Major interaction on record — check this product against your medications before combining. Based on 12 of 18 ingredients. Check your meds →
Dietary supplement

Rhythm Chocolate Ginger Snap Flavor Ingredients & Drug Interactions

by The Functional Chocolate Company

Rhythm Chocolate Ginger Snap Flavor label
See full label image
Bar 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 Rhythm Chocolate Ginger Snap Flavor 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

Rhythm Chocolate Ginger Snap Flavor is a dietary supplement by The Functional Chocolate Company with 18 active ingredients. Its ingredients are commonly taken for replacing fluids and electrolytes, preventing dehydration during exercise or illness, treating low blood sodium (under medical care).Based on those ingredients, 2,207 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are Dietary Fiber, PurGinger, Black Cohosh Root Extract. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

Jump to a section

Check Your Meds Against Rhythm Chocolate Ginger Snap Flavor by The Functional Chocolate Company

Ask about any prescription or over-the-counter medication and we check it for interactions with Rhythm Chocolate Ginger Snap Flavor by The Functional Chocolate Company — and tell you which ingredient is responsible.

Pharmacist-reviewed data Checks every ingredient Answer in seconds
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HelloPharmacist Scorecard of Rhythm Chocolate Ginger Snap Flavor by The Functional Chocolate Company

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 2 of its 17 active ingredients.
  • “Proprietary PMS Blend” is a proprietary blend — the label gives one combined amount (287 mg) without saying how much of each component you get.

Rhythm Chocolate Ginger Snap Flavor contains 16 ingredients, of which the active ones include Sodium, Wild Yam Extract, Dong Quai root extract, Maca, Cramp Bark, Black Cohosh Root Extract, Evening Primrose Oil, Madagascar Vanilla Extract, Vitex, Mushroom Powder, Ginger (PurGinger), Saffron (SaffSerene), and Cinnamon Bark Extract. The remaining ingredients are inactive — they're fillers and binders like cocoa mass, cane sugar, cocoa butter, soy lecithin, and natural vanilla extract that make up the chocolate bar form.

This is a functional chocolate blend designed around a proprietary PMS formula, combining botanical extracts traditionally used for hormonal support and symptom relief, alongside the ginger and cinnamon for their potential wellness benefits.

Does it work?

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

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

Why this rating?
  • The label markets this product for: help relieve premenstrual syndrome symptoms.
  • We looked for evidence on: Dysmenorrhea, Anxiety, Depression, PMS mood swings, menstrual cramps, appetite changes.
  • The strongest evidence on file: Ginger is rated "Possibly Effective" for Dysmenorrhea (Natural Medicines).
  • Also on file: Maca is rated "Insufficient Reliable Evidence To Rate" for Depression.
  • Also on file: Cramp Bark is rated "Insufficient Reliable Evidence To Rate" for Dysmenorrhea.

The evidence for what these ingredients actually do is mixed. Black Cohosh is possibly effective for menopausal symptoms — that's the strongest rating we have.

Ginger is possibly effective for pregnancy-related nausea, period pain (dysmenorrhea), and osteoarthritis, and saffron is possibly effective for chemotherapy-related nerve pain and Alzheimer's disease. For most other uses — whether Wild Yam, Dong Quai, Maca, Cramp Bark, Cinnamon, or vanilla — the evidence either isn't strong enough to rate or is insufficient.

Effectiveness data for the B-complex component and a few other ingredients isn't on file here.

The evidence, ingredient by ingredient Sodium Black Psyllium Wild Yam Dong Quai Maca Cramp Bark Black Cohosh Evening Primrose

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 11 of the 12 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 12 of 12.
  • General safety write-ups exist for 12 of 12.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

Sodium is well tolerated in normal dietary amounts, but the facts caution against excess intake or supplements without medical guidance because too much is linked to high blood pressure and heart strain. Wild Yam, Black Cohosh, Evening Primrose Oil, and Saffron are generally well tolerated short-term at typical doses, though long-term safety in supplement amounts isn't well studied for most of them.

Ginger is generally well tolerated at food and supplement amounts, though doses above 5 grams per day increase the risk of side effects like heartburn and diarrhea. Mild adverse effects across these ingredients include gastrointestinal upset, headache, dizziness, and rash; serious adverse effects are rare but documented (liver problems with black cohosh, anaphylaxis with saffron or wild yam, and seizures in isolated case reports).

Pregnancy and breastfeeding safety varies: the data advises against most of these ingredients during pregnancy and breastfeeding, though Vanilla is likely safe, and Cinnamon is likely safe in pregnancy. For Wild Yam, Maca, Cramp Bark, Black Cohosh, Evening Primrose Oil, Dong Quai, and Saffron, there isn't enough safety data during pregnancy or breastfeeding — talk with your doctor or pharmacist before use.

Side effects, ingredient by ingredient Sodium Black Psyllium Wild Yam Dong Quai Maca Cramp Bark Black Cohosh Evening Primrose

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?
  • 9 of the 12 matched ingredients can interact with medications — Black Psyllium, Saffron, Black Cohosh, Dong Quai, Ginger, among others.
  • 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.
  • For scale: 2,208 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 your medications if you take blood thinners or antiplatelet drugs (warfarin, aspirin, clopidogrel, others) — dong quai and ginger carry documented risks. Blood pressure medications (antihypertensives), antidiabetes drugs, and estrogen therapy (birth control, hormone replacement) all have documented Moderate interactions.

Lithium, antidepressants, CNS depressants, and hepatotoxic drugs also have interactions documented in one or more of these ingredients. Run your exact list through the search tool on this page.

Check your own medication Run your meds through the checker above

The bottom line

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

This bar combines ginger and cinnamon with a blend of herbs traditionally used for menstrual and hormonal support. If you take blood thinners, blood pressure medications, diabetes drugs, or antidepressants — or any regular prescription — run this product and your exact medications through the interaction checker below first.

Pregnant or breastfeeding? Discuss this with your doctor or pharmacist before taking it.

For everyone else, short-term use is generally well tolerated, but talk with us if you have liver concerns or take multiple medications.

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

Assessment coverage: 12 of 17 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Feb 23, 2025.

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

At a glance

General information

Key facts about Rhythm Chocolate Ginger Snap Flavor, straight from the product label.

