ParaMax Part 2 Ingredients & Drug Interactions
What is this page for?
First and foremost: checking ParaMax Part 2 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
ParaMax Part 2 is a dietary supplement by Advanced Naturals with 5 active ingredients. Its ingredients are commonly taken for cough and sore throat, dry mouth and throat irritation, digestive upset and heartburn.Based on those ingredients, 2,156 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are Marshmallow, Clove, Orange. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against ParaMax Part 2 by Advanced Naturals
Ask about any prescription or over-the-counter medication and we check it for interactions with ParaMax Part 2 by Advanced Naturals — and tell you which ingredient is responsible.
AI summaries are generated from our interaction database for education only — always confirm with your pharmacist. How we use AI
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HelloPharmacist Scorecard of ParaMax Part 2 by Advanced Naturals
Four independent checks of what is known — a summary of the available information, not a grade of the product itself.
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
The stated purpose hasn't been mapped to our evidence data yet.
Why this rating?
- We haven't mapped this product's purpose to our evidence data yet — it'll be graded on the next content refresh.
Every active ingredient lists its own amount on the label.
Why this rating?
- The label discloses an exact amount for 5 of its 5 active ingredients.
- No proprietary blends here — you can verify the dose of every single component.
At least one ingredient has a documented Major-severity interaction. Check your medications for a personalized result.
Why this rating?
- 4 of the 5 matched ingredients can interact with medications — Clove, Wormwood, Marshmallow, Sweet Orange.
- The most serious interaction on file is rated Major.
- Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs; seizure medications; diabetes medications; lithium.
- For scale: 2,157 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.
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 5 matched ingredients.
- Pregnancy & breastfeeding safety ratings cover 5 of 5.
- General safety write-ups exist for 5 of 5.
- Remember: this measures how much safety information exists. Thin data is not the same as being safe.
HelloPharmacist summaryFully disclosed formula with no assessable stated purpose. Major medication interactions have been identified, and safety information is well characterized.
Assessment coverage: 5 of 5 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Apr 25, 2018.
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 ParaMax Part 2, straight from the product label.
| Brand | Advanced Naturals |
|---|---|
| Barcode (UPC) | 631257422217 |
| Net contents | 1 fl. oz. Tincture; 30 mL |
| Market status | Off market |
| Date entered into DSLD | Apr 25, 2018 |
| DSLD ID | 176154 |
| Product type | Botanical |
| Supplement form | Liquid |
| Dietary claims / uses | All Other, Structure/Function |
| Intended target group(s) | Adult (18 - 50 Years), Gluten Free, Dairy 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 ParaMax Part 2 by Advanced Naturals, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Marshmallow | 50 mg | -- |
| Clove | 50 mg | -- |
| Orange | 50 mg | -- |
| Black Walnut | 125 mg | -- |
| Wormwood | 50 mg | -- |
Other ingredients: filtered Water, Ethyl Alcohol
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
Directions: For the first 3 days, take one (1) capsule and seven (7) drops 3 times daily. After 3 days, take two (2) capsules and one (1) dropper full 3 times daily. Drops may be added to 2 oz. of filtered water.
While taking ParaMax, Super Critical Omega and Organic Triple FiberMax are highly recommended to help maximize your cleansing experience.
General Statements
Ratio of herbs to solvent (grams herb/ml solvent): Black Walnut 1:2 Other Herbs 1:5
Quality, purity and potency guaranteed through expiration.
Manufactured in USA in a GMP facility.
Natural digestive care
Natural ingredients used traditionally to support a healthy balance of intestinal flora
15-day program Advanced internal cleansing formula
Includes two powerful herbal formulas with natural ingredients used traditionally to help balance intestinal flora. Designed to be taken in harmony with your normal daily activity. No fasting necessary.
Formulation
Gluten free Dairy free
Precautions
Notice of usage: This program is not to be used more than three (3) times per year.
Keep out of reach of children.
Do not use this product if you are pregnant or nursing. Consult your healthcare professional before using this or any product if you are trying to conceive, have frequent diarrhea, are taking medication or have a medical condition.
Not for prolonged use. Do not exceed recommended amount. Notice: Discontinue use if adverse effects occur.
Tamper evident: Do not use if either the outer neck band or the inner seal on bottles is broken or missing.
Storage
Store at 86(0)F (30(0)C) or below.
General
#16412 031216
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.
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.
FDA Statement of Identity
Dietary Supplement
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
ParaMax Part 2 by Advanced Naturals 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 ParaMax Part 2 by Advanced Naturals
These are the 5 active ingredients this product is made of. Select any to open its full monograph.
