Strong Bones Ingredients & Drug Interactions
by Hawaii Pharm
What is this page for?
First and foremost: checking Strong Bones 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
Strong Bones is a dietary supplement by Hawaii Pharm with 3 active ingredients. Its ingredients are commonly taken for hot flashes and night sweats, other menopause symptoms, mood changes during menopause.Based on those ingredients, 1,260 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Red Clover Flower Extract, Dry, Black Cohosh Root Extract, Dry, Horsetail Herb Extract, Dry. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against Strong Bones by Hawaii Pharm
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HelloPharmacist Scorecard of Strong Bones by Hawaii Pharm
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
Strong Bones contains three active herbal extracts: black cohosh root extract, horsetail herb extract, and red clover flower extract, each contributing to the formula's intended effect on bone health. These are combined with a proprietary extract blend, plus alcohol, water, and glycerin as inactive ingredients.
Black cohosh is traditionally used for menopausal symptoms and bone support; horsetail is included for its mineral content and traditional use in bone health; and red clover brings phytoestrogens and flavonoid compounds to the blend. All three are popular in herbal bone support formulas, though the evidence for their effectiveness varies.
Does it work?
Not established
The evidence supporting these ingredients is mixed. Black cohosh shows possibly effective evidence for menopausal symptoms, which may indirectly relate to bone health during that transition, but there's insufficient evidence for acne, sexual dysfunction, anxiety, or breast cancer-related hot flashes.
For horsetail and red clover, the data we hold shows insufficient reliable evidence to rate them for urinary incontinence, obesity, tonsillitis, hair loss, menopausal symptoms, or osteoarthritis and osteoporosis. If bone strength is your goal, talk with your pharmacist or doctor about what the clinical evidence actually supports.
How safe is it?
Well-documented data
Black cohosh is generally well tolerated short-term, but rare cases of liver damage have been reported, so medical guidance is wise. The most common side effects are breast tenderness, dizziness, stomach upset, headache, irritability, rash, and tiredness.
Horsetail is well tolerated in the short term by healthy adults, though it can cause stomach bloating, increased bowel movements, and nausea; long-term use carries real risks, and crude horsetail may cause thiamine deficiency with prolonged use. Red clover is generally well tolerated short-term and causes muscle pain, nausea, and vaginal spotting in some people.
All three ingredients should be avoided during pregnancy — black cohosh and horsetail lack adequate safety data and may affect the uterus, and red clover has estrogen-like effects. None should be used while breastfeeding.
Meds to double-check
Moderate interaction found
Before taking this product, check whether you're on serotonergic antidepressants (duloxetine, sertraline, etc.) — black cohosh has a documented case of serotonin syndrome with these. Also flag hepatotoxic drugs, liver enzyme substrates (CYP2D6, CYP1A2, CYP2C19, CYP2C9, CYP3A4), blood sugar medications, diuretics, lithium, antiretroviral drugs, estrogen therapy, atorvastatin, cisplatin, methotrexate, tamoxifen, and blood thinners — all carry documented Moderate or Minor interactions with ingredients in this product.
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.
Strong Bones is a three-ingredient herbal blend aimed at bone support, but the evidence for effectiveness is limited and the interaction list is long. If you take any blood pressure or heart medication, blood sugar drugs, antidepressants, hormone therapy, lithium, methotrexate, tamoxifen, or other prescription medications, check your specific drugs with the search tool on this page before starting.
Avoid this product if you're pregnant or breastfeeding.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 3 of 3 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Oct 24, 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 Strong Bones, straight from the product label.
| Brand | Hawaii Pharm |
|---|---|
| Barcode (UPC) | 840253663672 |
| Net contents | 4 Fluid Ounce(s); 120 mL |
| Market status | On market |
| Date entered into DSLD | Oct 24, 2023 |
| DSLD ID | 301911 |
| Product type | Botanical |
| Supplement form | Liquid |
| Dietary claims / uses | All Other, Structure/Function |
| 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 Strong Bones by Hawaii Pharm, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Proprietary Extract Blend | 983 mg | -- |
| Black Cohosh Root Extract, Dry | 0 NP | -- |
| Horsetail Herb Extract, Dry | 0 NP | -- |
| Red Clover Flower Extract, Dry | 0 NP | -- |
Other ingredients: Alcohol, Water, 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.
Brand IP Statement(s)
Hawaii Pharm Herbal Extract Highest quality since 2008
Suggested/Recommended/Usage/Directions
Suggested use: Shake well before using. For adults add about 20-30 drops (0.7-1 mL, one full squeeze of the dropper bulb) to some juice or water, up to 4 times a day.
Precautions
Warning: We recommend to seek expert medical advice before taking.
Do not use if you are allergic to any ingredients.
Consult your physician before giving to children under 18, during pregnancy, if nursing or taking medications.
Consult your physician before giving to children under 18, during pregnancy, if nursing or taking medications.
May affect the ability to drive and operate machinery. May have contraindications, can cause side effects and adverse reactions. Do not use if seal is broken or missing.
Keep out of the reach of children!
Storage
Store in a cool dry place.
Seals/Symbols
cGMP Made in compliance with cGMP 21 CFR 111 in an FDA registered and inspected facility.
Organic Alcohol Based USA Made in United States of America
FDA Disclaimer Statement
This product has not been evaluated by the FDA and is not intended to diagnose, treat, cure or prevent any disease.
Formulation
Made in USA, Hawaii
Only natural ingredients Purity is laboratory tested and verified
All the raw materials are gluten-free by their nature No artificial colors, flavors, or preservatives
Not tested on animals
Organic Alcohol Based
FDA Statement of Identity
Herbal Supplement
Formula
Organic Alcohol Based
General Statements
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Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Strong Bones by Hawaii Pharm 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 Strong Bones by Hawaii Pharm
These are the 3 active ingredients this product is made of. Select any to open its full monograph.
Serving size0.7 mL Dosage formLiquid Servings per container120 Amounts shown are per serving.
Most supplement products combine several ingredients, and a medication can interact with the product through any one of them. Each ingredient below shows whether it has known drug interactions.
Proprietary Extract Blend
Other (inactive) ingredients: Alcohol, Water, Glycerin. These complete the product’s ingredient list but are not active constituents.
Strong Bones by Hawaii Pharm Drug Interactions
HelloPharmacist Interaction Report
Strong Bones by Hawaii Pharm contains three herbal extracts, and its ingredients interact with a substantial number of medications.
The most serious concern is black cohosh root extract and serotonergic drugs (antidepressants and similar medications) — there's a documented case of serotonin syndrome when black cohosh was added to duloxetine and sertraline. This is a Major-level interaction and worth checking before you start.
