Major interaction on record — check this product against your medications before combining. Based on 4 of 7 ingredients. Check your meds →
Dietary supplement

Osteo Bi-Flex Joint Formula Gummies Pomegranate Grape Ingredients & Drug Interactions

by Osteo Bi-Flex

Osteo Bi-Flex Joint Formula Gummies Pomegranate Grape label
See full label image
Gummy Or Jelly Category: Other Combinations
Most serious interaction: Major
Clinical methodology reviewed by · Updated Sep 16, 2026 · Label data from the NIH DSLD
What is this page for?

First and foremost: checking Osteo Bi-Flex Joint Formula Gummies Pomegranate Grape against your medications. The heart of this page is the interaction checker and the full interaction report — how this product’s ingredients may interact with prescription and over-the-counter medicines you may be taking.

Around that, we add a pharmacist’s high-level view of the product as a whole — what’s inside, the evidence for its stated use, how transparent the label is, and what safety data exists — so you can see the full picture in one place. It’s educational information from our licensed clinical databases and the clinical staff at HelloPharmacist — not medical advice — and we don’t sell or endorse products. Our editorial policy

The interaction bottom line Most serious interaction: Major

Osteo Bi-Flex Joint Formula Gummies Pomegranate Grape is a dietary supplement by Osteo Bi-Flex with 7 active ingredients. Its ingredients are commonly taken for treating or preventing b12 deficiency, pernicious anemia, low energy and fatigue.Based on those ingredients, 1,440 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are Green Tea extract, Joint Shield 5-Loxin Advanced Bosclear Boswellia serrata extract, Black Tea extract. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

Jump to a section

Check Your Meds Against Osteo Bi-Flex Joint Formula Gummies Pomegranate Grape by Osteo Bi-Flex

Ask about any prescription or over-the-counter medication and we check it for interactions with Osteo Bi-Flex Joint Formula Gummies Pomegranate Grape by Osteo Bi-Flex — and tell you which ingredient is responsible.

Pharmacist-reviewed data Checks every ingredient Answer in seconds
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HelloPharmacist Scorecard of Osteo Bi-Flex Joint Formula Gummies Pomegranate Grape by Osteo Bi-Flex

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

From our pharmacy team — supplement deep dive

Generated from HelloPharmacist’s pharmacist-curated databases and editorial rules · Last generated Sep 3, 2026

What’s inside

Partial disclosure
Ingredient Transparency · database check
Partial

Most active ingredients list an amount, but at least one is hidden in a blend or missing.

Why this rating?
  • The label discloses an exact amount for 3 of its 6 active ingredients.
  • “Energy Tea Blend” is a proprietary blend — the label gives one combined amount (25 mg) without saying how much of each component you get.

This product contains 6 active ingredients. Vitamin B12 is a B vitamin your body needs for nerve function and red blood cell formation.

Green tea and black tea extracts are both sources of caffeine and polyphenols, plant compounds with antioxidant properties. White Tea is also included.

Boswellia serrata extract, sold here as Joint Shield 5-Loxin Advanced Bosclear, comes from tree resin traditionally used for joint support. FruiteX-B Calcium Fructoborate is a boron compound.

Energy Tea Blend rounds out the formula as a component group. The gummies also contain inactive ingredients — corn syrup, gelatin, mannitol, natural flavors, citric acid, vegetable juice, pectin, and fractionated coconut oil — that serve as sweeteners, binders, and texture agents.

Does it work?

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

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

Why this rating?
  • The label markets this product for: joint strength and bone health.
  • We looked for evidence on: Osteoarthritis, Joint pain, Cartilage health.
  • The strongest evidence on file: Boswellia Serrata is rated "Possibly Effective" for Osteoarthritis (Natural Medicines).

Vitamin B12 in this product is effective for treating B12 deficiency and certain other conditions. The green and black tea extracts show some evidence; green tea is likely effective for human papillomavirus (HPV) and possibly effective for high cholesterol, while black tea is likely effective for mental alertness and possibly effective for heart health and bone strength.

Boswellia serrata extract is possibly effective for osteoarthritis but has insufficient evidence to rate it for allergies, asthma, Alzheimer disease, or cluster headaches. For the other active ingredients in this formula, we don't hold effectiveness ratings in our data.

The evidence, ingredient by ingredient Vitamin B12 Boswellia Serrata Green Tea Black Tea

How safe is it?

Well-documented data
Safety Information · database check
Well characterized

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

Why this rating?
  • We hold adverse-effect (side-effect) data for 4 of the 4 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 4 of 4.
  • General safety write-ups exist for 4 of 4.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

Vitamin B12 is generally well-tolerated when taken by mouth; excess is removed in the urine and there's no established upper limit. Allergic reactions to B12 are rare but possible.

The tea extracts are generally safe in moderate amounts, though green tea's concentrated extracts have rarely been linked to liver injury. Both tea extracts contain caffeine, which can cause nausea, restlessness, insomnia, and heart palpitations, especially at higher doses.

Boswellia serrata extract is generally well-tolerated short-term and may cause abdominal discomfort, diarrhea, heartburn, headache, or nausea in some people. For pregnancy: vitamin B12 is likely safe at normal doses; green tea and black tea are possibly safe but you should limit caffeine and check with your provider; Boswellia serrata safety data in pregnancy is insufficient, so it's best avoided.

For breastfeeding: vitamin B12 is considered safe; caffeine from the tea extracts passes into breast milk, so keep intake moderate; Boswellia serrata safety while breastfeeding is unknown, so avoid it.

Side effects, ingredient by ingredient Vitamin B12 Boswellia Serrata Green Tea Black Tea

Meds to double-check

Major interaction found
Known Interaction Concern · database check
Major identified

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

Why this rating?
  • 4 of the 4 matched ingredients can interact with medications — Boswellia Serrata, Vitamin B12, Green Tea, Black Tea.
  • The most serious interaction on file is rated Major.
  • Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs; immunosuppressants / transplant drugs; diabetes medications; lithium.
  • For scale: 1,441 individual medications appear in the full list. A big number alone doesn't make a product dangerous — what matters is whether YOUR medication is on it, so run yours through the interaction checker on this page.

