ShankhaPushpi Supreme Ingredients & Drug Interactions
What is this page for?
First and foremost: checking ShankhaPushpi Supreme 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
ShankhaPushpi Supreme is a dietary supplement by Harmony Nutraceuticals with 4 active ingredients. Its ingredients are commonly taken for flavoring and culinary use, digestive complaints like bloating and indigestion, boosting absorption of other supplements.Based on those ingredients, 1,073 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Black Pepper Fruit Extract, Zingiber officinale Extract, Long Pepper Fruit Extract. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against ShankhaPushpi Supreme by Harmony Nutraceuticals
Ask about any prescription or over-the-counter medication and we check it for interactions with ShankhaPushpi Supreme by Harmony Nutraceuticals — 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 ShankhaPushpi Supreme by Harmony Nutraceuticals
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
ShankhaPushpi Supreme has 4 active ingredients. Three of them — black pepper fruit extract, long pepper fruit extract, and ginger extract — contain piperine and gingerol compounds traditionally used in Ayurvedic medicine.
The fourth, triperine, is a proprietary blend of its component ingredients. We could not verify details for Shenowin.
The capsule itself is vegan.
Does it work?
Insufficient evidence
The evidence for this product's claimed uses is sparse. Black pepper's roles in hay fever, asthma, athletic performance, headache, depression, and diarrhea all have insufficient reliable evidence.
Long pepper shows the same gap for bronchitis, asthma, cancer, heart disease, and liver disease. Ginger has stronger data: it's possibly effective for pregnancy-related nausea, period pain (dysmenorrhea), and osteoarthritis, but it's possibly ineffective for muscle soreness after exercise and for nausea from chemotherapy.
Overall, we lack solid evidence that this product works for most of the conditions it may target.
How safe is it?
Well-documented data
Black pepper and ginger are generally well tolerated in the amounts you'd eat in food. At supplement strength, safety is less certain.
Black pepper users may notice a burning aftertaste, upset stomach, or reduced taste; rarely, allergic reactions occur. Ginger at higher doses (above 5 grams daily) increases side effects like stomach discomfort, burping, diarrhea, and heartburn — encapsulated ginger may cause fewer of these than powder.
Ginger is possibly safe in pregnancy for morning sickness, but check with your doctor first and keep amounts moderate. Long pepper and shenowin lack strong safety data at medicinal doses.
Long pepper is traditionally discouraged in pregnancy and breastfeeding — avoid it at supplement strength during those times.
Meds to double-check
Moderate interaction found
Check these medication types before taking this product (worst severity first): blood thinners and antiplatelet drugs (warfarin, phenprocoumon, clopidogrel, aspirin and similar); heart and blood pressure medications (propranolol, nifedipine, losartan); anti-seizure drugs (phenytoin); diabetes medications; HIV antivirals (nevirapine); antibiotics (rifampin); asthma medications (theophylline); immunosuppressants (cyclosporine); statins (atorvastatin); sedatives (pentobarbital); and any medications metabolized by the liver enzyme CYP3A4 or the transporter P-glycoprotein. These are all Moderate severity concerns.
We could not verify interaction data for Shenowin.
The bottom line
Scorecard at a glanceFormula with limited ingredient disclosure with insufficient evidence for its stated purpose. Moderate medication interactions have been identified, and safety information is well characterized.
If you take any medications — especially blood thinners, heart drugs, anti-seizure meds, diabetes drugs, or antivirals — you need to check your exact prescriptions with the tool on this page before starting ShankhaPushpi Supreme. The black pepper and ginger in this product interact with a large number of drugs.
If you're pregnant or nursing, talk with your pharmacist or doctor first, especially about the long pepper content. For most of the conditions this supplement targets, the evidence that it works isn't established.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 3 of 4 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Sep 25, 2025.
This Scorecard evaluates available label information, ingredient evidence, and known medication-safety considerations. It does not independently verify product identity, purity, potency, contamination, or manufacturing quality. How these ratings are computed
General information
Key facts about ShankhaPushpi Supreme, straight from the product label.
| Brand | Harmony Nutraceuticals |
|---|---|
| Barcode (UPC) | 817339020933 |
| Net contents | 120 Vegan Capsule(s) |
| Market status | On market |
| Date entered into DSLD | Sep 25, 2025 |
| DSLD ID | 333376 |
| Product type | Botanical |
| Supplement form | Capsule |
| Dietary claims / uses | All Other, Structure/Function |
| Intended target group(s) | Vegan, Vegetarian, Adult (18 - 50 Years), Kosher, Halal, Gluten Free |
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.
Supplement Facts
The label details for ShankhaPushpi Supreme by Harmony Nutraceuticals, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Black Pepper Fruit Extract | 0 NP | -- |
| Long Pepper Fruit Extract | 0 NP | -- |
| Triperine | 15 mg | -- |
| Shenowin | 665 mg | -- |
| Zingiber officinale Extract | 0 NP | -- |
Other ingredients: Vegan Capsule
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
ShankhaPushpi is a powerful cognitive and rejuvenating Ayurvedic herb. This traditional brain and nervine tonic supports attention, calmness, creativity, and memory. It replenishes and nurtures the adrenals, male, and female reproductive systems.
Vegan
Clinical Grade Certified Lab Tested
Brain - Mind - Nervine Harmony
No: Soy, dairy, egg, nuts, gluten, salt, sugar, artificial colors, artificial flavors or artificial sweeteners. NON-GMO. No fillers. Color variations are natural Nothing else, Pure goodness!
Made with Love in the USA
Formula
Shenowin, our maximum potency Shankhapushpi extract is synergized with Triperine, our proprietary extract of Ginger, Black Pepper, and Piper Longum to boost absorption, bioactivity, and efficacy.
Halal
Kosher
Synergized with Triperine
Suggested/Recommended/Usage/Directions
Suggested use: 1-2 capsules once or twice daily with or after meals or as directed by your healthcare practitioner.
Precautions
Caution: Keep out of reach of children.
Do not use if inner seal is missing or broken.
Pregnant and nursing women, individuals taking medications or persons with a health condition should consult their healthcare professional before using this product.
Storage
Protect from heat, light, and moisture.
Seals/Symbols
Harmonious and Sustainable GMP Certified Good Manufacturing GMP Certified Facility Eco-Friendly O-K!
FDA Statement of Identity
Pure Herbal Supplement
FDA Disclaimer Statement
These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, diagnose, treat, cure or prevent any disease.
