Organic Fermented Fruits Ingredients & Drug Interactions
by Dr. Mercola
What is this page for?
First and foremost: checking Organic Fermented Fruits 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
Organic Fermented Fruits is a dietary supplement by Dr. Mercola with 12 active ingredients. Its ingredients are commonly taken for iron-deficiency anemia, low iron stores during pregnancy, fatigue from iron deficiency.Based on those ingredients, 2,252 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are Dietary Fiber, Pomegranate Juice, Cranberry. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against Organic Fermented Fruits by Dr. Mercola
Ask about any prescription or over-the-counter medication and we check it for interactions with Organic Fermented Fruits by Dr. Mercola — 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 Organic Fermented Fruits by Dr. Mercola
Our pharmacy team’s full take, with four database checks built into the cards below — a summary of what is known, not a grade of the product itself.
What’s inside
Low disclosure
This product contains 11 ingredients, including iron and a fermented fruit blend. The blend comprises black currant, elderberry, noni, cranberry, pomegranate juice, blueberry, raspberry, apple, strawberry, and amla (Indian gooseberry).
Beyond these actives, the capsules contain two inactive ingredients: pullulan and rice.
Does it work?
Not established
The evidence for this product's ingredients is mixed. Iron is effective for iron deficiency anemia and anemia of chronic disease, and possibly effective for heart failure.
Pomegranate juice is possibly effective for high blood pressure but possibly ineffective for high cholesterol and blood sugar control. Cranberry is possibly effective for urinary tract infections.
Amla is possibly effective for acid reflux and high cholesterol. For most of the other fruits — black currant, elderberry, noni, blueberry, apple, and strawberry — the evidence we hold is insufficient to establish whether they work for their labeled purposes.
How safe is it?
Well-documented data
Iron is generally well tolerated at recommended doses but can cause stomach upset (nausea, constipation, diarrhea) and is toxic in excess; use only when there's a real need. Iron is often recommended in pregnancy but dosing should be guided by your prenatal provider, and it's generally acceptable while breastfeeding at appropriate doses.
Black currant berry is safe as food but concentrated supplements are less studied; food amounts are fine but check with your doctor before high-dose supplements. Elderberry extracts from ripe fruit are generally well tolerated, but raw or unripe berries, seeds, leaves, and bark are toxic.
The safety data on elderberry supplements during pregnancy and breastfeeding are insufficient; avoid supplements during both. Noni is generally tolerated in moderate amounts but rare liver injury and high potassium content are concerns; avoid during pregnancy and breastfeeding due to insufficient safety data.
Cranberry, pomegranate, blueberry, apple, and strawberry are all generally well tolerated as foods; concentrated extracts and supplements are less studied. Most of these fruits can cause mild gastrointestinal effects (diarrhea, flatulence, nausea) at higher supplement doses.
Meds to double-check
Major interaction found
Run the following medication types through our interaction checker on this page before taking this product: OATP substrate drugs (fexofenadine, atenolol, aliskiren) — apple juice cuts their blood levels sharply; blood thinners and antiplatelet drugs (warfarin, aspirin, clopidogrel, dabigatran) — multiple ingredients may increase bleeding risk; iron-sensitive medications (tetracycline and quinolone antibiotics, bisphosphonates, levothyroxine, methyldopa) — iron reduces their absorption; seizure medications (phenytoin) — noni may lower levels; and potassium-raising drugs (potassium-sparing diuretics, ACE inhibitors, ARBs) — noni's potassium content poses a risk. These are the major categories; use the search tool to check your exact medications.
The bottom line
Scorecard at a glanceFormula with limited ingredient disclosure with no established evidence rating for its marketed use. Major medication interactions have been identified, and safety information is well characterized.
This fermented fruit supplement contains iron and a mix of fruits that may offer modest support for a few conditions — iron for anemia, cranberry for urinary tract infections, pomegranate for blood pressure — though evidence is incomplete for most. The major concern is drug interactions, especially with iron, noni, apple juice, and blood thinners.
If you take any medications, check them against this product's ingredients before starting. Talk to your pharmacist about timing and whether this supplement fits your situation.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 11 of 12 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated May 23, 2024.
This Scorecard evaluates available label information, ingredient evidence, and known medication-safety considerations. It does not independently verify product identity, purity, potency, contamination, or manufacturing quality. How these ratings are computed
General information
Key facts about Organic Fermented Fruits, straight from the product label.
| Brand | Dr. Mercola |
|---|---|
| Barcode (UPC) | 810094212193 |
| Net contents | 180 Capsule(s) |
| Market status | On market |
| Date entered into DSLD | May 23, 2024 |
| DSLD ID | 308773 |
| Product type | Botanical With Nutrients |
| Supplement form | Capsule |
| Dietary claims / uses | All Other, Structure/Function |
| Intended target group(s) | Adult (18 - 50 Years), Organic, Sugar 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 Organic Fermented Fruits by Dr. Mercola, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Calories | 5 Calorie(s) | -- |
| Total Carbohydrates | 2 Gram(s) | 1% |
| Iron | 0.8 mg | 4% |
| Total Sugars | 0 Gram(s) | -- |
| Dietary Fiber | 1 Gram(s) | 4% |
| Fermented Fruit Blend | 1476 mg | -- |
| Black Currant | 0 NP | -- |
| Elderberry | 0 NP | -- |
| Noni | 0 NP | -- |
| Cranberry | 0 NP | -- |
| Pomegranate Juice | 0 NP | -- |
| Blueberry | 0 NP | -- |
| Raspberry | 0 NP | -- |
| Apple | 0 NP | -- |
| Strawberry | 0 NP | -- |
| Amla | 0 NP | -- |
Other ingredients: Pullulan, Rice
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.
Suggested/Recommended/Usage/Directions
Suggested use: Adults, as a dietary supplement, take three (3) capsules 1-2 times daily with food.
Precautions
Warning: Accidental overdose of iron-containing products is a leading cause of fatal poisoning in children under 6. Keep this product out of reach of children. In case of accidental overdose, call a doctor or poison control center immediately.
Do not use if safety seal is broken.
If you are nursing, pregnant, taking medication or have a medical condition, consult your physician before taking this product.
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.
Formulation
Immune support Whole food based
0g sugar
Certified Organic by: Quality Assurance International
Seals/Symbols
USDA Organic
FDA Statement of Identity
Dietary Supplement
General Statements
Providing quality products since 2001.
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Organic Fermented Fruits by Dr. Mercola 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 Organic Fermented Fruits by Dr. Mercola
These are the 12 active ingredients this product is made of. Select any to open its full monograph.
Serving size3 Capsule(s) Dosage formCapsule Servings per container60 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.
Iron
Interacts with80 drugs
Iron is an essential mineral your body needs to make hemoglobin and carry oxygen in the blood. Supplements are mainly useful for treating or preventin...
Iron monograph & interactionsDietary Fiber
Interacts with2,025 drugs
Black psyllium is a soluble-fiber supplement made from the seeds of a Plantago plant, used mostly to ease constipation and support digestive health. I...
Dietary Fiber monograph & interactionsFermented Fruit Blend
- › Black Currant
- › Elderberry
- › Noni
- › Cranberry
- › Pomegranate Juice
- › Blueberry
- › Raspberry
- › Apple
- › Strawberry
- › Amla
Other (inactive) ingredients: Pullulan, Rice. These complete the product’s ingredient list but are not active constituents.
Organic Fermented Fruits by Dr. Mercola Drug Interactions
HelloPharmacist Interaction Report
Dr.
Mercola's Organic Fermented Fruits contains several ingredients with documented interactions to medications. The most serious is apple juice, which significantly reduces absorption of OATP substrate drugs — a group that includes the allergy medicine fexofenadine (Allegra), the blood pressure drug atenolol (Tenormin), and the hypertension medication aliskiren (Tekturna).
Drinking apple juice at the same time can cut blood levels of these drugs by over half.
Read the full breakdown — every affected drug type, severity by severity
Iron, the largest single-ingredient concern in this product, interacts moderately with antibiotics (quinolone and tetracycline types), blood pressure and thyroid medications, and several other drug classes by reducing their absorption — all can be managed by spacing doses 2 to 4 hours apart.
Noni fruit juice carries moderate interactions with blood pressure medications (raising low blood sugar risk if combined), blood thinners (warfarin), seizure medication (phenytoin), and potassium-sparing diuretics and ACE inhibitors (raising potassium to unsafe levels). Cranberry and pomegranate juice each interact moderately with blood thinners and certain statin drugs.
Black currant seed oil theoretically increases bleeding risk with blood thinners and antiplatelet drugs. Elderberry may interfere with immunosuppressants.
