Protective Breast Formula Ingredients & Drug Interactions
by Nature's Way
What is this page for?
First and foremost: checking Protective Breast Formula 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
Protective Breast Formula is a dietary supplement by Nature's Way with 9 active ingredients. Its ingredients are commonly taken for replacing fluids and electrolytes, preventing dehydration during exercise or illness, treating low blood sodium (under medical care).Based on those ingredients, 1,500 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are Green Tea leaf extract, Turmeric rhizome extract, Grape seed extract. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against Protective Breast Formula by Nature's Way
Ask about any prescription or over-the-counter medication and we check it for interactions with Protective Breast Formula by Nature's Way — 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 Protective Breast Formula by Nature's Way
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
Protective Breast Formula contains 9 active ingredients. The major ones are sodium, vitamin D3, calcium, turmeric rhizome extract, green tea leaf extract, grape seed extract, and an extract called Indolplex diindolylmethane (BR-DIM) complex—plus calcium D-glucarate and maitake mushroom extract.
The product also contains inactive ingredients (cellulose, stearic acid, magnesium stearate, silica, glycerin, and others) that serve as fillers, binders, and flow agents in the tablet.
Does it work?
Strong evidence
Evidence for this formula's effectiveness in breast health is not established in the data we hold. Individual ingredients show mixed support: green tea extract is rated Likely Effective for human papillomavirus (HPV); turmeric and grape seed extract are rated Possibly Effective for several conditions (depression, high cholesterol, hay fever, and chronic venous insufficiency), though these uses differ from breast-specific claims.
Calcium D-glucarate, diindolylmethane, and maitake mushroom extract all carry ratings of Insufficient Reliable Evidence for the cancers and breast conditions they are studied for. Vitamin D3 and calcium have established roles in bone and metabolic health, but no specific breast-health effectiveness rating is documented here.
How safe is it?
Well-documented data
The ingredients in this formula are generally well tolerated at recommended doses, though several warrant caution. Sodium is essential in small amounts, but excess intake is linked to high blood pressure and heart strain—avoid supplemental sodium above normal dietary amounts without medical advice.
Vitamin D3 is generally safe at recommended doses, though very high doses over time can cause toxicity with symptoms of high blood calcium; use only under a doctor's guidance during pregnancy. Calcium is considered safe at recommended amounts during pregnancy and breastfeeding, but avoid very high doses.
Turmeric is generally well tolerated as a food but concentrated supplements have been rarely linked to liver damage; food amounts are likely fine, but medicinal doses need doctor approval, and the safety data in pregnancy advises caution. Diindolylmethane is generally well tolerated short-term but long-term safety is unknown, and it should be avoided in pregnancy due to possible hormone effects and during breastfeeding due to lack of safety data.
Maitake mushroom extract lacks long-term safety data and should be avoided in pregnancy and while breastfeeding. Green tea extract is generally well tolerated but rare liver injury has been reported with concentrated extracts; moderate tea is likely fine in pregnancy, but high-dose extracts should be avoided, and caffeine passes into breast milk so intake should stay moderate.
Grape seed extract appears well tolerated; grapes as food are safe in pregnancy and breastfeeding, but concentrated supplements lack sufficient safety data during pregnancy.
Meds to double-check
Major interaction found
Before taking this product, check with your doctor or pharmacist if you use HIV integrase inhibitors (dolutegravir, elvitegravir), beta-blockers like nadolol, the statin atorvastatin, ephedrine, blood pressure medicines, thyroid hormone (levothyroxine), heart rhythm drugs (verapamil, diltiazem, digoxin), sotalol, lithium, corticosteroids, blood thinners or antiplatelet drugs, antidiabetes medications, or cancer drugs. These represent the most serious or most common interactions documented in our data.
The bottom line
Scorecard at a glanceFully disclosed formula with strong clinical evidence behind its ingredients' uses. Major medication interactions have been identified, and safety information is well characterized.
This formula combines nutrients and plant extracts studied for various health benefits, though its specific value for breast health is not established in our data. If you take any blood pressure medicines, heart drugs, HIV antivirals, thyroid medication, blood thinners, mood stabilizers, or cancer treatments, you'll need to check this product against your exact medications before starting—the interactions are real and some are serious.
Talk with your own doctor or pharmacist about whether this product fits your health situation and medications.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 9 of 9 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Jun 24, 2020.
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 Protective Breast Formula, straight from the product label.
| Brand | Nature's Way |
|---|---|
| Barcode (UPC) | 763948058860 |
| Net contents | 60 Tablet(s) |
| Market status | On market |
| Date entered into DSLD | Jun 24, 2020 |
| DSLD ID | 228075 |
| Product type | Other Combinations |
| Supplement form | Tablet Or Pill |
| Dietary claims / uses | All Other, Structure/Function |
| Intended target group(s) | Women (not pregnant or lactating), Adult Female (18 - 50 Years), Gluten Free, Dairy Free |
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.
Supplement Facts
The label details for Protective Breast Formula by Nature's Way, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Calories | 10 Calorie(s) | -- |
| Total Carbohydrates | 2 Gram(s) | 1% |
| Sodium | 10 mg | 1% |
| Vitamin D3 | 10 mcg | 50% |
| Calcium D-Glucarate | 200 mg | -- |
| Calcium | 24 mg | 2% |
| Indolplex Diindolylmethane (BR-DIM) Complex | 120 mg | -- |
| Turmeric rhizome extract | 1 Gram(s) | -- |
| Maitake Mushroom extract | 90 mg | -- |
| Green Tea leaf extract | 500 mg | -- |
| Grape seed extract | 100 mg | -- |
Other ingredients: Cellulose, Sodium Croscarmellose, Stearic Acid, modified Food Starch, Magnesium Stearate, Hypromellose, Modified Corn Starch, Titanium Dioxide color, Glycerin, Tocophersolan, Phosphatidylcholine, Silica, Vegetable juice color
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.
Precautions
Warning: Do not use this product if you are pregnant, nursing, or attempting to become pregnant. If you have a blood clotting disorder, or if you are taking any medications, consult a healthcare professional before use.
A harmeless but noticable change in urine color may occur during usage of this product.
Keep out of reach of children.
Safety sealed with printed inner seal. Do not use if seal is broken or missing.
Formulation
Gluten free. No yeast-derived ingredients, wheat, or dairy products.
The key ingredients in this formula provide a vital foundation for breast health.
Brand IP Statement(s)
Indoplex and BR-DIM is a proprietary, enhanced bioavailability complex containing Diindolylmethane licensed from BioResponse, LLC., Boulder, CO. 2019 Nature's Way Brands, LLC
General Statements
Nature's Way since 1969
Certain nutrients from food provide protective benefits for breast health, but getting all of these nutrients from our daily diet can be difficult, so we created Protective Breast Formula dietary supplement to make it simple.
A portion of the proceeds from the sale of this product will be donated to support women's health research.
Christine Horner, M.D., FACS is an expert in the field of women's breast health and has been a health activist for more than 20 years. She has done significant research into key nutritional and lifestyle interventions proven to promote breast health. Dr. Horner created this exceptional formula, based on her expertise in this field, and in collaboration with Nature's Way. In her book, Waking the Warrior Goddess, Dr. Horner identifies five critical keys for breast health, upon which the Protective Breast Formula is based.
FDA Statement of Identity
Dietary Supplement
Suggested/Recommended/Usage/Directions
Recommendation: Take 2 tablets daily with food. If desired, take 1 tablet twice daily with food. For more active support, take up to 2 tablets twice daily.
FDA Disclaimer Statement
This statement has not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.
Formula
Indoplex and BR-DIM is a proprietary, enhanced bioavailability complex containing Diindolylmethane licensed from BioResponse, LLC., Boulder, CO.
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Protective Breast Formula by Nature's Way 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 Protective Breast Formula by Nature's Way
These are the 9 active ingredients this product is made of. Select any to open its full monograph.
Serving size2 Tablet(s) Dosage formTablet Or Pill 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.
Sodium
Interacts with205 drugs
Sodium is an essential mineral and electrolyte your body needs to balance fluids, support nerves, and help muscles work. Most people in modern diets g...
Sodium monograph & interactionsVitamin D3
Interacts with715 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,...
Vitamin D3 monograph & interactionsCalcium D-Glucarate
Interacts with126 drugs
Calcium D-glucarate is a supplement form of a natural compound found in fruits and vegetables that is promoted for 'detoxification' and helping the bo...
Calcium D-Glucarate monograph & interactionsCalcium
Interacts with168 drugs
Calcium is an essential mineral your body needs for strong bones, nerve signaling, and muscle function, and supplements can help fill gaps when diet f...
Calcium monograph & interactionsIndolplex Diindolylmethane (BR-DIM) Complex
Interacts with269 drugs
Diindolylmethane (DIM) is a compound made when your body digests cruciferous vegetables, and it is sold as a supplement mainly for hormone balance and...
Indolplex Diindolylmethane (BR-DIM) Complex monograph & interactionsTurmeric rhizome extract
Interacts with1,133 drugs
Turmeric is a popular spice whose main active compounds, curcuminoids, are studied mostly for inflammation and joint pain. Some research is promising,...
Turmeric rhizome extract monograph & interactionsMaitake Mushroom extract
Interacts with260 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 bl...
Maitake Mushroom extract monograph & interactionsGreen Tea leaf extract
Interacts with1,293 drugs
Green tea is a popular beverage rich in antioxidants called catechins, and drinking it in normal amounts is considered safe for most people. Concentra...
Green Tea leaf extract monograph & interactionsGrape seed extract
Interacts with910 drugs
Grapes and grape products like grape seed extract contain antioxidant compounds such as resveratrol and proanthocyanidins that may support heart and b...
Grape seed extract monograph & interactionsOther (inactive) ingredients: Cellulose, Sodium Croscarmellose, Stearic Acid, Modified Food Starch, Magnesium Stearate, Hypromellose, Modified Corn Starch, Titanium Dioxide color, Glycerin, Tocophersolan, Phosphatidylcholine, Silica, Vegetable juice color. These complete the product’s ingredient list but are not active constituents.