Brand IP Statement(s)
Shenowin and Triperine are trademarks of Harmony Nutraceuticals, LLC
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
ShankhaPushpi Supreme by Harmony Nutraceuticals 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 ShankhaPushpi Supreme by Harmony Nutraceuticals
These are the 4 active ingredients this product is made of. Select any to open its full monograph.
Serving size1 Capsule(s) Dosage formCapsule Servings per container120 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.
Shenowin
Other (inactive) ingredients: Vegan Capsule. These complete the product’s ingredient list but are not active constituents.
ShankhaPushpi Supreme by Harmony Nutraceuticals Drug Interactions
HelloPharmacist Interaction Report
ShankhaPushpi Supreme by Harmony Nutraceuticals contains ingredients that do interact with medications.
The most serious interactions come from black pepper fruit extract and ginger, both of which affect how your body handles a wide range of drugs.
Read the full breakdown — every affected drug type, severity by severity
Black pepper raises blood levels of heart medications (propranolol), anti-seizure drugs (phenytoin), HIV antivirals (nevirapine), antibiotics (rifampin), and asthma medications (theophylline). It may also increase levels of the immunosuppressant cyclosporine, the statin atorvastatin, and the sedative pentobarbital — these are all Moderate severity concerns.
Ginger creates Moderate risks with blood thinners (warfarin, phenprocoumon, and other anticoagulants/antiplatelets), diabetes medications, the blood pressure drug losartan, and nifedipine (a calcium channel blocker). It can also change how your body processes many drugs that rely on the liver enzyme CYP3A4, and it may increase absorption of drugs transported by P-glycoprotein.
Long pepper extract raises blood levels of propranolol and theophylline, and it carries the same Moderate concerns as black pepper for blood thinners, diabetes drugs, cyclosporine, and pentobarbital. It also affects CYP3A4 substrates and P-glycoprotein substrates similarly.
We could not check Shenowin — that ingredient's interaction data is not on file with us.
Altogether, these interactions span 1,059 individual medications. Use the medication checker on this page to look up your exact drugs before you start.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against ShankhaPushpi Supreme?
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 ShankhaPushpi Supreme interact with 1,073 drugs. Click any drug to see the details.
3 of the 4 ingredients in ShankhaPushpi Supreme interact with drugs. Each result below shows which ingredient is responsible. Black Pepper Fruit Extract Zingiber officinale Extract Long Pepper Fruit Extract
AlmotriptanAlmogran, Axert
How Almotriptan interacts with ShankhaPushpi Supreme — through 3 ingredients. Tap an ingredient for the detail:
Long Pepper Fruit ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, Indian long pepper might increase the effects and adverse effects of CYP3A4 substrates.
Read the full Long Pepper Fruit Extract + Almotriptan interactionBlack Pepper Fruit ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP3A4.
Read the full Black Pepper Fruit Extract + Almotriptan interactionZingiber Officinale ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Ginger might increase or decrease the levels of CYP3A4 substrates.
Read the full Zingiber Officinale Extract + Almotriptan interactionAlogliptinNesina
How Alogliptin interacts with ShankhaPushpi Supreme — through 3 ingredients. Tap an ingredient for the detail:
Zingiber Officinale ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Antidiabetes Drugs Moderate
Interaction Summary
Ginger might increase or decrease the levels of CYP3A4 substrates.
Read the full Zingiber Officinale Extract + Alogliptin interactionLong Pepper Fruit ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Antidiabetes Drugs Moderate
Interaction Summary
Theoretically, Indian long pepper might increase the effects and adverse effects of CYP3A4 substrates.
Read the full Long Pepper Fruit Extract + Alogliptin interactionBlack Pepper Fruit ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Antidiabetes Drugs Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP3A4.
Read the full Black Pepper Fruit Extract + Alogliptin interactionAlogliptin, MetforminKazano
How Alogliptin, Metformin interacts with ShankhaPushpi Supreme — through 3 ingredients. Tap an ingredient for the detail:
Zingiber Officinale ExtractAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, taking ginger with antidiabetes drugs might increase the risk of hypoglycemia.
Read the full Zingiber Officinale Extract + Alogliptin, Metformin interactionBlack Pepper Fruit ExtractAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, black pepper might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Read the full Black Pepper Fruit Extract + Alogliptin, Metformin interactionLong Pepper Fruit ExtractAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, Indian long pepper might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Read the full Long Pepper Fruit Extract + Alogliptin, Metformin interactionAlogliptin, PioglitazoneOseni
How Alogliptin, Pioglitazone interacts with ShankhaPushpi Supreme — through 3 ingredients. Tap an ingredient for the detail:
Long Pepper Fruit ExtractAntidiabetes Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, Indian long pepper might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Read the full Long Pepper Fruit Extract + Alogliptin, Pioglitazone interactionZingiber Officinale ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Antidiabetes Drugs Moderate
Interaction Summary
Ginger might increase or decrease the levels of CYP3A4 substrates.
Read the full Zingiber Officinale Extract + Alogliptin, Pioglitazone interactionBlack Pepper Fruit ExtractAntidiabetes Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, black pepper might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Read the full Black Pepper Fruit Extract + Alogliptin, Pioglitazone interactionAlpelisibPiqray
How Alpelisib interacts with ShankhaPushpi Supreme — through 3 ingredients. Tap an ingredient for the detail:
Black Pepper Fruit ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP3A4.
Read the full Black Pepper Fruit Extract + Alpelisib interactionLong Pepper Fruit ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, Indian long pepper might increase the effects and adverse effects of CYP3A4 substrates.
Read the full Long Pepper Fruit Extract + Alpelisib interactionZingiber Officinale ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Ginger might increase or decrease the levels of CYP3A4 substrates.
Read the full Zingiber Officinale Extract + Alpelisib interactionAlprazolamNiravam, Xanax
How Alprazolam interacts with ShankhaPushpi Supreme — through 3 ingredients. Tap an ingredient for the detail:
Zingiber Officinale ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Ginger might increase or decrease the levels of CYP3A4 substrates.
Read the full Zingiber Officinale Extract + Alprazolam interactionLong Pepper Fruit ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, Indian long pepper might increase the effects and adverse effects of CYP3A4 substrates.
Read the full Long Pepper Fruit Extract + Alprazolam interactionBlack Pepper Fruit ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP3A4.