Brand The Functional Chocolate Company
Barcode (UPC) 860005767205
Net contents 1.75 Ounce(s); 50 Gram(s)
Market status On market
Date entered into DSLD Feb 23, 2025
DSLD ID 327268
Product type Botanical With Nutrients
Supplement form Bar
Dietary claims / uses Nutrient, All Other, Structure/Function
Intended target group(s) Vegan, Vegetarian, Girls: (All), Adult Female (18 - 50 Years), Seniors/Mature (>50 Years) - Women ONLY, Gluten Free
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 Rhythm Chocolate Ginger Snap Flavor by The Functional Chocolate Company, 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:
16.66 Gram(s)
Maximum serving Sizes:
16.66 Gram(s)
Servings per container
3
UPC/BARCODE
860005767205
IngredientAmount% DV
Calories84 Calorie(s)--
Total Carbohydrates6 Gram(s)2%
Sodium0 mg--
Total Sugars5 Gram(s)--
Cholesterol0 mg--
Total Fat4 Gram(s)6%
Saturated Fat2.5 Gram(s)11.5%
Trans Fat0 Gram(s)--
Dietary Fiber1 Gram(s)4%
Protein2 Gram(s)4%
Wild Yam Extract0 NP--
Fat Calories38 Calorie(s)--
Dong Quai root extract0 NP--
natural Caramel0 NP--
Maca0 NP--
Cramp Bark0 NP--
Black Cohosh Root Extract0 NP--
Evening Primrose Oil0 NP--
Madagascar Vanilla Extract0 NP--
Proprietary PMS Blend287 mg--
Vitex0 NP--
Mushroom, Powder0 NP--
PurGinger0 NP--
SaffSerene0 NP--
PANMOL B-Complex US1500 NP--
Cinnamon Bark Extract, Natural0 NP--

Other ingredients: Cocoa mass, Cane Sugar, Natural, Pure, Cocoa Butter, Soy Lecithin, Vanilla Extract, Natural, Natural Flavors

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

3 servings per bar

Formulation

Formulated to help pause your PMS

Having your balance rudely interrupted by PMS, mood swings, cramps, weight fluctuations and appetite changes is endlessly frustrating. Rhythm Chocolate incorporates a carefully selected blend of botanicals and vitamins to help restore harmony, including the patented ingredient, SaffSerene (featuring saffron flowers grown in Turkey and Morocco) clinically shown to provide a 50% reduction in the severity of PMS symptoms and help support healthy mood, balance and stress levels.

Vegan

Ethnically sourced Plant based

Cholesterol free Gluten free GMO free

Formula

60% Cacao

FDA Statement of Identity

Dietary Supplement

Seals/Symbols

Vegan

Suggested/Recommended/Usage/Directions

Instructions: Ages 12+ enjoy 1 serving (2 squares) or more as desired. Limit to no more than 2 bars in a day.

FDA Disclaimer Statement

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

Precautions

This product is manufactured in a facility that processes milk, soy, tree nuts and peanuts.

Consult your doctor before use if you are on medication, have a medical condition or are pregnant or nursing.

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

See for yourself

Rhythm Chocolate Ginger Snap Flavor by The Functional Chocolate Company label

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

Rhythm Chocolate Ginger Snap Flavor 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 Rhythm Chocolate Ginger Snap Flavor by The Functional Chocolate Company

These are the 18 active ingredients this product is made of. Select any to open its full monograph.

Serving size16.66 Gram(s) Dosage formBar Servings per container3 Amounts shown are per serving.

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

Sodium

Interacts with
205 drugs
0 mg per serving

Sodium is an essential mineral and electrolyte your body needs to balance fluids, support nerves, and help muscles work. Most people in modern diets g...

Sodium monograph & interactions

Dietary Fiber

Interacts with
2,025 drugs
1 Gram(s) per serving

Black psyllium is a soluble-fiber supplement made from the seeds of a Plantago plant, used mostly to ease constipation and support digestive health. I...

Dietary Fiber monograph & interactions

Protein

2 Gram(s) per serving

Fat Calories

38 Calorie(s) per serving

Proprietary PMS Blend

287 mg per serving

Other (inactive) ingredients: Cocoa mass, Cane Sugar, Natural, Pure, Cocoa Butter, Soy Lecithin, Vanilla Extract, Natural, Natural Flavors. These complete the product’s ingredient list but are not active constituents.

Interaction report

Rhythm Chocolate Ginger Snap Flavor by The Functional Chocolate Company Drug Interactions

Want to check YOUR meds against Rhythm Chocolate Ginger Snap Flavor?

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
2,207Drugs
2 Major 1,412 Moderate 793 Minor

Ingredients driving the most interactions

Dietary Fiber 2,025
PurGinger 1,007
Black Cohosh Root Extract 652
SaffSerene 521
Cinnamon Bark Extract, Natural 442

Individual Drug Interactions

The ingredients in Rhythm Chocolate Ginger Snap Flavor interact with 2,207 drugs. Click any drug to see the details.

9 of the 18 ingredients in Rhythm Chocolate Ginger Snap Flavor interact with drugs. Each result below shows which ingredient is responsible. Dietary Fiber PurGinger Black Cohosh Root Extract SaffSerene Cinnamon Bark Extract, Natural Evening Primrose Oil Sodium Dong Quai root extract Wild Yam Extract

Each ingredient & the kinds of drugs it affects

For each ingredient in Rhythm Chocolate Ginger Snap Flavor 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.

Dietary Fiber7 drug types · 2,025 drugs

Carbamazepine (Tegretol)

Theoretically, black psyllium might reduce the effects of carbamazepine and increase the risk for convulsions.
Theoretically, black psyllium might reduce carbamazepine absorption. A preliminary study using blond psyllium reported decreased carbamazepine bioavailability due to binding of the drug to psyllium, as well as reduction of available fluid in the gut for dissolution of the drug. This interaction may also occur with black psyllium.

Likelihood Probable Evidence D
Lithium

Theoretically, taking black psyllium at the same time as lithium might reduce lithium absorption.
The fiber in black psyllium might reduce lithium absorption and plasma levels. Some case reports describe a reduction in plasma lithium levels with concomitant administration of blond psyllium. This was reversed when psyllium was stopped. This interaction may also occur with black psyllium.

Likelihood Probable Evidence D
Metformin (Glucophage)

Theoretically, black psyllium might increase the therapeutic and adverse effects of metformin.
Animal research shows that concurrent consumption of blond psyllium with metformin slows and increases the absorption of metformin. This interaction may also occur with black psyllium. To avoid changes in absorption, take psyllium 30-60 minutes after metformin.

Likelihood Possible Evidence D
Olanzapine (Zyprexa)

Theoretically, taking black psyllium at the same time as olanzapine might reduce olanzapine absorption.
The fiber in black psyllium might decrease the absorption of olanzapine. A single case report describes a reduction in the effectiveness of olanzapine when it was concomitantly administered with an unspecified type of psyllium 3 grams orally twice daily. This effect was reversed when psyllium was stopped.

Likelihood Possible Evidence D
Digoxin (Lanoxin)

Theoretically, taking black psyllium at the same time as digoxin might reduce digoxin absorption and decrease digoxin levels.
Psyllium might bind digoxin in the gut. However, some clinical evidence suggests that psyllium does not impact digoxin absorption.

Likelihood Unlikely Evidence B
Ethinyl Estradiol

Theoretically, taking black psyllium at the same time as ethinyl estradiol might alter levels of estradiol.
Concurrent use of blond psyllium with ethinyl estradiol results in a slight increase in the extent of ethinyl estradiol absorption and a slower rate of absorption. This is unlikely to be clinically significant.

