohosh: a cause of abnormal postmenopausal liver function tests. Climacteric 2008;11:84-8. PubMed
- Australian Adverse Drug Reactions Advisory Committee. Black cohosh and liver toxicity - an update. Aust Adv Drug Reactions Bull 2007;26:11.
- Gurley BJ, Swain A, Hubbard MA, et al. Clinical assessement of CYP2D6-mediated herb-drug interactions in humans: Effects of milk-thistle, black cohosh, goldenseal, kava kava, St. John's wort, and Echinacea. Mol Nutr Food Res 2008;52:755-63.
- Spangler L, Newton KM, Grothaus LC, et al. The effects of black cohosh therapies on lipids, fibrinogen, glucose and insulin. Maturitas 2007;57:195-204. PubMed
- Teschke R, Bahre R, Genthner A, et al. Suspected black cohosh hepatotoxicity - challenges and pitfalls of causality assessment. Maturitas 2009;63:302-14. PubMed
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