Interactions on record — worth a quick check against your medications. Based on 7 of 9 ingredients. Check your meds →
Dietary supplement

Koflet Ingredients & Drug Interactions

by Himalaya

Lozenge Category: Botanical
Most serious interaction: Moderate
The interaction bottom line Most serious interaction: Moderate

Koflet is a dietary supplement by Himalaya with 9 active ingredients. Its ingredients are commonly taken for toothache and oral pain, digestive upset, antimicrobial and antifungal.Based on those ingredients, 1,371 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Pepper, Ginger, Clove. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

HelloPharmacist Scorecard of Koflet by Himalaya

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.

From our pharmacy team — supplement deep dive

What’s inside

Low disclosure
Ingredient Transparency · database check
Low

Most active ingredients don't disclose an individual amount — you can't tell how much of each you're getting.

Why this rating?
  • The label discloses an exact amount for 0 of its 8 active ingredients.
  • “Proprietary Herbal Blend” is a proprietary blend — the label gives one combined amount (85 mg) without saying how much of each component you get.
  • “Trikatu Herbal Blend” is a proprietary blend — the label gives one combined amount (40 mg) without saying how much of each component you get.

Koflet contains eight ingredients, including six with documented active constituents: ginger, clove, cardamom, long pepper, cinnamon, and catechu. The product also lists a proprietary herbal blend and trikatu herbal blend, which bundle some of these ingredients.

Ginger is included for its warming and potential anti-inflammatory properties. Clove, long pepper, and cinnamon are traditional warming spices.

Cardamom and catechu are included for digestive support. The lozenges are sweetened with cane sugar and liquid glucose as inactive ingredients.

Does it work?

Not established
Evidence for Intended Use · database check
By FDA rules, dietary supplements can’t claim to treat, cure, or prevent disease — so labels speak in careful marketing language. We discern each product’s intended use from its name, label claims, and label statements, then grade the clinical evidence for that use. How these ratings are computed
Not established

The graded evidence we hold for these ingredients covers different conditions than the ones this product is marketed for, so there's no established rating for its stated use.

Why this rating?
  • The label markets this product for: Respiratory and immune system support.
  • We looked for evidence on: Acute respiratory distress syndrome (ARDS), Asthma, Bronchitis, Common cold, Cough, Chronic obstructive pulmonary disease (COPD) — and 4 related terms.
  • The closest evidence on file: Clove is rated "Insufficient Reliable Evidence To Rate" for Cough (Natural Medicines).
  • Also on file: Indian Long Pepper is rated "Insufficient Reliable Evidence To Rate" for Bronchitis, Asthma, Common cold, Cough, and more.
  • Also on file: Black Pepper is rated "Insufficient Reliable Evidence To Rate" for Asthma.

Evidence for Koflet's effectiveness is mixed and limited. Ginger in the product may be possibly effective for pregnancy-induced nausea and vomiting, dysmenorrhea (period pain), and osteoarthritis, but it's possibly ineffective for exercise-induced muscle soreness and chemotherapy-induced nausea.

Clove shows possibly effective evidence only for ventilator-associated pneumonia—a hospital setting—and insufficient evidence for cough, pain, or digestive complaints. Cardamom, long pepper, and cinnamon all have insufficient reliable evidence to support their use for the conditions they're traditionally used for (respiratory infection, diabetes, dyslipidemia, and others).

Catechu also lacks solid evidence for osteoarthritis or muscle soreness. For a cough lozenge specifically, the evidence supporting the ingredients in this product is not established in our data.

How safe is it?

Well-documented data
Safety Information · database check
Well characterized

Adverse-effect, pregnancy, and general safety data are on file for most of these ingredients.

Why this rating?
  • We hold adverse-effect (side-effect) data for 6 of the 7 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 7 of 7.
  • General safety write-ups exist for 7 of 7.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

Ginger is generally well tolerated in typical food and supplement amounts; higher doses (5 grams daily or more) increase side effects like heartburn, diarrhea, burping, and mouth irritation. Clove as a food spice is safe, but concentrated clove oil is toxic in small amounts and should be avoided.

Cardamom in food amounts is generally well tolerated; one mild skin reaction was reported in a trial. Long pepper lacks adequate safety data in medicinal doses.

Cinnamon in food amounts is likely safe, but large supplement doses carry theoretical liver risk from coumarin content. Catechu safety data in humans is limited; one combination product containing catechu was linked to liver and lung injury reports.

Ginger is rated likely to possibly safe in pregnancy; clove, cinnamon, and catechu are likely safe or lack clear data for lactation. Long pepper safety information for pregnancy and lactation is insufficient—the product advises avoiding it.

If you're pregnant or breastfeeding, discuss this product with your doctor or pharmacist.

Meds to double-check

Moderate interaction found
Known Interaction Concern · database check
Moderate identified

The most serious documented interaction for these ingredients is Moderate. Check your medications for a personalized result.

Why this rating?
  • 6 of the 7 matched ingredients can interact with medications — Clove, Indian Long Pepper, Catechu, Black Pepper, Ginger, among others.
  • The most serious interaction on file is rated Moderate.
  • Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs; immunosuppressants / transplant drugs; diabetes medications; lithium.
  • For scale: 1,372 individual medications appear in the full list. A big number alone doesn't make a product dangerous — what matters is whether YOUR medication is on it, so run yours through the interaction checker on this page.

Before taking Koflet, double-check if you use blood thinners (warfarin, phenprocoumon) or antiplatelet drugs—ginger and long pepper may increase bleeding risk. If you take diabetes medications, watch for low blood sugar (ginger, clove, long pepper, and cinnamon may lower it further).

Blood pressure medications like losartan or antihypertensives need review—ginger and catechu may affect them. Heart medications including nifedipine, propranolol, and theophylline require checking, as several ingredients may alter their levels.

Finally, if you take cyclosporine or other drugs metabolized by liver enzymes (CYP1A2, CYP2D6, CYP2C9, CYP3A4, or P-glycoprotein), these ingredients may raise drug levels and side effects. Use the interaction checker on this page with your specific medications.

Check your own medication Run your meds through the checker above

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.

Koflet may appeal to those seeking a traditional herbal lozenge for throat comfort, but its active ingredients carry multiple moderate-severity interactions with common medications like blood thinners, diabetes drugs, and heart medications. If you take any prescription medications, check them against the interaction tool before use.

Pregnant or breastfeeding individuals should discuss it with their pharmacist or doctor first.

Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI

Assessment coverage: 7 of 8 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Sep 25, 2013.

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

At a glance

General information

Key facts about Koflet, straight from the product label.

Brand Himalaya
Net contents 20 Lozenge(s)
Market status On market
Date entered into DSLD Sep 25, 2013
DSLD ID 25845
Product type Botanical
Supplement form Lozenge
Dietary claims / uses All Other, Structure/Function
Intended target group(s) Adult (18 - 50 Years)
From the label
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 Koflet by Himalaya, sourced from the NIH Dietary Supplement Label Database.

Supplement Facts

Daily Value (DV) Target Group(s):
Adults and children 4 or more years of age
Minimum serving Sizes:
1 Lozenge(s)
Maximum serving Sizes:
1 Lozenge(s)
Servings per container
20
IngredientAmount% DV
Calories10 {Calories}--
Total Carbohydrates3 Gram(s)1%
Sugar2 Gram(s)--
Ginger0 NP--
Clove0 NP--
Proprietary Herbal Blend85 mg--
Cardamom0 NP--
Long Pepper0 NP--
Cinnamon0 NP--
Pepper0 NP--
Chebulic Myrobalan0 NP--
Cutch Tree0 NP--
Trikatu Herbal Blend40 mg--

Other ingredients: Cane Sugar, Glucose, Liquid

Tap any ingredient to jump to its full detail below.

