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

PM Packet Ingredients & Drug Interactions

by Nature's Sunshine

PM Packet label
See full label image
Capsule Category: Other Combinations
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 PM Packet 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

PM Packet is a dietary supplement by Nature's Sunshine with 8 active ingredients. Its ingredients are commonly taken for bone health and osteoporosis, correcting vitamin d deficiency, immune system support.Based on those ingredients, 1,124 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Vitamin D, Reishi Mushroom, Beta-Glucan. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

Jump to a section

Check Your Meds Against PM Packet by Nature's Sunshine

Ask about any prescription or over-the-counter medication and we check it for interactions with PM Packet 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 PM Packet 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 Jul 11, 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 3 of its 12 active ingredients.
  • “Elderberry D3fense Proprietary Blend” is a proprietary blend — the label gives one combined amount (406 mg) without saying how much of each component you get.
  • “Immune Stimulator Proprietary Blend” is a proprietary blend — the label gives one combined amount (110 mg) without saying how much of each component you get.

PM Packet contains 12 active ingredients selected for immune and sleep support. Vitamin D is included for bone health and immune function.

The formula features mushroom extracts — Maitake, Reishi, and Cordyceps — along with Elderberry fruit extract, which traditional preparations use for seasonal wellness. Royal jelly, Beta-glucan (from yeast), Larch arabinogalactan (a prebiotic fiber), Olive leaf extract, and Echinacea round out the blend.

White Willow Bark Extract and Colostrum are also present. The capsules contain gelatin, cellulose, silicon dioxide, magnesium stearate, and water as inactive ingredients.

Does it work?

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

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

Why this rating?
  • The label markets this product for: immune support and seasonal health defense.
  • We looked for evidence on: Common cold, Coronavirus disease 2019 (COVID-19), Bronchitis, Cough, Allergic rhinitis (hay fever), Asthma — and 4 related terms.
  • The strongest evidence on file: Vitamin D is rated "Possibly Effective" for Coronavirus disease 2019 (COVID-19) (Natural Medicines).
  • Also on file: Vitamin D is rated "Possibly Effective" for Allergic rhinitis (hay fever).
  • Also on file: Royal Jelly is rated "Possibly Ineffective" for Allergic rhinitis (hay fever).

The evidence for most ingredients in this formula is not well established in the data we hold. Vitamin D is effective for rickets, renal bone disease, low vitamin D bone disease (osteomalacia), and certain rare calcium-regulation disorders — but this product's dose relative to those conditions isn't stated.

Beta-glucan shows likely effectiveness for cholesterol and heart health. Royal jelly may help with menopausal symptoms.

For the other ingredients — Elderberry, Maitake, Reishi, Cordyceps, Arabinogalactan, Olive leaf, and Echinacea — the evidence is insufficient to rate them for the conditions this product seems intended to address (immune support, sleep, seasonal wellness). If you're considering PM Packet for a specific health goal, ask your pharmacist whether the formula targets that goal and what the evidence shows.

The evidence, ingredient by ingredient Vitamin D Elderberry Olive Royal Jelly Echinacea Maitake Mushroom Cordyceps Reishi Mushroom

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 10 of the 10 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 10 of 10.
  • General safety write-ups exist for 10 of 10.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

Most ingredients are generally well tolerated at normal doses. Vitamin D is safe at recommended amounts but can cause toxicity at very high doses; use only under your doctor's guidance during pregnancy, and check with your doctor before taking higher amounts.

Elderberry from properly cooked fruit is well tolerated, but raw or unripe berries, seeds, leaves, and bark can be toxic with symptoms like nausea, vomiting, severe diarrhea, and dizziness. Elderberry should be avoided during pregnancy and breastfeeding due to insufficient safety data.

Maitake mushroom, Cordyceps, Reishi, and Echinacea are generally well tolerated short-term but lack long-term safety data; all should be avoided during pregnancy and breastfeeding. Maitake and Cordyceps may cause gastrointestinal effects like diarrhea or stomach discomfort.

Reishi may cause dizziness, dry mouth, nausea, or rash. Echinacea may trigger serious allergic reactions (including anaphylaxis) in people sensitive to ragweed or related plants, and rare cases of hepatitis have been reported.

Royal jelly can trigger serious allergic reactions, including anaphylaxis and asthma, in people with a history of asthma or atopy. Olive leaf extract and Beta-glucan are generally well tolerated; gastrointestinal effects and headache are possible with olive leaf.

Arabinogalactan may cause bloating or gas. Larch arabinogalactan and Cordyceps have limited long-term safety data and should be avoided in pregnancy and breastfeeding without your doctor's approval.

White Willow Bark Extract and Colostrum safety data are not on file.

Side effects, ingredient by ingredient Vitamin D Elderberry Olive Royal Jelly Echinacea Maitake Mushroom Cordyceps Reishi Mushroom

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?
  • 9 of the 10 matched ingredients can interact with medications — Elderberry, Royal Jelly, Maitake Mushroom, Cordyceps, Reishi Mushroom, among others.
  • 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: 1,125 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.

Check the following medication types before you start: antihypertensive (blood pressure) drugs, anticoagulant or antiplatelet agents (blood thinners), diabetes medications, immunosuppressants, heart rhythm drugs (verapamil, diltiazem, digoxin), atorvastatin (Lipitor), warfarin (Coumadin), etoposide and other cancer drugs, and any drug metabolized by your liver's CYP3A4 or CYP1A2 enzymes — a large group that includes many common medications. If you take caffeine or any supplement, let us know that too.

No interactions are documented for the ingredients we checked against a small set of common over-the-counter and herbal products, but this product affects far too many medication classes to skip this step.

Check your own medication Run your meds through the checker above

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.

PM Packet is a multi-ingredient supplement with documented interactions across a broad range of medications. If you take any prescription drugs — especially blood pressure meds, heart rhythm drugs, blood thinners, diabetes drugs, cancer drugs, or immunosuppressants — you need to check your exact medications with the tool on this page before starting.

Pregnant or breastfeeding? Talk to your pharmacist or doctor first; several ingredients lack adequate safety data, and Elderberry should be avoided.

Even if you're generally healthy, let your pharmacist know you're considering this product.

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

Assessment coverage: 10 of 12 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Aug 22, 2025.

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 PM Packet, straight from the product label.

Brand Nature's Sunshine
Net contents 30 Packet(s); 60 Capsule(s)
Market status On market
Date entered into DSLD Aug 22, 2025
DSLD ID 334368
Product type Other Combinations
Supplement form Capsule
Dietary claims / uses Nutrient, All Other, Structure/Function
Intended target group(s) Adult (18 - 50 Years)
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 PM Packet 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:
1 PM Packet(s)
Maximum serving Sizes:
1 PM Packet(s)
Servings per container
30
IngredientAmount% DV
Vitamin D50 mcg250%
Elderberry Fruit Extract0 NP--
Elderberry D3fense Proprietary Blend406 mg--
Immune Stimulator Proprietary Blend110 mg--
Maitake whole Mushroom0 NP--
Olive Leaf Extract0 NP--
Arabinogalactan100 mg--
Cordyceps0 NP--
Reishi Mushroom0 NP--
Royal Jelly0 NP--
Beta-Glucan200 mg--
White Willow Bark Extract0 NP--
Echinacea0 NP--
Colostrum0 NP--

Other ingredients: Gelatin, Water, Cellulose, Silicon Dioxide, Magnesium Stearate

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.
Suggested/Recommended/Usage/Directions

Recommended use: Take the contents of one AM packet with breakfast; take the contents of one PM packet with your evening meal. Follow this pattern for 30 days.