Before starting this product, check with your own doctor or pharmacist if you take nadolol or other beta-blockers for blood pressure or heart problems, ephedrine or other stimulants, atorvastatin or other cholesterol medications, warfarin or other blood thinners, seizure medications (especially felbamate, valproate, ethosuximide, or phenytoin), metformin for diabetes, or immunosuppressant drugs. Black tea extract and green tea extract can also affect medications processed through your liver's CYP2D6, CYP2C19, CYP1A2, CYP2C9, or CYP3A4 enzymes — Boswellia serrata may do the same — so mention those enzyme systems to your pharmacist if you're on multiple drugs.

Check your own medication Run your meds through the checker above

The bottom line

Scorecard at a glancePartially disclosed formula with some supporting evidence for its stated purpose. Major medication interactions have been identified, and safety information is well characterized.

This gummy could be worth trying if you're looking for joint support and don't take blood pressure, heart, seizure, diabetes, or cholesterol medications — but check your exact prescriptions first with the tool on this page. If you take any regular medications, especially nadolol, ephedrine, atorvastatin, warfarin, seizure drugs, or metformin, talk with your doctor or pharmacist before adding this product.

The caffeine content means you should also be cautious if you're sensitive to stimulants or pregnant.

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

Assessment coverage: 4 of 6 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Aug 22, 2017.

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

At a glance

General information

Key facts about Osteo Bi-Flex Joint Formula Gummies Pomegranate Grape, straight from the product label.

Brand Osteo Bi-Flex
Barcode (UPC) 030768648374
Net contents 120 Gummie(s)
Market status On market
Date entered into DSLD Aug 22, 2017
DSLD ID 75678
Product type Other Combinations
Supplement form Gummy Or Jelly
Dietary claims / uses All Other, Structure/Function
Intended target group(s) Adult (18 - 50 Years), Gluten Free
From the label
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.

Supplement Facts

The label details for Osteo Bi-Flex Joint Formula Gummies Pomegranate Grape by Osteo Bi-Flex, sourced from the NIH Dietary Supplement Label Database.

Supplement Facts

Daily Value (DV) Target Group(s):
Adults and children 4 or more years of age
Minimum serving Sizes:
2 Gummie(s)
Maximum serving Sizes:
2 Gummie(s)
Servings per container
60
UPC/BARCODE
030768648374
IngredientAmount% DV
Calories15 Calorie(s)--
Total Carbohydrates3 Gram(s)1%
Sugar2 Gram(s)--
Vitamin B121000 mcg16667%
FruiteX-B Calcium Fructoborate226 mg--
Green Tea extract0 NP--
Black Tea extract0 NP--
White Tea0 NP--
Joint Shield 5-Loxin Advanced Bosclear Boswellia serrata extract40 mg--
Energy Tea Blend25 mg--

Other ingredients: Corn Syrup, Gelatin, Mannitol, Natural flavors, Citric Acid, Vegetable Juice, Pectin, fractionated Coconut Oil

Tap any ingredient to jump to its full detail below.

Label statements
These statements are the manufacturer’s wording, reproduced from the product label — the label is saying it, not HelloPharmacist. We don’t verify or endorse them.
Seals/Symbols

#1 Pharmacist recommended brand 2016-2017 U.S. News & World Report Pharmacy Times

General Statements

Made with natural colors and flavors Based on the results of the Pharmacy Times Survey among pharmacists who recommend a “bone/joint strengthener” dietary supplement, 2016-2017. Natural color variation is normal and does not affect the quality of the product.

40 Points

#1 Pharmacist recommended brand

Joint health Helps support joint function

Pomegranate grape & other natural flavors

Full Half full Nearly empty

Made in the USA with select ingredients from around the world.

Brand IP Statement(s)

Osteo Bi-Flex is manufactured under the highest standards for product quality, purity and potency.

Join the Ambassador’s Club for Rewards Visit www.osteobiflex.com for more information.

Osteo Bi-Flex Joint Formula gummies are a delicious way to get the support your joints need. They help give you the right nutritional support that can make all the difference – whether you’re accomplishing daily activities or getting through your day.

Our Joint Formula Gummies combine a pleasantly sweet pomegranate grape flavor with joint supporting ingredients, so you can enjoy a fun and flavorful way to get the joint support you’ve come to depend on from Osteo Bi-Flex. Osteo Bi-Flex Joint Formula Gummies give you the right support that can make all the difference to help get you through your day.

5-Loxin Advanced is a registered trademark and BosClear is a trademark of PL Thomas - Laila Nutra, LLC and are used under license.

FruiteX-B., manufactured under U.S. patent #5,962,049, is a registered trademark of VDF FutureCeuticals, Inc.

General

64837 01B B55408

Formulation

Shellfish free

Free of gluten No artificial flavors

Suggested/Recommended/Usage/Directions

2 per day

Directions For Adult Use: Take two (2) gummies daily.

FDA Statement of Identity

Dietary Supplement

Precautions

As a reminder, discuss the supplements and medications you take with your health care providers.

Caution: If you are pregnant, nursing, taking any medications or have any medical condition, consult your doctor before use.

Discontinue use and consult your doctor if any adverse reactions occur.

Not intended for use by persons under the age of 18. Keep out of reach of children.

Tamper Resistant: Do not use if seal under cap is broken or missing.

Storage

Store at room temperature and avoid excessive heat.

FDA Disclaimer Statement

These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.

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

See for yourself

Osteo Bi-Flex Joint Formula Gummies Pomegranate Grape by Osteo Bi-Flex label

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

Osteo Bi-Flex Joint Formula Gummies Pomegranate Grape label

Label images are published by the NIH Dietary Supplement Label Database for the version of this product on file. Always read your actual product label.

