Liver Efficiency Formula Ingredients & Drug Interactions
What is this page for?
First and foremost: checking Liver Efficiency Formula 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
Liver Efficiency Formula is a dietary supplement by Life Extension with 2 active ingredients. Its ingredients are commonly taken for fatigue and low energy, stress and adaptogen support, liver health.Based on those ingredients, 803 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Schisandra Fruit Extract. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against Liver Efficiency Formula by Life Extension
Ask about any prescription or over-the-counter medication and we check it for interactions with Liver Efficiency Formula by Life Extension — 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 Liver Efficiency Formula by Life Extension
Our pharmacy team’s full take, with four database checks built into the cards below — a summary of what is known, not a grade of the product itself.
What’s inside
Full disclosure
This formula contains 2 active ingredients. Schisandra fruit extract is a traditional botanical used in herbal practice; the other active ingredient is Extramel, which we have no detailed information on file.
The capsule also contains several inactive ingredients — beta-cyclodextrin, cellulose, microcrystalline cellulose, tricalcium phosphate, silica, and stearate — which are binders and fillers used to form and stabilize the capsule.
Does it work?
Not established
The evidence for schisandra in this product is not established in our data. For the uses listed — asthma, athletic performance, cough, diabetes, diarrhea, and hepatitis — the reliability of evidence is insufficient to rate whether it works.
We hold no effectiveness information for Extramel.
How safe is it?
Well-documented data
Schisandra is generally well tolerated in short-term use in healthy adults, but high-quality long-term safety data are limited. The most common side effects reported are decreased appetite, heartburn, stomach upset, and a rash called urticaria.
The safety data advises against use during pregnancy, as traditional sources suggest it may stimulate the uterus. There is not enough reliable safety information for use while breastfeeding, so it should be avoided.
Meds to double-check
Moderate interaction found
Before taking this product, check your medications against these categories: immunosuppressants like tacrolimus, sedatives and anesthetics like midazolam, antifungals like voriconazole, blood thinners like warfarin, and any drug your doctor says is metabolized by your liver (especially through CYP3A4, CYP2C9, or CYP2C19 pathways). These are Moderate-severity interactions.
Use the search tool below to verify your exact prescriptions.
The bottom line
Scorecard at a glanceFully disclosed formula with no established evidence rating for its marketed use. Moderate medication interactions have been identified, and safety information is well characterized.
This product is not for everyone — schisandra has serious interaction potential with immunosuppressants, sedatives, blood thinners, and antifungals. If you take any prescription medication, check it against the tool on this page before you start.
Pregnant or breastfeeding? Skip this one.
Talk to your pharmacist about whether it's right for your situation.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 1 of 2 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Mar 25, 2025.
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 Liver Efficiency Formula, straight from the product label.
| Brand | Life Extension |
|---|---|
| Barcode (UPC) | 737870160830 |
| Net contents | 30 Vegetarian Capsule(s) |
| Market status | On market |
| Date entered into DSLD | Mar 25, 2025 |
| DSLD ID | 328521 |
| Product type | Botanical |
| Supplement form | Capsule |
| Dietary claims / uses | All Other, Structure/Function |
| Intended target group(s) | Adult (18 - 50 Years), Gluten Free |
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.
Supplement Facts
The label details for Liver Efficiency Formula by Life Extension, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Schisandra Fruit Extract | 250 mg | -- |
| Extramel | 10 mg | -- |
Other ingredients: Beta-Cyclodextrin, Cellulose, Microcrystalline Cellulose, Tricalcium Phosphate, Silica, Stearate
Tap any ingredient to jump to its full detail below.
These statements are the manufacturer’s wording, reproduced from the product label — the label is saying it, not HelloPharmacist. We don’t verify or endorse them.
General Statements
Scan for product info
Precautions
Read the entire label and follow the directions carefully prior to use.
Warnings: Keep out of reach of children.
Do not exceed recommended dose. Do not purchase if outer seal damaged.