Label statements
These statements are the manufacturer’s wording, reproduced from the product label — the label is saying it, not HelloPharmacist. We don’t verify or endorse them.
General Statements

Nature's Balanced Mucosal Support Formula

The Himalaya Difference. Found in 1930. Worldwide in over 70 countries. 80,000 sq. ft. R&D with over 100 physicians and scientists. 1,214 published clinical trials on Himalaya products. Seed-to-shelf, 700 acres of farmland. Patents: 7 granted, 76 pending.

Product of INDIA

Herbal Healthcare

FDA Statement of Identity

Herbal Supplement

Seals/Symbols

H SINCE 1930

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.

Storage

Store in a cool dry place, away from direct sunlight. Do not refrigerate.

Brand IP Statement(s)

Koflet(R) Lozenges are a proprietary herbal formula which assists the normal function of bronchial mucous membrane and muscles. Koflet(R) Lozenges also help support a noraml immune system function.

Suggested/Recommended/Usage/Directions

Directions: One lozenge dissolved slowly in the mouth, three to four times per day.

See for yourself

Koflet by Himalaya label

The label scan from the NIH Dietary Supplement Label Database. Tap to enlarge.

What’s inside

The Ingredients in Koflet by Himalaya

These are the 9 active ingredients this product is made of. Select any to open its full monograph.

Serving size1 Lozenge(s) Dosage formLozenge Servings per container20 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.

Sugar

2 Gram(s) per serving

Proprietary Herbal Blend

85 mg per serving

Trikatu Herbal Blend

40 mg per serving

Other (inactive) ingredients: Cane Sugar, Glucose, Liquid. These complete the product’s ingredient list but are not active constituents.

Interaction report

Koflet by Himalaya Drug Interactions

Want to check YOUR meds against Koflet?

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 checker
1,371Drugs
1,345 Moderate 26 Minor

Ingredients driving the most interactions

Pepper 1,019
Ginger 1,007
Clove 977

Each ingredient & the kinds of drugs it affects

For each ingredient in Koflet 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.

Pepper17 drug types · 1,019 drugs

Anticoagulant/Antiplatelet Drugs

Theoretically, black pepper might increase the risk of bleeding when taken with antiplatelet or anticoagulant drugs.
In vitro research shows that piperine, a constituent of black pepper, seems to inhibit platelet aggregation. This has not been reported in humans.

Likelihood Possible Evidence D
Antidiabetes Drugs

Theoretically, black pepper might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Animal research shows that piperine, a constituent of black pepper, can reduce blood glucose levels. Monitor blood glucose levels closely. Dose adjustments might be necessary.

Likelihood Possible Evidence D
Atorvastatin (Lipitor)

Theoretically, black pepper might increase blood levels of atorvastatin.
Animal research shows that taking piperine, a constituent of black pepper, 35 mg/kg can increase the maximum serum concentration of atorvastatin three-fold. This has not been reported in humans.

Likelihood Possible Evidence D
Cyclosporine (Neoral, Sandimmune)

Theoretically, black pepper might increase the effects and side effects of cyclosporine.
In vitro research shows that piperine, a constituent of black pepper, increases the bioavailability of cyclosporine. This has not been reported in humans.

Likelihood Possible Evidence D
Cytochrome P450 2D6 (Cyp2D6) Substrates

Theoretically, black pepper might increase levels of drugs metabolized by CYP2D6.
In vitro research suggests that some constituents of black pepper inhibit CYP2D6. This has not been reported in humans.

Likelihood Possible Evidence D
Cytochrome P450 3A4 (Cyp3A4) Substrates

Theoretically, black pepper might increase levels of drugs metabolized by CYP3A4.
In vitro research and pharmacokinetic simulation data suggest that piperine, a constituent of black pepper, as well as the pepper fruit seem to inhibit CYP3A4. This has not been reported in humans.

Likelihood Possible Evidence D
Lithium

Theoretically, black pepper might increase blood levels of lithium due to its diuretic effects. The dose of lithium might need to be reduced.
Black pepper is thought to have diuretic properties.

Likelihood Probable Evidence D
Nevirapine (Viramune)

Black pepper might increase blood levels of nevirapine.
Clinical research shows that piperine, a constituent of black pepper, increases the plasma concentration of nevirapine. However, no adverse effects were observed in this study.

Likelihood Probable Evidence D
P-Glycoprotein Substrates

Theoretically, black pepper might increase levels of P-glycoprotein substrates.
In vitro research shows that piperine, a constituent of black pepper, seems to inhibit P-glycoprotein.

Likelihood Possible Evidence D
Pentobarbital (Nembutal)

Theoretically, black pepper might increase the sedative effects of pentobarbital.
Animal research shows that piperine, a constituent of black pepper, increases pentobarbital-induced sleeping time.

Likelihood Possible Evidence D
Phenytoin (Dilantin)

Black pepper might increase blood levels of phenytoin.
Clinical research shows that piperine, a constituent of black pepper, seems to increase absorption, slow elimination, and increase levels of phenytoin. Taking a single dose of black pepper 1 gram along with phenytoin seems to double the serum concentration of phenytoin. Consuming a soup with black pepper providing piperine 44 mg/200 mL of soup along with phenytoin also seems to increase phenytoin levels when compared with consuming the same soup without black pepper.

Likelihood Possible Evidence B
Propranolol (Inderal)

Black pepper might increase blood levels of propranolol.
Clinical research shows that piperine, a constituent of black pepper, seems to increase absorption and slow elimination of propranolol.

Likelihood Possible Evidence B
Rifampin (Rifadin)

Black pepper might increase blood levels of rifampin.
Clinical research shows that piperine, a constituent of black pepper, seems to increase absorption and serum levels of rifampin.

Likelihood Possible Evidence B
Theophylline

Black pepper might increase blood levels of theophylline.
Clinical research shows that piperine, a constituent of black pepper, seems to increase absorption and slow elimination of theophylline.

Likelihood Possible Evidence D
Amoxicillin (Amoxil, Trimox)

Theoretically, black pepper might increase the effects and side effects of amoxicillin.
Animal research shows that taking piperine, a constituent of black pepper, with amoxicillin increases plasma levels of amoxicillin. This has not been reported in humans.

Likelihood Possible Evidence D
Carbamazepine (Tegretol)

Theoretically, black pepper might increase blood levels of carbamazepine, potentially increasing the effects and side effects of carbamazepine.
One clinical study in patients taking carbamazepine 300 mg or 500 mg twice daily shows that taking a single 20 mg dose of purified piperine, a constituent of black pepper, increases carbamazepine levels. Piperine may increase carbamazepine absorption by increasing blood flow to the GI tract, increasing the surface area of the small intestine, or inhibiting cytochrome P450 3A4 (CYP3A4) in the gut wall. Absorption was significantly increased by 7-10 mcg/mL/hour. The time to eliminate carbamazepine was also increased by 4-8 hours. Although carbamazepine levels were increased, this did not appear to increase side effects. In vitro research also shows that piperine can increase carbamazepine levels by 11% in a time-dependent manner.

