Major interaction on record — check this product against your medications before combining. Based on 25 of 27 ingredients. Check your meds →
Dietary supplement

Superfood Shake Natural Strawberry Ingredients & Drug Interactions

by Invigor8

Superfood Shake Natural Strawberry label
See full label image
Powder Category: Other Combinations
Most serious interaction: Major
Clinical methodology reviewed by · Updated Sep 16, 2026 · Label data from the NIH DSLD
What is this page for?

First and foremost: checking Superfood Shake Natural Strawberry 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: Major

Superfood Shake Natural Strawberry is a dietary supplement by Invigor8 with 27 active ingredients. Its ingredients are commonly taken for constipation, diarrhea, high cholesterol.Based on those ingredients, 2,283 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are Dietary Fiber, Bacopa herb extract, Beet root powder. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

Jump to a section

Check Your Meds Against Superfood Shake Natural Strawberry by Invigor8

Ask about any prescription or over-the-counter medication and we check it for interactions with Superfood Shake Natural Strawberry by Invigor8 — and tell you which ingredient is responsible.

Pharmacist-reviewed data Checks every ingredient Answer in seconds
Prefer a human? Send your question to our licensed pharmacists — free, answered by email within 24 hours.

HelloPharmacist Scorecard of Superfood Shake Natural Strawberry by Invigor8

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

Low disclosure
Ingredient Transparency · database check
Low

Most active ingredients don't disclose an individual amount — you can't tell how much of each you're getting.

Why this rating?
  • The label discloses an exact amount for 5 of its 27 active ingredients.
  • “Digestive Enzyme Complex” is a proprietary blend — the label gives one combined amount (653 mg) without saying how much of each component you get.
  • “Pure Protein Complex” is a proprietary blend — the label gives one combined amount (20 Gram(s)) without saying how much of each component you get.
  • “Prebiotic-Fiber Complex” is a proprietary blend — the label gives one combined amount (3 Gram(s)) without saying how much of each component you get.

This shake contains 26 ingredients including several active nutrients. The product includes sodium, vitamin A, calcium, and iron as mineral and vitamin components.

It also contains digestive enzymes (amylase, papain, lipase, and neutral protease) to support nutrient breakdown, plus Bifidobacterium bifidum, a probiotic. The shake is built on a whey protein base—both whey concentrate and isolate—and includes fruit powders (strawberry, cranberry, red raspberry, banana, and beet root), plus seeds and plant extracts like flaxseed, chia, and chicory root, along with the amino acid L-theanine, coconut powder, bromelain, lactase, and bacopa herb extract.

Several inactive ingredients are also present, including xylitol (a sweetener), xanthan gum, natural flavors, and stevia leaf extract.

Does it work?

Moderate evidence
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
Moderate

Some clinical evidence supports this product's ingredients for its stated purpose, but it isn't conclusive.

Why this rating?
  • The label markets this product for: weight loss and digestive health support.
  • We looked for evidence on: Athletic performance, Age-related cognitive decline, hunger control, satiety.
  • The strongest evidence on file: Beet is rated "Possibly Effective" for Athletic performance (Natural Medicines).
  • Also on file: Whey Protein is rated "Possibly Effective" for Athletic performance.
  • Also on file: Iron is rated "Possibly Ineffective" for Athletic performance.

The evidence for effectiveness varies across this product's ingredients. Calcium is Effective for preventing kidney failure and treating low blood calcium, and Likely Effective for osteoporosis.

Iron is Effective for iron-deficiency anemia and pregnancy-related anemia. Vitamin A is Effective for vitamin A deficiency and Possibly Effective for oral leukoplakia, aging skin, measles, ulcerative colitis, and bronchopulmonary dysplasia.

For other ingredients, the evidence is less established. Flaxseed is Possibly Effective for high cholesterol, diabetes, breast pain, high blood pressure, and constipation.

Beet is Possibly Effective for athletic performance and exercise-related muscle soreness. Lactase is Effective for lactose intolerance.

Cranberry is Possibly Effective for urinary tract infections. Bromelain, banana, strawberry, chia, chicory root, L-theanine, papain, bacopa, coconut powder, red raspberry, bifidobacterium, and lipase either show Insufficient Reliable Evidence To Rate or no established effectiveness for their claimed uses in our data.

The evidence, ingredient by ingredient Black Psyllium Sodium Vitamin A Calcium Iron Papain Bromelain Lipase

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 25 of the 25 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 24 of 25.
  • General safety write-ups exist for 25 of 25.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

Most ingredients in this shake are generally well tolerated at recommended amounts. Calcium, iron, lactase, and coconut are generally well tolerated when used as directed.

Vitamin A is generally well tolerated below the tolerable upper intake level but can cause toxicity at very high doses. Sodium is essential in small amounts but too much is linked to high blood pressure and heart strain—normal dietary sodium is fine, but avoid sodium supplements or very high intake without medical advice.

Some ingredients carry cautions: L-theanine is generally well tolerated short-term but long-term safety is not well studied. Flaxseed commonly causes bloating, gas, and diarrhea—start with small amounts and drink plenty of water.

Bacopa may cause abdominal cramps, diarrhea, headache, and nausea in 12–30% of users. Bromelain, papain, and chicory may trigger allergic reactions in sensitive individuals.

Whey protein can trigger or worsen acne in some users and may cause bloating, cramps, diarrhea, and nausea. No safety rating is on file for papain, lipase, or bifidobacterium in pregnancy; for L-theanine, bromelain, bacopa, and banana, the data advises against use in pregnancy.

Sodium's pregnancy rating is conflicting (Likely Safe vs. Possibly Unsafe), so discuss with your doctor.

Side effects, ingredient by ingredient Black Psyllium Sodium Vitamin A Calcium Iron Papain Bromelain Lipase

Meds to double-check

Major interaction found
Known Interaction Concern · database check
Major identified

At least one ingredient has a documented Major-severity interaction. Check your medications for a personalized result.

Why this rating?
  • 20 of the 25 matched ingredients can interact with medications — Papain, Chicory, Black Psyllium, Beet, Red Raspberry, among others.
  • The most serious interaction on file is rated Major.
  • Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs; diabetes medications; heart-rhythm medications; lithium; Parkinson's medications.
  • For scale: 2,284 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.

Before taking this shake, double-check with your pharmacist if you're on levodopa (Parkinson disease)—whey protein can severely reduce how your body absorbs it. Blood pressure medications (antihypertensives) may become less effective due to sodium content.

HIV drugs dolutegravir and elvitegravir have Major interactions with calcium. Blood thinners (anticoagulants like warfarin) and antiplatelet drugs may have their effects increased by strawberry and flaxseed.

Antibiotics (especially quinolones, tetracyclines, and bisphosphonates) can have reduced absorption due to calcium and iron. Thyroid medication (levothyroxine) absorption may drop due to iron and calcium.

Lithium levels can spike dangerously with high sodium intake. Diabetes drugs may be affected by flaxseed or chicory.

CYP3A4 substrate medications (a very large class) may be affected by beet root and bacopa. If you take any prescription medication, run it through the checker below.

Check your own medication Run your meds through the checker above

The bottom line

Scorecard at a glanceFormula with limited ingredient disclosure with some supporting evidence for its stated purpose. Major medication interactions have been identified, and safety information is well characterized.

This is a nutrient-dense shake with digestive enzymes and probiotics, but it's not right for everyone—especially if you take levodopa for Parkinson disease, HIV integrase inhibitors, certain antibiotics, blood thinners, or blood pressure medications. If you're on any prescription drugs, check each one against our medication interaction tool before you start.

Talk to your pharmacist or doctor about whether this product fits your health needs.

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

Assessment coverage: 26 of 27 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Dec 26, 2020.

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 Superfood Shake Natural Strawberry, straight from the product label.

Brand Invigor8
Net contents 645 Gram(s); 22.6 Ounce(s)
Market status On market
Date entered into DSLD Dec 26, 2020
DSLD ID 238623
Product type Other Combinations
Supplement form Powder
Dietary claims / uses All Other, Structure/Function
Intended target group(s) Adult (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 Superfood Shake Natural Strawberry by Invigor8, 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:
43 Gram(s)
Maximum serving Sizes:
43 Gram(s)
Servings per container
15
IngredientAmount% DV
Calories170 Calorie(s)--
Total Carbohydrates19 Gram(s)7%
Dietary Fiber2 Gram(s)7%
Sodium105 mg5%
Cholesterol25 mg8%
Vitamin A22 mcg2%
Calcium151 mg12%
Iron2 mg11%
Total Fat2 Gram(s)3%
Amylase0 NP--
Papain0 NP--
L-Theanine0 NP--
Coconut powder0 NP--
Bromelain0 NP--
Added Sugars0 Gram(s)--
Lipase0 NP--
Total Sugars2 Gram(s)--
Saturated Fat1 Gram(s)5%
Protein20 Gram(s)40%
Beet root powder0 NP--
Lactase0 NP--
Flaxseed powder0 NP--
Red Raspberry fruit powder0 NP--
Digestive Enzyme Complex653 mg--
Cranberry juice powder0 NP--
Strawberry fruit powder0 NP--
Bifidobacterium bifidum0 NP--
Neutral Protease0 NP--
Banana fruit powder0 NP--
Bacopa herb extract0 NP--
Chia seed powder0 NP--
Chicory root extract0 NP--
Pure Protein Complex20 Gram(s)--
100% grass-fed Whey Protein concentrate0 NP--
100% grass-fed Whey Protein isolate0 NP--
Prebiotic-Fiber Complex3 Gram(s)--
Essential Fatty Acid Complex2 Gram(s)--
Immunity Booster Complex500 mg--
Bovine Colostrum powder0 NP--
Cognitive Enhancers200 mg--
Probiotic Complex132 mg--
Lactobacillus acidophilus0 NP--
Fruit + Veggie Complex3320 mg--

Other ingredients: Whey Protein concentrate, Whey Protein Isolate, Xylitol, Natural flavors, Xanthan Gum, Powder, Stevia leaf extract

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

Incredible taste

All-in-one

Formulation

Gluten free Soy free Non-GMO No sugar added

Lose weight

Controls hunger Digestive health

Formula

21 grams protein + 05 super greens 100% grass-fed whey protein

170 calories serving

FDA Statement of Identity

Dietary Supplement

Precautions

Contains: Milk, treenuts (coconut).

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

See for yourself

Superfood Shake Natural Strawberry by Invigor8 label

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

Superfood Shake Natural Strawberry 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 Superfood Shake Natural Strawberry by Invigor8

These are the 27 active ingredients this product is made of. Select any to open its full monograph.

Serving size43 Gram(s) Dosage formPowder Servings per container15 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.

Dietary Fiber

Interacts with
2,025 drugs
2 Gram(s) per serving

Black psyllium is a soluble-fiber supplement made from the seeds of a Plantago plant, used mostly to ease constipation and support digestive health. I...

Dietary Fiber monograph & interactions

Sodium

Interacts with
205 drugs
105 mg per serving

Sodium is an essential mineral and electrolyte your body needs to balance fluids, support nerves, and help muscles work. Most people in modern diets g...

Sodium monograph & interactions

Vitamin A

Interacts with
387 drugs
22 mcg per serving

Vitamin A is an essential nutrient important for vision, skin, immune function, and growth. Most people get enough from a balanced diet, and supplemen...

Vitamin A monograph & interactions

Calcium

Interacts with
168 drugs
151 mg per serving

Calcium is an essential mineral your body needs for strong bones, nerve signaling, and muscle function, and supplements can help fill gaps when diet f...

Calcium monograph & interactions

Iron

Interacts with
80 drugs
2 mg per serving

Iron is an essential mineral your body needs to make hemoglobin and carry oxygen in the blood. Supplements are mainly useful for treating or preventin...

Iron monograph & interactions

Protein

20 Gram(s) per serving

Digestive Enzyme Complex

653 mg per serving

Pure Protein Complex

20 Gram(s) per serving

Prebiotic-Fiber Complex

3 Gram(s) per serving

Essential Fatty Acid Complex

2 Gram(s) per serving

Immunity Booster Complex

500 mg per serving

Cognitive Enhancers

200 mg per serving

Probiotic Complex

Interacts with
182 drugs
132 mg per serving

Lactobacillus acidophilus is a 'friendly' bacterium used as a probiotic to support gut and vaginal health. It is generally well tolerated in healthy p...

Probiotic Complex monograph & interactions

Other (inactive) ingredients: Whey Protein concentrate, Whey Protein Isolate, Xylitol, Natural flavors, Xanthan Gum, Powder, Stevia leaf extract. These complete the product’s ingredient list but are not active constituents.

Interaction report

Superfood Shake Natural Strawberry by Invigor8 Drug Interactions

Want to check YOUR meds against Superfood Shake Natural Strawberry?

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
2,283Drugs
21 Major 1,524 Moderate 738 Minor

Ingredients driving the most interactions

Dietary Fiber 2,025
Bacopa herb extract 930
Beet root powder 861
Cranberry juice powder 712
Flaxseed powder 597

Individual Drug Interactions

The ingredients in Superfood Shake Natural Strawberry interact with 2,283 drugs. Click any drug to see the details.

19 of the 27 ingredients in Superfood Shake Natural Strawberry interact with drugs. Each result below shows which ingredient is responsible. Dietary Fiber Bacopa herb extract Beet root powder Cranberry juice powder Flaxseed powder L-Theanine Vitamin A Strawberry fruit powder Sodium Probiotic Complex Calcium Bromelain Red Raspberry fruit powder Chicory root extract Coconut powder Iron 100% grass-fed Whey Protein concentrate Banana fruit powder Papain

Each ingredient & the kinds of drugs it affects

For each ingredient in Superfood Shake Natural Strawberry 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.

Dietary Fiber7 drug types · 2,025 drugs

Carbamazepine (Tegretol)

Theoretically, black psyllium might reduce the effects of carbamazepine and increase the risk for convulsions.
Theoretically, black psyllium might reduce carbamazepine absorption. A preliminary study using blond psyllium reported decreased carbamazepine bioavailability due to binding of the drug to psyllium, as well as reduction of available fluid in the gut for dissolution of the drug. This interaction may also occur with black psyllium.

Likelihood Probable Evidence D
Lithium

Theoretically, taking black psyllium at the same time as lithium might reduce lithium absorption.
The fiber in black psyllium might reduce lithium absorption and plasma levels. Some case reports describe a reduction in plasma lithium levels with concomitant administration of blond psyllium. This was reversed when psyllium was stopped. This interaction may also occur with black psyllium.

Likelihood Probable Evidence D
Metformin (Glucophage)

Theoretically, black psyllium might increase the therapeutic and adverse effects of metformin.
Animal research shows that concurrent consumption of blond psyllium with metformin slows and increases the absorption of metformin. This interaction may also occur with black psyllium. To avoid changes in absorption, take psyllium 30-60 minutes after metformin.

Likelihood Possible Evidence D
Olanzapine (Zyprexa)

Theoretically, taking black psyllium at the same time as olanzapine might reduce olanzapine absorption.
The fiber in black psyllium might decrease the absorption of olanzapine. A single case report describes a reduction in the effectiveness of olanzapine when it was concomitantly administered with an unspecified type of psyllium 3 grams orally twice daily. This effect was reversed when psyllium was stopped.

Likelihood Possible Evidence D
Digoxin (Lanoxin)

Theoretically, taking black psyllium at the same time as digoxin might reduce digoxin absorption and decrease digoxin levels.
Psyllium might bind digoxin in the gut. However, some clinical evidence suggests that psyllium does not impact digoxin absorption.

Likelihood Unlikely Evidence B
Ethinyl Estradiol

Theoretically, taking black psyllium at the same time as ethinyl estradiol might alter levels of estradiol.
Concurrent use of blond psyllium with ethinyl estradiol results in a slight increase in the extent of ethinyl estradiol absorption and a slower rate of absorption. This is unlikely to be clinically significant.

Likelihood Unlikely Evidence D
Oral Drugs

Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Psyllium seems to have variable effects on drug absorption. To avoid changes in absorption, take psyllium 30-60 minutes after oral medications. Animal research shows that blond psyllium delays and increases the absorption of metformin and ethinyl estradiol. Case reports and animal research suggest that blond psyllium might reduce absorption of lithium, digoxin, olanzapine, and carbamazepine. Finally, some pharmacokinetic studies show that psyllium does not affect the absorption of levothyroxine or warfarin. Although many of these studies evaluated blond psyllium, the fiber content in black psyllium may have similar effects.

Likelihood Possible Evidence B
Dietary Fiber full monograph & interactions

Bacopa herb extract8 drug types · 930 drugs

Anticholinergic Drugs

Theoretically, concurrent use might decrease the effectiveness of both agents.
Bacopa seems to inhibit acetylcholinesterase and might increase acetylcholine levels, which could counteract the effects of anticholinergic drugs. Similarly, anticholinergic drugs might counteract the cholinergic effects of bacopa.

Likelihood Possible Evidence D
Cevimeline (Evoxac)

Theoretically, bacopa might increase the effects and adverse effects of cevimeline.
In one case, a 58-year-old female taking cevimeline long-term for Sjogren syndrome experienced hyperhidrosis, malaise, nausea, and tachycardia shortly after taking a single dose of bacopa. Symptoms resolved after two days. Cevimeline is metabolized by cytochrome P450 (CYP) 2D6 and CYP3A4, and researchers theorize that bacopa may have inhibited these isoenzymes. However, it is unclear if bacopa causes clinically significant inhibition of either CYP2D6 or CYP3A4.

Likelihood Possible Evidence D
Cholinergic Drugs

Theoretically, concurrent use of bacopa with other cholinergic drugs might have additive effects.
Bacopa seems to inhibit acetylcholinesterase and might increase acetylcholine levels. Theoretically, this could result in additive cholinergic effects when used with cholinergic drugs.

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

Theoretically, bacopa might increase the levels and adverse effects of CYP1A2 substrates.
Research on the effects of bacopa extracts on CYP1A2 enzymes is conflicting. Some in vitro evidence shows that bacopa extract can moderately and non-competitively inhibit CYP1A2, while other in vitro evidence suggests that any effect is unlikely to be clinically significant.

Likelihood Possible Evidence D
Cytochrome P450 2C19 (Cyp2C19) Substrates

Theoretically, bacopa might increase the levels and adverse effects of CYP2C19 substrates.
In vitro evidence suggests that bacopa extract can moderately and non-competitively inhibit CYP2C19 enzymes. It is not known whether this is clinically significant.

Likelihood Possible Evidence D
Cytochrome P450 2C9 (Cyp2C9) Substrates

Theoretically, bacopa might increase the levels and adverse effects of CYP2C9 substrates.
Research on the effect of bacopa extracts on CYP2C9 enzymes is conflicting. Some in vitro evidence suggests that bacopa extract can moderately and non-competitively inhibit CYP2C9, while other in vitro evidence suggests that any effect is unlikely to be clinically significant.

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

Theoretically, bacopa might increase the levels and adverse effects of CYP3A4 substrates.
Research on the effects of bacopa extracts on CYP3A4 enzymes is conflicting. Some in vitro evidence suggests that bacopa extract can moderately and competitively inhibit CYP3A4, while other in vitro evidence suggests that any effect is unlikely to be clinically significant.

Likelihood Possible Evidence D
Thyroid Hormone

Theoretically, bacopa might have additive effects when used with thyroid hormone.
Animal research suggests that bacopa increases thyroxine (T4) levels in mice by about 40%.

Likelihood Possible Evidence D
Bacopa herb extract full monograph & interactions

Beet root powder3 drug types · 861 drugs

Cytochrome P450 3A4 (Cyp3A4) Substrates

Theoretically, beet might increase the levels of CYP3A4 substrates.
In vitro research suggests that betanin, the major pigment in beet, competitively inhibits CYP3A4 in a dose-dependent manner similarly to strong CYP3A4 inhibitor ketoconazole.

Likelihood Possible Evidence D
Antihypertensive Drugs

Beet and beetroot contain nitrates, which can cause vasodilation, potentially leading to lower blood pressure. However, a study published in the European Journal of Clinical Nutrition using concentrated beetroot juice found no significant impact on blood pressure or heart rate in different age groups. Other small clinical studies suggest that while beet consumption might transiently lower blood pressure due to vessel dilation, there's no consistent evidence of a lasting effect. Overall, the theoretical risk of reduced blood pressure due to beet's nitrate content exists, but studies generally indicate a low and temporary impact rather than a sustained decrease.

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

Theoretically, beet might decrease the levels and clinical effects of CYP1A2 substrates.
In vitro research suggests that beet induces CYP1A2 enzymes.

Likelihood Possible Evidence D
Beet root powder full monograph & interactions

Cranberry juice powder6 drug types · 712 drugs

Atorvastatin (Lipitor)

Theoretically, cranberry might increase levels and adverse effects of atorvastatin.
In one case report, a patient taking atorvastatin experienced upper back pain, rhabdomyolysis, and abnormal liver function after drinking cranberry juice 16 ounces daily for 2 weeks. Theoretically, this may have been caused by inhibition of cytochrome P450 3A4 (CYP3A4) enzymes by cranberry juice, as atorvastatin is a CYP3A4 substrate. Creatinine kinase and liver enzymes normalized within 2 weeks of stopping cranberry juice. Patients taking atorvastatin should avoid large quantities of cranberry juice.