Consult with your physician if you are undergoing treatment for a medical condition or if you are pregnant or lactating.
To report a serious adverse event or obtain product information, contact 1-866-280-2852.
Suggested/Recommended/Usage/Directions
Directions: take one (1) capsule daily, or as recommended by a healthcare practitioner.
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.
Formulation
Gluten free Non GMO Le certified
Supports optimal levels of antioxidants in liver metabolism
Seals/Symbols
Non GMO Le certified
FDA Statement of Identity
Dietary Supplement
Storage
Store tightly closed in a cool, dry place.
Brand IP Statement(s)
Extramel is a registered trademark of Bionov.
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Liver Efficiency Formula by Life Extension 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 Liver Efficiency Formula by Life Extension
These are the 2 active ingredients this product is made of. Select any to open its full monograph.
Serving size1 Vegetarian Capsule(s) Dosage formCapsule Servings per container30 Amounts shown are per serving.
Most supplement products combine several ingredients, and a medication can interact with the product through any one of them. Each ingredient below shows whether it has known drug interactions.
Schisandra Fruit Extract
Interacts with803 drugs
Schisandra is a traditional Chinese medicine berry used as an adaptogen for stress, fatigue, and liver support. Human evidence is limited and most cla...
Schisandra Fruit Extract monograph & interactionsExtramel
Other (inactive) ingredients: Beta-Cyclodextrin, Cellulose, Microcrystalline Cellulose, Tricalcium Phosphate, Silica, Stearate. These complete the product’s ingredient list but are not active constituents.
Liver Efficiency Formula by Life Extension Drug Interactions
HelloPharmacist Interaction Report
Life Extension's Liver Efficiency Formula contains schisandra fruit extract, which does interact with a number of medications.
The most serious interactions involve drugs metabolized by your liver's CYP3A4 enzyme system — schisandra can increase levels of these medications, potentially making them stronger than intended. This includes immunosuppressants like tacrolimus, sedatives like midazolam, and certain antifungals like voriconazole.
Read the full breakdown — every affected drug type, severity by severity
Schisandra also affects other liver enzyme systems. It may boost levels of drugs processed through P-glycoprotein (a natural transporter in your gut and organs), and it theoretically may decrease effectiveness of blood thinners like warfarin by speeding up how your liver breaks them down.
Additionally, it may either increase or decrease levels of other medications metabolized by CYP2C9 and CYP2C19 enzymes, depending on the specific drug.
We could not check the second ingredient, Extramel, because we hold no interaction data for it. Altogether, these interactions span 790 individual medications.
Before starting this supplement, run your exact prescriptions through the medication checker on this page — schisandra touches a lot of common drugs.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against Liver Efficiency Formula?
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 Liver Efficiency Formula interact with 803 drugs. Click any drug to see the details.
