Pan-Ox-5 Ingredients & Drug Interactions
What is this page for?
First and foremost: checking Pan-Ox-5 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
Pan-Ox-5 is a dietary supplement by Douglas Laboratories with 12 active ingredients. Its ingredients are commonly taken for digestive support for protein digestion, wound cleaning (debridement of dead tissue), sore throat and inflammation.Based on those ingredients, 881 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Beet root powder, Citrus Pectin, Papain. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against Pan-Ox-5 by Douglas Laboratories
Ask about any prescription or over-the-counter medication and we check it for interactions with Pan-Ox-5 by Douglas Laboratories — 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
Ask the Pharmacist
A licensed pharmacist will answer your question by email — free, usually within 24 hours.
Got it — thank you!
A licensed pharmacist will answer within 24 hours. Keep an eye on your email (worth checking spam, just in case).
HelloPharmacist Scorecard of Pan-Ox-5 by Douglas Laboratories
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
Full disclosure
Pan-Ox-5 contains 12 active ingredients, most of them digestive enzymes designed to support digestion. Papain is a protein-breaking enzyme from papaya.
Lipase, pepsin, pancreatin, and proteolytic enzymes (via protease) all help break down fats or proteins in food. Diastase breaks down starches.
Rennin and Aspergillus Oryza are enzymes that aid digestion further. The product also includes ox bile extract to help with fat digestion, beet root powder for nutrient content, citrus pectin for fiber, betaine to support stomach acid, and glutamic acid.
The tablet also contains inactive ingredients like cellulose, vegetable stearate, myrrh gum, and silica.
Does it work?
Moderate evidence
The evidence for most of Pan-Ox-5's ingredients is not well established. For papain, there is insufficient reliable evidence for cancer, dental cavities, radiation skin damage, exercise muscle soreness, shingles, or parasite infection.
Beet root powder shows possibly effective evidence for athletic performance and possibly effective for exercise-related muscle soreness, but only possibly ineffective for chronic lung disease (COPD). Citrus pectin is possibly effective for high cholesterol, but there is insufficient evidence for blood sugar control or radiation exposure.
For lipase, pepsin, and the other enzymes, we hold no effectiveness data in our records.
How safe is it?
Well-documented data
Most ingredients in Pan-Ox-5 are generally well tolerated at normal doses. Papain can cause allergic reactions, including itchy eyes, runny nose, sneezing, stomach cramps, and diarrhea in sensitive people.
Beet may cause red or black stools (harmless) and rarely low calcium or kidney damage with very large amounts. Citrus pectin may cause gas, loose stools, and mild cramps, and rarely allergic reactions including severe reactions in sensitive individuals.
Pepsin and lipase may cause digestive upset or allergic reactions. Papain is best avoided in pregnancy due to safety concerns, and you should not take concentrated papain while breastfeeding because there isn't enough safety data.
There is limited safety data for lipase, pectin supplements, and pepsin in pregnancy and breastfeeding—talk with your doctor before using if you are pregnant or nursing.
Meds to double-check
Moderate interaction found
Check with your pharmacist before taking Pan-Ox-5 if you use warfarin (Moderate interaction with papain), lovastatin (Moderate with citrus pectin), tetracycline antibiotics (Moderate with citrus pectin), or digoxin (Moderate with citrus pectin). Beet root powder may affect medications broken down by CYP3A4 liver enzymes (Moderate) or CYP1A2 enzymes (Minor), and could theoretically lower blood pressure (Minor).
Use our medication search tool to verify your exact prescriptions.
The bottom line
Scorecard at a glanceFully disclosed formula with some supporting evidence for its stated purpose. Moderate medication interactions have been identified, and safety information is well characterized.
Pan-Ox-5 is a digestive enzyme blend that may help some people, though evidence for most ingredients is limited. If you take warfarin, a cholesterol drug, tetracycline antibiotics, or digoxin, or if you have liver enzyme concerns, check your medications with our tool before starting.
Talk to your pharmacist or doctor before using this product, especially if you're pregnant, breastfeeding, or have serious digestive conditions.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 5 of 12 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Jun 1, 2012.