Strawberry and amla (Indian gooseberry) both theoretically increase bleeding risk with anticoagulant and antiplatelet medications. We could not check raspberry for interactions, as we hold no data for it.
Altogether, these interactions span 1,360 individual medications. Check your exact medications with the search tool on this page before starting.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against Organic Fermented Fruits?
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 Organic Fermented Fruits interact with 2,252 drugs. Click any drug to see the details.
11 of the 12 ingredients in Organic Fermented Fruits interact with drugs. Each result below shows which ingredient is responsible. Dietary Fiber Pomegranate Juice Cranberry Noni Strawberry Apple Amla Black Currant Elderberry Blueberry Iron
AtorvastatinAtorvaliq
How Atorvastatin interacts with Organic Fermented Fruits — through 5 ingredients. Tap an ingredient for the detail:
AppleOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple + Atorvastatin interactionNoniHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking noni with hepatotoxic drugs might increase the risk of liver damage.
Read the full Noni + Atorvastatin interactionCranberryCytochrome P450 3a4 (cyp3a4) Substrates, Atorvastatin (lipitor) Moderate
Interaction Summary
Theoretically, cranberry might increase the levels and adverse effects of CYP3A4 substrates.
Read the full Cranberry + Atorvastatin interactionDietary FiberOral Drugs Minor
Interaction Summary
Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Read the full Dietary Fiber + Atorvastatin interactionPomegranate JuiceCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, pomegranate might increase levels of drugs metabolized by CYP3A4, but most research suggests this interaction is unlikely to be clinically significant.
Read the full Pomegranate Juice + Atorvastatin interactionAtorvastatin CalciumLipitor
How Atorvastatin Calcium interacts with Organic Fermented Fruits — through 5 ingredients. Tap an ingredient for the detail:
AppleOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple + Atorvastatin Calcium interactionCranberryAtorvastatin (lipitor), Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, cranberry might increase levels and adverse effects of atorvastatin.
Read the full Cranberry + Atorvastatin Calcium interactionNoniHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking noni with hepatotoxic drugs might increase the risk of liver damage.
Read the full Noni + Atorvastatin Calcium interactionDietary FiberOral Drugs Minor
Interaction Summary
Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Read the full Dietary Fiber + Atorvastatin Calcium interactionPomegranate JuiceCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, pomegranate might increase levels of drugs metabolized by CYP3A4, but most research suggests this interaction is unlikely to be clinically significant.
Read the full Pomegranate Juice + Atorvastatin Calcium interactionBosentanTracleer
How Bosentan interacts with Organic Fermented Fruits — through 5 ingredients. Tap an ingredient for the detail:
AppleOrganic Anion-transporting Polypeptide Substrates (oatp), Antihypertensive Drugs Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple + Bosentan interactionNoniHepatotoxic Drugs, Antihypertensive Drugs Moderate
Interaction Summary
Theoretically, taking noni with hepatotoxic drugs might increase the risk of liver damage.
Read the full Noni + Bosentan interactionPomegranate JuiceCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 2c9 (cyp2c9) Substrates +1 Moderate
Interaction Summary
Theoretically, pomegranate might increase levels of drugs metabolized by CYP3A4, but most research suggests this interaction is unlikely to be clinically significant.
Read the full Pomegranate Juice + Bosentan interactionCranberryCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 2c9 (cyp2c9) Substrates Moderate
Interaction Summary
Theoretically, cranberry might increase the levels and adverse effects of CYP3A4 substrates.
Read the full Cranberry + Bosentan interactionDietary FiberOral Drugs Minor
Interaction Summary
Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Read the full Dietary Fiber + Bosentan interactionBrincidofovirTembexa
How Brincidofovir interacts with Organic Fermented Fruits — through 2 ingredients. Tap an ingredient for the detail:
AppleOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple + Brincidofovir interactionDietary FiberOral Drugs Minor
Interaction Summary
Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Read the full Dietary Fiber + Brincidofovir interactionCeliprololCelicard
How Celiprolol interacts with Organic Fermented Fruits — through 5 ingredients. Tap an ingredient for the detail:
AppleAntihypertensive Drugs, Organic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Consuming apple juice with antihypertensive drugs might interfere with blood pressure control.
Read the full Apple + Celiprolol interactionPomegranate JuiceAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, taking pomegranate with antihypertensive drugs might increase the risk of hypotension.
Read the full Pomegranate Juice + Celiprolol interactionStrawberryP-glycoprotein Substrates Moderate
Interaction Summary
In vitro research suggests that strawberry extract can inhibit p-glycoprotein efflux.
Read the full Strawberry + Celiprolol interactionNoniAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, noni may increase the risk of hypotension when used in combination with antihypertensive drugs.
Read the full Noni + Celiprolol interactionDietary FiberOral Drugs Minor
Interaction Summary
Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Read the full Dietary Fiber + Celiprolol interactionCerivastatin SodiumBaycol
How Cerivastatin Sodium interacts with Organic Fermented Fruits — through 3 ingredients. Tap an ingredient for the detail:
AppleOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple + Cerivastatin Sodium interactionNoniHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking noni with hepatotoxic drugs might increase the risk of liver damage.
Read the full Noni + Cerivastatin Sodium interactionDietary FiberOral Drugs Minor
Interaction Summary
Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Read the full Dietary Fiber + Cerivastatin Sodium interactionCinoxacinCinobac
How Cinoxacin interacts with Organic Fermented Fruits — through 4 ingredients. Tap an ingredient for the detail:
AppleOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple + Cinoxacin interactionIronQuinolone Antibiotics Moderate
Interaction Summary
Iron might decrease levels of quinolone antibiotics by reducing their absorption.
Read the full Iron + Cinoxacin interactionNoniHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking noni with hepatotoxic drugs might increase the risk of liver damage.
Read the full Noni + Cinoxacin interactionDietary FiberOral Drugs Minor
Interaction Summary
Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Read the full Dietary Fiber + Cinoxacin interactionCiprofloxacinCiloxan, Cipro, Cipro IV, Cipro XR, Ciprobay, Otiprio
How Ciprofloxacin interacts with Organic Fermented Fruits — through 4 ingredients. Tap an ingredient for the detail:
AppleOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple + Ciprofloxacin interactionIronQuinolone Antibiotics Moderate
Interaction Summary
Iron might decrease levels of quinolone antibiotics by reducing their absorption.
Read the full Iron + Ciprofloxacin interactionNoniHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking noni with hepatotoxic drugs might increase the risk of liver damage.
Read the full Noni + Ciprofloxacin interactionDietary FiberOral Drugs Minor
Interaction Summary
Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Read the full Dietary Fiber + Ciprofloxacin interactionCiprofloxacin, HydrocortisoneCipro HC Otic
How Ciprofloxacin, Hydrocortisone interacts with Organic Fermented Fruits — through 1 ingredient. Tap an ingredient for the detail:
AppleOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple + Ciprofloxacin, Hydrocortisone interactionClinafloxacinClinafloxacin
How Clinafloxacin interacts with Organic Fermented Fruits — through 3 ingredients. Tap an ingredient for the detail:
AppleOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple + Clinafloxacin interactionIronQuinolone Antibiotics Moderate
Interaction Summary
Iron might decrease levels of quinolone antibiotics by reducing their absorption.
Read the full Iron + Clinafloxacin interactionDietary FiberOral Drugs Minor
Interaction Summary
Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Read the full Dietary Fiber + Clinafloxacin interactionEnoxacinPenetrex
How Enoxacin interacts with Organic Fermented Fruits — through 3 ingredients. Tap an ingredient for the detail:
AppleOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple + Enoxacin interactionIronQuinolone Antibiotics Moderate
Interaction Summary
Iron might decrease levels of quinolone antibiotics by reducing their absorption.
Read the full Iron + Enoxacin interactionDietary FiberOral Drugs Minor
Interaction Summary
Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Read the full Dietary Fiber + Enoxacin interactionEtoposideEtopophos, VePesid, VP16
How Etoposide interacts with Organic Fermented Fruits — through 5 ingredients. Tap an ingredient for the detail:
AppleOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple + Etoposide interactionCranberryCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, cranberry might increase the levels and adverse effects of CYP3A4 substrates.
Read the full Cranberry + Etoposide interactionStrawberryP-glycoprotein Substrates Moderate
Interaction Summary
In vitro research suggests that strawberry extract can inhibit p-glycoprotein efflux.
Read the full Strawberry + Etoposide interactionPomegranate JuiceCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, pomegranate might increase levels of drugs metabolized by CYP3A4, but most research suggests this interaction is unlikely to be clinically significant.