Read the full Black Pepper Fruit Extract + Alprazolam interactionAlteplase, TpaActilyse, Activase
How Alteplase, Tpa interacts with ShankhaPushpi Supreme — through 3 ingredients. Tap an ingredient for the detail:
Long Pepper Fruit ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, Indian long pepper might increase the risk of bleeding when taken with anticoagulant/antiplatelet drugs.
Read the full Long Pepper Fruit Extract + Alteplase, Tpa interactionZingiber Officinale ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Ginger may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Zingiber Officinale Extract + Alteplase, Tpa interactionBlack Pepper Fruit ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, black pepper might increase the risk of bleeding when taken with antiplatelet or anticoagulant drugs.
Read the full Black Pepper Fruit Extract + Alteplase, Tpa interactionAluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium HydroxideAscriptin Codeine #2
How Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide interacts with ShankhaPushpi Supreme — through 3 ingredients. Tap an ingredient for the detail:
Black Pepper Fruit ExtractAnticoagulant/antiplatelet Drugs, Cytochrome P450 2d6 (cyp2d6) Substrates Moderate
Interaction Summary
Theoretically, black pepper might increase the risk of bleeding when taken with antiplatelet or anticoagulant drugs.
Read the full Black Pepper Fruit Extract + Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide interactionZingiber Officinale ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Ginger may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Zingiber Officinale Extract + Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide interactionLong Pepper Fruit ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, Indian long pepper might increase the risk of bleeding when taken with anticoagulant/antiplatelet drugs.
Read the full Long Pepper Fruit Extract + Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide interactionAluminum Hydroxide, Aspirin, Magnesium HydroxideAscriptin
How Aluminum Hydroxide, Aspirin, Magnesium Hydroxide interacts with ShankhaPushpi Supreme — through 3 ingredients. Tap an ingredient for the detail:
Long Pepper Fruit ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, Indian long pepper might increase the risk of bleeding when taken with anticoagulant/antiplatelet drugs.
Read the full Long Pepper Fruit Extract + Aluminum Hydroxide, Aspirin, Magnesium Hydroxide interactionZingiber Officinale ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Ginger may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Zingiber Officinale Extract + Aluminum Hydroxide, Aspirin, Magnesium Hydroxide interactionBlack Pepper Fruit ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, black pepper might increase the risk of bleeding when taken with antiplatelet or anticoagulant drugs.
Read the full Black Pepper Fruit Extract + Aluminum Hydroxide, Aspirin, Magnesium Hydroxide interactionAlvimopanEntereg
How Alvimopan interacts with ShankhaPushpi Supreme — through 3 ingredients. Tap an ingredient for the detail:
Long Pepper Fruit ExtractP-glycoprotein Substrates Moderate
Interaction Summary
Theoretically, Indian long pepper might increase levels of P-glycoprotein substrates.
Read the full Long Pepper Fruit Extract + Alvimopan interactionBlack Pepper Fruit ExtractP-glycoprotein Substrates Moderate
Interaction Summary
Theoretically, black pepper might increase levels of P-glycoprotein substrates.
Read the full Black Pepper Fruit Extract + Alvimopan interactionZingiber Officinale ExtractP-glycoprotein Substrates Moderate
Interaction Summary
Ginger might increase the absorption and blood levels of P-glycoprotein (P-gp) substrates.
Read the full Zingiber Officinale Extract + Alvimopan interactionAmbrisentanLetairis, Volibris
How Ambrisentan interacts with ShankhaPushpi Supreme — through 3 ingredients. Tap an ingredient for the detail:
Zingiber Officinale ExtractP-glycoprotein Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Ginger might increase the absorption and blood levels of P-glycoprotein (P-gp) substrates.
Read the full Zingiber Officinale Extract + Ambrisentan interactionBlack Pepper Fruit ExtractCytochrome P450 3a4 (cyp3a4) Substrates, P-glycoprotein Substrates Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP3A4.
Read the full Black Pepper Fruit Extract + Ambrisentan interactionLong Pepper Fruit ExtractP-glycoprotein Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, Indian long pepper might increase levels of P-glycoprotein substrates.
Read the full Long Pepper Fruit Extract + Ambrisentan interactionAmiodaroneCordarone, Pacerone
How Amiodarone interacts with ShankhaPushpi Supreme — through 3 ingredients. Tap an ingredient for the detail:
Long Pepper Fruit ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, Indian long pepper might increase the effects and adverse effects of CYP3A4 substrates.
Read the full Long Pepper Fruit Extract + Amiodarone interactionBlack Pepper Fruit ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP3A4.
Read the full Black Pepper Fruit Extract + Amiodarone interactionZingiber Officinale ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Ginger might increase or decrease the levels of CYP3A4 substrates.
Read the full Zingiber Officinale Extract + Amiodarone interactionAmitriptylineElavil
How Amitriptyline interacts with ShankhaPushpi Supreme — through 3 ingredients. Tap an ingredient for the detail:
Zingiber Officinale ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 2c9 (cyp2c9) Substrates +1 Moderate
Interaction Summary
Ginger might increase or decrease the levels of CYP3A4 substrates.
Read the full Zingiber Officinale Extract + Amitriptyline interactionBlack Pepper Fruit ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 2d6 (cyp2d6) Substrates +1 Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP3A4.
Read the full Black Pepper Fruit Extract + Amitriptyline interactionLong Pepper Fruit ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, Indian long pepper might increase the effects and adverse effects of CYP3A4 substrates.
Read the full Long Pepper Fruit Extract + Amitriptyline interactionAmitriptyline, ChlordiazepoxideLimbitrol DS
How Amitriptyline, Chlordiazepoxide interacts with ShankhaPushpi Supreme — through 3 ingredients. Tap an ingredient for the detail:
Black Pepper Fruit ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 2d6 (cyp2d6) Substrates +1 Moderate
Interaction Summary
Theoretically, black pepper might decrease levels and clinical effects of drugs metabolized by CYP1A2.
Read the full Black Pepper Fruit Extract + Amitriptyline, Chlordiazepoxide interactionZingiber Officinale ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 2c9 (cyp2c9) Substrates +1 Moderate
Interaction Summary
Theoretically, ginger might increase the levels of CYP1A2 substrates.
Read the full Zingiber Officinale Extract + Amitriptyline, Chlordiazepoxide interactionLong Pepper Fruit ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, Indian long pepper might increase the effects and adverse effects of CYP3A4 substrates.
