Interactions on record — worth a quick check against your medications. Check your meds →
Dietary supplement

PBS Ingredients & Drug Interactions

by Nature's Sunshine

PBS label
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Capsule Category: Botanical
Most serious interaction: Moderate
Clinical methodology reviewed by · Updated Sep 16, 2026 · Label data from the NIH DSLD
What is this page for?

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

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

The interaction bottom line Most serious interaction: Moderate

PBS is a dietary supplement by Nature's Sunshine with 5 active ingredients. Its ingredients are commonly taken for fatigue and low energy, physical and athletic performance, stress resistance (adaptogen).Based on those ingredients, 1,370 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Goldenseal Root Extract, Eleuthero, Burdock. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

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Check Your Meds Against PBS by Nature's Sunshine

Ask about any prescription or over-the-counter medication and we check it for interactions with PBS by Nature's Sunshine — and tell you which ingredient is responsible.

Pharmacist-reviewed data Checks every ingredient Answer in seconds
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HelloPharmacist Scorecard of PBS by Nature's Sunshine

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

From our pharmacy team — supplement deep dive

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

What’s inside

Low disclosure
Ingredient Transparency · database check
Low

Most active ingredients don't disclose an individual amount — you can't tell how much of each you're getting.

Why this rating?
  • The label discloses an exact amount for 0 of its 5 active ingredients.
  • “Proprietary Blend” is a proprietary blend — the label gives one combined amount (853 mg) without saying how much of each component you get.

PBS contains five active ingredients. Eleuthero is an adaptogenic root traditionally used for stress and stamina.

Goldenseal root extract is valued for its berberine content and immune support role. Horseradish is a pungent root with potential respiratory and urinary tract benefits.

Burdock is a root used in traditional herbalism for skin and detoxification support. Nopal, also called prickly pear cactus, is used in diabetes management and general wellness.

The product also contains inactive ingredients—cellulose and the capsule itself—which are fillers and the delivery form.

Does it work?

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

The graded evidence we hold for these ingredients covers different conditions than the ones this product is marketed for, so there's no established rating for its stated use.

Why this rating?
  • The label markets this product for: digestive and glandular system support.
  • We looked for evidence on: Dyspepsia, Flatulence, Gastritis, Peptic ulcers, Colic, gastric health — and 3 related terms.
  • The closest evidence on file: Horseradish is rated "Insufficient Reliable Evidence To Rate" for Colic (Natural Medicines).
  • Also on file: Prickly Pear Cactus is rated "Insufficient Reliable Evidence To Rate" for Dyspepsia.
  • Also on file: Goldenseal is rated "Insufficient Reliable Evidence To Rate" for Flatulence, Peptic ulcers, Gastritis.

Evidence for this product's active ingredients is mixed. Eleuthero is rated possibly effective for genital herpes, but evidence is insufficient for familial Mediterranean fever, bipolar disorder, osteoporosis, and chronic fatigue syndrome.

Goldenseal is rated possibly ineffective for masking urine drug tests; evidence is insufficient for acne, hay fever, anorexia nervosa, and chronic fatigue syndrome. Horseradish, burdock, and nopal lack sufficient evidence for most of their claimed uses, with one exception: nopal is rated possibly effective for diabetes.

Overall, reliable evidence supporting this combination for any specific condition is limited or absent in the data we hold.

The evidence, ingredient by ingredient Eleuthero Goldenseal Horseradish Burdock Prickly Pear Cactus

How safe is it?

Well-documented data
Safety Information · database check
Well characterized

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

Why this rating?
  • We hold adverse-effect (side-effect) data for 5 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.

Eleuthero is generally well tolerated for short-term use, though long-term safety data are limited. Common side effects include diarrhea, indigestion, headache, nausea, and rash.

Nervousness occurs in about 7 percent of people, and some report anxiety, irritability, and low mood at higher doses; it may also raise blood pressure. The safety data advises against eleuthero during pregnancy and breastfeeding.

Goldenseal safety data are limited when used beyond a single dose; common side effects from its berberine content include abdominal pain and distension, constipation, diarrhea, nausea, and vomiting. The safety data advises against goldenseal during pregnancy and breastfeeding.

Horseradish at food amounts is generally safe; large supplement amounts can cause bloody vomiting, diarrhea, and in rare cases, fainting. Avoid medicinal amounts during pregnancy; limit to food amounts while breastfeeding.

Burdock is likely safe as food and for short-term use but lacks full human safety data. Rare allergic reactions and one case of liver disease have been reported.