Read the full breakdown — every affected drug type, severity by severity
Black cohosh also carries Moderate interactions with drugs metabolized by your liver's CYP2D6 enzyme, hepatotoxic drugs (which can damage your liver), the statin atorvastatin, cisplatin (a chemotherapy drug), estrogen therapy, and OATP drug transporters. Horsetail herb extract has Moderate interactions with blood sugar medications, diuretics (water pills), lithium, and antiretroviral drugs including efavirenz.
Red clover flower extract interacts Moderately with estrogen therapy, methotrexate, and tamoxifen, and carries Minor interactions with several liver enzyme systems and blood thinners.
Additionally, the individual medication count across all three ingredients is substantial. Altogether, these interactions span 1,240 individual medications.
Before you take this product, search your exact medications below — especially if you're on antidepressants, hormone therapy, blood sugar drugs, diuretics, or any cancer medication.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against Strong Bones?
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 Strong Bones interact with 1,260 drugs. Click any drug to see the details.
3 of the 3 ingredients in Strong Bones interact with drugs. Each result below shows which ingredient is responsible. Red Clover Flower Extract, Dry Black Cohosh Root Extract, Dry Horsetail Herb Extract, Dry
Ado-trastuzumab EmtansineKadcyla
How Ado-trastuzumab Emtansine interacts with Strong Bones — through 1 ingredient. Tap an ingredient for the detail:
Red Clover Flower Extract, DryCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, red clover might increase levels of drugs metabolized by CYP3A4; however, a small clinical study found no effect.
Read the full Red Clover Flower Extract, Dry + Ado-trastuzumab Emtansine interactionAbciximabReoPro
How Abciximab interacts with Strong Bones — through 1 ingredient. Tap an ingredient for the detail:
Red Clover Flower Extract, DryAnticoagulant/antiplatelet Drugs Minor
Interaction Summary
Although some laboratory research suggests that red clover may have anticoagulant and antiplatelet activity, clinical research has not shown this effect.
Read the full Red Clover Flower Extract, Dry + Abciximab interactionAbemaciclibVerzenio
How Abemaciclib interacts with Strong Bones — through 1 ingredient. Tap an ingredient for the detail:
Red Clover Flower Extract, DryCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, red clover might increase levels of drugs metabolized by CYP3A4; however, a small clinical study found no effect.
Read the full Red Clover Flower Extract, Dry + Abemaciclib interactionAbrocitinibCibinqo
How Abrocitinib interacts with Strong Bones — through 1 ingredient. Tap an ingredient for the detail:
Red Clover Flower Extract, DryCytochrome P450 2c19 (cyp2c19) Substrates, Cytochrome P450 2c9 (cyp2c9) Substrates +1 Minor
Interaction Summary
Theoretically, red clover might increase the levels and clinical effects of drugs metabolized by CYP2C19.
Read the full Red Clover Flower Extract, Dry + Abrocitinib interactionAcalabrutinibCalquence
How Acalabrutinib interacts with Strong Bones — through 1 ingredient. Tap an ingredient for the detail:
Red Clover Flower Extract, DryCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, red clover might increase levels of drugs metabolized by CYP3A4; however, a small clinical study found no effect.
Read the full Red Clover Flower Extract, Dry + Acalabrutinib interactionAcenocoumarolSintrom
How Acenocoumarol interacts with Strong Bones — through 1 ingredient. Tap an ingredient for the detail:
Red Clover Flower Extract, DryAnticoagulant/antiplatelet Drugs Minor
Interaction Summary
Although some laboratory research suggests that red clover may have anticoagulant and antiplatelet activity, clinical research has not shown this effect.
Read the full Red Clover Flower Extract, Dry + Acenocoumarol interactionAcetylsalicylic AcidEntrophen
How Acetylsalicylic Acid interacts with Strong Bones — through 1 ingredient. Tap an ingredient for the detail:
Red Clover Flower Extract, DryAnticoagulant/antiplatelet Drugs Minor
Interaction Summary
Although some laboratory research suggests that red clover may have anticoagulant and antiplatelet activity, clinical research has not shown this effect.
Read the full Red Clover Flower Extract, Dry + Acetylsalicylic Acid interactionAgomelatineValdoxan
How Agomelatine interacts with Strong Bones — through 1 ingredient. Tap an ingredient for the detail:
Red Clover Flower Extract, DryCytochrome P450 2c19 (cyp2c19) Substrates, Cytochrome P450 2c9 (cyp2c9) Substrates +1 Minor
Interaction Summary
Theoretically, red clover might increase the levels and clinical effects of drugs metabolized by CYP2C19.
Read the full Red Clover Flower Extract, Dry + Agomelatine interactionAlfentanilAlfenta
How Alfentanil interacts with Strong Bones — through 1 ingredient. Tap an ingredient for the detail:
Red Clover Flower Extract, DryCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, red clover might increase levels of drugs metabolized by CYP3A4; however, a small clinical study found no effect.
Read the full Red Clover Flower Extract, Dry + Alfentanil interactionAlfuzosinUroxatral
How Alfuzosin interacts with Strong Bones — through 1 ingredient. Tap an ingredient for the detail:
Red Clover Flower Extract, DryCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, red clover might increase levels of drugs metabolized by CYP3A4; however, a small clinical study found no effect.
Read the full Red Clover Flower Extract, Dry + Alfuzosin interactionAliskirenTekturna
How Aliskiren interacts with Strong Bones — through 1 ingredient. Tap an ingredient for the detail:
Red Clover Flower Extract, DryCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, red clover might increase levels of drugs metabolized by CYP3A4; however, a small clinical study found no effect.
Read the full Red Clover Flower Extract, Dry + Aliskiren interactionAlpelisibPiqray
How Alpelisib interacts with Strong Bones — through 1 ingredient. Tap an ingredient for the detail:
Red Clover Flower Extract, DryCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, red clover might increase levels of drugs metabolized by CYP3A4; however, a small clinical study found no effect.
Read the full Red Clover Flower Extract, Dry + Alpelisib interactionAlprazolamNiravam, Xanax
How Alprazolam interacts with Strong Bones — through 1 ingredient. Tap an ingredient for the detail:
Red Clover Flower Extract, DryCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, red clover might increase levels of drugs metabolized by CYP3A4; however, a small clinical study found no effect.
Read the full Red Clover Flower Extract, Dry + Alprazolam interactionAlteplase, TpaActilyse, Activase
How Alteplase, Tpa interacts with Strong Bones — through 1 ingredient. Tap an ingredient for the detail:
Red Clover Flower Extract, DryAnticoagulant/antiplatelet Drugs Minor
Interaction Summary
Although some laboratory research suggests that red clover may have anticoagulant and antiplatelet activity, clinical research has not shown this effect.