Protective Breast Formula by Nature's Way Drug Interactions
HelloPharmacist Interaction Report
Protective Breast Formula by Nature's Way has interactions documented across several of its active ingredients.
Through its sodium, vitamin D3, calcium D-glucarate, calcium, diindolylmethane, turmeric, maitake mushroom, green tea extract, and grape seed extract content, this product may interact with a range of medications. The most serious interaction is a Major-severity effect: calcium can significantly reduce levels of two HIV integrase inhibitors—dolutegravir and elvitegravir—by nearly 40%, potentially compromising their ability to control viral load.
Calcium also poses a Major risk if given intravenously alongside the antibiotic ceftriaxone, which can cause dangerous precipitation in the lungs and kidneys.
Read the full breakdown — every affected drug type, severity by severity
Sodium in this formula interacts with several Moderate-severity drug types: blood pressure medications (antihypertensives), mood stabilizers like lithium, corticosteroids, the antiviral didanosine, and certain electrolyte-balancing drugs. Vitamin D3 at high doses interacts Moderately with heart rhythm drugs (verapamil, diltiazem, digoxin), blood pressure medications (thiazide diuretics), and the cholesterol drug atorvastatin.
Calcium has additional Moderate interactions with thyroid hormone (levothyroxine), heart drugs (sotalol, diltiazem), and the HIV drug raltegravir. Green tea extract carries three Major-severity interactions: it significantly reduces levels of the beta-blocker nadolol (by ~85%) and the statin atorvastatin (by ~24%), and it may increase the risk of serious side effects when combined with the stimulant ephedrine.
Turmeric, diindolylmethane, maitake mushroom, and grape seed extract each carry Moderate interactions with multiple drug categories—including cancer drugs, immunosuppressants, antidiabetes agents, anticoagulants, and several enzyme substrates. Altogether, these interactions span 1,501 individual medications.
We could not check interaction data for Maitake Mushroom extract because no monograph is held for it in our system. Use the medication checker below to search for your exact prescriptions before starting this product.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against Protective Breast Formula?
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 Protective Breast Formula interact with 1,500 drugs. Click any drug to see the details.
9 of the 9 ingredients in Protective Breast Formula interact with drugs. Each result below shows which ingredient is responsible. Green Tea leaf extract Turmeric rhizome extract Grape seed extract Vitamin D3 Indolplex Diindolylmethane (BR-DIM) Complex Maitake Mushroom extract Sodium Calcium Calcium D-Glucarate
AllopurinolCaplenal, Cosuric, Rimapurinol, Zyloprim, Zyloric
How Allopurinol interacts with Protective Breast Formula — through 2 ingredients. Tap an ingredient for the detail:
Green Tea Leaf ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use might have additive adverse hepatotoxic effects.
Read the full Green Tea Leaf Extract + Allopurinol interactionTurmeric Rhizome ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, turmeric might increase the risk of liver damage when taken with hepatotoxic drugs.
Read the full Turmeric Rhizome Extract + Allopurinol interactionAlmotriptanAlmogran, Axert
How Almotriptan interacts with Protective Breast Formula — through 4 ingredients. Tap an ingredient for the detail:
Turmeric Rhizome ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Turmeric might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full Turmeric Rhizome Extract + Almotriptan interactionGrape Seed ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
It is unclear if grape seed extract inhibits or induces CYP3A4; research is conflicting.
Read the full Grape Seed Extract + Almotriptan interactionGreen Tea Leaf ExtractCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Green tea is unlikely to produce clinically significant changes in the levels and clinical effects of CYP3A4 substrates.
Read the full Green Tea Leaf Extract + Almotriptan interactionVitamin D3Cytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Vitamin D might induce CYP3A4 enzymes and reduce the bioavailability of CYP3A4 substrates.
Read the full Vitamin D3 + Almotriptan interactionAlogliptinNesina
How Alogliptin interacts with Protective Breast Formula — through 5 ingredients. Tap an ingredient for the detail:
Turmeric Rhizome ExtractAntidiabetes Drugs, Hepatotoxic Drugs +1 Moderate
Interaction Summary
Theoretically, taking turmeric with antidiabetes drugs might increase the risk of hypoglycemia.
Read the full Turmeric Rhizome Extract + Alogliptin interactionGreen Tea Leaf ExtractHepatotoxic Drugs, Antidiabetes Drugs +1 Moderate
Interaction Summary
Theoretically, concomitant use might have additive adverse hepatotoxic effects.
Read the full Green Tea Leaf Extract + Alogliptin interactionGrape Seed ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
It is unclear if grape seed extract inhibits or induces CYP3A4; research is conflicting.
Read the full Grape Seed Extract + Alogliptin interactionMaitake Mushroom ExtractAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, combining maitake mushroom with antidiabetes drugs might increase the risk of hypoglycemia.
Read the full Maitake Mushroom Extract + Alogliptin interactionVitamin D3Cytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Vitamin D might induce CYP3A4 enzymes and reduce the bioavailability of CYP3A4 substrates.
Read the full Vitamin D3 + Alogliptin interactionAlogliptin, MetforminKazano
How Alogliptin, Metformin interacts with Protective Breast Formula — through 3 ingredients. Tap an ingredient for the detail:
Turmeric Rhizome ExtractAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, taking turmeric with antidiabetes drugs might increase the risk of hypoglycemia.
Read the full Turmeric Rhizome Extract + Alogliptin, Metformin interactionMaitake Mushroom ExtractAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, combining maitake mushroom with antidiabetes drugs might increase the risk of hypoglycemia.
Read the full Maitake Mushroom Extract + Alogliptin, Metformin interactionGreen Tea Leaf ExtractAntidiabetes Drugs, Metformin (glucophage) Minor
Interaction Summary
Theoretically, taking green tea with antidiabetes drugs might interfere with blood glucose control.
Read the full Green Tea Leaf Extract + Alogliptin, Metformin interactionAlogliptin, PioglitazoneOseni
How Alogliptin, Pioglitazone interacts with Protective Breast Formula — through 5 ingredients. Tap an ingredient for the detail:
Maitake Mushroom ExtractAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, combining maitake mushroom with antidiabetes drugs might increase the risk of hypoglycemia.
Read the full Maitake Mushroom Extract + Alogliptin, Pioglitazone interactionTurmeric Rhizome ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Hepatotoxic Drugs +1 Moderate
Interaction Summary
Turmeric might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full Turmeric Rhizome Extract + Alogliptin, Pioglitazone interactionGreen Tea Leaf ExtractPioglitazone (actos), Antidiabetes Drugs +2 Moderate
Interaction Summary
Theoretically, green tea might increase the levels and clinical effects of pioglitazone.
Read the full Green Tea Leaf Extract + Alogliptin, Pioglitazone interactionGrape Seed ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
It is unclear if grape seed extract inhibits or induces CYP3A4; research is conflicting.
Read the full Grape Seed Extract + Alogliptin, Pioglitazone interactionVitamin D3Cytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Vitamin D might induce CYP3A4 enzymes and reduce the bioavailability of CYP3A4 substrates.
Read the full Vitamin D3 + Alogliptin, Pioglitazone interactionAlpelisibPiqray
How Alpelisib interacts with Protective Breast Formula — through 4 ingredients. Tap an ingredient for the detail:
Turmeric Rhizome ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Turmeric might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full Turmeric Rhizome Extract + Alpelisib interactionGrape Seed ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
It is unclear if grape seed extract inhibits or induces CYP3A4; research is conflicting.
Read the full Grape Seed Extract + Alpelisib interactionVitamin D3Cytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Vitamin D might induce CYP3A4 enzymes and reduce the bioavailability of CYP3A4 substrates.
Read the full Vitamin D3 + Alpelisib interactionGreen Tea Leaf ExtractCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Green tea is unlikely to produce clinically significant changes in the levels and clinical effects of CYP3A4 substrates.
Read the full Green Tea Leaf Extract + Alpelisib interactionAlprazolamNiravam, Xanax
How Alprazolam interacts with Protective Breast Formula — through 4 ingredients. Tap an ingredient for the detail:
Grape Seed ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
It is unclear if grape seed extract inhibits or induces CYP3A4; research is conflicting.
Read the full Grape Seed Extract + Alprazolam interactionTurmeric Rhizome ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Turmeric might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full Turmeric Rhizome Extract + Alprazolam interactionGreen Tea Leaf ExtractCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Green tea is unlikely to produce clinically significant changes in the levels and clinical effects of CYP3A4 substrates.
Read the full Green Tea Leaf Extract + Alprazolam interactionVitamin D3Cytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Vitamin D might induce CYP3A4 enzymes and reduce the bioavailability of CYP3A4 substrates.
Read the full Vitamin D3 + Alprazolam interactionAlteplase, TpaActilyse, Activase
How Alteplase, Tpa interacts with Protective Breast Formula — through 3 ingredients. Tap an ingredient for the detail:
Green Tea Leaf ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, green tea may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Green Tea Leaf Extract + Alteplase, Tpa interactionGrape Seed ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, grape extracts may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Grape Seed Extract + Alteplase, Tpa interactionTurmeric Rhizome ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Turmeric may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Turmeric Rhizome Extract + Alteplase, Tpa interactionAltretamineHexalen
How Altretamine interacts with Protective Breast Formula — through 1 ingredient. Tap an ingredient for the detail:
Turmeric Rhizome ExtractAlkylating Agents Moderate
Interaction Summary
Turmeric has antioxidant effects.
Read the full Turmeric Rhizome Extract + Altretamine interactionAluminum Acetate, Benzethonium ChlorideBuro-Sol Otic Solution
How Aluminum Acetate, Benzethonium Chloride interacts with Protective Breast Formula — through 2 ingredients. Tap an ingredient for the detail:
CalciumAluminum Moderate
Interaction Summary
Calcium citrate might increase aluminum absorption and toxicity.