The safety data advise against medicinal amounts during pregnancy and breastfeeding. Nopal is generally well tolerated as food; supplement safety is less well studied.

Common side effects include mild diarrhea, indigestion, nausea, and abdominal fullness. The safety data advise against supplement amounts during pregnancy and breastfeeding.

Side effects, ingredient by ingredient Eleuthero Goldenseal Horseradish Burdock Prickly Pear Cactus

Meds to double-check

Moderate interaction found
Known Interaction Concern · database check
Moderate identified

The most serious documented interaction for these ingredients is Moderate. Check your medications for a personalized result.

Why this rating?
  • 5 of the 5 matched ingredients can interact with medications — Burdock, Horseradish, Prickly Pear Cactus, Goldenseal, Eleuthero.
  • The most serious interaction on file is rated Moderate.
  • Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs; immunosuppressants / transplant drugs; diabetes medications; heart-rhythm medications.
  • For scale: 1,371 individual medications appear in the full list. A big number alone doesn't make a product dangerous — what matters is whether YOUR medication is on it, so run yours through the interaction checker on this page.

Before taking PBS, double-check with your doctor or pharmacist if you take digoxin (Lanoxin) for heart rhythm, any blood thinners or antiplatelet drugs, diabetes medications, blood pressure drugs, thyroid hormone, immunosuppressants, sedatives or other central nervous system depressants, or any medication metabolized by your liver (CYP1A2, CYP2C9, CYP2D6, CYP3A4 enzymes) or transported by P-glycoprotein. No interactions are documented for the inactive ingredients we could check.

Check your own medication Run your meds through the checker above

The bottom line

Scorecard at a glanceFormula with limited ingredient disclosure with no established evidence rating for its marketed use. Moderate medication interactions have been identified, and safety information is well characterized.

PBS may appeal to those seeking traditional herbal support, but it carries substantial interaction potential—particularly with blood thinners, diabetes medications, blood pressure drugs, and liver-metabolized prescriptions—and long-term safety data are sparse. If you take any regular medications, especially digoxin, thyroid medication, blood thinners, diabetes drugs, or medications that rely on liver breakdown, talk with your doctor or pharmacist before starting this product.

Pregnancy and breastfeeding are not advised; discuss this product with your healthcare provider before use if you're in either situation or planning to be.

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

Assessment coverage: 5 of 5 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Sep 24, 2019.

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

At a glance

General information

Key facts about PBS, straight from the product label.

Brand Nature's Sunshine
Barcode (UPC) 099904010543
Net contents 100 Capsule(s)
Market status On market
Date entered into DSLD Sep 24, 2019
DSLD ID 206713
Product type Botanical
Supplement form Capsule
Dietary claims / uses All Other, Structure/Function
Intended target group(s) Adult (18 - 50 Years), Kosher
From the label
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.

Supplement Facts

The label details for PBS by Nature's Sunshine, sourced from the NIH Dietary Supplement Label Database.

Supplement Facts

Daily Value (DV) Target Group(s):
Adults and children 4 or more years of age
Minimum serving Sizes:
2 Capsule(s)
Maximum serving Sizes:
2 Capsule(s)
Servings per container
50
UPC/BARCODE
099904010543
IngredientAmount% DV
Proprietary Blend853 mg--
Eleuthero0 NP--
Goldenseal Root Extract0 NP--
Horseradish0 NP--
Burdock0 NP--
Nopal0 NP--

Other ingredients: Capsule, Cellulose

Tap any ingredient to jump to its full detail below.

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

010010541116 Digestive and glandular system support Guaranteed pure

Nature's Sunshine uses natural source materials that are subject to color variation. Product of U.S.A. Since 1972 Quality, service, integrity

Suggested/Recommended/Usage/Directions

Recommendation Take two capsules with a meal three times daily.

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.

Precautions

This bottle was sealed for your protection. Do not use if inner seal is missing or damaged.

FDA Statement of Identity

Herbal Dietary Supplement

Seals/Symbols

Ko Pareve

Formula

Ko Pareve

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

See for yourself

PBS by Nature's Sunshine label

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

PBS label

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

View the full label (PDF)
What’s inside

The Ingredients in PBS by Nature's Sunshine

These are the 5 active ingredients this product is made of. Select any to open its full monograph.

Serving size2 Capsule(s) Dosage formCapsule Servings per container50 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.

Proprietary Blend

853 mg per serving

Other (inactive) ingredients: Capsule, Cellulose. These complete the product’s ingredient list but are not active constituents.