Read the full Red Clover Flower Extract, Dry + Alteplase, Tpa interactionAluminum Hydroxide, Aspirin, Magnesium HydroxideAscriptin
How Aluminum Hydroxide, Aspirin, Magnesium Hydroxide interacts with Strong Bones — through 1 ingredient. Tap an ingredient for the detail:
Red Clover Flower Extract, DryAnticoagulant/antiplatelet Drugs Minor
Interaction Summary
Although some laboratory research suggests that red clover may have anticoagulant and antiplatelet activity, clinical research has not shown this effect.
Read the full Red Clover Flower Extract, Dry + Aluminum Hydroxide, Aspirin, Magnesium Hydroxide interactionAmlodipineNorliqva
How Amlodipine interacts with Strong Bones — through 1 ingredient. Tap an ingredient for the detail:
Red Clover Flower Extract, DryCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, red clover might increase levels of drugs metabolized by CYP3A4; however, a small clinical study found no effect.
Read the full Red Clover Flower Extract, Dry + Amlodipine interactionAmlodipine BenzoateKaterzia
How Amlodipine Benzoate interacts with Strong Bones — through 1 ingredient. Tap an ingredient for the detail:
Red Clover Flower Extract, DryCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, red clover might increase levels of drugs metabolized by CYP3A4; however, a small clinical study found no effect.
Read the full Red Clover Flower Extract, Dry + Amlodipine Benzoate interactionAmlodipine BesilateIstin
How Amlodipine Besilate interacts with Strong Bones — through 1 ingredient. Tap an ingredient for the detail:
Red Clover Flower Extract, DryCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, red clover might increase levels of drugs metabolized by CYP3A4; however, a small clinical study found no effect.
Read the full Red Clover Flower Extract, Dry + Amlodipine Besilate interactionAmlodipine BesylateNorvasc
How Amlodipine Besylate interacts with Strong Bones — through 1 ingredient. Tap an ingredient for the detail:
Red Clover Flower Extract, DryCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, red clover might increase levels of drugs metabolized by CYP3A4; however, a small clinical study found no effect.
Read the full Red Clover Flower Extract, Dry + Amlodipine Besylate interactionAmlodipine Besylate, BenazeprilLotrel
How Amlodipine Besylate, Benazepril interacts with Strong Bones — through 1 ingredient. Tap an ingredient for the detail:
Red Clover Flower Extract, DryCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, red clover might increase levels of drugs metabolized by CYP3A4; however, a small clinical study found no effect.
Read the full Red Clover Flower Extract, Dry + Amlodipine Besylate, Benazepril interactionAmlodipine, CelecoxibConsensi
How Amlodipine, Celecoxib interacts with Strong Bones — through 1 ingredient. Tap an ingredient for the detail:
Red Clover Flower Extract, DryCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 2c9 (cyp2c9) Substrates Minor
Interaction Summary
Theoretically, red clover might increase levels of drugs metabolized by CYP3A4; however, a small clinical study found no effect.
Read the full Red Clover Flower Extract, Dry + Amlodipine, Celecoxib interactionAmprenavirAgenerase
How Amprenavir interacts with Strong Bones — through 1 ingredient. Tap an ingredient for the detail:
Red Clover Flower Extract, DryCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, red clover might increase levels of drugs metabolized by CYP3A4; however, a small clinical study found no effect.
Read the full Red Clover Flower Extract, Dry + Amprenavir interactionAnacaulase-bcdbNexoBrid
How Anacaulase-bcdb interacts with Strong Bones — through 1 ingredient. Tap an ingredient for the detail:
Red Clover Flower Extract, DryAnticoagulant/antiplatelet Drugs Minor
Interaction Summary
Although some laboratory research suggests that red clover may have anticoagulant and antiplatelet activity, clinical research has not shown this effect.
Read the full Red Clover Flower Extract, Dry + Anacaulase-bcdb interactionAnagrelideAgrylin
How Anagrelide interacts with Strong Bones — through 1 ingredient. Tap an ingredient for the detail:
Red Clover Flower Extract, DryCytochrome P450 1a2 (cyp1a2) Substrates, Anticoagulant/antiplatelet Drugs Minor
Interaction Summary
Theoretically, red clover might increase levels of drugs metabolized by CYP1A2; however, a small clinical study found no effect.
Read the full Red Clover Flower Extract, Dry + Anagrelide interactionAnisindioneMiradon
How Anisindione interacts with Strong Bones — through 1 ingredient. Tap an ingredient for the detail:
Red Clover Flower Extract, DryAnticoagulant/antiplatelet Drugs Minor
Interaction Summary
Although some laboratory research suggests that red clover may have anticoagulant and antiplatelet activity, clinical research has not shown this effect.
Read the full Red Clover Flower Extract, Dry + Anisindione interactionAntithrombin IiiThrombate III
How Antithrombin Iii interacts with Strong Bones — through 1 ingredient. Tap an ingredient for the detail:
Red Clover Flower Extract, DryAnticoagulant/antiplatelet Drugs Minor
Interaction Summary
Although some laboratory research suggests that red clover may have anticoagulant and antiplatelet activity, clinical research has not shown this effect.
Read the full Red Clover Flower Extract, Dry + Antithrombin Iii interactionApalutamideErleada
How Apalutamide interacts with Strong Bones — through 1 ingredient. Tap an ingredient for the detail:
Red Clover Flower Extract, DryCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, red clover might increase levels of drugs metabolized by CYP3A4; however, a small clinical study found no effect.
Read the full Red Clover Flower Extract, Dry + Apalutamide interactionApixabanEliquis
How Apixaban interacts with Strong Bones — through 1 ingredient. Tap an ingredient for the detail:
Red Clover Flower Extract, DryAnticoagulant/antiplatelet Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Although some laboratory research suggests that red clover may have anticoagulant and antiplatelet activity, clinical research has not shown this effect.
Read the full Red Clover Flower Extract, Dry + Apixaban interactionApremilastOtezla
How Apremilast interacts with Strong Bones — through 1 ingredient. Tap an ingredient for the detail:
Red Clover Flower Extract, DryCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, red clover might increase levels of drugs metabolized by CYP3A4; however, a small clinical study found no effect.
Read the full Red Clover Flower Extract, Dry + Apremilast interactionAprepitantCinvanti, Emend
How Aprepitant interacts with Strong Bones — through 1 ingredient. Tap an ingredient for the detail:
Red Clover Flower Extract, DryCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, red clover might increase levels of drugs metabolized by CYP3A4; however, a small clinical study found no effect.
Read the full Red Clover Flower Extract, Dry + Aprepitant interactionEach ingredient & the kinds of drugs it affects
For each ingredient in Strong Bones 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.