View the full label (PDF)
What’s inside

The Ingredients in Osteo Bi-Flex Joint Formula Gummies Pomegranate Grape by Osteo Bi-Flex

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

Serving size2 Gummie(s) Dosage formGummy Or Jelly 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.

Sugar

2 Gram(s) per serving

Vitamin B12

Interacts with
20 drugs
1000 mcg per serving Form: Cyanocobalamin

Vitamin B12 (cobalamin) is an essential nutrient your body needs to make red blood cells, keep nerves healthy, and support DNA. Supplements are very h...

Vitamin B12 monograph & interactions

FruiteX-B Calcium Fructoborate

226 mg per serving

Joint Shield 5-Loxin Advanced Bosclear Boswellia serrata extract

Interacts with
952 drugs
40 mg per serving

Boswellia serrata is a tree resin used in traditional medicine, mainly for joint pain and inflammation. Some studies suggest it may help with osteoart...

Joint Shield 5-Loxin Advanced Bosclear Boswellia serrata extract monograph & interactions

Energy Tea Blend

25 mg per serving

Other (inactive) ingredients: Corn Syrup, Gelatin, Mannitol, Natural flavors, Citric Acid, Vegetable Juice, Pectin, Fractionated Coconut Oil. These complete the product’s ingredient list but are not active constituents.

Interaction report

Osteo Bi-Flex Joint Formula Gummies Pomegranate Grape by Osteo Bi-Flex Drug Interactions

Want to check YOUR meds against Osteo Bi-Flex Joint Formula Gummies Pomegranate Grape?

Ask about interactions with your drugs in plain English — “Can I take it with lisinopril?” — and we find you the answer in seconds, ingredient by ingredient.

 Go to the checker
1,440Drugs
13 Major 1,352 Moderate 75 Minor

Ingredients driving the most interactions

Green Tea extract 1,293
Joint Shield 5-Loxin Advanced Bosclear Boswellia serrata extract 952
Black Tea extract 694
Vitamin B12 20

Individual Drug Interactions

The ingredients in Osteo Bi-Flex Joint Formula Gummies Pomegranate Grape interact with 1,440 drugs. Click any drug to see the details.

4 of the 7 ingredients in Osteo Bi-Flex Joint Formula Gummies Pomegranate Grape interact with drugs. Each result below shows which ingredient is responsible. Green Tea extract Joint Shield 5-Loxin Advanced Bosclear Boswellia serrata extract Black Tea extract Vitamin B12

Each ingredient & the kinds of drugs it affects

For each ingredient in Osteo Bi-Flex Joint Formula Gummies Pomegranate Grape with known interactions, here are the types of medications they can affect. Open any type for the detail — or search your exact drug in the checker above.

Green Tea extract58 drug types · 1,293 drugs

Atorvastatin (Lipitor)

Green tea extract seems to reduce the levels and clinical effects of atorvastatin.
In healthy humans, taking green tea extract 300 mg or 600 mg along with atorvastatin reduces plasma levels of atorvastatin by approximately 24%. The elimination of atorvastatin is not affected. Atorvastatin is a substrate of organic anion-transporting polypeptides (OATPs). Research shows that two of the major catechins found in green tea, epicatechin gallate (ECG) and epigallocatechin gallate (EGCG), inhibit OATPs. Some OATPs are expressed in the small intestine and are responsible for the uptake of drugs and other compounds, which may have resulted in reduced plasma levels of atorvastatin. It is not clear if drinking green tea alters the absorption of atorvastatin.

Likelihood Likely Evidence B
Ephedrine

Theoretically, concomitant use might increase the risk for stimulant adverse effects.
Green tea contains caffeine. There is evidence that using ephedrine with caffeine might increase the risk of serious life-threatening or debilitating adverse effects such as hypertension, myocardial infarction, stroke, seizures, and death.

Likelihood Probable Evidence D
Nadolol (Corgard)

Green tea seems to reduce the levels and clinical effects of nadolol.
Preliminary clinical research shows that green tea consumption reduces plasma concentrations of nadolol. Compared to a control group, both peak levels and total drug exposure (AUC) of nadolol were reduced by approximately 85% in subjects who drank green tea daily for two weeks. Drinking green tea with nadolol also significantly reduced nadolol's systolic blood pressure lowering effect. Other clinical research shows that a single dose of green tea can affect plasma nadolol levels for at least one hour. Green tea catechins have been shown to inhibit organic anion transporting polypeptides (OATP), one of which, OATP1A2, is involved in the uptake of nadolol in the intestine The interaction is thought to be due primarily to the epigallocatechin gallate (EGCG) content of green tea.

Likelihood Likely Evidence B
5-Fluorouracil

Theoretically, high doses of green tea might increase the effects and side effects of 5-fluorouracil.
Animal research shows that taking green tea in amounts equivalent to about 6 cups daily in humans for 4 weeks prior to receiving a single injection of 5-fluorouracil increases the maximum plasma levels of 5-fluorouracil by about 2.5-fold and the area under the curve by 425%.

Likelihood Possible Evidence D
Adenosine (Adenocard)

Theoretically, green tea might decrease the vasodilatory effects of adenosine and interfere with its use prior to stress testing.
Green tea contains caffeine. Caffeine is a competitive inhibitor of adenosine at the cellular level. However, caffeine doesn't seem to affect supplemental adenosine because high interstitial levels of adenosine overcome the antagonistic effects of caffeine. It is recommended that methylxanthines and methylxanthine-containing products be stopped 24 hours prior to pharmacological stress tests. However, methylxanthines appear more likely to interfere with dipyridamole (Persantine) than adenosine-induced stress testing.