Interaction report

PBS by Nature's Sunshine Drug Interactions

Want to check YOUR meds against PBS?

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

 Go to the checker
1,370Drugs
1,347 Moderate 23 Minor

Ingredients driving the most interactions

Goldenseal Root Extract 1,237
Eleuthero 1,140
Burdock 122
Nopal 86
Horseradish 16

Individual Drug Interactions

The ingredients in PBS interact with 1,370 drugs. Click any drug to see the details.

5 of the 5 ingredients in PBS interact with drugs. Each result below shows which ingredient is responsible. Goldenseal Root Extract Eleuthero Burdock Nopal Horseradish

Each ingredient & the kinds of drugs it affects

For each ingredient in PBS 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.

Goldenseal Root Extract16 drug types · 1,237 drugs

Anticoagulant/Antiplatelet Drugs

Theoretically, goldenseal might increase the risk of bleeding when used with anticoagulant or antiplatelet drugs.
Goldenseal contains berberine. In vitro and animal research shows that berberine can inhibit platelet aggregation. However, this effect has not been reported in humans.

Likelihood Possible Evidence D
Antidiabetes Drugs

Theoretically, goldenseal might increase the risk of hypoglycemia when used with antidiabetes drugs.
Goldenseal contains berberine. Clinical research shows that berberine can lower blood glucose levels. However, this effect has not been reported with goldenseal.

Likelihood Possible Evidence D
Antihypertensive Drugs

Theoretically, goldenseal might increase the risk of hypotension when taken with antihypertensive drugs.
Goldenseal contains berberine. Animal research shows that berberine can have hypotensive effects. Also, an analysis of clinical research shows that taking berberine in combination with amlodipine can lower systolic and diastolic blood pressure when compared with amlodipine alone. However, this effect has not been reported with goldenseal.

Likelihood Possible Evidence D
Cns Depressants

Theoretically, goldenseal might increase the sedative effects of CNS depressants.
Goldenseal contains berberine. Animal research shows that berberine can have sedative effects. However, this effect has not been reported in humans.

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

Theoretically, goldenseal might increase serum levels of drugs metabolized by CYP2C9.
In vitro research shows that goldenseal root extract can modestly inhibit CYP2C9. This effect may be due to its alkaloid constituents, hydrastine and berberine. However, this effect has not been reported in humans.

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

Goldenseal might increase serum levels of drugs metabolized by CYP2D6.
Clinical and in vitro research shows that goldenseal can significantly inhibit CYP2D6 enzymes, potentially increasing levels of drugs metabolized by CYP2D6.

Likelihood Probable Evidence B
Cytochrome P450 2E1 (Cyp2E1) Substrates

Theoretically, goldenseal might increase serum levels of drugs metabolized by CYP2E1.
In vitro research shows that goldenseal root extract can inhibit the activity of CYP2E1. However, this effect has not been reported in humans.

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

Goldenseal might increase serum levels of drugs metabolized by CYP3A4.
Most clinical and in vitro research shows that goldenseal inhibits CYP3A4 enzyme activity and increases serum levels of CYP3A4 substrates, such as midazolam. However, in one small clinical study, goldenseal did not affect the levels of indinavir, a CYP3A4 substrate, in healthy volunteers. This is likely due to the fact that indinavir has a high oral bioavailability, making it an inadequate probe for CYP3A4 interactions and/or that it is primarily metabolized by hepatic CYP3A, while goldenseal has more potential to inhibit intestinal CYP3A enzyme activity. Both goldenseal extract and its isolated constituents berberine and hydrastine inhibit CYP3A, with hydrastine possibly having more inhibitory potential than berberine.

Likelihood Possible Evidence B
Dextromethorphan (Robitussin Dm, Others)

Theoretically, goldenseal might increase serum levels of dextromethorphan.
Goldenseal contains berberine. A small clinical study shows that berberine can inhibit cytochrome P450 2D6 (CYP2D6) activity and reduce the metabolism of dextromethorphan.

Likelihood Possible Evidence D
Digoxin (Lanoxin)

Goldenseal might increase serum levels of digoxin, although this effect is unlikely to be clinically significant.
Clinical research shows that goldenseal modestly increases digoxin peak levels by about 14% in healthy volunteers. However, goldenseal does not seem to affect other pharmacokinetic parameters such as area under the curve (AUC). This suggests that goldenseal does not cause a clinically significant interaction with digoxin. Digoxin is a P-glycoprotein substrate. Some evidence suggests that goldenseal constituents might affect P-glycoprotein; however, it is unclear whether these constituents inhibit or induce P-glycoprotein.

