RNA Spray Ingredients & Drug Interactions
What is this page for?
First and foremost: checking RNA Spray 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
RNA Spray is a dietary supplement by Complete Ascentials with 36 active ingredients. Its ingredients are commonly taken for common cold and immune support, antioxidant support, skin health and collagen formation.Based on those ingredients, 1,429 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are Siberian Ginseng, Chinese Red Ginseng, Guarana. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against RNA Spray by Complete Ascentials
Ask about any prescription or over-the-counter medication and we check it for interactions with RNA Spray by Complete Ascentials — and tell you which ingredient is responsible.
AI summaries are generated from our interaction database for education only — always confirm with your pharmacist. How we use AI
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HelloPharmacist Scorecard of RNA Spray by Complete Ascentials
Our pharmacy team’s full take, with four database checks built into the cards below — a summary of what is known, not a grade of the product itself.
What’s inside
Low disclosure
RNA Spray contains 36 ingredients, many of which are proprietary or difficult to verify. The active ingredients we can identify include vitamin C (ascorbic acid), boron, American ginseng, germanium, indium, progesterone, and fulvic acid.
Beyond these, the product lists Korean ginseng, human growth hormone, colostrum, fatty acids, and a range of minerals and substances with names like "Earth Magnetic," "Cosmic Ray," and "DNA/RNA" that we cannot evaluate from available data. The remaining ingredients are inactive excipients: alcohol, glycerin, and purified water.
Does it work?
Couldn't assess
Vitamin C in this product is effective for vitamin C deficiency and possibly effective for anemia of chronic disease, atrial fibrillation, cataracts, and exercise-induced respiratory infections. Boron is likely effective for boron deficiency and possibly effective for vaginal yeast infections and radiation dermatitis.
American ginseng is possibly effective for upper respiratory tract infections but has insufficient evidence for anemia of chronic disease or breast cancer. For fulvic acid, germanium, indium, and progesterone, the data shows insufficient evidence or no established effectiveness for the conditions listed.
Many of the other 21 ingredients in this formula—including Korean ginseng, human growth hormone, serotonin, dopamine, and the proprietary blends—we cannot assess because interaction or effectiveness data is not on file for them.
How safe is it?
Well-documented data
Vitamin C is generally well tolerated at normal supplement doses but can cause abdominal cramps, heartburn, diarrhea, nausea, and headache—especially above 2 grams daily. Kidney stones may occur in those prone to them.
Boron is generally safe at doses below 20 mg daily but can cause skin problems and digestion issues at higher doses; high amounts are toxic. American ginseng is generally well tolerated short-term but may cause headache, and long-term safety isn't well studied.
Fulvic acid appears generally tolerated but can cause diarrhea, headache, and sore throat. Germanium and indium carry serious safety concerns: germanium has caused kidney failure and death in more than 30 cases and should be avoided; indium lacks reliable safety data in humans.
Progesterone is a hormone and should only be used under medical supervision—common side effects include breast tenderness, mood changes, and fluid retention. During pregnancy, vitamin C at normal amounts is considered safe, but boron, American ginseng, germanium, indium, and progesterone should be avoided.
During breastfeeding, boron, American ginseng, fulvic acid, germanium, and indium should be avoided.
Meds to double-check
Major interaction found
Before taking this product, double-check if you use warfarin or other blood thinners (anticoagulants or antiplatelet drugs)—American ginseng and fulvic acid can reduce their effectiveness. Estrogen-based birth control and hormone therapy may be affected by vitamin C.
Chemotherapy drugs (alkylating agents and antitumor antibiotics), thyroid medication (levothyroxine and other thyroid hormones), and immunosuppressants all interact moderately with ingredients here. Antidiabetes drugs and older antidepressants (MAOIs) may also be affected.
The bottom line
Scorecard at a glanceFormula with limited ingredient disclosure with no assessable stated purpose. Major medication interactions have been identified, and safety information is well characterized.
This product contains many ingredients we cannot fully evaluate, alongside several with documented interactions with common medications and serious safety concerns (germanium and indium especially). If you take warfarin, estrogen, thyroid medication, chemotherapy, immunosuppressants, or antidiabetes drugs, you need to check your specific medications with the tool on this page before using it.
Talk with your pharmacist or doctor—this product is not appropriate for everyone, and personalized advice matters.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 11 of 36 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Apr 23, 2020.
This Scorecard evaluates available label information, ingredient evidence, and known medication-safety considerations. It does not independently verify product identity, purity, potency, contamination, or manufacturing quality. How these ratings are computed
General information
Key facts about RNA Spray, straight from the product label.
| Brand | Complete Ascentials |
|---|---|
| Net contents | 1 Ounce(s) |
| Market status | On market |
| Date entered into DSLD | Apr 23, 2020 |
| DSLD ID | 214584 |
| Product type | Other Combinations |
| Supplement form | Liquid |
| Dietary claims / uses | All Other |
| Intended target group(s) | Adult (18 - 50 Years) |
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 RNA Spray by Complete Ascentials, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Ascorbic Acid | 0 NP | -- |
| Boron | 0 NP | -- |
| Korean Ginseng | 0 NP | -- |
| American Ginseng | 0 NP | -- |
| Germanium | 0 NP | -- |
| Indium | 0 NP | -- |
| Minerals | 0 NP | -- |
| Progesterone | 0 NP | -- |
| Human Growth Hormone | 0 NP | -- |
| Chinese Red Ginseng | 0 NP | -- |
| Homeopathic Nano-Dilurtion Proprietary Blend | 0 NP | -- |
| 12 Cell Minerals | 0 NP | -- |
| Fatty Acids | 0 NP | -- |
| Colostrum | 0 NP | -- |
| Sequoia giganticus | 0 NP | -- |
| Seratonin | 0 NP | -- |
| Dopamine | 0 NP | -- |
| Fulvic Acid | 0 NP | -- |
| Earth Magnetic | 0 NP | -- |
| Cosmic Ray | 0 NP | -- |
| DNA/RNA | 0 NP | -- |
| APT | 0 NP | -- |
| IGF-1 | 0 NP | -- |
| All B USP Vitamins | 0 NP | -- |
| Gold | 0 NP | -- |
| Silver | 0 NP | -- |
| C.A. WXXX | 0 NP | -- |
| Gem Stones | 0 NP | -- |
| Fruits | 0 NP | -- |
| Leptin | 0 NP | -- |
| Spirulina/Chlorella | 0 NP | -- |
| Endorphins | 0 NP | -- |
| L-Gulonolactone Oxidase | 0 NP | -- |
| Ginsengs | 0 NP | -- |
| Siberian Ginseng | 0 NP | -- |
| Apple Cider Vinegar | 0 NP | -- |
| Guarana | 0 NP | -- |
| Trace Minerals | 0 NP | -- |
| Cervical | 0 NP | -- |
Other ingredients: Alcohol, Glycerin, purified Water
Tap any ingredient to jump to its full detail below.
These statements are the manufacturer’s wording, reproduced from the product label — the label is saying it, not HelloPharmacist. We don’t verify or endorse them.
Formulation
RNA Spray is a breakthrough innovation designed to support ascension and well-being.
Homeopathic proprietary blend
Suggested/Recommended/Usage/Directions
Directions: 3-5 sprays in mouth, 3 times per day, on an empty stomach (30 minutes between food or drink.) Use 5 days per week, take 2 days off. Repeat this schedule.
Precautions
Caution: Consult with your health care professional prior to use.
Warning: If pregnant or nursing, consult a physician before using.
General Statements
Visit our website www.CompleteAscentials.com
Seals/Symbols
Made in the USA
GMP Good manufacturing practice Consistent quality
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
RNA Spray by Complete Ascentials label
The label scan from the NIH Dietary Supplement Label Database. Tap to enlarge.
Label images are published by the NIH Dietary Supplement Label Database for the version of this product on file. Always read your actual product label.
View the full label (PDF)The Ingredients in RNA Spray by Complete Ascentials
These are the 36 active ingredients this product is made of. Select any to open its full monograph.
Serving size3 Spray(s) Dosage formLiquid 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.
Ascorbic Acid
Interacts with207 drugs
Vitamin C (ascorbic acid) is an essential nutrient your body needs but cannot make, so you must get it from food or supplements. It's important for im...
Ascorbic Acid monograph & interactionsBoron
No knowninteractions
Boron is a trace mineral found in many plant foods and sold as a supplement, mainly promoted for bone, joint, and hormone health. The human evidence f...
Boron monograph & interactionsMinerals
- › Trace Minerals
Homeopathic Nano-Dilurtion Proprietary Blend
- › Germanium
- › Indium
- › Progesterone
- › Human Growth Hormone
- › 12 Cell Minerals
- › Fatty Acids
- › Colostrum
- › Sequoia giganticus
- › Seratonin
- › Dopamine
- › Fulvic Acid
- › Earth Magnetic
- › Cosmic Ray
- › DNA/RNA
- › APT
- › IGF-1
- › All B USP Vitamins
- › Gold
- › Silver
- › C.A. WXXX
- › Gem Stones
- › Fruits
- › Leptin
- › Spirulina/Chlorella
- › Endorphins
- › L-Gulonolactone Oxidase
Ginsengs
- › Korean Ginseng
- › American Ginseng
- › Chinese Red Ginseng
- › Siberian Ginseng
Apple Cider Vinegar
Interacts with162 drugs
Apple cider vinegar is a fermented apple product that many people use hoping to help with blood sugar, weight, or digestion. The evidence for most of...
Apple Cider Vinegar monograph & interactionsGuarana
Interacts with655 drugs
Guarana is an Amazonian seed that is naturally high in caffeine, which explains most of its stimulant and energy effects. While it may give a short-te...
Guarana monograph & interactionsCervical
Other (inactive) ingredients: Alcohol, Glycerin, Purified Water. These complete the product’s ingredient list but are not active constituents.
RNA Spray by Complete Ascentials Drug Interactions
HelloPharmacist Interaction Report
RNA Spray by Complete Ascentials contains several ingredients with documented interactions with medications.
The most serious concern is American ginseng, which significantly reduces the effectiveness of warfarin (a blood thinner used to prevent clots). Vitamin C in this product may moderately interact with estrogens (found in birth control pills and hormone therapy), potentially increasing estrogen levels, and with warfarin at high doses, reducing its effectiveness.
Vitamin C also interacts moderately with chemotherapy drugs (alkylating agents and antitumor antibiotics), levothyroxine (thyroid medication), and several other drugs including indinavir, fluphenazine, and aluminum-containing products.
