ORAC Super 7 Ingredients & Drug Interactions
What is this page for?
First and foremost: checking ORAC Super 7 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
ORAC Super 7 is a dietary supplement by Nature's Answer with 12 active ingredients. Its ingredients are commonly taken for antioxidant support, weight loss, heart health.Based on those ingredients, 1,437 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are Green Tea extract, Goji extract, Pomegranate. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against ORAC Super 7 by Nature's Answer
Ask about any prescription or over-the-counter medication and we check it for interactions with ORAC Super 7 by Nature's Answer — 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 ORAC Super 7 by Nature's Answer
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
ORAC Super 7 contains 11 active ingredients: white grape juice concentrate, blueberry juice concentrate, grape seed extract, pomegranate, red grape juice concentrate, green tea extract, green coffee extract, mangosteen extract, acai extract, goji extract, and a proprietary blend of herbs and botanicals. These are fruit and plant extracts chosen for their antioxidant content ("ORAC" stands for oxygen radical absorbance capacity — a measure of antioxidant activity).
The product also contains inactive ingredients including water, various juice concentrates (strawberry, cranberry, red raspberry), natural flavor, stevia extract, pectin, xanthan gum, pear puree and juice, apple juice concentrate, potassium sorbate, citric acid, agave nectar, and Quik-Sorb.
Does it work?
Strong evidence
Evidence for most ingredients is limited or mixed. White grape juice, grape seed extract, red grape juice, and muscadine grape extract are possibly effective for chronic venous insufficiency (heaviness and swelling in the legs from poor circulation), but possibly ineffective for chemotherapy-related nausea, allergies, and weight loss.
Green tea extract is likely effective for human papillomavirus (HPV) skin lesions and possibly effective for ovarian cancer and high cholesterol. Green coffee extract is likely effective for mental alertness and possibly effective for Parkinson disease, heart failure, and diabetes.
Pomegranate is possibly effective for high blood pressure but possibly ineffective for high cholesterol and diabetes. For blueberry, acai, goji, and mangosteen, the evidence we hold either shows insufficient data or does not establish clear benefit.
How safe is it?
Well-documented data
The grape components, blueberry, pomegranate, and acai are generally well tolerated when used as supplements. Most common side effects are mild gastrointestinal — abdominal pain, diarrhea, nausea, headache, and joint pain.
Green tea and green coffee extracts are well tolerated at moderate doses, though high-dose green tea extract has rarely been linked to liver injury. Mangosteen extract in studies up to 560 mg daily caused mild side effects like tiredness, headache, constipation, and nausea, though causation isn't certain.
Goji has rare reports of allergic reactions and liver inflammation. Anaphylaxis (a severe allergic reaction) has been reported with grape and goji products in sensitive individuals.
During pregnancy, grapes as food are fine, but concentrated grape supplements and wine should be avoided due to limited safety data. Green tea and green coffee should be limited because of their caffeine — discuss safe amounts with your doctor.
For mangosteen and goji, there isn't enough safety data; avoid supplement amounts during pregnancy. For breastfeeding, caffeine from green tea and green coffee passes into breast milk — keep intake low and watch your baby for fussiness or sleep trouble.
Concentrated supplements of mangosteen, goji, acai, and blueberry extracts haven't been well studied while nursing; caution is advised.
Meds to double-check
Major interaction found
Before taking ORAC Super 7, double-check with your doctor or pharmacist if you take: blood thinners or antiplatelet drugs (warfarin, aspirin, clopidogrel) — goji and grape components may increase bleeding risk; blood pressure medications or ACE inhibitors — pomegranate may lower blood pressure further; cholesterol drugs like atorvastatin or rosuvastatin — grape and green tea extracts may reduce their effects; diabetes medications — blueberry and acai may lower blood sugar; antiseizure medications (phenytoin, valproate, ethosuximide, felbamate) — green tea's caffeine may reduce seizure control; heart or sedative medications including cyclosporine, midazolam, nadolol, or flecainide — grape components and goji may interfere; and any stimulant or decongestant containing ephedrine — green tea and green coffee carry a serious risk of heart attack, stroke, or death when combined. No interactions are documented for the proprietary blend ingredient we could not check.
The bottom line
Scorecard at a glanceFormula with limited ingredient disclosure with strong clinical evidence behind its ingredients' uses. Major medication interactions have been identified, and safety information is well characterized.
ORAC Super 7 is a fruit and plant extract blend with some evidence for chronic venous insufficiency and HPV skin lesions, though most benefits are not well established. If you take warfarin, any blood pressure or cholesterol medications, diabetes drugs, heart medications, antiseizure drugs, or any drug metabolized by your liver, you need to check this product against your exact medication list before starting — the interactions are real and potentially serious.
Talk with your doctor or pharmacist about whether it's right for you and whether it can be safely combined with what you're already taking.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 11 of 11 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated May 22, 2016.
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 ORAC Super 7, straight from the product label.
| Brand | Nature's Answer |
|---|---|
| Barcode (UPC) | 083000261909 |
| Net contents | 32 fl. Oz.; 960 mL |
| Market status | On market |
| Date entered into DSLD | May 22, 2016 |
| DSLD ID | 59949 |
| Product type | Botanical |
| Supplement form | Liquid |
| Dietary claims / uses | All Other, Structure/Function |
| Intended target group(s) | Adult (18 - 50 Years), Gluten Free |
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.
Supplement Facts
The label details for ORAC Super 7 by Nature's Answer, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Calories | 15 {Calories} | -- |
| Total Carbohydrates | 4 Gram(s) | 2% |
| Sugar | 4 Gram(s) | -- |
| White Grape juice concentrate | 0 NP | -- |
| Blueberry juice concentrate | 0 NP | -- |
| Grape seed extract | 0 NP | -- |
| Pomegranate | 0 NP | -- |
| Red Grape juice concentrate | 0 NP | -- |
| Green Tea extract | 50 mg | -- |
| Green Coffee extract | 0 NP | -- |
| Mangosteen extract | 0 NP | -- |
| Acai extract | 0 NP | -- |
| Proprietary Bio-Active Blend {Herb/Botanical} | 4530 mg | -- |
| Goji extract | 0 NP | -- |
| Muscadine Grape extract | 0 NP | -- |
Other ingredients: Water, Strawberry juice concentrate, Cranberry juice concentrate, Natural flavor, Red Raspberry concentrate, Stevia extract, Grapefruit Pectin, Xanthan Gum, Pear puree, Pear juice concentrate, Apple juice concentrate, Potassium Sorbate, Citric Acid, Agave Nectar, Quik-Sorb
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.
