Liver Support Ingredients & Drug Interactions
by Renew Life
What is this page for?
First and foremost: checking Liver Support 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 Support is a dietary supplement by Renew Life with 16 active ingredients. Its ingredients are commonly taken for diabetic nerve pain (neuropathy), blood sugar support in diabetes, antioxidant support.Based on those ingredients, 1,630 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are Green Tea Leaf Extract, Quercetin, Milk Thistle seed extract. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against Liver Support by Renew Life
Ask about any prescription or over-the-counter medication and we check it for interactions with Liver Support by Renew Life — 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 Support by Renew Life
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
Partial disclosure
Liver Support contains 16 active and inactive ingredients. The active components include Alpha Lipoic Acid, Glycine, L-Leucine, L-Isoleucine, L-Methionine, L-Valine, Vitamin C, Quercetin, L-Taurine, Phosphatidylcholine, Selenium, Green Tea Leaf Extract, Artichoke Leaf Extract, N-Acetyl Cysteine, L-Glutathione, and an Amino Acid Complex.
These are combined with a capsule as the inactive ingredient.
Does it work?
Strong evidence
Evidence for this product's effectiveness is mixed and varies by ingredient. Vitamin C is established as effective for vitamin C deficiency and possibly effective for anemia and exercise-induced respiratory infections.
N-Acetyl Cysteine is effective for acetaminophen poisoning, atelectasis, and bronchial procedures. Several ingredients carry "Possibly Effective" ratings: Alpha Lipoic Acid for diabetic nerve damage and cholesterol issues, Quercetin for athletic performance (though rated possibly ineffective), Green Tea for HPV and ovarian cancer prevention, and Artichoke for cholesterol and digestion.
Most other uses—such as Glycine for ADHD, Milk Thistle for liver disease, or Taurine for heart failure—are rated "Possibly Effective" or lack sufficient evidence to rate. The facts we hold do not establish this product as a proven treatment for general liver support.
How safe is it?
Well-documented data
Individual ingredients in this product are generally well tolerated at typical doses. Alpha Lipoic Acid commonly causes headache, heartburn, and nausea.
Vitamin C at high doses can cause stomach cramps and diarrhea. N-Acetyl Cysteine may cause nausea, diarrhea, and dry mouth.
Milk Thistle and Artichoke occasionally cause mild digestive upset. Regarding pregnancy and breastfeeding: Alpha Lipoic Acid safety data are insufficient—avoid supplemental doses unless your doctor approves.
Glycine has insufficient safety data in pregnancy and breastfeeding. L-Methionine is rated likely safe in pregnancy but supplement doses beyond food amounts have not been proven safe, and breastfeeding safety is not well studied.
Vitamin C at normal prenatal amounts is likely safe, but avoid high-dose supplements in pregnancy and breastfeeding. Quercetin, Green Tea, and Artichoke all lack sufficient safety data—avoid supplemental doses during pregnancy and breastfeeding.
Taurine is rated likely safe in pregnancy and breastfeeding. Phosphatidylcholine and Selenium have insufficient or mixed pregnancy data—talk with your doctor.
N-Acetyl Cysteine is possibly safe in pregnancy and breastfeeding safety data are not on file. Milk Thistle safety in pregnancy and breastfeeding is not well established.
Meds to double-check
Major interaction found
Before taking this product, double-check with your doctor or pharmacist if you take: heart medications (nadolol, atorvastatin)—Green Tea Leaf Extract may greatly reduce their effectiveness; nitroglycerin—N-Acetyl Cysteine raises the risk of severe low blood pressure and headache; blood thinners or antiplatelet drugs (warfarin, aspirin, clopidogrel)—several ingredients may increase bleeding risk; chemotherapy drugs (alkylating agents, antitumor antibiotics)—Vitamin C and Alpha Lipoic Acid may interfere; ephedrine or stimulants—Green Tea Leaf Extract may cause dangerous effects; seizure medications (phenytoin, valproate, felbamate, ethosuximide)—Green Tea may weaken them; diabetes drugs—Alpha Lipoic Acid and Artichoke may lower blood sugar further; blood pressure medications—Taurine and Artichoke may strengthen their effects; and hepatitis C antivirals or morphine—Milk Thistle may alter their levels. No interactions are documented for L-Leucine, L-Isoleucine, L-Valine, and L-Glutathione.
The bottom line
Scorecard at a glancePartially disclosed formula with clinical evidence supporting its stated purpose. Major medication interactions have been identified, and safety information is well characterized.
This product is a blend of amino acids, antioxidants, and herbal extracts marketed for liver support, though clinical evidence for its effectiveness in liver health is not firmly established in the data we hold. If you take heart medications (especially nadolol or atorvastatin), blood thinners, diabetes drugs, seizure medications, or nitroglycerin, you need to review this product with your doctor or pharmacist before starting—the interactions are significant.
Anyone pregnant, breastfeeding, or managing a serious health condition should discuss this supplement with their healthcare provider first.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 12 of 16 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Jul 27, 2021.
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 Support, straight from the product label.
| Brand | Renew Life |
|---|---|
| Net contents | 90 Vegetarian Capsule(s) |
| Market status | On market |
| Date entered into DSLD | Jul 27, 2021 |
| DSLD ID | 250787 |
| Product type | Other Combinations |
| Supplement form | Capsule |
| Dietary claims / uses | Nutrient, All Other, Structure/Function |
| Intended target group(s) | Adult (18 - 50 Years), Gluten Free, Dairy Free |
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.
Supplement Facts
The label details for Liver Support by Renew Life, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Alpha Lipoic Acid | 100 mg | -- |
| Glycine | 0 NP | -- |
| L-Leucine | 0 NP | -- |
| L-Isoleucine | 0 NP | -- |
| L-Methionine | 0 NP | -- |
| L-Valine | 0 NP | -- |
| Vitamin C | 300 mg | 333% |
| Quercetin | 75 mg | -- |
| L-Taurine | 0 NP | -- |
| Phosphatidylcholine | 30 mg | -- |
| Selenium | 175 mcg | 318% |
| Green Tea Leaf Extract | 30 mg | -- |
| Artichoke leaf extract | 30 mg | -- |
| N-Acetyl Cysteine | 0 NP | -- |
| L-Glutathione | 10 mg | -- |
| Amino Acid Complex | 600 mg | -- |
| Milk Thistle seed extract | 600 mg | -- |
Other ingredients: Capsule
Tap any ingredient to jump to its full detail below.
These statements are the manufacturer’s wording, reproduced from the product label — the label is saying it, not HelloPharmacist. We don’t verify or endorse them.
Formulation
Herbal detox formula Daily liver support and protection Promotes effective liver detoxification
Gluten Free - Dairy Free
Quality, purity and potency guaranteed through expiration.
Free of gluten and dairy
Made in the USA of global ingredients
Formula
600 mg milk thistle
Includes 600 mg milk thistle, an amino acid complex, vitamin C and herbs for daily liver support
FDA Statement of Identity
Dietary Supplement
Suggested/Recommended/Usage/Directions
Directions: Take three (3) capsules daily or as directed by a healthcare professional.
Precautions
Contains: Soy
Keep out of reach of children.
Consult your physician prior to using this or any product if you are pregnant, nursing, taking any medication or have a medical condition.
Discontinue if adverse effects occur.
Warning: This product can expose you to chemicals including lead, which is known to the State of California to cause birth defects or other reproductive harm. For more information, go to www.P65Warnings.ca.gov.
Storage
Store at 86 degrees F (30 degrees C) or below.
Brand IP Statement(s)
Copyright 2018 Patents: www.renewlife.com/patents
General Statements
Listen to your gut... you'll be glad you did. Did you know toxins are all around us? They live in the environment, in processed foods and even in your own digestive tract. While your body was built to handle toxins, today's world can put a lot of stress on you. Renew Life herbal cleanse and detox formulas promote regularity and work in harmony with your body's natural detoxification process. Helping you feel lighter, brighter and more energized to take on the day.
At Renew Life, we're cleansing pioneers with double decades of experience and innovation on our side to help you cleanse and maintain your body's natural harmony. Visit RenewLife.com for help finding the right cleanse for you.
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.
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Liver Support by Renew Life 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 Support by Renew Life
These are the 16 active ingredients this product is made of. Select any to open its full monograph.
Serving size3 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.
Alpha Lipoic Acid
Interacts with263 drugs
Alpha-lipoic acid (ALA) is an antioxidant made naturally by the body and found in small amounts in foods. It is most studied for diabetic nerve pain,...
Alpha Lipoic Acid monograph & interactionsVitamin C
Interacts with207 drugs
Vitamin C (ascorbic acid) is an essential nutrient your body needs but cannot make, so you must get it from food or supplements. It's important for im...
Vitamin C monograph & interactionsQuercetin
Interacts with1,169 drugs
Quercetin is a plant flavonoid with antioxidant and anti-inflammatory properties found in many common foods and sold as a supplement. While early rese...
Quercetin monograph & interactionsPhosphatidylcholine
No knowninteractions
Phosphatidylcholine is a phospholipid that is part of every cell membrane and a source of choline. People take it for liver, brain, and gut health, bu...
Phosphatidylcholine monograph & interactionsSelenium
Interacts with321 drugs
Selenium is an essential trace mineral your body needs in small amounts for thyroid function, antioxidant defense, and immune health. Most people who...
Selenium monograph & interactionsGreen Tea Leaf Extract
Interacts with1,293 drugs
Green tea is a popular beverage rich in antioxidants called catechins, and drinking it in normal amounts is considered safe for most people. Concentra...
Green Tea Leaf Extract monograph & interactionsArtichoke leaf extract
Interacts with363 drugs
Artichoke leaf extract is a generally well-tolerated supplement that may have a mild cholesterol-lowering effect and is often used for indigestion, th...
Artichoke leaf extract monograph & interactionsL-Glutathione
Amino Acid Complex
- › Glycine
- › L-Leucine
- › L-Isoleucine
- › L-Methionine
- › L-Valine
- › L-Taurine
- › N-Acetyl Cysteine
Milk Thistle seed extract
Interacts with954 drugs
Milk thistle is a popular herbal supplement most often used for liver health, and its main active component is a group of compounds called silymarin....
Milk Thistle seed extract monograph & interactionsOther (inactive) ingredients: Capsule. These complete the product’s ingredient list but are not active constituents.
Liver Support by Renew Life Drug Interactions
HelloPharmacist Interaction Report
Renew Life Liver Support has documented interactions with medications through multiple ingredients.
The most serious concern is a Major interaction: Green Tea Leaf Extract can substantially reduce the effectiveness of the heart drug nadolol (Corzaal) and the cholesterol medication atorvastatin (Lipitor), and it may dangerously amplify stimulant effects if combined with ephedrine. Additionally, N-Acetyl Cysteine carries a Major interaction with nitroglycerin, raising the risk of severe low blood pressure and severe headaches.