Read the full Pomegranate Juice + Etoposide interactionDietary FiberOral Drugs Minor
Interaction Summary
Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Read the full Dietary Fiber + Etoposide interactionEzetimibe, AtorvastatinLiptruzet
How Ezetimibe, Atorvastatin interacts with Organic Fermented Fruits — through 5 ingredients. Tap an ingredient for the detail:
AppleOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple + Ezetimibe, Atorvastatin interactionCranberryAtorvastatin (lipitor), Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, cranberry might increase levels and adverse effects of atorvastatin.
Read the full Cranberry + Ezetimibe, Atorvastatin interactionNoniHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking noni with hepatotoxic drugs might increase the risk of liver damage.
Read the full Noni + Ezetimibe, Atorvastatin interactionPomegranate JuiceCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, pomegranate might increase levels of drugs metabolized by CYP3A4, but most research suggests this interaction is unlikely to be clinically significant.
Read the full Pomegranate Juice + Ezetimibe, Atorvastatin interactionDietary FiberOral Drugs Minor
Interaction Summary
Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Read the full Dietary Fiber + Ezetimibe, Atorvastatin interactionFexofenadineAllegra
How Fexofenadine interacts with Organic Fermented Fruits — through 5 ingredients. Tap an ingredient for the detail:
AppleOrganic Anion-transporting Polypeptide Substrates (oatp), Fexofenadine (allegra) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple + Fexofenadine interactionCranberryCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, cranberry might increase the levels and adverse effects of CYP3A4 substrates.
Read the full Cranberry + Fexofenadine interactionStrawberryP-glycoprotein Substrates Moderate
Interaction Summary
In vitro research suggests that strawberry extract can inhibit p-glycoprotein efflux.
Read the full Strawberry + Fexofenadine interactionPomegranate JuiceCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, pomegranate might increase levels of drugs metabolized by CYP3A4, but most research suggests this interaction is unlikely to be clinically significant.
Read the full Pomegranate Juice + Fexofenadine interactionDietary FiberOral Drugs Minor
Interaction Summary
Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Read the full Dietary Fiber + Fexofenadine interactionFexofenadine, PseudoephedrineAllegra D
How Fexofenadine, Pseudoephedrine interacts with Organic Fermented Fruits — through 5 ingredients. Tap an ingredient for the detail:
AppleOrganic Anion-transporting Polypeptide Substrates (oatp), Fexofenadine (allegra) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple + Fexofenadine, Pseudoephedrine interactionCranberryCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, cranberry might increase the levels and adverse effects of CYP3A4 substrates.
Read the full Cranberry + Fexofenadine, Pseudoephedrine interactionStrawberryP-glycoprotein Substrates Moderate
Interaction Summary
In vitro research suggests that strawberry extract can inhibit p-glycoprotein efflux.
Read the full Strawberry + Fexofenadine, Pseudoephedrine interactionDietary FiberOral Drugs Minor
Interaction Summary
Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Read the full Dietary Fiber + Fexofenadine, Pseudoephedrine interactionPomegranate JuiceCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, pomegranate might increase levels of drugs metabolized by CYP3A4, but most research suggests this interaction is unlikely to be clinically significant.
Read the full Pomegranate Juice + Fexofenadine, Pseudoephedrine interactionFluvastatinLescol, Lescol XL
How Fluvastatin interacts with Organic Fermented Fruits — through 5 ingredients. Tap an ingredient for the detail:
AppleOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple + Fluvastatin interactionNoniHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking noni with hepatotoxic drugs might increase the risk of liver damage.
Read the full Noni + Fluvastatin interactionCranberryCytochrome P450 2c9 (cyp2c9) Substrates Minor
Interaction Summary
Theoretically, cranberry might increase the levels and adverse effects of CYP2C9 substrates.
Read the full Cranberry + Fluvastatin interactionPomegranate JuiceCytochrome P450 2c9 (cyp2c9) Substrates Minor
Interaction Summary
Theoretically, pomegranate might increase levels of drugs metabolized by CYP2C9.
Read the full Pomegranate Juice + Fluvastatin interactionDietary FiberOral Drugs Minor
Interaction Summary
Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Read the full Dietary Fiber + Fluvastatin interactionGatifloxacinTequin, Tequin Injection
How Gatifloxacin interacts with Organic Fermented Fruits — through 4 ingredients. Tap an ingredient for the detail:
AppleOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple + Gatifloxacin interactionNoniHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking noni with hepatotoxic drugs might increase the risk of liver damage.
Read the full Noni + Gatifloxacin interactionIronQuinolone Antibiotics Moderate
Interaction Summary
Iron might decrease levels of quinolone antibiotics by reducing their absorption.
Read the full Iron + Gatifloxacin interactionDietary FiberOral Drugs Minor
Interaction Summary
Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Read the full Dietary Fiber + Gatifloxacin interactionGemifloxacinFactive
How Gemifloxacin interacts with Organic Fermented Fruits — through 3 ingredients. Tap an ingredient for the detail:
AppleOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple + Gemifloxacin interactionIronQuinolone Antibiotics Moderate
Interaction Summary
Iron might decrease levels of quinolone antibiotics by reducing their absorption.
Read the full Iron + Gemifloxacin interactionDietary FiberOral Drugs Minor
Interaction Summary
Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Read the full Dietary Fiber + Gemifloxacin interactionGlyburideAlbert Glyburide, Diabeta, Glycron, Glynase, Glynase PresTab, Micronase +1 more
How Glyburide interacts with Organic Fermented Fruits — through 7 ingredients. Tap an ingredient for the detail:
AppleAntidiabetes Drugs, Organic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Theoretically, consuming apple juice with antidiabetes drugs might interfere with blood glucose control.
Read the full Apple + Glyburide interactionAmlaAntidiabetes Drugs Moderate
Interaction Summary
Taking Indian gooseberry with antidiabetes drugs might increase the risk of hypoglycemia.
Read the full Amla + Glyburide interactionNoniHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking noni with hepatotoxic drugs might increase the risk of liver damage.
Read the full Noni + Glyburide interactionDietary FiberOral Drugs Minor
Interaction Summary
Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Read the full Dietary Fiber + Glyburide interactionPomegranate JuiceCytochrome P450 2c9 (cyp2c9) Substrates Minor
Interaction Summary
Theoretically, pomegranate might increase levels of drugs metabolized by CYP2C9.
Read the full Pomegranate Juice + Glyburide interactionBlueberryAntidiabetes Drugs Minor
Interaction Summary
Theoretically, blueberries or blueberry leaf extracts might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Read the full Blueberry + Glyburide interactionCranberryCytochrome P450 2c9 (cyp2c9) Substrates Minor
Interaction Summary
Theoretically, cranberry might increase the levels and adverse effects of CYP2C9 substrates.
Read the full Cranberry + Glyburide interactionGlyburide, MetforminGlucovance
How Glyburide, Metformin interacts with Organic Fermented Fruits — through 7 ingredients. Tap an ingredient for the detail:
AppleOrganic Anion-transporting Polypeptide Substrates (oatp), Antidiabetes Drugs Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple + Glyburide, Metformin interactionNoniHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking noni with hepatotoxic drugs might increase the risk of liver damage.
Read the full Noni + Glyburide, Metformin interactionAmlaAntidiabetes Drugs Moderate
Interaction Summary
Taking Indian gooseberry with antidiabetes drugs might increase the risk of hypoglycemia.
Read the full Amla + Glyburide, Metformin interactionDietary FiberMetformin (glucophage), Oral Drugs Moderate
Interaction Summary
Theoretically, black psyllium might increase the therapeutic and adverse effects of metformin.
Read the full Dietary Fiber + Glyburide, Metformin interactionPomegranate JuiceCytochrome P450 2c9 (cyp2c9) Substrates Minor
Interaction Summary
Theoretically, pomegranate might increase levels of drugs metabolized by CYP2C9.
Read the full Pomegranate Juice + Glyburide, Metformin interactionCranberryCytochrome P450 2c9 (cyp2c9) Substrates Minor
Interaction Summary
Theoretically, cranberry might increase the levels and adverse effects of CYP2C9 substrates.
Read the full Cranberry + Glyburide, Metformin interactionBlueberryAntidiabetes Drugs Minor
Interaction Summary
Theoretically, blueberries or blueberry leaf extracts might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Read the full Blueberry + Glyburide, Metformin interactionGrepafloxacinRaxar
How Grepafloxacin interacts with Organic Fermented Fruits — through 3 ingredients. Tap an ingredient for the detail:
AppleOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple + Grepafloxacin interactionIronQuinolone Antibiotics Moderate
Interaction Summary
Iron might decrease levels of quinolone antibiotics by reducing their absorption.
