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 13 active ingredients. Its ingredients are commonly taken for high blood pressure, exercise and athletic performance, heart and circulation support.Based on those ingredients, 903 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Beet root powder, Betaine HCl, Citrus Pectin. 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
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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
Low disclosure
Pan-Ox-5 contains 13 active ingredients: three digestive enzymes (protease, lipase, and pepsin) that help break down proteins and fats; pancreatin, a blend of enzymes; and plant and food-derived compounds — beet root powder, citrus pectin, betaine hydrochloride, papain, plus amylase, glutamic acid, diastase, ox bile powder, and vegetable rennet. The enzymes and bile are meant to support digestion.
The product also contains inactive ingredients like microcrystalline cellulose, rice bran, and silica as fillers and binders.
Does it work?
Moderate evidence
The evidence for most ingredients in this product is not established or is mixed. Beet root powder is possibly effective for athletic performance and exercise-induced muscle soreness.
Citrus pectin is possibly effective for high cholesterol. For the other ingredients — protease, pepsin, lipase, papain, betaine HCl, and the rest — the evidence is insufficient to rate their effectiveness for the conditions studied, or no effectiveness data is held in our system.
How safe is it?
Well-documented data
Protease and pepsin are generally well tolerated but may cause digestive upset or allergic reactions; rare occupational airborne exposures have triggered asthma or allergic rhinitis. Lipase is generally well tolerated in supplement form, though adverse effects in infants and pregnancy safety have not been thoroughly studied.
Beet root powder is well tolerated as a food and short-term supplement; the most common effect is red or black stools (harmless), though large amounts could theoretically cause low blood calcium or kidney damage. Betaine HCl may irritate the stomach and is not safe for people with ulcers, gastritis, or acid reflux.
Citrus pectin is generally well tolerated but can rarely cause diarrhea, gas, or mild cramps, and allergic reactions are rare but possible. Papain is well tolerated as a food or supplement at normal doses but can cause allergic reactions and, at high doses, rare severe stomach or esophageal problems.
Safety data in pregnancy and breastfeeding is limited or absent for most ingredients; avoid papain and betaine HCl in pregnancy, and discuss with your doctor or pharmacist before use during pregnancy or breastfeeding.
Meds to double-check
Moderate interaction found
Before taking Pan-Ox-5, double-check warfarin (blood thinner) — papain may raise its effect to unsafe levels. Also confirm any medications processed by the liver enzyme CYP3A4, lovastatin, tetracycline antibiotics, digoxin, H2-blockers, antacids, and proton pump inhibitors — citrus pectin and beet root powder may reduce how well they work.
No interactions are documented for the other checked ingredients.
The bottom line
Scorecard at a glanceFormula with limited ingredient disclosure 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 with protein and fat digestion. If you take warfarin, any CYP3A4-processed medication, lovastatin, tetracycline antibiotics, digoxin, acid-reduction drugs, or have ulcers or gastritis, talk to your pharmacist before starting.
Pregnant or breastfeeding women should discuss this product with their doctor or pharmacist first.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 8 of 13 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Apr 11, 2022.
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) | 310539978948 |
| Net contents | 180 Tablet(s) |
| Market status | On market |
| Date entered into DSLD | Apr 11, 2022 |
| DSLD ID | 261516 |
| Product type | Other Combinations |
| Supplement form | Tablet Or Pill |
| Dietary claims / uses | All Other, Structure/Function |
| Intended target group(s) | Adult (18 - 50 Years), Gluten Free |
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.
Supplement Facts
The label details for Pan-Ox-5 by Douglas Laboratories, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Amylase | 0 NP | -- |
| Protease | 0 NP | -- |
| Lipase | 0 NP | -- |
| Beet root powder | 100 mg | -- |
| Glutamic Acid | 10 mg | -- |
| Citrus Pectin | 12.5 mg | -- |
| Betaine HCl | 60 mg | -- |
| Lipase | 0 NP | -- |
| Pepsin | 0 NP | -- |
| Ox Bile powder | 65 mg | -- |
| Papain | 0 NP | -- |
| Pancreatin | 37.5 mg | -- |
| Diastase | 0 NP | -- |
| Vegetable Rennet | 15 mg | -- |
Other ingredients: Microcrystalline Cellulose, Rice Bran, Coating, Croscarmellose Sodium, Stearic Acid, Vegetable Stearate, 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.
Suggested/Recommended/Usage/Directions
Suggested Usage: As a dietary supplement, adults take 1 tablet with each meal daily or as directed by your health professional.
Precautions
Warning: If you are pregnant, nursing, have any health condition or taking any medication, consult your health professional before using this product.
Discontinue immediately if a burning sensation occurs. Not recommended for people with ulcers.
Keep out of the reach of children.
Use only if safety seal is intact.
Storage
Store in a cool, dry place.
Formulation
Gluten-free, non-GMO
Support for healthy digestion
FDA Disclaimer Statement
This statement has not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.
General Statements
Scan to learn about our manufacturing excellence Contents may not fill package in order to accommodate required labeling. Please rely on stated quantity.