Read the full breakdown — every affected drug type, severity by severity
Moderate interactions span several medication categories. Alpha Lipoic Acid, Vitamin C, Quercetin, Selenium, and Artichoke Leaf Extract may increase bleeding risk with blood thinners like warfarin and antiplatelet drugs.
Alpha Lipoic Acid, Vitamin C, and Green Tea Leaf Extract may interfere with chemotherapy drugs (alkylating agents and antitumor antibiotics). Vitamin C can alter estrogen levels in oral contraceptives and hormone replacement therapy, and it may reduce warfarin effectiveness at high doses.
Quercetin may increase levels of several medications including statins (pravastatin), the immunosuppressant cyclosporine, and the antibiotic sulfasalazine. Green Tea Leaf Extract may also weaken seizure medications (felbamate, valproate, ethosuximide, phenytoin).
Taurine and Artichoke Leaf Extract may compound the effects of blood pressure medications. Alpha Lipoic Acid and Artichoke may increase the risk of low blood sugar with diabetes drugs.
Milk Thistle may affect blood glucose control, interact with hepatitis C antivirals, and theoretically alter warfarin activity.
Minor interactions include Selenium with oral contraceptives and niacin, and Alpha Lipoic Acid with diabetes medications at lower risk. Altogether, these interactions span 1,631 individual medications.
We could not check L-Leucine, L-Isoleucine, L-Valine, and L-Glutathione—interaction data are not on file for these. Check your exact medications using the tool on this page before starting this product.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against Liver Support?
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 Support interact with 1,630 drugs. Click any drug to see the details.
10 of the 16 ingredients in Liver Support interact with drugs. Each result below shows which ingredient is responsible. Green Tea Leaf Extract Quercetin Milk Thistle seed extract Artichoke leaf extract Selenium N-Acetyl Cysteine Alpha Lipoic Acid Vitamin C L-Taurine Glycine
Aminophylline, Amobarbital, EphedrineAmesec
How Aminophylline, Amobarbital, Ephedrine interacts with Liver Support — through 2 ingredients. Tap an ingredient for the detail:
Green Tea Leaf ExtractEphedrine, Stimulant Drugs Major
Interaction Summary
Theoretically, concomitant use might increase the risk for stimulant adverse effects.
Read the full Green Tea Leaf Extract + Aminophylline, Amobarbital, Ephedrine interactionSeleniumBarbiturates Moderate
Interaction Summary
Theoretically, selenium might prolong the sedating effects of barbiturates.
Read the full Selenium + Aminophylline, Amobarbital, Ephedrine interactionAtorvastatinAtorvaliq
How Atorvastatin interacts with Liver Support — through 3 ingredients. Tap an ingredient for the detail:
Green Tea Leaf ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Organic Anion-transporting Polypeptide Substrates (oatp) +2 Major
Interaction Summary
Green tea is unlikely to produce clinically significant changes in the levels and clinical effects of CYP3A4 substrates.
Read the full Green Tea Leaf Extract + Atorvastatin interactionQuercetinCytochrome P450 3a4 (cyp3a4) Substrates, Organic Anion-transporting Polypeptide Substrates (oatp) Moderate
Interaction Summary
Theoretically, concomitant use might alter the effects and adverse effects of CYP3A4 substrates.
Read the full Quercetin + Atorvastatin interactionMilk Thistle Seed ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Glucuronidated Drugs +2 Moderate
Interaction Summary
It is unclear if milk thistle inhibits CYP3A4; research is conflicting.
Read the full Milk Thistle Seed Extract + Atorvastatin interactionAtorvastatin CalciumLipitor
How Atorvastatin Calcium interacts with Liver Support — through 3 ingredients. Tap an ingredient for the detail:
Green Tea Leaf ExtractAtorvastatin (lipitor), Organic Anion-transporting Polypeptide Substrates (oatp) +2 Major
Interaction Summary
Green tea extract seems to reduce the levels and clinical effects of atorvastatin.
Read the full Green Tea Leaf Extract + Atorvastatin Calcium interactionMilk Thistle Seed ExtractHmg-coa Reductase Inhibitors ("statins"), Organic Anion-transporting Polypeptide Substrates (oatp) +2 Moderate
Interaction Summary
Theoretically, milk thistle might interfere with statin therapy by decreasing the activity of organic anion transporting polypeptide 1B1 (OATB1B1) and inhibiting breast cancer resistance protein (BCRP).
Read the full Milk Thistle Seed Extract + Atorvastatin Calcium interactionQuercetinOrganic Anion-transporting Polypeptide Substrates (oatp), Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, concomitant use might increase the effects and adverse effects of OATP substrates.
Read the full Quercetin + Atorvastatin Calcium interactionBendroflumethiazide, NadololCorzide
How Bendroflumethiazide, Nadolol interacts with Liver Support — through 5 ingredients. Tap an ingredient for the detail:
Green Tea Leaf ExtractDiuretic Drugs, Nadolol (corgard) Major
Interaction Summary
Theoretically, using green tea with diuretic drugs might increase the risk of hypokalemia.
Read the full Green Tea Leaf Extract + Bendroflumethiazide, Nadolol interactionQuercetinAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, taking quercetin with antihypertensive drugs might increase the risk of hypotension.
Read the full Quercetin + Bendroflumethiazide, Nadolol interactionN-acetyl CysteineAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, N-acetyl cysteine might increase the risk of hypotension when taken with antihypertensive drugs.
Read the full N-acetyl Cysteine + Bendroflumethiazide, Nadolol interactionL-taurineAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, taurine might increase the risk of hypotension when taken with antihypertensive drugs.
Read the full L-taurine + Bendroflumethiazide, Nadolol interactionArtichoke Leaf ExtractAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, artichoke leaf extract may increase the risk of hypotension when taken with antihypertensive drugs.
Read the full Artichoke Leaf Extract + Bendroflumethiazide, Nadolol interactionCarbetapentane Tannate, Chlorpheniramine Tannate, Ephedrine Tannate, Phenylephrine TannateQuadratuss, Ry Tuss, Rynatuss, Tri Tannate Plus
How Carbetapentane Tannate, Chlorpheniramine Tannate, Ephedrine Tannate, Phenylephrine Tannate interacts with Liver Support — through 3 ingredients. Tap an ingredient for the detail:
Green Tea Leaf ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Ephedrine +1 Major
Interaction Summary
Green tea is unlikely to produce clinically significant changes in the levels and clinical effects of CYP3A4 substrates.
Read the full Green Tea Leaf Extract + Carbetapentane Tannate, Chlorpheniramine Tannate, Ephedrine Tannate, Phenylephrine Tannate interactionQuercetinCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, concomitant use might alter the effects and adverse effects of CYP3A4 substrates.
Read the full Quercetin + Carbetapentane Tannate, Chlorpheniramine Tannate, Ephedrine Tannate, Phenylephrine Tannate interactionMilk Thistle Seed ExtractCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
It is unclear if milk thistle inhibits CYP3A4; research is conflicting.
Read the full Milk Thistle Seed Extract + Carbetapentane Tannate, Chlorpheniramine Tannate, Ephedrine Tannate, Phenylephrine Tannate interactionDyphylline, Ephedrine, Guaifenesin, PhenobarbitalLufyllin-EPG
How Dyphylline, Ephedrine, Guaifenesin, Phenobarbital interacts with Liver Support — through 2 ingredients. Tap an ingredient for the detail:
Green Tea Leaf ExtractEphedrine, Stimulant Drugs +1 Major
Interaction Summary
Theoretically, concomitant use might increase the risk for stimulant adverse effects.
Read the full Green Tea Leaf Extract + Dyphylline, Ephedrine, Guaifenesin, Phenobarbital interactionSeleniumBarbiturates Moderate
Interaction Summary
Theoretically, selenium might prolong the sedating effects of barbiturates.
Read the full Selenium + Dyphylline, Ephedrine, Guaifenesin, Phenobarbital interactionEphedrine, Guaifenesin (otc Drug)Ephedrine Formula 400, Ephedrine Plus Tabs
How Ephedrine, Guaifenesin (otc Drug) interacts with Liver Support — through 1 ingredient. Tap an ingredient for the detail:
Green Tea Leaf ExtractStimulant Drugs, Ephedrine Major
Interaction Summary
Theoretically, concomitant use might increase stimulant adverse effects.
Read the full Green Tea Leaf Extract + Ephedrine, Guaifenesin (otc Drug) interactionEphedrine, Guaifenesin, Phenobarbital, TheophyllineMudrane GG
How Ephedrine, Guaifenesin, Phenobarbital, Theophylline interacts with Liver Support — through 2 ingredients. Tap an ingredient for the detail:
Green Tea Leaf ExtractEphedrine, Stimulant Drugs +2 Major
Interaction Summary
Theoretically, concomitant use might increase the risk for stimulant adverse effects.
Read the full Green Tea Leaf Extract + Ephedrine, Guaifenesin, Phenobarbital, Theophylline interactionSeleniumBarbiturates Moderate
Interaction Summary
Theoretically, selenium might prolong the sedating effects of barbiturates.
Read the full Selenium + Ephedrine, Guaifenesin, Phenobarbital, Theophylline interactionEphedrine, Hydroxyzine, TheophyllineAmi Rax, Marax
How Ephedrine, Hydroxyzine, Theophylline interacts with Liver Support — through 1 ingredient. Tap an ingredient for the detail:
Green Tea Leaf ExtractEphedrine, Stimulant Drugs +1 Major
Interaction Summary
Theoretically, concomitant use might increase the risk for stimulant adverse effects.
Read the full Green Tea Leaf Extract + Ephedrine, Hydroxyzine, Theophylline interactionEphedrine, Phenobarbital, Potassium Iodide, TheophyllineMudrane, Quadrinal
How Ephedrine, Phenobarbital, Potassium Iodide, Theophylline interacts with Liver Support — through 2 ingredients. Tap an ingredient for the detail:
Green Tea Leaf ExtractStimulant Drugs, Theophylline +2 Major
Interaction Summary
Theoretically, concomitant use might increase stimulant adverse effects.
Read the full Green Tea Leaf Extract + Ephedrine, Phenobarbital, Potassium Iodide, Theophylline interactionSeleniumBarbiturates Moderate
Interaction Summary
Theoretically, selenium might prolong the sedating effects of barbiturates.
Read the full Selenium + Ephedrine, Phenobarbital, Potassium Iodide, Theophylline interactionEphedrine, Phenobarbital, TheophyllineTedral
How Ephedrine, Phenobarbital, Theophylline interacts with Liver Support — through 2 ingredients. Tap an ingredient for the detail:
Green Tea Leaf ExtractPhenobarbital (luminal), Ephedrine +2 Major
Interaction Summary
Theoretically, green tea might reduce the effects of phenobarbital and increase the risk for convulsions.
Read the full Green Tea Leaf Extract + Ephedrine, Phenobarbital, Theophylline interactionSeleniumBarbiturates Moderate
Interaction Summary
Theoretically, selenium might prolong the sedating effects of barbiturates.
