Major interaction on record — check this product against your medications before combining. Based on 15 of 35 ingredients. Check your meds →
Dietary supplement

Multi-Flower Ingredients & Drug Interactions

by Energique

Multi-Flower label
See full label image
Liquid Category: Other Combinations
Most serious interaction: Major
Clinical methodology reviewed by · Updated Sep 23, 2026 · Label data from the NIH DSLD
What is this page for?

First and foremost: checking Multi-Flower 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: Major

Multi-Flower is a dietary supplement by Energique with 35 active ingredients. Its ingredients are commonly taken for cold and flu-type symptoms, sore throat and mouth health, antimicrobial support.Based on those ingredients, 1,259 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are Vitis vinifera, Malus, Ornithogalum umbellatum. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

Jump to a section

Check Your Meds Against Multi-Flower by Energique

Ask about any prescription or over-the-counter medication and we check it for interactions with Multi-Flower by Energique — and tell you which ingredient is responsible.

Pharmacist-reviewed data Checks every ingredient Answer in seconds
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HelloPharmacist Scorecard of Multi-Flower by Energique

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 35 active ingredients.

This liquid supplement contains 35 ingredients, most of them plant extracts and compounds. The active components include apple, horse chestnut seed extract, agrimony, heather, centaury, chicory root, holly leaf, larch arabinogalactan, honeysuckle flowers, olive, star of Bethlehem, and aspen bark, along with several plant materials we have limited data on.

The product is made with water and ethanol (alcohol) as inactive ingredients.

Does it work?

Couldn't assess
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
Not assessable

We hold no graded evidence for this product's ingredients for its stated purpose.

Why this rating?
  • The label markets this product for: may temporarily relieve emotional conflicts.
  • Our graded evidence for these ingredients doesn't cover that particular purpose.

The evidence for this product's effectiveness is limited. Individual ingredients have been studied for specific conditions—horse chestnut for chronic venous insufficiency (possibly effective), and apple for various conditions like diabetes and heart health (all insufficient evidence).

Most other ingredients lack established evidence in our data. The product as a whole has no effectiveness rating on file, so we can't tell you whether this particular combination works for any particular purpose.

The evidence, ingredient by ingredient Rock Rose Horse Chestnut Agrimony Heather Centaury Chicory Holly Larch Arabinogalactan

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 11 of the 15 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 14 of 15.
  • General safety write-ups exist for 15 of 15.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

Several ingredients raise safety concerns. Apple is well tolerated in food amounts.

Horse chestnut seed extract (when properly processed to remove toxic compounds) is generally well tolerated, though dizziness, upset stomach, headache, and itching have been reported; raw plant parts are toxic. Chicory is usually well tolerated but can cause gas, bloating, and allergic reactions in sensitive people.

Holly leaf can cause stomach irritation, nausea, vomiting, and diarrhea; the berries are toxic. Star of Bethlehem contains cardiac glycosides (heart-active compounds) and can cause serious heart rhythm problems or death—this is a rare but serious risk.

Aspen contains aspirin-like compounds and theoretically carries similar risks as aspirin. For pregnancy and breastfeeding: rock rose, heather, centaury, honeysuckle, and several others lack adequate safety data and should be avoided during pregnancy and breastfeeding.

Horse chestnut, chicory, holly, and star of Bethlehem are flagged as unsafe or possibly unsafe in pregnancy. Larch arabinogalactan lacks enough data—talk with your doctor or pharmacist before using if you're pregnant or nursing.

Side effects, ingredient by ingredient Rock Rose Horse Chestnut Agrimony Heather Centaury Chicory Holly Larch Arabinogalactan

Meds to double-check

Major interaction found
Known Interaction Concern · database check
Major identified

At least one ingredient has a documented Major-severity interaction. Check your medications for a personalized result.

Why this rating?
  • 9 of the 15 matched ingredients can interact with medications — Chicory, Aspen, Apple, Grape, Honeysuckle, among others.
  • The most serious interaction on file is rated Major.
  • Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs; immunosuppressants / transplant drugs; diabetes medications; heart-rhythm medications; lithium.
  • For scale: 1,260 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 your exact medications against these drug types: OATP substrates (fexofenadine, atenolol, aliskiren) and other drugs that depend on OATP for absorption—Major severity from apple. Then check for: anticoagulant or antiplatelet drugs (blood thinners), antihypertensive drugs (blood pressure medicines), atenolol specifically, antidiabetes drugs, lithium, fexofenadine, and aliskiren—all Moderate from apple and other ingredients.

Also check for: corticosteroids, diuretics, stimulant laxatives, macrolide and tetracycline antibiotics, digoxin, quinine, aspirin, and immunosuppressant drugs—all Moderate from star of Bethlehem, aspen, agrimony, chicory, and larch.

Check your own medication Run your meds through the checker above

The bottom line

Scorecard at a glanceFormula with limited ingredient disclosure with no assessable stated purpose. Major medication interactions have been identified, and safety information is well characterized.

This product is a complex blend with significant interaction risks, especially if you take heart medications, blood thinners, diabetes drugs, or blood pressure medicines. The most serious concern is the apple content and its effect on multiple drug types.

If you're considering this supplement, check every medication you take against the tool on this page first, and talk it over with your pharmacist or doctor—especially if you're pregnant, nursing, or have heart or blood sugar concerns.

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

Assessment coverage: 15 of 35 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Aug 22, 2025.

This Scorecard evaluates available label information, ingredient evidence, and known medication-safety considerations. It does not independently verify product identity, purity, potency, contamination, or manufacturing quality. How these ratings are computed

At a glance

General information

Key facts about Multi-Flower, straight from the product label.

Brand Energique
Net contents 1 Fluid Ounce(s); 30 mL
Market status On market
Date entered into DSLD Aug 22, 2025
DSLD ID 329393
Product type Other Combinations
Supplement form Liquid
Dietary claims / uses All Other, Structure/Function
Intended target group(s) Children 4 or More Years of Age, 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 Multi-Flower by Energique, 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:
5 Drop(s)
Maximum serving Sizes:
10 Drop(s)
IngredientAmount% DV
Scleranthus annuus0 NP--
Mimulus guttatus0 NP--
Helianthemum nummularium0 NP--
Aesculus carnea0 NP--
Aesculus hippocastanum0 NP--
Agrimonia eupatoria0 NP--
Bromus ramosus0 NP--
Calluna vulgaris0 NP--
Carpinus betulus0 NP--
Castanea sativa0 NP--
Centaurium umbellatum0 NP--
Ceratostigma willmottianum0 NP--
Cichorium intybus0 NP--
Clematis vitalba0 NP--
Fagus sylvatica0 NP--
Gentianella amarella0 NP--
Ilex aquifolium0 NP--
Impatiens glandulifera0 NP--
Larix0 NP--
Lonicera caprifolium0 NP--
Malus0 NP--
Olea europaea0 NP--
Ornithogalum umbellatum0 NP--
Pinus sylvestris0 NP--
Populus tremula0 NP--
Prunus cerasifera0 NP--
Quercus robur0 NP--
Rock Water0 NP--
Rosa canina0 NP--
Salix vitellina0 NP--
Sinapis arvensis0 NP--
Ulex europaeus0 NP--
Ulmus procera0 NP--
Verbena0 NP--
Vitis vinifera0 NP--

Other ingredients: Water, Ethanol

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.
Precautions

Warnings: If pregnant or breastfeeding, ask a health professional before use.