1 of the 2 ingredients in Liver Efficiency Formula interact with drugs. Each result below shows which ingredient is responsible. Schisandra Fruit Extract
Acetaminophen, Dextromethorphan, Guaifenesin, PhenylephrineConar-A
How Acetaminophen, Dextromethorphan, Guaifenesin, Phenylephrine interacts with Liver Efficiency Formula — through 1 ingredient. Tap an ingredient for the detail:
Schisandra Fruit ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Schisandra Fruit Extract + Acetaminophen, Dextromethorphan, Guaifenesin, Phenylephrine interactionAcetaminophen, Dextromethorphan, Guaifenesin, PhenylpropanolamineAnatuss
How Acetaminophen, Dextromethorphan, Guaifenesin, Phenylpropanolamine interacts with Liver Efficiency Formula — through 1 ingredient. Tap an ingredient for the detail:
Schisandra Fruit ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Schisandra Fruit Extract + Acetaminophen, Dextromethorphan, Guaifenesin, Phenylpropanolamine interactionAcetaminophen, Dextromethorphan, Guaifenesin, PseudoephedrineRobitussin Cold, Severe Cold, Suphedrine Cold/Cough
How Acetaminophen, Dextromethorphan, Guaifenesin, Pseudoephedrine interacts with Liver Efficiency Formula — through 1 ingredient. Tap an ingredient for the detail:
Schisandra Fruit ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Schisandra Fruit Extract + Acetaminophen, Dextromethorphan, Guaifenesin, Pseudoephedrine interactionAcetaminophen, Dextromethorphan, Phenylpropanolamine, PyrilamineTheracaps
How Acetaminophen, Dextromethorphan, Phenylpropanolamine, Pyrilamine interacts with Liver Efficiency Formula — through 1 ingredient. Tap an ingredient for the detail:
Schisandra Fruit ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Schisandra Fruit Extract + Acetaminophen, Dextromethorphan, Phenylpropanolamine, Pyrilamine interactionAcetaminophen, Dextromethorphan, PseudoephedrineAlka-Seltzer PLUS Flu Liquid Gels, Non Aspirin Cold Caps, Tylenol Cold, Tylenol Flu Daytime Ex Strength, Tylenol Flu Ex Strength
How Acetaminophen, Dextromethorphan, Pseudoephedrine interacts with Liver Efficiency Formula — through 1 ingredient. Tap an ingredient for the detail:
Schisandra Fruit ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Schisandra Fruit Extract + Acetaminophen, Dextromethorphan, Pseudoephedrine interactionAcetaminophen, HydrocodoneAnexsia, Anodynos DHC, Azdone, Co-Gesic, Doucet, Lorcet +9 more
How Acetaminophen, Hydrocodone interacts with Liver Efficiency Formula — through 1 ingredient. Tap an ingredient for the detail:
Schisandra Fruit ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Schisandra Fruit Extract + Acetaminophen, Hydrocodone interactionAcetaminophen, IbuprofenCombogesic
How Acetaminophen, Ibuprofen interacts with Liver Efficiency Formula — through 1 ingredient. Tap an ingredient for the detail:
Schisandra Fruit ExtractCytochrome P450 2c9 (cyp2c9) Substrates Moderate
Interaction Summary
Theoretically, schisandra might decrease the levels and clinical effects of CYP2C9 substrates.
Read the full Schisandra Fruit Extract + Acetaminophen, Ibuprofen interactionAcetaminophen, Phenylephrine, ChlorpheniramineSuper Cold Tabs
How Acetaminophen, Phenylephrine, Chlorpheniramine interacts with Liver Efficiency Formula — through 1 ingredient. Tap an ingredient for the detail:
Schisandra Fruit ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Schisandra Fruit Extract + Acetaminophen, Phenylephrine, Chlorpheniramine interactionAdagrasibKrazati
How Adagrasib interacts with Liver Efficiency Formula — through 1 ingredient. Tap an ingredient for the detail:
Schisandra Fruit ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Schisandra Fruit Extract + Adagrasib interactionAerosphere Budesonide, Formoterol Fumarate, GlycopyrrolateBreztri
How Aerosphere Budesonide, Formoterol Fumarate, Glycopyrrolate interacts with Liver Efficiency Formula — through 1 ingredient. Tap an ingredient for the detail:
Schisandra Fruit ExtractCytochrome P450 2c19 (cyp2c19) Substrates, Cytochrome P450 2c9 (cyp2c9) Substrates Moderate
Interaction Summary
Theoretically, schisandra might increase the levels and clinical effects of CYP2C19 substrates.
Read the full Schisandra Fruit Extract + Aerosphere Budesonide, Formoterol Fumarate, Glycopyrrolate interactionAfatinib DimaleateGilotrif
How Afatinib Dimaleate interacts with Liver Efficiency Formula — through 1 ingredient. Tap an ingredient for the detail:
Schisandra Fruit ExtractP-glycoprotein Substrates Moderate
Interaction Summary
Schisandra might increase the levels and clinical effects of P-glycoprotein substrates.