FDA Disclaimer Statement

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

Precautions

Pregnant or lactating women should consult their health care provider prior to taking this supplement.

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

Formulation

Nature's Sunshine uses natural source materials that are subject to color variation.

Supports the body's immune function 30 day program

Immune System support The immune system works to protect our body. Phagocytes, lymphocytes, T-cells, B-cells and memory cells all perform specific functions to help our bodies stay healthy. Diet, exercise, sleep, hydration and proper supplementation are all factors that help strengthen the immune system and reduce the stress factors that may weaken it. The ingredients in this 30-day Immune System program are formulated to support and fortify the body's immune functions.

General Statements

Please recycle this carton. We are committed to you and our planet. Scan QR code to learn more.

Maximize the benefits Eat a healthy and balanced diet Increase your physical activity Drink plenty of water throughout the day Herbal experts since 1972 New Look! Same great product

Formula

Elderberry D3fense Contains vitamin D3 that supports both the innate and adaptive immune branches, and an array of herbal ingredients that have been traditionally used to defend against the negative effects of seasonal changes. Immune Stimulator Nutritionally support your immune system and strengthen your defenses. Boost your immune system with colostrum, beta-glucans, mushrooms and antioxidants.

Contents PM Packet 1 Elderberry D3fense capsule 1 Immune Stimulator capsule

Seals/Symbols

Guaranteed Pure

FDA Statement of Identity

Dietary Supplement

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

See for yourself

PM Packet by Nature's Sunshine label

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

PM Packet 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 PM Packet by Nature's Sunshine

These are the 8 active ingredients this product is made of. Select any to open its full monograph.

Serving size1 PM Packet(s) Dosage formCapsule Servings per container30 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.

Vitamin D

Interacts with
715 drugs
50 mcg per serving Form: Cholecalciferol, Vitamin D3

Vitamin D is a fat-soluble vitamin that helps your body absorb calcium and is important for healthy bones, muscles, and immune function. Many people,...

Vitamin D monograph & interactions

Elderberry D3fense Proprietary Blend

Interacts with
121 drugs
406 mg per serving

Elderberry is a popular herbal supplement, mainly taken to help with colds and flu. Some small studies suggest it may modestly shorten cold or flu sym...

Elderberry D3fense Proprietary Blend monograph & interactions

Immune Stimulator Proprietary Blend

110 mg per serving

Arabinogalactan

Interacts with
121 drugs
100 mg per serving

Larch arabinogalactan is a soluble fiber from larch trees that is mainly used as a prebiotic and for immune support. Early research is interesting but...

Arabinogalactan monograph & interactions

Beta-Glucan

Interacts with
293 drugs
200 mg per serving Form: Saccharomyces cerevisiae

Beta-glucans are natural fibers found in oats, barley, mushrooms, and yeast. The strongest evidence supports the oat and barley types for modestly low...

Beta-Glucan monograph & interactions

Other (inactive) ingredients: Gelatin, Water, Cellulose, Silicon Dioxide, Magnesium Stearate. These complete the product’s ingredient list but are not active constituents.

Interaction report

PM Packet by Nature's Sunshine Drug Interactions

Want to check YOUR meds against PM Packet?

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
1,124Drugs
1,120 Moderate 4 Minor

Ingredients driving the most interactions

Vitamin D 715
Reishi Mushroom 375
Beta-Glucan 293
Maitake whole Mushroom 260
Cordyceps 249

Individual Drug Interactions

The ingredients in PM Packet interact with 1,124 drugs. Click any drug to see the details.

7 of the 8 ingredients in PM Packet interact with drugs. Each result below shows which ingredient is responsible. Vitamin D Reishi Mushroom Beta-Glucan Maitake whole Mushroom Cordyceps Elderberry D3fense Proprietary Blend Arabinogalactan

Each ingredient & the kinds of drugs it affects

For each ingredient in PM Packet 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.

Vitamin D8 drug types · 715 drugs

Aluminum

Vitamin D might increase aluminum absorption and toxicity, but this has only been reported in people with renal failure.
The protein that transports calcium across the intestinal wall can also bind and transport aluminum. This protein is stimulated by vitamin D, which may therefore increase aluminum absorption. This mechanism may contribute to increased aluminum levels and toxicity in people with renal failure, when they take vitamin D and aluminum-containing phosphate binders chronically.

Likelihood Probable Evidence B
Atorvastatin (Lipitor)

Vitamin D might reduce absorption of atorvastatin.
A small, low-quality clinical study shows that taking vitamin D reduces levels of atorvastatin and its active metabolites by up to 55%. However, while atorvastatin levels decreased, total cholesterol, low-density lipoprotein (LDL) cholesterol, and high-density lipoprotein (HDL) cholesterol levels did not substantially change. Atorvastatin is metabolized in the gut by CYP3A4 enzymes, and researchers theorized that vitamin D might induce CYP3A4, causing reduced levels of atorvastatin. However, this proposed mechanism was not specifically studied.

Likelihood Probable Evidence B
Calcipotriene (Dovonex)

Taking calcipotriene with vitamin D increases the risk for hypercalcemia.
Calcipotriene is a vitamin D analog used topically for psoriasis. It can be absorbed in sufficient amounts to cause systemic effects, including hypercalcemia. Theoretically, combining calcipotriene with vitamin D supplements might increase the risk of hypercalcemia.

Likelihood Probable Evidence D
Digoxin (Lanoxin)

Theoretically, hypercalcemia induced by high-dose vitamin D can increase the risk of arrhythmia from digoxin.
High doses of vitamin D can cause hypercalcemia. Hypercalcemia increases the risk of fatal cardiac arrhythmias with digoxin. Avoid vitamin D doses above the tolerable upper intake level (4000 IU daily for adults) and monitor serum calcium levels in people taking vitamin D and digoxin concurrently.

Likelihood Possible Evidence D
Diltiazem (Cardizem, Others)

Theoretically, hypercalcemia induced by high-dose vitamin D can reduce the therapeutic effects of diltiazem for arrhythmia.
High doses of vitamin D can cause hypercalcemia. Hypercalcemia can reduce the effectiveness of verapamil in atrial fibrillation. Theoretically this could also occur with diltiazem. Avoid vitamin D doses above the tolerable upper intake level (4000 IU daily for adults) and monitor serum calcium levels in people taking vitamin D and diltiazem concurrently.

Likelihood Probable Evidence B
Thiazide Diuretics

Theoretically, taking thiazide diuretics and high-dose vitamin D can increase the risk of hypercalcemia.
Thiazide diuretics decrease urinary calcium excretion, which could lead to hypercalcemia if vitamin D supplements are taken concurrently. This has been reported in people being treated with vitamin D for hypoparathyroidism, and also in elderly people with normal parathyroid function who were taking a thiazide, vitamin D, and calcium-containing antacids daily.