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

Theoretically, cranberry might increase the levels and adverse effects of CYP3A4 substrates.
A case of upper back pain, rhabdomyolysis, and abnormal liver function has been reported for a patient taking atorvastatin, a CYP3A4 substrate, in combination with cranberry juice 16 ounces daily for 2 weeks. Creatinine kinase and liver enzymes normalized within 2 weeks of stopping cranberry juice. Also, animal research suggests that cranberry juice, administered intraduodenally 30 minutes prior to nifedipine, a CYP3A4 substrate, inhibits nifedipine metabolism and increases the area under the concentration-time curve by 1.6-fold compared to control.

Likelihood Possible Evidence D
Nifedipine (Procardia)

Theoretically, cranberry might increase the levels and adverse effects of nifedipine.
Animal research suggests that cranberry juice, administered intraduodenally 30 minutes prior to nifedipine treatment, inhibits nifedipine metabolism and increases the area under the concentration-time curve by 1.6-fold compared to control. This interaction has not been reported in humans.

Likelihood Possible Evidence D
Warfarin (Coumadin)

Theoretically, cranberry might increase the levels and adverse effects of warfarin. However, research is conflicting.
There is contradictory evidence about the effect of cranberry juice on warfarin. Case reports have linked cranberry juice consumption to increases in the international normalized ratio (INR) in patients taking warfarin, resulting in severe spontaneous bleeding and excessive postoperative bleeding. Daily consumption of cranberry sauce for one week has also been linked to an increase in INR in one case report. In a small study in healthy young males, taking a high dose of 3 grams of cranberry juice concentrate capsules, equivalent to 57 grams of fruit daily, for 2 weeks produced a 30% increase in the area under the INR-time curve after a single 25-mg dose of warfarin. However, 3 very small clinical studies in patients stabilized on warfarin reported that cranberry juice 250 mL once or twice daily for 7 days (27% cranberry juice or pure cranberry juice) or 240 mL once daily for 14 days does not significantly increase INR or affect plasma warfarin levels. The reasons for these discrepant findings are unclear. It is possible that the form and dose of cranberry may play a role, as cranberry extracts and juices contain different constituents. Additionally, an in vitro study evaluating 5 different cranberry juices found varying effects, with only a cranberry concentrate, and not diluted cranberry juices, inhibiting CYP2C9. However, this concentrate did not inhibit CYP2C9 activity in humans.

Likelihood Possible Evidence B
Cytochrome P450 2C9 (Cyp2C9) Substrates

Theoretically, cranberry might increase the levels and adverse effects of CYP2C9 substrates. However, research is conflicting.
There is contradictory evidence about the effect of cranberry on CYP2C9 enzymes. In vitro evidence suggests that flavonoids in cranberry inhibit CYP2C9 enzymes. However, clinical research shows that cranberry juice does not significantly affect the levels, metabolism, or elimination of the CYP2C9 substrates flurbiprofen or diclofenac. Also, in patients stabilized on warfarin, drinking cranberry juice 250 mL daily for 7 days does not significantly increase the anticoagulant activity of warfarin, a CYP2C9 substrate. Additional pharmacokinetic research shows that cranberry juice does not increase peak plasma concentrations or area under the concentration-time curve of warfarin.

Likelihood Unlikely Evidence B
Diclofenac (Voltaren, Others)

Theoretically, cranberry might modestly increase the levels and adverse effects of diclofenac.
In vitro evidence suggests that cranberry juice inhibits diclofenac metabolism by human liver microsomes. However, drinking cranberry juice does not seem to affect diclofenac metabolism in humans.

Likelihood Unlikely Evidence B
Cranberry juice powder full monograph & interactions

Flaxseed powder5 drug types · 597 drugs

Antibiotic Drugs

Theoretically, antibiotics might interfere with the metabolism of flaxseed constituents, which could potentially alter the effects of flaxseed.
Some potential benefits of flaxseed are thought to be due to its lignan content. Secoisolariciresinol diglucoside (SDG), a major lignan precursor, is found in high concentrations in flaxseed. SDG is converted by bacteria in the colon to the lignans enterolactone and enterodiol. Antibiotics alter the flora of the colon, which could theoretically alter the metabolism of flaxseed.

Likelihood Possible Evidence D
Anticoagulant/Antiplatelet Drugs

Theoretically, using flaxseed in combination with anticoagulant or antiplatelet drugs might have additive effects and increase the risk of bleeding.
Some clinical evidence suggests that the oil contained in flaxseed can decrease platelet aggregation.

Likelihood Possible Evidence B
Antidiabetes Drugs

Theoretically, flaxseed might have additive effects when used with antidiabetes drugs and increase the risk for hypoglycemia.
Some clinical research suggests that flaxseed can lower blood glucose levels.

Likelihood Probable Evidence B
Antihypertensive Drugs

Theoretically, flaxseed might have additive effects when used with antihypertensive drugs and increase the risk of hypotension.
Clinical research shows that daily flaxseed consumption, especially for longer than 12 weeks, modestly reduces blood pressure.

Likelihood Possible Evidence D
Estrogens

Theoretically, taking flaxseed might decrease the effects of estrogens.
Flaxseed contains lignans with mild estrogenic and possible antiestrogenic effects. The lignans seem to compete with circulating endogenous estrogen and might reduce estrogen binding to estrogen receptors, resulting in an anti-estrogen effect. It is unclear if this effect transfers to exogenously administered estrogens.

Likelihood Possible Evidence D
Flaxseed powder full monograph & interactions

L-Theanine3 drug types · 565 drugs

Antihypertensive Drugs

Theanine might lower blood pressure, potentiating the effects of antihypertensive drugs.
Animal research shows that theanine can lower blood pressure in spontaneously hypertensive animals. Theoretically, concomitant use of theanine and antihypertensive drugs might potentiate the antihypertensive activity.

Likelihood Possible Evidence D
Cns Depressants

Theoretically, theanine might have additive sedative effects when used in conjunction with CNS depressants. However, it is unclear if this concern is clinically relevant.
Theoretically, theanine may compete with glutamate and/or increase plasma gamma-aminobutyric acid (GABA) levels, which could cause CNS depression. In one clinical study, some subjects taking oral theanine reported drowsiness.

Likelihood Unlikely Evidence D
Serotonergic Drugs

Clinical studies regarding the effects of L-theanine on serotonin levels are conflicting. Some studies suggest it can increase serotonin levels in the brain while others report that it may decrease them. Nevertheless, there have been no reports of l-theanine being a causative agent in serotonergic-related side effects or serotonin syndrome.

Likelihood Unlikely Evidence C
L-Theanine full monograph & interactions

Vitamin A4 drug types · 387 drugs

Retinoids

Concomitant use of retinoids with vitamin A supplements might produce supratherapeutic vitamin A levels.
Retinoids, which are vitamin A derivatives, could have additive toxic effects when taken with vitamin A supplements.

Likelihood Probable Evidence D
Hepatotoxic Drugs

Theoretically, taking high doses of vitamin A in combination with other potentially hepatotoxic drugs might increase the risk of liver disease.
The tolerable upper intake level (UL) is the highest level of intake that is likely to pose no risk of adverse effects. Doses of vitamin A above the UL can cause hepatotoxicity, ranging from elevated liver enzymes to liver failure.

Likelihood Possible Evidence C
Tetracycline Antibiotics

Theoretically, taking tetracycline antibiotics with high doses of vitamin A can increase the risk of pseudotumor cerebri.
Benign intracranial hypertension (pseudotumor cerebri) can occur with tetracyclines and with acute or chronic vitamin A toxicity. Case reports suggest that taking tetracyclines and vitamin A concurrently can increase the risk of this condition. Avoid high doses of vitamin A in people taking tetracyclines chronically.

Likelihood Possible Evidence D
Warfarin (Coumadin)

Theoretically, high doses of vitamin A could increase the risk of bleeding with warfarin.
Vitamin A toxicity is associated with hemorrhage and hypoprothrombinemia, possibly due to vitamin K antagonism. Advise patients taking warfarin to avoid doses of vitamin A above the tolerable upper intake level of 10,000 IU/day for adults.

Likelihood Possible Evidence D
Vitamin A full monograph & interactions

Strawberry fruit powder2 drug types · 316 drugs

Anticoagulant/Antiplatelet Drugs

In vitro and animal research suggests that strawberry extract can inhibit platelet aggregation due to its phenolic content. Theoretically, strawberry might increase the risk of bleeding when used with antiplatelet or anticoagulant drugs.
Some anticoagulant or antiplatelet drugs include aspirin, clopidogrel (Plavix), dalteparin (Fragmin), enoxaparin (Lovenox), heparin, ticlopidine (Ticlid), warfarin (Coumadin), and others.

Likelihood Possible Evidence D
P-Glycoprotein Substrates

In vitro research suggests that strawberry extract can inhibit p-glycoprotein efflux. Theoretically, strawberry might inhibit p-glycoprotein mediated drug efflux and potentially increase levels of drugs that are substrates of p-glycoprotein. Until more is known, strawberry should be used cautiously in people taking p-glycoprotein substrates.
Drugs that might be affected include some chemotherapeutic agents (etoposide, paclitaxel, vinblastine, vincristine, vindesine), antifungals (ketoconazole, itraconazole), protease inhibitors (amprenavir, indinavir, nelfinavir, saquinavir), H2 antagonists (cimetidine, ranitidine), some calcium channel blockers (diltiazem, verapamil), corticosteroids, erythromycin, cisapride (Propulsid), fexofenadine (Allegra), cyclosporine, loperamide (Imodium), quinidine, and others.

Likelihood Possible Evidence D
Strawberry fruit powder full monograph & interactions

Sodium7 drug types · 205 drugs

Antihypertensive Drugs

Theoretically, a high intake of dietary sodium might reduce the effectiveness of antihypertensive drugs.
High intake of dietary sodium can increase systolic and diastolic blood pressure. Also, high intake of sodium may necessitate increased use of antihypertensive medications to achieve blood pressure control in some patients, such as those with chronic kidney disease.

Likelihood Probable Evidence A
Corticosteroids

Concomitant use of mineralocorticoids and some glucocorticoids with sodium supplements might increase the risk of hypernatremia.
Mineralocorticoids and some glucocorticoids (corticosteroids) cause sodium retention. This effect is dose-related and depends on mineralocorticoid potency. It is most common with hydrocortisone, cortisone, and fludrocortisone, followed by prednisone and prednisolone.

Likelihood Possible Evidence D
Didanosine (Videx)

Concomitant use of didanosine with additional sodium from dietary or supplemental sources may increase the risk of hypernatremia.
Didanosine formulations contain a significant amount of sodium.

Likelihood Probable Evidence C
Lithium

Altering dietary intake of sodium might alter the levels and clinical effects of lithium.
High sodium intake can reduce plasma concentrations of lithium by increasing lithium excretion. Reducing sodium intake can significantly increase plasma concentrations of lithium and cause lithium toxicity in patients being treated with lithium carbonate. Stabilizing sodium intake is shown to reduce the percentage of patients with lithium level fluctuations above 0.8 mEq/L. Patients taking lithium should avoid significant alterations in their dietary intake of sodium.

Likelihood Probable Evidence B
Sodium Phosphates

Theoretically, concomitant use of sodium phosphate with sodium supplements might increase the risk of hypernatremia.
Use of high doses (> 45 mL in 24 hours) of sodium phosphate, such as those used for bowel cleansing before surgery, can lead to serious electrolyte disturbances, including hypernatremia. The risk of hypernatremia is highest in the elderly and people with other risk factors for electrolyte disturbances.

Likelihood Possible Evidence D
Sodium-Containing Drugs

Concomitant use of sodium-containing drugs with additional sodium from dietary or supplemental sources may increase the risk of hypernatremia and long-term sodium-related complications.
The Chronic Disease Risk Reduction (CDRR) intake level of 2.3 grams of sodium daily indicates the intake at which it is believed that chronic disease risk increases for the apparently healthy population. Some medications contain high quantities of sodium. When used in conjunction with sodium supplements or high-sodium diets, the CDRR may be exceeded. Additionally, concomitant use may increase the risk for hypernatremia; this risk is highest in the elderly and people with other risk factors for electrolyte disturbances.

Likelihood Possible Evidence D
Tolvaptan (Samsca)

Theoretically, concomitant use of tolvaptan with sodium might increase the risk of hypernatremia.
Tolvaptan is a vasopressin receptor 2 antagonist that is used to increase sodium levels in patients with hyponatremia. Patients taking tolvaptan should use caution with the use of sodium salts such as sodium chloride.

Likelihood Probable Evidence C
Sodium full monograph & interactions

Probiotic Complex1 drug type · 182 drugs

Antibiotic Drugs

Theoretically, taking Lactobacillus acidophilus with antibiotic drugs might decrease the effectiveness of L. acidophilus.
L. acidophilus preparations usually contain live and active organisms. Therefore, simultaneously taking antibiotics might kill a significant number of the organisms. Tell patients to separate administration of antibiotics and L. acidophilus preparations by at least two hours.

Likelihood Probable Evidence D
Probiotic Complex full monograph & interactions

Calcium18 drug types · 168 drugs

Ceftriaxone (Rocephin)

Co-administration of intravenous calcium and ceftriaxone can result in precipitation of a ceftriaxone-calcium salt in the lungs and kidneys.
Avoid administering intravenous calcium in any form, such as parenteral nutrition or Lactated Ringers, within 48 hours of intravenous ceftriaxone. Case reports in neonates show that administering intravenous ceftriaxone and calcium can result in precipitation of a ceftriaxone-calcium salt in the lungs and kidneys. In several cases, neonates have died as a result of this interaction. So far there are no reports in adults; however, there is still concern that this interaction might occur in adults.

Likelihood Probable Evidence D
Dolutegravir (Tivicay)

Calcium seems to reduce levels of dolutegravir.
Advise patients to take dolutegravir either 2 hours before or 6 hours after taking calcium supplements. Pharmacokinetic research suggests that taking calcium carbonate 1200 mg concomitantly with dolutegravir 50 mg reduces plasma levels of dolutegravir by almost 40%. Calcium appears to decrease levels of dolutegravir through chelation.

Likelihood Probable Evidence B
Elvitegravir (Vitekta)

Calcium seems to reduce levels of elvitegravir.
Advise patients to take elvitegravir either 2 hours before or 2 hours after taking calcium supplements. Pharmacokinetic research suggests that taking calcium along with elvitegravir can reduce blood levels of elvitegravir through chelation.

Likelihood Probable Evidence B
Aluminum

Calcium citrate might increase aluminum absorption and toxicity. Other types of calcium do not increase aluminum absorption.
Calcium citrate can increase the absorption of aluminum when taken with aluminum hydroxide. The increase in aluminum levels may become toxic, particularly in individuals with kidney disease. However, the effect of calcium citrate on aluminum absorption is due to the citrate anion rather than calcium cation. Calcium acetate does not appear to increase aluminum absorption.

Likelihood Possible Evidence B
Bictegravir/Emtricitabine/Tenofovir Alafenamide (Biktarvy)

Calcium might decrease levels of bictegravir/emtricitabine/tenofovir alafenamide by reducing its absorption when taken in a fasting state.
Advise patients that bictegravir/emtricitabine/tenofovir alafenamide and calcium can be taken together if taken with food. However, if taken on an empty stomach, bictegravir/emtricitabine/tenofovir alafenamide should not be taken with, or 2 hours after, calcium containing products.

Likelihood Probable Evidence D
Bisphosphonates

Calcium reduces the absorption of bisphosphonates.
Advise patients to take bisphosphonates at least 30 minutes before calcium, but preferably at a different time of day. Calcium supplements decrease absorption of bisphosphonates.

Likelihood Probable Evidence C
Calcipotriene (Dovonex)

Taking calcipotriene with calcium might increase the risk for hypercalcemia.
Calcipotriene is a vitamin D analog used topically for psoriasis. It can be absorbed in sufficient amounts to cause systemic effects, including hypercalcemia. Theoretically, combining calcipotriene with calcium supplements might increase the risk of hypercalcemia.

Likelihood Possible Evidence B
Digoxin (Lanoxin)

Using intravenous calcium with digoxin might increase the risk of fatal cardiac arrhythmias.
Hypercalcemia increases the risk of fatal cardiac arrhythmias with digoxin. However, one retrospective analysis of clinical data suggests that intravenous calcium does not increase the risk of dysrhythmias or mortality in patients receiving digoxin.

Likelihood Possible Evidence B
Diltiazem (Cardizem, Others)

Theoretically, calcium may reduce the therapeutic effects of diltiazem.
Hypercalcemia can reduce the effectiveness of verapamil in atrial fibrillation. Theoretically, calcium might increase this risk of hypercalcemia and reduce the effectiveness of diltiazem.

Likelihood Probable Evidence D
Levothyroxine (Synthroid, Others)

Calcium seems to reduce the absorption and effectiveness of levothyroxine.
Advise patients to take levothyroxine and calcium supplements at least 4 hours apart. Calcium reduces levothyroxine absorption, probably by forming insoluble complexes. Calcium carbonate supplements reduce effectiveness of levothyroxine in patients with hypothyroidism.

Likelihood Probable Evidence B
Lithium

Theoretically, concomitant use of calcium and lithium may increase this risk of hypercalcemia.
Clinical research suggests that long-term use of lithium may cause hypercalcemia in 10% to 60% of patients. Theoretically, concomitant use of lithium and calcium supplements may further increase this risk.

Likelihood Possible Evidence B
Quinolone Antibiotics

Calcium seems to reduce the absorption of quinolone antibiotics.
Advise patients to take oral quinolones at least 2 hours before or 4-6 hours after calcium supplements or calcium-fortified foods. Taking calcium at the same time as oral quinolones can reduce quinolone absorption. Calcium binds to quinolones in the gut.

Likelihood Probable Evidence B
Raltegravir (Isentress)

Calcium may reduce levels of raltegravir.
Pharmacokinetic research shows that taking a single dose of calcium carbonate 3000 mg along with raltegravir 400 mg twice daily modestly decreases the mean area under the curve of raltegravir, but the decrease does not necessitate a dose adjustment of raltegravir. However, a case of elevated HIV-1 RNA levels and documented resistance to raltegravir has been reported for a patient taking calcium carbonate 1 gram three times daily plus vitamin D3 (cholecalciferol) 400 IU three times daily in combination with raltegravir 400 mg twice daily for 11 months. It is thought that calcium reduced raltegravir levels by chelation, leading to treatment failure.

Likelihood Possible Evidence B
Sotalol (Betapace)

Calcium seems to reduce the absorption of sotalol.
Advise patients to separate doses by at least 2 hours before or 4-6 hours after calcium. Calcium appears to reduce the absorption of sotalol, probably by forming insoluble complexes.

Likelihood Possible Evidence B
Tetracycline Antibiotics

Calcium seems to reduce the absorption of tetracycline antibiotics.
Advise patients to take oral tetracyclines at least 2 hours before, or 4-6 hours after calcium supplements. Taking calcium at the same time as oral tetracyclines can reduce tetracycline absorption. Calcium binds to tetracyclines in the gut.

Likelihood Probable Evidence C
Thiazide Diuretics

Taking calcium along with thiazides might increase the risk of hypercalcemia and renal failure.
Thiazides reduce calcium excretion by the kidneys. Using thiazides along with moderately large amounts of calcium carbonate increases the risk of milk-alkali syndrome (hypercalcemia, metabolic alkalosis, renal failure). Patients may need to have their serum calcium levels and/or parathyroid function monitored regularly.

Likelihood Probable Evidence C
Verapamil (Calan, Others)

Theoretically, calcium may reduce the therapeutic effects of verapamil.
Hypercalcemia can reduce the effectiveness of verapamil in atrial fibrillation. Theoretically, use of calcium supplements may increase this risk of hypercalcemia and reduce the effectiveness of verapamil.

Likelihood Probable Evidence D
Calcium Channel Blockers

Intravenous calcium may decrease the effects of calcium channel blockers; oral calcium is unlikely to have this effect.
Intravenous calcium is used to decrease the effects of calcium channel blockers in the management of overdose. Intravenous calcium gluconate has been used before intravenous verapamil (Isoptin) to prevent or reduce the hypotensive effects without affecting the antiarrhythmic effects. But there is no evidence that dietary or supplemental calcium when taken orally interacts with calcium channel blockers.

Likelihood Unlikely Evidence D
Calcium full monograph & interactions

Bromelain2 drug types · 141 drugs

Anticoagulant/Antiplatelet Drugs

Bromelain may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
There is one case report of a patient experiencing minor bruising while taking bromelain with naproxen. Bromelain is thought to have antiplatelet activity. Whether this interaction is of concern with topical bromelain is unclear. Interference with coagulation of burn wounds has been reported in a patient receiving bromelain-based enzymatic debridement. However, observational research has found that topical bromelain debridement is not associated with increases or decreases in laboratory markers of coagulation when compared with surgical debridement.