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 Pan-Ox-5, straight from the product label.
| Brand | Douglas Laboratories |
|---|---|
| Barcode (UPC) | 310539006535 |
| Net contents | 60 Tablet(s) |
| Market status | On market |
| Date entered into DSLD | Jun 1, 2012 |
| DSLD ID | 9173 |
| Product type | Other Combinations |
| Supplement form | Tablet Or Pill |
| Dietary claims / uses | All Other |
| Intended target group(s) | Adult (18 - 50 Years), Dairy Free, 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 Pan-Ox-5 by Douglas Laboratories, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Papain | 48 mg | -- |
| Lipase | 50 mg | -- |
| Diastase | 7.5 mg | -- |
| Glutamic Acid | 10 mg | -- |
| Beet root powder | 100 mg | -- |
| Citrus Pectin | 12.5 mg | -- |
| Pepsin | 32.5 mg | -- |
| Ox Bile extract | 65 mg | -- |
| Aspergillus Oryza | 35 mg | -- |
| Rennin | 15 mg | -- |
| Betaine | 46 mg | -- |
| Pancreatin | 75 mg | -- |
Other ingredients: Cellulose, Vegetable Stearate, Myrrh Gum, Silica
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.
Formulation
This product contains NO yeast, wheat gluten, soy protein, milk/dairy, corn, sodium, sugar, starch, artificial coloring, preservatives or flavoring.
Suggested/Recommended/Usage/Directions
Suggested Usage: As a dietary supplement, adults take 1 tablet daily with meals or as directed by physician.
Precautions
KEEP OUT OF REACH OF CHILDREN.
Tamper resistant package, do not use if outer seal is missing.
Storage
For optimal storage conditions, store in a cool, dry place. (59(0)-77(0)F/15(0)-25(0)C) (35-65% relative humidity)
General Statements
Meets Douglas Laboratories spec [#7917]. Conforms to USP <2091> for weight. Meets USP <2040> for disintegration.
General
Formula #7917
FDA Statement of Identity
Dietary Enzyme Supplement
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Pan-Ox-5 by Douglas Laboratories 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 Pan-Ox-5 by Douglas Laboratories
These are the 12 active ingredients this product is made of. Select any to open its full monograph.
Serving size1 Tablet(s) Dosage formTablet Or Pill 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.
Papain
Interacts with2 drugs
Papain is a protein-digesting enzyme from the papaya plant that is used in digestive supplements and some topical products. While it has clear food an...
Papain monograph & interactionsLipase
No knowninteractions
Lipase is a digestive enzyme that helps your body break down dietary fats. It is well established as part of prescription pancreatic enzyme therapy fo...
Lipase monograph & interactionsDiastase
Glutamic Acid
Beet root powder
Interacts with861 drugs
Beet, especially beetroot juice, is a nitrate-rich food that may modestly lower blood pressure and slightly improve exercise performance in some peopl...
Beet root powder monograph & interactionsCitrus Pectin
Interacts with23 drugs
Pectin is a natural soluble fiber found in fruits like apples and citrus, and it is widely used in foods and as a fiber supplement. It may modestly he...
Citrus Pectin monograph & interactionsPepsin
No knowninteractions
Proteolytic enzymes are proteins that help break down other proteins, and common examples include bromelain (from pineapple), papain (from papaya), tr...
Pepsin monograph & interactionsOx Bile extract
Aspergillus Oryza
Rennin
Betaine
Pancreatin
Other (inactive) ingredients: Cellulose, Vegetable Stearate, Myrrh Gum, Silica. These complete the product’s ingredient list but are not active constituents.
Pan-Ox-5 by Douglas Laboratories Drug Interactions
HelloPharmacist Interaction Report
Pan-Ox-5 by Douglas Laboratories contains several digestive enzymes and plant extracts, and a few of them do interact with medications.
The most serious concern is papain, which may increase the effects and side effects of warfarin (a blood thinner used to prevent clots). In one case, a patient stable on warfarin developed an abnormally high blood clotting value after taking a papain-containing supplement.
Read the full breakdown — every affected drug type, severity by severity
Citrus pectin in this product can reduce absorption of three types of medication: lovastatin (a cholesterol drug), tetracycline antibiotics, and digoxin (a heart medication). This could potentially make these drugs less effective.
