ProMacular Ingredients & Drug Interactions
by HUMANX
What is this page for?
First and foremost: checking ProMacular 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
ProMacular is a dietary supplement by HUMANX with 5 active ingredients. Its ingredients are commonly taken for antioxidant support, skin health and aging, eye health.Based on those ingredients, 928 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Astaxanthin, Bilberry fruit extract, Vitamin C. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against ProMacular by HUMANX
Ask about any prescription or over-the-counter medication and we check it for interactions with ProMacular by HUMANX — and tell you which ingredient is responsible.
AI summaries are generated from our interaction database for education only — always confirm with your pharmacist. How we use AI
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HelloPharmacist Scorecard of ProMacular by HUMANX
Our pharmacy team’s full take, with four database checks built into the cards below — a summary of what is known, not a grade of the product itself.
What’s inside
Full disclosure
ProMacular contains 5 active ingredients. Astaxanthin, lutein, and zeaxanthin are carotenoids — pigments that concentrate in the eye and may support vision and eye health.
Vitamin C is an antioxidant vitamin that plays a role in tissue health and immune function. Bilberry fruit extract contains anthocyanidins, plant compounds with antioxidant properties.
The capsule also contains methylcellulose as an inactive ingredient.
Does it work?
Moderate evidence
The evidence for these ingredients is mixed. Lutein and zeaxanthin are rated possibly effective for age-related macular degeneration and cataracts.
Vitamin C is effective for preventing vitamin C deficiency and rated possibly effective for several conditions including exercise-induced respiratory infections and cataracts. Astaxanthin, bilberry fruit extract, and zeaxanthin lack sufficient reliable evidence to rate them for most of their proposed uses — we simply don't have enough strong studies.
Bilberry is rated possibly ineffective for night vision.
How safe is it?
Well-documented data
These ingredients are generally well tolerated at typical doses. Astaxanthin may cause abdominal pain, diarrhea, or red-colored stools, especially at higher doses.
Vitamin C at normal supplement levels is safe, but very high doses (above 2 grams daily) can cause abdominal cramps, heartburn, diarrhea, headache, and nausea; kidney stones have been reported in people prone to them. Bilberry is well tolerated but may cause dark-colored stools, flatulence, or mild gastrointestinal discomfort.
Lutein and zeaxanthin are generally well tolerated at typical doses. During pregnancy, avoid astaxanthin — there isn't enough safety data.
Vitamin C at normal dietary and supplement amounts is fine, but avoid high-dose supplements in pregnancy. Bilberry fruit, lutein, and zeaxanthin are considered likely safe in pregnancy at normal amounts.
For breastfeeding, astaxanthin safety is not established, and high-dose vitamin C and zeaxanthin supplements lack sufficient data — food amounts are fine. Bilberry and lutein are considered likely safe while breastfeeding.
Meds to double-check
Moderate interaction found
Before taking ProMacular, double-check if you're on oral contraceptives or hormone replacement therapy (including patches or creams) — Vitamin C can raise estrogen levels significantly. Blood thinners like warfarin need to be reviewed, as high-dose Vitamin C may reduce their effect.
Check if you're on diabetes medications or thyroid medication levothyroxine. If you're undergoing chemotherapy, talk to your oncology team first.
The medication checker below will flag these and other affected drugs.
The bottom line
Scorecard at a glanceFully disclosed formula with some supporting evidence for its stated purpose. Moderate medication interactions have been identified, and safety information is well characterized.
ProMacular is a five-ingredient eye-support formula with some evidence for lutein and zeaxanthin in macular degeneration. If you take oral contraceptives, hormone replacement therapy, blood thinners, diabetes medications, thyroid medication, or any chemotherapy, check your exact medications with our tool before you start — the interactions are real and dose-dependent.
Talk with your pharmacist about whether this product makes sense for you alongside what you're currently taking.
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 Feb 21, 2023.
This Scorecard evaluates available label information, ingredient evidence, and known medication-safety considerations. It does not independently verify product identity, purity, potency, contamination, or manufacturing quality. How these ratings are computed
General information
Key facts about ProMacular, straight from the product 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 ProMacular by HUMANX, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Astaxanthin | 4 mg | -- |
| Vitamin C | 150 mg | 167% |
| Bilberry fruit extract | 40 mg | -- |
| Lutein | 15 mg | -- |
| Zeaxanthin | 3 mg | -- |
Other ingredients: Methylcellulose
Tap any ingredient to jump to its full detail below.
These statements are the manufacturer’s wording, reproduced from the product label — the label is saying it, not HelloPharmacist. We don’t verify or endorse them.
Formula
ProMacular is a proprietary blend that supports macular health, eye hydration and optic nerve function, supplying the combination of lutein, zeaxanthin and astaxanthin to the back & front eye muscles.
Suggested/Recommended/Usage/Directions
Suggested Use: As a dietary supplement, take one capsule per day with a glass of water, or as recommended by your healthcare professional.
Precautions
Caution: Keep out of reach of children and pets.
Caution: Keep out of reach of children and pets.
Consult with a qualified healthcare professional prior to using this product. Do not exceed recommended daily intake. Do not use if safety seal is damaged or missing.
Storage
Store at room temperature, in a dry place. Protect product from excessive heat, freezing, humidity, and light.
General Statements
100% refund guarantee Refund guarantee We offer a full refund on the purchase price of your order (minus return costs) within 30 days of purchase. Restrictions apply. Please visit shophumanx.com for full details.
212 milligrams per serving
Formulation
Supports macular health, eye hydration & optic nerve function
FDA Statement of Identity
Dietary Supplement
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.
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
ProMacular by HUMANX label
The label scan from the NIH Dietary Supplement Label Database. Tap to enlarge.
Label images are published by the NIH Dietary Supplement Label Database for the version of this product on file. Always read your actual product label.
View the full label (PDF)The Ingredients in ProMacular by HUMANX
These are the 5 active ingredients this product is made of. Select any to open its full monograph.
Serving size1 Capsule(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.
Astaxanthin
Interacts with671 drugs
Astaxanthin is a reddish carotenoid pigment with strong antioxidant activity in the lab, and it is widely promoted for skin, eye, heart, and exercise...
Astaxanthin monograph & interactionsVitamin C
Interacts with207 drugs
Vitamin C (ascorbic acid) is an essential nutrient your body needs but cannot make, so you must get it from food or supplements. It's important for im...
Vitamin C monograph & interactionsBilberry fruit extract
Interacts with275 drugs
Bilberry is a blueberry-like fruit rich in antioxidant plant compounds called anthocyanins, and it has a long history of traditional use for eye healt...
Bilberry fruit extract monograph & interactionsLutein
No knowninteractions
Lutein is a plant-based antioxidant pigment that concentrates in the eye, and the best evidence suggests it (often combined with zeaxanthin) may help...
Lutein monograph & interactionsZeaxanthin
Interacts with86 drugs
Zeaxanthin is a carotenoid pigment that, along with lutein, concentrates in the macula of the eye and may help support long-term eye health. The stron...