Likelihood Possible Evidence D
Tetracycline Antibiotics

Theoretically, bromelain might increase levels of tetracycline antibiotics.
Laboratory research suggests that bromelain might increase the absorption of tetracycline antibiotics. However, a study in healthy adults reported no difference in tetracycline plasma levels when a 500 mg dose was taken with or without bromelain 80 mg.

Likelihood Possible Evidence B
Bromelain full monograph & interactions

Red Raspberry fruit powder2 drug types · 135 drugs

Anticoagulant/Antiplatelet Drugs

Theoretically, taking red raspberry leaf with anticoagulant/antiplatelet drugs might increase the risk of bleeding.
In vitro research suggests that red raspberry leaf extract has antiplatelet activity and enhances the in vitro effects of the antiplatelet medication cangrelor. This interaction has not been reported in humans.

Likelihood Possible Evidence D
Insulin

Red raspberry leaf might reduce glucose levels in patients being treated with insulin.
In one case report, a 38-year-old patient with gestational diabetes, whose blood glucose was being controlled with medical nutrition therapy and insulin, developed hypoglycemia after consuming two servings of raspberry leaf tea daily for 3 days beginning at 32 weeks' gestation. The patient required an insulin dose reduction. The hypoglycemia was considered to be probably related to use of red raspberry leaf tea.

Likelihood Possible Evidence D
Red Raspberry fruit powder full monograph & interactions

Chicory root extract1 drug type · 86 drugs

Antidiabetes Drugs

Theoretically, chicory might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Animal and in vitro research shows that chicory extracts have antidiabetic effects.

Likelihood Possible Evidence D
Chicory root extract full monograph & interactions

Coconut powder1 drug type · 86 drugs

Antidiabetes Drugs

Theoretically, taking coconut with antidiabetes drugs might increase the risk of hypoglycemia.
Animal research suggests that coconut milk might increase insulin levels and/or decrease blood glucose levels.

Likelihood Unlikely Evidence D
Coconut powder full monograph & interactions

Iron13 drug types · 80 drugs

Bictegravir/Emtricitabine/Tenofovir Alafenamide (Biktarvy)

Iron might decrease levels of bictegravir/emtricitabine/tenofovir alafenamide by reducing its absorption when taken in a fasting state.
Advise patients that bictegravir/emtricitabine/tenofovir alafenamide and iron can be taken together if taken with food. However, if taken on an empty stomach, bictegravir/emtricitabine/tenofovir alafenamide should not be taken with, or 2 hours after, iron containing products.

Likelihood Probable Evidence D
Bisphosphonates

Iron reduces the absorption of bisphosphonates.
Advise patients that doses of bisphosphonates should be separated by at least two hours from doses of all other medications, including supplements such as iron. Divalent cations, including iron, can decrease absorption of bisphosphonates by forming insoluble complexes in the gastrointestinal tract.

Likelihood Probable Evidence D
Denosumab (Prolia, Others)

Administration of intravenous iron within one month of denosumab administration might increase the risk of severe hypophosphatemia and hypocalcemia.
A case of severe hypocalcemia (albumin corrected calcium 6.88 mg/dL, ionized calcium 3.68 mg/dL) and hypophosphatemia (<0.5 mg/dL) with respiratory acidosis, QT interval prolongation, and nonsustained ventricular tachycardia was reported in a 76-year-old male who had received an iron polymaltose infusion within 2 weeks of a subcutaneous injection of denosumab. Serum parathyroid hormone was also elevated (348 pg/mL). Subsequent iron infusions with iron polymaltose and ferric carboxymaltose were followed by transient hypophosphatemia, but without hypocalcemia. Additionally, a literature review describes 6 additional cases of hypophosphatemia and hypocalcemia in patients 52-92 years of age who had been administered intravenous iron as either ferric carboxymaltose or iron polymaltose and subcutaneous denosumab within 1-4 weeks of each other.

Likelihood Possible Evidence D
Dolutegravir (Tivicay)

Iron might decrease dolutegravir levels by reducing its absorption.
Advise patients to take dolutegravir at least 2 hours before or 6 hours after taking iron. Pharmacokinetic research shows that iron can decrease the absorption of dolutegravir from the gastrointestinal tract through chelation. When taken under fasting conditions, a single dose of ferrous fumarate 324 mg orally along with dolutegravir 50 mg reduces overall exposure to dolutegravir by 54%.

Likelihood Probable Evidence B
Integrase Inhibitors

Theoretically, taking iron along with integrase inhibitors might decrease the levels and clinical effects of these drugs.
Iron is a divalent cation. There is concern that iron may decrease the absorption of integrase inhibitors from the gastrointestinal tract through chelation. One pharmacokinetic study shows that iron can decrease blood levels of the specific integrase inhibitor dolutegravir through chelation. Also, other pharmacokinetic research shows that other divalent cations such as calcium can decrease the absorption and levels of some integrase inhibitors through chelation.

Likelihood Possible Evidence D
Levodopa

Iron might decrease levodopa levels by reducing its absorption.
Advise patients to separate doses of levodopa and iron as much as possible. There is some evidence in healthy people that iron forms chelates with levodopa, reducing the amount of levodopa absorbed by around 50%. The clinical significance of this hasn't been determined.

Likelihood Probable Evidence B
Levothyroxine (Synthroid, Others)

Iron might decrease levothyroxine levels by reducing its absorption.
Advise patients to separate levothyroxine and iron doses by at least 2 hours. Iron can decrease the absorption and efficacy of levothyroxine by forming insoluble complexes in the gastrointestinal tract.

Likelihood Probable Evidence B
Methyldopa (Aldomet)

Iron might decrease methyldopa levels by reducing its absorption.
Advise patients to separate methyldopa and iron doses by at least 2 hours. Iron can decrease the absorption of methyldopa from the gastrointestinal tract through chelation, resulting in increases in blood pressure.

Likelihood Probable Evidence B
Mycophenolate Mofetil (Cellcept)

Theoretically, iron might decrease mycophenolate mofetil levels by reducing its absorption.
Advise patients to take iron 4-6 hours before, or 2 hours after, mycophenolate mofetil. It has been suggested that a decrease of absorption is possible, probably by forming nonabsorbable chelates. However, mycophenolate pharmacokinetics are not affected by iron supplementation in available clinical research.

Likelihood Unlikely Evidence D
Penicillamine (Cuprimine, Depen)

Iron might decrease penicillamine levels by reducing its absorption.
Advise patients to separate penicillamine and iron doses by at least 2 hours. Oral iron supplements can reduce absorption of penicillamine by 30% to 70%, probably due to chelate formation. In people with Wilson's disease, this interaction has led to reduced efficacy of penicillamine.

Likelihood Probable Evidence D
Quinolone Antibiotics

Iron might decrease levels of quinolone antibiotics by reducing their absorption.
Advise patients to separate quinolone antibiotics and iron doses by at least 2 hours. Iron decreases the absorption of quinolones due to formation of insoluble complexes in the gastrointestinal tract.

Likelihood Probable Evidence D
Tetracycline Antibiotics

Iron might decrease levels of tetracycline antibiotics by reducing their absorption.
Advise patients to take iron at least 2 hours before or 4 hours after tetracycline antibiotics. Concomitant use can decrease absorption of tetracycline antibiotics from the gastrointestinal tract by 50% to 90%.

Likelihood Probable Evidence D
Chloramphenicol

Theoretically, taking chloramphenicol with iron might reduce the response to iron therapy in iron deficiency anemia.
Chloramphenicol interferes with erythrocyte maturation. However, since chloramphenicol isn't usually taken for prolonged periods, this isn't likely to be clinically significant.

Likelihood Unlikely Evidence D
Iron full monograph & interactions

100% grass-fed Whey Protein concentrate4 drug types · 53 drugs

Levodopa

Theoretically, whey protein might decrease levodopa absorption.
Small clinical studies show that concomitant ingestion of protein or high doses of leucine or isoleucine (100 mg/kg) and levodopa can exacerbate tremor, rigidity, and the "on-off" syndrome in patients with Parkinson disease.

Likelihood Probable Evidence D
Bisphosphonates

Theoretically, whey protein might reduce the absorption of bisphosphonates.
Whey protein contains minerals such as calcium that bind bisphosphonates in the gut. Advise patients to take bisphosphonates at least 30 minutes before whey protein, but preferably at a different time of day.

Likelihood Probable Evidence D
Quinolone Antibiotics

Theoretically, whey protein might decrease quinolone absorption.
Whey protein contains minerals, such as calcium, that can bind to quinolones in the gut. To avoid this interaction, advise patients to take oral quinolones at least 2 hours before or 4-6 hours after whey protein.

Likelihood Probable Evidence D
Tetracycline Antibiotics

Theoretically, whey protein might decrease tetracycline absorption.
Whey protein contains minerals, such as calcium, that bind to tetracyclines in the gut. To avoid this interaction, advise patients to take oral tetracyclines at least 2 hours before or 4-6 hours after whey protein.

Likelihood Probable Evidence D
100% grass-fed Whey Protein concentrate full monograph & interactions

Banana fruit powder1 drug type · 5 drugs

Levodopa

Taking banana may reduce the effectiveness of levodopa.
A case report describes apparent wearing off in a patient with Parkinson disease after eating a banana every day. The wearing off subsided after removing dietary bananas.

Likelihood Possible Evidence D
Banana fruit powder full monograph & interactions

Papain1 drug type · 2 drugs

Warfarin (Coumadin)

Theoretically, papain might increase the effects and side effects of warfarin.
In one case report, a patient previously stable on warfarin was found to have an international normalization ratio (INR) of 7.4, which was attributed to ingestion of a supplement containing papain from papaya extract.

Likelihood Possible Evidence D
Papain full monograph & interactions
The maker

Brand information

Manufacturer and brand details for Superfood Shake Natural Strawberry, from the product label.

Invigor8

See all Invigor8 products
Name
Biomedical Research Laboratories, LLC
Pharmacist Counseling Corner

Superfood Shake Natural Strawberry by Invigor8: Common Questions

Does Superfood Shake Natural Strawberry by Invigor8 interact with any medications?
Yes. Based on its ingredients, Superfood Shake Natural Strawberry has a known interaction with 2,283 medications, including 21 rated major. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Superfood Shake Natural Strawberry contains 27 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.
Is this safe if I take blood pressure medication?
The sodium in this shake may reduce how well your blood pressure medication works, so it's important to talk with your doctor before adding it. Don't stop your medication—just let your pharmacist know you're using this product so they can help monitor your blood pressure control.
Can I take this if I'm on warfarin or another blood thinner?
Strawberry and flaxseed in this shake may theoretically increase bleeding risk when combined with blood thinners. Papain (an ingredient we have limited data on) also carries a concern. Check with your pharmacist before starting, as you may need your bleeding markers monitored more closely.
Will this help with digestion?
This shake includes digestive enzymes (amylase, lipase, protease) and the probiotic Bifidobacterium bifidum, which may support digestion in some people. However, the evidence for these ingredients' effectiveness in this context is insufficient. If you have a serious digestive condition, check with your doctor before using it.
Is the whey protein in this safe for someone with Parkinson disease?
No—whey protein can significantly reduce absorption of levodopa, the main medication for Parkinson disease, and worsen symptoms. If you take levodopa, do not use this product without talking to your neurologist first.
Does this contain any common allergens?
Yes. This shake contains whey protein (dairy), which can trigger acne in some users. Papain, bromelain, chicory, and coconut may cause allergic reactions in sensitive individuals. If you have food allergies or sensitivities, review the full ingredient list or talk to your pharmacist.
Can I take this if I'm pregnant?
Safety data for many ingredients—including L-theanine, bromelain, bacopa, papain, and banana—are insufficient or advise against use in pregnancy. Vitamin A safety is mixed. Iron and calcium are often recommended in pregnancy but should be dosed by your prenatal care provider. Talk with your OB or pharmacist before using this product.

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

Not sure if Superfood Shake Natural Strawberry is safe with your meds?

Our pharmacists answer your medication & supplement questions — free.

Ask a pharmacist

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.

Superfood Shake Natural Strawberry label
Go deeper

The Full Monographs Behind Superfood Shake Natural Strawberry’s Ingredients

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

Herb & supplement monograph

Black Psyllium

Interacts with 2,025 drugs

Black psyllium is a soluble-fiber supplement made from the seeds of a Plantago plant, used mostly to ease constipation and support digestive health. It is best known and most studied for rel...

Read the full Black Psyllium monograph → Herb & supplement monograph

Sodium

Interacts with 205 drugs

Sodium is an essential mineral and electrolyte your body needs to balance fluids, support nerves, and help muscles work. Most people in modern diets get more than enough—often too much—from...

Read the full Sodium monograph → Herb & supplement monograph

Vitamin A

Interacts with 387 drugs

Vitamin A is an essential nutrient important for vision, skin, immune function, and growth. Most people get enough from a balanced diet, and supplements are mainly useful for correcting a tr...

Read the full Vitamin A monograph → Herb & supplement monograph

Calcium

Interacts with 168 drugs

Calcium is an essential mineral your body needs for strong bones, nerve signaling, and muscle function, and supplements can help fill gaps when diet falls short. Most people do best getting...

Read the full Calcium monograph → Herb & supplement monograph

Iron

Interacts with 80 drugs

Iron is an essential mineral your body needs to make hemoglobin and carry oxygen in the blood. Supplements are mainly useful for treating or preventing iron deficiency and iron-deficiency an...

Read the full Iron monograph → Herb & supplement monograph

Papain

Interacts with 2 drugs

Papain is a protein-digesting enzyme from the papaya plant that is used in digestive supplements and some topical products. While it has clear food and laboratory uses, strong human evidence...

Read the full Papain monograph → Herb & supplement monograph

Bromelain

Interacts with 141 drugs

Bromelain is a group of protein-digesting enzymes from pineapple that people take mainly for inflammation, swelling, and sinus problems. Some early studies are promising, but the overall evi...

Read the full Bromelain monograph → Herb & supplement monograph

Lipase

Lipase is a digestive enzyme that helps your body break down dietary fats. It is well established as part of prescription pancreatic enzyme therapy for people who cannot make enough of their...

Read the full Lipase monograph → Herb & supplement monograph

Lactase

Lactase is a digestive enzyme supplement that helps people who lack enough natural lactase break down lactose, the sugar in milk and dairy. It can reduce gas, bloating, cramping, and diarrhe...

Read the full Lactase monograph → Herb & supplement monograph

Proteolytic Enzymes (proteases)

Proteolytic enzymes are proteins that help break down other proteins, and common examples include bromelain (from pineapple), papain (from papaya), trypsin, chymotrypsin, and pancreatin. Peo...

Read the full Proteolytic Enzymes (proteases) monograph → Herb & supplement monograph

Whey Protein

Interacts with 53 drugs

Whey protein is a high-quality, complete protein made from cow's milk that can help people meet protein needs and support muscle growth when combined with exercise. It is generally safe for...

Read the full Whey Protein monograph → Herb & supplement monograph

Chicory

Interacts with 86 drugs

Chicory is best known as a caffeine-free coffee substitute and as a source of inulin, a soluble prebiotic fiber that may support digestion and regularity. Strong human evidence for most othe...

Read the full Chicory monograph → Herb & supplement monograph

Flaxseed

Interacts with 597 drugs

Flaxseed is a nutritious food rich in fiber, omega-3 fats (ALA), and plant compounds called lignans. It is most reliably helpful for constipation and may modestly lower cholesterol, but evid...

Read the full Flaxseed monograph → Herb & supplement monograph

Chia

Chia seeds are a nutritious whole food rich in fiber, plant-based omega-3 fats (ALA), and protein. They are generally safe as part of a healthy diet, and may modestly help with regularity an...

Read the full Chia monograph → Herb & supplement monograph

Bovine Colostrum

Bovine colostrum is the nutrient-rich first milk from cows, packed with antibodies, growth factors, and protein. Early research suggests it may help with gut health, certain types of diarrhe...

Read the full Bovine Colostrum monograph → Herb & supplement monograph

Theanine

Interacts with 565 drugs

Theanine (usually L-theanine) is an amino acid found naturally in tea leaves that many people take to feel calmer and less stressed without strong drowsiness. Early research suggests it may...

Read the full Theanine monograph → Herb & supplement monograph

Bacopa

Interacts with 930 drugs

Bacopa is an Ayurvedic herb most often used for memory and thinking. Some small studies suggest it may modestly help memory when taken regularly for several weeks, but the evidence is limite...

Read the full Bacopa monograph → Herb & supplement monograph

Lactobacillus Acidophilus

Interacts with 182 drugs

Lactobacillus acidophilus is a 'friendly' bacterium used as a probiotic to support gut and vaginal health. It is generally well tolerated in healthy people, and there is reasonable evidence...

Read the full Lactobacillus Acidophilus monograph → Herb & supplement monograph

Bifidobacterium Bifidum

Interacts with 182 drugs

Bifidobacterium bifidum is a 'friendly' bacteria (probiotic) that naturally lives in the human gut and is taken to support digestion and gut balance. Some evidence suggests probiotics may he...

Read the full Bifidobacterium Bifidum monograph → Herb & supplement monograph

Coconut

Interacts with 86 drugs

Coconut is a nutritious tropical food enjoyed as oil, water, milk, and flesh, and it is generally safe to eat in normal food amounts. While some uses (like skin moisturizing and hydration) h...

Read the full Coconut monograph → Herb & supplement monograph

Beet

Interacts with 861 drugs

Beet, especially beetroot juice, is a nitrate-rich food that may modestly lower blood pressure and slightly improve exercise performance in some people. It is generally safe as a food, but s...

Read the full Beet monograph → Herb & supplement monograph

Red Raspberry

Interacts with 135 drugs

Red raspberry leaf is a traditional herbal remedy most often used as a tea in late pregnancy and for menstrual discomfort, but solid scientific evidence for these uses is limited. It is gene...

Read the full Red Raspberry monograph → Herb & supplement monograph

Cranberry

Interacts with 712 drugs

Cranberry is best known for helping to prevent repeated urinary tract infections (UTIs) in some people, and the evidence here is moderate but mixed. It is not a reliable treatment for an act...

Read the full Cranberry monograph → Herb & supplement monograph

Strawberry

Interacts with 316 drugs

Strawberry is a popular, nutrient-rich fruit that supplies vitamin C, fiber, and antioxidant plant compounds. Eating strawberries as part of a balanced diet is healthy for most people, but c...

Read the full Strawberry monograph → Herb & supplement monograph

Banana

Interacts with 5 drugs

Bananas are a nutritious, widely eaten fruit that provide potassium, fiber, vitamin B6, and quick energy, and they are part of a healthy diet. While some traditional uses (like easing diarrh...

