SM&W-S Ingredients & Drug Interactions
by Pure Herbs
What is this page for?
First and foremost: checking SM&W-S 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
SM&W-S is a dietary supplement by Pure Herbs with 6 active ingredients. Its ingredients are commonly taken for low libido and sexual function, energy and stamina, menopause symptoms.Based on those ingredients, 1,131 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are Yohimbe bark extract, Wild Yam root extract, Sarsaparilla Root Extract. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against SM&W-S by Pure Herbs
Ask about any prescription or over-the-counter medication and we check it for interactions with SM&W-S by Pure Herbs — 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 SM&W-S by Pure Herbs
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
Pure Herbs SM&W-S is a 6-ingredient liquid blend. The active ingredients are maca root extract, yohimbe bark extract, sarsaparilla root extract, stoneroot root extract, pumpkin seed extract, and wild yam root extract.
These are combined in a proprietary blend, so the individual amounts of each are not listed separately. The product contains no inactive fillers or other ingredients.
Does it work?
Not established
The evidence for this product's uses is limited. Maca root, yohimbe bark, sarsaparilla, and wild yam all show insufficient reliable evidence to rate their effects on sexual function, energy, hormonal balance, and other purported benefits.
The one exception is pumpkin seed extract, which is rated possibly effective for benign prostatic hyperplasia (BPH) — a condition where the prostate gland enlarges with age — but evidence for its other uses, including hair loss and urinary tract infections, is insufficient. Because the product is a blend with unlisted amounts, it's unclear whether the dose of pumpkin seed is high enough to deliver that benefit.
How safe is it?
Well-documented data
Yohimbe is the ingredient with the most serious safety concerns. It can cause serious heart and blood pressure effects — anxiety, agitation, tremors, rapid heartbeat, high blood pressure, and in rare cases, a dangerous spike in blood pressure (hypertensive crisis).
Because yohimbe potency varies unpredictably from batch to batch, these risks are harder to predict. Maca and sarsaparilla are generally well tolerated as foods, but their long-term safety as supplements has not been well studied.
Pumpkin seed is generally well tolerated; common mild side effects include abdominal discomfort, diarrhea, nausea, and vomiting. Rare cases of severe nausea, vomiting, diarrhea, or hair loss have been reported with high-dose wild pumpkin products, usually when they contained bitter compounds.
Wild yam is generally well tolerated short-term but may cause headache, fever, or upset stomach, especially at higher doses. None of the ingredients have adequate safety data for pregnancy or breastfeeding — the facts advise avoiding them in both situations.
Talk with your doctor or pharmacist about whether this product is right for you if you are pregnant, planning to become pregnant, or breastfeeding.
Meds to double-check
Major interaction found
Before you take this product, double-check with your doctor or pharmacist if you take any of these: monoamine oxidase inhibitors (MAOIs) or older antidepressants (Major interaction with yohimbe); blood pressure medications, heart drugs, psychiatric medications that are metabolized by your liver, stimulants, antipsychotics, or tricyclic antidepressants (all Moderate interactions with yohimbe); lithium, a mood stabilizer (Moderate interaction with both sarsaparilla and pumpkin seed); or digoxin, a heart medication (Moderate interaction with sarsaparilla). We were unable to check stoneroot root extract for interactions — no data is on file for it.
The bottom line
Scorecard at a glanceFormula with limited ingredient disclosure with no established evidence rating for its marketed use. Major medication interactions have been identified, and safety information is well characterized.
This blend is not for everyone. If you take any prescription medications — especially blood pressure drugs, antidepressants, heart medications, or lithium — you need to check each of your medications against this product before starting it.
Yohimbe in particular carries real cardiovascular and neurological risks. If you're pregnant, breastfeeding, or considering it, the safety data advise against use.
Talk with your own doctor or pharmacist about whether SM&W-S is appropriate for your health and your current medications.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 5 of 6 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Jan 23, 2023.
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 SM&W-S, straight from the product label.
| Brand | Pure Herbs |
|---|---|
| Net contents | 4 Fluid Ounce(s); 120 mL |
| Market status | On market |
| Date entered into DSLD | Jan 23, 2023 |
| DSLD ID | 281379 |
| Product type | Botanical |
| Supplement form | Liquid |
| Dietary claims / uses | All Other, Structure/Function |
| Intended target group(s) | Adult (18 - 50 Years), Women (not pregnant or lactating) |
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 SM&W-S by Pure Herbs, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Proprietary Blend | 2005 mg | -- |
| Maca root extract | 0 NP | -- |
| Yohimbe bark extract | 0 NP | -- |
| Sarsaparilla Root Extract | 0 NP | -- |
| Stoneroot Root Extract | 0 NP | -- |
| Pumpkin Seed Extract | 0 NP | -- |
| Wild Yam root extract | 0 NP | -- |
Other ingredients: None
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.
Suggested/Recommended/Usage/Directions
Directions: For adults, mix 2 mL (abt. 1/2 tsp) of extract in 2 fl. oz (60 mL) water one time daily preferably with a meal.
Shake well before use
Formulation
Helps to enhance stamina in men and women.
Formula
Helps to enhance stamina in men and women.
FDA Disclaimer Statement
This statement has not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.
Precautions
Warning: Not intended for use by pregnant or nursing women. If you have a medical condition or are taking medication, consult your doctor prior to use.
Discontinue use and consult with your doctor if any adverse reactions occur.
