Major interaction on record — check this product against your medications before combining. Check your meds →
Dietary supplement

Real Test Ingredients & Drug Interactions

by EXT

Real Test label
See full label image
Capsule Category: Botanical
Most serious interaction: Major
Clinical methodology reviewed by · Updated Sep 23, 2026 · Label data from the NIH DSLD
What is this page for?

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

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

The interaction bottom line Most serious interaction: Major

Real Test is a dietary supplement by EXT with 5 active ingredients. Its ingredients are commonly taken for digestive upset and diarrhea, anxiety and relaxation, sleep support.Based on those ingredients, 1,452 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are Salvia haematodes, Pausinystalia yohimbe, Semen nelumbinis. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

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Check Your Meds Against Real Test by EXT

Ask about any prescription or over-the-counter medication and we check it for interactions with Real Test by EXT — and tell you which ingredient is responsible.

Pharmacist-reviewed data Checks every ingredient Answer in seconds
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HelloPharmacist Scorecard of Real Test by EXT

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

From our pharmacy team — supplement deep dive

Generated from HelloPharmacist’s pharmacist-curated databases and editorial rules · Last generated Sep 10, 2026

What’s inside

Low disclosure
Ingredient Transparency · database check
Low

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

Why this rating?
  • The label discloses an exact amount for 0 of its 5 active ingredients.
  • “TEST MATRIX (Proprietary Blend)” is a proprietary blend — the label gives one combined amount (460 mg) without saying how much of each component you get.

Real Test contains five active ingredients. Lotus seed (Semen nelumbinis) is traditionally used for various conditions including sleep and nausea, though the evidence is insufficient to establish its effectiveness.

Safflower flower (Carthamus tinctorius) has been studied for heart and metabolic conditions, but evidence remains insufficient to rate it. Yohimbe bark (Pausinystalia yohimbe) is included for its yohimbine content, marketed for fatigue and sexual function, though evidence is insufficient.

Grains of paradise (Afromomum melegueta) and sage (Salvia haematodes) round out the blend — sage shows possibly effective evidence for menopausal symptoms, cholesterol, and cognitive function. The product also contains several inactive ingredients including gelatin, microcrystalline cellulose, silica, and a blue food dye.

Does it work?

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

There isn't enough reliable clinical evidence to rate this product's ingredients for its stated purpose.

Why this rating?
  • The label markets this product for: boost free testosterone and male sexual performance.
  • We looked for evidence on: Erectile dysfunction (ED), Antidepressant-induced sexual dysfunction, Athletic performance, Low testosterone, Hypogonadism, Sexual dysfunction.
  • The closest evidence on file: Sage is rated "Insufficient Reliable Evidence To Rate" for Athletic performance (Natural Medicines).
  • Also on file: Yohimbe is rated "Insufficient Reliable Evidence To Rate" for Antidepressant-induced sexual dysfunction, Athletic performance, Erectile dysfunction (ED).

The evidence for this product's active ingredients is mixed and incomplete. Sage is rated possibly effective for menopausal symptoms, cholesterol, and cognitive function — those are the strongest claims on file.

Lotus, safflower, yohimbe, and grains of paradise all lack sufficient reliable evidence for their marketed uses, meaning the studies either haven't been done, haven't been conclusive, or are too limited to rate them. If you're considering this product for a specific condition, talk it over with your doctor or pharmacist about whether the evidence supports its use for your situation.

The evidence, ingredient by ingredient Lotus Safflower Yohimbe Grains Of Paradise Sage

How safe is it?

Well-documented data
Safety Information · database check
Well characterized

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

Why this rating?
  • We hold adverse-effect (side-effect) data for 4 of the 5 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 5 of 5.
  • General safety write-ups exist for 5 of 5.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

Lotus is commonly eaten as food, but its safety as a concentrated supplement hasn't been well studied in humans. It can cause allergic reactions including hives and contact dermatitis, and a case of hives was documented in a young child after eating lotus root.

Safflower oil is generally tolerated at food doses, but high-dose supplements carry less safety data. Rare case reports link over-use to liver failure, though the exact doses involved are unclear.

Yohimbe carries the most cautionary profile — it can cause anxiety, agitation, tremors, nausea, headache, rapid heartbeat, high blood pressure, and in rare cases a hypertensive crisis. Blood pressure and heart effects are dose-related but serious.

Sage is well tolerated as tea or food, but concentrated extracts can rarely cause seizures (due to thujone, a potentially neurotoxic constituent), nausea, vomiting, and abdominal pain. Grains of paradise has limited safety data.

Side effects, ingredient by ingredient Lotus Safflower Yohimbe Grains Of Paradise Sage

Meds to double-check

Major interaction found
Known Interaction Concern · database check
Major identified

At least one ingredient has a documented Major-severity interaction. Check your medications for a personalized result.

Why this rating?
  • 4 of the 5 matched ingredients can interact with medications — Safflower, Lotus, Sage, Yohimbe.
  • The most serious interaction on file is rated Major.
  • Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs; seizure medications; diabetes medications.
  • For scale: 1,453 individual medications appear in the full list. A big number alone doesn't make a product dangerous — what matters is whether YOUR medication is on it, so run yours through the interaction checker on this page.

Check with your doctor or pharmacist before taking this product if you're on any of the following: monoamine oxidase inhibitors (MAOIs) — this is a Major concern; blood thinners or antiplatelet drugs (including warfarin); diabetes medications; blood pressure medications; tricyclic antidepressants; stimulant drugs; sedating medications or CNS depressants; phenothiazines; hormone therapies or estrogens; or medications metabolized by liver enzymes (CYP2D6, CYP2C19, CYP2C9, CYP3A4) or transported by P-glycoprotein. Altogether, these interactions span 1,453 individual medications.

Check your own medication Run your meds through the checker above

The bottom line

Scorecard at a glanceFormula with limited ingredient disclosure with insufficient evidence for its stated purpose. Major medication interactions have been identified, and safety information is well characterized.

Real Test is a multi-ingredient blend with notable interactions, especially if you take blood thinners, blood pressure medications, diabetes drugs, MAOIs, tricyclic antidepressants, or sedating medications. The strongest safety concern is yohimbe with MAOIs.

Before starting this product, talk with your own doctor or pharmacist about your medications and whether this blend is appropriate for you.

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

Assessment coverage: 5 of 5 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Oct 1, 2012.

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

At a glance

General information

Key facts about Real Test, straight from the product label.

Brand EXT
Barcode (UPC) 851780003954
Net contents 28 Capsule(s); 28 Dose(s)
Market status On market
Date entered into DSLD Oct 1, 2012
DSLD ID 12598
Product type Botanical
Supplement form Capsule
Dietary claims / uses All Other, Structure/Function
Intended target group(s) Adult Male (18-50 Years)
From the label
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.