Read the full Long Pepper Fruit Extract + Amitriptyline, Chlordiazepoxide interactionAmitriptyline, PerphenazineEtrafon, Etrafon-A, Etrafon-Forte, Triavil
How Amitriptyline, Perphenazine interacts with ShankhaPushpi Supreme — through 3 ingredients. Tap an ingredient for the detail:
Long Pepper Fruit ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, Indian long pepper might increase the effects and adverse effects of CYP3A4 substrates.
Read the full Long Pepper Fruit Extract + Amitriptyline, Perphenazine interactionBlack Pepper Fruit ExtractCytochrome P450 2d6 (cyp2d6) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP2D6.
Read the full Black Pepper Fruit Extract + Amitriptyline, Perphenazine interactionZingiber Officinale ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 2c9 (cyp2c9) Substrates +1 Moderate
Interaction Summary
Theoretically, ginger might increase the levels of CYP1A2 substrates.
Read the full Zingiber Officinale Extract + Amitriptyline, Perphenazine interactionAmlodipineNorliqva
How Amlodipine interacts with ShankhaPushpi Supreme — through 3 ingredients. Tap an ingredient for the detail:
Zingiber Officinale ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Calcium Channel Blockers Moderate
Interaction Summary
Ginger might increase or decrease the levels of CYP3A4 substrates.
Read the full Zingiber Officinale Extract + Amlodipine interactionLong Pepper Fruit ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, Indian long pepper might increase the effects and adverse effects of CYP3A4 substrates.
Read the full Long Pepper Fruit Extract + Amlodipine interactionBlack Pepper Fruit ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP3A4.
Read the full Black Pepper Fruit Extract + Amlodipine interactionAmlodipine BenzoateKaterzia
How Amlodipine Benzoate interacts with ShankhaPushpi Supreme — through 3 ingredients. Tap an ingredient for the detail:
Zingiber Officinale ExtractCalcium Channel Blockers, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, taking ginger with calcium channel blockers might increase the risk of hypotension.
Read the full Zingiber Officinale Extract + Amlodipine Benzoate interactionBlack Pepper Fruit ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP3A4.
Read the full Black Pepper Fruit Extract + Amlodipine Benzoate interactionLong Pepper Fruit ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, Indian long pepper might increase the effects and adverse effects of CYP3A4 substrates.
Read the full Long Pepper Fruit Extract + Amlodipine Benzoate interactionAmlodipine BesilateIstin
How Amlodipine Besilate interacts with ShankhaPushpi Supreme — through 3 ingredients. Tap an ingredient for the detail:
Long Pepper Fruit ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, Indian long pepper might increase the effects and adverse effects of CYP3A4 substrates.
Read the full Long Pepper Fruit Extract + Amlodipine Besilate interactionBlack Pepper Fruit ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP3A4.
Read the full Black Pepper Fruit Extract + Amlodipine Besilate interactionZingiber Officinale ExtractCalcium Channel Blockers, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, taking ginger with calcium channel blockers might increase the risk of hypotension.
Read the full Zingiber Officinale Extract + Amlodipine Besilate interactionAmlodipine BesylateNorvasc
How Amlodipine Besylate interacts with ShankhaPushpi Supreme — through 3 ingredients. Tap an ingredient for the detail:
Zingiber Officinale ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Calcium Channel Blockers Moderate
Interaction Summary
Ginger might increase or decrease the levels of CYP3A4 substrates.
Read the full Zingiber Officinale Extract + Amlodipine Besylate interactionLong Pepper Fruit ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, Indian long pepper might increase the effects and adverse effects of CYP3A4 substrates.
Read the full Long Pepper Fruit Extract + Amlodipine Besylate interactionBlack Pepper Fruit ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP3A4.
Read the full Black Pepper Fruit Extract + Amlodipine Besylate interactionAmlodipine Besylate, BenazeprilLotrel
How Amlodipine Besylate, Benazepril interacts with ShankhaPushpi Supreme — through 3 ingredients. Tap an ingredient for the detail:
Zingiber Officinale ExtractCalcium Channel Blockers, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, taking ginger with calcium channel blockers might increase the risk of hypotension.
Read the full Zingiber Officinale Extract + Amlodipine Besylate, Benazepril interactionBlack Pepper Fruit ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP3A4.
Read the full Black Pepper Fruit Extract + Amlodipine Besylate, Benazepril interactionLong Pepper Fruit ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, Indian long pepper might increase the effects and adverse effects of CYP3A4 substrates.
Read the full Long Pepper Fruit Extract + Amlodipine Besylate, Benazepril interactionAmlodipine, CelecoxibConsensi
How Amlodipine, Celecoxib interacts with ShankhaPushpi Supreme — through 3 ingredients. Tap an ingredient for the detail:
Long Pepper Fruit ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, Indian long pepper might increase the effects and adverse effects of CYP3A4 substrates.
Read the full Long Pepper Fruit Extract + Amlodipine, Celecoxib interactionZingiber Officinale ExtractCalcium Channel Blockers, Cytochrome P450 2c9 (cyp2c9) Substrates +1 Moderate
Interaction Summary
Theoretically, taking ginger with calcium channel blockers might increase the risk of hypotension.
Read the full Zingiber Officinale Extract + Amlodipine, Celecoxib interactionBlack Pepper Fruit ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP3A4.
Read the full Black Pepper Fruit Extract + Amlodipine, Celecoxib interactionAmoxicillin, Omeprazole Magnesium, RifabutinTalicia
How Amoxicillin, Omeprazole Magnesium, Rifabutin interacts with ShankhaPushpi Supreme — through 3 ingredients. Tap an ingredient for the detail:
Long Pepper Fruit ExtractAmoxicillin (amoxil, Trimox), Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, Indian long pepper might increase the effects and adverse effects of amoxicillin.
Read the full Long Pepper Fruit Extract + Amoxicillin, Omeprazole Magnesium, Rifabutin interactionZingiber Officinale ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 2c9 (cyp2c9) Substrates Moderate
Interaction Summary
Ginger might increase or decrease the levels of CYP3A4 substrates.
Read the full Zingiber Officinale Extract + Amoxicillin, Omeprazole Magnesium, Rifabutin interactionBlack Pepper Fruit ExtractAmoxicillin (amoxil, Trimox), Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, black pepper might increase the effects and side effects of amoxicillin.
Read the full Black Pepper Fruit Extract + Amoxicillin, Omeprazole Magnesium, Rifabutin interactionAmphetamineAdensys XR-ODT, Adzenys ER, Dyanavel XR, Mydayis
How Amphetamine interacts with ShankhaPushpi Supreme — through 1 ingredient. Tap an ingredient for the detail:
Black Pepper Fruit ExtractCytochrome P450 2d6 (cyp2d6) Substrates Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP2D6.