Keep out of reach of children.

In case of overdose, get medical help or contact a poison control center right away. Do not use if tamper evident seal is broken or missing.

If symptoms persist for more than 7 days, consult your health care professional.

Consult a physician for use in children under 12 years of age.

Storage

Store in a cool, dry place.

Formulation

Indications: May temporarily relieve emotional conflicts.

Homeopathic remedy

FDA Disclaimer Statement

Claims based on traditional homeopathic practice, not accepted medical evidence. Not FDA evaluated.

Suggested/Recommended/Usage/Directions

Directions: Adults and children 5 to 10 drops orally, 1-2 times daily or as otherwise directed by a health care professional.

Brand IP Statement(s)

Energique Since 1987

Formula

20% Ethanol

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

See for yourself

Multi-Flower by Energique label

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

Multi-Flower 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 Multi-Flower by Energique

These are the 35 active ingredients this product is made of. Select any to open its full monograph.

Serving size5 Drop(s) Dosage formLiquid 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.

Scleranthus annuus

0 NP per serving

Mimulus guttatus

0 NP per serving

Helianthemum nummularium

No known
interactions
0 NP per serving

Rock Rose usually refers to plants in the Cistus family, taken as a tea or extract and traditionally used for colds, sore throats, and as an antimicro...

Helianthemum nummularium monograph & interactions

Aesculus carnea

0 NP per serving

Aesculus hippocastanum

Interacts with
122 drugs
0 NP per serving

Horse chestnut seed extract is most often used for chronic venous insufficiency, where standardized products may help reduce leg swelling, pain, and h...

Aesculus hippocastanum monograph & interactions

Agrimonia eupatoria

Interacts with
86 drugs
0 NP per serving

Agrimony is a traditional European herb rich in tannins that has long been used for sore throats, mild diarrhea, and minor skin problems. Good-quality...

Agrimonia eupatoria monograph & interactions

Bromus ramosus

0 NP per serving

Calluna vulgaris

No known
interactions
0 NP per serving

Heather (Calluna vulgaris) is a traditional European herb used mainly as a tea for urinary and minor inflammatory complaints, but high-quality human s...

Calluna vulgaris monograph & interactions

Carpinus betulus

0 NP per serving

Castanea sativa

0 NP per serving

Centaurium umbellatum

No known
interactions
0 NP per serving

Centaury is a bitter-tasting herb traditionally used to stimulate appetite and ease mild digestive complaints. Solid human studies are lacking, so its...

Centaurium umbellatum monograph & interactions

Ceratostigma willmottianum

0 NP per serving

Cichorium intybus

Interacts with
86 drugs
0 NP per serving

Chicory is best known as a caffeine-free coffee substitute and as a source of inulin, a soluble prebiotic fiber that may support digestion and regular...

Cichorium intybus monograph & interactions

Clematis vitalba

0 NP per serving

Fagus sylvatica

0 NP per serving

Gentianella amarella

0 NP per serving

Ilex aquifolium

No known
interactions
0 NP per serving

Holly (Ilex aquifolium) is a common ornamental shrub whose bright red berries are poisonous and should never be eaten. There is very little reliable h...

Ilex aquifolium monograph & interactions

Impatiens glandulifera

0 NP per serving

Larix

Interacts with
121 drugs
0 NP per serving

Larch arabinogalactan is a soluble fiber from larch trees that is mainly used as a prebiotic and for immune support. Early research is interesting but...

Larix monograph & interactions

Lonicera caprifolium

Interacts with
122 drugs
0 NP per serving

Honeysuckle, especially Japanese honeysuckle flower (Lonicera japonica), is a staple of traditional Chinese medicine used mainly for colds, sore throa...

Lonicera caprifolium monograph & interactions

Malus

Interacts with
300 drugs
0 NP per serving

Apples are a nutritious whole food that provides fiber, vitamins, and antioxidant plant compounds, and eating them regularly fits well into a healthy...

Malus monograph & interactions

Olea europaea

No known
interactions
0 NP per serving

Olive comes from the same tree that gives us olives and olive oil, and its leaf and fruit contain antioxidant compounds like oleuropein and hydroxytyr...

Olea europaea monograph & interactions

Ornithogalum umbellatum

Interacts with
156 drugs
0 NP per serving

Star of Bethlehem is a small flowering plant best known as one of the ingredients in Bach flower remedies, where it is used for emotional shock and gr...

Ornithogalum umbellatum monograph & interactions

Pinus sylvestris

0 NP per serving

Populus tremula

Interacts with
39 drugs
0 NP per serving

Aspen bark and leaf contain salicin, a natural compound related to aspirin, which is why it is traditionally used for pain, fever, and inflammation. S...

Populus tremula monograph & interactions

Prunus cerasifera

0 NP per serving

Quercus robur

0 NP per serving

Rock Water

0 NP per serving

Rosa canina

0 NP per serving

Salix vitellina

0 NP per serving

Sinapis arvensis

0 NP per serving

Ulex europaeus

0 NP per serving

Ulmus procera

0 NP per serving

Verbena

No known
interactions
0 NP per serving

Verbena (Verbena officinalis), also called vervain, is a traditional herb people use for relaxation, sleep, and minor digestive complaints. Solid huma...

Verbena monograph & interactions

Vitis vinifera

Interacts with
910 drugs
0 NP per serving

Grapes and grape products like grape seed extract contain antioxidant compounds such as resveratrol and proanthocyanidins that may support heart and b...

Vitis vinifera monograph & interactions

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

Interaction report

Multi-Flower by Energique Drug Interactions

Want to check YOUR meds against Multi-Flower?

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
1,259Drugs
47 Major 1,191 Moderate 21 Minor

Ingredients driving the most interactions

Vitis vinifera 910
Malus 300
Ornithogalum umbellatum 156
Aesculus hippocastanum 122
Lonicera caprifolium 122

Individual Drug Interactions

The ingredients in Multi-Flower interact with 1,259 drugs. Click any drug to see the details.