Supplement Facts

The label details for Real Test by EXT, sourced from the NIH Dietary Supplement Label Database.

Supplement Facts

Daily Value (DV) Target Group(s):
Adults and children 4 or more years of age
Minimum serving Sizes:
1 Capsule(s)
Maximum serving Sizes:
1 Capsule(s)
Servings per container
28
UPC/BARCODE
851780003954
IngredientAmount% DV
Semen nelumbinis0 NP--
Carthamus tinctorius0 NP--
Pausinystalia yohimbe0 NP--
TEST MATRIX (Proprietary Blend)460 mg--
Afromomum meleguea0 NP--
Salvia haematodes0 NP--

Other ingredients: Gelatin, Microcrystalline Cellulose, Silica, Capsicum annuum, Cellulose, Oryza sativa wax, Magnesium Stearate, Stearic Acid, FD&C Blue No. 1, Titanium Dioxide

Tap any ingredient to jump to its full detail below.

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

POTENT ANDROGENIC/ESTROGENIC MODULATOR - BOOST UP FREE TESTOSTERONE

Laboratory Certified

ANDROGENIC TESTOSTERONE BOOSTER

TEST BOOSTER - MUSCLE GROWTH, ANDROGENIC, MALE PERFORMANCE, INCREASED STRENGTH

RESEARCH STRENGTH

(chart) Marked Dose-Dependent. Inhibition of Extradiol. Alkaline Phosphate Activity Induction of Alkaline Phosphatease (AP %) 0 20 40 60 80 100 120 Concentration (ug/ml) 0.5 1.0 1.5 2.0

When combined with a proper exercise and nutrition regimen. Statements based on early stage independent 3rd party in vivo and / or in vitro model scientific research data findings.

Rev. 01-001-RTT001 05/12

To report an adverse event or for more information call: 954.926.0900 (tel)

Precautions

Warnings: Consult with a licensed physician before using this product. Do not take this product if you have prostate hypertrophy, liver disease, kidney or heart disease, or are being treated for any medical condition. This product should not be taken by women.

Please read the warning on the back of this label carefully before consumption.

KEEP OUT OF REACH OF CHILDREN

In particular, those women who are pregnant, lactating or trying to become pregnant, should not take this product.

Do not take this product if you have been diagnosed with elevated cholesterol, prostate cancer, testicular cancer or breast cancer, or are under the age of 18. KEEP THIS PRODUCT AND ALL SUPPLEMENTS OUT OF THE REACH OF CHILDREN. Must be 18 years of age or older to purchase this product.

DO NOT take prior to consulting with a physician.

Brand IP Statement(s)

REAL TEST(TM) - a novel test boosting agent with antiaromatase estrogen blocking characteristics.

REAL TEST(TM) is the most sophisticated, anti-aromatase formula to date. It works by minimizing estrogen activity therefore increasing Testosterone production. REAL TEST(TM) for a leaner, harder, sharper physique.

FDA Statement of Identity

DIETARY SUPPLEMENT

Suggested/Recommended/Usage/Directions

Suggested Usage: Take one (1) capsule daily, (in the morning) at the same time each day, or as directed by a qualified healthcare practitioner. Must be taken on a full stomach. For best results take four to eight (4-8) consecutive weeks (1-2 Cycles). Do not take this product longer than eight (8) consecutive weeks. A four (4) week break between cycles is recommended. Use only as directed. Do not exceed recommended dose.

FDA Disclaimer Statement

THESE STATEMENTS HAVE NOT BEEN EVALUATED BY THE FOOD AND DRUG ADMINISTRATION. THIS PRODUCT IS NOT INTENDED TO DIAGNOSE, TREAT, CURE, OR PREVENT ANY DISEASE.

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

See for yourself

Real Test by EXT label

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

Real Test label

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

View the full label (PDF)
What’s inside

The Ingredients in Real Test by EXT

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

Serving size1 Capsule(s) Dosage formCapsule Servings per container28 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.

TEST MATRIX (Proprietary Blend)

460 mg per serving

Other (inactive) ingredients: Gelatin, Microcrystalline Cellulose, Silica, Capsicum annuum, Cellulose, Oryza sativa wax, Magnesium Stearate, Stearic Acid, FD&C Blue No. 1, Titanium Dioxide. These complete the product’s ingredient list but are not active constituents.

Interaction report

Real Test by EXT Drug Interactions

Want to check YOUR meds against Real Test?

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

 Go to the checker
1,452Drugs
9 Major 1,431 Moderate 12 Minor

Ingredients driving the most interactions

Salvia haematodes 1,296
Pausinystalia yohimbe 1,125
Semen nelumbinis 212
Carthamus tinctorius 208

Individual Drug Interactions

The ingredients in Real Test interact with 1,452 drugs. Click any drug to see the details.

4 of the 5 ingredients in Real Test interact with drugs. Each result below shows which ingredient is responsible. Salvia haematodes Pausinystalia yohimbe Semen nelumbinis Carthamus tinctorius

Each ingredient & the kinds of drugs it affects

For each ingredient in Real Test 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.

Salvia haematodes14 drug types · 1,296 drugs

Anticholinergic Drugs

Theoretically, sage might decrease the clinical effects of anticholinergic drugs.
In vitro evidence suggests that common sage (Salvia officinalis) and Spanish sage (Salvia lavandulaefolia) can inhibit acetylcholinesterase and might increase acetylcholine levels.

Likelihood Possible Evidence D
Anticonvulsants

Theoretically, sage might interfere with the clinical effects of anticonvulsant drugs.
Some species of sage can cause convulsions when consumed in large quantities.

Likelihood Possible Evidence D
Antidiabetes Drugs

Theoretically, taking sage with antidiabetes drugs might increase the risk of hypoglycemia.
In patients with polycystic ovary syndrome (PCOS) or inadequately controlled type 2 diabetes, common sage (Salvia officinalis) has demonstrated hypoglycemic activity. However, other clinical research in patients with inadequately controlled type 2 diabetes shows that common sage extract does not lower fasting blood glucose levels.

Likelihood Possible Evidence B
Antihypertensive Drugs

Theoretically, sage might increase or decrease the effects of antihypertensive drugs.
Animal research suggests that common sage (Salvia officinalis) can cause prolonged blood pressure reduction. However, clinical research suggests that Spanish sage (Salvia lavandulaefolia) can increase blood pressure in some people with hypertension. Until more is known, use with caution.

Likelihood Possible Evidence D
Benzodiazepines

Theoretically, taking sage might increase the sedative and adverse effects of benzodiazepines.
In vitro evidence suggests that certain components of common sage (Salvia officinalis) can bind to benzodiazepine receptors. This effect has not been reported in humans.