Serving size1 Dropperful(s) Dosage formLiquid Servings per container45 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.
Marshmallow
Interacts with2,040 drugs
Marshmallow root is a traditional herb rich in soothing, gel-like fibers called mucilage, which is why it has long been used for coughs, sore throats,...
Marshmallow monograph & interactionsClove
Interacts with977 drugs
Clove is a common cooking spice that is also used in traditional medicine, especially as a topical numbing agent for tooth pain thanks to its main com...
Clove monograph & interactionsOrange
Interacts with246 drugs
Sweet orange is a common citrus fruit that is a good source of vitamin C, fiber, and antioxidants, and is enjoyed as a food worldwide. Its peel and es...
Orange monograph & interactionsBlack Walnut
No knowninteractions
Black walnut is a tree whose green hulls are traditionally used as a natural antiparasitic and digestive remedy, but solid human evidence for these us...
Black Walnut monograph & interactionsWormwood
Interacts with50 drugs
Wormwood is a very bitter herb traditionally used to stimulate appetite and ease digestion, and it has early research interest in Crohn's disease. It...
Wormwood monograph & interactionsOther (inactive) ingredients: Filtered Water, Ethyl Alcohol. These complete the product’s ingredient list but are not active constituents.
ParaMax Part 2 by Advanced Naturals Drug Interactions
ParaMax Part 2 contains 5 ingredients, and 4 of them have known drug interactions. Altogether they interact with 2,156 medications. Here’s the picture, then you can look up your own drug.
Want to check YOUR meds against ParaMax Part 2?
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 ParaMax Part 2 interact with 2,156 drugs. Click any drug to see the details.
4 of the 5 ingredients in ParaMax Part 2 interact with drugs. Each result below shows which ingredient is responsible. Marshmallow Clove Orange Wormwood
"phentolamineOraVerse, Rogitine, Ryzumvi
How "phentolamine interacts with ParaMax Part 2 — through 1 ingredient. Tap an ingredient for the detail:
MarshmallowOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow + "phentolamine interaction6-mercaptopurinePurinethol
How 6-mercaptopurine interacts with ParaMax Part 2 — through 1 ingredient. Tap an ingredient for the detail:
MarshmallowOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow + 6-mercaptopurine interactionAbacavirZiagen
How Abacavir interacts with ParaMax Part 2 — through 1 ingredient. Tap an ingredient for the detail:
MarshmallowOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow + Abacavir interactionAbacavir Sulfate, Dolutegravir, LamivudineTriumeq
How Abacavir Sulfate, Dolutegravir, Lamivudine interacts with ParaMax Part 2 — through 1 ingredient. Tap an ingredient for the detail:
MarshmallowOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow + Abacavir Sulfate, Dolutegravir, Lamivudine interactionAbacavir, LamivudineEpzicom
How Abacavir, Lamivudine interacts with ParaMax Part 2 — through 1 ingredient. Tap an ingredient for the detail:
MarshmallowOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow + Abacavir, Lamivudine interactionAbciximabReoPro
How Abciximab interacts with ParaMax Part 2 — through 2 ingredients. Tap an ingredient for the detail:
MarshmallowOral Drugs, Anticoagulant/antiplatelet Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow + Abciximab interactionCloveAnticoagulant/antiplatelet Drugs Minor
Interaction Summary
Theoretically, clove oil may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Clove + Abciximab interactionAcamprosateCampral
How Acamprosate interacts with ParaMax Part 2 — through 1 ingredient. Tap an ingredient for the detail:
MarshmallowOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow + Acamprosate interactionAcebutololRhotral, Sectral
How Acebutolol interacts with ParaMax Part 2 — through 1 ingredient. Tap an ingredient for the detail:
MarshmallowOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow + Acebutolol interactionAcenocoumarolSintrom
How Acenocoumarol interacts with ParaMax Part 2 — through 2 ingredients. Tap an ingredient for the detail:
CloveAnticoagulant/antiplatelet Drugs Minor
Interaction Summary
Theoretically, clove oil may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Clove + Acenocoumarol interactionMarshmallowOral Drugs, Anticoagulant/antiplatelet Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow + Acenocoumarol interactionAcepromazineAtravet
How Acepromazine interacts with ParaMax Part 2 — through 1 ingredient. Tap an ingredient for the detail:
MarshmallowOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow + Acepromazine interactionAcetohydroxamic AcidLithostat
How Acetohydroxamic Acid interacts with ParaMax Part 2 — through 1 ingredient. Tap an ingredient for the detail:
MarshmallowOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow + Acetohydroxamic Acid interactionAcetophenazineTindal
How Acetophenazine interacts with ParaMax Part 2 — through 1 ingredient. Tap an ingredient for the detail:
MarshmallowOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow + Acetophenazine interactionAcetylcholineMiochol-E
How Acetylcholine interacts with ParaMax Part 2 — through 1 ingredient. Tap an ingredient for the detail:
MarshmallowOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow + Acetylcholine interactionAcetylcysteine (prescription Drug)Cetylev, Legubeti
How Acetylcysteine (prescription Drug) interacts with ParaMax Part 2 — through 1 ingredient. Tap an ingredient for the detail:
MarshmallowOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow + Acetylcysteine (prescription Drug) interactionAcetylsalicylic AcidEntrophen
How Acetylsalicylic Acid interacts with ParaMax Part 2 — through 2 ingredients. Tap an ingredient for the detail:
MarshmallowAnticoagulant/antiplatelet Drugs, Oral Drugs Minor
Interaction Summary
Theoretically, marshmallow flower might have antiplatelet effects.