Read the full Selenium + Ephedrine, Phenobarbital, Theophylline interactionEzetimibe, AtorvastatinLiptruzet
How Ezetimibe, Atorvastatin interacts with Liver Support — through 3 ingredients. Tap an ingredient for the detail:
Green Tea Leaf ExtractOrganic Anion-transporting Polypeptide Substrates (oatp), Cytochrome P450 3a4 (cyp3a4) Substrates +2 Major
Interaction Summary
Theoretically, green tea might reduce the absorption of organic anion-transporting polypeptide (OATP) substrates.
Read the full Green Tea Leaf Extract + Ezetimibe, Atorvastatin interactionMilk Thistle Seed ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Glucuronidated Drugs +2 Moderate
Interaction Summary
It is unclear if milk thistle inhibits CYP3A4; research is conflicting.
Read the full Milk Thistle Seed Extract + Ezetimibe, Atorvastatin interactionQuercetinOrganic Anion-transporting Polypeptide Substrates (oatp), Cytochrome P450 3a4 (cyp3a4) Substrates +1 Moderate
Interaction Summary
Theoretically, concomitant use might increase the effects and adverse effects of OATP substrates.
Read the full Quercetin + Ezetimibe, Atorvastatin interactionNadololCorgard, Nadolol
How Nadolol interacts with Liver Support — through 5 ingredients. Tap an ingredient for the detail:
Green Tea Leaf ExtractNadolol (corgard) Major
Interaction Summary
Green tea seems to reduce the levels and clinical effects of nadolol.
Read the full Green Tea Leaf Extract + Nadolol interactionQuercetinAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, taking quercetin with antihypertensive drugs might increase the risk of hypotension.
Read the full Quercetin + Nadolol interactionArtichoke Leaf ExtractAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, artichoke leaf extract may increase the risk of hypotension when taken with antihypertensive drugs.
Read the full Artichoke Leaf Extract + Nadolol interactionL-taurineAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, taurine might increase the risk of hypotension when taken with antihypertensive drugs.
Read the full L-taurine + Nadolol interactionN-acetyl CysteineAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, N-acetyl cysteine might increase the risk of hypotension when taken with antihypertensive drugs.
Read the full N-acetyl Cysteine + Nadolol interactionNitroglycerinGonitro, Nitro Time, Nitro-Bid, Nitrocine Timecaps, Nitrogard, Nitrogard SR +7 more
How Nitroglycerin interacts with Liver Support — through 1 ingredient. Tap an ingredient for the detail:
N-acetyl CysteineNitroglycerin Major
Interaction Summary
N-acetyl cysteine can increase the risk for hypotension and headaches when taken with intravenous or transdermal nitroglycerin.
Read the full N-acetyl Cysteine + Nitroglycerin interaction6-mercaptopurinePurinethol
How 6-mercaptopurine interacts with Liver Support — through 2 ingredients. Tap an ingredient for the detail:
SeleniumImmunosuppressants Moderate
Interaction Summary
Theoretically, selenium supplementation may reduce the effectiveness of immunosuppressant therapy.
Read the full Selenium + 6-mercaptopurine interactionGreen Tea Leaf ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use might have additive adverse hepatotoxic effects.
Read the full Green Tea Leaf Extract + 6-mercaptopurine interactionAdo-trastuzumab EmtansineKadcyla
How Ado-trastuzumab Emtansine interacts with Liver Support — through 3 ingredients. Tap an ingredient for the detail:
QuercetinCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, concomitant use might alter the effects and adverse effects of CYP3A4 substrates.
Read the full Quercetin + Ado-trastuzumab Emtansine interactionGreen Tea Leaf ExtractCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Green tea is unlikely to produce clinically significant changes in the levels and clinical effects of CYP3A4 substrates.
Read the full Green Tea Leaf Extract + Ado-trastuzumab Emtansine interactionMilk Thistle Seed ExtractCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
It is unclear if milk thistle inhibits CYP3A4; research is conflicting.
Read the full Milk Thistle Seed Extract + Ado-trastuzumab Emtansine interactionAbacavir Sulfate, Dolutegravir, LamivudineTriumeq
How Abacavir Sulfate, Dolutegravir, Lamivudine interacts with Liver Support — through 1 ingredient. Tap an ingredient for the detail:
Green Tea Leaf ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use might have additive adverse hepatotoxic effects.
Read the full Green Tea Leaf Extract + Abacavir Sulfate, Dolutegravir, Lamivudine interactionAbacavir, LamivudineEpzicom
How Abacavir, Lamivudine interacts with Liver Support — through 1 ingredient. Tap an ingredient for the detail:
Green Tea Leaf ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use might have additive adverse hepatotoxic effects.
Read the full Green Tea Leaf Extract + Abacavir, Lamivudine interactionAbametapirXeglyze
How Abametapir interacts with Liver Support — through 1 ingredient. Tap an ingredient for the detail:
Green Tea Leaf ExtractCytochrome P450 1a2 (cyp1a2) Inhibitors Moderate
Interaction Summary
Theoretically, concomitant use might increase the levels and adverse effects of caffeine.
Read the full Green Tea Leaf Extract + Abametapir interactionAbciximabReoPro
How Abciximab interacts with Liver Support — through 4 ingredients. Tap an ingredient for the detail:
SeleniumAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Selenium may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Selenium + Abciximab interactionN-acetyl CysteineAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, N-acetyl cysteine might increase the risk of bleeding when taken with anticoagulant or antiplatelet drugs.
Read the full N-acetyl Cysteine + Abciximab interactionGreen Tea Leaf ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, green tea may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Green Tea Leaf Extract + Abciximab interactionAlpha Lipoic AcidAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, alpha-lipoic acid may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Alpha Lipoic Acid + Abciximab interactionAbemaciclibVerzenio
How Abemaciclib interacts with Liver Support — through 3 ingredients. Tap an ingredient for the detail:
QuercetinCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, concomitant use might alter the effects and adverse effects of CYP3A4 substrates.
Read the full Quercetin + Abemaciclib interactionGreen Tea Leaf ExtractCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Green tea is unlikely to produce clinically significant changes in the levels and clinical effects of CYP3A4 substrates.
Read the full Green Tea Leaf Extract + Abemaciclib interactionMilk Thistle Seed ExtractCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
It is unclear if milk thistle inhibits CYP3A4; research is conflicting.
Read the full Milk Thistle Seed Extract + Abemaciclib interactionAbiraterone
How Abiraterone interacts with Liver Support — through 3 ingredients. Tap an ingredient for the detail:
QuercetinCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, concomitant use might alter the effects and adverse effects of CYP3A4 substrates.
Read the full Quercetin + Abiraterone interactionGreen Tea Leaf ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Hepatotoxic Drugs +1 Moderate
Interaction Summary
Green tea is unlikely to produce clinically significant changes in the levels and clinical effects of CYP3A4 substrates.
Read the full Green Tea Leaf Extract + Abiraterone interactionMilk Thistle Seed ExtractCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
It is unclear if milk thistle inhibits CYP3A4; research is conflicting.
Read the full Milk Thistle Seed Extract + Abiraterone interactionAbiraterone AcetateYonsa, Zytiga
How Abiraterone Acetate interacts with Liver Support — through 3 ingredients. Tap an ingredient for the detail:
Green Tea Leaf ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Hepatotoxic Drugs Moderate
Interaction Summary
Green tea is unlikely to produce clinically significant changes in the levels and clinical effects of CYP3A4 substrates.
Read the full Green Tea Leaf Extract + Abiraterone Acetate interactionQuercetinCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, concomitant use might alter the effects and adverse effects of CYP3A4 substrates.
Read the full Quercetin + Abiraterone Acetate interactionMilk Thistle Seed ExtractCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
It is unclear if milk thistle inhibits CYP3A4; research is conflicting.
Read the full Milk Thistle Seed Extract + Abiraterone Acetate interactionAbrocitinibCibinqo
How Abrocitinib interacts with Liver Support — through 7 ingredients. Tap an ingredient for the detail:
Alpha Lipoic AcidAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, alpha-lipoic acid may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Alpha Lipoic Acid + Abrocitinib interactionArtichoke Leaf ExtractCytochrome P450 2c19 (cyp2c19) Substrates Moderate
Interaction Summary
Theoretically, artichoke might increase serum levels of drugs metabolized by CYP2C19.
Read the full Artichoke Leaf Extract + Abrocitinib interactionGreen Tea Leaf ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, green tea may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Green Tea Leaf Extract + Abrocitinib interactionSeleniumAnticoagulant/antiplatelet Drugs, Immunosuppressants Moderate
Interaction Summary
Selenium may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Selenium + Abrocitinib interactionN-acetyl CysteineAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, N-acetyl cysteine might increase the risk of bleeding when taken with anticoagulant or antiplatelet drugs.
Read the full N-acetyl Cysteine + Abrocitinib interactionQuercetinCytochrome P450 2c9 (cyp2c9) Substrates Moderate
Interaction Summary
Theoretically, concomitant use might increase the levels and adverse effects of CYP2C9 substrates.
Read the full Quercetin + Abrocitinib interactionMilk Thistle Seed ExtractCytochrome P450 2c9 (cyp2c9) Substrates Minor
Interaction Summary
It is unclear if milk thistle inhibits CYP2C9; research is conflicting.
Read the full Milk Thistle Seed Extract + Abrocitinib interactionAcalabrutinibCalquence
How Acalabrutinib interacts with Liver Support — through 3 ingredients. Tap an ingredient for the detail:
QuercetinP-glycoprotein Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, concomitant use might alter the effects and adverse effects of P-glycoprotein substrates.
Read the full Quercetin + Acalabrutinib interactionGreen Tea Leaf ExtractCytochrome P450 3a4 (cyp3a4) Substrates, P-glycoprotein Substrates Moderate
Interaction Summary
Green tea is unlikely to produce clinically significant changes in the levels and clinical effects of CYP3A4 substrates.
Read the full Green Tea Leaf Extract + Acalabrutinib interactionMilk Thistle Seed ExtractCytochrome P450 3a4 (cyp3a4) Substrates, P-glycoprotein Substrates Minor
Interaction Summary
It is unclear if milk thistle inhibits CYP3A4; research is conflicting.
Read the full Milk Thistle Seed Extract + Acalabrutinib interactionAcarboseGlucobay, Prandase, Precose
How Acarbose interacts with Liver Support — through 5 ingredients. Tap an ingredient for the detail:
Milk Thistle Seed ExtractAntidiabetes Drugs Moderate
Interaction Summary
Taking milk thistle with antidiabetes drugs may increase the risk of hypoglycemia.
Read the full Milk Thistle Seed Extract + Acarbose interactionQuercetinAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, concomitant use of quercetin and antidiabetes drugs might increase the risk of hypoglycemia.
Read the full Quercetin + Acarbose interactionArtichoke Leaf ExtractAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, artichoke leaf extract may increase the risk of hypoglycemia when taken with antidiabetes drugs.