Likelihood Possible Evidence D
Cholinergic Drugs

Theoretically, sage might have additive effects when used with cholinergic drugs.
In vitro evidence suggests that common sage (Salvia officinalis) and Spanish sage (Salvia lavandulaefolia) can inhibit acetylcholinesterase and might increase acetylcholine levels.

Likelihood Possible Evidence D
Cns Depressants

Theoretically, taking sage might increase the sedative and adverse effects of CNS depressants.
Some constituents of sage have CNS depressant activity.

Likelihood Possible Evidence D
Cytochrome P450 2C19 (Cyp2C19) Substrates

Theoretically, sage might increase the levels and clinical effects of drugs metabolized by CYP2C19.
In vitro evidence suggests that aqueous extracts of sage can inhibit CYP2C19. So far, this interaction has not been reported in humans.

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

Theoretically, sage might increase the levels and clinical effects of drugs metabolized by CYP2C9.
In vitro evidence suggests that aqueous extracts of sage can inhibit CYP2C9. So far, this interaction has not been reported in humans.

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

Theoretically, sage might increase the levels and clinical effects of drugs metabolized by CYP2D6.
In vitro evidence suggests that aqueous extracts of sage can inhibit CYP2D6. So far, this interaction has not been reported in humans.

Likelihood Possible Evidence D
Cytochrome P450 2E1 (Cyp2E1) Substrates

Theoretically, sage might decrease the levels and clinical effects of drugs metabolized by CYP2E1.
Animal research suggests that drinking common sage (Salvia officinalis) tea increases the expression of CYP2E1. So far, this interaction has not been reported in humans.

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

Theoretically, sage might increase the levels and clinical effects of drugs metabolized by CYP3A4.
In vitro evidence suggests that aqueous extracts of sage can inhibit CYP3A4. So far, this interaction has not been reported in humans.

Likelihood Possible Evidence D
Estrogens

Theoretically, sage might interfere with hormone therapy.
In vitro evidence suggests that geraniol, a constituent of Spanish sage (Salvia lavandulaefolia), exerts estrogenic activity. The clinical significance of this effect is unclear.

Likelihood Possible Evidence D
P-Glycoprotein Substrates

Theoretically, sage might increase levels of drugs transported by P-glycoprotein.
In vitro research suggests that common sage (Salvia officinalis) can inhibit the multi-drug transporter protein, P-glycoprotein. This effect has not been reported in humans.

Likelihood Possible Evidence D
Salvia haematodes full monograph & interactions

Pausinystalia yohimbe13 drug types · 1,125 drugs

Monoamine Oxidase Inhibitors (Maois)

Concomitant use of MAOIs with yohimbe can result in additive effects.
Yohimbine, a constituent of yohimbe, has MAO inhibitory effects. At high doses, yohimbine is a non-selective inhibitor of MAO.

Likelihood Likely Evidence D
Antihypertensive Drugs

Theoretically, yohimbe might reduce the effects of antihypertensive drugs.
Yohimbine, a constituent of yohimbe, is an alpha-2 adrenoceptor antagonist and has been reported to increase blood pressure in clinical research. Theoretically, concomitant use of yohimbe and antihypertensive drugs can interfere with blood pressure control.

Likelihood Probable Evidence D
Clonidine (Catapres)

Theoretically, yohimbe might precipitate clonidine withdrawal.
Chronic clonidine use can downregulate alpha-2 adrenoreceptors. Animal research and one human case report suggest that concomitant administration of yohimbine, an alpha-2 adrenoceptor antagonist, may precipitate clonidine withdrawal and lead to sympathomimetic toxicity, including hypertensive crisis.

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

CYP2D6 inhibitors may increase the levels and adverse effects of yohimbine, a constituent of yohimbe.
In vitro and clinical research shows that the yohimbe bark constituent, yohimbine, is metabolized by CYP2D6 isoenzymes. Paroxetine, a cytochrome P450 (CYP) 2D6 inhibitor, increases the maximum serum concentration of yohimbine and reduces the clearance of yohimbine compared to yohimbine alone in patients who are extensive CYP2D6 metabolizers..

Likelihood Probable Evidence B
Cytochrome P450 2D6 (Cyp2D6) Substrates

Theoretically, yohimbe might increase the levels and adverse effects of CYP2D6 substrates.
In vitro research suggests that yohimbine, a constituent of yohimbe bark, inhibits CYP2D6 enzyme activity.

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

Theoretically, CYP3A4 inhibitors might increase the levels and adverse effects of yohimbine, a constituent of yohimbe bark.
In vitro and clinical research shows that the yohimbe bark constituent, yohimbine, is metabolized by CYP3A4 enzymes. Theoretically, drugs that inhibit CYP3A4 might increase the levels and adverse effects of yohimbine.

Likelihood Possible Evidence D
Paroxetine (Paxil)

Paroxetine decreases the clearance of yohimbine and may increase its effects.
Paroxetine, a cytochrome P450 (CYP) 2D6 inhibitor, increases the maximum serum concentration of yohimbine by about 350% and reduces the clearance of yohimbine by about 80% compared to yohimbine alone in patients who are extensive CYP2D6 metabolizers. No significant changes in pharmacokinetic parameters of yohimbine were observed with coadministration of paroxetine in patients who are poor CYP2D6 metabolizers.

Likelihood Probable Evidence B
Phenothiazines

Theoretically, using yohimbine with phenothiazines might have additive effects.
Yohimbine, a constituent of yohimbe, has alpha-2 adrenergic antagonist effects. Theoretically, combining it with phenothiazines can cause additive alpha-2 adrenergic antagonism.

Likelihood Possible Evidence D
Stimulant Drugs

Theoretically, taking yohimbe with stimulant drugs can have additive effects.
Yohimbine, a constituent of yohimbe, has sympathomimetic effects and increases blood pressure in a dose-dependent manner. Theoretically, taking yohimbe with stimulant drugs can have additive stimulant and hypertensive effects.

Likelihood Possible Evidence D
Tricyclic Antidepressants (Tcas)

Theoretically, taking yohimbe with TCAs can increase adverse effects.
A small clinical study in patients taking TCAs for at least 4 weeks shows that receiving doses of intravenous yohimbine 2.5-20 mg daily for up to 7 days precipitates severe anxiety, agitation, and tremor. The effects of yohimbe bark itself are unclear; oral yohimbe bark contains 0.6% to 1.38% yohimbine, but it is unclear how much is absorbed.

