Interactions on record — worth a quick check against your medications. Based on 6 of 7 ingredients. Check your meds →
Dietary supplement

Lymphatic System 4 Capsules Ingredients & Drug Interactions

by Dr. Morse's Cellular Botanicals

Lymphatic System 4 Capsules 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 Lymphatic System 4 Capsules 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

Lymphatic System 4 Capsules is a dietary supplement by Dr. Morse's Cellular Botanicals with 7 active ingredients. Its ingredients are commonly taken for memory and cognitive support, circulation problems, dizziness and ringing in the ears.Based on those ingredients, 1,140 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Red Clover, Chaparral, Periwinkle. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

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Check Your Meds Against Lymphatic System 4 Capsules by Dr. Morse's Cellular Botanicals

Ask about any prescription or over-the-counter medication and we check it for interactions with Lymphatic System 4 Capsules by Dr. Morse's Cellular Botanicals — and tell you which ingredient is responsible.

Pharmacist-reviewed data Checks every ingredient Answer in seconds
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HelloPharmacist Scorecard of Lymphatic System 4 Capsules by Dr. Morse's Cellular Botanicals

Our pharmacy team’s full take, with four database checks built into the cards below — a summary of what is known, not a grade of the product itself.

From our pharmacy team — supplement deep dive

Generated from HelloPharmacist’s pharmacist-curated databases and editorial rules · Last generated Jul 11, 2026

What’s inside

Low disclosure
Ingredient Transparency · database check
Low

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

Why this rating?
  • The label discloses an exact amount for 0 of its 7 active ingredients.
  • “Proprietary Blend” is a proprietary blend — the label gives one combined amount (900 mg) without saying how much of each component you get.

This product is a proprietary blend with seven active herbal ingredients. The blend includes periwinkle, red clover, bayberry, chaparral, bloodroot, graviola, and poke root — each chosen for traditional lymphatic support roles.

One inactive ingredient, a vegetarian capsule, holds the herbs.

Does it work?

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

Some clinical evidence supports this product's ingredients for its stated purpose, but it isn't conclusive.

Why this rating?
  • The label markets this product for: support cellular regeneration and vitality.
  • We looked for evidence on: Menopausal symptoms, Osteoporosis, Hyperlipidemia, Gingivitis, Periodontitis, Cough — and 4 related terms.
  • The strongest evidence on file: Bloodroot is rated "Possibly Effective" for Dental plaque (Natural Medicines).
  • Also on file: Bloodroot is rated "Possibly Effective" for Gingivitis.
  • Also on file: Red Clover is rated "Insufficient Reliable Evidence To Rate" for Osteoporosis, Hyperlipidemia, Menopausal symptoms.

The evidence for these herbs' effectiveness in supporting the lymphatic system isn't established in the data we hold. Red clover, bloodroot, and graviola have been studied for other uses — red clover for menopausal symptoms and bone health, bloodroot for dental plaque and gum health, and graviola for various conditions — but all those ratings are insufficient evidence.

For the lymphatic system specifically, no effectiveness data is available.

The evidence, ingredient by ingredient Periwinkle Red Clover Bayberry Chaparral Bloodroot Graviola

How safe is it?

Well-documented data
Safety Information · database check
Well characterized

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

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

Several of these ingredients carry serious safety red flags. Chaparral is linked to liver failure and has caused cases requiring transplant; the data advises against it altogether.

Periwinkle contains toxic alkaloids that can damage the liver, kidneys, and nervous system, and it should only be used with professional guidance. Bloodroot is potentially corrosive and toxic — long-term use of bloodroot products in the mouth has caused mouth sores and changes in taste.

Graviola may cause movement disorders similar to Parkinson's disease with regular use. Red clover is generally well tolerated short-term but may cause muscle pain, nausea, or vaginal spotting.

Bayberry in large amounts can irritate the stomach. None of these herbs are safe in pregnancy or while breastfeeding.