Red Clover Flower Extract, Dry
Estrogens
Theoretically, concomitant use of large amounts of red clover might interfere with estrogen therapy.
Red clover contains phytoestrogens which might have estrogenic activity in some people. Theoretically, red clover might compete for estrogen receptors and interfere with estrogen-containing drug therapy.
Methotrexate (Trexall, Others)
Theoretically, red clover might increase the risk of methotrexate toxicity.
In a case report, a 52-year-old female receiving weekly methotrexate injections for psoriasis developed symptoms of methotrexate toxicity, including severe vomiting and epigastric pain, after three days of taking red clover 430 mg daily. Toxicity resolved after red clover was discontinued. However, no liver function tests or methotrexate levels were reported.
Tamoxifen (Nolvadex)
Theoretically, the phytoestrogens in red clover might interfere with tamoxifen.
In vitro and animal research suggests that genistein, a constituent of red clover, might antagonize the antitumor effects of tamoxifen. However, there is some evidence from an animal study that red clover does not reduce the efficacy of tamoxifen. Until more is known, tell patients taking tamoxifen to avoid red clover.
Anticoagulant/Antiplatelet Drugs
Although some laboratory research suggests that red clover may have anticoagulant and antiplatelet activity, clinical research has not shown this effect.
In vitro research suggests that genistein in red clover has antiplatelet effects, and historically, red clover was thought to have anticoagulant effects due to its coumarin content. However, some experts state that this is unlikely as most natural coumarins have not been shown to have anticoagulant effects, and their content in red clover is low. Additionally, some clinical research in postmenopausal patients found no effect on coagulation or prothrombin time with the use of red clover flowering tops 378 mg daily for 12 months or red clover isoflavone (Rimostil) 50 mg daily for 2 years.
Caffeine
Theoretically, soy might reduce the clearance of caffeine; however, a small clinical study found no effect.
Red clover contains genistein. Taking genistein 1 gram daily for 14 days seems to inhibit caffeine clearance and metabolism in healthy females. However, this effect does not seem to occur with the lower amounts of genistein found in red clover. A clinical study in healthy postmenopausal individuals shows that taking red clover capsules standardized to contain 60 mg isoflavones twice daily for 14 days does not affect the pharmacokinetics of caffeine.
Cytochrome P450 1A2 (Cyp1A2) Substrates
Theoretically, red clover might increase levels of drugs metabolized by CYP1A2; however, a small clinical study found no effect.
In vitro evidence shows that red clover inhibits CYP1A2. However, a clinical study in healthy postmenopausal individuals shows that taking red clover capsules standardized to contain 60 mg isoflavones twice daily for 14 days does not affect the pharmacokinetics of caffeine, a CYP1A2 probe substrate.
Cytochrome P450 2C19 (Cyp2C19) Substrates
Theoretically, red clover might increase the levels and clinical effects of drugs metabolized by CYP2C19.
In vitro evidence suggests that red clover weakly inhibits CYP2C19. This interaction has not been reported in humans.
Cytochrome P450 2C9 (Cyp2C9) Substrates
Theoretically, red clover might increase levels of drugs metabolized by CYP2C9; however, a small clinical study found no effect.
In vitro evidence suggests that red clover might inhibit CYP2C9. However, a clinical study in healthy postmenopausal individuals shows that taking red clover capsules standardized to contain 60 mg isoflavones twice daily for 14 days does not affect the pharmacokinetics of tolbutamide, a CYP2C9 probe substrate.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, red clover might increase levels of drugs metabolized by CYP3A4; however, a small clinical study found no effect.
In vitro evidence shows that red clover might inhibit CYP3A4 isoenzymes. However, a clinical study in healthy postmenopausal individuals shows that taking red clover capsules standardized to contain 60 mg isoflavones twice daily for 14 days does not affect the pharmacokinetics of alprazolam, a CYP3A4 probe substrate.
Black Cohosh Root Extract, Dry
Atorvastatin (Lipitor)
Taking black cohosh with atorvastatin might increase the risk for elevated liver function tests.
In one case report, a patient taking atorvastatin (Lipitor) developed significantly elevated liver function enzymes after starting black cohosh 100 mg four times daily. Liver enzymes returned to normal when black cohosh was discontinued. It is unclear whether the elevated liver enzymes were due to black cohosh itself or an interaction between atorvastatin and black cohosh.
Cisplatin (Platinol-Aq)
Theoretically, black cohosh may reduce the clinical effects of cisplatin.
Animal research suggests that black cohosh might decrease the cytotoxic effect of cisplatin on breast cancer cells.
Cytochrome P450 2D6 (Cyp2D6) Substrates
Some research suggests that black cohosh might inhibit CYP2D6, but there is conflicting evidence.
Some clinical research suggests that black cohosh might modestly inhibit CYP2D6 and increase levels of drugs metabolized by this enzyme. However, contradictory clinical research shows a specific black cohosh product (Remifemin, Enzymatic Therapy) 40 mg twice daily does not significantly inhibit metabolism of a CYP2D6 substrate in healthy study volunteers. Until more is known, use black cohosh cautiously in patients taking drugs metabolized by CYP2D6.
Estrogens
Theoretically, black cohosh may alter the effects of estrogen therapy.
Some research suggests that black cohosh has estrogenic effects. This may enhance or inhibit the effects of estrogen therapy.
Hepatotoxic Drugs
Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
There is concern that black cohosh might be linked to cases of liver failure and autoimmune hepatitis.
Serotonergic Drugs
Combining serotonergic drugs with black cohosh might cause additive serotonergic effects.
Black cohosh might increase the risk of serotonin syndrome when combined with other serotonergic drugs. Black cohosh acts as an agonist at several serotonin receptor subtypes and might interact with other serotonergic medications. In one case, a 55-year-old female who had been on stable treatment with sertraline 50 mg and duloxetine 60 mg daily developed serotonin syndrome after taking black cohosh extract 40 mg daily for 3 days.
Organic Anion-Transporting Polypeptide Substrates (Oatp)
Black cohosh may inhibit one form of OATP, OATP2B1, which could reduce the bioavailability and clinical effects of OATP2B1 substrates.
In vitro research shows that black cohosh modestly inhibits OATP2B1. OATPs are expressed in the small intestine and liver and are responsible for the uptake of drugs and other compounds into the body. Inhibition of OATP may reduce the bioavailability of oral drugs that are substrates of OATP.
Horsetail Herb Extract, Dry
Antidiabetes Drugs
Theoretically, taking horsetail with antidiabetes drugs might increase the risk of hypoglycemia.
Equisetum myriochaetum has demonstrated hypoglycemic activity in clinical research. In an animal diabetic model, Equisetum giganteum had hypoglycemic effects. It is unclear whether other horsetail species have hypoglycemic effects.