Likelihood Possible Evidence D
Anticoagulant/Antiplatelet Drugs

Theoretically, combining yohimbe bark with antiplatelet or anticoagulant drugs might have additive effects; however, this has not been reported in clinical research.
Research in healthy adults shows that taking yohimbine, a constituent of yohimbe bark, in doses of 8 mg or more, seems to inhibit platelet aggregation in vitro by binding to the alpha-2 adrenoceptor. The effects of yohimbe bark itself are unclear; yohimbe bark contains 0.6% to 1.38% yohimbine, but it is unclear how much is absorbed.

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

Theoretically, yohimbe might decrease the levels and clinical effects of CYP1A2 substrates.
In vitro research shows that yohimbe extract induces CYP1A2 enzymes.

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

Theoretically, yohimbe might decrease the levels and clinical effects of CYP3A4 substrates.
In vitro research shows that yohimbe extract induces CYP3A4 enzymes.

Likelihood Possible Evidence D
Pausinystalia yohimbe full monograph & interactions

Semen nelumbinis3 drug types · 212 drugs

Anticoagulant/Antiplatelet Drugs

Theoretically, concurrent use of lotus with other antiplatelet drugs might reduce platelet aggregation and increase the risk of bleeding.
Neferine and isoliensinine, constituents of lotus, have been shown to inhibit platelet aggregation, in vitro. These constituents can inhibit the production of pro-aggregating factors like prostaglandins.

Likelihood Possible Evidence D
Antidiabetes Drugs

Theoretically, lotus might have additive effects with antidiabetes drugs and increase the risk of hypoglycemia.
Animal research shows that the ethanolic extract of lotus reduces blood glucose levels and potentiates the effects of injected insulin. Monitor blood glucose levels closely. Dose adjustments might be necessary.

Likelihood Possible Evidence D
Pentobarbital (Nembutal)

Theoretically, taking lotus concomitantly with pentobarbital might increase sedation.
Animal research shows that lotus extract increases pentobarbitone-induced sleeping time. It is not known if this occurs in humans or if this effect occurs with other barbiturates or sedatives.

Likelihood Possible Evidence D
Semen nelumbinis full monograph & interactions

Carthamus tinctorius3 drug types · 208 drugs

Anticoagulant/Antiplatelet Drugs

High doses of safflower oil might increase the risk of bleeding when taken with anticoagulant or antiplatelet drugs.
Small clinical studies show that taking safflower oil, approximately 55 grams daily for 2-3 weeks, decreases platelet aggregation. However, taking lower doses of safflower oil, such as 5 grams daily for 4 weeks, does not seem to affect platelet function. In one case report, a 74-year-old male stabilized on warfarin developed urinary tract bleeding and an elevated INR after taking a safflower extract 20 grams daily for 14 days.

Likelihood Possible Evidence B
Antidiabetes Drugs

Theoretically, safflower oil might alter the effects of antidiabetes drugs.
Some clinical research shows that taking safflower oil 10 grams daily for 3 weeks can increase fasting blood glucose in patients with type 2 diabetes. However, clinical research in patients with metabolic syndrome with or without impaired glucose tolerance shows that taking safflower oil 8 grams daily for 12 weeks reduces fasting glucose levels by around 8 mg/dL. Some clinical research also shows that taking safflower oil 8 grams daily for 16 weeks does not affect fasting glucose levels in patients with type 2 diabetes.

Likelihood Possible Evidence B
Warfarin

Theoretically, safflower oil might increase the risk of bleeding when taken with warfarin.
In one case report, a 74-year-old male stabilized on warfarin developed urinary tract bleeding and an elevated INR after taking a safflower extract 20 grams daily for 14 days.

Likelihood Possible Evidence D
Carthamus tinctorius full monograph & interactions
The maker

Brand information

Manufacturer and brand details for Real Test, from the product label.

EXT

See all EXT products
Phone Number
954.926.0900
Pharmacist Counseling Corner

Real Test by EXT: Common Questions

Does Real Test by EXT interact with any medications?
Yes. Based on its ingredients, Real Test has a known interaction with 1,452 medications, including 9 rated major. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Real Test contains 5 active ingredients, and an interaction can come from any of them. We check every ingredient, combine the results into one list per medication, and show which ingredient and mechanism is responsible.
Where does this information come from?
The product label data comes from the NIH Dietary Supplement Label Database (DSLD); the interaction data is built on the Natural Medicines database and reviewed by HelloPharmacist pharmacists.
Can I take Real Test if I'm pregnant?
No — yohimbe is listed as possibly unsafe in pregnancy and may affect the uterus. Sage is likely unsafe in medicinal amounts during pregnancy because of its thujone content, though food amounts are probably fine. Safflower is listed as possibly unsafe, and lotus and grains of paradise don't have enough safety data. Talk with your doctor before taking this product if you're pregnant or planning to become pregnant.
Is it safe while breastfeeding?
No — yohimbe and grains of paradise should be avoided while breastfeeding because safety hasn't been established. Sage is listed as possibly unsafe during lactation because it has traditionally been used to reduce milk supply. Lotus and safflower also lack enough reliable information. Check with your doctor or pharmacist before taking this product if you're nursing.
What is yohimbe in this product for?
Yohimbe contains yohimbine, an active compound traditionally used for fatigue and sexual dysfunction. The evidence to support these uses is insufficient, and yohimbine can cause serious effects on blood pressure, heart rate, and mood — so it requires careful consideration before use.
Can this product cause allergic reactions?
Yes. Lotus can trigger allergic reactions such as hives and contact dermatitis; a documented case showed hives in a child after eating lotus root. If you have a history of allergies to plants or seeds, mention this to your pharmacist before taking this product.
What are the most common side effects I might experience?
Yohimbe is most likely to cause side effects and can bring on anxiety, agitation, tremors, nausea, headache, rapid heartbeat, and high blood pressure — especially at higher doses. Sage may cause nausea, vomiting, abdominal pain, and diarrhea. Lotus and safflower are generally well tolerated, though safflower oil has been linked to liver problems in rare over-use cases.
Does sage in this product really help with hot flashes and high cholesterol?
Sage is rated possibly effective for menopausal symptoms and high cholesterol based on available research, so there is some evidence supporting these uses — though it is not considered proven. Talk with your doctor about whether sage or this product is a good option for your specific situation.

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

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Label information is sourced from the NIH Dietary Supplement Label Database and reflects the product version on file; always read your actual product label. This page is for education only and is not a substitute for professional medical advice. Confirm with your pharmacist or doctor before combining supplements and medications.

Real Test label
Go deeper

The Full Monographs Behind Real Test’s Ingredients

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

Herb & supplement monograph

Lotus

Interacts with 212 drugs

Lotus is an edible aquatic plant used in food and traditional medicine across Asia, with parts like the seeds, leaves, and flowers taken for digestion, calm, and overall wellness. Most healt...