Read the full breakdown — every affected drug type, severity by severity
American ginseng carries moderate-severity interactions with immunosuppressants, antidiabetes drugs, and monoamine oxidase inhibitors (MAOIs, older antidepressants). Fulvic acid may moderately interfere with blood thinners (anticoagulants and antiplatelet drugs), immunosuppressants, and thyroid hormone therapy.
Progesterone in this product carries a minor interaction with paclitaxel (a chemotherapy drug) and a moderate one with estrogens.
Several ingredients in this product we could not check for interactions: Korean ginseng, human growth hormone, Chinese red ginseng, the proprietary homeopathic blend, 12 cell minerals, fatty acids, colostrum, Sequoia giganteus, serotonin, dopamine, earth magnetic, cosmic ray, DNA/RNA, APT, IGF-1, B vitamins, and gold. Altogether, these interactions span 1,374 individual medications.
Please use the search tool below to check your exact medications before starting this product.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against RNA Spray?
Ask about interactions with your drugs in plain English — “Can I take it with lisinopril?” — and we find you the answer in seconds, ingredient by ingredient.
Go to the checkerIngredients driving the most interactions
Individual Drug Interactions
The ingredients in RNA Spray interact with 1,429 drugs. Click any drug to see the details.
8 of the 36 ingredients in RNA Spray interact with drugs. Each result below shows which ingredient is responsible. Siberian Ginseng Chinese Red Ginseng Guarana Fulvic Acid American Ginseng Ascorbic Acid Apple Cider Vinegar Progesterone
Aminophylline, Amobarbital, EphedrineAmesec
How Aminophylline, Amobarbital, Ephedrine interacts with RNA Spray — through 2 ingredients. Tap an ingredient for the detail:
GuaranaStimulant Drugs, Ephedrine Major
Interaction Summary
Theoretically, concomitant use might increase stimulant adverse effects.
Read the full Guarana + Aminophylline, Amobarbital, Ephedrine interactionChinese Red GinsengStimulant Drugs Moderate
Interaction Summary
Theoretically, taking Panax ginseng with stimulant drugs might increase the risk of adverse stimulant effects.
Read the full Chinese Red Ginseng + Aminophylline, Amobarbital, Ephedrine interactionCarbetapentane Tannate, Chlorpheniramine Tannate, Ephedrine Tannate, Phenylephrine TannateQuadratuss, Ry Tuss, Rynatuss, Tri Tannate Plus
How Carbetapentane Tannate, Chlorpheniramine Tannate, Ephedrine Tannate, Phenylephrine Tannate interacts with RNA Spray — through 3 ingredients. Tap an ingredient for the detail:
GuaranaEphedrine, Stimulant Drugs Major
Interaction Summary
Theoretically, concomitant use might increase the risk for stimulant adverse effects.
Read the full Guarana + Carbetapentane Tannate, Chlorpheniramine Tannate, Ephedrine Tannate, Phenylephrine Tannate interactionChinese Red GinsengCytochrome P450 3a4 (cyp3a4) Substrates, Stimulant Drugs Moderate
Interaction Summary
Theoretically, Panax ginseng might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full Chinese Red Ginseng + Carbetapentane Tannate, Chlorpheniramine Tannate, Ephedrine Tannate, Phenylephrine Tannate interactionSiberian GinsengCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, eleuthero might increase levels of drugs metabolized by CYP3A4.
Read the full Siberian Ginseng + Carbetapentane Tannate, Chlorpheniramine Tannate, Ephedrine Tannate, Phenylephrine Tannate interactionDyphylline, Ephedrine, Guaifenesin, PhenobarbitalLufyllin-EPG
How Dyphylline, Ephedrine, Guaifenesin, Phenobarbital interacts with RNA Spray — through 2 ingredients. Tap an ingredient for the detail:
GuaranaPhenobarbital (luminal), Ephedrine +1 Major
Interaction Summary
Theoretically, guarana might reduce the effects of phenobarbital and increase the risk for convulsions.
Read the full Guarana + Dyphylline, Ephedrine, Guaifenesin, Phenobarbital interactionChinese Red GinsengStimulant Drugs Moderate
Interaction Summary
Theoretically, taking Panax ginseng with stimulant drugs might increase the risk of adverse stimulant effects.
Read the full Chinese Red Ginseng + Dyphylline, Ephedrine, Guaifenesin, Phenobarbital interactionEphedrine, Guaifenesin (otc Drug)Ephedrine Formula 400, Ephedrine Plus Tabs
How Ephedrine, Guaifenesin (otc Drug) interacts with RNA Spray — through 2 ingredients. Tap an ingredient for the detail:
GuaranaStimulant Drugs, Ephedrine Major
Interaction Summary
Theoretically, concomitant use might increase stimulant adverse effects.
Read the full Guarana + Ephedrine, Guaifenesin (otc Drug) interactionChinese Red GinsengStimulant Drugs Moderate
Interaction Summary
Theoretically, taking Panax ginseng with stimulant drugs might increase the risk of adverse stimulant effects.
Read the full Chinese Red Ginseng + Ephedrine, Guaifenesin (otc Drug) interactionEphedrine, Guaifenesin, Phenobarbital, TheophyllineMudrane GG
How Ephedrine, Guaifenesin, Phenobarbital, Theophylline interacts with RNA Spray — through 3 ingredients. Tap an ingredient for the detail:
GuaranaPhenobarbital (luminal), Ephedrine +2 Major
Interaction Summary
Theoretically, guarana might reduce the effects of phenobarbital and increase the risk for convulsions.
Read the full Guarana + Ephedrine, Guaifenesin, Phenobarbital, Theophylline interactionChinese Red GinsengStimulant Drugs Moderate
Interaction Summary
Theoretically, taking Panax ginseng with stimulant drugs might increase the risk of adverse stimulant effects.
Read the full Chinese Red Ginseng + Ephedrine, Guaifenesin, Phenobarbital, Theophylline interactionSiberian GinsengCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, eleuthero might increase levels of drugs metabolized by CYP1A2.
Read the full Siberian Ginseng + Ephedrine, Guaifenesin, Phenobarbital, Theophylline interactionEphedrine, Hydroxyzine, TheophyllineAmi Rax, Marax
How Ephedrine, Hydroxyzine, Theophylline interacts with RNA Spray — through 3 ingredients. Tap an ingredient for the detail:
GuaranaStimulant Drugs, Theophylline +1 Major
Interaction Summary
Theoretically, concomitant use might increase stimulant adverse effects.
Read the full Guarana + Ephedrine, Hydroxyzine, Theophylline interactionSiberian GinsengCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, eleuthero might increase levels of drugs metabolized by CYP1A2.
Read the full Siberian Ginseng + Ephedrine, Hydroxyzine, Theophylline interactionChinese Red GinsengStimulant Drugs Moderate
Interaction Summary
Theoretically, taking Panax ginseng with stimulant drugs might increase the risk of adverse stimulant effects.
Read the full Chinese Red Ginseng + Ephedrine, Hydroxyzine, Theophylline interactionEphedrine, Phenobarbital, Potassium Iodide, TheophyllineMudrane, Quadrinal
How Ephedrine, Phenobarbital, Potassium Iodide, Theophylline interacts with RNA Spray — through 2 ingredients. Tap an ingredient for the detail:
GuaranaPhenobarbital (luminal), Ephedrine +2 Major
Interaction Summary
Theoretically, guarana might reduce the effects of phenobarbital and increase the risk for convulsions.
Read the full Guarana + Ephedrine, Phenobarbital, Potassium Iodide, Theophylline interactionChinese Red GinsengStimulant Drugs Moderate
Interaction Summary
Theoretically, taking Panax ginseng with stimulant drugs might increase the risk of adverse stimulant effects.
Read the full Chinese Red Ginseng + Ephedrine, Phenobarbital, Potassium Iodide, Theophylline interactionEphedrine, Phenobarbital, TheophyllineTedral
How Ephedrine, Phenobarbital, Theophylline interacts with RNA Spray — through 2 ingredients. Tap an ingredient for the detail:
GuaranaStimulant Drugs, Theophylline +2 Major
Interaction Summary
Theoretically, concomitant use might increase stimulant adverse effects.
Read the full Guarana + Ephedrine, Phenobarbital, Theophylline interactionChinese Red GinsengStimulant Drugs Moderate
Interaction Summary
Theoretically, taking Panax ginseng with stimulant drugs might increase the risk of adverse stimulant effects.
Read the full Chinese Red Ginseng + Ephedrine, Phenobarbital, Theophylline interactionWarfarinWarfarin
How Warfarin interacts with RNA Spray — through 6 ingredients. Tap an ingredient for the detail:
American GinsengWarfarin (coumadin) Major
Interaction Summary
American ginseng seems to decrease the effectiveness of warfarin therapy.
Read the full American Ginseng + Warfarin interactionSiberian GinsengAnticoagulant/antiplatelet Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates +2 Moderate
Interaction Summary
Theoretically, eleuthero may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Siberian Ginseng + Warfarin interactionGuaranaAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, guarana may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Guarana + Warfarin interactionChinese Red GinsengAnticoagulant/antiplatelet Drugs, Warfarin (coumadin) +1 Moderate
Interaction Summary
Although Panax ginseng has shown antiplatelet effects in the laboratory, it is unlikely to increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Chinese Red Ginseng + Warfarin interactionAscorbic AcidWarfarin (coumadin) Moderate
Interaction Summary
High-dose vitamin C might reduce the levels and effectiveness of warfarin.
Read the full Ascorbic Acid + Warfarin interactionFulvic AcidAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, taking fulvic acid may decrease the effectiveness of anticoagulant and antiplatelet drugs.
Read the full Fulvic Acid + Warfarin interactionWarfarin SodiumCoumadin, Panwarfin, Sofarin
How Warfarin Sodium interacts with RNA Spray — through 6 ingredients. Tap an ingredient for the detail:
American GinsengWarfarin (coumadin) Major
Interaction Summary
American ginseng seems to decrease the effectiveness of warfarin therapy.
Read the full American Ginseng + Warfarin Sodium interactionAscorbic AcidWarfarin (coumadin) Moderate
Interaction Summary
High-dose vitamin C might reduce the levels and effectiveness of warfarin.
Read the full Ascorbic Acid + Warfarin Sodium interactionFulvic AcidAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, taking fulvic acid may decrease the effectiveness of anticoagulant and antiplatelet drugs.