Read the full Marshmallow + Acetylsalicylic Acid interactionCloveAnticoagulant/antiplatelet Drugs Minor
Interaction Summary
Theoretically, clove oil may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Clove + Acetylsalicylic Acid interactionAcitretinSoriatane
How Acitretin interacts with ParaMax Part 2 — through 1 ingredient. Tap an ingredient for the detail:
MarshmallowOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow + Acitretin interactionAcrivastine, PseudoephedrineSemprex D
How Acrivastine, Pseudoephedrine interacts with ParaMax Part 2 — through 1 ingredient. Tap an ingredient for the detail:
MarshmallowOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow + Acrivastine, Pseudoephedrine interactionAcyclovirAvaclyr, Sitavig, Zovirax, Zovirax Injection
How Acyclovir interacts with ParaMax Part 2 — through 1 ingredient. Tap an ingredient for the detail:
MarshmallowOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow + Acyclovir interactionAdalimumab-bwwdHadlima
How Adalimumab-bwwd interacts with ParaMax Part 2 — through 1 ingredient. Tap an ingredient for the detail:
MarshmallowOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow + Adalimumab-bwwd interactionAdefovirHepsera
How Adefovir interacts with ParaMax Part 2 — through 1 ingredient. Tap an ingredient for the detail:
MarshmallowOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow + Adefovir interactionAdenosineATP Tablets
How Adenosine interacts with ParaMax Part 2 — through 1 ingredient. Tap an ingredient for the detail:
MarshmallowOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow + Adenosine interactionAlbendazoleAlbenza
How Albendazole interacts with ParaMax Part 2 — through 1 ingredient. Tap an ingredient for the detail:
MarshmallowOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow + Albendazole interactionAlbuterolProAir HFA, Proventil, Ventolin (U.S.), Volmax
How Albuterol interacts with ParaMax Part 2 — through 1 ingredient. Tap an ingredient for the detail:
MarshmallowOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow + Albuterol interactionAlcuroniumAlcuronium
How Alcuronium interacts with ParaMax Part 2 — through 1 ingredient. Tap an ingredient for the detail:
MarshmallowOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow + Alcuronium interactionAlectinib HydrochlorideAlecensa
How Alectinib Hydrochloride interacts with ParaMax Part 2 — through 1 ingredient. Tap an ingredient for the detail:
MarshmallowOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow + Alectinib Hydrochloride interactionAlemtuzumabCampath
How Alemtuzumab interacts with ParaMax Part 2 — through 1 ingredient. Tap an ingredient for the detail:
MarshmallowOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow + Alemtuzumab interactionAlendronateBinosto, Fosamax
How Alendronate interacts with ParaMax Part 2 — through 1 ingredient. Tap an ingredient for the detail:
MarshmallowOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow + Alendronate interactionAlendronate Sodium
How Alendronate Sodium interacts with ParaMax Part 2 — through 1 ingredient. Tap an ingredient for the detail:
MarshmallowOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow + Alendronate Sodium interactionAlendronate Sodium, CholecalciferolFosamax Plus D
How Alendronate Sodium, Cholecalciferol interacts with ParaMax Part 2 — through 1 ingredient. Tap an ingredient for the detail:
MarshmallowOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow + Alendronate Sodium, Cholecalciferol interactionAlginic Acid, Aluminum HydroxideRafton
How Alginic Acid, Aluminum Hydroxide interacts with ParaMax Part 2 — through 1 ingredient. Tap an ingredient for the detail:
MarshmallowOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow + Alginic Acid, Aluminum Hydroxide interactionEach ingredient & the kinds of drugs it affects
For each ingredient in ParaMax Part 2 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.