Read the full Schisandra Fruit Extract + Afatinib Dimaleate interactionAgomelatineValdoxan
How Agomelatine interacts with Liver Efficiency Formula — through 1 ingredient. Tap an ingredient for the detail:
Schisandra Fruit ExtractCytochrome P450 2c19 (cyp2c19) Substrates, Cytochrome P450 2c9 (cyp2c9) Substrates Moderate
Interaction Summary
Theoretically, schisandra might increase the levels and clinical effects of CYP2C19 substrates.
Read the full Schisandra Fruit Extract + Agomelatine interactionAlfentanilAlfenta
How Alfentanil interacts with Liver Efficiency Formula — through 1 ingredient. Tap an ingredient for the detail:
Schisandra Fruit ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Schisandra Fruit Extract + Alfentanil interactionAlfuzosinUroxatral
How Alfuzosin interacts with Liver Efficiency Formula — through 1 ingredient. Tap an ingredient for the detail:
Schisandra Fruit ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Schisandra Fruit Extract + Alfuzosin interactionAliskirenTekturna
How Aliskiren interacts with Liver Efficiency Formula — through 1 ingredient. Tap an ingredient for the detail:
Schisandra Fruit ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Schisandra Fruit Extract + Aliskiren interactionAlmotriptanAlmogran, Axert
How Almotriptan interacts with Liver Efficiency Formula — through 1 ingredient. Tap an ingredient for the detail:
Schisandra Fruit ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Schisandra Fruit Extract + Almotriptan interactionAlogliptinNesina
How Alogliptin interacts with Liver Efficiency Formula — through 1 ingredient. Tap an ingredient for the detail:
Schisandra Fruit ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Schisandra Fruit Extract + Alogliptin interactionAlogliptin, PioglitazoneOseni
How Alogliptin, Pioglitazone interacts with Liver Efficiency Formula — through 1 ingredient. Tap an ingredient for the detail:
Schisandra Fruit ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Schisandra Fruit Extract + Alogliptin, Pioglitazone interactionAlpelisibPiqray
How Alpelisib interacts with Liver Efficiency Formula — through 1 ingredient. Tap an ingredient for the detail:
Schisandra Fruit ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Schisandra Fruit Extract + Alpelisib interactionAlprazolamNiravam, Xanax
How Alprazolam interacts with Liver Efficiency Formula — through 1 ingredient. Tap an ingredient for the detail:
Schisandra Fruit ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Schisandra Fruit Extract + Alprazolam interactionAlvimopanEntereg
How Alvimopan interacts with Liver Efficiency Formula — through 1 ingredient. Tap an ingredient for the detail:
Schisandra Fruit ExtractP-glycoprotein Substrates Moderate
Interaction Summary
Schisandra might increase the levels and clinical effects of P-glycoprotein substrates.
Read the full Schisandra Fruit Extract + Alvimopan interactionAmbrisentanLetairis, Volibris
How Ambrisentan interacts with Liver Efficiency Formula — through 1 ingredient. Tap an ingredient for the detail:
Schisandra Fruit ExtractP-glycoprotein Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Schisandra might increase the levels and clinical effects of P-glycoprotein substrates.
Read the full Schisandra Fruit Extract + Ambrisentan interactionAmiodaroneCordarone, Pacerone
How Amiodarone interacts with Liver Efficiency Formula — through 1 ingredient. Tap an ingredient for the detail:
Schisandra Fruit ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Schisandra Fruit Extract + Amiodarone interactionAmitriptylineElavil
How Amitriptyline interacts with Liver Efficiency Formula — through 1 ingredient. Tap an ingredient for the detail:
Schisandra Fruit ExtractCytochrome P450 2c19 (cyp2c19) Substrates, Cytochrome P450 2c9 (cyp2c9) Substrates +1 Moderate
Interaction Summary
Theoretically, schisandra might increase the levels and clinical effects of CYP2C19 substrates.
