Stress Manager Ingredients & Drug Interactions
What is this page for?
First and foremost: checking Stress Manager 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
Stress Manager is a dietary supplement by Herb Pharm Professional with 5 active ingredients. Its ingredients are commonly taken for fatigue and low energy, physical and athletic performance, stress resistance (adaptogen).Based on those ingredients, 1,372 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Rhodiola extract, Eleuthero extract, Schisandra extract. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against Stress Manager by Herb Pharm Professional
Ask about any prescription or over-the-counter medication and we check it for interactions with Stress Manager by Herb Pharm Professional — 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 Stress Manager by Herb Pharm Professional
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
Stress Manager contains five active ingredients. Eleuthero extract, reishi mushroom extract, schisandra extract, holy basil extract, and rhodiola extract are blended together in a proprietary formula.
The product also contains certified organic cane alcohol, distilled water, and certified organic vegetable glycerin as inactive ingredients to deliver and preserve the herbal extracts.
Does it work?
Not established
The evidence for what this blend does is limited. For eleuthero, the data shows it may be possibly effective for genital herpes, but evidence is insufficient for chronic fatigue syndrome, bipolar disorder, and osteoporosis.
Reishi mushroom appears possibly ineffective for high cholesterol. For schisandra, rhodiola, and holy basil, the effectiveness data we hold shows insufficient evidence for conditions like anxiety, asthma, diabetes, and headache.
None of these ingredients have strong evidence backing them for the stress-management use this product claims.
How safe is it?
Well-documented data
Short-term use of these herbs is generally well tolerated, but long-term safety data are limited for all of them. The most common side effects you might notice are gastrointestinal—nausea, stomach upset, diarrhea, and loose stools.
Eleuthero and rhodiola may cause headache; reishi may cause dizziness; holy basil may cause nausea or loose stools. Eleuthero has been reported to cause nervousness, anxiety, and irritability in some users, especially at higher doses, and may raise blood pressure in certain groups.
Reishi can cause dizziness and respiratory allergy to its spores. Do not use this product during pregnancy or while breastfeeding—safety data are insufficient or raise concerns for all five ingredients.
Meds to double-check
Moderate interaction found
Before taking this product, check your medications if you're on any of the following: blood thinners or antiplatelet drugs (bleeding risk); diabetes medications (blood sugar may drop further); blood pressure medications (pressure may drop more); sedatives like midazolam; immunosuppressants like tacrolimus; warfarin; heart medications like digoxin; or drugs metabolized by liver enzymes CYP1A2, CYP2C9, CYP2C19, or CYP3A4. Use the medication checker on this page with your exact prescriptions.
The bottom line
Scorecard at a glanceFormula with limited ingredient disclosure with no established evidence rating for its marketed use. Moderate medication interactions have been identified, and safety information is well characterized.
Stress Manager is a multi-ingredient herbal blend with multiple Moderate drug interactions, most notably with blood thinners, diabetes drugs, blood pressure medications, and certain sedatives and immunosuppressants. If you take any prescription medications, check them against the interaction tool before starting.
This product is not appropriate during pregnancy or breastfeeding. Talk with your pharmacist or doctor to see if it's right for you.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 5 of 5 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Feb 25, 2019.
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 Stress Manager, straight from the product label.
| Brand | Herb Pharm Professional |
|---|---|
| Barcode (UPC) | 090700030230 |
| Net contents | 2 fl. Oz.; 60 mL |
| Market status | On market |
| Date entered into DSLD | Feb 25, 2019 |
| DSLD ID | 199999 |
| Product type | Botanical |
| Supplement form | Liquid |
| Dietary claims / uses | All Other |
| Intended target group(s) | Adult (18 - 50 Years), 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 Stress Manager by Herb Pharm Professional, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Eleuthero extract | 0 NP | -- |
| Reishi Mushroom Extract | 0 NP | -- |
| Schisandra extract | 0 NP | -- |
| Holy Basil extract | 0 NP | -- |
| Rhodiola extract | 0 NP | -- |
| Proprietary Extract Blend | 679 mg | -- |
Other ingredients: certified organic Cane Alcohol, distilled Water, certified organic Vegetable Glycerin
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
Suggested use Shake well before using Add 1 full squeeze of the dropper bulb to 2 oz. of water or juice, 3 or 4 times per day. Best taken between meals. Practitioner may increase dosage if desired.
Precautions
Keep out of the reach of children
Storage
Store away from heat & light
General
003
Formula
Eleuthero - Rhodiola
FDA Statement of Identity
Herbal Supplement
Formulation
Gluten-free
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Stress Manager by Herb Pharm Professional 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 Stress Manager by Herb Pharm Professional
These are the 5 active ingredients this product is made of. Select any to open its full monograph.
Serving size0.7 mL Dosage formLiquid Servings per container84 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 Extract Blend
Other (inactive) ingredients: Certified organic Cane Alcohol, Distilled Water, Certified organic Vegetable Glycerin. These complete the product’s ingredient list but are not active constituents.
Stress Manager by Herb Pharm Professional Drug Interactions
HelloPharmacist Interaction Report
Stress Manager by Herb Pharm Professional contains five active ingredients, and together they interact with a substantial number of medications.
The most serious interactions are Moderate in severity.
Read the full breakdown — every affected drug type, severity by severity
Eleuthero extract is the primary concern here. It may increase blood levels of several types of drugs by slowing how your liver breaks them down, including those metabolized by CYP1A2 and CYP2C9 enzymes, as well as P-glycoprotein substrates—effects seen in lab and animal studies but not yet reported in people.
More notably, eleuthero may increase bleeding risk when combined with blood thinners (anticoagulants) or antiplatelet drugs, and there's a case report of it raising digoxin (a heart medication) levels in an older adult. It may also lower blood sugar when used with diabetes drugs and could interfere with immunosuppressants.