Likelihood Possible Evidence B
Cytochrome P450 1A2 (Cyp1A2) Substrates

Theoretically, black pepper might decrease levels and clinical effects of drugs metabolized by CYP1A2.
In vitro research suggests that black pepper induces CYP1A2. This has not been reported in humans.

Likelihood Possible Evidence D

Ginger14 drug types · 1,007 drugs

Anticoagulant/Antiplatelet Drugs

Ginger may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs. However, research is conflicting.
Laboratory research suggests that ginger inhibits thromboxane synthetase and decreases platelet aggregation. However, this has not been demonstrated unequivocally in humans, with mixed results from clinical trials. Theoretically, excessive amounts of ginger might increase the risk of bleeding when used with anticoagulant/antiplatelet drugs.

Likelihood Possible Evidence B
Antidiabetes Drugs

Theoretically, taking ginger with antidiabetes drugs might increase the risk of hypoglycemia.
Animal and human research suggests that ginger might increase insulin levels and/or decrease blood glucose levels.

Likelihood Possible Evidence D
Cytochrome P450 3A4 (Cyp3A4) Substrates

Ginger might increase or decrease the levels of CYP3A4 substrates.
In vitro research and some case reports suggest that ginger inhibits CYP3A4 activity. Three case reports from the World Health Organization (WHO) adverse drug reaction database describe increased toxicity in patients taking ginger and cancer medications that are CYP3A4 substrates (imatinib, dabrafenib, and crizotinib). However, the causality of this interaction is unclear due to the presence of multiple interacting drugs and routes of administration.
Conversely, other in vitro research suggests that ginger induces CYP3A4 activity, leading to reduced levels of CYP3A4 substrates. However, this interaction has not been reported in humans.

Likelihood Possible Evidence D
Losartan (Cozaar)

Theoretically, ginger might increase levels of losartan and the risk of hypotension.
In animal research, ginger increased the levels and hypotensive effects of a single dose of losartan. It is not clear if ginger alters the concentration or effects of losartan when taken continuously. Additionally, this interaction has not been shown in humans.

Likelihood Possible Evidence D
Nifedipine (Procardia)

Ginger may have antiplatelet effects and increase the risk of bleeding if used with nifedipine.
Clinical research shows that combined treatment with ginger 1 gram plus nifedipine 10 mg significantly inhibits platelet aggregation when compared to nifedipine or ginger alone.

Likelihood Possible Evidence B
P-Glycoprotein Substrates

Ginger might increase the absorption and blood levels of P-glycoprotein (P-gp) substrates.
In vitro research and case reports suggest that ginger inhibits drug efflux by P-gp, potentially increasing absorption and serum levels of P-gp substrates. Two case reports from the World Health Organization (WHO) adverse drug reaction database describe increased toxicity in patients taking ginger and cancer medications that are P-gp substrates (trametinib, crizotinib). However, the causality of this interaction is unclear due to the presence of multiple interacting drugs and routes of administration.

Likelihood Possible Evidence D
Phenprocoumon (Marcoumar, Others)

Ginger might increase the risk of bleeding with phenprocoumon.
Phenprocoumon, a warfarin-related anticoagulant, might increase the international normalized ratio (INR) when taken with ginger. There is one case report of a 76-year-old woman with a stable INR on phenprocoumon that increased to greater than 10 when she began consuming dried ginger and ginger tea.

Likelihood Possible Evidence D
Warfarin (Coumadin)

Ginger might increase the risk of bleeding with warfarin.
Laboratory research suggests that ginger might inhibit thromboxane synthetase and decrease platelet aggregation. In one case report, ginger increased the INR when taken with phenprocoumon, which has similar pharmacological effects as warfarin. In another case report, ginger increased the INR when taken with a combination of warfarin, hydrochlorothiazide, and acetaminophen. A longitudinal analysis suggests that taking ginger increases the risk of bleeding in patients taking warfarin for at least 4 months. However, research in healthy people suggests that ginger has no effect on INR, or the pharmacokinetics or pharmacodynamics of warfarin. Until more is known, monitor INRs closely in patients taking large amounts of ginger.

Likelihood Possible Evidence B
Calcium Channel Blockers

Theoretically, taking ginger with calcium channel blockers might increase the risk of hypotension.
Some animal and in vitro research suggests that ginger has hypotensive and calcium channel-blocking effects. Another animal study shows that concomitant administration of ginger and the calcium channel blocker amlodipine leads to greater reductions in blood pressure when compared with amlodipine alone.

Likelihood Unlikely Evidence D
Cyclosporine (Neoral, Sandimmune)

Theoretically, when taken prior to cyclosporine, ginger might decrease cyclosporine levels.
In an animal model, ginger juice taken 2 hours prior to cyclosporine administration reduced the maximum concentration and area under the curve of cyclosporine by 51% and 40%, respectively. This effect was not observed when ginger juice and cyclosporine were administered at the same time.

Likelihood Possible Evidence D
Cytochrome P450 1A2 (Cyp1A2) Substrates

Theoretically, ginger might increase the levels of CYP1A2 substrates.
In vitro research shows that ginger inhibits CYP1A2 activity. However, this interaction has not been reported in humans.

Likelihood Possible Evidence D
Cytochrome P450 2B6 (Cyp2B6) Substrates

Theoretically, ginger might increase the levels of CYP2B6 substrates.
In vitro research shows that ginger inhibits CYP2B6 activity. However, this interaction has not been reported in humans.

Likelihood Possible Evidence D
Cytochrome P450 2C9 (Cyp2C9) Substrates

Theoretically, ginger might increase the levels of CYP2C9 substrates.
In vitro research shows that ginger inhibits CYP2C9 activity. However, this interaction has not been reported in humans.

Likelihood Possible Evidence D
Metronidazole (Flagyl)

Theoretically, ginger might increase levels of metronidazole.
In an animal model, ginger increased the absorption and plasma half-life of metronidazole. In addition, the elimination rate and clearance of metronidazole was significantly reduced.

Likelihood Possible Evidence D

Clove7 drug types · 977 drugs

Antidiabetes Drugs

Theoretically, concomitant use of clove extracts with antidiabetes drugs might increase the risk of hypoglycemia.
Clinical and laboratory research suggest that polyphenol extracts from clove flower buds might lower blood glucose levels. Dosing adjustments for insulin or oral hypoglycemic agents may be necessary when taken with clove. Monitor blood glucose levels closely.

Likelihood Possible Evidence D
Cytochrome P450 1A2 (Cyp1A2) Substrates

Theoretically, concomitant use of clove may increase levels of drugs metabolized by CYP1A2.
In vitro research shows that eugenol, the principal constituent of clove, can inhibit CYP1A2 in a dose-dependent manner,. This effect has not been reported in humans.

Likelihood Possible Evidence D
Cytochrome P450 2C9 (Cyp2C9) Substrates

Theoretically, concomitant use of clove may increase levels of drugs metabolized by CYP2C9.
In vitro research shows that eugenol, the principal constituent of clove, inhibits CYP2C9 in a dose-dependent manner. This effect has not been reported in humans.

Likelihood Possible Evidence D
Cytochrome P450 2D6 (Cyp2D6) Substrates

Theoretically, concomitant use of clove may increase levels of drugs metabolized by CYP2D6.
In vitro research shows that eugenol, the principal constituent of clove, can inhibit CYP2D6 in a dose-dependent manner. This effect has not been reported in humans.

Likelihood Possible Evidence D
Cytochrome P450 3A4 (Cyp3A4) Substrates

Theoretically, concomitant use of clove may increase levels of drugs metabolized by CYP3A4.
In vitro research shows that eugenol, the principal constituent of clove, can inhibit CYP3A4 in a dose-dependent manner. This effect has not been reported in humans.