Read the full Iron + Grepafloxacin interactionDietary FiberOral Drugs Minor
Interaction Summary
Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Read the full Dietary Fiber + Grepafloxacin interactionIrinotecanCamptosar, Onivyde
How Irinotecan interacts with Organic Fermented Fruits — through 4 ingredients. Tap an ingredient for the detail:
AppleOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple + Irinotecan interactionCranberryCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, cranberry might increase the levels and adverse effects of CYP3A4 substrates.
Read the full Cranberry + Irinotecan interactionPomegranate JuiceCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, pomegranate might increase levels of drugs metabolized by CYP3A4, but most research suggests this interaction is unlikely to be clinically significant.
Read the full Pomegranate Juice + Irinotecan interactionDietary FiberOral Drugs Minor
Interaction Summary
Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Read the full Dietary Fiber + Irinotecan interactionIrinotecan Hydrochloride
How Irinotecan Hydrochloride interacts with Organic Fermented Fruits — through 3 ingredients. Tap an ingredient for the detail:
AppleOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple + Irinotecan Hydrochloride interactionCranberryCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, cranberry might increase the levels and adverse effects of CYP3A4 substrates.
Read the full Cranberry + Irinotecan Hydrochloride interactionPomegranate JuiceCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, pomegranate might increase levels of drugs metabolized by CYP3A4, but most research suggests this interaction is unlikely to be clinically significant.
Read the full Pomegranate Juice + Irinotecan Hydrochloride interactionIsoniazid, Pyrazinamide, RifampinRifater
How Isoniazid, Pyrazinamide, Rifampin interacts with Organic Fermented Fruits — through 3 ingredients. Tap an ingredient for the detail:
AppleOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple + Isoniazid, Pyrazinamide, Rifampin interactionNoniHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking noni with hepatotoxic drugs might increase the risk of liver damage.
Read the full Noni + Isoniazid, Pyrazinamide, Rifampin interactionDietary FiberOral Drugs Minor
Interaction Summary
Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Read the full Dietary Fiber + Isoniazid, Pyrazinamide, Rifampin interactionIsoniazid, RifampinRifamate
How Isoniazid, Rifampin interacts with Organic Fermented Fruits — through 3 ingredients. Tap an ingredient for the detail:
AppleOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple + Isoniazid, Rifampin interactionNoniHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking noni with hepatotoxic drugs might increase the risk of liver damage.
Read the full Noni + Isoniazid, Rifampin interactionDietary FiberOral Drugs Minor
Interaction Summary
Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Read the full Dietary Fiber + Isoniazid, Rifampin interactionLevofloxacinLeva-pak, Levaquin, Levaquin Injection
How Levofloxacin interacts with Organic Fermented Fruits — through 4 ingredients. Tap an ingredient for the detail:
AppleOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple + Levofloxacin interactionIronQuinolone Antibiotics Moderate
Interaction Summary
Iron might decrease levels of quinolone antibiotics by reducing their absorption.
Read the full Iron + Levofloxacin interactionNoniHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking noni with hepatotoxic drugs might increase the risk of liver damage.
Read the full Noni + Levofloxacin interactionDietary FiberOral Drugs Minor
Interaction Summary
Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Read the full Dietary Fiber + Levofloxacin interactionLevofloxacin (ophthalmic)Levofloxacin
How Levofloxacin (ophthalmic) interacts with Organic Fermented Fruits — through 2 ingredients. Tap an ingredient for the detail:
AppleOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple + Levofloxacin (ophthalmic) interactionIronQuinolone Antibiotics Moderate
Interaction Summary
Iron might decrease levels of quinolone antibiotics by reducing their absorption.
Read the full Iron + Levofloxacin (ophthalmic) interactionLomefloxacinMaxaquin
How Lomefloxacin interacts with Organic Fermented Fruits — through 4 ingredients. Tap an ingredient for the detail:
AppleOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple + Lomefloxacin interactionNoniHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking noni with hepatotoxic drugs might increase the risk of liver damage.
Read the full Noni + Lomefloxacin interactionIronQuinolone Antibiotics Moderate
Interaction Summary
Iron might decrease levels of quinolone antibiotics by reducing their absorption.
Read the full Iron + Lomefloxacin interactionDietary FiberOral Drugs Minor
Interaction Summary
Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Read the full Dietary Fiber + Lomefloxacin interactionLovastatinAltocor, Mevacor
How Lovastatin interacts with Organic Fermented Fruits — through 5 ingredients. Tap an ingredient for the detail:
AppleOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple + Lovastatin interactionNoniHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking noni with hepatotoxic drugs might increase the risk of liver damage.
Read the full Noni + Lovastatin interactionCranberryCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, cranberry might increase the levels and adverse effects of CYP3A4 substrates.
Read the full Cranberry + Lovastatin interactionPomegranate JuiceCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, pomegranate might increase levels of drugs metabolized by CYP3A4, but most research suggests this interaction is unlikely to be clinically significant.
Read the full Pomegranate Juice + Lovastatin interactionDietary FiberOral Drugs Minor
Interaction Summary
Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Read the full Dietary Fiber + Lovastatin interactionMethotrexateOtrexup, Rasuvo, Reditrex, Rheumatrex
How Methotrexate interacts with Organic Fermented Fruits — through 3 ingredients. Tap an ingredient for the detail:
AppleOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple + Methotrexate interactionNoniHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking noni with hepatotoxic drugs might increase the risk of liver damage.
Read the full Noni + Methotrexate interactionDietary FiberOral Drugs Minor
Interaction Summary
Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Read the full Dietary Fiber + Methotrexate interactionEach ingredient & the kinds of drugs it affects
For each ingredient in Organic Fermented Fruits 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.
Dietary Fiber
Carbamazepine (Tegretol)
Theoretically, black psyllium might reduce the effects of carbamazepine and increase the risk for convulsions.
Theoretically, black psyllium might reduce carbamazepine absorption. A preliminary study using blond psyllium reported decreased carbamazepine bioavailability due to binding of the drug to psyllium, as well as reduction of available fluid in the gut for dissolution of the drug. This interaction may also occur with black psyllium.
Lithium
Theoretically, taking black psyllium at the same time as lithium might reduce lithium absorption.
The fiber in black psyllium might reduce lithium absorption and plasma levels. Some case reports describe a reduction in plasma lithium levels with concomitant administration of blond psyllium. This was reversed when psyllium was stopped. This interaction may also occur with black psyllium.
Metformin (Glucophage)
Theoretically, black psyllium might increase the therapeutic and adverse effects of metformin.
Animal research shows that concurrent consumption of blond psyllium with metformin slows and increases the absorption of metformin. This interaction may also occur with black psyllium. To avoid changes in absorption, take psyllium 30-60 minutes after metformin.
Olanzapine (Zyprexa)
Theoretically, taking black psyllium at the same time as olanzapine might reduce olanzapine absorption.
The fiber in black psyllium might decrease the absorption of olanzapine. A single case report describes a reduction in the effectiveness of olanzapine when it was concomitantly administered with an unspecified type of psyllium 3 grams orally twice daily. This effect was reversed when psyllium was stopped.
Digoxin (Lanoxin)
Theoretically, taking black psyllium at the same time as digoxin might reduce digoxin absorption and decrease digoxin levels.
Psyllium might bind digoxin in the gut. However, some clinical evidence suggests that psyllium does not impact digoxin absorption.
Ethinyl Estradiol
Theoretically, taking black psyllium at the same time as ethinyl estradiol might alter levels of estradiol.
Concurrent use of blond psyllium with ethinyl estradiol results in a slight increase in the extent of ethinyl estradiol absorption and a slower rate of absorption. This is unlikely to be clinically significant.
Oral Drugs
Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Psyllium seems to have variable effects on drug absorption. To avoid changes in absorption, take psyllium 30-60 minutes after oral medications. Animal research shows that blond psyllium delays and increases the absorption of metformin and ethinyl estradiol. Case reports and animal research suggest that blond psyllium might reduce absorption of lithium, digoxin, olanzapine, and carbamazepine. Finally, some pharmacokinetic studies show that psyllium does not affect the absorption of levothyroxine or warfarin. Although many of these studies evaluated blond psyllium, the fiber content in black psyllium may have similar effects.
Pomegranate Juice
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.
Cranberry
Atorvastatin (Lipitor)
Theoretically, cranberry might increase levels and adverse effects of atorvastatin.