Read the full Schisandra Fruit Extract + Amitriptyline interactionAmitriptyline, ChlordiazepoxideLimbitrol DS
How Amitriptyline, Chlordiazepoxide interacts with Liver Efficiency Formula — through 1 ingredient. Tap an ingredient for the detail:
Schisandra Fruit ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 2c19 (cyp2c19) Substrates +1 Moderate
Interaction Summary
Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Schisandra Fruit Extract + Amitriptyline, Chlordiazepoxide interactionAmitriptyline, PerphenazineEtrafon, Etrafon-A, Etrafon-Forte, Triavil
How Amitriptyline, Perphenazine interacts with Liver Efficiency Formula — through 1 ingredient. Tap an ingredient for the detail:
Schisandra Fruit ExtractCytochrome P450 2c19 (cyp2c19) Substrates, Cytochrome P450 2c9 (cyp2c9) Substrates +1 Moderate
Interaction Summary
Theoretically, schisandra might increase the levels and clinical effects of CYP2C19 substrates.
Read the full Schisandra Fruit Extract + Amitriptyline, Perphenazine interactionAmlodipineNorliqva
How Amlodipine interacts with Liver Efficiency Formula — through 1 ingredient. Tap an ingredient for the detail:
Schisandra Fruit ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Schisandra Fruit Extract + Amlodipine interactionAmlodipine BenzoateKaterzia
How Amlodipine Benzoate interacts with Liver Efficiency Formula — through 1 ingredient. Tap an ingredient for the detail:
Schisandra Fruit ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Schisandra Fruit Extract + Amlodipine Benzoate interactionAmlodipine BesilateIstin
How Amlodipine Besilate interacts with Liver Efficiency Formula — through 1 ingredient. Tap an ingredient for the detail:
Schisandra Fruit ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Schisandra Fruit Extract + Amlodipine Besilate interactionAmlodipine BesylateNorvasc
How Amlodipine Besylate interacts with Liver Efficiency Formula — through 1 ingredient. Tap an ingredient for the detail:
Schisandra Fruit ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Schisandra Fruit Extract + Amlodipine Besylate interactionEach ingredient & the kinds of drugs it affects
For each ingredient in Liver Efficiency Formula with known interactions, here are the types of medications it can affect. Open any type for the detail — or search your exact drug in the checker above.
Schisandra Fruit Extract
Cyclophosphamide
Theoretically, schisandra might increase the levels and clinical effects of cyclophosphamide.
In vitro research shows that schisandra increases the concentration of cyclophosphamide, likely through inhibition of cytochrome P450 3A4. After multiple doses of the schisandra constituents schisandrin A and schisantherin A, the maximum concentration of cyclophosphamide was increased by 7% and 75%, respectively, while the overall exposure to cyclophosphamide was increased by 29% and 301%, respectively.
Cyclosporine (Neoral, Sandimmune)
Schisandra can increase the levels and clinical effects of cyclosporine.
A small observational study in children with aplastic anemia found that taking schisandra with cyclosporine increased cyclosporine trough levels by 93% without increasing the risk of adverse events. However, the dose of cyclosporine was reduced in 9% of children to maintain appropriate cyclosporine blood concentrations.
Cytochrome P450 2C19 (Cyp2C19) Substrates
Theoretically, schisandra might increase the levels and clinical effects of CYP2C19 substrates.
In vitro research shows that schisandra inhibits CYP2C19, and animal research shows that schisandra increases the concentration of voriconazole, a CYP2C19 substrate. Theoretically, schisandra may also inhibit the metabolism of other CYP2C19 substrates. This effect has not been reported in humans.
Cytochrome P450 2C9 (Cyp2C9) Substrates
Theoretically, schisandra might decrease the levels and clinical effects of CYP2C9 substrates.
In vitro and animal research suggests that schisandra induces CYP2C9 enzymes. This effect has not been reported in humans.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.