Schisandra extract carries multiple Moderate interactions: it strongly increases levels of certain sedatives and immunosuppressants (midazolam, tacrolimus), increases some CYP3A4 and CYP2C19 substrates, and may decrease warfarin effectiveness. Reishi mushroom may lower blood pressure beyond what blood pressure medications already do, increase bleeding risk at higher doses, and potentially add to blood sugar-lowering effects.
Holy basil may increase bleeding risk and lower blood sugar further. Rhodiola may add to blood pressure-lowering and blood sugar-lowering effects, and may increase losartan levels.
Altogether, these interactions span 1,354 individual medications. Use the medication checker on this page with your exact prescriptions before starting.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against Stress Manager?
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 Stress Manager interact with 1,372 drugs. Click any drug to see the details.
5 of the 5 ingredients in Stress Manager interact with drugs. Each result below shows which ingredient is responsible. Rhodiola extract Eleuthero extract Schisandra extract Reishi Mushroom Extract Holy Basil extract
6-mercaptopurinePurinethol
How 6-mercaptopurine interacts with Stress Manager — through 2 ingredients. Tap an ingredient for the detail:
Eleuthero ExtractImmunosuppressants Moderate
Interaction Summary
Theoretically, eleuthero might interfere with immunosuppressive drugs because of its immunostimulant activity.
Read the full Eleuthero Extract + 6-mercaptopurine interactionRhodiola ExtractImmunosuppressants Moderate
Interaction Summary
Theoretically, rhodiola use might interfere with immunosuppressive therapy.
Read the full Rhodiola Extract + 6-mercaptopurine interactionAdo-trastuzumab EmtansineKadcyla
How Ado-trastuzumab Emtansine interacts with Stress Manager — through 3 ingredients. Tap an ingredient for the detail:
Schisandra ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Schisandra Extract + Ado-trastuzumab Emtansine interactionEleuthero ExtractCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, eleuthero might increase levels of drugs metabolized by CYP3A4.
Read the full Eleuthero Extract + Ado-trastuzumab Emtansine interactionRhodiola ExtractCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, rhodiola might increase levels of drugs metabolized by CYP3A4.
Read the full Rhodiola Extract + Ado-trastuzumab Emtansine interactionAbciximabReoPro
How Abciximab interacts with Stress Manager — through 3 ingredients. Tap an ingredient for the detail:
Eleuthero ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, eleuthero may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Eleuthero Extract + Abciximab interactionHoly Basil ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, holy basil seed oil might increase the risk of bleeding when used with anticoagulant or antiplatelet drugs.
Read the full Holy Basil Extract + Abciximab interactionReishi Mushroom ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, high doses of reishi mushroom might increase the risk of bleeding.
Read the full Reishi Mushroom Extract + Abciximab interactionAbemaciclibVerzenio
How Abemaciclib interacts with Stress Manager — through 3 ingredients. Tap an ingredient for the detail:
Schisandra ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Schisandra Extract + Abemaciclib interactionRhodiola ExtractCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, rhodiola might increase levels of drugs metabolized by CYP3A4.
Read the full Rhodiola Extract + Abemaciclib interactionEleuthero ExtractCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, eleuthero might increase levels of drugs metabolized by CYP3A4.
Read the full Eleuthero Extract + Abemaciclib interactionAbiraterone
How Abiraterone interacts with Stress Manager — through 3 ingredients. Tap an ingredient for the detail:
Schisandra ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Schisandra Extract + Abiraterone interactionEleuthero ExtractCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, eleuthero might increase levels of drugs metabolized by CYP3A4.
Read the full Eleuthero Extract + Abiraterone interactionRhodiola ExtractCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, rhodiola might increase levels of drugs metabolized by CYP3A4.
Read the full Rhodiola Extract + Abiraterone interactionAbiraterone AcetateYonsa, Zytiga
How Abiraterone Acetate interacts with Stress Manager — through 3 ingredients. Tap an ingredient for the detail:
Schisandra ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Schisandra Extract + Abiraterone Acetate interactionEleuthero ExtractCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, eleuthero might increase levels of drugs metabolized by CYP3A4.
Read the full Eleuthero Extract + Abiraterone Acetate interactionRhodiola ExtractCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, rhodiola might increase levels of drugs metabolized by CYP3A4.
Read the full Rhodiola Extract + Abiraterone Acetate interactionAbrocitinibCibinqo
How Abrocitinib interacts with Stress Manager — through 5 ingredients. Tap an ingredient for the detail:
Reishi Mushroom ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, high doses of reishi mushroom might increase the risk of bleeding.
Read the full Reishi Mushroom Extract + Abrocitinib interactionRhodiola ExtractImmunosuppressants, Cytochrome P450 2c9 (cyp2c9) Substrates Moderate
Interaction Summary
Theoretically, rhodiola use might interfere with immunosuppressive therapy.
Read the full Rhodiola Extract + Abrocitinib interactionSchisandra ExtractCytochrome P450 2c19 (cyp2c19) Substrates, Cytochrome P450 2c9 (cyp2c9) Substrates Moderate
Interaction Summary
Theoretically, schisandra might increase the levels and clinical effects of CYP2C19 substrates.
Read the full Schisandra Extract + Abrocitinib interactionEleuthero ExtractAnticoagulant/antiplatelet Drugs, Immunosuppressants +1 Moderate
Interaction Summary
Theoretically, eleuthero may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Eleuthero Extract + Abrocitinib interactionHoly Basil ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, holy basil seed oil might increase the risk of bleeding when used with anticoagulant or antiplatelet drugs.
Read the full Holy Basil Extract + Abrocitinib interactionAcalabrutinibCalquence
How Acalabrutinib interacts with Stress Manager — through 3 ingredients. Tap an ingredient for the detail:
Eleuthero ExtractCytochrome P450 3a4 (cyp3a4) Substrates, P-glycoprotein Substrates Moderate
Interaction Summary
Theoretically, eleuthero might increase levels of drugs metabolized by CYP3A4.