Marshmallow
Lithium
Theoretically, due to potential diuretic effects, marshmallow might reduce excretion and increase levels of lithium.
Marshmallow is thought to have diuretic properties. To avoid lithium toxicity, the dose of lithium might need to be decreased when used with marshmallow.
Anticoagulant/Antiplatelet Drugs
Theoretically, marshmallow flower might have antiplatelet effects.
Animal research suggests that marshmallow flower extract has antiplatelet effects. However, the root and leaf of marshmallow, not the flower, are the plant parts most commonly found in dietary supplements. Theoretically, use of marshmallow flower with anticoagulant/antiplatelet drugs can have additive effects, and might increase the risk for bleeding in some patients.
Oral Drugs
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Marshmallow contains mucilage which can affect oral drug absorption. To avoid changes in absorption, take marshmallow 30-60 minutes after oral medications.
Clove
Antidiabetes Drugs
Theoretically, concomitant use of clove extracts with antidiabetes drugs might increase the risk of hypoglycemia.
Clinical and laboratory research suggest that polyphenol extracts from clove flower buds might lower blood glucose levels. Dosing adjustments for insulin or oral hypoglycemic agents may be necessary when taken with clove. Monitor blood glucose levels closely.
Cytochrome P450 1A2 (Cyp1A2) Substrates
Theoretically, concomitant use of clove may increase levels of drugs metabolized by CYP1A2.
In vitro research shows that eugenol, the principal constituent of clove, can inhibit CYP1A2 in a dose-dependent manner,. This effect has not been reported in humans.
Cytochrome P450 2C9 (Cyp2C9) Substrates
Theoretically, concomitant use of clove may increase levels of drugs metabolized by CYP2C9.
In vitro research shows that eugenol, the principal constituent of clove, inhibits CYP2C9 in a dose-dependent manner. This effect has not been reported in humans.
Cytochrome P450 2D6 (Cyp2D6) Substrates
Theoretically, concomitant use of clove may increase levels of drugs metabolized by CYP2D6.
In vitro research shows that eugenol, the principal constituent of clove, can inhibit CYP2D6 in a dose-dependent manner. This effect has not been reported in humans.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, concomitant use of clove may increase levels of drugs metabolized by CYP3A4.
In vitro research shows that eugenol, the principal constituent of clove, can inhibit CYP3A4 in a dose-dependent manner. This effect has not been reported in humans.
Anticoagulant/Antiplatelet Drugs
Theoretically, clove oil may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Laboratory research suggests that eugenol, a constituent of clove, has antiplatelet activity. This interaction has not been reported in humans.
Ibuprofen (Advil, Others)
Theoretically, topical application of clove oil with ibuprofen might increase the absorption and side effects of topical ibuprofen.
Laboratory research shows that topical application of clove oil increases the absorption of topical ibuprofen. This interaction has not been reported in humans.
Orange
Celiprolol (Celicard)
Consuming sweet orange with celiprolol can decrease oral absorption of celiprolol.
A pharmacokinetic study in healthy volunteers shows that celiprolol levels, after a single dose of 100 mg, are decreased by up to 90% in people who drink sweet orange juice 200 mL three times daily. It's not known if lower consumption of sweet orange juice will have the same effect. Theoretically, this occurs due to short-term inhibition of organic anion transporting polypeptide (OATP). Recommend separating drug administration and consumption of sweet orange by at least 4 hours.
Ivermectin (Stromectol, Others)
Consuming sweet orange juice with ivermectin can decrease the oral absorption of ivermectin.
A pharmacokinetic study in healthy volunteers shows that taking ivermectin orally with sweet orange juice 750 mL over 4 hours reduces the bioavailability of ivermectin. This effect does not seem to be related to effects on P-glycoprotein. The effect on ivermectin is more pronounced in males compared to females.
Organic Anion-Transporting Polypeptide Substrates (Oatp)
Consuming sweet orange juice can decrease oral absorption of OATP substrates. Separate administration by at least 4 hours.
Clinical research shows that consuming sweet orange juice inhibits OATP, which reduces bioavailability of oral drugs that are substrates of OATP. For example, sweet orange juice decreases bioavailability of fexofenadine, a substrate of OATP, by about 72% and of celiprolol, another OATP substrate, by up to 90%. Since sweet orange juice seems to affect OATP for a short time, recommend separating drug administration and consumption of sweet orange juice by at least 4 hours.
Pravastatin (Pravachol)
Consuming sweet orange juice with pravastatin can increase the absorption of pravastatin.