General Statements
ORAC stands for "Oxygen Radical Absorbance Capacity". ORAC describes a laboratory analysis of the antioxidant activity against the peroxyl radical, which is one of the most common reactive oxygen species (ROS) that cause coddative. The greater the amount of free radicals a food or nutrient can combat, the higher its ORAC score.
Since 1972
Scientific studies continue to support the long standing health benefits of antioxidants. Advanced research is focusing on fruits that have a high-ORAC value.
Powerful Antioxidant
Brand IP Statement(s)
This standard, developed in a collaborated effort by the National Institute on Aging and the USDA Human Nutrition Research Center on Aging is what prompted Nature's Answer to develop "ORAC Super 7".
ORAC Super 7 contains a hand selected combination of some of the world's most powerful, high ORAC scoring berry and fruit extracts.
Quik-Sorb, Nature's Answer's exclusive proprietary blend of herbs know to enhance the delivery of nutrients to the body, completes this delicious, high ORAC formulation.
ORAC Super 7 - "It's Nature's Answer"
2014 Nature's Answer Quik-Sorb is a trademark of Bio-Botanica Inc.
Formula
To further enhance this anti-oxidant formula, ORAC Super 7 adds additional all natural ingredients, such as organic apple, organic pear and organic agave nectar.
Concentrated blend of high ORAC berry and fruit extracts
provides Green Tea
Acai, mangosteen, goji (wolfberry), pomegranate, green coffee bean, muscadine grape and blueberry with organic juices
FDA Disclaimer Statement
This statement has not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.
General
27190 Rev. 04/14
Seals/Symbols
OTCO
5,000 - 7,000 ORAC UNITS PER 1 oz. SERVING!
Quik-Sorb
Gluten Free
FDA Statement of Identity
Liquid Dietary Supplement
Formulation
"Optimal protection, optimal absorption"
Free of yeast, wheat, soy, artificial colors/flavors.
Gluten Free
To further enhance this anti-oxidant formula, ORAC Super 7 adds additional all natural ingredients, such as organic apple, organic pear and organic agave nectar.
Suggested/Recommended/Usage/Directions
Suggested Use: As a dietary supplement take two (2) Tablespoons (30 mL, one ounce) daily with a meal, or as directed by your healthcare practitioner. May be mixed with water or juice. Shake well before use.
Storage
Refrigerate after opening.
Precautions
Caution: Keep out of reach of children.
Do not use if safety seal is damaged or missing.
If pregnant, nursing or on medication, consult with your healthcare practitioner.
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
ORAC Super 7 by Nature's Answer 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 ORAC Super 7 by Nature's Answer
These are the 12 active ingredients this product is made of. Select any to open its full monograph.
Serving size2 Tbsp Dosage formLiquid Servings per container32 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.
Sugar
Green Tea extract
Interacts with1,293 drugs
Green tea is a popular beverage rich in antioxidants called catechins, and drinking it in normal amounts is considered safe for most people. Concentra...
Green Tea extract monograph & interactionsProprietary Bio-Active Blend {Herb/Botanical}
Other (inactive) ingredients: Water, Strawberry juice concentrate, Cranberry juice concentrate, Natural flavor, Red Raspberry concentrate, Stevia extract, Grapefruit Pectin, Xanthan Gum, Pear puree, Pear juice concentrate, Apple juice concentrate, Potassium Sorbate, Citric Acid, Agave Nectar, Quik-Sorb. These complete the product’s ingredient list but are not active constituents.
ORAC Super 7 by Nature's Answer Drug Interactions
HelloPharmacist Interaction Report
ORAC Super 7 by Nature's Answer interacts with medications through its white grape juice concentrate, grape seed extract, red grape juice concentrate, pomegranate, blueberry juice concentrate, green tea extract, green coffee extract, mangosteen extract, acai extract, and goji extract.
The most serious interaction is with goji extract and warfarin (Coumadin) — a blood thinner — where goji can boost warfarin's effects and raise your bleeding risk; this is documented in multiple case reports.
Read the full breakdown — every affected drug type, severity by severity
Green tea extract and green coffee extract both contain caffeine and carry Major-severity interactions with ephedrine (a stimulant found in some supplements and decongestants) — combined use risks dangerous effects like heart attack, stroke, seizure, and death. Green tea also reduces levels of the heart medication nadolol and the cholesterol drug atorvastatin, potentially weakening their effects.
Both extracts also interact with several other medications that affect how your liver processes drugs.
The grape components (white grape juice concentrate, grape seed extract, red grape juice concentrate, and muscadine grape extract) all share a set of Moderate interactions affecting drug-metabolizing enzymes and blood thinners. They may reduce levels of some drugs like cyclosporine (an immunosuppressant) or midazolam (a sedative), or increase levels of others depending on how your liver breaks them down.
Pomegranate adds Moderate interactions with blood pressure drugs, ACE inhibitors, the blood thinner warfarin, and the cholesterol medication rosuvastatin. Blueberry carries Minor interactions with diabetes medications and certain painkillers and anti-anxiety drugs.
Altogether, these interactions span 1,438 individual medications. Check your exact medications with the tool on this page before starting.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against ORAC Super 7?
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 ORAC Super 7 interact with 1,437 drugs. Click any drug to see the details.
8 of the 12 ingredients in ORAC Super 7 interact with drugs. Each result below shows which ingredient is responsible. Green Tea extract Goji extract Pomegranate White Grape juice concentrate Green Coffee extract Mangosteen extract Blueberry juice concentrate Acai extract
AcepromazineAtravet
How Acepromazine interacts with ORAC Super 7 — through 2 ingredients. Tap an ingredient for the detail:
Green Tea ExtractPhenothiazines Minor
Interaction Summary
Theoretically, phenothiazines might increase the levels and adverse effects of caffeine.
Read the full Green Tea Extract + Acepromazine interactionGreen Coffee ExtractPhenothiazines Minor
Interaction Summary
Theoretically, phenothiazines might increase the levels and adverse effects of caffeine.
Read the full Green Coffee Extract + Acepromazine interactionAmoxapineAsendin
How Amoxapine interacts with ORAC Super 7 — through 1 ingredient. Tap an ingredient for the detail:
Green Coffee ExtractTricyclic Antidepressants (tcas) Minor
Interaction Summary
Theoretically, TCAs might bind with coffee constituents when taken at the same time.