Read the full Eleuthero Extract + Acalabrutinib interactionRhodiola ExtractCytochrome P450 3a4 (cyp3a4) Substrates, P-glycoprotein Substrates Moderate
Interaction Summary
Theoretically, rhodiola might increase levels of drugs metabolized by CYP3A4.
Read the full Rhodiola Extract + Acalabrutinib interactionSchisandra ExtractCytochrome P450 3a4 (cyp3a4) Substrates, P-glycoprotein Substrates Moderate
Interaction Summary
Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Schisandra Extract + Acalabrutinib interactionAcarboseGlucobay, Prandase, Precose
How Acarbose interacts with Stress Manager — through 4 ingredients. Tap an ingredient for the detail:
Holy Basil ExtractAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, holy basil might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Read the full Holy Basil Extract + Acarbose interactionEleuthero ExtractAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, eleuthero might have additive effects when used with antidiabetes drugs.
Read the full Eleuthero Extract + Acarbose interactionRhodiola ExtractAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, taking rhodiola with antidiabetes drugs might increase the risk of hypoglycemia.
Read the full Rhodiola Extract + Acarbose interactionReishi Mushroom ExtractAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, reishi mushroom might have additive effects with antidiabetes drugs.
Read the full Reishi Mushroom Extract + Acarbose interactionAcebutololRhotral, Sectral
How Acebutolol interacts with Stress Manager — through 2 ingredients. Tap an ingredient for the detail:
Reishi Mushroom ExtractAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, concurrent use of reishi mushroom with antihypertensive drugs might increase the risk of hypotension.
Read the full Reishi Mushroom Extract + Acebutolol interactionRhodiola ExtractAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, taking rhodiola with antihypertensive drugs might increase the risk of hypotension.
Read the full Rhodiola Extract + Acebutolol interactionAcenocoumarolSintrom
How Acenocoumarol interacts with Stress Manager — through 3 ingredients. Tap an ingredient for the detail:
Reishi Mushroom ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, high doses of reishi mushroom might increase the risk of bleeding.
Read the full Reishi Mushroom Extract + Acenocoumarol interactionEleuthero ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, eleuthero may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Eleuthero Extract + Acenocoumarol interactionHoly Basil ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, holy basil seed oil might increase the risk of bleeding when used with anticoagulant or antiplatelet drugs.
Read the full Holy Basil Extract + Acenocoumarol interactionAcetaminophenChildren's Tylenol, Children's Tylenol Meltaways, Tylenol, Tylenol Ex Strength
How Acetaminophen interacts with Stress Manager — through 2 ingredients. Tap an ingredient for the detail:
Eleuthero ExtractCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, eleuthero might increase levels of drugs metabolized by CYP1A2.
Read the full Eleuthero Extract + Acetaminophen interactionRhodiola ExtractCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, rhodiola might increase levels of drugs metabolized by CYP1A2.
Read the full Rhodiola Extract + Acetaminophen interactionAcetaminophen, AspirinGemnisyn
How Acetaminophen, Aspirin interacts with Stress Manager — through 4 ingredients. Tap an ingredient for the detail:
Eleuthero ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Anticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, eleuthero might increase levels of drugs metabolized by CYP1A2.
Read the full Eleuthero Extract + Acetaminophen, Aspirin interactionHoly Basil ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, holy basil seed oil might increase the risk of bleeding when used with anticoagulant or antiplatelet drugs.
Read the full Holy Basil Extract + Acetaminophen, Aspirin interactionReishi Mushroom ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, high doses of reishi mushroom might increase the risk of bleeding.
Read the full Reishi Mushroom Extract + Acetaminophen, Aspirin interactionRhodiola ExtractCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, rhodiola might increase levels of drugs metabolized by CYP1A2.
Read the full Rhodiola Extract + Acetaminophen, Aspirin interactionAcetaminophen, Aspirin, CaffeineExcedrin, Excedrin Extra Strength, Excedrin Migraine
How Acetaminophen, Aspirin, Caffeine interacts with Stress Manager — through 5 ingredients. Tap an ingredient for the detail:
Schisandra ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Schisandra Extract + Acetaminophen, Aspirin, Caffeine interactionEleuthero ExtractAnticoagulant/antiplatelet Drugs, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Moderate
Interaction Summary
Theoretically, eleuthero may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Eleuthero Extract + Acetaminophen, Aspirin, Caffeine interactionHoly Basil ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, holy basil seed oil might increase the risk of bleeding when used with anticoagulant or antiplatelet drugs.
Read the full Holy Basil Extract + Acetaminophen, Aspirin, Caffeine interactionReishi Mushroom ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, high doses of reishi mushroom might increase the risk of bleeding.
Read the full Reishi Mushroom Extract + Acetaminophen, Aspirin, Caffeine interactionRhodiola ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, rhodiola might increase levels of drugs metabolized by CYP1A2.
Read the full Rhodiola Extract + Acetaminophen, Aspirin, Caffeine interactionAcetaminophen, Brompheniramine, PhenylpropanolamineDimetapp Cold and Flu
How Acetaminophen, Brompheniramine, Phenylpropanolamine interacts with Stress Manager — through 2 ingredients. Tap an ingredient for the detail:
Eleuthero ExtractCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, eleuthero might increase levels of drugs metabolized by CYP1A2.
Read the full Eleuthero Extract + Acetaminophen, Brompheniramine, Phenylpropanolamine interactionRhodiola ExtractCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, rhodiola might increase levels of drugs metabolized by CYP1A2.
Read the full Rhodiola Extract + Acetaminophen, Brompheniramine, Phenylpropanolamine interactionAcetaminophen, ButalbitalAxocet, Bancap, Bucet, Butex Forte, Esgic CF, Orbivan CF +5 more
How Acetaminophen, Butalbital interacts with Stress Manager — through 2 ingredients. Tap an ingredient for the detail:
Eleuthero ExtractCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, eleuthero might increase levels of drugs metabolized by CYP1A2.