In one case report, a patient taking atorvastatin experienced upper back pain, rhabdomyolysis, and abnormal liver function after drinking cranberry juice 16 ounces daily for 2 weeks. Theoretically, this may have been caused by inhibition of cytochrome P450 3A4 (CYP3A4) enzymes by cranberry juice, as atorvastatin is a CYP3A4 substrate. Creatinine kinase and liver enzymes normalized within 2 weeks of stopping cranberry juice. Patients taking atorvastatin should avoid large quantities of cranberry juice.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, cranberry might increase the levels and adverse effects of CYP3A4 substrates.
A case of upper back pain, rhabdomyolysis, and abnormal liver function has been reported for a patient taking atorvastatin, a CYP3A4 substrate, in combination with cranberry juice 16 ounces daily for 2 weeks. Creatinine kinase and liver enzymes normalized within 2 weeks of stopping cranberry juice. Also, animal research suggests that cranberry juice, administered intraduodenally 30 minutes prior to nifedipine, a CYP3A4 substrate, inhibits nifedipine metabolism and increases the area under the concentration-time curve by 1.6-fold compared to control.
Nifedipine (Procardia)
Theoretically, cranberry might increase the levels and adverse effects of nifedipine.
Animal research suggests that cranberry juice, administered intraduodenally 30 minutes prior to nifedipine treatment, inhibits nifedipine metabolism and increases the area under the concentration-time curve by 1.6-fold compared to control. This interaction has not been reported in humans.
Warfarin (Coumadin)
Theoretically, cranberry might increase the levels and adverse effects of warfarin. However, research is conflicting.
There is contradictory evidence about the effect of cranberry juice on warfarin. Case reports have linked cranberry juice consumption to increases in the international normalized ratio (INR) in patients taking warfarin, resulting in severe spontaneous bleeding and excessive postoperative bleeding. Daily consumption of cranberry sauce for one week has also been linked to an increase in INR in one case report. In a small study in healthy young males, taking a high dose of 3 grams of cranberry juice concentrate capsules, equivalent to 57 grams of fruit daily, for 2 weeks produced a 30% increase in the area under the INR-time curve after a single 25-mg dose of warfarin. However, 3 very small clinical studies in patients stabilized on warfarin reported that cranberry juice 250 mL once or twice daily for 7 days (27% cranberry juice or pure cranberry juice) or 240 mL once daily for 14 days does not significantly increase INR or affect plasma warfarin levels. The reasons for these discrepant findings are unclear. It is possible that the form and dose of cranberry may play a role, as cranberry extracts and juices contain different constituents. Additionally, an in vitro study evaluating 5 different cranberry juices found varying effects, with only a cranberry concentrate, and not diluted cranberry juices, inhibiting CYP2C9. However, this concentrate did not inhibit CYP2C9 activity in humans.
Cytochrome P450 2C9 (Cyp2C9) Substrates
Theoretically, cranberry might increase the levels and adverse effects of CYP2C9 substrates. However, research is conflicting.
There is contradictory evidence about the effect of cranberry on CYP2C9 enzymes. In vitro evidence suggests that flavonoids in cranberry inhibit CYP2C9 enzymes. However, clinical research shows that cranberry juice does not significantly affect the levels, metabolism, or elimination of the CYP2C9 substrates flurbiprofen or diclofenac. Also, in patients stabilized on warfarin, drinking cranberry juice 250 mL daily for 7 days does not significantly increase the anticoagulant activity of warfarin, a CYP2C9 substrate. Additional pharmacokinetic research shows that cranberry juice does not increase peak plasma concentrations or area under the concentration-time curve of warfarin.
Diclofenac (Voltaren, Others)
Theoretically, cranberry might modestly increase the levels and adverse effects of diclofenac.
In vitro evidence suggests that cranberry juice inhibits diclofenac metabolism by human liver microsomes. However, drinking cranberry juice does not seem to affect diclofenac metabolism in humans.
Noni
Ace Inhibitors (Aceis)
Theoretically, combining noni and ACE inhibitors might increase the risk of hyperkalemia.
Noni juice contains significant amounts of potassium, about 6 mEq/100 mL juice. This may increase the risk for hyperkalemia when used in conjunction with ACE inhibitors, which can also increase potassium levels.
Angiotensin Receptor Blockers (Arbs)
Theoretically, combining noni and ARBs might increase the risk of hyperkalemia.
Noni juice contains significant amounts of potassium, about 6 mEq/100 mL juice. This may increase the risk for hyperkalemia when used in conjunction with ARBs, which can also increase potassium levels.
Antihypertensive Drugs
Theoretically, noni may increase the risk of hypotension when used in combination with antihypertensive drugs.
Preliminary clinical research suggests that drinking noni juice can reduce blood pressure in individuals with hypertension.
Hepatotoxic Drugs
Theoretically, taking noni with hepatotoxic drugs might increase the risk of liver damage.
There is concern that noni might cause hepatotoxicity in some patients. Advise patients against combining noni with potentially hepatotoxic drugs.
Phenytoin (Dilantin)
Theoretically, taking noni fruit juice concomitantly with phenytoin may lower phenytoin levels and increase the risk of seizures.
In one case report, an adult taking phenytoin for partial seizures experienced low serum phenytoin levels while taking noni juice 90-200 mL daily. Serum phenytoin levels increased after decreasing noni juice consumption; similarly, serum phenytoin levels decreased after increasing noni juice consumption. Some researchers believe noni juice may induce cytochrome P450 2C9 enzymes, which would decrease phenytoin levels, but this has not been well studied. Patients may need additional monitoring when starting or stopping noni juice supplementation.
Potassium-Sparing Diuretics
Theoretically, combing noni and a potassium-sparing diuretic might increase the risk of hyperkalemia.
Noni juice contains significant amounts of potassium, about 6 mEq/100 mL juice. This may increase the risk for hyperkalemia when used in conjunction with potassium-sparing diuretics, which can also increase potassium levels.
Warfarin (Coumadin)
Theoretically, taking noni juice concomitantly with warfarin might decrease the effectiveness of warfarin.
In one case, a 41-year-old patient stabilized on warfarin had a decreased international normalized ratio (INR) following consumption of a specific commercial noni juice product (Noni juice 4 Everything). While the patient was still taking noni juice, an increase in warfarin dose did not produce an increase in INR. However, it should be noted that this particular product contained extracts and derivatives from more than 115 components, many of which contained vitamin K. Furthermore, vitamin K was listed as a separate ingredient of the product, suggesting that the product was possibly fortified with vitamin K. It has not been verified that noni fruit alone contains a significant amount of vitamin K or interacts with warfarin.
Ranitidine (Zantac)
Taking noni fruit with ranitidine might increase the levels and clinical effects of ranitidine.
Clinical evidence shows that taking an aqueous extract of noni fruit 30 minutes prior to taking a single oral dose of ranitidine can increase the rate of absorption and plasma concentration of ranitidine.
Strawberry
Anticoagulant/Antiplatelet Drugs
In vitro and animal research suggests that strawberry extract can inhibit platelet aggregation due to its phenolic content. Theoretically, strawberry might increase the risk of bleeding when used with antiplatelet or anticoagulant drugs.
Some anticoagulant or antiplatelet drugs include aspirin, clopidogrel (Plavix), dalteparin (Fragmin), enoxaparin (Lovenox), heparin, ticlopidine (Ticlid), warfarin (Coumadin), and others.
P-Glycoprotein Substrates
In vitro research suggests that strawberry extract can inhibit p-glycoprotein efflux. Theoretically, strawberry might inhibit p-glycoprotein mediated drug efflux and potentially increase levels of drugs that are substrates of p-glycoprotein. Until more is known, strawberry should be used cautiously in people taking p-glycoprotein substrates.
Drugs that might be affected include some chemotherapeutic agents (etoposide, paclitaxel, vinblastine, vincristine, vindesine), antifungals (ketoconazole, itraconazole), protease inhibitors (amprenavir, indinavir, nelfinavir, saquinavir), H2 antagonists (cimetidine, ranitidine), some calcium channel blockers (diltiazem, verapamil), corticosteroids, erythromycin, cisapride (Propulsid), fexofenadine (Allegra), cyclosporine, loperamide (Imodium), quinidine, and others.
Apple
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.
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.
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.
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.
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.
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.
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.
Amla
Anticoagulant/Antiplatelet Drugs
Theoretically, Indian gooseberry may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs; however, research is conflicting.
