Interactions on record — worth a quick check against your medications. Based on 6 of 7 ingredients. Check your meds →
Dietary supplement

Super Miraforte with Standardized Lignans Ingredients & Drug Interactions

by Life Extension

Super Miraforte with Standardized Lignans label
See full label image
Capsule Category: Other Combinations
Most serious interaction: Moderate
Clinical methodology reviewed by · Updated Sep 16, 2026 · Label data from the NIH DSLD
What is this page for?

First and foremost: checking Super Miraforte with Standardized Lignans 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

The interaction bottom line Most serious interaction: Moderate

Super Miraforte with Standardized Lignans is a dietary supplement by Life Extension with 7 active ingredients. Its ingredients are commonly taken for zinc deficiency, immune support, cold symptoms.Based on those ingredients, 1,079 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Bioperine, Chrysin, Zinc. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

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Check Your Meds Against Super Miraforte with Standardized Lignans by Life Extension

Ask about any prescription or over-the-counter medication and we check it for interactions with Super Miraforte with Standardized Lignans by Life Extension — and tell you which ingredient is responsible.

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HelloPharmacist Scorecard of Super Miraforte with Standardized Lignans by Life Extension

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.

From our pharmacy team — supplement deep dive

Generated from HelloPharmacist’s pharmacist-curated databases and editorial rules · Last generated Jul 11, 2026

What’s inside

Full disclosure
Ingredient Transparency · database check
Full

Every active ingredient lists its own amount on the label.

Why this rating?
  • The label discloses an exact amount for 7 of its 7 active ingredients.
  • No proprietary blends here — you can verify the dose of every single component.

This product contains 7 ingredients, of which the most prominent are zinc (the only one with established ratings for conditions like zinc deficiency and Wilson disease), maca root extract, muira puama bark extract, chrysin, stinging and dwarf nettle extracts, HMRlignan, and bioperine (black pepper extract). The inactive ingredients are cellulose, maltodextrin, rice concentrate, and silica—standard capsule fillers and flow agents.

Does it work?

Leans against
Evidence for Intended Use · database check
By FDA rules, dietary supplements can’t claim to treat, cure, or prevent disease — so labels speak in careful marketing language. We discern each product’s intended use from its name, label claims, and label statements, then grade the clinical evidence for that use. How these ratings are computed
Leans against

The strongest graded evidence we hold for the stated purpose leans against a benefit.

Why this rating?
  • The label markets this product for: Sexual function and male vitality support.
  • We looked for evidence on: Erectile dysfunction (ED), Age-related testosterone deficiency, Antidepressant-induced sexual dysfunction, Sexual performance, Libido enhancement, Stamina and energy.
  • The closest evidence on file: Zinc is rated "Possibly Ineffective" for Sexual dysfunction (Natural Medicines).
  • Also on file: Maca is rated "Insufficient Reliable Evidence To Rate" for Antidepressant-induced sexual dysfunction, Age-related testosterone deficiency.
  • Also on file: Muira Puama is rated "Insufficient Reliable Evidence To Rate" for Sexual dysfunction, Erectile dysfunction (ED).

Zinc is effective for zinc deficiency and likely effective for Wilson disease (a rare copper-storage disorder); it's possibly effective for acne, age-related macular degeneration (AMD), and some forms of diabetes. The other active ingredients—maca, muira puama, chrysin, and bioperine—do not have enough reliable evidence in our data to rate their effectiveness for any condition.

Their traditional uses and proposed benefits lack established support.

The evidence, ingredient by ingredient Zinc Maca Muira Puama Chrysin Hemlock Black Pepper

How safe is it?

Well-documented data
Safety Information · database check
Well characterized

Adverse-effect, pregnancy, and general safety data are on file for most of these ingredients.

Why this rating?
  • We hold adverse-effect (side-effect) data for 4 of the 6 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 6 of 6.
  • General safety write-ups exist for 6 of 6.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

Zinc is generally well tolerated at recommended doses (below the 40 mg daily upper limit for adults), but higher doses can cause abdominal cramps, diarrhea, nausea, and vomiting, and over time may deplete copper. Maca is generally well tolerated as a food but is flagged as unsafe in pregnancy and breastfeeding due to insufficient safety data in supplement amounts.

Muira puama and chrysin have limited human safety data and are advised against in pregnancy and breastfeeding. Bioperine (black pepper) is well tolerated in food amounts and single medicinal doses, though concentrated supplements carry less research.

HMRlignan, which the facts identify as hemlock, is marked as unsafe and poisonous in any amount—it can cause severe toxicity and death, and must never be used during pregnancy or breastfeeding. If this product contains actual hemlock, it should not be used at all.

Side effects, ingredient by ingredient Zinc Maca Muira Puama Chrysin Hemlock Black Pepper

Meds to double-check

Moderate interaction found
Known Interaction Concern · database check
Moderate identified

The most serious documented interaction for these ingredients is Moderate. Check your medications for a personalized result.

Why this rating?
  • 3 of the 6 matched ingredients can interact with medications — Black Pepper, Zinc, Chrysin.
  • The most serious interaction on file is rated Moderate.
  • Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs; immunosuppressants / transplant drugs; diabetes medications; lithium.
  • For scale: 1,080 individual medications appear in the full list. A big number alone doesn't make a product dangerous — what matters is whether YOUR medication is on it, so run yours through the interaction checker on this page.

Check before taking if you use quinolone or tetracycline antibiotics, cephalexin, penicillamine, ritonavir or other HIV medications, integrase inhibitors, seizure drugs (phenytoin, mephenytoin), blood thinners or antiplatelet drugs, propranolol, hormone therapy or hormonal contraceptives, aromatase inhibitors, diclofenac, or theophylline. These are all Moderate-severity interactions.

The timing and spacing matter—don't skip them without talking to your pharmacist first.

Check your own medication Run your meds through the checker above

The bottom line

Scorecard at a glanceFully disclosed formula with graded evidence leaning against its stated purpose. Moderate medication interactions have been identified, and safety information is well characterized.

If you take quinolone or tetracycline antibiotics, cephalexin, penicillamine, HIV medications, seizure drugs, blood thinners, or beta-blockers, you'll need to time this supplement carefully or skip it entirely. Pregnant and breastfeeding people should avoid this product.

Talk to your pharmacist before starting, especially if you're on any prescription medication.

Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI

Assessment coverage: 6 of 7 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Jun 25, 2025.

This Scorecard evaluates available label information, ingredient evidence, and known medication-safety considerations. It does not independently verify product identity, purity, potency, contamination, or manufacturing quality. How these ratings are computed

At a glance

General information

Key facts about Super Miraforte with Standardized Lignans, straight from the product label.

Brand Life Extension
Barcode (UPC) 737870194019
Net contents 120 Vegetarian Capsule(s)
Market status On market
Date entered into DSLD Jun 25, 2025
DSLD ID 328719
Product type Other Combinations
Supplement form Capsule
Dietary claims / uses All Other, Structure/Function
Intended target group(s) Adult Male (18-50 Years), Gluten Free
From the label
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 Super Miraforte with Standardized Lignans by Life Extension, sourced from the NIH Dietary Supplement Label Database.