Keep out of reach of children
Brand IP Statement(s)
Pure Herbs, Ltd. Natural Herbal Extracts
FDA Statement of Identity
Dietary Supplement
General Statements
"No expense has been spared to provide the finest nature has to offer."
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
SM&W-S by Pure Herbs 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 SM&W-S by Pure Herbs
These are the 6 active ingredients this product is made of. Select any to open its full monograph.
Serving size2 mL Dosage formLiquid Servings per container60 Amounts shown are per serving.
Most supplement products combine several ingredients, and a medication can interact with the product through any one of them. Each ingredient below shows whether it has known drug interactions.
Proprietary Blend
- › Maca root extract
- › Yohimbe bark extract
- › Sarsaparilla Root Extract
- › Stoneroot Root Extract
- › Pumpkin Seed Extract
- › Wild Yam root extract
Other (inactive) ingredients: None. These complete the product’s ingredient list but are not active constituents.
SM&W-S by Pure Herbs Drug Interactions
HelloPharmacist Interaction Report
Pure Herbs SM&W-S contains yohimbe bark extract, sarsaparilla root extract, and pumpkin seed extract, all of which interact with medications.
The most serious concern is yohimbe's Major interaction with monoamine oxidase inhibitors (MAOIs) — a class of older antidepressants — where concomitant use can produce additive effects and raise the risk of a dangerous reaction. Yohimbe also carries Moderate interactions with a broad range of drug types: blood pressure medications (antihypertensives), heart and psychiatric drugs metabolized by liver enzymes (CYP2D6 and CYP3A4 substrates and inhibitors), stimulants, antipsychotics (phenothiazines), and tricyclic antidepressants, where it may worsen side effects or reduce drug effectiveness.
Read the full breakdown — every affected drug type, severity by severity
Sarsaparilla and pumpkin seed extract each interact with lithium, a mood stabilizer — theoretically reducing its excretion and raising its levels in the blood, which could require a dose adjustment. Sarsaparilla also may increase the risk of heart toxicity if used with digoxin (a heart medication), due to potassium loss from its diuretic properties.
We hold no interaction data for stoneroot root extract, so we cannot assess whether it interacts with any medications. Use the medication checker on this page to review your exact prescriptions before starting this product.
Altogether, these interactions span 1,132 individual medications.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against SM&W-S?
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 SM&W-S interact with 1,131 drugs. Click any drug to see the details.
4 of the 6 ingredients in SM&W-S interact with drugs. Each result below shows which ingredient is responsible. Yohimbe bark extract Wild Yam root extract Sarsaparilla Root Extract Pumpkin Seed Extract
AbametapirXeglyze
How Abametapir interacts with SM&W-S — through 1 ingredient. Tap an ingredient for the detail:
Yohimbe Bark ExtractCytochrome P450 3a4 (cyp3a4) Inhibitors Moderate
Interaction Summary
Theoretically, CYP3A4 inhibitors might increase the levels and adverse effects of yohimbine, a constituent of yohimbe bark.
Read the full Yohimbe Bark Extract + Abametapir interactionAbiraterone
How Abiraterone interacts with SM&W-S — through 1 ingredient. Tap an ingredient for the detail:
Yohimbe Bark ExtractCytochrome P450 3a4 (cyp3a4) Inhibitors, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Moderate
Interaction Summary
Theoretically, CYP3A4 inhibitors might increase the levels and adverse effects of yohimbine, a constituent of yohimbe bark.
Read the full Yohimbe Bark Extract + Abiraterone interactionAbiraterone AcetateYonsa, Zytiga
How Abiraterone Acetate interacts with SM&W-S — through 1 ingredient. Tap an ingredient for the detail:
Yohimbe Bark ExtractCytochrome P450 2d6 (cyp2d6) Inhibitors, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
CYP2D6 inhibitors may increase the levels and adverse effects of yohimbine, a constituent of yohimbe.
Read the full Yohimbe Bark Extract + Abiraterone Acetate interactionAcebutololRhotral, Sectral
How Acebutolol interacts with SM&W-S — through 1 ingredient. Tap an ingredient for the detail:
Yohimbe Bark ExtractAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, yohimbe might reduce the effects of antihypertensive drugs.
Read the full Yohimbe Bark Extract + Acebutolol interactionAcepromazineAtravet
How Acepromazine interacts with SM&W-S — through 1 ingredient. Tap an ingredient for the detail:
Yohimbe Bark ExtractPhenothiazines Moderate
Interaction Summary
Theoretically, using yohimbine with phenothiazines might have additive effects.
Read the full Yohimbe Bark Extract + Acepromazine interactionAcetaminophen, Aspirin, CaffeineExcedrin, Excedrin Extra Strength, Excedrin Migraine
How Acetaminophen, Aspirin, Caffeine interacts with SM&W-S — through 1 ingredient. Tap an ingredient for the detail:
Yohimbe Bark ExtractAnticoagulant/antiplatelet Drugs, Cytochrome P450 1a2 (cyp1a2) Substrates +2 Moderate
Interaction Summary
Theoretically, combining yohimbe bark with antiplatelet or anticoagulant drugs might have additive effects; however, this has not been reported in clinical research.
Read the full Yohimbe Bark Extract + Acetaminophen, Aspirin, Caffeine interactionAcetaminophen, Brompheniramine, PhenylpropanolamineDimetapp Cold and Flu
How Acetaminophen, Brompheniramine, Phenylpropanolamine interacts with SM&W-S — through 1 ingredient. Tap an ingredient for the detail:
Yohimbe Bark ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Stimulant Drugs Moderate
Interaction Summary
Theoretically, yohimbe might decrease the levels and clinical effects of CYP1A2 substrates.