Read the full Banana monograph →
Sources

Sources & How We Checked

Superfood Shake Natural Strawberry'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 485 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 Psyllium 18 references
  1. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
  2. Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.
  3. Covington TR, et al. Handbook of Nonprescription Drugs. 11th ed. Washington, DC: American Pharmaceutical Association, 1996.
  4. Etman M. Effect of a bulk forming laxative on the bioavailablility of carbamazepine in man. Drug Dev Ind Pharm 1995;21:1901-6.
  5. Perlman BB. Interaction between lithium salts and ispaghula husk. Lancet 1990;335:416.
  6. Vaswani SK, Hamilton RG, Valentine MD, Adkinson NF. Psyllium laxative-induced anaphylaxis, asthma, and rhinitis. Allergy 1996;51:266-8. PubMed
  7. Lantner RR, Espiritu BR, Zumerchik P, Tobin MC. Anaphylaxis following ingestion of a psyllium-containing cereal. JAMA 1990;264:2534-6. DOI
  8. Kaplan MJ. Anaphylactic reaction to "Heartwise." N Engl J Med 1990;323:1072-3. DOI
  9. Nordstrom M, Melander A, Robertsson E, Steen B. Influence of wheat bran and of a bulk-forming ispaghula cathartic on the bioavailability of digoxin in geriatric in-patients. Drug Nutr Interact 1987;5:67-9..
  10. Robinson DS, Benjamin DM, McCormack JJ. Interaction of warfarin and nonsystemic gastrointestinal drugs. Clin Pharmacol Ther 1971;12:491-5. PubMed
  11. Garcia JJ, Fernandez N, Diez MJ, et al. Influence of two dietary fibers in the oral bioavailability and other pharmacokinetic parameters of ethinyloestradiol. Contraception 2000;62:253-7. PubMed
  12. Fernandez N, Lopez C, Díez R, et al. Drug interactions with the dietary fiber Plantago ovata husk. Expert Opin Drug Metab Toxicol 2012;8(11):1377-86.
  13. Semen plantaginis in: WHO Monographs on Selected Medicinal Plants, volume 1. World Health Organization, Geneva, 1999. Available at http://apps.who.int/medicinedocs/en/d/Js2200e/. Accessed November 26, 1026.
  14. Code of Federal Regulations, Title 21 (21CFR 101.17). Food labeling warning, notice, and safe handling statements. Available at www.ecfr.gov/cgi-bin/text-idx?SID=20f647d3b74161501f46564b915b4048&mc=true&node=se21.2.101_117&rgn=div8. Accessed December 3, 2
  15. Code of Federal Regulations, Title 21 (21CFR 201.319). Specific labeling requirements - water-soluble gums, hydrophilic gums, and hydrophilic mucilloids. Available at www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?fr=201.319. Accessed Dece
  16. Diez R, Garcia JJ, Diez MJ, Sierra M, Sahagun AM, Fernandez N. Influence of Plantago ovata husk (dietary fiber) on the bioavailability and other pharmacokinetic parameters of metformin in diabetic rabbits. BMC Complement Altern Med. 2017 Jun 7;17(1):298. PubMed
  17. Chiu AC, Sherman SI. Effects of pharmacological fiber supplements on levothyroxine absorption. Thyroid. 1998;8(8):667-71. PubMed
  18. Merrick C, Madden CA, Capurso NA. A Case of Blunted Orally Disintegrating Olanzapine Effect Due to Coadministered Psyllium. J Clin Psychiatry 2021;82(2):20cr13633. PubMed

See these in context on the Black Psyllium monograph →

Sodium 38 references
  1. Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
  2. Food and Drug Administration Science Background: Safety of Sodium Phosphates Oral Solution. September 17, 2001. Available at: http://www.fda.gov/cder/drug/safety/sodiumphospate.htm
  3. Coton T, Mallaret C, Coilliot C, Carre D, Guisset M. Severe acute ulcerated gastritis induced by salt. Presse Med 2009;38(3):499-500. PubMed
  4. Frings-Meuthen P, Buehlmeier J, Baecker N, et al. High sodium chloride intake exacerbates immobilization-induced bone resorption and protein losses. J Appl Physiol 2011;111(2):537-542. PubMed
  5. Frings-Meuthen P, Baecker N, Heer M. Low-grade metabolic acidosis may be the cause of sodium chloride-induced exaggerated bone resorption. J Bone Miner Res 2008;23(4):517-524. PubMed
  6. Alam S, Johnson AG. A meta-analysis of randomised controlled trials (RCT) among healthy normotensive and essential hypertensive elderly patients to determine the effect of high salt (NaCl) diet of blood pressure. J Hum Hypertens 1999;13(6):367-74.
  7. Boudville N, Ward S, Benaroia M, House AA. Increased sodium intake correlates with greater use of antihypertensive agents by subjects with chronic kidney disease. Am J Hypertens 2005;18(10):1300-5. PubMed
  8. Bennett WM. Drug interactions and consequences of sodium restriction. Am J Clin Nutr 1997;65(2 Suppl):678S-681S. PubMed
  9. Okusa MD, Crystal LJ. Clinical manifestations and management of acute lithium intoxication. Am J Med 1994;97(4):383-9. PubMed
  10. Food and Nutrition Board, Institute of Medicine. Dietary reference intakes for water, potassium, sodium, chloride, and sulfate. Washington, DC: National Academy Press, 2005. Available at: http://www.nap.edu/openbook.php?record_id=10925. DOI
  11. D'Elia L, Rossi G, Ippolito R, Cappuccio FP, Strazzullo P. Habitual salt intake and risk of gastric cancer: a meta-analysis of prospective studies. Clin Nutr 2012;31(4):489-98. PubMed
  12. Goldsmith SR. Hyponatremia in heart failure: time for a trial. J Card Fail 2013;19(6):398-400. PubMed
  13. Willocks L, Brettle R, Keen J, Valentine C, Pinching AJ. Formulations of didanosine (ddI) and salt overload. Lancet 1992;339(8786):190.
  14. Chen L, Zhang Z, Chen W, Whelton PK, Appel LJ. Lower Sodium Intake and Risk of Headaches: Results From the Trial of Nonpharmacologic Interventions in the Elderly. Am J Public Health. 2016;106(7):1270-5. PubMed
  15. Cook NR, Appel LJ, Whelton PK. Lower levels of sodium intake and reduced cardiovascular risk. Circulation. 2014;129(9):981-9. PubMed
  16. Cook NR, Appel LJ, Whelton PK. Sodium Intake and All-Cause Mortality Over 20 Years in the Trials of Hypertension Prevention. J Am Coll Cardiol. 2016;68(15):1609-1617. PubMed
  17. Mente A, O'Donnell M, Rangarajan S, et al. Associations of urinary sodium excretion with cardiovascular events in individuals with and without hypertension: a pooled analysis of data from four studies. Lancet. 2016;388(10043):465-75. PubMed
  18. Moosavian SP, Haghighatdoost F, Surkan PJ, Azadbakht L. Salt and obesity: a systematic review and meta-analysis of observational studies. Int J Food Sci Nutr. 2017;68(3):265-277. PubMed
  19. O'Donnell M, Mente A, Rangarajan S, et al. Urinary sodium and potassium excretion, mortality, and cardiovascular events. N Engl J Med. 2014;371(7):612-23. DOI
  20. Poggio R, Gutierrez L, Matta MG, Elorriaga N, Irazola V, Rubinstein A. Daily sodium consumption and CVD mortality in the general population: systematic review and meta-analysis of prospective studies. Public Health Nutr. 2015;18(4):695-704. PubMed
  21. Stallings VA, Harrison M, Oria M; Committee to Review the Dietary Reference Intakes for Sodium and Potassium, Food and Nutrition Board, Health and Medicine Division, National Academies of Sciences, Engineering, and Medicine. Washington (DC): National Acad
  22. Mahtani KR, Heneghan C, Onakpoya I, et al. Reduced Salt Intake for Heart Failure: A Systematic Review. JAMA Intern Med. 2018 Dec 1;178(12):1693-1700. PubMed
  23. Yancy CW. Sodium Restriction in Heart Failure: Too Much Uncertainty-Do the Trials. JAMA Intern Med. 2018 Dec 1;178(12):1700-1701. PubMed
  24. He FJ, Campbell NRC, Ma Y, MacGregor GA, Cogswell ME, Cook NR. Errors in estimating usual sodium intake by the Kawasaki formula alter its relationship with mortality: implications for public health. Int J Epidemiol. 2018;47(6):1784-1795. PubMed
  25. Murthy K, Ondrey GJ, Malkani N, et al. THE EFFECTS OF HYPONATREMIA ON BONE DENSITY AND FRACTURES: A SYSTEMATIC REVIEW AND META-ANALYSIS. Endocr Pract. 2019;25(4):366-378. PubMed
  26. Messerli FH, Hofstetter L, Syrogiannouli L, et al. Sodium intake, life expectancy, and all-cause mortality. Eur Heart J 2021;42(21):2103-2112. PubMed
  27. Graudal NA, Hubeck-Graudal T, Jurgens G. Effects of low sodium diet versus high sodium diet on blood pressure, renin, aldosterone, catecholamines, cholesterol, and triglyceride. Cochrane Database Syst Rev 2020;12(12):CD004022. PubMed
  28. Giatti S, Santos RB, Aielo AN, et al. Association of sodium with obstructive sleep apnea. The ELSA-Brasil study. Ann Am Thorac Soc 2021;18(3):502-510. PubMed
  29. Nan X, Lu H, Wu J, et al. The interactive association between sodium intake, alcohol consumption and hypertension among elderly in northern China: a cross-sectional study. BMC Geriatr 2021;21(1):135. PubMed
  30. Kyozuka H, Fukusda T, Murata T, et al. Impact of preconception sodium intake on hypertensive disorders of pregnancy: The Japan Environment and Children's study. Pregnancy Hypertens 2021;23:66-72. PubMed
  31. Zhao L, Ogden CL, Yang Q, et al. Association of usual sodium intake with obesity among US children and adolescents, NHANES 2009-2016. Obesity (Silver Spring) 2021;29(3):587-594. PubMed
  32. Ma Y, He FJ, Sun Q, et al. 24-Hour urinary sodium and potassium excretion and cardiovascular risk. N Engl J Med 2022;386(3):252-263. PubMed
  33. Liu J, Yang X, Zhang P, et al. Association of urinary sodium excretion and left ventricular hypertrophy in people with type 2 diabetes mellitus: A cross-sectional study. Front Endocrinol (Lausanne) 2021;12:728493. PubMed
  34. Filippini T, Malavolti M, Whelton PK, Vinceti M. Sodium intake and risk of hypertension: A systematic review and dose-response meta-analysis of observational cohort studies. Curr Hypertens Rep 2022;24(5):133-144. PubMed
  35. Wang DD, Li Y, Nguyen XT, et al. Dietary sodium and potassium intake and risk of non-fatal cardiovascular diseases: The million veteran program. Nutrients 2022;14(5):1121. PubMed
  36. Kwak JH, Park CH, Eun CS, et al. The associations of dietary intake of high sodium and low zinc with gastric cancer mortality: A prospective cohort study in Korea. Nutr Cancer 2022;74(10):3501-3508. PubMed
  37. George S, Maiti R, Mishra BR, Jena M, Mohapatra D. Effect of regulated add-on sodium chloride intake on stabilization of serum lithium concentration in bipolar disorder: A randomized controlled trial. Bipolar Disord 2023;25(1):66-75. PubMed
  38. Zhou TL, Schütten MTJ, Kroon AA, et al. Urinary Sodium Excretion and Salt Intake Are Not Associated With Blood Pressure Variability in a White General Population. J Am Heart Assoc 2023;12(1):e026578. PubMed

See these in context on the Sodium monograph →

Vitamin A 31 references
  1. McEvoy GK, ed. AHFS Drug Information. Bethesda, MD: American Society of Health-System Pharmacists, 1998.
  2. Griffiths JK. The vitamin A paradox. J Pediatr 2000;137:604-7.. PubMed
  3. Hardman JG, Limbird LL, Molinoff PB, eds. Goodman and Gillman's The Pharmacological Basis of Therapeutics, 9th ed. New York, NY: McGraw-Hill, 1996.
  4. Hansten PD, Horn JR. Drug Interactions Analysis and Management. Vancouver, WA: Applied Therapeutics Inc., 1997 and updates.
  5. FDA Talk Paper. Vitamin A and birth defects (T95-56). Food and Drug Administration, U.S. Department of Health and Human Services, Rockville, MD. October 6, 1995.
  6. Russell RM. The vitamin A spectrum: from deficiency to toxicity. Am J Clin Nutr 2000;71:878-84. PubMed
  7. 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.
  8. Feskanich D, Singh V, Willett WC, Colditz GA. Vitamin A intake and hip fractures among postmenopausal women. JAMA 2002;287:47-54. PubMed
  9. Melhus H, Michaelsson K, Kindmark A, et al. Excessive dietary intake of vitamin A is associated with reduced bone mineral density and increased risk for hip fracture. Ann Intern Med 1998;129:770-8. PubMed
  10. Michaelsson K, Lithell H, Vessby B, Melhus H. Serum retinol levels and the risk of fracture. N Engl J Med 2003;348:287-94.. PubMed
  11. Botterweck AA, van den Brandt PA, Goldbohm RA. Vitamins, carotenoids, dietary fiber, and the risk of gastric carcinoma: results from a prospective study after 6.3 years of follow-up. Cancer 2000;88:737-48.. DOI
  12. Meyskens FL Jr, Graham V, Chvapil M, et al. A phase I trial of beta-all-trans-retinoic acid delivered via a collagen sponge and a cervical cap for mild or moderate intraepithelial cervical neoplasia. J Natl Cancer Inst 1983;71:921-5..
  13. Hathcock JN, Hattan DG, Jenkins MY, et al. Evaluation of vitamin A toxicity. Am J Clin Nutr 1990;52:183-202.. PubMed
  14. Walters BN, Gubbay SS. Tetracycline and benign intracranial hypertension: report of five cases. Br Med J 1981;282:19-20.. PubMed
  15. Pearson MG, Littlewood SM, Bowden AN. Tetracycline and benign intracranial hypertension (letter). Br Med J 1981;282:568-9.. PubMed
  16. Azais-Braesco V, Pascal G. Vitamin A in pregnancy: requirements and safety limits. Am J Clin Nutr 2000;71:1325S-33S. PubMed
  17. Smedts HP, de Vries JH, Rakhshandehroo M, et al. High maternal vitamin E intake by diet or supplements is associated with congenital heart defects in the offspring. BJOG 2009;116:416-23. PubMed
  18. Grotto, I., Mimouni, M., Gdalevich, M., and Mimouni, D. Vitamin A supplementation and childhood morbidity from diarrhea and respiratory infections: a meta-analysis. J Pediatr 2003;142(3):297-304. PubMed
  19. Mahalanabis, D., Lahiri, M., Paul, D., Gupta, S., Gupta, A., Wahed, M. A., and Khaled, M. A. Randomized, double-blind, placebo-controlled clinical trial of the efficacy of treatment with zinc or vitamin A in infants and young children with severe acute l
  20. Long, K. Z., Montoya, Y., Hertzmark, E., Santos, J. I., and Rosado, J. L. A double-blind, randomized, clinical trial of the effect of vitamin A and zinc supplementation on diarrheal disease and respiratory tract infections in children in Mexico City, Mex
  21. Fritz, H., Kennedy, D., Fergusson, D., Fernandes, R., Doucette, S., Cooley, K., Seely, A., Sagar, S., Wong, R., and Seely, D. Vitamin A and retinoid derivatives for lung cancer: a systematic review and meta analysis. PLoS.One. 2011;6(6):e21107. PubMed
  22. Mayo-Wilson, E., Imdad, A., Herzer, K., Yakoob, M. Y., and Bhutta, Z. A. Vitamin A supplements for preventing mortality, illness, and blindness in children aged under 5: systematic review and meta-analysis. BMJ 2011;343:d5094. PubMed
  23. Mazumder S, Taneja S, Bhatia K, Yoshida S, Kaur J, Dube B, Toteja GS, Bahl R, Fontaine O, Martines J, Bhandari N; Neovita India Study Group. Efficacy of early neonatal supplementation with vitamin A to reduce mortality in infancy in Haryana, India (Neovit
  24. Baineni R, Gulati R, Delhi CK. Vitamin A toxicity presenting as bone pain. Arch Dis Child. 2017;102(6):556-8. PubMed
  25. Darlow BA, Graham PJ, Rojas-Reyes MX. Vitamin A supplementation to prevent mortality and short- and long-term morbidity in very low birth weight infants. Cochrane Database Syst Rev. 2016;(8):CD000501. PubMed
  26. Haider BA, Sharma R, Bhutta ZA. Neonatal vitamin A supplementation for the prevention of mortality and morbidity in term neonates in low and middle income countries. Cochrane Database Syst Rev. 2017;2:CD006980. PubMed
  27. Mohammad YM, Raslan IR, Al-Hussain FA. Idiopathic Intracranial Hypertension Induced by Topical Application of Vitamin A. J Neuroophthalmol. 2016;36(4):412-3. PubMed
  28. Masnadi Shirazi K, Nikniaz Z, Masnadi Shirazi A, Rohani M. Vitamin A supplementation decreases disease activity index in patients with ulcerative colitis: A randomized controlled clinical trial. Complement Ther Med. 2018 Dec;41:215-219. PubMed
  29. Ding Y, Hu P, Yang Y, et al. Impact of maternal daily oral low-dose vitamin A supplementation on the mother-infant pair: a randomised placebo-controlled trial in China. Nutrients 2021;13(7):2370. PubMed
  30. Knapik JJ, Hoedebecke SS. Vitamin A and bone fractures: systematic review and meta-analysis. J Spec Oper Med 2021;21(2):100-7. PubMed
  31. Imdad A, Mayo-Wilson E, Haykal MR, et al. Vitamin A supplementation for preventing morbidity and mortality in children from six months to five years of age. Cochrane Database Syst Rev 2022;3(3):CD008524. PubMed