Clinical research shows that taking Indian gooseberry 500 mg as a single dose or twice daily for 10 days reduces platelet aggregation by about 24% to 36%, increases bleeding time by about 3.8-5.9 seconds, and increases clotting time by about 9.8-12.7 seconds when compared to baseline. However, taking Indian gooseberry 500 mg along with clopidogrel 75 mg or ecosprin 75 mg, as a single dose or for 10 days, does not significantly reduce platelet aggregation or increase bleeding time or clotting time when compared with clopidogrel 75 mg or ecosprin 75 mg alone. Until more is known, use caution when taking Indian gooseberry in combination with anticoagulant/antiplatelet drugs.
Antidiabetes Drugs
Taking Indian gooseberry with antidiabetes drugs might increase the risk of hypoglycemia.
Clinical research shows that taking Indian gooseberry fruit or fruit extract alone or in conjunction with antidiabetes medications can lower blood glucose levels. Dose adjustments to diabetes medications might be necessary.
Aspirin
Theoretically, Indian gooseberry may increase the risk of bleeding if used with aspirin; however, research is conflicting.
Clinical research shows that taking Indian gooseberry 500 mg as a single dose or twice daily for 10 days reduces platelet aggregation by about 24% to 36%, increases bleeding time by about 3.8-5.9 seconds, and increases clotting time by about 9.8-12.7 seconds when compared to baseline. However, taking a single dose of Indian gooseberry 500 mg along with ecosprin 75 mg, or taking a combination of Indian gooseberry 500 mg twice daily plus ecosprin 75 mg once daily for 10 days, does not significantly reduce platelet aggregation or increase bleeding time or clotting time when compared with ecosprin 75 mg alone.
Clopidogrel (Plavix)
Theoretically, Indian gooseberry may increase the risk of bleeding if used with clopidogrel; however, research is conflicting.
Clinical research shows that taking Indian gooseberry 500 mg as a single dose or twice daily for 10 days reduces platelet aggregation by about 24% to 36%, increases bleeding time by about 3.8-5.9 seconds, and increases clotting time by about 9.8-12.7 seconds when compared to baseline. However, taking a single dose of Indian gooseberry 500 mg along with clopidogrel 75 mg, or taking a combination of Indian gooseberry 500 mg twice daily plus clopidogrel 75 mg once daily for 10 days, does not significantly reduce platelet aggregation or increase bleeding time or clotting time when compared with clopidogrel 75 mg alone.
Black Currant
Anticoagulant/Antiplatelet Drugs
Theoretically, black currant seed oil might increase the risk of bleeding if used in combination with anticoagulant or antiplatelet drugs.
Gamma-linolenic acid (GLA), a constituent of black currant seed oil, appears to have antiplatelet effects.
Phenothiazines
Theoretically, black currant seed oil might increase the risk of seizure in patients receiving phenothiazines.
Black currant seed oil contains gamma-linolenic acid (GLA). There is some concern that taking supplements containing GLA might cause seizures, or lower the seizure threshold, when taken with phenothiazines, although there is no evidence that black currant seed oil causes seizures. In one report, three patients with schizophrenia who had received phenothiazines developed EEG changes suggestive of temporal lobe epilepsy after starting treatment with GLA, although none experienced an actual seizure. In another report, two patients with schizophrenia who were stabilized on phenothiazines developed seizures when evening primrose 4 grams daily, which contains GLA, was added. One of these patients had a prior history of seizures.
Elderberry
Immunosuppressants
Theoretically, elderberry might interfere with immunosuppressant therapy due to its immunostimulant activity.
Elderberry has immunostimulant activity, increasing the production of cytokines, including interleukin and tumor necrosis factor.
Pazopanib (Votrient)
Theoretically, elderberry might interact with pazopanib, potentially increasing the risk of adverse effects.
Blueberry
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.
Iron
Bictegravir/Emtricitabine/Tenofovir Alafenamide (Biktarvy)
Iron might decrease levels of bictegravir/emtricitabine/tenofovir alafenamide by reducing its absorption when taken in a fasting state.
Advise patients that bictegravir/emtricitabine/tenofovir alafenamide and iron can be taken together if taken with food. However, if taken on an empty stomach, bictegravir/emtricitabine/tenofovir alafenamide should not be taken with, or 2 hours after, iron containing products.
Bisphosphonates
Iron reduces the absorption of bisphosphonates.
Advise patients that doses of bisphosphonates should be separated by at least two hours from doses of all other medications, including supplements such as iron. Divalent cations, including iron, can decrease absorption of bisphosphonates by forming insoluble complexes in the gastrointestinal tract.
Denosumab (Prolia, Others)
Administration of intravenous iron within one month of denosumab administration might increase the risk of severe hypophosphatemia and hypocalcemia.
A case of severe hypocalcemia (albumin corrected calcium 6.88 mg/dL, ionized calcium 3.68 mg/dL) and hypophosphatemia (<0.5 mg/dL) with respiratory acidosis, QT interval prolongation, and nonsustained ventricular tachycardia was reported in a 76-year-old male who had received an iron polymaltose infusion within 2 weeks of a subcutaneous injection of denosumab. Serum parathyroid hormone was also elevated (348 pg/mL). Subsequent iron infusions with iron polymaltose and ferric carboxymaltose were followed by transient hypophosphatemia, but without hypocalcemia. Additionally, a literature review describes 6 additional cases of hypophosphatemia and hypocalcemia in patients 52-92 years of age who had been administered intravenous iron as either ferric carboxymaltose or iron polymaltose and subcutaneous denosumab within 1-4 weeks of each other.
Dolutegravir (Tivicay)
Iron might decrease dolutegravir levels by reducing its absorption.
Advise patients to take dolutegravir at least 2 hours before or 6 hours after taking iron. Pharmacokinetic research shows that iron can decrease the absorption of dolutegravir from the gastrointestinal tract through chelation. When taken under fasting conditions, a single dose of ferrous fumarate 324 mg orally along with dolutegravir 50 mg reduces overall exposure to dolutegravir by 54%.
Integrase Inhibitors
Theoretically, taking iron along with integrase inhibitors might decrease the levels and clinical effects of these drugs.
Iron is a divalent cation. There is concern that iron may decrease the absorption of integrase inhibitors from the gastrointestinal tract through chelation. One pharmacokinetic study shows that iron can decrease blood levels of the specific integrase inhibitor dolutegravir through chelation. Also, other pharmacokinetic research shows that other divalent cations such as calcium can decrease the absorption and levels of some integrase inhibitors through chelation.
Levodopa
Iron might decrease levodopa levels by reducing its absorption.
Advise patients to separate doses of levodopa and iron as much as possible. There is some evidence in healthy people that iron forms chelates with levodopa, reducing the amount of levodopa absorbed by around 50%. The clinical significance of this hasn't been determined.
Levothyroxine (Synthroid, Others)
Iron might decrease levothyroxine levels by reducing its absorption.
Advise patients to separate levothyroxine and iron doses by at least 2 hours. Iron can decrease the absorption and efficacy of levothyroxine by forming insoluble complexes in the gastrointestinal tract.
Methyldopa (Aldomet)
Iron might decrease methyldopa levels by reducing its absorption.
Advise patients to separate methyldopa and iron doses by at least 2 hours. Iron can decrease the absorption of methyldopa from the gastrointestinal tract through chelation, resulting in increases in blood pressure.
Mycophenolate Mofetil (Cellcept)
Theoretically, iron might decrease mycophenolate mofetil levels by reducing its absorption.
Advise patients to take iron 4-6 hours before, or 2 hours after, mycophenolate mofetil. It has been suggested that a decrease of absorption is possible, probably by forming nonabsorbable chelates. However, mycophenolate pharmacokinetics are not affected by iron supplementation in available clinical research.
Penicillamine (Cuprimine, Depen)
Iron might decrease penicillamine levels by reducing its absorption.
Advise patients to separate penicillamine and iron doses by at least 2 hours. Oral iron supplements can reduce absorption of penicillamine by 30% to 70%, probably due to chelate formation. In people with Wilson's disease, this interaction has led to reduced efficacy of penicillamine.
Quinolone Antibiotics
Iron might decrease levels of quinolone antibiotics by reducing their absorption.
Advise patients to separate quinolone antibiotics and iron doses by at least 2 hours. Iron decreases the absorption of quinolones due to formation of insoluble complexes in the gastrointestinal tract.
Tetracycline Antibiotics
Iron might decrease levels of tetracycline antibiotics by reducing their absorption.
Advise patients to take iron at least 2 hours before or 4 hours after tetracycline antibiotics. Concomitant use can decrease absorption of tetracycline antibiotics from the gastrointestinal tract by 50% to 90%.
Chloramphenicol
Theoretically, taking chloramphenicol with iron might reduce the response to iron therapy in iron deficiency anemia.
Chloramphenicol interferes with erythrocyte maturation. However, since chloramphenicol isn't usually taken for prolonged periods, this isn't likely to be clinically significant.