Beet root powder may theoretically affect how your body processes certain medications broken down by liver enzymes called CYP3A4 and CYP1A2, and might lower blood pressure, though human study evidence is limited.
We could not check several ingredients in this product for interactions: Diastase, Glutamic Acid, Ox Bile extract, Aspergillus Oryza, Rennin, Betaine, and Pancreatin. Altogether, these interactions span 870 individual medications.
Use the medication checker on this page to look up your exact prescriptions before starting Pan-Ox-5.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against Pan-Ox-5?
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 Pan-Ox-5 interact with 881 drugs. Click any drug to see the details.
3 of the 12 ingredients in Pan-Ox-5 interact with drugs. Each result below shows which ingredient is responsible. Beet root powder Citrus Pectin Papain
Acetaminophen, Dextromethorphan, Guaifenesin, PhenylpropanolamineAnatuss
How Acetaminophen, Dextromethorphan, Guaifenesin, Phenylpropanolamine interacts with Pan-Ox-5 — through 1 ingredient. Tap an ingredient for the detail:
Beet Root PowderCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, beet might increase the levels of CYP3A4 substrates.
Read the full Beet Root Powder + Acetaminophen, Dextromethorphan, Guaifenesin, Phenylpropanolamine interactionAcetaminophen, Dextromethorphan, Guaifenesin, PseudoephedrineRobitussin Cold, Severe Cold, Suphedrine Cold/Cough
How Acetaminophen, Dextromethorphan, Guaifenesin, Pseudoephedrine interacts with Pan-Ox-5 — through 1 ingredient. Tap an ingredient for the detail:
Beet Root PowderCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, beet might increase the levels of CYP3A4 substrates.
Read the full Beet Root Powder + Acetaminophen, Dextromethorphan, Guaifenesin, Pseudoephedrine interactionAcetaminophen, Dextromethorphan, Phenylpropanolamine, PyrilamineTheracaps
How Acetaminophen, Dextromethorphan, Phenylpropanolamine, Pyrilamine interacts with Pan-Ox-5 — through 1 ingredient. Tap an ingredient for the detail:
Beet Root PowderCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, beet might increase the levels of CYP3A4 substrates.
Read the full Beet Root Powder + Acetaminophen, Dextromethorphan, Phenylpropanolamine, Pyrilamine interactionAcetaminophen, Dextromethorphan, PseudoephedrineAlka-Seltzer PLUS Flu Liquid Gels, Non Aspirin Cold Caps, Tylenol Cold, Tylenol Flu Daytime Ex Strength, Tylenol Flu Ex Strength
How Acetaminophen, Dextromethorphan, Pseudoephedrine interacts with Pan-Ox-5 — through 1 ingredient. Tap an ingredient for the detail:
Beet Root PowderCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, beet might decrease the levels and clinical effects of CYP1A2 substrates.
Read the full Beet Root Powder + Acetaminophen, Dextromethorphan, Pseudoephedrine interactionAcetaminophen, HydrocodoneAnexsia, Anodynos DHC, Azdone, Co-Gesic, Doucet, Lorcet +9 more
How Acetaminophen, Hydrocodone interacts with Pan-Ox-5 — through 1 ingredient. Tap an ingredient for the detail:
Beet Root PowderCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, beet might decrease the levels and clinical effects of CYP1A2 substrates.
Read the full Beet Root Powder + Acetaminophen, Hydrocodone interactionAcetaminophen, Phenylephrine, ChlorpheniramineSuper Cold Tabs
How Acetaminophen, Phenylephrine, Chlorpheniramine interacts with Pan-Ox-5 — through 1 ingredient. Tap an ingredient for the detail:
Beet Root PowderCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, beet might increase the levels of CYP3A4 substrates.
Read the full Beet Root Powder + Acetaminophen, Phenylephrine, Chlorpheniramine interactionAdagrasibKrazati
How Adagrasib interacts with Pan-Ox-5 — through 1 ingredient. Tap an ingredient for the detail:
Beet Root PowderCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, beet might increase the levels of CYP3A4 substrates.
Read the full Beet Root Powder + Adagrasib interactionAlfentanilAlfenta
How Alfentanil interacts with Pan-Ox-5 — through 1 ingredient. Tap an ingredient for the detail:
Beet Root PowderCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, beet might increase the levels of CYP3A4 substrates.