Likelihood Unlikely Evidence D
Oral Drugs

Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Psyllium seems to have variable effects on drug absorption. To avoid changes in absorption, take psyllium 30-60 minutes after oral medications. Animal research shows that blond psyllium delays and increases the absorption of metformin and ethinyl estradiol. Case reports and animal research suggest that blond psyllium might reduce absorption of lithium, digoxin, olanzapine, and carbamazepine. Finally, some pharmacokinetic studies show that psyllium does not affect the absorption of levothyroxine or warfarin. Although many of these studies evaluated blond psyllium, the fiber content in black psyllium may have similar effects.

Likelihood Possible Evidence B
Dietary Fiber full monograph & interactions

PurGinger14 drug types · 1,007 drugs

Anticoagulant/Antiplatelet Drugs

Ginger may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs. However, research is conflicting.
Laboratory research suggests that ginger inhibits thromboxane synthetase and decreases platelet aggregation. However, this has not been demonstrated unequivocally in humans, with mixed results from clinical trials. Theoretically, excessive amounts of ginger might increase the risk of bleeding when used with anticoagulant/antiplatelet drugs.

Likelihood Possible Evidence B
Antidiabetes Drugs

Theoretically, taking ginger with antidiabetes drugs might increase the risk of hypoglycemia.
Animal and human research suggests that ginger might increase insulin levels and/or decrease blood glucose levels.

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

Ginger might increase or decrease the levels of CYP3A4 substrates.
In vitro research and some case reports suggest that ginger inhibits CYP3A4 activity. Three case reports from the World Health Organization (WHO) adverse drug reaction database describe increased toxicity in patients taking ginger and cancer medications that are CYP3A4 substrates (imatinib, dabrafenib, and crizotinib). However, the causality of this interaction is unclear due to the presence of multiple interacting drugs and routes of administration.
Conversely, other in vitro research suggests that ginger induces CYP3A4 activity, leading to reduced levels of CYP3A4 substrates. However, this interaction has not been reported in humans.

Likelihood Possible Evidence D
Losartan (Cozaar)

Theoretically, ginger might increase levels of losartan and the risk of hypotension.
In animal research, ginger increased the levels and hypotensive effects of a single dose of losartan. It is not clear if ginger alters the concentration or effects of losartan when taken continuously. Additionally, this interaction has not been shown in humans.

Likelihood Possible Evidence D
Nifedipine (Procardia)

Ginger may have antiplatelet effects and increase the risk of bleeding if used with nifedipine.
Clinical research shows that combined treatment with ginger 1 gram plus nifedipine 10 mg significantly inhibits platelet aggregation when compared to nifedipine or ginger alone.

Likelihood Possible Evidence B
P-Glycoprotein Substrates

Ginger might increase the absorption and blood levels of P-glycoprotein (P-gp) substrates.
In vitro research and case reports suggest that ginger inhibits drug efflux by P-gp, potentially increasing absorption and serum levels of P-gp substrates. Two case reports from the World Health Organization (WHO) adverse drug reaction database describe increased toxicity in patients taking ginger and cancer medications that are P-gp substrates (trametinib, crizotinib). However, the causality of this interaction is unclear due to the presence of multiple interacting drugs and routes of administration.

Likelihood Possible Evidence D
Phenprocoumon (Marcoumar, Others)

Ginger might increase the risk of bleeding with phenprocoumon.
Phenprocoumon, a warfarin-related anticoagulant, might increase the international normalized ratio (INR) when taken with ginger. There is one case report of a 76-year-old woman with a stable INR on phenprocoumon that increased to greater than 10 when she began consuming dried ginger and ginger tea.

Likelihood Possible Evidence D
Warfarin (Coumadin)

Ginger might increase the risk of bleeding with warfarin.
Laboratory research suggests that ginger might inhibit thromboxane synthetase and decrease platelet aggregation. In one case report, ginger increased the INR when taken with phenprocoumon, which has similar pharmacological effects as warfarin. In another case report, ginger increased the INR when taken with a combination of warfarin, hydrochlorothiazide, and acetaminophen. A longitudinal analysis suggests that taking ginger increases the risk of bleeding in patients taking warfarin for at least 4 months. However, research in healthy people suggests that ginger has no effect on INR, or the pharmacokinetics or pharmacodynamics of warfarin. Until more is known, monitor INRs closely in patients taking large amounts of ginger.

Likelihood Possible Evidence B
Calcium Channel Blockers

Theoretically, taking ginger with calcium channel blockers might increase the risk of hypotension.
Some animal and in vitro research suggests that ginger has hypotensive and calcium channel-blocking effects. Another animal study shows that concomitant administration of ginger and the calcium channel blocker amlodipine leads to greater reductions in blood pressure when compared with amlodipine alone.

Likelihood Unlikely Evidence D
Cyclosporine (Neoral, Sandimmune)

Theoretically, when taken prior to cyclosporine, ginger might decrease cyclosporine levels.
In an animal model, ginger juice taken 2 hours prior to cyclosporine administration reduced the maximum concentration and area under the curve of cyclosporine by 51% and 40%, respectively. This effect was not observed when ginger juice and cyclosporine were administered at the same time.

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

Theoretically, ginger might increase the levels of CYP1A2 substrates.
In vitro research shows that ginger inhibits CYP1A2 activity. However, this interaction has not been reported in humans.

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

Theoretically, ginger might increase the levels of CYP2B6 substrates.
In vitro research shows that ginger inhibits CYP2B6 activity. However, this interaction has not been reported in humans.

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

Theoretically, ginger might increase the levels of CYP2C9 substrates.
In vitro research shows that ginger inhibits CYP2C9 activity. However, this interaction has not been reported in humans.

Likelihood Possible Evidence D
Metronidazole (Flagyl)

Theoretically, ginger might increase levels of metronidazole.
In an animal model, ginger increased the absorption and plasma half-life of metronidazole. In addition, the elimination rate and clearance of metronidazole was significantly reduced.

Likelihood Possible Evidence D
PurGinger full monograph & interactions

Black Cohosh Root Extract7 drug types · 652 drugs

Atorvastatin (Lipitor)

Taking black cohosh with atorvastatin might increase the risk for elevated liver function tests.
In one case report, a patient taking atorvastatin (Lipitor) developed significantly elevated liver function enzymes after starting black cohosh 100 mg four times daily. Liver enzymes returned to normal when black cohosh was discontinued. It is unclear whether the elevated liver enzymes were due to black cohosh itself or an interaction between atorvastatin and black cohosh.

Likelihood Possible Evidence D
Cisplatin (Platinol-Aq)

Theoretically, black cohosh may reduce the clinical effects of cisplatin.
Animal research suggests that black cohosh might decrease the cytotoxic effect of cisplatin on breast cancer cells.