Brand information
Manufacturer and brand details for Organic Fermented Fruits, from the product label.
Dr. Mercola
See all Dr. Mercola products- Name
- NHP
- Street Address
- 125 SW 3rd Place
- City
- Cape Coral
- State
- FL
- ZipCode
- 33991
- Phone Number
- (877) 985-2696
Organic Fermented Fruits by Dr. Mercola: Common Questions
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The Full Monographs Behind Organic Fermented Fruits’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Iron
Interacts with 80 drugsIron is an essential mineral your body needs to make hemoglobin and carry oxygen in the blood. Supplements are mainly useful for treating or preventing iron deficiency and iron-deficiency an...
Read the full Iron monograph → Herb & supplement monographBlack Psyllium
Interacts with 2,025 drugsBlack psyllium is a soluble-fiber supplement made from the seeds of a Plantago plant, used mostly to ease constipation and support digestive health. It is best known and most studied for rel...
Read the full Black Psyllium monograph → Herb & supplement monographBlack Currant
Interacts with 140 drugsBlack currant is a nutritious berry that is rich in vitamin C and antioxidants, and its seed oil contains the omega-6 fatty acid GLA. While it is enjoyed safely as a food and is popular as a...
Read the full Black Currant monograph → Herb & supplement monographElderberry
Interacts with 121 drugsElderberry is a popular herbal supplement, mainly taken to help with colds and flu. Some small studies suggest it may modestly shorten cold or flu symptoms, but the evidence is limited and n...
Read the full Elderberry monograph → Herb & supplement monographNoni
Interacts with 542 drugsNoni is a tropical fruit used widely in folk medicine and sold mostly as a juice or supplement, but solid human evidence for its many claimed benefits is limited. While moderate juice intake...
Read the full Noni monograph → Herb & supplement monographCranberry
Interacts with 712 drugsCranberry is best known for helping to prevent repeated urinary tract infections (UTIs) in some people, and the evidence here is moderate but mixed. It is not a reliable treatment for an act...
Read the full Cranberry 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 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 monographApple
Interacts with 300 drugsApples 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 monographStrawberry
Interacts with 316 drugsStrawberry is a popular, nutrient-rich fruit that supplies vitamin C, fiber, and antioxidant plant compounds. Eating strawberries as part of a balanced diet is healthy for most people, but c...
Read the full Strawberry monograph → Herb & supplement monographIndian Gooseberry
Interacts with 208 drugsIndian gooseberry (amla) is a vitamin C-rich fruit used in Ayurvedic medicine for many purposes, from antioxidant support to cholesterol and digestion. Early research is promising for some u...
Read the full Indian Gooseberry monograph →Sources & How We Checked
Organic Fermented Fruits'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 225 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.
Iron 72 references
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- Ullen H, Augustsson K, Gustavsson C, Steineck G. Supplementary iron intake and risk of cancer: reversed causality? Cancer Lett 1997;114:215-6.
- Reunanen A, Takkunen H, Knekt P, et al. Body iron stores, dietary iron intake and coronary heart disease mortality. J Intern Med 1995;238:223-30. PubMed
- Lund EK, Wharf SG, Fairweather-Tait SJ, Johnson IT. Oral ferrous sulfate supplements increase the free radical-generating capacity of feces from healthy volunteers. Am J Clin Nutr 1999;69:250-5.
- Rehman A, Collis CS, Yang M, et al. The effects of iron and vitamin C co-supplementation on oxidative damage to DNA in healthy volunteers. Biochem Biophys Res Comm 1998;246:293-8. PubMed
- Klipstein-Grobusch K, Grobbee DE, den Breeijen JH, et al. Dietary iron and risk of myocardial infarction in the Rotterdam Study. Am J Epidemiol 1999;149:421-8. PubMed
- Hansten PD, Horn JR. Drug Interactions Analysis and Management. Vancouver, WA: Applied Therapeutics Inc., 1997 and updates.
- Tatro DS, ed. Drug Interactions Facts. Facts and Comparisons Inc., St. Louis, MO. 1999.
- Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. Washington, DC: National Academy Press, 2002.
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- Tuomainen TP, Punnonen K, Nyyssonen K, Salonen JT. Association between body iron stores and the risk of acute myocardial infarction in men. Circulation 1998;97:1461-6.. PubMed
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- Campbell NRC, Hasinoff B. Ferrous sulfate reduces levodopa bioavailability: Chelation as a possible mechanism. Clin Pharmacol Ther 1989;45:220-5.. PubMed
- Campbell NRC, Hasinoff BB, Stalts H, et al. Ferrous sulfate reduces thyroxine efficacy in patients with hypothyroidism. Ann Int Med 1992;117:1010-3.. PubMed
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- Comparison of oral iron supplements. Pharmacist's Letter / Prescriber's Letter 2008;24(8):240811.
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- Köpcke W., Sauerland M. C. Meta-analysis of efficacy and tolerability data on iron proteinsuccinylate in patients with iron deficiency anemia of different severity. Arzneimittelforschung 1995;45(11):1211-1216.
- Campbell N. R., Campbell R. R., Hasinoff B. B. Ferrous sulfate reduces methyldopa absorption: methyldopa: iron complex formation as a likely mechanism. Clin Invest Med 1990;13(6):329-332.
- Morii M., Ueno K., Ogawa A., Kato R., Yoshimura H., Wada K., Hashimoto H., Takada M., Tanaka K., Nakatani T., Shibakawa M. Impairment of mycophenolate mofetil absorption by iron ion. Clin Pharmacol Ther 2000;68(6):613-616. PubMed
- Gelone D. K., Park J. M., Lake K. D. Lack of an effect of oral iron administration on mycophenolic acid pharmacokinetics in stable renal transplant recipients. Pharmacotherapy 2007;27(9):1272-1278. PubMed
- Ducray P. S., Banken L., Gerber M., Boutouyrie B., Zandt H. Absence of an interaction between iron and mycophenolate mofetil absorption. Br J Clin Pharmacol 2006;62(4):492-495. PubMed
- Lorenz M., Wolzt M., Weigel G., Puttinger H., Hörl W. H., Födinger M., Speiser W., Sunder-Plassmann G. Ferrous sulfate does not affect mycophenolic acid pharmacokinetics in kidney transplant patients. Am J Kidney Dis 2004;43(6):1098-1103. PubMed
- Osman M. A., Patel R. B., Schuna A., Sundstrom W. R., Welling P. G. Reduction in oral penicillamine absorption by food, antacid, and ferrous sulfate. Clin Pharmacol Ther 1983;33(4):465-470. PubMed
- Michael, B., Coyne, D. W., Fishbane, S., Folkert, V., Lynn, R., Nissenson, A. R., Agarwal, R., Eschbach, J. W., Fadem, S. Z., Trout, J. R., Strobos, J., and Warnock, D. G. Sodium ferric gluconate complex in hemodialysis patients: adverse reactions compar
- Zhang, X., Ouyang, J., Wieczorek, R., and DeSoto, F. Iron medication-induced gastric mucosal injury. Pathol.Res Pract 2009;205(8):579-581. PubMed
- Barbieri, P. G. [To-day exposure to occupational carcinogens and their effects. The experience of the rubber industry, iron metallurgy, asphalt work and aviculture]. Epidemiol.Prev 2009;33(4-5 Suppl 2):94-105.
- Macedo, A. and Cardoso, S. [Routine iron supplementation in pregnancy]. Acta Med Port. 2010;23(5):785-792.