Side effects, ingredient by ingredient Periwinkle Red Clover Bayberry Chaparral Bloodroot Graviola

Meds to double-check

Moderate interaction found
Known Interaction Concern · database check
Moderate identified

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

Why this rating?
  • 4 of the 6 matched ingredients can interact with medications — Red Clover, Periwinkle, Chaparral, Graviola.
  • The most serious interaction on file is rated Moderate.
  • Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs.
  • For scale: 1,141 individual medications appear in the full list. A big number alone doesn't make a product dangerous — what matters is whether YOUR medication is on it, so run yours through the interaction checker on this page.

Before taking this product, check with your pharmacist if you take blood pressure medication (periwinkle may lower it further), estrogen therapy or tamoxifen (red clover may interfere), methotrexate (red clover may increase toxicity), drugs processed by your liver's CYP1A2, CYP2C9, CYP2C19, or CYP3A4 systems (red clover may affect levels), carbamazepine (graviola may lower its levels), or any medication that stresses your liver (chaparral could add to liver damage).

Check your own medication Run your meds through the checker above

The bottom line

Scorecard at a glanceFormula with limited ingredient disclosure with some supporting evidence for its stated purpose. Moderate medication interactions have been identified, and safety information is well characterized.

This product combines herbs with serious safety concerns — particularly chaparral and periwinkle — and significant medication interactions. If you take any prescription drugs, blood pressure medication, estrogen therapy, methotrexate, tamoxifen, or medications processed by your liver, check them against the interaction tool before considering this product.

Talk to your pharmacist or doctor about whether any of these herbs fit your situation.

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

Assessment coverage: 6 of 7 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Feb 22, 2024.

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 Lymphatic System 4 Capsules, straight from the product label.

Brand Dr. Morse's Cellular Botanicals
Net contents 90 Veggiecap(s)
Market status On market
Date entered into DSLD Feb 22, 2024
DSLD ID 302966
Product type Botanical
Supplement form Capsule
Dietary claims / uses All Other, Structure/Function
Intended target group(s) Adult (18 - 50 Years)
From the label
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.

Supplement Facts

The label details for Lymphatic System 4 Capsules by Dr. Morse's Cellular Botanicals, 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:
2 Capsule(s)
Maximum serving Sizes:
2 Capsule(s)
Servings per container
45
IngredientAmount% DV
Proprietary Blend900 mg--
Periwinkle0 NP--
Red Clover0 NP--
Bayberry0 NP--
Chaparral0 NP--
Bloodroot0 NP--
Graviola0 NP--
Poke Root0 NP--

Other ingredients: Vegetarian 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.
Formulation

Support cellular regeneration with our tissue specific formulas! Created with over 45 years of experience and the highest quality ingredients available. Experience health and vitality like never before!

Our formulas are made with organic, wildcrafted or consciously cultivated herbs

Made in the USA with global ingredients

Formula

Our formulas are made with organic, wildcrafted or consciously cultivated herbs

Suggested/Recommended/Usage/Directions

Suggested Use 2 capsules, 3 times a day.

Precautions

See our website for any precautions.

Keep out of reach of children.

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.

FDA Statement of Identity

Dietary Supplement

General Statements

90 Veggiecaps (450 mg each)

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

See for yourself

Lymphatic System 4 Capsules by Dr. Morse's Cellular Botanicals label

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

Lymphatic System 4 Capsules 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 Lymphatic System 4 Capsules by Dr. Morse's Cellular Botanicals

These are the 7 active ingredients this product is made of. Select any to open its full monograph.

Serving size2 Capsule(s) Dosage formCapsule Servings per container45 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.

Proprietary Blend

900 mg per serving

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

Interaction report

Lymphatic System 4 Capsules by Dr. Morse's Cellular Botanicals Drug Interactions

Want to check YOUR meds against Lymphatic System 4 Capsules?

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
1,140Drugs
550 Moderate 590 Minor

Ingredients driving the most interactions

Red Clover 867
Chaparral 370
Periwinkle 172
Graviola 1

Individual Drug Interactions

The ingredients in Lymphatic System 4 Capsules interact with 1,140 drugs. Click any drug to see the details.

