Interactions on record — worth a quick check against your medications. Based on 7 of 8 ingredients. Check your meds →
Dietary supplement

LiverMax II Ingredients & Drug Interactions

by Advanced Naturals

LiverMax II label
See full label image
Capsule Category: Botanical
Most serious interaction: Moderate
Clinical methodology reviewed by · Updated Sep 9, 2026 · Label data from the NIH DSLD
What is this page for?

First and foremost: checking LiverMax II 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

The interaction bottom line Most serious interaction: Moderate

LiverMax II is a dietary supplement by Advanced Naturals with 8 active ingredients. Its ingredients are commonly taken for blood sugar control, boosting breast milk supply, high cholesterol.Based on those ingredients, 1,246 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Belleric Myrobalan, Schizandra extract, Indian Tinospora extract. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

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Check Your Meds Against LiverMax II by Advanced Naturals

Ask about any prescription or over-the-counter medication and we check it for interactions with LiverMax II by Advanced Naturals — and tell you which ingredient is responsible.

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Computed from our clinical databases

HelloPharmacist Scorecard of LiverMax II by Advanced Naturals

Four independent checks of what is known — a summary of the available information, not a grade of the product itself.

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

The stated purpose hasn't been mapped to our evidence data yet.

Why this rating?
  • We haven't mapped this product's purpose to our evidence data yet — it'll be graded on the next content refresh.
Ingredient Transparency
Partial

Most active ingredients list an amount, but at least one is hidden in a blend or missing.

Why this rating?
  • The label discloses an exact amount for 5 of its 8 active ingredients.
  • “Triphala” is listed as a grouped ingredient — the label gives one combined amount (200 mg) without saying how much of each component you get.
Known Interaction Concern
Moderate identified

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

Why this rating?
  • 7 of the 7 matched ingredients can interact with medications — Schisandra, Fenugreek, Indian Gooseberry, Terminalia, Andrographis, among others.
  • The most serious interaction on file is rated Moderate.
  • Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs; immunosuppressants / transplant drugs; diabetes medications.
  • For scale: 1,247 individual medications appear in the full list. A big number alone doesn't make a product dangerous — what matters is whether YOUR medication is on it, so run yours through the interaction checker on this page.
Safety Information
Well characterized

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

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

HelloPharmacist summaryPartially disclosed formula with no assessable stated purpose. Moderate medication interactions have been identified, and safety information is well characterized.

Assessment coverage: 7 of 8 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Apr 22, 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

At a glance

General information

Key facts about LiverMax II, straight from the product label.

Brand Advanced Naturals
Barcode (UPC) 631257422675
Net contents 60 Vegetable Capsule(s)
Market status Off market
Date entered into DSLD Apr 22, 2021
DSLD ID 245808
Product type Botanical
Supplement form Capsule
Dietary claims / uses All Other, Structure/Function
Intended target group(s) Adult (18 - 50 Years), Gluten Free, Dairy Free
From the label
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.

Supplement Facts

The label details for LiverMax II by Advanced Naturals, sourced from the NIH Dietary Supplement Label Database.

Supplement Facts

Daily Value (DV) Target Group(s):
Adults and children 4 or more years of age
Minimum serving Sizes:
1 Capsule(s)
Maximum serving Sizes:
2 Capsule(s)
Servings per container
30
UPC/BARCODE
631257422675
IngredientAmount% DV
Chebulic Myrobalan0 NP--
Amla0 NP--
Belleric Myrobalan0 NP--
Fenugreek200 mg--
Broccoli100 mmg--
Triphala200 mg--
Andrographis extract100 mg--
Indian Tinospora extract200 mg--
Schizandra extract200 mg--

Other ingredients: Vegetable Capsule

Tap any ingredient to jump to its full detail below.

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

Dietary Supplement

Formulation

Natural ingredients traditionally used to support normal detoxification functions Two-part liver support system

Gluten free Dairy free No artificial ingredients

Quality, purity, and potency guaranteed through expiration.

Manufactured in USA in a GMP facility. Formulated with natural herbal and mineral ingredients traditionally used to support normal detoxification functions Designed to be taken in harmony with your normal daily activity

General Statements

Natural digestive care

Please Note: We recommend checking our ingredients in a reference book from your health practitioner or physician. Self-education and knowledge are the keys to good health.

For nearly two decades, Advanced Naturals has been formulating superior-quality digestive care supplements to help people achieve optimal health from the inside out.

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.

Suggested/Recommended/Usage/Directions

Suggested Use: For the first 3 days, take 1 capsule of LiverMax I (morning formula) in the morning and 1 capsule of LiverMax II (evening formula) at night. After 3 days, increase to 2 capsules of LiverMax I in the morning and 2 capsules of LiverMax II in the evening. This program may be taken as needed to assist natural detoxification functions. These products work best when taken on an empty stomach, allowing 30 minutes before eating.

Directions: For the first 3 days, take 1 capsule each day in the evening on an empty stomach. After 3 days, take 2 capsules each day in the evening on an empty stomach.

Precautions

Notice of Usage: This program is not to be used for more than three (3) times per year.

Keep out of reach of children.

Consult your health care professional before using this or any product if you are pregnant, nursing, or under medical supervision.

Tamper Evident: Do not use this product if either the outer neck band or the inner seal is broken.

Storage

Store in a dry place at 59-86 degrees F (15-30 degrees C).

Is this label outdated? Report a formula or label change and our pharmacy team will review it.

See for yourself

LiverMax II by Advanced Naturals label

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

LiverMax II label

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)
What’s inside

The Ingredients in LiverMax II by Advanced Naturals

These are the 8 active ingredients this product is made of. Select any to open its full monograph.

Serving size1 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.

Fenugreek

Interacts with
389 drugs
200 mg per serving

Fenugreek is a common kitchen spice that is also taken as a supplement, mainly for blood sugar, cholesterol, and to support breast milk production. So...

Fenugreek monograph & interactions

Broccoli

Interacts with
187 drugs
100 mmg per serving

Broccoli is a nutritious cruciferous vegetable rich in fiber, vitamins, and plant compounds like sulforaphane that have drawn scientific interest for...

Broccoli monograph & interactions

Triphala

200 mg per serving

Andrographis extract

Interacts with
413 drugs
100 mg per serving

Andrographis is a bitter Asian herb traditionally used for colds, flu, and infections, and some studies suggest it may ease cold symptoms and shorten...

Andrographis extract monograph & interactions

Indian Tinospora extract

Interacts with
612 drugs
200 mg per serving

Tinospora cordifolia, known as Guduchi or Giloy in Ayurvedic medicine, is a climbing plant traditionally used to support immunity and treat fevers. Ea...

Indian Tinospora extract monograph & interactions

Schizandra extract

Interacts with
803 drugs
200 mg per serving

Schisandra is a traditional Chinese medicine berry used as an adaptogen for stress, fatigue, and liver support. Human evidence is limited and most cla...

Schizandra extract monograph & interactions

Other (inactive) ingredients: Vegetable Capsule. These complete the product’s ingredient list but are not active constituents.

Interaction report

LiverMax II by Advanced Naturals Drug Interactions

LiverMax II contains 8 ingredients, and 7 of them have known drug interactions. Altogether they interact with 1,246 medications. Here’s the picture, then you can look up your own drug.