A small pharmacokinetic study in healthy volunteers shows that consuming sweet orange juice 800 mL over 3 hours, including before, during, and after taking pravastatin 10 mg, increases pravastatin levels by about 149%, without affecting pravastatin elimination. Theoretically this effect might be due to modulation of organic anion transporting polypeptides (OATPs) by sweet orange juice. Sweet orange juice does not seem to affect simvastatin levels, but it is not known if sweet orange affects any of the other statins.
Fexofenadine (Allegra)
Consuming sweet orange juice with fexofenadine can decrease oral absorption of fexofenadine.
Clinical research shows that coadministration of sweet orange juice 1200 mL decreases bioavailability of fexofenadine by about 72%. In an animal model, sweet orange juice decreased bioavailability of fexofenadine by 31%. Fexofenadine manufacturer data indicates that concomitant administration of sweet orange juice and fexofenadine results in larger wheal and flare sizes in research models. This suggests that sweet orange reduces the clinical response to fexofenadine. Theoretically, this occurs due to short-term inhibition of organic anion transporting polypeptide (OATP). Recommend separating drug administration and consumption of sweet orange by at least 4 hours.
P-Glycoprotein Substrates
Sweet orange juice seems to modulate P-glycoprotein (P-gp), which might affect the blood levels of P-gp substrates.
Animal and in vitro research suggest that orange juice extract inhibits drug efflux by P-gp, increasing absorption and levels of P-gp substrates. In contrast, pharmacokinetic research in humans shows that drinking large amounts of sweet orange juice decreases absorption and levels of the P-gp substrate celiprolol. This suggests that orange juice actually induces drug efflux by P-gp or affects drug levels by another mechanism such as inhibiting the gut drug transporter called organic anion transporting polypeptide (OATP). Until more is known, sweet orange juice should be used cautiously in people taking P-gp substrates.
Quinolone Antibiotics
Calcium-fortified sweet orange juice might reduce quinolone absorption.
Calcium binds to quinolones in the gut. Theoretically, the calcium in certain fortified orange juices can also bind to quinolone antibiotics and reduce their absorption and levels.
Wormwood
Anticonvulsants
Theoretically, taking wormwood might interfere with the effects of anticonvulsant drugs.
Thujone, a constituent of wormwood, has convulsant effects.
Brand information
Manufacturer and brand details for ParaMax Part 2, from the product label.
Advanced Naturals
See all Advanced Naturals products- Name
- Advanced Naturals
- City
- Palm Harbor
- State
- FL
- ZipCode
- 34683
- Phone Number
- 1-800-690-9988
- Web Address
- www.advancednaturals.com
ParaMax Part 2 by Advanced Naturals: Common Questions
Does ParaMax Part 2 by Advanced Naturals interact with any medications?
How can one product interact with so many drugs?
Where does this information come from?
Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
Not sure if ParaMax Part 2 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 ParaMax Part 2’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Marshmallow
Interacts with 2,040 drugsMarshmallow root is a traditional herb rich in soothing, gel-like fibers called mucilage, which is why it has long been used for coughs, sore throats, and stomach irritation. Evidence for th...
Read the full Marshmallow monograph → Herb & supplement monographClove
Interacts with 977 drugsClove is a common cooking spice that is also used in traditional medicine, especially as a topical numbing agent for tooth pain thanks to its main compound, eugenol. Food amounts are general...
Read the full Clove monograph → Herb & supplement monographSweet Orange
Interacts with 246 drugsSweet orange is a common citrus fruit that is a good source of vitamin C, fiber, and antioxidants, and is enjoyed as a food worldwide. Its peel and essential oil are used in aromatherapy and...
Read the full Sweet Orange monograph → Herb & supplement monographBlack Walnut
Black walnut is a tree whose green hulls are traditionally used as a natural antiparasitic and digestive remedy, but solid human evidence for these uses is lacking. It contains a compound ca...
Read the full Black Walnut monograph → Herb & supplement monographWormwood
Interacts with 50 drugsWormwood is a very bitter herb traditionally used to stimulate appetite and ease digestion, and it has early research interest in Crohn's disease. It contains thujone, which can be toxic in...
Read the full Wormwood monograph →Sources & How We Checked
ParaMax Part 2'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 61 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.
Marshmallow 5 references
- Monographs on the medicinal uses of plant drugs. Exeter, UK: European Scientific Co-op Phytother, 1997.
- Leung AY, Foster S. Encyclopedia of Common Natural Ingredients Used in Food, Drugs and Cosmetics. 2nd ed. New York, NY: John Wiley & Sons, 1996.
- McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
- Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
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