9 of the 35 ingredients in Multi-Flower interact with drugs. Each result below shows which ingredient is responsible. Vitis vinifera Malus Ornithogalum umbellatum Aesculus hippocastanum Lonicera caprifolium Larix Agrimonia eupatoria Cichorium intybus Populus tremula

Each ingredient & the kinds of drugs it affects

For each ingredient in Multi-Flower 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.

Vitis vinifera9 drug types · 910 drugs

Anticoagulant/Antiplatelet Drugs

Theoretically, grape extracts may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
In vitro evidence suggests that grape extracts might decrease platelet aggregation.

Likelihood Possible Evidence D
Cyclosporine (Neoral, Sandimmune)

Ingesting grape juice with cyclosporine can reduce cyclosporine absorption.
A small pharmacokinetic study in healthy young adults shows that intake of purple grape juice 200 mL along with cyclosporine can decrease the absorption of cyclosporine by up to 30% when compared with water. Separate doses of grape juice and cyclosporine by at least 2 hours to avoid this interaction.

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

Theoretically, grape juice might reduce the levels of CYP1A2 substrates.
A small pharmacokinetic study in healthy adults shows that ingestion of 200 mL of grape juice decreases phenacetin plasma levels. This is thought to be due to induction of CYP1A2.

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

Theoretically, grape seed extract may increase the levels of CYP2D6 substrates.
In vitro evidence suggests that grape seed extract might inhibit CYP2D6 enzymes. However, this interaction has not been reported in humans.

Likelihood Possible Evidence D
Cytochrome P450 2E1 (Cyp2E1) Substrates

Theoretically, grape seed extract might increase the levels of CYP2E1 substrates.
In vitro and animal research suggests that grape seed proanthocyanidin extract inhibits CYP2E1 enzymes. However, this interaction has not been reported in humans.

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

It is unclear if grape seed extract inhibits or induces CYP3A4; research is conflicting.
In vitro evidence suggests that grape seed extract might inhibit CYP3A4 enzymes. However, evidence from animal research shows that grape seed extract may induce CYP3A4 in the liver. So far, these interactions have not been reported in humans.

Likelihood Possible Evidence D
Midazolam (Versed)

Theoretically, long-term intake of grape seed extract might decrease the effects of midazolam.
Animal research shows that subchronic ingestions of grape seed extract can increase the elimination of intravenous midazolam by increasing hepatic CYP3A4 activity. Single doses of grape seed extract do not appear to affect midazolam elimination.

Likelihood Possible Evidence D
Phenacetin

Grape juice might decrease phenacetin absorption.
A small pharmacokinetic study in healthy adults shows that ingestion of 200 mL of grape juice decreases phenacetin plasma levels. This is thought to be due to induction of cytochrome P450 1A2 (CYP1A2).

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

It is unclear if grape juice or grape seed extract inhibits CYP2C9; research is conflicting.
In vitro evidence shows that grape seed extract or grape juice might inhibit CYP2C9 enzymes. However, a small pharmacokinetic study in healthy adults shows that drinking 8 ounces of grape juice once does not affect the clearance of flurbiprofen, a probe-drug for CYP2C9 metabolism. The effects of continued grape juice consumption are unclear.

Likelihood Unlikely Evidence D
Vitis vinifera full monograph & interactions

Malus7 drug types · 300 drugs

Organic Anion-Transporting Polypeptide Substrates (Oatp)

Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Research shows that consuming apple juice inhibits OATP, which reduces bioavailability of oral drugs that are substrates of OATP. Fexofenadine, atenolol, and aliskiren are substrates of OATP. Clinical research shows that coadministration of apple juice decreases bioavailability of fexofenadine by up to 78%, aliskiren by 63%, and atenolol by up to 82%. These effects appear to increase with larger quantities of apple juice. It is thought that apple juice might affect OATP for only a short time. Therefore, separating drug administration and consumption of apple juice by at least 4 hours might avoid this interaction.

Likelihood Likely Evidence B
Aliskiren (Tekturna, Rasilez)

Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of aliskiren.
Pharmacokinetic research shows that coadministration of apple juice 200 mL along with aliskiren 150 mg decreases the bioavailability of aliskiren by 63%. Apple juice seems to inhibit organic anion transporting polypeptide (OATP), which is involved in drug uptake in the gut, liver, and kidney. It is thought that apple juice might affect OATP for only a short time. Therefore, separating drug administration and consumption of apple juice by at least 4 hours might avoid this interaction.

Likelihood Probable Evidence B
Antidiabetes Drugs

Theoretically, consuming apple juice with antidiabetes drugs might interfere with blood glucose control.
Clinical research suggests that consuming apples or drinking apple juice can raise blood glucose levels, with the effects of drinking apple juice being more significant than consuming apples.

Likelihood Possible Evidence D
Antihypertensive Drugs

Consuming apple juice with antihypertensive drugs might interfere with blood pressure control.
Some clinical evidence suggests that consuming apple and cherry juice can increase blood pressure in elderly patients.

Likelihood Probable Evidence B
Atenolol (Tenormin)

Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of atenolol.
Pharmacokinetic research shows that coadministration of apple juice 600-1200 mL decreases levels of atenolol by 58% to 82% in a dose-dependent manner. Apple juice seems to inhibit organic anion transporting polypeptide (OATP), which is involved in drug uptake in the gut, liver, and kidney. It is thought that apple juice might affect OATP for only a short time. Therefore, separating drug administration and consumption of apple juice by at least 4 hours might avoid this interaction.

Likelihood Probable Evidence B
Fexofenadine (Allegra)

Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of fexofenadine.
Pharmacokinetic research shows that coadministration of apple juice 400-1200 mL along with fexofenadine 60-120 mg decreases bioavailability of fexofenadine by up to 78%. Coadministration with smaller quantities of apple juice (150 mL or less) does not appear to affect the bioavailability of fexofenadine. Apple juice seems to inhibit organic anion transporting polypeptide (OATP), which is involved in drug uptake in the gut, liver, and kidney. It is thought that apple juice might affect OATP for only a short time. Therefore, separating drug administration and consumption of apple juice by at least 4 hours might avoid this interaction.

Likelihood Likely Evidence B
Lithium

There is some concern that concomitant consumption of apple juice might decrease oral absorption and blood levels of lithium.
In one case report, a patient had an undetectable serum lithium level when lithium citrate was administered with apple juice. When lithium was administered with an alternative beverage, the lithium level became detectable and the patient demonstrated clinical improvement.

Likelihood Possible Evidence D
Malus full monograph & interactions

Ornithogalum umbellatum7 drug types · 156 drugs

Corticosteroids

Theoretically, taking star of Bethlehem with prolonged corticosteroid therapy might increase the risk of toxicity.
Star of Bethlehem contains cardiac glycosides. Concomitant use of corticosteroids with star of Bethlehem can increase the therapeutic and adverse effects of long-term corticosteroid use due to potassium depletion and electrolyte imbalance.