Zeaxanthin monograph & interactionsOther (inactive) ingredients: Methylcellulose. These complete the product’s ingredient list but are not active constituents.
ProMacular by HUMANX Drug Interactions
HelloPharmacist Interaction Report
ProMacular by HUMANX contains five active ingredients, and several of them interact with medications.
The most serious concern involves Vitamin C, which can increase blood levels of estrogens in oral contraceptives and hormone replacement therapy — including topical forms — potentially raising estrogen levels by up to 55% in some cases.
Read the full breakdown — every affected drug type, severity by severity
Vitamin C also interacts with blood thinners (anticoagulants) like warfarin; high doses may reduce warfarin's effectiveness and your blood's ability to clot. It can interfere with the thyroid medication levothyroxine by increasing absorption.
It may theoretically reduce the effectiveness of certain chemotherapy drugs (alkylating agents and antitumor antibiotics that work through free-radical damage). Additionally, it interacts with the antipsychotic fluphenazine and the HIV medication indinavir, and can increase aluminum absorption from aluminum-containing compounds.
Astaxanthin may theoretically decrease levels of drugs metabolized through two liver pathways (CYP3A4 and CYP2B6 substrates), though this has not been reported in humans. Bilberry fruit extract interacts with blood thinners and diabetes medications (increasing low blood sugar risk), and may theoretically reduce levels of CYP2E1-metabolized drugs or interfere with the cancer drug erlotinib.
Zeaxanthin may theoretically increase the risk of low blood sugar when combined with diabetes medications.
Lutein has no interactions documented in our data. Altogether, these interactions span 917 individual medications.
Use the medication checker on this page to see if any of your prescriptions are affected before you start.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against ProMacular?
Ask about interactions with your drugs in plain English — “Can I take it with lisinopril?” — and we find you the answer in seconds, ingredient by ingredient.
Go to the checkerIngredients driving the most interactions
Individual Drug Interactions
The ingredients in ProMacular interact with 928 drugs. Click any drug to see the details.
4 of the 5 ingredients in ProMacular interact with drugs. Each result below shows which ingredient is responsible. Astaxanthin Bilberry fruit extract Vitamin C Zeaxanthin
Ado-trastuzumab EmtansineKadcyla
How Ado-trastuzumab Emtansine interacts with ProMacular — through 1 ingredient. Tap an ingredient for the detail:
AstaxanthinCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, astaxanthin may decrease levels of drugs metabolized by CYP3A4.
Read the full Astaxanthin + Ado-trastuzumab Emtansine interactionAbciximabReoPro
How Abciximab interacts with ProMacular — through 1 ingredient. Tap an ingredient for the detail:
Bilberry Fruit ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, bilberry fruit extract might increase the risk of bleeding when taken with anticoagulant or antiplatelet drugs.
Read the full Bilberry Fruit Extract + Abciximab interactionAbemaciclibVerzenio
How Abemaciclib interacts with ProMacular — through 1 ingredient. Tap an ingredient for the detail:
AstaxanthinCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, astaxanthin may decrease levels of drugs metabolized by CYP3A4.
Read the full Astaxanthin + Abemaciclib interactionAbiraterone
How Abiraterone interacts with ProMacular — through 1 ingredient. Tap an ingredient for the detail:
AstaxanthinCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, astaxanthin may decrease levels of drugs metabolized by CYP3A4.
Read the full Astaxanthin + Abiraterone interactionAbiraterone AcetateYonsa, Zytiga
How Abiraterone Acetate interacts with ProMacular — through 1 ingredient. Tap an ingredient for the detail:
AstaxanthinCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, astaxanthin may decrease levels of drugs metabolized by CYP3A4.
Read the full Astaxanthin + Abiraterone Acetate interactionAbrocitinibCibinqo
How Abrocitinib interacts with ProMacular — through 1 ingredient. Tap an ingredient for the detail:
Bilberry Fruit ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, bilberry fruit extract might increase the risk of bleeding when taken with anticoagulant or antiplatelet drugs.
Read the full Bilberry Fruit Extract + Abrocitinib interactionAcalabrutinibCalquence
How Acalabrutinib interacts with ProMacular — through 1 ingredient. Tap an ingredient for the detail:
AstaxanthinCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, astaxanthin may decrease levels of drugs metabolized by CYP3A4.
Read the full Astaxanthin + Acalabrutinib interactionAcarboseGlucobay, Prandase, Precose
How Acarbose interacts with ProMacular — through 2 ingredients. Tap an ingredient for the detail:
Bilberry Fruit ExtractAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, bilberry leaf or fruit extract may increase the risk of hypoglycemia when taken with antidiabetes drugs.
Read the full Bilberry Fruit Extract + Acarbose interactionZeaxanthinAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, taking zeaxanthin with antidiabetes drugs might increase the risk of hypoglycemia.
Read the full Zeaxanthin + Acarbose interactionAcenocoumarolSintrom
How Acenocoumarol interacts with ProMacular — through 1 ingredient. Tap an ingredient for the detail:
Bilberry Fruit ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, bilberry fruit extract might increase the risk of bleeding when taken with anticoagulant or antiplatelet drugs.
Read the full Bilberry Fruit Extract + Acenocoumarol interactionAcetaminophenChildren's Tylenol, Children's Tylenol Meltaways, Tylenol, Tylenol Ex Strength
How Acetaminophen interacts with ProMacular — through 2 ingredients. Tap an ingredient for the detail:
Bilberry Fruit ExtractCytochrome P450 2e1 (cyp2e1) Substrates Moderate
Interaction Summary
Theoretically, bilberry fruit extract might decrease levels of drugs metabolized by CYP2E1.
Read the full Bilberry Fruit Extract + Acetaminophen interactionVitamin CAcetaminophen (tylenol, Others) Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C + Acetaminophen interactionAcetaminophen, AspirinGemnisyn
How Acetaminophen, Aspirin interacts with ProMacular — through 2 ingredients. Tap an ingredient for the detail:
Bilberry Fruit ExtractCytochrome P450 2e1 (cyp2e1) Substrates, Anticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, bilberry fruit extract might decrease levels of drugs metabolized by CYP2E1.
Read the full Bilberry Fruit Extract + Acetaminophen, Aspirin interactionVitamin CAcetaminophen (tylenol, Others), Aspirin Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C + Acetaminophen, Aspirin interactionAcetaminophen, Aspirin, CaffeineExcedrin, Excedrin Extra Strength, Excedrin Migraine
How Acetaminophen, Aspirin, Caffeine interacts with ProMacular — through 3 ingredients. Tap an ingredient for the detail:
Bilberry Fruit ExtractAnticoagulant/antiplatelet Drugs, Cytochrome P450 2e1 (cyp2e1) Substrates Moderate
Interaction Summary
Theoretically, bilberry fruit extract might increase the risk of bleeding when taken with anticoagulant or antiplatelet drugs.