Read the full Green Coffee Extract + Amoxapine interactionCarphenazineProketazin
How Carphenazine interacts with ORAC Super 7 — through 2 ingredients. Tap an ingredient for the detail:
Green Coffee ExtractPhenothiazines Minor
Interaction Summary
Theoretically, phenothiazines might increase the levels and adverse effects of caffeine.
Read the full Green Coffee Extract + Carphenazine interactionGreen Tea ExtractPhenothiazines Minor
Interaction Summary
Theoretically, phenothiazines might increase the levels and adverse effects of caffeine.
Read the full Green Tea Extract + Carphenazine interactionCyamemazineTercian
How Cyamemazine interacts with ORAC Super 7 — through 2 ingredients. Tap an ingredient for the detail:
Green Tea ExtractPhenothiazines Minor
Interaction Summary
Theoretically, phenothiazines might increase the levels and adverse effects of caffeine.
Read the full Green Tea Extract + Cyamemazine interactionGreen Coffee ExtractPhenothiazines Minor
Interaction Summary
Theoretically, phenothiazines might increase the levels and adverse effects of caffeine.
Read the full Green Coffee Extract + Cyamemazine interactionEsketamineSpravato
How Esketamine interacts with ORAC Super 7 — through 1 ingredient. Tap an ingredient for the detail:
Green Coffee ExtractTricyclic Antidepressants (tcas) Minor
Interaction Summary
Theoretically, TCAs might bind with coffee constituents when taken at the same time.
Read the full Green Coffee Extract + Esketamine interactionIsopropamide, ProchlorperazineCombid
How Isopropamide, Prochlorperazine interacts with ORAC Super 7 — through 2 ingredients. Tap an ingredient for the detail:
Green Tea ExtractPhenothiazines Minor
Interaction Summary
Theoretically, phenothiazines might increase the levels and adverse effects of caffeine.
Read the full Green Tea Extract + Isopropamide, Prochlorperazine interactionGreen Coffee ExtractPhenothiazines Minor
Interaction Summary
Theoretically, phenothiazines might increase the levels and adverse effects of caffeine.
Read the full Green Coffee Extract + Isopropamide, Prochlorperazine interactionIsopropamide, TrifluoperazineStelabid Forte, Stelabid No 1, Stelabid No 2
How Isopropamide, Trifluoperazine interacts with ORAC Super 7 — through 2 ingredients. Tap an ingredient for the detail:
Green Coffee ExtractPhenothiazines Minor
Interaction Summary
Theoretically, phenothiazines might increase the levels and adverse effects of caffeine.
Read the full Green Coffee Extract + Isopropamide, Trifluoperazine interactionGreen Tea ExtractPhenothiazines Minor
Interaction Summary
Theoretically, phenothiazines might increase the levels and adverse effects of caffeine.
Read the full Green Tea Extract + Isopropamide, Trifluoperazine interactionPericyazinePericyazine
How Pericyazine interacts with ORAC Super 7 — through 2 ingredients. Tap an ingredient for the detail:
Green Tea ExtractPhenothiazines Minor
Interaction Summary
Theoretically, phenothiazines might increase the levels and adverse effects of caffeine.
Read the full Green Tea Extract + Pericyazine interactionGreen Coffee ExtractPhenothiazines Minor
Interaction Summary
Theoretically, phenothiazines might increase the levels and adverse effects of caffeine.
Read the full Green Coffee Extract + Pericyazine interactionProchlorperazineCompazine, Prochlor
How Prochlorperazine interacts with ORAC Super 7 — through 2 ingredients. Tap an ingredient for the detail:
Green Tea ExtractPhenothiazines Minor
Interaction Summary
Theoretically, phenothiazines might increase the levels and adverse effects of caffeine.
Read the full Green Tea Extract + Prochlorperazine interactionGreen Coffee ExtractPhenothiazines Minor
Interaction Summary
Theoretically, phenothiazines might increase the levels and adverse effects of caffeine.
Read the full Green Coffee Extract + Prochlorperazine interactionPromazineSparine
How Promazine interacts with ORAC Super 7 — through 2 ingredients. Tap an ingredient for the detail:
Green Coffee ExtractPhenothiazines Minor
Interaction Summary
Theoretically, phenothiazines might increase the levels and adverse effects of caffeine.
Read the full Green Coffee Extract + Promazine interactionGreen Tea ExtractPhenothiazines Minor
Interaction Summary
Theoretically, phenothiazines might increase the levels and adverse effects of caffeine.
Read the full Green Tea Extract + Promazine interactionPromethazinePhenergan
How Promethazine interacts with ORAC Super 7 — through 2 ingredients. Tap an ingredient for the detail:
Green Tea ExtractPhenothiazines Minor
Interaction Summary
Theoretically, phenothiazines might increase the levels and adverse effects of caffeine.
Read the full Green Tea Extract + Promethazine interactionGreen Coffee ExtractPhenothiazines Minor
Interaction Summary
Theoretically, phenothiazines might increase the levels and adverse effects of caffeine.
Read the full Green Coffee Extract + Promethazine interactionProtriptylineVivactil
How Protriptyline interacts with ORAC Super 7 — through 1 ingredient. Tap an ingredient for the detail:
Green Coffee ExtractTricyclic Antidepressants (tcas) Minor
Interaction Summary
Theoretically, TCAs might bind with coffee constituents when taken at the same time.
Read the full Green Coffee Extract + Protriptyline interactionTrifluoperazineStelazine
How Trifluoperazine interacts with ORAC Super 7 — through 2 ingredients. Tap an ingredient for the detail:
Green Coffee ExtractPhenothiazines Minor
Interaction Summary
Theoretically, phenothiazines might increase the levels and adverse effects of caffeine.
Read the full Green Coffee Extract + Trifluoperazine interactionGreen Tea ExtractPhenothiazines Minor
Interaction Summary
Theoretically, phenothiazines might increase the levels and adverse effects of caffeine.
Read the full Green Tea Extract + Trifluoperazine interactionTriflupromazineVesprin
How Triflupromazine interacts with ORAC Super 7 — through 2 ingredients. Tap an ingredient for the detail:
Green Tea ExtractPhenothiazines Minor
Interaction Summary
Theoretically, phenothiazines might increase the levels and adverse effects of caffeine.
Read the full Green Tea Extract + Triflupromazine interactionGreen Coffee ExtractPhenothiazines Minor
Interaction Summary
Theoretically, phenothiazines might increase the levels and adverse effects of caffeine.
Read the full Green Coffee Extract + Triflupromazine interactionEach ingredient & the kinds of drugs it affects
For each ingredient in ORAC Super 7 with known interactions, here are the types of medications they can affect. Open any type for the detail — or search your exact drug in the checker above.