Read the full Fulvic Acid + Warfarin Sodium interactionChinese Red GinsengCytochrome P450 3a4 (cyp3a4) Substrates, Anticoagulant/antiplatelet Drugs +1 Moderate
Interaction Summary
Theoretically, Panax ginseng might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full Chinese Red Ginseng + Warfarin Sodium interactionSiberian GinsengCytochrome P450 2c9 (cyp2c9) Substrates, Anticoagulant/antiplatelet Drugs +2 Moderate
Interaction Summary
Theoretically, eleuthero might increase levels of drugs metabolized by CYP2C9.
Read the full Siberian Ginseng + Warfarin Sodium interactionGuaranaAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, guarana may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Guarana + Warfarin Sodium interaction6-mercaptopurinePurinethol
How 6-mercaptopurine interacts with RNA Spray — through 4 ingredients. Tap an ingredient for the detail:
Fulvic AcidImmunosuppressants Moderate
Interaction Summary
Theoretically, taking fulvic acid might decrease the effects of immunosuppressive therapy.
Read the full Fulvic Acid + 6-mercaptopurine interactionChinese Red GinsengImmunosuppressants Moderate
Interaction Summary
Theoretically, Panax ginseng use might interfere with immunosuppressive therapy.
Read the full Chinese Red Ginseng + 6-mercaptopurine interactionAmerican GinsengImmunosuppressants Moderate
Interaction Summary
Theoretically, American ginseng use might interfere with immunosuppressive therapy.
Read the full American Ginseng + 6-mercaptopurine interactionSiberian GinsengImmunosuppressants Moderate
Interaction Summary
Theoretically, eleuthero might interfere with immunosuppressive drugs because of its immunostimulant activity.
Read the full Siberian Ginseng + 6-mercaptopurine interactionAdo-trastuzumab EmtansineKadcyla
How Ado-trastuzumab Emtansine interacts with RNA Spray — through 2 ingredients. Tap an ingredient for the detail:
Chinese Red GinsengCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, Panax ginseng might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full Chinese Red Ginseng + Ado-trastuzumab Emtansine interactionSiberian GinsengCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, eleuthero might increase levels of drugs metabolized by CYP3A4.
Read the full Siberian Ginseng + Ado-trastuzumab Emtansine interactionAbciximabReoPro
How Abciximab interacts with RNA Spray — through 4 ingredients. Tap an ingredient for the detail:
Siberian GinsengAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, eleuthero may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Siberian Ginseng + Abciximab interactionGuaranaAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, guarana may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Guarana + Abciximab interactionChinese Red GinsengAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Although Panax ginseng has shown antiplatelet effects in the laboratory, it is unlikely to increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Chinese Red Ginseng + Abciximab interactionFulvic AcidAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, taking fulvic acid may decrease the effectiveness of anticoagulant and antiplatelet drugs.
Read the full Fulvic Acid + Abciximab interactionAbemaciclibVerzenio
How Abemaciclib interacts with RNA Spray — through 2 ingredients. Tap an ingredient for the detail:
Chinese Red GinsengCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, Panax ginseng might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full Chinese Red Ginseng + Abemaciclib interactionSiberian GinsengCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, eleuthero might increase levels of drugs metabolized by CYP3A4.
Read the full Siberian Ginseng + Abemaciclib interactionAbiraterone
How Abiraterone interacts with RNA Spray — through 3 ingredients. Tap an ingredient for the detail:
Chinese Red GinsengCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, Panax ginseng might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full Chinese Red Ginseng + Abiraterone interactionSiberian GinsengCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, eleuthero might increase levels of drugs metabolized by CYP3A4.
Read the full Siberian Ginseng + Abiraterone interactionGuaranaCytochrome P450 1a2 (cyp1a2) Inhibitors Minor
Interaction Summary
Theoretically, concomitant use might increase the levels and adverse effects of caffeine.
Read the full Guarana + Abiraterone interactionAbiraterone AcetateYonsa, Zytiga
How Abiraterone Acetate interacts with RNA Spray — through 2 ingredients. Tap an ingredient for the detail:
Chinese Red GinsengCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, Panax ginseng might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full Chinese Red Ginseng + Abiraterone Acetate interactionSiberian GinsengCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, eleuthero might increase levels of drugs metabolized by CYP3A4.
Read the full Siberian Ginseng + Abiraterone Acetate interactionAbrocitinibCibinqo
How Abrocitinib interacts with RNA Spray — through 5 ingredients. Tap an ingredient for the detail:
Chinese Red GinsengAnticoagulant/antiplatelet Drugs, Immunosuppressants Moderate
Interaction Summary
Although Panax ginseng has shown antiplatelet effects in the laboratory, it is unlikely to increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Chinese Red Ginseng + Abrocitinib interactionFulvic AcidImmunosuppressants, Anticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, taking fulvic acid might decrease the effects of immunosuppressive therapy.
Read the full Fulvic Acid + Abrocitinib interactionAmerican GinsengImmunosuppressants Moderate
Interaction Summary
Theoretically, American ginseng use might interfere with immunosuppressive therapy.
Read the full American Ginseng + Abrocitinib interactionGuaranaAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, guarana may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Guarana + Abrocitinib interactionSiberian GinsengCytochrome P450 2c9 (cyp2c9) Substrates, Anticoagulant/antiplatelet Drugs +1 Moderate
Interaction Summary
Theoretically, eleuthero might increase levels of drugs metabolized by CYP2C9.
Read the full Siberian Ginseng + Abrocitinib interactionAcalabrutinibCalquence
How Acalabrutinib interacts with RNA Spray — through 2 ingredients. Tap an ingredient for the detail:
Siberian GinsengCytochrome P450 3a4 (cyp3a4) Substrates, P-glycoprotein Substrates Moderate
Interaction Summary
Theoretically, eleuthero might increase levels of drugs metabolized by CYP3A4.
Read the full Siberian Ginseng + Acalabrutinib interactionChinese Red GinsengCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, Panax ginseng might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full Chinese Red Ginseng + Acalabrutinib interactionAcarboseGlucobay, Prandase, Precose
How Acarbose interacts with RNA Spray — through 5 ingredients. Tap an ingredient for the detail:
Chinese Red GinsengAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, taking Panax ginseng with antidiabetes drugs might increase the risk of hypoglycemia.
Read the full Chinese Red Ginseng + Acarbose interactionSiberian GinsengAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, eleuthero might have additive effects when used with antidiabetes drugs.
Read the full Siberian Ginseng + Acarbose interactionAmerican GinsengAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, taking American ginseng with antidiabetes drugs might increase the risk of hypoglycemia.
Read the full American Ginseng + Acarbose interactionGuaranaAntidiabetes Drugs Minor
Interaction Summary
Theoretically, taking guarana with antidiabetes drugs might interfere with blood glucose control.
Read the full Guarana + Acarbose interactionApple Cider VinegarAntidiabetes Drugs Minor
Interaction Summary
Theoretically, taking apple cider vinegar with antidiabetes drugs might increase the risk of hypoglycemia.
Read the full Apple Cider Vinegar + Acarbose interactionAcenocoumarolSintrom
How Acenocoumarol interacts with RNA Spray — through 4 ingredients. Tap an ingredient for the detail:
GuaranaAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, guarana may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Guarana + Acenocoumarol interactionChinese Red GinsengAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Although Panax ginseng has shown antiplatelet effects in the laboratory, it is unlikely to increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Chinese Red Ginseng + Acenocoumarol interactionFulvic AcidAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, taking fulvic acid may decrease the effectiveness of anticoagulant and antiplatelet drugs.
Read the full Fulvic Acid + Acenocoumarol interactionSiberian GinsengAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, eleuthero may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Siberian Ginseng + Acenocoumarol interactionAcetaminophenChildren's Tylenol, Children's Tylenol Meltaways, Tylenol, Tylenol Ex Strength
How Acetaminophen interacts with RNA Spray — through 2 ingredients. Tap an ingredient for the detail:
Siberian GinsengCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, eleuthero might increase levels of drugs metabolized by CYP1A2.
Read the full Siberian Ginseng + Acetaminophen interactionAscorbic AcidAcetaminophen (tylenol, Others) Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Ascorbic Acid + Acetaminophen interactionAcetaminophen, AspirinGemnisyn
How Acetaminophen, Aspirin interacts with RNA Spray — through 5 ingredients. Tap an ingredient for the detail:
Chinese Red GinsengAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Although Panax ginseng has shown antiplatelet effects in the laboratory, it is unlikely to increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Chinese Red Ginseng + Acetaminophen, Aspirin interactionFulvic AcidAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, taking fulvic acid may decrease the effectiveness of anticoagulant and antiplatelet drugs.
Read the full Fulvic Acid + Acetaminophen, Aspirin interactionSiberian GinsengAnticoagulant/antiplatelet Drugs, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, eleuthero may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Siberian Ginseng + Acetaminophen, Aspirin interactionGuaranaAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, guarana may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Guarana + Acetaminophen, Aspirin interactionAscorbic AcidAcetaminophen (tylenol, Others), Aspirin Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Ascorbic Acid + Acetaminophen, Aspirin interactionAcetaminophen, Aspirin, CaffeineExcedrin, Excedrin Extra Strength, Excedrin Migraine
How Acetaminophen, Aspirin, Caffeine interacts with RNA Spray — through 5 ingredients. Tap an ingredient for the detail:
GuaranaAnticoagulant/antiplatelet Drugs, Stimulant Drugs Moderate
Interaction Summary
Theoretically, guarana may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Guarana + Acetaminophen, Aspirin, Caffeine interactionSiberian GinsengCytochrome P450 1a2 (cyp1a2) Substrates, Anticoagulant/antiplatelet Drugs +1 Moderate
Interaction Summary
Theoretically, eleuthero might increase levels of drugs metabolized by CYP1A2.
Read the full Siberian Ginseng + Acetaminophen, Aspirin, Caffeine interactionFulvic AcidAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, taking fulvic acid may decrease the effectiveness of anticoagulant and antiplatelet drugs.
Read the full Fulvic Acid + Acetaminophen, Aspirin, Caffeine interactionChinese Red GinsengCaffeine, Anticoagulant/antiplatelet Drugs +2 Moderate
Interaction Summary
Theoretically, taking Panax ginseng with caffeine might increase the risk of adverse stimulant effects.
Read the full Chinese Red Ginseng + Acetaminophen, Aspirin, Caffeine interactionAscorbic AcidAspirin, Acetaminophen (tylenol, Others) Minor
Interaction Summary
Acidification of the urine by vitamin C might increase aspirin levels.