Read the full Beet Root Powder + Alfentanil interactionAlfuzosinUroxatral
How Alfuzosin interacts with Pan-Ox-5 — through 1 ingredient. Tap an ingredient for the detail:
Beet Root PowderCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, beet might increase the levels of CYP3A4 substrates.
Read the full Beet Root Powder + Alfuzosin interactionAliskirenTekturna
How Aliskiren interacts with Pan-Ox-5 — through 1 ingredient. Tap an ingredient for the detail:
Beet Root PowderCytochrome P450 3a4 (cyp3a4) Substrates, Antihypertensive Drugs Moderate
Interaction Summary
Theoretically, beet might increase the levels of CYP3A4 substrates.
Read the full Beet Root Powder + Aliskiren interactionAlmotriptanAlmogran, Axert
How Almotriptan interacts with Pan-Ox-5 — through 1 ingredient. Tap an ingredient for the detail:
Beet Root PowderCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, beet might increase the levels of CYP3A4 substrates.
Read the full Beet Root Powder + Almotriptan interactionAlogliptinNesina
How Alogliptin interacts with Pan-Ox-5 — through 1 ingredient. Tap an ingredient for the detail:
Beet Root PowderCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, beet might increase the levels of CYP3A4 substrates.
Read the full Beet Root Powder + Alogliptin interactionAlogliptin, PioglitazoneOseni
How Alogliptin, Pioglitazone interacts with Pan-Ox-5 — through 1 ingredient. Tap an ingredient for the detail:
Beet Root PowderCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, beet might increase the levels of CYP3A4 substrates.
Read the full Beet Root Powder + Alogliptin, Pioglitazone interactionAlpelisibPiqray
How Alpelisib interacts with Pan-Ox-5 — through 1 ingredient. Tap an ingredient for the detail:
Beet Root PowderCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, beet might increase the levels of CYP3A4 substrates.
Read the full Beet Root Powder + Alpelisib interactionAlprazolamNiravam, Xanax
How Alprazolam interacts with Pan-Ox-5 — through 1 ingredient. Tap an ingredient for the detail:
Beet Root PowderCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, beet might increase the levels of CYP3A4 substrates.
Read the full Beet Root Powder + Alprazolam interactionAmbrisentanLetairis, Volibris
How Ambrisentan interacts with Pan-Ox-5 — through 1 ingredient. Tap an ingredient for the detail:
Beet Root PowderAntihypertensive Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Beet and beetroot contain nitrates, which can cause vasodilation, potentially leading to lower blood pressure.
Read the full Beet Root Powder + Ambrisentan interactionAmiodaroneCordarone, Pacerone
How Amiodarone interacts with Pan-Ox-5 — through 1 ingredient. Tap an ingredient for the detail:
Beet Root PowderCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, beet might increase the levels of CYP3A4 substrates.
Read the full Beet Root Powder + Amiodarone interactionAmitriptylineElavil
How Amitriptyline interacts with Pan-Ox-5 — through 1 ingredient. Tap an ingredient for the detail:
Beet Root PowderCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, beet might increase the levels of CYP3A4 substrates.
Read the full Beet Root Powder + Amitriptyline interactionAmitriptyline, ChlordiazepoxideLimbitrol DS
How Amitriptyline, Chlordiazepoxide interacts with Pan-Ox-5 — through 1 ingredient. Tap an ingredient for the detail:
Beet Root PowderCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, beet might decrease the levels and clinical effects of CYP1A2 substrates.
Read the full Beet Root Powder + Amitriptyline, Chlordiazepoxide interactionAmitriptyline, PerphenazineEtrafon, Etrafon-A, Etrafon-Forte, Triavil
How Amitriptyline, Perphenazine interacts with Pan-Ox-5 — through 1 ingredient. Tap an ingredient for the detail:
Beet Root PowderCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, beet might decrease the levels and clinical effects of CYP1A2 substrates.
Read the full Beet Root Powder + Amitriptyline, Perphenazine interactionAmlodipineNorliqva
How Amlodipine interacts with Pan-Ox-5 — through 1 ingredient. Tap an ingredient for the detail:
Beet Root PowderAntihypertensive Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Beet and beetroot contain nitrates, which can cause vasodilation, potentially leading to lower blood pressure.