Read the full Eleuthero Extract + Acetaminophen, Butalbital interactionRhodiola ExtractCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, rhodiola might increase levels of drugs metabolized by CYP1A2.
Read the full Rhodiola Extract + Acetaminophen, Butalbital interactionAcetaminophen, Butalbital, CaffeineEsgic, Esgic Plus, Fiogesic, Fioricet, Repan, Tecnal +1 more
How Acetaminophen, Butalbital, Caffeine interacts with Stress Manager — through 3 ingredients. Tap an ingredient for the detail:
Schisandra ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Schisandra Extract + Acetaminophen, Butalbital, Caffeine interactionEleuthero ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, eleuthero might increase levels of drugs metabolized by CYP1A2.
Read the full Eleuthero Extract + Acetaminophen, Butalbital, Caffeine interactionRhodiola ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, rhodiola might increase levels of drugs metabolized by CYP1A2.
Read the full Rhodiola Extract + Acetaminophen, Butalbital, Caffeine interactionAcetaminophen, Butalbital, Caffeine, CodeineEsgic with Codeine, Fioricet w/ Codeine
How Acetaminophen, Butalbital, Caffeine, Codeine interacts with Stress Manager — through 3 ingredients. Tap an ingredient for the detail:
Eleuthero ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 2d6 (cyp2d6) Substrates +1 Moderate
Interaction Summary
Theoretically, eleuthero might increase levels of drugs metabolized by CYP3A4.
Read the full Eleuthero Extract + Acetaminophen, Butalbital, Caffeine, Codeine interactionSchisandra ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Schisandra Extract + Acetaminophen, Butalbital, Caffeine, Codeine interactionRhodiola ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Minor
Interaction Summary
Theoretically, rhodiola might increase levels of drugs metabolized by CYP1A2.
Read the full Rhodiola Extract + Acetaminophen, Butalbital, Caffeine, Codeine interactionAcetaminophen, Butalbital, CodeineBancap w/ Codeine
How Acetaminophen, Butalbital, Codeine interacts with Stress Manager — through 2 ingredients. Tap an ingredient for the detail:
Eleuthero ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 2d6 (cyp2d6) Substrates Moderate
Interaction Summary
Theoretically, eleuthero might increase levels of drugs metabolized by CYP1A2.
Read the full Eleuthero Extract + Acetaminophen, Butalbital, Codeine interactionRhodiola ExtractCns Depressants, Cytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, rhodiola might increase the risk of adverse effects when taken with CNS depressants.
Read the full Rhodiola Extract + Acetaminophen, Butalbital, Codeine interactionAcetaminophen, Butalbital, Codeine PhosphatePhrenilin #3
How Acetaminophen, Butalbital, Codeine Phosphate interacts with Stress Manager — through 2 ingredients. Tap an ingredient for the detail:
Eleuthero ExtractCytochrome P450 2d6 (cyp2d6) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, eleuthero might increase levels of drugs metabolized by CYP2D6.
Read the full Eleuthero Extract + Acetaminophen, Butalbital, Codeine Phosphate interactionRhodiola ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cns Depressants Minor
Interaction Summary
Theoretically, rhodiola might increase levels of drugs metabolized by CYP1A2.
Read the full Rhodiola Extract + Acetaminophen, Butalbital, Codeine Phosphate interactionAcetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, PhenylephrineHycomine Compound
How Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interacts with Stress Manager — through 3 ingredients. Tap an ingredient for the detail:
Eleuthero ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Moderate
Interaction Summary
Theoretically, eleuthero might increase levels of drugs metabolized by CYP1A2.
Read the full Eleuthero Extract + Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interactionSchisandra ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Schisandra Extract + Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interactionRhodiola ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cns Depressants +1 Minor
Interaction Summary
Theoretically, rhodiola might increase levels of drugs metabolized by CYP1A2.
Read the full Rhodiola 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 Stress Manager — through 3 ingredients. Tap an ingredient for the detail:
Eleuthero ExtractCytochrome P450 2d6 (cyp2d6) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Moderate
Interaction Summary
Theoretically, eleuthero might increase levels of drugs metabolized by CYP2D6.
Read the full Eleuthero Extract + Acetaminophen, Caffeine, Codeine interactionSchisandra ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Schisandra Extract + Acetaminophen, Caffeine, Codeine interactionRhodiola ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cns Depressants +1 Minor
Interaction Summary
Theoretically, rhodiola might increase levels of drugs metabolized by CYP3A4.
Read the full Rhodiola Extract + Acetaminophen, Caffeine, Codeine interactionAcetaminophen, Caffeine, Codeine, SalicylamideCodalan No.1, Codalan No.2, Codalan No.3
How Acetaminophen, Caffeine, Codeine, Salicylamide interacts with Stress Manager — through 3 ingredients. Tap an ingredient for the detail:
Schisandra ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Schisandra Extract + Acetaminophen, Caffeine, Codeine, Salicylamide interactionEleuthero ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 2d6 (cyp2d6) Substrates +1 Moderate
Interaction Summary
Theoretically, eleuthero might increase levels of drugs metabolized by CYP3A4.
Read the full Eleuthero Extract + Acetaminophen, Caffeine, Codeine, Salicylamide interactionRhodiola ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cns Depressants +1 Minor
Interaction Summary
Theoretically, rhodiola might increase levels of drugs metabolized by CYP1A2.
Read the full Rhodiola Extract + Acetaminophen, Caffeine, Codeine, Salicylamide interactionAcetaminophen, Caffeine, DihydrocodeineDHC Plus, Panlor DC, Panlor SS
How Acetaminophen, Caffeine, Dihydrocodeine interacts with Stress Manager — through 3 ingredients. Tap an ingredient for the detail:
Eleuthero ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Moderate
Interaction Summary
Theoretically, eleuthero might increase levels of drugs metabolized by CYP1A2.