Green Tea extract
Atorvastatin (Lipitor)
Green tea extract seems to reduce the levels and clinical effects of atorvastatin.
In healthy humans, taking green tea extract 300 mg or 600 mg along with atorvastatin reduces plasma levels of atorvastatin by approximately 24%. The elimination of atorvastatin is not affected. Atorvastatin is a substrate of organic anion-transporting polypeptides (OATPs). Research shows that two of the major catechins found in green tea, epicatechin gallate (ECG) and epigallocatechin gallate (EGCG), inhibit OATPs. Some OATPs are expressed in the small intestine and are responsible for the uptake of drugs and other compounds, which may have resulted in reduced plasma levels of atorvastatin. It is not clear if drinking green tea alters the absorption of atorvastatin.
Ephedrine
Theoretically, concomitant use might increase the risk for stimulant adverse effects.
Green tea contains caffeine. There is evidence that using ephedrine with caffeine might increase the risk of serious life-threatening or debilitating adverse effects such as hypertension, myocardial infarction, stroke, seizures, and death.
Nadolol (Corgard)
Green tea seems to reduce the levels and clinical effects of nadolol.
Preliminary clinical research shows that green tea consumption reduces plasma concentrations of nadolol. Compared to a control group, both peak levels and total drug exposure (AUC) of nadolol were reduced by approximately 85% in subjects who drank green tea daily for two weeks. Drinking green tea with nadolol also significantly reduced nadolol's systolic blood pressure lowering effect. Other clinical research shows that a single dose of green tea can affect plasma nadolol levels for at least one hour. Green tea catechins have been shown to inhibit organic anion transporting polypeptides (OATP), one of which, OATP1A2, is involved in the uptake of nadolol in the intestine The interaction is thought to be due primarily to the epigallocatechin gallate (EGCG) content of green tea.
5-Fluorouracil
Theoretically, high doses of green tea might increase the effects and side effects of 5-fluorouracil.
Animal research shows that taking green tea in amounts equivalent to about 6 cups daily in humans for 4 weeks prior to receiving a single injection of 5-fluorouracil increases the maximum plasma levels of 5-fluorouracil by about 2.5-fold and the area under the curve by 425%.
Adenosine (Adenocard)
Theoretically, green tea might decrease the vasodilatory effects of adenosine and interfere with its use prior to stress testing.
Green tea contains caffeine. Caffeine is a competitive inhibitor of adenosine at the cellular level. However, caffeine doesn't seem to affect supplemental adenosine because high interstitial levels of adenosine overcome the antagonistic effects of caffeine. It is recommended that methylxanthines and methylxanthine-containing products be stopped 24 hours prior to pharmacological stress tests. However, methylxanthines appear more likely to interfere with dipyridamole (Persantine) than adenosine-induced stress testing.
Anticoagulant/Antiplatelet Drugs
Theoretically, green tea may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Conflicting reports exist regarding the effect of green tea on bleeding risk when used with anticoagulant or antiplatelet drugs; however, most evidence suggests that drinking green tea in moderate amounts is unlikely to cause a significant interaction. Green tea contains small amounts of vitamin K, approximately 7 mcg per cup. Some case reports have associated the antagonism of warfarin with the vitamin K content of green tea. However, these reports are rare, and very large doses of green tea (about 8-16 cups daily) appear to be needed to cause these effects. Furthermore, the catechins and caffeine in green tea are reported to have antiplatelet activity.
Beta-Adrenergic Agonists
Green tea contains caffeine. Theoretically, concomitant use of large amounts of caffeine might increase cardiac inotropic effects of beta-agonists.
Bortezomib (Velcade)
Theoretically, green tea might interfere with the effects of bortezomib.
In vitro research shows that green tea polyphenols, such as epigallocatechin gallate (EGCG), interact with bortezomib and block its proteasome inhibitory action. This prevents the induction of cell death in multiple myeloma or glioblastoma cancer cell lines. Advise patients taking bortezomib, not to take green tea.
Carbamazepine (Tegretol)
Theoretically, green tea might reduce the effects of carbamazepine and increase the risk for convulsions.
Green tea contains caffeine. Animal research suggests that taking caffeine can lower the anticonvulsant effects of carbamazepine and can induce seizures when taken in doses above 400 mg/kg. Human research has shown that taking caffeine 300 mg in three divided doses along with carbamazepine 200 mg reduces the bioavailability of carbamazepine by 32% and prolongs the plasma half-life of carbamazepine 2-fold in healthy individuals.
Celiprolol (Celicard)
Theoretically, green tea might reduce the levels and clinical effects of celiprolol.
In a small human study, taking green tea daily for 4 days appears to decrease blood and urine levels of celiprolol by at least 98%. This interaction is possibly due to the inhibition of organic anion transporting polypeptide (OATP). Green tea catechins have been shown to inhibit organic anion transporting polypeptides (OATP), one of which, OATP1A2, is found in the intestine The interaction is thought to be due primarily to the epigallocatechin gallate (EGCG) content of green tea.
Cimetidine (Tagamet)
Theoretically, concomitant use might increase the effects and adverse effects of caffeine in green tea.
Green tea contains caffeine. Cimetidine can reduce caffeine clearance by 31% to 42%.
Clozapine (Clozaril)
Theoretically, green tea might increase the levels and adverse effects of clozapine and acutely exacerbate psychotic symptoms.
Animal research suggests that, although green tea extract does not affect the elimination of clozapine, it delays the time to reach peak concentration and reduces the peak plasma levels. Also, concomitant administration of green tea and clozapine might theoretically cause acute exacerbation of psychotic symptoms due to the caffeine in green tea. Caffeine can increase the effects and toxicity of clozapine. Caffeine doses of 400-1000 mg daily inhibit clozapine metabolism. Clozapine is metabolized by cytochrome P450 1A2 (CYP1A2). Researchers speculate that caffeine might inhibit CYP1A2. However, there is no reliable evidence that caffeine affects CYP1A2. There is also speculation that genetic factors might make some patients be more sensitive to the interaction between clozapine and caffeine.
Contraceptive Drugs
Theoretically, concomitant use might increase the effects and adverse effects of caffeine found in green tea.
Green tea contains caffeine. Oral contraceptives can decrease caffeine clearance by 40% to 65%.
Cytochrome P450 1A2 (Cyp1A2) Inhibitors
Theoretically, concomitant use might increase the levels and adverse effects of caffeine.