Likelihood Possible Evidence D
Anticoagulant/Antiplatelet Drugs

Theoretically, clove oil may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Laboratory research suggests that eugenol, a constituent of clove, has antiplatelet activity. This interaction has not been reported in humans.

Likelihood Unlikely Evidence D
Ibuprofen (Advil, Others)

Theoretically, topical application of clove oil with ibuprofen might increase the absorption and side effects of topical ibuprofen.
Laboratory research shows that topical application of clove oil increases the absorption of topical ibuprofen. This interaction has not been reported in humans.

Likelihood Possible Evidence D

Long Pepper14 drug types · 896 drugs

Anticoagulant/Antiplatelet Drugs

Theoretically, Indian long pepper might increase the risk of bleeding when taken with anticoagulant/antiplatelet drugs.
In vitro research shows that Indian long pepper extract inhibits platelet aggregation.

Likelihood Possible Evidence D
Antidiabetes Drugs

Theoretically, Indian long pepper might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Animal research shows that piperine, a constituent of Indian long pepper, can reduce blood glucose levels. Monitor blood glucose levels closely. Dose adjustments might be necessary.

Likelihood Possible Evidence D
Cyclosporine (Neoral, Sandimmune)

Theoretically, Indian long pepper might increase the effects and adverse effects of cyclosporine.
In vitro research shows that piperine, a constituent of Indian long pepper, increases the bioavailability of cyclosporine.

Likelihood Possible Evidence D
Cytochrome P450 3A4 (Cyp3A4) Substrates

Theoretically, Indian long pepper might increase the effects and adverse effects of CYP3A4 substrates.
In vitro research shows that piperine, a constituent of Indian long pepper, inhibits CYP3A4.

Likelihood Possible Evidence D
Nevirapine (Viramune)

Theoretically, Indian long pepper might increase blood levels of nevirapine.
A small pharmacokinetic study shows that piperine, a constituent of Indian long pepper, increases the plasma concentration and systemic exposure of nevirapine. However, no adverse effects were associated with the elevated plasma levels of nevirapine.

Likelihood Probable Evidence B
P-Glycoprotein Substrates

Theoretically, Indian long pepper might increase levels of P-glycoprotein substrates.
In vitro research shows that piperine, a constituent of Indian long pepper, can inhibit P-glycoprotein.

Likelihood Possible Evidence D
Pentobarbital (Nembutal)

Theoretically, Indian long pepper might increase the sedative effects of pentobarbital.
Animal research shows that piperine, a constituent of Indian long pepper, can increase pentobarbitone-induced sleeping time.

Likelihood Possible Evidence D
Phenytoin (Dilantin)

Theoretically, Indian long pepper might increase blood levels of phenytoin.
A small pharmacokinetic study shows that piperine, a constituent of Indian long pepper, increases phenytoin serum levels and slows its elimination.

Likelihood Possible Evidence B
Propranolol (Inderal)

Theoretically, Indian long pepper might increase blood levels of propranolol.
A small pharmacokinetic study shows that piperine, a constituent of Indian long pepper, accelerates absorption and increases serum concentrations of propranolol.

Likelihood Possible Evidence B
Rifampin (Rifadin)

Theoretically, Indian long pepper might increase blood levels of rifampin.
Piperine, a constituent of Indian long pepper, seems to increase absorption and serum levels of rifampin.

Likelihood Possible Evidence D
Theophylline

Indian long pepper might increase blood levels of theophylline.
A small pharmacokinetic study shows that piperine, a constituent of Indian long pepper, increases serum concentrations and slows elimination of theophylline.

Likelihood Possible Evidence B
Amoxicillin (Amoxil, Trimox)

Theoretically, Indian long pepper might increase the effects and adverse effects of amoxicillin.
Evidence from animal research shows that piperine, a constituent of Indian long pepper, increases the plasma levels of amoxicillin when taken concomitantly.

Likelihood Possible Evidence D
Carbamazepine (Tegretol)

Theoretically, Indian long pepper might increase blood levels of carbamazepine.
A small pharmacokinetic study in patients taking carbamazepine 300 mg or 500 mg twice daily shows that a single 20 mg dose of purified piperine, which is a constituent of Indian long pepper, increases carbamazepine levels. Piperine may increase absorption by increasing blood flow to the GI tract, increasing the surface area of the small intestine, or by cytochrome P450 3A4 (CYP3A4) inhibition in the gut wall. Absorption was significantly increased by 7-10 mcg/mL/hour. The time to eliminate carbamazepine was also increased by 4-8 hours. Although carbamazepine levels were increased, this did not appear to increase side effects.

Likelihood Possible Evidence B
Cefotaxime (Claforan)

Theoretically, Indian long pepper might increase the effects and adverse effects of cefotaxime.
Animal research shows that piperine, a constituent of Indian long pepper, increases the plasma levels of cefotaxime when taken concomitantly.

Likelihood Possible Evidence D

Cutch Tree4 drug types · 475 drugs

Antihypertensive Drugs

Theoretically, concomitant use with antihypertensive drugs might increase the risk of hypotension.
Catechu might lower blood pressure.

Likelihood Possible Evidence D
Cytochrome P450 1A2 (Cyp1A2) Substrates

Theoretically, black catechu may increase the levels and clinical effects of CYP1A2 substrates.
Animal research shows that black catechu can increase theophylline concentrations in the blood, possibly by inhibiting CYP1A2. Theophylline is a CYP1A2 substrate.

Likelihood Possible Evidence D
Immunosuppressants

Theoretically, catechu might interfere with immunosuppressant therapy.
Animal and in vitro studies suggest that catechu has immunomodulating effects.

Likelihood Possible Evidence D
Theophylline

Theoretically, black catechu may increase the levels and clinical effects of theophylline.
Animal research shows that black catechu can increase theophylline concentrations in the blood, possibly by inhibiting cytochrome P450 1A2.

Likelihood Possible Evidence D

Cinnamon2 drug types · 442 drugs

Antidiabetes Drugs

Theoretically, cassia cinnamon may have additive effects with antidiabetes drugs.
Cassia cinnamon may lower blood glucose levels, and have additive effects in patients treated with antidiabetic agents. Dose adjustments to diabetes medications might be necessary.

Likelihood Possible Evidence B
Hepatotoxic Drugs

Theoretically, large doses of cassia cinnamon might cause additive effects when used with hepatotoxic drugs.
There is some concern that ingesting large amounts of cassia cinnamon for an extended duration might cause hepatotoxicity in some people. Cassia cinnamon contains coumarin, which can cause hepatotoxicity in animal models. In humans, very high doses of coumarin from 50-7000 mg/day can result in hepatotoxicity that resolves when coumarin use is discontinued. Lower amounts might also cause liver problems in sensitive people, such as those with liver disease or those taking potentially hepatotoxic agents.

Likelihood Possible Evidence D
The maker

Brand information

Manufacturer and brand details for Koflet, from the product label.