Read the full Ascorbic Acid + Acetaminophen, Aspirin, Caffeine interactionAcetaminophen, Brompheniramine, PhenylpropanolamineDimetapp Cold and Flu
How Acetaminophen, Brompheniramine, Phenylpropanolamine interacts with RNA Spray — through 4 ingredients. Tap an ingredient for the detail:
GuaranaStimulant Drugs, Phenylpropanolamine Moderate
Interaction Summary
Theoretically, concomitant use might increase stimulant adverse effects.
Read the full Guarana + Acetaminophen, Brompheniramine, Phenylpropanolamine interactionSiberian GinsengCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, eleuthero might increase levels of drugs metabolized by CYP1A2.
Read the full Siberian Ginseng + Acetaminophen, Brompheniramine, Phenylpropanolamine interactionChinese Red GinsengStimulant Drugs Moderate
Interaction Summary
Theoretically, taking Panax ginseng with stimulant drugs might increase the risk of adverse stimulant effects.
Read the full Chinese Red Ginseng + Acetaminophen, Brompheniramine, Phenylpropanolamine interactionAscorbic AcidAcetaminophen (tylenol, Others) Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Ascorbic Acid + Acetaminophen, Brompheniramine, Phenylpropanolamine interactionAcetaminophen, ButalbitalAxocet, Bancap, Bucet, Butex Forte, Esgic CF, Orbivan CF +5 more
How Acetaminophen, Butalbital interacts with RNA Spray — through 2 ingredients. Tap an ingredient for the detail:
Siberian GinsengCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, eleuthero might increase levels of drugs metabolized by CYP1A2.
Read the full Siberian Ginseng + Acetaminophen, Butalbital interactionAscorbic AcidAcetaminophen (tylenol, Others) Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Ascorbic Acid + Acetaminophen, Butalbital interactionAcetaminophen, Butalbital, CaffeineEsgic, Esgic Plus, Fiogesic, Fioricet, Repan, Tecnal +1 more
How Acetaminophen, Butalbital, Caffeine interacts with RNA Spray — through 4 ingredients. Tap an ingredient for the detail:
Siberian GinsengCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, eleuthero might increase levels of drugs metabolized by CYP1A2.
Read the full Siberian Ginseng + Acetaminophen, Butalbital, Caffeine interactionGuaranaStimulant Drugs Moderate
Interaction Summary
Theoretically, concomitant use might increase stimulant adverse effects.
Read the full Guarana + Acetaminophen, Butalbital, Caffeine interactionChinese Red GinsengCaffeine, Stimulant Drugs +1 Moderate
Interaction Summary
Theoretically, taking Panax ginseng with caffeine might increase the risk of adverse stimulant effects.
Read the full Chinese Red Ginseng + Acetaminophen, Butalbital, Caffeine interactionAscorbic AcidAcetaminophen (tylenol, Others) Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Ascorbic Acid + Acetaminophen, Butalbital, Caffeine interactionAcetaminophen, Butalbital, Caffeine, CodeineEsgic with Codeine, Fioricet w/ Codeine
How Acetaminophen, Butalbital, Caffeine, Codeine interacts with RNA Spray — through 4 ingredients. Tap an ingredient for the detail:
Chinese Red GinsengCytochrome P450 3a4 (cyp3a4) Substrates, Stimulant Drugs +2 Moderate
Interaction Summary
Theoretically, Panax ginseng might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full Chinese Red Ginseng + Acetaminophen, Butalbital, Caffeine, Codeine interactionGuaranaStimulant Drugs Moderate
Interaction Summary
Theoretically, concomitant use might increase stimulant adverse effects.
Read the full Guarana + Acetaminophen, Butalbital, Caffeine, Codeine interactionSiberian GinsengCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 2d6 (cyp2d6) Substrates +1 Moderate
Interaction Summary
Theoretically, eleuthero might increase levels of drugs metabolized by CYP1A2.
Read the full Siberian Ginseng + Acetaminophen, Butalbital, Caffeine, Codeine interactionAscorbic AcidAcetaminophen (tylenol, Others) Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Ascorbic Acid + Acetaminophen, Butalbital, Caffeine, Codeine interactionAcetaminophen, Butalbital, CodeineBancap w/ Codeine
How Acetaminophen, Butalbital, Codeine interacts with RNA Spray — through 3 ingredients. Tap an ingredient for the detail:
Chinese Red GinsengCytochrome P450 2d6 (cyp2d6) Substrates Moderate
Interaction Summary
Theoretically, Panax ginseng might increase levels of drugs metabolized by CYP2D6.
Read the full Chinese Red Ginseng + Acetaminophen, Butalbital, Codeine interactionSiberian GinsengCytochrome P450 2d6 (cyp2d6) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, eleuthero might increase levels of drugs metabolized by CYP2D6.
Read the full Siberian Ginseng + Acetaminophen, Butalbital, Codeine interactionAscorbic AcidAcetaminophen (tylenol, Others) Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Ascorbic Acid + Acetaminophen, Butalbital, Codeine interactionAcetaminophen, Butalbital, Codeine PhosphatePhrenilin #3
How Acetaminophen, Butalbital, Codeine Phosphate interacts with RNA Spray — through 3 ingredients. Tap an ingredient for the detail:
Siberian GinsengCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 2d6 (cyp2d6) Substrates Moderate
Interaction Summary
Theoretically, eleuthero might increase levels of drugs metabolized by CYP1A2.
Read the full Siberian Ginseng + Acetaminophen, Butalbital, Codeine Phosphate interactionChinese Red GinsengCytochrome P450 2d6 (cyp2d6) Substrates Moderate
Interaction Summary
Theoretically, Panax ginseng might increase levels of drugs metabolized by CYP2D6.
Read the full Chinese Red Ginseng + Acetaminophen, Butalbital, Codeine Phosphate interactionAscorbic AcidAcetaminophen (tylenol, Others) Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Ascorbic Acid + Acetaminophen, Butalbital, Codeine Phosphate interactionAcetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, PhenylephrineHycomine Compound
How Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interacts with RNA Spray — through 4 ingredients. Tap an ingredient for the detail:
Chinese Red GinsengCaffeine, Cytochrome P450 3a4 (cyp3a4) Substrates +2 Moderate
Interaction Summary
Theoretically, taking Panax ginseng with caffeine might increase the risk of adverse stimulant effects.
Read the full Chinese Red Ginseng + Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interactionSiberian GinsengCytochrome P450 2d6 (cyp2d6) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Moderate
Interaction Summary
Theoretically, eleuthero might increase levels of drugs metabolized by CYP2D6.
Read the full Siberian Ginseng + Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interactionGuaranaStimulant Drugs Moderate
Interaction Summary
Theoretically, concomitant use might increase stimulant adverse effects.
Read the full Guarana + Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interactionAscorbic AcidAcetaminophen (tylenol, Others) Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Ascorbic Acid + Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interactionEach ingredient & the kinds of drugs it affects
For each ingredient in RNA Spray 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.
Siberian Ginseng
Anticoagulant/Antiplatelet Drugs
Theoretically, eleuthero may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
In vitro and animal research shows that a constituent of eleuthero, dihydroxybenzoic acid, appears to inhibit platelet aggregation. Concomitant use with anticoagulant or antiplatelet drugs might increase the risk of bleeding. This effect has not been reported in humans.
Antidiabetes Drugs
Theoretically, eleuthero might have additive effects when used with antidiabetes drugs.
Animal research suggests that certain constituents of eleuthero have hypoglycemic activity in both healthy and diabetic animals. A small study in adults with type 2 diabetes also shows that taking eleuthero for 3 months can lower blood glucose levels. However, one very small study in healthy individuals shows that taking powdered eleuthero 3 grams, 40 minutes prior to a 75-gram oral glucose tolerance test, significantly increases postprandial blood glucose levels when compared with placebo. These contradictory findings might be due to patient-specific variability and variability in active ingredient ratios.
Cytochrome P450 1A2 (Cyp1A2) Substrates
Theoretically, eleuthero might increase levels of drugs metabolized by CYP1A2.
In vitro and animal research suggest that standardized extracts of eleuthero inhibit CYP1A2. This effect has not been reported in humans.
Cytochrome P450 2C9 (Cyp2C9) Substrates
Theoretically, eleuthero might increase levels of drugs metabolized by CYP2C9.
In vitro and animal research suggest that standardized extracts of eleuthero might inhibit CYP2C9. This effect has not been reported in humans.
Digoxin (Lanoxin)
Eleuthero might increase serum digoxin levels and increase the risk of side effects.
In one case report, a 74-year-old male who was stabilized on digoxin presented with an elevated serum digoxin level after starting an eleuthero supplement, without symptoms of toxicity. After stopping the supplement, serum digoxin levels returned to normal. It is not clear whether this was due to a pharmacokinetic interaction or to interference with the digoxin assay. Although the product was found to be free of digoxin and digitoxin, it was not tested for other contaminants.
Immunosuppressants
Theoretically, eleuthero might interfere with immunosuppressive drugs because of its immunostimulant activity.
Animal and in vitro research shows that eleuthero extracts have immunomodulatory effects, including increasing cellular and humoral activity.
P-Glycoprotein Substrates
Theoretically, eleuthero might increase levels of P-glycoprotein substrates.
In vitro research suggests that eleuthero can inhibit the multi-drug transporter protein, P-glycoprotein. However, it is too soon to tell if this is clinically important. This interaction has not been reported in humans.
Cytochrome P450 2D6 (Cyp2D6) Substrates
Theoretically, eleuthero might increase levels of drugs metabolized by CYP2D6.
In vitro and animal research suggest that standardized extracts of eleuthero might inhibit CYP2D6. However, research in healthy human volunteers has found that taking eleuthero 485 mg twice daily for 14 days does not inhibit CYP2D6 drug metabolism.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, eleuthero might increase levels of drugs metabolized by CYP3A4.
In vitro and animal research suggest that standardized extracts of eleuthero might inhibit CYP3A4. However, research in healthy human volunteers has found that taking eleuthero 485 mg twice daily for 14 days does not inhibit CYP3A4 drug metabolism.
Organic Anion-Transporting Polypeptide Substrates (Oatp)
Theoretically, eleuthero might decrease levels of drugs metabolized by OATP.
In vitro research suggests that eleuthero inhibits OATP2B1, which might reduce the bioavailability of oral drugs that are substrates of OATP2B1. Due to the weak inhibitory effect identified in this study, this interaction is not likely to be clinically significant.