Likelihood Possible Evidence B
Anticoagulant/Antiplatelet Drugs

Theoretically, green tea may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Conflicting reports exist regarding the effect of green tea on bleeding risk when used with anticoagulant or antiplatelet drugs; however, most evidence suggests that drinking green tea in moderate amounts is unlikely to cause a significant interaction. Green tea contains small amounts of vitamin K, approximately 7 mcg per cup. Some case reports have associated the antagonism of warfarin with the vitamin K content of green tea. However, these reports are rare, and very large doses of green tea (about 8-16 cups daily) appear to be needed to cause these effects. Furthermore, the catechins and caffeine in green tea are reported to have antiplatelet activity.

Likelihood Unlikely Evidence D
Beta-Adrenergic Agonists

Green tea contains caffeine. Theoretically, concomitant use of large amounts of caffeine might increase cardiac inotropic effects of beta-agonists.

Likelihood Probable Evidence D
Bortezomib (Velcade)

Theoretically, green tea might interfere with the effects of bortezomib.
In vitro research shows that green tea polyphenols, such as epigallocatechin gallate (EGCG), interact with bortezomib and block its proteasome inhibitory action. This prevents the induction of cell death in multiple myeloma or glioblastoma cancer cell lines. Advise patients taking bortezomib, not to take green tea.

Likelihood Possible Evidence D
Carbamazepine (Tegretol)

Theoretically, green tea might reduce the effects of carbamazepine and increase the risk for convulsions.
Green tea contains caffeine. Animal research suggests that taking caffeine can lower the anticonvulsant effects of carbamazepine and can induce seizures when taken in doses above 400 mg/kg. Human research has shown that taking caffeine 300 mg in three divided doses along with carbamazepine 200 mg reduces the bioavailability of carbamazepine by 32% and prolongs the plasma half-life of carbamazepine 2-fold in healthy individuals.

Likelihood Possible Evidence D
Celiprolol (Celicard)

Theoretically, green tea might reduce the levels and clinical effects of celiprolol.
In a small human study, taking green tea daily for 4 days appears to decrease blood and urine levels of celiprolol by at least 98%. This interaction is possibly due to the inhibition of organic anion transporting polypeptide (OATP). Green tea catechins have been shown to inhibit organic anion transporting polypeptides (OATP), one of which, OATP1A2, is found in the intestine The interaction is thought to be due primarily to the epigallocatechin gallate (EGCG) content of green tea.

Likelihood Possible Evidence D
Cimetidine (Tagamet)

Theoretically, concomitant use might increase the effects and adverse effects of caffeine in green tea.
Green tea contains caffeine. Cimetidine can reduce caffeine clearance by 31% to 42%.

Likelihood Likely Evidence B
Clozapine (Clozaril)

Theoretically, green tea might increase the levels and adverse effects of clozapine and acutely exacerbate psychotic symptoms.
Animal research suggests that, although green tea extract does not affect the elimination of clozapine, it delays the time to reach peak concentration and reduces the peak plasma levels. Also, concomitant administration of green tea and clozapine might theoretically cause acute exacerbation of psychotic symptoms due to the caffeine in green tea. Caffeine can increase the effects and toxicity of clozapine. Caffeine doses of 400-1000 mg daily inhibit clozapine metabolism. Clozapine is metabolized by cytochrome P450 1A2 (CYP1A2). Researchers speculate that caffeine might inhibit CYP1A2. However, there is no reliable evidence that caffeine affects CYP1A2. There is also speculation that genetic factors might make some patients be more sensitive to the interaction between clozapine and caffeine.

Likelihood Possible Evidence B
Contraceptive Drugs

Theoretically, concomitant use might increase the effects and adverse effects of caffeine found in green tea.
Green tea contains caffeine. Oral contraceptives can decrease caffeine clearance by 40% to 65%.

Likelihood Probable Evidence B
Cytochrome P450 1A2 (Cyp1A2) Inhibitors

Theoretically, concomitant use might increase the levels and adverse effects of caffeine.
Green tea contains caffeine. Caffeine is metabolized by cytochrome P450 1A2 (CYP1A2),. Theoretically, drugs that inhibit CYP1A2 may decrease the clearance rate of caffeine from green tea and increase caffeine levels.

Likelihood Possible Evidence D
Dipyridamole (Persantine)

Theoretically, green tea might decrease the vasodilatory effects of dipyridamole and interfere with its use prior to stress testing.
Green tea contains caffeine. Caffeine might inhibit dipyridamole-induced vasodilation. It is recommended that methylxanthines and methylxanthine-containing products be stopped 24 hours prior to pharmacological stress tests. Methylxanthines appear more likely to interfere with dipyridamole (Persantine) than adenosine-induced stress testing.

Likelihood Probable Evidence B
Disulfiram (Antabuse)

Theoretically, disulfiram might increase the risk of adverse effects from caffeine.
In human research, disulfiram decreases the clearance and increases the half-life of caffeine.

Likelihood Probable Evidence B
Diuretic Drugs

Theoretically, using green tea with diuretic drugs might increase the risk of hypokalemia.
Green tea contains caffeine. In excessive amounts, caffeine can reduce potassium levels due to stimulation of the sodium-potassium pump. Diuretics can also cause lower potassium levels.

Likelihood Possible Evidence D
Estrogens

Theoretically, estrogens might increase the levels and adverse effects of caffeine.
Green tea contains caffeine. Estrogen inhibits caffeine metabolism.

Likelihood Probable Evidence B
Ethosuximide (Zarontin)

Theoretically, green tea might reduce the effects of ethosuximide and increase the risk for convulsions.
Green tea contains caffeine. Animal research suggests that caffeine 92.4 mg/kg can decrease the anticonvulsant activity of ethosuximide. However, this effect has not been reported in humans.

Likelihood Possible Evidence D
Felbamate (Felbatol)

Theoretically, green tea might reduce the effects of felbamate and increase the risk for convulsions.
Green tea contains caffeine. Animal research suggests that a high dose of caffeine 161.7 mg/kg can decreases the anticonvulsant activity of felbamate. However, this effect has not been reported in humans.