4 of the 7 ingredients in Lymphatic System 4 Capsules interact with drugs. Each result below shows which ingredient is responsible. Red Clover Chaparral Periwinkle Graviola

Each ingredient & the kinds of drugs it affects

For each ingredient in Lymphatic System 4 Capsules 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.

Red Clover9 drug types · 867 drugs

Estrogens

Theoretically, concomitant use of large amounts of red clover might interfere with estrogen therapy.
Red clover contains phytoestrogens which might have estrogenic activity in some people. Theoretically, red clover might compete for estrogen receptors and interfere with estrogen-containing drug therapy.

Likelihood Probable Evidence D
Methotrexate (Trexall, Others)

Theoretically, red clover might increase the risk of methotrexate toxicity.
In a case report, a 52-year-old female receiving weekly methotrexate injections for psoriasis developed symptoms of methotrexate toxicity, including severe vomiting and epigastric pain, after three days of taking red clover 430 mg daily. Toxicity resolved after red clover was discontinued. However, no liver function tests or methotrexate levels were reported.

Likelihood Possible Evidence D
Tamoxifen (Nolvadex)

Theoretically, the phytoestrogens in red clover might interfere with tamoxifen.
In vitro and animal research suggests that genistein, a constituent of red clover, might antagonize the antitumor effects of tamoxifen. However, there is some evidence from an animal study that red clover does not reduce the efficacy of tamoxifen. Until more is known, tell patients taking tamoxifen to avoid red clover.

Likelihood Possible Evidence D
Anticoagulant/Antiplatelet Drugs

Although some laboratory research suggests that red clover may have anticoagulant and antiplatelet activity, clinical research has not shown this effect.
In vitro research suggests that genistein in red clover has antiplatelet effects, and historically, red clover was thought to have anticoagulant effects due to its coumarin content. However, some experts state that this is unlikely as most natural coumarins have not been shown to have anticoagulant effects, and their content in red clover is low. Additionally, some clinical research in postmenopausal patients found no effect on coagulation or prothrombin time with the use of red clover flowering tops 378 mg daily for 12 months or red clover isoflavone (Rimostil) 50 mg daily for 2 years.

Likelihood Unlikely Evidence B
Caffeine

Theoretically, soy might reduce the clearance of caffeine; however, a small clinical study found no effect.
Red clover contains genistein. Taking genistein 1 gram daily for 14 days seems to inhibit caffeine clearance and metabolism in healthy females. However, this effect does not seem to occur with the lower amounts of genistein found in red clover. A clinical study in healthy postmenopausal individuals shows that taking red clover capsules standardized to contain 60 mg isoflavones twice daily for 14 days does not affect the pharmacokinetics of caffeine.

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

Theoretically, red clover might increase levels of drugs metabolized by CYP1A2; however, a small clinical study found no effect.
In vitro evidence shows that red clover inhibits CYP1A2. However, a clinical study in healthy postmenopausal individuals shows that taking red clover capsules standardized to contain 60 mg isoflavones twice daily for 14 days does not affect the pharmacokinetics of caffeine, a CYP1A2 probe substrate.

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

Theoretically, red clover might increase the levels and clinical effects of drugs metabolized by CYP2C19.
In vitro evidence suggests that red clover weakly inhibits CYP2C19. This interaction has not been reported in humans.

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

Theoretically, red clover might increase levels of drugs metabolized by CYP2C9; however, a small clinical study found no effect.
In vitro evidence suggests that red clover might inhibit CYP2C9. However, a clinical study in healthy postmenopausal individuals shows that taking red clover capsules standardized to contain 60 mg isoflavones twice daily for 14 days does not affect the pharmacokinetics of tolbutamide, a CYP2C9 probe substrate.