Likelihood Probable Evidence D
Verapamil (Calan, Others)

Hypercalcemia induced by high-dose vitamin D can reduce the therapeutic effects of verapamil for arrhythmia.
Hypercalcemia due to high doses of vitamin D can reduce the effectiveness of verapamil in atrial fibrillation. Avoid vitamin D doses above the tolerable upper intake level (4000 IU daily for adults) and monitor serum calcium levels in people taking vitamin D and verapamil concurrently.

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

Vitamin D might induce CYP3A4 enzymes and reduce the bioavailability of CYP3A4 substrates.
There is some concern that vitamin D might induce CYP3A4. In vitro research suggests that vitamin D induces CYP3A4 transcription. Additionally, observational research has found that increased UV light exposure and serum vitamin D levels are associated with decreased serum levels of CYP3A4 substrates such as tacrolimus and sirolimus, while no association between UV light exposure or vitamin D levels and levels of mycophenolic acid, a non-CYP3A4 substrate, was found. A small, low-quality clinical study shows that taking vitamin D reduces levels of the CYP3A4 substrate atorvastatin and its active metabolites by up to 55%; however, the clinical effects of atorvastatin were not reduced. While researchers theorized that vitamin D might induce CYP3A4, this proposed mechanism was not specifically studied.

Likelihood Possible Evidence D
Vitamin D full monograph & interactions

Reishi Mushroom3 drug types · 375 drugs

Anticoagulant/Antiplatelet Drugs

Theoretically, high doses of reishi mushroom might increase the risk of bleeding.
A dose of 1.5 grams daily of reishi mushroom does not seem to decrease platelet aggregation, but a higher dose of 3 grams daily does.

Likelihood Possible Evidence D
Antidiabetes Drugs

Theoretically, reishi mushroom might have additive effects with antidiabetes drugs.
Animal research suggests that reishi mushroom decreases blood sugar. However, in patients with type 2 diabetes, taking reishi mushroom does not reduce fasting glucose levels, and its effects on glycated hemoglobin are inconsistent.

Likelihood Possible Evidence D
Antihypertensive Drugs

Theoretically, concurrent use of reishi mushroom with antihypertensive drugs might increase the risk of hypotension.
Reishi mushroom has shown hypotensive activity in animal research. Clinical evidence suggests that reishi mushroom reduces blood pressure in some, but not all, patients with hypertension.

Likelihood Possible Evidence D
Reishi Mushroom full monograph & interactions

Beta-Glucan2 drug types · 293 drugs

Antihypertensive Drugs

Theoretically, taking beta-glucans with antihypertensive drugs might increase the risk of hypotension.
Clinical research shows that taking beta-glucans may reduce systolic and diastolic blood pressure in some hypertensive individuals.

Likelihood Possible Evidence D
Immunosuppressants

Theoretically, beta-glucans might interfere with immunosuppressive therapy.
Some clinical research shows that beta-glucans have immunostimulant effects.

Likelihood Possible Evidence D
Beta-Glucan full monograph & interactions

Maitake whole Mushroom3 drug types · 260 drugs

Antidiabetes Drugs

Theoretically, combining maitake mushroom with antidiabetes drugs might increase the risk of hypoglycemia.
Clinical research shows that taking maitake mushroom polysaccharide (MMP) can lower blood glucose levels in patients with types 2 diabetes.

Likelihood Possible Evidence B
Antihypertensive Drugs

Theoretically, combining maitake mushroom with antihypertensive drugs might increase the risk of hypotension.
Animal research shows that maitake mushroom can lower blood pressure.

Likelihood Possible Evidence D
Warfarin (Coumadin)

There is limited evidence that maitake mushroom may increase the anticoagulant effects of warfarin.
In a case report, a patient previously stabilized on warfarin developed an elevated international normalized ratio (INR) of 5.1 after taking maitake mushroom (Grifron-Pro Maitake D-Fraction) 1 drop/kg daily in three divided doses for one week. The elevated INR resolved after holding warfarin for two days, then reducing the dose by 11%. It is thought that the beta-glucan constituent of maitake mushroom might cause warfarin dissociation from proteins, resulting in increased free warfarin levels and increased warfarin effects.

Likelihood Possible Evidence D
Maitake whole Mushroom full monograph & interactions

Cordyceps3 drug types · 249 drugs

Anticoagulant/Antiplatelet Drugs

Theoretically, cordyceps may increase the risk of bleeding when used with antiplatelet or anticoagulant drugs.
In vitro and animal research suggests that cordyceps extract inhibits platelet aggregation and function. However, this interaction has not been reported in humans.

Likelihood Possible Evidence D
Immunosuppressants

Theoretically, concurrent use of cordyceps might interfere with immunosuppressive therapy.
Animal and in vitro research suggests that cordyceps stimulates the immune system. However, limited clinical research suggests that taking cordyceps may lower the necessary therapeutic dose of the immunosuppressant cyclosporine, which suggests that cordyceps may have an immunosuppressive effect.

Likelihood Possible Evidence B
Testosterone

Theoretically, concurrent use of cordyceps and testosterone might have additive effects.
Animal research suggests that cordyceps can increase testosterone levels. The clinical significance of this finding is unclear.

Likelihood Possible Evidence D
Cordyceps full monograph & interactions

Elderberry D3fense Proprietary Blend2 drug types · 121 drugs

Immunosuppressants

Theoretically, elderberry might interfere with immunosuppressant therapy due to its immunostimulant activity.
Elderberry has immunostimulant activity, increasing the production of cytokines, including interleukin and tumor necrosis factor.

Likelihood Possible Evidence B
Pazopanib (Votrient)

Theoretically, elderberry might interact with pazopanib, potentially increasing the risk of adverse effects.
In one case, a 65-year-old patient taking pazopanib for 4 weeks for soft-tissue sarcoma developed severe nausea, loose stools, and elevated alanine transaminase and aspartate transaminase levels and was diagnosed with grade 3 liver injury. The patient reported taking elderberry supplements for 2 years, dose unspecified, and was also taking a multivitamin and a calcium supplement. The patient's symptoms and liver enzyme levels improved upon discontinuation of pazopanib and all supplements. Pazopanib treatment was re-initiated, at a lower dose, with no further evidence of liver injury. It was unclear in this case report if the elderberry supplements were derived from the berry, the flower, or the combination.

Likelihood Possible Evidence D
Elderberry D3fense Proprietary Blend full monograph & interactions

Arabinogalactan1 drug type · 121 drugs

Immunosuppressants

Theoretically, larch arabinogalactan might interfere with immunosuppression therapy due to immunostimulant effects. Immunosuppressant drugs include azathioprine (Imuran), basiliximab (Simulect), cyclosporine (Neoral, Sandimmune), daclizumab (Zenapax), muromonab-CD3 (OKT3, Orthoclone OKT3), mycophenolate (CellCept), tacrolimus (FK506, Prograf), sirolimus (Rapamune), prednisone (Deltasone, Orasone), corticosteroids (glucocorticoids), and other drugs.

