Major interaction on record — check this product against your medications before combining. Based on 5 of 6 ingredients. Check your meds →
Dietary supplement

Rhino Double Horn Libi XX Ingredients & Drug Interactions

by Samson Pharmaceuticals

Rhino Double Horn Libi XX label
See full label image
Capsule Category: Botanical With Nutrients
Most serious interaction: Major
Clinical methodology reviewed by · Updated Sep 16, 2026 · Label data from the NIH DSLD
What is this page for?

First and foremost: checking Rhino Double Horn Libi XX 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

Rhino Double Horn Libi XX is a dietary supplement by Samson Pharmaceuticals with 6 active ingredients. Its ingredients are commonly taken for flavoring and culinary use, digestive complaints like bloating and indigestion, boosting absorption of other supplements.Based on those ingredients, 1,364 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are Black Pepper, Horny Goat Weed, Rauwolfia serpentina. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

Jump to a section

Check Your Meds Against Rhino Double Horn Libi XX by Samson Pharmaceuticals

Ask about any prescription or over-the-counter medication and we check it for interactions with Rhino Double Horn Libi XX by Samson Pharmaceuticals — and tell you which ingredient is responsible.

Pharmacist-reviewed data Checks every ingredient Answer in seconds
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HelloPharmacist Scorecard of Rhino Double Horn Libi XX by Samson Pharmaceuticals

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

From our pharmacy team — supplement deep dive

Generated from HelloPharmacist’s pharmacist-curated databases and editorial rules · Last generated Jul 11, 2026

What’s inside

Low disclosure
Ingredient Transparency · database check
Low

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

Why this rating?
  • The label discloses an exact amount for 1 of its 6 active ingredients.
  • “Proprietary Blend” is a proprietary blend — the label gives one combined amount (450 mg) without saying how much of each component you get.

Rhino Double Horn Libi XX contains 6 active ingredients. Black pepper provides piperine, which may enhance absorption of other compounds.

Zinc gluconate is a mineral form of zinc. Horny goat weed is a traditional herbal extract.

Rauwolfia serpentina (Indian snakeroot) is a plant containing alkaloid compounds including reserpine. The product also includes Oryza sativa extract (rice extract) and white willow bark.

Inactive ingredients include gelatin capsules and rice powder.

Does it work?

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

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

Why this rating?
  • The label markets this product for: Male sexual enhancement and performance.
  • We looked for evidence on: Erectile dysfunction (ED), Anxiety, Insomnia, Low libido, Sexual performance.
  • The closest evidence on file: Horny Goat Weed is rated "Insufficient Reliable Evidence To Rate" for Erectile dysfunction (ED) (Natural Medicines).
  • Also on file: Indian Snakeroot is rated "Insufficient Reliable Evidence To Rate" for Anxiety, Insomnia.
  • Also on file: Zinc is rated "Insufficient Reliable Evidence To Rate" for Erectile dysfunction (ED).

Evidence for this product's effectiveness is not established in the data we hold. Black pepper, zinc, horny goat weed, and Rauwolfia serpentina all show insufficient reliable evidence or no rating for their intended uses in this supplement.

The facts provide no effectiveness information for Oryza sativa extract or white willow bark.

The evidence, ingredient by ingredient Black Pepper Black Rice Horny Goat Weed Indian Snakeroot Zinc

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.

Black pepper is generally well tolerated in food amounts, though concentrated supplements warrant caution. Common side effects are burning aftertaste, indigestion, and reduced taste; allergic reactions are rare.

Zinc is well tolerated below 40 mg daily but can cause stomach cramps, diarrhea, metallic taste, and nausea at higher doses. Horny goat weed is tolerated short-term, with reported dizziness, dry mouth, nosebleeds, thirst, and vomiting; one rare case of respiratory arrest was noted.

Rauwolfia serpentina carries serious cautions: it contains potent alkaloids that can trigger depression, abnormal heart rhythms, and other severe effects, especially at high doses or with long-term use. The safety data advises against horny goat weed and Rauwolfia serpentina in pregnancy and breastfeeding.

No pregnancy or breastfeeding data are on file for black pepper, zinc, Oryza sativa extract, or white willow bark.

Side effects, ingredient by ingredient Black Pepper Black Rice Horny Goat Weed Indian Snakeroot Zinc

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 — Horny Goat Weed, Indian Snakeroot, Black Pepper, Zinc.
  • The most serious interaction on file is rated Major.
  • Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs; immunosuppressants / transplant drugs; diabetes medications; heart-rhythm medications; lithium; Parkinson's medications.
  • For scale: 1,365 individual medications appear in the full list. A big number alone doesn't make a product dangerous — what matters is whether YOUR medication is on it, so run yours through the interaction checker on this page.