Supplement Facts

Daily Value (DV) Target Group(s):
Adults and children 4 or more years of age
Minimum serving Sizes:
2 Vegetarian Capsule(s)
Maximum serving Sizes:
2 Vegetarian Capsule(s)
Servings per container
60
UPC/BARCODE
737870194019
IngredientAmount% DV
Zinc7.5 mg68%
Maca160 mg--
Muira Puama Bark Extract212.5 mg--
Chrysin750 mg--
Stinging & Dwarf Nettle Extracts141 mg--
HMRlignan16.7 mg--
Bioperine7.5 mg--

Other ingredients: Cellulose, Maltodextrin, Rice Concentrate, Silica, Cellulose, Powder

Tap any ingredient to jump to its full detail below.

Label statements
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.
General Statements

Scan for product info

Precautions

Read the entire label and follow the directions carefully prior to use.

Caution: If you are taking any medication, use only under physician supervision.

Men with existing prostate cancer may not be able to use this product. Elevations in free testosterone can unmasks an occult (hidden) prostate cancer. Anyone with this concern should have a baseline PSA prior to using this product and a follow-up PSA test 60 days later. If a significant elevation of PSA is found, discontinue this product and advise physician. Do not take more than 15 mg per day of Bioperine.

Warnings: Keep out of reach of children.

Do not exceed recommended dose. Do not purchase if outer seal is broken or damaged.

When using nutritional supplements, please consult with your physician if you are undergoing treatment for a medical condition or if you are pregnant or lactating.

To report a serious adverse event or obtain product information, contact 1-866-280-2852.

Suggested/Recommended/Usage/Directions

Directions: For adult men, take two (2) capsules twice daily (two in the morning and two in the evening), or as recommended by a healthcare practitioner.

FDA Disclaimer Statement

These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.

Formulation

Gluten free Non GMO LE Certified

Helps maintain healthy levels of testosterone

Seals/Symbols

Non GMO LE Certified

FDA Statement of Identity

Dietary Supplement

Brand IP Statement(s)

HMRlignan is a trademark used under sublicense from Linnea S.A. Bioperine is a registered trademark of Sabinsa Corp.

Storage

Store tightly closed in a cool, dry place.

Is this label outdated? Report a formula or label change and our pharmacy team will review it.

See for yourself

Super Miraforte with Standardized Lignans by Life Extension label

The label scan from the NIH Dietary Supplement Label Database. Tap to enlarge.

Super Miraforte with Standardized Lignans label

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)
What’s inside

The Ingredients in Super Miraforte with Standardized Lignans by Life Extension

These are the 7 active ingredients this product is made of. Select any to open its full monograph.

Serving size2 Vegetarian Capsule(s) Dosage formCapsule Servings per container60 Amounts shown are per serving.

Most supplement products combine several ingredients, and a medication can interact with the product through any one of them. Each ingredient below shows whether it has known drug interactions.

Zinc

Interacts with
67 drugs
7.5 mg per serving Form: Zinc Monomethionine

Zinc is an essential mineral that your body needs for immune function, wound healing, taste, and smell. Most people get enough from food, but suppleme...

Zinc monograph & interactions

Maca

No known
interactions
160 mg per serving

Maca is a nutrient-rich Andean root often used for energy, libido, and menopause symptoms. Early studies suggest it may modestly help sexual desire an...

Maca monograph & interactions

Muira Puama Bark Extract

No known
interactions
212.5 mg per serving

Muira puama is a Brazilian plant traditionally used as an aphrodisiac and general tonic, often nicknamed 'potency wood.' Human research is very limite...

Muira Puama Bark Extract monograph & interactions

Chrysin

Interacts with
358 drugs
750 mg per serving

Chrysin is a plant flavonoid sold mainly as a bodybuilding supplement claimed to raise testosterone or block estrogen, but human studies have not show...

Chrysin monograph & interactions

Stinging & Dwarf Nettle Extracts

141 mg per serving Form: Dwarf Nettle Root Extract, Stinging Nettle Root Extract

HMRlignan

No known
interactions
16.7 mg per serving Form: Norway Spruce Knotwood Extract

Hemlock (Conium maculatum) is a highly poisonous plant that has no safe or proven medicinal use today. Even small amounts can cause paralysis and deat...

HMRlignan monograph & interactions

Bioperine

Interacts with
1,019 drugs
7.5 mg per serving Form: Piperine

Black pepper is a common kitchen spice that is generally safe in the amounts used in food. Its extract, piperine, is mostly added to supplements to he...

Bioperine monograph & interactions

Other (inactive) ingredients: Cellulose, Maltodextrin, Rice Concentrate, Silica, Cellulose, Powder. These complete the product’s ingredient list but are not active constituents.

Interaction report

Super Miraforte with Standardized Lignans by Life Extension Drug Interactions

Want to check YOUR meds against Super Miraforte with Standardized Lignans?

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 checker
1,079Drugs
1,017 Moderate 62 Minor

Ingredients driving the most interactions

Bioperine 1,019
Chrysin 358
Zinc 67

Individual Drug Interactions

The ingredients in Super Miraforte with Standardized Lignans interact with 1,079 drugs. Click any drug to see the details.

3 of the 7 ingredients in Super Miraforte with Standardized Lignans interact with drugs. Each result below shows which ingredient is responsible. Bioperine Chrysin Zinc

Each ingredient & the kinds of drugs it affects

For each ingredient in Super Miraforte with Standardized Lignans 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.

Bioperine17 drug types · 1,019 drugs

Anticoagulant/Antiplatelet Drugs

Theoretically, black pepper might increase the risk of bleeding when taken with antiplatelet or anticoagulant drugs.
In vitro research shows that piperine, a constituent of black pepper, seems to inhibit platelet aggregation. This has not been reported in humans.

Likelihood Possible Evidence D
Antidiabetes Drugs

Theoretically, black pepper might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Animal research shows that piperine, a constituent of black pepper, can reduce blood glucose levels. Monitor blood glucose levels closely. Dose adjustments might be necessary.

Likelihood Possible Evidence D
Atorvastatin (Lipitor)

Theoretically, black pepper might increase blood levels of atorvastatin.
Animal research shows that taking piperine, a constituent of black pepper, 35 mg/kg can increase the maximum serum concentration of atorvastatin three-fold. This has not been reported in humans.

Likelihood Possible Evidence D
Cyclosporine (Neoral, Sandimmune)

Theoretically, black pepper might increase the effects and side effects of cyclosporine.
In vitro research shows that piperine, a constituent of black pepper, increases the bioavailability of cyclosporine. This has not been reported in humans.

Likelihood Possible Evidence D
Cytochrome P450 2D6 (Cyp2D6) Substrates

Theoretically, black pepper might increase levels of drugs metabolized by CYP2D6.
In vitro research suggests that some constituents of black pepper inhibit CYP2D6. This has not been reported in humans.

Likelihood Possible Evidence D
Cytochrome P450 3A4 (Cyp3A4) Substrates

Theoretically, black pepper might increase levels of drugs metabolized by CYP3A4.
In vitro research and pharmacokinetic simulation data suggest that piperine, a constituent of black pepper, as well as the pepper fruit seem to inhibit CYP3A4. This has not been reported in humans.