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

Theoretically, red clover might increase levels of drugs metabolized by CYP3A4; however, a small clinical study found no effect.
In vitro evidence shows that red clover might inhibit CYP3A4 isoenzymes. However, a clinical study in healthy postmenopausal individuals shows that taking red clover capsules standardized to contain 60 mg isoflavones twice daily for 14 days does not affect the pharmacokinetics of alprazolam, a CYP3A4 probe substrate.

Likelihood Unlikely Evidence B
Red Clover full monograph & interactions

Chaparral1 drug type · 370 drugs

Hepatotoxic Drugs

Theoretically, chaparral might have additive adverse effects on the liver when used with hepatotoxic drugs.

Likelihood Possible Evidence D
Chaparral full monograph & interactions

Periwinkle1 drug type · 172 drugs

Antihypertensive Drugs

Theoretically, taking periwinkle may increase the effects of antihypertensive drugs due to the hypotensive activity of vincamine, a constituent of periwinkle.

Likelihood Probable Evidence D
Periwinkle full monograph & interactions

Graviola1 drug type · 1 drug

Carbamazepine (Tegretol)

Theoretically, graviola might decrease concentrations of carbamazepine when used concomitantly.
A study in rats shows that graviola extract reduces the area under the curve of carbamazepine by 46% and maximum concentration by 35% when compared with carbamazepine alone.

Likelihood Possible Evidence D
Graviola full monograph & interactions
The maker

Brand information

Manufacturer and brand details for Lymphatic System 4 Capsules, from the product label.

Dr. Morse's Cellular Botanicals

See all Dr. Morse's Cellular Botanicals products
Name
Western Botanicals FL, LLC
City
Spanish Fork
State
UT
ZipCode
84660
Phone Number
(800) 651-4372
Web Address
DMHHC.com
Pharmacist Counseling Corner

Lymphatic System 4 Capsules by Dr. Morse's Cellular Botanicals: Common Questions

Does Lymphatic System 4 Capsules by Dr. Morse's Cellular Botanicals interact with any medications?
Yes. Based on its ingredients, Lymphatic System 4 Capsules has a known interaction with 1,140 medications. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Lymphatic System 4 Capsules contains 7 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.
Is this safe to take if I'm pregnant or breastfeeding?
No. The safety data advises against all these herbs during pregnancy and breastfeeding. Periwinkle and chaparral are outright unsafe, and bloodroot, bayberry, and graviola lack enough safety information — so they're best avoided. Talk to your doctor before using any herbal product while pregnant or nursing.
What exactly is in the proprietary blend?
The blend contains periwinkle, red clover, bayberry, chaparral, bloodroot, graviola, and poke root. The exact amounts of each aren't listed on the label, which is common with proprietary blends — so you can't know how much of each herb you're getting per capsule.
Can chaparral really cause liver damage?
Yes. The data shows chaparral can cause serious liver toxicity including hepatitis, cirrhosis, and liver failure — there have been cases requiring liver transplant. The safety notes advise against it altogether, not just caution. If you have any liver concerns, you should definitely avoid this product.
What side effects might I experience?
Periwinkle can cause skin flushing, low blood pressure, and damage to the liver and kidneys. Red clover may cause muscle pain, nausea, or vaginal spotting. Bloodroot can cause nausea and vomiting, and long-term use in the mouth causes mouth sores and taste changes. Graviola may cause nausea and belly pain, and regular use has been linked to movement disorders. Chaparral and bayberry can cause stomach upset.
Does this product actually work for lymphatic health?
We don't have effectiveness data for these herbs specifically for the lymphatic system. Some have been studied for other uses, but those studies showed insufficient evidence. There's no established proof this blend supports lymphatic function.
Why can't you check poke root for interactions?
We hold no interaction data for poke root, so we can't tell you whether it interacts with your medications. That's another reason to run your exact drug list through the checker on this page before starting.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Not sure if Lymphatic System 4 Capsules is safe with your meds?

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Ask a pharmacist

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.