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

Some research suggests that black cohosh might inhibit CYP2D6, but there is conflicting evidence.
Some clinical research suggests that black cohosh might modestly inhibit CYP2D6 and increase levels of drugs metabolized by this enzyme. However, contradictory clinical research shows a specific black cohosh product (Remifemin, Enzymatic Therapy) 40 mg twice daily does not significantly inhibit metabolism of a CYP2D6 substrate in healthy study volunteers. Until more is known, use black cohosh cautiously in patients taking drugs metabolized by CYP2D6.

Likelihood Possible Evidence B
Estrogens

Theoretically, black cohosh may alter the effects of estrogen therapy.
Some research suggests that black cohosh has estrogenic effects. This may enhance or inhibit the effects of estrogen therapy.

Likelihood Possible Evidence D
Hepatotoxic Drugs

Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
There is concern that black cohosh might be linked to cases of liver failure and autoimmune hepatitis.

Likelihood Possible Evidence D
Serotonergic Drugs

Combining serotonergic drugs with black cohosh might cause additive serotonergic effects.
Black cohosh might increase the risk of serotonin syndrome when combined with other serotonergic drugs. Black cohosh acts as an agonist at several serotonin receptor subtypes and might interact with other serotonergic medications. In one case, a 55-year-old female who had been on stable treatment with sertraline 50 mg and duloxetine 60 mg daily developed serotonin syndrome after taking black cohosh extract 40 mg daily for 3 days.

Likelihood Possible Evidence D
Organic Anion-Transporting Polypeptide Substrates (Oatp)

Black cohosh may inhibit one form of OATP, OATP2B1, which could reduce the bioavailability and clinical effects of OATP2B1 substrates.
In vitro research shows that black cohosh modestly inhibits OATP2B1. OATPs are expressed in the small intestine and liver and are responsible for the uptake of drugs and other compounds into the body. Inhibition of OATP may reduce the bioavailability of oral drugs that are substrates of OATP.

Likelihood Possible Evidence D
Black Cohosh Root Extract full monograph & interactions

SaffSerene4 drug types · 521 drugs

Antidiabetes Drugs

Theoretically, concomitant use of saffron with antidiabetes drugs might increase the risk of hypoglycemia.
Some clinical research shows that taking saffron extract reduces fasting levels of glucose when used in addition to hypoglycemic agents. However, saffron powder itself has not been shown to reduce fasting glucose levels.

Likelihood Possible Evidence B
Antihypertensive Drugs

Theoretically, concomitant use of saffron with antihypertensive drugs might have additive effects.
Animal and human research suggests that saffron extract can decrease blood pressure.

Likelihood Possible Evidence D
Caffeine

Theoretically, saffron might inhibit the metabolism of caffeine.
A small clinical study suggests that taking saffron powder 300 mg in 150 mL water daily for 5 days and then taking caffeine 200 mg seems to reduce caffeine metabolite levels in the saliva and urine in males, but not females. Theoretically, this may be due to the inhibition of cytochrome P450 1A2 by saffron.

Likelihood Possible Evidence B
Cns Depressants

Theoretically, concomitant use of saffron and CNS depressants might have additive sedative effects.
Clinical research shows that taking saffron extract 60 mg orally daily for 26 weeks can cause drowsiness and sedation. Animal research suggests that adding saffron to hexobarbital further increases sleeping and slows motor activity.

Likelihood Possible Evidence D
SaffSerene full monograph & interactions

Cinnamon Bark Extract, Natural2 drug types · 442 drugs

Antidiabetes Drugs

Theoretically, cassia cinnamon may have additive effects with antidiabetes drugs.
Cassia cinnamon may lower blood glucose levels, and have additive effects in patients treated with antidiabetic agents. Dose adjustments to diabetes medications might be necessary.

Likelihood Possible Evidence B
Hepatotoxic Drugs

Theoretically, large doses of cassia cinnamon might cause additive effects when used with hepatotoxic drugs.
There is some concern that ingesting large amounts of cassia cinnamon for an extended duration might cause hepatotoxicity in some people. Cassia cinnamon contains coumarin, which can cause hepatotoxicity in animal models. In humans, very high doses of coumarin from 50-7000 mg/day can result in hepatotoxicity that resolves when coumarin use is discontinued. Lower amounts might also cause liver problems in sensitive people, such as those with liver disease or those taking potentially hepatotoxic agents.

Likelihood Possible Evidence D
Cinnamon Bark Extract, Natural full monograph & interactions

Evening Primrose Oil5 drug types · 233 drugs

Anticoagulant/Antiplatelet Drugs

Theoretically, evening primrose oil may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Evening primrose oil contains gamma linolenic acid (GLA). There is preliminary clinical evidence that GLA can reduce platelet aggregation and prolong bleeding time.

Likelihood Possible Evidence D
Lithium

Theoretically, concomitant use of lithium with evening primrose oil might decrease lithium levels and effects.
In a case report, a patient on a stable dose of lithium for 10 years experienced a reduction in lithium levels after taking evening primrose oil 500 mg daily. Baseline levels were 0.69 mmol/L, which decreased to 0.37 mmol/L after 2 months and 0.23 mmol/L after 3 months of use. Lithium levels increased within 6 weeks of discontinuing evening primrose oil, to 0.73 mmol/L; no clinical effects were noted.

Likelihood Possible Evidence D
Lopinavir/Ritonavir (Kaletra)

Theoretically, evening primrose oil might increase the levels and effects of lopinavir.
In a case report, an HIV patient who took evening primrose oil (Efamol) along with lopinavir/ritonavir experienced an increase in serum levels of lopinavir to 15.2 mg/L. Six weeks after discontinuing evening primrose oil, levels of lopinavir returned to the normal range of 5-10 mg/L. When re-challenged with evening primrose oil for a week, the patient's lopinavir levels increased from 6.69 to 8.11 mg/L. It is suspected that evening primrose oil increases levels of lopinavir by inhibiting cytochrome P450 3A4 (CYP3A4), which metabolizes lopinavir. However, this effect has not been reported in other research.

Likelihood Possible Evidence D
Phenothiazines

Theoretically, taking evening primrose oil with phenothiazines might increase the risk of convulsions.
Evening primrose oil contains gamma-linolenic acid (GLA). There is some concern that taking supplements containing GLA might cause seizures, or lower the seizure threshold, when taken with phenothiazines. In one report, three patients with schizophrenia who had received phenothiazines developed EEG changes suggestive of temporal lobe epilepsy after starting treatment with GLA, although none experienced an actual seizure. In another report, two patients with schizophrenia who were stabilized on phenothiazines developed seizures when evening primrose oil 4 grams daily was added. One of these patients had a prior history of seizures. It is unclear whether evening primrose oil had any additive epileptogenic effects with the phenothiazines; there is no evidence that taking evening primrose oil alone causes seizures.