Read the full Yohimbe Bark Extract + Acetaminophen, Brompheniramine, Phenylpropanolamine interactionAcetaminophen, Butalbital, CaffeineEsgic, Esgic Plus, Fiogesic, Fioricet, Repan, Tecnal +1 more
How Acetaminophen, Butalbital, Caffeine interacts with SM&W-S — through 1 ingredient. Tap an ingredient for the detail:
Yohimbe Bark ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Moderate
Interaction Summary
Theoretically, yohimbe might decrease the levels and clinical effects of CYP1A2 substrates.
Read the full Yohimbe Bark Extract + Acetaminophen, Butalbital, Caffeine interactionAcetaminophen, Butalbital, Caffeine, CodeineEsgic with Codeine, Fioricet w/ Codeine
How Acetaminophen, Butalbital, Caffeine, Codeine interacts with SM&W-S — through 1 ingredient. Tap an ingredient for the detail:
Yohimbe Bark ExtractStimulant Drugs, Cytochrome P450 1a2 (cyp1a2) Substrates +2 Moderate
Interaction Summary
Theoretically, taking yohimbe with stimulant drugs can have additive effects.
Read the full Yohimbe Bark Extract + Acetaminophen, Butalbital, Caffeine, Codeine interactionAcetaminophen, Butalbital, CodeineBancap w/ Codeine
How Acetaminophen, Butalbital, Codeine interacts with SM&W-S — through 1 ingredient. Tap an ingredient for the detail:
Yohimbe Bark ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 2d6 (cyp2d6) Substrates Moderate
Interaction Summary
Theoretically, yohimbe might decrease the levels and clinical effects of CYP1A2 substrates.
Read the full Yohimbe Bark Extract + Acetaminophen, Butalbital, Codeine interactionAcetaminophen, Butalbital, Codeine PhosphatePhrenilin #3
How Acetaminophen, Butalbital, Codeine Phosphate interacts with SM&W-S — through 1 ingredient. Tap an ingredient for the detail:
Yohimbe Bark ExtractCytochrome P450 2d6 (cyp2d6) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, yohimbe might increase the levels and adverse effects of CYP2D6 substrates.
Read the full Yohimbe Bark Extract + Acetaminophen, Butalbital, Codeine Phosphate interactionAcetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, PhenylephrineHycomine Compound
How Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interacts with SM&W-S — through 1 ingredient. Tap an ingredient for the detail:
Yohimbe Bark ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +3 Moderate
Interaction Summary
Theoretically, yohimbe might decrease the levels and clinical effects of CYP1A2 substrates.
Read the full Yohimbe Bark Extract + Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interactionAcetaminophen, Caffeine, CodeineGesic C15, Gesic C30, Gesic C8, Lenoltec 1, Lenoltec 2, Lenoltec 3 +1 more
How Acetaminophen, Caffeine, Codeine interacts with SM&W-S — through 1 ingredient. Tap an ingredient for the detail:
Yohimbe Bark ExtractCytochrome P450 2d6 (cyp2d6) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates +2 Moderate
Interaction Summary
Theoretically, yohimbe might increase the levels and adverse effects of CYP2D6 substrates.
Read the full Yohimbe Bark Extract + Acetaminophen, Caffeine, Codeine interactionAcetaminophen, Caffeine, Codeine, SalicylamideCodalan No.1, Codalan No.2, Codalan No.3
How Acetaminophen, Caffeine, Codeine, Salicylamide interacts with SM&W-S — through 1 ingredient. Tap an ingredient for the detail:
Yohimbe Bark ExtractStimulant Drugs, Cytochrome P450 1a2 (cyp1a2) Substrates +2 Moderate
Interaction Summary
Theoretically, taking yohimbe with stimulant drugs can have additive effects.
Read the full Yohimbe Bark Extract + Acetaminophen, Caffeine, Codeine, Salicylamide interactionAcetaminophen, Caffeine, DihydrocodeineDHC Plus, Panlor DC, Panlor SS
How Acetaminophen, Caffeine, Dihydrocodeine interacts with SM&W-S — through 1 ingredient. Tap an ingredient for the detail:
Yohimbe Bark ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates +2 Moderate
Interaction Summary
Theoretically, yohimbe might decrease the levels and clinical effects of CYP3A4 substrates.
Read the full Yohimbe Bark Extract + Acetaminophen, Caffeine, Dihydrocodeine interactionAcetaminophen, Caffeine, IsomethepteneMigralam
How Acetaminophen, Caffeine, Isometheptene interacts with SM&W-S — through 1 ingredient. Tap an ingredient for the detail:
Yohimbe Bark ExtractStimulant Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Moderate
Interaction Summary
Theoretically, taking yohimbe with stimulant drugs can have additive effects.
Read the full Yohimbe Bark Extract + Acetaminophen, Caffeine, Isometheptene interactionAcetaminophen, Caffeine, PyrilamineMidol Max Strength Menstrual
How Acetaminophen, Caffeine, Pyrilamine interacts with SM&W-S — through 1 ingredient. Tap an ingredient for the detail:
Yohimbe Bark ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Moderate
Interaction Summary
Theoretically, yohimbe might decrease the levels and clinical effects of CYP1A2 substrates.