See these in context on the Vitamin A monograph →

Calcium 62 references
  1. Shils M, Olson A, Shike M. Modern Nutrition in Health and Disease. 8th ed. Philadelphia, PA: Lea and Febiger, 1994.
  2. Hernandez-Avila M, Gonzalez-Cossio T, Hernandez-Avila JE, et al. Dietary calcium supplements to lower blood lead levels in lactating women: a randomized placebo-controlled trial. Epidemiology 2003;14:206-12.. PubMed
  3. Thys-Jacobs S, Ceccarelli S, Bierman A, et al. Calcium supplementation in premenstrual syndrome: a randomized crossover trial. J Gen Intern Med 1989;4:183-9. PubMed
  4. Maton PN, Burton ME. Antacids revisited: a review of their clinical pharmacology and recommended therapeutic use. Drugs 1999;57:855-70.
  5. Clemens JD, Feinstein AR. Calcium carbonate and constipation: a historical review of medical mythopoeia. Gastroenterology 1977;72:957-61. DOI
  6. Saunders D, Sillery J, Chapman R. Effect of calcium carbonate and aluminum hydroxide on human intestinal function. Dig Dis Sci 1988;33:409-13. PubMed
  7. Friedman PA, Bushinsky DA. Diuretic effects on calcium metabolism. Semin Nephrol 1999;19:551-6.
  8. Koo WK, Walters JC, Esterlitz J, et al. Maternal calcium supplementation and fetal bone mineralization. Obstet Gynecol 1999;94:577-82. DOI
  9. Raman L, Rajalakshmi K, Krishnamachari KAVR, et al. Effect of calcium supplementation to undernourished mothers during pregnancy on the bone density of the neonates. Am J Clin Nutr 1978; 31:466-9. DOI
  10. Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
  11. Chan JM, Giovannucci E, Andersson SO, et al. Dairy products, calcium, phosphorous, vitamin D, and risk of prostate cancer. Cancer Causes Control 1998;9:559-66.
  12. Butner LE, Fulco PP, Feldman G, et al. Calcium carbonate-induced hypothyroidism. Ann Intern Med 2000:132:595. PubMed
  13. Schneyer CR. Calcium carbonate and reduction of levothyroxine efficacy. JAMA 1998;279:750. PubMed
  14. Moser LR, Smythe MA, Tisdale JE. The use of calcium salts in the prevention and management of verapamil-induced hypotension. Ann Pharmacother 2000;34:622-9. PubMed
  15. Singh N, Singh PN, Hershman JM. Effect of calcium carbonate on the absorption of levothyroxine. JAMA 2000;283:2822-5. PubMed
  16. Kahela P, Anttila M, Tikkanen R, Sundquist H. Effect of food, food constituents and fluid volume on the bioavailability of sotalol. Acta Pharmacol Toxicol (Copenh) 1979;44:7-12.. PubMed
  17. Pletz MW, Petzold P, Allen A, et al. Effect of calcium carbonate on bioavailability of orally administered gemifloxacin. Antimicrob Agents Chemother 2003;47:2158-60.. PubMed
  18. Bar-Or D, Yoel G. Calcium and calciferol antagonize effect of verapamil in atrial fibrillation. Br Med J 1981;282:1585-6.
  19. Decktor DL, Robinson M, Maton PN, et al. Effects of aluminum/magnesium hydroxide and calcium carbonate on esophageal and gastric pH in subjects with heartburn. Am J Ther 1995;2:546-52. PubMed
  20. Simoneau G. Absence of rebound effect with calcium carbonate. Eur J Drug Metab Pharmacokinet 1996;21:351-7. PubMed
  21. Peters ML, Leonard M, Licata AA. Role of alendronate and risedronate in preventing and treating osteoporosis. Cleve Clin J Med 2001;68:945-51. PubMed
  22. Bourke JF, Mumford R, Whittaker P, et al. The effects of topical calcipotriol on systemic calcium homeostasis in patients with chronic plaque psoriasis. J Am Acad Dermatol 1997;37:929-34.
  23. Gueguen L, Pointillart A. The bioavailability of dietary calcium. J Am Coll Nutr 2000;19:119s-136s. PubMed
  24. Vella A, Gerber TC, Hayes DL, Reeder GS. Digoxin, hypercalcaemia, and cardiac conduction. Postgrad Med J 1999;75:554-6. PubMed
  25. Bania TC, Blaufeux B, Hughes S, et al. Calcium and digoxin vs. calcium alone for severe verapamil toxicity. Acad Emerg Med 2000;7:1089-96. PubMed
  26. Tseng M, Breslow RA, Graubard BI, Ziegler RG. Dairy, calcium, and vitamin D intakes and prostate cancer risk in the National Health and Nutrition Examination Epidemiologic Follow-up Study cohort. Am J Clin Nutr 2005;81:1147-54. PubMed
  27. Weingarten MA, Zalmanovici A, Yaphe J. Dietary calcium supplementation for preventing colorectal cancer and adenomatous polyps. Cochrane Database Syst Rev 2004;(1):CD003548. PubMed
  28. Tavani A, Bertuccio P, Bosetti C, et al. Dietary intake of calcium, vitamin D, phosphorus and the risk of prostate cancer. Eur Urol 2005;48:27-33. PubMed
  29. Giovannucci E, Liu Y, Stampfer MJ, Willett WC. A prospective study of calcium intake and incident and fatal prostate cancer. Cancer Epidemiol Biomarkers Prev 2006;15:203-10. PubMed
  30. Rocephin (ceftriaxone) and calcium interaction. Pharmacist's Letter / Prescriber's Letter 2007;23(10):231005.
  31. Bolland MJ, Barber PA, Doughty RN, et al. Vascular events in healthy older women receiving calcium supplementation: randomised control trial. BMJ 2008;336:262-6.
  32. Bolland MJ, Avenell A, Baron JA, et al. Effect of calcium supplements on risk of myocardial infarction and cardiovascular events: meta-analysis. BMJ 2010;341:c3691. PubMed
  33. Calcium supplementation and vascular events. Pharmacist's Letter / Prescriber's Letter 2008;24(3):240306.
  34. Dietary reference intakes for calcium and vitamin D. Institute of Medicine, November 30, 2010. Available at: http://www.iom.edu/~/media/Files/Report%20Files/2010/Dietary-Reference-Intakes-for-Calcium-and-Vitamin-D/Vitamin%20D%20and%20Calcium%202010%20Repo
  35. Coburn JW, Mischel MG, Goodman WG, et al. Calcium citrate markedly enhances aluminum absorption from aluminum hydroxide. Am J Kidney Dis. 1991;17(6):708-11. PubMed
  36. Bradley JS, Wassel RT, Lee L, et al. Intravenous ceftriaxone and calcium in the neonate: assessing the risk for cardiopulmonary adverse events. Pediatrics. 2009;123(4):e609-13. PubMed
  37. Kays MB, Overholser BR, Mueller BA, et al. Effects of sevelamer hydrochloride and calcium acetate on the oral bioavailability of ciprofloxacin. Am J Kidney Dis. 2003;42(6):1253-9. PubMed
  38. Neuhofel, A. L., Wilton, J. H., Victory, J. M., Hejmanowsk, L. G., and Amsden, G. W. Lack of bioequivalence of ciprofloxacin when administered with calcium-fortified orange juice: a new twist on an old interaction. J Clin Pharmacol. 2002;42(4):461-466. DOI
  39. Dickinson, H. O., Nicolson, D. J., Cook, J. V., Campbell, F., Beyer, F. R., Ford, G. A., and Mason, J. Calcium supplementation for the management of primary hypertension in adults. Cochrane.Database.Syst.Rev. 2006;(2):CD004639. PubMed
  40. Jones, B. J. and Twomey, P. J. Requesting patterns for serum calcium concentration in patients on long-term lithium therapy. Int J Clin Pract. 2009;63(1):170-172. PubMed
  41. Levine, M., Nikkanen, H., and Pallin, D. J. The effects of intravenous calcium in patients with digoxin toxicity. J Emerg.Med. 2011;40(1):41-46. PubMed
  42. Castelo-Branco, C., Ciria-Recasens, M., Cancelo-Hidalgo, M. J., Palacios, S., Haya-Palazuelos, J., Carbonell-Abello, J., Blanch-Rubio, J., Martinez-Zapata, M. J., Manasanch, J., and Perez-Edo, L. Efficacy of ossein-hydroxyapatite complex compared with ca
  43. Li K, Kaaks R, Linseisen J, Rohrmann S. Associations of dietary calcium intake and calcium supplementation with myocardial infarction and stroke risk and overall cardiovascular mortality in the Heidelberg cohort of the European Prospective Investigation i
  44. Chung M, Tang AM, Fu Z. Calcium Intake and Cardiovascular Disease Risk: An Updated Systematic Review and Meta-analysis. Ann Intern Med. 2016 Oct 25. PubMed
  45. Nolan CR, Califano JR, Butzin CA. Influence of calcium acetate or calcium citrate on intestinal aluminum absorption. Kidney Int. 1990;38(5):937-41. PubMed
  46. Lewis JR, Radavelli-Bagatini S, Rejnmark L, et al. The effects of calcium supplementation on verified coronary heart disease hospitalization and death in postmenopausal women: a collaborative meta-analysis of randomized controlled trials. J Bone Miner Res PubMed
  47. 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
  48. Lappe J, Watson P, Travers-Gustafson D, Recker R, Garland C, Gorham E, Baggerly K, McDonnell SL. Effect of Vitamin D and Calcium Supplementation on Cancer Incidence in Older Women: A Randomized Clinical Trial. JAMA. 2017 Mar 28;317(12):1234-1243. PubMed
  49. Grove ML, Cook D. Calcium and heart attacks. Doesn't apply to most calcium prescriptions. BMJ. 2010;341:c5003. PubMed
  50. Insentress [package insert]. Whitehouse Station, NJ: Merck Sharp & Dohme Corp.; 2014.
  51. Roberts JL, Kiser JJ, Hindman JT, Meditz AL. Virologic failure with a raltegravir-containing antiretroviral regimen and concomitant calcium administration. Pharmacotherapy 2011;31(10):298e-302e. DOI
  52. Vitekta [package insert]. Foster City, CA: Gilead Sciences, Inc.; 2014.
  53. Storan ER, O'Gorman SM, Murphy A, Laing M. Case Report of Calciphylaxis Secondary to Calcium and Vitamin D<sub>3</sub> Supplementation. J Cutan Med Surg. 2017;21(2):162-163. DOI
  54. Jenkins DJA, Spence JD, Giovannucci EL, et al. Supplemental vitamins and minerals for CVD prevention and treatment. J Am Coll Cardiol 2018;71(22):2570-84. PubMed
  55. Borkenhagen JF, Connor EL, Stafstrom CE. Neonatal hypocalcemic seizures due to excessive maternal calcium ingestion. Pediatr Neurol 2013;48(6):469-71. PubMed
  56. WHO recommendations on antenatal care for a positive pregnancy experience. Geneva: World Health Organization; 2016 (http://www.who.int/reproductivehealth/publications/maternal_perinatal_health/ anc-positive-pregnancy-experience/en/).
  57. Aune D, Navarro Rosenblatt DA, Chan DS, et al. Dairy products, calcium, and prostate cancer risk: a systematic review and meta-analysis of cohort studies. Am J Clin Nutr. 2015;101(1):87-117. PubMed
  58. Lan T, Park Y, Colditz GA, et al. Adolescent dairy product and calcium intake in relation to later prostate cancer risk and mortality in the NIH-AARP Diet and Health Study. Cancer Causes Control. 2020;31(10):891-904. PubMed
  59. Zhang Y, Li Y, Liu J, et al. Association of Vitamin D or Calcium Supplementation with Cardiovascular Outcomes and Mortality: A Meta-Analysis with Trial Sequential Analysis. J Nutr Health Aging 2021;25(2):263-270. PubMed
  60. Myung SK, Kim HB, Lee YJ, Choi YJ, Oh SW. Calcium Supplements and Risk of Cardiovascular Disease: A Meta-Analysis of Clinical Trials. Nutrients 2021;13(2):368. PubMed
  61. Hetaimish B. Neonatal Calcinosis Cutis After Treatment of Hypocalcemia with Calcium Gluconate: A Report of 2 Cases. Am J Case Rep 2024;25:e943397. PubMed
  62. 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 Calcium monograph →

Iron 72 references
  1. McEvoy GK, ed. AHFS Drug Information. Bethesda, MD: American Society of Health-System Pharmacists, 1998.
  2. Bruner AB, Joffe A, Duggan AK, et al. Randomized study of cognitive effects of iron supplementation in non- anaemic iron-deficient adolescent girls. Lancet 1996;348:992-6.
  3. Ullen H, Augustsson K, Gustavsson C, Steineck G. Supplementary iron intake and risk of cancer: reversed causality? Cancer Lett 1997;114:215-6.
  4. Reunanen A, Takkunen H, Knekt P, et al. Body iron stores, dietary iron intake and coronary heart disease mortality. J Intern Med 1995;238:223-30. PubMed
  5. Lund EK, Wharf SG, Fairweather-Tait SJ, Johnson IT. Oral ferrous sulfate supplements increase the free radical-generating capacity of feces from healthy volunteers. Am J Clin Nutr 1999;69:250-5.
  6. Rehman A, Collis CS, Yang M, et al. The effects of iron and vitamin C co-supplementation on oxidative damage to DNA in healthy volunteers. Biochem Biophys Res Comm 1998;246:293-8. PubMed
  7. Klipstein-Grobusch K, Grobbee DE, den Breeijen JH, et al. Dietary iron and risk of myocardial infarction in the Rotterdam Study. Am J Epidemiol 1999;149:421-8. PubMed
  8. Hansten PD, Horn JR. Drug Interactions Analysis and Management. Vancouver, WA: Applied Therapeutics Inc., 1997 and updates.
  9. Tatro DS, ed. Drug Interactions Facts. Facts and Comparisons Inc., St. Louis, MO. 1999.
  10. 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.
  11. Campbell N, Paddock V, Sundaram R. Alteration of methyldopa absorption, metabolism, and blood pressure control by ferrous sulfate and ferrous gluconate. Clin Pharmacol Ther 1988;43:381-6..
  12. Schumann K, Borch-Iohnsen B, Hentze MW, Marx JJ. Tolerable upper intakes for dietary iron set by the US Food and Nutrition Board (commentary). Am J Clin Nutr 2002;76:499-500. PubMed
  13. Tuomainen TP, Punnonen K, Nyyssonen K, Salonen JT. Association between body iron stores and the risk of acute myocardial infarction in men. Circulation 1998;97:1461-6.. PubMed
  14. Salonen JT, Nyyssonen K, Korpela H, et al. High stored iron levels are associated with excess risk of myocardial infarction in Eastern Finnish men. Circulation 1992;86:803-11.. PubMed
  15. Campbell NRC, Hasinoff B. Ferrous sulfate reduces levodopa bioavailability: Chelation as a possible mechanism. Clin Pharmacol Ther 1989;45:220-5.. PubMed
  16. Campbell NRC, Hasinoff BB, Stalts H, et al. Ferrous sulfate reduces thyroxine efficacy in patients with hypothyroidism. Ann Int Med 1992;117:1010-3.. PubMed
  17. Kiechl S, Willeit J, Egger G, et al. Body iron stores and the risk of carotid atherosclerosis: prospective results from the Bruneck study. Circulation 1997;96:3300-07. PubMed
  18. Comparison of oral iron supplements. Pharmacist's Letter / Prescriber's Letter 2008;24(8):240811.
  19. Tran T., Wax J. R., Philput C., Steinfeld J. D., Ingardia C. J. Intentional iron overdose in pregnancy--management and outcome. J Emerg Med 2000;18(2):225-228. PubMed
  20. Toblli J. E., Brignoli, R. Iron(III)-hydroxide polymaltose complex in iron deficiency anemia / review and meta-analysis. Arzneimittelforschung 2007;57(6A):431-438. PubMed
  21. Köpcke W., Sauerland M. C. Meta-analysis of efficacy and tolerability data on iron proteinsuccinylate in patients with iron deficiency anemia of different severity. Arzneimittelforschung 1995;45(11):1211-1216.
  22. Campbell N. R., Campbell R. R., Hasinoff B. B. Ferrous sulfate reduces methyldopa absorption: methyldopa: iron complex formation as a likely mechanism. Clin Invest Med 1990;13(6):329-332.
  23. Morii M., Ueno K., Ogawa A., Kato R., Yoshimura H., Wada K., Hashimoto H., Takada M., Tanaka K., Nakatani T., Shibakawa M. Impairment of mycophenolate mofetil absorption by iron ion. Clin Pharmacol Ther 2000;68(6):613-616. PubMed
  24. Gelone D. K., Park J. M., Lake K. D. Lack of an effect of oral iron administration on mycophenolic acid pharmacokinetics in stable renal transplant recipients. Pharmacotherapy 2007;27(9):1272-1278. PubMed
  25. Ducray P. S., Banken L., Gerber M., Boutouyrie B., Zandt H. Absence of an interaction between iron and mycophenolate mofetil absorption. Br J Clin Pharmacol 2006;62(4):492-495. PubMed
  26. Lorenz M., Wolzt M., Weigel G., Puttinger H., Hörl W. H., Födinger M., Speiser W., Sunder-Plassmann G. Ferrous sulfate does not affect mycophenolic acid pharmacokinetics in kidney transplant patients. Am J Kidney Dis 2004;43(6):1098-1103. PubMed
  27. Osman M. A., Patel R. B., Schuna A., Sundstrom W. R., Welling P. G. Reduction in oral penicillamine absorption by food, antacid, and ferrous sulfate. Clin Pharmacol Ther 1983;33(4):465-470. PubMed
  28. Michael, B., Coyne, D. W., Fishbane, S., Folkert, V., Lynn, R., Nissenson, A. R., Agarwal, R., Eschbach, J. W., Fadem, S. Z., Trout, J. R., Strobos, J., and Warnock, D. G. Sodium ferric gluconate complex in hemodialysis patients: adverse reactions compar
  29. Zhang, X., Ouyang, J., Wieczorek, R., and DeSoto, F. Iron medication-induced gastric mucosal injury. Pathol.Res Pract 2009;205(8):579-581. PubMed
  30. Barbieri, P. G. [To-day exposure to occupational carcinogens and their effects. The experience of the rubber industry, iron metallurgy, asphalt work and aviculture]. Epidemiol.Prev 2009;33(4-5 Suppl 2):94-105.
  31. Macedo, A. and Cardoso, S. [Routine iron supplementation in pregnancy]. Acta Med Port. 2010;23(5):785-792.
  32. Bastide, N. M., Pierre, F. H., and Corpet, D. E. Heme iron from meat and risk of colorectal cancer: a meta-analysis and a review of the mechanisms involved. Cancer Prev Res (Phila) 2011;4(2):177-184. PubMed
  33. Stevens, R. G. Iron and the risk of cancer. Med Oncol Tumor Pharmacother. 1990;7(2-3):177-181. PubMed
  34. van den, Hombergh J., Dalderop, E., and Smit, Y. Does iron therapy benefit children with severe malaria-associated anaemia? A clinical trial with 12 weeks supplementation of oral iron in young children from the Turiani Division, Tanzania. J.Trop.Pediatr. PubMed
  35. Liabeuf S, Gras V, Moragny J, et al. Ulceration of the oral mucosa following direct contact with ferrous sulfate in elderly patients: a case report and a review of the French National Pharmacovigilance Database. Clin Interv Aging. 2014 Apr 25;9:737-40. PubMed
  36. Qiao L, Feng Y. Intakes of heme iron and zinc and colorectal cancer incidence: a meta-analysis of prospective studies. Cancer Causes Control. 2013 Jun;24(6):1175-83. PubMed
  37. 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
  38. 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
  39. Song I, Borland J, Arya N, Wynne B, Piscitelli S. Pharmacokinetics of dolutegravir when administered with mineral supplements in healthy adult subjects. J Clin Pharmacol. 2015;55(5):490-6. PubMed
  40. Esan MO, Boele van Hensbroek M, Nkhoma E, et al. Iron supplementation in HIV infected Malawian children with anemia: a double-blind, randomized, controlled trial. Clin Inf Dis 2013;57(11):1626-34.doi:10.1093/cid/cit528. PubMed
  41. Zlotkin S, Newton S, Aimone AM, et al. Effect of iron fortification on malaria incidence in infants and young children in Ghana: a randomized trial. JAMA 2013;310(9):938-47. PubMed
  42. Khambalia AZ, Aimone A, Nagubandi P, et al. High maternal iron status, dietary iron intake and iron supplement use in pregnancy and risk of gestational diabetes mellitus: a prospective study and systematic review. Diabet Med. 2016;33(9):1211-21. PubMed
  43. Kinnunen TI, Luoto R, Helin A, Hemminki E. Supplemental iron intake and the risk of glucose intolerance in pregnancy: re-analysis of a randomised controlled trial in Finland. Matern Child Nutr. 2016;12(1):74-84.
  44. Low MS, Speedy J, Styles CE, De-Regil LM, Pasricha SR. Daily iron supplementation for improving anaemia, iron status and health in menstruating women. Cochrane Database Syst Rev. 2016;4:CD009747. PubMed
  45. Melit LE, Marginean CO, Mocanu S, Marginean MO. A rare case of iron-pill induced gastritis in a female teenager: A case report and a review of the literature. Medicine (Baltimore). 2017;96(30):e7550. PubMed
  46. Neuberger A, Okebe J, Yahav D, Paul M. Oral iron supplements for children in malaria-endemic areas. Cochrane Database Syst Rev. 2016;2:CD006589. PubMed
  47. Peña-Rosas JP, De-Regil LM, Gomez Malave H, Flores-Urrutia MC, Dowswell T. Intermittent oral iron supplementation during pregnancy. Cochrane Database Syst Rev. 2015;(10):CD009997. PubMed
  48. Brabin B, Gies S, Roberts SA, et al. Excess risk of preterm birth with periconceptional iron supplementation in a malaria endemic area: analysis of secondary data on birth outcomes in a double blind randomized controlled safety trial in Burkina Faso. Mala PubMed
  49. Kaundal R, Bhatia P, Jain A, et al. Randomized controlled trial of twice-daily versus alternate-day oral iron therapy in the treatment of iron-deficiency anemia. Ann Hematol 2020;99(1):57-63. PubMed
  50. Li N, Zhao G, Wu W, et al. The efficacy and safety of vitamin C for iron supplementation in adult patients with iron deficiency anemia: A randomized clinical trial. JAMA Netw Open. 2020;3(11):e2023644.<br> PubMed
  51. Houston BL, Hurrie D, Graham J, et al. Efficacy of iron supplementation on fatigue and physical capacity in non-anaemic iron-deficient adults: a systematic review of randomised controlled trials. BMJ Open. 2018;8(4):e019240. PubMed
  52. Koch RM, Tchernodrinski S, Principe DR. Case report: Rapid onset, ischemic-type gastritis after initiating oral iron supplementation. Front Med (Lausanne) 2022;9:1010897. PubMed
  53. Milman NT. Iron supplementation in pregnant Danish women revisited: Effects on prepartum and postpartum iron deficiency, anemia, serum erythropoietin; including iron status, erythropoietin and anthropometrics in newborns. A randomized, placebo-controlled
  54. Rogozinska E, Daru J, Nicolaides M, et al. Iron preparations for women of reproductive age with iron deficiency anaemia in pregnancy (FRIDA): a systematic review and network meta-analysis. Lancet Haematol 2021;8(7):e503-e512. PubMed
  55. Shah AA, Donovan K, Seeley C, et al. Risk of infection associated with administration of intravenous iron: A systematic review and meta-analysis. JAMA Netw Open 2021;4(11):e2133935. PubMed
  56. Gamad N, Saha PK, Sharma P, Suri V, Chakrabarti A, Saha L. A randomized controlled trial comparing the efficacy, tolerability, and cost of oral iron preparations in iron-deficiency anemia in pregnancy. J Obstet Gynaecol Res 2021;47(11):3828-3841. PubMed
  57. El-Hawy MA, Abd Al-Salam SA, Bahbah WA. Comparing oral iron bisglycinate chelate, lactoferrin, lactoferrin with iron and iron polymaltose complex in the treatment of children with iron deficiency anemia. Clin Nutr ESPEN 2021;46:367-371. PubMed
  58. Adams A, Scheckel B, Habsaoui A, et al. Intravenous iron versus oral iron versus no iron with or without erythropoiesis- stimulating agents (ESA) for cancer patients with anaemia: a systematic review and network meta-analysis. Cochrane Database Syst Rev 2 PubMed
  59. Kancherla K, Constantin H, Kanawati A, Graham E. Iron-induced Hypophosphatemic Osteomalacia-An Atypical Case of Bilateral Femoral Stress Fractures. J Am Acad Orthop Surg Glob Res Rev 2023;7(5):e22. PubMed
  60. Shi R, Marin JG, Beaulieu M. Skin staining following intravenous iron extravasation in a patient with chronic kidney disease: A case report. Can J Kidney Health Dis 2023;10:20543581231165705. PubMed
  61. Varandas C, Vieira J, Correia CJ, et al. Hypersensitivity reactions to iron products: 10-year experience in a Portuguese tertiary Centre. Eur Ann Allergy Clin Immunol 2023.
  62. Jara Vidal M, López García MC, Quílez Toboso RP. Kounis syndrome after intravenous iron administration. Med Clin (Barc) 2023. DOI
  63. Jara Vidal M, Ruiz de Assín Valverde A, Aznar Rodríguez S. Severe hypophospathemia secondary to intravenous iron. Med Clin (Barc) 2023. DOI
  64. Samões B, Silva B, Martins A, et al. Hypophosphatemic osteomalacia induced by intravenous iron therapy: a case report. Joint Bone Spine 2023;90(5):105586. PubMed
  65. Seng NW, Barco JB, Wong MH, et al. Hypophosphatemia related to intravenous iron therapy with ferric carboxymaltose: A case series. Transfus Med 2023. PubMed
  66. Fernandez-Flores A, Fernandez-Parrado M, Alzoghby-Abi Chaker J, Angulo AG. Axillary cutaneous hemosiderosis in a patient with hyperhidrosis, after intravenous iron infusion. Am J Dermatopathol 2023;45(7):463-465. PubMed
  67. Ye S, Grill V, Luo J, Nguyen HH. Concurrent Denosumab and Parenteral Iron Therapy Precipitating Severe Hypocalcemia and Hypophosphatemia. JCEM Case Rep 2024;2(2):luae005. PubMed
  68. Yerigeri K. Hemochromatosis in an Adult Female With Previous Iron Deficiency Anemia on Iron Supplementation. Cureus 2023;15(12):e50166. PubMed
  69. Meyers M, Salmon M, Libert I, Klá&scaron;terský J. A meta-analysis on the risk of infection associated with intravenous iron therapy in cancer-associated anaemia: a double-edged sword?. Curr Opin Oncol 2024;36(4):223-232. PubMed
  70. Short V, Allen R, Earley CJ, et al. A randomized double-blind pilot study to evaluate the efficacy, safety, and tolerability of intravenous iron versus oral iron for the treatment of restless legs syndrome in patients with iron deficiency anemia. Am J Hem PubMed
  71. Bellos I, Frountzas M, Pergialiotis V. Comparative Risk of Hypophosphatemia Following the Administration of Intravenous Iron Formulations: A Network Meta-Analysis. Transfus Med Rev 2020;34(3):188-194. PubMed
  72. 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 Iron monograph →