Read the full Artichoke Leaf Extract + Acarbose interactionGreen Tea Leaf ExtractHepatotoxic Drugs, Antidiabetes Drugs Moderate
Interaction Summary
Theoretically, concomitant use might have additive adverse hepatotoxic effects.
Read the full Green Tea Leaf Extract + Acarbose interactionAlpha Lipoic AcidAntidiabetes Drugs Minor
Interaction Summary
Theoretically, taking alpha-lipoic acid with antidiabetes drugs might increase the risk of hypoglycemia.
Read the full Alpha Lipoic Acid + Acarbose interactionAcebutololRhotral, Sectral
How Acebutolol interacts with Liver Support — through 5 ingredients. Tap an ingredient for the detail:
L-taurineAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, taurine might increase the risk of hypotension when taken with antihypertensive drugs.
Read the full L-taurine + Acebutolol interactionN-acetyl CysteineAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, N-acetyl cysteine might increase the risk of hypotension when taken with antihypertensive drugs.
Read the full N-acetyl Cysteine + Acebutolol interactionQuercetinAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, taking quercetin with antihypertensive drugs might increase the risk of hypotension.
Read the full Quercetin + Acebutolol interactionGreen Tea Leaf ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use might have additive adverse hepatotoxic effects.
Read the full Green Tea Leaf Extract + Acebutolol interactionArtichoke Leaf ExtractAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, artichoke leaf extract may increase the risk of hypotension when taken with antihypertensive drugs.
Read the full Artichoke Leaf Extract + Acebutolol interactionAcenocoumarolSintrom
How Acenocoumarol interacts with Liver Support — through 4 ingredients. Tap an ingredient for the detail:
Alpha Lipoic AcidAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, alpha-lipoic acid may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Alpha Lipoic Acid + Acenocoumarol interactionGreen Tea Leaf ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, green tea may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Green Tea Leaf Extract + Acenocoumarol interactionN-acetyl CysteineAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, N-acetyl cysteine might increase the risk of bleeding when taken with anticoagulant or antiplatelet drugs.
Read the full N-acetyl Cysteine + Acenocoumarol interactionSeleniumAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Selenium may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Selenium + Acenocoumarol interactionAcetaminophenChildren's Tylenol, Children's Tylenol Meltaways, Tylenol, Tylenol Ex Strength
How Acetaminophen interacts with Liver Support — through 3 ingredients. Tap an ingredient for the detail:
Green Tea Leaf ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use might have additive adverse hepatotoxic effects.
Read the full Green Tea Leaf Extract + Acetaminophen interactionMilk Thistle Seed ExtractGlucuronidated Drugs Moderate
Interaction Summary
Theoretically, milk thistle might affect the clearance of drugs that undergo glucuronidation.
Read the full Milk Thistle Seed Extract + Acetaminophen interactionVitamin CAcetaminophen (tylenol, Others) Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C + Acetaminophen interactionAcetaminophen, AspirinGemnisyn
How Acetaminophen, Aspirin interacts with Liver Support — through 7 ingredients. Tap an ingredient for the detail:
Milk Thistle Seed ExtractGlucuronidated Drugs Moderate
Interaction Summary
Theoretically, milk thistle might affect the clearance of drugs that undergo glucuronidation.
Read the full Milk Thistle Seed Extract + Acetaminophen, Aspirin interactionQuercetinOrganic Anion Transporter 3 (oat3) Substrates, Organic Anion Transporter 1 (oat1) Substrates Moderate
Interaction Summary
Theoretically, concomitant use might increase the effects and adverse effects of OAT3 substrates.
Read the full Quercetin + Acetaminophen, Aspirin interactionN-acetyl CysteineAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, N-acetyl cysteine might increase the risk of bleeding when taken with anticoagulant or antiplatelet drugs.
Read the full N-acetyl Cysteine + Acetaminophen, Aspirin interactionGreen Tea Leaf ExtractAnticoagulant/antiplatelet Drugs, Hepatotoxic Drugs Moderate
Interaction Summary
Theoretically, green tea may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Green Tea Leaf Extract + Acetaminophen, Aspirin interactionSeleniumAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Selenium may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Selenium + Acetaminophen, Aspirin interactionAlpha Lipoic AcidAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, alpha-lipoic acid may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Alpha Lipoic Acid + Acetaminophen, Aspirin interactionVitamin CAcetaminophen (tylenol, Others), Aspirin Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C + Acetaminophen, Aspirin interactionEach ingredient & the kinds of drugs it affects
For each ingredient in Liver Support 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.
Green Tea Leaf Extract
Atorvastatin (Lipitor)
Green tea extract seems to reduce the levels and clinical effects of atorvastatin.
In healthy humans, taking green tea extract 300 mg or 600 mg along with atorvastatin reduces plasma levels of atorvastatin by approximately 24%. The elimination of atorvastatin is not affected. Atorvastatin is a substrate of organic anion-transporting polypeptides (OATPs). Research shows that two of the major catechins found in green tea, epicatechin gallate (ECG) and epigallocatechin gallate (EGCG), inhibit OATPs. Some OATPs are expressed in the small intestine and are responsible for the uptake of drugs and other compounds, which may have resulted in reduced plasma levels of atorvastatin. It is not clear if drinking green tea alters the absorption of atorvastatin.
Ephedrine
Theoretically, concomitant use might increase the risk for stimulant adverse effects.
Green tea contains caffeine. There is evidence that using ephedrine with caffeine might increase the risk of serious life-threatening or debilitating adverse effects such as hypertension, myocardial infarction, stroke, seizures, and death.
Nadolol (Corgard)
Green tea seems to reduce the levels and clinical effects of nadolol.
Preliminary clinical research shows that green tea consumption reduces plasma concentrations of nadolol. Compared to a control group, both peak levels and total drug exposure (AUC) of nadolol were reduced by approximately 85% in subjects who drank green tea daily for two weeks. Drinking green tea with nadolol also significantly reduced nadolol's systolic blood pressure lowering effect. Other clinical research shows that a single dose of green tea can affect plasma nadolol levels for at least one hour. Green tea catechins have been shown to inhibit organic anion transporting polypeptides (OATP), one of which, OATP1A2, is involved in the uptake of nadolol in the intestine The interaction is thought to be due primarily to the epigallocatechin gallate (EGCG) content of green tea.
5-Fluorouracil
Theoretically, high doses of green tea might increase the effects and side effects of 5-fluorouracil.
Animal research shows that taking green tea in amounts equivalent to about 6 cups daily in humans for 4 weeks prior to receiving a single injection of 5-fluorouracil increases the maximum plasma levels of 5-fluorouracil by about 2.5-fold and the area under the curve by 425%.
Adenosine (Adenocard)
Theoretically, green tea might decrease the vasodilatory effects of adenosine and interfere with its use prior to stress testing.
Green tea contains caffeine. Caffeine is a competitive inhibitor of adenosine at the cellular level. However, caffeine doesn't seem to affect supplemental adenosine because high interstitial levels of adenosine overcome the antagonistic effects of caffeine. It is recommended that methylxanthines and methylxanthine-containing products be stopped 24 hours prior to pharmacological stress tests. However, methylxanthines appear more likely to interfere with dipyridamole (Persantine) than adenosine-induced stress testing.
Anticoagulant/Antiplatelet Drugs
Theoretically, green tea may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Conflicting reports exist regarding the effect of green tea on bleeding risk when used with anticoagulant or antiplatelet drugs; however, most evidence suggests that drinking green tea in moderate amounts is unlikely to cause a significant interaction. Green tea contains small amounts of vitamin K, approximately 7 mcg per cup. Some case reports have associated the antagonism of warfarin with the vitamin K content of green tea. However, these reports are rare, and very large doses of green tea (about 8-16 cups daily) appear to be needed to cause these effects. Furthermore, the catechins and caffeine in green tea are reported to have antiplatelet activity.
Beta-Adrenergic Agonists
Green tea contains caffeine. Theoretically, concomitant use of large amounts of caffeine might increase cardiac inotropic effects of beta-agonists.
Bortezomib (Velcade)
Theoretically, green tea might interfere with the effects of bortezomib.
In vitro research shows that green tea polyphenols, such as epigallocatechin gallate (EGCG), interact with bortezomib and block its proteasome inhibitory action. This prevents the induction of cell death in multiple myeloma or glioblastoma cancer cell lines. Advise patients taking bortezomib, not to take green tea.
Carbamazepine (Tegretol)
Theoretically, green tea might reduce the effects of carbamazepine and increase the risk for convulsions.
Green tea contains caffeine. Animal research suggests that taking caffeine can lower the anticonvulsant effects of carbamazepine and can induce seizures when taken in doses above 400 mg/kg. Human research has shown that taking caffeine 300 mg in three divided doses along with carbamazepine 200 mg reduces the bioavailability of carbamazepine by 32% and prolongs the plasma half-life of carbamazepine 2-fold in healthy individuals.
Celiprolol (Celicard)
Theoretically, green tea might reduce the levels and clinical effects of celiprolol.
In a small human study, taking green tea daily for 4 days appears to decrease blood and urine levels of celiprolol by at least 98%. This interaction is possibly due to the inhibition of organic anion transporting polypeptide (OATP). Green tea catechins have been shown to inhibit organic anion transporting polypeptides (OATP), one of which, OATP1A2, is found in the intestine The interaction is thought to be due primarily to the epigallocatechin gallate (EGCG) content of green tea.
Cimetidine (Tagamet)
Theoretically, concomitant use might increase the effects and adverse effects of caffeine in green tea.
Green tea contains caffeine. Cimetidine can reduce caffeine clearance by 31% to 42%.
Clozapine (Clozaril)
Theoretically, green tea might increase the levels and adverse effects of clozapine and acutely exacerbate psychotic symptoms.
Animal research suggests that, although green tea extract does not affect the elimination of clozapine, it delays the time to reach peak concentration and reduces the peak plasma levels. Also, concomitant administration of green tea and clozapine might theoretically cause acute exacerbation of psychotic symptoms due to the caffeine in green tea. Caffeine can increase the effects and toxicity of clozapine. Caffeine doses of 400-1000 mg daily inhibit clozapine metabolism. Clozapine is metabolized by cytochrome P450 1A2 (CYP1A2). Researchers speculate that caffeine might inhibit CYP1A2. However, there is no reliable evidence that caffeine affects CYP1A2. There is also speculation that genetic factors might make some patients be more sensitive to the interaction between clozapine and caffeine.
Contraceptive Drugs
Theoretically, concomitant use might increase the effects and adverse effects of caffeine found in green tea.
Green tea contains caffeine. Oral contraceptives can decrease caffeine clearance by 40% to 65%.
Cytochrome P450 1A2 (Cyp1A2) Inhibitors
Theoretically, concomitant use might increase the levels and adverse effects of caffeine.
Green tea contains caffeine. Caffeine is metabolized by cytochrome P450 1A2 (CYP1A2),. Theoretically, drugs that inhibit CYP1A2 may decrease the clearance rate of caffeine from green tea and increase caffeine levels.