Read the full Beet Root Powder + Amlodipine interactionAmlodipine BenzoateKaterzia
How Amlodipine Benzoate interacts with Pan-Ox-5 — through 1 ingredient. Tap an ingredient for the detail:
Beet Root PowderAntihypertensive Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Beet and beetroot contain nitrates, which can cause vasodilation, potentially leading to lower blood pressure.
Read the full Beet Root Powder + Amlodipine Benzoate interactionAmlodipine BesilateIstin
How Amlodipine Besilate interacts with Pan-Ox-5 — through 1 ingredient. Tap an ingredient for the detail:
Beet Root PowderCytochrome P450 3a4 (cyp3a4) Substrates, Antihypertensive Drugs Moderate
Interaction Summary
Theoretically, beet might increase the levels of CYP3A4 substrates.
Read the full Beet Root Powder + Amlodipine Besilate interactionAmlodipine BesylateNorvasc
How Amlodipine Besylate interacts with Pan-Ox-5 — through 1 ingredient. Tap an ingredient for the detail:
Beet Root PowderAntihypertensive Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Beet and beetroot contain nitrates, which can cause vasodilation, potentially leading to lower blood pressure.
Read the full Beet Root Powder + Amlodipine Besylate interactionAmlodipine Besylate, BenazeprilLotrel
How Amlodipine Besylate, Benazepril interacts with Pan-Ox-5 — through 1 ingredient. Tap an ingredient for the detail:
Beet Root PowderCytochrome P450 3a4 (cyp3a4) Substrates, Antihypertensive Drugs Moderate
Interaction Summary
Theoretically, beet might increase the levels of CYP3A4 substrates.
Read the full Beet Root Powder + Amlodipine Besylate, Benazepril interactionAmlodipine, CelecoxibConsensi
How Amlodipine, Celecoxib interacts with Pan-Ox-5 — through 1 ingredient. Tap an ingredient for the detail:
Beet Root PowderAntihypertensive Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Beet and beetroot contain nitrates, which can cause vasodilation, potentially leading to lower blood pressure.
Read the full Beet Root Powder + Amlodipine, Celecoxib interactionAmoxicillin, Omeprazole Magnesium, RifabutinTalicia
How Amoxicillin, Omeprazole Magnesium, Rifabutin interacts with Pan-Ox-5 — through 1 ingredient. Tap an ingredient for the detail:
Beet Root PowderCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, beet might increase the levels of CYP3A4 substrates.
Read the full Beet Root Powder + Amoxicillin, Omeprazole Magnesium, Rifabutin interactionAmphotericin, TetracyclineMysteclin-F
How Amphotericin, Tetracycline interacts with Pan-Ox-5 — through 1 ingredient. Tap an ingredient for the detail:
Citrus PectinTetracycline Antibiotics Moderate
Interaction Summary
Theoretically, pectin might reduce the absorption of tetracycline antibiotics, potentially decreasing their effectiveness.
Read the full Citrus Pectin + Amphotericin, Tetracycline interactionAmprenavirAgenerase
How Amprenavir interacts with Pan-Ox-5 — through 1 ingredient. Tap an ingredient for the detail:
Beet Root PowderCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, beet might increase the levels of CYP3A4 substrates.
Read the full Beet Root Powder + Amprenavir interactionApalutamideErleada
How Apalutamide interacts with Pan-Ox-5 — through 1 ingredient. Tap an ingredient for the detail:
Beet Root PowderCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, beet might increase the levels of CYP3A4 substrates.
Read the full Beet Root Powder + Apalutamide interactionEach ingredient & the kinds of drugs it affects
For each ingredient in Pan-Ox-5 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.
Beet root powder
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, beet might increase the levels of CYP3A4 substrates.
In vitro research suggests that betanin, the major pigment in beet, competitively inhibits CYP3A4 in a dose-dependent manner similarly to strong CYP3A4 inhibitor ketoconazole.