Diuretic Drugs
Theoretically, taking horsetail with diuretic drugs might increase potassium loss and the risk of hypokalemia.
Laboratory research shows that various species of horsetail have diuretic properties. Due to its diuretic effects, there has been concern that taking horsetail along with potassium-depleting diuretics might increase the risk for hypokalemia. However, pharmacokinetic research in humans shows that taking horsetail 900 mg daily for 4 days does not affect urinary excretion of electrolytes, including potassium and sodium, despite having a diuretic effect similar to taking hydrochlorothiazide 25 mg daily. It is unclear if taking horsetail for a longer duration would affect electrolyte levels. Until more is known, use with caution.
Efavirenz (Sustiva)
Theoretically, horsetail might decrease the levels and clinical effects of efavirenz.
In two case reports, patients were found to have detectable viral loads when taking horsetail-containing supplements along with an antiretroviral regimen that included efavirenz. In one case, the antiretroviral regimen included zidovudine, lamivudine, and efavirenz; in the other case, the regimen consisted of emtricitabine, tenofovir disoproxil fumarate, and efavirenz. One month after discontinuing horsetail, the viral loads became undetectable in both cases. The exact mechanism of this interaction is unknown. It is also unclear if this interaction is specific to efavirenz or if it is related to various components of antiretroviral therapy.
Lithium
Theoretically, horsetail might increase the levels and adverse effects of lithium.
Animal research suggests that horsetail has diuretic properties. Theoretically, due to these potential diuretic effects, horsetail might reduce excretion and increase levels of lithium. The dose of lithium might need to be decreased.
Nucleoside Reverse Transcriptase Inhibitors (Nrtis)
Theoretically, horsetail might decrease the levels and clinical effects of NRTIs.
In two case reports, patients were found to have detectable viral loads when taking horsetail-containing supplements along with an antiretroviral therapy. In one case, the antiretroviral regimen included zidovudine, lamivudine, and efavirenz; in the other case, the regimen consisted of emtricitabine, tenofovir disoproxil fumarate, and efavirenz. One month after discontinuing the supplement, the viral loads became undetectable in both cases. The exact mechanism of these interactions is unknown. It is also unclear if these interactions are specific to NRTIs or if they are related to various components of antiretroviral therapy.
Brand information
Manufacturer and brand details for Strong Bones, from the product label.
Hawaii Pharm
See all Hawaii Pharm products- Name
- Hawaii Pharm LLC
- Street Address
- 510 Sumner St. Ste. 613
- City
- Honolulu
- State
- HI
- ZipCode
- 96817
- Phone Number
- 888-854-2924
- Web Address
- www.hawaiipharm.com
Strong Bones by Hawaii Pharm: 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 Strong Bones’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Black Cohosh
Interacts with 652 drugsBlack cohosh is a North American plant most often used to ease menopause symptoms like hot flashes, but the research is mixed and far from settled. It is generally well tolerated for short-t...
Read the full Black Cohosh monograph → Herb & supplement monographHorsetail
Interacts with 188 drugsHorsetail is a traditional herb most often used as a mild diuretic and for hair, nail, and bone support, but high-quality human evidence is limited. It can cause thiamine (vitamin B1) loss w...
Read the full Horsetail monograph → Herb & supplement monographRed Clover
Interacts with 867 drugsRed clover is a plant rich in isoflavones (plant compounds with weak estrogen-like activity) that is most often used for menopause symptoms like hot flashes. The evidence is mixed and genera...
Read the full Red Clover monograph →Sources & How We Checked
Strong Bones'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 106 references behind this product’s interaction data
Every citation that drives the interaction findings for this product’s ingredients, from the evidence-graded Natural Medicines (TRC Healthcare) database. Open an ingredient to browse its citations — links open the study on PubMed or the publisher’s site.
Black Cohosh 68 references
- McFarlin BL, Gibson MH, O'Rear J, Harman P. A national survey of herbal preparation use by nurse-midwives for labor stimulation. Review of the literature and recommendations for practice. J Nurse Midwifery 1999;44:205-16. PubMed
- Whiting PW, Clouston A, Kerlin P. Black cohosh and other herbal remedies associated with acute hepatitis. Med J Aust 2002;177:440-3. PubMed
- Pepping J. Black cohosh: Cimicifuga racemosa. Am J Health Syst Pharm 1999;56:1400-2. PubMed
- Liske E. Therapeutic efficacy and safety of Cimicifuga racemosa for gynecologic disorders. Adv Ther 1998;15:45-53.
- Kruse SO, Lohning A, Pauli GF, et al. Fukiic and piscidic acid esters from the rhizome of Cimicifuga racemosa and the in vitro estrogenic activity of fukinolic acid. Planta Med 1999;65:763-4.
- Jacobson JS, Troxel AB, Evans J, et al. Randomized trial of black cohosh for the treatment of hot flashes among women with a history of breast cancer. J Clin Oncol 2001;19:2739-45. PubMed
- Gunn TR, Wright IM. The use of black and blue cohosh in labour. N Z Med J 1996;109:410-1.
- Baillie N, Rasmussen P. Black and blue cohosh in labour. N Z Med J 1997;110:20-1.
- Lontos S, Jones RM, Angus PW, Gow PJ. Acute liver failure associated with the use of herbal preparations containing black cohosh. Med J Aust 2003;179:390-1.. DOI
- Wuttke W, Seidlova-Wuttke D, Gorkow C. The Cimicifuga preparation BNO 1055 vs. conjugated estrogens in a double-blind placebo-controlled study: effects on menopause symptoms and bone markers. Maturitas 2003;44:S67-77. PubMed
- Huntley A, Ernst E. A systematic review of the safety of black cohosh. Menopause 2003;10:58-64.. DOI
- Cohen SM, O'Connor AM, Hart J, et al. Autoimmune hepatitis associated with the use of black cohosh: a case study. Menopause 2004;11:575-7. PubMed
- Vitetta L, Thomsen M, Sali A. Black cohosh and other herbal remedies associated with acute hepatitis. Med J Aust 2003;178:411-2.. PubMed
- Thomsen M, Vitetta L, Schmidt M, Sali A. Acute liver failure associated with the use of herbal preparations containing black cohosh. Med J Aust 2004;180:598-600.. DOI
- Cohen B, Schardt D. Center for Science in the Public Interest. Letter to Food and Drug Administration. Commissioner Mark McClellan, MD, PhD. March 4, 2004.