Read the full Calcium + Aluminum Acetate, Benzethonium Chloride interactionVitamin D3Aluminum Moderate
Interaction Summary
Vitamin D might increase aluminum absorption and toxicity, but this has only been reported in people with renal failure.
Read the full Vitamin D3 + Aluminum Acetate, Benzethonium Chloride interactionAluminum ChlorideAluminum Chloride, Anhydrol Forte, Driclor, Drysol
How Aluminum Chloride interacts with Protective Breast Formula — through 2 ingredients. Tap an ingredient for the detail:
Vitamin D3Aluminum Moderate
Interaction Summary
Vitamin D might increase aluminum absorption and toxicity, but this has only been reported in people with renal failure.
Read the full Vitamin D3 + Aluminum Chloride interactionCalciumAluminum Moderate
Interaction Summary
Calcium citrate might increase aluminum absorption and toxicity.
Read the full Calcium + Aluminum Chloride interactionAluminum HydroxideAlu-Cap, Amphojel, Gaviscon
How Aluminum Hydroxide interacts with Protective Breast Formula — through 2 ingredients. Tap an ingredient for the detail:
CalciumAluminum Moderate
Interaction Summary
Calcium citrate might increase aluminum absorption and toxicity.
Read the full Calcium + Aluminum Hydroxide interactionVitamin D3Aluminum Moderate
Interaction Summary
Vitamin D might increase aluminum absorption and toxicity, but this has only been reported in people with renal failure.
Read the full Vitamin D3 + Aluminum Hydroxide interactionAluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium HydroxideAscriptin Codeine #2
How Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide interacts with Protective Breast Formula — through 5 ingredients. Tap an ingredient for the detail:
Vitamin D3Aluminum Moderate
Interaction Summary
Vitamin D might increase aluminum absorption and toxicity, but this has only been reported in people with renal failure.
Read the full Vitamin D3 + Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide interactionCalciumAluminum Moderate
Interaction Summary
Calcium citrate might increase aluminum absorption and toxicity.
Read the full Calcium + Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide interactionTurmeric Rhizome ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Turmeric may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Turmeric Rhizome Extract + Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide interactionGreen Tea Leaf ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, green tea may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Green Tea Leaf Extract + Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide interactionGrape Seed ExtractAnticoagulant/antiplatelet Drugs, Cytochrome P450 2d6 (cyp2d6) Substrates Moderate
Interaction Summary
Theoretically, grape extracts may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Grape Seed Extract + Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide interactionAluminum Hydroxide, Aspirin, Magnesium HydroxideAscriptin
How Aluminum Hydroxide, Aspirin, Magnesium Hydroxide interacts with Protective Breast Formula — through 5 ingredients. Tap an ingredient for the detail:
Grape Seed ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, grape extracts may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Grape Seed Extract + Aluminum Hydroxide, Aspirin, Magnesium Hydroxide interactionTurmeric Rhizome ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Turmeric may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Turmeric Rhizome Extract + Aluminum Hydroxide, Aspirin, Magnesium Hydroxide interactionCalciumAluminum Moderate
Interaction Summary
Calcium citrate might increase aluminum absorption and toxicity.
Read the full Calcium + Aluminum Hydroxide, Aspirin, Magnesium Hydroxide interactionVitamin D3Aluminum Moderate
Interaction Summary
Vitamin D might increase aluminum absorption and toxicity, but this has only been reported in people with renal failure.
Read the full Vitamin D3 + Aluminum Hydroxide, Aspirin, Magnesium Hydroxide interactionGreen Tea Leaf ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, green tea may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Green Tea Leaf Extract + Aluminum Hydroxide, Aspirin, Magnesium Hydroxide interactionAluminum Hydroxide, Magnesium Hydroxide (otc Drug)Maalox, Mucogel
How Aluminum Hydroxide, Magnesium Hydroxide (otc Drug) interacts with Protective Breast Formula — through 2 ingredients. Tap an ingredient for the detail:
Vitamin D3Aluminum Moderate
Interaction Summary
Vitamin D might increase aluminum absorption and toxicity, but this has only been reported in people with renal failure.
Read the full Vitamin D3 + Aluminum Hydroxide, Magnesium Hydroxide (otc Drug) interactionCalciumAluminum Moderate
Interaction Summary
Calcium citrate might increase aluminum absorption and toxicity.
Read the full Calcium + Aluminum Hydroxide, Magnesium Hydroxide (otc Drug) interactionAluminum Hydroxide, Magnesium Hydroxide, Simethicone (otc Drug)Mylanta
How Aluminum Hydroxide, Magnesium Hydroxide, Simethicone (otc Drug) interacts with Protective Breast Formula — through 2 ingredients. Tap an ingredient for the detail:
CalciumAluminum Moderate
Interaction Summary
Calcium citrate might increase aluminum absorption and toxicity.
Read the full Calcium + Aluminum Hydroxide, Magnesium Hydroxide, Simethicone (otc Drug) interactionVitamin D3Aluminum Moderate
Interaction Summary
Vitamin D might increase aluminum absorption and toxicity, but this has only been reported in people with renal failure.
Read the full Vitamin D3 + Aluminum Hydroxide, Magnesium Hydroxide, Simethicone (otc Drug) interactionAluminum, CalciumDomeboro
How Aluminum, Calcium interacts with Protective Breast Formula — through 2 ingredients. Tap an ingredient for the detail:
Vitamin D3Aluminum Moderate
Interaction Summary
Vitamin D might increase aluminum absorption and toxicity, but this has only been reported in people with renal failure.
Read the full Vitamin D3 + Aluminum, Calcium interactionCalciumAluminum Moderate
Interaction Summary
Calcium citrate might increase aluminum absorption and toxicity.
Read the full Calcium + Aluminum, Calcium interactionAluminum, Magnesium (otc Drug)Almagel
How Aluminum, Magnesium (otc Drug) interacts with Protective Breast Formula — through 2 ingredients. Tap an ingredient for the detail:
CalciumAluminum Moderate
Interaction Summary
Calcium citrate might increase aluminum absorption and toxicity.
Read the full Calcium + Aluminum, Magnesium (otc Drug) interactionVitamin D3Aluminum Moderate
Interaction Summary
Vitamin D might increase aluminum absorption and toxicity, but this has only been reported in people with renal failure.
Read the full Vitamin D3 + Aluminum, Magnesium (otc Drug) interactionAluminum, Magnesium Hydroxide (otc Drug)Wingel
How Aluminum, Magnesium Hydroxide (otc Drug) interacts with Protective Breast Formula — through 2 ingredients. Tap an ingredient for the detail:
Vitamin D3Aluminum Moderate
Interaction Summary
Vitamin D might increase aluminum absorption and toxicity, but this has only been reported in people with renal failure.
Read the full Vitamin D3 + Aluminum, Magnesium Hydroxide (otc Drug) interactionCalciumAluminum Moderate
Interaction Summary
Calcium citrate might increase aluminum absorption and toxicity.
Read the full Calcium + Aluminum, Magnesium Hydroxide (otc Drug) interactionAlvimopanEntereg
How Alvimopan interacts with Protective Breast Formula — through 2 ingredients. Tap an ingredient for the detail:
Green Tea Leaf ExtractP-glycoprotein Substrates Moderate
Interaction Summary
Green tea might increase the levels and adverse effects of P-glycoprotein (P-gp) substrates.
Read the full Green Tea Leaf Extract + Alvimopan interactionTurmeric Rhizome ExtractP-glycoprotein Substrates Minor
Interaction Summary
Theoretically, turmeric might increase the absorption of P-glycoprotein substrates.
Read the full Turmeric Rhizome Extract + Alvimopan interactionAmbenonium ChlorideMytelase
How Ambenonium Chloride interacts with Protective Breast Formula — through 1 ingredient. Tap an ingredient for the detail:
Green Tea Leaf ExtractStimulant Drugs Moderate
Interaction Summary
Theoretically, concomitant use might increase stimulant adverse effects.
Read the full Green Tea Leaf Extract + Ambenonium Chloride interactionAmbrisentanLetairis, Volibris
How Ambrisentan interacts with Protective Breast Formula — through 6 ingredients. Tap an ingredient for the detail:
Green Tea Leaf ExtractCytochrome P450 3a4 (cyp3a4) Substrates, P-glycoprotein Substrates +1 Moderate
Interaction Summary
Green tea is unlikely to produce clinically significant changes in the levels and clinical effects of CYP3A4 substrates.
Read the full Green Tea Leaf Extract + Ambrisentan interactionSodiumAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, a high intake of dietary sodium might reduce the effectiveness of antihypertensive drugs.
Read the full Sodium + Ambrisentan interactionGrape Seed ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
It is unclear if grape seed extract inhibits or induces CYP3A4; research is conflicting.
Read the full Grape Seed Extract + Ambrisentan interactionTurmeric Rhizome ExtractP-glycoprotein Substrates, Hepatotoxic Drugs +1 Moderate
Interaction Summary
Theoretically, turmeric might increase the absorption of P-glycoprotein substrates.
Read the full Turmeric Rhizome Extract + Ambrisentan interactionMaitake Mushroom ExtractAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, combining maitake mushroom with antihypertensive drugs might increase the risk of hypotension.
Read the full Maitake Mushroom Extract + Ambrisentan interactionVitamin D3Cytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Vitamin D might induce CYP3A4 enzymes and reduce the bioavailability of CYP3A4 substrates.
Read the full Vitamin D3 + Ambrisentan interactionAmilorideAmilamont, Midamor
How Amiloride interacts with Protective Breast Formula — through 2 ingredients. Tap an ingredient for the detail:
Maitake Mushroom ExtractAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, combining maitake mushroom with antihypertensive drugs might increase the risk of hypotension.
Read the full Maitake Mushroom Extract + Amiloride interactionSodiumAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, a high intake of dietary sodium might reduce the effectiveness of antihypertensive drugs.