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

Theoretically, evening primrose may increase the levels and clinical effects of CYP2C9 substrates.
In vitro research shows that linoleic acid, a constituent of evening primrose oil, inhibits CYP2C9.

Likelihood Possible Evidence D
Evening Primrose Oil full monograph & interactions

Sodium7 drug types · 205 drugs

Antihypertensive Drugs

Theoretically, a high intake of dietary sodium might reduce the effectiveness of antihypertensive drugs.
High intake of dietary sodium can increase systolic and diastolic blood pressure. Also, high intake of sodium may necessitate increased use of antihypertensive medications to achieve blood pressure control in some patients, such as those with chronic kidney disease.

Likelihood Probable Evidence A
Corticosteroids

Concomitant use of mineralocorticoids and some glucocorticoids with sodium supplements might increase the risk of hypernatremia.
Mineralocorticoids and some glucocorticoids (corticosteroids) cause sodium retention. This effect is dose-related and depends on mineralocorticoid potency. It is most common with hydrocortisone, cortisone, and fludrocortisone, followed by prednisone and prednisolone.

Likelihood Possible Evidence D
Didanosine (Videx)

Concomitant use of didanosine with additional sodium from dietary or supplemental sources may increase the risk of hypernatremia.
Didanosine formulations contain a significant amount of sodium.

Likelihood Probable Evidence C
Lithium

Altering dietary intake of sodium might alter the levels and clinical effects of lithium.
High sodium intake can reduce plasma concentrations of lithium by increasing lithium excretion. Reducing sodium intake can significantly increase plasma concentrations of lithium and cause lithium toxicity in patients being treated with lithium carbonate. Stabilizing sodium intake is shown to reduce the percentage of patients with lithium level fluctuations above 0.8 mEq/L. Patients taking lithium should avoid significant alterations in their dietary intake of sodium.

Likelihood Probable Evidence B
Sodium Phosphates

Theoretically, concomitant use of sodium phosphate with sodium supplements might increase the risk of hypernatremia.
Use of high doses (> 45 mL in 24 hours) of sodium phosphate, such as those used for bowel cleansing before surgery, can lead to serious electrolyte disturbances, including hypernatremia. The risk of hypernatremia is highest in the elderly and people with other risk factors for electrolyte disturbances.

Likelihood Possible Evidence D
Sodium-Containing Drugs

Concomitant use of sodium-containing drugs with additional sodium from dietary or supplemental sources may increase the risk of hypernatremia and long-term sodium-related complications.
The Chronic Disease Risk Reduction (CDRR) intake level of 2.3 grams of sodium daily indicates the intake at which it is believed that chronic disease risk increases for the apparently healthy population. Some medications contain high quantities of sodium. When used in conjunction with sodium supplements or high-sodium diets, the CDRR may be exceeded. Additionally, concomitant use may increase the risk for hypernatremia; this risk is highest in the elderly and people with other risk factors for electrolyte disturbances.

Likelihood Possible Evidence D
Tolvaptan (Samsca)

Theoretically, concomitant use of tolvaptan with sodium might increase the risk of hypernatremia.
Tolvaptan is a vasopressin receptor 2 antagonist that is used to increase sodium levels in patients with hyponatremia. Patients taking tolvaptan should use caution with the use of sodium salts such as sodium chloride.

Likelihood Probable Evidence C
Sodium full monograph & interactions

Dong Quai root extract3 drug types · 163 drugs

Warfarin (Coumadin)

Dong quai may increase the risk of bleeding when used with warfarin.
Case reports suggest that concomitant use of dong quai with warfarin can increase the anticoagulant effects of warfarin and increase the risk of bleeding. In one case, after 4 weeks of taking dong quai 565 mg once or twice daily, the international normalized ratio (INR) increased to 4.9. The INR normalized 4 weeks after discontinuation of dong quai.

Likelihood Probable Evidence D
Anticoagulant/Antiplatelet Drugs

Theoretically, dong quai may increase the risk of bleeding when used with anticoagulant or antiplatelet drugs; however, research is conflicting.
Animal studies suggest that dong quai has antithrombin activity and inhibits platelet aggregation due to its coumarin components. Additionally, some case reports in humans suggest that dong quai can increase the anticoagulant effects of warfarin. However, clinical research in healthy adults shows that taking 1 gram of dong quai root daily for 3 weeks does not significantly inhibit platelet aggregation or cause bleeding. Until more is known, use dong quai with caution in patients taking antiplatelet/anticoagulant drugs.

Likelihood Possible Evidence D
Estrogens

Theoretically, dong quai may reduce the effects of estrogens.
Dong quai has estrogenic effects. Theoretically, concomitant use of large amounts of dong quai might interfere with hormone replacement therapy due to competition for estrogen receptors.

Likelihood Possible Evidence D
Dong Quai root extract full monograph & interactions

Wild Yam Extract1 drug type · 41 drugs

Estrogens

Theoretically, wild yam might increase or decrease the effects of estrogen.
Wild yam root shows estrogenic and anti-estrogenic effects in vitro. Theoretically, wild yam might interfere with hormone therapy.

Likelihood Possible Evidence D
Wild Yam Extract full monograph & interactions
The maker

Brand information

Manufacturer and brand details for Rhythm Chocolate Ginger Snap Flavor, from the product label.

The Functional Chocolate Company

See all The Functional Chocolate Company products
Name
The Functional Chocolate Company, LLC
City
Evergreen
State
CO
ZipCode
80439
Phone Number
833-438-6246
Web Address
www.funcho.co
Pharmacist Counseling Corner

Rhythm Chocolate Ginger Snap Flavor by The Functional Chocolate Company: Common Questions

Does Rhythm Chocolate Ginger Snap Flavor by The Functional Chocolate Company interact with any medications?
Yes. Based on its ingredients, Rhythm Chocolate Ginger Snap Flavor has a known interaction with 2,207 medications, including 2 rated major. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Rhythm Chocolate Ginger Snap Flavor contains 18 active ingredients, and an interaction can come from any of them. We check every ingredient, combine the results into one list per medication, and show which ingredient and mechanism is responsible.
Where does this information come from?
The product label data comes from the NIH Dietary Supplement Label Database (DSLD); the interaction data is built on the Natural Medicines database and reviewed by HelloPharmacist pharmacists.
Can I take this if I'm on blood thinners like warfarin?
No — not without checking with your pharmacist or doctor first. Dong quai and ginger both interact with warfarin and increase bleeding risk. This is a Major interaction for dong quai and Moderate for ginger, so it's important to verify your specific medications before taking this product.
Is this safe during pregnancy?
The safety data advises against most of these ingredients during pregnancy — Wild Yam, Maca, Cramp Bark, Black Cohosh, Evening Primrose Oil, Dong Quai, and Saffron all have insufficient data or recommendations to avoid. Although ginger is often used for morning sickness, keep amounts moderate and check with your doctor first. Talk with your pharmacist or doctor for personalized advice.
What's the ginger in this for?
Ginger is possibly effective for pregnancy-related nausea, period pain, and osteoarthritis pain. The amount in a chocolate bar is a food-level dose, which is generally well tolerated, though higher doses can cause heartburn or digestive upset.
Does Black Cohosh really help with hot flashes?
Black Cohosh is rated possibly effective for menopausal symptoms like hot flashes — that's the strongest evidence we have for any ingredient in this bar. It's generally well tolerated short-term, though long-term safety hasn't been as thoroughly studied.
Can I take this with my diabetes medication?
Check with your pharmacist first. Ginger, Saffron, and Cinnamon all have documented interactions with antidiabetes drugs and may theoretically increase the risk of low blood sugar. Your doctor may need to adjust your dose if you use this product regularly.
What are the common side effects?
Most people tolerate these ingredients well. Mild side effects that have been reported include heartburn, diarrhea, nausea, headache, and dizziness — usually at higher doses or with extended use. Serious side effects are rare. If you notice any unusual symptoms, stop use and talk to your pharmacist.