Read the full Yohimbe Bark Extract + Acetaminophen, Caffeine, Pyrilamine interactionAcetaminophen, Chlorpheniramine Maleate, Dextromethorphan HbrVicks Formula 44M Cough, Cold & Flu Relief
How Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interacts with SM&W-S — through 1 ingredient. Tap an ingredient for the detail:
Yohimbe Bark ExtractCytochrome P450 2d6 (cyp2d6) Inhibitors, Cytochrome P450 1a2 (cyp1a2) Substrates +2 Moderate
Interaction Summary
CYP2D6 inhibitors may increase the levels and adverse effects of yohimbine, a constituent of yohimbe.
Read the full Yohimbe Bark Extract + Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interactionAcetaminophen, Chlorpheniramine, Codeine, PhenylephrineColrex
How Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interacts with SM&W-S — through 1 ingredient. Tap an ingredient for the detail:
Yohimbe Bark ExtractStimulant Drugs, Cytochrome P450 2d6 (cyp2d6) Substrates +3 Moderate
Interaction Summary
Theoretically, taking yohimbe with stimulant drugs can have additive effects.
Read the full Yohimbe Bark Extract + Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interactionAcetaminophen, Chlorpheniramine, DextromethorphanCoricidin II Extra Strength Cold and Flu
How Acetaminophen, Chlorpheniramine, Dextromethorphan interacts with SM&W-S — through 1 ingredient. Tap an ingredient for the detail:
Yohimbe Bark ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 2d6 (cyp2d6) Inhibitors +2 Moderate
Interaction Summary
Theoretically, yohimbe might decrease the levels and clinical effects of CYP1A2 substrates.
Read the full Yohimbe Bark Extract + Acetaminophen, Chlorpheniramine, Dextromethorphan interactionAcetaminophen, Chlorpheniramine, Dextromethorphan HydrobromideCoricidin HBP Maximum Strength Flu
How Acetaminophen, Chlorpheniramine, Dextromethorphan Hydrobromide interacts with SM&W-S — through 1 ingredient. Tap an ingredient for the detail:
Yohimbe Bark ExtractCytochrome P450 2d6 (cyp2d6) Substrates, Cytochrome P450 2d6 (cyp2d6) Inhibitors +2 Moderate
Interaction Summary
Theoretically, yohimbe might increase the levels and adverse effects of CYP2D6 substrates.
Read the full Yohimbe Bark Extract + Acetaminophen, Chlorpheniramine, Dextromethorphan Hydrobromide interactionAcetaminophen, Chlorpheniramine, Dextromethorphan, PhenylpropanolamineMulti Symptom Cold Relief
How Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylpropanolamine interacts with SM&W-S — through 1 ingredient. Tap an ingredient for the detail:
Yohimbe Bark ExtractStimulant Drugs, Cytochrome P450 2d6 (cyp2d6) Inhibitors +3 Moderate
Interaction Summary
Theoretically, taking yohimbe with stimulant drugs can have additive effects.
Read the full Yohimbe Bark Extract + Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylpropanolamine interactionAcetaminophen, Chlorpheniramine, Dextromethorphan, PseudoephedrineChildren's Tylenol Cold Plus Cough, Tylenol Cold Ex Strength
How Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine interacts with SM&W-S — through 1 ingredient. Tap an ingredient for the detail:
Yohimbe Bark ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 2d6 (cyp2d6) Inhibitors +3 Moderate
Interaction Summary
Theoretically, yohimbe might decrease the levels and clinical effects of CYP1A2 substrates.
Read the full Yohimbe Bark Extract + Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine interactionAcetaminophen, Chlorpheniramine, Guaifenesin, Phenylephrine, SalicylamideRhinogesic GG
How Acetaminophen, Chlorpheniramine, Guaifenesin, Phenylephrine, Salicylamide interacts with SM&W-S — through 1 ingredient. Tap an ingredient for the detail:
Yohimbe Bark ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Stimulant Drugs +2 Moderate
Interaction Summary
Theoretically, yohimbe might decrease the levels and clinical effects of CYP3A4 substrates.
Read the full Yohimbe Bark Extract + Acetaminophen, Chlorpheniramine, Guaifenesin, Phenylephrine, Salicylamide interactionAcetaminophen, Chlorpheniramine, PhenylephrineAlka-Seltzer PLUS, Histex SR, Protid
How Acetaminophen, Chlorpheniramine, Phenylephrine interacts with SM&W-S — through 1 ingredient. Tap an ingredient for the detail:
Yohimbe Bark ExtractStimulant Drugs, Cytochrome P450 2d6 (cyp2d6) Inhibitors +2 Moderate
Interaction Summary
Theoretically, taking yohimbe with stimulant drugs can have additive effects.
Read the full Yohimbe Bark Extract + Acetaminophen, Chlorpheniramine, Phenylephrine interactionAcetaminophen, Chlorpheniramine, Phenylephrine, SalicylamideRhinogesic, Rhinogesic JR
How Acetaminophen, Chlorpheniramine, Phenylephrine, Salicylamide interacts with SM&W-S — through 1 ingredient. Tap an ingredient for the detail:
Yohimbe Bark ExtractCytochrome P450 2d6 (cyp2d6) Inhibitors, Cytochrome P450 3a4 (cyp3a4) Substrates +2 Moderate
Interaction Summary
CYP2D6 inhibitors may increase the levels and adverse effects of yohimbine, a constituent of yohimbe.
