Marshmallow & Fenugreek Ingredients & Drug Interactions
What is this page for?
First and foremost: checking Marshmallow & Fenugreek 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
Marshmallow & Fenugreek is a dietary supplement by Nature's Sunshine with 3 active ingredients. Its ingredients are commonly taken for sore throat and cough, heartburn and acid reflux, digestive upset and ibs.Based on those ingredients, 2,074 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Marshmallow, Slippery Elm, Fenugreek. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against Marshmallow & Fenugreek by Nature's Sunshine
Ask about any prescription or over-the-counter medication and we check it for interactions with Marshmallow & Fenugreek by Nature's Sunshine — and tell you which ingredient is responsible.
AI summaries are generated from our interaction database for education only — always confirm with your pharmacist. How we use AI
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HelloPharmacist Scorecard of Marshmallow & Fenugreek by Nature's Sunshine
Our pharmacy team’s full take, with four database checks built into the cards below — a summary of what is known, not a grade of the product itself.
What’s inside
Low disclosure
This product contains three active ingredients: slippery elm, marshmallow, and fenugreek, all traditional herbs often used for digestive comfort. Slippery elm inner bark is known for its mucilage content, which coats the digestive tract.
Marshmallow root and leaf similarly contain mucilage. Fenugreek seed is included for its traditional uses.
The capsule is an inactive ingredient used to deliver the blend.
Does it work?
Not established
The evidence for what these herbs actually do is still being established. For slippery elm, we don't have reliable evidence yet that it works for cancer, constipation, cough, inflammatory bowel disease, or diarrhea.
Marshmallow similarly lacks solid evidence for vaginal candidiasis, diarrhea, leg ulcers, eczema, or respiratory tract infections. Fenugreek is possibly effective for sexual dysfunction, sexual arousal, dysmenorrhea (period pain), and type 2 diabetes—but the other uses in this product haven't been proven.
How safe is it?
Well-documented data
Slippery elm and marshmallow are generally well tolerated for short-term use, but human safety data are limited. Fenugreek is generally well tolerated in food amounts, though supplement doses can cause side effects like bloating, diarrhea, nausea, and abdominal pain.
Rarely, fenugreek can cause serious allergic reactions including bronchospasm and shock. All three ingredients carry pregnancy cautions.
Slippery elm and marshmallow lack enough safety data in pregnancy—marshmallow should be avoided during pregnancy. Fenugreek is likely unsafe in pregnancy because it may affect the uterus and can cause an unusual body odor in newborns.
For breastfeeding, fenugreek is possibly safe and is sometimes used to boost milk supply, but discuss it with your provider first. Slippery elm and marshmallow have too little breastfeeding data, so caution is advised.
Meds to double-check
Moderate interaction found
Before you start this product, check with your doctor or pharmacist if you take blood thinners like warfarin or clopidogrel, diabetes medications, blood pressure drugs (especially metoprolol), seizure medications like phenytoin, theophylline, or sildenafil. The slippery elm and marshmallow in here may also slow how your body absorbs any oral medication you take, so spacing them out by 30–60 minutes can help.
Marshmallow may also affect lithium levels.
The bottom line
Scorecard at a glanceFormula with limited ingredient disclosure with no established evidence rating for its marketed use. Moderate medication interactions have been identified, and safety information is well characterized.
This product is a traditional blend, but the evidence that it actually works for any specific condition hasn't been proven yet. If you take blood thinners, diabetes medications, blood pressure drugs, seizure medications, or theophylline, you'll need to talk with your doctor or pharmacist before starting it—the interactions are real and could affect how your drugs work.
If you're pregnant, breastfeeding, or thinking about either, check with your provider first.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 3 of 3 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Oct 24, 2022.
This Scorecard evaluates available label information, ingredient evidence, and known medication-safety considerations. It does not independently verify product identity, purity, potency, contamination, or manufacturing quality. How these ratings are computed
General information
Key facts about Marshmallow & Fenugreek, straight from the product label.
| Brand | Nature's Sunshine |
|---|---|
| Barcode (UPC) | 099904008434 |
| Net contents | 100 Capsule(s) |
| Market status | On market |
| Date entered into DSLD | Oct 24, 2022 |
| DSLD ID | 278168 |
| Product type | Botanical |
| Supplement form | Capsule |
| Dietary claims / uses | All Other, Structure/Function |
| Intended target group(s) | Adult (18 - 50 Years) |
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 Marshmallow & Fenugreek by Nature's Sunshine, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Proprietary Blend | 1000 mg | -- |
| Slippery Elm | 0 NP | -- |
| Marshmallow | 0 NP | -- |
| Fenugreek | 0 NP | -- |
Other ingredients: Capsule
Tap any ingredient to jump to its full detail below.