Before taking this product, check your exact medications against these Major-severity interactions with Rauwolfia serpentina: beta-blockers, antipsychotic drugs, levodopa, and digoxin (heart medication). Also check for Moderate interactions with black pepper (propranolol, anti-HIV drugs, antibiotics, anti-seizure and asthma medications), zinc (antibiotics, HIV drugs, chemotherapy), and horny goat weed (blood pressure drugs, estrogens, blood thinners, and drugs processed by liver enzymes).

Use the medication checker below.

Check your own medication Run your meds through the checker above

The bottom line

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

This product combines several potent herbal ingredients and carries significant medication interactions, especially if you take heart medications, blood pressure drugs, antiretrovirals, seizure drugs, or blood thinners. Rauwolfia serpentina in particular requires careful medical supervision and is not appropriate in pregnancy or while nursing.

Talk with your pharmacist or doctor before starting, especially if you're on any prescriptions.

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

Assessment coverage: 5 of 6 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Dec 18, 2021.

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 Rhino Double Horn Libi XX, straight from the product label.

Brand Samson Pharmaceuticals
Barcode (UPC) 610466048500
Net contents 1 Capsule(s); 500 mg
Market status On market
Date entered into DSLD Dec 18, 2021
DSLD ID 263704
Product type Botanical With Nutrients
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 Rhino Double Horn Libi XX by Samson Pharmaceuticals, 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
1
UPC/BARCODE
610466048500
IngredientAmount% DV
Proprietary Blend450 mg--
Black Pepper0 NP--
Zinc Gluconate50 mg333%
Oryza sativa Extract0 NP--
Horny Goat Weed0 NP--
White Willow Bark0 NP--
Rauwolfia serpentina0 NP--

Other ingredients: Gelatin Capsule, Rice powder

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.
Seals/Symbols

FDA Registered 100% Premium Guaranteed Quality

Made In U.S.A.

FDA Statement of Identity

Dietary Supplement

Formula

Male sexual enhancer

Suggested/Recommended/Usage/Directions

Directions: Take one capsule 60-90 minutes prior to sexual activity. Do not take with food, it works best when taken in between meals, or at least one hour after eating.

Precautions

Warning: Consult with a physician to determine if this product is safe for you to use or not. This product contains herbs, powders and extracts that can have an effect on your health.

Do not take if you have any heart issues, high blood pressure, liver issues, or any condition you are being treated for.

This product is not intended to cure any disease or condition. Do not take if you have any heart issues, high blood pressure, liver issues, or any condition you are being treated for. Consult your physician before you take this product or any sexual enhancement product.

Keep out of reach of children.

Caution: Do not take more than one capsule per 24 hour period.

Not intended for use by persons under the age of 18

Formulation

Effects are normally active only when physically stimulated.

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 diseases.

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

See for yourself

Rhino Double Horn Libi XX by Samson Pharmaceuticals label

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

Rhino Double Horn Libi XX 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 Rhino Double Horn Libi XX by Samson Pharmaceuticals

These are the 6 active ingredients this product is made of. Select any to open its full monograph.

Serving size1 Capsule(s) Dosage formCapsule Servings per container1 Amounts shown are per serving.

Most supplement products combine several ingredients, and a medication can interact with the product through any one of them. Each ingredient below shows whether it has known drug interactions.

Proprietary Blend

450 mg per serving

Zinc Gluconate

Interacts with
67 drugs
50 mg per serving

Zinc is an essential mineral that your body needs for immune function, wound healing, taste, and smell. Most people get enough from food, but suppleme...

Zinc Gluconate monograph & interactions

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

Interaction report

Rhino Double Horn Libi XX by Samson Pharmaceuticals Drug Interactions

Want to check YOUR meds against Rhino Double Horn Libi XX?

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
1,364Drugs
83 Major 1,279 Moderate 2 Minor

Ingredients driving the most interactions

Black Pepper 1,019
Horny Goat Weed 963
Rauwolfia serpentina 843
Zinc Gluconate 67

Individual Drug Interactions

The ingredients in Rhino Double Horn Libi XX interact with 1,364 drugs. Click any drug to see the details.

4 of the 6 ingredients in Rhino Double Horn Libi XX interact with drugs. Each result below shows which ingredient is responsible. Black Pepper Horny Goat Weed Rauwolfia serpentina Zinc Gluconate

Each ingredient & the kinds of drugs it affects

For each ingredient in Rhino Double Horn Libi XX 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.

Black Pepper17 drug types · 1,019 drugs

Anticoagulant/Antiplatelet Drugs

Theoretically, black pepper might increase the risk of bleeding when taken with antiplatelet or anticoagulant drugs.
In vitro research shows that piperine, a constituent of black pepper, seems to inhibit platelet aggregation. This has not been reported in humans.