Dipyridamole (Persantine)
Theoretically, green tea might decrease the vasodilatory effects of dipyridamole and interfere with its use prior to stress testing.
Green tea contains caffeine. Caffeine might inhibit dipyridamole-induced vasodilation. It is recommended that methylxanthines and methylxanthine-containing products be stopped 24 hours prior to pharmacological stress tests. Methylxanthines appear more likely to interfere with dipyridamole (Persantine) than adenosine-induced stress testing.
Disulfiram (Antabuse)
Theoretically, disulfiram might increase the risk of adverse effects from caffeine.
In human research, disulfiram decreases the clearance and increases the half-life of caffeine.
Diuretic Drugs
Theoretically, using green tea with diuretic drugs might increase the risk of hypokalemia.
Green tea contains caffeine. In excessive amounts, caffeine can reduce potassium levels due to stimulation of the sodium-potassium pump. Diuretics can also cause lower potassium levels.
Estrogens
Theoretically, estrogens might increase the levels and adverse effects of caffeine.
Green tea contains caffeine. Estrogen inhibits caffeine metabolism.
Ethosuximide (Zarontin)
Theoretically, green tea might reduce the effects of ethosuximide and increase the risk for convulsions.
Green tea contains caffeine. Animal research suggests that caffeine 92.4 mg/kg can decrease the anticonvulsant activity of ethosuximide. However, this effect has not been reported in humans.
Felbamate (Felbatol)
Theoretically, green tea might reduce the effects of felbamate and increase the risk for convulsions.
Green tea contains caffeine. Animal research suggests that a high dose of caffeine 161.7 mg/kg can decreases the anticonvulsant activity of felbamate. However, this effect has not been reported in humans.
Fexofenadine (Allegra)
Green tea can decrease blood levels of fexofenadine.
Clinical research shows that green tea can significantly decrease blood levels and excretion of fexofenadine. Taking green tea extract with a dose of fexofenadine decreased bioavailability of fexofenadine by about 30%. In vitro, green tea inhibits the cellular accumulation of fexofenadine by inhibiting the organic anion transporting polypeptide (OATP) drug transporter. Research shows that two of the major catechins found in green tea, epicatechin gallate (ECG) and epigallocatechin gallate (EGCG), inhibit OATPs, specifically OATP1A2, OATP1B1, and OATP2B1. In addition, green tea has been shown to reduce the absorption of some drugs that are OATP substrates.
Flutamide (Eulexin)
Theoretically, green tea might increase the levels and adverse effects of flutamide.
Green tea contains caffeine. In vitro evidence suggests that caffeine can inhibit the metabolism of flutamide. Theoretically, concomitant use of caffeine and flutamide might increase serum concentrations of flutamide and increase the risk adverse effects.
Fluvoxamine (Luvox)
Theoretically, fluvoxamine might increase the levels and adverse effects of caffeine.
Green tea contains caffeine. Fluvoxamine reduces caffeine metabolism.
Hepatotoxic Drugs
Theoretically, concomitant use might have additive adverse hepatotoxic effects.
Green tea extract supplements have been linked to several cases of hepatotoxicity and might have additive hepatotoxic effects with other drugs..
Imatinib (Gleevec)
Theoretically, green tea might reduce the levels and clinical effects of imatinib.
In animal research, a single dose of green tea extract reduces the area under the curve (AUC) of imatinib by up to approximately 64% and its main metabolite N-desmethyl imatinib by up to approximately 81%. This interaction has not been shown in humans. The mechanism of action is unclear but may involve multiple pathways.
Quercetin
Antidiabetes Drugs
Theoretically, concomitant use of quercetin and antidiabetes drugs might increase the risk of hypoglycemia.
Clinical research suggests that a combination of quercetin, myricetin, and chlorogenic acid reduce levels of fasting glucose in patients with type 2 diabetes, including those already taking antidiabetes agents. The effect of quercetin alone is unknown.
Antihypertensive Drugs
Theoretically, taking quercetin with antihypertensive drugs might increase the risk of hypotension.
Quercetin can modestly decrease blood pressure in people with mild hypertension. Theoretically, it might have additive blood pressure lowering effects when used with antihypertensive drugs.
Cyclosporine (Neoral, Sandimmune)
Theoretically, concomitant use might increase the levels and adverse effects of cyclosporine.
A small study in healthy volunteers shows that pretreatment with quercetin increases plasma levels and prolongs the half-life of a single dose of cyclosporine, possibly due to inhibition of p-glycoprotein or cytochrome P450 3A4 (CYP3A4), which metabolizes cyclosporin.
Cytochrome P450 2C8 (Cyp2C8) Substrates
Theoretically, concomitant use might increase the levels and adverse effects of CYP2C8 substrates.
In vitro research shows that quercetin inhibits CYP2C8. Inhibition of paclitaxel (Taxol) metabolism via CYP2C8 has been reported in vitro. However, a small study in humans found no effect of quercetin on rosiglitazone (Avandia), which is also a CYP2C8 substrate.
Cytochrome P450 2C9 (Cyp2C9) Substrates
Theoretically, concomitant use might increase the levels and adverse effects of CYP2C9 substrates.
A small clinical study in healthy volunteers shows that taking quercetin 500 mg twice daily for 10 days prior to taking diclofenac, a CYP2C9 substrate, increases diclofenac plasma levels by 75% and prolongs the half-life by 32.5%. Animal research also shows that pretreatment with quercetin increases plasma levels and prolongs the half-life of losartan (Cozaar), a substrate of CYP2C9. Furthermore, laboratory research shows that quercetin inhibits CYP2C9.
Cytochrome P450 2D6 (Cyp2D6) Substrates
Theoretically, concomitant use might increase the levels and adverse effects of CYP2D6 substrates.
In vitro research show that quercetin inhibits CYP2D6. This effect has not been reported in humans.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, concomitant use might alter the effects and adverse effects of CYP3A4 substrates.
A small clinical study in healthy volunteers shows that pretreatment with quercetin increases plasma levels and prolongs the half-life of a single dose of cyclosporine (Neoral, Sandimmune), a substrate of CYP3A4. Animal research also shows that pretreatment with quercetin increases plasma levels and prolongs the half-life of losartan (Cozaar) and quetiapine (Seroquel), substrates of CYP3A4. Other laboratory research also shows that quercetin inhibits CYP3A4. However, one clinical study shows that quercetin can increase the metabolism of midazolam, a substrate of CYP3A4, and decrease serum concentrations of midazolam by about 24% in some healthy individuals, suggesting possible induction of CYP3A4.
Diclofenac (Voltaren, Others)
Theoretically, concomitant use might increase the levels and adverse effects of diclofenac.
A small clinical study in healthy volunteers shows that taking quercetin 500 mg twice daily for 10 days prior to taking diclofenac increases diclofenac plasma levels by 75% and prolongs the half-life by 32.5%. This is thought to be due to inhibition of CYP2C9 by quercetin.
Losartan (Cozaar)
Theoretically, concomitant use might increase the effects and adverse effects of losartan and decrease the effects of its active metabolite.
Animal research shows that pretreatment with quercetin increases plasma levels and prolongs the half-life of losartan (Cozaar) while decreasing plasma levels of losartan's active metabolite. This metabolite, which is around 10-fold more potent than losartan, is the result of cytochrome P450 (CYP) 2C9- and CYP3A4-mediated transformation of losartan. Additionally, in vitro research shows that quercetin may inhibit P-glycoprotein-mediated efflux of losartan from the intestines, resulting in increased absorption of losartan. These results suggest that concomitant use of quercetin and losartan might increase systemic exposure to losartan while also decreasing plasma concentrations of losartan's active and more potent metabolite.
Midazolam (Versed)
Theoretically, concomitant use might decrease the levels and effects of midazolam.
A small clinical study in healthy volunteers shows that quercetin can increase the metabolism of midazolam, with a decrease in AUC of about 24%.
Mitoxantrone
Theoretically, quercetin might increase the effects and adverse effects of mitoxantrone.
In vitro research shows that quercetin increases the intracellular accumulation and cytotoxicity of mitoxantrone, possibly through inhibition of breast cancer resistance protein (BCRP), of which mitoxantrone is a substrate. So far, this interaction has not been reported in humans.
Organic Anion Transporter 1 (Oat1) Substrates
Theoretically, concomitant use might increase the effects and adverse effects of OAT1 substrates.
In vitro research shows that quercetin is a strong non-competitive inhibitor of OAT1, with half-maximal inhibitory concentration (IC50) values less than 10 mcM. So far, this interaction has not been reported in humans.
Organic Anion Transporter 3 (Oat3) Substrates
Theoretically, concomitant use might increase the effects and adverse effects of OAT3 substrates.
In vitro research shows that quercetin is a strong non-competitive inhibitor of OAT3, with half-maximal inhibitory concentration (IC50) values as low as 0.75 mcM. So far, this interaction has not been reported in humans.
Organic Anion-Transporting Polypeptide Substrates (Oatp)
Theoretically, concomitant use might increase the effects and adverse effects of OATP substrates.
In vitro evidence shows that quercetin can inhibit organic anion-transporting peptide (OATP) 1B1-mediated uptake of estrone-3-sulfate and pravastatin. Furthermore, clinical research in healthy males shows that intake of quercetin along with pravastatin increases the AUC of pravastatin by 24%, prolongs its half-life by 14%, and decreases its apparent clearance by 18%, suggesting that quercetin modestly inhibits the uptake of pravastatin in hepatic cells.
P-Glycoprotein Substrates
Theoretically, concomitant use might alter the effects and adverse effects of P-glycoprotein substrates.
There is preliminary evidence that quercetin inhibits the gastrointestinal P-glycoprotein efflux pump, which might increase the bioavailability and serum levels of drugs transported by the pump. A small study in healthy volunteers reported that pretreatment with quercetin increased bioavailability and plasma levels after a single dose of cyclosporine (Neoral, Sandimmune). Also, two small studies have shown that quercetin might decrease the absorption of talinolol, a substrate transported by the gastrointestinal P-glycoprotein efflux pump. However, in another small study, several days of quercetin treatment did not significantly affect the pharmacokinetics of saquinavir (Invirase). The reason for these discrepancies is not entirely clear. Until more is known, use quercetin cautiously in combination with P-glycoprotein substrates.
Pravastatin (Pravachol)
Theoretically, concomitant use might increase the effects and adverse effects of pravastatin.
In vitro evidence shows that quercetin can inhibit OATP 1B1-mediated uptake of pravastatin. Also, preliminary clinical research in healthy males shows that intake of quercetin along with pravastatin increases the maximum concentration of pravastatin by 24%, prolongs its half-life by 14%, and decreases its apparent clearance by 18%, suggesting that quercetin modestly inhibits the uptake of pravastatin in hepatic cells.
Prazosin (Minipress)
Theoretically, quercetin might increase the effects and adverse effects of prazosin.
In vitro research shows that quercetin inhibits the transcellular efflux of prazosin, possibly through inhibition of breast cancer resistance protein (BCRP), of which prazosin is a substrate. BCRP is an ATP-binding cassette efflux transporter in the intestines, kidneys, and liver. So far, this interaction has not been reported in humans.