Want to check YOUR meds against LiverMax II?

Ask about interactions with your drugs in plain English — “Can I take it with lisinopril?” — and we find you the answer in seconds, ingredient by ingredient.

 Go to the checker
1,246Drugs
1,246 Moderate

Ingredients driving the most interactions

Belleric Myrobalan 933
Schizandra extract 803
Indian Tinospora extract 612
Andrographis extract 413
Fenugreek 389

Individual Drug Interactions

The ingredients in LiverMax II interact with 1,246 drugs. Click any drug to see the details.

7 of the 8 ingredients in LiverMax II interact with drugs. Each result below shows which ingredient is responsible. Belleric Myrobalan Schizandra extract Indian Tinospora extract Andrographis extract Fenugreek Amla Broccoli

Each ingredient & the kinds of drugs it affects

For each ingredient in LiverMax II 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.

Belleric Myrobalan7 drug types · 933 drugs

Anticoagulant/Antiplatelet Drugs

Theoretically, concomitant use of Terminalia arjuna with anticoagulant or antiplatelet drugs may increase the risk of bleeding in some patients.
In vitro, Terminalia arjuna bark extract inhibits platelet aggregation, decreases platelet activation, and shows antithrombotic properties.

Likelihood Possible Evidence D
Antidiabetes Drugs

Theoretically, concomitant use of Terminalia bellirica or Terminalia chebula with antidiabetes drugs could affect blood sugar control and increase the risk of hypoglycemia.
Animal and in vitro research shows that Terminalia bellirica and Terminalia chebula fruit and seed extract have hypoglycemic effects.

Likelihood Possible Evidence D
Chlorzoxazone (Parafon Forte, Paraflex)

Theoretically, use of Terminalia chebula may increase the risk of adverse effects from chlorzoxazone.
Animal research shows that enteral administration of Terminalia chebula for 15 days prior to administration of chlorzoxazone increases blood levels of chlorzoxazone and decreases chlorzoxazone clearance. It is speculated that Terminalia chebula reduces the metabolism of chlorzoxazone by inhibiting cytochrome P450 2E1.

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

Theoretically, use of Terminalia arjuna may increase the levels and clinical effects of CYP2C9 substrates.
In vitro research shows that Terminalia arjuna extract inhibits CYP2C9 enzymes and reduces CYP2C9 substrate metabolism.

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

Theoretically, use of Terminalia arjuna may increase the levels and clinical effects of CYP2D6 substrates.
In vitro research shows that Terminalia arjuna extract inhibits CYP2D6 enzymes and reduces CYP2D6 substrate metabolism.

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

Theoretically, use of Terminalia arjuna may increase the levels and clinical effects of CYP3A4 substrates.
In vitro research shows that Terminalia arjuna extract inhibits CYP3A4 enzymes and reduces CYP3A4 substrate metabolism.

Likelihood Possible Evidence D
Omeprazole (Prilosec)

Theoretically, use of Terminalia chebula may increase the risk of adverse effects from omeprazole.
Animal research shows that enteral administration of Terminalia chebula for 15 days prior to administration of omeprazole increases blood levels of omeprazole and decreases omeprazole clearance. It is speculated that Terminalia chebula reduces the metabolism of omeprazole by inhibiting cytochrome P450 2C19.

Likelihood Possible Evidence D
Belleric Myrobalan full monograph & interactions

Schizandra extract12 drug types · 803 drugs

Cyclophosphamide

Theoretically, schisandra might increase the levels and clinical effects of cyclophosphamide.
In vitro research shows that schisandra increases the concentration of cyclophosphamide, likely through inhibition of cytochrome P450 3A4. After multiple doses of the schisandra constituents schisandrin A and schisantherin A, the maximum concentration of cyclophosphamide was increased by 7% and 75%, respectively, while the overall exposure to cyclophosphamide was increased by 29% and 301%, respectively.

Likelihood Probable Evidence D
Cyclosporine (Neoral, Sandimmune)

Schisandra can increase the levels and clinical effects of cyclosporine.
A small observational study in children with aplastic anemia found that taking schisandra with cyclosporine increased cyclosporine trough levels by 93% without increasing the risk of adverse events. However, the dose of cyclosporine was reduced in 9% of children to maintain appropriate cyclosporine blood concentrations.

Likelihood Probable Evidence B
Cytochrome P450 2C19 (Cyp2C19) Substrates

Theoretically, schisandra might increase the levels and clinical effects of CYP2C19 substrates.
In vitro research shows that schisandra inhibits CYP2C19, and animal research shows that schisandra increases the concentration of voriconazole, a CYP2C19 substrate. Theoretically, schisandra may also inhibit the metabolism of other CYP2C19 substrates. This effect has not been reported in humans.

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

Theoretically, schisandra might decrease the levels and clinical effects of CYP2C9 substrates.
In vitro and animal research suggests that schisandra induces CYP2C9 enzymes. This effect has not been reported in humans.

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

Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.
Most clinical and laboratory research shows that schisandra, administered either as a single dose or up to twice daily for 14 days, inhibits CYP3A4 and increases the concentration of CYP3A4 substrates such as cyclophosphamide, midazolam, tacrolimus, and talinolol. Although one in vitro and animal study shows that schisandra may induce CYP3A4 metabolism, this effect appears to be overpowered by schisandra's CYP3A4 inhibitory activity and has not been reported in humans.

Likelihood Probable Evidence D
Midazolam (Versed)

Schisandra can increase the levels and clinical effects of midazolam.
A small pharmacokinetic study in healthy adults shows that taking schisandra extract (Hezheng Pharmaceutical Co.) containing deoxyschizandrin 33.75 mg twice daily for 8 days and a single dose of midazolam 15 mg on day 8 increases the overall exposure to midazolam by about 119%, increases the peak plasma level of midazolam by 86%, and decreases midazolam clearance by about 52%. This effect has been attributed to inhibition of CYP3A4 by schisandra.

Likelihood Probable Evidence B
P-Glycoprotein Substrates

Schisandra might increase the levels and clinical effects of P-glycoprotein substrates.
In vitro research shows that schisandra extracts and constituents such as schisandrin B inhibit P-glycoprotein mediated efflux in intestinal cells and in P-glycoprotein over-expressing cell lines. Additionally, a small clinical study shows that schisandra increases the peak concentration and overall exposure to talinolol, a P-glycoprotein probe substrate. Theoretically, schisandra might inhibit the efflux of other P-glycoprotein substrates.

Likelihood Possible Evidence D
Sirolimus (Rapamune)

Schisandra can increase the levels and clinical effects of sirolimus.
A small pharmacokinetic study in healthy volunteers shows that taking 3 capsules of schisandra (Hezheng Pharmaceutical Company) containing a total of 33.75 mg deoxyschizandrin twice daily for 13 days and then taking a single dose of sirolimus 2 mg increases the overall exposure and peak level of sirolimus by two-fold. This effect is thought to be due to inhibition of cytochrome P450 3A4 by schisandra, as well as possible inhibition of the P-glycoprotein drug transporter.