Likelihood Possible Evidence D
Lithium

Theoretically, black pepper might increase blood levels of lithium due to its diuretic effects. The dose of lithium might need to be reduced.
Black pepper is thought to have diuretic properties.

Likelihood Probable Evidence D
Nevirapine (Viramune)

Black pepper might increase blood levels of nevirapine.
Clinical research shows that piperine, a constituent of black pepper, increases the plasma concentration of nevirapine. However, no adverse effects were observed in this study.

Likelihood Probable Evidence D
P-Glycoprotein Substrates

Theoretically, black pepper might increase levels of P-glycoprotein substrates.
In vitro research shows that piperine, a constituent of black pepper, seems to inhibit P-glycoprotein.

Likelihood Possible Evidence D
Pentobarbital (Nembutal)

Theoretically, black pepper might increase the sedative effects of pentobarbital.
Animal research shows that piperine, a constituent of black pepper, increases pentobarbital-induced sleeping time.

Likelihood Possible Evidence D
Phenytoin (Dilantin)

Black pepper might increase blood levels of phenytoin.
Clinical research shows that piperine, a constituent of black pepper, seems to increase absorption, slow elimination, and increase levels of phenytoin. Taking a single dose of black pepper 1 gram along with phenytoin seems to double the serum concentration of phenytoin. Consuming a soup with black pepper providing piperine 44 mg/200 mL of soup along with phenytoin also seems to increase phenytoin levels when compared with consuming the same soup without black pepper.

Likelihood Possible Evidence B
Propranolol (Inderal)

Black pepper might increase blood levels of propranolol.
Clinical research shows that piperine, a constituent of black pepper, seems to increase absorption and slow elimination of propranolol.

Likelihood Possible Evidence B
Rifampin (Rifadin)

Black pepper might increase blood levels of rifampin.
Clinical research shows that piperine, a constituent of black pepper, seems to increase absorption and serum levels of rifampin.

Likelihood Possible Evidence B
Theophylline

Black pepper might increase blood levels of theophylline.
Clinical research shows that piperine, a constituent of black pepper, seems to increase absorption and slow elimination of theophylline.

Likelihood Possible Evidence D
Amoxicillin (Amoxil, Trimox)

Theoretically, black pepper might increase the effects and side effects of amoxicillin.
Animal research shows that taking piperine, a constituent of black pepper, with amoxicillin increases plasma levels of amoxicillin. This has not been reported in humans.

Likelihood Possible Evidence D
Carbamazepine (Tegretol)

Theoretically, black pepper might increase blood levels of carbamazepine, potentially increasing the effects and side effects of carbamazepine.
One clinical study in patients taking carbamazepine 300 mg or 500 mg twice daily shows that taking a single 20 mg dose of purified piperine, a constituent of black pepper, increases carbamazepine levels. Piperine may increase carbamazepine absorption by increasing blood flow to the GI tract, increasing the surface area of the small intestine, or inhibiting cytochrome P450 3A4 (CYP3A4) in the gut wall. Absorption was significantly increased by 7-10 mcg/mL/hour. The time to eliminate carbamazepine was also increased by 4-8 hours. Although carbamazepine levels were increased, this did not appear to increase side effects. In vitro research also shows that piperine can increase carbamazepine levels by 11% in a time-dependent manner.

Likelihood Possible Evidence B
Cytochrome P450 1A2 (Cyp1A2) Substrates

Theoretically, black pepper might decrease levels and clinical effects of drugs metabolized by CYP1A2.
In vitro research suggests that black pepper induces CYP1A2. This has not been reported in humans.

Likelihood Possible Evidence D
Bioperine full monograph & interactions

Chrysin9 drug types · 358 drugs

Anticoagulant/Antiplatelet Drugs

Theoretically, chrysin might increase the risk of bleeding when taken with anticoagulant or antiplatelet drugs.
In vitro evidence suggests that chrysin might inhibit platelet aggregation.

Likelihood Possible Evidence D
Aromatase Inhibitors

Theoretically, chrysin might increase the effects and adverse effects of aromatase inhibitors.
In vitro research suggests that chrysin might decrease estrogen synthesis by acting as an aromatase (estrogen synthetase) inhibitor..

Likelihood Possible Evidence D
Contraceptive Drugs

Theoretically, chrysin might reduce the efficacy of estrogen-containing contraceptive drugs.
In vitro research suggests that chrysin might have antiestrogenic activity.

Likelihood Possible Evidence D
Diclofenac (Voltaren, Others)

Theoretically, chrysin might increase the effects and adverse effects of diclofenac.
In vitro research suggests that chrysin and its sulfate conjugate inhibit diclofenac metabolism. It is speculated that chrysin and its sulfate conjugate reduce the metabolism of diclofenac by inhibiting cytochrome P450 2C9. This effect has not been reported in humans.

Likelihood Possible Evidence D
Estrogens

Theoretically, chrysin might decrease the effects of estrogen therapy.
In vitro research suggests that chrysin might have antiestrogenic activity.

Likelihood Possible Evidence D
Mephenytoin (Mesantoin)

Theoretically, chrysin might increase the effects and adverse effects of mephenytoin.
In vitro research suggests that chrysin and its sulfate and glucuronide conjugates inhibit S-mephenytoin metabolism. It is speculated that chrysin and its conjugates reduce the metabolism of S-mephenytoin by inhibiting cytochrome P450 2C19. This effect has not been reported in humans.

Likelihood Possible Evidence D
Cytochrome P450 1A2 (Cyp1A2) Substrates

Theoretically, chrysin might increase levels of drugs metabolized by CYP1A2.
In vitro research suggests that chrysin inhibits CYP1A2 isozymes. However, chrysin does not appear to inhibit CYP1A2-dependent caffeine metabolism in animals. Due to chrysin's low bioavailability and rapid metabolism to glucuronide and sulfate conjugates, this interaction is unlikely.

Likelihood Unlikely Evidence D
Glucuronidated Drugs

Theoretically, chrysin might increase the clearance of drugs that are UGT1A1 substrates, thereby reducing their effectiveness.
In vitro research suggests that chrysin might induce UDP-glucuronosyltransferase 1A1 (UGT1A1).

Likelihood Unlikely Evidence D
Testosterone

Theoretically, chrysin might increase the effects and adverse effects of testosterone.
In vitro research suggests that chrysin and its sulfate conjugate inhibit testosterone metabolism. It is speculated that chrysin and its sulfate conjugate reduce the metabolism of testosterone by inhibiting cytochrome P450 3A4. This effect has not been reported in humans.

Likelihood Possible Evidence D
Chrysin full monograph & interactions

Zinc10 drug types · 67 drugs

Bictegravir/Emtricitabine/Tenofovir Alafenamide (Biktarvy)

Theoretically, zinc might decrease levels of bictegravir/emtricitabine/tenofovir alafenamide by reducing its absorption.
Advise patients that bictegravir/emtricitabine/tenofovir alafenamide should be taken at least 2 hours before or 6 hours after zinc containing products.