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

Not sure if Rhythm Chocolate Ginger Snap Flavor is safe with your meds?

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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.

Rhythm Chocolate Ginger Snap Flavor label
Go deeper

The Full Monographs Behind Rhythm Chocolate Ginger Snap Flavor’s Ingredients

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

Herb & supplement monograph

Sodium

Interacts with 205 drugs

Sodium is an essential mineral and electrolyte your body needs to balance fluids, support nerves, and help muscles work. Most people in modern diets get more than enough—often too much—from...

Read the full Sodium monograph → Herb & supplement monograph

Black Psyllium

Interacts with 2,025 drugs

Black psyllium is a soluble-fiber supplement made from the seeds of a Plantago plant, used mostly to ease constipation and support digestive health. It is best known and most studied for rel...

Read the full Black Psyllium monograph → Herb & supplement monograph

Wild Yam

Interacts with 41 drugs

Wild yam is a root traditionally used for menopausal symptoms, cramps, and as a so-called 'natural' hormone supplement, but solid human evidence for these uses is lacking. Despite popular cl...

Read the full Wild Yam monograph → Herb & supplement monograph

Dong Quai

Interacts with 163 drugs

Dong Quai is a traditional Chinese herb often called "female ginseng" and is mostly used for menstrual and menopausal complaints. High-quality scientific evidence that it works for these use...

Read the full Dong Quai monograph → Herb & supplement monograph

Maca

Maca is a nutrient-rich Andean root often used for energy, libido, and menopause symptoms. Early studies suggest it may modestly help sexual desire and some menopause symptoms, but the evide...

Read the full Maca monograph → Herb & supplement monograph

Cramp Bark

Cramp Bark is the dried bark of Viburnum opulus, traditionally used to ease muscle and menstrual cramps. Modern, high-quality human studies are very limited, so its effectiveness is not well...

Read the full Cramp Bark monograph → Herb & supplement monograph

Black Cohosh

Interacts with 652 drugs

Black cohosh is a North American plant most often used to ease menopause symptoms like hot flashes, but the research is mixed and far from settled. It is generally well tolerated for short-t...

Read the full Black Cohosh monograph → Herb & supplement monograph

Evening Primrose

Interacts with 233 drugs

Evening primrose oil is a seed oil rich in gamma-linolenic acid (GLA), an omega-6 fatty acid, that is popularly used for skin conditions, PMS, and breast pain. The evidence behind most of th...

Read the full Evening Primrose monograph → Herb & supplement monograph

Vanilla

Vanilla is best known and very safe as a food flavoring, and small amounts used in cooking are not a concern for most people. As a health supplement, evidence for any specific medical benefi...

Read the full Vanilla monograph → Herb & supplement monograph

Ginger

Interacts with 1,007 drugs

Ginger is a widely used culinary spice with a long history in traditional medicine, and it has the strongest evidence for helping with nausea and vomiting, including from motion sickness, pr...

Read the full Ginger monograph → Herb & supplement monograph

Saffron

Interacts with 521 drugs

Saffron is a costly spice that has shown promise in early studies for mild-to-moderate depression and some mood and PMS symptoms, but most research uses small trials, so results are not defi...

Read the full Saffron monograph → Herb & supplement monograph

Cassia Cinnamon

Interacts with 442 drugs

Cassia cinnamon is the common, inexpensive cinnamon used in cooking, and it is also taken as a supplement, most often for blood sugar support. The evidence for its health benefits is mixed a...

Read the full Cassia Cinnamon monograph →
Sources

Sources & How We Checked

Rhythm Chocolate Ginger Snap Flavor'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 295 references behind this product’s interaction data