Likelihood Probable Evidence B
Tacrolimus (Prograf)

Schisandra can increase the levels and clinical effects of tacrolimus.
Clinical research in healthy children and adults, transplant patients, and patients with nephrotic syndrome and various rheumatic immunologic disorders shows that taking schisandra with tacrolimus increases tacrolimus peak levels by 183% to 268%, prolongs or delays time to peak tacrolimus concentrations, increases overall exposure to tacrolimus by 126% to 343%, and decreases tacrolimus clearance by 19% to 73%. This effect is thought to be due to inhibition of P-glycoprotein drug transporter and CYP3A4 and CYP3A5 by schisandra. Some clinical and observational studies suggest that schisandra increases tacrolimus levels similarly in both expressors and non-expressors of CYP3A5, while other studies suggest it does so to a greater degree in CYP3A5 expressors than non-expressors. Animal research suggests that the greatest increase in tacrolimus levels occurs when schisandra is taken either concomitantly or up to 2 hours before tacrolimus, and clinical and observational research in humans suggests that schisandra may increase whole blood levels of tacrolimus and decrease clearance of tacrolimus in a dose-dependent manner.

Likelihood Probable Evidence B
Talinolol

Schisandra can increase the levels and clinical effects of talinolol.
A small pharmacokinetic study in healthy volunteers shows that taking schisandra extract 300 mg twice daily for 14 days with a single dose of talinolol 100 mg on day 14 increases the peak talinolol level by 51% and the overall exposure to talinolol by 47%. This effect is thought to be due to the possible inhibition of cytochrome P450 3A4 and P-glycoprotein by schisandra. tly.

Likelihood Probable Evidence B
Voriconazole (Vfend)

Theoretically, schisandra might increase the levels and clinical effects of voriconazole.
Animal research shows that oral schisandra given daily for 1 or 14 days increases levels of intravenously administered voriconazole, a cytochrome P450 (CYP) 2C19 substrate. This effect is thought to be due to inhibition of CYP2C19 by schisandra. However, this interaction has not been reported in humans.

Likelihood Possible Evidence D
Warfarin (Coumadin)

Theoretically, schisandra might decrease the levels and clinical effects of warfarin.
Animal research suggests that oral schisandra extract, given daily for 6 days, reduces levels of intravenously administered warfarin. This effect might be due to the induction of cytochrome P450 (CYP) 2C9 metabolism by schisandra. However, this interaction has not been reported in humans.

Likelihood Possible Evidence D
Schizandra extract full monograph & interactions

Indian Tinospora extract6 drug types · 612 drugs

Antidiabetes Drugs

Theoretically, Tinospora cordifolia might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Clinical research in adults with type 2 diabetes shows that Tinospora cordifolia can reduce fasting blood glucose and glycated hemoglobin. Additionally, animal research shows that Tinospora cordifolia has hypoglycemic effects.

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

Theoretically, Tinospora cordifolia might increase levels of drugs metabolized by CYP1A2.
In vitro research shows that Tinospora cordifolia extract inhibits CYP1A2 at high concentrations. However, this interaction has not been reported in humans.

Likelihood Possible Evidence D
Cytochrome P450 2C19 (Cyp2C19) Substrates

Theoretically, Tinospora cordifolia might increase levels of drugs metabolized by CYP2C19.
In vitro research shows that Tinospora cordifolia extract inhibits CYP2C19 at high concentrations. However, this interaction has not been reported in humans.

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

Theoretically, Tinospora cordifolia might increase levels of drugs metabolized by CYP2C9.
In vitro research shows that Tinospora cordifolia extract inhibits CYP2C9. Animal research shows that Tinospora cordifolia extract 400 mg/kg twice daily for 14 days reduces the clearance and increases plasma levels of glyburide, a CYP2C9 substrate. However, this interaction has not been reported in humans.

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

Theoretically, Tinospora cordifolia might increase levels of drugs metabolized by CYP2D6.
In vitro research shows that Tinospora cordifolia extract inhibits CYP2D6 at high concentrations. However, this interaction has not been reported in humans.

Likelihood Possible Evidence D
Immunosuppressants

Theoretically, Tinospora cordifolia might reduce the effectiveness of immunosuppressants.
In vitro and animal research shows that Tinospora cordifolia has immunostimulant effects.

Likelihood Possible Evidence D
Indian Tinospora extract full monograph & interactions

Andrographis extract6 drug types · 413 drugs

Anticoagulant/Antiplatelet Drugs

Theoretically, andrographis might increase the risk of bleeding when used with anticoagulant or antiplatelet drugs.
Animal and laboratory studies suggest that andrographis has antiplatelet effects.

Likelihood Possible Evidence D
Antihypertensive Drugs

Theoretically, andrographis might increase the risk of hypotension when used with antihypertensive drugs.
Animal research suggests that andrographis has hypotensive effects.

Likelihood Possible Evidence D
Immunosuppressants

Theoretically, andrographis might interfere with the effects of immunosuppressive drugs.
Laboratory research suggests that andrographolide has immunostimulant activity.

Likelihood Possible Evidence D
Celecoxib (Celebrex)

Theoretically, andrographis extract might increase the maximum concentration and time to peak concentration of celecoxib. The clinical significance of these changes is unclear.
Animal research suggests that andrographis extract taken orally increases the maximum concentration and time to peak concentration of celecoxib but does not appear to impact the area under the curve.

Likelihood Possible Evidence D
Etoricoxib (Arcoxia)

Theoretically, andrographis might decrease the absorption of etoricoxib, although the clinical significance is unclear.
Animal research shows that andrographis extract, or the constituent andrographolide, taken orally with etoricoxib decreases the bioavailability of etoricoxib. However, this reduced bioavailability is not correlated with a reduction in the anti-inflammatory effects of etoricoxib in arthritic mice models. The clinical significance of this interaction is unclear.

Likelihood Possible Evidence D
Glipizide (Glucotrol)

Theoretically, andrographis extract might increase the maximum concentration and area under the curve of glipizide; however, opposite effects are seen with the constituent, andrographolide. The clinical significance of this interaction is unclear.
Animal research suggests that andrographis extract taken orally with glipizide in diabetes-induced rats increases the maximum concentration and area under the curve of glipizide. However, the opposite effect is seen with the constituent, andrographolide, in which the maximum concentration and area under the curve are decreased when taken with glipizide.

Likelihood Possible Evidence D
Andrographis extract full monograph & interactions

Fenugreek9 drug types · 389 drugs

Anticoagulant/Antiplatelet Drugs

Theoretically, fenugreek might have additive effects when used with anticoagulant or antiplatelet drugs.
Some of the constituents in fenugreek have antiplatelet effects in animal and in vitro research. However, common fenugreek products might not contain sufficient concentrations of these constituents for clinical effects. A clinical study in patients with coronary artery disease or diabetes shows that taking fenugreek seed powder 2.5 grams twice daily for 3 months does not affect platelet aggregation, fibrinolytic activity, or fibrinogen levels .

Likelihood Unlikely Evidence B
Antidiabetes Drugs

Theoretically, fenugreek seed might have additive hypoglycemic effects when used with antidiabetes drugs.
Clinical research shows that fenugreek seed can reduce fasting blood glucose and 2-hour postprandial glucose levels in adults with type 2 diabetes.