Read the full Black Pepper Fruit Extract + Amphetamine interactionAmphetamine Aspartate, Amphetamine Sulfate, Dextroamphetamine Saccharate, Dextroamphetamine SulfateAdderall, Adderall XR
How Amphetamine Aspartate, Amphetamine Sulfate, Dextroamphetamine Saccharate, Dextroamphetamine Sulfate interacts with ShankhaPushpi Supreme — through 1 ingredient. Tap an ingredient for the detail:
Black Pepper Fruit ExtractCytochrome P450 2d6 (cyp2d6) Substrates Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP2D6.
Read the full Black Pepper Fruit Extract + Amphetamine Aspartate, Amphetamine Sulfate, Dextroamphetamine Saccharate, Dextroamphetamine Sulfate interactionAmphetamine SulfateBenzedrine, Evekeo ODT
How Amphetamine Sulfate interacts with ShankhaPushpi Supreme — through 1 ingredient. Tap an ingredient for the detail:
Black Pepper Fruit ExtractCytochrome P450 2d6 (cyp2d6) Substrates Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP2D6.
Read the full Black Pepper Fruit Extract + Amphetamine Sulfate interactionAmphotericin, TetracyclineMysteclin-F
How Amphotericin, Tetracycline interacts with ShankhaPushpi Supreme — through 3 ingredients. Tap an ingredient for the detail:
Black Pepper Fruit ExtractP-glycoprotein Substrates Moderate
Interaction Summary
Theoretically, black pepper might increase levels of P-glycoprotein substrates.
Read the full Black Pepper Fruit Extract + Amphotericin, Tetracycline interactionLong Pepper Fruit ExtractP-glycoprotein Substrates Moderate
Interaction Summary
Theoretically, Indian long pepper might increase levels of P-glycoprotein substrates.
Read the full Long Pepper Fruit Extract + Amphotericin, Tetracycline interactionZingiber Officinale ExtractP-glycoprotein Substrates Moderate
Interaction Summary
Ginger might increase the absorption and blood levels of P-glycoprotein (P-gp) substrates.
Read the full Zingiber Officinale Extract + Amphotericin, Tetracycline interactionAmprenavirAgenerase
How Amprenavir interacts with ShankhaPushpi Supreme — through 3 ingredients. Tap an ingredient for the detail:
Zingiber Officinale ExtractP-glycoprotein Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Ginger might increase the absorption and blood levels of P-glycoprotein (P-gp) substrates.
Read the full Zingiber Officinale Extract + Amprenavir interactionLong Pepper Fruit ExtractP-glycoprotein Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, Indian long pepper might increase levels of P-glycoprotein substrates.
Read the full Long Pepper Fruit Extract + Amprenavir interactionBlack Pepper Fruit ExtractCytochrome P450 3a4 (cyp3a4) Substrates, P-glycoprotein Substrates Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP3A4.
Read the full Black Pepper Fruit Extract + Amprenavir interactionAnacaulase-bcdbNexoBrid
How Anacaulase-bcdb interacts with ShankhaPushpi Supreme — through 3 ingredients. Tap an ingredient for the detail:
Long Pepper Fruit ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, Indian long pepper might increase the risk of bleeding when taken with anticoagulant/antiplatelet drugs.
Read the full Long Pepper Fruit Extract + Anacaulase-bcdb interactionZingiber Officinale ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Ginger may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Zingiber Officinale Extract + Anacaulase-bcdb interactionBlack Pepper Fruit ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, black pepper might increase the risk of bleeding when taken with antiplatelet or anticoagulant drugs.
Read the full Black Pepper Fruit Extract + Anacaulase-bcdb interactionAnagrelideAgrylin
How Anagrelide interacts with ShankhaPushpi Supreme — through 3 ingredients. Tap an ingredient for the detail:
Black Pepper Fruit ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Anticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, black pepper might decrease levels and clinical effects of drugs metabolized by CYP1A2.
Read the full Black Pepper Fruit Extract + Anagrelide interactionZingiber Officinale ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Anticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, ginger might increase the levels of CYP1A2 substrates.
Read the full Zingiber Officinale Extract + Anagrelide interactionLong Pepper Fruit ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, Indian long pepper might increase the risk of bleeding when taken with anticoagulant/antiplatelet drugs.
Read the full Long Pepper Fruit Extract + Anagrelide interactionAnisindioneMiradon
How Anisindione interacts with ShankhaPushpi Supreme — through 3 ingredients. Tap an ingredient for the detail:
Long Pepper Fruit ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, Indian long pepper might increase the risk of bleeding when taken with anticoagulant/antiplatelet drugs.
Read the full Long Pepper Fruit Extract + Anisindione interactionZingiber Officinale ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Ginger may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Zingiber Officinale Extract + Anisindione interactionBlack Pepper Fruit ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, black pepper might increase the risk of bleeding when taken with antiplatelet or anticoagulant drugs.
Read the full Black Pepper Fruit Extract + Anisindione interactionEach ingredient & the kinds of drugs it affects
For each ingredient in ShankhaPushpi Supreme with known interactions, here are the types of medications they can affect. Open any type for the detail — or search your exact drug in the checker above.
Black Pepper Fruit Extract
Anticoagulant/Antiplatelet Drugs
Theoretically, black pepper might increase the risk of bleeding when taken with antiplatelet or anticoagulant drugs.
In vitro research shows that piperine, a constituent of black pepper, seems to inhibit platelet aggregation. This has not been reported in humans.
Antidiabetes Drugs
Theoretically, black pepper might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Animal research shows that piperine, a constituent of black pepper, can reduce blood glucose levels. Monitor blood glucose levels closely. Dose adjustments might be necessary.
Atorvastatin (Lipitor)
Theoretically, black pepper might increase blood levels of atorvastatin.
Animal research shows that taking piperine, a constituent of black pepper, 35 mg/kg can increase the maximum serum concentration of atorvastatin three-fold. This has not been reported in humans.
Cyclosporine (Neoral, Sandimmune)
Theoretically, black pepper might increase the effects and side effects of cyclosporine.
In vitro research shows that piperine, a constituent of black pepper, increases the bioavailability of cyclosporine. This has not been reported in humans.
Cytochrome P450 2D6 (Cyp2D6) Substrates
Theoretically, black pepper might increase levels of drugs metabolized by CYP2D6.