- Seidlova-Wuttke D, Hesse O, Jarry H, et al. Evidence for selective estrogen receptor modulator activity in a black cohosh (Cimicifuga racemosa) extract: comparison with estradiol-17beta. Eur J Endocrinol 2003;149:351-62. PubMed
- Rockwell S, Liu Y, Higgins SA. Alteration of the effects of cancer therapy agents on breast cancer cells by the herbal medicine black cohosh. Breast Cancer Res Treat 2005;90:233-9. PubMed
- Levitsky J, Alli TA, Wisecarver J, Sorrell MF. Fulminant liver failure associated with the use of black cohosh. Dig Dis Sci 2005;50:538-9. PubMed
- 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
- Nappi RE, Malavasi B, Brundu B, Facchinetti F. Efficacy of Cimicifuga racemosa on climacteric complaints: a randomized study versus low-dose transdermal estradiol. Gynecol Endocrinol 2005;20:30-5.
- Gurley BJ, Gardner SF, Hubbard MA, et al. In vivo effects of goldenseal, kava kava, black cohosh, and valerian on human cytochrome P450 1A2, 2D6, 2E1, and 3A4/5 phenotypes. Clin Pharmacol Ther 2005;77:415-26. PubMed
- Minciullo PL, Saija A, Patafi M, et al. Muscle damage induced by black cohosh (Cimicifuga racemosa). Phytomedicine 2006;13:115-8. PubMed
- Wuttke W, Gorkow C, Seidlova-Wuttke D. Effects of black cohosh (Cimicifuga racemosa) on bone turnover, vaginal mucosa, and various blood parameters in postmenopausal women: a double-blind, placebo-controlled, and conjugated estrogens-controlled study. Men PubMed
- MHRA. Black cohosh (Cimicifuga racemosa) - risk of liver problems. Herbal Safety News July 2006. Available at: http://www.mhra.gov.uk/home/idcplg?IdcService=SS_GET_PAGE&useSecondary= true&ssDocName=CON2024131&ssTargetNodeId=663.
- Dugoua JJ, Seely D, Perri D, et al. Safety and efficacy of black cohosh (cimicifuga racemosa) during pregnancy and lactation. Can J Clin Pharmacol 2006;13:e257-61.
- Raus K, Brucker C, Gorkow C, Wuttke W. First-time proof of endometrial safety of the special black cohosh extract (Actaea or Cimicifuga racemosa extract) CR BNO 1055. Menopause 2006;13:678-91. PubMed
- Lynch CR, Folkers ME, Hutson WR. Fulminant hepatic failure associated with the use of black cohosh: a case report. Liver Transpl 2006;12:989-92. PubMed
- Bai W, Henneicke-von Zepelin HH, Wang S, et al. Efficacy and tolerability of a medicinal product containing an isopropanolic black cohosh extract in Chinese women with menopausal symptoms: A randomized, double blind, parallel-controlled study versus tibol
- Meyer S, Vogt T, Obermann EC, et al. Cutaneous pseudolymphoma induced by Cimicifuga racemosa. Dermatology 2007;214:94-6.
- Gori L, Firenzuoli F. Is black cohosh a hepatotoxic medicinal herb? Forsch Komplementarmed 2007;14:109-10. PubMed
- Assessment of case reports connected to herbal medicinal products containing cimicifugae racemosa rhizoma (black cohosh, root). Doc. Ref. EMEA/269259/2006. Available at: www.emea.eu.int/pdfs/human/hmpc/26925806en.pdf (Accessed 30 November 2007).
- Chung DJ, Kim HY, Park KH, et al. Black cohosh and St. John's wort (GYNO-Plus) for climacteric symptoms. Yonsei Med J 2007;48:289-94. PubMed
- Chow ECY, Teo M, Ring JA, Chen JW. Liver failure associated with the use of black cohosh for menopausal symptoms. Med J Aust 2008;188:420-2. PubMed
- Mahady GB, Low Dog T, Barrett ML, et al. United States Pharmacopeia review of the black cohosh case reports of hepatotoxicity. Menopause 2008;15:628-38. PubMed
- Hepatotoxicity with black cohosh. Australian Adv Drug Reactions Bull 2006;25:6. Available at: www.tga.gov.au/adr/aadrb/aadr0604.htm#a1.
- Dunbar K, Solga SF. Black cohosh, safety, and public awareness. Liver Int 2007;27:1017. PubMed
- Patel NM, Derkits RM. Possible increase in liver enzymes secondary to atorvastatin and black cohosh administration. J Pharm Pract 2007;20:341-6. DOI
- Joy D, Joy J, Duane P. Black cohosh: a cause of abnormal postmenopausal liver function tests. Climacteric 2008;11:84-8. PubMed
- Australian Adverse Drug Reactions Advisory Committee. Black cohosh and liver toxicity - an update. Aust Adv Drug Reactions Bull 2007;26:11.
- Gurley BJ, Swain A, Hubbard MA, et al. Clinical assessement of CYP2D6-mediated herb-drug interactions in humans: Effects of milk-thistle, black cohosh, goldenseal, kava kava, St. John's wort, and Echinacea. Mol Nutr Food Res 2008;52:755-63.
- Spangler L, Newton KM, Grothaus LC, et al. The effects of black cohosh therapies on lipids, fibrinogen, glucose and insulin. Maturitas 2007;57:195-204. PubMed
- Teschke R, Bahre R, Genthner A, et al. Suspected black cohosh hepatotoxicity - challenges and pitfalls of causality assessment. Maturitas 2009;63:302-14. PubMed
- Brasky TM, Lampe JW, Potter JD, et al. Specialty supplements and breast cancer risk in the VITamins And Lifestyle (VITAL) cohort. Cancer Epidemiol Biomarkers Prev 2010;19:1696-708. 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
- Vermes G, Bánhidy F, Acs N. The effects of remifemin on subjective symptoms of menopause. Adv Ther 2005;22:148-54. PubMed
- Nuntanakorn, P., Jiang, B., Einbond, L. S., Yang, H., Kronenberg, F., Weinstein, I. B., and Kennelly, E. J. Polyphenolic constituents of Actaea racemosa. J Nat Prod 2006;69(3):314-318.
- Oktem M, Eroglu D, Karahan HB, Taskintuna N, Kuscu E, Zeyneloglu HB. Black cohosh and fluoxetine in the treatment of postmenopausal symptoms: a prospective, randomized trial. Adv Ther 2007;24:448-61. PubMed
- Briese V, Stammwitz U, Friede M, Henneicke-von Zepelin HH. Black cohosh with or without St. John's wort for symptom-specific climacteric treatment--results of a large-scale, controlled, observational study. Maturitas 2007;57:405-14. PubMed
- Naser, B. and Liske, E. Liver failure associated with the use of black cohosh for menopausal symptoms. Med J Aust. 1-19-2009;190(2):99. PubMed
- van de Meerendonk, H. W., van Hunsel, F. P., and van der Wiel, H. E. [Autoimmune hepatitis induced by Actaea racemosa. Side affects of an herb extract]. Ned.Tijdschr.Geneeskd. 2-7-2009;153(6):246-249.