Likelihood Possible Evidence D
Digoxin (Lanoxin)

Theoretically, taking star of Bethlehem in combination with digoxin might have additive effects and increase the risk of toxicity.
Star of Bethlehem contains cardiac glycosides with effects similar to digoxin.

Likelihood Possible Evidence D
Diuretic Drugs

Theoretically, taking diuretics with star of Bethlehem might increase the risk of toxicity.
Star of Bethlehem contains cardiac glycosides. Theoretically, concomitant use of potassium-depleting diuretics and star of Bethlehem can increase the risk of cardiac glycoside toxicity due to potassium depletion.

Likelihood Possible Evidence D
Macrolide Antibiotics

Theoretically, taking macrolide antibiotics with star of Bethlehem might increase the risk of cardiac glycoside toxicity.
Star of Bethlehem contains cardiac glycosides. Macrolide antibiotics appear to increase the gastrointestinal absorption of oral digoxin. Theoretically, concomitant use of macrolide antibiotics might increase the absorption of the cardiac glycosides found in star of Bethlehem and increase the risk of adverse effects.

Likelihood Possible Evidence D
Quinine

Theoretically, taking quinine with star of Bethlehem might increase the risk of cardiac glycoside toxicity.
Star of Bethlehem contains cardiac glycosides. Quinine may reduce the clearance of oral digoxin. Theoretically, concomitant use of quinine might reduce the clearance of cardiac glycosides found in star of Bethlehem and increase the risk of adverse effects.

Likelihood Possible Evidence D
Stimulant Laxatives

Theoretically, excessive use of stimulant laxatives with star of Bethlehem might increase the risk of toxicity.
Star of Bethlehem contains cardiac glycosides. Excessive use of stimulant laxatives can cause diarrhea, resulting in potassium depletion. This might increase the risk of cardiac glycoside toxicity.

Likelihood Possible Evidence D
Tetracycline Antibiotics

Theoretically, taking tetracycline antibiotics with star of Bethlehem might increase the risk of cardiac glycoside toxicity.
Star of Bethlehem contains cardiac glycosides similar to digitalis. Tetracycline antibiotics appear to increase the gastrointestinal absorption of oral digoxin. Theoretically, concomitant use of tetracycline antibiotics might increase the absorption of the cardiac glycosides found in star of Bethlehem and increase the risk of adverse effects.

Likelihood Possible Evidence D
Ornithogalum umbellatum full monograph & interactions

Aesculus hippocastanum1 drug type · 122 drugs

Anticoagulant/Antiplatelet Drugs

Horse chestnut may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Horse chestnut contains the constituent esculin which has been shown to have antithrombotic effects. Therefore, horse chestnut might have antiplatelet effects. This has not been shown in humans.

Likelihood Possible Evidence D
Aesculus hippocastanum full monograph & interactions

Lonicera caprifolium1 drug type · 122 drugs

Anticoagulant/Antiplatelet Drugs

Theoretically, honeysuckle might increase the risk of bleeding when taken with anticoagulant or antiplatelet drugs.
In vitro research shows that polyphenols extracted from honeysuckle can inhibit platelet aggregation.

Likelihood Possible Evidence D
Lonicera caprifolium full monograph & interactions

Larix1 drug type · 121 drugs

Immunosuppressants

Theoretically, larch arabinogalactan might interfere with immunosuppression therapy due to immunostimulant effects. Immunosuppressant drugs include azathioprine (Imuran), basiliximab (Simulect), cyclosporine (Neoral, Sandimmune), daclizumab (Zenapax), muromonab-CD3 (OKT3, Orthoclone OKT3), mycophenolate (CellCept), tacrolimus (FK506, Prograf), sirolimus (Rapamune), prednisone (Deltasone, Orasone), corticosteroids (glucocorticoids), and other drugs.

Likelihood Possible Evidence D
Larix full monograph & interactions

Agrimonia eupatoria1 drug type · 86 drugs

Antidiabetes Drugs

Theoretically, taking agrimony with antidiabetes drugs might increase the risk of hypoglycemia.
Agrimony has demonstrated hypoglycemic effects in animal research.

Likelihood Possible Evidence D
Agrimonia eupatoria full monograph & interactions

Cichorium intybus1 drug type · 86 drugs

Antidiabetes Drugs

Theoretically, chicory might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Animal and in vitro research shows that chicory extracts have antidiabetic effects.

Likelihood Possible Evidence D
Cichorium intybus full monograph & interactions

Populus tremula3 drug types · 39 drugs

Aspirin

Aspen contains salicin, a plant salicylate. Theoretically, aspen might have an additive effect with other salicylate-containing drugs, such as aspirin.

Likelihood Possible Evidence D
Choline Magnesium Trisalicylate (Trilisate)

Aspen contains salicin, a plant salicylate. Theoretically, aspen might have an additive effect with other salicylate-containing drugs such as choline magnesium trisalicylate.

Likelihood Possible Evidence D
Salsalate (Disalcid)

Aspen contains salicin, a plant salicylate. Theoretically, aspen might have an additive effect with other salicylate-containing drugs such as salsalate.

Likelihood Possible Evidence D
Populus tremula full monograph & interactions
The maker

Brand information

Manufacturer and brand details for Multi-Flower, from the product label.

Energique

See all Energique products
Name
Energique, Inc.
Street Address
201 Apple Blvd.
City
Woodbine
State
IA
ZipCode
51579
Phone Number
800.869.8078
Pharmacist Counseling Corner

Multi-Flower by Energique: Common Questions

Does Multi-Flower by Energique interact with any medications?
Yes. Based on its ingredients, Multi-Flower has a known interaction with 1,259 medications, including 47 rated major. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Multi-Flower contains 35 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.
Can I take this if I'm pregnant or breastfeeding?
Not safely without talking to your doctor first. Several ingredients—including horse chestnut, chicory, holly, and star of Bethlehem—are flagged as unsafe or possibly unsafe in pregnancy. Others like rock rose, heather, centaury, honeysuckle, and aspen lack enough safety data. Your pharmacist or doctor needs to weigh the risks and benefits for your situation.
What's the alcohol content in this liquid?
The product is made with ethanol (alcohol) as an inactive ingredient, but the label doesn't specify the percentage. If you need to avoid alcohol—for health, religious, or personal reasons—ask the pharmacy for the exact amount before using it.
Does apple in this supplement work like whole apples?
The apple in this product can interact with medications just like apple juice does—it inhibits how your body absorbs certain drugs and can significantly lower their blood levels. Even though it's one ingredient among 35, the interaction risk is real and serious for some medications.
Is this supplement safe for someone with a heart condition?
Not without checking with your doctor first. Star of Bethlehem contains cardiac glycosides—compounds that act on the heart—and can cause serious heart rhythm problems. If you take digoxin, other heart medications, diuretics, or certain antibiotics, this product poses real risks.
Will this help with anxiety or stress?
We don't have effectiveness data showing this product works for anxiety, stress, or any other condition. Many of the individual ingredients lack good evidence, and the product as a whole has no established use in our data.
What are the most common side effects?
The ingredients we have data on are generally well tolerated, but some can cause upset stomach, gas, bloating, headache, and itching. However, star of Bethlehem and holly leaf carry risk of nausea, vomiting, and diarrhea. If you have any symptoms after starting it, stop and call your pharmacist.