Most clinical and laboratory research shows that schisandra, administered either as a single dose or up to twice daily for 14 days, inhibits CYP3A4 and increases the concentration of CYP3A4 substrates such as cyclophosphamide, midazolam, tacrolimus, and talinolol. Although one in vitro and animal study shows that schisandra may induce CYP3A4 metabolism, this effect appears to be overpowered by schisandra's CYP3A4 inhibitory activity and has not been reported in humans.
Midazolam (Versed)
Schisandra can increase the levels and clinical effects of midazolam.
A small pharmacokinetic study in healthy adults shows that taking schisandra extract (Hezheng Pharmaceutical Co.) containing deoxyschizandrin 33.75 mg twice daily for 8 days and a single dose of midazolam 15 mg on day 8 increases the overall exposure to midazolam by about 119%, increases the peak plasma level of midazolam by 86%, and decreases midazolam clearance by about 52%. This effect has been attributed to inhibition of CYP3A4 by schisandra.
P-Glycoprotein Substrates
Schisandra might increase the levels and clinical effects of P-glycoprotein substrates.
In vitro research shows that schisandra extracts and constituents such as schisandrin B inhibit P-glycoprotein mediated efflux in intestinal cells and in P-glycoprotein over-expressing cell lines. Additionally, a small clinical study shows that schisandra increases the peak concentration and overall exposure to talinolol, a P-glycoprotein probe substrate. Theoretically, schisandra might inhibit the efflux of other P-glycoprotein substrates.
Sirolimus (Rapamune)
Schisandra can increase the levels and clinical effects of sirolimus.
A small pharmacokinetic study in healthy volunteers shows that taking 3 capsules of schisandra (Hezheng Pharmaceutical Company) containing a total of 33.75 mg deoxyschizandrin twice daily for 13 days and then taking a single dose of sirolimus 2 mg increases the overall exposure and peak level of sirolimus by two-fold. This effect is thought to be due to inhibition of cytochrome P450 3A4 by schisandra, as well as possible inhibition of the P-glycoprotein drug transporter.
Tacrolimus (Prograf)
Schisandra can increase the levels and clinical effects of tacrolimus.
Clinical research in healthy children and adults, transplant patients, and patients with nephrotic syndrome and various rheumatic immunologic disorders shows that taking schisandra with tacrolimus increases tacrolimus peak levels by 183% to 268%, prolongs or delays time to peak tacrolimus concentrations, increases overall exposure to tacrolimus by 126% to 343%, and decreases tacrolimus clearance by 19% to 73%. This effect is thought to be due to inhibition of P-glycoprotein drug transporter and CYP3A4 and CYP3A5 by schisandra. Some clinical and observational studies suggest that schisandra increases tacrolimus levels similarly in both expressors and non-expressors of CYP3A5, while other studies suggest it does so to a greater degree in CYP3A5 expressors than non-expressors. Animal research suggests that the greatest increase in tacrolimus levels occurs when schisandra is taken either concomitantly or up to 2 hours before tacrolimus, and clinical and observational research in humans suggests that schisandra may increase whole blood levels of tacrolimus and decrease clearance of tacrolimus in a dose-dependent manner.
Talinolol
Schisandra can increase the levels and clinical effects of talinolol.
A small pharmacokinetic study in healthy volunteers shows that taking schisandra extract 300 mg twice daily for 14 days with a single dose of talinolol 100 mg on day 14 increases the peak talinolol level by 51% and the overall exposure to talinolol by 47%. This effect is thought to be due to the possible inhibition of cytochrome P450 3A4 and P-glycoprotein by schisandra.
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Voriconazole (Vfend)
Theoretically, schisandra might increase the levels and clinical effects of voriconazole.
Animal research shows that oral schisandra given daily for 1 or 14 days increases levels of intravenously administered voriconazole, a cytochrome P450 (CYP) 2C19 substrate. This effect is thought to be due to inhibition of CYP2C19 by schisandra. However, this interaction has not been reported in humans.
Warfarin (Coumadin)
Theoretically, schisandra might decrease the levels and clinical effects of warfarin.