Chinese Red Ginseng
Anticoagulant/Antiplatelet Drugs
Although Panax ginseng has shown antiplatelet effects in the laboratory, it is unlikely to increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
In vitro evidence suggests that ginsenoside constituents in Panax ginseng might decrease platelet aggregation. However, research in humans suggests that ginseng does not affect platelet aggregation. Animal research indicates low oral bioavailability of Rb1 and rapid elimination of Rg1, which might explain the discrepancy between in vitro and human research. Until more is known, use with caution in patients concurrently taking anticoagulant or antiplatelet drugs.
Antidiabetes Drugs
Theoretically, taking Panax ginseng with antidiabetes drugs might increase the risk of hypoglycemia.
Clinical research suggests that Panax ginseng might decrease blood glucose levels. Monitor blood glucose levels closely.
Caffeine
Theoretically, taking Panax ginseng with caffeine might increase the risk of adverse stimulant effects.
Panax ginseng has been shown to have stimulant effects. Theoretically, caffeine might have an additive effect on the stimulant effects of Panax ginseng.
Cytochrome P450 2D6 (Cyp2D6) Substrates
Theoretically, Panax ginseng might increase levels of drugs metabolized by CYP2D6. However, research is conflicting.
There is some evidence that Panax ginseng can inhibit the CYP2D6 enzyme by approximately 6%. In addition, in animal research, Panax ginseng inhibits the metabolism of dextromethorphan, a drug metabolized by CYP2D6, by a small amount. However, contradictory research suggests Panax ginseng might not inhibit CYP2D6. Until more is known, use Panax ginseng cautiously in patients taking drugs metabolized by these enzymes.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, Panax ginseng might increase or decrease levels of drugs metabolized by CYP3A4.
Panax ginseng may affect the clearance of drugs metabolized by CYP3A4. One such drug is imatinib. Inhibition of CYP3A4 was believed to be responsible for a case of imatinib-induced hepatotoxicity. In contrast, Panax ginseng has been shown to increase the clearance of midazolam, another drug metabolized by CYP3A4. Clinical research shows that Panax ginseng can reduce midazolam area under the curve by 44%, maximum plasma concentration by 26%, and time to reach maximum plasma concentration by 29%. Midazolam metabolism was also increased in animals given Panax ginseng. Until more is known, use Panax ginseng cautiously in combination with CYP3A4 substrates.
Estrogens
Theoretically, concomitant use of large amounts of Panax ginseng might interfere with hormone replacement therapy.
Laboratory research and some case reports suggest that Panax ginseng can have estrogenic effects due to competition for estrogen receptors. The estrogenic activity is attributed to the ginsenoside constituents of Panax ginseng.
Furosemide (Lasix)
Theoretically, Panax ginseng might reduce the effects of furosemide.
There is some concern that Panax ginseng might contribute to furosemide resistance. There is one case of resistance to furosemide diuresis in a patient taking a germanium-containing ginseng product.
Imatinib (Gleevec)
Theoretically, Panax ginseng might increase the effects and adverse effects of imatinib.
A case of imatinib-induced hepatotoxicity has been reported for a 26-year-old male with chronic myelogenous leukemia stabilized on imatinib for 7 years. The patient took imatinib 400 mg along with a Panax ginseng-containing energy drink daily for 3 months. Since imatinib-associated hepatotoxicity typically occurs within 2 years of initiating therapy, it is believed that Panax ginseng affected imatinib toxicity though inhibition of cytochrome P450 3A4. CYP3A4 is the primary enzyme involved in imatinib metabolism.
Immunosuppressants
Theoretically, Panax ginseng use might interfere with immunosuppressive therapy.
Panax ginseng might have immune system stimulating properties.
Insulin
Theoretically, taking Panax ginseng with insulin might increase the risk of hypoglycemia.
Clinical research suggests that Panax ginseng might decrease blood glucose levels. Insulin dose adjustments might be necessary in patients taking Panax ginseng; use with caution.
Midazolam (Versed)
Theoretically, Panax ginseng may increase the clearance of midazolam.
Midazolam is metabolized by cytochrome P450 3A4 (CYP3A4). Clinical research suggests that Panax ginseng can reduce midazolam area under the curve by 44%, maximum plasma concentration by 26%, and time to reach maximum plasma concentration by 29%. Midazolam metabolism was also increased in animals given Panax ginseng.
Monoamine Oxidase Inhibitors (Maois)
Theoretically, Panax ginseng can interfere with MAOI therapy.
Concomitant use of Panax ginseng with phenelzine (Nardil) is associated with insomnia, headache, tremors, and hypomania.
Nifedipine (Procardia)
Theoretically, taking Panax ginseng with nifedipine might increase serum levels of nifedipine and the risk of hypotension.
Preliminary clinical research shows that concomitant use can increase serum levels of nifedipine in healthy volunteers. This might cause the blood pressure lowering effects of nifedipine to be increased when taken concomitantly with Panax ginseng.
Qt Interval-Prolonging Drugs
Theoretically, Panax ginseng has an additive effect with drugs that prolong the QT interval and potentially increase the risk of ventricular arrhythmias. However, research is conflicting.
Clinical research shows that short-term use of Panax ginseng can increase the QT interval. However, no changes in QT interval have been identified with prolonged use.
Raltegravir (Isentress)
Theoretically, taking Panax ginseng with raltegravir might increase the risk of liver toxicity.
A case report suggests that concomitant use of Panax ginseng with raltegravir can increase serum levels of raltegravir, resulting in elevated liver enzymes levels.
Selegiline (Eldepryl)
Theoretically, Panax ginseng might increase or decrease levels of selegiline, possibly altering the effects and side effects of selegiline.
Animal research shows that taking selegiline with a low dose of Panax ginseng extract (1 gram/kg) reduces selegiline bioavailability, while taking a high dose of Panax ginseng extract (3 grams/kg) increases selegiline bioavailability. More research is needed to confirm these effects.
Stimulant Drugs
Theoretically, taking Panax ginseng with stimulant drugs might increase the risk of adverse stimulant effects.
Panax ginseng has been shown to have stimulant effects.
Warfarin (Coumadin)
Panax ginseng might affect the clearance of warfarin. However, this interaction appears to be unlikely.
There has been a single case report of decreased effectiveness of warfarin in a patient who also took Panax ginseng. However, it is questionable whether Panax ginseng was the cause of this decrease in warfarin effectiveness. Some research in humans and animals suggests that Panax ginseng does not affect the pharmacokinetics of warfarin. However, other research in humans suggests that Panax ginseng might modestly increase the clearance of the S-warfarin isomer. More evidence is needed to determine whether Panax ginseng causes a significant interaction with warfarin.
Fexofenadine (Allegra)
Theoretically, Panax ginseng might decrease blood levels of oral or intravenous fexofenadine.
Animal research suggests that taking Panax ginseng in combination with oral or intravenous fexofenadine may reduce the bioavailability of fexofenadine. Some scientists have attributed this effect to the ability of Panax ginseng to increase the expression of P-glycoprotein.
Lopinavir/Ritonavir (Kaletra)
Although Panax ginseng has demonstrated variable effects on cytochrome P450 3A4 (CYP3A4), which metabolizes lopinavir, Panax ginseng is unlikely to alter levels of lopinavir/ritonavir.
Lopinavir is metabolized by CYP3A4 and is administered with the CYP3A4 inhibitor ritonavir to increase its plasma concentrations. Panax ginseng has shown variable effects on CYP3A4 activity in humans. However, taking Panax ginseng (Vitamer Laboratories) 500 mg twice daily for 14 days did not alter the pharmacokinetics of lopinavir/ritonavir in 12 healthy volunteers.
Guarana
Ephedrine
Theoretically, concomitant use might increase the risk for stimulant adverse effects.
Guarana contains caffeine. Use of ephedrine with caffeine can increase the risk of stimulatory adverse effects. There is evidence that using ephedrine with caffeine might increase the risk of serious life-threatening or debilitating adverse effects such as hypertension, myocardial infarction, stroke, seizures, and death.
Adenosine (Adenocard)
Theoretically, guarana might decrease the vasodilatory effects of adenosine and interfere with its use prior to stress testing.
Guarana contains caffeine. Caffeine is a competitive inhibitor of adenosine at the cellular level. However, caffeine does not seem to affect supplemental adenosine because high interstitial levels of adenosine overcome the antagonistic effects of caffeine. It is recommended that methylxanthines and methylxanthine-containing products be stopped 24 hours prior to pharmacological stress tests. However, methylxanthines appear more likely to interfere with dipyridamole (Persantine) than adenosine-induced stress testing.
Anticoagulant/Antiplatelet Drugs
Theoretically, guarana may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
In vitro and animal research suggests that guarana extract can inhibit platelet aggregation. This effect may be due to the caffeine in guarana, which is also reported to have antiplatelet activity. This interaction has not been reported in humans.
Beta-Adrenergic Agonists
Theoretically, concomitant use might increase the clinical effects of beta-adrenergic agonists.
Guarana contains caffeine. Theoretically, concomitant use of large amounts of caffeine might increase cardiac inotropic effects of beta-agonists.
Carbamazepine (Tegretol)
Theoretically, guarana might reduce the effects of carbamazepine and increase the risk for convulsions.
Animal research suggests that taking caffeine can lower the anticonvulsant effects of carbamazepine and can induce seizures when given to animals in doses above 400 mg/kg. Human research has shown that taking caffeine 300 mg in three divided doses along with carbamazepine 200 mg reduces the bioavailability of carbamazepine by 32% and prolongs the plasma half-life of carbamazepine two-fold in healthy individuals.
Cimetidine (Tagamet)
Theoretically, concomitant use might increase the effects and adverse effects of caffeine in guarana.
Guarana contains caffeine. Cimetidine decreases the rate of caffeine clearance by 31% to 42%.
Clozapine (Clozaril)
Theoretically, guarana might increase the levels and adverse effects of clozapine and acutely exacerbate psychotic symptoms.
Guarana contains caffeine. Caffeine can increase the effects and toxicity of clozapine. Caffeine doses of 400-1000 mg per day inhibit clozapine metabolism. Clozapine is metabolized by cytochrome P450 1A2 (CYP1A2). Researchers speculate that caffeine might inhibit CYP1A2. However, there is no reliable evidence that caffeine affects CYP1A2. There is also speculation that genetic factors might make some patients more sensitive to the interaction between clozapine and caffeine.
Dipyridamole (Persantine)
Theoretically, guarana might decrease the vasodilatory effects of dipyridamole and interfere with its use prior to stress testing.