In vitro research suggests that some constituents of black pepper inhibit CYP2D6. This has not been reported in humans.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, black pepper might increase levels of drugs metabolized by CYP3A4.
In vitro research and pharmacokinetic simulation data suggest that piperine, a constituent of black pepper, as well as the pepper fruit seem to inhibit CYP3A4. This has not been reported in humans.
Lithium
Theoretically, black pepper might increase blood levels of lithium due to its diuretic effects. The dose of lithium might need to be reduced.
Black pepper is thought to have diuretic properties.
Nevirapine (Viramune)
Black pepper might increase blood levels of nevirapine.
Clinical research shows that piperine, a constituent of black pepper, increases the plasma concentration of nevirapine. However, no adverse effects were observed in this study.
P-Glycoprotein Substrates
Theoretically, black pepper might increase levels of P-glycoprotein substrates.
In vitro research shows that piperine, a constituent of black pepper, seems to inhibit P-glycoprotein.
Pentobarbital (Nembutal)
Theoretically, black pepper might increase the sedative effects of pentobarbital.
Animal research shows that piperine, a constituent of black pepper, increases pentobarbital-induced sleeping time.
Phenytoin (Dilantin)
Black pepper might increase blood levels of phenytoin.
Clinical research shows that piperine, a constituent of black pepper, seems to increase absorption, slow elimination, and increase levels of phenytoin. Taking a single dose of black pepper 1 gram along with phenytoin seems to double the serum concentration of phenytoin. Consuming a soup with black pepper providing piperine 44 mg/200 mL of soup along with phenytoin also seems to increase phenytoin levels when compared with consuming the same soup without black pepper.
Propranolol (Inderal)
Black pepper might increase blood levels of propranolol.
Clinical research shows that piperine, a constituent of black pepper, seems to increase absorption and slow elimination of propranolol.
Rifampin (Rifadin)
Black pepper might increase blood levels of rifampin.
Clinical research shows that piperine, a constituent of black pepper, seems to increase absorption and serum levels of rifampin.
Theophylline
Black pepper might increase blood levels of theophylline.
Clinical research shows that piperine, a constituent of black pepper, seems to increase absorption and slow elimination of theophylline.
Amoxicillin (Amoxil, Trimox)
Theoretically, black pepper might increase the effects and side effects of amoxicillin.
Animal research shows that taking piperine, a constituent of black pepper, with amoxicillin increases plasma levels of amoxicillin. This has not been reported in humans.
Carbamazepine (Tegretol)
Theoretically, black pepper might increase blood levels of carbamazepine, potentially increasing the effects and side effects of carbamazepine.
One clinical study in patients taking carbamazepine 300 mg or 500 mg twice daily shows that taking a single 20 mg dose of purified piperine, a constituent of black pepper, increases carbamazepine levels. Piperine may increase carbamazepine absorption by increasing blood flow to the GI tract, increasing the surface area of the small intestine, or inhibiting cytochrome P450 3A4 (CYP3A4) in the gut wall. Absorption was significantly increased by 7-10 mcg/mL/hour. The time to eliminate carbamazepine was also increased by 4-8 hours. Although carbamazepine levels were increased, this did not appear to increase side effects. In vitro research also shows that piperine can increase carbamazepine levels by 11% in a time-dependent manner.
Cytochrome P450 1A2 (Cyp1A2) Substrates
Theoretically, black pepper might decrease levels and clinical effects of drugs metabolized by CYP1A2.
In vitro research suggests that black pepper induces CYP1A2. This has not been reported in humans.
Zingiber officinale Extract
Anticoagulant/Antiplatelet Drugs
Ginger may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs. However, research is conflicting.
Laboratory research suggests that ginger inhibits thromboxane synthetase and decreases platelet aggregation. However, this has not been demonstrated unequivocally in humans, with mixed results from clinical trials. Theoretically, excessive amounts of ginger might increase the risk of bleeding when used with anticoagulant/antiplatelet drugs.
Antidiabetes Drugs
Theoretically, taking ginger with antidiabetes drugs might increase the risk of hypoglycemia.
Animal and human research suggests that ginger might increase insulin levels and/or decrease blood glucose levels.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Ginger might increase or decrease the levels of CYP3A4 substrates.
In vitro research and some case reports suggest that ginger inhibits CYP3A4 activity. Three case reports from the World Health Organization (WHO) adverse drug reaction database describe increased toxicity in patients taking ginger and cancer medications that are CYP3A4 substrates (imatinib, dabrafenib, and crizotinib). However, the causality of this interaction is unclear due to the presence of multiple interacting drugs and routes of administration.
Conversely, other in vitro research suggests that ginger induces CYP3A4 activity, leading to reduced levels of CYP3A4 substrates. However, this interaction has not been reported in humans.
Losartan (Cozaar)
Theoretically, ginger might increase levels of losartan and the risk of hypotension.
In animal research, ginger increased the levels and hypotensive effects of a single dose of losartan. It is not clear if ginger alters the concentration or effects of losartan when taken continuously. Additionally, this interaction has not been shown in humans.
Nifedipine (Procardia)
Ginger may have antiplatelet effects and increase the risk of bleeding if used with nifedipine.
Clinical research shows that combined treatment with ginger 1 gram plus nifedipine 10 mg significantly inhibits platelet aggregation when compared to nifedipine or ginger alone.
P-Glycoprotein Substrates
Ginger might increase the absorption and blood levels of P-glycoprotein (P-gp) substrates.
In vitro research and case reports suggest that ginger inhibits drug efflux by P-gp, potentially increasing absorption and serum levels of P-gp substrates. Two case reports from the World Health Organization (WHO) adverse drug reaction database describe increased toxicity in patients taking ginger and cancer medications that are P-gp substrates (trametinib, crizotinib). However, the causality of this interaction is unclear due to the presence of multiple interacting drugs and routes of administration.
Phenprocoumon (Marcoumar, Others)
Ginger might increase the risk of bleeding with phenprocoumon.
Phenprocoumon, a warfarin-related anticoagulant, might increase the international normalized ratio (INR) when taken with ginger. There is one case report of a 76-year-old woman with a stable INR on phenprocoumon that increased to greater than 10 when she began consuming dried ginger and ginger tea.
Warfarin (Coumadin)
Ginger might increase the risk of bleeding with warfarin.