Green tea contains caffeine. Caffeine is metabolized by cytochrome P450 1A2 (CYP1A2),. Theoretically, drugs that inhibit CYP1A2 may decrease the clearance rate of caffeine from green tea and increase caffeine levels.
Dipyridamole (Persantine)
Theoretically, green tea might decrease the vasodilatory effects of dipyridamole and interfere with its use prior to stress testing.
Green tea contains caffeine. Caffeine might inhibit dipyridamole-induced vasodilation. It is recommended that methylxanthines and methylxanthine-containing products be stopped 24 hours prior to pharmacological stress tests. Methylxanthines appear more likely to interfere with dipyridamole (Persantine) than adenosine-induced stress testing.
Disulfiram (Antabuse)
Theoretically, disulfiram might increase the risk of adverse effects from caffeine.
In human research, disulfiram decreases the clearance and increases the half-life of caffeine.
Diuretic Drugs
Theoretically, using green tea with diuretic drugs might increase the risk of hypokalemia.
Green tea contains caffeine. In excessive amounts, caffeine can reduce potassium levels due to stimulation of the sodium-potassium pump. Diuretics can also cause lower potassium levels.
Estrogens
Theoretically, estrogens might increase the levels and adverse effects of caffeine.
Green tea contains caffeine. Estrogen inhibits caffeine metabolism.
Ethosuximide (Zarontin)
Theoretically, green tea might reduce the effects of ethosuximide and increase the risk for convulsions.
Green tea contains caffeine. Animal research suggests that caffeine 92.4 mg/kg can decrease the anticonvulsant activity of ethosuximide. However, this effect has not been reported in humans.
Felbamate (Felbatol)
Theoretically, green tea might reduce the effects of felbamate and increase the risk for convulsions.
Green tea contains caffeine. Animal research suggests that a high dose of caffeine 161.7 mg/kg can decreases the anticonvulsant activity of felbamate. However, this effect has not been reported in humans.
Fexofenadine (Allegra)
Green tea can decrease blood levels of fexofenadine.
Clinical research shows that green tea can significantly decrease blood levels and excretion of fexofenadine. Taking green tea extract with a dose of fexofenadine decreased bioavailability of fexofenadine by about 30%. In vitro, green tea inhibits the cellular accumulation of fexofenadine by inhibiting the organic anion transporting polypeptide (OATP) drug transporter. Research shows that two of the major catechins found in green tea, epicatechin gallate (ECG) and epigallocatechin gallate (EGCG), inhibit OATPs, specifically OATP1A2, OATP1B1, and OATP2B1. In addition, green tea has been shown to reduce the absorption of some drugs that are OATP substrates.
Flutamide (Eulexin)
Theoretically, green tea might increase the levels and adverse effects of flutamide.
Green tea contains caffeine. In vitro evidence suggests that caffeine can inhibit the metabolism of flutamide. Theoretically, concomitant use of caffeine and flutamide might increase serum concentrations of flutamide and increase the risk adverse effects.
Fluvoxamine (Luvox)
Theoretically, fluvoxamine might increase the levels and adverse effects of caffeine.
Green tea contains caffeine. Fluvoxamine reduces caffeine metabolism.
Hepatotoxic Drugs
Theoretically, concomitant use might have additive adverse hepatotoxic effects.
Green tea extract supplements have been linked to several cases of hepatotoxicity and might have additive hepatotoxic effects with other drugs..
Imatinib (Gleevec)
Theoretically, green tea might reduce the levels and clinical effects of imatinib.
In animal research, a single dose of green tea extract reduces the area under the curve (AUC) of imatinib by up to approximately 64% and its main metabolite N-desmethyl imatinib by up to approximately 81%. This interaction has not been shown in humans. The mechanism of action is unclear but may involve multiple pathways.
Goji extract
Warfarin (Coumadin)
Goji can increase the effects of warfarin and possibly increase the risk of bleeding.
There are at least 5 case reports of increased international normalized ratio (INR) in patients stabilized on warfarin who began drinking goji juice, concentrated goji tea, or goji wine. Goji may inhibit the metabolism of warfarin by cytochrome P450 2C9 (CYP2C9).
Antihypertensive Drugs
Theoretically, concomitant use of goji root bark, but not goji fruit, with antihypertensive drugs might have additive effects.
Animal and in vitro research suggest that goji root bark has hypotensive effects. However, goji fruit juice does not appear to reduce systolic or diastolic blood pressure in humans.
Cytochrome P450 2C19 (Cyp2C19) Substrates
Theoretically, goji berry might inhibit CYP2C19 and reduce metabolism of CYP2C19 substrates.
In vitro research shows that goji berry tincture and juice inhibit CYP2C19 enzymes. Concomitant use with goji may decrease metabolism and increase levels of CYP2C19 substrates. However, this has not been reported in humans.
Cytochrome P450 2C9 (Cyp2C9) Substrates
Theoretically, goji berry might inhibit CYP2C9 and reduce metabolism of CYP2C9 substrates.
In vitro research shows that goji berry tincture and juice inhibit CYP2C9 enzymes. Additionally, multiple case reports suggest that goji berry concentrated tea and juice inhibit the metabolism of warfarin, a CYP2C9 substrate. Concomitant use with goji may decrease metabolism and increase levels of CYP2C9 substrates.
Cytochrome P450 2D6 (Cyp2D6) Substrates
Theoretically, goji berry might inhibit CYP2D6 and reduce metabolism of CYP2D6 substrates.
In vitro research shows that goji berry juice inhibits CYP2D6 enzymes. Concomitant use with goji may decrease metabolism and increase levels of CYP2D6 substrates. However, this has not been reported in humans.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, goji berry might inhibit CYP3A4 and reduce metabolism of CYP3A4 substrates.
In vitro research shows that goji berry juice inhibits CYP3A4 enzymes. Concomitant use with goji may decrease metabolism and increase levels of CYP3A4 substrates. However, this has not been reported in humans.
Flecainide (Tambocor)
Theoretically, goji berry might increase the levels and clinical effects of flecainide.
In one case report, a 75-year-old patient stable on flecainide and warfarin presented to the emergency room with fainting and pleomorphic arrhythmia caused by flecainide toxicity. Flecainide toxicity was attributed to drinking 1-2 glasses of concentrated goji tea daily for 2 weeks. Theoretically, goji may have inhibited the cytochrome P450 2D6 (CYP2D6) metabolism of flecainide.
Antidiabetes Drugs
Theoretically, concomitant use of goji fruit polysaccharides or goji root bark with antidiabetes drugs might have additive effects.