Himalaya

See all Himalaya products
Name
The Himalaya Drug Company
City
Makali
State
Bangalore
ZipCode
562 123
Pharmacist Counseling Corner

Koflet by Himalaya: Common Questions

Does Koflet by Himalaya interact with any medications?
Yes. Based on its ingredients, Koflet has a known interaction with 1,371 medications. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Koflet contains 9 active ingredients, and an interaction can come from any of them. We check every ingredient, combine the results into one list per medication, and show which ingredient and mechanism is responsible.
Where does this information come from?
The product label data comes from the NIH Dietary Supplement Label Database (DSLD); the interaction data is built on the Natural Medicines database and reviewed by HelloPharmacist pharmacists.
Does Koflet actually help with cough?
The evidence for cough relief from these ingredients isn't established in our data. Clove has insufficient reliable evidence for cough, and the other herbal components also lack solid evidence for respiratory symptoms. Talk to your pharmacist about whether it's right for your cough.
Can I use Koflet if I'm on blood thinners?
No—do not use it without checking with your doctor or pharmacist first. Ginger and long pepper in Koflet may increase bleeding risk when combined with warfarin, aspirin, or other blood thinners. This is a Moderate severity concern.
What are the common side effects of Koflet?
Ginger and clove can cause heartburn, burping, diarrhea, abdominal discomfort, and a peppery or burning sensation in the mouth and throat. Cinnamon has rarely caused rash. Most people tolerate it well, but higher doses increase the risk of these effects.
Is Koflet safe during pregnancy?
Ginger is rated likely to possibly safe in pregnancy. Cinnamon and clove are likely safe. However, long pepper and catechu lack enough data, and long pepper is traditionally discouraged. If you're pregnant, talk with your doctor before using this product.
Can I use Koflet if I take diabetes medication?
Ginger, clove, long pepper, and cinnamon may all lower blood sugar further. If you take insulin or a diabetes drug, there's a risk of low blood sugar. Check with your pharmacist before using it and monitor your blood glucose closely.
What is the Trikatu blend in Koflet?
Trikatu is a traditional herbal blend listed as a component—its individual ingredients are also listed separately in this product (ginger, long pepper, and cinnamon). You can review the interactions and safety data for each one on this page.

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.

Koflet label
Go deeper

The Full Monographs Behind Koflet’s Ingredients

Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.

Herb & supplement monograph

Clove

Interacts with 977 drugs

Clove is a common cooking spice that is also used in traditional medicine, especially as a topical numbing agent for tooth pain thanks to its main compound, eugenol. Food amounts are general...

Read the full Clove monograph →
Herb & supplement monograph

Cardamom

Cardamom is a popular cooking spice that has long been used in traditional medicine for digestion and fresh breath. As a food, it is generally safe for most people, but high-dose supplements...

Read the full Cardamom monograph →
Herb & supplement monograph

Cassia Cinnamon

Interacts with 442 drugs

Cassia cinnamon is the common, inexpensive cinnamon used in cooking, and it is also taken as a supplement, most often for blood sugar support. The evidence for its health benefits is mixed a...

Read the full Cassia Cinnamon monograph →
Herb & supplement monograph

Catechu

Interacts with 475 drugs

Catechu is an astringent extract made from the heartwood of the Acacia (Senegalia) catechu tree, used traditionally for mouth sores, sore throat, diarrhea, and minor skin problems. Strong hu...

Read the full Catechu monograph →
Herb & supplement monograph

Ginger

Interacts with 1,007 drugs

Ginger is a widely used culinary spice with a long history in traditional medicine, and it has the strongest evidence for helping with nausea and vomiting, including from motion sickness, pr...

Read the full Ginger monograph →
Herb & supplement monograph

Indian Long Pepper

Interacts with 896 drugs

Indian long pepper (pippali) is a spice long used in Ayurvedic medicine and is best known for its piperine content, which may increase how well the body absorbs certain other substances. Mod...

Read the full Indian Long Pepper monograph →
Herb & supplement monograph

Black Pepper

Interacts with 1,019 drugs

Black pepper is a common kitchen spice that is generally safe in the amounts used in food. Its extract, piperine, is mostly added to supplements to help the body absorb other ingredients (li...

Read the full Black Pepper monograph →
Sources

Sources & How We Checked

Koflet'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.

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 162 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.