- Bastide, N. M., Pierre, F. H., and Corpet, D. E. Heme iron from meat and risk of colorectal cancer: a meta-analysis and a review of the mechanisms involved. Cancer Prev Res (Phila) 2011;4(2):177-184. PubMed
- Stevens, R. G. Iron and the risk of cancer. Med Oncol Tumor Pharmacother. 1990;7(2-3):177-181. PubMed
- van den, Hombergh J., Dalderop, E., and Smit, Y. Does iron therapy benefit children with severe malaria-associated anaemia? A clinical trial with 12 weeks supplementation of oral iron in young children from the Turiani Division, Tanzania. J.Trop.Pediatr. PubMed
- Liabeuf S, Gras V, Moragny J, et al. Ulceration of the oral mucosa following direct contact with ferrous sulfate in elderly patients: a case report and a review of the French National Pharmacovigilance Database. Clin Interv Aging. 2014 Apr 25;9:737-40. PubMed
- Qiao L, Feng Y. Intakes of heme iron and zinc and colorectal cancer incidence: a meta-analysis of prospective studies. Cancer Causes Control. 2013 Jun;24(6):1175-83. PubMed
- Jalloh MA, Gregory PJ, Hein D, et al. Dietary supplement interactions with antiretrovirals: a systematic review. Int J STD AIDS. 2017 Jan;28(1):4-15. PubMed
- Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents: Drug Interactions between Integrase Inhibitors and Other Drugs. AIDSinfo. July 14, 2016. Available at: https://aidsinfo.nih.gov/guidelines/html/1/adult-and-adolescen
- Song I, Borland J, Arya N, Wynne B, Piscitelli S. Pharmacokinetics of dolutegravir when administered with mineral supplements in healthy adult subjects. J Clin Pharmacol. 2015;55(5):490-6. PubMed
- Esan MO, Boele van Hensbroek M, Nkhoma E, et al. Iron supplementation in HIV infected Malawian children with anemia: a double-blind, randomized, controlled trial. Clin Inf Dis 2013;57(11):1626-34.doi:10.1093/cid/cit528. PubMed
- Zlotkin S, Newton S, Aimone AM, et al. Effect of iron fortification on malaria incidence in infants and young children in Ghana: a randomized trial. JAMA 2013;310(9):938-47. PubMed
- Khambalia AZ, Aimone A, Nagubandi P, et al. High maternal iron status, dietary iron intake and iron supplement use in pregnancy and risk of gestational diabetes mellitus: a prospective study and systematic review. Diabet Med. 2016;33(9):1211-21. PubMed
- Kinnunen TI, Luoto R, Helin A, Hemminki E. Supplemental iron intake and the risk of glucose intolerance in pregnancy: re-analysis of a randomised controlled trial in Finland. Matern Child Nutr. 2016;12(1):74-84.
- Low MS, Speedy J, Styles CE, De-Regil LM, Pasricha SR. Daily iron supplementation for improving anaemia, iron status and health in menstruating women. Cochrane Database Syst Rev. 2016;4:CD009747. PubMed
- Melit LE, Marginean CO, Mocanu S, Marginean MO. A rare case of iron-pill induced gastritis in a female teenager: A case report and a review of the literature. Medicine (Baltimore). 2017;96(30):e7550. PubMed
- Neuberger A, Okebe J, Yahav D, Paul M. Oral iron supplements for children in malaria-endemic areas. Cochrane Database Syst Rev. 2016;2:CD006589. PubMed
- Peña-Rosas JP, De-Regil LM, Gomez Malave H, Flores-Urrutia MC, Dowswell T. Intermittent oral iron supplementation during pregnancy. Cochrane Database Syst Rev. 2015;(10):CD009997. PubMed
- Brabin B, Gies S, Roberts SA, et al. Excess risk of preterm birth with periconceptional iron supplementation in a malaria endemic area: analysis of secondary data on birth outcomes in a double blind randomized controlled safety trial in Burkina Faso. Mala PubMed
- Kaundal R, Bhatia P, Jain A, et al. Randomized controlled trial of twice-daily versus alternate-day oral iron therapy in the treatment of iron-deficiency anemia. Ann Hematol 2020;99(1):57-63. PubMed
- Li N, Zhao G, Wu W, et al. The efficacy and safety of vitamin C for iron supplementation in adult patients with iron deficiency anemia: A randomized clinical trial. JAMA Netw Open. 2020;3(11):e2023644.<br> PubMed
- Houston BL, Hurrie D, Graham J, et al. Efficacy of iron supplementation on fatigue and physical capacity in non-anaemic iron-deficient adults: a systematic review of randomised controlled trials. BMJ Open. 2018;8(4):e019240. PubMed
- Koch RM, Tchernodrinski S, Principe DR. Case report: Rapid onset, ischemic-type gastritis after initiating oral iron supplementation. Front Med (Lausanne) 2022;9:1010897. PubMed
- Milman NT. Iron supplementation in pregnant Danish women revisited: Effects on prepartum and postpartum iron deficiency, anemia, serum erythropoietin; including iron status, erythropoietin and anthropometrics in newborns. A randomized, placebo-controlled
- Rogozinska E, Daru J, Nicolaides M, et al. Iron preparations for women of reproductive age with iron deficiency anaemia in pregnancy (FRIDA): a systematic review and network meta-analysis. Lancet Haematol 2021;8(7):e503-e512. PubMed
- Shah AA, Donovan K, Seeley C, et al. Risk of infection associated with administration of intravenous iron: A systematic review and meta-analysis. JAMA Netw Open 2021;4(11):e2133935. PubMed
- Gamad N, Saha PK, Sharma P, Suri V, Chakrabarti A, Saha L. A randomized controlled trial comparing the efficacy, tolerability, and cost of oral iron preparations in iron-deficiency anemia in pregnancy. J Obstet Gynaecol Res 2021;47(11):3828-3841. PubMed
- El-Hawy MA, Abd Al-Salam SA, Bahbah WA. Comparing oral iron bisglycinate chelate, lactoferrin, lactoferrin with iron and iron polymaltose complex in the treatment of children with iron deficiency anemia. Clin Nutr ESPEN 2021;46:367-371. PubMed
- Adams A, Scheckel B, Habsaoui A, et al. Intravenous iron versus oral iron versus no iron with or without erythropoiesis- stimulating agents (ESA) for cancer patients with anaemia: a systematic review and network meta-analysis. Cochrane Database Syst Rev 2 PubMed
- Kancherla K, Constantin H, Kanawati A, Graham E. Iron-induced Hypophosphatemic Osteomalacia-An Atypical Case of Bilateral Femoral Stress Fractures. J Am Acad Orthop Surg Glob Res Rev 2023;7(5):e22. PubMed
- Shi R, Marin JG, Beaulieu M. Skin staining following intravenous iron extravasation in a patient with chronic kidney disease: A case report. Can J Kidney Health Dis 2023;10:20543581231165705. PubMed
- Varandas C, Vieira J, Correia CJ, et al. Hypersensitivity reactions to iron products: 10-year experience in a Portuguese tertiary Centre. Eur Ann Allergy Clin Immunol 2023.
- Jara Vidal M, López García MC, Quílez Toboso RP. Kounis syndrome after intravenous iron administration. Med Clin (Barc) 2023. DOI
- Jara Vidal M, Ruiz de Assín Valverde A, Aznar Rodríguez S. Severe hypophospathemia secondary to intravenous iron. Med Clin (Barc) 2023. DOI
- Samões B, Silva B, Martins A, et al. Hypophosphatemic osteomalacia induced by intravenous iron therapy: a case report. Joint Bone Spine 2023;90(5):105586. PubMed
- Seng NW, Barco JB, Wong MH, et al. Hypophosphatemia related to intravenous iron therapy with ferric carboxymaltose: A case series. Transfus Med 2023. PubMed
- Fernandez-Flores A, Fernandez-Parrado M, Alzoghby-Abi Chaker J, Angulo AG. Axillary cutaneous hemosiderosis in a patient with hyperhidrosis, after intravenous iron infusion. Am J Dermatopathol 2023;45(7):463-465. PubMed
- Ye S, Grill V, Luo J, Nguyen HH. Concurrent Denosumab and Parenteral Iron Therapy Precipitating Severe Hypocalcemia and Hypophosphatemia. JCEM Case Rep 2024;2(2):luae005. PubMed
- Yerigeri K. Hemochromatosis in an Adult Female With Previous Iron Deficiency Anemia on Iron Supplementation. Cureus 2023;15(12):e50166. PubMed
- Meyers M, Salmon M, Libert I, Klášterský J. A meta-analysis on the risk of infection associated with intravenous iron therapy in cancer-associated anaemia: a double-edged sword?. Curr Opin Oncol 2024;36(4):223-232. PubMed
- Short V, Allen R, Earley CJ, et al. A randomized double-blind pilot study to evaluate the efficacy, safety, and tolerability of intravenous iron versus oral iron for the treatment of restless legs syndrome in patients with iron deficiency anemia. Am J Hem PubMed
- Bellos I, Frountzas M, Pergialiotis V. Comparative Risk of Hypophosphatemia Following the Administration of Intravenous Iron Formulations: A Network Meta-Analysis. Transfus Med Rev 2020;34(3):188-194. PubMed
- US Food and Drug Administration (FDA). Biktarvy Prescribing Information. October 2024. Available at: https://www.accessdata.fda.gov/drugsatfda_docs/label/2024/210251Orig1s020lbl.pdf. Accessed July 16, 2025.
Black Psyllium 18 references
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- Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.
- Covington TR, et al. Handbook of Nonprescription Drugs. 11th ed. Washington, DC: American Pharmaceutical Association, 1996.
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