Animal research suggests that oral schisandra extract, given daily for 6 days, reduces levels of intravenously administered warfarin. This effect might be due to the induction of cytochrome P450 (CYP) 2C9 metabolism by schisandra. However, this interaction has not been reported in humans.
Brand information
Manufacturer and brand details for Liver Efficiency Formula, from the product label.
Life Extension
See all Life Extension products- Name
- Quality Supplements and Vitamins, Inc.
- City
- Ft. Lauderdale
- State
- FL
- ZipCode
- 33309
- Phone Number
- 1-866-280-2852
- Web Address
- LifeExtension.com
Liver Efficiency Formula by Life Extension: Common Questions
Does Liver Efficiency Formula by Life Extension interact with any medications?
How can one product interact with so many drugs?
Where does this information come from?
Can I take this if I'm pregnant or breastfeeding?
What are the most common side effects?
Does this formula actually work for liver health or the conditions listed?
Why does this interact with so many medications?
What is Extramel?
Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
Not sure if Liver Efficiency Formula is safe with your meds?
Our pharmacists answer your medication & supplement questions — free.
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 Liver Efficiency Formula’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Sources & How We Checked
Liver Efficiency Formula'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 26 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.
Schisandra 26 references
- Leung AY, Foster S. Encyclopedia of Common Natural Ingredients Used in Food, Drugs and Cosmetics. 2nd ed. New York, NY: John Wiley & Sons, 1996.
- Iwata H, Tezuka Y, Kadota S, et al. Identification and characterization of potent CYP3A4 inhibitors in Schisandra fruit extract. Drug Metab Dispos 2004;32:1351-8. PubMed
- Mu Y, Zhang J, Zhang S, et al. Traditional Chinese medicines Wu Wei Zi (Schisandra chinensis Baill) and Gan Cao (Glycyrrhiza uralensis Fisch) activate pregnane X receptor and increase warfarin clearance in rats. J Pharmacol Exp Ther 2006;316:1369-77. PubMed
- Xin HW, Wu XC, Li Q, et al. Effects of Schisandra sphenanthera extract on the pharmacokinetics of tacrolimus in healthy volunteers. Br J Clin Pharmacol 2007;64:469-75.
- Qin XL, Bi HC, Wang XD, et al. Mechanistic understanding of the different effects of Wuhzi Tablet (Schisandra sphenanthera extract) on the absorption and first-pass intestinal and hepatic metabolism of tacrolimus (FK506). Int J Pharm 2010;389:114-21.
- Makino, T., Mizuno, F., and Mizukami, H. Does a kampo medicine containing schisandra fruit affect pharmacokinetics of nifedipine like grapefruit juice? Biol.Pharm.Bull. 2006;29(10):2065-2069. PubMed
- Fan L, Mao XQ, Tao GY, Wang G, Jiang F, Chen Y, Li Q, Zhang W, Lei HP, Hu DL, Huang YF, Wang D, Zhou HH. Effect of Schisandra chinensis extract and Ginkgo biloba extract on the pharmacokinetics of talinolol in healthy volunteers. Xenobiotica. 2009 Mar;39(
- Jiang W, Wang X, Xu X, Kong L. Effect of Schisandra sphenanthera extract on the concentration of tacrolimus in the blood of liver transplant patients. Int J Clin Pharmacol Ther. 2010 Mar;48(3):224-9. PubMed
- Xin HW, Wu XC, Li Q, Yu AR, Xiong L. Effects of Schisandra sphenanthera extract on the pharmacokinetics of midazolam in healthy volunteers. Br J Clin Pharmacol. 2009 May;67(5):541-6.
- Li J, Chen S, Qin X, et at. Wuzhi Tablet (<i>Schisandra sphenanthera</i> Extract) is a Promising Tacrolimus-Sparing Agent for Renal Transplant Recipients Who are CYP3A5 Expressers: a Two-Phase Prospective Study. Drug Metab Dispos. 2017;45(11):1114-1119.