Lymphatic System 4 Capsules label
Go deeper

The Full Monographs Behind Lymphatic System 4 Capsules’s Ingredients

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

Herb & supplement monograph

Periwinkle

Interacts with 172 drugs

Periwinkle (Vinca minor) is a flowering plant whose alkaloids are the source of vinpocetine, a compound marketed for memory and brain circulation. Evidence in humans is limited and mixed, an...

Read the full Periwinkle monograph → Herb & supplement monograph

Red Clover

Interacts with 867 drugs

Red clover is a plant rich in isoflavones (plant compounds with weak estrogen-like activity) that is most often used for menopause symptoms like hot flashes. The evidence is mixed and genera...

Read the full Red Clover monograph → Herb & supplement monograph

Bayberry

Bayberry is a traditional herb used mainly as an astringent for diarrhea, sore throats, and minor skin or gum problems, but there is very little modern human research to confirm it works. It...

Read the full Bayberry monograph → Herb & supplement monograph

Chaparral

Interacts with 370 drugs

Chaparral is a desert shrub long used in traditional medicine, but there is no reliable proof it treats any condition. It has been linked to serious and sometimes irreversible liver and kidn...

Read the full Chaparral monograph → Herb & supplement monograph

Bloodroot

Bloodroot is a North American plant whose red root sap contains potent alkaloids that are corrosive to skin and tissue. It has a long folk history, but there is no good evidence it safely tr...

Read the full Bloodroot monograph → Herb & supplement monograph

Graviola

Interacts with 1 drug

Graviola (soursop) is a tropical fruit tree whose leaves, fruit, and bark are used in traditional medicine, especially in parts of South America, Africa, and Asia. Despite popular online cla...

Read the full Graviola monograph →
Sources

Sources & How We Checked

Lymphatic System 4 Capsules'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 69 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.

Periwinkle 5 references
  1. Blumenthal M, ed. The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. Trans. S. Klein. Boston, MA: American Botanical Council, 1998.
  2. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
  3. Ellenhorn MJ, et al. Ellenhorn's Medical Toxicology: Diagnoses and Treatment of Human Poisoning. 2nd ed. Baltimore, MD: Williams & Wilkins, 1997.
  4. Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.
  5. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.