Animal and in vitro research show that goji root bark and fruit polysaccharides might have hypoglycemic effects. However, clinical research has only shown that taking goji fruit polysaccharides with or without antidiabetes drugs modestly reduces postprandial glucose when compared with control, with no reports of hypoglycemia.
Pomegranate
Ace Inhibitors (Aceis)
Theoretically, taking pomegranate with ACEIs might increase the risk of adverse effects.
Pomegranate juice is thought to have ACE inhibitor-like effects.
Antihypertensive Drugs
Theoretically, taking pomegranate with antihypertensive drugs might increase the risk of hypotension.
Consuming pomegranate juice can modestly lower blood pressure.
Cytochrome P450 2D6 (Cyp2D6) Substrates
Theoretically, pomegranate might increase levels of drugs metabolized by CYP2D6.
In vitro, pomegranate juice inhibits CYP2D6. However, the clinical significance of this potential interaction in humans is not known.
Rosuvastatin (Crestor)
Theoretically, taking pomegranate with rosuvastatin might increase the risk of adverse effects.
In one case, a patient taking rosuvastatin 5 mg every other day in combination with ezetimibe 10 mg daily developed rhabdomyolysis after drinking pomegranate juice 200 mL twice weekly for 3 weeks. This patient had a history of elevated creatine kinase levels while not receiving any statin treatment. This suggests a possible underlying myopathy and predisposition to rhabdomyolysis.
Warfarin (Coumadin)
Theoretically, pomegranate might increase warfarin levels and increase the risk of bleeding. Also, discontinuing regular consumption of pomegranate juice might decrease warfarin levels.
In one case report, a patient had a stable, therapeutic bleeding time, as measured by international normalized ratio (INR), while taking warfarin in combination with pomegranate juice 2-3 times per week. The patient became subtherapeutic within about 10 days after discontinuing pomegranate juice, which required a warfarin dose increase. In another case report, a patient with a stable INR for over one year presented with an INR of 14. The patient noted no changes to medications or diet but did report consuming around 3 liters of pomegranate juice over the previous week. The patient's INR stabilized upon moderation of pomegranate juice consumption. The mechanism of this potential interaction is unclear.
Carbamazepine (Tegretol)
Theoretically, taking pomegranate with carbamazepine might increase the risk of adverse effects, although research suggests this interaction is unlikely to be clinically significant.
Animal research shows that pomegranate juice may inhibit cytochrome P450 3A4 (CYP3A4) metabolism of carbamazepine and increase levels of carbamazepine by 1.5 times without prolonging the elimination half-life. This suggests that pomegranate juice inhibits intestinal CYP3A4, but might not inhibit hepatic CYP3A4. However, some human research suggests that pomegranate does not significantly inhibit CYP3A4 drug metabolism in humans.
Cytochrome P450 2C9 (Cyp2C9) Substrates
Theoretically, pomegranate might increase levels of drugs metabolized by CYP2C9.
Some animal and in vitro research shows that pomegranate juice inhibits intestinal, but not hepatic, CYP2C9 isoenzyme activity. However, clinical research shows that neither pomegranate juice nor pomegranate extract have a significant effect on CYP2C9 activity in humans.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, pomegranate might increase levels of drugs metabolized by CYP3A4, but most research suggests this interaction is unlikely to be clinically significant.
Pomegranate contains several polyphenols that have individually been shown to inhibit CYP3A4. However, there is contradictory evidence about the effect of whole pomegranate juice on CYP3A4 activity. In vitro, pomegranate juice significantly inhibits the CYP3A4 enzyme, with comparable inhibition to grapefruit juice. In an animal model, pomegranate juice inhibits CYP3A4 metabolism of carbamazepine and increases levels of carbamazepine by 1.5 times; however, in human volunteers, drinking a single glass of pomegranate juice 240 mL or taking 200 mL daily for 2 weeks does not significantly affect levels of the CYP3A4 substrate midazolam after oral or intravenous administration. Another study in healthy volunteers shows that consuming pomegranate juice 300 mL three times daily for three days also does not significantly affect levels of simvastatin, a CYP3A4 substrate This suggests that pomegranate is unlikely to significantly affect levels of CYP3A4 substrates in humans.
Tolbutamide (Orinase)
Theoretically, pomegranate might increase levels of tolbutamide, although research suggests this interaction is unlikely to be clinically significant.
Animal research shows that pomegranate juice inhibits the cytochrome P450 2C9 (CYP2C9) metabolism of tolbutamide. Pomegranate juice increased tolbutamide levels by 1.2 times without prolonging the elimination half-life. This suggests that pomegranate juice inhibits intestinal CYP2C9, but might not inhibit hepatic CYP2C9. Despite this evidence, clinical research shows that neither pomegranate juice nor pomegranate extract have a significant effect on CYP2C9 activity in humans. This interaction does not appear to be clinically significant in humans.
White Grape juice concentrate
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.
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.
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.
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.
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.
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.
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.
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).
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.
Green Coffee extract
Ephedrine
Theoretically, concomitant use might increase the risk of stimulant adverse effects.
Coffee contains caffeine. There is evidence that using ephedrine with caffeine might increase the risk of serious life-threatening or debilitating adverse effects such as hypertension, myocardial infarction, stroke, seizures, and death. Tell patients to avoid taking caffeine with ephedrine and other stimulants.
Adenosine (Adenocard)
Theoretically, coffee might decrease the vasodilatory effects of adenosine and interfere with its use prior to stress testing.
Coffee contains caffeine. Caffeine is a competitive inhibitor of adenosine at the cellular level. However, caffeine does not seem to affect supplemental adenosine because high interstitial levels of adenosine overcome the antagonistic effects of caffeine. It is recommended that methylxanthines such as caffeine, as well as methylxanthine-containing products, be stopped 24 hours prior to pharmacological stress tests. However, methylxanthines appear more likely to interfere with dipyridamole (Persantine) than adenosine-induced stress testing.
Alendronate (Fosamax)
Coffee reduces alendronate bioavailability.
Separate coffee ingestion and alendronate administration by two hours. Coffee reduces alendronate bioavailability by 60%.
Anticoagulant/Antiplatelet Drugs
Theoretically, coffee may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Coffee contains caffeine. Caffeine is reported to have antiplatelet activity. Theoretically, the caffeine in coffee might increase the risk of bleeding when used concomitantly with these agents. However, this interaction has not been reported in humans. There is some evidence that caffeinated coffee might increase the fibrinolytic activity in blood.