Read the full Lotus monograph → Herb & supplement monograph

Safflower

Interacts with 208 drugs

Safflower is a thistle-like plant used mainly for its seed oil (a common cooking oil) and its colorful flowers. Safflower oil is a reasonable source of unsaturated fats, but strong proof tha...

Read the full Safflower monograph → Herb & supplement monograph

Yohimbe

Interacts with 1,125 drugs

Yohimbe is a West African tree bark that contains yohimbine, a compound mainly promoted for erectile dysfunction and as an aphrodisiac. A prescription form of yohimbine has some evidence for...

Read the full Yohimbe monograph → Herb & supplement monograph

Grains Of Paradise

Grains of paradise is a West African spice in the ginger family that people use for digestion, as a spice, and more recently in supplements aimed at metabolism. Early human research suggests...

Read the full Grains Of Paradise monograph → Herb & supplement monograph

Sage

Interacts with 1,296 drugs

Sage is a common kitchen herb that is generally safe in food amounts and is traditionally used for sore throats, digestion, sweating, and memory. Some early research is encouraging for sore...

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Sources

Sources & How We Checked

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

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

The 114 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.

Lotus 5 references
  1. Yu, J. and Hu, W. S. [Effects of neferine on platelet aggregation in rabbits]. Yao Xue.Xue.Bao. 1997;32(1):1-4.
  2. Yang, J. and Zhou, K. NMR spectroscopic analysis of neferine and isoliensinine. Magn Reson.Chem 2004;42(11):994-997. PubMed
  3. Mukherjee, P. K., Saha, K., Balasubramanian, R., Pal, M., and Saha, B. P. Studies on psychopharmacological effects of Nelumbo nucifera Gaertn. rhizome extract. J Ethnopharmacol. 1996;54(2-3):63-67. PubMed
  4. Mukherjee, P. K., Saha, K., Pal, M., and Saha, B. P. Effect of Nelumbo nucifera rhizome extract on blood sugar level in rats. J Ethnopharmacol. 1997;58(3):207-213. PubMed
  5. Hiraguchi Y, Tokuda R, Gen M, et al. Identification of a novel food allergen in lotus root. Allergol Int. 2018;67(1):141-143. PubMed

See these in context on the Lotus monograph →

Safflower 14 references
  1. The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999.
  2. Leung AY, Foster S. Encyclopedia of Common Natural Ingredients Used in Food, Drugs and Cosmetics. 2nd ed. New York, NY: John Wiley & Sons, 1996.
  3. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
  4. Borkman M, Chisholm DJ, Furler SM, et al. Effects of fish oil supplementation on glucose and lipid metabolism in NIDDM. Diabetes 1989;38:1314-9.. PubMed
  5. Amato, P. and Quercia, R. A. A historical perspective and review of the safety of lipid emulsion in pregnancy. Nutr Clin Pract. 1991;6(5):189-192. PubMed
  6. Demke, D. M., Peters, G. R., Linet, O. I., Metzler, C. M., and Klott, K. A. Effects of a fish oil concentrate in patients with hypercholesterolemia. Atherosclerosis 1988;70(1-2):73-80. PubMed
  7. Kaji, K., Yoshida, S., Nagata, N., Yamashita, T., Mizukoshi, E., Honda, M., Kojima, Y., and Kaneko, S. An open-label study of administration of EH0202, a health-food additive, to patients with chronic hepatitis C. J Gastroenterol. 2004;39(9):873-878. PubMed
  8. Kwon, J. S., Snook, J. T., Wardlaw, G. M., and Hwang, D. H. Effects of diets high in saturated fatty acids, canola oil, or safflower oil on platelet function, thromboxane B2 formation, and fatty acid composition of platelet phospholipids. Am.J.Clin.Nutr. PubMed
  9. Lloyd-Still, J. D., Simon, S. H., Wessel, H. U., and Gibson, L. E. Negative effects of oral fatty acid supplementation on sweat chloride in cystic fibrosis. Pediatrics 1979;64(1):50-52. DOI
  10. Challen, A. D., Branch, W. J., and Cummings, J. H. The effect of aspirin and linoleic acid on platelet aggregation, platelet fatty acid composition and haemostasis in man. Hum Nutr Clin Nutr 1983;37(3):197-208.
  11. Asp ML, Collene AL, Norris LE, Cole RM, Stout MB, Tang SY, Hsu JC, Belury MA. Time-dependent effects of safflower oil to improve glycemia, inflammation and blood lipids in obese, post-menopausal women with type 2 diabetes: a randomized, double-masked, cro
  12. Liu Y, Liu S, Shi Y, et al. Effects of safflower injection on the pharmacodynamics and pharmacokinetics of warfarin in rats. Xenobiotica. 2017 Oct 25:1-6. [Epub ahead of print] PubMed
  13. de Ataide EC, Reges Perales S, de Oliveira Peres MA, et al. Acute liver failure induced by Carthamus tinctorius oil: Case reports and literature review. Transplant Proc. 2018;50(2):476-477. PubMed
  14. Ruyvaran M, Zamani A, Mohamadian A, et al. Safflower (Carthamus tinctorius L.) oil could improve abdominal obesity, blood pressure, and insulin resistance in patients with metabolic syndrome: a randomized, double-blind, placebo-controlled clinical trial. PubMed