Read the full Yohimbe Bark Extract + Acetaminophen, Chlorpheniramine, Phenylephrine, Salicylamide interactionAcetaminophen, Chlorpheniramine, PhenylpropanolamineAlumadrine, Conex, Sinadrin Max Strength, Sinulin
How Acetaminophen, Chlorpheniramine, Phenylpropanolamine interacts with SM&W-S — through 1 ingredient. Tap an ingredient for the detail:
Yohimbe Bark ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Stimulant Drugs +2 Moderate
Interaction Summary
Theoretically, yohimbe might decrease the levels and clinical effects of CYP1A2 substrates.
Read the full Yohimbe Bark Extract + Acetaminophen, Chlorpheniramine, Phenylpropanolamine interactionAcetaminophen, Chlorpheniramine, Phenylpropanolamine, OpiumHista-Derfule
How Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium interacts with SM&W-S — through 1 ingredient. Tap an ingredient for the detail:
Yohimbe Bark ExtractCytochrome P450 2d6 (cyp2d6) Inhibitors, Stimulant Drugs +2 Moderate
Interaction Summary
CYP2D6 inhibitors may increase the levels and adverse effects of yohimbine, a constituent of yohimbe.
Read the full Yohimbe Bark Extract + Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium interactionAcetaminophen, Chlorpheniramine, Phenylpropanolamine, PhenyltoloxamineNorel Plus
How Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Phenyltoloxamine interacts with SM&W-S — through 1 ingredient. Tap an ingredient for the detail:
Yohimbe Bark ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Stimulant Drugs +2 Moderate
Interaction Summary
Theoretically, yohimbe might decrease the levels and clinical effects of CYP3A4 substrates.
Read the full Yohimbe Bark Extract + Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Phenyltoloxamine interactionAcetaminophen, Chlorpheniramine, PseudoephedrineAlka-Seltzer PLUS Liquid Gels, Children's Tylenol Cold, Codimal, Comtrex, Extra Strength Tylenol Allergy Sinus, Lorsin +3 more
How Acetaminophen, Chlorpheniramine, Pseudoephedrine interacts with SM&W-S — through 1 ingredient. Tap an ingredient for the detail:
Yohimbe Bark ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Stimulant Drugs +2 Moderate
Interaction Summary
Theoretically, yohimbe might decrease the levels and clinical effects of CYP1A2 substrates.
Read the full Yohimbe Bark Extract + Acetaminophen, Chlorpheniramine, Pseudoephedrine interactionEach ingredient & the kinds of drugs it affects
For each ingredient in SM&W-S 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.
Yohimbe bark extract
Monoamine Oxidase Inhibitors (Maois)
Concomitant use of MAOIs with yohimbe can result in additive effects.
Yohimbine, a constituent of yohimbe, has MAO inhibitory effects. At high doses, yohimbine is a non-selective inhibitor of MAO.
Antihypertensive Drugs
Theoretically, yohimbe might reduce the effects of antihypertensive drugs.
Yohimbine, a constituent of yohimbe, is an alpha-2 adrenoceptor antagonist and has been reported to increase blood pressure in clinical research. Theoretically, concomitant use of yohimbe and antihypertensive drugs can interfere with blood pressure control.
Clonidine (Catapres)
Theoretically, yohimbe might precipitate clonidine withdrawal.
Chronic clonidine use can downregulate alpha-2 adrenoreceptors. Animal research and one human case report suggest that concomitant administration of yohimbine, an alpha-2 adrenoceptor antagonist, may precipitate clonidine withdrawal and lead to sympathomimetic toxicity, including hypertensive crisis.
Cytochrome P450 2D6 (Cyp2D6) Inhibitors
CYP2D6 inhibitors may increase the levels and adverse effects of yohimbine, a constituent of yohimbe.
In vitro and clinical research shows that the yohimbe bark constituent, yohimbine, is metabolized by CYP2D6 isoenzymes. Paroxetine, a cytochrome P450 (CYP) 2D6 inhibitor, increases the maximum serum concentration of yohimbine and reduces the clearance of yohimbine compared to yohimbine alone in patients who are extensive CYP2D6 metabolizers..
Cytochrome P450 2D6 (Cyp2D6) Substrates
Theoretically, yohimbe might increase the levels and adverse effects of CYP2D6 substrates.
In vitro research suggests that yohimbine, a constituent of yohimbe bark, inhibits CYP2D6 enzyme activity.
Cytochrome P450 3A4 (Cyp3A4) Inhibitors
Theoretically, CYP3A4 inhibitors might increase the levels and adverse effects of yohimbine, a constituent of yohimbe bark.
In vitro and clinical research shows that the yohimbe bark constituent, yohimbine, is metabolized by CYP3A4 enzymes. Theoretically, drugs that inhibit CYP3A4 might increase the levels and adverse effects of yohimbine.
Paroxetine (Paxil)
Paroxetine decreases the clearance of yohimbine and may increase its effects.
Paroxetine, a cytochrome P450 (CYP) 2D6 inhibitor, increases the maximum serum concentration of yohimbine by about 350% and reduces the clearance of yohimbine by about 80% compared to yohimbine alone in patients who are extensive CYP2D6 metabolizers. No significant changes in pharmacokinetic parameters of yohimbine were observed with coadministration of paroxetine in patients who are poor CYP2D6 metabolizers.
Phenothiazines
Theoretically, using yohimbine with phenothiazines might have additive effects.
Yohimbine, a constituent of yohimbe, has alpha-2 adrenergic antagonist effects. Theoretically, combining it with phenothiazines can cause additive alpha-2 adrenergic antagonism.