These statements are the manufacturer’s wording, reproduced from the product label — the label is saying it, not HelloPharmacist. We don’t verify or endorse them.
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.
General Statements
Bottle made from 100% post consumer recycled material. We are committed to you and our planet. Scan to learn more.
We source the world's purest ingredients, no matter where they are grown, to ensure the active nutrients are delivered just as nature intended.
New look! Same great product
Precautions
Do not use if inner seal is missing or damaged.
Formulation
Traditional respiratory support Naturally soothing
Guaranteed pure
FDA Statement of Identity
Dietary Supplement
Brand IP Statement(s)
Natures Sunshine Herbal experts since 1972
Suggested/Recommended/Usage/Directions
Recommended Use: Take 2 capsules with a meal twice daily.
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Marshmallow & Fenugreek by Nature's Sunshine label
The label scan from the NIH Dietary Supplement Label Database. Tap to enlarge.
Label images are published by the NIH Dietary Supplement Label Database for the version of this product on file. Always read your actual product label.
View the full label (PDF)The Ingredients in Marshmallow & Fenugreek by Nature's Sunshine
These are the 3 active ingredients this product is made of. Select any to open its full monograph.
Serving size2 Capsule(s) Dosage formCapsule Servings per container50 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
- › Slippery Elm
- › Marshmallow
- › Fenugreek
Other (inactive) ingredients: Capsule. These complete the product’s ingredient list but are not active constituents.
Marshmallow & Fenugreek by Nature's Sunshine Drug Interactions
HelloPharmacist Interaction Report
Nature's Sunshine Marshmallow & Fenugreek has documented interactions with medications through its fenugreek, marshmallow, and slippery elm content.
The most serious concern is fenugreek's moderate-severity interaction with blood thinners like warfarin (Coumadin) and clopidogrel (Plavix), which could increase bleeding risk or alter how these drugs work.
Read the full breakdown — every affected drug type, severity by severity
Fenugreek also interacts moderately with diabetes medications—it can lower blood sugar on its own, so combining it with antidiabetes drugs might cause your blood sugar to drop too far. It similarly affects blood pressure medications like metoprolol, seizure drugs like phenytoin, and theophylline (used for breathing problems).
Marshmallow and slippery elm both contain mucilage, which may slow how your body absorbs oral medications; taking either one 30–60 minutes after your other drugs can help. Marshmallow also theoretically affects lithium levels due to possible diuretic effects.
Additionally, marshmallow has a minor interaction with blood thinners if the flower part is used. Altogether, these interactions span 2,075 individual medications.
Before you start this product, run your exact prescriptions through the interaction checker on this page.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against Marshmallow & Fenugreek?
Ask about interactions with your drugs in plain English — “Can I take it with lisinopril?” — and we find you the answer in seconds, ingredient by ingredient.
Go to the checkerIngredients driving the most interactions
Individual Drug Interactions
The ingredients in Marshmallow & Fenugreek interact with 2,074 drugs. Click any drug to see the details.
3 of the 3 ingredients in Marshmallow & Fenugreek interact with drugs. Each result below shows which ingredient is responsible. Marshmallow Slippery Elm Fenugreek
Adalimumab-bwwdHadlima
How Adalimumab-bwwd interacts with Marshmallow & Fenugreek — through 2 ingredients. Tap an ingredient for the detail:
Slippery ElmOral Drugs Moderate
Interaction Summary
Theoretically, slippery elm may slow the absorption and reduce serum levels of oral drugs.
Read the full Slippery Elm + Adalimumab-bwwd interactionMarshmallowOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow + Adalimumab-bwwd interactionAdefovirHepsera
How Adefovir interacts with Marshmallow & Fenugreek — through 2 ingredients. Tap an ingredient for the detail:
Slippery ElmOral Drugs Moderate
Interaction Summary
Theoretically, slippery elm may slow the absorption and reduce serum levels of oral drugs.
Read the full Slippery Elm + Adefovir interactionMarshmallowOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow + Adefovir interactionAdenosineATP Tablets
How Adenosine interacts with Marshmallow & Fenugreek — through 2 ingredients. Tap an ingredient for the detail:
Slippery ElmOral Drugs Moderate
Interaction Summary
Theoretically, slippery elm may slow the absorption and reduce serum levels of oral drugs.