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.

Multi-Flower label
Go deeper

The Full Monographs Behind Multi-Flower’s Ingredients

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

Herb & supplement monograph

Rock Rose

Rock Rose usually refers to plants in the Cistus family, taken as a tea or extract and traditionally used for colds, sore throats, and as an antimicrobial; it is also a Bach flower remedy us...

Read the full Rock Rose monograph → Herb & supplement monograph

Horse Chestnut

Interacts with 122 drugs

Horse chestnut seed extract is most often used for chronic venous insufficiency, where standardized products may help reduce leg swelling, pain, and heaviness. Raw, unprocessed horse chestnu...

Read the full Horse Chestnut monograph → Herb & supplement monograph

Agrimony

Interacts with 86 drugs

Agrimony is a traditional European herb rich in tannins that has long been used for sore throats, mild diarrhea, and minor skin problems. Good-quality human studies are very limited, so its...

Read the full Agrimony monograph → Herb & supplement monograph

Heather

Heather (Calluna vulgaris) is a traditional European herb used mainly as a tea for urinary and minor inflammatory complaints, but high-quality human studies are lacking. It is generally cons...

Read the full Heather monograph → Herb & supplement monograph

Centaury

Centaury is a bitter-tasting herb traditionally used to stimulate appetite and ease mild digestive complaints. Solid human studies are lacking, so its benefits remain largely unproven, and i...

Read the full Centaury monograph → Herb & supplement monograph

Chicory

Interacts with 86 drugs

Chicory is best known as a caffeine-free coffee substitute and as a source of inulin, a soluble prebiotic fiber that may support digestion and regularity. Strong human evidence for most othe...

Read the full Chicory monograph → Herb & supplement monograph

Holly

Holly (Ilex aquifolium) is a common ornamental shrub whose bright red berries are poisonous and should never be eaten. There is very little reliable human evidence supporting any health bene...

Read the full Holly monograph → Herb & supplement monograph

Larch Arabinogalactan

Interacts with 121 drugs

Larch arabinogalactan is a soluble fiber from larch trees that is mainly used as a prebiotic and for immune support. Early research is interesting but limited, and most claims are not yet fi...

Read the full Larch Arabinogalactan monograph → Herb & supplement monograph

Honeysuckle

Interacts with 122 drugs

Honeysuckle, especially Japanese honeysuckle flower (Lonicera japonica), is a staple of traditional Chinese medicine used mainly for colds, sore throat, and inflammation. Modern human eviden...

Read the full Honeysuckle monograph → Herb & supplement monograph

Apple

Interacts with 300 drugs

Apples are a nutritious whole food that provides fiber, vitamins, and antioxidant plant compounds, and eating them regularly fits well into a healthy diet. While research suggests apples may...

Read the full Apple monograph → Herb & supplement monograph

Olive

Olive comes from the same tree that gives us olives and olive oil, and its leaf and fruit contain antioxidant compounds like oleuropein and hydroxytyrosol. Olive oil as part of a Mediterrane...

Read the full Olive monograph → Herb & supplement monograph

Star Of Bethlehem

Interacts with 156 drugs

Star of Bethlehem is a small flowering plant best known as one of the ingredients in Bach flower remedies, where it is used for emotional shock and grief. There is no solid scientific eviden...

Read the full Star Of Bethlehem monograph → Herb & supplement monograph

Aspen

Interacts with 39 drugs

Aspen bark and leaf contain salicin, a natural compound related to aspirin, which is why it is traditionally used for pain, fever, and inflammation. Solid human studies are lacking, and beca...

Read the full Aspen monograph → Herb & supplement monograph

Verbena

Verbena (Verbena officinalis), also called vervain, is a traditional herb people use for relaxation, sleep, and minor digestive complaints. Solid human research is limited, so its benefits r...

Read the full Verbena monograph → Herb & supplement monograph

Grape

Interacts with 910 drugs

Grapes and grape products like grape seed extract contain antioxidant compounds such as resveratrol and proanthocyanidins that may support heart and blood vessel health. While the food is he...

Read the full Grape monograph →
Sources

Sources & How We Checked

Multi-Flower'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 125 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.

Rock Rose 2 references
  1. Herbs at a Glance — NIH National Center for Complementary and Integrative Health (NCCIH) Source
  2. Herbal and Dietary Supplements — MedlinePlus (U.S. National Library of Medicine) Source