Antihypertensive Drugs
Beet and beetroot contain nitrates, which can cause vasodilation, potentially leading to lower blood pressure. However, a study published in the European Journal of Clinical Nutrition using concentrated beetroot juice found no significant impact on blood pressure or heart rate in different age groups. Other small clinical studies suggest that while beet consumption might transiently lower blood pressure due to vessel dilation, there's no consistent evidence of a lasting effect. Overall, the theoretical risk of reduced blood pressure due to beet's nitrate content exists, but studies generally indicate a low and temporary impact rather than a sustained decrease.
Cytochrome P450 1A2 (Cyp1A2) Substrates
Theoretically, beet might decrease the levels and clinical effects of CYP1A2 substrates.
In vitro research suggests that beet induces CYP1A2 enzymes.
Citrus Pectin
Digoxin (Lanoxin)
Theoretically, pectin might reduce the absorption of digoxin, potentially decreasing its effectiveness.
A small clinical study shows that taking digoxin with a kaolin-pectin suspension reduces the absorption of digoxin by about 62%. It is unclear if these effects are due to pectin, kaolin, or the combination.
Lovastatin (Mevacor)
Theoretically, pectin might reduce the absorption of lovastatin, potentially decreasing its effectiveness.
Case reports suggest that concomitant use of pectin and lovastatin might reduce the cholesterol-lowering effect of lovastatin, possibly due to reduced intestinal absorption of lovastatin.
Tetracycline Antibiotics
Theoretically, pectin might reduce the absorption of tetracycline antibiotics, potentially decreasing their effectiveness.
A small clinical study shows that taking tetracycline with bismuth subsalicylate in a kaolin-pectin suspension reduces the absorption of tetracycline by about 34%. It is unclear if these effects are due to pectin, kaolin, bismuth subsalicylate, or the combination.
Papain
Warfarin (Coumadin)
Theoretically, papain might increase the effects and side effects of warfarin.
In one case report, a patient previously stable on warfarin was found to have an international normalization ratio (INR) of 7.4, which was attributed to ingestion of a supplement containing papain from papaya extract.
Brand information
Manufacturer and brand details for Pan-Ox-5, from the product label.
Douglas Laboratories
See all Douglas Laboratories products- Name
- Douglas Laboratories
- City
- Pittsburgh
- State
- PA
- ZipCode
- 15205
- Web Address
- www.douglaslabs.com
Pan-Ox-5 by Douglas Laboratories: Common Questions
Does Pan-Ox-5 by Douglas Laboratories interact with any medications?
How can one product interact with so many drugs?
Where does this information come from?
Does Pan-Ox-5 actually help with digestion?
Can I take Pan-Ox-5 if I'm pregnant?
Can I take Pan-Ox-5 while breastfeeding?
What are the most common side effects?
Can I take this if I have a papaya allergy?
Why is the medication count so high?
Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
Not sure if Pan-Ox-5 is safe with your meds?
Our pharmacists answer your medication & supplement questions — free.
Label information is sourced from the NIH Dietary Supplement Label Database and reflects the product version on file; always read your actual product label. This page is for education only and is not a substitute for professional medical advice. Confirm with your pharmacist or doctor before combining supplements and medications.
The Full Monographs Behind Pan-Ox-5’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Papain
Interacts with 2 drugsPapain is a protein-digesting enzyme from the papaya plant that is used in digestive supplements and some topical products. While it has clear food and laboratory uses, strong human evidence...
Read the full Papain monograph → Herb & supplement monographLipase
Lipase is a digestive enzyme that helps your body break down dietary fats. It is well established as part of prescription pancreatic enzyme therapy for people who cannot make enough of their...
Read the full Lipase monograph → Herb & supplement monographBeet
Interacts with 861 drugsBeet, especially beetroot juice, is a nitrate-rich food that may modestly lower blood pressure and slightly improve exercise performance in some people. It is generally safe as a food, but s...
Read the full Beet monograph → Herb & supplement monographPectin
Interacts with 23 drugsPectin is a natural soluble fiber found in fruits like apples and citrus, and it is widely used in foods and as a fiber supplement. It may modestly help with cholesterol, blood sugar, and di...
Read the full Pectin monograph → Herb & supplement monographProteolytic Enzymes (proteases)
Proteolytic enzymes are proteins that help break down other proteins, and common examples include bromelain (from pineapple), papain (from papaya), trypsin, chymotrypsin, and pancreatin. Peo...