Read the full Eleuthero Extract + Acetaminophen, Caffeine, Dihydrocodeine interactionSchisandra ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Schisandra Extract + Acetaminophen, Caffeine, Dihydrocodeine interactionRhodiola ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cns Depressants +1 Minor
Interaction Summary
Theoretically, rhodiola might increase levels of drugs metabolized by CYP1A2.
Read the full Rhodiola Extract + Acetaminophen, Caffeine, Dihydrocodeine interactionAcetaminophen, Caffeine, IsomethepteneMigralam
How Acetaminophen, Caffeine, Isometheptene interacts with Stress Manager — through 3 ingredients. Tap an ingredient for the detail:
Eleuthero ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, eleuthero might increase levels of drugs metabolized by CYP1A2.
Read the full Eleuthero Extract + Acetaminophen, Caffeine, Isometheptene interactionSchisandra ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Schisandra Extract + Acetaminophen, Caffeine, Isometheptene interactionRhodiola ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, rhodiola might increase levels of drugs metabolized by CYP3A4.
Read the full Rhodiola Extract + Acetaminophen, Caffeine, Isometheptene interactionAcetaminophen, Caffeine, PyrilamineMidol Max Strength Menstrual
How Acetaminophen, Caffeine, Pyrilamine interacts with Stress Manager — through 3 ingredients. Tap an ingredient for the detail:
Schisandra ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Schisandra Extract + Acetaminophen, Caffeine, Pyrilamine interactionEleuthero ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, eleuthero might increase levels of drugs metabolized by CYP3A4.
Read the full Eleuthero Extract + Acetaminophen, Caffeine, Pyrilamine interactionRhodiola ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, rhodiola might increase levels of drugs metabolized by CYP1A2.
Read the full Rhodiola Extract + Acetaminophen, Caffeine, Pyrilamine interactionAcetaminophen, Chlorpheniramine Maleate, Dextromethorphan HbrVicks Formula 44M Cough, Cold & Flu Relief
How Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interacts with Stress Manager — through 3 ingredients. Tap an ingredient for the detail:
Eleuthero ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 2d6 (cyp2d6) Substrates +1 Moderate
Interaction Summary
Theoretically, eleuthero might increase levels of drugs metabolized by CYP1A2.
Read the full Eleuthero Extract + Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interactionSchisandra ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Schisandra Extract + Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interactionRhodiola ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, rhodiola might increase levels of drugs metabolized by CYP1A2.
Read the full Rhodiola Extract + Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interactionAcetaminophen, Chlorpheniramine, Codeine, PhenylephrineColrex
How Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interacts with Stress Manager — through 3 ingredients. Tap an ingredient for the detail:
Eleuthero ExtractCytochrome P450 2d6 (cyp2d6) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Moderate
Interaction Summary
Theoretically, eleuthero might increase levels of drugs metabolized by CYP2D6.
Read the full Eleuthero Extract + Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interactionSchisandra ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Schisandra Extract + Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interactionRhodiola ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cns Depressants +1 Minor
Interaction Summary
Theoretically, rhodiola might increase levels of drugs metabolized by CYP3A4.
Read the full Rhodiola Extract + Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interactionAcetaminophen, Chlorpheniramine, DextromethorphanCoricidin II Extra Strength Cold and Flu
How Acetaminophen, Chlorpheniramine, Dextromethorphan interacts with Stress Manager — through 3 ingredients. Tap an ingredient for the detail:
Schisandra ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Schisandra Extract + Acetaminophen, Chlorpheniramine, Dextromethorphan interactionEleuthero ExtractCytochrome P450 2d6 (cyp2d6) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Moderate
Interaction Summary
Theoretically, eleuthero might increase levels of drugs metabolized by CYP2D6.
Read the full Eleuthero Extract + Acetaminophen, Chlorpheniramine, Dextromethorphan interactionRhodiola ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, rhodiola might increase levels of drugs metabolized by CYP1A2.
Read the full Rhodiola Extract + Acetaminophen, Chlorpheniramine, Dextromethorphan interactionAcetaminophen, Chlorpheniramine, Dextromethorphan HydrobromideCoricidin HBP Maximum Strength Flu
How Acetaminophen, Chlorpheniramine, Dextromethorphan Hydrobromide interacts with Stress Manager — through 3 ingredients. Tap an ingredient for the detail:
Eleuthero ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 2d6 (cyp2d6) Substrates +1 Moderate
Interaction Summary
Theoretically, eleuthero might increase levels of drugs metabolized by CYP1A2.
Read the full Eleuthero Extract + Acetaminophen, Chlorpheniramine, Dextromethorphan Hydrobromide interactionSchisandra ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Schisandra Extract + Acetaminophen, Chlorpheniramine, Dextromethorphan Hydrobromide interactionRhodiola ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, rhodiola might increase levels of drugs metabolized by CYP1A2.
Read the full Rhodiola Extract + Acetaminophen, Chlorpheniramine, Dextromethorphan Hydrobromide interactionEach ingredient & the kinds of drugs it affects
For each ingredient in Stress Manager 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.
Rhodiola extract
Antidiabetes Drugs
Theoretically, taking rhodiola with antidiabetes drugs might increase the risk of hypoglycemia.
In vitro and animal research shows that rhodiola extract can decrease blood glucose due to alpha-glucosidase activity.
Antihypertensive Drugs
Theoretically, taking rhodiola with antihypertensive drugs might increase the risk of hypotension.
In vitro and animal research shows that rhodiola extract inhibits angiotensin-converting enzyme (ACE) and might lower blood pressure.
Cytochrome P450 2C9 (Cyp2C9) Substrates
Theoretically, rhodiola might increase levels of drugs metabolized by CYP2C9.
In vitro research shows that rhodiola inhibits CYP2C9. This effect is highly variable and appears to be dependent on the rhodiola product studied. Also, a clinical study in healthy young males found that taking rhodiola extract 290 mg daily for 14 days reduces the metabolism of losartan, a CYP2C9 substrate, by 21% after 4 hours.