See these in context on the Safflower monograph →

Yohimbe 66 references
  1. Leung AY, Foster S. Encyclopedia of Common Natural Ingredients Used in Food, Drugs and Cosmetics. 2nd ed. New York, NY: John Wiley & Sons, 1996.
  2. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
  3. Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.
  4. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
  5. Milman N, Scheibel J, Jessen O. Lysine prophylaxis in recurrent herpes simplex labialis: a double-blind, controlled crossover study. Acta Derm Venereol 1980;60:85-7.
  6. Teloken C, Rhoden EL, Sogari P, et al. Therapeutic effects of high dose yohimbine hydrochloride on organic erectile dysfunction. J Urol 1998;159:122-4. PubMed
  7. Jacobsen FM. Fluoxetine-induced sexual dysfunction and an open trial of yohimbine. J Clin Psychiatry 1992;53:119-22.
  8. Hollander E, McCarley A. Yohimbine treatment of sexual side effects induced by serotonin reuptake blockers. J Clin Psychiatry 1992;53:207-9.
  9. Sandler B, Aronson P. Yohimbine-induced cutaneous drug eruption, progressive renal failure, and lupus-like syndrome. Urol 1993;41:343-5. PubMed
  10. Kearney T, Tu N, Haller C. Adverse drug events associated with yohimbine-containing products: a retrospective review of the California Poison Control System reported cases. Ann Pharmacother 2010;44:1022-9. PubMed
  11. VandenBrink, B. M., Foti, R. S., Rock, D. A., Wienkers, L. C., and Wahlstrom, J. L. Prediction of CYP2D6 drug interactions from in vitro data: evidence for substrate-dependent inhibition. Drug Metab Dispos. 2012;40(1):47-53. PubMed
  12. Abebe, W. An overview of herbal supplement utilization with particular emphasis on possible interactions with dental drugs and oral manifestations. J Dent.Hyg. 2003;77(1):37-46.
  13. Mustonen, P., Savola, J., and Lassila, R. Atipamezole, an imidazoline-type alpha(2)-adrenoceptor inhibitor, binds to human platelets and inhibits their adrenaline-induced aggregation more effectively than yohimbine. Thromb.Res 8-1-2000;99(3):231-237.
  14. Cameron, O. G., Zubieta, J. K., Grunhaus, L., and Minoshima, S. Effects of yohimbine on cerebral blood flow, symptoms, and physiological functions in humans. Psychosom.Med 2000;62(4):549-559. PubMed
  15. Bowes, M. P., Peters, R. H., Kernan, W. J., Jr., and Hopper, D. L. Effects of yohimbine and idazoxan on motor behaviors in male rats. Pharmacol.Biochem.Behav. 1992;41(4):707-713.
  16. Bagheri, H., Schmitt, L., Berlan, M., and Montastruc, J. L. Effect of 3 weeks treatment with yohimbine on salivary secretion in healthy volunteers and in depressed patients treated with tricyclic antidepressants. Br J Clin Pharmacol 1992;34(6):555-558. PubMed
  17. Bagheri, H., Bompart, G., Girolami, J. P., Montastruc, J. L., and Montastruc, P. Is yohimbine-induced increase in salivary secretion a kinin-dependent mechanism? Fundam.Clin Pharmacol 1992;6(1):17-20. PubMed
  18. Swann, A. C., Birnbaum, D., Jagar, A. A., Dougherty, D. M., and Moeller, F. G. Acute yohimbine increases laboratory-measured impulsivity in normal subjects. Biol.Psychiatry 5-15-2005;57(10):1209-1211. PubMed
  19. Adeniyi, A. A., Brindley, G. S., Pryor, J. P., and Ralph, D. J. Yohimbine in the treatment of orgasmic dysfunction. Asian J Androl 2007;9(3):403-407. PubMed
  20. Murburg, M. M., Villacres, E. C., Ko, G. N., and Veith, R. C. Effects of yohimbine on human sympathetic nervous system function. J Clin Endocrinol.Metab 1991;73(4):861-865. PubMed
  21. Giampreti, A., Lonati, D., Locatelli, C., Rocchi, L., and Campailla, M. T. Acute neurotoxicity after yohimbine ingestion by a body builder. Clin Toxicol.(Phila) 2009;47(8):827-829. PubMed
  22. Bloomer, R. J., Canale, R. E., Blankenship, M. M., Hammond, K. G., Fisher-Wellman, K. H., and Schilling, B. K. Effect of the dietary supplement Meltdown on catecholamine secretion, markers of lipolysis, and metabolic rate in men and women: a randomized,
  23. Myers, A. and Barrueto, F., Jr. Refractory priapism associated with ingestion of yohimbe extract. J Med Toxicol. 2009;5(4):223-225.
  24. Berlin, I., Crespo-Laumonnier, B., Cournot, A., Landault, C., Aubin, F., Legrand, J. C., and Puech, A. J. The alpha 2-adrenergic receptor antagonist yohimbine inhibits epinephrine-induced platelet aggregation in healthy subjects. Clin Pharmacol.Ther. 199
  25. Swann, A. C. Mechanisms of impulsivity in bipolar disorder and related illness. Epidemiol.Psichiatr.Soc. 2010;19(2):120-130.
  26. Shibao, C., Okamoto, L. E., Gamboa, A., Yu, C., Diedrich, A., Raj, S. R., Robertson, D., and Biaggioni, I. Comparative efficacy of yohimbine against pyridostigmine for the treatment of orthostatic hypotension in autonomic failure. Hypertension 2010;56(5) PubMed
  27. Soeter, M. and Kindt, M. Stimulation of the noradrenergic system during memory formation impairs extinction learning but not the disruption of reconsolidation. Neuropsychopharmacology 2012;37(5):1204-1215. PubMed
  28. Cimolai, N. and Cimolai, T. Yohimbine use for physical enhancement and its potential toxicity. J Diet.Suppl 2011;8(4):346-354. PubMed
  29. Bagheri, H., Berlan, M., Montastruc, J. L., and Montastruc, P. Yohimbine and lacrimal secretion. Br J Clin Pharmacol. 1990;30(1):151-152.
  30. Landis, E. and Shore, E. Yohimbine-induced bronchospasm. Chest 1989;96(6):1424. PubMed
  31. Susset, J. G., Tessier, C. D., Wincze, J., Bansal, S., Malhotra, C., and Schwacha, M. G. Effect of yohimbine hydrochloride on erectile impotence: a double-blind study. J Urol. 1989;141(6):1360-1363. PubMed
  32. Chatelut, E., Rispail, Y., Berlan, M., and Montastruc, J. L. Yohimbine increases human salivary secretion. Br.J Clin Pharmacol. 1989;28(3):366-368. PubMed
  33. Montastruc, P., Berlan, M., and Montastruc, J. L. Effects of yohimbine on submaxillary salivation in dogs. Br J Pharmacol 1989;98(1):101-104. PubMed
  34. Charney, D. S., Price, L. H., and Heninger, G. R. Desipramine-yohimbine combination treatment of refractory depression. Implications for the beta-adrenergic receptor hypothesis of antidepressant action. Arch.Gen.Psychiatry 1986;43(12):1155-1161. PubMed
  35. Braddock, L., Cowen, P. J., Elliott, J. M., Fraser, S., and Stump, K. Binding of yohimbine and imipramine to platelets in depressive illness. Psychol.Med 1986;16(4):765-773. PubMed