Likelihood Possible Evidence D
Antidiabetes Drugs

Theoretically, black pepper might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Animal research shows that piperine, a constituent of black pepper, can reduce blood glucose levels. Monitor blood glucose levels closely. Dose adjustments might be necessary.

Likelihood Possible Evidence D
Atorvastatin (Lipitor)

Theoretically, black pepper might increase blood levels of atorvastatin.
Animal research shows that taking piperine, a constituent of black pepper, 35 mg/kg can increase the maximum serum concentration of atorvastatin three-fold. This has not been reported in humans.

Likelihood Possible Evidence D
Cyclosporine (Neoral, Sandimmune)

Theoretically, black pepper might increase the effects and side effects of cyclosporine.
In vitro research shows that piperine, a constituent of black pepper, increases the bioavailability of cyclosporine. This has not been reported in humans.

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

Theoretically, black pepper might increase levels of drugs metabolized by CYP2D6.
In vitro research suggests that some constituents of black pepper inhibit CYP2D6. This has not been reported in humans.

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

Theoretically, black pepper might increase levels of drugs metabolized by CYP3A4.
In vitro research and pharmacokinetic simulation data suggest that piperine, a constituent of black pepper, as well as the pepper fruit seem to inhibit CYP3A4. This has not been reported in humans.

Likelihood Possible Evidence D
Lithium

Theoretically, black pepper might increase blood levels of lithium due to its diuretic effects. The dose of lithium might need to be reduced.
Black pepper is thought to have diuretic properties.

Likelihood Probable Evidence D
Nevirapine (Viramune)

Black pepper might increase blood levels of nevirapine.
Clinical research shows that piperine, a constituent of black pepper, increases the plasma concentration of nevirapine. However, no adverse effects were observed in this study.

Likelihood Probable Evidence D
P-Glycoprotein Substrates

Theoretically, black pepper might increase levels of P-glycoprotein substrates.
In vitro research shows that piperine, a constituent of black pepper, seems to inhibit P-glycoprotein.

Likelihood Possible Evidence D
Pentobarbital (Nembutal)

Theoretically, black pepper might increase the sedative effects of pentobarbital.
Animal research shows that piperine, a constituent of black pepper, increases pentobarbital-induced sleeping time.

Likelihood Possible Evidence D
Phenytoin (Dilantin)

Black pepper might increase blood levels of phenytoin.
Clinical research shows that piperine, a constituent of black pepper, seems to increase absorption, slow elimination, and increase levels of phenytoin. Taking a single dose of black pepper 1 gram along with phenytoin seems to double the serum concentration of phenytoin. Consuming a soup with black pepper providing piperine 44 mg/200 mL of soup along with phenytoin also seems to increase phenytoin levels when compared with consuming the same soup without black pepper.

Likelihood Possible Evidence B
Propranolol (Inderal)

Black pepper might increase blood levels of propranolol.
Clinical research shows that piperine, a constituent of black pepper, seems to increase absorption and slow elimination of propranolol.

Likelihood Possible Evidence B
Rifampin (Rifadin)

Black pepper might increase blood levels of rifampin.
Clinical research shows that piperine, a constituent of black pepper, seems to increase absorption and serum levels of rifampin.

Likelihood Possible Evidence B
Theophylline

Black pepper might increase blood levels of theophylline.
Clinical research shows that piperine, a constituent of black pepper, seems to increase absorption and slow elimination of theophylline.

Likelihood Possible Evidence D
Amoxicillin (Amoxil, Trimox)

Theoretically, black pepper might increase the effects and side effects of amoxicillin.
Animal research shows that taking piperine, a constituent of black pepper, with amoxicillin increases plasma levels of amoxicillin. This has not been reported in humans.

Likelihood Possible Evidence D
Carbamazepine (Tegretol)

Theoretically, black pepper might increase blood levels of carbamazepine, potentially increasing the effects and side effects of carbamazepine.
One clinical study in patients taking carbamazepine 300 mg or 500 mg twice daily shows that taking a single 20 mg dose of purified piperine, a constituent of black pepper, increases carbamazepine levels. Piperine may increase carbamazepine absorption by increasing blood flow to the GI tract, increasing the surface area of the small intestine, or inhibiting cytochrome P450 3A4 (CYP3A4) in the gut wall. Absorption was significantly increased by 7-10 mcg/mL/hour. The time to eliminate carbamazepine was also increased by 4-8 hours. Although carbamazepine levels were increased, this did not appear to increase side effects. In vitro research also shows that piperine can increase carbamazepine levels by 11% in a time-dependent manner.