Guarana contains caffeine. Caffeine might inhibit dipyridamole-induced vasodilation. It is recommended that methylxanthines and methylxanthine-containing products be stopped 24 hours prior to pharmacological stress tests. Methylxanthines appear more likely to interfere with dipyridamole than adenosine-induced stress testing.
Disulfiram (Antabuse)
Theoretically, disulfiram might increase the risk of adverse effects from caffeine.
In human research, disulfiram decreases the clearance and increases the half-life of caffeine.
Diuretic Drugs
Theoretically, using guarana with diuretic drugs might increase the risk of hypokalemia.
Guarana contains caffeine. Caffeine, especially in excessive amounts, can reduce potassium levels due to stimulation of the sodium-potassium pump. Diuretics can also lower potassium levels.
Estrogens
Theoretically, estrogens might increase the levels and adverse effects of caffeine.
Guarana contains caffeine. Estrogen inhibits caffeine metabolism.
Ethosuximide (Zarontin)
Theoretically, guarana might reduce the effects of ethosuximide and increase the risk for convulsions.
Guarana contains caffeine. Animal research shows that caffeine 92.4 mg/kg can decrease the anticonvulsant activity of ethosuximide. This effect has not been observed in humans.
Felbamate (Felbatol)
Theoretically, guarana might reduce the effects of felbamate and increase the risk for convulsions.
Guarana contains caffeine. Animal research shows that a high dose of caffeine 161.7 mg/kg can decreases the anticonvulsant activity of felbamate. This effect has not been observed in humans.
Flutamide (Eulexin)
Theoretically, guarana might increase the levels and adverse effects of flutamide.
Guarana contains caffeine. In vitro evidence shows that caffeine can inhibit the metabolism of flutamide. However, this effect has not been reported in humans.
Fluvoxamine (Luvox)
Theoretically, fluvoxamine might increase the levels and adverse effects of caffeine.
Guarana contains caffeine. Fluvoxamine reduces caffeine metabolism.
Lithium
Theoretically, abrupt guarana withdrawal might increase the levels and adverse effects of lithium.
Guarana contains caffeine. Theoretically, abrupt caffeine withdrawal might increase serum lithium levels. There are two case reports of lithium tremor that worsened upon abrupt coffee withdrawal.
Monoamine Oxidase Inhibitors (Maois)
Theoretically, concomitant use might increase the risk of a hypertensive crisis.
Guarana contains caffeine. Caffeine has been shown to inhibit MAO-A and -B in laboratory studies. Concomitant intake of large amounts of caffeine with MAOIs might precipitate a hypertensive crisis. In a case report, a patient that consumed 10-12 cups of caffeinated coffee and took the MAOI tranylcypromine presented with severe hypertension. Hypertension was resolved after the patient switched to drinking decaffeinated coffee.
Nicotine
Theoretically, concomitant use might increase the risk of hypertension.
Guarana contains caffeine. Concomitant use of caffeine and nicotine has been shown to have additive cardiovascular effects, including increased heart rate and blood pressure. Blood pressure was increased by 10.8/12.4 mmHg when the agents were used concomitantly.
Pentobarbital (Nembutal)
Theoretically, guarana might decrease the effects of pentobarbital.
Guarana contains caffeine. In vivo evidence suggests that caffeine can negate the hypnotic effects of pentobarbital in humans. However, animal research suggests that guarana does not alter the hypnotic effect of pentobarbital.
Phenobarbital (Luminal)
Theoretically, guarana might reduce the effects of phenobarbital and increase the risk for convulsions.
Guarana contains caffeine. Animal research shows that caffeine can decrease the anticonvulsant activity of phenobarbital. The exact mechanism of this interaction is unclear.
Phenylpropanolamine
Theoretically, phenylpropanolamine might increase the risk of hypertension, as well as the levels and adverse effects of caffeine.
Guarana contains caffeine. Concomitant use of phenylpropanolamine and caffeine might cause an additive increase in blood pressure. Phenylpropanolamine also seems to increase caffeine serum levels.
Phenytoin (Dilantin)
Theoretically, guarana might reduce the effects of phenytoin and increase the risk for convulsions.
Guarana contains caffeine. Animal research shows that caffeine can decrease the anticonvulsant activity of phenytoin. The effect does not seem to be related to the seizure threshold-lowering effects of caffeine. However, the exact mechanism of this interaction is unclear.
Pioglitazone (Actos)
Theoretically, guarana might increase the levels and clinical effects of pioglitazone.
Guarana contains caffeine. Animal research suggests that caffeine can modestly increase the maximum concentration, area under the curve, and half-life of pioglitazone, and also reduce its clearance. This increased the antidiabetic effects of pioglitazone. However, the exact mechanism of this interaction is unclear.
Riluzole (Rilutek)
Theoretically, concomitant use might increase the levels and adverse effects of both caffeine and riluzole.
Guarana contains caffeine. Caffeine and riluzole are both metabolized by cytochrome P450 1A2 (CYP1A2), and concomitant use might reduce the metabolism of one or both agents.
Stimulant Drugs
Theoretically, concomitant use might increase stimulant adverse effects.
Guarana contains caffeine. Due to the central nervous system (CNS) stimulant effects of caffeine, concomitant use with stimulant drugs can increase the risk of adverse effects.
Fulvic Acid
Anticoagulant/Antiplatelet Drugs
Theoretically, taking fulvic acid may decrease the effectiveness of anticoagulant and antiplatelet drugs.
In vitro evidence shows that fulvic acid, formed from the oxidation and polymerization of protocatechuic acid, can shorten prothrombin time in human plasma, increasing the risk of clot formation.
Immunosuppressants
Theoretically, taking fulvic acid might decrease the effects of immunosuppressive therapy.
Animal research shows that fulvic acid stimulates immune function.
Thyroid Hormone
Theoretically, taking fulvic acid with thyroid hormone therapy might interfere with the ability to normalize thyroid function.
Animal research shows that fulvic acid increases the plasma level of thyroid-stimulating hormone (TSH) and decreases the thyroxine (T4):triiodothyronine (T3) ratio.
American Ginseng
Warfarin (Coumadin)
American ginseng seems to decrease the effectiveness of warfarin therapy.
Healthy patients receiving warfarin 5 mg daily, who also take American ginseng 1 gram twice daily, seem to have a significantly reduced international normalized ratio (INR).
Antidiabetes Drugs
Theoretically, taking American ginseng with antidiabetes drugs might increase the risk of hypoglycemia.
American ginseng seems to lower postprandial blood glucose. Theoretically, concomitant use with antidiabetes drugs might enhance blood glucose lowering effects and possibly cause hypoglycemia.
Immunosuppressants
Theoretically, American ginseng use might interfere with immunosuppressive therapy.
American ginseng seems to stimulate immune function. Theoretically, American ginseng might decrease the effectiveness of immunosuppressant drugs.
Monoamine Oxidase Inhibitors (Maois)
Theoretically, American ginseng can interfere with MAOI therapy.
There is one case report of insomnia, headache, and tremors when an unspecified ginseng product was used with phenelzine (Nardil), an MAOI. There is also one case report of hypomania when an unspecified ginseng product was used with phenelzine. Theoretically, American ginseng may interfere with MAOI therapy.
Ascorbic Acid
Alkylating Agents
Theoretically, antioxidant effects of vitamin C might reduce the effectiveness of alkylating agents.
The use of antioxidants like vitamin C during chemotherapy is controversial. There is concern that antioxidants could reduce the activity of chemotherapy drugs that generate free radicals, such as cyclophosphamide, chlorambucil, carmustine, busulfan, and thiotepa. In contrast, some researchers theorize that antioxidants might make chemotherapy more effective by reducing oxidative stress that could interfere with apoptosis (cell death) of cancer cells. More evidence is needed to determine what effect, if any, antioxidants such as vitamin C have on chemotherapy.
Aluminum
Vitamin C can increase the amount of aluminum absorbed from aluminum compounds.
Research in animals and humans shows that vitamin C increases aluminum absorption, theoretically by chelating aluminum and keeping it in solution where it is available for absorption. In people with normal renal function, urinary excretion of aluminum will likely increase, making aluminum retention and toxicity unlikely. Patients with renal failure who take aluminum-containing compounds such as phosphate binders should avoid vitamin C supplements in doses above the recommended dietary allowances.
Antitumor Antibiotics
Theoretically, the antioxidant effects of vitamin C might reduce the effectiveness of antitumor antibiotics.
The use of antioxidants like vitamin C during chemotherapy is controversial. There is concern that antioxidants could reduce the activity of chemotherapy drugs which generate free radicals, such as doxorubicin. In contrast, some researchers theorize that antioxidants might make chemotherapy more effective by reducing oxidative stress that could interfere with apoptosis (cell death) of cancer cells. More evidence is needed to determine what effects, if any, antioxidants such as vitamin C have on chemotherapy.
Estrogens
Vitamin C might increase blood levels of estrogens.
Increases in plasma estrogen levels of up to 55% occur under some circumstances when vitamin C is taken concurrently with oral contraceptives or hormone replacement therapy, including topical products. It is suggested that vitamin C prevents oxidation of estrogen in the tissues, regenerates oxidized estrogen, and reduces sulfate conjugation of estrogen in the gut wall. When tissue levels of vitamin C are high, these processes are already maximized and supplemental vitamin C does not have any effect on estrogen levels. Increases in plasma estrogen levels may occur when patients who are deficient in vitamin C take supplements. Monitor these patients for estrogen-related side effects.
Fluphenazine (Prolixin)
Theoretically, vitamin C might decrease levels of fluphenazine.
In one patient there was a clinically significant decrease in fluphenazine levels when vitamin C (500 mg twice daily) was started. The mechanism is not known, and there is no further data to confirm this interaction.
Indinavir (Crixivan)
Vitamin C can modestly reduce indinavir levels.
One pharmacokinetic study shows that taking vitamin C 1 gram orally once daily along with indinavir 800 mg orally three times daily reduces the area under the concentration-time curve of indinavir by 14%. The mechanism of this interaction is unknown, but it is unlikely to be clinically significant in most patients. The effect of higher doses of vitamin C on indinavir levels is unknown.
Levothyroxine (Synthroid, Others)
Vitamin C can increase levothyroxine absorption.
Two clinical studies in adults with poorly controlled hypothyroidism show that swallowing levothyroxine with a glass of water containing vitamin C 500-1000 mg in solution reduces thyroid stimulating hormone (TSH) levels and increases thyroxine (T4) levels when compared with taking levothyroxine alone. This suggests that vitamin C increases the oral absorption of levothyroxine, possibly due to a reduction in pH.