Immunosuppressants
Theoretically, rhodiola use might interfere with immunosuppressive therapy.
In vitro and animal research show that rhodiola has immunostimulatory effects.
Losartan (Cozaar)
Rhodiola might increase the levels and adverse effects of losartan.
A clinical study in healthy young males found that taking rhodiola extract 290 mg daily for 14 days reduces the metabolism of losartan, a CYP2C9 substrate, by 21% after 4 hours.
P-Glycoprotein Substrates
Theoretically, rhodiola might increase levels of P-glycoprotein substrates.
In vitro research shows that rhodiola inhibits P-glycoprotein. Theoretically, using rhodiola with P-glycoprotein substrates might increase drug levels and potentially increase the risk of adverse effects.
Antidepressant Drugs
Theoretically, rhodiola might increase the risk of adverse effects when taken with antidepressants.
A review of adverse event reports in Poland identified cases of tachyarrhythmias, myalgia, arthralgia, gum pain, restless leg syndrome, swallowing disorders, and changes in consciousness when rhodiola was taken in combination with paroxetine, escitalopram, fluoxetine, sertraline, trazodone, and/or duloxetine.
Cns Depressants
Theoretically, rhodiola might increase the risk of adverse effects when taken with CNS depressants.
A review of adverse event reports in Poland identified cases of excessive sedation, myoclonus, hypotension, and hallucinations when rhodiola was taken with haloperidol, diazepam, or alprazolam.
Cytochrome P450 1A2 (Cyp1A2) Substrates
Theoretically, rhodiola might increase levels of drugs metabolized by CYP1A2.
In vitro research shows that rhodiola inhibits CYP1A2. This effect is highly variable and appears to be dependent on the rhodiola product studied. However, a clinical study in healthy young males found that taking rhodiola extract 290 mg daily for 14 days does not inhibit the metabolism of caffeine, a CYP1A2 substrate.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, rhodiola might increase levels of drugs metabolized by CYP3A4.
In vitro research shows that rhodiola inhibits CYP3A4. This effect is highly variable and appears to be dependent on the rhodiola product studied. However, a clinical study in healthy young males found that taking rhodiola extract 290 mg daily for 14 days does not inhibit the metabolism of midazolam, a CYP3A4 substrate.
Eleuthero extract
Anticoagulant/Antiplatelet Drugs
Theoretically, eleuthero may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
In vitro and animal research shows that a constituent of eleuthero, dihydroxybenzoic acid, appears to inhibit platelet aggregation. Concomitant use with anticoagulant or antiplatelet drugs might increase the risk of bleeding. This effect has not been reported in humans.
Antidiabetes Drugs
Theoretically, eleuthero might have additive effects when used with antidiabetes drugs.
Animal research suggests that certain constituents of eleuthero have hypoglycemic activity in both healthy and diabetic animals. A small study in adults with type 2 diabetes also shows that taking eleuthero for 3 months can lower blood glucose levels. However, one very small study in healthy individuals shows that taking powdered eleuthero 3 grams, 40 minutes prior to a 75-gram oral glucose tolerance test, significantly increases postprandial blood glucose levels when compared with placebo. These contradictory findings might be due to patient-specific variability and variability in active ingredient ratios.
Cytochrome P450 1A2 (Cyp1A2) Substrates
Theoretically, eleuthero might increase levels of drugs metabolized by CYP1A2.
In vitro and animal research suggest that standardized extracts of eleuthero inhibit CYP1A2. This effect has not been reported in humans.
Cytochrome P450 2C9 (Cyp2C9) Substrates
Theoretically, eleuthero might increase levels of drugs metabolized by CYP2C9.
In vitro and animal research suggest that standardized extracts of eleuthero might inhibit CYP2C9. This effect has not been reported in humans.
Digoxin (Lanoxin)
Eleuthero might increase serum digoxin levels and increase the risk of side effects.
In one case report, a 74-year-old male who was stabilized on digoxin presented with an elevated serum digoxin level after starting an eleuthero supplement, without symptoms of toxicity. After stopping the supplement, serum digoxin levels returned to normal. It is not clear whether this was due to a pharmacokinetic interaction or to interference with the digoxin assay. Although the product was found to be free of digoxin and digitoxin, it was not tested for other contaminants.
Immunosuppressants
Theoretically, eleuthero might interfere with immunosuppressive drugs because of its immunostimulant activity.
Animal and in vitro research shows that eleuthero extracts have immunomodulatory effects, including increasing cellular and humoral activity.
P-Glycoprotein Substrates
Theoretically, eleuthero might increase levels of P-glycoprotein substrates.
In vitro research suggests that eleuthero can inhibit the multi-drug transporter protein, P-glycoprotein. However, it is too soon to tell if this is clinically important. This interaction has not been reported in humans.
Cytochrome P450 2D6 (Cyp2D6) Substrates
Theoretically, eleuthero might increase levels of drugs metabolized by CYP2D6.
In vitro and animal research suggest that standardized extracts of eleuthero might inhibit CYP2D6. However, research in healthy human volunteers has found that taking eleuthero 485 mg twice daily for 14 days does not inhibit CYP2D6 drug metabolism.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, eleuthero might increase levels of drugs metabolized by CYP3A4.
In vitro and animal research suggest that standardized extracts of eleuthero might inhibit CYP3A4. However, research in healthy human volunteers has found that taking eleuthero 485 mg twice daily for 14 days does not inhibit CYP3A4 drug metabolism.
Organic Anion-Transporting Polypeptide Substrates (Oatp)
Theoretically, eleuthero might decrease levels of drugs metabolized by OATP.
In vitro research suggests that eleuthero inhibits OATP2B1, which might reduce the bioavailability of oral drugs that are substrates of OATP2B1. Due to the weak inhibitory effect identified in this study, this interaction is not likely to be clinically significant.