  36. Bolme, P., Corrodi, H., Fuxe, K., Hokfelt, T., Lidbrink, P., and Goldstein, M. Possible involvement of central adrenaline neurons in vasomotor and respiratory control. Studies with clonidine and its interactions with piperoxane and yohimbine. Eur J Pharm PubMed
  37. Charney, D. S., Heninger, G. R., and Sternberg, D. E. Assessment of alpha 2 adrenergic autoreceptor function in humans: effects of oral yohimbine. Life Sci 6-7-1982;30(23):2033-2041.
  38. Boon, N. A., Elliott, J. M., Grahame-Smith, D. G., John-Green, T., and Stump, K. A comparison of alpha 2-adrenoreceptor binding characteristics of intact human platelets identified by [3H]-yohimbine and [3H]- dihydroergocryptine. J Auton.Pharmacol 1983;3
  39. Andrejak, M., Ward, M., and Schmitt, H. Cardiovascular effects of yohimbine in anaesthetized dogs. Eur.J Pharmacol 10-28-1983;94(3-4):219-228. PubMed
  40. Brodde, O. E., Anlauf, M., Arroyo, J., Wagner, R., Weber, F., and Buck, K. D. Hypersensitivity of adrenergic receptors and blood-pressure response to oral yohimbine in orthostatic hypotension. N.Engl.J Med 4-28-1983;308(17):1033-1034. PubMed
  41. Charney, D. S., Heninger, G. R., and Redmond, D. E., Jr. Yohimbine induced anxiety and increased noradrenergic function in humans: effects of diazepam and clonidine. Life Sci. 7-4-1983;33(1):19-29. PubMed
  42. Knoll, L. D., Benson, R. C., Jr., Bilhartz, D. L., Minich, P. J., and Furlow, W. L. A randomized crossover study using yohimbine and isoxsuprine versus pentoxifylline in the management of vasculogenic impotence. J Urol. 1996;155(1):144-146. DOI
  43. Betz, J. M., White, K. D., and der Marderosian, A. H. Gas chromatographic determination of yohimbine in commercial yohimbe products. J AOAC Int 1995;78(5):1189-1194. DOI
  44. Bagheri, H., Chale, J. J., Guyen, L. N., Tran, M. A., Berlan, M., and Montastruc, J. L. Evidence for activation of both adrenergic and cholinergic nervous pathways by yohimbine, an alpha 2-adrenoceptor antagonist. Fundam.Clin Pharmacol 1995;9(3):248-254.
  45. Kennedy, S. H., Gnam, W., Ralevski, E., and Brown, G. M. Melatonin responses to clonidine and yohimbine challenges. J Psychiatry Neurosci. 1995;20(4):297-304.
  46. Musso, N. R., Vergassola, C., Pende, A., and Lotti, G. Yohimbine effects on blood pressure and plasma catecholamines in human hypertension. Am J Hypertens. 1995;8(6):565-571. PubMed
  47. Morgan, C. A., III, Southwick, S. M., Grillon, C., Davis, M., Krystal, J. H., and Charney, D. S. Yohimbine-facilitated acoustic startle reflex in humans. Psychopharmacology (Berl) 1993;110(3):342-346. PubMed
  48. Adler, L. E., Hoffer, L., Nagamoto, H. T., Waldo, M. C., Kisley, M. A., and Giffith, J. M. Yohimbine impairs P50 auditory sensory gating in normal subjects. Neuropsychopharmacology 1994;10(4):249-257. PubMed
  49. Biaggioni, I., Robertson, R. M., and Robertson, D. Manipulation of norepinephrine metabolism with yohimbine in the treatment of autonomic failure. J Clin Pharmacol. 1994;34(5):418-423. PubMed
  50. Kenney, W. L., Zappe, D. H., Tankersley, C. G., and Derr, J. A. Effect of systemic yohimbine on the control of skin blood flow during local heating and dynamic exercise. Am J Physiol 1994;266(2 Pt 2):H371-H376. PubMed
  51. Friesen, K., Palatnick, W., and Tenenbein, M. Benign course after massive ingestion of yohimbine. J Emerg.Med 1993;11(3):287-288. PubMed
  52. Bierer, L. M., Aisen, P. S., Davidson, M., Ryan, T. M., Stern, R. G., Schmeidler, J., and Davis, K. L. A pilot study of oral physostigmine plus yohimbine in patients with Alzheimer disease. Alzheimer Dis.Assoc.Disord. 1993;7(2):98-104. PubMed
  53. Mann, K., Klingler, T., Noe, S., Roschke, J., Muller, S., and Benkert, O. Effects of yohimbine on sexual experiences and nocturnal penile tumescence and rigidity in erectile dysfunction. Arch.Sex Behav. 1996;25(1):1-16. PubMed
  54. Rowland, D. L., Kallan, K., and Slob, A. K. Yohimbine, erectile capacity, and sexual response in men. Arch Sex Behav 1997;26(1):49-62.
  55. Bremner, J. D., Innis, R. B., Ng, C. K., Staib, L. H., Salomon, R. M., Bronen, R. A., Duncan, J., Southwick, S. M., Krystal, J. H., Rich, D., Zubal, G., Dey, H., Soufer, R., and Charney, D. S. Positron emission tomography measurement of cerebral metaboli
  56. Riley AJ, Goodman R, Kellett JM, and et al. Double blind trial of yohimbine hydrochloride in the treatment of erection inadequacy. Sexual Marital Ther 1989;4(1):17-26. DOI
  57. Cohen PA, Wang YH, Maller G, DeSouza R, Khan IA. Pharmaceutical quantities of yohimbine found in dietary supplements in the USA. Drug Test Anal. 2015 Sep 22. PubMed
  58. Ruck B, Shih RD, Marcus SM. Hypertensive crisis from herbal treatment of impotence. Am J Emerg Med. 1999;17:317-318. PubMed
  59. Wylie KR. Yohimbine and sinusitis. Br J Psychiatry. 1996;169(3):384-5. PubMed
  60. Le Corre P, Parmer RJ, Kailasam MT, et al. Human sympathetic activation by alpha2-adrenergic blockade with yohimbine: Bimodal, epistatic influence of cytochrome P450-mediated drug metabolism. Clin Pharmacol Ther. 2004;76(2):139-53.
  61. Mueller-Schoell A, Michelet R, Weinelt F, Kloft C, Mikus G. CYP2D6 phenotype explains reported yohimbine concentrations in four severe acute intoxications. Arch Toxicol. 2021. PubMed
  62. Bharucha AE, Skaar T, Andrews CN, et al Relationship of cytochrome P450 pharmacogenetics to the effects of yohimbine on gastrointestinal transit and catecholamines in healthy subjects. Neurogastroenterol Motil. 2008;20(8):891-9. PubMed
  63. Schmauss M, Laakmann G, Dieterle D. Effects of alpha 2-receptor blockade in addition to tricyclic antidepressants in therapy-resistant depression. J Clin Psychopharmacol. 1988;8(2):108-11.
  64. Haron MH, Dale O, Martin K, et al. Evaluation of the Herb-Drug Interaction Potential of Commonly Used Botanicals on the US Market with Regard to PXR- and AhR-Mediated Influences on CYP3A4 and CYP1A2. J Diet Suppl 2022. PubMed
  65. Hodapp B, Haggerty A, Feldman R, Timpe J. Intracranial hemorrhage after a single dose of Yohimbine in a chronic user of clonidine. Am J Emerg Med 2022;62:145. PubMed
  66. Vay M, Meyer MJ, Blank A, et al. Oral yohimbine as a new probe drug to predict CYP2D6 activity: results of a fixed-sequence phase I trial. Clin Pharmacokinet. 2020;59(7):927-939. PubMed