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

Theoretically, black pepper might decrease levels and clinical effects of drugs metabolized by CYP1A2.
In vitro research suggests that black pepper induces CYP1A2. This has not been reported in humans.

Likelihood Possible Evidence D
Black Pepper full monograph & interactions

Horny Goat Weed6 drug types · 963 drugs

Anticoagulant/Antiplatelet Drugs

Theoretically, horny goat weed might increase the risk of bleeding.
In vitro research and animal research shows that horny goat weed can inhibit platelet aggregation and thrombus formation. This effect has not been reported in humans.

Likelihood Possible Evidence D
Antihypertensive Drugs

Theoretically, horny goat weed might increase the risk of hypotension.
Laboratory research suggests that horny goat weed might have hypotensive effects. This effect has not been reported in humans.

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

Theoretically, horny goat weed might increase the effects and side effects of CYP1A2 substrates.
In vitro, horny goat weed leaf extract inhibits CYP1A2. This effect has not been reported in humans.

Likelihood Possible Evidence D
Cytochrome P450 2B6 (Cyp2B6) Substrates

Theoretically, horny goat weed might increase the effects and side effects of CYP2B6 substrates.
In vitro, horny goat weed leaf extract inhibits CYP2B6. This effect has not been reported in humans.

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

Theoretically, horny goat weed might increase the effects and side effects of CYP3A4 substrates.
In vitro, horny goat weed extract inhibits CYP3A4 and suppresses CYP3A4 mRNA expression. This effect has not been reported in humans.

Likelihood Possible Evidence D
Estrogens

Theoretically, concomitant use of horny goat weed with estrogens might increase their therapeutic and adverse effects.
In vitro evidence suggests that horny goat weed has estrogenic activity. In clinical research, horny goat weed has been shown to increase blood levels of estrogen in some females.

Likelihood Possible Evidence D
Horny Goat Weed full monograph & interactions

Rauwolfia serpentina13 drug types · 843 drugs

Antipsychotic Drugs

Theoretically, concomitant use might increase the risk of adverse effects.
Concomitant use of neuroleptics with Indian snakeroot may potentiate the effects of these drugs, as well as the alkaloid constituents of Indian snakeroot.

Likelihood Probable Evidence D
Beta-Blockers

Theoretically, taking Indian snakeroot with beta-blockers might increase the risk of bradycardia and/or hypotension.
Indian snakeroot contains small amounts of reserpine. Reserpine causes catecholamine-depletion. Concomitant use of Indian snakeroot and beta-blockers might increase the risk or bradycardia and/or hypotension.

Likelihood Probable Evidence D
Digoxin (Lanoxin)

Theoretically, taking Indian snakeroot with digoxin might increase the risk of bradycardia.
Bradycardia has been reported in clinical trials using Indian snakeroot. Concomitant use of digoxin with Indian snakeroot might potentiate this effect.

Likelihood Probable Evidence D
Levodopa

Theoretically, taking Indian snakeroot with levodopa may reduce the effectiveness of levodopa.
Extrapyramidal motor symptoms and Parkinson-like symptoms have been reported in clinical trials using Indian snakeroot. Concomitant use of Indian snakeroot with levodopa may reduce the effectiveness of levodopa and increase extrapyramidal motor symptoms.

Likelihood Probable Evidence D
Anticoagulant/Antiplatelet Drugs

Theoretically, taking Indian snakeroot might increase the risk of bleeding when used with antiplatelet or anticoagulant drugs.
Indian snakeroot contains small amounts of the drug yohimbine. In vitro research shows that yohimbine inhibits platelet aggregation.

Likelihood Possible Evidence D
Antidiabetes Drugs

Theoretically, concomitant use of Indian snakeroot with antidiabetes drugs might increase the risk of hypoglycemia.
Animal research shows that Indian snakeroot lowers blood glucose levels. This effect has not been reported in humans.

Likelihood Possible Evidence D
Antihypertensive Drugs

Theoretically, concomitant use of Indian snakeroot and antihypertensive drugs might increase the risk of hypotension.
Indian snakeroot, which contains reserpine, can reduce both systolic and diastolic blood pressure.

Likelihood Possible Evidence B
Cns Depressants

Theoretically, taking Indian snakeroot might cause additive sedative effects.
Sedation and drowsiness have been reported in clinical trials using Indian snakeroot.

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

Theoretically, Indian snakeroot might inhibit CYP2D6 enzymes and reduce the metabolism of CYP2D6 substrates.
Indian snakeroot contains small amounts of the drug yohimbine. In vitro research shows that yohimbine inhibits CYP2D6 enzyme activity.