Read the full Bilberry Fruit Extract + Acetaminophen, Aspirin, Caffeine interactionAstaxanthinCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, astaxanthin may decrease levels of drugs metabolized by CYP3A4.
Read the full Astaxanthin + Acetaminophen, Aspirin, Caffeine interactionVitamin CAcetaminophen (tylenol, Others), Aspirin Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C + Acetaminophen, Aspirin, Caffeine interactionAcetaminophen, Brompheniramine, PhenylpropanolamineDimetapp Cold and Flu
How Acetaminophen, Brompheniramine, Phenylpropanolamine interacts with ProMacular — through 2 ingredients. Tap an ingredient for the detail:
Bilberry Fruit ExtractCytochrome P450 2e1 (cyp2e1) Substrates Moderate
Interaction Summary
Theoretically, bilberry fruit extract might decrease levels of drugs metabolized by CYP2E1.
Read the full Bilberry Fruit Extract + Acetaminophen, Brompheniramine, Phenylpropanolamine interactionVitamin CAcetaminophen (tylenol, Others) Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C + Acetaminophen, Brompheniramine, Phenylpropanolamine interactionAcetaminophen, ButalbitalAxocet, Bancap, Bucet, Butex Forte, Esgic CF, Orbivan CF +5 more
How Acetaminophen, Butalbital interacts with ProMacular — through 2 ingredients. Tap an ingredient for the detail:
Bilberry Fruit ExtractCytochrome P450 2e1 (cyp2e1) Substrates Moderate
Interaction Summary
Theoretically, bilberry fruit extract might decrease levels of drugs metabolized by CYP2E1.
Read the full Bilberry Fruit Extract + Acetaminophen, Butalbital interactionVitamin CAcetaminophen (tylenol, Others) Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C + Acetaminophen, Butalbital interactionAcetaminophen, Butalbital, CaffeineEsgic, Esgic Plus, Fiogesic, Fioricet, Repan, Tecnal +1 more
How Acetaminophen, Butalbital, Caffeine interacts with ProMacular — through 3 ingredients. Tap an ingredient for the detail:
Bilberry Fruit ExtractCytochrome P450 2e1 (cyp2e1) Substrates Moderate
Interaction Summary
Theoretically, bilberry fruit extract might decrease levels of drugs metabolized by CYP2E1.
Read the full Bilberry Fruit Extract + Acetaminophen, Butalbital, Caffeine interactionAstaxanthinCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, astaxanthin may decrease levels of drugs metabolized by CYP3A4.
Read the full Astaxanthin + Acetaminophen, Butalbital, Caffeine interactionVitamin CAcetaminophen (tylenol, Others) Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C + Acetaminophen, Butalbital, Caffeine interactionAcetaminophen, Butalbital, Caffeine, CodeineEsgic with Codeine, Fioricet w/ Codeine
How Acetaminophen, Butalbital, Caffeine, Codeine interacts with ProMacular — through 3 ingredients. Tap an ingredient for the detail:
AstaxanthinCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, astaxanthin may decrease levels of drugs metabolized by CYP3A4.
Read the full Astaxanthin + Acetaminophen, Butalbital, Caffeine, Codeine interactionBilberry Fruit ExtractCytochrome P450 2e1 (cyp2e1) Substrates Moderate
Interaction Summary
Theoretically, bilberry fruit extract might decrease levels of drugs metabolized by CYP2E1.
Read the full Bilberry Fruit Extract + Acetaminophen, Butalbital, Caffeine, Codeine interactionVitamin CAcetaminophen (tylenol, Others) Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C + Acetaminophen, Butalbital, Caffeine, Codeine interactionAcetaminophen, Butalbital, CodeineBancap w/ Codeine
How Acetaminophen, Butalbital, Codeine interacts with ProMacular — through 2 ingredients. Tap an ingredient for the detail:
Bilberry Fruit ExtractCytochrome P450 2e1 (cyp2e1) Substrates Moderate
Interaction Summary
Theoretically, bilberry fruit extract might decrease levels of drugs metabolized by CYP2E1.
Read the full Bilberry Fruit Extract + Acetaminophen, Butalbital, Codeine interactionVitamin CAcetaminophen (tylenol, Others) Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C + Acetaminophen, Butalbital, Codeine interactionAcetaminophen, Butalbital, Codeine PhosphatePhrenilin #3
How Acetaminophen, Butalbital, Codeine Phosphate interacts with ProMacular — through 2 ingredients. Tap an ingredient for the detail:
Bilberry Fruit ExtractCytochrome P450 2e1 (cyp2e1) Substrates Moderate
Interaction Summary
Theoretically, bilberry fruit extract might decrease levels of drugs metabolized by CYP2E1.
Read the full Bilberry Fruit Extract + Acetaminophen, Butalbital, Codeine Phosphate interactionVitamin CAcetaminophen (tylenol, Others) Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C + Acetaminophen, Butalbital, Codeine Phosphate interactionAcetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, PhenylephrineHycomine Compound
How Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interacts with ProMacular — through 3 ingredients. Tap an ingredient for the detail:
Bilberry Fruit ExtractCytochrome P450 2e1 (cyp2e1) Substrates Moderate
Interaction Summary
Theoretically, bilberry fruit extract might decrease levels of drugs metabolized by CYP2E1.
Read the full Bilberry Fruit Extract + Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interactionAstaxanthinCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, astaxanthin may decrease levels of drugs metabolized by CYP3A4.
Read the full Astaxanthin + Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interactionVitamin CAcetaminophen (tylenol, Others) Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C + Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interactionAcetaminophen, Caffeine, CodeineGesic C15, Gesic C30, Gesic C8, Lenoltec 1, Lenoltec 2, Lenoltec 3 +1 more
How Acetaminophen, Caffeine, Codeine interacts with ProMacular — through 3 ingredients. Tap an ingredient for the detail:
AstaxanthinCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, astaxanthin may decrease levels of drugs metabolized by CYP3A4.
Read the full Astaxanthin + Acetaminophen, Caffeine, Codeine interactionBilberry Fruit ExtractCytochrome P450 2e1 (cyp2e1) Substrates Moderate
Interaction Summary
Theoretically, bilberry fruit extract might decrease levels of drugs metabolized by CYP2E1.
Read the full Bilberry Fruit Extract + Acetaminophen, Caffeine, Codeine interactionVitamin CAcetaminophen (tylenol, Others) Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C + Acetaminophen, Caffeine, Codeine interactionAcetaminophen, Caffeine, Codeine, SalicylamideCodalan No.1, Codalan No.2, Codalan No.3
How Acetaminophen, Caffeine, Codeine, Salicylamide interacts with ProMacular — through 3 ingredients. Tap an ingredient for the detail:
AstaxanthinCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, astaxanthin may decrease levels of drugs metabolized by CYP3A4.
Read the full Astaxanthin + Acetaminophen, Caffeine, Codeine, Salicylamide interactionBilberry Fruit ExtractCytochrome P450 2e1 (cyp2e1) Substrates Moderate
Interaction Summary
Theoretically, bilberry fruit extract might decrease levels of drugs metabolized by CYP2E1.