Stimulant Drugs
Theoretically, taking yohimbe with stimulant drugs can have additive effects.
Yohimbine, a constituent of yohimbe, has sympathomimetic effects and increases blood pressure in a dose-dependent manner. Theoretically, taking yohimbe with stimulant drugs can have additive stimulant and hypertensive effects.
Tricyclic Antidepressants (Tcas)
Theoretically, taking yohimbe with TCAs can increase adverse effects.
A small clinical study in patients taking TCAs for at least 4 weeks shows that receiving doses of intravenous yohimbine 2.5-20 mg daily for up to 7 days precipitates severe anxiety, agitation, and tremor. The effects of yohimbe bark itself are unclear; oral yohimbe bark contains 0.6% to 1.38% yohimbine, but it is unclear how much is absorbed.
Anticoagulant/Antiplatelet Drugs
Theoretically, combining yohimbe bark with antiplatelet or anticoagulant drugs might have additive effects; however, this has not been reported in clinical research.
Research in healthy adults shows that taking yohimbine, a constituent of yohimbe bark, in doses of 8 mg or more, seems to inhibit platelet aggregation in vitro by binding to the alpha-2 adrenoceptor. The effects of yohimbe bark itself are unclear; yohimbe bark contains 0.6% to 1.38% yohimbine, but it is unclear how much is absorbed.
Cytochrome P450 1A2 (Cyp1A2) Substrates
Theoretically, yohimbe might decrease the levels and clinical effects of CYP1A2 substrates.
In vitro research shows that yohimbe extract induces CYP1A2 enzymes.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, yohimbe might decrease the levels and clinical effects of CYP3A4 substrates.
In vitro research shows that yohimbe extract induces CYP3A4 enzymes.
Wild Yam root extract
Estrogens
Theoretically, wild yam might increase or decrease the effects of estrogen.
Wild yam root shows estrogenic and anti-estrogenic effects in vitro. Theoretically, wild yam might interfere with hormone therapy.
Sarsaparilla Root Extract
Digoxin (Lanoxin)
Theoretically, concomitant use of sarsaparilla with digoxin might increase the risk of cardiac toxicity.
Sarsaparilla is thought to have diuretic properties, which could potentially cause potassium loss. Overuse or misuse of sarsaparilla with cardiac glycoside therapy might increase the risk of cardiac toxicity due to potassium loss.
Lithium
Theoretically, sarsaparilla might increase the effects and adverse effects of lithium.
Sarsaparilla is thought to have diuretic properties. Due to these effects, sarsaparilla might reduce excretion and increase levels of lithium. The dose of lithium might need to be decreased.
Pumpkin Seed Extract
Lithium
Pumpkin might reduce excretion and increase levels of lithium.
Pumpkin is thought to have diuretic properties. Theoretically, this might reduce excretion and increase levels of lithium. The dose of lithium might need to be decreased.
Brand information
Manufacturer and brand details for SM&W-S, from the product label.
Pure Herbs
See all Pure Herbs products- Name
- Pure Herbs, Ltd.
- City
- Sterling Heights
- State
- MI
- Phone Number
- (800) 860-4372
- Web Address
- www.pureherbs.com
SM&W-S by Pure Herbs: Common Questions
Does SM&W-S by Pure Herbs interact with any medications?
How can one product interact with so many drugs?
Where does this information come from?
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Does pumpkin seed in this product help with prostate or urinary issues?
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Why is lithium a concern with this product?
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 SM&W-S’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Maca
Maca is a nutrient-rich Andean root often used for energy, libido, and menopause symptoms. Early studies suggest it may modestly help sexual desire and some menopause symptoms, but the evide...
Read the full Maca monograph → Herb & supplement monographYohimbe
Interacts with 1,125 drugsYohimbe is a West African tree bark that contains yohimbine, a compound mainly promoted for erectile dysfunction and as an aphrodisiac. A prescription form of yohimbine has some evidence for...
Read the full Yohimbe monograph → Herb & supplement monographSarsaparilla
Interacts with 2 drugsSarsaparilla is a traditional root used in teas, tonics, and old-fashioned root beer flavoring. Modern evidence for its health claims is very limited and comes mostly from lab studies, so it...
Read the full Sarsaparilla monograph → Herb & supplement monographPumpkin
Interacts with 1 drugPumpkin is a nutritious squash, and its seeds and seed oil are the parts most often used as supplements, mainly for urinary and prostate symptoms. The evidence for these uses is limited and...
Read the full Pumpkin monograph → Herb & supplement monographWild Yam
Interacts with 41 drugsWild yam is a root traditionally used for menopausal symptoms, cramps, and as a so-called 'natural' hormone supplement, but solid human evidence for these uses is lacking. Despite popular cl...
Read the full Wild Yam monograph →Sources & How We Checked
SM&W-S'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 82 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.
Maca 1 reference
- Valerio, L. G., Jr. and Gonzales, G. F. Toxicological aspects of the South American herbs cat's claw (Uncaria tomentosa) and Maca (Lepidium meyenii) : a critical synopsis. Toxicol.Rev 2005;24(1):11-35. PubMed
Yohimbe 66 references
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- Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
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- Myers, A. and Barrueto, F., Jr. Refractory priapism associated with ingestion of yohimbe extract. J Med Toxicol. 2009;5(4):223-225.