- Wong, V. C., Lim, C. E., Luo, X., and Wong, W. S. Current alternative and complementary therapies used in menopause. Gynecol.Endocrinol. 2009;25(3):166-174. PubMed
- Pierard, S., Coche, J. C., Lanthier, P., Dekoninck, X., Lanthier, N., Rahier, J., and Geubel, A. P. Severe hepatitis associated with the use of black cohosh: a report of two cases and an advice for caution. Eur J Gastroenterol Hepatol. 2009;21(8):941-945 PubMed
- Vannacci, A., Lapi, F., Gallo, E., Vietri, M., Toti, M., Menniti-Ippolito, F., Raschetti, R., Firenzuoli, F., and Mugelli, A. A case of hepatitis associated with long-term use of Cimicifuga racemosa. Altern.Ther Health Med 2009;15(3):62-63.
- Zimmermann, R., Witte, A., Voll, R. E., Strobel, J., and Frieser, M. Coagulation activation and fluid retention associated with the use of black cohosh: a case study. Climacteric. 2010;13(2):187-191. PubMed
- Amsterdam JD, Yao Y, Mao JJ, Soeller I, Rockwell K, Shults J. Randomized, double-blind, placebo-controlled trial of Cimicifuga racemosa (black cohosh) in women with anxiety disorder due to menopause. J Clin Psychopharmacol 2009;29:478-83. PubMed
- Bai WP, Wang SY, Liu JL, Geng L, Hu LN, Zhang ZL, Chen SL, Zheng SR. [Efficacy and safety of remifemin compared to tibolone for controlling of perimenopausal symptoms]. Zhonghua Fu Chan Ke Za Zhi 2009;44:597-600.
- McKenzie, S. C. and Rahman, A. Bradycardia in a patient taking black cohosh. Med J Aust. 10-18-2010;193(8):479-481. PubMed
- Stolze H. [An alternative to treat menopausal complaints]. Gynecologie 1982;1:14-16.
- Guzman G, Kallwitz ER, Wojewoda C, et al. Liver Injury with Features Mimicking Autoimmune Hepatitis following the Use of Black Cohosh. Case Rep Med. 2009;2009:918156. PubMed
- Enbom ET, Le MD, Oesterich L, Rutgers J, French SW. Mechanism of hepatotoxicity due to black cohosh (Cimicifuga racemosa): histological, immunohistochemical and electron microscopy analysis of two liver biopsies with clinical correlation. Exp Mol Pathol. PubMed
- Sen A. Orobuccolingual dyskinesia after long-term use of black cohosh and ginseng. J Neuropsychiatry Clin Neurosci 2013 Fall;25(4):E50. PubMed
- Hoban CL, Byard RW, Musgrave IF. Analysis of spontaneous adverse drug reactions to echinacea, valerian, black cohosh and ginkgo in Australia from 2000 to 2015. J Integr Med. 2019;17(5):338-343. PubMed
- Pkhaladze L, Davidova N, Khomasuridze A, Shengelia R, Panossian AG. Actaea racemosa L. is more effective in combination with Rhodiola rosea L. for relief of menopausal symptoms: a randomized, double-blind, placebo-controlled study. Pharmaceuticals (Basel) PubMed
- Yalçin M, Oguz A, Bestepe EE, Saglam NGU, Ergelen M. Black cohosh associated mania in a patient with unipolar depression. Int J Psychiatry Med 2020 Sep 21:91217420961185. doi: 10.1177/0091217420961185. PubMed
- Brar HS, Marathi R. Case of cholestatic drug-induced liver injury (DILI) associated with black cohosh. BMJ Case Rep 2021;14(5):e240408. PubMed
- Castelo-Branco C, Navarro C, Beltrán E, Losa F, Camacho M; on the behalf of the Natural Products Study Group of the Spanish Menopause Society. Black cohosh efficacy and safety for menopausal symptoms. The Spanish Menopause Society statement. Gynecol Endoc PubMed
- Trant AA, Chagpar A, Wei W, et al. The Effect of Black Cohosh on Ki67 expression and Tumor Volume: A Pilot Study of Ductal Carcinoma in Situ Patients. Integr Cancer Ther 2022;21:15347354221137290. PubMed
- Dernbach MR, Carpenter JE, Shah N, Carter GB. Black Cohosh Interactions with Prescription Medications Associated with Serotonin Toxicity and Rhabdomyolysis: A Case Report. J Emerg Med 2024;66(5):e592-e596. PubMed
Horsetail 14 references
- Sudan BJ. Seborrhoeic dermatitis induced by nicotine of horsetails (Equisetum arvense L.). Contact Dermatitis 1985;13:201-2.
- Perez Gutierrez RM, Laguna GY, Walkowski A. Diuretic activity of Mexican equisetum. J Ethnopharmacol 1985;14:269-72. PubMed
- Lemus I, Garcia R, Erazo S, et al. Diuretic activity of an Equisetum bogotense tea (Platero herb): evaluation in healthy volunteers. J Ethnopharmacol 1996;54:55-8. PubMed
- Revilla MC, Andrade-Cetto A, Islas S, Wiedenfeld H. Hypoglycemic effect of Equisetum myriochaetum aerial parts on type 2 diabetic patients. J Ethnopharmacol 2002;81:117-20. PubMed
- Tiktinskii, O. L. and Bablumian, I. A. [Therapeutic action of Java tea and field horsetail in uric acid diathesis]. Urol.Nefrol.(Mosk) 1983;3(1):47-50.
- Henderson JA, Evans EV, and McIntosh RA. The antithiamine action of Equisetum. J Amer Vet Med Assoc 1952;120:375-378.
- Carneiro DM, Freire RC, Honório TC, Zoghaib I, Cardoso FF, Tresvenzol LM, de Paula JR, Sousa AL, Jardim PC, da Cunha LC. Randomized, Double-Blind Clinical Trial to Assess the Acute Diuretic Effect of Equisetum arvense (Field Horsetail) in Healthy Voluntee
- Klnçalp S, Ekiz F, Basar Ö, Coban S, Yüksel O. Equisetum arvense (Field Horsetail)-induced liver injury. Eur J Gastroenterol Hepatol. 2012 Feb;24(2):213-4. PubMed
- Ortega García JA, Angulo MG, Sobrino-Najul EJ, Soldin OP, Mira AP, Martínez-Salcedo E, Claudio L. Prenatal exposure of a girl with autism spectrum disorder to 'horsetail' (Equisetum arvense) herbal remedy and alcohol: a case report. J Med Case Rep. 2011 M PubMed
- Cordova E, Morganti L, Rodriguez C. Possible Drug-Herb Interaction between Herbal Supplement Containing Horsetail (Equisetum arvense) and Antiretroviral Drugs. J Int Assoc Provid AIDS Care. 2017;16(1):11-13.