Read the full Bilberry Fruit Extract + Acetaminophen, Caffeine, Codeine, Salicylamide interactionVitamin CAcetaminophen (tylenol, Others) Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C + Acetaminophen, Caffeine, Codeine, Salicylamide interactionAcetaminophen, Caffeine, DihydrocodeineDHC Plus, Panlor DC, Panlor SS
How Acetaminophen, Caffeine, Dihydrocodeine interacts with ProMacular — through 3 ingredients. Tap an ingredient for the detail:
Bilberry Fruit ExtractCytochrome P450 2e1 (cyp2e1) Substrates Moderate
Interaction Summary
Theoretically, bilberry fruit extract might decrease levels of drugs metabolized by CYP2E1.
Read the full Bilberry Fruit Extract + Acetaminophen, Caffeine, Dihydrocodeine interactionAstaxanthinCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, astaxanthin may decrease levels of drugs metabolized by CYP3A4.
Read the full Astaxanthin + Acetaminophen, Caffeine, Dihydrocodeine interactionVitamin CAcetaminophen (tylenol, Others) Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C + Acetaminophen, Caffeine, Dihydrocodeine interactionAcetaminophen, Caffeine, IsomethepteneMigralam
How Acetaminophen, Caffeine, Isometheptene interacts with ProMacular — through 3 ingredients. Tap an ingredient for the detail:
AstaxanthinCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, astaxanthin may decrease levels of drugs metabolized by CYP3A4.
Read the full Astaxanthin + Acetaminophen, Caffeine, Isometheptene interactionBilberry Fruit ExtractCytochrome P450 2e1 (cyp2e1) Substrates Moderate
Interaction Summary
Theoretically, bilberry fruit extract might decrease levels of drugs metabolized by CYP2E1.
Read the full Bilberry Fruit Extract + Acetaminophen, Caffeine, Isometheptene interactionVitamin CAcetaminophen (tylenol, Others) Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C + Acetaminophen, Caffeine, Isometheptene interactionAcetaminophen, Caffeine, PyrilamineMidol Max Strength Menstrual
How Acetaminophen, Caffeine, Pyrilamine interacts with ProMacular — through 3 ingredients. Tap an ingredient for the detail:
Bilberry Fruit ExtractCytochrome P450 2e1 (cyp2e1) Substrates Moderate
Interaction Summary
Theoretically, bilberry fruit extract might decrease levels of drugs metabolized by CYP2E1.
Read the full Bilberry Fruit Extract + Acetaminophen, Caffeine, Pyrilamine interactionAstaxanthinCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, astaxanthin may decrease levels of drugs metabolized by CYP3A4.
Read the full Astaxanthin + Acetaminophen, Caffeine, Pyrilamine interactionVitamin CAcetaminophen (tylenol, Others) Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C + Acetaminophen, Caffeine, Pyrilamine interactionAcetaminophen, Chlorpheniramine Maleate, Dextromethorphan HbrVicks Formula 44M Cough, Cold & Flu Relief
How Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interacts with ProMacular — through 3 ingredients. Tap an ingredient for the detail:
AstaxanthinCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, astaxanthin may decrease levels of drugs metabolized by CYP3A4.
Read the full Astaxanthin + Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interactionBilberry Fruit ExtractCytochrome P450 2e1 (cyp2e1) Substrates Moderate
Interaction Summary
Theoretically, bilberry fruit extract might decrease levels of drugs metabolized by CYP2E1.
Read the full Bilberry Fruit Extract + Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interactionVitamin CAcetaminophen (tylenol, Others) Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C + Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interactionAcetaminophen, Chlorpheniramine, Codeine, PhenylephrineColrex
How Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interacts with ProMacular — through 3 ingredients. Tap an ingredient for the detail:
AstaxanthinCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, astaxanthin may decrease levels of drugs metabolized by CYP3A4.
Read the full Astaxanthin + Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interactionBilberry Fruit ExtractCytochrome P450 2e1 (cyp2e1) Substrates Moderate
Interaction Summary
Theoretically, bilberry fruit extract might decrease levels of drugs metabolized by CYP2E1.
Read the full Bilberry Fruit Extract + Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interactionVitamin CAcetaminophen (tylenol, Others) Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C + Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interactionAcetaminophen, Chlorpheniramine, DextromethorphanCoricidin II Extra Strength Cold and Flu
How Acetaminophen, Chlorpheniramine, Dextromethorphan interacts with ProMacular — through 3 ingredients. Tap an ingredient for the detail:
Bilberry Fruit ExtractCytochrome P450 2e1 (cyp2e1) Substrates Moderate
Interaction Summary
Theoretically, bilberry fruit extract might decrease levels of drugs metabolized by CYP2E1.
Read the full Bilberry Fruit Extract + Acetaminophen, Chlorpheniramine, Dextromethorphan interactionAstaxanthinCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, astaxanthin may decrease levels of drugs metabolized by CYP3A4.
Read the full Astaxanthin + Acetaminophen, Chlorpheniramine, Dextromethorphan interactionVitamin CAcetaminophen (tylenol, Others) Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C + Acetaminophen, Chlorpheniramine, Dextromethorphan interactionAcetaminophen, Chlorpheniramine, Dextromethorphan HydrobromideCoricidin HBP Maximum Strength Flu
How Acetaminophen, Chlorpheniramine, Dextromethorphan Hydrobromide interacts with ProMacular — through 3 ingredients. Tap an ingredient for the detail:
AstaxanthinCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, astaxanthin may decrease levels of drugs metabolized by CYP3A4.
Read the full Astaxanthin + Acetaminophen, Chlorpheniramine, Dextromethorphan Hydrobromide interactionBilberry Fruit ExtractCytochrome P450 2e1 (cyp2e1) Substrates Moderate
Interaction Summary
Theoretically, bilberry fruit extract might decrease levels of drugs metabolized by CYP2E1.
Read the full Bilberry Fruit Extract + Acetaminophen, Chlorpheniramine, Dextromethorphan Hydrobromide interactionVitamin CAcetaminophen (tylenol, Others) Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C + Acetaminophen, Chlorpheniramine, Dextromethorphan Hydrobromide interactionAcetaminophen, Chlorpheniramine, Dextromethorphan, PhenylpropanolamineMulti Symptom Cold Relief
How Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylpropanolamine interacts with ProMacular — through 3 ingredients. Tap an ingredient for the detail:
Bilberry Fruit ExtractCytochrome P450 2e1 (cyp2e1) Substrates Moderate
Interaction Summary
Theoretically, bilberry fruit extract might decrease levels of drugs metabolized by CYP2E1.
Read the full Bilberry Fruit Extract + Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylpropanolamine interactionAstaxanthinCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, astaxanthin may decrease levels of drugs metabolized by CYP3A4.