Likelihood Possible Evidence D
Fexofenadine (Allegra)

Green tea can decrease blood levels of fexofenadine.
Clinical research shows that green tea can significantly decrease blood levels and excretion of fexofenadine. Taking green tea extract with a dose of fexofenadine decreased bioavailability of fexofenadine by about 30%. In vitro, green tea inhibits the cellular accumulation of fexofenadine by inhibiting the organic anion transporting polypeptide (OATP) drug transporter. Research shows that two of the major catechins found in green tea, epicatechin gallate (ECG) and epigallocatechin gallate (EGCG), inhibit OATPs, specifically OATP1A2, OATP1B1, and OATP2B1. In addition, green tea has been shown to reduce the absorption of some drugs that are OATP substrates.

Likelihood Probable Evidence B
Flutamide (Eulexin)

Theoretically, green tea might increase the levels and adverse effects of flutamide.
Green tea contains caffeine. In vitro evidence suggests that caffeine can inhibit the metabolism of flutamide. Theoretically, concomitant use of caffeine and flutamide might increase serum concentrations of flutamide and increase the risk adverse effects.

Likelihood Possible Evidence D
Fluvoxamine (Luvox)

Theoretically, fluvoxamine might increase the levels and adverse effects of caffeine.
Green tea contains caffeine. Fluvoxamine reduces caffeine metabolism.

Likelihood Probable Evidence D
Hepatotoxic Drugs

Theoretically, concomitant use might have additive adverse hepatotoxic effects.
Green tea extract supplements have been linked to several cases of hepatotoxicity and might have additive hepatotoxic effects with other drugs..

Likelihood Unlikely Evidence D
Imatinib (Gleevec)

Theoretically, green tea might reduce the levels and clinical effects of imatinib.
In animal research, a single dose of green tea extract reduces the area under the curve (AUC) of imatinib by up to approximately 64% and its main metabolite N-desmethyl imatinib by up to approximately 81%. This interaction has not been shown in humans. The mechanism of action is unclear but may involve multiple pathways.

Likelihood Possible Evidence D
Green Tea extract full monograph & all 58 interactions

Joint Shield 5-Loxin Advanced Bosclear Boswellia serrata extract6 drug types · 952 drugs

Cytochrome P450 1A2 (Cyp1A2) Substrates

Theoretically, Boswellia serrata might increase the levels of CYP1A2 substrates.
In vitro research shows that Boswellia serrata gum resin inhibits CYP1A2 enzymes.

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

Theoretically, Boswellia serrata might increase the levels of CYP2C19 substrates.
In vitro research shows that Boswellia serrata gum resin inhibits CYP2C19 enzymes.

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

Theoretically, Boswellia serrata might increase the levels of CYP2C9 substrates.
In vitro research shows that Boswellia serrata gum resin inhibits CYP2C9 enzymes.

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

Theoretically, Boswellia serrata might increase the levels of CYP2D6 substrates.
In vitro research shows that Boswellia serrata gum resin inhibits CYP2D6 enzymes.

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

Theoretically, Boswellia serrata might increase or decrease the levels and clinical effects of CYP3A4 substrates.
In vitro research shows that Boswellia serrata gum resin inhibits CYP3A4 enzymes. Other in vitro research shows that Boswellia serrata extract inhibits CYP3A4 enzymes at most concentrations, although it may modestly induce enzyme activity at low concentrations.

Likelihood Possible Evidence D
Immunosuppressants

Theoretically, Boswellia serrata might alter the effects of immunosuppressive drugs.
Some in vitro research suggests that Boswellia serrata extracts might inhibit mediators of autoimmune disorders such as leukotrienes and reduce production of antibodies and cell-mediated immunity. However, other in vitro research suggests that, when coupled with calcium ions, boswellic acids containing the keto group have immunostimulant properties within specific cell signaling pathways.

Likelihood Possible Evidence D
Joint Shield 5-Loxin Advanced Bosclear Boswellia serrata extract full monograph & interactions

Black Tea extract46 drug types · 694 drugs

Ephedrine

Theoretically, concomitant use might increase the risk for simulant adverse effects.
Black tea contains caffeine. There is evidence that using ephedrine with caffeine might increase the risk of serious life-threatening or debilitating adverse effects such as hypertension, myocardial infarction, stroke, seizures, and death. Tell patients to avoid taking caffeine with ephedrine and other stimulants.

Likelihood Probable Evidence D
Adenosine (Adenocard)

Theoretically, black tea might decrease the vasodilatory effects of adenosine and interfere with its use prior to stress testing.
Black tea contains caffeine. Caffeine is a competitive inhibitor of adenosine at the cellular level. However, caffeine does not seem to affect supplemental adenosine because high interstitial levels of adenosine overcome the antagonistic effects of caffeine. It is recommended that methylxanthines such as caffeine, as well as methylxanthine-containing products, be stopped 24 hours prior to pharmacological stress tests. However, methylxanthines appear more likely to interfere with dipyridamole (Persantine) than adenosine-induced stress testing.

Likelihood Possible Evidence B
Anticoagulant/Antiplatelet Drugs

Theoretically, black tea may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Black tea contains caffeine. Caffeine is reported to have antiplatelet activity. Theoretically, the caffeine in black tea might increase the risk of bleeding when used concomitantly with antiplatelet drugs. However, this interaction has not been reported in humans.

Likelihood Possible Evidence D
Beta-Adrenergic Agonists

Theoretically, concomitant use of large amounts of black tea might increase cardiac inotropic effects of beta-agonists.
Black tea contains caffeine. Caffeine can increase cardiac inotropic effects of beta-agonists.

Likelihood Probable Evidence D
Carbamazepine (Tegretol)

Theoretically, black tea might reduce the effects of carbamazepine and increase the risk for convulsion.
Black tea contains caffeine. Animal research suggests that caffeine can lower the anticonvulsant effects of carbamazepine and can induce seizures when taken in doses above 400 mg/kg. Human research has shown that taking caffeine 300 mg in three divided doses along with carbamazepine 200 mg reduces the bioavailability of carbamazepine by 32% and prolongs the plasma half-life of carbamazepine 2-fold in healthy individuals.

