SuperFoods Ingredients & Drug Interactions
by Hero Nutritionals Yummi Bears
What is this page for?
First and foremost: checking SuperFoods 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
SuperFoods is a dietary supplement by Hero Nutritionals Yummi Bears with 23 active ingredients. Its ingredients are commonly taken for common cold and immune support, antioxidant support, skin health and collagen formation.Based on those ingredients, 1,366 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are Pomegranate, Grape, Beet. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against SuperFoods by Hero Nutritionals Yummi Bears
Ask about any prescription or over-the-counter medication and we check it for interactions with SuperFoods by Hero Nutritionals Yummi Bears — and tell you which ingredient is responsible.
AI summaries are generated from our interaction database for education only — always confirm with your pharmacist. How we use AI
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HelloPharmacist Scorecard of SuperFoods by Hero Nutritionals Yummi Bears
Our pharmacy team’s full take, with four database checks built into the cards below — a summary of what is known, not a grade of the product itself.
What’s inside
Low disclosure
This gummy contains 22 active ingredients: the vitamins C, E, and A; the vegetables carrot, cauliflower, broccoli, spinach, Brussels sprout, tomato, beet, cabbage, and pumpkin; the fruits grape, strawberry, blueberry, pomegranate, raspberry, plum, apple, acerola cherry, and blackberry; and the herb parsley. The product also lists a Certified Organic Fruit & Vegetable Blend and an Antioxidant Fruit and Vegetable Blend, whose individual components are the ingredients already named above.
The gummy is made with glucose syrup, cane sugar, gelatin, lactic acid, citric acid, natural flavors, organic colors, coconut oil, and carnauba wax as inactive ingredients to form and preserve the product.
Does it work?
Moderate evidence
Most of these ingredients have limited or unclear evidence for specific health claims. Vitamin C is effective for vitamin C deficiency and possibly effective for anemia of chronic disease, exercise-related respiratory infections, cataracts, and atrial fibrillation.
Vitamin E is effective for vitamin E deficiency and possibly effective for Alzheimer disease and G6PD deficiency. Vitamin A is effective for vitamin A deficiency and possibly effective for measles, aging skin, and ulcerative colitis.
Broccoli is possibly effective for colorectal cancer. Plum is possibly effective for constipation.
Beet is possibly effective for athletic performance and exercise soreness. For most other ingredients — including carrot, grape, blueberry, strawberry, spinach, pumpkin, parsley, and the other vegetables — the evidence is either insufficient to rate or has not been established in our data.
How safe is it?
Well-documented data
These ingredients are generally well tolerated at normal food amounts. High-dose vitamin C can cause stomach cramps, diarrhea, nausea, and kidney stones in those prone to them.
High-dose vitamin E raises the risk of bleeding and hemorrhagic stroke. High-dose vitamin A is toxic and can damage the liver, cause headache, and in severe cases, coma.
Most of the vegetables and fruits are safe as food; concentrated extracts are less studied. Pregnancy and breastfeeding: Normal food amounts of these ingredients are considered safe in pregnancy.
Vitamin C at high doses and vitamin A at high doses should be avoided in pregnancy because of birth-defect risk — stick to recommended amounts from prenatal vitamins. Parsley in medicinal amounts may stimulate the uterus and should be avoided in pregnancy; food amounts are fine.
For breastfeeding, standard dietary amounts are safe; high-dose supplements of vitamin C, vitamin E, and most vegetable extracts lack enough safety data — check with your doctor or pharmacist before taking concentrated supplements while nursing.
Meds to double-check
Major interaction found
Before taking this product, check with your doctor or pharmacist about: OATP substrates like atenolol, fexofenadine, and aliskiren (Major severity — apple significantly cuts their blood levels); anticoagulants and antiplatelet agents like warfarin, aspirin, and clopidogrel (Moderate — multiple ingredients, especially vitamin E, grape, strawberry, plum, parsley, and spinach, raise bleeding risk); estrogens in birth control or hormone therapy (Moderate — vitamin C raises estrogen levels); liver-metabolizing enzymes and substrates like those processed by CYP3A4, CYP2D6, CYP1A2 (Moderate — vitamin E, grape, pomegranate, broccoli, cauliflower, Brussels sprout, cabbage, and beet can change drug metabolism); chemotherapy drugs including alkylating agents and antitumor antibiotics (Moderate — vitamins C and E may reduce their effectiveness); antidiabetes medications (Moderate — spinach, cabbage, parsley, and blueberry may lower blood sugar); antihypertensive drugs (Moderate — apple, pomegranate, and beet may affect blood pressure); and diuretics, cyclosporine, levothyroxine, and lithium (Moderate — specific vegetables and vitamins have interactions with each).