Read the full Sodium + Amiloride interactionAmiloride, HydrochlorothiazideAmil-Co, Amilzide, Moduret 25, Moduretic
How Amiloride, Hydrochlorothiazide interacts with Protective Breast Formula — through 6 ingredients. Tap an ingredient for the detail:
SodiumAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, a high intake of dietary sodium might reduce the effectiveness of antihypertensive drugs.
Read the full Sodium + Amiloride, Hydrochlorothiazide interactionIndolplex Diindolylmethane (br-dim) ComplexDiuretic Drugs Moderate
Interaction Summary
Theoretically, diindolylmethane might increase the risk of hyponatremia if used with sodium-depleting diuretics.
Read the full Indolplex Diindolylmethane (br-dim) Complex + Amiloride, Hydrochlorothiazide interactionMaitake Mushroom ExtractAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, combining maitake mushroom with antihypertensive drugs might increase the risk of hypotension.
Read the full Maitake Mushroom Extract + Amiloride, Hydrochlorothiazide interactionGreen Tea Leaf ExtractDiuretic Drugs Moderate
Interaction Summary
Theoretically, using green tea with diuretic drugs might increase the risk of hypokalemia.
Read the full Green Tea Leaf Extract + Amiloride, Hydrochlorothiazide interactionCalciumThiazide Diuretics Moderate
Interaction Summary
Taking calcium along with thiazides might increase the risk of hypercalcemia and renal failure.
Read the full Calcium + Amiloride, Hydrochlorothiazide interactionVitamin D3Thiazide Diuretics Moderate
Interaction Summary
Theoretically, taking thiazide diuretics and high-dose vitamin D can increase the risk of hypercalcemia.
Read the full Vitamin D3 + Amiloride, Hydrochlorothiazide interactionAminosalicylic AcidPaser
How Aminosalicylic Acid interacts with Protective Breast Formula — through 2 ingredients. Tap an ingredient for the detail:
Turmeric Rhizome ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, turmeric might increase the risk of liver damage when taken with hepatotoxic drugs.
Read the full Turmeric Rhizome Extract + Aminosalicylic Acid interactionGreen Tea Leaf ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use might have additive adverse hepatotoxic effects.
Read the full Green Tea Leaf Extract + Aminosalicylic Acid interactionAmiodaroneCordarone, Pacerone
How Amiodarone interacts with Protective Breast Formula — through 4 ingredients. Tap an ingredient for the detail:
Green Tea Leaf ExtractHepatotoxic Drugs, Cytochrome P450 1a2 (cyp1a2) Inhibitors +1 Moderate
Interaction Summary
Theoretically, concomitant use might have additive adverse hepatotoxic effects.
Read the full Green Tea Leaf Extract + Amiodarone interactionGrape Seed ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
It is unclear if grape seed extract inhibits or induces CYP3A4; research is conflicting.
Read the full Grape Seed Extract + Amiodarone interactionTurmeric Rhizome ExtractHepatotoxic Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, turmeric might increase the risk of liver damage when taken with hepatotoxic drugs.
Read the full Turmeric Rhizome Extract + Amiodarone interactionVitamin D3Cytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Vitamin D might induce CYP3A4 enzymes and reduce the bioavailability of CYP3A4 substrates.
Read the full Vitamin D3 + Amiodarone interactionAmitriptylineElavil
How Amitriptyline interacts with Protective Breast Formula — through 5 ingredients. Tap an ingredient for the detail:
Turmeric Rhizome ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Turmeric might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full Turmeric Rhizome Extract + Amitriptyline interactionGrape Seed ExtractCytochrome P450 2c9 (cyp2c9) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates +2 Moderate
Interaction Summary
It is unclear if grape juice or grape seed extract inhibits CYP2C9; research is conflicting.
Read the full Grape Seed Extract + Amitriptyline interactionGreen Tea Leaf ExtractCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Green tea is unlikely to produce clinically significant changes in the levels and clinical effects of CYP3A4 substrates.
Read the full Green Tea Leaf Extract + Amitriptyline interactionIndolplex Diindolylmethane (br-dim) ComplexCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, diindolylmethane might lower serum levels of CYP1A2 substrates.
Read the full Indolplex Diindolylmethane (br-dim) Complex + Amitriptyline interactionVitamin D3Cytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Vitamin D might induce CYP3A4 enzymes and reduce the bioavailability of CYP3A4 substrates.
Read the full Vitamin D3 + Amitriptyline interactionAmitriptyline, ChlordiazepoxideLimbitrol DS
How Amitriptyline, Chlordiazepoxide interacts with Protective Breast Formula — through 5 ingredients. Tap an ingredient for the detail:
Grape Seed ExtractCytochrome P450 2d6 (cyp2d6) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates +2 Moderate
Interaction Summary
Theoretically, grape seed extract may increase the levels of CYP2D6 substrates.
Read the full Grape Seed Extract + Amitriptyline, Chlordiazepoxide interactionTurmeric Rhizome ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, turmeric might increase levels of drugs metabolized by CYP1A2.
Read the full Turmeric Rhizome Extract + Amitriptyline, Chlordiazepoxide interactionIndolplex Diindolylmethane (br-dim) ComplexCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, diindolylmethane might lower serum levels of CYP1A2 substrates.
Read the full Indolplex Diindolylmethane (br-dim) Complex + Amitriptyline, Chlordiazepoxide interactionGreen Tea Leaf ExtractCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Green tea is unlikely to produce clinically significant changes in the levels and clinical effects of CYP3A4 substrates.
Read the full Green Tea Leaf Extract + Amitriptyline, Chlordiazepoxide interactionVitamin D3Cytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Vitamin D might induce CYP3A4 enzymes and reduce the bioavailability of CYP3A4 substrates.
Read the full Vitamin D3 + Amitriptyline, Chlordiazepoxide interactionAmitriptyline, PerphenazineEtrafon, Etrafon-A, Etrafon-Forte, Triavil
How Amitriptyline, Perphenazine interacts with Protective Breast Formula — through 5 ingredients. Tap an ingredient for the detail:
Turmeric Rhizome ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, turmeric might increase levels of drugs metabolized by CYP1A2.
Read the full Turmeric Rhizome Extract + Amitriptyline, Perphenazine interactionGrape Seed ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates +2 Moderate
Interaction Summary
It is unclear if grape seed extract inhibits or induces CYP3A4; research is conflicting.
Read the full Grape Seed Extract + Amitriptyline, Perphenazine interactionVitamin D3Cytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Vitamin D might induce CYP3A4 enzymes and reduce the bioavailability of CYP3A4 substrates.
Read the full Vitamin D3 + Amitriptyline, Perphenazine interactionIndolplex Diindolylmethane (br-dim) ComplexCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, diindolylmethane might lower serum levels of CYP1A2 substrates.
Read the full Indolplex Diindolylmethane (br-dim) Complex + Amitriptyline, Perphenazine interactionGreen Tea Leaf ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Phenothiazines Minor
Interaction Summary
Green tea is unlikely to produce clinically significant changes in the levels and clinical effects of CYP3A4 substrates.
Read the full Green Tea Leaf Extract + Amitriptyline, Perphenazine interactionAmlodipineNorliqva
How Amlodipine interacts with Protective Breast Formula — through 7 ingredients. Tap an ingredient for the detail:
Grape Seed ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
It is unclear if grape seed extract inhibits or induces CYP3A4; research is conflicting.
Read the full Grape Seed Extract + Amlodipine interactionTurmeric Rhizome ExtractAmlodipine (norvasc), Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Taking turmeric with amlodipine may increase levels of amlodipine.
Read the full Turmeric Rhizome Extract + Amlodipine interactionMaitake Mushroom ExtractAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, combining maitake mushroom with antihypertensive drugs might increase the risk of hypotension.
Read the full Maitake Mushroom Extract + Amlodipine interactionSodiumAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, a high intake of dietary sodium might reduce the effectiveness of antihypertensive drugs.
Read the full Sodium + Amlodipine interactionGreen Tea Leaf ExtractCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Green tea is unlikely to produce clinically significant changes in the levels and clinical effects of CYP3A4 substrates.
Read the full Green Tea Leaf Extract + Amlodipine interactionVitamin D3Cytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Vitamin D might induce CYP3A4 enzymes and reduce the bioavailability of CYP3A4 substrates.
Read the full Vitamin D3 + Amlodipine interactionCalciumCalcium Channel Blockers Minor
Interaction Summary
Intravenous calcium may decrease the effects of calcium channel blockers; oral calcium is unlikely to have this effect.
Read the full Calcium + Amlodipine interactionEach ingredient & the kinds of drugs it affects
For each ingredient in Protective Breast Formula 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.
Green Tea leaf extract
Atorvastatin (Lipitor)
Green tea extract seems to reduce the levels and clinical effects of atorvastatin.
In healthy humans, taking green tea extract 300 mg or 600 mg along with atorvastatin reduces plasma levels of atorvastatin by approximately 24%. The elimination of atorvastatin is not affected. Atorvastatin is a substrate of organic anion-transporting polypeptides (OATPs). Research shows that two of the major catechins found in green tea, epicatechin gallate (ECG) and epigallocatechin gallate (EGCG), inhibit OATPs. Some OATPs are expressed in the small intestine and are responsible for the uptake of drugs and other compounds, which may have resulted in reduced plasma levels of atorvastatin. It is not clear if drinking green tea alters the absorption of atorvastatin.
Ephedrine
Theoretically, concomitant use might increase the risk for stimulant adverse effects.
Green tea contains caffeine. There is evidence that using ephedrine with caffeine might increase the risk of serious life-threatening or debilitating adverse effects such as hypertension, myocardial infarction, stroke, seizures, and death.
Nadolol (Corgard)
Green tea seems to reduce the levels and clinical effects of nadolol.