Read the full Slippery Elm + Adenosine interactionMarshmallowOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow + Adenosine interactionAfatinib DimaleateGilotrif
How Afatinib Dimaleate interacts with Marshmallow & Fenugreek — through 2 ingredients. Tap an ingredient for the detail:
Slippery ElmOral Drugs Moderate
Interaction Summary
Theoretically, slippery elm may slow the absorption and reduce serum levels of oral drugs.
Read the full Slippery Elm + Afatinib Dimaleate interactionMarshmallowOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow + Afatinib Dimaleate interactionAgomelatineValdoxan
How Agomelatine interacts with Marshmallow & Fenugreek — through 2 ingredients. Tap an ingredient for the detail:
Slippery ElmOral Drugs Moderate
Interaction Summary
Theoretically, slippery elm may slow the absorption and reduce serum levels of oral drugs.
Read the full Slippery Elm + Agomelatine interactionMarshmallowOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow + Agomelatine interactionAlbendazoleAlbenza
How Albendazole interacts with Marshmallow & Fenugreek — through 2 ingredients. Tap an ingredient for the detail:
Slippery ElmOral Drugs Moderate
Interaction Summary
Theoretically, slippery elm may slow the absorption and reduce serum levels of oral drugs.
Read the full Slippery Elm + Albendazole interactionMarshmallowOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow + Albendazole interactionAlbiglutideTanzeum
How Albiglutide interacts with Marshmallow & Fenugreek — through 1 ingredient. Tap an ingredient for the detail:
FenugreekAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, fenugreek seed might have additive hypoglycemic effects when used with antidiabetes drugs.
Read the full Fenugreek + Albiglutide interactionAlbuterolProAir HFA, Proventil, Ventolin (U.S.), Volmax
How Albuterol interacts with Marshmallow & Fenugreek — through 2 ingredients. Tap an ingredient for the detail:
Slippery ElmOral Drugs Moderate
Interaction Summary
Theoretically, slippery elm may slow the absorption and reduce serum levels of oral drugs.
Read the full Slippery Elm + Albuterol interactionMarshmallowOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow + Albuterol interactionAlcuroniumAlcuronium
How Alcuronium interacts with Marshmallow & Fenugreek — through 2 ingredients. Tap an ingredient for the detail:
Slippery ElmOral Drugs Moderate
Interaction Summary
Theoretically, slippery elm may slow the absorption and reduce serum levels of oral drugs.
Read the full Slippery Elm + Alcuronium interactionMarshmallowOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow + Alcuronium interactionAlectinib HydrochlorideAlecensa
How Alectinib Hydrochloride interacts with Marshmallow & Fenugreek — through 2 ingredients. Tap an ingredient for the detail:
Slippery ElmOral Drugs Moderate
Interaction Summary
Theoretically, slippery elm may slow the absorption and reduce serum levels of oral drugs.
Read the full Slippery Elm + Alectinib Hydrochloride interactionMarshmallowOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow + Alectinib Hydrochloride interactionAlemtuzumabCampath
How Alemtuzumab interacts with Marshmallow & Fenugreek — through 2 ingredients. Tap an ingredient for the detail:
Slippery ElmOral Drugs Moderate
Interaction Summary
Theoretically, slippery elm may slow the absorption and reduce serum levels of oral drugs.
Read the full Slippery Elm + Alemtuzumab interactionMarshmallowOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow + Alemtuzumab interactionAlendronateBinosto, Fosamax
How Alendronate interacts with Marshmallow & Fenugreek — through 2 ingredients. Tap an ingredient for the detail:
Slippery ElmOral Drugs Moderate
Interaction Summary
Theoretically, slippery elm may slow the absorption and reduce serum levels of oral drugs.
Read the full Slippery Elm + Alendronate interactionMarshmallowOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow + Alendronate interactionAlendronate Sodium
How Alendronate Sodium interacts with Marshmallow & Fenugreek — through 2 ingredients. Tap an ingredient for the detail:
Slippery ElmOral Drugs Moderate
Interaction Summary
Theoretically, slippery elm may slow the absorption and reduce serum levels of oral drugs.
Read the full Slippery Elm + Alendronate Sodium interactionMarshmallowOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow + Alendronate Sodium interactionAlendronate Sodium, CholecalciferolFosamax Plus D
How Alendronate Sodium, Cholecalciferol interacts with Marshmallow & Fenugreek — through 2 ingredients. Tap an ingredient for the detail:
Slippery ElmOral Drugs Moderate
Interaction Summary
Theoretically, slippery elm may slow the absorption and reduce serum levels of oral drugs.