Likelihood Probable Evidence B
Clopidogrel (Plavix)

Theoretically, fenugreek seed might alter the clinical effects of clopidogrel by inhibiting its conversion to the active form.
Animal research shows that fenugreek seed 200 mg/kg daily for 14 days increases the maximum serum concentration of clopidogrel by 21%. It is unclear how this affects the pharmacokinetics of the active metabolite of clopidogrel; however, this study found that concomitant use of fenugreek seed and clopidogrel prolonged bleeding time by an additional 11%.

Likelihood Possible Evidence D
Metoprolol (Toprol)

Theoretically, fenugreek seed might have additive hypotensive effects when used with metoprolol.
Animal research shows that fenugreek seed 300 mg/kg daily for 2 weeks decreases systolic and diastolic blood pressure by 9% and 11%, respectively, when administered alone, and by 15% and 22%, respectively, when given with metoprolol 10 mg/kg.

Likelihood Probable Evidence B
Phenytoin (Dilantin)

Theoretically, fenugreek might decrease plasma levels of phenytoin.
Animal research shows that taking fenugreek seeds for 1 week decreases maximum concentrations and the area under the curve of a single dose of phenytoin by 44% and 72%, respectively. This seems to be related to increased clearance. So far, this interaction has not been reported in humans.

Likelihood Possible Evidence D
Sildenafil (Viagra)

Theoretically, concurrent use of sildenafil and fenugreek might reduce levels and therapeutic effects of sildenafil.
Animal research shows that taking fenugreek seeds for 1 week reduces maximum concentrations and the area under the curve of a single dose of sildenafil by 27% and 48%, respectively. So far, this interaction has not been reported in humans.

Likelihood Possible Evidence D
Theophylline

Theoretically, fenugreek may reduce the levels and clinical effects of theophylline.
Animal research shows that fenugreek 50 grams daily for 7 days reduces the maximum serum concentration (Cmax) of theophylline by 28% and the area under the plasma drug concentration-time curve (AUC) by 22%.

Likelihood Possible Evidence D
Warfarin (Coumadin)

Theoretically, fenugreek might have additive effects with warfarin and increase the international normalized ratio (INR).
Some fenugreek constituents have antiplatelet effects, although these might not be present in concentrations that are clinically significant. In one case report, a patient taking warfarin experienced an increased INR when starting to take fenugreek in combination with boldo.

Likelihood Possible Evidence D
Antihypertensive Drugs

Fenugreek may also have an additive effect on blood pressure-lowering medications. Studies on animals have shown that fenugreek seed can decrease both systolic and diastolic blood pressure by up to 22% when combined with metoprolol. Therefore, it is essential to monitor your blood pressure regularly if you are taking fenugreek and metoprolol together or any other antihypertensive drugs.

Likelihood Possible Evidence C
Fenugreek full monograph & interactions

Amla4 drug types · 208 drugs

Anticoagulant/Antiplatelet Drugs

Theoretically, Indian gooseberry may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs; however, research is conflicting.
Clinical research shows that taking Indian gooseberry 500 mg as a single dose or twice daily for 10 days reduces platelet aggregation by about 24% to 36%, increases bleeding time by about 3.8-5.9 seconds, and increases clotting time by about 9.8-12.7 seconds when compared to baseline. However, taking Indian gooseberry 500 mg along with clopidogrel 75 mg or ecosprin 75 mg, as a single dose or for 10 days, does not significantly reduce platelet aggregation or increase bleeding time or clotting time when compared with clopidogrel 75 mg or ecosprin 75 mg alone. Until more is known, use caution when taking Indian gooseberry in combination with anticoagulant/antiplatelet drugs.

Likelihood Possible Evidence B
Antidiabetes Drugs

Taking Indian gooseberry with antidiabetes drugs might increase the risk of hypoglycemia.
Clinical research shows that taking Indian gooseberry fruit or fruit extract alone or in conjunction with antidiabetes medications can lower blood glucose levels. Dose adjustments to diabetes medications might be necessary.

Likelihood Possible Evidence B
Aspirin

Theoretically, Indian gooseberry may increase the risk of bleeding if used with aspirin; however, research is conflicting.
Clinical research shows that taking Indian gooseberry 500 mg as a single dose or twice daily for 10 days reduces platelet aggregation by about 24% to 36%, increases bleeding time by about 3.8-5.9 seconds, and increases clotting time by about 9.8-12.7 seconds when compared to baseline. However, taking a single dose of Indian gooseberry 500 mg along with ecosprin 75 mg, or taking a combination of Indian gooseberry 500 mg twice daily plus ecosprin 75 mg once daily for 10 days, does not significantly reduce platelet aggregation or increase bleeding time or clotting time when compared with ecosprin 75 mg alone.

Likelihood Possible Evidence B
Clopidogrel (Plavix)

Theoretically, Indian gooseberry may increase the risk of bleeding if used with clopidogrel; however, research is conflicting.
Clinical research shows that taking Indian gooseberry 500 mg as a single dose or twice daily for 10 days reduces platelet aggregation by about 24% to 36%, increases bleeding time by about 3.8-5.9 seconds, and increases clotting time by about 9.8-12.7 seconds when compared to baseline. However, taking a single dose of Indian gooseberry 500 mg along with clopidogrel 75 mg, or taking a combination of Indian gooseberry 500 mg twice daily plus clopidogrel 75 mg once daily for 10 days, does not significantly reduce platelet aggregation or increase bleeding time or clotting time when compared with clopidogrel 75 mg alone.

Likelihood Possible Evidence B
Amla full monograph & interactions

Broccoli2 drug types · 187 drugs

Cytochrome P450 1A2 (Cyp1A2) Substrates

Theoretically, broccoli might reduce the levels and effects of drugs metabolized by CYP1A2.
Pharmacokinetic research in humans shows that eating 500 grams of fresh broccoli daily for 6-12 days can increase CYP1A2 activity by 10% to 200%. Induction of CYP1A2 activity by broccoli is attributed to its glucosinolate constituents.

Likelihood Possible Evidence B
Cytochrome P450 2A6 (Cyp2A6) Substrates

Theoretically, broccoli might reduce the levels and effects of drugs metabolized by CYP2A6.
Pharmacokinetic research in humans shows that eating 500 grams of broccoli daily for 6 days increases CYP2A6 activity by 135% to 550%. Induction of CYP2A6 activity is attributed to its glucosinolate constituents.

Likelihood Possible Evidence B
Broccoli full monograph & interactions
The maker

Brand information

Manufacturer and brand details for LiverMax II, from the product label.

Advanced Naturals

See all Advanced Naturals products
Name
Advanced Naturals
City
Palm Harbor
State
FL
ZipCode
34683
Phone Number
1-800-690-9988
Web Address
www.advancednaturals.com
Pharmacist Counseling Corner

LiverMax II by Advanced Naturals: Common Questions

Does LiverMax II by Advanced Naturals interact with any medications?
Yes. Based on its ingredients, LiverMax II has a known interaction with 1,246 medications. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
LiverMax II contains 8 active ingredients, and an interaction can come from any of them. We check every ingredient, combine the results into one list per medication, and show which ingredient and mechanism is responsible.
Where does this information come from?
The product label data comes from the NIH Dietary Supplement Label Database (DSLD); the interaction data is built on the Natural Medicines database and reviewed by HelloPharmacist pharmacists.