Likelihood Possible Evidence D
Ephedrine

Theoretically, taking Indian snakeroot with ephedrine might alter the effects and side effects of ephedrine.
Indian snakeroot contains small amounts of reserpine. Reserpine reduces indirect sympathomimetic drug activity. However, another constituent of Indian snakeroot, yohimbine, has stimulant activity and may increase the risk of adverse effects with ephedrine.

Likelihood Probable Evidence D
Monoamine Oxidase Inhibitors (Maois)

Theoretically, taking Indian snakeroot with MAOIs might cause additive effects.
Yohimbine, a constituent of Indian snakeroot, has MAO inhibitory effects. At high doses, yohimbine is a non-selective inhibitor of MAO.

Likelihood Possible Evidence D
Stimulant Drugs

Theoretically, concomitant use might cause additive effects.
Yohimbine, a constituent of Indian snakeroot, has sympathomimetic effects and increases blood pressure in a dose-dependent manner. Theoretically, taking Indian snakeroot with stimulant drugs can have additive stimulant and hypertensive effects.

Likelihood Possible Evidence D
Tricyclic Antidepressants (Tcas)

Theoretically, concomitant use might alter the effects of Indian snakeroot and increase the risk of adverse effects.
A small clinical study in patients taking TCAs for at least 4 weeks shows that receiving doses of intravenous yohimbine, a constituent of Indian snakeroot, 2.5-20 mg daily for up to 7 days precipitates severe anxiety, agitation, and tremor. Also, concomitant use of TCAs with Indian snakeroot may decrease the effects of other rauwolfia alkaloids.

Likelihood Possible Evidence D
Rauwolfia serpentina full monograph & interactions

Zinc Gluconate10 drug types · 67 drugs

Bictegravir/Emtricitabine/Tenofovir Alafenamide (Biktarvy)

Theoretically, zinc might decrease levels of bictegravir/emtricitabine/tenofovir alafenamide by reducing its absorption.
Advise patients that bictegravir/emtricitabine/tenofovir alafenamide should be taken at least 2 hours before or 6 hours after zinc containing products.

Likelihood Probable Evidence D
Cephalexin (Keflex)

Zinc might decrease cephalexin levels by chelating with cephalexin in the gut and preventing its absorption.
A pharmacokinetic study shows that zinc sulfate 250 mg taken concomitantly with cephalexin 500 mg decreases peak levels of cephalexin by 31% and reduces the exposure to cephalexin by 27%. Also, taking zinc sulfate 3 hours before cephalexin decreases peak levels of cephalexin by 11% and reduces the exposure to cephalexin by 18%. By decreasing cephalexin levels, zinc might increase the risk of treatment failure. This effect does not occur when zinc is taken 3 hours after the cephalexin dose. To avoid an interaction, advise patients take zinc sulfate 3 hours after taking cephalexin.

Likelihood Probable Evidence B
Cisplatin (Platinol-Aq)

Theoretically, zinc might interfere with the therapeutic effects of cisplatin.
Animal research suggests that zinc stimulates tumor cell production of the protein metallothionein, which binds and inactivates cisplatin. It is not known whether zinc supplements or high dietary zinc intake can cause clinically significant interference with cisplatin therapy. Cisplatin might also increase zinc excretion.

Likelihood Possible Evidence D
Integrase Inhibitors

Theoretically, taking zinc along with integrase inhibitors might decrease the levels and clinical effects of these drugs.
Zinc is a divalent cation. Pharmacokinetic studies have shown that other divalent cations such as calcium and iron can decrease blood levels of the integrase inhibitor dolutegravir through chelation.

Likelihood Possible Evidence D
Penicillamine (Cuprimine, Depen)

Zinc might reduce the levels and clinical effects of penicillamine.
By forming an insoluble complex with penicillamine, zinc interferes with penicillamine absorption and activity. Zinc supplements reduce the efficacy of low-dose penicillamine (0.5-1 gram/day), but do not seem to affect higher doses (1-2.75 gram/day), provided dosing times are separated. Advise patients to take zinc and penicillamine at least 2 hours apart.

Likelihood Probable Evidence B
Quinolone Antibiotics

Zinc can decrease the levels and clinical effects of quinolones antibiotics.
Quinolones form complexes with zinc in the gastrointestinal tract, reducing absorption of both the quinolone and zinc if taken at the same time. Advise patients to take these drugs at least 2 hours before, or 4-6 hours after, zinc supplements.

Likelihood Probable Evidence B
Ritonavir (Norvir)

Zinc modestly reduces levels of ritonavir.
Clinical research shows that zinc might reduce serum ritonavir levels by chelating with ritonavir in the gut and preventing its absorption. In patients with HIV, ritonavir is taken with atazanavir to prevent the metabolism and increase the effects of atazanavir. A pharmacokinetic study shows that, in patients being treated with atazanavir/ritonavir, co-administration of zinc sulfate (Solvazinc tablets) 125 mg as a single dose or as multiple daily doses for 2 weeks reduces plasma levels of ritonavir by about 16%. However, atazanavir levels still remains high enough to prevent HIV virus replication. Therefore, the decrease in ritonavir levels is not likely to be clinically significant.