Likelihood Probable Evidence D
Cephalexin (Keflex)

Zinc might decrease cephalexin levels by chelating with cephalexin in the gut and preventing its absorption.
A pharmacokinetic study shows that zinc sulfate 250 mg taken concomitantly with cephalexin 500 mg decreases peak levels of cephalexin by 31% and reduces the exposure to cephalexin by 27%. Also, taking zinc sulfate 3 hours before cephalexin decreases peak levels of cephalexin by 11% and reduces the exposure to cephalexin by 18%. By decreasing cephalexin levels, zinc might increase the risk of treatment failure. This effect does not occur when zinc is taken 3 hours after the cephalexin dose. To avoid an interaction, advise patients take zinc sulfate 3 hours after taking cephalexin.

Likelihood Probable Evidence B
Cisplatin (Platinol-Aq)

Theoretically, zinc might interfere with the therapeutic effects of cisplatin.
Animal research suggests that zinc stimulates tumor cell production of the protein metallothionein, which binds and inactivates cisplatin. It is not known whether zinc supplements or high dietary zinc intake can cause clinically significant interference with cisplatin therapy. Cisplatin might also increase zinc excretion.

Likelihood Possible Evidence D
Integrase Inhibitors

Theoretically, taking zinc along with integrase inhibitors might decrease the levels and clinical effects of these drugs.
Zinc is a divalent cation. Pharmacokinetic studies have shown that other divalent cations such as calcium and iron can decrease blood levels of the integrase inhibitor dolutegravir through chelation.

Likelihood Possible Evidence D
Penicillamine (Cuprimine, Depen)

Zinc might reduce the levels and clinical effects of penicillamine.
By forming an insoluble complex with penicillamine, zinc interferes with penicillamine absorption and activity. Zinc supplements reduce the efficacy of low-dose penicillamine (0.5-1 gram/day), but do not seem to affect higher doses (1-2.75 gram/day), provided dosing times are separated. Advise patients to take zinc and penicillamine at least 2 hours apart.

Likelihood Probable Evidence B
Quinolone Antibiotics

Zinc can decrease the levels and clinical effects of quinolones antibiotics.
Quinolones form complexes with zinc in the gastrointestinal tract, reducing absorption of both the quinolone and zinc if taken at the same time. Advise patients to take these drugs at least 2 hours before, or 4-6 hours after, zinc supplements.

Likelihood Probable Evidence B
Ritonavir (Norvir)

Zinc modestly reduces levels of ritonavir.
Clinical research shows that zinc might reduce serum ritonavir levels by chelating with ritonavir in the gut and preventing its absorption. In patients with HIV, ritonavir is taken with atazanavir to prevent the metabolism and increase the effects of atazanavir. A pharmacokinetic study shows that, in patients being treated with atazanavir/ritonavir, co-administration of zinc sulfate (Solvazinc tablets) 125 mg as a single dose or as multiple daily doses for 2 weeks reduces plasma levels of ritonavir by about 16%. However, atazanavir levels still remains high enough to prevent HIV virus replication. Therefore, the decrease in ritonavir levels is not likely to be clinically significant.

Likelihood Probable Evidence B
Tetracycline Antibiotics

Zinc might reduce levels of tetracycline antibiotics.
Tetracyclines form complexes with zinc in the gastrointestinal tract, which can reduce absorption of both the tetracycline and zinc when taken at the same time. Taking zinc sulfate 200 mg with tetracycline reduces absorption of the antibiotic by 30% to 40%. Demeclocycline and minocycline cause a similar interaction. However, doxycycline does not seem to interact significantly with zinc. Advise patients to take tetracyclines at least 2 hours before, or 4-6 hours after, zinc supplements to avoid any interactions.

Likelihood Probable Evidence B
Amiloride (Midamor)

Amiloride can modestly reduce zinc excretion and increase zinc levels.
Clinical research shows that amiloride can reduce urinary zinc excretion, especially at doses of 10 mg per day or more. This zinc-sparing effect can help to counteract zinc losses caused by thiazide diuretics, but it is unlikely to cause zinc toxicity at usual amiloride doses. The other potassium-sparing diuretics, spironolactone (Aldactone) and triamterene (Dyrenium), do not seem to have a zinc-sparing effect.

Likelihood Probable Evidence B
Atazanavir (Reyataz)

Zinc modestly reduces levels of atazanavir, although this effect does not seem to be clinically significant.
Clinical research shows that zinc might decrease serum atazanavir levels by chelating with atazanavir in the gut and preventing its absorption. Although a single dose of zinc sulfate (Solvazinc tablets) 125 mg orally does not affect atazanavir concentrations in patients being treated with atazanavir/ritonavir, co-administration of zinc sulfate 125 mg daily for 2 weeks reduces plasma levels of atazanavir by about 22% in these patients. However, despite this decrease, atazanavir levels still remain at high enough concentrations for the prevention of HIV virus replication.

Likelihood Probable Evidence B
Zinc full monograph & interactions
The maker

Brand information

Manufacturer and brand details for Super Miraforte with Standardized Lignans, from the product label.

Life Extension

See all Life Extension products
Name
Quality Supplements and Vitamins, Inc.
City
Ft. Lauderdale
State
FL
ZipCode
33309
Phone Number
1-866-280-2852
Web Address
LifeExtension.com
Pharmacist Counseling Corner

Super Miraforte with Standardized Lignans by Life Extension: Common Questions

Does Super Miraforte with Standardized Lignans by Life Extension interact with any medications?
Yes. Based on its ingredients, Super Miraforte with Standardized Lignans has a known interaction with 1,079 medications. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Super Miraforte with Standardized Lignans contains 7 active ingredients, and an interaction can come from any of them. We check every ingredient, combine the results into one list per medication, and show which ingredient and mechanism is responsible.
Where does this information come from?
The product label data comes from the NIH Dietary Supplement Label Database (DSLD); the interaction data is built on the Natural Medicines database and reviewed by HelloPharmacist pharmacists.
What is zinc in this product for?
Zinc is used to treat or prevent zinc deficiency and is likely effective for Wilson disease. It's also possibly effective for acne, age-related macular degeneration, and some types of diabetes. The product uses it as its main active ingredient.
Can I take this if I'm pregnant or breastfeeding?
No. Maca, muira puama, and chrysin all lack enough safety data and are advised against during pregnancy and breastfeeding. Additionally, HMRlignan (hemlock) is unsafe in any amount and poses serious risk to a developing baby or nursing infant. Talk with your doctor or pharmacist about safer options.
What are the side effects of zinc in this product?
At recommended doses, zinc is generally well tolerated. However, some people experience abdominal cramps, diarrhea, nausea, vomiting, or a metallic taste—these are usually dose-related. Long-term high-dose zinc can deplete copper, potentially leading to anemia and low white blood cell counts.
Why does this product contain hemlock (HMRlignan)?
Hemlock is poisonous and causes severe toxicity—burning in the mouth and throat, vomiting, paralysis, respiratory arrest, and death. It should never be taken in any amount. If this ingredient is actually hemlock, the product should not be used.
Does this product have any established benefits beyond zinc?
No. Maca, muira puama, chrysin, and the nettle extracts all lack enough reliable evidence in our data for us to rate their effectiveness. Bioperine (black pepper) is included as an absorption enhancer but has no established benefit for any condition itself.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

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Super Miraforte with Standardized Lignans label
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The Full Monographs Behind Super Miraforte with Standardized Lignans’s Ingredients

Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.