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.

LiverMax II label
Go deeper

The Full Monographs Behind LiverMax II’s Ingredients

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

Herb & supplement monograph

Fenugreek

Interacts with 389 drugs

Fenugreek is a common kitchen spice that is also taken as a supplement, mainly for blood sugar, cholesterol, and to support breast milk production. Some early research is encouraging for blo...

Read the full Fenugreek monograph → Herb & supplement monograph

Broccoli

Interacts with 187 drugs

Broccoli is a nutritious cruciferous vegetable rich in fiber, vitamins, and plant compounds like sulforaphane that have drawn scientific interest for health benefits. Eating broccoli as food...

Read the full Broccoli monograph → Herb & supplement monograph

Indian Gooseberry

Interacts with 208 drugs

Indian gooseberry (amla) is a vitamin C-rich fruit used in Ayurvedic medicine for many purposes, from antioxidant support to cholesterol and digestion. Early research is promising for some u...

Read the full Indian Gooseberry monograph → Herb & supplement monograph

Terminalia

Interacts with 933 drugs

Terminalia is a group of traditional Ayurvedic tree species (most notably Terminalia arjuna) used for heart, digestive, and general wellness purposes. Some small studies suggest possible ben...

Read the full Terminalia monograph → Herb & supplement monograph

Andrographis

Interacts with 413 drugs

Andrographis is a bitter Asian herb traditionally used for colds, flu, and infections, and some studies suggest it may ease cold symptoms and shorten how long they last. The evidence is limi...

Read the full Andrographis monograph → Herb & supplement monograph

Tinospora Cordifolia

Interacts with 612 drugs

Tinospora cordifolia, known as Guduchi or Giloy in Ayurvedic medicine, is a climbing plant traditionally used to support immunity and treat fevers. Early laboratory and small human studies s...

Read the full Tinospora Cordifolia monograph → Herb & supplement monograph

Schisandra

Interacts with 803 drugs

Schisandra is a traditional Chinese medicine berry used as an adaptogen for stress, fatigue, and liver support. Human evidence is limited and most claims are not well proven, but it appears...

Read the full Schisandra monograph →
Sources

Sources & How We Checked

LiverMax II's label data comes from the NIH Dietary Supplement Label Database; the ingredient interaction data is from the Natural Medicines database, reviewed by our pharmacists.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

The 118 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.

Indian Gooseberry 6 references
  1. Sabu, M. C. and Kuttan, R. Anti-diabetic activity of medicinal plants and its relationship with their antioxidant property. J Ethnopharmacol. 2002;81(2):155-160. PubMed
  2. Fatima N, Pingali U, Muralidhar N. Study of pharmacodynamic interaction of Phyllanthus emblica extract with clopidogrel and ecosprin in patients with type II diabetes mellitus. Phytomedicine. 2014;21(5):579-85. PubMed
  3. Shanmugarajan D, Girish C, Harivenkatesh N, Chanaveerappa B, Prasanna Lakshmi NC. Antihypertensive and pleiotropic effects of Phyllanthus emblica extract as an add-on therapy in patients with essential hypertension-A randomized double-blind placebo-contro
  4. Akhtar MS, Ramzan A, Ali A, Ahmad M. Effect of amla fruit (Emblica officinalis Gaertn.) on blood glucose and lipid profile of normal subjects and type 2 diabetic patients. Int J Food Sci Nutr. 2011;62(6):609-16.
  5. Usharani P, Fatima N, Muralidhar N. Effects of Phyllanthus emblica extract on endothelial dysfunction and biomarkers of oxidative stress in patients with type 2 diabetes mellitus: a randomized, double-blind, controlled study. Diabetes Metab Syndr Obes. 20 PubMed
  6. Majeed M, Mundkur L, Paulose S, Nagabhushanam K. Novel Emblica officinalis extract containing ß-glucogallin vs. metformin: a randomized, open-label, comparative efficacy study in newly diagnosed type 2 diabetes mellitus patients with dyslipidemia. Food Fu

See these in context on the Indian Gooseberry monograph →

Terminalia 9 references
  1. Sabu, M. C. and Kuttan, R. Anti-diabetic activity of medicinal plants and its relationship with their antioxidant property. J Ethnopharmacol. 2002;81(2):155-160. PubMed
  2. Rao, N. K. and Nammi, S. Antidiabetic and renoprotective effects of the chloroform extract of Terminalia chebula Retz. seeds in streptozotocin-induced diabetic rats. BMC.Complement Altern.Med 2006;6:17. PubMed
  3. Murali, Y. K., Anand, P., Tandon, V., Singh, R., Chandra, R., and Murthy, P. S. Long-term effects of Terminalia chebula Retz. on hyperglycemia and associated hyperlipidemia, tissue glycogen content and in vitro release of insulin in streptozotocin induced
  4. Senthilkumar, G. P. and Subramanian, S. Evaluation of antioxidant potential of Terminalia chebula fruits studies in streptozotocin-induced diabetic rats. Pharmaceutical Biology (Netherlands) 2007;45:511-518.
  5. Malik N, Dhawan V, Bahl A, Kaul D. Inihbitory effects of Terminalia arjuna on platelet activation in vitro in healthy subjects and patients with coronary artery disease. Platelets. 2009;20(3):183-1190.
  6. Varghese A, Savai J, Pandita N, Gaud RS. In vitro modulatory effects of Terminalia arjuna, arjunic acid, arjunetin, and arjungenin on CYP3A4, CYP2D6, and CYP2C9 enzyme activity in human liver microsomes. Toxicology Reports. 2015(2):806-16. PubMed
  7. Wu G, Dong Z, Dong J, et al. Effects of mongolian medicine Terminalia chebula Retz. on 6 CYP450 enzymes in rats. Int J Clin Exp Pathol 2020;13(12):3128-3138.
  8. Das A, Naveen J, Sreerama YN, Gnanesh Kumar BS, Baskaran V. Low-glycemic foods with wheat, barley and herbs (Terminalia chebula, Terminalia bellerica and Emblica officinalis) inhibit a-amylase, a-glucosidase and DPP-IV activity in high fat and low dose st
  9. Eltimamy M, Elshamarka M, Aboelsaad M, Sayed M, Moawad H. Effects of alcoholic extract of Terminalia Chebula dried fruit on blood biochemical profile in diabetic rats. J Diabetes Metab Disord 2022;21(1):159-170. PubMed