Read the full Proteolytic Enzymes (proteases) monograph →Sources & How We Checked
Pan-Ox-5'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 40 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.
Papain 11 references
- The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999.
- Shaw D, Leon C, Kolev S, Murray V. Traditional remedies and food supplements: a 5-year toxicological study (1991-1995). Drug Saf 1997;17:342-56.
- Shuttleworth D, Hill S, Marks R, Connelly DM. Relief of experimentally induced pruritus with a novel eutectic mixture of local anaesthetic agents. Br J Dermatol 1988;119:535-40.
- Mansfield LE, Ting S, Haverly RW, Yoo TJ. The incidence and clinical implications of hypersensitivity to papain in an allergic population, confirmed by blinded oral challenge. Ann Allergy 1985;55:541-3.
- Martin, T., Uhder, K., Kurek, R., Roeddiger, S., Schneider, L., Vogt, H. G., Heyd, R., and Zamboglou, N. Does prophylactic treatment with proteolytic enzymes reduce acute toxicity of adjuvant pelvic irradiation? Results of a double-blind randomized trial PubMed
- Walker-Renard, P. Update on the medicinal management of phytobezoars. Am J Gastroenterol. 1993;88(10):1663-1666.
- Tymoszuk D, Wiszniewska M, Walusiak-Skorupa J. Papain-induced occupational rhinoconjunctivitis and asthma - A case report. Med Pr 2016;67(1):109-12. PubMed
- Soto-Mera MT, López-Rico MR, Filgueira JF, et al. Occupational allergy to papain. Allergy 2000;55(10):983-4. PubMed
- Tarlo SM, Shaikh W, Bell B, et al. Papain-induced allergic reactions. Clin Allergy 1978;8(3):207-15. PubMed
- Baur X, König G, Bencze K, Fruhmann G. Clinical symptoms and results of skin test, RAST and bronchial provocation test in thirty-three papain workers: Evidence for strong immunogenic potency and clinically relevant proteolytic e?ects of airborne papain. C
- Novey HS, Keenan WJ, Fairshter RD, Wells ID, Wilson AF, Culver BD. Pulmonary disease in workers exposed to papain: clinico-physiological and immunological studies. Clin Allergy 1980;10(6):721-31. PubMed
Lipase 1 reference
- Casper C, Hascoet JM, Ertl T, et al. Recombinant bile salt-stimulated lipase in preterm infant feeding: A randomized phase 3 study. PLoS One. 2016;11(5):e0156071. PubMed
Beet 14 references
- Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.
- Clifford T, Berntzen B, Davison GW, et al. Effects of beetroot juice on recovery of muscle function and performance between bouts of repeated sprint exercise. Nutrients 2016;8. pii: E506. PubMed
- Siervo M, Lara J, Ogbonmwan I, Mathers JC. Inorganic nitrate and beetroot juice supplementation reduces blood pressure in adults: a systematic review and meta-analysis. J Nutr 2013;143:818-26. PubMed
- Clifford T, Howatson G, West DJ, Stevenson EJ. Beetroot juice is more beneficial than sodium nitrate for attenuating muscle pain after strenuous eccentric-bias exercise. Appl Physiol Nutr Metab. 2017;42(11):1185-1191. PubMed
- Clifford T, Bell O, West DJ, Howatson G, Stevenson EJ. The effects of beetroot juice supplementation on indices of muscle damage following eccentric exercise. Eur J Appl Physiol. 2016;116(2):353-62. PubMed
- Wylie LJ, Kelly J, Bailey SJ, et al. Beetroot juice and exercise: pharmacodynamic and dose-response relationships. J Appl Physiol (1985). 2013;115(3):325-36. PubMed
- Garnacho-Castaño MV, Palau-Salvà G, Cuenca E, et al. Effects of a single dose of beetroot juice on cycling time trial performance at ventilatory thresholds intensity in male triathletes. J Int Soc Sports Nutr. 2018;15(1):49. PubMed
- Rasica L, Porcelli S, Marzorati M, et al. Ergogenic effects of beetroot juice supplementation during severe-intensity exercise in obese adolescents. Am J Physiol Regul Integr Comp Physiol. 2018;315(3):R453-R460. PubMed