Preliminary clinical research shows that green tea consumption reduces plasma concentrations of nadolol. Compared to a control group, both peak levels and total drug exposure (AUC) of nadolol were reduced by approximately 85% in subjects who drank green tea daily for two weeks. Drinking green tea with nadolol also significantly reduced nadolol's systolic blood pressure lowering effect. Other clinical research shows that a single dose of green tea can affect plasma nadolol levels for at least one hour. Green tea catechins have been shown to inhibit organic anion transporting polypeptides (OATP), one of which, OATP1A2, is involved in the uptake of nadolol in the intestine The interaction is thought to be due primarily to the epigallocatechin gallate (EGCG) content of green tea.
5-Fluorouracil
Theoretically, high doses of green tea might increase the effects and side effects of 5-fluorouracil.
Animal research shows that taking green tea in amounts equivalent to about 6 cups daily in humans for 4 weeks prior to receiving a single injection of 5-fluorouracil increases the maximum plasma levels of 5-fluorouracil by about 2.5-fold and the area under the curve by 425%.
Adenosine (Adenocard)
Theoretically, green tea might decrease the vasodilatory effects of adenosine and interfere with its use prior to stress testing.
Green tea contains caffeine. Caffeine is a competitive inhibitor of adenosine at the cellular level. However, caffeine doesn't seem to affect supplemental adenosine because high interstitial levels of adenosine overcome the antagonistic effects of caffeine. It is recommended that methylxanthines and methylxanthine-containing products be stopped 24 hours prior to pharmacological stress tests. However, methylxanthines appear more likely to interfere with dipyridamole (Persantine) than adenosine-induced stress testing.
Anticoagulant/Antiplatelet Drugs
Theoretically, green tea may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Conflicting reports exist regarding the effect of green tea on bleeding risk when used with anticoagulant or antiplatelet drugs; however, most evidence suggests that drinking green tea in moderate amounts is unlikely to cause a significant interaction. Green tea contains small amounts of vitamin K, approximately 7 mcg per cup. Some case reports have associated the antagonism of warfarin with the vitamin K content of green tea. However, these reports are rare, and very large doses of green tea (about 8-16 cups daily) appear to be needed to cause these effects. Furthermore, the catechins and caffeine in green tea are reported to have antiplatelet activity.
Beta-Adrenergic Agonists
Green tea contains caffeine. Theoretically, concomitant use of large amounts of caffeine might increase cardiac inotropic effects of beta-agonists.
Bortezomib (Velcade)
Theoretically, green tea might interfere with the effects of bortezomib.
In vitro research shows that green tea polyphenols, such as epigallocatechin gallate (EGCG), interact with bortezomib and block its proteasome inhibitory action. This prevents the induction of cell death in multiple myeloma or glioblastoma cancer cell lines. Advise patients taking bortezomib, not to take green tea.
Carbamazepine (Tegretol)
Theoretically, green tea might reduce the effects of carbamazepine and increase the risk for convulsions.
Green tea contains caffeine. Animal research suggests that taking caffeine can lower the anticonvulsant effects of carbamazepine and can induce seizures when taken in doses above 400 mg/kg. Human research has shown that taking caffeine 300 mg in three divided doses along with carbamazepine 200 mg reduces the bioavailability of carbamazepine by 32% and prolongs the plasma half-life of carbamazepine 2-fold in healthy individuals.
Celiprolol (Celicard)
Theoretically, green tea might reduce the levels and clinical effects of celiprolol.
In a small human study, taking green tea daily for 4 days appears to decrease blood and urine levels of celiprolol by at least 98%. This interaction is possibly due to the inhibition of organic anion transporting polypeptide (OATP). Green tea catechins have been shown to inhibit organic anion transporting polypeptides (OATP), one of which, OATP1A2, is found in the intestine The interaction is thought to be due primarily to the epigallocatechin gallate (EGCG) content of green tea.
Cimetidine (Tagamet)
Theoretically, concomitant use might increase the effects and adverse effects of caffeine in green tea.
Green tea contains caffeine. Cimetidine can reduce caffeine clearance by 31% to 42%.
Clozapine (Clozaril)
Theoretically, green tea might increase the levels and adverse effects of clozapine and acutely exacerbate psychotic symptoms.
Animal research suggests that, although green tea extract does not affect the elimination of clozapine, it delays the time to reach peak concentration and reduces the peak plasma levels. Also, concomitant administration of green tea and clozapine might theoretically cause acute exacerbation of psychotic symptoms due to the caffeine in green tea. Caffeine can increase the effects and toxicity of clozapine. Caffeine doses of 400-1000 mg daily inhibit clozapine metabolism. Clozapine is metabolized by cytochrome P450 1A2 (CYP1A2). Researchers speculate that caffeine might inhibit CYP1A2. However, there is no reliable evidence that caffeine affects CYP1A2. There is also speculation that genetic factors might make some patients be more sensitive to the interaction between clozapine and caffeine.
Contraceptive Drugs
Theoretically, concomitant use might increase the effects and adverse effects of caffeine found in green tea.
Green tea contains caffeine. Oral contraceptives can decrease caffeine clearance by 40% to 65%.
Cytochrome P450 1A2 (Cyp1A2) Inhibitors
Theoretically, concomitant use might increase the levels and adverse effects of caffeine.
Green tea contains caffeine. Caffeine is metabolized by cytochrome P450 1A2 (CYP1A2),. Theoretically, drugs that inhibit CYP1A2 may decrease the clearance rate of caffeine from green tea and increase caffeine levels.
Dipyridamole (Persantine)
Theoretically, green tea might decrease the vasodilatory effects of dipyridamole and interfere with its use prior to stress testing.
Green tea contains caffeine. Caffeine might inhibit dipyridamole-induced vasodilation. It is recommended that methylxanthines and methylxanthine-containing products be stopped 24 hours prior to pharmacological stress tests. Methylxanthines appear more likely to interfere with dipyridamole (Persantine) than adenosine-induced stress testing.
Disulfiram (Antabuse)
Theoretically, disulfiram might increase the risk of adverse effects from caffeine.
In human research, disulfiram decreases the clearance and increases the half-life of caffeine.
Diuretic Drugs
Theoretically, using green tea with diuretic drugs might increase the risk of hypokalemia.
Green tea contains caffeine. In excessive amounts, caffeine can reduce potassium levels due to stimulation of the sodium-potassium pump. Diuretics can also cause lower potassium levels.
Estrogens
Theoretically, estrogens might increase the levels and adverse effects of caffeine.
Green tea contains caffeine. Estrogen inhibits caffeine metabolism.
Ethosuximide (Zarontin)
Theoretically, green tea might reduce the effects of ethosuximide and increase the risk for convulsions.
Green tea contains caffeine. Animal research suggests that caffeine 92.4 mg/kg can decrease the anticonvulsant activity of ethosuximide. However, this effect has not been reported in humans.
Felbamate (Felbatol)
Theoretically, green tea might reduce the effects of felbamate and increase the risk for convulsions.
Green tea contains caffeine. Animal research suggests that a high dose of caffeine 161.7 mg/kg can decreases the anticonvulsant activity of felbamate. However, this effect has not been reported in humans.
Fexofenadine (Allegra)
Green tea can decrease blood levels of fexofenadine.
Clinical research shows that green tea can significantly decrease blood levels and excretion of fexofenadine. Taking green tea extract with a dose of fexofenadine decreased bioavailability of fexofenadine by about 30%. In vitro, green tea inhibits the cellular accumulation of fexofenadine by inhibiting the organic anion transporting polypeptide (OATP) drug transporter. Research shows that two of the major catechins found in green tea, epicatechin gallate (ECG) and epigallocatechin gallate (EGCG), inhibit OATPs, specifically OATP1A2, OATP1B1, and OATP2B1. In addition, green tea has been shown to reduce the absorption of some drugs that are OATP substrates.
Flutamide (Eulexin)
Theoretically, green tea might increase the levels and adverse effects of flutamide.
Green tea contains caffeine. In vitro evidence suggests that caffeine can inhibit the metabolism of flutamide. Theoretically, concomitant use of caffeine and flutamide might increase serum concentrations of flutamide and increase the risk adverse effects.
Fluvoxamine (Luvox)
Theoretically, fluvoxamine might increase the levels and adverse effects of caffeine.
Green tea contains caffeine. Fluvoxamine reduces caffeine metabolism.
Hepatotoxic Drugs
Theoretically, concomitant use might have additive adverse hepatotoxic effects.
Green tea extract supplements have been linked to several cases of hepatotoxicity and might have additive hepatotoxic effects with other drugs..
Imatinib (Gleevec)
Theoretically, green tea might reduce the levels and clinical effects of imatinib.
In animal research, a single dose of green tea extract reduces the area under the curve (AUC) of imatinib by up to approximately 64% and its main metabolite N-desmethyl imatinib by up to approximately 81%. This interaction has not been shown in humans. The mechanism of action is unclear but may involve multiple pathways.
Turmeric rhizome extract
Alkylating Agents
Turmeric has antioxidant effects. Theoretically, this may reduce the activity of chemotherapy drugs that generate free radicals. However, research is conflicting.
In vitro research suggests that curcumin, a constituent of turmeric, inhibits mechlorethamine-induced apoptosis of breast cancer cells by up to 70%. Also, animal research shows that curcumin inhibits cyclophosphamide-induced tumor regression. However, some in vitro research shows that curcumin does not affect the apoptosis capacity of etoposide. Also, other laboratory research suggests that curcumin might augment the cytotoxic effects of alkylating agents. Reasons for the discrepancies may relate to the dose of curcumin and the specific chemotherapeutic agent. Lower doses of curcumin might have antioxidant effects while higher doses might have pro-oxidant effects. More evidence is needed to determine what effect, if any, turmeric might have on alkylating agents.
Amlodipine (Norvasc)
Taking turmeric with amlodipine may increase levels of amlodipine.