Papain 11 references
  1. The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999.
  2. Shaw D, Leon C, Kolev S, Murray V. Traditional remedies and food supplements: a 5-year toxicological study (1991-1995). Drug Saf 1997;17:342-56.
  3. Shuttleworth D, Hill S, Marks R, Connelly DM. Relief of experimentally induced pruritus with a novel eutectic mixture of local anaesthetic agents. Br J Dermatol 1988;119:535-40.
  4. Mansfield LE, Ting S, Haverly RW, Yoo TJ. The incidence and clinical implications of hypersensitivity to papain in an allergic population, confirmed by blinded oral challenge. Ann Allergy 1985;55:541-3.
  5. Martin, T., Uhder, K., Kurek, R., Roeddiger, S., Schneider, L., Vogt, H. G., Heyd, R., and Zamboglou, N. Does prophylactic treatment with proteolytic enzymes reduce acute toxicity of adjuvant pelvic irradiation? Results of a double-blind randomized trial PubMed
  6. Walker-Renard, P. Update on the medicinal management of phytobezoars. Am J Gastroenterol. 1993;88(10):1663-1666.
  7. Tymoszuk D, Wiszniewska M, Walusiak-Skorupa J. Papain-induced occupational rhinoconjunctivitis and asthma - A case report. Med Pr 2016;67(1):109-12. PubMed
  8. Soto-Mera MT, López-Rico MR, Filgueira JF, et al. Occupational allergy to papain. Allergy 2000;55(10):983-4. PubMed
  9. Tarlo SM, Shaikh W, Bell B, et al. Papain-induced allergic reactions. Clin Allergy 1978;8(3):207-15. PubMed
  10. Baur X, König G, Bencze K, Fruhmann G. Clinical symptoms and results of skin test, RAST and bronchial provocation test in thirty-three papain workers: Evidence for strong immunogenic potency and clinically relevant proteolytic e?ects of airborne papain. C
  11. Novey HS, Keenan WJ, Fairshter RD, Wells ID, Wilson AF, Culver BD. Pulmonary disease in workers exposed to papain: clinico-physiological and immunological studies. Clin Allergy 1980;10(6):721-31. PubMed

See these in context on the Papain monograph →

Theanine 6 references
  1. Yokogoshi H, Kobayashi M. Hypotensive effect of gamma-glutamylethylamide in spontaneously hypertensive rats. Life Sci 1998;62:1065-8.
  2. Haskell, C. F., Kennedy, D. O., Milne, A. L., Wesnes, K. A., and Scholey, A. B. The effects of L-theanine, caffeine and their combination on cognition and mood. Biol.Psychol. 2008;77(2):113-122. PubMed
  3. Yokogoshi, H., Kato, Y., Sagesaka, Y. M., Takihara-Matsuura, T., Kakuda, T., and Takeuchi, N. Reduction effect of theanine on blood pressure and brain 5-hydroxyindoles in spontaneously hypertensive rats. Biosci.Biotechnol.Biochem. 1995;59(4):615-618. PubMed
  4. Lyon MR, Kapoor MP, Juneja LR. The effects of L-theanine (Suntheanine®) on objective sleep quality in boys with attention deficit hyperactivity disorder (ADHD): a randomized, double-blind, placebo-controlled clinical trial. Altern Med Rev. 2011;16(4):348-
  5. Hidese S, Ota M, Wakabayashi C, et al. Effects of chronic l-theanine administration in patients with major depressive disorder: an open-label study. Acta Neuropsychiatr 2017;29(2):72-9.
  6. Tsuchiya T, Honda H, Oikawa M, et al. Oral administration of the amino acids cystine and theanine attenuates the adverse events of S-1 adjuvant chemotherapy in gastrointestinal cancer patients. Int J Clin Oncol 2016;21(6):1085-90. PubMed

See these in context on the Theanine monograph →

Coconut 10 references
  1. Teuber SS, Peterson WR. Systemic allergic reaction to coconut (Cocos nucifera) in 2 subjects with hypersensitivity to tree nut and demonstration of cross-reactivity to legumin-like seed storage proteins: new coconut and walnut food allergens. J Allergy Cl PubMed
  2. Rosado A, Fernandez-Rivas M, Gonzalez-Mancebo E, et al. Anaphylaxis to coconut. Allergy 2002;57(2):182-3. PubMed
  3. Karmakar PR, Das A, Chatterjee BP. Placebo-controlled immunotherapy with Cocos nucifera pollen extract. Int Arch Allergy Immunol 1994;103(2):194-201. PubMed
  4. Anagnostou K. Coconut Allergy Revisited. Children (Basel). 2017;4(10). pii: E85. PubMed
  5. Cifuentes L, Mistrello G, Amato S, et al. Identification of cross-reactivity between buckwheat and coconut. Ann Allergy Asthma Immunol. 2015;115(6):530-2. PubMed
  6. Michavila Gomez A, Amat Bou M, Gonzalez Cortés MV, Segura Navas L, Moreno Palanques MA, Bartolomé B. Coconut anaphylaxis: Case report and review. Allergol Immunopathol (Madr). 2015;43(2):219-20. PubMed
  7. 21CFR170.3. U.S. Food and Drug Administration Department of Health and Human Services. Updated April 1, 2017. https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?fr=170.3
  8. Alatawi KA, Alshubaily FA. Coconut products alleviate hyperglycaemic, hyperlipidimic and nephropathy indices in streptozotocin-induced diabetic wistar rats. Saudi J Biol Sci. 2021;28(8):4224-4231. PubMed
  9. Kruse L, Lor J, Yousif R, Pongracic JA, Fishbein AB. Coconut allergy: Characteristics of reactions and diagnostic predictors in a pediatric tertiary care center. Ann Allergy Asthma Immunol 2021;126(5):562-568.
  10. Pathmanandavel K, Kaur N, Joshi P, Ford LS. Anaphylaxis and allergy to coconut: An Australian pediatric case series. J Allergy Clin Immunol Pract 2020;8(10):3657-3659. PubMed

See these in context on the Coconut monograph →

Bromelain 19 references
  1. Nettis E, Napoli G, Ferrannini A, Tursi A. IgE-mediated allergy to bromelain. Allergy 2001;56:257-8. PubMed
  2. Taussig SJ, Batkin S. Bromelain, the enzyme complex of pineapple (Ananas comosus) and its clinical application. An update. J Ethnopharmacol 1988;22:191-203.. PubMed
  3. Bradbrook ID, Morrison PJ, Rogers HJ. The effect of bromelain on the absorption of orally administered tetracycline. Br J Clin Pharmacol 1978;6:552-4. PubMed
  4. Bush TM, Rayburn KS, Holloway SW, et al. Adverse interactions between herbal and dietary substances and prescription medications: a clinical survey. Altern Ther Health Med 2007;13:30-5.
  5. Brien S, Lewith G, Walker AF, et al. Bromelain as an adjunctive treatment for moderate-to-severe osteoarthritis of the knee: a randomized placebo-controlled pilot study. QJM 2006;99:841-50. PubMed
  6. Mori S, Ojima Y, Hirose T, et al. The clinical effect of proteolytic enzyme containing bromelain and trypsin on urinary tract infection evaluated by double blind method. Acta Obstet Gynaecol Jpn 1972;19:147-53.
  7. Glaser D, Hilberg T. The influence of bromelain on platelet count and platelet activity in vitro. Platelets 2006;17:37-41. PubMed
  8. Heinicke R M, van der Wal L, Yokoyama M. Effect of bromelain (Ananase) on human platelet aggregation. Experientia 1972;28:844-5. PubMed
  9. Gailhofer, G., Wilders-Truschnig, M., Smolle, J., and Ludvan, M. Asthma caused by bromelain: an occupational allergy. Clin Allergy 1988;18(5):445-450. PubMed
  10. Mattei, O., Fabri, G., and Farina, G. [Occupational health experience regarding four cases of asthma due to bromelain (author's transl)]. Medicina del Lavoro 1979;70(5):404-409.
  11. Galleguillos, F. and Rodriguez, J. C. Asthma caused by bromelin inhalation. Clin Allergy 1978;8(1):21-24. PubMed
  12. Perez-Camo I, Quirce S, Duran MA, and et al. Latex allergy: evidence of cross-reactivity with papain and bromelain [abstract]. Allergy 1996;51(suppl 31):48.
  13. Martin GJ, Ehrenreich J, and Asbell N. Bromelain: pineapple proteases with anti-edema activity. Exp Med Surg 1962;20:227-247.
  14. Kasemsuk T, Saengpetch N, Sibmooh N, Unchern S. Improved WOMAC score following 16-week treatment with bromelain for knee osteoarthritis. Clin Rheumatol. 2016 Oct;35(10):2531-40. PubMed
  15. Kutlu Ö, DemirbaS A, Elmas ÖF, Güvenç U, Metin A. Fixed drug eruption: a new side effect of bromelain. Contact Dermatitis 2020. Online ahead of print. PubMed
  16. Shoham Y, Shapira E, Haik J, et al. Bromelain-based enzymatic debridement of chronic wounds: Results of a multicentre randomized controlled trial. Wound Repair Regen 2021;29(6):899-907. PubMed
  17. Pfister P, Garcia Wendel PD, Kim BS, et al. Coagulation side effects of enzymatic debridement in burned patients. Burns 2022. PubMed
  18. Hasham S, Riyat H, Fletcher A, O'Boyle CP, Alexander S. To bleed or not to bleed? Case series and discussion of haemorrhage risk with enzymatic debridement in burn injuries. Scars Burn Heal 2023;9:20595131231168333. PubMed
  19. Leelakanok N, Petchsomrit A, Janurai T, Saechan C, Sunsandee N. Efficacy and safety of bromelain: A systematic review and meta-analysis. Nutr Health 2023. PubMed

See these in context on the Bromelain monograph →

Lipase 1 reference
  1. Casper C, Hascoet JM, Ertl T, et al. Recombinant bile salt-stimulated lipase in preterm infant feeding: A randomized phase 3 study. PLoS One. 2016;11(5):e0156071. PubMed

See these in context on the Lipase monograph →

Beet 14 references
  1. Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.
  2. Clifford T, Berntzen B, Davison GW, et al. Effects of beetroot juice on recovery of muscle function and performance between bouts of repeated sprint exercise. Nutrients 2016;8. pii: E506. PubMed
  3. Siervo M, Lara J, Ogbonmwan I, Mathers JC. Inorganic nitrate and beetroot juice supplementation reduces blood pressure in adults: a systematic review and meta-analysis. J Nutr 2013;143:818-26. PubMed
  4. Clifford T, Howatson G, West DJ, Stevenson EJ. Beetroot juice is more beneficial than sodium nitrate for attenuating muscle pain after strenuous eccentric-bias exercise. Appl Physiol Nutr Metab. 2017;42(11):1185-1191. PubMed
  5. Clifford T, Bell O, West DJ, Howatson G, Stevenson EJ. The effects of beetroot juice supplementation on indices of muscle damage following eccentric exercise. Eur J Appl Physiol. 2016;116(2):353-62. PubMed
  6. Wylie LJ, Kelly J, Bailey SJ, et al. Beetroot juice and exercise: pharmacodynamic and dose-response relationships. J Appl Physiol (1985). 2013;115(3):325-36. PubMed
  7. Garnacho-Casta&ntilde;o MV, Palau-Salv&agrave; G, Cuenca E, et al. Effects of a single dose of beetroot juice on cycling time trial performance at ventilatory thresholds intensity in male triathletes. J Int Soc Sports Nutr. 2018;15(1):49. PubMed
  8. Rasica L, Porcelli S, Marzorati M, et al. Ergogenic effects of beetroot juice supplementation during severe-intensity exercise in obese adolescents. Am J Physiol Regul Integr Comp Physiol. 2018;315(3):R453-R460. PubMed
  9. Henrohn D, Bj&ouml;rkstrand K, Lundberg JO, et al. Effects of oral supplementation with nitrate-rich beetroot juice in patients with pulmonary arterial hypertension-results from BEET-PAH, an exploratory randomized, double-blind, placebo-controlled, crosso
  10. Serra-Payá N, Garnacho-Castaño MV, Sánchez-Nuño S, et al. The relationship between resistance exercise performance and ventilatory efficiency after beetroot juice intake in well-trained athletes. Nutrients 2021;13(4):1094. PubMed
  11. Haron MH, Dale O, Martin K, et al. Evaluation of the Herb-Drug Interaction Potential of Commonly Used Botanicals on the US Market with Regard to PXR- and AhR-Mediated Influences on CYP3A4 and CYP1A2. J Diet Suppl 2022. PubMed
  12. Hemmatinafar M, Zaremoayedi L, Koushkie Jahromi M, et al. Effect of Beetroot Juice Supplementation on Muscle Soreness and Performance Recovery after Exercise-Induced Muscle Damage in Female Volleyball Players. Nutrients 2023;15(17):3763. PubMed
  13. Lim SH, Bae S, Lee HS, Han HK, Choi CI. Effect of Betanin, the Major Pigment of Red Beetroot (Beta vulgaris L.), on the Activity of Recombinant Human Cytochrome P450 Enzymes. Pharmaceuticals (Basel) 2023;16(9):1224. PubMed
  14. Oscherwitz M, Tamayo RM, Heudebert A, Centor R. A Case of Pseudo-Hematochezia from Beet Supplement Ingestion. Am J Med 2023;136(9):e177-e178. PubMed

See these in context on the Beet monograph →

Lactase 1 reference
  1. Laukkanen A, Ruoppi P, Remes S, Koistinen T, M&auml;kinen-Kiljunen S. Lactase-induced occupational protein contact dermatitis and allergic rhinoconjunctivitis. Contact Dermatitis. 2007;57(2):89-93. PubMed

See these in context on the Lactase monograph →

Flaxseed 37 references
  1. Kolonel LN, Nomura AM, Cooney RV. Dietary fat and prostate cancer: current status. J Natl Cancer Inst 1999;91:414-28. PubMed
  2. Ramon JM, Bou R, Romea S, et al. Dietary fat intake and prostate cancer risk: a case-control study in Spain. Cancer Causes Control 2000;11:679-85. PubMed
  3. Thompson LU, Rickard SE, Cheung F, et al. Variability in anticancer lignan levels in flaxseed. Nutr Cancer 1997;27:26-30. PubMed
  4. Nordstrom DC, Honkanen VE, Nasu Y, et al. Alpha-linolenic acid in the treatment of rheumatoid arthritis. A double-blind, placebo-controlled and randomized study: flaxseed vs. safflower seed. Rheumatol Int 1995;14:231-4. PubMed
  5. Cunnane SC, Ganguli S, Menard C, et al. High alpha-linolenic acid flaxseed (Linum usitatissimum): some nutritional properties in humans. Br J Nutr 1993;69:443-53.
  6. Clark WF, Parbtani A, Huff MW, et al. Flaxseed: a potential treatment for lupus nephritis. Kidney Int 1995;48:475-80. PubMed
  7. Cunnane SC, Hamadeh MJ, Liede AC, et al. Nutritional attributes of traditional flaxseed in healthy young adults. Am J Clin Nutr 1995;61:62-8. PubMed
  8. De Stefani E, Deneo-Pellegrini H, Boffetta P, et al. Alpha-linolenic acid and risk of prostate cancer: a case-control study in Uruguay. Cancer Epidemiol Biomarkers Prev 2000;9:335-8.
  9. Giovannucci E, Rimm EB, Colditz GA, et al. A prospective study of dietary fat and risk of prostate cancer. J Natl Cancer Inst 1993;85:1571-9. PubMed
  10. Clark WF, Kortas C, Heidenheim P, et al. Flaxseed in lupus nephritis: a two-year nonplacebo-controlled crossover study. J Am Coll Nutr 2001;20:143-8. PubMed
  11. Serraino M, Thompson LU. The effect of flaxseed supplementation on early risk markers for mammary carcinogenesis. Cancer Lett 1991;60:135-42. PubMed
  12. Rickard SE, Yuan YV, Thompson LU. Plasma insulin-like growth factor I levels in rats are reduced by dietary supplementation of flaxseed or its lignan secoisolariciresinol diglycoside. Cancer Lett 2000;161:47-55. PubMed
  13. Mousavi Y, Adlercreutz H. Enterolactone and estradiol inhibit each other's proliferative effect on MCF-7 breast cancer cells in culture. J Steroid Biochem Mol Biol 1992;41:615-9.. PubMed
  14. Adlercreutz H, Fotsis T, Bannwart C, et al. Determination of urinary lignans and phytoestrogen metabolites, potential antiestrogens and anticarcinogens, in urine of women on various habitual diets. J Steroid Biochem 1986;25:791-7.. PubMed
  15. Rose DP. Dietary fiber and breast cancer. Nutr Cancer 1990;13:1-8.. PubMed
  16. Lemay A, Dodin S, Kadri N, et al. Flaxseed dietary supplement versus hormone replacement therapy in hypercholesterolemic menopausal women. Obstet Gynecol 2002;100:495-504.. DOI
  17. Brooks JD, Ward WE, Lewis JE, et al. Supplementation with flaxseed alters estrogen metabolism in postmenopausal women to a greater extent than does supplementation with an equal amount of soy. Am J Clin Nutr 2004;79:318-25.. PubMed
  18. Laaksonen DE, Laukkanen JA, Niskanen L, et al. Serum linoleic and total polyunsaturated fatty acids in relation to prostate and other cancers: a population-based cohort study. Int J Cancer 2004;111:444-50.. PubMed
  19. Dodin S, Lemay A, Jacques H, et al. The effects of flaxseed dietary supplement on lipid profile, bone mineral density, and symptoms in menopausal women: a randomized, double-blind, wheat germ placebo-controlled clinical trial. J Clin Endocrinol Metab 2005 PubMed
  20. Brouwer IA, Katan MB, Zock PL. Dietary alpha-linolenic acid is associated with reduced risk of fatal coronary heart disease, but increased prostate cancer risk: a meta-analysis. J Nutr 2004;134:919-22.
  21. Demark-Wahnefried W, Polascik TJ, George SL, et al. Flaxseed supplementation (not dietary fat restriction) reduces prostate cancer proliferation rates in men presurgery. Cancer Epidemiol Biomarkers Prev 2008;17:3577-87. PubMed
  22. Thompson LU, Chen JM, Li T, et al. Dietary flaxseed alters tumor biological markers in postmenopausal breast cancer. Clin Cancer Res 2005;11:3828-35. PubMed
  23. Mani UV, Mani I, Biswas M, Kumar SN. An open-label study on the effect of flax seed powder (Linum usitatissimum) supplementation in the management of diabetes mellitus. J Diet Suppl 2011;8:257-65.
  24. Rhee Y, Brunt A. Flaxseed supplementation improved insulin resistance in obese glucose intolerant people: a randomized crossover design. Nutr J 2011;10:44. PubMed
  25. Cornish SM, Chilibeck PD, Paus-Jennsen L, et al. A randomized controlled trial of the effects of flaxseed lignan complex on metabolic syndrome composite score and bone mineral in older adults. Appl Physiol Nutr Metab 2009;34:89-98. PubMed
  26. Cockerell KM, Watkins AS, Reeves LB, et al. Effects of linseeds on the symptoms of irritable bowel syndrome: a pilot randomised controlled trial. J Hum Nutr Diet 2012;25:435-43. PubMed
  27. Colli MC, Bracht A, Soares AA, et al. Evaluation of the efficacy of flaxseed meal and flaxseed extract in reducing menopausal symptoms. J Med Food 2012;15:840-5. PubMed
  28. Allman, M. A., Pena, M. M., and Pang, D. Supplementation with flaxseed oil versus sunflowerseed oil in healthy young men consuming a low fat diet: effects on platelet composition and function. Eur.J Clin.Nutr. 1995;49(3):169-178.
  29. Simbalista RL, Sauerbronn AV, Aldrighi JM, Areas JA. Consumption of a flaxseed-rich food is not more effective than a placebo in alleviating the climacteric symptoms of postmenopausal women. J Nutr 2010;140:293-7. PubMed
  30. Patade A, Devareddy L, Lucas EA, et al. Flaxseed reduces total and LDL cholesterol concentrations in Native American postmenopausal women. J Womens Health (Larchmt) 2008;17:355-66. PubMed
  31. Rodriguez-Leyva D, Weighell W, Edel AL, LaVallee R, Dibrov E, Pinneker R, Maddaford TG, Ramjiawan B, Aliani M, Guzman R, Pierce GN. Potent antihypertensive action of dietary flaxseed in hypertensive patients. Hypertension. 2013 Dec;62(6):1081-9. PubMed
  32. Bloedon LT, Balikai S, Chittams J, et al. Flaxseed and cardiovascular risk factors: results from a double blind, randomized, controlled clinical trial. J Am Coll Nutr 2008;27:65-74. PubMed
  33. Ursoniu S, Sahebkar A, Andrica F, Serban C, Banach M; Lipid and Blood Pressure Meta-analysis Collaboration Group. Effects of flaxseed supplements on blood pressure: a systematic review and meta-analysis of controlled clinical trial. Clin Nutr. 2016 Jun;3 PubMed
  34. Mohammadi-Sartang M, Sohrabi Z, Barati-Bodaji R, Raeisi-Dehkordi H, Mazloom Z. Flaxseed supplementation on glucose control and insulin sensitivity: a systematic review and meta-analysis of 25 randomized, placebo-controlled trials. Nutr Rev. 2018 Feb 1;76( PubMed
  35. Haidari F, Banaei-Jahromi N, Zakerkish M, Ahmadi K. The effects of flaxseed supplementation on metabolic status in women with polycystic ovary syndrome: a randomized open-labeled controlled clinical trial. Nutr J. 2020;19(1):8. PubMed
  36. Villarreal-Renteria AI, Herrera-Echauri DD, Rodríguez-Rocha NP, et al. Effect of flaxseed (Linum usitatissimum) supplementation on glycemic control and insulin resistance in prediabetes and type 2 diabetes: A systematic review and meta-analysis of randomi
  37. Li L, Li H, Gao Y, Vafaei S, Zhang X, Yang M. Effect of flaxseed supplementation on blood pressure: a systematic review, and dose-response meta-analysis of randomized clinical trials. Food Funct 2023;14(2):675-690. PubMed