Read the full Slippery Elm + Alendronate Sodium, Cholecalciferol interactionMarshmallowOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow + Alendronate Sodium, Cholecalciferol interactionAlfentanilAlfenta
How Alfentanil interacts with Marshmallow & Fenugreek — through 2 ingredients. Tap an ingredient for the detail:
Slippery ElmOral Drugs Moderate
Interaction Summary
Theoretically, slippery elm may slow the absorption and reduce serum levels of oral drugs.
Read the full Slippery Elm + Alfentanil interactionMarshmallowOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow + Alfentanil interactionAlfuzosinUroxatral
How Alfuzosin interacts with Marshmallow & Fenugreek — through 2 ingredients. Tap an ingredient for the detail:
Slippery ElmOral Drugs Moderate
Interaction Summary
Theoretically, slippery elm may slow the absorption and reduce serum levels of oral drugs.
Read the full Slippery Elm + Alfuzosin interactionMarshmallowOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow + Alfuzosin interactionAlginic Acid, Aluminum HydroxideRafton
How Alginic Acid, Aluminum Hydroxide interacts with Marshmallow & Fenugreek — through 2 ingredients. Tap an ingredient for the detail:
Slippery ElmOral Drugs Moderate
Interaction Summary
Theoretically, slippery elm may slow the absorption and reduce serum levels of oral drugs.
Read the full Slippery Elm + Alginic Acid, Aluminum Hydroxide interactionMarshmallowOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow + Alginic Acid, Aluminum Hydroxide interactionAliskirenTekturna
How Aliskiren interacts with Marshmallow & Fenugreek — through 3 ingredients. Tap an ingredient for the detail:
Slippery ElmOral Drugs Moderate
Interaction Summary
Theoretically, slippery elm may slow the absorption and reduce serum levels of oral drugs.
Read the full Slippery Elm + Aliskiren interactionFenugreekAntihypertensive Drugs Minor
Interaction Summary
Fenugreek may also have an additive effect on blood pressure-lowering medications.
Read the full Fenugreek + Aliskiren interactionMarshmallowOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow + Aliskiren interactionAlitretinoinPanretin
How Alitretinoin interacts with Marshmallow & Fenugreek — through 2 ingredients. Tap an ingredient for the detail:
Slippery ElmOral Drugs Moderate
Interaction Summary
Theoretically, slippery elm may slow the absorption and reduce serum levels of oral drugs.
Read the full Slippery Elm + Alitretinoin interactionMarshmallowOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow + Alitretinoin interactionAllopurinolCaplenal, Cosuric, Rimapurinol, Zyloprim, Zyloric
How Allopurinol interacts with Marshmallow & Fenugreek — through 2 ingredients. Tap an ingredient for the detail:
Slippery ElmOral Drugs Moderate
Interaction Summary
Theoretically, slippery elm may slow the absorption and reduce serum levels of oral drugs.
Read the full Slippery Elm + Allopurinol interactionMarshmallowOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow + Allopurinol interactionAlmotriptanAlmogran, Axert
How Almotriptan interacts with Marshmallow & Fenugreek — through 2 ingredients. Tap an ingredient for the detail:
Slippery ElmOral Drugs Moderate
Interaction Summary
Theoretically, slippery elm may slow the absorption and reduce serum levels of oral drugs.
Read the full Slippery Elm + Almotriptan interactionMarshmallowOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow + Almotriptan interactionAlogliptinNesina
How Alogliptin interacts with Marshmallow & Fenugreek — through 3 ingredients. Tap an ingredient for the detail:
Slippery ElmOral Drugs Moderate
Interaction Summary
Theoretically, slippery elm may slow the absorption and reduce serum levels of oral drugs.
Read the full Slippery Elm + Alogliptin interactionFenugreekAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, fenugreek seed might have additive hypoglycemic effects when used with antidiabetes drugs.
Read the full Fenugreek + Alogliptin interactionMarshmallowOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow + Alogliptin interactionAlogliptin, MetforminKazano
How Alogliptin, Metformin interacts with Marshmallow & Fenugreek — through 3 ingredients. Tap an ingredient for the detail:
FenugreekAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, fenugreek seed might have additive hypoglycemic effects when used with antidiabetes drugs.