See these in context on the Terminalia monograph →

Fenugreek 30 references
  1. Madar Z, Thorne R. Dietary fiber. Prog Food Nutr Sci 1987;11:153-74.
  2. Sharma RD, Raghuram TC, Rao NS. Effect of fenugreek seeds on blood glucose and serum lipids in type I diabetes. Eur J Clin Nutr 1990;44:301-6.
  3. Patil SP, Niphadkar PV, Bapat MM. Allergy to fenugreek (Trigonella foenum graecum). Ann Allergy Asthma Immunol 1997;78:297-300. PubMed
  4. Lambert J, Cormier J. Potential interaction between warfarin and boldo-fenugreek. Pharmacotherapy 2001;21:509-12. PubMed
  5. Bordia A, Verma SK, Srivastava KC. Effect of ginger (Zingiber officinale Rosc.) and fenugreek (Trigonella foenumgraecum L.) on blood lipids, blood sugar and platelet aggregation in patients with coronary artery disease. Prostaglandins Leukot Essent Fatty PubMed
  6. Yalcin SS, Tekinalp G, Ozalp I. Peculiar odor of traditional food and maple syrup urine disease. Pediatr Int 1999;41:108-9. PubMed
  7. Sewell AC, Mosandl A, Bohles H. False diagnosis of maple syrup urine disease owing to ingestion of herbal tea. N Engl J Med 1999;341:769.. PubMed
  8. Abdo MS, al-Kafawi AA. Experimental studies on the effect of Trigonella foenum-graecum (abstract). Planta Med 1969;17:14-8.
  9. Gupta A, Gupta R, Lal B. Effect of Trigonella foenum-graecum (fenugreek) seeds on glycaemic control and insulin resistance in type 2 diabetes mellitus: a double blind placebo controlled study. J Assoc Physicians India 2001;49:1057-61.
  10. Gabay MP. Galactogogues: medications that induce lactation. J Hum Lact 2002;18:274-9. PubMed
  11. Chevassus H, Gaillard JB, Farret A, et al. A fenugreek seed extract selectively reduces spontaneous fat intake in overweight subjects. Eur J Clin Pharmacol 2010;66(5):449-55. PubMed
  12. Turkyilmaz C, Onal E, Hirfanoglu IM, et al. The effect of galactagogue herbal tea on breast milk production and short-term catch-up of birth weight in the first week of life. J Altern Complement Med 2011;17(2):139-42. PubMed
  13. Swafford S, Berens P. Effect of fenugreek on breast milk volume. Abstract presented at: 5th International Meeting of the Academy of Breastfeeding Medicine; September 11-13,2000, Tucson, Arizona.
  14. Abdel-Barry, J. A., Abdel-Hassan, I. A., Jawad, A. M., and al Hakiem, M. H. Hypoglycaemic effect of aqueous extract of the leaves of Trigonella foenum-graecum in healthy volunteers. East Mediterr.Health J 2000;6(1):83-88. DOI
  15. Parvizpur, A., Ahmadiani, A., and Kamalinejad, M. Probable role of spinal purinoceptors in the analgesic effect of Trigonella foenum (TFG) leaves extract. J Ethnopharmacol 3-8-2006;104(1-2):108-112. PubMed
  16. Mora, A., Herrrera, A., Lopez, C., Dahbi, G., Mamani, R., Pita, J. M., Alonso, M. P., Llovo, J., Bernardez, M. I., Blanco, J. E., Blanco, M., and Blanco, J. Characteristics of the Shiga-toxin-producing enteroaggregative Escherichia coli O104:H4 German ou
  17. Blanco, J. [Stx2a-producing enteroaggregative Escherichia coli O104:H4-ST678. Microbiological diagnostic already, for this and other STEC/VTEC serotypes!]. Enferm.Infecc.Microbiol.Clin. 2012;30(2):84-89.
  18. Beutin, L. and Martin, A. Outbreak of Shiga toxin-producing Escherichia coli (STEC) O104:H4 infection in Germany causes a paradigm shift with regard to human pathogenicity of STEC strains. J Food Prot. 2012;75(2):408-418. PubMed
  19. King LA, Nogareda F, Weill FX, Mariani-Kurkdjian P, Loukiadis E, Gault G, Jourdan-DaSilva N, Bingen E, Macé M, Thevenot D, Ong N, Castor C, Noël H, Van Cauteren D, Charron M, Vaillant V, Aldabe B, Goulet V, Delmas G, Couturier E, Le Strat Y, Combe C, Delm
  20. Reeder C, Legrand A, O'Connor-Von SK. The Effect of Fenugreek on Milk Production and Prolactin Levels in Mothers of Preterm Infants. Clinical Lactation 2013;4(4):159-165. DOI
  21. Al-Jenoobi FI, Ahad A, Mahrous GM, Al-Mohizea AM, AlKharfy KM, Al-Suwayeh SA. Effects of fenugreek, garden cress, and black seed on theophylline pharmacokinetics in beagle dogs. Pharm Biol 2015;53(2):296-300. PubMed
  22. Rao A, Steels E, Inder WJ, Abraham S, Vitetta L. Testofen, a specialised Trigonella foenum-graecum seed extract reduces age-related symptoms of androgen decrease, increases testosterone levels and improves sexual function in healthy aging males in a doubl
  23. Steels E, Rao A, Vitetta L. Physiological aspects of male libido enhanced by standardized Trigonella foenum-graecum extract and mineral formulation. Phytother Res. 2011 Sep;25(9):1294-300.
  24. Gong J, Fang K, Dong H, Wang D, Hu M, Lu F. Effect of fenugreek on hyperglycaemia and hyperlipidemia in diabetes and prediabetes: A meta-analysis. J Ethnopharmacol. 2016 Dec 24;194:260-268. PubMed
  25. Ouzir M, El Bairi K, Amzazi S. Toxicological properties of fenugreek (Trigonella foenum graecum). Food Chem Toxicol. 2016 Oct;96:145-54. PubMed
  26. Khodamoradi K, Khosropanah MH, Ayati Z, et al. The Effects of Fenugreek on Cardiometabolic Risk Factors in Adults: A Systematic Review and Meta-analysis. Complement Ther Med. 2020;52:102416. PubMed
  27. Alkharfy K, Jan B, Alotaibi K, et al. Clopidogrel-herb Interactions: A Pharmacokinetic and Pharmacodynamic Assessment in a Rat Model. Curr Drug Metab 2021;22(12):969-977. PubMed
  28. Bin Jardan YA, Ahad A, Raish M, Alam MA, Al-Mohizea AM, Al-Jenoobi FI. Effects of garden cress, fenugreek and black seed on the pharmacodynamics of metoprolol: an herb-drug interaction study in rats with hypertension. Pharm Biol 2021;59(1):1088-1097. PubMed
  29. Al-Mohizea AM, Ahad A, El-Maghraby GM, et al. Effects of Nigella sativa, Lepidium sativum and Trigonella foenum-graecum on sildenafil disposition in beagle dogs. Eur J Drug Metab Pharmacokinet. 2015;40(2):219-24. PubMed
  30. Alkharfy KM, Al-Jenoobi FI, Al-Mohizea AM, et al. Effects of Lepidium sativum, Nigella sativa and Trigonella foenum-graceum on phenytoin pharmacokinetics in beagle dogs. Phytother Res. 2013;27(12):1800-4.