Beta-Adrenergic Agonists
Theoretically, concomitant use of large amounts of coffee might increase cardiac inotropic effects of beta-agonists.
Coffee contains caffeine. Caffeine can increase cardiac inotropic effects of beta-agonists.
Cimetidine (Tagamet)
Theoretically, cimetidine might increase the effects and adverse effects of caffeine in coffee.
Coffee contains caffeine. Cimetidine can reduce caffeine clearance by 31% to 42%.
Clozapine (Clozaril)
Theoretically, coffee might increase the levels and adverse effects of clozapine and acutely exacerbate psychotic symptoms.
Coffee contains caffeine. Caffeine can increase the effects and toxicity of clozapine. Caffeine doses of 400-1000 mg daily inhibit clozapine metabolism. Clozapine is metabolized by cytochrome P450 1A2 (CYP1A2). Researchers speculate that caffeine might inhibit CYP1A2. However, there is no reliable evidence that caffeine affects CYP1A2. There is also speculation that genetic factors might make some patients be more sensitive to the interaction between clozapine and caffeine.
Contraceptive Drugs
Theoretically, concomitant use might increase the effects and adverse effects of caffeine found in coffee.
Coffee contains caffeine. Oral contraceptive drugs can decrease caffeine clearance by 40% to 65%.
Dipyridamole (Persantine)
Theoretically, coffee might decrease the vasodilatory effects of dipyridamole and interfere with its use prior to stress testing.
Coffee contains caffeine. Caffeine is a methylxyanthine that may inhibit dipyridamole-induced vasodilation. It is recommended that methylxanthines such as caffeine, as well as methylxanthine-containing products such as coffee, be stopped 24 hours prior to pharmacological stress tests. Methylxanthines appear more likely to interfere with dipyridamole (Persantine) than adenosine-induced stress testing.
Disulfiram (Antabuse)
Theoretically, disulfiram might increase the risk of adverse effects from caffeine.
Coffee contains caffeine. In human research, disulfiram decreases the clearance and increases the half-life of caffeine.
Diuretic Drugs
Theoretically, concomitant use might increase the risk of hypokalemia.
Coffee contains caffeine. Caffeine, especially in excessive amounts, can reduce potassium levels due to stimulation of the sodium-potassium pump. Diuretics can also cause lower potassium levels.
Estrogens
Theoretically, estrogens might increase the levels and adverse effects of caffeine.
Coffee contains caffeine. Estrogen inhibits caffeine metabolism.
Fluvoxamine (Luvox)
Theoretically, fluvoxamine might increase the levels and adverse effects of caffeine.
Coffee contains caffeine. Fluvoxamine reduces caffeine metabolism.
Lamotrigine (Lamictal)
Coffee consumption can decrease the levels and clinical effects of lamotrigine.
A pharmacokinetic study in patients taking lamotrigine shows that consumption of coffee, both caffeinated and decaffeinated, can decrease the area under the concentration-time curve (AUC) and the peak plasma level (Cmax) of lamotrigine. Each additional cup of coffee reduced the AUC and Cmax by 4% and 3%, respectively. It is unclear whether this interaction is due to induction of lamotrigine metabolism or inhibition of lamotrigine absorption.
Levothyroxine (Synthroid, Others)
Coffee can reduce the absorption of levothyroxine.
In some patients, coffee can reduce levothyroxine absorption, possibly through the formation of non-absorbable complexes. A pharmacokinetic study in these patients found that 25-30 mL of espresso coffee consumed with levothyroxine tablets delayed the time to peak plasma levels by 38-43 minutes, reduced the peak plasma level (Cmax) by 19% to 36%, and reduced the area under the curve (AUC) by 27% to 36%. Coffee consumed one hour after levothyroxine did not affect absorption. It is not known whether this interaction occurs with other types of coffee. Tell patients to avoid drinking coffee at the same time that they take their levothyroxine, and for up to an hour afterwards.
Lithium
Theoretically, abrupt coffee withdrawal might increase the levels and adverse effects of lithium.
Coffee contains caffeine. Abrupt caffeine withdrawal can increase serum lithium levels. Two cases of lithium tremor that worsened with abrupt coffee withdrawal have been reported. There is also one case of a 2.8-fold increase in blood lithium levels after a patient taking lithium reduced his coffee consumption from 13-20 cups daily to 10 cups daily.
Monoamine Oxidase Inhibitors (Maois)
Theoretically, concomitant use might increase the risk of a hypertensive crisis.
Coffee contains caffeine. Caffeine has been shown to inhibit monoamine oxidase (MAO) A and B in laboratory studies. Concomitant intake of large amounts of caffeine with MAOIs might precipitate a hypertensive crisis. In a case report, a patient that consumed 10-12 cups of caffeinated coffee and took the MAOI tranylcypromine presented with severe hypertension. Hypertension was resolved after the patient switched to drinking decaffeinated coffee.
Nicotine
Theoretically, concomitant use might increase the risk of hypertension.
Coffee contains caffeine. Concomitant use of caffeine and nicotine has been shown to have additive cardiovascular effects, including increased heart rate and blood pressure. Blood pressure was increased by 10.8/12.4 mmHg when the agents were used concomitantly.
Pentobarbital (Nembutal)
Theoretically, coffee might reduce the effects of pentobarbital.
Coffee contains caffeine. Theoretically, caffeine might negate the hypnotic effects of pentobarbital.
Phenylpropanolamine
Theoretically, phenylpropanolamine might increase the risk of hypertension, as well as the levels and adverse effects of caffeine.
Coffee contains caffeine. Concomitant use of phenylpropanolamine and caffeine might cause an additive increase in blood pressure. Phenylpropanolamine also seems to increase caffeine serum levels.
Pioglitazone (Actos)
Theoretically, coffee might increase the levels and clinical effects of pioglitazone.
Coffee contains caffeine. Animal research suggests that caffeine can modestly increase the maximum concentration, area under the curve, and half-life of pioglitazone, and also reduce its clearance. This increased the antidiabetic effects of pioglitazone. However, the exact mechanism of this interaction is unclear.
Quinolone Antibiotics
Theoretically, quinolone antibiotics might increase the levels and adverse effects of caffeine.
Coffee contains caffeine. Concomitant use of caffeine and quinolones can decrease caffeine clearance and increase effects and risk of adverse effects.
Riluzole (Rilutek)
Theoretically, concomitant use might increase the levels and adverse effects of both caffeine and riluzole.
Coffee contains caffeine. Caffeine and riluzole are both metabolized by cytochrome P450 1A2 (CYP1A2), and concomitant use might reduce metabolism of one or both agents.