Herb & supplement monograph

Zinc

Interacts with 67 drugs

Zinc is an essential mineral that your body needs for immune function, wound healing, taste, and smell. Most people get enough from food, but supplements can help correct or prevent a defici...

Read the full Zinc monograph → Herb & supplement monograph

Maca

Maca is a nutrient-rich Andean root often used for energy, libido, and menopause symptoms. Early studies suggest it may modestly help sexual desire and some menopause symptoms, but the evide...

Read the full Maca monograph → Herb & supplement monograph

Muira Puama

Muira puama is a Brazilian plant traditionally used as an aphrodisiac and general tonic, often nicknamed 'potency wood.' Human research is very limited, so its benefits are not well proven,...

Read the full Muira Puama monograph → Herb & supplement monograph

Chrysin

Interacts with 358 drugs

Chrysin is a plant flavonoid sold mainly as a bodybuilding supplement claimed to raise testosterone or block estrogen, but human studies have not shown these benefits, largely because the bo...

Read the full Chrysin monograph → Herb & supplement monograph

Hemlock

Hemlock (Conium maculatum) is a highly poisonous plant that has no safe or proven medicinal use today. Even small amounts can cause paralysis and death, so it should never be consumed or app...

Read the full Hemlock monograph → Herb & supplement monograph

Black Pepper

Interacts with 1,019 drugs

Black pepper is a common kitchen spice that is generally safe in the amounts used in food. Its extract, piperine, is mostly added to supplements to help the body absorb other ingredients (li...

Read the full Black Pepper monograph →
Sources

Sources & How We Checked

Super Miraforte with Standardized Lignans'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.

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 161 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.