- García Gavilán MD, Moreno García AM, Rosales Zabal JM, Navarro Jarabo JM, Sánchez Cantos A. Case of drug-induced acute pancreatitis produced by horsetail infusions. Rev Esp Enferm Dig. 2017 Apr;109(4):301-304. PubMed
- Vieira GT, de Oliveira TT, Carneiro MAA, et al. Antidiabetic effect of Equisetum giganteum L. extract on alloxan-diabetic rabbit. J Ethnopharmacol. 2020;260:112898. PubMed
- Health Canada. Organism-Equisetum arvense. Available at: http://webprod.hc-sc.gc.ca/nhpid-bdipsn/ingredReq.do?id=6117&lang=eng. Accessed 21-July 2021.
- Bates D, Duong TB, Kheyson S, Moore K. Hyponatremia Secondary to Decreased Oral Intake and SIADH and Possibly Exacerbated by Horsetail (Equisetum arvense). Can J Hosp Pharm 2021;74(4):386-389. PubMed
Red Clover 24 references
- Kurzer MS, Xu X. Dietary phytoestrogens. Annu Rev Nutr 1997;17:353-81. PubMed
- Electronic Code of Federal Regulations. Title 21. Part 182 -- Substances Generally Recognized As Safe. Available at: https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?CFRPart=182
- Budzinski JW, Foster BC, Vandenhoek S, Arnason JT. An in vitro evaluation of human cytochrome P450 3A4 inhibition by selected commercial herbal extracts and tinctures. Phytomedicine 2000;7:273-82. PubMed
- This P, De La Rochefordiere A, Clough K, et al. Phytoestrogens after breast cancer. Endocr Relat Cancer 2001;8:129-34. PubMed
- Tice J, Cummings SR, Ettinger B, et al. Few adverse effects of two red clover extracts rich in phytoestrogens: a multicenter, placebo-controlled trial. Alt Ther 2001;7:S33.
- Ingram DM, Hickling C, West L, et al. A double-blind randomized controlled trial of isoflavones in the treatment of cyclical mastalgia. The Breast 2002;11:170-4. PubMed
- Unger M, Frank A. Simultaneous determination of the inhibitory potency of herbal extracts on the activity of six major cytochrome P450 enzymes using liquid chromatography/mass spectrometry and automated online extraction. Rapid Commun Mass Spectrom 2004;1 PubMed
- 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
- Geller SE, Shulman LP, van Breemen RB, et al. Safety and efficacy of black cohosh and red clover for the management of vasomotor symptoms: a randomized controlled trial. Menopause 2009;16:1156-66. PubMed
- Hidalgo LA, Chedraui PA, Morocho N, et al. The effect of red clover isoflavones on menopausal symptoms, lipids and vaginal cytology in menopausal women: a randomized, double-blind, placebo-controlled study. Gynecol Endocrinol 2005;21(5):257-264. PubMed
- Campbell MJ, Woodside JV, Honour JW, et al. Effect of red clover-derived isoflavone supplementation on insulin-like growth factor, lipid and antioxidant status in healthy female volunteers: a pilot study. Eur J Clin Nutr 2004;58(1):173-179. PubMed
- Guerrero JA, Lozano ML, Castillo J, et al. Flavonoids inhibit platelet function through binding to the thromboxane A2 receptor. J Thromb Haemost 2005;3(2):369-376. PubMed
- Kondo K, Suzuki Y, Ikeda Y, Umemura K. Genistein, an isoflavone included in soy, inhibits thrombotic vessel occlusion in the mouse femoral artery and in vitro platelet aggregation. Eur J Pharmacol 2002;455(1):53-57. PubMed
- Polini N, Rauschemberger MB, Mendiberri J, et al. Effect of genistein and raloxifene on vascular dependent platelet aggregation. Mol Cell Endocrinol 2007;267(1-2):55-62. PubMed
- Wuttke W, Jarry H, Seidlova-Wuttke D. Plant-derived alternative treatments for the aging male: facts and myths. Aging Male 2010;13(2):75-81. PubMed
- Villaseca P. Non-estrogen conventional and phytochemical treatments for vasomotor symptoms: what needs to be known for practice. Climacteric 2012;15(2):115-124. PubMed
- Chen, Y., Xiao, C. Q., He, Y. J., Chen, B. L., Wang, G., Zhou, G., Zhang, W., Tan, Z. R., Cao, S., Wang, L. P., and Zhou, H. H. Genistein alters caffeine exposure in healthy female volunteers. Eur.J Clin.Pharmacol. 2011;67(4):347-353. PubMed
- Friedman, J. A., Taylor, S. A., McDermott, W., and Alikhani, P. Multifocal and recurrent subarachnoid hemorrhage due to an herbal supplement containing natural coumarins. Neurocrit.Care 2007;7(1):76-80. PubMed
- Hooper, L., Madhavan, G., Tice, J. A., Leinster, S. J., and Cassidy, A. Effects of isoflavones on breast density in pre- and post-menopausal women: a systematic review and meta-analysis of randomized controlled trials. Hum.Reprod.Update. 2010;16(6):745-7 PubMed
- Orr A and Parker R. Red clover causing symptoms suggestive of methotrexate toxicity in a patient on high-dose methotrexate. Menopause Int. 2013;19(3):133-134. PubMed
- Clifton-Bligh PB, et al. Red cover isoflavones enriched with formononetin lower serum LDL cholesterol- a randomized, double-blind, placebo-controlled trial. Eur J Clin Nutr. 2015;69(1):134-142.
- Risk assessment for peri- and post-menopausal women taking food supplements containing isolated isoflavones. EFSA Panel on Food Additives and Nutrient Sources added to Food (ANS). 2015. DOI
- Ferraris C, Ballestra B, Listorti C, et al. Red clover and lifestyle changes to contrast menopausal symptoms in premenopausal patients with hormone-sensitive breast cancer receiving tamoxifen. Breast Cancer Res Treat 2020;180(1):157-65. doi: 10.1007/s1054 PubMed
- Chen L, Choi J, Leonard SW, et al. No Clinically Relevant Pharmacokinetic Interactions of a Red Clover Dietary Supplement with Cytochrome P450 Enzymes in Women. J Agric Food Chem. 2020;68(47):13929-13939. PubMed
Parts of this content are provided by the Therapeutic Research Center, LLC.
DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.
© 2021 Therapeutic Research Center, LLC