Likelihood Probable Evidence B
Tetracycline Antibiotics

Zinc might reduce levels of tetracycline antibiotics.
Tetracyclines form complexes with zinc in the gastrointestinal tract, which can reduce absorption of both the tetracycline and zinc when taken at the same time. Taking zinc sulfate 200 mg with tetracycline reduces absorption of the antibiotic by 30% to 40%. Demeclocycline and minocycline cause a similar interaction. However, doxycycline does not seem to interact significantly with zinc. Advise patients to take tetracyclines at least 2 hours before, or 4-6 hours after, zinc supplements to avoid any interactions.

Likelihood Probable Evidence B
Amiloride (Midamor)

Amiloride can modestly reduce zinc excretion and increase zinc levels.
Clinical research shows that amiloride can reduce urinary zinc excretion, especially at doses of 10 mg per day or more. This zinc-sparing effect can help to counteract zinc losses caused by thiazide diuretics, but it is unlikely to cause zinc toxicity at usual amiloride doses. The other potassium-sparing diuretics, spironolactone (Aldactone) and triamterene (Dyrenium), do not seem to have a zinc-sparing effect.

Likelihood Probable Evidence B
Atazanavir (Reyataz)

Zinc modestly reduces levels of atazanavir, although this effect does not seem to be clinically significant.
Clinical research shows that zinc might decrease serum atazanavir levels by chelating with atazanavir in the gut and preventing its absorption. Although a single dose of zinc sulfate (Solvazinc tablets) 125 mg orally does not affect atazanavir concentrations in patients being treated with atazanavir/ritonavir, co-administration of zinc sulfate 125 mg daily for 2 weeks reduces plasma levels of atazanavir by about 22% in these patients. However, despite this decrease, atazanavir levels still remain at high enough concentrations for the prevention of HIV virus replication.

Likelihood Probable Evidence B
Zinc Gluconate full monograph & interactions
The maker

Brand information

Manufacturer and brand details for Rhino Double Horn Libi XX, from the product label.

Samson Pharmaceuticals

See all Samson Pharmaceuticals products
Name
Samson Pharmaceuticals Inc.
City
Commerce
State
CA
ZipCode
90040
Phone Number
(877) 888-8460
Web Address
www.samsonstore.com
Pharmacist Counseling Corner

Rhino Double Horn Libi XX by Samson Pharmaceuticals: Common Questions

Does Rhino Double Horn Libi XX by Samson Pharmaceuticals interact with any medications?
Yes. Based on its ingredients, Rhino Double Horn Libi XX has a known interaction with 1,364 medications, including 83 rated major. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Rhino Double Horn Libi XX contains 6 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.
Does this product work for sexual function?
The evidence for horny goat weed on sexual dysfunction is insufficient reliable evidence to rate — we don't have enough data to say whether it's effective. Talk with your doctor about whether it might help your situation.
Can I take this if I'm pregnant or nursing?
No. Horny goat weed and Rauwolfia serpentina should not be used in pregnancy or while breastfeeding due to safety concerns. There isn't enough data for the other ingredients. Speak with your doctor or pharmacist before taking this product if you're pregnant, nursing, or planning to become pregnant.
What are the most common side effects?
Black pepper can cause burning aftertaste and indigestion. Zinc may cause stomach cramps, diarrhea, metallic taste, or nausea. Horny goat weed may cause dizziness, dry mouth, nosebleeds, or thirst. Rauwolfia serpentina commonly causes sedation, weight gain, constipation, and increased appetite.
Is black pepper safe to take as a supplement?
Black pepper in food amounts is generally safe. Concentrated supplements should be used more cautiously and ideally under medical advice, since they can affect how your body absorbs or processes certain drugs.
What is Rauwolfia serpentina, and why is it in this product?
Rauwolfia serpentina, also called Indian snakeroot, is a plant containing alkaloid compounds traditionally used in herbal remedies. It's included in this product for its purported effects, but it carries serious interactions with heart and neurological medications and should only be used under medical supervision.
How much zinc is in this product?
The product facts don't specify the amount of zinc gluconate per capsule. Check the label or contact the manufacturer to confirm the dose before taking it, especially if you're also taking antibiotics or other zinc-sensitive medications.

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

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Go deeper

The Full Monographs Behind Rhino Double Horn Libi XX’s Ingredients

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

Herb & supplement monograph

Black Pepper

Interacts with 1,019 drugs

Black pepper is a common kitchen spice that is generally safe in the amounts used in food. Its extract, piperine, is mostly added to supplements to help the body absorb other ingredients (li...