Read the full Astaxanthin + Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylpropanolamine interactionVitamin CAcetaminophen (tylenol, Others) Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C + Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylpropanolamine interactionAcetaminophen, Chlorpheniramine, Dextromethorphan, PseudoephedrineChildren's Tylenol Cold Plus Cough, Tylenol Cold Ex Strength
How Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine interacts with ProMacular — through 3 ingredients. Tap an ingredient for the detail:
AstaxanthinCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, astaxanthin may decrease levels of drugs metabolized by CYP3A4.
Read the full Astaxanthin + Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine interactionBilberry Fruit ExtractCytochrome P450 2e1 (cyp2e1) Substrates Moderate
Interaction Summary
Theoretically, bilberry fruit extract might decrease levels of drugs metabolized by CYP2E1.
Read the full Bilberry Fruit Extract + Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine interactionVitamin CAcetaminophen (tylenol, Others) Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C + Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine interactionEach ingredient & the kinds of drugs it affects
For each ingredient in ProMacular 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.
Astaxanthin
Cytochrome P450 2B6 (Cyp2B6) Substrates
Theoretically, astaxanthin may decrease levels of drugs metabolized by CYP2B6.
In vitro research shows that astaxanthin induces cytochrome CYP2B6 enzyme activity in human hepatocytes. This effect has not been reported in humans.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, astaxanthin may decrease levels of drugs metabolized by CYP3A4.
In vitro research shows that astaxanthin induces CYP3A4 enzyme activity in human hepatocytes. This effect has not been reported in humans.
Bilberry fruit extract
Anticoagulant/Antiplatelet Drugs
Theoretically, bilberry fruit extract might increase the risk of bleeding when taken with anticoagulant or antiplatelet drugs.
In vitro, animal, and clinical research suggest that anthocyanidin extracts from bilberry can inhibit platelet aggregation.
Antidiabetes Drugs
Theoretically, bilberry leaf or fruit extract may increase the risk of hypoglycemia when taken with antidiabetes drugs.
Animal research suggests that bilberry leaf extract might have blood glucose-lowering activity. Also, one small clinical trial in patients with type 2 diabetes shows that taking bilberry fruit extract 470 mg as a single dose prior to an oral glucose tolerance test lowers plasma glucose levels when compared with placebo.
Cytochrome P450 2E1 (Cyp2E1) Substrates
Theoretically, bilberry fruit extract might decrease levels of drugs metabolized by CYP2E1.
Animal research shows that exposure to small concentrations of bilberry extract in drinking water for around one month increased CYP2E1 activity by 31%. However, exposure over a 2-month period did not increase CYP2E1 activity. This effect has not been reported in humans.
Erlotinib (Tarceva)
Theoretically, bilberry fruit extract might reduce the efficacy of erlotinib.
In vitro research suggests that bilberry fruit extract and its constituents, delphinidin and delphinidin-3-O-glucoside, inhibit the activity of erlotinib. This interaction has not been reported in humans.
Vitamin C
Alkylating Agents
Theoretically, antioxidant effects of vitamin C might reduce the effectiveness of alkylating agents.
The use of antioxidants like vitamin C during chemotherapy is controversial. There is concern that antioxidants could reduce the activity of chemotherapy drugs that generate free radicals, such as cyclophosphamide, chlorambucil, carmustine, busulfan, and thiotepa. In contrast, some researchers theorize that antioxidants might make chemotherapy more effective by reducing oxidative stress that could interfere with apoptosis (cell death) of cancer cells. More evidence is needed to determine what effect, if any, antioxidants such as vitamin C have on chemotherapy.
Aluminum
Vitamin C can increase the amount of aluminum absorbed from aluminum compounds.
Research in animals and humans shows that vitamin C increases aluminum absorption, theoretically by chelating aluminum and keeping it in solution where it is available for absorption. In people with normal renal function, urinary excretion of aluminum will likely increase, making aluminum retention and toxicity unlikely. Patients with renal failure who take aluminum-containing compounds such as phosphate binders should avoid vitamin C supplements in doses above the recommended dietary allowances.
Antitumor Antibiotics
Theoretically, the antioxidant effects of vitamin C might reduce the effectiveness of antitumor antibiotics.
The use of antioxidants like vitamin C during chemotherapy is controversial. There is concern that antioxidants could reduce the activity of chemotherapy drugs which generate free radicals, such as doxorubicin. In contrast, some researchers theorize that antioxidants might make chemotherapy more effective by reducing oxidative stress that could interfere with apoptosis (cell death) of cancer cells. More evidence is needed to determine what effects, if any, antioxidants such as vitamin C have on chemotherapy.
Estrogens
Vitamin C might increase blood levels of estrogens.
Increases in plasma estrogen levels of up to 55% occur under some circumstances when vitamin C is taken concurrently with oral contraceptives or hormone replacement therapy, including topical products. It is suggested that vitamin C prevents oxidation of estrogen in the tissues, regenerates oxidized estrogen, and reduces sulfate conjugation of estrogen in the gut wall. When tissue levels of vitamin C are high, these processes are already maximized and supplemental vitamin C does not have any effect on estrogen levels. Increases in plasma estrogen levels may occur when patients who are deficient in vitamin C take supplements. Monitor these patients for estrogen-related side effects.
Fluphenazine (Prolixin)
Theoretically, vitamin C might decrease levels of fluphenazine.
In one patient there was a clinically significant decrease in fluphenazine levels when vitamin C (500 mg twice daily) was started. The mechanism is not known, and there is no further data to confirm this interaction.
Indinavir (Crixivan)
Vitamin C can modestly reduce indinavir levels.
One pharmacokinetic study shows that taking vitamin C 1 gram orally once daily along with indinavir 800 mg orally three times daily reduces the area under the concentration-time curve of indinavir by 14%. The mechanism of this interaction is unknown, but it is unlikely to be clinically significant in most patients. The effect of higher doses of vitamin C on indinavir levels is unknown.
Levothyroxine (Synthroid, Others)
Vitamin C can increase levothyroxine absorption.
Two clinical studies in adults with poorly controlled hypothyroidism show that swallowing levothyroxine with a glass of water containing vitamin C 500-1000 mg in solution reduces thyroid stimulating hormone (TSH) levels and increases thyroxine (T4) levels when compared with taking levothyroxine alone. This suggests that vitamin C increases the oral absorption of levothyroxine, possibly due to a reduction in pH.
Warfarin (Coumadin)
High-dose vitamin C might reduce the levels and effectiveness of warfarin.
Vitamin C in high doses may cause diarrhea and possibly reduce warfarin absorption. There are reports of two people who took up to 16 grams daily of vitamin C and had a reduction in prothrombin time. Lower doses of 5-10 grams daily can also reduce warfarin absorption. In many cases, this does not seem to be clinically significant. However, a case of warfarin resistance has been reported for a patient who took vitamin C 500 mg twice daily. Cessation of vitamin C supplementation resulted in a rapid increase in international normalized ratio (INR). Tell patients taking warfarin to avoid taking vitamin C in excessively high doses (greater than 10 grams daily). Lower doses may be safe, but the anticoagulation activity of warfarin should be monitored. Patients who are stabilized on warfarin while taking vitamin C should avoid adjusting vitamin C dosage to prevent the possibility of warfarin resistance.