- Berlin, I., Crespo-Laumonnier, B., Cournot, A., Landault, C., Aubin, F., Legrand, J. C., and Puech, A. J. The alpha 2-adrenergic receptor antagonist yohimbine inhibits epinephrine-induced platelet aggregation in healthy subjects. Clin Pharmacol.Ther. 199
- Swann, A. C. Mechanisms of impulsivity in bipolar disorder and related illness. Epidemiol.Psichiatr.Soc. 2010;19(2):120-130.
- Shibao, C., Okamoto, L. E., Gamboa, A., Yu, C., Diedrich, A., Raj, S. R., Robertson, D., and Biaggioni, I. Comparative efficacy of yohimbine against pyridostigmine for the treatment of orthostatic hypotension in autonomic failure. Hypertension 2010;56(5) PubMed
- Soeter, M. and Kindt, M. Stimulation of the noradrenergic system during memory formation impairs extinction learning but not the disruption of reconsolidation. Neuropsychopharmacology 2012;37(5):1204-1215. PubMed
- Cimolai, N. and Cimolai, T. Yohimbine use for physical enhancement and its potential toxicity. J Diet.Suppl 2011;8(4):346-354. PubMed
- Bagheri, H., Berlan, M., Montastruc, J. L., and Montastruc, P. Yohimbine and lacrimal secretion. Br J Clin Pharmacol. 1990;30(1):151-152.
- Landis, E. and Shore, E. Yohimbine-induced bronchospasm. Chest 1989;96(6):1424. PubMed
- Susset, J. G., Tessier, C. D., Wincze, J., Bansal, S., Malhotra, C., and Schwacha, M. G. Effect of yohimbine hydrochloride on erectile impotence: a double-blind study. J Urol. 1989;141(6):1360-1363. PubMed
- Chatelut, E., Rispail, Y., Berlan, M., and Montastruc, J. L. Yohimbine increases human salivary secretion. Br.J Clin Pharmacol. 1989;28(3):366-368. PubMed
- Montastruc, P., Berlan, M., and Montastruc, J. L. Effects of yohimbine on submaxillary salivation in dogs. Br J Pharmacol 1989;98(1):101-104. PubMed
- Charney, D. S., Price, L. H., and Heninger, G. R. Desipramine-yohimbine combination treatment of refractory depression. Implications for the beta-adrenergic receptor hypothesis of antidepressant action. Arch.Gen.Psychiatry 1986;43(12):1155-1161. PubMed
- Braddock, L., Cowen, P. J., Elliott, J. M., Fraser, S., and Stump, K. Binding of yohimbine and imipramine to platelets in depressive illness. Psychol.Med 1986;16(4):765-773. PubMed
- Bolme, P., Corrodi, H., Fuxe, K., Hokfelt, T., Lidbrink, P., and Goldstein, M. Possible involvement of central adrenaline neurons in vasomotor and respiratory control. Studies with clonidine and its interactions with piperoxane and yohimbine. Eur J Pharm PubMed
- Charney, D. S., Heninger, G. R., and Sternberg, D. E. Assessment of alpha 2 adrenergic autoreceptor function in humans: effects of oral yohimbine. Life Sci 6-7-1982;30(23):2033-2041.
- Boon, N. A., Elliott, J. M., Grahame-Smith, D. G., John-Green, T., and Stump, K. A comparison of alpha 2-adrenoreceptor binding characteristics of intact human platelets identified by [3H]-yohimbine and [3H]- dihydroergocryptine. J Auton.Pharmacol 1983;3
- Andrejak, M., Ward, M., and Schmitt, H. Cardiovascular effects of yohimbine in anaesthetized dogs. Eur.J Pharmacol 10-28-1983;94(3-4):219-228. PubMed
- Brodde, O. E., Anlauf, M., Arroyo, J., Wagner, R., Weber, F., and Buck, K. D. Hypersensitivity of adrenergic receptors and blood-pressure response to oral yohimbine in orthostatic hypotension. N.Engl.J Med 4-28-1983;308(17):1033-1034. PubMed
- Charney, D. S., Heninger, G. R., and Redmond, D. E., Jr. Yohimbine induced anxiety and increased noradrenergic function in humans: effects of diazepam and clonidine. Life Sci. 7-4-1983;33(1):19-29. PubMed
- Knoll, L. D., Benson, R. C., Jr., Bilhartz, D. L., Minich, P. J., and Furlow, W. L. A randomized crossover study using yohimbine and isoxsuprine versus pentoxifylline in the management of vasculogenic impotence. J Urol. 1996;155(1):144-146. DOI
- Betz, J. M., White, K. D., and der Marderosian, A. H. Gas chromatographic determination of yohimbine in commercial yohimbe products. J AOAC Int 1995;78(5):1189-1194. DOI
- Bagheri, H., Chale, J. J., Guyen, L. N., Tran, M. A., Berlan, M., and Montastruc, J. L. Evidence for activation of both adrenergic and cholinergic nervous pathways by yohimbine, an alpha 2-adrenoceptor antagonist. Fundam.Clin Pharmacol 1995;9(3):248-254.
- Kennedy, S. H., Gnam, W., Ralevski, E., and Brown, G. M. Melatonin responses to clonidine and yohimbine challenges. J Psychiatry Neurosci. 1995;20(4):297-304.