Warfarin (Coumadin)
High-dose vitamin C might reduce the levels and effectiveness of warfarin.
Vitamin C in high doses may cause diarrhea and possibly reduce warfarin absorption. There are reports of two people who took up to 16 grams daily of vitamin C and had a reduction in prothrombin time. Lower doses of 5-10 grams daily can also reduce warfarin absorption. In many cases, this does not seem to be clinically significant. However, a case of warfarin resistance has been reported for a patient who took vitamin C 500 mg twice daily. Cessation of vitamin C supplementation resulted in a rapid increase in international normalized ratio (INR). Tell patients taking warfarin to avoid taking vitamin C in excessively high doses (greater than 10 grams daily). Lower doses may be safe, but the anticoagulation activity of warfarin should be monitored. Patients who are stabilized on warfarin while taking vitamin C should avoid adjusting vitamin C dosage to prevent the possibility of warfarin resistance.
Acetaminophen (Tylenol, Others)
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
A small pharmacokinetic study in healthy volunteers shows that taking high-dose vitamin C (3 grams) 1.5 hours after taking acetaminophen 1 gram slightly increases the apparent half-life of acetaminophen from around 2.3 hours to 3.1 hours. Ascorbic acid competitively inhibits sulfate conjugation of acetaminophen. However, to compensate, elimination of acetaminophen glucuronide and unconjugated acetaminophen increases. This effect is not likely to be clinically significant.
Aspirin
Acidification of the urine by vitamin C might increase aspirin levels.
It has been suggested that acidification of the urine by vitamin C could increase reabsorption of salicylates by the renal tubules, and increase plasma salicylate levels. However, short-term use of up to 6 grams daily of vitamin C does not seem to affect urinary pH or salicylate excretion, suggesting this interaction is not clinically significant.
Choline Magnesium Trisalicylate (Trilisate)
Acidification of the urine by vitamin C might increase choline magnesium trisalicylate levels.
It has been suggested that acidification of the urine by vitamin C could increase reabsorption of salicylates by the renal tubules, and increase plasma salicylate levels. However, short-term use of up to 6 grams daily of vitamin C does not seem to affect urinary pH or salicylate excretion, suggesting this interaction probably is not clinically significant.
Niacin
Vitamin C might decrease the beneficial effects of niacin on high-density lipoprotein (HDL) cholesterol levels.
A combination of niacin and simvastatin (Zocor) effectively raises HDL cholesterol levels in patients with coronary disease and low HDL levels. Clinical research shows that taking a combination of antioxidants (vitamin C, vitamin E, beta-carotene, and selenium) along with niacin and simvastatin (Zocor) attenuates this rise in HDL, specifically the HDL-2 and apolipoprotein A1 fractions, by more than 50% in patients with coronary disease. It is not known whether this adverse effect is due to a single antioxidant such as vitamin C, or to the combination. It also is not known whether it will occur in other patient populations.
Salsalate (Disalcid)
Acidification of the urine by vitamin C might increase salsalate levels.
It has been suggested that acidification of the urine by vitamin C could increase reabsorption of salicylates by the renal tubules, and increase plasma salicylate levels. However, short-term use of up to 6 grams/day vitamin C does not seem to affect urinary pH or salicylate excretion, suggesting this interaction probably is not clinically significant.
Apple Cider Vinegar
Digoxin (Lanoxin)
Theoretically, concomitant use of apple cider vinegar with digoxin might increase the risk of cardiac toxicity.
A case of hypokalemia related to chronic use of apple cider vinegar has been reported. Theoretically, overuse of apple cider vinegar could decrease potassium levels, increasing the risk of toxicity with digoxin.
Diuretic Drugs
Theoretically, concomitant use of apple cider vinegar with diuretic drugs might increase the risk of hypokalemia.
A case of hypokalemia related to chronic use of apple cider vinegar has been reported. There is some concern that people taking apple cider vinegar along with potassium depleting diuretics might have an increased risk for hypokalemia.
Insulin
Theoretically, concomitant use of apple cider vinegar with insulin might increase the risk of hypokalemia.
A case of hypokalemia related to chronic use of apple cider vinegar has been reported. Theoretically, overuse of apple cider vinegar concomitantly with insulin might increase the risk of hypokalemia.
Antidiabetes Drugs
Theoretically, taking apple cider vinegar with antidiabetes drugs might increase the risk of hypoglycemia.
Apple cider vinegar might reduce fasting and postprandial blood glucose levels and decrease gastric emptying in people with diabetes. However, not all research agrees. Theoretically, it might have additive effects on glucose levels when used with antidiabetes drugs.
Progesterone
Estrogens
Theoretically, using estrogen along with progesterone supplements or non-prescription bioidentical progesterone products might alter the effects of estrogen.
Concomitant use of estrogen with prescription progesterone products can cause breast tenderness. Also, use of conjugated equine estrogens with oral micronized progesterone in postmenopausal patients seems to blunt the beneficial effects of estrogen on the lipoprotein profile, although it might not affect estrogen-induced reduction in plasma lipoprotein (a). It is unclear if this interaction would be clinically significant with the doses found in oral or topical progesterone supplements or non-prescription bioidentical products.
Paclitaxel (Abraxane, Onxol)
Theoretically, using paclitaxel along with progesterone supplements or non-prescription bioidentical progesterone products might increase paclitaxel levels and adverse effects.
Human research suggests that administering high-dose progesterone intravenously along with paclitaxel can increase plasma levels of paclitaxel without affecting neutrophil and platelet nadir counts. It is unclear if this interaction would be clinically significant with the doses found in oral or topical progesterone supplements or non-prescription bioidentical products.
Brand information
Manufacturer and brand details for RNA Spray, from the product label.
Complete Ascentials
See all Complete Ascentials products- Name
- Network Holdings, LLC
- Street Address
- 133 N Lexington St, P.O. Box 26
- City
- Spring Green
- State
- WI
- ZipCode
- 53588
- Phone Number
- 1-888-550-8231
- Web Address
- www.CompleteAscentials.com
RNA Spray by Complete Ascentials: Common Questions
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Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
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The Full Monographs Behind RNA Spray’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Vitamin C
Interacts with 207 drugsVitamin C (ascorbic acid) is an essential nutrient your body needs but cannot make, so you must get it from food or supplements. It's important for immune function, collagen, and acts as an...
Read the full Vitamin C monograph → Herb & supplement monographBoron
Boron is a trace mineral found in many plant foods and sold as a supplement, mainly promoted for bone, joint, and hormone health. The human evidence for most of these uses is limited or prel...
Read the full Boron monograph → Herb & supplement monographGermanium
Germanium is a chemical element sometimes sold as a dietary supplement, but there is no reliable evidence it treats any disease. More importantly, germanium supplements have been linked to s...
Read the full Germanium monograph → Herb & supplement monographIndium
Indium is a metallic chemical element sometimes sold as a liquid 'trace mineral' supplement with bold anti-aging and energy claims, but it is not a recognized essential nutrient and there is...
Read the full Indium monograph → Herb & supplement monographProgesterone
Interacts with 42 drugsProgesterone is a natural hormone, and prescription forms are used for fertility support, menstrual problems, and hormone therapy. Over-the-counter "natural" progesterone creams are not well...
Read the full Progesterone monograph → Herb & supplement monographFulvic Acid
Interacts with 257 drugsFulvic acid is a natural compound formed when plants and microbes break down in soil, and it is sold as a supplement for energy, gut, and overall wellness. Human research is very limited, so...
Read the full Fulvic Acid monograph → Herb & supplement monographAmerican Ginseng
Interacts with 217 drugsAmerican ginseng is an herbal root used as an 'adaptogen' to support energy, stress, immune function, and blood sugar. Some uses—such as reducing the chance or length of colds and modestly l...
Read the full American Ginseng monograph → Herb & supplement monographPanax Ginseng
Interacts with 1,130 drugsPanax ginseng is a popular traditional herb used to boost energy, ease stress, and support overall wellness, though scientific evidence is mixed and mostly preliminary. It is generally well...
Read the full Panax Ginseng monograph → Herb & supplement monographEleuthero
Interacts with 1,140 drugsEleuthero is an herb traditionally used as an 'adaptogen' to fight fatigue, boost energy, and help the body handle stress. The scientific evidence behind these uses is limited and mixed, so...
Read the full Eleuthero monograph → Herb & supplement monographApple Cider Vinegar
Interacts with 162 drugsApple cider vinegar is a fermented apple product that many people use hoping to help with blood sugar, weight, or digestion. The evidence for most of these uses is limited and mixed, and the...
Read the full Apple Cider Vinegar monograph → Herb & supplement monographGuarana
Interacts with 655 drugsGuarana is an Amazonian seed that is naturally high in caffeine, which explains most of its stimulant and energy effects. While it may give a short-term boost in alertness and reduce fatigue...
Read the full Guarana monograph →Sources & How We Checked
RNA Spray's label data comes from the NIH Dietary Supplement Label Database; the ingredient interaction data is from the Natural Medicines database, reviewed by our pharmacists.
- NIH Dietary Supplement Label Database (DSLD) — The official product label on file for this supplement.
- Natural Medicines (Therapeutic Research Center) — Evidence-graded clinical reference behind the ingredient interaction data.
Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.
The 343 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.
Vitamin C 51 references
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- Morris JC, Beeley L, Ballantine N. Interaction of ethinyloestradiol with ascorbic acid in man [letter]. Br Med J (Clin Res Ed) 1981;283:503.
- Labriola D, Livingston R. Possible interactions between dietary antioxidants and chemotherapy. Oncology 1999;13:1003-8.
- Dwyer JH, Merz NB, Shirocre AM, et al. Progression of early atherosclerosis and intake of vitamin C and vitamin E from supplements and food. The Los Angeles Atherosclerosis Study. 41st Annual Conference on Cardiovascular Disease Epidemiology and Prevent
- Levine M, Rumsey SC, Daruwala R, et al. Criteria and recommendations for vitamin C intake. JAMA 1999;281:1415-23. PubMed
- Hansten PD, Horn JR. Drug Interactions Analysis and Management. Vancouver, WA: Applied Therapeutics Inc., 1997 and updates.
- Segal S, Kaminski S. Drug-nutrient interactions. American Druggist 1996 Jul;42-8.
- Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes for Vitamin C, Vitamin E, Selenium, and Carotenoids. Washington, DC: National Academy Press, 2000. Available at: http://www.nap.edu/books/0309069351/html/.