See these in context on the Fenugreek monograph →

Broccoli 5 references
  1. Kristal AR, Lampe JW. Brassica vegetables and prostate cancer risk: a review of the epidemiological evidence. Nutr Cancer 2002;42:1-9. PubMed
  2. Chakrabarti A, Prais L, Foulds IS. Allergic contact dermatitis to broccoli. Br J Dermatol 2003;148:172-3. PubMed
  3. Hakooz, N. and Hamdan, I. Effects of dietary broccoli on human in vivo caffeine metabolism: a pilot study on a group of Jordanian volunteers. Curr Drug Metab 2007;8(1):9-15. PubMed
  4. Kall MA, Vang O, Clausen J. Effects of dietary broccoli on human drug metabolising activity. Cancer Lett. 1997;114(1-2):169-70. PubMed
  5. Bauman JE, Hsu CH, Centuori S, et al. Randomized Crossover Trial Evaluating Detoxification of Tobacco Carcinogens by Broccoli Seed and Sprout Extract in Current Smokers. Cancers (Basel). 2022;14(9):2129. Published 2022 Apr 24. PubMed

See these in context on the Broccoli monograph →

Andrographis 26 references
  1. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
  2. Thamlikitkul V, Dechatiwongse T, Theerapong S, et al. Efficacy of Andrographis paniculata, Nees for pharyngotonsillitis in adults. J Med Assoc Thai 1991;74:437-42.
  3. Zhang CY, Tan BK. Mechanisms of cardiovascular activity of Andrographis paniculata in the anaesthetized rat. J Ethnopharmacol 1997;56:97-101. PubMed
  4. Zhao HY, Fang WY. Antithrombotic effects of Andrographis paniculata nees in preventing myocardial infarction. Chin Med J (Engl) 1991;104:770-5.
  5. Amroyan E, Gabrielian E, Panossian A, et al. Inhibitory effect of andrographolide from Andrographis paniculata on PAF-induced platelet aggregation. Phytomedicine 1999;6:27-31. PubMed
  6. Zhang C, Kuroyangi M, Tan BK. Cardiovascular activity of 14-deoxy-11,12-didehydroandrographolide in the anaesthetised rat and isolated right atria. Pharmacol Res 1998;38:413-7. PubMed
  7. Puri A, Saxena R, Saxena RP, et al. Immunostimulant agents from Andrographis paniculata. J Nat Prod 1993;56:995-9. PubMed
  8. Melchoir J, Spasov AA, Ostrovskij OV, et al. Double-blind, placebo-controlled pilot and phase III study of activity of standardized Andrographis paniculata Herba Nees extract fixed combination (Kan Jang) in the treatment of uncomplicated upper-respirator
  9. Calabrese C, Berman SH, Babish JG, et al. A phase I trial of andrographolide in HIV positive patients and normal volunteers. Phytother Res 2000;14:333-8. PubMed
  10. Gabrielian ES, Shukarian AK, Goukasova GI, et al. A double blind, placebo-controlled study of Andrographis paniculata fixed combination Kan Jang in the treatment of acute upper respiratory tract infections including sinusitis. Phytomedicine 2002;9:589-97 PubMed
  11. Poolsup N, Suthisisang C, Prathanturarug S, et al. Andrographis paniculata in the symptomatic treatment of uncomplicated upper respiratory tract infection: systematic review of randomized controlled trials. J Clin Pharm Ther 2004;29:37-45. PubMed
  12. Coon JT, Ernst E. Andrographis paniculata in the treatment of upper respiratory tract infections: a systematic review of safety and efficacy. Planta Med 2004;70:293-8.
  13. Kligler, B., Ulbricht, C., Basch, E., Kirkwood, C. D., Abrams, T. R., Miranda, M., Singh Khalsa, K. P., Giles, M., Boon, H., and Woods, J. Andrographis paniculata for the treatment of upper respiratory infection: a systematic review by the natural standa
  14. Burgos, R. A., Hancke, J. L., Bertoglio, J. C., Aguirre, V., Arriagada, S., Calvo, M., and Caceres, D. D. Efficacy of an Andrographis paniculata composition for the relief of rheumatoid arthritis symptoms: a prospective randomized placebo-controlled tria
  15. Saxena, R. C., Singh, R., Kumar, P., Yadav, S. C., Negi, M. P., Saxena, V. S., Joshua, A. J., Vijayabalaji, V., Goudar, K. S., Venkateshwarlu, K., and Amit, A. A randomized double blind placebo controlled clinical evaluation of extract of Andrographis pa
  16. Tang, T., Targan, S. R., Li, Z. S., Xu, C., Byers, V. S., and Sandborn, W. J. Randomised clinical trial: herbal extract HMPL-004 in active ulcerative colitis - a double-blind comparison with sustained release mesalazine. Aliment.Pharmacol Ther 2011;33(2) PubMed
  17. Sandborn, W. J., Targan, S. R., Byers, V. S., Rutty, D. A., Mu, H., Zhang, X., and Tang, T. Andrographis paniculata extract (HMPL-004) for active ulcerative colitis. Am J Gastroenterol. 2013;108(1):90-98. PubMed
  18. Melchior, J., Palm, S., and Wikman, G. Controlled clinical study of standardized Andrographis paniculata extract in common cold - a pilot trial. Phytomedicine. 1997;3(4):315-318. PubMed
  19. Balap A, Atre B, Lohidasan S, et al. Pharmacokinetic and pharmacodynamic herb-drug interaction of Andrographis paniculata (Nees) extract and andrographolide with etoricoxib after oral administration in rats. J Ethnopharmacol. 2016 May 13;183:9-17. PubMed
  20. Bertoglio JC, Baumgartner M, Palma R, et al. Andrographis paniculata decreases fatigue in patients with relapsing-remitting multiple sclerosis: a 12-month double-blind placebo-controlled pilot study. BMC Neurol. 2016; 16(1):77. PubMed
  21. Suwankesawong W, Saokaew S, Permsuwan U, et al. Characterization of hypersensitivity reactions reported among Andrographis paniculata users in Thailand using Health Product Vigilance Center (HPVC) database. BMC Complement Altern Med. 2014; 14:515. PubMed
  22. Ciampi E, Uribe-San-Martin R, Cárcamo C, et al. Efficacy of andrographolide in not active progressive multiple sclerosis: a prospective exploratory double-blind, parallel-group, randomized, placebo-controlled trial. BMC Neurol 2020;20(1):173. PubMed
  23. Worakunphanich W, Thavorncharoensap M, Youngkong S, Thadanipon K, Thakkinstian A. Safety of Andrographis paniculata: A systematic review and meta-analysis. Pharmacoepidemiol Drug Saf 2021;30(6):727-739.
  24. More SJ, Tandulwadkar SS, Balap AR, Lohidasan S, Sinnathambi A, Mahadik KR. Effect of Andrographis paniculata extract and Andrographolide on the pharmacokinetics of Aceclofenac and Celecoxib in rats. Futur J Pharm Sci. 2023;9(1):1. PubMed
  25. Sundhani E, Nugroho AE, Nurrochmad A, Puspitasari I, Amalia Prihati D, Lukitaningsih E. Pharmacokinetic Herb-Drug Interactions of Glipizide with Andrographis paniculata (Burm. f.) and Andrographolide in Normal and Diabetic Rats by Validated HPLC Method. M PubMed
  26. Shang YX, Shen C, Stub T, et al. Adverse Effects of Andrographolide Derivative Medications Compared to the Safe use of Herbal Preparations of Andrographis paniculata: Results of a Systematic Review and Meta-Analysis of Clinical Studies. Front Pharmacol 20 PubMed