Acetaminophen (Tylenol, Others)
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
A small pharmacokinetic study in healthy volunteers shows that taking high-dose vitamin C (3 grams) 1.5 hours after taking acetaminophen 1 gram slightly increases the apparent half-life of acetaminophen from around 2.3 hours to 3.1 hours. Ascorbic acid competitively inhibits sulfate conjugation of acetaminophen. However, to compensate, elimination of acetaminophen glucuronide and unconjugated acetaminophen increases. This effect is not likely to be clinically significant.
Aspirin
Acidification of the urine by vitamin C might increase aspirin levels.
It has been suggested that acidification of the urine by vitamin C could increase reabsorption of salicylates by the renal tubules, and increase plasma salicylate levels. However, short-term use of up to 6 grams daily of vitamin C does not seem to affect urinary pH or salicylate excretion, suggesting this interaction is not clinically significant.
Choline Magnesium Trisalicylate (Trilisate)
Acidification of the urine by vitamin C might increase choline magnesium trisalicylate levels.
It has been suggested that acidification of the urine by vitamin C could increase reabsorption of salicylates by the renal tubules, and increase plasma salicylate levels. However, short-term use of up to 6 grams daily of vitamin C does not seem to affect urinary pH or salicylate excretion, suggesting this interaction probably is not clinically significant.
Niacin
Vitamin C might decrease the beneficial effects of niacin on high-density lipoprotein (HDL) cholesterol levels.
A combination of niacin and simvastatin (Zocor) effectively raises HDL cholesterol levels in patients with coronary disease and low HDL levels. Clinical research shows that taking a combination of antioxidants (vitamin C, vitamin E, beta-carotene, and selenium) along with niacin and simvastatin (Zocor) attenuates this rise in HDL, specifically the HDL-2 and apolipoprotein A1 fractions, by more than 50% in patients with coronary disease. It is not known whether this adverse effect is due to a single antioxidant such as vitamin C, or to the combination. It also is not known whether it will occur in other patient populations.
Salsalate (Disalcid)
Acidification of the urine by vitamin C might increase salsalate levels.
It has been suggested that acidification of the urine by vitamin C could increase reabsorption of salicylates by the renal tubules, and increase plasma salicylate levels. However, short-term use of up to 6 grams/day vitamin C does not seem to affect urinary pH or salicylate excretion, suggesting this interaction probably is not clinically significant.
Zeaxanthin
Antidiabetes Drugs
Theoretically, taking zeaxanthin with antidiabetes drugs might increase the risk of hypoglycemia.
In an animal diabetic model, zeaxanthin has hypoglycemic effects. However, population research has found that increasing intake of dietary zeaxanthin plus lutein does not decrease the risk of developing type 2 diabetes.
Brand information
Manufacturer and brand details for ProMacular, from the product label.
HUMANX
See all HUMANX products- Name
- Ilumina LLC
- Street Address
- 302 Washington St #151
- City
- San Diego
- State
- CA
- ZipCode
- 92103
- Web Address
- www.shophumanx.com
ProMacular by HUMANX: Common Questions
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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.
The Full Monographs Behind ProMacular’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Astaxanthin
Interacts with 671 drugsAstaxanthin is a reddish carotenoid pigment with strong antioxidant activity in the lab, and it is widely promoted for skin, eye, heart, and exercise benefits. Early human studies are promis...
Read the full Astaxanthin monograph → Herb & supplement monographVitamin C
Interacts with 207 drugsVitamin C (ascorbic acid) is an essential nutrient your body needs but cannot make, so you must get it from food or supplements. It's important for immune function, collagen, and acts as an...
Read the full Vitamin C monograph → Herb & supplement monographBilberry
Interacts with 275 drugsBilberry is a blueberry-like fruit rich in antioxidant plant compounds called anthocyanins, and it has a long history of traditional use for eye health, circulation, and mild diarrhea. While...
Read the full Bilberry monograph → Herb & supplement monographLutein
Lutein is a plant-based antioxidant pigment that concentrates in the eye, and the best evidence suggests it (often combined with zeaxanthin) may help slow progression of age-related macular...
Read the full Lutein monograph → Herb & supplement monographZeaxanthin
Interacts with 86 drugsZeaxanthin is a carotenoid pigment that, along with lutein, concentrates in the macula of the eye and may help support long-term eye health. The strongest evidence relates to slowing progres...
Read the full Zeaxanthin monograph →Sources & How We Checked
ProMacular's label data comes from the NIH Dietary Supplement Label Database; the ingredient interaction data is from the Natural Medicines database, reviewed by our pharmacists.
- NIH Dietary Supplement Label Database (DSLD) — The official product label on file for this supplement.
- Natural Medicines (Therapeutic Research Center) — Evidence-graded clinical reference behind the ingredient interaction data.
Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.
The 74 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.
Astaxanthin 3 references
- Kupcinskas L, Lafolie P, Lignell A, et al. Efficacy of the natural antioxidant astaxanthin in the treatment of functional dyspepsia in patients with or without Helicobacter pylori infection: A prospective, randomized, double blind, and placebo-controlled
- Kistler, A., Liechti, H., Pichard, L., Wolz, E., Oesterhelt, G., Hayes, A., and Maurel, P. Metabolism and CYP-inducer properties of astaxanthin in man and primary human hepatocytes. Arch.Toxicol. 2002;75(11-12):665-675. PubMed
- Choi HD, Youn YK, Shin WG. Positive effects of astaxanthin on lipid profiles and oxidative stress in overweight subjects. Plant Foods Hum Nutr. 2011;66:363-369. PubMed
Vitamin C 51 references
- McEvoy GK, ed. AHFS Drug Information. Bethesda, MD: American Society of Health-System Pharmacists, 1998.
- Back DJ, Breckenridge AM, MacIver M, et al. Interaction of ethinyloestradiol with ascorbic acid in man. Br Med J (Clin Res Ed) 1981;282:1516.
- Morris JC, Beeley L, Ballantine N. Interaction of ethinyloestradiol with ascorbic acid in man [letter]. Br Med J (Clin Res Ed) 1981;283:503.
- Labriola D, Livingston R. Possible interactions between dietary antioxidants and chemotherapy. Oncology 1999;13:1003-8.
- Dwyer JH, Merz NB, Shirocre AM, et al. Progression of early atherosclerosis and intake of vitamin C and vitamin E from supplements and food. The Los Angeles Atherosclerosis Study. 41st Annual Conference on Cardiovascular Disease Epidemiology and Prevent
- Levine M, Rumsey SC, Daruwala R, et al. Criteria and recommendations for vitamin C intake. JAMA 1999;281:1415-23. PubMed
- Hansten PD, Horn JR. Drug Interactions Analysis and Management. Vancouver, WA: Applied Therapeutics Inc., 1997 and updates.