See these in context on the Yohimbe monograph →

Grains Of Paradise 2 references
  1. Dietary Supplements: What You Need to Know — NIH Office of Dietary Supplements Source
  2. Using Dietary Supplements Wisely — NIH NCCIH Source

See these in context on the Grains Of Paradise monograph →

Sage 27 references
  1. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
  2. Todorov S, Philianos S, Petkov V, et al. Experimental pharmacological study of three species from genus Salvia. Acta Physiol Pharmacol (Bulg) 1984;10:13-20.
  3. Perry NS, Bollen C, Perry EK, Ballard C. Salvia for dementia therapy: review of pharmacological activity and pilot tolerability clinical trial. Pharmacol Biochem Behav 2003;75:651-9.. PubMed
  4. Saller R, Buechi S, Meyrat R, Schmidhauser C. Combined herbal preparation for topical treatment of Herpes labialis. Forsch Komplementarmed Klass Naturheilkd 2001;8:373-82. PubMed
  5. Akhondzadeh S, Noroozian M, Mohammadi M, et al. Salvia officinalis extract in the treatment of patients with mild to moderate Alzheimer's disease: a double blind, randomized and placebo-controlled trial. J Clin Pharm Ther 2003;28:53-9.
  6. Perry NB, Anderson RE, Brennan NJ, et al. Essential oils from dalmatian sage (Salvia officinalis l.): variations among individuals, plant parts, seasons, and sites. J Agric Food Chem 1999;47:2048-54..
  7. Foster BC, Vandenhoek S, Hana J, et al. In vitro inhibition of human cytochrome P450-mediated metabolism of marker substrates by natural products. Phytomedicine 2003;10:334-42.. PubMed
  8. Burkhard PR, Burkhardt K, Haenggeli CA, Landis T. Plant-induced seizures: reappearance of an old problem. J Neurol 1999;246:667-70. PubMed
  9. Bommer S, Klein P, Suter A. First time proof of sage's tolerability and efficacy in menopausal women with hot flushes. Adv Ther 2011;28:490-500. PubMed
  10. Hellum BH, Nilsen OG. The in vitro inhibitory potential of trade herbal products on human CYP2D6-mediated metabolism and the influence of ethanol. Basic Clin Pharmacol Toxicol. 2007 Nov;101:350-8.
  11. Orhan, I., Kartal, M., Kan, Y., and Sener, B. Activity of essential oils and individual components against acetyl- and butyrylcholinesterase. Z.Naturforsch.C. 2008;63(7-8):547-553.
  12. Perry, N. S., Houghton, P. J., Theobald, A., Jenner, P., and Perry, E. K. In-vitro inhibition of human erythrocyte acetylcholinesterase by salvia lavandulaefolia essential oil and constituent terpenes. J Pharm Pharmacol 2000;52(7):895-902.
  13. Perry, N. S., Houghton, P. J., Sampson, J., Theobald, A. E., Hart, S., Lis-Balchin, M., Hoult, J. R., Evans, P., Jenner, P., Milligan, S., and Perry, E. K. In-vitro activity of S. lavandulaefolia (Spanish sage) relevant to treatment of Alzheimer's diseas
  14. Futrell, J. M. and Rietschel, R. L. Spice allergy evaluated by results of patch tests. Cutis 1993;52(5):288-290.
  15. Kavvadias, D., Monschein, V., Sand, P., Riederer, P., and Schreier, P. Constituents of sage (Salvia officinalis) with in vitro affinity to human brain benzodiazepine receptor. Planta Med. 2003;69(2):113-117.
  16. Savelev, S. U., Okello, E. J., and Perry, E. K. Butyryl- and acetyl-cholinesterase inhibitory activities in essential oils of Salvia species and their constituents. Phytother Res 2004;18(4):315-324.
  17. Kennedy, D. O., Pace, S., Haskell, C., Okello, E. J., Milne, A., and Scholey, A. B. Effects of cholinesterase inhibiting sage (Salvia officinalis) on mood, anxiety and performance on a psychological stressor battery. Neuropsychopharmacology 2006;31(4):84 PubMed
  18. Hubbert, M., Sievers, H., Lehnfeld, R., and Kehrl, W. Efficacy and tolerability of a spray with Salvia officinalis in the treatment of acute pharyngitis - a randomised, double-blind, placebo-controlled study with adaptive design and interim analysis. Eur
  19. Lima, C. F., Fernandes-Ferreira, M., and Pereira-Wilson, C. Drinking of Salvia officinalis tea increases CCl(4)-induced hepatotoxicity in mice. Food Chem.Toxicol. 2007;45(3):456-464.
  20. Hellum, B. H. and Nilsen, O. G. In vitro inhibition of CYP3A4 metabolism and P-glycoprotein-mediated transport by trade herbal products. Basic Clin Pharmacol Toxicol. 2008;102(5):466-475.
  21. Mayer, E., Gescheidt-Shoshany, H., and Weltfriend, S. Allergic contact dermatitis caused by Salvia officinalis extract. Contact Dermatitis 2011;64(4):237-238. PubMed
  22. Halicioglu, O., Astarcioglu, G., Yaprak, I., and Aydinlioglu, H. Toxicity of Salvia officinalis in a newborn and a child: an alarming report. Pediatr.Neurol. 2011;45(4):259-260. PubMed
  23. Sertoli, A., Fabbri, P., Campolmi, P., and Panconesi, E. Allergic contact dermatitis to Salvia Officinalis, Inula Viscosa and Conyza Bonariensis. Contact Dermatitis 1978;4(5):314-315.
  24. Vandecasteele K, Ost P, Oosterlinck W, et al. Evaluation of the efficacy and safety of Salvia officinalis in controlling hot flashes in prostate cancer patients treated with androgen deprivation. Phytother Res. 2012;26(2):208-13.
  25. Kianbakht S, Dabaghian FH. Improved glycemic control and lipid profile in hyperlipidemic type 2 diabetic patients consuming Salvia officinalis L. leaf extract: a randomized placebo. Controlled clinical trial. Complement Ther Med. 2013;21(5):441-6. PubMed
  26. Amini L, Mojab F, Jahanfar S, Sepidarkish M, Raoofi Z, Maleki-Hajiagha A. Efficacy of Salvia officinalis extract on the prevention of insulin resistance in euglycemic patients with polycystic ovary syndrome: A double-blinded placebo-controlled clinical tr
  27. Behradmanesh S, Derees F, Rafieian-Kopaei M. Effect of Salvia officinalis on diabetic patients. J Renal Inj Prev. 2013;2(2):51-4.

See these in context on the Sage monograph →

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DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

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