Animal research shows that giving amlodipine 1 mg/kg as a single dose following the use of turmeric extract 200 mg/kg daily for 2 weeks increases the maximum concentration and area under the curve by 53% and 56%, respectively, when compared with amlodipine alone. Additional animal research shows that taking amlodipine 1 mg/kg with a curcumin 2 mg/kg pretreatment for 10 days increases the maximum concentration and area under the curve by about 2-fold when compared with amlodipine alone.
Anticoagulant/Antiplatelet Drugs
Turmeric may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs. However, research is conflicting.
Curcumin, a constituent of turmeric, has demonstrated antiplatelet effects in vitro. Furthermore, two case reports have found that taking turmeric along with warfarin or fluindione was associated with an increased international normalized ratio (INR). However, one clinical study in healthy volunteers shows that taking curcumin 500 mg daily for 3 weeks, alone or with aspirin 100 mg, does not increase antiplatelet effects or bleeding risk. It is possible that the dose of turmeric used in this study was too low to produce a notable effect.
Antidiabetes Drugs
Theoretically, taking turmeric with antidiabetes drugs might increase the risk of hypoglycemia.
Animal research and case reports suggest that curcumin, a turmeric constituent, can reduce blood glucose levels in patients with diabetes. Furthermore, clinical research in adults with type 2 diabetes shows that taking curcumin 475 mg daily for 10 days prior to taking glyburide 5 mg decreased postprandial glucose levels for up to 24 hours when compared with glyburide alone, despite the lack of a significant pharmacokinetic interaction. Other clinical studies in patients with diabetes show that taking curcumin daily can reduce blood glucose levels when compared with placebo.
Antitumor Antibiotics
Turmeric has antioxidant effects. Theoretically, this may reduce the activity of chemotherapy drugs that generate free radicals. However, research is conflicting.
In vitro and animal research shows that curcumin, a constituent of turmeric, inhibits doxorubicin-induced apoptosis of breast cancer cells by up to 65%. However, curcumin does not seem to affect the apoptosis capacity of daunorubicin. In fact, some research shows that curcumin might augment the cytotoxic effects of antitumor antibiotics, increasing their effectiveness. Reasons for the discrepancies may relate to the dose of curcumin and the chemotherapeutic agent. Lower doses of curcumin might have antioxidant effects while higher doses might have pro-oxidant effects. More evidence is needed to determine what effects, if any, antioxidants such as turmeric have on antitumor antibiotics.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Turmeric might increase or decrease levels of drugs metabolized by CYP3A4.
In vitro and animal research show that turmeric and its constituents curcumin and curcuminoids inhibit CYP3A4. Also, 8 case reports from the World Health Organization (WHO) adverse drug reaction database describe increased toxicity in patients taking turmeric and cancer medications that are CYP3A4 substrates, including everolimus, ruxolitinib, ibrutinib, and palbociclib, and bortezomib. In another case report, a transplant patient presented with acute nephrotoxicity and elevated tacrolimus levels after consuming turmeric powder at a dose of 15 or more spoonfuls daily for ten days prior. It was thought that turmeric increased levels of tacrolimus due to CYP3A4 inhibition.
Conversely, other in vitro research suggests that turmeric induces CYP3A4 activity, leading to reduced levels of CYP3A4 substrates. An animal model suggests that induction of CYP3A4 occurs after daily curcumin use for 1 week. However, the induction of CYP3A4 by turmeric has not been reported in humans.
Hepatotoxic Drugs
Theoretically, turmeric might increase the risk of liver damage when taken with hepatotoxic drugs.
There is concern that turmeric might cause hepatotoxicity, especially when highly bioavailable formulations are used in high doses.
Methotrexate (Trexall, Others)
Theoretically, turmeric might have additive effects when used with hepatotoxic drugs such as methotrexate.
In one case report, a 39-year-old female taking methotrexate, turmeric, and linseed oil developed hepatotoxicity.
Organic Anion-Transporting Polypeptide Substrates (Oatp)
Theoretically, turmeric might increase blood levels of OATP4C1 substrates.
In vitro research shows that the turmeric constituent curcumin competitively inhibits OATP4C1 transport. This transporter is expressed in the kidney and facilitates the renal excretion of certain drugs. Theoretically, taking turmeric might decrease renal excretion of OATP substrates.
Sulfasalazine (Azulfidine)
Turmeric might increase the effects and adverse effects of sulfasalazine.
Clinical research shows that taking the turmeric constituent, curcumin, can increase blood levels of sulfasalazine by 3.2-fold.
Tacrolimus (Prograf)
Turmeric might increase the effects and adverse effects of tacrolimus.
In one case report, a transplant patient presented with acute nephrotoxicity and elevated tacrolimus levels of 29 ng/mL. The patient previously had tacrolimus levels within the therapeutic range at 9.7 ng/mL. Ten days prior to presenting at the emergency room the patient started consumption of turmeric powder at a dose of 15 or more spoonfuls daily. It was thought that turmeric increased levels of tacrolimus due to cytochrome P450 3A4 (CYP3A4) inhibition. In vitro and animal research show that turmeric and its constituent curcumin inhibit CYP3A4.
Talinolol
Turmeric may reduce the absorption of talinolol in some situations.
Clinical research shows that taking curcumin for 6 days decreases the bioavailability of talinolol when taken together on the seventh day. The clinical significance of this effect is unclear.
Tamoxifen (Nolvadex)
Theoretically, turmeric might reduce the levels and clinical effects of tamoxifen.
In a small clinical trial in patients with breast cancer taking tamoxifen 20-30 mg daily, adding curcumin 1200 mg plus piperine 10 mg three times daily reduces the 24-hour area under the curve of tamoxifen and the active metabolite endoxifen by 12.8% and 12.4%, respectively, as well as the maximum concentrations of tamoxifen, when compared with tamoxifen alone. However, in the absence of piperine, the area under the curve for endoxifen and the maximum concentration of tamoxifen were not significantly reduced. Effects were most pronounced in patients who were extensive cytochrome P450 (CYP) 2D6 metabolizers.
Topoisomerase I Inhibitors
Turmeric has antioxidant effects. There is some concern that this may reduce the activity of chemotherapy drugs that generate free radicals. However, research is conflicting.
In vitro research shows that curcumin, a constituent of turmeric, inhibits camptothecin-induced apoptosis of breast cancer cells by up to 71%. However, other in vitro research shows that curcumin augments the cytotoxic effects of camptothecin. Reasons for the discrepancies may relate to the dose of curcumin and the chemotherapeutic agents. Lower doses of curcumin might have antioxidant effects while higher doses might have pro-oxidant effects. More evidence is needed to determine what effect, if any, turmeric might have.
Tramadol (Ultram)
Theoretically, turmeric might increase or decrease levels of tramadol.
Animal research suggests that a single dose of curcumin, a constituent of turmeric, may increase tramadol's maximum concentration (Cmax) by inhibiting metabolism, while continued daily use for 7 days may reduce the area under the curve (AUC) due to the induction of drug-metabolizing enzymes such as cytochrome P450 3A4 (CYP3A4). However, this interaction has not been reported in humans.
Warfarin (Coumadin)
Turmeric might increase the risk of bleeding with warfarin.
One case of increased international normalized ratio (INR) has been reported for a patient taking warfarin who began taking turmeric. Prior to taking turmeric, the patient had stable INR measurements. Within a few weeks of starting turmeric supplementation, the patient's INR increased to 10. Additionally, curcumin, the active constituent in turmeric, has demonstrated antiplatelet effects in vitro, which may produce additive effects when taken with warfarin.
Cytochrome P450 1A2 (Cyp1A2) Substrates
Theoretically, turmeric might increase levels of drugs metabolized by CYP1A2. However, research is conflicting.
In vitro and animal research show that the turmeric constituent, curcumin, inhibits CYP1A2. However, other in vitro research suggests that curcumin does not significantly affect CYP1A2.
Docetaxel (Taxotere)
Theoretically, turmeric might increase blood levels of oral docetaxel.
Animal research suggests that the turmeric constituent, curcumin, enhances the oral bioavailability of docetaxel. However, the significance of this interaction is unclear, as this drug is typically administered intravenously in clinical settings.
Estrogens
Theoretically, large amounts of turmeric might interfere with hormone replacement therapy through competition for estrogen receptors.
In vitro research shows that curcumin, a constituent of turmeric, displaces the binding of estrogen to its receptors.
Glyburide (Diabeta, Others)
Theoretically, taking turmeric and glyburide in combination might increase the risk of hypoglycemia.
Clinical research shows that taking curcumin 475 mg daily for 10 days prior to taking glyburide 5 mg increases blood levels of glyburide by 12% at 2 hours after the dose in patients with type 2 diabetes. While maximal blood concentrations of glyburide were not affected, turmeric modestly decreased postprandial glucose levels for up to 24 hours when compared to glyburide alone, possibly due to the hypoglycemic effect of turmeric demonstrated in animal research.
Losartan (Cozaar)
Theoretically, turmeric might increase the effects of losartan.
Research in hypertensive rats shows that taking turmeric can increase the hypotensive effects of losartan.
Norfloxacin (Noroxin)
Theoretically, turmeric might increase the effects and adverse effects of norfloxacin.
Animal research shows that taking curcumin, a turmeric constituent, can increase blood levels of orally administered norfloxacin.
P-Glycoprotein Substrates
Theoretically, turmeric might increase the absorption of P-glycoprotein substrates.
In vitro and animal research shows that curcuminoids and other constituents found in turmeric can inhibit P-glycoprotein expression and activity.
Paclitaxel (Abraxane, Onxol)
Theoretically, turmeric might alter blood levels of paclitaxel, although any effect may not be clinically relevant.
Clinical research in adults with breast cancer receiving intravenous paclitaxel suggests that taking turmeric may modestly alter paclitaxel pharmacokinetics. Patients received paclitaxel on day 1, followed by either no treatment or turmeric 2 grams daily from days 2-22. Pharmacokinetic modeling suggests that turmeric reduces the maximum concentration and area under the curve of paclitaxel by 12.1% and 7.7%, respectively. However, these changes are not likely to be considered clinically relevant. Conversely, animal research suggests that curcumin, a constituent of turmeric, enhances the oral bioavailability of paclitaxel. However, the significance of this interaction is unclear, as this drug is typically administered intravenously in clinical settings.