Zinc 88 references
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  2. Eby GA, Davis DR, Halcomb WW. Reduction in duration of common colds by zinc gluconate lozenges in a double-blind study. Antimicrob Agents Chemother 1984;25:20-4. DOI
  3. Smith DS, Helzner EC, Nuttall CE Jr, et al. Failure of zinc gluconate in treatment of acute upper respiratory tract infections. Antimicrob Agents Chemother 1989;33:646-8. PubMed
  4. Blondeau JM. Expanded activity and utility of the new fluoroquinolones: a review. Clin Ther 1999;21:3-40. PubMed
  5. Reyes AJ, Olhaberry JV, Leary WP, et al. Urinary zinc excretion, diuretics, zinc deficiency and some side-effects of diuretics. S Afr Med J 1983;64:936-41.
  6. Kugelmas M. Preliminary observation: oral zinc sulfate replacement is effective in treating muscle cramps in cirrhotic patients. J Am Coll Nutr 2000;19:13-5. PubMed
  7. Hebel SK, ed. Drug Facts and Comparisons. 52nd ed. St. Louis: Facts and Comparisons, 1998.
  8. Chan S, Gerson B, Subramaniam S. The role of copper, molybdenum, selenium, and zinc in nutrition and health. Clin Lab Med 1998;18:673-85. DOI
  9. Brewer GJ, Yuzbasiyan-Gurkan V, Johnson V, et al. Treatment of Wilson's disease with zinc: XI. Interaction with other anticopper agents. J Am Coll Nutr 1993;12:26-30. PubMed
  10. Fosmire GJ. Zinc toxicity. Am J Clin Nutr 1990;51:225-7.
  11. Lomaestro BM, Bailie GR. Absorption interactions with fluoroquinolones. 1995 update. Drug Saf 1995;12:314-33. PubMed
  12. Hansten PD, Horn JR. Drug Interactions Analysis and Management. Vancouver, WA: Applied Therapeutics Inc., 1997 and updates.
  13. Seelig MS. Auto-immune complications of D-penicillamine - A possible result of zinc and magnesium depletion and of pyridoxine inactivation. J Am Coll Nutr 1982;1:207-14. PubMed
  14. Neuvonen PJ. Interactions with the absorption of tetracyclines. Drugs 1976;11:45-54.. PubMed
  15. Hirt M, Nobel S, Barron E. Zinc nasal gel for the treatment of common cold symptoms: A double-blind, placebo-controlled trial. Ear Nose Throat J 2000;79:778-82.. DOI
  16. Simkin PA. Oral zinc sulphate in rheumatoid arthritis. Lancet 1976;2:539-42. PubMed
  17. Wray D. A double-blind trial of systemic zinc sulfate in recurrent aphthous stomatitis. Oral Surg Oral Med Oral Pathol 1982;53:469-72. PubMed
  18. Douglas RM, Miles HB, Moore BW, et al. Failure of effervescent zinc acetate lozenges to alter the course of upper respiratory tract infections in Australian adults. Antimicrob Agents Chemother 1987;31:1263-5. PubMed
  19. Lagiou P, Wuu J, Trichopoulou A, et al. Diet and benign prostatic hyperplasia: a study in Greece. Urology 1999;54:284-90. PubMed
  20. Ewing CI, Gibbs AC, Ashcroft C, David TJ. Failure of oral zinc supplementation in atopic eczema. Eur J Clin Nutr 1991;45:507-10.
  21. Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. Washington, DC: National Academy Press, 2002.
  22. Age-Related Eye Disease Study Research Group. A randomized, placebo-controlled, clinical trial of high-dose supplementation with vitamins C and E, beta carotene, and zinc for age-related macular degeneration and vision loss. AREDS report no. 8. Arch Oph
  23. Greenberg JE, Lynn M, Kirsner RS, et al. Mucocutaneous pigmented macule as a result of zinc deposition. J Cutan Pathol 2002;29:613-5. PubMed
  24. Godfrey HR, Godfrey NJ, Godfrey JC, Riley D. A randomized clinical trial on the treatment of oral herpes with topical zinc oxide/glycine. Altern Ther Health Med 2001;7:49-56.
  25. Turner RB. Ineffectiveness of intranasal zinc gluconate for prevention of experimental rhinovirus colds. Clin Infect Dis 2001;33:1865-70. PubMed
  26. Belongia EA, Berg R, Liu K. A randomized trial of zinc nasal spray for the treatment of upper respiratory illness in adults. Am J Med 2001;111:103-8. PubMed
  27. Mossad SB. Effect of zincum gluconicum nasal gel on the duration and symptom severity of the common cold in otherwise healthy adults. QJM 2003;96:35-43. DOI
  28. Leitzmann MF, Stampfer MJ, Wu K, et al. Zinc supplement use and risk of prostate cancer. J Natl Cancer Inst 2003;95:1004-7.. PubMed
  29. Jafek BW, Linschoten M, Murrow BW. Zicam Induced Anosmia. American Rhinologic Society 49th Annual Fall Scientific Meeting abstract. Orlando, Florida. September 20, 2003. http://app.american-rhinologic.org/programs/2003ARSFallProgram071503.pdf (Accessed 24
  30. Uebayashi H, Hatanaka T, Kanemura F, Tonosaki K. Acute anosmia in the mouse: behavioral discrimination among the four basic taste substances. Physiol Behav 2001;72:291-6.. PubMed
  31. Barrett S. Zicam Marketers Sued. United States District Court Western District of Michigan Southern Division, Filed October 14, 2003, Case No. 4:03CV0146.
  32. Bilici M, Yildirim F, Kandil S, et al. Double-blind, placebo-controlled study of zinc sulfate in the treatment of attention deficit hyperactivity disorder. Prog Neuropsychopharmacol Biol Psychiatry 2004;28:181-90.. PubMed
  33. Polk RE, Healy DP, Sahai J, et al. Effect of ferrous sulfate and multivitamins with zinc on absorption of ciprofloxacin in normal volunteers. Antimicrob Agents Chemother 1989;33:1841-4. PubMed
  34. Mery C, Delrieu F, Ghozlan R, et al. Controlled trial of D-penicillamine in rheumatoid arthritis. Dose effect and the role of zinc. Scand J Rheumatol 1976;5:241-7. PubMed
  35. Penttila O, Hurme H, Neuvonen PJ. Effect of zinc sulfate on the absorption of tetracycline and doxycycline in man. Eur J Clin Pharmacol 1975;9:131-4.
  36. Kondo Y, Yamagata K, Satoh M, et al. Optimal administration schedule of cisplatin for bladder tumor with minimal induction of metallothionein. J Urol 2003;170:2467-70. PubMed
  37. Doz F, Berens ME, Deschepper CF, et al. Experimental basis for increasing the therapeutic index of cis-diamminedicarboxylatocyclobutaneplatinum(II) in brain tumor therapy by a high-zinc diet. Cancer Chemother Pharmacol 1992;29:219-26.
  38. Wester PO. Urinary zinc excretion during treatment with different diuretics. Acta Med Scand 1980;208:209-12. PubMed
  39. Golik A, Modai D, Weissgarten J, et al. Hydrochlorothiazide-amiloride causes excessive urinary zinc excretion. Clin Pharmacol Ther 1987;42:42-4. PubMed
  40. Leary WP, Reyes AJ, Van der Byl K. Urinary magnesium and zinc excretion after two different single doses of amiloride in healthy adults. Curr Ther Res 1983;34:205-16.
  41. McBride K, Slotnick B, Margolis FL. Does intranasal application of zinc sulfate produce anosmia in the mouse? An olfactometric and anatomical study. Chem Senses 2003;28:659-70. PubMed
  42. Burd GD. Morphological study of the effects of intranasal zinc sulfate irrigation on the mouse olfactory epithelium and olfactory bulb. Microsc Res Tech 1993;24:195-213. PubMed
  43. Ducray A, Bondier JR, Michel G, et al. Recovery following peripheral destruction of olfactory neurons in young and adult mice. Eur J Neurosci 2002;15:1907-17. PubMed
  44. Mayer AD, Rosenblatt JS. Peripheral olfactory deafferentation of the primary olfactory system in rats using ZnSO4 nasal spray with special reference to maternal behavior. Physiol Behav 1993;53:587-92. PubMed
  45. DeCook CA, Hirsch AR. Anosmia due to inhalational zinc: a case report (abstract). Chem Senses 2000;25:659.
  46. Tisdall FF, Brown A, Defries RD. Persistent anosmia following zinc sulfate nasal spraying. JPed 1938;18:60-2. DOI
  47. Lawson KA, Wright ME, Subar A, et al. Multivitamin use and risk of prostate cancer in the National Institutes of Health-AARP Diet and Health Study. J Natl Cancer Inst 2007;99:754-64. PubMed