Schisandra extract
Cyclophosphamide
Theoretically, schisandra might increase the levels and clinical effects of cyclophosphamide.
In vitro research shows that schisandra increases the concentration of cyclophosphamide, likely through inhibition of cytochrome P450 3A4. After multiple doses of the schisandra constituents schisandrin A and schisantherin A, the maximum concentration of cyclophosphamide was increased by 7% and 75%, respectively, while the overall exposure to cyclophosphamide was increased by 29% and 301%, respectively.
Cyclosporine (Neoral, Sandimmune)
Schisandra can increase the levels and clinical effects of cyclosporine.
A small observational study in children with aplastic anemia found that taking schisandra with cyclosporine increased cyclosporine trough levels by 93% without increasing the risk of adverse events. However, the dose of cyclosporine was reduced in 9% of children to maintain appropriate cyclosporine blood concentrations.
Cytochrome P450 2C19 (Cyp2C19) Substrates
Theoretically, schisandra might increase the levels and clinical effects of CYP2C19 substrates.
In vitro research shows that schisandra inhibits CYP2C19, and animal research shows that schisandra increases the concentration of voriconazole, a CYP2C19 substrate. Theoretically, schisandra may also inhibit the metabolism of other CYP2C19 substrates. This effect has not been reported in humans.
Cytochrome P450 2C9 (Cyp2C9) Substrates
Theoretically, schisandra might decrease the levels and clinical effects of CYP2C9 substrates.
In vitro and animal research suggests that schisandra induces CYP2C9 enzymes. This effect has not been reported in humans.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.
Most clinical and laboratory research shows that schisandra, administered either as a single dose or up to twice daily for 14 days, inhibits CYP3A4 and increases the concentration of CYP3A4 substrates such as cyclophosphamide, midazolam, tacrolimus, and talinolol. Although one in vitro and animal study shows that schisandra may induce CYP3A4 metabolism, this effect appears to be overpowered by schisandra's CYP3A4 inhibitory activity and has not been reported in humans.
Midazolam (Versed)
Schisandra can increase the levels and clinical effects of midazolam.
A small pharmacokinetic study in healthy adults shows that taking schisandra extract (Hezheng Pharmaceutical Co.) containing deoxyschizandrin 33.75 mg twice daily for 8 days and a single dose of midazolam 15 mg on day 8 increases the overall exposure to midazolam by about 119%, increases the peak plasma level of midazolam by 86%, and decreases midazolam clearance by about 52%. This effect has been attributed to inhibition of CYP3A4 by schisandra.
P-Glycoprotein Substrates
Schisandra might increase the levels and clinical effects of P-glycoprotein substrates.
In vitro research shows that schisandra extracts and constituents such as schisandrin B inhibit P-glycoprotein mediated efflux in intestinal cells and in P-glycoprotein over-expressing cell lines. Additionally, a small clinical study shows that schisandra increases the peak concentration and overall exposure to talinolol, a P-glycoprotein probe substrate. Theoretically, schisandra might inhibit the efflux of other P-glycoprotein substrates.
Sirolimus (Rapamune)
Schisandra can increase the levels and clinical effects of sirolimus.
A small pharmacokinetic study in healthy volunteers shows that taking 3 capsules of schisandra (Hezheng Pharmaceutical Company) containing a total of 33.75 mg deoxyschizandrin twice daily for 13 days and then taking a single dose of sirolimus 2 mg increases the overall exposure and peak level of sirolimus by two-fold. This effect is thought to be due to inhibition of cytochrome P450 3A4 by schisandra, as well as possible inhibition of the P-glycoprotein drug transporter.
Tacrolimus (Prograf)
Schisandra can increase the levels and clinical effects of tacrolimus.
Clinical research in healthy children and adults, transplant patients, and patients with nephrotic syndrome and various rheumatic immunologic disorders shows that taking schisandra with tacrolimus increases tacrolimus peak levels by 183% to 268%, prolongs or delays time to peak tacrolimus concentrations, increases overall exposure to tacrolimus by 126% to 343%, and decreases tacrolimus clearance by 19% to 73%. This effect is thought to be due to inhibition of P-glycoprotein drug transporter and CYP3A4 and CYP3A5 by schisandra. Some clinical and observational studies suggest that schisandra increases tacrolimus levels similarly in both expressors and non-expressors of CYP3A5, while other studies suggest it does so to a greater degree in CYP3A5 expressors than non-expressors. Animal research suggests that the greatest increase in tacrolimus levels occurs when schisandra is taken either concomitantly or up to 2 hours before tacrolimus, and clinical and observational research in humans suggests that schisandra may increase whole blood levels of tacrolimus and decrease clearance of tacrolimus in a dose-dependent manner.
Talinolol
Schisandra can increase the levels and clinical effects of talinolol.
A small pharmacokinetic study in healthy volunteers shows that taking schisandra extract 300 mg twice daily for 14 days with a single dose of talinolol 100 mg on day 14 increases the peak talinolol level by 51% and the overall exposure to talinolol by 47%. This effect is thought to be due to the possible inhibition of cytochrome P450 3A4 and P-glycoprotein by schisandra.
tly.
Voriconazole (Vfend)
Theoretically, schisandra might increase the levels and clinical effects of voriconazole.
Animal research shows that oral schisandra given daily for 1 or 14 days increases levels of intravenously administered voriconazole, a cytochrome P450 (CYP) 2C19 substrate. This effect is thought to be due to inhibition of CYP2C19 by schisandra. However, this interaction has not been reported in humans.
Warfarin (Coumadin)
Theoretically, schisandra might decrease the levels and clinical effects of warfarin.
Animal research suggests that oral schisandra extract, given daily for 6 days, reduces levels of intravenously administered warfarin. This effect might be due to the induction of cytochrome P450 (CYP) 2C9 metabolism by schisandra. However, this interaction has not been reported in humans.
Reishi Mushroom Extract
Anticoagulant/Antiplatelet Drugs
Theoretically, high doses of reishi mushroom might increase the risk of bleeding.