- Segal S, Kaminski S. Drug-nutrient interactions. American Druggist 1996 Jul;42-8.
- Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes for Vitamin C, Vitamin E, Selenium, and Carotenoids. Washington, DC: National Academy Press, 2000. Available at: http://www.nap.edu/books/0309069351/html/.
- Houston JB, Levy G. Drug biotransformation interactions in man VI: Acetaminophen and ascorbic acid. J Pharm Sci 1976;65:1218-21. PubMed
- Brown BG, Zhao XQ, Chait A, et al. Simvastatin and niacin, antioxidant vitamins, or the combination for the prevention of coronary disease. N Engl J Med 2001;345:1583-93. DOI
- Rosenthal G. Interaction of ascorbic acid and warfarin. JAMA 1971;215:1671. DOI
- Hume R, Johnstone JM, Weyers E. Interaction of ascorbic acid and warfarin. JAMA 1972;219:1479. DOI
- Smith EC, Skalski RJ, Johnson GC, Rossi GV. Interaction of ascorbic acid and warfarin. JAMA 1972;221:1166. DOI
- Traxer O, Huet B, Poindexter J, et al. Effect of ascorbic acid consumption on urinary stone risk factors. J Urol 2003;170:397-401.. PubMed
- Domingo JL, Gomez M, Llobet JM, Richart C. Effect of ascorbic acid on gastrointestinal aluminum absorption (letter). Lancet 1991;338:1467.
- Domingo JL, Gomez M, Llobet JM, Corbella J. Influence of some dietary constituents on aluminum absorption and retention in rats. Kidney Int 1991;39:598-601. PubMed
- Partridge NA, Regnier FE, White JL, Hem SL. Influence of dietary constituents on intestinal absorption of aluminum. Kidney Int 1989;35:1413-7. PubMed
- Mc Leod DC, Nahata MC. Inefficacy of ascorbic acid as a urinary acidifier (letter). N Engl J Med 1977;296:1413. DOI
- Hansten PD, Hayton WL. Effect of antacid and ascorbic acid on serum salicylate concentration. J Clin Pharmacol 1980;20:326-31. PubMed
- Dysken MW, Cumming RJ, Channon RA, Davis JM. Drug interaction between ascorbic acid and fluphenazine. JAMA 1979;241:2008. DOI
- Vihtamaki T, Parantainen J, Koivisto AM, et al. Oral ascorbic acid increases plasma oestradiol during postmenopausal hormone replacement therapy. Maturitas 2002;42:129-35. PubMed
- Slain D, Amsden JR, Khakoo RA, et al. Effect of high-dose vitamin C on the steady-state pharmacokinetics of the protease inhibitor indinavir in healthy volunteers. Pharmacotherapy 2005;25:165-70. PubMed
- Cheung MC, Zhao XQ, Chait A, et al. Antioxidant supplements block the response of HDL to simvastatin-niacin therapy in patients with coronary artery disease and low HDL. Arterioscler Thromb Vasc Biol 2001;21:1320-6. PubMed
- Feetam CL, Leach RH, Meynell MJ. Lack of a clinically important interaction between warfarin and ascorbic acid. Toxicol Appl Pharmacol 1975;31:544-7. PubMed
- Weintraub M, Griner PF. Warfarin and ascorbic acid: lack of evidence for a drug interaction. Toxicol Appl Pharmacol 1974;28:53-6. PubMed
- Lee DH, Folsom AR, Harnack L, et al. Does supplemental vitamin C increase cardiovascular disease risk in women with diabetes? Am J Clin Nutr 2004;80:1194-200. PubMed
- Taylor EN, Stampfer MJ, Curhan GC. Dietary factors and the risk of incident kidney stones in men: new insights after 14 years of follow-up. J Am Soc Nephrol 2004;15:3225-32. PubMed
- Ward NC, Hodgson JM, Croft KD, et al. The combination of vitamin C and grape-seed polyphenols increases blood pressure: a randomized, double-blind, placebo-controlled trial. J Hypertens 2005;23:427-34.. PubMed
- Prasad KN. Rationale for using high-dose multiple dietary antioxidants as an adjunct to radiation therapy and chemotherapy. J Nutr 2004;134:3182S-3S. PubMed
- Conklin KA. Cancer chemotherapy and antioxidants. J Nutr 2004;134:3201S-3204S. PubMed
- Fairweather-Tait S, Hickson K, McGaw B, et al. Orange juice enhances aluminium absorption from antacid preparation. Eur J Clin Nutr. 1994;48(1):71-3.
- Gruenwald, J., Graubaum, H. J., Busch, R., and Bentley, C. Safety and tolerance of ester-C compared with regular ascorbic acid. Adv.Ther. 2006;23(1):171-178.
- Rahimi, R., Nikfar, S., Rezaie, A., and Abdollahi, M. A meta-analysis on the efficacy and safety of combined vitamin C and E supplementation in preeclamptic women. Hypertens.Pregnancy. 2009;28(4):417-434. PubMed
- Einerson, B., Nathorn, C., Kitiyakara, C., Sirada, M., and Thamlikitkul, V. The efficacy of ascorbic acid in suboptimal responsive anemic hemodialysis patients receiving erythropoietin: a meta-analysis. J Med.Assoc.Thai. 2011;94 Suppl 1:S134-S146.
- Li, G., Li, L., Yu, C., and Chen, L. Effect of vitamins C and E supplementation on Helicobacter pylori eradication: a meta-analysis. Br.J Nutr 2011;106(11):1632-1637.
- Chen X, Shen L, Gu X, et al. High-dose supplementation with vitamin C--induced pediatric urolithiasis: the first case report in a child and literature review. Urology. 2014;84(4):922-4. PubMed
- Sattar A, Willman JE, Kolluri R. Possible warfarin resistance due to interaction with ascorbic acid: case report and literature review. Am J Health Syst Pharm. 2013;70(9):782-6. PubMed
- Yaich S, Chaabouni Y, Charfeddine K, et al. Secondary oxalosis due to excess vitamin C intake: a cause of graft loss in a renal transplant recipient. Saudi J Kidney Dis Transpl. 2014;25(1):113-6. PubMed
- Jalloh MA, Gregory PJ, Hein D, et al. Dietary supplement interactions with antiretrovirals: a systematic review. Int J STD AIDS. 2017 Jan;28(1):4-15. PubMed
- Rumbold A, Ota E, Nagata C, Shahrook S, Crowther CA. Vitamin C supplementation in pregnancy. Cochrane Database Syst Rev. 2015;(9):CD004072. PubMed
- Seo MS, Kim JK, Shim JY. High-dose vitamin C promotes regression of multiple pulmonary metastases originating from hepatocellular carcinoma. Yonsei Med J. 2015;56(5):1449-52. PubMed
- Skelin M, Lucijanic T, Amidzic Klaric D, et al. Factors Affecting Gastrointestinal Absorption of Levothyroxine: A Review. Clin Ther. 2017 Feb;39(2):378-403. PubMed
- Jiang K, Tang K, Liu H, Xu H, Ye Z, Chen Z. Ascorbic acid supplements and kidney stones incidence among men and women: a systematic review and meta-analysis. Urol J. 2019;16(2):115-120.