Likelihood Possible Evidence B
Cimetidine (Tagamet)

Theoretically, concomitant use might increase the effects and adverse effects of caffeine in black tea.
Black tea contains caffeine. Cimetidine can reduces caffeine clearance by 31% to 42%.

Likelihood Likely Evidence B
Clozapine (Clozaril)

Theoretically, black tea might increase the levels and adverse effects of clozapine and acutely exacerbate psychotic symptoms.
Concomitant administration of black tea and clozapine might theoretically cause acute exacerbation of psychotic symptoms due to the caffeine in black tea. Caffeine can increase the effects and toxicity of clozapine. Caffeine doses of 400-1000 mg daily inhibit clozapine metabolism. Clozapine is metabolized by cytochrome P450 1A2 (CYP1A2). Researchers speculate that caffeine might inhibit CYP1A2. However, there is no reliable evidence that caffeine affects CYP1A2. There is also speculation that genetic factors might make some patients be more sensitive to the interaction between clozapine and caffeine.

Likelihood Possible Evidence B
Contraceptive Drugs

Theoretically, concomitant use might increase the effects and adverse effects of caffeine found in black tea.
Black tea contains caffeine. Oral contraceptive drugs can decrease caffeine clearance by 40% to 65%.

Likelihood Probable Evidence B
Cytochrome P450 1A2 (Cyp1A2) Inhibitors

Theoretically, concomitant use might increase the levels and adverse effects of caffeine.
Black tea contains caffeine. Caffeine is metabolized by CYP1A2,. Theoretically, drugs that inhibit CYP1A2 may decrease the clearance rate of caffeine from black tea and increase caffeine levels.

Likelihood Possible Evidence D
Dipyridamole (Persantine)

Theoretically, black tea might decrease the vasodilatory effects of dipyridamole and interfere with its use prior to stress testing.
Black tea contains caffeine. Caffeine is a methylxanthine that may inhibit dipyridamole-induced vasodilation. It is recommended that methylxanthines such as caffeine, as well as methylxanthine-containing products such as black tea, be stopped 24 hours prior to pharmacological stress tests. Methylxanthines appear more likely to interfere with dipyridamole (Persantine) than adenosine-induced stress testing.

Likelihood Probable Evidence B
Disulfiram (Antabuse)

Theoretically, disulfiram might increase the risk of adverse effects from caffeine.
Black tea contains caffeine. In human research, disulfiram decreases the clearance and increases the half-life of caffeine.

Likelihood Probable Evidence B
Diuretic Drugs

Theoretically, using black tea with diuretic drugs might increase the risk of hypokalemia.
Black tea contains caffeine. Caffeine, especially in excessive amounts, can reduce potassium levels due to stimulation of the sodium-potassium pump. Diuretics can also cause lower potassium levels.

Likelihood Possible Evidence D
Estrogens

Theoretically, estrogens might increase the levels and adverse effects of caffeine.
Black tea contains caffeine. Estrogen inhibits caffeine metabolism.

Likelihood Probable Evidence B
Ethosuximide (Zarontin)

Theoretically, black tea might reduce the effects of ethosuximide and increase the risk for convulsions.
Black tea contains caffeine. Animal research suggests that caffeine 92.4 mg/kg can decrease the anticonvulsant activity of ethosuximide. However, this effect has not been observed in humans.

Likelihood Possible Evidence D
Felbamate (Felbatol)

Theoretically, black tea might reduce the effects of felbamate and increase the risk for convulsions.
Black tea contains caffeine. Animal research suggests that a high dose of caffeine 161.7 mg/kg can decrease the anticonvulsant activity of felbamate. However, this effect has not been observed in humans.

Likelihood Possible Evidence D
Flutamide (Eulexin)

Theoretically, black tea might increase the levels and adverse effects of flutamide.
Black tea contains caffeine. In vitro evidence suggests that caffeine can inhibit the metabolism of flutamide. Theoretically, concomitant use of caffeine and flutamide might increase serum concentrations of flutamide and increase the risk of adverse effects.

Likelihood Possible Evidence D
Fluvoxamine (Luvox)

Theoretically, fluvoxamine might increase the levels and adverse effects of caffeine.
Black tea contains caffeine. Fluvoxamine reduces caffeine metabolism.

Likelihood Probable Evidence B
Lithium

Theoretically, abrupt black tea withdrawal might increase the levels and adverse effects of lithium.
Black tea contains caffeine. Abrupt caffeine withdrawal can increase serum lithium levels. Two cases of lithium tremor that worsened with abrupt coffee withdrawal have been reported.

Likelihood Probable Evidence D
Monoamine Oxidase Inhibitors (Maois)

Theoretically, concomitant use might increase the risk of a hypertensive crisis.
Black tea contains caffeine. Caffeine has been shown to inhibit monoamine oxidase (MAO) A and B in laboratory studies. Concomitant intake of large amounts of caffeine with MAOIs might precipitate a hypertensive crisis. In a case report, a patient that consumed 10-12 cups of caffeinate coffee and took the MAOI tranylcypromine presented with severe hypertension. Hypertension was resolved after the patients switched to drinking decaffeinated coffee.

Likelihood Possible Evidence D
Nicotine

Theoretically, concomitant use might increase the risk of hypertension.
Black tea contains caffeine. Concomitant use of caffeine and nicotine has been shown to have additive cardiovascular effects, including increased heart rate and blood pressure. Blood pressure was increased by 10.8/12.4 mmHg when the agents were used concomitantly.