See these in context on the Flaxseed monograph →

Red Raspberry 8 references
  1. Eagon PK, Elm MS, Hunter DS, et al. Medicinal herbs: modulation of estrogen action. Era of Hope Mtg, Dept Defense; Breast Cancer Res Prog, Atlanta, GA 2000;Jun 8-11.
  2. Parsons M, Simpson M, Ponton T. Raspberry leaf and its effects on labour: safety and efficacy. Aust Coll Midwives Inc J 1999;12:20-5.
  3. Simpson M, Parsons M, Greenwood J, Wade K. Raspberry leaf in pregnancy: its safety and efficacy in labor. J Midwifery Womens Health 2001;46:51-9.. PubMed
  4. Mullen W, McGinn J, Lean ME, et al. Ellagitannins, flavonoids, and other phenolics in red raspberries and their contribution to antioxidant capacity and vasorelaxation properties. J Agric Food Chem 2002;50:5191-6.. PubMed
  5. Sherson, D., Andersen, B., Hansen, I., and Kjoller, H. Occupational asthma due to freeze-dried raspberry. Ann Allergy Asthma Immunol. 2003;90(6):660-663. PubMed
  6. Cheang KI, Nguyen TT, Karjane NW, Salley KE. Raspberry Leaf and Hypoglycemia in Gestational Diabetes Mellitus. Obstet Gynecol. 2016;128(6):1421-4. PubMed
  7. Dudzinska D, Bednarska K, Boncler M, Luzak B, Watala C. The influence of Rubus idaeus and Rubus caesius leaf extracts on platelet aggregation in whole blood. Cross-talk of platelets and neutrophils. Platelets. 2016;27(5):433-9.
  8. Henrotin Y, Cozannet RL, Fança-Berthon P, et al. Rubus idaeus extract improves symptoms in knee osteoarthritis patients: results from a phase II double-blind randomized controlled trial. BMC Musculoskelet Disord 2022;23(1):650. PubMed

See these in context on the Red Raspberry monograph →

Cranberry 33 references
  1. Anon. Possible interaction between warfarin and cranberry juice. Current Problems in Pharmacovigilance 2003;29:8. PubMed
  2. Greenblatt DJ, von Moltke LL, Perloff ES, et al. Interaction of flurbiprofen with cranberry juice, grape juice, tea, and fluconazole: in vitro and clinical studies. Clin Pharmacol Ther 2006;79:125-33. PubMed
  3. Hodek P, Trefil P, Stiborova M. Flavonoids-potent and versatile biologically active compounds interacting with cytochromes P450. Chem Biol Interact 2002;139:1-21.. PubMed
  4. Grant P. Warfarin and cranberry juice: An interaction? J Heart Valve Dis 2004;13:25-6.
  5. Suvarna R, Pirmohamed M, Henderson L. Possible interaction between warfarin and cranberry juice. BMJ 2003;327:1454. PubMed
  6. Li Z, Seeram NP, Carpenter CL, et al. Cranberry does not affect prothrombin time in male subjects on warfarin. J Am Diet Assoc 2006;106:2057-61. PubMed
  7. Lilja JJ, Backman JT, Neuvonen PJ. Effects of daily ingestion of cranberry juice on the pharmacokinetics of warfarin, tizanidine, and midazolam - probes of CYP2C9, CYP1A2 and CYP3A4. Clin Pharmacol The 2007:81:833-9. PubMed
  8. Wing DA, Rumney PJ, Preslicka CW, Chung JH. Daily cranberry juice for the prevention of asymptomatic bacteriuria in pregnancy: a randomized, controlled pilot study. J Urol 2008;180:1367-72. PubMed
  9. Mohammed Abdul MI, Jiang X, Williams KM, et al. Pharmacodynamic interaction of warfarin with cranberry but not with garlic in healthy subjects. Br J Pharmacol 2008;154:1691-700. PubMed
  10. McMurdo MET, Argo I, Phillips G, et al. Cranberry or trimethoprim for the prevention of recurrently urinary tract infections? A randomized controlled trial in older women. J Antimicrob Chemother 2009;63:389-95.
  11. Mergenhagen KA, Sherman O. Elevated International Normalized Ratio after concurrent ingestion of cranberry sauce and warfarin. Am J Health-Syst Pharm 2008;65:2113-6. PubMed
  12. Ansell J, McDonough M, Zhao Y, et al. The absence of an interaction between warfarin and cranberry juice: a randomized, double-blind trial. J Clin Pharmacol 2009;49:824-30. PubMed
  13. Haber SL, Cauthon KA, Raney EC. Cranberry and warfarin interaction: a case report and review of the literature. Consult Pharm 2012;27:58-65. PubMed
  14. Hamann GL, Campbell JD, George CM. Warfarin-cranberry juice interaction. Ann Pharmacother 2011;45:e17. PubMed
  15. Roberts D, Flanagan P. Case report: Cranberry juice and warfarin. Home Healthc Nurse 2011;29:92-7.
  16. Garcia-Calatayud, S., Larreina Cordoba, J. J., and Lozano De La Torre MJ. [Severe cranberry juice poisoning]. An.Esp.Pediatr. 2002;56(1):72-73.
  17. Patel, D. A., Gillespie, B., Sobel, J. D., Leaman, D., Nyirjesy, P., Weitz, M. V., and Foxman, B. Risk factors for recurrent vulvovaginal candidiasis in women receiving maintenance antifungal therapy: results of a prospective cohort study. Am J Obstet.Gy PubMed
  18. Isele, H. [Fatal bleeding under warfarin plus cranberry juice. Is it due to salicylic acid?]. MMW.Fortschr.Med 3-11-2004;146(11):13.
  19. Linsenmeyer, T. A., Harrison, B., Oakley, A., Kirshblum, S., Stock, J. A., and Millis, S. R. Evaluation of cranberry supplement for reduction of urinary tract infections in individuals with neurogenic bladders secondary to spinal cord injury. A prospecti
  20. McMurdo, M. E., Bissett, L. Y., Price, R. J., Phillips, G., and Crombie, I. K. Does ingestion of cranberry juice reduce symptomatic urinary tract infections in older people in hospital? A double-blind, placebo-controlled trial. Age Ageing 2005;34(3):256- PubMed
  21. Sylvan, L. and Justice, N. P. Possible interaction between warfarin and cranberry juice. Am Fam.Physician 9-15-2005;72(6):1000.
  22. Niklasson, A. and Andren, L. [Interaction between Waran and cranberry juice]. Lakartidningen 3-15-2006;103(11):853-854.
  23. Rindone, J. P. and Murphy, T. W. Warfarin-cranberry juice interaction resulting in profound hypoprothrombinemia and bleeding. Am J Ther 2006;13(3):283-284. PubMed
  24. Uesawa, Y. and Mohri, K. Effects of cranberry juice on nifedipine pharmacokinetics in rats. J Pharm Pharmacol 2006;58(8):1067-1072. PubMed
  25. Valentova, K., Stejskal, D., Bednar, P., Vostalova, J., Cihalik, C., Vecerova, R., Koukalova, D., Kolar, M., Reichenbach, R., Sknouril, L., Ulrichova, J., and Simanek, V. Biosafety, antioxidant status, and metabolites in urine after consumption of dried
  26. Royer, D. J., George, J. N., and Terrell, D. R. Thrombocytopenia as an adverse effect of complementary and alternative medicines, herbal remedies, nutritional supplements, foods, and beverages. Eur J Haematol 2010;84(5):421-429. PubMed
  27. Stapleton, A. E., Dziura, J., Hooton, T. M., Cox, M. E., Yarova-Yarovaya, Y., Chen, S., and Gupta, K. Recurrent urinary tract infection and urinary Escherichia coli in women ingesting cranberry juice daily: a randomized controlled trial. Mayo.Clin.Proc. PubMed
  28. Doad GJ, Kabange W. Cranberry juice, atorvastatin and back pain. J Med Assoc Ga 2014;103(1):14.
  29. Griffiths AP, Beddall A, Pegler S. Fatal haemopericardium and gastrointestinal haemorrhage due to possible interaction of cranberry juice with warfarin. J R Soc Promot Health 2008;128(6):324-6. PubMed
  30. Mellen CK, Ford M, Rindone JP. Effect of high-dose cranberry juice on the pharmacodynamics of warfarin in patients. Br J Clin Pharmacol 2010;70(1):139-42. PubMed
  31. Ushijima K, Tsuruoka S, Tsuda H, Hasegawa G, Obi Y, Kaneda T, Takahashi M, Maekawa T, Sasaki T, Koshimizu TA, Fujimura A. Cranberry juice suppressed the diclofenac metabolism by human liver microsomes, but not in healthy human subjects. Br J Clin Pharmaco PubMed
  32. Ngo N, Brantley SJ, Carrizosa DR, et al. The warfarin-cranberry juice interaction revisited: A systematic in vitro-in vivo evaluation. J Exp Pharmacol. 2010;2010(2):83-91.
  33. Williams G, Stothart CI, Hahn D, Stephens JH, Craig JC, Hodson EM. Cranberries for preventing urinary tract infections. Cochrane Database Syst Rev 2023;11(11):CD001321. PubMed

See these in context on the Cranberry monograph →

Strawberry 18 references
  1. Grattan CE, Harman RR. Contact urticaria to strawberry. Contact Dermatitis 1985;13:191-2. . PubMed
  2. Dutta-Roy, A. K., Crosbie, L., and Gordon, M. J. Effects of tomato extract on human platelet aggregation in vitro. Platelets. 2001;12(4):218-227. PubMed
  3. Van Gelder, J., Deferme, S., Naesens, L., De Clercq, E., van den, Mooter G., Kinget, R., and Augustijns, P. Intestinal absorption enhancement of the ester prodrug tenofovir disoproxil fumarate through modulation of the biochemical barrier by defined este
  4. Deferme, S., Van Gelder, J., and Augustijns, P. Inhibitory effect of fruit extracts on P-glycoprotein-related efflux carriers: an in-vitro screening. J Pharm Pharmacol 2002;54(9):1213-1219.
  5. Naemura, A., Mitani, T., Ijiri, Y., Tamura, Y., Yamashita, T., Okimura, M., and Yamamoto, J. Anti-thrombotic effect of strawberries. Blood Coagul.Fibrinolysis 2005;16(7):501-509. PubMed
  6. Basu A, Betts NM, Nguyen A, Newman ED, Fu D, Lyons TJ. Freeze-dried strawberries lower serum cholesterol and lipid peroxidation in adults with abdominal adiposity and elevated serum lipids. J Nutr. 2014;144(6):830-7. PubMed
  7. Feresin RG, Johnson SA, Pourafshar S, et al. Impact of daily strawberry consumption on blood pressure and arterial stiffness in pre- and stage 1-hypertensive postmenopausal women: a randomized controlled trial. Food Funct. 2017;8(11):4139-4149. PubMed
  8. Moazen S, Amani R, Homayouni Rad A, Shahbazian H, Ahmadi K, Taha Jalali M. Effects of freeze-dried strawberry supplementation on metabolic biomarkers of atherosclerosis in subjects with type 2 diabetes: a randomized double-blind controlled trial. Ann Nutr PubMed
  9. Schell J, Scofield RH, Barrett JR, et al. Strawberries improve pain and inflammation in obese adults with radiographic evidence of knee osteoarthritis. Nutrients. 2017;9(9):949. PubMed
  10. Zunino SJ, Parelman MA, Freytag TL, et al. Effects of dietary strawberry powder on blood lipids and inflammatory markers in obese human subjects. Br J Nutr. 2012;108(5):900-9. PubMed
  11. Amani R, Moazen S, Shahbazian H, Ahmadi K, Jalali MT. Flavonoid-rich beverage effects on lipid profile and blood pressure in diabetic patients. World J Diabetes. 2014;5(6):962-8. PubMed
  12. Cabrera-Freitag P, Bermejo Becerro A, Abreu Ramírez MG, et al. Allergy to strawberry in children from the Mediterranean area: is it really allergy? J Investig Allergol Clin Immunol 2020;30(4):283-5. PubMed
  13. Hadi A, Askarpour M, Miraghajani M, Symonds ME, Sheikhi A, Ghaedi E. Effects of strawberry supplementation on cardiovascular risk factors: a comprehensive systematic review and meta-analysis of randomized controlled trials. Food Funct 2019;10(11):6987-98. PubMed
  14. Gao Q, Qin LQ, Arafa A, Eshak ES, Dong JY. Effects of strawberry intervention on cardiovascular risk factors: a meta-analysis of randomised controlled trials. Br J Nutr 2020;124(3):241-6. PubMed
  15. Basu A, Izuora K, Hooyman A, Scofield HR, Ebersole JL. Dietary Strawberries Improve Serum Metabolites of Cardiometabolic Risks in Adults with Features of the Metabolic Syndrome in a Randomized Controlled Crossover Trial. Int J Mol Sci 2023;24(3):2051. PubMed
  16. Huang L, Xiao D, Zhang X, et al. Strawberry Consumption, Cardiometabolic Risk Factors, and Vascular Function: A Randomized Controlled Trial in Adults with Moderate Hypercholesterolemia. J Nutr 2021;151(6):1517-1526. PubMed
  17. Basu A, Izuora K, Betts NM, et al. Dietary Strawberries Improve Cardiometabolic Risks in Adults with Obesity and Elevated Serum LDL Cholesterol in a Randomized Controlled Crossover Trial. Nutrients 2021;13(5):1421. PubMed
  18. Wilken MR, Lambert MNT, Christensen CB, Jeppesen PB. Effects of Anthocyanin-rich Berries on the Risk of Metabolic Syndrome: A Systematic Review and Meta-analysis. Rev Diabet Stud 2022;18(1):42-57. PubMed

See these in context on the Strawberry monograph →

Bifidobacterium Bifidum 7 references
  1. Pierce A. The American Pharmaceutical Association Practical Guide to Natural Medicines. New York: The Stonesong Press, 1999:19.
  2. Xiao JZ, Takahashi S, Odamaki T, et al. Antibiotic susceptibility of bifidobacterial strains distributed in the Japanese market. Biosci Biotechnol Biochem. 2010;74(2):336-42. PubMed
  3. Rerksuppaphol S, Rerksuppaphol L. Randomized controlled trial of probiotics to reduce common cold in schoolchildren. Pediatr Int. 2012;54(5):682-7. PubMed
  4. Karamali M, Dadkhah F, Sadrkhanlou M, et al. Effects of probiotic supplementation on glycaemic control and lipid profiles in gestational diabetes: a randomized, double-blind, placebo-controlled trial. Diabetes Metab 2016;42(4):234-41. PubMed
  5. Badehnoosh B, Karamali M, Zarrati M, et al. The effects of probiotic supplementation on biomarkers of inflammation, oxidative stress and pregnancy outcomes in gestational diabetes. J Matern Fetal Neonatal Med. 2018 May;31(9):1128-1136.
  6. Pruccoli G, Silvestro E, Pace Napoleone C, Aidala E, Garazzino S, Scolfaro C. Are probiotics safe? Bifidobacterium bacteremia in a child with severe heart failure. Infez Med. 2019;27(2):175-178.
  7. Esaiassen E, Hjerde E, Cavanagh JP, Simonsen GS, Klingenberg C; Norwegian Study Group on Invasive Bifidobacterial Infections. Bifidobacterium bacteremia: Clinical characteristics and a genomic approach to assess pathogenicity. J Clin Microbiol. 2017;55(7) PubMed

See these in context on the Bifidobacterium Bifidum monograph →

Proteolytic Enzymes (proteases) 3 references
  1. Weeks JA, Harper RA, Simon RA, Burdick JD. Assessment of sensitization risk of a laundry pre-spotter containing protease. Cutan Ocul Toxicol. 2011;30(4):272-9. PubMed
  2. Marquès LI, Lara S, Abós T, Bartolomé B. Occupational rhinitis due to pepsin. J Investig Allergol Clin Immunol. 2006;16(2):136-7. DOI
  3. Cartier A, Malo JL, Pineau L, Dolovich J. Occupational asthma due to pepsin. J Allergy Clin Immunol. 1984;73(5 Pt 1):574-7. PubMed

See these in context on the Proteolytic Enzymes (proteases) monograph →

Banana 11 references
  1. Ble-Castillo JL, Aparicio-Trápala MA, Francisco-Luria MU, Córdova-Uscanga R, Rodríguez-Hernández A, Méndez JD, Díaz-Zagoya JC. Effects of native banana starch supplementation on body weight and insulin sensitivity in obese type 2 diabetics. Int J Environ PubMed
  2. Jiménez-Domínguez G, Ble-Castillo JL, Aparicio-Trápala MA, Juárez-Rojop IE, Tovilla-Zárate CA, Ble-Castillo DJ, García-Vázquez C, Olvera-Hernández V, Pérez-Pimienta B, Diaz-Zagoya JC, Mendez JD. Effects of Acute Ingestion of Native Banana Starch on Glycem
  3. Nieman DC, Gillitt ND, Sha W, et al. Metabolomics-Based Analysis of Banana and Pear Ingestion on Exercise Performance and Recovery. J Proteome Res 2015;14(12):5367-77. doi: 10.1021/acs.jproteome.5b00909. PubMed
  4. Rabbani GH, Ahmed S, Hossain I, Islam R, Marni F, Akhtar M, Majid N. Green banana reduces clinical severity of childhood shigellosis: a double-blind, randomized, controlled clinical trial. Pediatr Infect Dis J. 2009 May;28(5):420-5. PubMed
  5. Schoeffl V, Varatorn R, Blinnikov O, Vidamaly V. Intestinal obstruction due to phytobezoars of banana seeds: a case report. Asian J Surg. 2004 Oct;27(4):348-51. PubMed
  6. Don M, Longo G. Food protein-induced enterocolitis syndrome due to banana: an uncommon entity. Eur Ann Allergy Clin Immunol. 2013 Apr;45(2):61-2.
  7. Tazoe M, Narita M, Sakuta R, Nagai T, Narita N. Hyperkalemia and hyperdopaminemia induced by an obsessive eating of banana in an anorexia nervosa adolescent. Brain Dev. 2007 Jul;29(6):369-72. PubMed
  8. Meynadier J, Meynadier JM, Guilhou JJ. [Contact urticaria in atopic patients. Apropos of 2 cases]. Ann Dermatol Venereol. 1982;109(10):871-4.
  9. Hauswirth DW, Burks AW. Banana anaphylaxis with a negative commercial skin test. J Allergy Clin Immunol. 2005 Mar;115(3):632-3. PubMed
  10. Hotozuka S, Yasu T, Hikita E, Shirota M. Interaction Between Levodopa and Banana in a Patient With Parkinson's Disease. Am J Ther 2022;29(4):465-467. PubMed
  11. Arias-Córdova Y, Ble-Castillo JL, García-Vázquez C, et al. Resistant Starch Consumption Effects on Glycemic Control and Glycemic Variability in Patients with Type 2 Diabetes: A Randomized Crossover Study. Nutrients 2021;13(11):4052. PubMed