Likelihood Probable Evidence B
Losartan (Cozaar)

Theoretically, goldenseal might decrease the conversion of losartan to its active form.
Goldenseal contains berberine. A small clinical study shows that berberine inhibits cytochrome P450 2C9 (CYP2C9) activity and reduces the metabolism of losartan. However, this effect has not been reported with goldenseal.

Likelihood Possible Evidence D
Metformin (Glucophage)

Theoretically, goldenseal might reduce blood levels of metformin.
In vitro research shows that goldenseal extract decreases the bioavailability of metformin, likely by interfering with transport, intestinal permeability, or other processes involved in metformin absorption. It is unclear which, if any, of metformin's transporters are inhibited by goldenseal. Goldenseal does not appear to alter the clearance or half-life of metformin.

Likelihood Possible Evidence D
P-Glycoprotein Substrates

Theoretically, goldenseal might increase or decrease serum levels of P-glycoprotein (P-gp) substrates.
There is conflicting evidence about the effect of goldenseal on P-gp. In vitro research suggests that berberine, a constituent of goldenseal, modestly inhibits P-gp efflux. Other evidence suggests that berberine induces P-gp. In healthy volunteers, goldenseal modestly increases peak levels of the P-gp substrate digoxin by about 14%. However, it does not seem to affect other pharmacokinetic parameters such as area under the curve (AUC). This suggests that goldenseal is not a potent inhibitor of P-gp-mediated drug efflux. Until more is known, goldenseal should be used cautiously with P-gp substrates.

Likelihood Probable Evidence B
Pentobarbital (Nembutal)

Theoretically, goldenseal might increase the sedative effects of pentobarbital.
Animal research shows that berberine, a constituent of goldenseal, can prolong pentobarbital-induced sleeping time. However, this effect has not been reported with goldenseal.

Likelihood Possible Evidence D
Tacrolimus (Prograf)

Theoretically, goldenseal might increase serum levels of tacrolimus.
Goldenseal contains berberine. In a 16-year-old patient with idiopathic nephrotic syndrome who was being treated with tacrolimus 6.5 mg twice daily, intake of berberine 200 mg three times daily increased the blood concentration of tacrolimus from 8 to 22 ng/mL. Following a reduction of tacrolimus dosing to 3 mg daily, blood levels of tacrolimus decreased to 12 ng/mL.

Likelihood Possible Evidence D
Oseltamivir (Tamiflu)

Theoretically, goldenseal might reduce the therapeutic effects of oseltamivir by decreasing its conversion to its active form.
In vitro evidence suggests that goldenseal reduces the formation of the active compound from the prodrug oseltamivir. The mechanism of action and clinical relevance is unclear.

Likelihood Possible Evidence D
Goldenseal Root Extract full monograph & interactions

Eleuthero10 drug types · 1,140 drugs

Anticoagulant/Antiplatelet Drugs

Theoretically, eleuthero may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
In vitro and animal research shows that a constituent of eleuthero, dihydroxybenzoic acid, appears to inhibit platelet aggregation. Concomitant use with anticoagulant or antiplatelet drugs might increase the risk of bleeding. This effect has not been reported in humans.

Likelihood Possible Evidence D
Antidiabetes Drugs

Theoretically, eleuthero might have additive effects when used with antidiabetes drugs.
Animal research suggests that certain constituents of eleuthero have hypoglycemic activity in both healthy and diabetic animals. A small study in adults with type 2 diabetes also shows that taking eleuthero for 3 months can lower blood glucose levels. However, one very small study in healthy individuals shows that taking powdered eleuthero 3 grams, 40 minutes prior to a 75-gram oral glucose tolerance test, significantly increases postprandial blood glucose levels when compared with placebo. These contradictory findings might be due to patient-specific variability and variability in active ingredient ratios.

Likelihood Possible Evidence B
Cytochrome P450 1A2 (Cyp1A2) Substrates

Theoretically, eleuthero might increase levels of drugs metabolized by CYP1A2.
In vitro and animal research suggest that standardized extracts of eleuthero inhibit CYP1A2. This effect has not been reported in humans.

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

Theoretically, eleuthero might increase levels of drugs metabolized by CYP2C9.
In vitro and animal research suggest that standardized extracts of eleuthero might inhibit CYP2C9. This effect has not been reported in humans.