Grape seed extract
Anticoagulant/Antiplatelet Drugs
Theoretically, grape extracts may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
In vitro evidence suggests that grape extracts might decrease platelet aggregation.
Cyclosporine (Neoral, Sandimmune)
Ingesting grape juice with cyclosporine can reduce cyclosporine absorption.
A small pharmacokinetic study in healthy young adults shows that intake of purple grape juice 200 mL along with cyclosporine can decrease the absorption of cyclosporine by up to 30% when compared with water. Separate doses of grape juice and cyclosporine by at least 2 hours to avoid this interaction.
Cytochrome P450 1A2 (Cyp1A2) Substrates
Theoretically, grape juice might reduce the levels of CYP1A2 substrates.
A small pharmacokinetic study in healthy adults shows that ingestion of 200 mL of grape juice decreases phenacetin plasma levels. This is thought to be due to induction of CYP1A2.
Cytochrome P450 2D6 (Cyp2D6) Substrates
Theoretically, grape seed extract may increase the levels of CYP2D6 substrates.
In vitro evidence suggests that grape seed extract might inhibit CYP2D6 enzymes. However, this interaction has not been reported in humans.
Cytochrome P450 2E1 (Cyp2E1) Substrates
Theoretically, grape seed extract might increase the levels of CYP2E1 substrates.
In vitro and animal research suggests that grape seed proanthocyanidin extract inhibits CYP2E1 enzymes. However, this interaction has not been reported in humans.
Cytochrome P450 3A4 (Cyp3A4) Substrates
It is unclear if grape seed extract inhibits or induces CYP3A4; research is conflicting.
In vitro evidence suggests that grape seed extract might inhibit CYP3A4 enzymes. However, evidence from animal research shows that grape seed extract may induce CYP3A4 in the liver. So far, these interactions have not been reported in humans.
Midazolam (Versed)
Theoretically, long-term intake of grape seed extract might decrease the effects of midazolam.
Animal research shows that subchronic ingestions of grape seed extract can increase the elimination of intravenous midazolam by increasing hepatic CYP3A4 activity. Single doses of grape seed extract do not appear to affect midazolam elimination.
Phenacetin
Grape juice might decrease phenacetin absorption.
A small pharmacokinetic study in healthy adults shows that ingestion of 200 mL of grape juice decreases phenacetin plasma levels. This is thought to be due to induction of cytochrome P450 1A2 (CYP1A2).
Cytochrome P450 2C9 (Cyp2C9) Substrates
It is unclear if grape juice or grape seed extract inhibits CYP2C9; research is conflicting.
In vitro evidence shows that grape seed extract or grape juice might inhibit CYP2C9 enzymes. However, a small pharmacokinetic study in healthy adults shows that drinking 8 ounces of grape juice once does not affect the clearance of flurbiprofen, a probe-drug for CYP2C9 metabolism. The effects of continued grape juice consumption are unclear.
Vitamin D3
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.
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.
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.
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.
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.
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.
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.
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.
Indolplex Diindolylmethane (BR-DIM) Complex
Diuretic Drugs
Theoretically, diindolylmethane might increase the risk of hyponatremia if used with sodium-depleting diuretics.
Large doses of diindolylmethane (600 mg daily) have been associated with two cases of asymptomatic hyponatremia in clinical research.
Estrogens
Theoretically, diindolylmethane might increase or decrease the effects of estrogens.
Diindolylmethane might have mild estrogenic or antiestrogenic effects. Theoretically, large amounts of diindolylmethane might interfere with hormone replacement therapy.
Cytochrome P450 1A2 (Cyp1A2) Substrates
Theoretically, diindolylmethane might lower serum levels of CYP1A2 substrates.
In vitro evidence suggests that diindolylmethane can induce CYP1A2. Theoretically, it might increase metabolism of CYP1A2 substrates and lower serum concentrations. This interaction has not been reported in humans.
Maitake Mushroom extract
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.
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.
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.
Sodium
Antihypertensive Drugs
Theoretically, a high intake of dietary sodium might reduce the effectiveness of antihypertensive drugs.
High intake of dietary sodium can increase systolic and diastolic blood pressure. Also, high intake of sodium may necessitate increased use of antihypertensive medications to achieve blood pressure control in some patients, such as those with chronic kidney disease.
Corticosteroids
Concomitant use of mineralocorticoids and some glucocorticoids with sodium supplements might increase the risk of hypernatremia.
Mineralocorticoids and some glucocorticoids (corticosteroids) cause sodium retention. This effect is dose-related and depends on mineralocorticoid potency. It is most common with hydrocortisone, cortisone, and fludrocortisone, followed by prednisone and prednisolone.
Didanosine (Videx)
Concomitant use of didanosine with additional sodium from dietary or supplemental sources may increase the risk of hypernatremia.
Didanosine formulations contain a significant amount of sodium.
Lithium
Altering dietary intake of sodium might alter the levels and clinical effects of lithium.
High sodium intake can reduce plasma concentrations of lithium by increasing lithium excretion. Reducing sodium intake can significantly increase plasma concentrations of lithium and cause lithium toxicity in patients being treated with lithium carbonate. Stabilizing sodium intake is shown to reduce the percentage of patients with lithium level fluctuations above 0.8 mEq/L. Patients taking lithium should avoid significant alterations in their dietary intake of sodium.
Sodium Phosphates
Theoretically, concomitant use of sodium phosphate with sodium supplements might increase the risk of hypernatremia.
Use of high doses (> 45 mL in 24 hours) of sodium phosphate, such as those used for bowel cleansing before surgery, can lead to serious electrolyte disturbances, including hypernatremia. The risk of hypernatremia is highest in the elderly and people with other risk factors for electrolyte disturbances.
Sodium-Containing Drugs
Concomitant use of sodium-containing drugs with additional sodium from dietary or supplemental sources may increase the risk of hypernatremia and long-term sodium-related complications.
The Chronic Disease Risk Reduction (CDRR) intake level of 2.3 grams of sodium daily indicates the intake at which it is believed that chronic disease risk increases for the apparently healthy population. Some medications contain high quantities of sodium. When used in conjunction with sodium supplements or high-sodium diets, the CDRR may be exceeded. Additionally, concomitant use may increase the risk for hypernatremia; this risk is highest in the elderly and people with other risk factors for electrolyte disturbances.
Tolvaptan (Samsca)
Theoretically, concomitant use of tolvaptan with sodium might increase the risk of hypernatremia.
Tolvaptan is a vasopressin receptor 2 antagonist that is used to increase sodium levels in patients with hyponatremia. Patients taking tolvaptan should use caution with the use of sodium salts such as sodium chloride.
Calcium
Ceftriaxone (Rocephin)
Co-administration of intravenous calcium and ceftriaxone can result in precipitation of a ceftriaxone-calcium salt in the lungs and kidneys.
Avoid administering intravenous calcium in any form, such as parenteral nutrition or Lactated Ringers, within 48 hours of intravenous ceftriaxone. Case reports in neonates show that administering intravenous ceftriaxone and calcium can result in precipitation of a ceftriaxone-calcium salt in the lungs and kidneys. In several cases, neonates have died as a result of this interaction. So far there are no reports in adults; however, there is still concern that this interaction might occur in adults.
Dolutegravir (Tivicay)
Calcium seems to reduce levels of dolutegravir.
Advise patients to take dolutegravir either 2 hours before or 6 hours after taking calcium supplements. Pharmacokinetic research suggests that taking calcium carbonate 1200 mg concomitantly with dolutegravir 50 mg reduces plasma levels of dolutegravir by almost 40%. Calcium appears to decrease levels of dolutegravir through chelation.
Elvitegravir (Vitekta)
Calcium seems to reduce levels of elvitegravir.
Advise patients to take elvitegravir either 2 hours before or 2 hours after taking calcium supplements. Pharmacokinetic research suggests that taking calcium along with elvitegravir can reduce blood levels of elvitegravir through chelation.
Aluminum
Calcium citrate might increase aluminum absorption and toxicity. Other types of calcium do not increase aluminum absorption.
Calcium citrate can increase the absorption of aluminum when taken with aluminum hydroxide. The increase in aluminum levels may become toxic, particularly in individuals with kidney disease. However, the effect of calcium citrate on aluminum absorption is due to the citrate anion rather than calcium cation. Calcium acetate does not appear to increase aluminum absorption.
Bictegravir/Emtricitabine/Tenofovir Alafenamide (Biktarvy)
Calcium might decrease levels of bictegravir/emtricitabine/tenofovir alafenamide by reducing its absorption when taken in a fasting state.
Advise patients that bictegravir/emtricitabine/tenofovir alafenamide and calcium can be taken together if taken with food. However, if taken on an empty stomach, bictegravir/emtricitabine/tenofovir alafenamide should not be taken with, or 2 hours after, calcium containing products.
Bisphosphonates
Calcium reduces the absorption of bisphosphonates.
Advise patients to take bisphosphonates at least 30 minutes before calcium, but preferably at a different time of day. Calcium supplements decrease absorption of bisphosphonates.
Calcipotriene (Dovonex)
Taking calcipotriene with calcium might increase 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 calcium supplements might increase the risk of hypercalcemia.
Digoxin (Lanoxin)
Using intravenous calcium with digoxin might increase the risk of fatal cardiac arrhythmias.
Hypercalcemia increases the risk of fatal cardiac arrhythmias with digoxin. However, one retrospective analysis of clinical data suggests that intravenous calcium does not increase the risk of dysrhythmias or mortality in patients receiving digoxin.
Diltiazem (Cardizem, Others)
Theoretically, calcium may reduce the therapeutic effects of diltiazem.