See these in context on the Rock Rose monograph →

Horse Chestnut 21 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. Ellenhorn MJ, et al. Ellenhorn's Medical Toxicology: Diagnoses and Treatment of Human Poisoning. 2nd ed. Baltimore, MD: Williams & Wilkins, 1997.
  3. Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.
  4. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
  5. Greeske K, Pohlmann BK. Horse chestnut seed extract-an effective therapy principle in general practice. Drug therapy of chronic venous insufficiency. Fortschr Med 1996;114:196-200.
  6. Robbers JE, Tyler VE. Tyler's Herbs of Choice: The Therapeutic Use of Phytomedicinals. New York, NY: The Haworth Herbal Press, 1999.
  7. Takegoshi K, Tohyama T, Okuda K, et al. A case of Venoplant-induced hepatic injury. Gastroenterol Jpn 1986;21:62-5.
  8. Jaspersen-Schib R, Theus L, Guirguis-Oeschger M, et al. [Serious plant poisonings in Switzerland 1966-1994. Case analysis from the Swiss Toxicology Information Center]. Schweiz Med Wochenschr 1996;126:1085-98.
  9. Popp W, Horak F, Jager S, et al. Horse chestnut (Aesculus hippocastanum) pollen: a frequent cause of allergic sensitization in urban children. Allergy 1992;47:380-3.
  10. Diaz-Perales A, Collada C, Blanco C, et al. Cross-reactions in the latex-fruit syndrome: A relevant role of chitinases but not of complex asparagine-linked glycans. J Allergy Clin Immunol 1999;104:681-7. PubMed
  11. Blanco C, Diaz-Perales A, Collada C, et al. Class I chitinases as potential panallergens involved in the latex-fruit syndrome. J Allergy Clin Immunol 1999;103:507-13. PubMed
  12. Comaish JS, Kersey PJ. Contact dermatitis to extract of horse chestnut (esculin). Contact Dermatitis 1980;6:150-1. PubMed
  13. Pittler MH, Ernst E. Horse chestnut seed extract for chronic venous insufficiency (Cochrane Review). In: The Cochrane Library, Issue 3, 2004. Chichester, UK: John Wiley & Sons, Ltd. PubMed
  14. Ottillinger, B. and Greeske, K. Rational therapy of chronic venous insufficiency--chances and limits of the therapeutic use of horse-chestnut seeds extract. BMC.Cardiovasc.Disord. 2001;1(1):5. PubMed
  15. Pittler, M. H. and Ernst, E. Horse chestnut seed extract for chronic venous insufficiency. Cochrane.Database.Syst.Rev. 2004;(2):CD003230. PubMed
  16. Fang, Y., Zhao, L., Yan, F., Xia, X., Xu, D., and Cui, X. Escin improves sperm quality in male patients with varicocele-associated infertility. Phytomedicine. 2010;17(3-4):192-196. PubMed
  17. De Smet, P. A., Van den Eertwegh, A. J., Lesterhuis, W., and Stricker, B. H. Hepatotoxicity associated with herbal tablets. BMJ 7-13-1996;313(7049):92.
  18. Rehn, D., Unkauf, M., Klein, P., Jost, V., and Lucker, P. W. Comparative clinical efficacy and tolerability of oxerutins and horse chestnut extract in patients with chronic venous insufficiency. Arzneimittelforschung 1996;46(5):483-487.
  19. Edem E, Kahyaoglu B, Çakar MA. Acute Effusive Pericarditis due to Horse Chestnut Consumption. Am J Case Rep. 2016;17:305-8. PubMed
  20. Costa Santos D, Lérias G, Madruga I. Drug-induced Liver Injury Due to a Horse Chestnut Dietary Supplement. Eur J Case Rep Intern Med 2021;8(3):002389. PubMed
  21. Yi HY, Lee JY. Poisoning due to consumption of horse chestnut seed. Clin Exp Emerg Med 2021;8(4):333-335. PubMed

See these in context on the Horse Chestnut monograph →

Agrimony 4 references
  1. Newall CA, Anderson LA, Philpson JD. Herbal Medicine: A Guide for Healthcare Professionals. London, UK: The Pharmaceutical Press, 1996.
  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. Gray AM, Flatt PR. Actions of the traditional anti-diabetic plant, Agrimony eupatoria (agrimony): effects on hyperglycaemia, cellular glucose metabolism and insulin secretion. Br J Nutr 1998;80:109-14.
  4. Swanston-Flatt SK, Day C, Bailey CJ, Flatt PR. Traditional plant treatments for diabetes. Studies in normal and streptozotocin diabetic mice. Diabetologia 1990;33:462-4. PubMed

See these in context on the Agrimony monograph →

Heather 2 references
  1. Herbs and Supplements — MedlinePlus Source
  2. Using Dietary Supplements Wisely — NIH NCCIH Source

See these in context on the Heather monograph →

Centaury 1 reference
  1. Martynyuk L, Martynyuk L, Ruzhitska O, Martynyuk O. Effect of the herbal combination Canephron N on diabetic nephropathy in patients with diabetes mellitus: results of a comparative cohort study. J Altern Complement Med. 2014;20(6):472-478. PubMed

See these in context on the Centaury monograph →

Chicory 13 references
  1. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
  2. Stone-Dorshow T, Levitt MD. Gaseous response to ingestion of a poorly absorbed fructo-oligosaccharide sweetener. Am J Clin Nutr 1987;46:61-5. PubMed
  3. Briet F, et al. Symptomatic response to varying levels of fructo-oligosaccharides consumed occasionally or regularly. Eur J Clin Nutr 1995;49:501-7.
  4. Bouhnik Y, Vahedi K, Achour L, et al. Short-chain fructo-oligosaccharide administration dose-dependently increases fecal bifidobacteria in healthy humans. J Nutr 1999;129:113-6. PubMed
  5. Cummings JH, Macfarlane GT, Englyst HN. Prebiotic digestion and fermentation. Am J Clin Nutr 2001;73:415S-420S. PubMed
  6. Cadot, P., Kochuyt, A. M., van Ree, R., and Ceuppens, J. L. Oral allergy syndrome to chicory associated with birch pollen allergy. Int.Arch.Allergy Immunol. 2003;131(1):19-24. PubMed
  7. Friis, B., Hjorth, N., Vail, J. T., Jr., and Mitchell, J. C. Occupational contact dermatitis from Cichorium (chicory, endive) and Lactuca (lettuce). Contact Dermatitis 1975;1(5):311-313.
  8. Nemery, B. and Demedts, M. Occupational asthma in a chicory grower. Lancet 3-25-1989;1(8639):672-673. PubMed
  9. Pirson F, Detry B, Pilette C. Occupational rhinoconjunctivitis and asthma caused by chicory and oral allergy syndrome associated with bet v 1-related protein. J Investig Allergol Clin Immunol 2009;19(4):306-10.
  10. Willi R, Pfab F, Huss-Marp J, et al. Contact anaphylaxis and protein contact dermatitis in a cook handling chicory leaves. Contact Dermatitis 2009;60(4):226-7. PubMed
  11. Street RA, Sidana J, Prinsloo G. Cichorium intybus: traditional uses, phytochemistry, pharmacology, and toxicology. Evid Based Complement Alternat Med 2013;2013:579319.
  12. Bonnema AL, Kolberg LW, Thomas W, Slavin JL. Gastrointestinal tolerance of chicory inulin products. J Am Diet Assoc 2010;110(6):865-8. PubMed
  13. Devi Kt R, Sivalingam N. Cichorium intybus attenuates Streptozotocin-induced pancreatic ß-cell damage by inhibiting NF-?B activation and oxidative stress. J Appl Biomed 2020;18(2-3):70-9. PubMed

See these in context on the Chicory monograph →

Holly 2 references
  1. The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999.
  2. Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.