Laboratory research suggests that ginger might inhibit thromboxane synthetase and decrease platelet aggregation. In one case report, ginger increased the INR when taken with phenprocoumon, which has similar pharmacological effects as warfarin. In another case report, ginger increased the INR when taken with a combination of warfarin, hydrochlorothiazide, and acetaminophen. A longitudinal analysis suggests that taking ginger increases the risk of bleeding in patients taking warfarin for at least 4 months. However, research in healthy people suggests that ginger has no effect on INR, or the pharmacokinetics or pharmacodynamics of warfarin. Until more is known, monitor INRs closely in patients taking large amounts of ginger.
Calcium Channel Blockers
Theoretically, taking ginger with calcium channel blockers might increase the risk of hypotension.
Some animal and in vitro research suggests that ginger has hypotensive and calcium channel-blocking effects. Another animal study shows that concomitant administration of ginger and the calcium channel blocker amlodipine leads to greater reductions in blood pressure when compared with amlodipine alone.
Cyclosporine (Neoral, Sandimmune)
Theoretically, when taken prior to cyclosporine, ginger might decrease cyclosporine levels.
In an animal model, ginger juice taken 2 hours prior to cyclosporine administration reduced the maximum concentration and area under the curve of cyclosporine by 51% and 40%, respectively. This effect was not observed when ginger juice and cyclosporine were administered at the same time.
Cytochrome P450 1A2 (Cyp1A2) Substrates
Theoretically, ginger might increase the levels of CYP1A2 substrates.
In vitro research shows that ginger inhibits CYP1A2 activity. However, this interaction has not been reported in humans.
Cytochrome P450 2B6 (Cyp2B6) Substrates
Theoretically, ginger might increase the levels of CYP2B6 substrates.
In vitro research shows that ginger inhibits CYP2B6 activity. However, this interaction has not been reported in humans.
Cytochrome P450 2C9 (Cyp2C9) Substrates
Theoretically, ginger might increase the levels of CYP2C9 substrates.
In vitro research shows that ginger inhibits CYP2C9 activity. However, this interaction has not been reported in humans.
Metronidazole (Flagyl)
Theoretically, ginger might increase levels of metronidazole.
In an animal model, ginger increased the absorption and plasma half-life of metronidazole. In addition, the elimination rate and clearance of metronidazole was significantly reduced.
Long Pepper Fruit Extract
Anticoagulant/Antiplatelet Drugs
Theoretically, Indian long pepper might increase the risk of bleeding when taken with anticoagulant/antiplatelet drugs.
In vitro research shows that Indian long pepper extract inhibits platelet aggregation.
Antidiabetes Drugs
Theoretically, Indian long pepper might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Animal research shows that piperine, a constituent of Indian long pepper, can reduce blood glucose levels. Monitor blood glucose levels closely. Dose adjustments might be necessary.
Cyclosporine (Neoral, Sandimmune)
Theoretically, Indian long pepper might increase the effects and adverse effects of cyclosporine.
In vitro research shows that piperine, a constituent of Indian long pepper, increases the bioavailability of cyclosporine.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, Indian long pepper might increase the effects and adverse effects of CYP3A4 substrates.
In vitro research shows that piperine, a constituent of Indian long pepper, inhibits CYP3A4.
Nevirapine (Viramune)
Theoretically, Indian long pepper might increase blood levels of nevirapine.
A small pharmacokinetic study shows that piperine, a constituent of Indian long pepper, increases the plasma concentration and systemic exposure of nevirapine. However, no adverse effects were associated with the elevated plasma levels of nevirapine.
P-Glycoprotein Substrates
Theoretically, Indian long pepper might increase levels of P-glycoprotein substrates.
In vitro research shows that piperine, a constituent of Indian long pepper, can inhibit P-glycoprotein.
Pentobarbital (Nembutal)
Theoretically, Indian long pepper might increase the sedative effects of pentobarbital.
Animal research shows that piperine, a constituent of Indian long pepper, can increase pentobarbitone-induced sleeping time.
Phenytoin (Dilantin)
Theoretically, Indian long pepper might increase blood levels of phenytoin.
A small pharmacokinetic study shows that piperine, a constituent of Indian long pepper, increases phenytoin serum levels and slows its elimination.
Propranolol (Inderal)
Theoretically, Indian long pepper might increase blood levels of propranolol.
A small pharmacokinetic study shows that piperine, a constituent of Indian long pepper, accelerates absorption and increases serum concentrations of propranolol.
Rifampin (Rifadin)
Theoretically, Indian long pepper might increase blood levels of rifampin.
Piperine, a constituent of Indian long pepper, seems to increase absorption and serum levels of rifampin.
Theophylline
Indian long pepper might increase blood levels of theophylline.
A small pharmacokinetic study shows that piperine, a constituent of Indian long pepper, increases serum concentrations and slows elimination of theophylline.
Amoxicillin (Amoxil, Trimox)
Theoretically, Indian long pepper might increase the effects and adverse effects of amoxicillin.
Evidence from animal research shows that piperine, a constituent of Indian long pepper, increases the plasma levels of amoxicillin when taken concomitantly.
Carbamazepine (Tegretol)
Theoretically, Indian long pepper might increase blood levels of carbamazepine.
A small pharmacokinetic study in patients taking carbamazepine 300 mg or 500 mg twice daily shows that a single 20 mg dose of purified piperine, which is a constituent of Indian long pepper, increases carbamazepine levels. Piperine may increase absorption by increasing blood flow to the GI tract, increasing the surface area of the small intestine, or by cytochrome P450 3A4 (CYP3A4) inhibition in the gut wall. Absorption was significantly increased by 7-10 mcg/mL/hour. The time to eliminate carbamazepine was also increased by 4-8 hours. Although carbamazepine levels were increased, this did not appear to increase side effects.
Cefotaxime (Claforan)
Theoretically, Indian long pepper might increase the effects and adverse effects of cefotaxime.
Animal research shows that piperine, a constituent of Indian long pepper, increases the plasma levels of cefotaxime when taken concomitantly.
Brand information
Manufacturer and brand details for ShankhaPushpi Supreme, from the product label.
Harmony Nutraceuticals
See all Harmony Nutraceuticals products- Name
- Harmony Nutraceuticals, LLC
- Street Address
- 3701 NW 62nd Street
- City
- OKC
- State
- OK
- ZipCode
- 73112
- Phone Number
- (405) 601-4518
- Web Address
- www.HarmonyVeda.com
ShankhaPushpi Supreme by Harmony Nutraceuticals: Common Questions
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Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
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Label information is sourced from the NIH Dietary Supplement Label Database and reflects the product version on file; always read your actual product label. This page is for education only and is not a substitute for professional medical advice. Confirm with your pharmacist or doctor before combining supplements and medications.