Likelihood Possible Evidence D
Arabinogalactan full monograph & interactions
The maker

Brand information

Manufacturer and brand details for PM Packet, 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
(800) 223-8225
Web Address
naturessunshine.com
Pharmacist Counseling Corner

PM Packet by Nature's Sunshine: Common Questions

Does PM Packet by Nature's Sunshine interact with any medications?
Yes. Based on its ingredients, PM Packet has a known interaction with 1,124 medications. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
PM Packet contains 8 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.
Can I take this if I'm pregnant or breastfeeding?
Vitamin D at recommended doses is often used in pregnancy, but use it only under your doctor's guidance. Elderberry, Maitake, Cordyceps, and Reishi should be avoided during pregnancy and breastfeeding — there isn't enough safety data. Royal Jelly, Echinacea, and Arabinogalactan also lack reliable safety information for pregnancy or nursing. Talk with your doctor or pharmacist before using this product.
Will this help me sleep?
The data we hold doesn't show that the ingredients in PM Packet have proven effectiveness for sleep. While several have immune-support or traditional wellness uses, none are rated as effective for sleep in our records. If better sleep is your goal, ask your pharmacist what the evidence shows for this specific formula.
What are the side effects I should watch for?
Most common side effects are mild: stomach discomfort, diarrhea, nausea, dizziness, or headache. Echinacea and Royal Jelly can trigger serious allergic reactions in people sensitive to ragweed or with a history of asthma — symptoms include rash, swelling, trouble breathing, and in rare cases anaphylaxis. At very high doses or with long-term use, Vitamin D can cause toxicity with symptoms of high blood calcium. If you notice severe allergic symptoms or signs of toxicity, stop and contact your doctor.
Can I take this with my heart or blood pressure medication?
Several ingredients may interact with heart and blood pressure drugs. Vitamin D can interfere with verapamil, diltiazem, and digoxin, and Reishi and Royal Jelly may lower blood pressure too much when combined with blood pressure medications. Use the medication checker on this page with your exact drug name and dose — don't skip this step.
What if I'm on a blood thinner like warfarin?
Maitake mushroom, Royal Jelly, and Reishi (at doses above 1.5 grams daily) may increase bleeding risk with warfarin, and Echinacea may change how quickly your body clears warfarin. Cordyceps and Echinacea also theoretically increase bleeding risk with blood thinners. Check with your pharmacist before starting.
Is this safe if I'm allergic to ragweed?
Echinacea is in the same plant family as ragweed and can trigger allergic reactions in people sensitive to ragweed — sometimes severe ones. If you have ragweed allergies or a history of asthma or atopy (a tendency to allergic reactions), talk with your pharmacist or doctor before using this product.

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.

PM Packet label
Go deeper

The Full Monographs Behind PM Packet’s Ingredients

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

Herb & supplement monograph

Vitamin D

Interacts with 715 drugs

Vitamin D is a fat-soluble vitamin that helps your body absorb calcium and is important for healthy bones, muscles, and immune function. Many people, especially those with low sun exposure,...

Read the full Vitamin D monograph → Herb & supplement monograph

Elderberry

Interacts with 121 drugs

Elderberry is a popular herbal supplement, mainly taken to help with colds and flu. Some small studies suggest it may modestly shorten cold or flu symptoms, but the evidence is limited and n...

Read the full Elderberry monograph → Herb & supplement monograph

Olive

Olive comes from the same tree that gives us olives and olive oil, and its leaf and fruit contain antioxidant compounds like oleuropein and hydroxytyrosol. Olive oil as part of a Mediterrane...

Read the full Olive monograph → Herb & supplement monograph

Royal Jelly

Interacts with 174 drugs

Royal jelly is a nutrient-rich substance made by worker bees to feed the queen bee. People take it for menopause symptoms, energy, skin, and immune support, but solid human evidence is limit...

Read the full Royal Jelly monograph → Herb & supplement monograph

Echinacea

Interacts with 816 drugs

Echinacea is a popular herb taken to help prevent or shorten the common cold, but study results are mixed and the overall benefit appears small at best. It is generally well tolerated for sh...

Read the full Echinacea monograph → Herb & supplement monograph

Maitake Mushroom

Interacts with 260 drugs

Maitake is an edible mushroom long used as food and in traditional Japanese medicine, and it is being studied for possible immune, blood sugar, and blood pressure effects. The human evidence...

Read the full Maitake Mushroom monograph → Herb & supplement monograph

Cordyceps

Interacts with 249 drugs

Cordyceps is a fungus used in traditional Chinese medicine for energy, exercise performance, and lung and immune support. Human research is limited and mostly low quality, so its benefits ar...

Read the full Cordyceps monograph → Herb & supplement monograph

Reishi Mushroom

Interacts with 375 drugs

Reishi is a traditional Asian mushroom widely used to support the immune system and overall wellness. Human evidence for most of its claimed benefits is limited or low-quality, so it should...

Read the full Reishi Mushroom monograph → Herb & supplement monograph

Larch Arabinogalactan

Interacts with 121 drugs

Larch arabinogalactan is a soluble fiber from larch trees that is mainly used as a prebiotic and for immune support. Early research is interesting but limited, and most claims are not yet fi...

Read the full Larch Arabinogalactan monograph → Herb & supplement monograph

Beta-glucans

Interacts with 293 drugs

Beta-glucans are natural fibers found in oats, barley, mushrooms, and yeast. The strongest evidence supports the oat and barley types for modestly lowering cholesterol and blood sugar, while...

Read the full Beta-glucans monograph →
Sources

Sources & How We Checked

PM Packet'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 157 references behind this product’s interaction data

Every citation that drives the interaction findings for this product’s ingredients, from the evidence-graded Natural Medicines (TRC Healthcare) database. Open an ingredient to browse its citations — links open the study on PubMed or the publisher’s site.