See these in context on the Holly monograph →

Larch Arabinogalactan 8 references
  1. D'Adamo P. Larch arabinogalactan. J Naturopath Med 1996;6:33-7.
  2. Kelly GS. Larch arabinogalactan: Clinical relevance of a novel immune-enhancing polysaccharide. Alt Med Rev 1999;4:96-103.
  3. Marett R, Slavin JL. No long-term benefits of supplementation with arabinogalactan on serum lipids and glucose. J Am Diet Assoc 2004;104:636-9.
  4. Robinson RR, Feirtag J, Slavin JL. Effects of dietary arabinogalactan on gastrointestinal and blood parameters in healthy human subjects. J Am Coll Nutr 2001;20:279-85. PubMed
  5. Udani JK, Singh BB, Barrett ML, Singh VJ. Proprietary arabinogalactan extract increases antibody response to the pneumonia vaccine: a randomized, double-blind, placebo-controlled, pilot study in healthy volunteers. Nutr J 2010;9:32. PubMed
  6. Grube B, Stier H, Riede L, Gruenwald J. Tolerability of a proprietary larch arabinogalactan extract: a randomized, double-blind, placebo-controlled clinical trial in healthy subjects. Food Nutr Sci 2012;3:1533-8. DOI
  7. Dion C, Chappuis E, Ripoll C. Does larch arabinogalactan enhance immune function? A review of mechanistic and clinical trials. Nutr Metab (Lond) 2016;13:28. PubMed
  8. Riede L, Grube B, Gruenwald J. Larch arabinogalactan effects on reducing incidence of upper respiratory tract infections. Curr Med Res Opin 2013;29(3):251-8.

See these in context on the Larch Arabinogalactan monograph →

Honeysuckle 3 references
  1. Chang WC, Hsu FL. Inhibition of platelet activation and endothelial cell injury by polyphenolic compounds isolated from Lonicera japonica Thunb. Prostaglandins Leukot Essent Fatty Acids 1992;45:307-12. PubMed
  2. Webster RM. Honeysuckle contact dermatitis. Cutis 1993;51:424.
  3. Zhou LF, Lu R. Compound-honeysuckle-induced drug eruption with special manifestations: A case report. World J Clin Cases 2022;10(22):8018-8024. PubMed

See these in context on the Honeysuckle monograph →

Apple 16 references
  1. The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999.
  2. Bailey DG, Dresser GK, Munoz C, et al. Reduction of fexofenadine bioavailability by fruit juices. Clin Pharmacol Ther 2001;69:P21.
  3. Rodriguez J, Crespo JF, Lopez-Rubio A, et al. Clinical cross-reactivity among foods of the Rosaceae family. J Allergy Clin Immunol 2000;106:183-189. PubMed
  4. Greenblatt DJ. Analysis of drug interactions involving fruit beverages and organic anion-transporting polypeptides. J Clin Pharmacol 2009;49:1403-7. PubMed
  5. Bailey DG. Fruit juice inhibition of uptake transport: a new type of food-drug interaction. Br J Clin Pharmacol 2010;70:645-55. PubMed
  6. Kamath AV, Yao M, Zhang Y, Chong S. Effect of fruit juices on the oral bioavailability of fexofenadine in rats. J Pharm Sci 2005;94:233-9. PubMed
  7. Tapaninen T, Neuvonen PJ, Niemi M. Orange and apple juice greatly reduce the plasma concentrations of the OATP2B1 substrate aliskiren. Br J Clin Pharmacol 2011;71:718-26. PubMed
  8. Jeon H, Jang IJ, Lee S, et al. Apple juice greatly reduces systemic exposure to atenolol. Br J Clin Pharmacol 2012 May 11. doi: 10.1111/j.1365-2125.2012.04324.x. [Epub ahead of print]. PubMed
  9. Visvanathan, R., Chen, R., Horowitz, M., and Chapman, I. Blood pressure responses in healthy older people to 50 g carbohydrate drinks with differing glycaemic effects. Br J Nutr 2004;92(2):335-340. PubMed
  10. Asp, N. G., Agardh, C. D., Ahren, B., Dencker, I., Johansson, C. G., Lundquist, I., Nyman, M., Sartor, G., and Schersten, B. Dietary fibre in type II diabetes. Acta Med Scand Suppl 1981;656:47-50. PubMed
  11. Akamine Y, Miura M, Komori H, et al. Effects of one-time apple juice ingestion on the pharmacokinetics of fexofenadine enantiomers. Eur J Clin Pharmacol. 2014 Sep;70(9):1087-95. PubMed
  12. Luo J, Imai H, Ohyama T, et al. The Pharmacokinetic Exposure to Fexofenadine is Volume-Dependently Reduced in Healthy Subjects Following Oral Administration With Apple Juice. Clin Transl Sci. 2016 Aug;9(4):201-6. PubMed
  13. Tsiougkos N, Vovolis V. Repeated anaphylactic episodes to orange and apple. Eur Ann Allergy Clin Immunol. 2013 May;45(3):113-5.
  14. Rubido S, García-Caballero L, Abeleira MT, Limeres J, García M, Diz P. Effect of chewing an apple on dental plaque removal and on salivary bacterial viability. PLoS One. 2018;13(7):e0199812. PubMed
  15. Krishnasamy S, Lomer MCE, Marciani L, et al. Processing apples to puree or juice speeds gastric emptying and reduces postprandial intestinal volumes and satiety in healthy adults. J Nutr 2020;150(11):2890-9. PubMed
  16. Awan S, Abelleira A, Khehra L, Hieber R. Undetectable serum lithium concentrations after coadministration of liquid lithium citrate and apple juice: A case report. Ment Health Clin. 2021;11(1):27-30. PubMed

See these in context on the Apple monograph →

Olive 2 references
  1. Liccardi G, D'Amato M, D'Amato G. Oleaceae pollinosis: a review. Int Arch Allergy Immunol 1996;111:210-7. PubMed
  2. Somerville V, Moore R, Braakhuis A. The effect of olive leaf extract on upper respiratory illness in high school athletes: A randomised control trial. Nutrients. 2019;11(2). pii: E358. PubMed

See these in context on the Olive monograph →

Star Of Bethlehem 8 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. Ellenhorn MJ, et al. Ellenhorn's Medical Toxicology: Diagnoses and Treatment of Human Poisoning. 2nd ed. Baltimore, MD: Williams & Wilkins, 1997.
  3. Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.
  4. Burnham TH, ed. Drug Facts and Comparisons, Updated Monthly. Facts and Comparisons, St. Louis, MO.
  5. Waud RA. The action of Ornithogalum umbellatum on the heart. J Pharmacol Exp Ther 1954;111:147-51. DOI
  6. Vogelsang A. Ornithogalum umbellatum in the treatment of congestive heart failure: progress report. J Am Geriatr Soc 1961;9:1096-9.
  7. Vogelsang A. Clinical trial of Ornithogalum umbellatum on the human heart; preliminary report. Can Med Assoc J 1955;73:295-6.
  8. Smith JA, Paterson GR. Rhodexin A and rhodexoside in Ornithogalum umbellatum. J Pharm Pharmacol 1967;19:221-5.