The Full Monographs Behind ShankhaPushpi Supreme’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Black Pepper
Interacts with 1,019 drugsBlack pepper is a common kitchen spice that is generally safe in the amounts used in food. Its extract, piperine, is mostly added to supplements to help the body absorb other ingredients (li...
Read the full Black Pepper monograph → Herb & supplement monographIndian Long Pepper
Interacts with 896 drugsIndian long pepper (pippali) is a spice long used in Ayurvedic medicine and is best known for its piperine content, which may increase how well the body absorbs certain other substances. Mod...
Read the full Indian Long Pepper monograph → Herb & supplement monographGinger
Interacts with 1,007 drugsGinger is a widely used culinary spice with a long history in traditional medicine, and it has the strongest evidence for helping with nausea and vomiting, including from motion sickness, pr...
Read the full Ginger monograph →Sources & How We Checked
ShankhaPushpi Supreme'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 105 references behind this product’s interaction data
Every citation that drives the interaction findings for this product’s ingredients, from the evidence-graded Natural Medicines (TRC Healthcare) database. Open an ingredient to browse its citations — links open the study on PubMed or the publisher’s site.
Black Pepper 29 references
- Leung AY, Foster S. Encyclopedia of Common Natural Ingredients Used in Food, Drugs and Cosmetics. 2nd ed. New York, NY: John Wiley & Sons, 1996.
- Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
- Bano G, Amla V, Raina RK, et al. The effect of piperine on pharmacokinetics of phenytoin in healthy volunteers. Planta Med 1987;53:568-9. PubMed
- Bano G, et al. Effect of piperine on bioavailability and pharmacokinetics of propranolol and theophylline in healthy volunteers. Eur J Clin Pharmacol 1991;41;615-7. PubMed
- Cohle SD, Trestrail JD III, Graham MA, et al. Fatal pepper aspiration. Am J Dis Child 1988;142:633-6. PubMed
- Bhardwaj RK, Glaeser H, Becquemont L, et al. Piperine, a major constituent of black pepper, inhibits human P-glycoprotein and CYP3A4. J Pharmacol Exp Ther 2002;302:645-50. PubMed
- Velpandian T, Jasuja R, Bhardwaj RK, et al. Piperine in food: interference in the pharmacokinetics of phenytoin. Eur J Drug Metab Pharmacokinet 2001;26:241-7. PubMed
- Pattanaik S, Hota D, Prabhakar S, et al. Pharmacokinetic interaction of a single dose of piperine with steady-state carbamazepine in epilepsy patients. Phytother Res 2009;23:1281-6.
- Munakata, M., Kobayashi, K., Niisato-Nezu, J., Tanaka, S., Kakisaka, Y., Ebihara, T., Ebihara, S., Haginoya, K., Tsuchiya, S., and Onuma, A. Olfactory stimulation using black pepper oil facilitates oral feeding in pediatric patients receiving long-term en
- Myers, B. M., Smith, J. L., and Graham, D. Y. Effect of red pepper and black pepper on the stomach. Am J Gastroenterol 1987;82(3):211-214.
- Raghavendra, R. H. and Naidu, K. A. Spice active principles as the inhibitors of human platelet aggregation and thromboxane biosynthesis. Prostaglandins Leukot.Essent.Fatty Acids 2009;81(1):73-78. PubMed
- Subehan, Usia, T., Kadota, S., and Tezuka, Y. Mechanism-based inhibition of human liver microsomal cytochrome P450 2D6 (CYP2D6) by alkamides of Piper nigrum. Planta Med 2006;72(6):527-532.
- Kasibhatta, R. and Naidu, M. U. Influence of piperine on the pharmacokinetics of nevirapine under fasting conditions: a randomised, crossover, placebo-controlled study. Drugs R.D. 2007;8(6):383-391. PubMed
- Usia, T., Iwata, H., Hiratsuka, A., Watabe, T., Kadota, S., and Tezuka, Y. CYP3A4 and CYP2D6 inhibitory activities of Indonesian medicinal plants. Phytomedicine. 2006;13(1-2):67-73. PubMed
- Mujumdar, A. M., Dhuley, J. N., Deshmukh, V. K., Raman, P. H., Thorat, S. L., and Naik, S. R. Effect of piperine on pentobarbitone induced hypnosis in rats. Indian J Exp.Biol. 1990;28(5):486-487.
- Panda, S. and Kar, A. Piperine lowers the serum concentrations of thyroid hormones, glucose and hepatic 5'D activity in adult male mice. Horm.Metab Res. 2003;35(9):523-526. PubMed
- Lawless, H. and Stevens, D. A. Effects of oral chemical irritation on taste. Physiol Behav. 1984;32(6):995-998. PubMed
- Hiwale, A. R., Dhuley, J. N., and Naik, S. R. Effect of co-administration of piperine on pharmacokinetics of beta-lactam antibiotics in rats. Indian J Exp.Biol. 2002;40(3):277-281.
- Han, Y., Chin Tan, T. M., and Lim, L. Y. In vitro and in vivo evaluation of the effects of piperine on P-gp function and expression. Toxicol.Appl.Pharmacol. 8-1-2008;230(3):283-289. PubMed
- Sharma, P., Varma, M. V., Chawla, H. P., and Panchagnula, R. In situ and in vivo efficacy of peroral absorption enhancers in rats and correlation to in vitro mechanistic studies. Farmaco 2005;60(11-12):874-883. PubMed
- Aher, S., Biradar, S., Gopu, C. L., and Paradkar, A. Novel pepper extract for enhanced P-glycoprotein inhibition. J Pharm.Pharmacol. 2009;61(9):1179-1186. PubMed
- Zutshi, R. K., Singh, R., Zutshi, U., Johri, R. K., and Atal, C. K. Influence of piperine on rifampicin blood levels in patients of pulmonary tuberculosis. J Assoc.Physicians India 1985;33(3):223-224.
- Marotta, R. B. and Floch, M. H. Diet and nutrition in ulcer disease. Med Clin North Am 1991;75(4):967-979. PubMed
- Subehan, Usia, T., Iwata, H., Kadota, S., and Tezuka, Y. Mechanism-based inhibition of CYP3A4 and CYP2D6 by Indonesian medicinal plants. J Ethnopharmacol. 5-24-2006;105(3):449-455. PubMed
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DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.
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