Vitamin D 26 references
  1. McEvoy GK, ed. AHFS Drug Information. Bethesda, MD: American Society of Health-System Pharmacists, 1998.
  2. Tatro DS, ed. Drug Interactions Facts. Facts and Comparisons Inc., St. Louis, MO. 1999.
  3. Koutkia P, Chen TC, Holick MF. Vitamin D intoxication associated with an over-the-counter supplement. N Engl J Med 2001;345:66-7. PubMed
  4. Bar-Or D, Yoel G. Calcium and calciferol antagonize effect of verapamil in atrial fibrillation. Br Med J 1981;282:1585-6.
  5. Demontis R, Leflon A, Fournier A, et al. 1 alpha(OH) vitamin D3 increases plasma aluminum in hemodialyzed patients taking AI(OH)3. Clin Nephrol 1986;26:146-9.
  6. Crowe M, Wollner L, Griffiths RA. Hypercalcemia following vitamin D and thiazide therapy in the elderly. Practitioner 1984;228:312-3.
  7. Parfitt AM. Thiazide-induced hypercalcemia in vitamin D-treated hypoparathyroidism. Ann Intern Med 1972;77:557-63. PubMed
  8. Thiazide diuretics and the risk of osteoporosis. Pharmacist's Letter/Prescriber's Letter 2003;19(11):191105.
  9. Moon J. The role of vitamin D in toxic metal absorption. J Am Coll Nutr 1994;13:559-64.
  10. Demontis R, Reissi D, Noel C, et al. Indirect clinical evidence that 1alphaOH vitamin D<SUB>3</SUB> increases the intestinal absorption of aluminum. Clin Nephrol 1989;31:123-7.
  11. Adler AJ, Berlyne GM. Duodenal aluminum absorption in the rat: effect of vitamin D. Am J Physiol 1985;249:G209-13. PubMed
  12. Schwartz JB. Effects of vitamin D supplementation in atorvastatin-treated patients: A new drug interaction with an unexpected consequence. Clin Pharmacol Ther 2009;85:198-203. PubMed
  13. Dietary reference intakes for calcium and vitamin D. Institute of Medicine, November 30, 2010. Available at: http://www.iom.edu/~/media/Files/Report%20Files/2010/Dietary-Reference-Intakes-for-Calcium-and-Vitamin-D/Vitamin%20D%20and%20Calcium%202010%20Repo
  14. Cox KA, Dunn MA. Aluminum toxicity alters the regulation of calbindin-D28k protein and mRNA expression in chick intestine. J Nutr 2001;131:2007-13. PubMed
  15. Escribano, J., Balaguer, A., Pagone, F., Feliu, A., and Roque, I. Figuls. Pharmacological interventions for preventing complications in idiopathic hypercalciuria. Cochrane.Database.Syst.Rev. 2009;(1):CD004754. PubMed
  16. Carlton, S., Clopton, D., and Cappuzzo, K. A. Vitamin D deficiency: appropriate replenishment therapies and the effects of vitamin D toxicity. Consult Pharm 2010;25(3):171-177. PubMed
  17. Wang, H., Xia, N., Yang, Y., and Peng, D. Q. Influence of vitamin D supplementation on plasma lipid profiles: a meta-analysis of randomized controlled trials. Lipids Health Dis. 2012;11:42. PubMed
  18. Turner AN, Carr Reese P, Fields KS, Anderson J, Ervin M, Davis JA, Fichorova RN, Roberts MW, Klebanoff MA, Jackson RD. A blinded, randomized controlled trial of high-dose vitamin D supplementation to reduce recurrence of bacterial vaginosis. Am J Obstet G PubMed
  19. Weiner M, Epstein FH. Signs and symptoms of electrolyte disorders. Yale J Biol Med. 1970;43(2):76-109.
  20. Lappe J, Watson P, Travers-Gustafson D, Recker R, Garland C, Gorham E, Baggerly K, McDonnell SL. Effect of Vitamin D and Calcium Supplementation on Cancer Incidence in Older Women: A Randomized Clinical Trial. JAMA. 2017 Mar 28;317(12):1234-1243. PubMed
  21. Roth DE, Leung M, Mesfin E, Qamar H, Watterworth J, Papp E. Vitamin D supplementation during pregnancy: state of the evidence from a systematic review of randomised trials. BMJ. 2017;359:j5237. PubMed
  22. Murai IH, Fernandes AL, Sales LP, et al. Effect of a single high dose of vitamin D3 on hospital length of stay in patients with moderate to severe COVID-19: A randomized clinical trial. JAMA. 2021.
  23. Wang Z, Schuetz EG, Xu Y, Thummel KE. Interplay between vitamin D and the drug metabolizing enzyme CYP3A4. J Steroid Biochem Mol Biol 2013;136:54-8. PubMed
  24. Doyle D, Browne U, Brickley A, Murphy D. Vitamin D-induced hypercalcaemia and acute kidney injury in sarcoidosis. BMJ Case Rep 2023;16(1):e250580. PubMed
  25. Williamson A, Martineau AR, Sheikh A, Jolliffe D, Griffiths CJ. Vitamin D for the management of asthma. Cochrane Database Syst Rev 2023;2(2):CD011511. PubMed
  26. Kinesya E, Santoso D, Gde Arya N, et al. Vitamin D as adjuvant therapy for diabetic foot ulcers: Systematic review and meta-analysis approach. Clin Nutr ESPEN 2023;54:137-143. PubMed

See these in context on the Vitamin D monograph →

Elderberry 6 references
  1. Barak V, Halperin T, Kalickman I. The effect of Sambucol, a black elderberry-based, natural product, on the production of human cytokines: I. Inflammatory cytokines. Eur Cytokine Netw 2001;12:290-6..
  2. Elderberry (Sambucus species). The Poison Plant Patch, Novia Scotia Museum, 2007. Available at: http://museum.gov.ns.ca/poison/?section=species&id=117 (Accessed 16 October 2009).
  3. European elder. Canadian Poisonous Plants Information System. Available at: http://www.cbif.gc.ca/pls/pp/ppack.jump?p_null=all&p_psn=121&p_type=all&p_sci=comm&p_x=px (Accessed 16 October 2009).
  4. Raus K, Pleschka S, Klein P, Schoop R, Fisher P. Effect of an echinacea-based hot drink versus oseltamivir in Influenza treatment: a randomized, double-blind, double-dummy, multicenter, noninferiority clinical trial. . Curr Ther Res Clin Exp. 2015;20;77:6 PubMed
  5. Ramachandran A, Antala D, Pudasainee P, Panginikkod S, Gupta H. A Plausible Association Between the Use of Elderberry and Autoimmune Hepatitis. Cureus 2022;14(4):e24250. PubMed
  6. Agarwal N, Mangla A. Elderberry interaction with pazopanib in a patient with soft-tissue sarcoma: A case report and literature review. Mol Clin Oncol 2024;20(5):36. PubMed

See these in context on the Elderberry monograph →

Maitake Mushroom 8 references
  1. Kabir Y, Kimura S. Dietary mushrooms reduce blood pressure in spontaneously hypertensive rats (SHR). J Nutr Sci Vitaminol (Tokyo) 1989;35:91-4. PubMed
  2. Kabir Y, Yamaguchi M, Kimura S. Effect of shiitake (Lentinus edodes) and maitake (Grifola frondosa) mushrooms on blood pressure and plasma lipids of spontaneously hypertensive rats. J Nutr Sci Vitaminol (Tokyo) 1987;33:341-6. PubMed
  3. Konno S, Tortorelis DG, Fullerton SA, et al. A possible hypoglycaemic effect of maitake mushroom on Type 2 diabetic patients. Diabet Med 2001;18:1010. PubMed
  4. Chen JT, Tominaga K, Sato Y, et al. Maitake mushroom (Grifola frondosa) extract induces ovulation in patients with polycystic ovary syndrome: a possible monotherapy and a combination therapy after failure with first-line clomiphene citrate. J Altern Compl
  5. Hanselin MR, Vande Griend JP, Linnebur SA. INR elevation with maitake extract in combination with warfarin. Ann Pharmacother 2010;44:223-4. PubMed
  6. Talpur, N. A., Echard, B. W., Fan, A. Y., Jaffari, O., Bagchi, D., and Preuss, H. G. Antihypertensive and metabolic effects of whole Maitake mushroom powder and its fractions in two rat strains. Mol.Cell Biochem. 2002;237(1-2):129-136. PubMed
  7. Deng, G., Lin, H., Seidman, A., Fornier, M., D'Andrea, G., Wesa, K., Yeung, S., Cunningham-Rundles, S., Vickers, A. J., and Cassileth, B. A phase I/II trial of a polysaccharide extract from Grifola frondosa (Maitake mushroom) in breast cancer patients: i
  8. Wesa KM, Cunningham-Rundles S, Klimek VM, et al. Maitake mushroom extract in myelodysplastic syndromes (MDS): a phase II study. Cancer Immunol Immunother 2015;64(2):237-47. PubMed