Hypercalcemia can reduce the effectiveness of verapamil in atrial fibrillation. Theoretically, calcium might increase this risk of hypercalcemia and reduce the effectiveness of diltiazem.
Levothyroxine (Synthroid, Others)
Calcium seems to reduce the absorption and effectiveness of levothyroxine.
Advise patients to take levothyroxine and calcium supplements at least 4 hours apart. Calcium reduces levothyroxine absorption, probably by forming insoluble complexes. Calcium carbonate supplements reduce effectiveness of levothyroxine in patients with hypothyroidism.
Lithium
Theoretically, concomitant use of calcium and lithium may increase this risk of hypercalcemia.
Clinical research suggests that long-term use of lithium may cause hypercalcemia in 10% to 60% of patients. Theoretically, concomitant use of lithium and calcium supplements may further increase this risk.
Quinolone Antibiotics
Calcium seems to reduce the absorption of quinolone antibiotics.
Advise patients to take oral quinolones at least 2 hours before or 4-6 hours after calcium supplements or calcium-fortified foods. Taking calcium at the same time as oral quinolones can reduce quinolone absorption. Calcium binds to quinolones in the gut.
Raltegravir (Isentress)
Calcium may reduce levels of raltegravir.
Pharmacokinetic research shows that taking a single dose of calcium carbonate 3000 mg along with raltegravir 400 mg twice daily modestly decreases the mean area under the curve of raltegravir, but the decrease does not necessitate a dose adjustment of raltegravir. However, a case of elevated HIV-1 RNA levels and documented resistance to raltegravir has been reported for a patient taking calcium carbonate 1 gram three times daily plus vitamin D3 (cholecalciferol) 400 IU three times daily in combination with raltegravir 400 mg twice daily for 11 months. It is thought that calcium reduced raltegravir levels by chelation, leading to treatment failure.
Sotalol (Betapace)
Calcium seems to reduce the absorption of sotalol.
Advise patients to separate doses by at least 2 hours before or 4-6 hours after calcium. Calcium appears to reduce the absorption of sotalol, probably by forming insoluble complexes.
Tetracycline Antibiotics
Calcium seems to reduce the absorption of tetracycline antibiotics.
Advise patients to take oral tetracyclines at least 2 hours before, or 4-6 hours after calcium supplements. Taking calcium at the same time as oral tetracyclines can reduce tetracycline absorption. Calcium binds to tetracyclines in the gut.
Thiazide Diuretics
Taking calcium along with thiazides might increase the risk of hypercalcemia and renal failure.
Thiazides reduce calcium excretion by the kidneys. Using thiazides along with moderately large amounts of calcium carbonate increases the risk of milk-alkali syndrome (hypercalcemia, metabolic alkalosis, renal failure). Patients may need to have their serum calcium levels and/or parathyroid function monitored regularly.
Verapamil (Calan, Others)
Theoretically, calcium may reduce the therapeutic effects of verapamil.
Hypercalcemia can reduce the effectiveness of verapamil in atrial fibrillation. Theoretically, use of calcium supplements may increase this risk of hypercalcemia and reduce the effectiveness of verapamil.
Calcium Channel Blockers
Intravenous calcium may decrease the effects of calcium channel blockers; oral calcium is unlikely to have this effect.
Intravenous calcium is used to decrease the effects of calcium channel blockers in the management of overdose. Intravenous calcium gluconate has been used before intravenous verapamil (Isoptin) to prevent or reduce the hypotensive effects without affecting the antiarrhythmic effects. But there is no evidence that dietary or supplemental calcium when taken orally interacts with calcium channel blockers.
Calcium D-Glucarate
Alcohol (Ethanol)
Theoretically, concomitant use with alcohol might decrease calcium D-glucarate activity.
There is some evidence that urinary excretion of calcium D-glucarate metabolites increases in people consuming alcohol.
Glucuronidated Drugs
Theoretically, calcium D-glucarate might increase the clearance of drugs that undergo glucuronidation.
The calcium D-glucarate metabolite, D-glucaro-1,4-lactone, inhibits the enzyme beta-glucuronidase, reducing deconjugation of glucuronides in the intestine and thereby reducing reabsorption of the drugs.
Kanamycin
Theoretically, calcium D-glucarate may reduce plasma levels of kanamycin.
Calcium D-glucarate may increase the rate of kanamycin elimination, which may decrease its clinical and adverse effects.
Brand information
Manufacturer and brand details for Protective Breast Formula, from the product label.
Nature's Way
See all Nature's Way products- Name
- Nature's Way Brands, LLC
- City
- Green Bay
- State
- WI
- ZipCode
- 54311
- Phone Number
- 1-800-962-8873
- Web Address
- naturesway.com
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Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
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The Full Monographs Behind Protective Breast Formula’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Sodium
Interacts with 205 drugsSodium is an essential mineral and electrolyte your body needs to balance fluids, support nerves, and help muscles work. Most people in modern diets get more than enough—often too much—from...
Read the full Sodium monograph → Herb & supplement monographVitamin D
Interacts with 715 drugsVitamin 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 monographCalcium D-glucarate
Interacts with 126 drugsCalcium D-glucarate is a supplement form of a natural compound found in fruits and vegetables that is promoted for 'detoxification' and helping the body clear excess hormones. Human evidence...
Read the full Calcium D-glucarate monograph → Herb & supplement monographCalcium
Interacts with 168 drugsCalcium is an essential mineral your body needs for strong bones, nerve signaling, and muscle function, and supplements can help fill gaps when diet falls short. Most people do best getting...
Read the full Calcium monograph → Herb & supplement monographDiindolylmethane
Interacts with 269 drugsDiindolylmethane (DIM) is a compound made when your body digests cruciferous vegetables, and it is sold as a supplement mainly for hormone balance and cancer prevention. Although early lab s...
Read the full Diindolylmethane monograph → Herb & supplement monographTurmeric
Interacts with 1,133 drugsTurmeric is a popular spice whose main active compounds, curcuminoids, are studied mostly for inflammation and joint pain. Some research is promising, but quality is mixed and curcumin is po...
Read the full Turmeric monograph → Herb & supplement monographMaitake Mushroom
Interacts with 260 drugsMaitake 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 monographGreen Tea
Interacts with 1,293 drugsGreen tea is a popular beverage rich in antioxidants called catechins, and drinking it in normal amounts is considered safe for most people. Concentrated green tea extracts are a different s...
Read the full Green Tea monograph → Herb & supplement monographGrape
Interacts with 910 drugsGrapes and grape products like grape seed extract contain antioxidant compounds such as resveratrol and proanthocyanidins that may support heart and blood vessel health. While the food is he...
Read the full Grape monograph →Sources & How We Checked
Protective Breast Formula'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 508 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.
Sodium 38 references
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
- Food and Drug Administration Science Background: Safety of Sodium Phosphates Oral Solution. September 17, 2001. Available at: http://www.fda.gov/cder/drug/safety/sodiumphospate.htm
- Coton T, Mallaret C, Coilliot C, Carre D, Guisset M. Severe acute ulcerated gastritis induced by salt. Presse Med 2009;38(3):499-500. PubMed
- Frings-Meuthen P, Buehlmeier J, Baecker N, et al. High sodium chloride intake exacerbates immobilization-induced bone resorption and protein losses. J Appl Physiol 2011;111(2):537-542. PubMed
- Frings-Meuthen P, Baecker N, Heer M. Low-grade metabolic acidosis may be the cause of sodium chloride-induced exaggerated bone resorption. J Bone Miner Res 2008;23(4):517-524. PubMed
- Alam S, Johnson AG. A meta-analysis of randomised controlled trials (RCT) among healthy normotensive and essential hypertensive elderly patients to determine the effect of high salt (NaCl) diet of blood pressure. J Hum Hypertens 1999;13(6):367-74.
- Boudville N, Ward S, Benaroia M, House AA. Increased sodium intake correlates with greater use of antihypertensive agents by subjects with chronic kidney disease. Am J Hypertens 2005;18(10):1300-5. PubMed
- Bennett WM. Drug interactions and consequences of sodium restriction. Am J Clin Nutr 1997;65(2 Suppl):678S-681S. PubMed
- Okusa MD, Crystal LJ. Clinical manifestations and management of acute lithium intoxication. Am J Med 1994;97(4):383-9. PubMed
- Food and Nutrition Board, Institute of Medicine. Dietary reference intakes for water, potassium, sodium, chloride, and sulfate. Washington, DC: National Academy Press, 2005. Available at: http://www.nap.edu/openbook.php?record_id=10925. DOI
- D'Elia L, Rossi G, Ippolito R, Cappuccio FP, Strazzullo P. Habitual salt intake and risk of gastric cancer: a meta-analysis of prospective studies. Clin Nutr 2012;31(4):489-98. PubMed
- Goldsmith SR. Hyponatremia in heart failure: time for a trial. J Card Fail 2013;19(6):398-400. PubMed
- Willocks L, Brettle R, Keen J, Valentine C, Pinching AJ. Formulations of didanosine (ddI) and salt overload. Lancet 1992;339(8786):190.
- Chen L, Zhang Z, Chen W, Whelton PK, Appel LJ. Lower Sodium Intake and Risk of Headaches: Results From the Trial of Nonpharmacologic Interventions in the Elderly. Am J Public Health. 2016;106(7):1270-5. PubMed
- Cook NR, Appel LJ, Whelton PK. Lower levels of sodium intake and reduced cardiovascular risk. Circulation. 2014;129(9):981-9. PubMed
- Cook NR, Appel LJ, Whelton PK. Sodium Intake and All-Cause Mortality Over 20 Years in the Trials of Hypertension Prevention. J Am Coll Cardiol. 2016;68(15):1609-1617. PubMed
- Mente A, O'Donnell M, Rangarajan S, et al. Associations of urinary sodium excretion with cardiovascular events in individuals with and without hypertension: a pooled analysis of data from four studies. Lancet. 2016;388(10043):465-75. PubMed
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