Likelihood Probable Evidence B
Organic Anion-Transporting Polypeptide Substrates (Oatp)

Theoretically, black tea might reduce the absorption of organic anion-transporting polypeptide (OATP) substrates.
In vitro, black tea extract inhibits organic anion-transporting polypeptide (OATP)2B1. OATP2B1 is expressed in the small intestine and liver and is responsible for the uptake of drugs and other compounds. In an animal model, black tea extract was found to inhibit the absorption of rosuvastatin, a substrate of OATP2B1. However, this effect has not been reported in humans.

Likelihood Possible Evidence D
Pentobarbital (Nembutal)

Theoretically, black tea might decrease the effects of pentobarbital.
Black tea contains caffeine. Theoretically, caffeine might negate the hypnotic effects of pentobarbital.

Likelihood Possible Evidence B
Phenobarbital (Luminal)

Theoretically, black tea might reduce the effects of phenobarbital and increase the risk for convulsions.
Black tea contains caffeine. Animal research suggests that caffeine can decrease the anticonvulsant activity of phenobarbital. The exact mechanism of this interaction is unclear.

Likelihood Possible Evidence D
Phenylpropanolamine

Theoretically, phenylpropanolamine might increase the risk of hypertension, as well as the levels and adverse effects of caffeine.
Black tea contains caffeine. Concomitant use of phenylpropanolamine and caffeine might cause an additive increase in blood pressure. Phenylpropanolamine also seems to increase caffeine serum levels.

Likelihood Probable Evidence B
Phenytoin (Dilantin)

Theoretically, black tea might reduce the effects of phenytoin and increase the risk for convulsions.
Black tea contains caffeine. Animal research suggests that caffeine can decrease the anticonvulsant activity of phenytoin. The effect does not seem to be related to the seizure threshold-lowering effects of caffeine. However, the exact mechanism of this interaction is unclear.

Likelihood Possible Evidence D
Black Tea extract full monograph & all 46 interactions

Vitamin B121 drug type · 20 drugs

Metformin (Glucophage)

Metformin, a common medication used to manage type 2 diabetes, has been associated with lower vitamin B12 levels in some individuals. Prolonged use of metformin can interfere with the absorption of B12 in the digestive system, potentially leading to a deficiency in this essential vitamin.

Likelihood Possible Evidence A
Vitamin B12 full monograph & interactions
The maker

Brand information

Manufacturer and brand details for Osteo Bi-Flex Joint Formula Gummies Pomegranate Grape, from the product label.

Osteo Bi-Flex

See all Osteo Bi-Flex products
Name
Rexall Sundown, Inc.
City
Boca Raton
State
FL
ZipCode
33487
Phone Number
1-888-848-2435
Web Address
www.osteobiflex.com
Pharmacist Counseling Corner

Osteo Bi-Flex Joint Formula Gummies Pomegranate Grape by Osteo Bi-Flex: Common Questions

Does Osteo Bi-Flex Joint Formula Gummies Pomegranate Grape by Osteo Bi-Flex interact with any medications?
Yes. Based on its ingredients, Osteo Bi-Flex Joint Formula Gummies Pomegranate Grape has a known interaction with 1,440 medications, including 13 rated major. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Osteo Bi-Flex Joint Formula Gummies Pomegranate Grape contains 7 active ingredients, and an interaction can come from any of them. We check every ingredient, combine the results into one list per medication, and show which ingredient and mechanism is responsible.
Where does this information come from?
The product label data comes from the NIH Dietary Supplement Label Database (DSLD); the interaction data is built on the Natural Medicines database and reviewed by HelloPharmacist pharmacists.
Does this have caffeine?
Yes. Both the green tea and black tea extracts in this formula contain caffeine. If you're sensitive to stimulants, pregnant, or taking ephedrine or other energizing drugs, mention that to your doctor or pharmacist before using this product.
Is it okay to take this while pregnant?
Vitamin B12 is considered safe in pregnancy at normal doses. The tea extracts are possibly safe but you should limit caffeine, so check with your provider about the amount in these gummies. Boswellia serrata's safety in pregnancy hasn't been established well enough, so it's best avoided — talk to your doctor before taking this product if you're pregnant or planning to become pregnant.
Can I take this while breastfeeding?
Vitamin B12 is safe during breastfeeding. However, the caffeine in the tea extracts does pass into your breast milk, so keep it moderate if you're nursing. Boswellia serrata safety while breastfeeding is unknown, so discuss this product with your pharmacist or doctor before starting it.
What does Boswellia serrata do?
Boswellia serrata is a tree resin that's possibly effective for osteoarthritis — it may help with joint discomfort. We don't have enough evidence yet to say whether it works for allergies, asthma, or other conditions, but that's what this ingredient is meant to support in a joint formula.
Are there any fillers in this?
Yes. The gummies contain several inactive ingredients: corn syrup, gelatin, mannitol, natural flavors, citric acid, vegetable juice, pectin, and fractionated coconut oil. These help form, sweeten, and flavor the gummy.
Can I take this if I'm on blood thinners like warfarin?
Black tea extract in this product may reduce warfarin's effectiveness if you consume large amounts regularly. Check with your doctor or pharmacist before starting this product if you take warfarin or any other blood thinner — they may need to monitor your medication levels.

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

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Osteo Bi-Flex Joint Formula Gummies Pomegranate Grape label
Go deeper

The Full Monographs Behind Osteo Bi-Flex Joint Formula Gummies Pomegranate Grape’s Ingredients

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

Herb & supplement monograph

Vitamin B12

Interacts with 20 drugs

Vitamin B12 (cobalamin) is an essential nutrient your body needs to make red blood cells, keep nerves healthy, and support DNA. Supplements are very helpful for people who are deficient — su...

Read the full Vitamin B12 monograph → Herb & supplement monograph

Boswellia Serrata

Interacts with 952 drugs

Boswellia serrata is a tree resin used in traditional medicine, mainly for joint pain and inflammation. Some studies suggest it may help with osteoarthritis symptoms, but the overall evidenc...