Read the full Fenugreek + Alogliptin, Metformin interactionSlippery ElmOral Drugs Moderate
Interaction Summary
Theoretically, slippery elm may slow the absorption and reduce serum levels of oral drugs.
Read the full Slippery Elm + Alogliptin, Metformin interactionMarshmallowOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow + Alogliptin, Metformin interactionAlogliptin, PioglitazoneOseni
How Alogliptin, Pioglitazone interacts with Marshmallow & Fenugreek — through 3 ingredients. Tap an ingredient for the detail:
Slippery ElmOral Drugs Moderate
Interaction Summary
Theoretically, slippery elm may slow the absorption and reduce serum levels of oral drugs.
Read the full Slippery Elm + Alogliptin, Pioglitazone interactionFenugreekAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, fenugreek seed might have additive hypoglycemic effects when used with antidiabetes drugs.
Read the full Fenugreek + Alogliptin, Pioglitazone interactionMarshmallowOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow + Alogliptin, Pioglitazone interactionAlosetronLotronex
How Alosetron interacts with Marshmallow & Fenugreek — through 2 ingredients. Tap an ingredient for the detail:
Slippery ElmOral Drugs Moderate
Interaction Summary
Theoretically, slippery elm may slow the absorption and reduce serum levels of oral drugs.
Read the full Slippery Elm + Alosetron interactionMarshmallowOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow + Alosetron interactionAlpelisibPiqray
How Alpelisib interacts with Marshmallow & Fenugreek — through 2 ingredients. Tap an ingredient for the detail:
Slippery ElmOral Drugs Moderate
Interaction Summary
Theoretically, slippery elm may slow the absorption and reduce serum levels of oral drugs.
Read the full Slippery Elm + Alpelisib interactionMarshmallowOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow + Alpelisib interactionAlpha 1-proteinaseZemaira
How Alpha 1-proteinase interacts with Marshmallow & Fenugreek — through 2 ingredients. Tap an ingredient for the detail:
Slippery ElmOral Drugs Moderate
Interaction Summary
Theoretically, slippery elm may slow the absorption and reduce serum levels of oral drugs.
Read the full Slippery Elm + Alpha 1-proteinase interactionMarshmallowOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow + Alpha 1-proteinase interactionAlprazolamNiravam, Xanax
How Alprazolam interacts with Marshmallow & Fenugreek — through 2 ingredients. Tap an ingredient for the detail:
Slippery ElmOral Drugs Moderate
Interaction Summary
Theoretically, slippery elm may slow the absorption and reduce serum levels of oral drugs.
Read the full Slippery Elm + Alprazolam interactionMarshmallowOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow + Alprazolam interactionAlteplase, TpaActilyse, Activase
How Alteplase, Tpa interacts with Marshmallow & Fenugreek — through 3 ingredients. Tap an ingredient for the detail:
Slippery ElmOral Drugs Moderate
Interaction Summary
Theoretically, slippery elm may slow the absorption and reduce serum levels of oral drugs.
Read the full Slippery Elm + Alteplase, Tpa interactionFenugreekAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, fenugreek might have additive effects when used with anticoagulant or antiplatelet drugs.
Read the full Fenugreek + Alteplase, Tpa interactionMarshmallowOral Drugs, Anticoagulant/antiplatelet Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow + Alteplase, Tpa interactionAltretamineHexalen
How Altretamine interacts with Marshmallow & Fenugreek — through 2 ingredients. Tap an ingredient for the detail:
Slippery ElmOral Drugs Moderate
Interaction Summary
Theoretically, slippery elm may slow the absorption and reduce serum levels of oral drugs.
Read the full Slippery Elm + Altretamine interactionMarshmallowOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow + Altretamine interactionEach ingredient & the kinds of drugs it affects
For each ingredient in Marshmallow & Fenugreek 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.
Marshmallow
Lithium
Theoretically, due to potential diuretic effects, marshmallow might reduce excretion and increase levels of lithium.
Marshmallow is thought to have diuretic properties. To avoid lithium toxicity, the dose of lithium might need to be decreased when used with marshmallow.
Anticoagulant/Antiplatelet Drugs
Theoretically, marshmallow flower might have antiplatelet effects.
Animal research suggests that marshmallow flower extract has antiplatelet effects. However, the root and leaf of marshmallow, not the flower, are the plant parts most commonly found in dietary supplements. Theoretically, use of marshmallow flower with anticoagulant/antiplatelet drugs can have additive effects, and might increase the risk for bleeding in some patients.