Quetiapine (Seroquel)
Theoretically, concomitant use might increase the effects and adverse effects of quetiapine.
Animal research shows that pretreatment with quercetin can increase plasma levels of quetiapine and prolong its clearance, possibly due to inhibition of cytochrome P450 3A4 (CYP3A4) by quercetin. Additionally, the brain-to-plasma ratio of quetiapine concentrations increased, possibly due to inhibition of P-glycoprotein at the blood-brain barrier. This interaction has not been reported in humans.
Quinolone Antibiotics
Theoretically, concomitant use might inhibit the effects of quinolone antibiotics.
In vitro, quercetin binds to the DNA gyrase site on bacteria, which may interfere with the activity of quinolone antibiotics.
Sulfasalazine (Azulfidine)
Theoretically, quercetin might increase the effects and adverse effects of sulfasalazine.
Animal research shows that quercetin increases the maximum serum concentration (Cmax) and area under the curve (AUC) of sulfasalazine, possibly through inhibition of breast cancer resistance protein (BCRP), of which sulfasalazine is a substrate. So far, this interaction has not been reported in humans.
Warfarin (Coumadin)
Theoretically, quercetin may increase the risk of bleeding if used with warfarin.
Animal and in vitro studies show that quercetin might increase serum levels of warfarin. Quercetin and warfarin have the same human serum albumin (HSA) binding site, and in vitro research shows that quercetin has stronger affinity for the HSA binding site and can theoretically displace warfarin, causing higher serum levels of warfarin. Animal research shows that taking quercetin for 2 weeks before initiating warfarin increases the maximum serum level of warfarin by 30%, the half-life by 10%, and the overall exposure by 63% when compared with control. Concomitant administration of quercetin and warfarin, without quercetin pre-treatment, also increased these measures, but to a lesser degree. Researchers theorize that inhibition of CYP3A4 by quercetin may explain these effects. So far, this interaction has not been reported in humans.
Milk Thistle seed extract
Antidiabetes Drugs
Taking milk thistle with antidiabetes drugs may increase the risk of hypoglycemia.
Clinical research shows that milk thistle extract, alone or along with tree turmeric extract, can lower blood glucose levels and glycated hemoglobin (HbA1c) in patients with type 2 diabetes, including those already taking antidiabetes drugs. Additionally, animal research shows that milk thistle extract increases the metformin maximum plasma concentration and area under the curve and decreases the renal clearance of metformin, due to inhibition of the multi-drug and toxin extrusion protein 1 (MATE1) renal tubular transport protein.
Cytochrome P450 2B6 (Cyp2B6) Substrates
Theoretically, milk thistle might inhibit CYP2B6.
An in vitro study shows that silybin, a constituent of milk thistle, binds to and noncompetitively inhibits CYP2B6. Additionally, silybin might downregulate the expression of CYP2B6 by decreasing mRNA and protein levels.
Glucuronidated Drugs
Theoretically, milk thistle might affect the clearance of drugs that undergo glucuronidation.
Laboratory research shows that milk thistle constituents inhibit uridine diphosphoglucuronosyl transferase (UGT), the major phase 2 enzyme that is responsible for glucuronidation. Theoretically, this could decrease the clearance and increase levels of glucuronidated drugs. Other laboratory research suggests that a milk thistle extract of silymarin might inhibit beta-glucuronidase, although the significance of this effect is unclear.
Ledipasvir
Theoretically, milk thistle might increase the levels and clinical effects of ledipasvir.
Animal research in rats shows that milk thistle increases the area under the curve (AUC) for ledipasvir and slows its elimination.
Morphine
Theoretically, concomitant use of milk thistle with morphine might affect serum levels of morphine and either increase or decrease its effects.
Animal research shows that milk thistle reduces serum levels of morphine by up to 66%. In contrast, laboratory research shows that milk thistle constituents inhibit uridine diphosphoglucuronosyl transferase (UGT), the major phase 2 enzyme that is responsible for glucuronidation. Theoretically, this could decrease the clearance and increase morphine levels. The effect of taking milk thistle on morphine metabolism in humans is not known.
Raloxifene (Evista)
Theoretically, milk thistle might decrease the clearance and increase levels of raloxifene.
Laboratory research suggests that the milk thistle constituents silibinin and silymarin inhibit the glucuronidation of raloxifene in the intestines.
Sirolimus (Rapamune)
Milk thistle might decrease the clearance of sirolimus.
Pharmacokinetic research shows that a milk thistle extract of silymarin decreases the apparent clearance of sirolimus in hepatically impaired renal transplant patients. It is unclear if this interaction occurs in patients without hepatic impairment.
Sofosbuvir (Solvaldi)
Theoretically, milk thistle might decrease the levels and clinical effects of sofosbuvir.
Animal research in rats shows that milk thistle reduces the metabolism of sofosbuvir, as well as the hepatic uptake of its active metabolite.
Tamoxifen (Nolvadex)
Theoretically, the milk thistle constituent silibinin might increase tamoxifen levels and interfere with its conversion to an active metabolite.
Animal research suggests that the milk thistle constituent silibinin might increase plasma levels of tamoxifen and alter its conversion to an active metabolite. The mechanism appears to involve inhibition of pre-systemic metabolism of tamoxifen by cytochrome P450 (CYP) 2C9 and CYP3A4, and inhibition of P-glycoprotein-mediated efflux of tamoxifen into the intestine for excretion. Whether this interaction occurs in humans is not known.
Warfarin (Coumadin)
Theoretically, milk thistle might increase the effects of warfarin.
In one case report, a man stabilized on warfarin experienced an increase in INR from 2.64 to 4.12 after taking a combination product containing milk thistle 200 mg daily, as well as dandelion, wild yam, niacinamide, and vitamin B12. Levels returned to normal after stopping the supplement. Although a direct correlation between milk thistle and the change in INR cannot be confirmed, some in vitro research suggests that milk thistle might inhibit cytochrome P450 2C9 (CYP2C9), an enzyme involved in the metabolism of various drugs, including warfarin.
Cytochrome P450 2C9 (Cyp2C9) Substrates
It is unclear if milk thistle inhibits CYP2C9; research is conflicting.
In vitro research suggests that milk thistle might inhibit CYP2C9. Additionally, 3 case reports from the World Health Organization (WHO) adverse drug reaction database describe increased toxicity in patients taking milk thistle and cancer medications that are CYP2C9 substrates, including imatinib and capecitabine. However, contradictory clinical research shows that milk thistle extract does not inhibit CYP2C9 or significantly affect levels of the CYP2C9 substrate tolbutamide. Differences in results could be due to differences in dosages or formulations utilized.
Cytochrome P450 3A4 (Cyp3A4) Substrates
It is unclear if milk thistle inhibits CYP3A4; research is conflicting.
While laboratory research shows conflicting results, pharmacokinetic research shows that taking milk thistle extract 420-1350 mg daily does not significantly affect the metabolism of the CYP3A4 substrates irinotecan, midazolam, or indinavir. However, 8 case reports from the World Health Organization (WHO) adverse drug reaction database describe increased toxicity in patients taking milk thistle and cancer medications that are CYP3A4 substrates, including gefitinib, sorafenib, doxorubicin, and vincristine.
Estrogens
Theoretically, milk thistle might interfere with estrogen therapy through competition for estrogen receptors.
Animal research suggests that a milk thistle extract of silymarin binds to estrogen receptor beta.
Hmg-Coa Reductase Inhibitors ("Statins")
Theoretically, milk thistle might interfere with statin therapy by decreasing the activity of organic anion transporting polypeptide 1B1 (OATB1B1) and inhibiting breast cancer resistance protein (BCRP).
Preliminary evidence suggests that a milk thistle extract of silymarin can decrease the activity of the OATP1B1, which transports HMG-CoA reductase inhibitors into the liver to their site of action, and animal research shows this increases the maximum plasma concentration of pitavastatin and pravastatin. The silibinin component also inhibits BCRP, which transports statins from the liver into the bile for excretion. However, in a preliminary study in healthy males, silymarin 140 mg three times daily had no effect on the pharmacokinetics of a single 10 mg dose of rosuvastatin.
Indinavir (Crixivan)
Theoretically, milk thistle may induce cytochrome P450 3A4 (CYP3A4) enzymes and increase the metabolism of indinavir; however, results are conflicting.
One pharmacokinetic study shows that taking milk thistle (Standardized Milk Thistle, General Nutrition Corp.) 175 mg three times daily in combination with multiple doses of indinavir 800 mg every 8 hours decreases the mean trough levels of indinavir by 25%. However, results from the same pharmacokinetic study show that milk thistle does not affect the overall exposure to indinavir. Furthermore, two other pharmacokinetic studies show that taking specific milk thistle extract (Legalon, Rottapharm Madaus; Thisilyn, Nature's Way) 160-450 mg every 8 hours in combination with multiple doses of indinavir 800 mg every 8 hours does not reduce levels of indinavir.
Organic Anion-Transporting Polypeptide Substrates (Oatp)
Milk thistle may inhibit one form of OATP, OATP-B1, which could reduce the bioavailability and clinical effects of OATP-B1 substrates.
In vitro research shows that milk thistle inhibits OATP-B1. Two case reports from the World Health Organization (WHO) adverse drug reaction database describe increased toxicity in patients taking milk thistle and cancer medications that are OATP substrates, including sorafenib and methotrexate. OATPs are expressed in the small intestine and liver and are responsible for the uptake of drugs and other compounds into the body. Inhibition of OATP may reduce the bioavailability of oral drugs that are substrates of OATP.
P-Glycoprotein Substrates
Theoretically, milk thistle might increase the absorption of P-glycoprotein substrates. However, this effect does not seem to be clinically significant.
In vitro research shows that milk thistle can inhibit P-glycoprotein activity and 1 case report from the World Health Organization (WHO) adverse drug reaction database describes increased abdominal pain in a patient taking milk thistle and the cancer medication vincristine, a P-glycoprotein substrate, though this patient was also taking methotrexate. However, a small pharmacokinetic study in healthy volunteers shows that taking milk thistle (Enzymatic Therapy Inc.) 900 mg, standardized to 80% silymarin, in 3 divided doses daily for 14 days does not affect absorption of digoxin, a P-glycoprotein substrate.
Artichoke leaf extract
Antidiabetes Drugs
Theoretically, artichoke leaf extract may increase the risk of hypoglycemia when taken with antidiabetes drugs.
A meta-analysis of small clinical studies shows that taking artichoke leaf extract for 8-12 weeks can modestly reduce fasting plasma glucose when compared with placebo.
Antihypertensive Drugs
Theoretically, artichoke leaf extract may increase the risk of hypotension when taken with antihypertensive drugs.
A meta-analysis of small clinical studies in patients with hypertension shows that taking artichoke can reduce systolic blood pressure by around 3 mmHg and diastolic blood pressure by around 2 mmHg when compared with placebo.