- Musso, N. R., Vergassola, C., Pende, A., and Lotti, G. Yohimbine effects on blood pressure and plasma catecholamines in human hypertension. Am J Hypertens. 1995;8(6):565-571. PubMed
- Morgan, C. A., III, Southwick, S. M., Grillon, C., Davis, M., Krystal, J. H., and Charney, D. S. Yohimbine-facilitated acoustic startle reflex in humans. Psychopharmacology (Berl) 1993;110(3):342-346. PubMed
- Adler, L. E., Hoffer, L., Nagamoto, H. T., Waldo, M. C., Kisley, M. A., and Giffith, J. M. Yohimbine impairs P50 auditory sensory gating in normal subjects. Neuropsychopharmacology 1994;10(4):249-257. PubMed
- Biaggioni, I., Robertson, R. M., and Robertson, D. Manipulation of norepinephrine metabolism with yohimbine in the treatment of autonomic failure. J Clin Pharmacol. 1994;34(5):418-423. PubMed
- Kenney, W. L., Zappe, D. H., Tankersley, C. G., and Derr, J. A. Effect of systemic yohimbine on the control of skin blood flow during local heating and dynamic exercise. Am J Physiol 1994;266(2 Pt 2):H371-H376. PubMed
- Friesen, K., Palatnick, W., and Tenenbein, M. Benign course after massive ingestion of yohimbine. J Emerg.Med 1993;11(3):287-288. PubMed
- Bierer, L. M., Aisen, P. S., Davidson, M., Ryan, T. M., Stern, R. G., Schmeidler, J., and Davis, K. L. A pilot study of oral physostigmine plus yohimbine in patients with Alzheimer disease. Alzheimer Dis.Assoc.Disord. 1993;7(2):98-104. PubMed
- Mann, K., Klingler, T., Noe, S., Roschke, J., Muller, S., and Benkert, O. Effects of yohimbine on sexual experiences and nocturnal penile tumescence and rigidity in erectile dysfunction. Arch.Sex Behav. 1996;25(1):1-16. PubMed
- Rowland, D. L., Kallan, K., and Slob, A. K. Yohimbine, erectile capacity, and sexual response in men. Arch Sex Behav 1997;26(1):49-62.
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- Riley AJ, Goodman R, Kellett JM, and et al. Double blind trial of yohimbine hydrochloride in the treatment of erection inadequacy. Sexual Marital Ther 1989;4(1):17-26. DOI
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Sarsaparilla 3 references
- Blumenthal M, ed. The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. Trans. S. Klein. Boston, MA: American Botanical Council, 1998.
- Leung AY, Foster S. Encyclopedia of Common Natural Ingredients Used in Food, Drugs and Cosmetics. 2nd ed. New York, NY: John Wiley & Sons, 1996.
- Vandenplas O, Depelchin S, Toussaint G, et al. Occupational asthma caused by sarsaparilla root dust. J Allergy Clin Immunol 1996;97:1416-8. PubMed
Pumpkin 5 references
- Marks L, Partin AW, Epstein JI, et al. Effects of a saw palmetto herbal blend in men with symptomatic benign prostatic hyperplasia. J Urol 2000;163:1451-6. DOI
- Cho YH, Lee SY, Jeong DW, et al. Effect of pumpkin seed oil on hair growth in men with androgenetic alopecia: a randomized, double-blind, placebo-controlled trial. Evid Based Complement Alternat Med 2014;2014:549721. PubMed
- Vahlensieck W, Theurer C, Pfitzer E, Patz B, Banik N, Engelmann U. Effects of pumpkin seed in men with lower urinary tract symptoms due to benign prostatic hyperplasia in the one-year, randomized, placebo-controlled GRANU study. Urol Int 2015;94(3):286-95 PubMed
- Assouly P. Hair loss associated with cucurbit poisoning. JAMA Dermatol. 2018 May 1;154(5):617-618. PubMed
- Gawryjolek J, Ludwig H, Zbikowska-Götz M, Bartuzi Z, Krogulska A. Anaphylaxis after consumption of pumpkin seeds in a 2-y-old child tolerant to its pulp: A case study. Nutrition 2021;89:111272. PubMed
Wild Yam 7 references
- McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
- Eagon PK, Elm MS, Hunter DS, et al. Medicinal herbs: modulation of estrogen action. Era of Hope Mtg, Dept Defense; Breast Cancer Res Prog, Atlanta, GA 2000;Jun 8-11.
- Cheong JL, Bucknall R. Retinal vein thrombosis associated with a herbal phytoestrogen preparation in a susceptible patient. Postgrad Med J 2005;81:266-7.. PubMed
- Rosenberg Zand, R. S., Jenkins, D. J., and Diamandis, E. P. Effects of natural products and nutraceuticals on steroid hormone-regulated gene expression. Clin Chim.Acta 2001;312(1-2):213-219. PubMed
- Araghiniknam M, Chung S, Nelson-White T, and et al. Antioxidant activity of Dioscorea and dehydroepiandrosterone (DHEA) in older humans. Life Sciences 1996;59:L147-L157.
- Zeng M, Zhang L, Li M, et al. Estrogenic effects of the extracts from the Chinese Yam (Dioscorea opposite Thunb.) and its effective compounds in vitro and in vivo. Molecules. 2018 Jan 23;23(2). Pii: E11. PubMed
- Lu J, Wong RN, Zhang L, et al. Comparative analysis of proteins with stimulating activity on ovarian estradiol biosynthesis from four different Dioscorea species in vitro using both phenotypic and target-based approaches: implication for treating menopaus
Parts of this content are provided by the Therapeutic Research Center, LLC.
DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.
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