Ginger 64 references
  1. Fischer-Rasmussen W, Kjaer SK, Dahl C, Asping U. Ginger treatment of hyperemesis gravidarum. Eur J Obstet Gynecol Reprod Biol 1991;38:19-24. PubMed
  2. Jewell D, Young G. Interventions for nausea and vomiting in early pregnancy. Cochrane Database Syst Rev 2000;(2):CD000145. PubMed
  3. Vutyavanich T, Kraisarin T, Ruangsri R. Ginger for nausea and vomiting in pregnancy: randomized, double-masked, placebo-controlled trial. Obstet Gynecol 2001;97:577-82. DOI
  4. Backon J. Ginger in preventing nausea and vomiting of pregnancy; a caveat due to its thromboxane synthetase activity and effect on testosterone binding. Eur J Obstet Gynecol Reprod Biol 1991;42:163-4. PubMed
  5. Srivastava KC. Effect of onion and ginger consumption on platelet thromboxane production in humans. Prostaglandins Leukot Essent Fatty Acids 1989;35:183-5. PubMed
  6. Stewart JJ, Wood MJ, Wood CD, Mims ME. Effects of ginger on motion sickness susceptibility and gastric function. Pharmacology 1991;42:111-20. PubMed
  7. Smith C, Crowther C, Willson K, et al. A randomized controlled trial of ginger to treat nausea and vomiting in pregnancy. Obstet Gynecol 2004;103:639-45. PubMed
  8. Portnoi G, Chng LA, Karimi-Tabesh L, et al. Prospective comparative study of the safety and effectiveness of ginger for the treatment of nausea and vomiting in pregnancy. Am J Obstet Gynecol 2003;189:1374-7.. PubMed
  9. Wigler I, Grotto I, Caspi D, Yaron M. The effects of Zintona EC (a ginger extract) on symptomatic gonarthritis. Osteoarthritis Cartilage 2003;11:783-9. PubMed
  10. Ghayur MN, Gilani AH. Ginger lowers blood pressure through blockade of voltage-dependent calcium channels. J Cardiovasc Pharmacol 2005;45:74-80. PubMed
  11. Thomson M, Al-Qattan KK, Al-Sawan SM, et al. The use of ginger (Zingiber officinale Rosc.) as a potential anti-inflammatory and antithrombotic agent. Prostaglandins Leukot Essent Fatty Acids 2002;67:475-8. PubMed
  12. Kanerva L, Estlander T, Jolanki R. Occupational allergic contact dermatitis from spices. Contact Dermatitis 1996;35:157-62. PubMed
  13. Akhani SP, Vishwakarma SL, Goyal RK. Anti-diabetic activity of Zingiber officinale in streptozotocin-induced type I diabetic rats. J Pharm Pharmacol 2004;56:101-5.
  14. Kruth P, Brosi E, Fux R, et al. Ginger-associated overanticoagulation by phenprocoumon. Ann Pharmacother 2004;38:257-60. PubMed
  15. Jiang X, Williams KM, Liauw WS, et al. Effect of ginkgo and ginger on the pharmacokinetics and pharmacodynamics of warfarin in healthy subjects. Br J Clin Pharmacol 2005;59:425-32. PubMed
  16. Borrelli F, Capasso R, Aviello G, et al. Effectiveness and safety of ginger in the treatment of pregnancy-induced nausea and vomiting. Obstet Gynecol 2005;105:849-56. PubMed
  17. Smith C, Crowther C, Wilson K et al. A randomized controlled trial of ginger to treat nausea and vomiting in pregnancy. Obstet Gynecol 2004;103:639-45. PubMed
  18. Jiang X, Blair EY, McLachlan AJ. Investigation of the effects of herbal medicines on warfarin response in healthy subjects: a population pharmacokinetic-pharmacodynamic modeling approach. J Clin Pharmacol 2006;46:1370-8. PubMed
  19. Chittumma P, Kaewkiattikun K, Wiriyasiriwach B. Comparison of the effectiveness of ginger and vitamin B6 for treatment of nausea and vomiting in early pregnancy: a randomized double-blind controlled trial. J Med Assoc Thai 2007;90:15-20.
  20. Ozgoli G, Goli M, Moattar F. Comparison of effects of ginger, mefenamic acid, and ibuprofen on pain in women with primary dysmenorrhea. J Altern Complement Med 2009;15:129-32. PubMed
  21. Black CD, Herring MP, Hurley DJ, O'Connor PJ. Ginger (Zingiber officinale) reduces muscle pain caused by eccentric exercise. J Pain 2010;11:894-903. PubMed
  22. Heitmann K, Nordeng H, Holst L. Safety of ginger use in pregnancy: results from a large population-based cohort study. Eur J Clin Pharmacol 2012 Jun 17. PubMed
  23. Ryan JL, Heckler CE, Roscoe JA, et al. Ginger (Zingiber officinale) reduces acute chemotherapy-induced nausea: a URCC CCOP study of 576 patients. Support Care Cancer. 2012;20:1479-89. PubMed
  24. Backon J. Ginger as an antiemetic: possible side effects due to its thromboxane synthetase activity. Anaesthesia. 1991;46(8):705-6.. PubMed
  25. Abebe W. Herbal medication: potential for adverse interactions with analgesic drugs. J Clin Pharm Ther. 2002;27:391-401. PubMed
  26. Argento A, Tiraferri E, Marzaloni M. [Oral anticoagulants and medicinal plants. An emerging interaction]. Ann Ital Med Int. 2000;15:139-43.
  27. Young HY, Liao JC, Chang YS, et al. Synergistic effect of ginger and nifedipine on human platelet aggregation: a study in hypertensive patients and normal volunteers. Am J Chin Med. 2006;34:545-51. PubMed
  28. Greenway FL, Liu Z, Martin CK, et al. Safety and efficacy of NT, an herbal supplement, in treating human obesity. Int J Obes (Lond). 2006;30:1737-41. PubMed
  29. Shalansky S, Lynd L, Richardson K, et al. Risk of warfarin-related bleeding events and supratherapeutic international normalized ratios associated with complementary and alternative medicine: a longitudinal analysis. Pharmacotherapy. 2007;27:1237-47. PubMed
  30. Lesho EP, Saullo L, Udvari-Nagy S. A 76-year-old woman with erratic anticoagulation. Cleve Clin J Med. 2004;71:651-6. PubMed
  31. Okonta JM, Uboh M, Obonga WO. Herb-Drug Interaction: A Case Study of Effect of Ginger on the Pharmacokinetic of Metronidazole in Rabbit. Indian Journal of Pharmaceutical Sciences (India) 2008;70(230):232. PubMed
  32. Chiang HM, Chao PD, Hsiu SL, et al. Ginger significantly decreased the oral bioavailability of cyclosporine in rats. Am J Chin Med. 2006;34:845-55. PubMed
  33. Bhandari U, Kanojia R, Pillai KK. Effect of ethanolic extract of Zingiber officinale on dyslipidaemia in diabetic rats. J Ethnopharmacol. 2005;97:227-30. PubMed
  34. Ojewole JA. Analgesic, antiinflammatory and hypoglycaemic effects of ethanol extract of Zingiber officinale (Roscoe) rhizomes (Zingiberaceae) in mice and rats. Phytother Res. 2006;20:764-72.
  35. Al-Amin ZM, Thomson M, Al-Qattan KK, et al. Anti-diabetic and hypolipidaemic properties of ginger (Zingiber officinale) in streptozotocin-induced diabetic rats. Br J Nutr. 2006;96:660-6.
  36. Islam MS, Choi H. Comparative effects of dietary ginger (Zingiber officinale) and garlic (Allium sativum) investigated in a type 2 diabetes model of rats. J Med Food. 2008;11:152-9.
  37. Cady RK, Goldstein J, Nett R, et al. A double-blind placebo-controlled pilot study of sublingual feverfew and ginger (LipiGesic M) in the treatment of migraine. Headache 2011;51:1078-86.
  38. Futrell, J. M. and Rietschel, R. L. Spice allergy evaluated by results of patch tests. Cutis 1993;52(5):288-290.
  39. Sripramote, M. and Lekhyananda, N. A randomized comparison of ginger and vitamin B6 in the treatment of nausea and vomiting of pregnancy. J Med Assoc.Thai. 2003;86(9):846-853.
  40. Lohsiriwat, S., Rukkiat, M., Chaikomin, R., and Leelakusolvong, S. Effect of ginger on lower esophageal sphincter pressure. J.Med.Assoc.Thai. 2010;93(3):366-372.
  41. Liu, P. H. and Ho, H. L. Ginger and drug bezoar induced small bowel obstruction. J R.Coll.Surg.Edinb. 1983;28(6):397-398.
  42. Maghbooli M, Golipour F, Moghimi Esfandabadi A, Yousefi M. Comparison between the efficacy of ginger and sumatriptan in the ablative treatment of the common migraine. Phytother Res 2014;28(3):412-5. PubMed
  43. Mahluji S, Attari VE, Mobasseri M, Payahoo L, Ostadrahimi A, Golzari SE. Effects of ginger (Zingiber officinale) on plasma glucose level, HbA1c and insulin sensitivity in type 2 diabetic patients. Int J Food Sci Nutr 2013;64(6):682-6.
  44. Mozaffari-Khosravi H, Talaei B, Jalali BA, Najarzadeh A, Mozayan MR. The effect of ginger powder supplementation on insulin resistance and glycemic indices in patients with type 2 diabetes: a randomized, double-blind, placebo-controlled trial. Complement PubMed
  45. Paramdeep G. Efficacy and tolerability of ginger (Zingiber officinale) in patients of osteoarthritis of knee. Indian J Physiol Pharmacol 2013;57(2):177-83.
  46. Rahnama P, Montazeri A, Huseini HF, Kianbakht S, Naseri M. Effect of Zingiber officinale R. rhizomes (ginger) on pain relief in primary dysmenorrhea: a placebo randomized trial. BMC Complement Altern Med 2012;12:92. PubMed
  47. Viljoen E, Visser J, Koen N, Musekiwa A. A systematic review and meta-analysis of the effect and safety of ginger in the treatment of pregnancy-associated nausea and vomiting. Nutr J 2014;13:20. PubMed
  48. Bartels EM, Folmer VN, Bliddal H, et al. Efficacy and safety of ginger in osteoarthritis patients: a meta-analysis of randomized placebo-controlled trials. Osteoarthritis Cartilage. 2015;23(1):13-21. PubMed
  49. Choi JS, Han JY, Ahn HK, et al. Assessment of fetal and neonatal outcomes in the offspring of women who had been treated with dried ginger (Zingiberis rhizoma siccus) for a variety of illnesses during pregnancy. J Obstet Gynaecol. 2015;35(2):125-30.
  50. Marx W, McKavanagh D, McCarthy AL, Bird R, Ried K, Chan A, Isenring L. The effect of ginger (Zingiber officinale) on platelet aggregation: A systematic literature review. PLoS One. 2015;10(10):e0141119. PubMed
  51. Crichton M, Marshall S, Marx W, McCarthy AL, Isenring E. Efficacy of ginger (Zingiber officinale) in ameliorating chemotherapy-induced nausea and vomiting and chemotherapy-related outcomes: A systematic review update and meta-analysis. J Acad Nutr Diet. 2 PubMed
  52. Martins LB, Rodrigues AMDS, Monteze NM, et al. Double-blind placebo-controlled randomized clinical trial of ginger (Zingiber officinale Rosc.) in the prophylactic treatment of migraine. Cephalalgia. 2020;40(1):88-95.
  53. Martins LB, Rodrigues AMDS, Rodrigues DF, Dos Santos LC, Teixeira AL, Ferreira AVM. Double-blind placebo-controlled randomized clinical trial of ginger (Zingiber officinale Rosc.) addition in migraine acute treatment. Cephalalgia. 2019;39(1):68-76.
  54. Ahad A, Raish M, Bin Jardan YA, Alam MA, Al-Mohizea AM, Al-Jenoobi FI. Effect of Hibiscus sabdariffa and Zingiber officinale on the antihypertensive activity and pharmacokinetic of losartan in hypertensive rats. Xenobiotica. 2020:1-11.
  55. Okuhira H, Nakatani Y, Furukawa F, Kanazawa N. Anaphylaxis to ginger induced by herbal medicine. Allergol Int. 2020;69(1):159-160. PubMed
  56. Yamprasert R, Chanvimalueng W, Mukkasombut N, Itharat A. Ginger extract versus Loratadine in the treatment of allergic rhinitis: a randomized controlled trial. BMC Complement Med Ther. 2020;20(1):116. PubMed
  57. Ebrahimzadeh A, Ebrahimzadeh A, Mirghazanfari SM, Hazrati E, Hadi S, Milajerdi A. The effect of ginger supplementation on metabolic profiles in patients with type 2 diabetes mellitus: a systematic review and meta-analysis of randomized controlled trials. PubMed
  58. Alam MA, Bin Jardan YA, Alzenaidy B, et al. Effect of Hibiscus sabdariffa and Zingiber officinale on pharmacokinetics and pharmacodynamics of amlodipine. J Pharm Pharmacol 2021;73(9):1151-60.
  59. Akbarzadeh E, Heydari M, Atarzadeh F, Jaladat AM. Chronic dysuria following ginger (Zingiber officinale) use: a case report. Galen Med J 2018;7:e1086. DOI
  60. Haron MH, Dale O, Martin K, et al. Evaluation of the Herb-Drug Interaction Potential of Commonly Used Botanicals on the US Market with Regard to PXR- and AhR-Mediated Influences on CYP3A4 and CYP1A2. J Diet Suppl 2022. PubMed
  61. Rostamkhani H, Veisi P, Niknafs B, Jafarabadi MA, Ghoreishi Z. The effect of zingiber officinale on prooxidant-antioxidant balance and glycemic control in diabetic patients with ESRD undergoing hemodialysis: a double-blind randomized control trial. BMC Co PubMed
  62. Husain I, Dale OR, Idrisi M, et al. Evaluation of the Herb-Drug Interaction (HDI) Potential of Zingiber officinale and Its Major Phytoconstituents. J Agric Food Chem. 2023;71(19):7521-7534.
  63. Committee on Practice Bulletins-Obstetrics. ACOG Practice Bulletin No. 189: Nausea And Vomiting Of Pregnancy. Obstet Gynecol. 2018;131(1):e15-e30. PubMed
  64. Pochet S, Lechon AS, Lescrainier C, et al. Herb-anticancer drug interactions in real life based on VigiBase, the WHO global database. Sci Rep 2022;12(1):14178. PubMed