Likelihood Possible Evidence D
Digoxin (Lanoxin)

Eleuthero might increase serum digoxin levels and increase the risk of side effects.
In one case report, a 74-year-old male who was stabilized on digoxin presented with an elevated serum digoxin level after starting an eleuthero supplement, without symptoms of toxicity. After stopping the supplement, serum digoxin levels returned to normal. It is not clear whether this was due to a pharmacokinetic interaction or to interference with the digoxin assay. Although the product was found to be free of digoxin and digitoxin, it was not tested for other contaminants.

Likelihood Unlikely Evidence D
Immunosuppressants

Theoretically, eleuthero might interfere with immunosuppressive drugs because of its immunostimulant activity.
Animal and in vitro research shows that eleuthero extracts have immunomodulatory effects, including increasing cellular and humoral activity.

Likelihood Possible Evidence D
P-Glycoprotein Substrates

Theoretically, eleuthero might increase levels of P-glycoprotein substrates.
In vitro research suggests that eleuthero can inhibit the multi-drug transporter protein, P-glycoprotein. However, it is too soon to tell if this is clinically important. This interaction has not been reported in humans.

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

Theoretically, eleuthero might increase levels of drugs metabolized by CYP2D6.
In vitro and animal research suggest that standardized extracts of eleuthero might inhibit CYP2D6. However, research in healthy human volunteers has found that taking eleuthero 485 mg twice daily for 14 days does not inhibit CYP2D6 drug metabolism.

Likelihood Unlikely Evidence B
Cytochrome P450 3A4 (Cyp3A4) Substrates

Theoretically, eleuthero might increase levels of drugs metabolized by CYP3A4.
In vitro and animal research suggest that standardized extracts of eleuthero might inhibit CYP3A4. However, research in healthy human volunteers has found that taking eleuthero 485 mg twice daily for 14 days does not inhibit CYP3A4 drug metabolism.

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

Theoretically, eleuthero might decrease levels of drugs metabolized by OATP.
In vitro research suggests that eleuthero inhibits OATP2B1, which might reduce the bioavailability of oral drugs that are substrates of OATP2B1. Due to the weak inhibitory effect identified in this study, this interaction is not likely to be clinically significant.

Likelihood Possible Evidence D
Eleuthero full monograph & interactions

Burdock1 drug type · 122 drugs

Anticoagulant/Antiplatelet Drugs

Theoretically, taking burdock with anticoagulant or antiplatelet drugs might increase the risk of bleeding.

In vitro research shows that lignans from burdock reduce rabbit platelet aggregation by inhibiting platelet activating factor. This interaction has not been reported in humans.

Likelihood Possible Evidence D
Burdock full monograph & interactions

Nopal1 drug type · 86 drugs

Antidiabetes Drugs

Combining prickly pear cactus with antidiabetes drugs might increase the risk of hypoglycemia.
Case reports show that combining prickly pear cactus with antidiabetes drugs such as chlorpropamide, glyburide, glipizide, and metformin can increase the risk of hypoglycemia in patients with type 2 diabetes. Advise patients to monitor glucose levels closely. Dose adjustments may be necessary.

Likelihood Probable Evidence D
Nopal full monograph & interactions

Horseradish1 drug type · 16 drugs

Thyroid Hormone

Theoretically, horseradish might interfere with the effects of thyroid hormone.
Horseradish and other members of the cabbage and mustard family are associated with depressed thyroid function.

Likelihood Possible Evidence D
Horseradish full monograph & interactions
The maker

Brand information

Manufacturer and brand details for PBS, from the product label.

Nature's Sunshine

See all Nature's Sunshine products
Name
Nature's Sunshine Products, Inc.
City
Spanish Fork
State
UT
ZipCode
84660
Phone Number
1-800-223-8225
Web Address
www.naturessunshine.com
Pharmacist Counseling Corner