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

Sodium 38 references
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  5. Frings-Meuthen P, Baecker N, Heer M. Low-grade metabolic acidosis may be the cause of sodium chloride-induced exaggerated bone resorption. J Bone Miner Res 2008;23(4):517-524. PubMed
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  12. Goldsmith SR. Hyponatremia in heart failure: time for a trial. J Card Fail 2013;19(6):398-400. PubMed
  13. Willocks L, Brettle R, Keen J, Valentine C, Pinching AJ. Formulations of didanosine (ddI) and salt overload. Lancet 1992;339(8786):190.
  14. Chen L, Zhang Z, Chen W, Whelton PK, Appel LJ. Lower Sodium Intake and Risk of Headaches: Results From the Trial of Nonpharmacologic Interventions in the Elderly. Am J Public Health. 2016;106(7):1270-5. PubMed
  15. Cook NR, Appel LJ, Whelton PK. Lower levels of sodium intake and reduced cardiovascular risk. Circulation. 2014;129(9):981-9. PubMed
  16. Cook NR, Appel LJ, Whelton PK. Sodium Intake and All-Cause Mortality Over 20 Years in the Trials of Hypertension Prevention. J Am Coll Cardiol. 2016;68(15):1609-1617. PubMed
  17. Mente A, O'Donnell M, Rangarajan S, et al. Associations of urinary sodium excretion with cardiovascular events in individuals with and without hypertension: a pooled analysis of data from four studies. Lancet. 2016;388(10043):465-75. PubMed
  18. Moosavian SP, Haghighatdoost F, Surkan PJ, Azadbakht L. Salt and obesity: a systematic review and meta-analysis of observational studies. Int J Food Sci Nutr. 2017;68(3):265-277. PubMed
  19. O'Donnell M, Mente A, Rangarajan S, et al. Urinary sodium and potassium excretion, mortality, and cardiovascular events. N Engl J Med. 2014;371(7):612-23. DOI
  20. Poggio R, Gutierrez L, Matta MG, Elorriaga N, Irazola V, Rubinstein A. Daily sodium consumption and CVD mortality in the general population: systematic review and meta-analysis of prospective studies. Public Health Nutr. 2015;18(4):695-704. PubMed
  21. Stallings VA, Harrison M, Oria M; Committee to Review the Dietary Reference Intakes for Sodium and Potassium, Food and Nutrition Board, Health and Medicine Division, National Academies of Sciences, Engineering, and Medicine. Washington (DC): National Acad
  22. Mahtani KR, Heneghan C, Onakpoya I, et al. Reduced Salt Intake for Heart Failure: A Systematic Review. JAMA Intern Med. 2018 Dec 1;178(12):1693-1700. PubMed
  23. Yancy CW. Sodium Restriction in Heart Failure: Too Much Uncertainty-Do the Trials. JAMA Intern Med. 2018 Dec 1;178(12):1700-1701. PubMed
  24. He FJ, Campbell NRC, Ma Y, MacGregor GA, Cogswell ME, Cook NR. Errors in estimating usual sodium intake by the Kawasaki formula alter its relationship with mortality: implications for public health. Int J Epidemiol. 2018;47(6):1784-1795. PubMed
  25. Murthy K, Ondrey GJ, Malkani N, et al. THE EFFECTS OF HYPONATREMIA ON BONE DENSITY AND FRACTURES: A SYSTEMATIC REVIEW AND META-ANALYSIS. Endocr Pract. 2019;25(4):366-378. PubMed
  26. Messerli FH, Hofstetter L, Syrogiannouli L, et al. Sodium intake, life expectancy, and all-cause mortality. Eur Heart J 2021;42(21):2103-2112. PubMed
  27. Graudal NA, Hubeck-Graudal T, Jurgens G. Effects of low sodium diet versus high sodium diet on blood pressure, renin, aldosterone, catecholamines, cholesterol, and triglyceride. Cochrane Database Syst Rev 2020;12(12):CD004022. PubMed
  28. Giatti S, Santos RB, Aielo AN, et al. Association of sodium with obstructive sleep apnea. The ELSA-Brasil study. Ann Am Thorac Soc 2021;18(3):502-510. PubMed
  29. Nan X, Lu H, Wu J, et al. The interactive association between sodium intake, alcohol consumption and hypertension among elderly in northern China: a cross-sectional study. BMC Geriatr 2021;21(1):135. PubMed
  30. Kyozuka H, Fukusda T, Murata T, et al. Impact of preconception sodium intake on hypertensive disorders of pregnancy: The Japan Environment and Children's study. Pregnancy Hypertens 2021;23:66-72. PubMed
  31. Zhao L, Ogden CL, Yang Q, et al. Association of usual sodium intake with obesity among US children and adolescents, NHANES 2009-2016. Obesity (Silver Spring) 2021;29(3):587-594. PubMed
  32. Ma Y, He FJ, Sun Q, et al. 24-Hour urinary sodium and potassium excretion and cardiovascular risk. N Engl J Med 2022;386(3):252-263. PubMed
  33. Liu J, Yang X, Zhang P, et al. Association of urinary sodium excretion and left ventricular hypertrophy in people with type 2 diabetes mellitus: A cross-sectional study. Front Endocrinol (Lausanne) 2021;12:728493. PubMed
  34. Filippini T, Malavolti M, Whelton PK, Vinceti M. Sodium intake and risk of hypertension: A systematic review and dose-response meta-analysis of observational cohort studies. Curr Hypertens Rep 2022;24(5):133-144. PubMed
  35. Wang DD, Li Y, Nguyen XT, et al. Dietary sodium and potassium intake and risk of non-fatal cardiovascular diseases: The million veteran program. Nutrients 2022;14(5):1121. PubMed
  36. Kwak JH, Park CH, Eun CS, et al. The associations of dietary intake of high sodium and low zinc with gastric cancer mortality: A prospective cohort study in Korea. Nutr Cancer 2022;74(10):3501-3508. PubMed
  37. George S, Maiti R, Mishra BR, Jena M, Mohapatra D. Effect of regulated add-on sodium chloride intake on stabilization of serum lithium concentration in bipolar disorder: A randomized controlled trial. Bipolar Disord 2023;25(1):66-75. PubMed
  38. Zhou TL, Schütten MTJ, Kroon AA, et al. Urinary Sodium Excretion and Salt Intake Are Not Associated With Blood Pressure Variability in a White General Population. J Am Heart Assoc 2023;12(1):e026578. PubMed

See these in context on the Sodium monograph →

Black Psyllium 18 references
  1. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
  2. Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.
  3. Covington TR, et al. Handbook of Nonprescription Drugs. 11th ed. Washington, DC: American Pharmaceutical Association, 1996.
  4. Etman M. Effect of a bulk forming laxative on the bioavailablility of carbamazepine in man. Drug Dev Ind Pharm 1995;21:1901-6.
  5. Perlman BB. Interaction between lithium salts and ispaghula husk. Lancet 1990;335:416.
  6. Vaswani SK, Hamilton RG, Valentine MD, Adkinson NF. Psyllium laxative-induced anaphylaxis, asthma, and rhinitis. Allergy 1996;51:266-8. PubMed
  7. Lantner RR, Espiritu BR, Zumerchik P, Tobin MC. Anaphylaxis following ingestion of a psyllium-containing cereal. JAMA 1990;264:2534-6. DOI
  8. Kaplan MJ. Anaphylactic reaction to "Heartwise." N Engl J Med 1990;323:1072-3. DOI
  9. Nordstrom M, Melander A, Robertsson E, Steen B. Influence of wheat bran and of a bulk-forming ispaghula cathartic on the bioavailability of digoxin in geriatric in-patients. Drug Nutr Interact 1987;5:67-9..
  10. Robinson DS, Benjamin DM, McCormack JJ. Interaction of warfarin and nonsystemic gastrointestinal drugs. Clin Pharmacol Ther 1971;12:491-5. PubMed
  11. Garcia JJ, Fernandez N, Diez MJ, et al. Influence of two dietary fibers in the oral bioavailability and other pharmacokinetic parameters of ethinyloestradiol. Contraception 2000;62:253-7. PubMed
  12. Fernandez N, Lopez C, Díez R, et al. Drug interactions with the dietary fiber Plantago ovata husk. Expert Opin Drug Metab Toxicol 2012;8(11):1377-86.
  13. Semen plantaginis in: WHO Monographs on Selected Medicinal Plants, volume 1. World Health Organization, Geneva, 1999. Available at http://apps.who.int/medicinedocs/en/d/Js2200e/. Accessed November 26, 1026.
  14. Code of Federal Regulations, Title 21 (21CFR 101.17). Food labeling warning, notice, and safe handling statements. Available at www.ecfr.gov/cgi-bin/text-idx?SID=20f647d3b74161501f46564b915b4048&mc=true&node=se21.2.101_117&rgn=div8. Accessed December 3, 2
  15. Code of Federal Regulations, Title 21 (21CFR 201.319). Specific labeling requirements - water-soluble gums, hydrophilic gums, and hydrophilic mucilloids. Available at www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?fr=201.319. Accessed Dece
  16. Diez R, Garcia JJ, Diez MJ, Sierra M, Sahagun AM, Fernandez N. Influence of Plantago ovata husk (dietary fiber) on the bioavailability and other pharmacokinetic parameters of metformin in diabetic rabbits. BMC Complement Altern Med. 2017 Jun 7;17(1):298. PubMed
  17. Chiu AC, Sherman SI. Effects of pharmacological fiber supplements on levothyroxine absorption. Thyroid. 1998;8(8):667-71. PubMed
  18. Merrick C, Madden CA, Capurso NA. A Case of Blunted Orally Disintegrating Olanzapine Effect Due to Coadministered Psyllium. J Clin Psychiatry 2021;82(2):20cr13633. PubMed