See these in context on the Periwinkle monograph →

Red Clover 24 references
  1. Kurzer MS, Xu X. Dietary phytoestrogens. Annu Rev Nutr 1997;17:353-81. PubMed
  2. Electronic Code of Federal Regulations. Title 21. Part 182 -- Substances Generally Recognized As Safe. Available at: https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?CFRPart=182
  3. Budzinski JW, Foster BC, Vandenhoek S, Arnason JT. An in vitro evaluation of human cytochrome P450 3A4 inhibition by selected commercial herbal extracts and tinctures. Phytomedicine 2000;7:273-82. PubMed
  4. This P, De La Rochefordiere A, Clough K, et al. Phytoestrogens after breast cancer. Endocr Relat Cancer 2001;8:129-34. PubMed
  5. Tice J, Cummings SR, Ettinger B, et al. Few adverse effects of two red clover extracts rich in phytoestrogens: a multicenter, placebo-controlled trial. Alt Ther 2001;7:S33.
  6. Ingram DM, Hickling C, West L, et al. A double-blind randomized controlled trial of isoflavones in the treatment of cyclical mastalgia. The Breast 2002;11:170-4. PubMed
  7. Unger M, Frank A. Simultaneous determination of the inhibitory potency of herbal extracts on the activity of six major cytochrome P450 enzymes using liquid chromatography/mass spectrometry and automated online extraction. Rapid Commun Mass Spectrom 2004;1 PubMed
  8. Cheong JL, Bucknall R. Retinal vein thrombosis associated with a herbal phytoestrogen preparation in a susceptible patient. Postgrad Med J 2005;81:266-7.. PubMed
  9. Geller SE, Shulman LP, van Breemen RB, et al. Safety and efficacy of black cohosh and red clover for the management of vasomotor symptoms: a randomized controlled trial. Menopause 2009;16:1156-66. PubMed
  10. Hidalgo LA, Chedraui PA, Morocho N, et al. The effect of red clover isoflavones on menopausal symptoms, lipids and vaginal cytology in menopausal women: a randomized, double-blind, placebo-controlled study. Gynecol Endocrinol 2005;21(5):257-264. PubMed
  11. Campbell MJ, Woodside JV, Honour JW, et al. Effect of red clover-derived isoflavone supplementation on insulin-like growth factor, lipid and antioxidant status in healthy female volunteers: a pilot study. Eur J Clin Nutr 2004;58(1):173-179. PubMed
  12. Guerrero JA, Lozano ML, Castillo J, et al. Flavonoids inhibit platelet function through binding to the thromboxane A2 receptor. J Thromb Haemost 2005;3(2):369-376. PubMed
  13. Kondo K, Suzuki Y, Ikeda Y, Umemura K. Genistein, an isoflavone included in soy, inhibits thrombotic vessel occlusion in the mouse femoral artery and in vitro platelet aggregation. Eur J Pharmacol 2002;455(1):53-57. PubMed
  14. Polini N, Rauschemberger MB, Mendiberri J, et al. Effect of genistein and raloxifene on vascular dependent platelet aggregation. Mol Cell Endocrinol 2007;267(1-2):55-62. PubMed
  15. Wuttke W, Jarry H, Seidlova-Wuttke D. Plant-derived alternative treatments for the aging male: facts and myths. Aging Male 2010;13(2):75-81. PubMed
  16. Villaseca P. Non-estrogen conventional and phytochemical treatments for vasomotor symptoms: what needs to be known for practice. Climacteric 2012;15(2):115-124. PubMed
  17. Chen, Y., Xiao, C. Q., He, Y. J., Chen, B. L., Wang, G., Zhou, G., Zhang, W., Tan, Z. R., Cao, S., Wang, L. P., and Zhou, H. H. Genistein alters caffeine exposure in healthy female volunteers. Eur.J Clin.Pharmacol. 2011;67(4):347-353. PubMed
  18. Friedman, J. A., Taylor, S. A., McDermott, W., and Alikhani, P. Multifocal and recurrent subarachnoid hemorrhage due to an herbal supplement containing natural coumarins. Neurocrit.Care 2007;7(1):76-80. PubMed
  19. Hooper, L., Madhavan, G., Tice, J. A., Leinster, S. J., and Cassidy, A. Effects of isoflavones on breast density in pre- and post-menopausal women: a systematic review and meta-analysis of randomized controlled trials. Hum.Reprod.Update. 2010;16(6):745-7 PubMed
  20. Orr A and Parker R. Red clover causing symptoms suggestive of methotrexate toxicity in a patient on high-dose methotrexate. Menopause Int. 2013;19(3):133-134. PubMed
  21. Clifton-Bligh PB, et al. Red cover isoflavones enriched with formononetin lower serum LDL cholesterol- a randomized, double-blind, placebo-controlled trial. Eur J Clin Nutr. 2015;69(1):134-142.
  22. Risk assessment for peri- and post-menopausal women taking food supplements containing isolated isoflavones. EFSA Panel on Food Additives and Nutrient Sources added to Food (ANS). 2015. DOI
  23. Ferraris C, Ballestra B, Listorti C, et al. Red clover and lifestyle changes to contrast menopausal symptoms in premenopausal patients with hormone-sensitive breast cancer receiving tamoxifen. Breast Cancer Res Treat 2020;180(1):157-65. doi: 10.1007/s1054 PubMed
  24. Chen L, Choi J, Leonard SW, et al. No Clinically Relevant Pharmacokinetic Interactions of a Red Clover Dietary Supplement with Cytochrome P450 Enzymes in Women. J Agric Food Chem. 2020;68(47):13929-13939. PubMed

See these in context on the Red Clover monograph →

Bayberry 3 references
  1. Newall CA, Anderson LA, Philpson JD. Herbal Medicine: A Guide for Healthcare Professionals. London, UK: The Pharmaceutical Press, 1996.
  2. Foster S, Tyler VE. Tyler's Honest Herbal: A Sensible Guide to the Use of Herbs and Related Remedies. 3rd ed., Binghamton, NY: Haworth Herbal Press, 1993.
  3. The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999.