- Henrohn D, Björkstrand K, Lundberg JO, et al. Effects of oral supplementation with nitrate-rich beetroot juice in patients with pulmonary arterial hypertension-results from BEET-PAH, an exploratory randomized, double-blind, placebo-controlled, crosso
- Serra-Payá N, Garnacho-Castaño MV, Sánchez-Nuño S, et al. The relationship between resistance exercise performance and ventilatory efficiency after beetroot juice intake in well-trained athletes. Nutrients 2021;13(4):1094. PubMed
- Haron MH, Dale O, Martin K, et al. Evaluation of the Herb-Drug Interaction Potential of Commonly Used Botanicals on the US Market with Regard to PXR- and AhR-Mediated Influences on CYP3A4 and CYP1A2. J Diet Suppl 2022. PubMed
- Hemmatinafar M, Zaremoayedi L, Koushkie Jahromi M, et al. Effect of Beetroot Juice Supplementation on Muscle Soreness and Performance Recovery after Exercise-Induced Muscle Damage in Female Volleyball Players. Nutrients 2023;15(17):3763. PubMed
- Lim SH, Bae S, Lee HS, Han HK, Choi CI. Effect of Betanin, the Major Pigment of Red Beetroot (Beta vulgaris L.), on the Activity of Recombinant Human Cytochrome P450 Enzymes. Pharmaceuticals (Basel) 2023;16(9):1224. PubMed
- Oscherwitz M, Tamayo RM, Heudebert A, Centor R. A Case of Pseudo-Hematochezia from Beet Supplement Ingestion. Am J Med 2023;136(9):e177-e178. PubMed
Pectin 11 references
- Jaakkola MS, et al. Asthma caused by occupational exposure to pectin. J Allergy Clin Immunol 1997;100:575-6. PubMed
- Westphal W, et al. [Exogenous allergic asthma following pectin exposure-a new occupational allergen]. Pneumologie 1990;44(Suppl 1):337-8.
- Baldwin JL, et al. Pectin-induced occupational asthma. Chest 1993;104:1936-7. PubMed
- Cohen AJ, Forse MS, Tarlo SM. Occupational asthma caused by pectin inhalation during the manufacture of jam. Chest 1993;103:309-11.
- Kraut A, et al. Christmas candy maker's asthma. IgG4-mediated pectin allergy. Chest 1992;102:1605-7. PubMed
- Richter WO, Jacob BG, Schwandt P. Interaction between fibre and lovastatin. Lancet 1991;338:706.
- Albert KS, Ayres JW, DiSanto AR, et al. Influence of kaolin-pectin suspension on digoxin bioavailability. J Pharm Sci 1978;67:1582-6. PubMed
- Albert KS, Welch RD, DeSante KA, et al. Decreased tetracycline bioavailability caused by a bismuth subsalicylate antidiarrheal mixture. J Pharm Sci 1979;68:586-8. PubMed
- Electronic Code of Federal Regulations. Title 21. Part 182 -- Substances Generally Recognized As Safe. Available at: https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?CFRPart=182
- Federal Register April 17,2003. Anti-Diarrheal Products for over-the-counter human use; final monograph. Available at: http://www.fda.gov/OHRMS/DOCKETS/98fr/03-9380.pdf (Accessed 27 December 2004).
- Washio K, Nakamura M, Sato N, et al. Anaphylaxis in a pectin- and cashew nut-allergic child caused by a citrus bath. Allergol Int 2022;71(1):155-157. PubMed
Proteolytic Enzymes (proteases) 3 references
- Weeks JA, Harper RA, Simon RA, Burdick JD. Assessment of sensitization risk of a laundry pre-spotter containing protease. Cutan Ocul Toxicol. 2011;30(4):272-9. PubMed
- Marquès LI, Lara S, Abós T, Bartolomé B. Occupational rhinitis due to pepsin. J Investig Allergol Clin Immunol. 2006;16(2):136-7. DOI
- Cartier A, Malo JL, Pineau L, Dolovich J. Occupational asthma due to pepsin. J Allergy Clin Immunol. 1984;73(5 Pt 1):574-7. PubMed
See these in context on the Proteolytic Enzymes (proteases) monograph →
Parts of this content are provided by the Therapeutic Research Center, LLC.
DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.
© 2021 Therapeutic Research Center, LLC