See these in context on the Ginger monograph →

Clove 26 references
  1. The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999.
  2. Electronic Code of Federal Regulations. Title 21. Part 182 -- Substances Generally Recognized As Safe. Available at: https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?CFRPart=182
  3. Kanerva L, Estlander T, Jolanki R. Occupational allergic contact dermatitis from spices. Contact Dermatitis 1996;35:157-62. PubMed
  4. Chen SJ, Wang MH, Chen IJ. Antiplatelet and calcium inhibitory properties of eugenol and sodium eugenol acetate. Gen Pharmacol 1996;27:629-33. PubMed
  5. Malson JL, Lee EM, Murty R, et al. Clove cigarette smoking: biochemical, physiological, and subjective effects. Pharmacol Biochem Behav 2003;74:739-45. PubMed
  6. Kirsch CM, Yenokida GG, Jensen WA, et al. Non-cardiogenic pulmonary oedema due to the intravenous administration of clove oil. Thorax 1990;45:235-6. PubMed
  7. Pallares, D. E. Link between clove cigarettes and urticaria? Postgrad.Med 10-1-1999;106(4):153. PubMed
  8. Barnard, D. R. Repellency of essential oils to mosquitoes (Diptera: Culicidae). J Med Entomol. 1999;36(5):625-629. PubMed
  9. Sanchez-Perez, J. and Garcia-Diez, A. Occupational allergic contact dermatitis from eugenol, oil of cinnamon and oil of cloves in a physiotherapist. Contact Dermatitis 1999;41(6):346-347. PubMed
  10. Andersen, K. E., Johansen, J. D., Bruze, M., Frosch, P. J., Goossens, A., Lepoittevin, J. P., Rastogi, S., White, I., and Menne, T. The time-dose-response relationship for elicitation of contact dermatitis in isoeugenol allergic individuals. Toxicol.Appl PubMed
  11. Alqareer, A., Alyahya, A., and Andersson, L. The effect of clove and benzocaine versus placebo as topical anesthetics. J Dent 2006;34(10):747-750. PubMed
  12. Lane, B. W., Ellenhorn, M. J., Hulbert, T. V., and McCarron, M. Clove oil ingestion in an infant. Hum.Exp Toxicol. 1991;10(4):291-294. PubMed
  13. Quirce, S., Fernandez-Nieto, M., del, Pozo, V, Sastre, B., and Sastre, J. Occupational asthma and rhinitis caused by eugenol in a hairdresser. Allergy 2008;63(1):137-138. PubMed
  14. Srivastava, K. C. and Malhotra, N. Acetyl eugenol, a component of oil of cloves (Syzygium aromaticum L.) inhibits aggregation and alters arachidonic acid metabolism in human blood platelets. Prostaglandins Leukot.Essent.Fatty Acids 1991;42(1):73-81. PubMed
  15. Dyrbye, B. A., Dubois, L., Vink, R., and Horn, J. A patient with clove oil intoxication. Anaesth.Intensive Care 2012;40(2):365-366.
  16. Guidotti, T. L., Laing, L., and Prakash, U. B. Clove cigarettes. The basis for concern regarding health effects. West J Med 1989;151(2):220-228.
  17. Anonymous. Evaluation of the health hazard of clove cigarettes. Council on Scientific Affairs. JAMA 12-23-1988;260(24):3641-3644. DOI
  18. Romaguera, C., Alomar, A., Camarasa, J. M., Garcia, Bravo B., Garcia, Perez A., Grimalt, F., Guerra, P., Lopez, Gorretcher B., Pascual, A. M., Miranda, A., and . Contact dermatitis in children. Contact Dermatitis 1985;12(5):283-284. PubMed
  19. Hackett, P. H., Rodriguez, G., and Roach, R. C. Clove cigarettes and high-altitude pulmonary edema. JAMA 6-28-1985;253(24):3551-3552. DOI
  20. Isaacs, G. Permanent local anaesthesia and anhidrosis after clove oil spillage. Lancet 4-16-1983;1(8329):882. PubMed
  21. Saeed, S. A. and Gilani, A. H. Antithrombotic activity of clove oil. J Pak Med Assoc 1994;44(5):112-115.
  22. Hartnoll, G., Moore, D., and Douek, D. Near fatal ingestion of oil of cloves. Arch.Dis Child 1993;69(3):392-393. PubMed
  23. Srivastava, K. C. Antiplatelet principles from a food spice clove (Syzygium aromaticum L) [corrected]. Prostaglandins Leukot.Essent.Fatty Acids 1993;48(5):363-372.
  24. Jiang Q, Wu Y, Zhang H, et al. Development of essential oils as skin permeation enhancers: penetration enhancement effect and mechanism of action. Pharmaceutical Biol. 2017;55(1):1592-1600. PubMed
  25. Mohan R, Jose S, Mulakkal J, Karpinsky-Semper D, Swick AG, Krishnakumar IM. Water-soluble polyphenol-rich clove extract lowers pre- and post-prandial blood glucose levels in healthy and prediabetic volunteers: an open label pilot study. BMC Complement Alt PubMed
  26. Alharbi NFM, Ahad A, Bin Jardan YA, Al-Jenoobi FI. Effect of eugenol on cytochrome P450 1A2, 2C9, 2D6, and 3A4 activity in human liver microsomes. Saudi Pharm J 2024;32(7):102118. PubMed