Read the full Black Pepper monograph → Herb & supplement monograph

Black Rice

Black rice is a nutritious whole-grain food that is rich in fiber, plant protein, and antioxidant pigments called anthocyanins. Eaten as part of a balanced diet it is a healthy choice, but s...

Read the full Black Rice monograph → Herb & supplement monograph

Horny Goat Weed

Interacts with 963 drugs

Horny goat weed (Epimedium) is a traditional Chinese herb most often marketed for low libido and erectile problems, but solid human evidence for these uses is lacking. While short-term use s...

Read the full Horny Goat Weed monograph → Herb & supplement monograph

Indian Snakeroot

Interacts with 843 drugs

Indian snakeroot is a traditional Ayurvedic plant that contains reserpine, a compound with real blood-pressure-lowering and sedative effects. Because its potent alkaloids can cause serious s...

Read the full Indian Snakeroot monograph → Herb & supplement monograph

Zinc

Interacts with 67 drugs

Zinc is an essential mineral that your body needs for immune function, wound healing, taste, and smell. Most people get enough from food, but supplements can help correct or prevent a defici...

Read the full Zinc monograph →
Sources

Sources & How We Checked

Rhino Double Horn Libi XX'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 173 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.

Black Pepper 29 references
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  6. Bhardwaj RK, Glaeser H, Becquemont L, et al. Piperine, a major constituent of black pepper, inhibits human P-glycoprotein and CYP3A4. J Pharmacol Exp Ther 2002;302:645-50. PubMed
  7. Velpandian T, Jasuja R, Bhardwaj RK, et al. Piperine in food: interference in the pharmacokinetics of phenytoin. Eur J Drug Metab Pharmacokinet 2001;26:241-7. PubMed
  8. Pattanaik S, Hota D, Prabhakar S, et al. Pharmacokinetic interaction of a single dose of piperine with steady-state carbamazepine in epilepsy patients. Phytother Res 2009;23:1281-6.
  9. Munakata, M., Kobayashi, K., Niisato-Nezu, J., Tanaka, S., Kakisaka, Y., Ebihara, T., Ebihara, S., Haginoya, K., Tsuchiya, S., and Onuma, A. Olfactory stimulation using black pepper oil facilitates oral feeding in pediatric patients receiving long-term en
  10. Myers, B. M., Smith, J. L., and Graham, D. Y. Effect of red pepper and black pepper on the stomach. Am J Gastroenterol 1987;82(3):211-214.
  11. Raghavendra, R. H. and Naidu, K. A. Spice active principles as the inhibitors of human platelet aggregation and thromboxane biosynthesis. Prostaglandins Leukot.Essent.Fatty Acids 2009;81(1):73-78. PubMed
  12. Subehan, Usia, T., Kadota, S., and Tezuka, Y. Mechanism-based inhibition of human liver microsomal cytochrome P450 2D6 (CYP2D6) by alkamides of Piper nigrum. Planta Med 2006;72(6):527-532.
  13. Kasibhatta, R. and Naidu, M. U. Influence of piperine on the pharmacokinetics of nevirapine under fasting conditions: a randomised, crossover, placebo-controlled study. Drugs R.D. 2007;8(6):383-391. PubMed
  14. Usia, T., Iwata, H., Hiratsuka, A., Watabe, T., Kadota, S., and Tezuka, Y. CYP3A4 and CYP2D6 inhibitory activities of Indonesian medicinal plants. Phytomedicine. 2006;13(1-2):67-73. PubMed
  15. Mujumdar, A. M., Dhuley, J. N., Deshmukh, V. K., Raman, P. H., Thorat, S. L., and Naik, S. R. Effect of piperine on pentobarbitone induced hypnosis in rats. Indian J Exp.Biol. 1990;28(5):486-487.
  16. Panda, S. and Kar, A. Piperine lowers the serum concentrations of thyroid hormones, glucose and hepatic 5'D activity in adult male mice. Horm.Metab Res. 2003;35(9):523-526. PubMed
  17. Lawless, H. and Stevens, D. A. Effects of oral chemical irritation on taste. Physiol Behav. 1984;32(6):995-998. PubMed
  18. Hiwale, A. R., Dhuley, J. N., and Naik, S. R. Effect of co-administration of piperine on pharmacokinetics of beta-lactam antibiotics in rats. Indian J Exp.Biol. 2002;40(3):277-281.
  19. Han, Y., Chin Tan, T. M., and Lim, L. Y. In vitro and in vivo evaluation of the effects of piperine on P-gp function and expression. Toxicol.Appl.Pharmacol. 8-1-2008;230(3):283-289. PubMed
  20. Sharma, P., Varma, M. V., Chawla, H. P., and Panchagnula, R. In situ and in vivo efficacy of peroral absorption enhancers in rats and correlation to in vitro mechanistic studies. Farmaco 2005;60(11-12):874-883. PubMed
  21. Aher, S., Biradar, S., Gopu, C. L., and Paradkar, A. Novel pepper extract for enhanced P-glycoprotein inhibition. J Pharm.Pharmacol. 2009;61(9):1179-1186. PubMed
  22. Zutshi, R. K., Singh, R., Zutshi, U., Johri, R. K., and Atal, C. K. Influence of piperine on rifampicin blood levels in patients of pulmonary tuberculosis. J Assoc.Physicians India 1985;33(3):223-224.
  23. Marotta, R. B. and Floch, M. H. Diet and nutrition in ulcer disease. Med Clin North Am 1991;75(4):967-979. PubMed
  24. Subehan, Usia, T., Iwata, H., Kadota, S., and Tezuka, Y. Mechanism-based inhibition of CYP3A4 and CYP2D6 by Indonesian medicinal plants. J Ethnopharmacol. 5-24-2006;105(3):449-455. PubMed
  25. Gimenez L, Zacharisen M. Severe pepper allergy in a young child. WMJ. 2011 Jun;110(3):138-9.
  26. Ren T, Yang M, Xiao M, Zhu J, Xie W, Zuo Z. Time-dependent inhibition of carbamazepine metabolism by piperine in anti-epileptic treatment. Life Sci. 2019;218:314-323. PubMed
  27. Thomas AB, Choudhary DC, Raje A, Nagrik SS. Pharmacokinetics and pharmacodynamic herb-drug interaction of piperine with atorvastatin in rats. J Chromatogr Sci 2021;59(4):371-80. PubMed
  28. 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
  29. Lin F, Hu Y, Zhang Y, Zhao L, Zhong D, Liu J. Predicting Food-Drug Interactions between Piperine and CYP3A4 Substrate Drugs Using PBPK Modeling. Int J Mol Sci 2024;25(20):10955. PubMed