See these in context on the Maitake Mushroom monograph →

Olive 2 references
  1. Liccardi G, D'Amato M, D'Amato G. Oleaceae pollinosis: a review. Int Arch Allergy Immunol 1996;111:210-7. PubMed
  2. Somerville V, Moore R, Braakhuis A. The effect of olive leaf extract on upper respiratory illness in high school athletes: A randomised control trial. Nutrients. 2019;11(2). pii: E358. PubMed

See these in context on the Olive monograph →

Larch Arabinogalactan 8 references
  1. D'Adamo P. Larch arabinogalactan. J Naturopath Med 1996;6:33-7.
  2. Kelly GS. Larch arabinogalactan: Clinical relevance of a novel immune-enhancing polysaccharide. Alt Med Rev 1999;4:96-103.
  3. Marett R, Slavin JL. No long-term benefits of supplementation with arabinogalactan on serum lipids and glucose. J Am Diet Assoc 2004;104:636-9.
  4. Robinson RR, Feirtag J, Slavin JL. Effects of dietary arabinogalactan on gastrointestinal and blood parameters in healthy human subjects. J Am Coll Nutr 2001;20:279-85. PubMed
  5. Udani JK, Singh BB, Barrett ML, Singh VJ. Proprietary arabinogalactan extract increases antibody response to the pneumonia vaccine: a randomized, double-blind, placebo-controlled, pilot study in healthy volunteers. Nutr J 2010;9:32. PubMed
  6. Grube B, Stier H, Riede L, Gruenwald J. Tolerability of a proprietary larch arabinogalactan extract: a randomized, double-blind, placebo-controlled clinical trial in healthy subjects. Food Nutr Sci 2012;3:1533-8. DOI
  7. Dion C, Chappuis E, Ripoll C. Does larch arabinogalactan enhance immune function? A review of mechanistic and clinical trials. Nutr Metab (Lond) 2016;13:28. PubMed
  8. Riede L, Grube B, Gruenwald J. Larch arabinogalactan effects on reducing incidence of upper respiratory tract infections. Curr Med Res Opin 2013;29(3):251-8.

See these in context on the Larch Arabinogalactan monograph →

Cordyceps 14 references
  1. Zhu JS, Halpern GM, Jones K. The scientific rediscovery of an ancient Chinese herbal medicine: Cordyceps sinensis: part I. J Altern Complement Med 1998;4:289-303.
  2. Zhu JS, Halpern GM, Jones K. The scientific rediscovery of a precious ancient Chinese herbal regimen: Cordyceps sinensis: part II. J Altern Complement Med 1998;4:429-57.
  3. Chen YJ, Shiao MS, Lee SS, Wang SY. Effect of Cordyceps sinensis on the proliferation and differentiation of human leukemic U937 cells. Life Sci 1997;60:2349-59. PubMed
  4. Zhao Y. [Inhibitory effects of alcoholic extract of Cordyceps sinensis on abdominal aortic thrombus formation in rabbits]. Chung Hua I Hsueh Tsa Chih (Taipei) 1991;71:612-5, 42.
  5. Chen GZ, Chen GL, Sun T, et al. Effects of Cordyceps sinensis on murine T lymphocyte subsets. Chin Med J (English) 1991;104:4-8.
  6. Zhu XY, Yu HY. [Immunosuppressive effect of cultured Cordyceps sinensis on cellular immune response]. Chung Hsi I Chieh Ho Tsa Chih 1990;10:485-7, 454.
  7. Hsu, C. C., Huang, Y. L., Tsai, S. J., Sheu, C. C., and Huang, B. M. In vivo and in vitro stimulatory effects of Cordyceps sinensis on testosterone production in mouse Leydig cells. Life Sci 9-5-2003;73(16):2127-2136. PubMed
  8. Ikumoto, T., Sasaki, S., Namba, H., Toyama, R., Moritoki, H., and Mouri, T. [Physiologically active compounds in the extracts from tochukaso and cultured mycelia of Cordyceps and Isaria]. Yakugaku Zasshi 1991;111(9):504-509. PubMed
  9. Wu, T. N., Yang, K. C., Wang, C. M., Lai, J. S., Ko, K. N., Chang, P. Y., and Liou, S. H. Lead poisoning caused by contaminated Cordyceps, a Chinese herbal medicine: two case reports. Sci.Total Environ. 4-5-1996;182(1-3):193-195. PubMed
  10. Hong T, Zhang M, Fan J. Cordyceps sinensis (a traditional Chinese medicine) for kidney transplant recipients (Review). Cochrane Database Syst Rev. 2015;(10):CD009698. doi: 10.1002/14651858.CD009698.pub2.
  11. Zhang HW, Lin ZX, Tung YS, Kwan TH, Mok CK, Leung C, Chan LS. Cordyceps sinensis (a traditional Chinese medicine) for treating chronic kidney disease (Review). Cochrane Database Syst Rev. 2014;(12):CD008353. doi: 10.1002/14651858.CD008353.pub2. PubMed
  12. Bee Yean O, Zoriah A. Efficacy of Cordyceps sinensis as an adjunctive treatment in hemodialysis patients: a systematic review and Meta-analysis. J Tradit Chin Med. 2019;39(1):1-14.
  13. Thurian D, Montani M, Stickel F. Drug-induced, mixed-type hepatitis following ingestion of Cordyceps sinensis. Int J Clin Pharmacol Ther 2022;60(2):115-120. PubMed
  14. Yu X, Mao Y, Shergis JL, et al. Effectiveness and safety of oral Cordyceps sinensis on stable COPD of GOLD stages 2-3: Systematic review and meta-analysis. Evid Based Complement Alternat Med. 2019;2019:4903671.