PBS by Nature's Sunshine: Common Questions

Does PBS by Nature's Sunshine interact with any medications?
Yes. Based on its ingredients, PBS has a known interaction with 1,370 medications. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
PBS contains 5 active ingredients, and an interaction can come from any of them. We check every ingredient, combine the results into one list per medication, and show which ingredient and mechanism is responsible.
Where does this information come from?
The product label data comes from the NIH Dietary Supplement Label Database (DSLD); the interaction data is built on the Natural Medicines database and reviewed by HelloPharmacist pharmacists.
Is PBS safe to take if I'm pregnant or breastfeeding?
No. The safety data advise against eleuthero, goldenseal, and horseradish at medicinal amounts during pregnancy, and against goldenseal and burdock during breastfeeding. Nopal and burdock safety data are insufficient for pregnancy and breastfeeding as well. Talk with your doctor or pharmacist before taking this product if you're pregnant, planning to become pregnant, or breastfeeding.
What's the main side effect I should watch for?
It depends on the ingredient, but the most common side effects across this product are digestive upset (nausea, diarrhea, abdominal pain) and headache. Eleuthero carries a specific risk of nervousness at higher doses and may raise blood pressure. If you notice any of these, talk with your doctor or pharmacist.
Does this product actually work for anything?
Eleuthero is possibly effective for genital herpes and nopal is possibly effective for diabetes, but evidence is limited or absent for most other uses in this product. For most of the conditions these ingredients claim to address—chronic fatigue, acne, respiratory infections, urinary tract infections—we hold insufficient evidence to say whether they work.
Why does this product interact with so many medications?
Several of these ingredients—especially eleuthero and goldenseal—inhibit liver enzymes that break down many common drugs, which can cause those drugs to stay in your system longer and reach higher levels. This is why it's so important to check your specific medications before starting.
Can I take PBS with my blood thinner?
Probably not safely without checking first. Eleuthero, goldenseal, and burdock all theoretically increase bleeding risk with anticoagulants and antiplatelet drugs. Talk with your doctor or pharmacist about whether this product is right for you before adding it.
What's in the capsule besides the herbs?
The inactive ingredients are cellulose (a plant-based filler) and the capsule shell itself. There are no other additives listed.

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

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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.

PBS label
Go deeper

The Full Monographs Behind PBS’s Ingredients

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

Herb & supplement monograph

Eleuthero

Interacts with 1,140 drugs

Eleuthero is an herb traditionally used as an 'adaptogen' to fight fatigue, boost energy, and help the body handle stress. The scientific evidence behind these uses is limited and mixed, so...

Read the full Eleuthero monograph → Herb & supplement monograph

Goldenseal

Interacts with 1,237 drugs

Goldenseal is a popular North American herb that contains berberine, a compound studied for antimicrobial effects. However, strong human evidence for its many traditional uses is largely lac...

Read the full Goldenseal monograph → Herb & supplement monograph

Horseradish

Interacts with 16 drugs

Horseradish is a pungent root used as a food and folk remedy, most often for sinus congestion and urinary tract complaints. Human evidence is limited, and while culinary amounts are generall...

Read the full Horseradish monograph → Herb & supplement monograph

Burdock

Interacts with 122 drugs

Burdock is a traditional herb most often used for skin problems and as a so-called 'blood purifier,' but high-quality human studies are lacking and most claims are not well proven. It is wid...

Read the full Burdock monograph → Herb & supplement monograph

Prickly Pear Cactus

Interacts with 86 drugs

Prickly pear cactus is a desert plant whose pads and fruit are eaten as food and taken as a supplement, mainly for blood sugar, cholesterol, and hangover symptoms. Some small studies suggest...

Read the full Prickly Pear Cactus monograph →
Sources

Sources & How We Checked

PBS's label data comes from the NIH Dietary Supplement Label Database; the ingredient interaction data is from the Natural Medicines database, reviewed by our pharmacists.

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

The 84 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.

Eleuthero 24 references
  1. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
  2. McRae S. Elevated serum digoxin levels in a patient taking digoxin and Siberian ginseng. CMAJ 1996;155:293-5.
  3. Awang DVC. Siberian ginseng toxicity may be case of mistaken identity (letter). CMAJ 1996;155:1237.
  4. Mills S, Bone K. Principles and Practice of Phytotherapy. London: Churchill Livingstone, 2000.
  5. Harkey MR, Henderson GL, Zhou L, et al. Effects of Siberian ginseng (Eleutherococcus senticosus) on c-DNA-expressed P450 drug metabolizing enzymes. Alt Ther 2001;7:S14.
  6. Hikino H, Takahashi M, Otake K, Konno C. Isolation and hypoglycemic activity of eleutherans A, B, C, D, E, F, and G: glycans of Eleutherococcus senticosus roots. J Nat Prod 1986;49:293-7. PubMed
  7. Yun-Choi HS, Kim JH, Lee JR. Potential inhibitors of platelet aggregation from plant sources, III. J Nat Prod 1987;50:1059-64. PubMed
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Horseradish 6 references
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Prickly Pear Cactus 9 references
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DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

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