See these in context on the Banana monograph →

Bacopa 12 references
  1. Stough C, Lloyd J, Clarke J, et al. The chronic effects of an extract of Bacopa monniera (Brahmi) on cognitive function in healthy human subjects. Psychopharmacology 2001;156:481-4..
  2. Yadav SK, Jain AK, Tripathi SN, Gupta JP. Irritable bowel syndrome: therapeutic evaluation of indigenous drugs. Indian J Med Res 1989;90:496-503..
  3. Morgan A, Stevens J. Does Bacopa monnieri improve memory performance in older persons? Results of a randomized, placebo-controlled, double-blind trial. J Altern Complement Med 2010;16:753-9.
  4. Kar, A., Panda, S., and Bharti, S. Relative efficacy of three medicinal plant extracts in the alteration of thyroid hormone concentrations in male mice. J Ethnopharmacol. 2002;81(2):281-285. PubMed
  5. Mukherjee, G. D. and Dey, C. D. Clinical trial on Brahmi. I. J.Exp.Med.Sci. 1966;10(1):5-11.
  6. Kar A, Pandit S, Mukherjee K, Bahadur S, Mukherjee PK. Safety assessment of selected medicinal food plants used in Ayurveda through CYP450 enzyme inhibition study. J Sci Food Agric 2017;97(1):333-40. doi: 10.1002/jsfa.7739. PubMed
  7. Kongkeaw C, Dilokthornsakul P, Thanarangsarit P, et al. Meta-analysis of randomized controlled trials on cognitive effects of Bacopa monnieri extract. J Ethnopharmacol 2014;151(1):528-35. PubMed
  8. Ramasamy S, Kiew LV, Chung LY. Inhibition of human cytochrome P450 enzymes by Bacopa monnieri standardized extract and constituents. Molecules 2014;19(2):2588-601. PubMed
  9. Prabhakar S, Vishnu VY, Modi M, et al. Efficacy of Bacopa monnieri (Brahmi) and donepezil in Alzheimer's disease and mild cognitive impairment: a randomized double-blind parallel phase 2b study. Ann Indian Acad Neurol 2020;23(6):767-73. PubMed
  10. Acquarulo B, Tandon P, Macica CM. Suspected cholinergic toxicity due to cevimeline hydrochloride and Bacopa monnieri interaction: a case report. J Med Case Rep 2022;16(1):253. PubMed
  11. Keegan AP, Stough C, Paris D, et al. Bacopa monnieri supplementation has no effect on serum brain-derived neurotrophic factor levels but beneficially modulates nuclear factor kappa B and cyclic AMP response element-binding protein levels in healthy elderl
  12. Yaworski AM, Blyumin M, Chang T, Mammen AL, Greene M. Necrotizing myopathy with elevated anti-HMGCR antibodies following exposure to the supplement Bacopa. Muscle Nerve 2023;67(2):E1-E3.

See these in context on the Bacopa monograph →

Chia 12 references
  1. Kolonel LN, Nomura AM, Cooney RV. Dietary fat and prostate cancer: current status. J Natl Cancer Inst 1999;91:414-28. PubMed
  2. Ramon JM, Bou R, Romea S, et al. Dietary fat intake and prostate cancer risk: a case-control study in Spain. Cancer Causes Control 2000;11:679-85. PubMed
  3. De Stefani E, Deneo-Pellegrini H, Boffetta P, et al. Alpha-linolenic acid and risk of prostate cancer: a case-control study in Uruguay. Cancer Epidemiol Biomarkers Prev 2000;9:335-8.
  4. Giovannucci E, Rimm EB, Colditz GA, et al. A prospective study of dietary fat and risk of prostate cancer. J Natl Cancer Inst 1993;85:1571-9. PubMed
  5. Laaksonen DE, Laukkanen JA, Niskanen L, et al. Serum linoleic and total polyunsaturated fatty acids in relation to prostate and other cancers: a population-based cohort study. Int J Cancer 2004;111:444-50.. PubMed
  6. Leitzmann MF, Stampfer MJ, Michaud DS, et al. Dietary intake of n-3 and n-6 fatty acids and the risk of prostate cancer. Am J Clin Nutr 2004;80:204-16. PubMed
  7. Brouwer IA, Katan MB, Zock PL. Dietary alpha-linolenic acid is associated with reduced risk of fatal coronary heart disease, but increased prostate cancer risk: a meta-analysis. J Nutr 2004;134:919-22.
  8. Chavarro JE, Stampfer MJ, Li H, et al. A prospective study of polyunsaturated fatty acid levels in blood and prostate cancer risk. Cancer Epidemiol Biomarkers Prev 2007;16:1364-70. PubMed
  9. Brouwer IA, Geleijnse JM, Klaasen VM, Smit LA, Giltay EJ, de Goede J, Heijboer AC, Kromhout D, Katan MB. Effect of alpha linolenic acid supplementation on serum prostate specific antigen (PSA): results from the alpha omega trial. PLoS One. 2013 Dec 11;8(1 PubMed
  10. García Jiménez S, Pastor Vargas C, de las Heras M, Sanz Maroto A, Vivanco F, Sastre J. Allergen characterization of chia seeds (Salvia hispanica), a new allergenic food. J Investig Allergol Clin Immunol. 2015;25(1):55-6.
  11. Vuksan V, Jenkins AL, Brissette C, et al. Salba-chia (Salvia hispanica L.) in the treatment of overweight and obese patients with type 2 diabetes: a double-blind randomized controlled trial. Nutr Metab Cardiovasc Dis 2017;27(2):138-46. PubMed
  12. Zbinden-Foncea H, Ramos-Navarro C, Hevia-Larraín V, et al. Neither Chia Flour nor Whey Protein Supplementation Further Improves Body Composition or Strength Gains after a Resistance Training Program in Young Subjects with a Habitual High Daily Protein Int

See these in context on the Chia monograph →

Chicory 13 references
  1. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
  2. Stone-Dorshow T, Levitt MD. Gaseous response to ingestion of a poorly absorbed fructo-oligosaccharide sweetener. Am J Clin Nutr 1987;46:61-5. PubMed
  3. Briet F, et al. Symptomatic response to varying levels of fructo-oligosaccharides consumed occasionally or regularly. Eur J Clin Nutr 1995;49:501-7.
  4. Bouhnik Y, Vahedi K, Achour L, et al. Short-chain fructo-oligosaccharide administration dose-dependently increases fecal bifidobacteria in healthy humans. J Nutr 1999;129:113-6. PubMed
  5. Cummings JH, Macfarlane GT, Englyst HN. Prebiotic digestion and fermentation. Am J Clin Nutr 2001;73:415S-420S. PubMed
  6. Cadot, P., Kochuyt, A. M., van Ree, R., and Ceuppens, J. L. Oral allergy syndrome to chicory associated with birch pollen allergy. Int.Arch.Allergy Immunol. 2003;131(1):19-24. PubMed
  7. Friis, B., Hjorth, N., Vail, J. T., Jr., and Mitchell, J. C. Occupational contact dermatitis from Cichorium (chicory, endive) and Lactuca (lettuce). Contact Dermatitis 1975;1(5):311-313.
  8. Nemery, B. and Demedts, M. Occupational asthma in a chicory grower. Lancet 3-25-1989;1(8639):672-673. PubMed
  9. Pirson F, Detry B, Pilette C. Occupational rhinoconjunctivitis and asthma caused by chicory and oral allergy syndrome associated with bet v 1-related protein. J Investig Allergol Clin Immunol 2009;19(4):306-10.
  10. Willi R, Pfab F, Huss-Marp J, et al. Contact anaphylaxis and protein contact dermatitis in a cook handling chicory leaves. Contact Dermatitis 2009;60(4):226-7. PubMed
  11. Street RA, Sidana J, Prinsloo G. Cichorium intybus: traditional uses, phytochemistry, pharmacology, and toxicology. Evid Based Complement Alternat Med 2013;2013:579319.
  12. Bonnema AL, Kolberg LW, Thomas W, Slavin JL. Gastrointestinal tolerance of chicory inulin products. J Am Diet Assoc 2010;110(6):865-8. PubMed
  13. Devi Kt R, Sivalingam N. Cichorium intybus attenuates Streptozotocin-induced pancreatic ß-cell damage by inhibiting NF-?B activation and oxidative stress. J Appl Biomed 2020;18(2-3):70-9. PubMed

See these in context on the Chicory monograph →

Whey Protein 25 references
  1. Martindale W. Martindale the Extra Pharmacopoeia. Pharmaceutical Press, 1999.
  2. Maton PN, Burton ME. Antacids revisited: a review of their clinical pharmacology and recommended therapeutic use. Drugs 1999;57:855-70.
  3. Bell SJ. Whey protein concentrates with and without immunoglobulins: a review. J Med Food 2000;3:1-13. PubMed
  4. Nutt JG, Woodward WR, Hammerstad JP, et al. The "on-off" phenomenon in Parkinson's disease. Relation to levodopa absorption and transport. N Engl J Med 1984;310:483-8. PubMed
  5. Baruzzi A, Contin M, Riva R, et al. Influence of meal ingestion time on pharmacokinetics of orally administered levodopa in parkinsonian patients. Clin Neuropharmacol 1987;10:527-37. PubMed
  6. Juncos JL, Fabbrini G, Mouradian MM, et al. Dietary influences on the antiparkinsonian response to levodopa. Arch Neurol 1987;44:1003-5. PubMed
  7. Eriksson T, Granerus AK, Linde A, et al. "On-off" phenomenon in Parkinson's disease: relationship between dopa and other large neutral amino acids in plasma. Neurology 1988;38:1245-8. PubMed
  8. Semla TP, Beizer JL, Higbee MD. Geriatric Dosage Handbook. 4th ed. Hudson, OH: Lexicomp, 1998.
  9. Pletz MW, Petzold P, Allen A, et al. Effect of calcium carbonate on bioavailability of orally administered gemifloxacin. Antimicrob Agents Chemother 2003;47:2158-60.. PubMed
  10. Peters ML, Leonard M, Licata AA. Role of alendronate and risedronate in preventing and treating osteoporosis. Cleve Clin J Med 2001;68:945-51. PubMed
  11. Micke, P., Beeh, K. M., and Buhl, R. Effects of long-term supplementation with whey proteins on plasma glutathione levels of HIV-infected patients. Eur.J Nutr 2002;41(1):12-18. PubMed
  12. Chitapanarux, T., Tienboon, P., Pojchamarnwiputh, S., and Leelarungrayub, D. Open-labeled pilot study of cysteine-rich whey protein isolate supplementation for nonalcoholic steatohepatitis patients. J Gastroenterol.Hepatol. 2009;24(6):1045-1050. PubMed
  13. Sataloff, R. T., Bittermann, T., Marks, L., Lurie, D., and Hawkshaw, M. The effects of glutathione enhancement on sensorineural hearing loss. Ear Nose Throat J 2010;89(9):422-433.
  14. Zhu, K., Meng, X., Kerr, D. A., Devine, A., Solah, V., Binns, C. W., and Prince, R. L. The effects of a two-year randomized, controlled trial of whey protein supplementation on bone structure, IGF-1, and urinary calcium excretion in older postmenopausal
  15. Bjorkman, M. P., Pilvi, T. K., Kekkonen, R. A., Korpela, R., and Tilvis, R. S. Similar effects of leucine rich and regular dairy products on muscle mass and functions of older polymyalgia rheumatica patients: a randomized crossover trial. J Nutr Health A
  16. Brun, A. C., Stordal, K., Johannesdottir, G. B., Bentsen, B. S., and Medhus, A. W. The effect of protein composition in liquid meals on gastric emptying rate in children with cerebral palsy. Clin.Nutr 2012;31(1):108-112. PubMed
  17. Gouni-Berthold, I., Schulte, D. M., Krone, W., Lapointe, J. F., Lemieux, P., Predel, H. G., and Berthold, H. K. The whey fermentation product malleable protein matrix decreases TAG concentrations in patients with the metabolic syndrome: a randomised plac
  18. Errichiello, L., Pezzella, M., Santulli, L., Striano, S., Zara, F., Minetti, C., Mainardi, P., and Striano, P. A proof-of-concept trial of the whey protein alfa-lactalbumin in chronic cortical myoclonus. Mov Disord. 2011;26(14):2573-2575. PubMed
  19. Carcillo, J. A., Dean, J. M., Holubkov, R., Berger, J., Meert, K. L., Anand, K. J., Zimmerman, J., Newth, C. J., Harrison, R., Burr, J., Willson, D. F., and Nicholson, C. The randomized comparative pediatric critical illness stress-induced immune suppres
  20. Chungchunlam, S. M., Moughan, P. J., Henare, S. J., and Ganesh, S. Effect of time of consumption of preloads on measures of satiety in healthy normal weight women. Appetite 2012;59(2):281-288. PubMed
  21. Rencuzogullari I, Börekçi A, Karakoyun S, et al. Coronary thrombosis in three coronary arteries due to whey protein. Am J Emerg Med. 2017;35(4):664.e3-664.e4. PubMed
  22. Silverberg NB. Whey protein precipitating moderate to severe acne flares in 5 teenaged athletes. Case Reports Cutis. 2012;90(2):70-2.
  23. Simonart T. Acne and whey protein supplementation among bodybuilders. Dermatology. 2012;225(3):256-8. PubMed
  24. Pontes TC, Costa Fernandes Filho GM, Pereira Trindade AS, Sobral Filho JF. Incidence of acne vulgaris in young adult users of protein-calorie supplements in the city of Jo&atilde;o Pessoa-PB. An Bras Dermatol. 2013;88(6):907-12.
  25. Adebamowo CA, Spiegelman D, Berkey CS, et al. Milk consumption and acne in teenaged boys. J Am Acad Dermatol. 2008 May;58(5):787-93. PubMed

See these in context on the Whey Protein monograph →

Bovine Colostrum 8 references
  1. Lewis CJ. Letter to reiterate certain public health and safety concerns to firms manufacturing or importing dietary supplements that contain specific bovine tissues. FDA. Available at: www.cfsan.fda.gov/~dms/dspltr05.html.
  2. Greenberg PD, Cello JP. Treatment of severe diarrhea caused by Cryptosporidium parvum with oral bovine immunoglobulin concentrate in patients with AIDS. J Acquir Immune Defic Syndr Hum Retrovirol 1996;13:348-54. PubMed
  3. Duff WR, Chilibeck PD, Rooke JJ, Kaviani M, Krentz JR, Haines DM. The effect of bovine colostrum supplementation in older adults during resistance training. Int J Sport Nutr Exerc Metab. 2014 Jun;24(3):276-85. PubMed
  4. Sanctuary MR, Kain JN, Chen SY, et al. Pilot study of probiotic/colostrum supplementation on gut function in children with autism and gastrointestinal symptoms. PLoS One. 2019;14(1):e0210064. PubMed
  5. Porcaro F, Caminiti L, Crisafulli G, Guglielmo F, Pajno GB. Anaphylaxis to cutaneous exposure to bovine colostrum based cream. Asian Pac J Allergy Immunol. 2019;37(1):9-11.
  6. Yan X, Pan X, Ding L, et al. Bovine colostrum to supplement the first feeding of very preterm infants: The PreColos randomized controlled trial. Clin Nutr 2023;42(8):1408-1417. PubMed
  7. Halasa M, Skonieczna-Zydecka K, Machalinski B, Bühner L, Baskiewicz-Halasa M. Six Weeks of Supplementation with Bovine Colostrum Effectively Reduces URTIs Symptoms Frequency and Gravity for Up to 20 Weeks in Pre-School Children. Nutrients 2023;15(16):3626 PubMed
  8. Simonsen MB, Kappel SS, Aunsholt L, Möller S, Sangild PT, Zachariassen G. Mineral supplementation for very preterm infants fed fortified human milk. J Pediatr Gastroenterol Nutr 2024;78(6):1389-1397. PubMed

See these in context on the Bovine Colostrum monograph →

Lactobacillus Acidophilus 15 references
  1. Pierce A. The American Pharmaceutical Association Practical Guide to Natural Medicines. New York: The Stonesong Press, 1999:19.
  2. Begtrup LM, de Muckadell OB, Kjeldsen J, Christensen RD, Jarbøl DE. Long-term treatment with probiotics in primary care patients with irritable bowel syndrome--a randomised, double-blind, placebo controlled trial. Scand J Gastroenterol 2013;48(10):1127-35 PubMed
  3. Chatterjee S, Kar P, Das T, Ray S, Gangulyt S, Rajendiran C, Mitra M. Randomised placebo-controlled double blind multicentric trial on efficacy and safety of Lactobacillus acidophilus LA-5 and Bifidobacterium BB-12 for prevention of antibiotic-associated
  4. Shavakhi A, Tabesh E, Yaghoutkar A, Hashemi H, Tabesh F, Khodadoostan M,Minakari M, Shavakhi S, Gholamrezaei A. The effects of multistrain probiotic compound on bismuth-containing quadruple therapy for Helicobacter pylori infection: a randomized placebo-c
  5. Karamali M, Dadkhah F, Sadrkhanlou M, et al. Effects of probiotic supplementation on glycaemic control and lipid profiles in gestational diabetes: a randomized, double-blind, placebo-controlled trial. Diabetes Metab 2016;42(4):234-41. PubMed
  6. Badehnoosh B, Karamali M, Zarrati M, et al. The effects of probiotic supplementation on biomarkers of inflammation, oxidative stress and pregnancy outcomes in gestational diabetes. J Matern Fetal Neonatal Med. 2018 May;31(9):1128-1136.
  7. Kumar S, Kumar R, Rohilla L, Jacob N, Yadav J, Sachdeva N. A high potency multi-strain probiotic improves glycemic control in children with new-onset type 1 diabetes mellitus: A randomized, double-blind, and placebo-controlled pilot study. Pediatr Diabete
  8. Shahriari A, Karimi E, Shahriari M, Aslani N, Khooshideh M, Arab A. The effect of probiotic supplementation on the risk of gestational diabetes mellitus among high-risk pregnant women: A parallel double-blind, randomized, placebo-controlled clinical trial PubMed
  9. Xiao SD, Zhang DZ, Lu H, et al. Multicenter, randomized, controlled trial of heat-killed Lactobacillus acidophilus LB in patients with chronic diarrhea. Adv Ther. 2003;20(5):253-60.
  10. Rossi F, Amadoro C, Gasperi M, Colavita G. Lactobacilli infection case reports in the last three years and safety implications. Nutrients. 2022;14(6):1178. PubMed
  11. Ozer M, Goksu SY, Shahverdiani A, Mustafa M. Lactobacillus acidophilus-induced endocarditis and associated splenic abscess. Case Rep Infect Dis 2020;2020:1382709.
  12. Sadrin S, Sennoune S, Gout B, et al. A 2-strain mixture of Lactobacillus acidophilus in the treatment of irritable bowel syndrome: A placebo-controlled randomized clinical trial. Dig Liver Dis 2020;52(5):534-540. PubMed
  13. Stoffer JN, Slingsby TJ, Giuliari GP. Lactobacillus acidophilus endophthalmitis after intravitreal bevacizumab injection requiring intraocular lens explantation. Can J Ophthalmol 2022;57(1):e21-e22. PubMed
  14. Cukovic-Cavka S, Likic R, Francetic I, Rustemovic N, Opacic M, Vucelic B. Lactobacillus acidophilus as a cause of liver abscess in a NOD2/CARD15-positive patient with Crohn's disease. Digestion 2006;73(2-3):107-10.
  15. Hui J, Ren Y, Wang Y, Han Q. Lactobacillus acidophilus endophthalmitis postcataract operation: A case report with a literature review. Ocul Immunol Inflamm 2023.

See these in context on the Lactobacillus Acidophilus monograph →

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

Keep exploring
Supplement interaction checker › Check any supplement or product against your medications Drug–drug interactions › Check two or more of your medications against each other Browse medications A–Z › Every drug we've checked against herbs & supplements NDC & pricing lookup › Find a drug’s NDCs, packaging and costs Ask a pharmacist › Free, personal answer from our licensed team