See these in context on the Cordyceps monograph →

Reishi Mushroom 17 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. Tao J, Feng KY. Experimental and clinical studies on inhibitory effect of ganoderma lucidum on platelet aggregation. J Tongji Med Univ 1990;10:240-3. PubMed
  3. Singh AB, Gupta SK, Pereira BM, Prakash D. Sensitization to Ganoderma lucidum in patients with respiratory allergy in India. Clin Exp Allergy 1995;25:440-7.
  4. Lee SY, Rhee HM. Cardiovascular effects of mycelium extract of Ganoderma lucidum: inhibition of sympathetic outflow as a mechanism of its hypotensive action. Chem Pharm Bull (Tokyo) 1990;38:1359-64. PubMed
  5. Kwok Y, Ng KFJ, Li, CCF, et al. A prospective, randomized, double-blind, placebo-controlled study of the platelet and global hemostatic effects of Ganoderma lucidum (Ling-Zhi) in healthy volunteers. Anesth Analg 2005;101:423-6. PubMed
  6. Wanmuang, H., Leopairut, J., Kositchaiwat, C., Wananukul, W., and Bunyaratvej, S. Fatal fulminant hepatitis associated with Ganoderma lucidum (Lingzhi) mushroom powder. J Med Assoc Thai. 2007;90(1):179-181.
  7. Seto, S. W., Lam, T. Y., Tam, H. L., Au, A. L., Chan, S. W., Wu, J. H., Yu, P. H., Leung, G. P., Ngai, S. M., Yeung, J. H., Leung, P. S., Lee, S. M., and Kwan, Y. W. Novel hypoglycemic effects of Ganoderma lucidum water-extract in obese/diabetic (+db/+db
  8. Chu, T. T., Benzie, I. F., Lam, C. W., Fok, B. S., Lee, K. K., and Tomlinson, B. Study of potential cardioprotective effects of Ganoderma lucidum (Lingzhi): results of a controlled human intervention trial. Br.J.Nutr. 2012;107(7):1017-1027.
  9. Jin, X., Ruiz, Beguerie J., Sze, D. M., and Chan, G. C. Ganoderma lucidum (Reishi mushroom) for cancer treatment. Cochrane.Database.Syst.Rev. 2012;6:CD007731.
  10. Kabir, Y., Kimura, S., and Tamura, T. Dietary effect of Ganoderma lucidum mushroom on blood pressure and lipid levels in spontaneously hypertensive rats (SHR). J Nutr Sci Vitaminol.(Tokyo) 1988;34(4):433-438. PubMed
  11. Kanmatsuse, K., Kajiwara, N., Hayashi, K., Shimogaichi, S., Fukinbara, I., Ishikawa, H., and Tamura, T. [Studies on Ganoderma lucidum. I. Efficacy against hypertension and side effects]. Yakugaku Zasshi 1985;105(10):942-947. PubMed
  12. Gao, Y., Lan, J., Dai, X., Ye, J., and Zhou, S. A Phase I/II Study of Ling Zhi Mushroom Ganoderma lucidum(W.Curt: Fr.) Lloyd (Aphyllophoromycetideae) Extract in Patients with Type II Diabetes Mellitus. International Journal of Medicinal Mushrooms 2004;6. DOI
  13. Jin H, Zhang G, Cao X, and et al. Treatment of hypertension by linzhi combined with hypotensor and its effects on arterial, arteriolar and capillary pressure and microcirculation. In: Niimi H, Xiu RJ, Sawada T, and et al. Microcirculatory Approach to Asi
  14. Klupp NL, Chang D, Hawke F, Kiat H, Cao H, Grant SJ, Bensoussan A. Ganoderma lucidum mushroom for the treatment of cardiovascular risk factors. Cochrane Database Syst Rev. 2015 Feb 17;2:CD007259. PubMed
  15. Zhao H, Zhang Q, Zhao L, Huang X, Wang J, Kang X. Spore Powder of Ganoderma lucidum Improves Cancer-Related Fatigue in Breast Cancer Patients Undergoing Endocrine Therapy: A Pilot Clinical Trial. Evid Based Complement Alternat Med. 2012;2012:809614.
  16. Pazzi F, Adsuar JC, Domínguez-Muñoz FJ, García-Gordillo MA, Gusi N, Collado-Mateo D. Ganoderma lucidum effects on mood and health-related quality of life in women with fibromyalgia. Healthcare (Basel) 2020;8(4):520. PubMed
  17. Kogure T, Koiwai A, Fukushi D, et al. Hypereosinophilia with hepatic nodule formation caused by Ganoderma lucidum. Intern Med 2021;60(24):3897-3903.

See these in context on the Reishi Mushroom monograph →

Royal Jelly 14 references
  1. Takahashi M, Matsuo I, Ohkido M. Contact dermatitis due to honeybee royal jelly. Contact Dermatitis 1983;9:452-5.
  2. Bullock RJ, et al. Fatal royal jelly-induced asthma. Med J Aust 1994;160:44. DOI
  3. Thien FC, Leung R, Baldo BA, et al. Asthma and anaphylaxis induced by royal jelly. Clin Exp Allergy 1996;26:216-22. PubMed
  4. Yonei Y, Shibagaki K, Tsukada N, et al. Case report: haemorrhagic colitis associated with royal jelly intake. J Gastroenterol Hepatol 1997;12:495-9.
  5. Harwood M, Harding S, Beasley R, Frankish PD. Asthma following royal jelly. N Z Med J 1996;109:325.
  6. Laporte JR, Ibaanez L, Vendrell L, Ballarin E. Bronchospasm induced by royal jelly. Allergy 1996;51:440. DOI
  7. Leung R, Thien FC, Baldo B, et al. Royal jelly-induced asthma and anaphylaxis: clinical characteristics and immunologic correlations. J Allergy Clin Immunol 1995;96:1004-7. PubMed
  8. Peacock S, Murray V, Turton C. Respiratory distress and royal jelly. BMJ 1995;311:1472. DOI
  9. Winther K, Hedman C. Assessment of the Effects of the Herbal Remedy Femal on the Symptoms of Premenstrual Syndrome: A Randomized, Double-Blind, Placebo-Controlled Study. Curr Ther Res Clin Exp 2002;63:344-53. DOI
  10. Lee NJ, Fermo JD. Warfarin and royal jelly interaction. Pharmacotherapy 2006;26:583-6. PubMed
  11. Tokunaga, K. H., Yoshida, C., Suzuki, K. M., Maruyama, H., Futamura, Y., Araki, Y., and Mishima, S. Antihypertensive effect of peptides from royal jelly in spontaneously hypertensive rats. Biol.Pharm.Bull. 2004;27(2):189-192. PubMed
  12. Sultana, A., Nabi, A. H., Nasir, U. M., Maruyama, H., Suzuki, K. M., Mishima, S., and Suzuki, F. A dipeptide YY derived from royal jelly proteins inhibits renin activity. Int.J.Mol.Med. 2008;21(6):677-681. DOI
  13. Gómez Torrijos E, Méndez Diaz Y, Borja Segade JM, et al. Occupational allergic respiratory disease due to royal jelly. Ann Allergy Asthma Immunol. 2016;117(1):102-3. PubMed
  14. Li JD, Cui L, Xu YY, Guan K. A case of anaphylaxis caused by major royal jelly protein 3 of royal jelly and its cross-reactivity with honeycomb. J Asthma Allergy 2021;14:1555-7. PubMed