Stimulant Drugs
Theoretically, concomitant use might increase stimulant adverse effects.
Coffee contains caffeine. Due to the central nervous system (CNS) stimulant effects of caffeine, concomitant use with stimulant drugs can increase the risk of adverse effects.
Theophylline
Theoretically, coffee might increase the levels and adverse effects of theophylline.
Coffee contains caffeine, which can increase theophylline levels.
Mangosteen extract
Anticoagulant/Antiplatelet Drugs
Theoretically, concomitant use of mangosteen with anticoagulant or antiplatelet drugs may increase the risk of bleeding.
In vitro and animal research shows that gamma-mangostin, a constituent of mangosteen, is a potent and competitive antagonist of the serotonin 2A (5-HT2A) receptor. Antagonism of the 5-HT2A receptor is believed to reduce platelet aggregation.
Donepezil (Aricept)
Theoretically, concomitant use of mangosteen with donepezil might increase the effects of donepezil.
Animal research shows that concomitant use of an aqueous extract of mangosteen pericarp with donepezil increases brain concentrations of donepezil at 4 hours by 64% without associated effects on systemic exposure.
Blueberry juice concentrate
Antidiabetes Drugs
Theoretically, blueberries or blueberry leaf extracts might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Animal and in vitro research suggests that blueberry and/or blueberry leaf extracts can lower blood glucose levels.
Buspirone (Buspar)
Theoretically, blueberry juice might increase blood levels of buspirone.
In vitro research shows that blueberry juice can inhibit the metabolism of buspirone, possibly by inhibiting cytochrome P450 3A (CYP3A) enzymes. However, pharmacokinetic research in humans shows that drinking 300 mL of blueberry juice 30 minutes before taking buspirone hydrochloride 10 mg does not significantly affect the concentration or clearance of buspirone.
Flurbiprofen (Ansaid, Others)
Theoretically, blueberry juice might increase blood levels of flurbiprofen.
In vitro research shows that blueberry juice can inhibit the metabolism of flurbiprofen, possibly by inhibiting cytochrome P450 2C9 (CYP2C9) enzymes. However, pharmacokinetic research in humans shows that drinking 300 mL of blueberry juice 30 minutes before taking flurbiprofen 100 mg does not significantly affect the concentration or clearance of flurbiprofen.
Acai extract
Antidiabetes Drugs
Theoretically, taking acai with antidiabetes drugs might interfere with glycemic control.
Preliminary clinical research in healthy adults has shown that taking acai may increase or decrease levels of fasting blood glucose.
Brand information
Manufacturer and brand details for ORAC Super 7, from the product label.
Nature's Answer
See all Nature's Answer products- Name
- Nature's Answer Inc.
- City
- Hauppauge
- State
- NY
- ZipCode
- 11788
- Phone Number
- (800) 439-2324
- Web Address
- www.naturesanswer.com
ORAC Super 7 by Nature's Answer: 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 ORAC Super 7’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Green Tea
Interacts with 1,293 drugsGreen tea is a popular beverage rich in antioxidants called catechins, and drinking it in normal amounts is considered safe for most people. Concentrated green tea extracts are a different s...
Read the full Green Tea monograph → Herb & supplement monographGrape
Interacts with 910 drugsGrapes 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 → Herb & supplement monographBlueberry
Interacts with 88 drugsBlueberries are a nutritious fruit rich in antioxidants called anthocyanins, and eating them as part of a balanced diet is healthy and safe for most people. Concentrated supplements are mark...
Read the full Blueberry monograph → Herb & supplement monographPomegranate
Interacts with 922 drugsPomegranate is a nutrient-rich fruit that is high in antioxidants and is widely enjoyed as food and juice. Early research suggests it may support heart health and blood pressure, but the evi...
Read the full Pomegranate monograph → Herb & supplement monographCoffee
Interacts with 591 drugsCoffee is a widely consumed beverage made from roasted coffee beans, valued mainly for its caffeine, which boosts alertness and energy. For most healthy adults, moderate coffee intake is gen...
Read the full Coffee monograph → Herb & supplement monographMangosteen
Interacts with 125 drugsMangosteen is a tropical fruit whose rind is rich in plant compounds called xanthones that act as antioxidants. While it is popular in juices and supplements for inflammation, immune support...
Read the full Mangosteen monograph → Herb & supplement monographAcai
Interacts with 86 drugsAcai is a nutritious Amazonian berry rich in antioxidants and healthy fats, and it is fine to enjoy as a food. However, strong human evidence is lacking for the bold health claims often atta...
Read the full Acai monograph → Herb & supplement monographGoji
Interacts with 1,000 drugsGoji berries are a nutritious fruit rich in antioxidants, vitamins, and plant polysaccharides, and they are safe for most people as a food. While they are popular for eye health, immune supp...
Read the full Goji monograph →Sources & How We Checked
ORAC Super 7'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 484 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.
Grape 34 references
- 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
- 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
- Vaswani SK, Hamilton RG, Carey RN, et al. Anaphylaxis recurrent urticaria and angioedema from grape hypersensitivity. J Allergy Clin Immunol 1998;101:S31.
- Chevallier A. The Encyclopedia of Medicinal Plants. London, UK: Dorling Kindersley, Ltd., 1996.
- 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
- 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
- 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
- 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
- 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.
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- Hollis, J. H., Houchins, J. A., Blumberg, J. B., and Mattes, R. D. Effects of concord grape juice on appetite, diet, body weight, lipid profile, and antioxidant status of adults. J Am Coll.Nutr. 2009;28(5):574-582. PubMed
- Dohadwala, M. M., Hamburg, N. M., Holbrook, M., Kim, B. H., Duess, M. A., Levit, A., Titas, M., Chung, W. B., Vincent, F. B., Caiano, T. L., Frame, A. A., Keaney, J. F., Jr., and Vita, J. A. Effects of Concord grape juice on ambulatory blood pressure in
- Rabe, E., Stucker, M., Esperester, A., Schafer, E., and Ottillinger, B. Efficacy and tolerability of a red-vine-leaf extract in patients suffering from chronic venous insufficiency--results of a double-blind placebo-controlled study. Eur.J Vasc.Endovasc. PubMed
- Trotta, M., Cesaretti, M., Conzi, R., Derchi, L. E., and Borgonovo, G. Elderly male with mesogastric pain. Small bowel obstruction caused by an intact fresh grape. Ann.Emerg.Med 2011;58(4):e1-e2. PubMed
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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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