Cytochrome P450 2B6 (Cyp2B6) Substrates
Theoretically, artichoke might increase serum levels of drugs metabolized by CYP2B6.
In vitro research shows that artichoke leaf extract inhibits CYP2B6 activity. However, this interaction has not been reported in humans.
Cytochrome P450 2C19 (Cyp2C19) Substrates
Theoretically, artichoke might increase serum levels of drugs metabolized by CYP2C19.
In vitro research shows that artichoke leaf extract inhibits CYP2C19 activity. However, this interaction has not been reported in humans.
Selenium
Anticoagulant/Antiplatelet Drugs
Selenium may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Clinical research suggests that taking selenium 10 mcg/kg/day can increase bleeding times by increasing prostacyclin production, which inhibits platelet activity. Other clinical research suggests that taking selenium 75 mcg daily, in combination with ascorbic acid 600 mg, alpha-tocopherol 300 mg, and beta-carotene 27 mg, reduces platelet aggregation.
Barbiturates
Theoretically, selenium might prolong the sedating effects of barbiturates.
Laboratory research suggests that selenium can inhibit the hepatic metabolism of barbiturates. Selenium seems to prolong the sedative effect of pentobarbital in animal models.
Immunosuppressants
Theoretically, selenium supplementation may reduce the effectiveness of immunosuppressant therapy.
In vitro research and preliminary clinical evidence suggests that selenium may stimulate the immune system.
Warfarin (Coumadin)
Theoretically, selenium might interfere with warfarin activity.
Animal research suggests that selenium can increase warfarin activity. Selenium might interact with warfarin by displacing it from albumin binding sites, reducing its metabolism in the liver, or by decreasing production of vitamin K-dependent clotting factors. Selenium can also prolong bleeding times in humans by increasing prostacyclin production, which inhibits platelet activity.
Contraceptive Drugs
Contraceptive drugs might increase levels of selenium, although the clinical significance of this effect is unclear.
Some research suggests that oral contraceptives increase serum selenium levels in women taking oral contraceptives; however, other research shows no change in selenium levels. It is suggested that an increase could be due to increased carrier proteins, indicating a redistribution of selenium rather than a change in total body selenium.
Niacin
Selenium might reduce the beneficial effects of niacin on high-density lipoprotein (HDL) levels.
A combination of niacin and simvastatin (Zocor) effectively raises HDL cholesterol levels in patients with coronary disease and low HDL levels. Clinical research shows that taking a combination of antioxidants (vitamin C, vitamin E, beta-carotene, and selenium) along with niacin and simvastatin (Zocor) attenuates this rise in HDL, specifically the HDL-2 and apolipoprotein A1 fractions, by more than 50% in patients with coronary disease. It is not known whether this adverse effect is due to a single antioxidant such as selenium, or to the combination. It also is not known whether it will occur in other patient populations.
N-Acetyl Cysteine
Nitroglycerin
N-acetyl cysteine can increase the risk for hypotension and headaches when taken with intravenous or transdermal nitroglycerin.
Clinical research shows that concomitant administration of N-acetyl cysteine and intravenous or transdermal nitroglycerin can cause severe hypotension and intolerable headaches. Furthermore, in vitro research suggests that N-acetyl cysteine increases the anticoagulant activity of nitroglycerin.
Activated Charcoal
N-acetyl cysteine might reduce the effects of activated charcoal, while activated charcoal might reduce the absorption of N-acetyl cysteine.
N-acetyl cysteine appears to reduce the capacity of activated charcoal to adsorb acetaminophen and salicylic acid. Conversely, although clinical research suggests that although activated charcoal can reduce the absorption of N-acetyl cysteine by up to 40%, it does not seem to reduce its clinical effects. Other clinical evidence suggests that activated charcoal does not affect the absorption of N-acetyl cysteine.
Anticoagulant/Antiplatelet Drugs
Theoretically, N-acetyl cysteine might increase the risk of bleeding when taken with anticoagulant or antiplatelet drugs.
Clinical research suggests that intravenous N-acetyl cysteine decreases prothrombin time, prolongs coagulation time, decreases platelet aggregation, and increases blood loss in surgical patients. Furthermore, in vitro research suggests that N-acetyl cysteine increases the anticoagulant activity of nitroglycerin.
Antihypertensive Drugs
Theoretically, N-acetyl cysteine might increase the risk of hypotension when taken with antihypertensive drugs.
Animal research suggests that N-acetyl cysteine potentiates the hypotensive effects of the angiotensin-converting enzyme inhibitors (ACEIs) captopril and enalaprilat. Theoretically, combining N-acetyl cysteine with other antihypertensive drugs might increase the risk of hypotension.
Chloroquine (Aralen)
Theoretically, N-acetyl cysteine might interfere with the antimalarial effects of chloroquine.
Animal research suggests that N-acetyl cysteine might reduce the antimalarial effects of chloroquine by increasing cellular levels of glutathione.
Alpha Lipoic Acid
Alkylating Agents
Theoretically, the antioxidant effects of alpha-lipoic acid might alter the effectiveness of alkylating agents.
The use of antioxidants like alpha-lipoic acid during chemotherapy is controversial. There are concerns that antioxidants could reduce the activity of chemotherapy drugs that generate free radicals. However, some researchers theorize that antioxidants might make chemotherapy more effective by reducing oxidative stress that might interfere with apoptosis (cell death) of cancer cells. More evidence is needed to determine what effect, if any, antioxidants such as alpha-lipoic acid have on chemotherapy. Advise patients to consult their oncologist before using alpha-lipoic acid.
Anticoagulant/Antiplatelet Drugs
Theoretically, alpha-lipoic acid may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
In vitro, alpha-lipoic acid inhibits platelet aggregation.
Antitumor Antibiotics
Theoretically, the antioxidant effects of alpha-lipoic acid might alter the effectiveness of antitumor antibiotics.
The use of antioxidants like alpha-lipoic acid during chemotherapy is controversial. There are concerns that antioxidants could reduce the activity of antitumor antibiotic drugs, which work by generating free radicals. However, some researchers theorize that antioxidants might make chemotherapy more effective by reducing oxidative stress that might interfere with apoptosis (cell death) of cancer cells. More evidence is needed to determine what effect, if any, antioxidants such as alpha-lipoic acid have on chemotherapy involving antitumor antibiotics. Advise patients to consult their oncologist before using alpha-lipoic acid.
Thyroid Hormone
Theoretically, alpha-lipoic acid might decrease the effects of thyroid hormone drugs.
Animal research suggests that co-administration of thyroxine with alpha-lipoic acid reduces conversion into the active T3 form.
Antidiabetes Drugs
Theoretically, taking alpha-lipoic acid with antidiabetes drugs might increase the risk of hypoglycemia.
Although some small clinical studies have suggested that alpha-lipoic acid can lower blood glucose levels, larger clinical studies in patients with diabetes have shown no clinically meaningful effect. Additionally, co-administration of single doses of alpha-lipoic acid and glyburide or acarbose did not cause detectable drug interactions in healthy volunteers.
Vitamin C
Alkylating Agents
Theoretically, antioxidant effects of vitamin C might reduce the effectiveness of alkylating agents.
The use of antioxidants like vitamin C during chemotherapy is controversial. There is concern that antioxidants could reduce the activity of chemotherapy drugs that generate free radicals, such as cyclophosphamide, chlorambucil, carmustine, busulfan, and thiotepa. In contrast, some researchers theorize that antioxidants might make chemotherapy more effective by reducing oxidative stress that could interfere with apoptosis (cell death) of cancer cells. More evidence is needed to determine what effect, if any, antioxidants such as vitamin C have on chemotherapy.
Aluminum
Vitamin C can increase the amount of aluminum absorbed from aluminum compounds.
Research in animals and humans shows that vitamin C increases aluminum absorption, theoretically by chelating aluminum and keeping it in solution where it is available for absorption. In people with normal renal function, urinary excretion of aluminum will likely increase, making aluminum retention and toxicity unlikely. Patients with renal failure who take aluminum-containing compounds such as phosphate binders should avoid vitamin C supplements in doses above the recommended dietary allowances.
Antitumor Antibiotics
Theoretically, the antioxidant effects of vitamin C might reduce the effectiveness of antitumor antibiotics.
The use of antioxidants like vitamin C during chemotherapy is controversial. There is concern that antioxidants could reduce the activity of chemotherapy drugs which generate free radicals, such as doxorubicin. In contrast, some researchers theorize that antioxidants might make chemotherapy more effective by reducing oxidative stress that could interfere with apoptosis (cell death) of cancer cells. More evidence is needed to determine what effects, if any, antioxidants such as vitamin C have on chemotherapy.
Estrogens
Vitamin C might increase blood levels of estrogens.
Increases in plasma estrogen levels of up to 55% occur under some circumstances when vitamin C is taken concurrently with oral contraceptives or hormone replacement therapy, including topical products. It is suggested that vitamin C prevents oxidation of estrogen in the tissues, regenerates oxidized estrogen, and reduces sulfate conjugation of estrogen in the gut wall. When tissue levels of vitamin C are high, these processes are already maximized and supplemental vitamin C does not have any effect on estrogen levels. Increases in plasma estrogen levels may occur when patients who are deficient in vitamin C take supplements. Monitor these patients for estrogen-related side effects.
Fluphenazine (Prolixin)
Theoretically, vitamin C might decrease levels of fluphenazine.
In one patient there was a clinically significant decrease in fluphenazine levels when vitamin C (500 mg twice daily) was started. The mechanism is not known, and there is no further data to confirm this interaction.
Indinavir (Crixivan)
Vitamin C can modestly reduce indinavir levels.
One pharmacokinetic study shows that taking vitamin C 1 gram orally once daily along with indinavir 800 mg orally three times daily reduces the area under the concentration-time curve of indinavir by 14%. The mechanism of this interaction is unknown, but it is unlikely to be clinically significant in most patients. The effect of higher doses of vitamin C on indinavir levels is unknown.
Levothyroxine (Synthroid, Others)
Vitamin C can increase levothyroxine absorption.
Two clinical studies in adults with poorly controlled hypothyroidism show that swallowing levothyroxine with a glass of water containing vitamin C 500-1000 mg in solution reduces thyroid stimulating hormone (TSH) levels and increases thyroxine (T4) levels when compared with taking levothyroxine alone. This suggests that vitamin C increases the oral absorption of levothyroxine, possibly due to a reduction in pH.
Warfarin (Coumadin)
High-dose vitamin C might reduce the levels and effectiveness of warfarin.
Vitamin C in high doses may cause diarrhea and possibly reduce warfarin absorption. There are reports of two people who took up to 16 grams daily of vitamin C and had a reduction in prothrombin time. Lower doses of 5-10 grams daily can also reduce warfarin absorption. In many cases, this does not seem to be clinically significant. However, a case of warfarin resistance has been reported for a patient who took vitamin C 500 mg twice daily. Cessation of vitamin C supplementation resulted in a rapid increase in international normalized ratio (INR). Tell patients taking warfarin to avoid taking vitamin C in excessively high doses (greater than 10 grams daily). Lower doses may be safe, but the anticoagulation activity of warfarin should be monitored. Patients who are stabilized on warfarin while taking vitamin C should avoid adjusting vitamin C dosage to prevent the possibility of warfarin resistance.