- Houston JB, Levy G. Drug biotransformation interactions in man VI: Acetaminophen and ascorbic acid. J Pharm Sci 1976;65:1218-21. PubMed
- Brown BG, Zhao XQ, Chait A, et al. Simvastatin and niacin, antioxidant vitamins, or the combination for the prevention of coronary disease. N Engl J Med 2001;345:1583-93. DOI
- Rosenthal G. Interaction of ascorbic acid and warfarin. JAMA 1971;215:1671. DOI
- Hume R, Johnstone JM, Weyers E. Interaction of ascorbic acid and warfarin. JAMA 1972;219:1479. DOI
- Smith EC, Skalski RJ, Johnson GC, Rossi GV. Interaction of ascorbic acid and warfarin. JAMA 1972;221:1166. DOI
- Traxer O, Huet B, Poindexter J, et al. Effect of ascorbic acid consumption on urinary stone risk factors. J Urol 2003;170:397-401.. PubMed
- Domingo JL, Gomez M, Llobet JM, Richart C. Effect of ascorbic acid on gastrointestinal aluminum absorption (letter). Lancet 1991;338:1467.
- Domingo JL, Gomez M, Llobet JM, Corbella J. Influence of some dietary constituents on aluminum absorption and retention in rats. Kidney Int 1991;39:598-601. PubMed
- Partridge NA, Regnier FE, White JL, Hem SL. Influence of dietary constituents on intestinal absorption of aluminum. Kidney Int 1989;35:1413-7. PubMed
- Mc Leod DC, Nahata MC. Inefficacy of ascorbic acid as a urinary acidifier (letter). N Engl J Med 1977;296:1413. DOI
- Hansten PD, Hayton WL. Effect of antacid and ascorbic acid on serum salicylate concentration. J Clin Pharmacol 1980;20:326-31. PubMed
- Dysken MW, Cumming RJ, Channon RA, Davis JM. Drug interaction between ascorbic acid and fluphenazine. JAMA 1979;241:2008. DOI
- Vihtamaki T, Parantainen J, Koivisto AM, et al. Oral ascorbic acid increases plasma oestradiol during postmenopausal hormone replacement therapy. Maturitas 2002;42:129-35. PubMed
- Slain D, Amsden JR, Khakoo RA, et al. Effect of high-dose vitamin C on the steady-state pharmacokinetics of the protease inhibitor indinavir in healthy volunteers. Pharmacotherapy 2005;25:165-70. PubMed
- Cheung MC, Zhao XQ, Chait A, et al. Antioxidant supplements block the response of HDL to simvastatin-niacin therapy in patients with coronary artery disease and low HDL. Arterioscler Thromb Vasc Biol 2001;21:1320-6. PubMed
- Feetam CL, Leach RH, Meynell MJ. Lack of a clinically important interaction between warfarin and ascorbic acid. Toxicol Appl Pharmacol 1975;31:544-7. PubMed
- Weintraub M, Griner PF. Warfarin and ascorbic acid: lack of evidence for a drug interaction. Toxicol Appl Pharmacol 1974;28:53-6. PubMed
- Lee DH, Folsom AR, Harnack L, et al. Does supplemental vitamin C increase cardiovascular disease risk in women with diabetes? Am J Clin Nutr 2004;80:1194-200. PubMed
- Taylor EN, Stampfer MJ, Curhan GC. Dietary factors and the risk of incident kidney stones in men: new insights after 14 years of follow-up. J Am Soc Nephrol 2004;15:3225-32. PubMed
- Ward NC, Hodgson JM, Croft KD, et al. The combination of vitamin C and grape-seed polyphenols increases blood pressure: a randomized, double-blind, placebo-controlled trial. J Hypertens 2005;23:427-34.. PubMed
- Prasad KN. Rationale for using high-dose multiple dietary antioxidants as an adjunct to radiation therapy and chemotherapy. J Nutr 2004;134:3182S-3S. PubMed
- Conklin KA. Cancer chemotherapy and antioxidants. J Nutr 2004;134:3201S-3204S. PubMed
- Fairweather-Tait S, Hickson K, McGaw B, et al. Orange juice enhances aluminium absorption from antacid preparation. Eur J Clin Nutr. 1994;48(1):71-3.
- Gruenwald, J., Graubaum, H. J., Busch, R., and Bentley, C. Safety and tolerance of ester-C compared with regular ascorbic acid. Adv.Ther. 2006;23(1):171-178.
- Rahimi, R., Nikfar, S., Rezaie, A., and Abdollahi, M. A meta-analysis on the efficacy and safety of combined vitamin C and E supplementation in preeclamptic women. Hypertens.Pregnancy. 2009;28(4):417-434. PubMed
- Einerson, B., Nathorn, C., Kitiyakara, C., Sirada, M., and Thamlikitkul, V. The efficacy of ascorbic acid in suboptimal responsive anemic hemodialysis patients receiving erythropoietin: a meta-analysis. J Med.Assoc.Thai. 2011;94 Suppl 1:S134-S146.
- Li, G., Li, L., Yu, C., and Chen, L. Effect of vitamins C and E supplementation on Helicobacter pylori eradication: a meta-analysis. Br.J Nutr 2011;106(11):1632-1637.
- Chen X, Shen L, Gu X, et al. High-dose supplementation with vitamin C--induced pediatric urolithiasis: the first case report in a child and literature review. Urology. 2014;84(4):922-4. PubMed
- Sattar A, Willman JE, Kolluri R. Possible warfarin resistance due to interaction with ascorbic acid: case report and literature review. Am J Health Syst Pharm. 2013;70(9):782-6. PubMed
- Yaich S, Chaabouni Y, Charfeddine K, et al. Secondary oxalosis due to excess vitamin C intake: a cause of graft loss in a renal transplant recipient. Saudi J Kidney Dis Transpl. 2014;25(1):113-6. PubMed
- Jalloh MA, Gregory PJ, Hein D, et al. Dietary supplement interactions with antiretrovirals: a systematic review. Int J STD AIDS. 2017 Jan;28(1):4-15. PubMed
- Rumbold A, Ota E, Nagata C, Shahrook S, Crowther CA. Vitamin C supplementation in pregnancy. Cochrane Database Syst Rev. 2015;(9):CD004072. PubMed
- Seo MS, Kim JK, Shim JY. High-dose vitamin C promotes regression of multiple pulmonary metastases originating from hepatocellular carcinoma. Yonsei Med J. 2015;56(5):1449-52. PubMed
- Skelin M, Lucijanic T, Amidzic Klaric D, et al. Factors Affecting Gastrointestinal Absorption of Levothyroxine: A Review. Clin Ther. 2017 Feb;39(2):378-403. PubMed
- Jiang K, Tang K, Liu H, Xu H, Ye Z, Chen Z. Ascorbic acid supplements and kidney stones incidence among men and women: a systematic review and meta-analysis. Urol J. 2019;16(2):115-120.
- Thomas S, Patel D, Bittel B, et al. Effect of High-Dose Zinc and Ascorbic Acid Supplementation vs Usual Care on Symptom Length and Reduction Among Ambulatory Patients With SARS-CoV-2 Infection: The COVID A to Z Randomized Clinical Trial. JAMA Netw Open. 2 PubMed
- Giffen MA, McLemore JL. Hyperoxalosis Secondary to Intravenous Vitamin C Administration as a Non-Allopathic Treatment for Cancer. Acad Forensic Pathol 2019;9(1-2):118-126. PubMed
- Maike A, Sturgill D, Gallan A. Oxalate Nephropathy in a Renal Transplant Recipient After Receiving High Dose Ascorbic Acid. Am J Med Sci 2021. PubMed
- Shen ZY, Chen YR, Wang MC, Chang SS. High-dose vitamin C-induced acute oxalate nephropathy in a renal transplant recipient: a case report and literature review. Asian J Surg 2022. PubMed
- Yanase F, Spano S, Maeda A, et al. Mega-dose sodium ascorbate: a pilot, single-dose, physiological effect, double-blind, randomized, controlled trial. Crit Care 2023;27(1):371. PubMed
- Sharma Y, Sumanadasa S, Shahi R, et al. Efficacy and safety of vitamin C supplementation in the treatment of community-acquired pneumonia: a systematic review and meta-analysis with trial sequential analysis. Sci Rep 2024;14(1):11846. PubMed
- Pejcic AV, Petrovic NZ, Djordjic MD, Milosavljevic MN. Vitamin C Levels in Pregnant Women and the Efficacy of Vitamin C Supplements in Preventing Premature Rupture of Membranes: A Systematic Review and Meta-Analysis. Balkan Med J 2024;41(4):248-260. PubMed
Boron 6 references
- Ellenhorn MJ, et al. Ellenhorn's Medical Toxicology: Diagnoses and Treatment of Human Poisoning. 2nd ed. Baltimore, MD: Williams & Wilkins, 1997.
- 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.
- Thai L, Hart LL. Boric acid vaginal suppositories. Ann Pharmacother 1993;27:1355-7.
- Acs N, Banhidy F, Puho E, Czeizel AE. Teratogenic effects of vaginal boric acid treatment during pregnancy. Int J Gynaecol Obstet 2006;93:55-6. PubMed
- Garabrant, D. H., Bernstein, L., Peters, J. M., and Smith, T. J. Respiratory and eye irritation from boron oxide and boric acid dusts. J Occup Med 1984;26(8):584-586. PubMed
- Hjelm C, Harari F, Vahter M. Pre- and postnatal environmental boron exposure and infant growth: results from a mother-child cohort in northern Argentina. Environ Res 2019;171:60-8. PubMed
American Ginseng 12 references
- Shader RI, Greenblatt DJ. Phenelzine and the dream machine-ramblings and reflections. J Clin Psychopharmacol 1985;5:65. PubMed
- Jones BD, Runikis AM. Interaction of ginseng with phenelzine. J Clin Psychopharmacol 1987;7:201-2. PubMed
- Janetzky K, Morreale AP. Probable interaction between warfarin and ginseng. Am J Health Syst Pharm 1997;54:692-3. PubMed
- Vuksan V, Sievenpiper JL, Koo VY, et al. American ginseng (Panax quinquefolius L) reduces postprandial glycemia in nondiabetic subjects and subjects with type 2 diabetes mellitus. Arch Intern Med 2000;160:1009-13. PubMed
- Vuksan V, Stavro MP, Sievenpiper JL, et al. Similar postprandial glycemic reductions with escalation of dose and administration time of American ginseng in type 2 diabetes. Diabetes Care 2000;23:1221-6. PubMed
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