- Qin XL, Li JL, Wang SH, Chen X, Huang M, Bi HC. Co-administration of Wuzhi tablet (Schisandra sphenanthera extract) alters tacrolimus pharmacokinetics in a dose- and time-dependent manner in rats. J Ethnopharmacol. 2020;263:113233. PubMed
- Yuan F, Liang X, Chen X, Qin X, Tan C, Wang L. CYP2C19 is involved in the effect of Wuzhi tablet (Schisandra sphenanthera extract) and its constituents on the pharmacokinetics of intravenous voriconazole. Pharmazie. 2020;75(11):559-564. DOI
- Zhang Z, Lu X, Dong L, Ma J, Fan X. Clinical observation on the effect of Wuzhi soft capsule on FK506 concentration in membranous nephropathy patients. Medicine (Baltimore). 2019;98(48):e18150. PubMed
- Yoo HH, Lee M, Lee MW, Lim SY, Shin J, Kim DH. Effects of Schisandra lignans on P-glycoprotein-mediated drug efflux in human intestinal Caco-2. Planta Med. 2007;73(5):444-50.
- Qiangrong P, Wang T, Lu Q, Hu X. Schisandrin B--a novel inhibitor of P-glycoprotein. Biochem Biophys Res Commun. 2005;335(2):406-11. PubMed
- Chen L, Ji N, Zhang M, Chen W. The influence of Wuzhi capsule on the pharmacokinetics of cyclophosphamide. Recent Pat Anticancer Drug Discov 2021. PubMed
- Cheng X, Ma J, Xu X, Zhang L, Wang X, Wu R. Effect of Wuzhi capsules on cyclosporine A concentration in children with aplastic anemia immunotherapy: a single-center observational study. Expert Rev Clin Pharmacol 2022:1-5. PubMed
- Cheng F, Li Q, Wang J, Zeng F, Zhang Y. Effects and safety evaluation of Wuzhi capsules combined with tacrolimus for the treatment of kidney transplantation recipients. J Clin Pharm Ther 2021;46(6):1636-49. PubMed
- Teng F, Wang W, Zhang W, et al. Effect of hepar-protecting Wuzhi capsule on pharmacokinetics and dose-effect character of tacrolimus in healthy volunteers. Biopharm Drug Dispos 2022.
- Kou K, Sun X, Li M, et al. Beneficial effects of Wuzhi capsule on tacrolimus blood concentrations in liver transplant patients with different donor-recipient CYP3A5 genotypes. J Clin Pharm Ther 2022;47(2):200-10. PubMed
- Peng Y, Jiang F, Zhou R, et al. Clinical evaluation of the efficacy and safety of co-administration of Wuzhi capsule and tacrolimus in adult Chinese patients with myasthenia gravis. Neuropsychiatr Dis Treat 2021;17:2281-9. PubMed
- Chen P, Dai R, She Y, et al. Prediction of tacrolimus and Wuzhi tablet pharmacokinetic interaction magnitude in renal transplant recipients. Clin Transplant 2022;36(12):e14807. PubMed
- Qu J, Bian R, Liu B, et al. The pharmacokinetic study of tacrolimus and Wuzhi capsule in Chinese liver transplant patients. Front Pharmacol 2022;13:956166. PubMed
- Zhou Y, Huang X, Liu L, et al. Effect of Wuzhi preparations on tacrolimus in CYP3A5 expressers during the early period after transplantation: A real-life experience from heart transplant recipients. Transpl Immunol 2023;76:101748. PubMed
- Huang Q, Lin X, Wang Y, et al. Tacrolimus pharmacokinetics in pediatric nephrotic syndrome: A combination of population pharmacokinetic modelling and machine learning approaches to improve individual prediction. Front Pharmacol 2022;13:942129. PubMed
- Wang CB, Zhang YJ, Zhao MM, Zhao LM. Population pharmacokinetic analyses of tacrolimus in non-transplant patients: a systematic review. Eur J Clin Pharmacol 2023;79(7):897-913. PubMed
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DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.
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