See these in context on the Royal Jelly monograph →

Beta-glucans 11 references
  1. Katz, D. L., Nawaz, H., Boukhalil, J., Giannamore, V., Chan, W., Ahmadi, R., and Sarrel, P. M. Acute effects of oats and vitamin E on endothelial responses to ingested fat. Am.J.Prev.Med. 2001;20(2):124-129. PubMed
  2. Keenan, J. M., Pins, J. J., Frazel, C., Moran, A., and Turnquist, L. Oat ingestion reduces systolic and diastolic blood pressure in patients with mild or borderline hypertension: a pilot trial. J.Fam.Pract. 2002;51(4):369.
  3. Maki, K. C., Galant, R., Samuel, P., Tesser, J., Witchger, M. S., Ribaya-Mercado, J. D., Blumberg, J. B., and Geohas, J. Effects of consuming foods containing oat beta-glucan on blood pressure, carbohydrate metabolism and biomarkers of oxidative stress i
  4. Bergendiova, K., Tibenska, E., and Majtan, J. Pleuran (beta-glucan from Pleurotus ostreatus) supplementation, cellular immune response and respiratory tract infections in athletes. Eur.J.Appl.Physiol 2011;111(9):2033-2040.
  5. Talbott S, Talbott J. Effect of beta 1,3/1,6 glucan on respiratory tract infection symptoms and mood state in marathon athletes. J Sports Sci Med 2009;8(4):509-515.
  6. Feldman S, Schwartz HI Kalman DS Mayers A Kohrman HM Clemens R Krieger DR. Randomized phase II clinical trials of Wellmune WGP&reg; for immune support during cold and flu season. The Journal of Applied Research 2009;9(1-2):30-42.
  7. McFarlin BK, Carpenter KC, Davidson T, McFarlin MA. Baker's yeast beta glucan supplementation increases salivary IgA and decreases cold/flu symptomatic days after intense exercise. J Diet Suppl. 2013;10(3):171-83. PubMed
  8. Jesenak M, Urbancek S, Majtan J, Banovcin P, Hercogova J. ß-Glucan-based cream (containing pleuran isolated from pleurotus ostreatus) in supportive treatment of mild-to-moderate atopic dermatitis. J Dermatolog Treat 2016;27(4):351-4.
  9. Mah E, Kaden VN, Kelley KM, Liska DJ. Beverage containing dispersible yeast ß-glucan decreases cold/flu symptomatic days after intense exercise: a randomized controlled trial. J Diet Suppl 2020;17(2):200-10. PubMed
  10. Zhong K, Liu Z, Lu Y, Xu X. Effects of yeast ß-glucans for the prevention and treatment of upper respiratory tract infection in healthy subjects: a systematic review and meta-analysis. Eur J Nutr. 2021. PubMed
  11. Cardenas FI, Mauguen A, Cheung IY, et al. Phase I trial of oral yeast-derived ß-glucan to enhance anti-GD2 immunotherapy of resistant high-risk neuroblastoma. Cancers (Basel) 2021;13(24):6265. PubMed

See these in context on the Beta-glucans monograph →

Echinacea 51 references
  1. Mullins RJ. Echinacea-associated anaphylaxis. Med J Aust 1998;168:170-1. PubMed
  2. Mullins RJ. Allergic reactions to Echinacea. J Allergy Clin Immunol 2000;104:S340-341 (Abstract 1003).
  3. Chavez ML, Chavez PI. Echinacea. Hosp Pharm 1998;33:180-8.
  4. Grimm W, Muller HH. A randomized controlled trial of the effect of fluid extract of Echinacea purpurea on the incidence and severity of colds and respiratory infections. Am J Med 1999;106:138-43. PubMed
  5. Taylor JA, Weber W, Standish L, et al. Efficacy and safety of echinacea in treating upper respiratory tract infections in children: a randomized controlled trial. JAMA 2003;290:2824-30.. PubMed
  6. Luettig B, Steinmuller C, Gifford GE, et al. Macrophage activation by the polysaccharide arabinogalactan isolated from plant cell cultures of Echinacea purpurea. J Natl Cancer Inst 1989;81:669-75. PubMed
  7. Stimpel M, Proksch A, Wagner H, et al. Macrophage activation and induction of macrophage cytotoxicity by purified polysaccharide fractions from the plant Echinacea purpurea. Infect Immun 1984;46:845-9. PubMed
  8. Budzinski JW, Foster BC, Vandenhoek S, Arnason JT. An in vitro evaluation of human cytochrome P450 3A4 inhibition by selected commercial herbal extracts and tinctures. Phytomedicine 2000;7:273-82. PubMed
  9. Gallo M, Sarkar M, Au W, et al. Pregnancy outcome following gestational exposure to echinacea: A prospective controlled study. Arch Intern Med 2000;160:3141-3. PubMed
  10. Soon SL, Crawford RI. Recurrent erythema nodosum associated with echinacea herbal therapy. J Am Acad Dermatol 2001;44:298-9. PubMed
  11. Mullins RJ, Heddle R. Adverse reactions associated with echinacea: the Australian experience. Ann Allergy Asthma Immunol 2002;88:42-51. PubMed
  12. Logan JL, Ahmed J. Critical hypokalemic renal tubular acidosis due to Sjogren's syndrome: association with the purported immune stimulant echinacea. Clin Rheumatol 2003;22:158-9.
  13. Schulten B, Bulitta M, Ballering-Bruhl B, et al. Efficacy of Echinacea purpurea in patients with a common cold. A placebo-controlled, randomised, double-blind clinical trial. Arzneimittelforschung 2001;51:563-8.. PubMed
  14. Yale SH, Glurich I. Analysis of the inhibitory potential of Ginkgo biloba, Echinacea purpurea, and Serenoa repens on the metabolic activity of cytochrome P450 3A4, 2D6, and 2C9. J Altern Complement Med 2005;11:433-9.
  15. Yale SH, Liu K. Echinacea purpurea therapy for the treatment of the common cold: a randomized, double-blind, placebo-controlled clinical trial. Arch Intern Med 2004;164:1237-41. PubMed
  16. Gorski JC, Huang S, Zaheer NA, et al. The effect of echinacea (Echinacea purpurea root) on cytochrome P450 activity in vivo.Clin Pharmacol Ther 2003;73 (Abstract PDII-A-8):P94. PubMed
  17. Lee AN, Werth VP. Activation of autoimmunity following use of immunostimulatory herbal supplements. Arch Dermatol 2004;140:723-7. PubMed
  18. Goel V, Lovlin R, Barton R, et al. Efficacy of a standardized echinacea preparation (Echinilin) for the treatment of the common cold: a randomized, double-blind, placebo-controlled trial. J Clin Pharm Ther 2004;29:75-83.
  19. Barrett B. Medicinal properties of Echinacea: a critical review. Phytomedicine 2003;10:66-86. PubMed
  20. Huntley AL, Thompson Coon J, Ernst E. The safety of herbal medicinal products derived from Echinacea species: a systematic review. Drug Saf 2005;28:387-400. PubMed
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  22. Gurley BJ, Gardner SF, Hubbard MA, et al. In vivo assessment of botanical supplementation on human cytochrome P450 phenotypes: Citrus aurantium, Echinacea purpurea, milk thistle, and saw palmetto. Clin Pharmacol Ther 2004;76:428-40. .
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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.

© 2021 Therapeutic Research Center, LLC

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