  48. Public Health Advisory. Loss of sense of smell with intranasal cold remedies containing zinc. U.S. Food and Drug Administration, June 16, 2009. Available at: http://www.fda.gov/Drugs/DrugSafety/PublicHealthAdvisories/ucm166059.htm (Accessed 16 June 2009)
  49. Dooren JC. FDA warns against use of Zicam. The Wall Street Journal, June 16, 2009. Available at: http://online.wsj.com/article/SB124516778692319231.html#mod=djemHL?mg=com-wsj (Accessed 16 June 2009).
  50. Alexander TH, Davidson TM. Intranasal zinc and anosmia: the zinc-induced anosmia syndrome. Laryngoscope 2006;116:217-20.
  51. Health Canada / GlaxoSmithKline Consumer Healthcare. Association of long-term, excessive use of zinc-containing Poli-Grip products with myeloneuropathy and blood dyscrasias. February 18, 2010. Available at: http://hc-sc.gc.ca/dhp-mps/alt_formats/pdf/medef
  52. GlaxoSmithKline Consumer Advisory. GlaxoSmithKline (GSK) warns about a potential health risk associated with long-term, excessive use of GSK's zinc-containing denture adhesives Super Polygrip Original, Ultra Fresh and Extra Care. February 18, 2010. Availa
  53. Science M, Johnstone J, Roth DE, et al. Zinc for the treatment of the common cold: a systematic review and meta-analysis of randomized controlled trials. CMAJ 2012;184:E551-61. PubMed
  54. Castilla-Higuero, L., Romero-Gomez, M., Suarez, E., and Castro, M. Acute hepatitis after starting zinc therapy in a patient with presymptomatic Wilson's disease. Hepatology 2000;32(4 Pt 1):877. PubMed
  55. Sharquie, K. E., Najim, R. A., Farjou, I. B., and Al Timimi, D. J. Oral zinc sulphate in the treatment of acute cutaneous leishmaniasis. Clin.Exp.Dermatol. 2001;26(1):21-26. PubMed
  56. Dreno, B., Moyse, D., Alirezai, M., Amblard, P., Auffret, N., Beylot, C., Bodokh, I., Chivot, M., Daniel, F., Humbert, P., Meynadier, J., and Poli, F. Multicenter randomized comparative double-blind controlled clinical trial of the safety and efficacy of
  57. Moore, R. Bleeding gastric erosion after oral zinc sulphate. Br.Med J 3-25-1978;1(6115):754. PubMed
  58. Jafek, B. W., Linschoten, M. R., and Murrow, B. W. Anosmia after intranasal zinc gluconate use. Am J Rhinol. 2004;18(3):137-141. DOI
  59. Simonart, T. and de, Maertelaer, V. Systemic treatments for cutaneous warts: a systematic review. J Dermatolog.Treat. 2012;23(1):72-77. PubMed
  60. Cochran, R. J., Tucker, S. B., and Flannigan, S. A. Topical zinc therapy for acne vulgaris. Int.J Dermatol. 1985;24(3):188-190. DOI
  61. Morgan, A. A. Bleeding gastric erosion after oral zinc sulphate. Br.Med.J. 5-13-1978;1(6122):1283-1284. PubMed
  62. Murphy, J. V. Intoxication following ingestion of elemental zinc. JAMA 6-22-1970;212(12):2119-2120.
  63. Lang, C. J., Rabas-Kolominsky, P., Engelhardt, A., Kobras, G., and Konig, H. J. Fatal deterioration of Wilson's disease after institution of oral zinc therapy. Arch Neurol. 1993;50(10):1007-1008. PubMed
  64. Fjellner, B. Drug-induced lupus erythematosus aggravated by oral zinc therapy. Acta Derm.Venereol. 1979;59(4):368-370. DOI
  65. Varas Lorenzo, M. J. Zinc acexamate and ranitidine in the short- and mid-term management of gastroduodenal ulcers. Curr Ther Res 21986;39:19-29.
  66. Bosch, F. and Jimenez, E. Post-marketing surveillance of zinc acexamate in peptic ulcer treatment. Clin Trials J 1990;27:301-312.
  67. DeCook, C. A. and Hirsch, A. R. Anosmia due to inhalational zinc: a case report (abstract). Chem Senses 2000;25:659.
  68. Crown LA, May JA. Zinc toxicity: denture adhesives, bone marrow failure and polyneuropathy. Tenn Med. 2012 Feb;105(2):39-40, 42.
  69. Dadamio J, Van Tournout M, Teughels W, Dekeyser C, Coucke W, Quirynen M. Efficacy of different mouthrinse formulations in reducing oral malodour: a randomized clinical trial. J Clin Periodontol. 2013 May;40(5):505-13. PubMed
  70. Moyle G, Else L, Jackson A, Back D, Yapa MH, Seymour N, Ringner-Nackter L, Karolia Z, Gazzard B, Boffito M. Coadministration of atazanavir-ritonavir and zinc sulfate: impact on hyperbilirubinemia and pharmacokinetics. Antimicrob Agents Chemother. 2013 Aug PubMed
  71. Zittel S, Ufer F, Gerloff C, Münchau A, Rosenkranz M. Severe myelopathy after denture cream use--is copper deficiency or excess zinc the cause? Clin Neurol Neurosurg. 2014 Jun;121:17-8. PubMed
  72. Jalloh MA, Gregory PJ, Hein D, et al. Dietary supplement interactions with antiretrovirals: a systematic review. Int J STD AIDS. 2017 Jan;28(1):4-15. PubMed
  73. Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents: Drug Interactions between Integrase Inhibitors and Other Drugs. AIDSinfo. July 14, 2016. Available at: https://aidsinfo.nih.gov/guidelines/html/1/adult-and-adolescen
  74. Ding Y, Jia YY, Li F, et al. The effect of staggered administration of zinc sulfate on the pharmacokinetics of oral cephalexin. Br J Clin Pharmacol. 2012 Mar;73(3):422-7. PubMed
  75. Fallah R, Sabbaghzadegan S, Karbasi SA, Binesh F. Efficacy of zinc sulfate supplement on febrile seizure recurrence prevention in children with normal serum zinc level: A randomised clinical trial. Nutrition. 2015;31(11-12):1358-61. PubMed
  76. Lazzerini M, Wanzira H. Oral zinc for treating diarrhoea in children. Cochrane Database Syst Rev. 2016;12:CD005436. PubMed
  77. Mahmoud AM, Al-Alem U, Dabbous F, et al. Zinc intake and risk of prostate cancer: Case-control study and meta-analysis. PLoS One. 2016;11(11):e0165956. PubMed
  78. Nagraj SK, George RP, Shetty N, Levenson D, Ferraiolo DM, Shrestha A. Interventions for managing taste disturbances. Cochrane Database Syst Rev. 2017 Dec 20;12(12):CD010470. PubMed
  79. Yee BE, Richards P, Sui JY, Marsch AF. Serum zinc levels and efficacy of zinc treatment in acne vulgaris: A systematic review and meta-analysis. Dermatol Ther. 2020:e14252. PubMed
  80. Janyajirawong R, Vilaichone RK, Sethasine S. Efficacy of zinc supplement in minimal hepatic encephalopathy: A prospective, randomized controlled study (Zinc-MHE Trial). Asian Pac J Cancer Prev 2021;22(9):2879-2887. PubMed
  81. Nakano M, Nakamura Y, Miyazaki A, Takahashi J. Zinc pharmacotherapy for elderly osteoporotic patients with zinc deficiency in a clinical setting. Nutrients 2021;13(6):1814. PubMed
  82. Tolino E, Skroza N, Mambrin A, et al. An open-label study comparing oral zinc to lymecycline in the treatment of acne vulgaris. J Clin Aesthet Dermatol 2021;14(5):56-58.
  83. Hunter J, Arentz S, Goldenberg J, et al. Zinc for the prevention or treatment of acute viral respiratory tract infections in adults: a rapid systematic review and meta-analysis of randomised controlled trials. BMJ Open. 2021;11(11):e047474. PubMed
  84. Yamazaki K, Kageyama H, Fujiyama T, Ito T, Urano S, Honda T. A case of systemic contact dermatitis due to zinc supplements. Int J Dermatol 2022. PubMed
  85. Magham K, Han J, Eilbert W, Bunney EB. Severe copper deficiency anemia caused by zinc supplement use. Am J Emerg Med 2023;72:222. PubMed
  86. Sivakumar RR, Chinnaiah Govindareddy D, Sahoo J, Bobby Z, Chinnakali P. Effect of daily zinc supplementation for 12 weeks on serum thyroid auto-antibody levels in children and adolescents with autoimmune thyroiditis - a randomized controlled trial. J Pedi PubMed
  87. AlDhasee O, AlMalki H, AlKharashi N, AlJeraisy N, Al Deeb M. Acute zinc sulfate overdose: clinical presentation and management. BMJ Case Rep 2025;18(1):e263899. PubMed
  88. US Food and Drug Administration (FDA). Biktarvy Prescribing Information. October 2024. Available at: https://www.accessdata.fda.gov/drugsatfda_docs/label/2024/210251Orig1s020lbl.pdf. Accessed July 16, 2025.