See these in context on the Star Of Bethlehem monograph →

Aspen 3 references
  1. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
  2. Goodman LS, Gilman A. The Pharmacological Basis of Therapeutics. 5th ed. New York, NY: Macmillan Publ. Co., Inc., 1975.
  3. Aalto-Korte K, Välimaa J, Henriks-Eckerman ML, Jolanki R. Allergic contact dermatitis from salicyl alcohol and salicylaldehyde in aspen bark (Populus tremula). Contact Dermatitis 2005;52(2):93-5.

See these in context on the Aspen monograph →

Verbena 6 references
  1. Neubauer N, Marz RW. Placebo-controlled, randomized, double-blind, clincal trial with Sinupret sugar coated tablets on the basis of a therapy with antibiotics and decongestant nasal drops in acute sinusitis. Phytomedicine 1994;1:177-81.
  2. Marz RW, Ismail C, Popp MA. Action profile and efficacy of a herbal combination preparation for the treatment of sinusitis. Wien Med Wochenschr 1999;149:202-8.
  3. 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
  4. Del Pozo MD, Gastaminza G, Navarro JA, et al. Allergic contact dermatitis from Verbena officinalis L. Contact Dermatitis 1994;31:200-1.
  5. Peric A, Kovacevic SV, Gacesa D, Peric AV. Efficacy and safety of combined treatment of acute rhinosinusitis by herbal medicinal product Sinupret and mometasone furoate nasal spray. ENT Updates 2017;7(2):68-74. DOI
  6. Grawish ME, Anees MM, Elsabaa HM, Abdel-Raziq MS, Zedan W. Short-term effects of Verbena officinalis Linn decoction on patients suffering from chronic generalized gingivitis: Double-blind randomized controlled multicenter clinical trial. Quintessence Int.

See these in context on the Verbena monograph →

Grape 34 references
  1. Kiesewetter H, Koscielny J, Kalus U, et al. Efficacy of orally administered extract of red vine leaf AS 195 (folia vitis viniferae) in chronic venous insufficiency (stages I-II). A randomized, double-blind, placebo-controlled trial. Arzneimittelforschung
  2. Xiao Dong S, Zhi Ping Z, Zhong Xiao W, et al. Possible enhancement of the first-pass metabolism of phenacetin by ingestion of grape juice in Chinese subjects. Br J Clin Pharmacol 1999;48:638-40. PubMed
  3. Vaswani SK, Hamilton RG, Carey RN, et al. Anaphylaxis recurrent urticaria and angioedema from grape hypersensitivity. J Allergy Clin Immunol 1998;101:S31.
  4. Chevallier A. The Encyclopedia of Medicinal Plants. London, UK: Dorling Kindersley, Ltd., 1996.
  5. Bernstein DI, Bernstein CK, Deng C, et al. Evaluation of the clinical efficacy and safety of grapeseed extract in the treatment of fall seasonal allergic rhinitis: a pilot study. Ann Allergy Asthma Immunol 2002;88:272-8.. PubMed
  6. Greenblatt DJ, von Moltke LL, Perloff ES, et al. Interaction of flurbiprofen with cranberry juice, grape juice, tea, and fluconazole: in vitro and clinical studies. Clin Pharmacol Ther 2006;79:125-33. PubMed
  7. Ward NC, Hodgson JM, Croft KD, et al. The combination of vitamin C and grape-seed polyphenols increases blood pressure: a randomized, double-blind, placebo-controlled trial. J Hypertens 2005;23:427-34.. PubMed
  8. Ray, S. D., Parikh, H., Hickey, E., Bagchi, M., and Bagchi, D. Differential effects of IH636 grape seed proanthocyanidin extract and a DNA repair modulator 4-aminobenzamide on liver microsomal cytochrome 4502E1-dependent aniline hydroxylation. Mol Cell B PubMed
  9. O'Byrne, D. J., Devaraj, S., Grundy, S. M., and Jialal, I. Comparison of the antioxidant effects of Concord grape juice flavonoids alpha-tocopherol on markers of oxidative stress in healthy adults. Am J Clin.Nutr. 2002;76(6):1367-1374.
  10. Schaefer, E., Peil, H., Ambrosetti, L., and Petrini, O. Oedema protective properties of the red vine leaf extract AS 195 (Folia vitis viniferae) in the treatment of chronic venous insufficiency. A 6-week observational clinical trial. Arzneimittelforschun PubMed
  11. Nishikawa, M., Ariyoshi, N., Kotani, A., Ishii, I., Nakamura, H., Nakasa, H., Ida, M., Nakamura, H., Kimura, N., Kimura, M., Hasegawa, A., Kusu, F., Ohmori, S., Nakazawa, K., and Kitada, M. Effects of continuous ingestion of green tea or grape seed extra
  12. de Lange, D. W., Scholman, W. L., Kraaijenhagen, R. J., Akkerman, J. W., and van de Wiel, A. Alcohol and polyphenolic grape extract inhibit platelet adhesion in flowing blood. Eur.J Clin.Invest 2004;34(12):818-824. PubMed
  13. Samet, J. M. and Coultas, D. B. Reduced forced vital capacity in California grape workers. What does it mean? Am Rev.Respir.Dis 1992;145(2 Pt 1):255-256. PubMed
  14. Gamsky, T. E., McCurdy, S. A., Samuels, S. J., and Schenker, M. B. Reduced FVC among California grape workers. Am Rev.Respir.Dis 1992;145(2 Pt 1):257-262. PubMed
  15. de Lange, D. W., Verhoef, S., Gorter, G., Kraaijenhagen, R. J., van de Wiel, A., and Akkerman, J. W. Polyphenolic grape extract inhibits platelet activation through PECAM-1: an explanation for the French paradox. Alcohol Clin.Exp.Res 2007;31(8):1308-1314 PubMed
  16. Etheridge, A. S., Black, S. R., Patel, P. R., So, J., and Mathews, J. M. An in vitro evaluation of cytochrome P450 inhibition and P-glycoprotein interaction with goldenseal, Ginkgo biloba, grape seed, milk thistle, and ginseng extracts and their constitu
  17. Krikorian, R., Nash, T. A., Shidler, M. D., Shukitt-Hale, B., and Joseph, J. A. Concord grape juice supplementation improves memory function in older adults with mild cognitive impairment. Br J Nutr. 2010;103(5):730-734. PubMed
  18. Ingersoll, G. L., Wasilewski, A., Haller, M., Pandya, K., Bennett, J., He, H., Hoffmire, C., and Berry, C. Effect of concord grape juice on chemotherapy-induced nausea and vomiting: results of a pilot study. Oncol.Nurs.Forum 2010;37(2):213-221. PubMed
  19. Oliveira-Freitas, V. L., Dalla, Costa T., Manfro, R. C., Cruz, L. B., and Schwartsmann, G. Influence of purple grape juice in cyclosporine bioavailability. J Ren Nutr. 2010;20(5):309-313. PubMed
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See these in context on the Grape 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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