FDA Statement of Identity
Dietary 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 13 active ingredients this product is made of. Select any to open its full monograph.
Serving size1 Tablet(s) Dosage formTablet Or Pill Servings per container180 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.
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 & interactionsGlutamic Acid
Citrus 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 & interactionsBetaine HCl
Interacts with36 drugs
Betaine hydrochloride is a supplement used to temporarily increase stomach acid in people who may have low acid levels. Evidence for its benefits is l...
Betaine HCl 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 & 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 powder
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 & interactionsDiastase
Vegetable Rennet
Other (inactive) ingredients: Microcrystalline Cellulose, Rice Bran, Coating, Croscarmellose Sodium, Stearic Acid, Vegetable Stearate, 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 that interact with medications.
The most serious concern is papain, which can increase the blood-thinning effects of warfarin (Coumadin) — a case report documented an unsafe rise in anticoagulation after a patient took a papain-containing supplement while stable on warfarin.
Read the full breakdown — every affected drug type, severity by severity
Beet root powder moderately interacts with drugs processed by the liver enzyme CYP3A4, theoretically raising their levels in a way similar to the antifungal ketoconazole. It also may cause minor reductions in blood pressure (though study results are mixed) and minor changes to how your body handles drugs processed by the liver enzyme CYP1A2.
Citrus pectin moderately reduces the absorption of three specific heart and cholesterol medications: lovastatin, tetracycline antibiotics, and digoxin — taking them together can decrease how well these drugs work. Betaine HCl increases stomach acid and may reduce the effectiveness of three acid-reduction drugs: H2-blockers, antacids, and proton pump inhibitors (PPIs).
We could not check amylase, glutamic acid, ox bile powder, diastase, or vegetable rennet — we hold no data on these ingredients. Protease, pepsin, and lipase have no known interactions documented in our data; however, the absence of documented interactions is not a guarantee none exist.
Altogether, these interactions span 892 individual medications. Use the medication checker below to look up your exact drugs before you start.
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 903 drugs. Click any drug to see the details.
4 of the 13 ingredients in Pan-Ox-5 interact with drugs. Each result below shows which ingredient is responsible. Beet root powder Betaine HCl 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 2 ingredients. 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 interactionBetaine HclProton Pump Inhibitors (ppis) Minor
Interaction Summary
Betaine hydrochloride increases stomach acidity and could decrease the effects of PPIs.
Read the full Betaine Hcl + 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.
Betaine HCl
Antacids
Betaine hydrochloride increases stomach acidity and could decrease the effects of antacids.
In human research, betaine hydrochloride increases stomach acidity. Antacids are taken to decrease stomach acidity. Theoretically, taking betaine hydrochloride along with antacids might decrease the effects of the antacids.
H2-Blockers
Betaine hydrochloride increases stomach acidity and could decrease the effects of H2-blockers.
In human research, betaine hydrochloride increases stomach acidity. H2-blockers are used to decrease stomach acidity. Theoretically, taking betaine hydrochloride along with H2-blockers might decrease the effects of H2-blockers.
Proton Pump Inhibitors (Ppis)
Betaine hydrochloride increases stomach acidity and could decrease the effects of PPIs.
In human research, betaine hydrochloride increases stomach acidity. PPIs are used to decrease stomach acidity. Theoretically, taking betaine hydrochloride along with PPIs might decrease the effects of PPIs
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
- Street Address
- 600 Boyce Road
- City
- Pittsburgh
- State
- PA
- ZipCode
- 15205
- Phone Number
- 1.800.245.4440
- 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?
Can I take Pan-Ox-5 if I'm pregnant or breastfeeding?
What are the digestive enzymes in this product supposed to do?
Will this product turn my stool red or dark?
Is beet root powder safe as a food versus a supplement?
Can I take this if I have acid reflux or stomach ulcers?
What should I know about papain in this product?
Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
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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.
Beet
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 monographBetaine Hydrochloride
Interacts with 36 drugsBetaine hydrochloride is a supplement used to temporarily increase stomach acid in people who may have low acid levels. Evidence for its benefits is limited and mostly based on tradition rat...
Read the full Betaine Hydrochloride 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 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 → Herb & supplement monographPapain
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 →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 42 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.
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 →
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
Betaine Hydrochloride 2 references
- Yago MR, Frymoyer A, Benet LZ, Smelick GS, Frassetto LA, Ding X, Dean B, Salphati L, Budha N, Jin JY, Dresser MJ, Ware JA. The use of betaine HCl to enhance dasatinib absorption in healthy volunteers with rabeprazole-induced hypochlorhydria. AAPS J. 2014 PubMed
- Yago MR, Frymoyer AR, Smelick GS, Frassetto LA, Budha NR, Dresser MJ, Ware JA, Benet LZ. Gastric reacidification with betaine HCl in healthy volunteers with rabeprazole-induced hypochlorhydria. Mol Pharm. 2013 Nov 4;10(11):4032-7. PubMed
See these in context on the Betaine Hydrochloride monograph →
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
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