See these in context on the Andrographis monograph →

Tinospora Cordifolia 16 references
  1. Stanely Mainzen Prince P, Menon VP. Hypoglycaemic and hypolipidaemic action of alcohol extract of Tinospora cordifolia roots in chemical induced diabetes in rats. Phytother Res 2003;17:410-3.
  2. Grover JK, Vats V, Rathi SS. Anti-hyperglycemic effect of Eugenia jambolana and Tinospora cordifolia in experimental diabetes and their effects on key metabolic enzymes involved in carbohydrate metabolism. J Ethnopharmacol 2000;73:461-70. PubMed
  3. Manjrekar PN, Jolly CI, Narayanan S. Comparative studies of the immunomodulatory activity of Tinospora cordifolia and Tinospora sinensis. Fitoterapia 2000;71:254-7. PubMed
  4. Prince PS, Menon VP. Antioxidant activity of Tinospora cordifolia roots in experimental diabetes. J Ethnopharmacol 1999;65:277-81. PubMed
  5. Stanely Mainzen Prince P, Menon VP, Gunasekaran G. Hypolipidaemic action of Tinospora cordifolia roots in alloxan diabetic rats. J Ethnopharmacol 1999;64:53-7. PubMed
  6. Badar VA, Thawani VR, Wakode PT, et al. Efficacy of Tinospora cordifolia in allergic rhinitis. J Ethnopharmacol 2005;96:445-9. PubMed
  7. Kapil A, Sharma S. Immunopotentiating compounds from Tinospora cordifolia. J Ethnopharmacol 1997;58:89-95. PubMed
  8. Nair PK, Rodriguez S, Ramachandran R, et al. Immune stimulating properties of a novel polysaccharide from the medicinal plant Tinospora cordifolia. Int Immunopharmacol 2004;4:1645-59. PubMed
  9. Castillo AL, Osi MO, Ramos JD, De Francia JL, Dujunco MU, Quilala PF. Efficacy and safety of Tinospora cordifolia lotion in Sarcoptes scabiei var hominis-infected pediatric patients: A single blind, randomized controlled trial. J Pharmacol Pharmacother. 2 PubMed
  10. Sahu R, Ahmed T, Sangana R, Punde R, Subudhi BB. Effect of Tinospora cordifolia aqua-alcoholic extract on pharmacokinetic of glibenclamide in rat: an herb-drug interaction study. J Pharm Biomed Anal. 2018;151:310-6. doi: 10.1016/j.jpba.2018.01.010. PubMed
  11. Patial V, Katoch S, Chhimwal J, Singh PP, Suresh PS, Padwad Y. Tinospora cordifolia activates PPAR? pathway and mitigates glomerular and tubular cell injury in diabetic kidney disease. Phytomedicine 2021;91:153663. PubMed
  12. Kulkarni AV, Hanchanale P, Prakash V, et al. Tinospora Cordifolia (Giloy)-Induced Liver Injury During the COVID-19 Pandemic-Multicenter Nationwide Study From India. Hepatol Commun 2022;6(6):1289-1300. PubMed
  13. Nagral A, Adhyaru K, Rudra OS, Gharat A, Bhandare S. Herbal Immune Booster-Induced Liver Injury in the COVID-19 Pandemic - A Case Series. J Clin Exp Hepatol. 2021;11(6):732-738. PubMed
  14. Chattopadhyay K, Wang H, Kaur J, et al. Effectiveness and Safety of Ayurvedic Medicines in Type 2 Diabetes Mellitus Management: A Systematic Review and Meta-Analysis. Front Pharmacol. 2022;13:821810. Published 2022 Jun 8. PubMed
  15. Nnamani I, Tolu-Akinnawo O, Dufera RR, Akintunde A, Maliakkal B. Tinospora cordifolia (Guduchi/Giloy)-Induced Liver Injury: A Case Review. Cureus 2023;15(5):e39793. PubMed
  16. May K, Jeitler M, Murthy V, Stapelfeldt E, Kessler CS. A Case Report of Acute Hepatitis Involving the Medicinal Herb Tinospora cordifolia Along with Other Variables. J Integr Complement Med 2023;29(5):327-333.

See these in context on the Tinospora Cordifolia monograph →

Schisandra 26 references
  1. Leung AY, Foster S. Encyclopedia of Common Natural Ingredients Used in Food, Drugs and Cosmetics. 2nd ed. New York, NY: John Wiley & Sons, 1996.
  2. Iwata H, Tezuka Y, Kadota S, et al. Identification and characterization of potent CYP3A4 inhibitors in Schisandra fruit extract. Drug Metab Dispos 2004;32:1351-8. PubMed
  3. Mu Y, Zhang J, Zhang S, et al. Traditional Chinese medicines Wu Wei Zi (Schisandra chinensis Baill) and Gan Cao (Glycyrrhiza uralensis Fisch) activate pregnane X receptor and increase warfarin clearance in rats. J Pharmacol Exp Ther 2006;316:1369-77. PubMed
  4. Xin HW, Wu XC, Li Q, et al. Effects of Schisandra sphenanthera extract on the pharmacokinetics of tacrolimus in healthy volunteers. Br J Clin Pharmacol 2007;64:469-75.
  5. Qin XL, Bi HC, Wang XD, et al. Mechanistic understanding of the different effects of Wuhzi Tablet (Schisandra sphenanthera extract) on the absorption and first-pass intestinal and hepatic metabolism of tacrolimus (FK506). Int J Pharm 2010;389:114-21.
  6. Makino, T., Mizuno, F., and Mizukami, H. Does a kampo medicine containing schisandra fruit affect pharmacokinetics of nifedipine like grapefruit juice? Biol.Pharm.Bull. 2006;29(10):2065-2069. PubMed
  7. Fan L, Mao XQ, Tao GY, Wang G, Jiang F, Chen Y, Li Q, Zhang W, Lei HP, Hu DL, Huang YF, Wang D, Zhou HH. Effect of Schisandra chinensis extract and Ginkgo biloba extract on the pharmacokinetics of talinolol in healthy volunteers. Xenobiotica. 2009 Mar;39(
  8. Jiang W, Wang X, Xu X, Kong L. Effect of Schisandra sphenanthera extract on the concentration of tacrolimus in the blood of liver transplant patients. Int J Clin Pharmacol Ther. 2010 Mar;48(3):224-9. PubMed
  9. Xin HW, Wu XC, Li Q, Yu AR, Xiong L. Effects of Schisandra sphenanthera extract on the pharmacokinetics of midazolam in healthy volunteers. Br J Clin Pharmacol. 2009 May;67(5):541-6.
  10. Li J, Chen S, Qin X, et at. Wuzhi Tablet (<i>Schisandra sphenanthera</i> Extract) is a Promising Tacrolimus-Sparing Agent for Renal Transplant Recipients Who are CYP3A5 Expressers: a Two-Phase Prospective Study. Drug Metab Dispos. 2017;45(11):1114-1119.
  11. Qin XL, Li JL, Wang SH, Chen X, Huang M, Bi HC. Co-administration of Wuzhi tablet (Schisandra sphenanthera extract) alters tacrolimus pharmacokinetics in a dose- and time-dependent manner in rats. J Ethnopharmacol. 2020;263:113233. PubMed
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See these in context on the Schisandra monograph →

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

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

© 2021 Therapeutic Research Center, LLC

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