- Thomas S, Patel D, Bittel B, et al. Effect of High-Dose Zinc and Ascorbic Acid Supplementation vs Usual Care on Symptom Length and Reduction Among Ambulatory Patients With SARS-CoV-2 Infection: The COVID A to Z Randomized Clinical Trial. JAMA Netw Open. 2 PubMed
- Giffen MA, McLemore JL. Hyperoxalosis Secondary to Intravenous Vitamin C Administration as a Non-Allopathic Treatment for Cancer. Acad Forensic Pathol 2019;9(1-2):118-126. PubMed
- Maike A, Sturgill D, Gallan A. Oxalate Nephropathy in a Renal Transplant Recipient After Receiving High Dose Ascorbic Acid. Am J Med Sci 2021. PubMed
- Shen ZY, Chen YR, Wang MC, Chang SS. High-dose vitamin C-induced acute oxalate nephropathy in a renal transplant recipient: a case report and literature review. Asian J Surg 2022. PubMed
- Yanase F, Spano S, Maeda A, et al. Mega-dose sodium ascorbate: a pilot, single-dose, physiological effect, double-blind, randomized, controlled trial. Crit Care 2023;27(1):371. PubMed
- Sharma Y, Sumanadasa S, Shahi R, et al. Efficacy and safety of vitamin C supplementation in the treatment of community-acquired pneumonia: a systematic review and meta-analysis with trial sequential analysis. Sci Rep 2024;14(1):11846. PubMed
- Pejcic AV, Petrovic NZ, Djordjic MD, Milosavljevic MN. Vitamin C Levels in Pregnant Women and the Efficacy of Vitamin C Supplements in Preventing Premature Rupture of Membranes: A Systematic Review and Meta-Analysis. Balkan Med J 2024;41(4):248-260. PubMed
Bilberry 14 references
- Cignarella A, Nastasi M, Cavalli E, Puglisi L. Novel lipid-lowering properties of Vaccinium myrtillus L. leaves, a traditional antidiabetic treatment, in several models of rat dyslipidaemia: a comparison with ciprofibrate. Thromb Res 1996;84:311-22. PubMed
- Morazzoni P, Magistretti MJ. Activity of Myrtocyan, an anthosyanoside complex from Vaccinium myrtillus (VMA), on platelet aggregation and adhesiveness. Fitoterapia 1990;61:13-21.
- Erlund, I., Koli, R., Alfthan, G., Marniemi, J., Puukka, P., Mustonen, P., Mattila, P., and Jula, A. Favorable effects of berry consumption on platelet function, blood pressure, and HDL cholesterol. Am J Clin Nutr 2008;87(2):323-331. PubMed
- Hawrelak, J. A. and Myers, S. P. Effects of two natural medicine formulations on irritable bowel syndrome symptoms: a pilot study. J Altern Complement Med 2010;16(10):1065-1071. PubMed
- Morazzoni P and Magistretti MJ. Effects of Vaccinium myrtillus anthocyanosides on prostacyclin-like activity in rat arterial issue. Fitoterapia 1986;57:11-14.
- Pulliero G, Montin S, Bettini V, and et al. Ex vivo study of the inhibitory effects of Vaccinium myrtillus anthocyanosides on human platelet aggregation. Fitoterapia 1989;60:69-75.
- Bottecchia D. Preliminary report on the inhibitory effect of vaccinium myrtillus anthocyanosides on platelet aggregation and clot retraction. Fitoterapia 1987;48:3-8.
- Fdez, M., Zaragoza, F., and Alvarez, P. In vitro platelet aggregation effects of anthocyanosides of vaccinium myrtilus L. Anales de la Real Academia de Farmacia 1983;49:79-90.
- Biedermann L, Mwinyi J, Scharl M, Frei P, Zeitz J, Kullak-Ublick GA, et al. Bilberry ingestion improves disease activity in mild to moderate ulcerative colitis-an open pilot study. 2013 May;7(4):271-9. PubMed
- Hoggard N, Cruickshank M, Moar KM, Bestwick C, Holst J, Russell W, et al. A single supplement of a standardized bilberry (Vaccinium myrtillus L.) extract (36% wet weight anthocyanins) modifies glycaemic response in individuals with type 2 diabetes control
- Aichinger G, Pahlke G, Nagel LJ, Berger W, Marko D. Bilberry extract, its major phenolic compounds, and soy isoflavone genistein antagonize the cytostatic drug erlotinib in human epithelial cells. Food Funct 2016;7(8):3628-36.
- Prokop J, Lněničková K, Cibicek N, et al. Effect of bilberry extract (Vaccinium myrtillus L.) on drug-metabolizing enzymes in rats. Food Chem Toxicol 2019;129:382-90. PubMed
- Chan SW, Chu TTW, Choi SW, Benzie IFF, Tomlinson B. Impact of short-term bilberry supplementation on glycemic control, cardiovascular disease risk factors, and antioxidant status in Chinese patients with type 2 diabetes. Phytother Res 2021. Online ahead o PubMed
- Bøhn SK, Myhrstad MCW, Thoresen M, et al. Bilberry/red grape juice decreases plasma biomarkers of inflammation and tissue damage in aged men with subjective memory impairment -a randomized clinical trial. BMC Nutr 2021;7(1):75. PubMed
Lutein 2 references
- Brown L, Rimm EB, Seddon JM, et al. A prospective study of carotenoid intake and risk of cataract extraction in US men. Am J Clin Nutr 1999;70:517-24. PubMed
- Chasan-Taber L, Willett WC, Seddon JM, et al. A prospective study of carotenoid and vitamin A intakes and risk of cataract extraction in US women. Am J Clin Nutr 1999;70:509-16. PubMed
Zeaxanthin 4 references
- Montonen J, Knekt P, Jarvinen R, Reunanen A. Dietary antioxidant intake and risk of type 2 diabetes. Diabetes Care 2004;27:362-6. PubMed
- Leermakers ET, Darweesh SK, Baena CP, et al. The effects of lutein on cardiometabolic health across the life course: a systematic review and meta-analysis. Am J Clin Nutr 2016;103(2):481-94. PubMed
- Kou L, Du M, Zhang C, Dai Z, Li X, Zhang B. The Hypoglycemic, Hypolipidemic, and Anti-Diabetic Nephritic Activities of Zeaxanthin in Diet-Streptozotocin-Induced Diabetic Sprague Dawley Rats. Appl Biochem Biotechnol 2017;182(3):944-955. PubMed
- Xu X, Zhao X, Berde Y, Low YL, Kuchan MJ. Milk and Plasma Lutein and Zeaxanthin Concentrations in Chinese Breast-Feeding Mother-Infant Dyads With Healthy Maternal Fruit and Vegetable Intake. J Am Coll Nutr 2019;38(2):179-184. PubMed
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