See these in context on the Clove monograph →

Cardamom 2 references
  1. Mobacken, H. and Fregert, S. Allergic contact dermatitis from cardamom. Contact Dermatitis 1975;1(3):175-176. PubMed
  2. Aghasi M, Koohdani F, Qorbani M, et al. Beneficial effects of green cardamom on serum SIRT1, glycemic indices and triglyceride levels in patients with type 2 diabetes mellitus: a randomized double-blind placebo controlled clinical trial. J Sci Food Agri PubMed

See these in context on the Cardamom monograph →

Indian Long Pepper 12 references
  1. Bano G, Amla V, Raina RK, et al. The effect of piperine on pharmacokinetics of phenytoin in healthy volunteers. Planta Med 1987;53:568-9. PubMed
  2. Bano G, et al. Effect of piperine on bioavailability and pharmacokinetics of propranolol and theophylline in healthy volunteers. Eur J Clin Pharmacol 1991;41;615-7. PubMed
  3. Bhardwaj RK, Glaeser H, Becquemont L, et al. Piperine, a major constituent of black pepper, inhibits human P-glycoprotein and CYP3A4. J Pharmacol Exp Ther 2002;302:645-50. PubMed
  4. Pattanaik S, Hota D, Prabhakar S, et al. Pharmacokinetic interaction of a single dose of piperine with steady-state carbamazepine in epilepsy patients. Phytother Res 2009;23:1281-6.
  5. Kasibhatta, R. and Naidu, M. U. Influence of piperine on the pharmacokinetics of nevirapine under fasting conditions: a randomised, crossover, placebo-controlled study. Drugs R.D. 2007;8(6):383-391. PubMed
  6. Mujumdar, A. M., Dhuley, J. N., Deshmukh, V. K., Raman, P. H., Thorat, S. L., and Naik, S. R. Effect of piperine on pentobarbitone induced hypnosis in rats. Indian J Exp.Biol. 1990;28(5):486-487.
  7. Panda, S. and Kar, A. Piperine lowers the serum concentrations of thyroid hormones, glucose and hepatic 5'D activity in adult male mice. Horm.Metab Res. 2003;35(9):523-526. PubMed
  8. Hiwale, A. R., Dhuley, J. N., and Naik, S. R. Effect of co-administration of piperine on pharmacokinetics of beta-lactam antibiotics in rats. Indian J Exp.Biol. 2002;40(3):277-281.
  9. Han, Y., Chin Tan, T. M., and Lim, L. Y. In vitro and in vivo evaluation of the effects of piperine on P-gp function and expression. Toxicol.Appl.Pharmacol. 8-1-2008;230(3):283-289. PubMed
  10. Sharma, P., Varma, M. V., Chawla, H. P., and Panchagnula, R. In situ and in vivo efficacy of peroral absorption enhancers in rats and correlation to in vitro mechanistic studies. Farmaco 2005;60(11-12):874-883. PubMed
  11. Zutshi, R. K., Singh, R., Zutshi, U., Johri, R. K., and Atal, C. K. Influence of piperine on rifampicin blood levels in patients of pulmonary tuberculosis. J Assoc.Physicians India 1985;33(3):223-224.
  12. Yadav V, Krishnan A, Vohora D. A systematic review on Piper longum L.: Bridging traditional knowledge and pharmacological evidence for future translational research. J Ethnopharmacol. 2020;247:112255. PubMed

See these in context on the Indian Long Pepper monograph →

Cassia Cinnamon 20 references
  1. Electronic Code of Federal Regulations. Title 21. Part 182 -- Substances Generally Recognized As Safe. Available at: https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?CFRPart=182
  2. Khan A, Safdar M, Ali Khan M, et al. Cinnamon improves glucose and lipids of people with type 2 diabetes. Diabetes Care 2003;26:3215-8. PubMed
  3. De Benito V, Alzaga R. Occupational allergic contact dermatitis from cassia (Chinese cinnamon) as a flavouring agent in coffee. Contact Dermatitis 1999;40:165. PubMed
  4. Drake TE, Maibach HI. Allergic contact dermatitis and stomatitis caused by a cinnamic aldehyde-flavored toothpaste. Arch Dermatol 1976;112:202-3.
  5. Press release. Cinnamon capsules to reduce blood sugar are medicinal products! Efficacy has not been scientifically proven - some products contain high levels of coumarin. Federal Institute of Risk Assessment (BfM), Germany, November 11, 2006. Available a
  6. Felter SP, Vassallo JD, Carlton BD, Daston GP. A safety assessment of coumarin taking into account species-specificity of toxicokinetics. Food Chem Toxicol 2006;44:462-75. PubMed
  7. Crawford P. Effectiveness of cinnamon for lowering hemoglobin A1C in patients with type 2 diabetes: a randomized, controlled trial. J Am Board Fam Med 2009;22:507-12. PubMed
  8. Akilen, R., Tsiami, A., Devendra, D., and Robinson, N. Glycated haemoglobin and blood pressure-lowering effect of cinnamon in multi-ethnic Type 2 diabetic patients in the UK: a randomized, placebo-controlled, double-blind clinical trial. Diabet.Med. 2010; PubMed
  9. Lu T, Sheng H Wu J Cheng Y Zhu J Chen Y. Cinnamon extract improves fasting blood glucose and glycosylated hemoglobin level in Chinese patients with type 2 diabetes. Nutr Res. 2012;32(6):408-412. PubMed
  10. Choi, J., Lee, K. T., Ka, H., Jung, W. T., Jung, H. J., and Park, H. J. Constituents of the essential oil of the Cinnamomum cassia stem bark and the biological properties. Arch Pharm Res 2001;24(5):418-423.
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Black Pepper 29 references
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Catechu 9 references
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  9. US Food and Drug Administration (FDA). FDA Alerts Consumers About Potentially Life-Threatening Health Problems Linked to Limbrel. December 19, 2017. Available at: https://www.fda.gov/food/alerts-advisories-safety-information/fda-alerts-consumers-about-pot

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Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

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