Read the full Boswellia Serrata monograph → Herb & supplement monograph

Green Tea

Interacts with 1,293 drugs

Green tea is a popular beverage rich in antioxidants called catechins, and drinking it in normal amounts is considered safe for most people. Concentrated green tea extracts are a different s...

Read the full Green Tea monograph → Herb & supplement monograph

Black Tea

Interacts with 694 drugs

Black tea is a popular caffeinated drink made from the fully oxidized leaves of the Camellia sinensis plant, and it contains caffeine and antioxidant plant compounds. Moderate tea drinking i...

Read the full Black Tea monograph →
Sources

Sources & How We Checked

Osteo Bi-Flex Joint Formula Gummies Pomegranate Grape's label data comes from the NIH Dietary Supplement Label Database; the ingredient interaction data is from the Natural Medicines database, reviewed by our pharmacists.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

The 415 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.

Vitamin B12 30 references
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  9. Uhl, W., Nolting, A., Golor, G., Rost, K. L., and Kovar, A. Safety of hydroxocobalamin in healthy volunteers in a randomized, placebo-controlled study. Clin Toxicol (Phila) 2006;44 Suppl 1:17-28. PubMed
  10. Borron, S. W., Baud, F. J., Barriot, P., Imbert, M., and Bismuth, C. Prospective study of hydroxocobalamin for acute cyanide poisoning in smoke inhalation. Ann Emerg.Med 2007;49(6):794-801, 801. PubMed
  11. Borron, S. W., Baud, F. J., Megarbane, B., and Bismuth, C. Hydroxocobalamin for severe acute cyanide poisoning by ingestion or inhalation. Am J Emerg.Med 2007;25(5):551-558. PubMed
  12. Lewis, J. G. Gout, Steatorrhoea, and Megaloblastic Anaemia. Ann Rheum.Dis 1962;21(3):284-286. PubMed
  13. Tal, S., Shavit, Y., Stern, F., and Malnick, S. Association between vitamin B12 levels and mortality in hospitalized older adults. J Am Geriatr.Soc 2010;58(3):523-526. PubMed
  14. Baztan, J. J., Gavidia, J. J., Gomez-Pavon, J., Esteve, A., and Ruiperez, I. High vitamin B12 levels and in-hospital mortality. J Am Geriatr.Soc 2010;58(11):2237-2238. PubMed
  15. Omboni, E., Checchini, M., and Longoni, F. [Hypopotassemia and megaloblastic anemia. Presentation of a case]. Minerva Med 8-31-1987;78(16):1255-1257.
  16. Aalfs As, Scholvinck LH, Horvath B. Acneiform eruption in a 5-year old due to vitamin B12 supplementation. Eur J Dermatol 2013;23(5):726-7. PubMed
  17. Balta I, Ozuguz P. Vitamin B12-induced acneiform eruption. Cutan Ocul Toxicol 2014;33(2):94-5. PubMed
  18. Carman KB, Belgemen T, Yis U. Involuntary movements misdiagnosed as seizure during vitamin B12 treatment. Pediatr Emerg Care 2013;29(11):1223-4. PubMed
  19. Djuric V, Bogic M, Popadic AP, et al. Anaphylactic reaction to hydroxycobalamin with tolerance to cyanocobalamin. Ann Allergy Asthma Immunol 2012;108(3):207-8. PubMed
  20. Kartel O, Gulec M, Demirel F, et al. Vitamin B12 allergy and successful desensitization with cyanocobalamin: A case report. Allergol Immunopath (Madr) 2012;40(5):324-5.
  21. Patiroglu T, Unal E, Yildirim S. Infantile tremor syndrome associated with cobalamin therapy: A case report. Clin Neurol Neurosurg 2013;115(9):1903-5. PubMed
  22. Schulte S, Barkema LW, Kardaun SH. Long-lasting atypical acneiform eruption with prominent comedones induced by hydroxocobalamin (vitamin B12). J Dtsch Dermatol Ges 2014;12(6):502-3.
  23. Zanus C, Alberini E, Costa P, et al. Involuntary movements after correction of vitamin B12 deficiency: A video-case report. Epileptic Disord 2012;14(2):174-80. PubMed
  24. Fanidi A, Carreras-Torres R, Larose TL, et al. Is high vitamin B12 status a cause of lung cancer? Int J Cancer. 2019 Sep 15;145(6):1499-1503. PubMed
  25. Fujita Y, Mizukami T, Maya Y, et al. Vitamin B12 allergy manifesting as lymphomatoid contact dermatitis. Eur J Dermatol. 2020;30(3):304-305. PubMed
  26. Dépret F, Hoffmann C, Daoud L, et al. Association between hydroxocobalamin administration and acute kidney injury after smoke inhalation: a multicenter retrospective study. Crit Care. 2019;23(1):421. PubMed
  27. Khairan P, Sobue T, Eshak ES, et al. Association of dietary intakes of vitamin B12, vitamin B6, folate, and methionine with the risk of esophageal cancer: the Japan Public Health Center-based (JPHC) prospective study. BMC Cancer 2021;21(1):982. PubMed
  28. Evans J, Pandya A, Ding Y, Qunibi WY. Hydroxocobalamin-Induced Oxalate Nephropathy in a Patient With Smoke Inhalation. Kidney Int Rep 2021;6(8):2228-2231. PubMed
  29. Lacombe V, Chabrun F, Lacout C, et al. Persistent elevation of plasma vitamin B12 is strongly associated with solid cancer. Sci Rep 2021;11(1):13361. PubMed
  30. Pegalajar-García MD, Cebolla-Verdugo M, Prados-Carmona Á, Llamas-Segura C, Navarro-Triviño FJ. Systemic allergic dermatitis to cobalt present in cyanocobalamin supplementation. Contact Dermatitis 2023;89(3):203-205. PubMed

See these in context on the Vitamin B12 monograph →

Green Tea 219 references
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See these in context on the Green Tea monograph →

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DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

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