Acetaminophen (Tylenol, Others)
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
A small pharmacokinetic study in healthy volunteers shows that taking high-dose vitamin C (3 grams) 1.5 hours after taking acetaminophen 1 gram slightly increases the apparent half-life of acetaminophen from around 2.3 hours to 3.1 hours. Ascorbic acid competitively inhibits sulfate conjugation of acetaminophen. However, to compensate, elimination of acetaminophen glucuronide and unconjugated acetaminophen increases. This effect is not likely to be clinically significant.
Aspirin
Acidification of the urine by vitamin C might increase aspirin levels.
It has been suggested that acidification of the urine by vitamin C could increase reabsorption of salicylates by the renal tubules, and increase plasma salicylate levels. However, short-term use of up to 6 grams daily of vitamin C does not seem to affect urinary pH or salicylate excretion, suggesting this interaction is not clinically significant.
Choline Magnesium Trisalicylate (Trilisate)
Acidification of the urine by vitamin C might increase choline magnesium trisalicylate levels.
It has been suggested that acidification of the urine by vitamin C could increase reabsorption of salicylates by the renal tubules, and increase plasma salicylate levels. However, short-term use of up to 6 grams daily of vitamin C does not seem to affect urinary pH or salicylate excretion, suggesting this interaction probably is not clinically significant.
Niacin
Vitamin C might decrease the beneficial effects of niacin on high-density lipoprotein (HDL) cholesterol levels.
A combination of niacin and simvastatin (Zocor) effectively raises HDL cholesterol levels in patients with coronary disease and low HDL levels. Clinical research shows that taking a combination of antioxidants (vitamin C, vitamin E, beta-carotene, and selenium) along with niacin and simvastatin (Zocor) attenuates this rise in HDL, specifically the HDL-2 and apolipoprotein A1 fractions, by more than 50% in patients with coronary disease. It is not known whether this adverse effect is due to a single antioxidant such as vitamin C, or to the combination. It also is not known whether it will occur in other patient populations.
Salsalate (Disalcid)
Acidification of the urine by vitamin C might increase salsalate levels.
It has been suggested that acidification of the urine by vitamin C could increase reabsorption of salicylates by the renal tubules, and increase plasma salicylate levels. However, short-term use of up to 6 grams/day vitamin C does not seem to affect urinary pH or salicylate excretion, suggesting this interaction probably is not clinically significant.
L-Taurine
Antihypertensive Drugs
Theoretically, taurine might increase the risk of hypotension when taken with antihypertensive drugs.
Some clinical evidence suggests that taurine can reduce both systolic and diastolic blood pressure.
Lithium
Theoretically, taurine might reduce excretion and increase plasma levels of lithium.
Taurine is thought to have diuretic properties, which might reduce the excretion of lithium.
Glycine
Clozapine (Clozaril)
Theoretically, glycine might decrease the effectiveness of clozapine.
One small clinical study in patients with schizophrenia shows that adding glycine to clozapine therapy worsens symptoms of schizophrenia when compared with clozapine alone. The mechanism of this interaction is unclear.
Brand information
Manufacturer and brand details for Liver Support, from the product label.
Renew Life
- Name
- Renew Life Formulas, Inc.
- City
- Palm Harbor
- State
- FL
- ZipCode
- 34683
- Phone Number
- 1-800-830-1800
- Web Address
- www.renewlife.com
Liver Support by Renew Life: Common Questions
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Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
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Label information is sourced from the NIH Dietary Supplement Label Database and reflects the product version on file; always read your actual product label. This page is for education only and is not a substitute for professional medical advice. Confirm with your pharmacist or doctor before combining supplements and medications.
The Full Monographs Behind Liver Support’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Alpha-lipoic Acid
Interacts with 263 drugsAlpha-lipoic acid (ALA) is an antioxidant made naturally by the body and found in small amounts in foods. It is most studied for diabetic nerve pain, where some evidence suggests it may help...
Read the full Alpha-lipoic Acid monograph → Herb & supplement monographVitamin C
Interacts with 207 drugsVitamin C (ascorbic acid) is an essential nutrient your body needs but cannot make, so you must get it from food or supplements. It's important for immune function, collagen, and acts as an...
Read the full Vitamin C monograph → Herb & supplement monographQuercetin
Interacts with 1,169 drugsQuercetin is a plant flavonoid with antioxidant and anti-inflammatory properties found in many common foods and sold as a supplement. While early research is interesting for allergies, blood...
Read the full Quercetin monograph → Herb & supplement monographPhosphatidylcholine
Phosphatidylcholine is a phospholipid that is part of every cell membrane and a source of choline. People take it for liver, brain, and gut health, but solid human evidence is limited for mo...
Read the full Phosphatidylcholine monograph → Herb & supplement monographSelenium
Interacts with 321 drugsSelenium is an essential trace mineral your body needs in small amounts for thyroid function, antioxidant defense, and immune health. Most people who eat a varied diet get enough, and supple...
Read the full Selenium monograph → Herb & supplement monographGreen Tea
Interacts with 1,293 drugsGreen tea is a popular beverage rich in antioxidants called catechins, and drinking it in normal amounts is considered safe for most people. Concentrated green tea extracts are a different s...
Read the full Green Tea monograph → Herb & supplement monographArtichoke
Interacts with 363 drugsArtichoke leaf extract is a generally well-tolerated supplement that may have a mild cholesterol-lowering effect and is often used for indigestion, though the evidence is modest. It is not a...
Read the full Artichoke monograph → Herb & supplement monographGlycine
Interacts with 1 drugGlycine is a non-essential amino acid your body makes on its own and that also appears in protein-rich foods. It is most studied for improving sleep quality, where early research is promisin...
Read the full Glycine monograph → Herb & supplement monographMethionine
Methionine is an essential amino acid that your body needs for protein building and many basic chemical reactions. Most people get enough from a normal diet, and supplements are generally no...
Read the full Methionine monograph → Herb & supplement monographTaurine
Interacts with 173 drugsTaurine is an amino acid your body makes naturally and that you also get from animal foods. It is widely used in energy drinks and sports supplements, and short-term use appears generally sa...
Read the full Taurine monograph → Herb & supplement monographN-acetyl Cysteine (nac)
Interacts with 294 drugsN-acetyl cysteine (NAC) is a supplement form of the amino acid cysteine and a building block for the antioxidant glutathione. It has well-established prescription uses for acetaminophen over...
Read the full N-acetyl Cysteine (nac) monograph → Herb & supplement monographMilk Thistle
Interacts with 954 drugsMilk thistle is a popular herbal supplement most often used for liver health, and its main active component is a group of compounds called silymarin. While it is generally well tolerated, th...
Read the full Milk Thistle monograph →Sources & How We Checked
Liver Support'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 604 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.
Alpha-lipoic Acid 48 references
- Labriola D, Livingston R. Possible interactions between dietary antioxidants and chemotherapy. Oncology 1999;13:1003-8.
- Anon. Alpha-lipoic acid. Altern Med Rev 1998;3:308-10.
- Konrad T, Vicini P, Kusterer K, et al. Alpha-lipoic acid treatment decreases serum lactate and pyruvate concentrations and improves glucose effectiveness in lean and obese patients with Type 2 diabetes. Diabetes Care 1999;22:280-7. PubMed
- Ziegler D, Hanefeld M, Ruhnau KJ, et al. Treatment of symptomatic diabetic peripheral neuropathy with the antioxidant alpha-lipoic acid: A 3-week, multicentre randomized controlled trial (ALADIN Study). Diabetologia 1995;38:1425-33.
- Gleiter CH, Schreeb KH, Freudenthaler S, et al. Lack of interaction between thioctic acid, glibenclamide and acarbose. Br J Clin Pharmacol 1999;48:819-25. PubMed
- Jacob S, Henriksen EJ, Tritschler HJ, et al. Improvement of insulin-stimulated glucose-disposal in type 2 diabetes after repeated parenteral administration of thioctic acid. Exp Clin Endocrinol Diabet 1996;104:284-8. PubMed
- Jacob S, Henriksen EJ, Schiemann AL, et al. Enhancement of glucose disposal in patients with type 2 diabetes by alpha-lipoic acid. Arzneimittelforschung 1995;45:872-4.
- Jacob S, Ruus P, Hermann R, et al. Oral administration of RAC-alpha-lipoic acid modulates insulin sensitivity in patients with type-2 diabetes mellitus: a placebo-controlled, pilot trial. Free Rad Biol Med 1999;27:309-14.
- Segermann J, Hotze A, Ulrich H, Rao GS. Effect of alpha-lipoic acid on the peripheral conversion of thyroxine to triiodothyronine and on serum lipid-, protein- and glucose levels. Arzneimittelforschung 1991;41:1294-8.
- Beitner H. Randomized, placebo controlled, double-blind study on the clinical efficacy of a cream containing 5% alpha-lipoic acid related to photoaging of facial skin. Br J Dermatol 2003;149:841-9.
- Ziegler D, Nowak H, Kempler P, et al. Treatment of symptomatic diabetic polyneuropathy with the antioxidant alpha-lipoic acid: A meta-analysis. Diabet Med 2004;21:114-21.
- Prasad KN. Rationale for using high-dose multiple dietary antioxidants as an adjunct to radiation therapy and chemotherapy. J Nutr 2004;134:3182S-3S. PubMed
- Conklin KA. Cancer chemotherapy and antioxidants. J Nutr 2004;134:3201S-3204S. PubMed
- Vincent HK, Bourguignon CM, Vincent KR, Taylor AG. Effects of alpha-lipoic acid supplementation in peripheral arterial disease: a pilot study. J Alt Complement Med 2007;13:577-84. PubMed
- Furukawa N, Miyamura N, Nishida K, et al. Possible relevance of alpha lipoic acid contained in a health supplement in a case of insulin autoimmune syndrome. Diabetes Res Clin Pract 2007;75:366-7. PubMed
- Ziegler D., Ametov A., Barinov A., Dyck P. J., Gurieva I., Low P. A., Munzel U., Yakhno N., Raz I., Novosadova M., Maus J., Samigullin, R. Oral treatment with alpha-lipoic acid improves symptomatic diabetic polyneuropathy: the SYDNEY 2 trial. Diabetes Car
- Gu X. M., Zhang S. S., Wu J. C., Tang Z. Y., Lu Z. Q., Li H., Liu C., Chen L., Ning, G. [Efficacy and safety of high-dose a-lipoic acid in the treatment of diabetic polyneuropathy]. Zhonghua Yi Xue Za Zhi 2010;90(35):2473-2476.
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See these in context on the N-acetyl Cysteine (nac) monograph →
Milk Thistle 69 references
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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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