See these in context on the Zinc monograph →

Maca 1 reference
  1. Valerio, L. G., Jr. and Gonzales, G. F. Toxicological aspects of the South American herbs cat's claw (Uncaria tomentosa) and Maca (Lepidium meyenii) : a critical synopsis. Toxicol.Rev 2005;24(1):11-35. PubMed

See these in context on the Maca monograph →

Muira Puama 2 references
  1. Waynberg, J. and Brewer, S. Effects of Herbal vX on libido and sexual activity in premenopausal and postmenopausal women. Adv Ther 2000;17(5):255-262. PubMed
  2. Nguyen S, Rajfer J, Shaheen M. Safety and efficacy of daily Revactin in men with erectile dysfunction: a 3-month pilot study. Transl Androl Urol. 2018;7(2):266-73. PubMed

See these in context on the Muira Puama monograph →

Chrysin 23 references
  1. Galijatovic A, Otake Y, Walle UK, Walle T. Extensive metabolism of the flavonoid chrysin by human Caco-2 and Hep G2 cells. Xenobiotica 1999;29:1241-56. PubMed
  2. Lee H, Yeom H, Kim YG, et al. Structure-related inhibition of human hepatic caffeine N3-demethylation by naturally occurring flavonoids. Biochem Pharmacol 1998;55:1369-75. PubMed
  3. Galijatovic A, Walle UK, Walle T. Induction of UDP-glucuronosyltransferase by the flavonoids chrysin and quercetin in Caco-2 cells. Pharm Res 2000;17:21-6.
  4. Walle UK, Galijatovic A, Walle T. Transport of the flavonoid chrysin and its conjugated metabolites by the human intestinal cell line Caco-2. Biochem Pharmacol 1999;58:431-8. PubMed
  5. Kao YC, Zhou C, Sherman M, et al. Molecular basis of the inhibition of human aromatase (estrogen synthetase) by flavone and isoflavone phytoestrogens: A site-directed mutagenesis study. Environ Health Perspect 1998;106:85-92. PubMed
  6. Jeong HJ, Shin YG, Kim IH, Pezzuto JM. Inhibition of aromatase activity by flavonoids. Arch Pharm Res 1999;22:309-12. PubMed
  7. Walle T, Otake Y, Galijatovic A, et al. Induction of UDP-glucuronosyltransferase UGT1A1 by the flavonoid chrysin in the human hepatoma cell line hep G2. Drug Metab Dispos 2000;28:1077-82. DOI
  8. Walle T, Otake Y, Brubaker JA, et al. Disposition and metabolism of the flavonoid chrysin in normal volunteers. Br J Clin Pharmacol 2001;51:143-6. DOI
  9. Galijatovic A, Otake Y, Walle UK, Walle T. Induction of UDP-glucuronosyltransferase UGT1A1 by the flavonoid chrysin in Caco-2 cells--potential role in carcinogen bioinactivation. Pharm Res 2001;18:374-9. PubMed
  10. Lautraite S, Musonda AC, Doehmer J, et al. Flavonoids inhibit genetic toxicity produced by carcinogens in cells expressing CYP1A2 and CYP1A1. Mutagenesis 2002;17:45-53. PubMed
  11. Han, D. H., Denison, M. S., Tachibana, H., and Yamada, K. Relationship between estrogen receptor-binding and estrogenic activities of environmental estrogens and suppression by flavonoids. Biosci.Biotechnol.Biochem 2002;66(7):1479-1487. PubMed
  12. O'Leary, K. A., de Pascual-Tereasa, S., Needs, P. W., Bao, Y. P., O'Brien, N. M., and Williamson, G. Effect of flavonoids and vitamin E on cyclooxygenase-2 (COX-2) transcription. Mutat.Res 7-13-2004;551(1-2):245-254. PubMed
  13. Woodman, O. L. and Chan, E. C. Vascular and anti-oxidant actions of flavonols and flavones. Clin Exp Pharmacol Physiol 2004;31(11):786-790. PubMed
  14. Simons, A. L., Renouf, M., Hendrich, S., and Murphy, P. A. Human gut microbial degradation of flavonoids: structure-function relationships. J Agric.Food Chem 5-18-2005;53(10):4258-4263. PubMed
  15. Kim, H. J., Lee, S. B., Park, S. K., Kim, H. M., Park, Y. I., and Dong, M. S. Effects of hydroxyl group numbers on the B-ring of 5,7-dihydroxyflavones on the differential inhibition of human CYP 1A and CYP1B1 enzymes. Arch Pharm Res 2005;28(10):1114-1121 PubMed
  16. Moon, Y. J., Wang, X., and Morris, M. E. Dietary flavonoids: effects on xenobiotic and carcinogen metabolism. Toxicol In Vitro 2006;20(2):187-210. PubMed
  17. Landolfi, R., Mower, R. L., and Steiner, M. Modification of platelet function and arachidonic acid metabolism by bioflavonoids. Structure-activity relations. Biochem Pharmacol 5-1-1984;33(9):1525-1530. PubMed
  18. Tsyrlov, I. B., Mikhailenko, V. M., and Gelboin, H. V. Isozyme- and species-specific susceptibility of cDNA-expressed CYP1A P-450s to different flavonoids. Biochim.Biophys Acta 4-13-1994;1205(2):325-335. PubMed
  19. Collins, B. M., McLachlan, J. A., and Arnold, S. F. The estrogenic and antiestrogenic activities of phytochemicals with the human estrogen receptor expressed in yeast. Steroids 1997;62(4):365-372. PubMed
  20. Kuiper, G. G., Lemmen, J. G., Carlsson, B., Corton, J. C., Safe, S. H., van der Saag, P. T., van der Burg, B., and Gustafsson, J. A. Interaction of estrogenic chemicals and phytoestrogens with estrogen receptor beta. Endocrinology 1998;139(10):4252-4263. PubMed
  21. Liu G, Xie W, He AD, et al. Antiplatelet activity of chrysin via inhibiting platelet aIIbß3-mediated signaling pathway. Mol Nutr Food Res 2016;60(9):1984-93.
  22. Noh K, Oh do G, Nepal MR, et al. Pharmacokinetic interaction of chrysin with caffeine in rats. Biomol Ther (Seoul) 2016;24(4):446-52. PubMed
  23. Mohos V, Fliszár-Nyúl E, Ungvári O, et al. Effects of Chrysin and Its Major Conjugated Metabolites Chrysin-7-Sulfate and Chrysin-7-Glucuronide on Cytochrome P450 Enzymes and on OATP, P-gp, BCRP, and MRP2 Transporters. Drug Metab Dispos 2020;48(10):1064-10 PubMed

See these in context on the Chrysin monograph →

Hemlock 18 references
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  2. Drummer OH, Roberts AN, Bedford PJ, et al. Three deaths from hemlock poisoning. Med J Aust 1995;162:592-3. PubMed
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  5. Biberci, E., Altuntas, Y., Cobanoglu, A., and Alpinar, A. Acute respiratory arrest following hemlock (Conium maculatum) intoxication. J.Toxicol.Clin.Toxicol. 2002;40(4):517-518.
  6. Foster, P. F., McFadden, R., Trevino, R., Galliardt, S., Kopczewski, L. A., Gugliuzza, K., Gonzalez, Z., and Wright, F. Successful transplantation of donor organs from a hemlock poisoning victim. Transplantation 9-15-2003;76(5):874-876. PubMed
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  8. Rizzi, D., Basile, C., Di Maggio, A., Sebastio, A., Introna, F., Jr., Rizzi, R., Scatizzi, A., De Marco, S., and Smialek, J. E. Clinical spectrum of accidental hemlock poisoning: neurotoxic manifestations, rhabdomyolysis and acute tubular necrosis. Nephr PubMed
  9. Rizzi, D., Basile, C., Di Maggio, A., Sebastio, A., Introna, F., Jr., Rizzi, R., Bruno, S., Scatizzi, A., and De Marco, S. Rhabdomyolysis and acute tubular necrosis in coniine (hemlock) poisoning. Lancet 12-16-1989;2(8677):1461-1462. PubMed
  10. Rizzi, D., Introna, F., Jr., Gagliano, Candela R., Di Nunno, C., Ricco, R., Recchia, R., and De, Michele, V. [Toxic rhabdomyolysis and tubular necrosis in hemlock poisoning. 4 case reports]. Clin.Ter. 2-15-1988;124(3):193-201.
  11. Montemurro, N. E., Di Maggio, A., Strippoli, P., Coviello, F., Godino, F., Miloro, G., and Scatizzi, A. Combined dialysis and plasma-exchange in acute renal failure. Biomater.Artif.Cells Immobilization Biotechnol. 1993;21(2):283-287. PubMed
  12. Scatizzi, A., Di Maggio, A., Rizzi, D., Sebastio, A. M., and Basile, C. Acute renal failure due to tubular necrosis caused by wildfowl-mediated hemlock poisoning. Ren Fail. 1993;15(1):93-96. PubMed
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See these in context on the Hemlock monograph →

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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

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