A dose of 1.5 grams daily of reishi mushroom does not seem to decrease platelet aggregation, but a higher dose of 3 grams daily does.
Antidiabetes Drugs
Theoretically, reishi mushroom might have additive effects with antidiabetes drugs.
Animal research suggests that reishi mushroom decreases blood sugar. However, in patients with type 2 diabetes, taking reishi mushroom does not reduce fasting glucose levels, and its effects on glycated hemoglobin are inconsistent.
Antihypertensive Drugs
Theoretically, concurrent use of reishi mushroom with antihypertensive drugs might increase the risk of hypotension.
Reishi mushroom has shown hypotensive activity in animal research. Clinical evidence suggests that reishi mushroom reduces blood pressure in some, but not all, patients with hypertension.
Holy Basil extract
Anticoagulant/Antiplatelet Drugs
Theoretically, holy basil seed oil might increase the risk of bleeding when used with anticoagulant or antiplatelet drugs.
Animal research shows that holy basil seed oil can prolong bleeding time, possibly due to inhibition of platelet aggregation. However, it is not known if this occurs in humans.
Antidiabetes Drugs
Theoretically, holy basil might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Small clinical studies show that taking holy basil can decrease fasting blood glucose and other measures of glycemic control in patients with type 2 diabetes.
Pentobarbital (Nembutal)
Theoretically, holy basil seed oil might increase the sedative effects of pentobarbital.
Animal research shows that holy basil seed oil increases pentobarbitone-induced sleeping time. However, it is not known if this occurs in humans or if this applies to other barbiturates or sedatives.
Brand information
Manufacturer and brand details for Stress Manager, from the product label.
Herb Pharm Professional
See all Herb Pharm Professional products- Name
- Herb Pharm
- City
- Williams
- State
- OR
- ZipCode
- 97544
- Phone Number
- 800-348-4372
- Web Address
- www.herb-pharm.com
Stress Manager by Herb Pharm Professional: 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 Stress Manager’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Eleuthero
Interacts with 1,140 drugsEleuthero is an herb traditionally used as an 'adaptogen' to fight fatigue, boost energy, and help the body handle stress. The scientific evidence behind these uses is limited and mixed, so...
Read the full Eleuthero monograph → Herb & supplement monographReishi Mushroom
Interacts with 375 drugsReishi is a traditional Asian mushroom widely used to support the immune system and overall wellness. Human evidence for most of its claimed benefits is limited or low-quality, so it should...
Read the full Reishi Mushroom monograph → Herb & supplement monographSchisandra
Interacts with 803 drugsSchisandra is a traditional Chinese medicine berry used as an adaptogen for stress, fatigue, and liver support. Human evidence is limited and most claims are not well proven, but it appears...
Read the full Schisandra monograph → Herb & supplement monographHoly Basil
Interacts with 212 drugsHoly basil (tulsi) is a traditional Ayurvedic herb most often used today for stress and general wellness, but the human evidence is mostly small and preliminary. It is generally well tolerat...
Read the full Holy Basil monograph → Herb & supplement monographRhodiola
Interacts with 1,271 drugsRhodiola is an herb traditionally used to fight fatigue and help the body cope with stress. Some small studies suggest it may modestly reduce fatigue and improve mood, but the evidence is li...
Read the full Rhodiola monograph →Sources & How We Checked
Stress Manager'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 88 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.
Eleuthero 24 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.
- McRae S. Elevated serum digoxin levels in a patient taking digoxin and Siberian ginseng. CMAJ 1996;155:293-5.
- Awang DVC. Siberian ginseng toxicity may be case of mistaken identity (letter). CMAJ 1996;155:1237.
- Mills S, Bone K. Principles and Practice of Phytotherapy. London: Churchill Livingstone, 2000.
- Harkey MR, Henderson GL, Zhou L, et al. Effects of Siberian ginseng (Eleutherococcus senticosus) on c-DNA-expressed P450 drug metabolizing enzymes. Alt Ther 2001;7:S14.
- Hikino H, Takahashi M, Otake K, Konno C. Isolation and hypoglycemic activity of eleutherans A, B, C, D, E, F, and G: glycans of Eleutherococcus senticosus roots. J Nat Prod 1986;49:293-7. PubMed
- Yun-Choi HS, Kim JH, Lee JR. Potential inhibitors of platelet aggregation from plant sources, III. J Nat Prod 1987;50:1059-64. PubMed
- Donovan JL, DeVane CL, Chavin KD, et al. Siberian Ginseng (Eleutheroccus senticosus) Effects on CYP2D6 and CYP3A4 Activity in Normal Volunteers. Drug Metab Dispos 2003;31:519-22.. PubMed
- Hartz AJ, Bentler S, Noyes R et al. Randomized controlled trial of Siberian ginseng for chronic fatigue. Psychol Med 2004;34:51-61. PubMed
- Sievenpiper JL, Arnason JT, Leiter LA, Vuksan V. Decreasing, null and increasing effects of eight popular types of ginseng on acute postprandial glycemic indices in healthy humans: the role of ginsenosides. J Am Coll Nutr 2004;23:248-58. PubMed
- Dasgupta A, Wu S, Actor J, et al. Effect of Asian and Siberian ginseng on serum digoxin measurement by five digoxin immunoassays. Significant variation in digoxin-like immunoreactivity among commercial ginsengs. Am J Clin Pathol 2003;119:298-303. DOI
- Takahashi T, Kaku T, Sato T, et al. Effects of Acanthopanax senticosus HARMS extract on drug transport in human intestinal cell line Caco-2. J Nat Med. 2010;64(1):55-62. PubMed
- Fuchikami H, Satoh H, Tsujimoto M, Ohdo S, Ohtani H, Sawada Y. Effects of herbal extracts on the function of human organic anion-transporting polypeptide OATP-B. Drug Metab Dispos 2006;34:577-82. PubMed
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