See these in context on the Black Psyllium monograph →

Wild Yam 7 references
  1. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
  2. Eagon PK, Elm MS, Hunter DS, et al. Medicinal herbs: modulation of estrogen action. Era of Hope Mtg, Dept Defense; Breast Cancer Res Prog, Atlanta, GA 2000;Jun 8-11.
  3. Cheong JL, Bucknall R. Retinal vein thrombosis associated with a herbal phytoestrogen preparation in a susceptible patient. Postgrad Med J 2005;81:266-7.. PubMed
  4. Rosenberg Zand, R. S., Jenkins, D. J., and Diamandis, E. P. Effects of natural products and nutraceuticals on steroid hormone-regulated gene expression. Clin Chim.Acta 2001;312(1-2):213-219. PubMed
  5. Araghiniknam M, Chung S, Nelson-White T, and et al. Antioxidant activity of Dioscorea and dehydroepiandrosterone (DHEA) in older humans. Life Sciences 1996;59:L147-L157.
  6. Zeng M, Zhang L, Li M, et al. Estrogenic effects of the extracts from the Chinese Yam (Dioscorea opposite Thunb.) and its effective compounds in vitro and in vivo. Molecules. 2018 Jan 23;23(2). Pii: E11. PubMed
  7. Lu J, Wong RN, Zhang L, et al. Comparative analysis of proteins with stimulating activity on ovarian estradiol biosynthesis from four different Dioscorea species in vitro using both phenotypic and target-based approaches: implication for treating menopaus

See these in context on the Wild Yam monograph →

Dong Quai 19 references
  1. Hirata JD, Swiersz LM, Zell B, et al. Does dong quai have estrogenic effects in postmenopausal women? A double-blind, placebo-controlled trial. Fertil Steril 1997;68:981-6. PubMed
  2. Page RL II, Lawrence JD. Potentiation of warfarin by dong quai. Pharmacotherapy 1999;19:870-6. PubMed
  3. Heck AM, DeWitt BA, Lukes AL. Potential interactions between alternative therapies and warfarin. Am J Health Syst Pharm 2000;57:1221-7. DOI
  4. Eagon PK, Elm MS, Hunter DS, et al. Medicinal herbs: modulation of estrogen action. Era of Hope Mtg, Dept Defense; Breast Cancer Res Prog, Atlanta, GA 2000;Jun 8-11.
  5. Dr. Duke's Phytochemical and Ethnobotanical Databases. Available at: http://www.ars-grin.gov/duke/.
  6. Amato P, Christophe S, Mellon PL. Estrogenic activity of herbs commonly used as remedies for menopausal symptoms. Menopause 2002;9:145-50. PubMed
  7. Shi M, Chang L, He G. [Stimulating action of Carthamus tinctorius L., Angelica sinensis (Oliv.) Diels and Leonurus sibiricus L. on the uterus]. Zhongguo Zhong Yao Za Zhi 1995;20:173-5, 192.
  8. Hoult JR, Paya M. Pharmacological and biochemical actions of simple coumarins: natural products with therapeutic potential. Gen Pharmacol 1996;27:713-22.. PubMed
  9. Cheong JL, Bucknall R. Retinal vein thrombosis associated with a herbal phytoestrogen preparation in a susceptible patient. Postgrad Med J 2005;81:266-7.. PubMed
  10. Chang CJ, Chiu JH, Tseng LM, et al. Modulation of HER2 expression by ferulic acid on human breast cancer MCF7 cells. Eur J Clin Invest 2006;36:588-96. PubMed
  11. Chuang CH, Doyle P, Wang JD, et al. Herbal medicines used during the first trimester and major congenital malformations: an analysis of data from a pregnancy cohort study. Drug Saf 2006;29:537-48. PubMed
  12. Lau CBS, Ho TCY, Chan TWL, Kim SCF. Use of dong quai (Angelica sinensis) to treat peri- and postmenopausal symptoms in women with breast cancer: is it appropriate? Menopause 2005;12:734-40.
  13. Ellis GR, Stephens MR. Untitled (photograph and a brief case report). BMJ 1999;319:650.
  14. Nambiar, S., Schwartz, R. H., and Constantino, A. Hypertension in mother and baby linked to ingestion of Chinese herbal medicine. West J Med 1999;171(3):152.
  15. Lee, S. K., Cho, H. K., Cho, S. H., Kim, S. S., Nahm, D. H., and Park, H. S. Occupational asthma and rhinitis caused by multiple herbal agents in a pharmacist. Ann.Allergy Asthma Immunol. 2001;86(4):469-474. PubMed
  16. Xu, J. and Li, G. [Observation on short-term effects of Angelica injection on chronic obstructive pulmonary disease patients with pulmonary hypertension]. Zhongguo Zhong Xi Yi Jie He Za Zhi 2000;20(3):187-189.
  17. Scott, G. N. and Elmer, G. W. Update on natural product--drug interactions. Am J Health Syst.Pharm 2-15-2002;59(4):339-347. PubMed
  18. Circosta, C., Pasquale, R. D., Palumbo, D. R., Samperi, S., and Occhiuto, F. Estrogenic activity of standardized extract of Angelica sinensis. Phytother.Res. 2006;20(8):665-669.
  19. Fung FY, Wong WH, Ang SK, et al. A randomized, double-blind, placebo- controlled study on the anti-haemostatic effects of Curcuma longa, Angelica sinensis and Panax ginseng. Phytomedicine. 2017;32:88-96. PubMed

See these in context on the Dong Quai monograph →

Maca 1 reference
  1. Valerio, L. G., Jr. and Gonzales, G. F. Toxicological aspects of the South American herbs cat's claw (Uncaria tomentosa) and Maca (Lepidium meyenii) : a critical synopsis. Toxicol.Rev 2005;24(1):11-35. PubMed

See these in context on the Maca monograph →

Black Cohosh 68 references
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See these in context on the Ginger monograph →

Saffron 22 references
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Cassia Cinnamon 20 references
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Parts of this content are provided by the Therapeutic Research Center, LLC.

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

© 2021 Therapeutic Research Center, LLC

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