See these in context on the Bayberry monograph →

Chaparral 16 references
  1. Smith BC, Desmond PV. Acute hepatitis induced by ingestion of the herbal medication chaparral. Aust N Z J Med 1993;23:526.. PubMed
  2. Gordon DW, Rosenthal G, Hart J, et al. Chaparral ingestion: the broadening spectrum of liver injury caused by herbal medications. JAMA 1995;273:489-90.
  3. Batchelor WB, Heathcote J, Wanless IR. Chaparral-induced hepatic injury. Am J Gastroenterol 1995;90:831-3.
  4. Katz M, Saibil F. Herbal hepatitis: subacute hepatic necrosis secondary to chaparral leaf. J Clin Gastroenterol 1990;12:203-6.
  5. Klepser TB, Klepser ME. Unsafe and potentially safe herbal therapies. Am J Health Syst Pharm 1999;56:125-38. PubMed
  6. Sheikh NM, Philen RM, Love LA. Chaparral-associated hepatotoxicity. Arch Intern Med 1997;157:913-9. DOI
  7. Heron S, Yarnell E. The safety of low-dose Larrea tridentata (DC) Coville (creosote bush or chaparral): a retrospective clinical study. J Altern Complement Med 2001;7:175-85..
  8. Chaparral-induced toxic hepatitis-California and Texas, 1992. MMWR Morb Mortal Wkly Rep 1992;41:812-4.. DOI
  9. Estes JD, Stolpman D, Olyaei A, et al. High prevalence of potentially hepatotoxic herbal supplement use in patients with fulminant hepatic failure. Arch Surg 2003;138:852-8.. PubMed
  10. Lambert JD, Zhao D, Meyers RO, et al. Nordihydroguaiaretic acid: hepatotoxicity and detoxification in the mouse. Toxicon 2002;40:1701-8.. PubMed
  11. Shasky DR. Contact dermatitis from Larrea tridentata (creosote bush). J Am Acad Dermatol 1986;15:302.. PubMed
  12. Smith AY, Feddersen RM, Gardner KD Jr, Davis CJ Jr. Cystic renal cell carcinoma and acquired renal cystic disease associated with consumption of chaparral tea: a case report. J Urol 1994;152:2089-91.. PubMed
  13. Kauma, H., Koskela, R., Makisalo, H., Autio-Harmainen, H., Lehtola, J., and Hockerstedt, K. Toxic acute hepatitis and hepatic fibrosis after consumption of chaparral tablets. Scand.J Gastroenterol. 2004;39(11):1168-1171. PubMed
  14. Leonforte, J. F. Contact dermatitis from Larrea (creosote bush). J Am Acad.Dermatol. 1986;14(2 Pt 1):202-207. PubMed
  15. Alderman, S., Kailas, S., Goldfarb, S., Singaram, C., and Malone, D. G. Cholestatic hepatitis after ingestion of chaparral leaf: confirmation by endoscopic retrograde cholangiopancreatography and liver biopsy. J Clin.Gastroenterol. 1994;19(3):242-247.
  16. Clark, F. Chaparral-induced toxic hepatitis: California and Texas, 1992. MMWR Morb Mortal Wkly Rep. 1992;41:812-814. DOI