Oral Drugs
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Marshmallow contains mucilage which can affect oral drug absorption. To avoid changes in absorption, take marshmallow 30-60 minutes after oral medications.
Slippery Elm
Oral Drugs
Theoretically, slippery elm may slow the absorption and reduce serum levels of oral drugs.
Slippery elm inner bark contains mucilage, which may interfere with the absorption of orally administered drugs.
Fenugreek
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 .
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.
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%.
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.
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.
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.
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%.
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.
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.
Brand information
Manufacturer and brand details for Marshmallow & Fenugreek, from the product label.
Nature's Sunshine
See all Nature's Sunshine products- Name
- Nature's Sunshine Products, Inc
- City
- Spanish Fork
- State
- Utah
- ZipCode
- 84660
- Phone Number
- 1-800-223-8225
- Web Address
- www.naturessunshine.com
Marshmallow & Fenugreek by Nature's Sunshine: Common Questions
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Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
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Label information is sourced from the NIH Dietary Supplement Label Database and reflects the product version on file; always read your actual product label. This page is for education only and is not a substitute for professional medical advice. Confirm with your pharmacist or doctor before combining supplements and medications.
The Full Monographs Behind Marshmallow & Fenugreek’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Slippery Elm
Interacts with 2,022 drugsSlippery elm is a traditional herbal remedy made from the inner bark of a North American elm tree, used mainly to soothe sore throats and irritated digestive tracts. Its mucilage can coat an...
Read the full Slippery Elm monograph → Herb & supplement monographMarshmallow
Interacts with 2,040 drugsMarshmallow root is a traditional herb rich in soothing, gel-like fibers called mucilage, which is why it has long been used for coughs, sore throats, and stomach irritation. Evidence for th...
Read the full Marshmallow monograph → Herb & supplement monographFenugreek
Interacts with 389 drugsFenugreek 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 →Sources & How We Checked
Marshmallow & Fenugreek's label data comes from the NIH Dietary Supplement Label Database; the ingredient interaction data is from the Natural Medicines database, reviewed by our pharmacists.
- NIH Dietary Supplement Label Database (DSLD) — The official product label on file for this supplement.
- Natural Medicines (Therapeutic Research Center) — Evidence-graded clinical reference behind the ingredient interaction data.
Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.
The 38 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.
Slippery Elm 3 references
- The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999.
- Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
- Czarnecki D, Nixon R, Bekhor P, and et al. Delayed prolonged contact urticaria from the elm tree. Contact Dermatitis 1993;28:196-197. PubMed
Marshmallow 5 references
- Monographs on the medicinal uses of plant drugs. Exeter, UK: European Scientific Co-op Phytother, 1997.
- Leung AY, Foster S. Encyclopedia of Common Natural Ingredients Used in Food, Drugs and Cosmetics. 2nd ed. New York, NY: John Wiley & Sons, 1996.
- McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
- Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
- Hage-Sleiman R, Mroueh M, Daher CF. Pharmacological evaluation of aqueous extract of Althaea officinalis flower grown in Lebanon. Pharm Biol 2011;49(3):327-33.
Fenugreek 30 references
- Madar Z, Thorne R. Dietary fiber. Prog Food Nutr Sci 1987;11:153-74.
- 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.
- Patil SP, Niphadkar PV, Bapat MM. Allergy to fenugreek (Trigonella foenum graecum). Ann Allergy Asthma Immunol 1997;78:297-300. PubMed
- Lambert J, Cormier J. Potential interaction between warfarin and boldo-fenugreek. Pharmacotherapy 2001;21:509-12. PubMed
- 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
- Yalcin SS, Tekinalp G, Ozalp I. Peculiar odor of traditional food and maple syrup urine disease. Pediatr Int 1999;41:108-9. PubMed
- 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
- Abdo MS, al-Kafawi AA. Experimental studies on the effect of Trigonella foenum-graecum (abstract). Planta Med 1969;17:14-8.
- 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.
- Gabay MP. Galactogogues: medications that induce lactation. J Hum Lact 2002;18:274-9. PubMed
- 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
- 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
- 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.
- 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
- 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
- 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
- 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.
- 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
- 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
- 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
- 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
- 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
- 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.
- 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
- Ouzir M, El Bairi K, Amzazi S. Toxicological properties of fenugreek (Trigonella foenum graecum). Food Chem Toxicol. 2016 Oct;96:145-54. PubMed
- 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
- 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
- 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
- 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
- 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.
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