See these in context on the Black Pepper monograph →

Zinc 88 references
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  3. Smith DS, Helzner EC, Nuttall CE Jr, et al. Failure of zinc gluconate in treatment of acute upper respiratory tract infections. Antimicrob Agents Chemother 1989;33:646-8. PubMed
  4. Blondeau JM. Expanded activity and utility of the new fluoroquinolones: a review. Clin Ther 1999;21:3-40. PubMed
  5. Reyes AJ, Olhaberry JV, Leary WP, et al. Urinary zinc excretion, diuretics, zinc deficiency and some side-effects of diuretics. S Afr Med J 1983;64:936-41.
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  19. Lagiou P, Wuu J, Trichopoulou A, et al. Diet and benign prostatic hyperplasia: a study in Greece. Urology 1999;54:284-90. PubMed
  20. Ewing CI, Gibbs AC, Ashcroft C, David TJ. Failure of oral zinc supplementation in atopic eczema. Eur J Clin Nutr 1991;45:507-10.
  21. Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. Washington, DC: National Academy Press, 2002.
  22. Age-Related Eye Disease Study Research Group. A randomized, placebo-controlled, clinical trial of high-dose supplementation with vitamins C and E, beta carotene, and zinc for age-related macular degeneration and vision loss. AREDS report no. 8. Arch Oph
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  24. Godfrey HR, Godfrey NJ, Godfrey JC, Riley D. A randomized clinical trial on the treatment of oral herpes with topical zinc oxide/glycine. Altern Ther Health Med 2001;7:49-56.
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See these in context on the Zinc monograph →

Black Rice 2 references
  1. Arsenic in Rice and Rice Products — U.S. Food and Drug Administration (FDA) Source
  2. Dietary Fiber — MedlinePlus (NIH) Source

See these in context on the Black Rice monograph →

Horny Goat Weed 11 references
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  4. Zhang CZ, Wang SX, Zhang Y, et al. In vitro estrogenic activities of Chinese medicinal plants traditionally used for the management of menopausal symptoms. J Ethnopharmacol 2005;98:295-300. PubMed
  5. Yap SP, Shen P, Li J, et al. Molecular and pharmacodynamic properties of estrogenic extracts from the traditional Chinese medicinal herb, Epimedium. J Ethnopharmacol 2007;113:218-24. PubMed
  6. Yan, F. F., Liu, Y., Liu, Y. F., and Zhao, Y. X. Herba Epimedii water extract elevates estrogen level and improves lipid metabolism in postmenopausal women. Phytother.Res. 2008;22(9):1224-1228. PubMed
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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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