See these in context on the Chaparral monograph →

Bloodroot 17 references
  1. Newall CA, Anderson LA, Philpson JD. Herbal Medicine: A Guide for Healthcare Professionals. London, UK: The Pharmaceutical Press, 1996.
  2. The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999.
  3. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
  4. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
  5. Tenenbaum, H., Dahan, M., and Soell, M. Effectiveness of a sanguinarine regimen after scaling and root planing. J Periodontol. 1999;70(3):307-311. PubMed
  6. Eversole, L. R., Eversole, G. M., and Kopcik, J. Sanguinaria-associated oral leukoplakia: comparison with other benign and dysplastic leukoplakic lesions. Oral Surg.Oral Med.Oral Pathol.Oral Radiol.Endod. 2000;89(4):455-464. PubMed
  7. Allen, C. L., Loudon, J., and Mascarenhas, A. K. Sanguinaria-related leukoplakia: epidemiologic and clinicopathologic features of a recently described entity. Gen.Dent. 2001;49(6):608-614.
  8. Kopczyk, R. A., Abrams, H., Brown, A. T., Matheny, J. L., and Kaplan, A. L. Clinical and microbiological effects of a sanguinaria-containing mouthrinse and dentifrice with and without fluoride during 6 months of use. J.Periodontol. 1991;62(10):617-622. PubMed
  9. Harper, D. S., Mueller, L. J., Fine, J. B., Gordon, J., and Laster, L. L. Clinical efficacy of a dentifrice and oral rinse containing sanguinaria extract and zinc chloride during 6 months of use. J.Periodontol. 1990;61(6):352-358. PubMed
  10. Kuftinec, M. M., Mueller-Joseph, L. J., and Kopczyk, R. A. Sanguinaria toothpaste and oral rinse regimen clinical efficacy in short- and long-term trials. J.Can.Dent.Assoc. 1990;56(7 Suppl):31-33.
  11. Frankos, V. H., Brusick, D. J., Johnson, E. M., Maibach, H. I., Munro, I., Squire, R. A., and Weil, C. S. Safety of Sanguinaria extract as used in commercial toothpaste and oral rinse products. J.Can.Dent.Assoc. 1990;56(7 Suppl):41-47.
  12. Cullinan, M. P., Powell, R. N., Faddy, M. J., and Seymour, G. J. Efficacy of a dentifrice and oral rinse containing sanguinaria extract in conjunction with initial periodontal therapy. Aust.Dent.J. 1997;42(1):47-51. PubMed
  13. Affleck, A. G. and Varma, S. A case of do-it-yourself Mohs' surgery using bloodroot obtained from the internet. Br.J Dermatol 2007;157(5):1078-1079. PubMed
  14. Cienki JJ, Zaret L. An Internet misadventure: bloodroot salve toxicity. J Altern Complement Med. 2010;16(10):1125-7. PubMed
  15. Hou JL, Brewer JD. Black salve and bloodroot extract in dermatologic conditions. Cutis. 2015;95(6):309-11.
  16. Schilling LM, Saedi N. Bloodroot paste: what dermatologists and patients need to know. Dermatol Surg 2016;42(10):1223-4. PubMed
  17. Schlichte MJ, Downing CP, Ramirez-Fort M, Gordon R, Tyring S. Bloodroot associated eschar. Dermatol Online J 2014;20(7). DOI

See these in context on the Bloodroot monograph →

Graviola 4 references
  1. Caparros-Lefebvre D, Elbaz A. Possible relation of atypical parkinsonism in the French West Indies with consumption of tropical plants: a case-control study. Caribbean Parkinsonism Study Group. Lancet 1999;354:281-6. PubMed
  2. Gavamukulya Y, Wamunyokoli F, El-Shemy HA. Annona muricata: Is the natural therapy to most disease conditions including cancer growing in our backyard? A systematic review of its research history and future prospects. Asian Pac J Trop Med. 2017;10(9):835- PubMed
  3. Abu Soukhon AA, Abu-Qatouseh L, Mansoor K, et al. Cytotoxicity Activity of Graviola Fruit Extract with Carbamazepine and Valproic Acid Show Antagonistic and Indifferent Effects. Asian Pac J Cancer Prev 2023;24(6):1869-1875. PubMed
  4. Cleret de Langavant L, Roze E, Petit A, et al. Annonaceae Consumption Worsens Disease Severity and Cognitive Deficits in Degenerative Parkinsonism. Mov Disord 2022;37(12):2355-2366. PubMed

See these in context on the Graviola monograph →

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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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