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 multivitamin gummy offers common fruits, vegetables, and vitamins, but the breadth of interactions means you need to check it carefully against your own medications before starting. If you take blood thinners, blood pressure medications, diabetes drugs, birth control, immunosuppressants, chemotherapy, or any psychiatric or cardiac medication, talk with your doctor or pharmacist first — even seemingly small doses of vitamin C, vitamin E, apple, or the cruciferous vegetables can shift how your drugs work.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 21 of 22 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Jul 21, 2022.
This Scorecard evaluates available label information, ingredient evidence, and known medication-safety considerations. It does not independently verify product identity, purity, potency, contamination, or manufacturing quality. How these ratings are computed
General information
Key facts about SuperFoods, straight from the product label.
| Brand | Hero Nutritionals Yummi Bears |
|---|---|
| Net contents | 90 Yummi Bear(s) |
| Market status | On market |
| Date entered into DSLD | Jul 21, 2022 |
| DSLD ID | 268226 |
| Product type | Botanical With Nutrients |
| Supplement form | Gummy Or Jelly |
| Dietary claims / uses | Nutrient, All Other, Structure/Function |
| Intended target group(s) | Children (All), No Allergies, Gluten Free, Dairy Free |
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.
Supplement Facts
The label details for SuperFoods by Hero Nutritionals Yummi Bears, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Calories | 25 Calorie(s) | -- |
| Total Carbohydrates | 5 Gram(s) | 2% |
| Sugar | 4 Gram(s) | -- |
| Vitamin C | 60 mg | 150%, 100% |
| Vitamin E | 15 IU | 150%, 50% |
| Vitamin A | 2500 IU | 100%, 50% |
| Carrot | 0 NP | -- |
| Grape | 0 NP | -- |
| Cauliflower | 0 NP | -- |
| Strawberry | 0 NP | -- |
| Blueberry | 0 NP | -- |
| Pomegranate | 0 NP | -- |
| Broccoli | 0 NP | -- |
| Tomato | 0 NP | -- |
| Spinach | 0 NP | -- |
| Brussels Sprout | 0 NP | -- |
| Raspberry | 0 NP | -- |
| Pumpkin | 0 NP | -- |
| Plum | 0 NP | -- |
| Apple | 0 NP | -- |
| Acerola Cherry | 0 NP | -- |
| Parsley | 0 NP | -- |
| Beet | 0 NP | -- |
| Blackberry | 0 NP | -- |
| Cabbage | 0 NP | -- |
| Certified Organic Fruit & Vegetable Blend | 82 mg | -- |
| Antioxidant Fruit and Vegetable Blend | 18 mg | -- |
Other ingredients: Glucose Syrup, Cane Sugar, Natural, Gelatin, Lactic Acid, Citric Acid, Natural flavors, organic Colors, Coconut Oil, Carnauba Wax
Tap any ingredient to jump to its full detail below.
These statements are the manufacturer’s wording, reproduced from the product label — the label is saying it, not HelloPharmacist. We don’t verify or endorse them.
General Statements
New look!
Actual size and serving:
Gummy product may settle over time.
Questions or comments? 800.500.HERO (4376) 8am-4pm, M-F, PST heronutritionals.com
Our passion continues in providing essential nutrients for the whole family, with Yummi Slices Adult Gummy Vitamins - a wide range of nutritional support for adults, in delicious, easy to take gummies.
Brand IP Statement(s)
The Original Gummy Vitamin
Pure love deserves pure nutrition The original gummy vitamin for over 20 years
Formulation
12 certified organic fruits & veggies in every serving
Non GMO Allergen free Gluten free Dairy free
Free of: Gluten, yeast, wheat, dairy, eggs, peanuts, shellfish, fish, artificial flavors, artificial colors and artificial preservatives.
Manufactured in the USA in our state-of-the-art certified organic facility.
Yummi Bears and Yummi Slices gummy vitamins are made in our state-of-the-art, certified organic facility in California, so you can be assured you are getting the best quality.
FDA Disclaimer Statement
Dietary Supplement
These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.
Formula
Yummi Bears SuperFoods Fruits + Veggies are rich in key antioxidants from 20 fruits and veggies which include A, C, and E. Essential nutrition never tasted so good!
Antiox powerful antioxidants Vitamin A eye and skin health Vitamin C antioxidant and immune support Vitamin E antioxidant and heart health
For over 20 years we've been making Yummi Bears - The Original Gummy Vitamin formulated just for kids.
And because you care about what goes into your kids, we care about what goes into our gummies: natural fruit flavors, colors and sweeteners - plus they're non-GMO, allergen and gluten free.
Suggested/Recommended/Usage/Directions
Suggested Use: As a dietary supplement, give each child three (3) bears per day.
Precautions
Keep out of reach of children.
Storage
Store in a cool, dry place. Do not use if safety seal is broken. Keep sealed for freshness.
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
SuperFoods by Hero Nutritionals Yummi Bears label
The label scan from the NIH Dietary Supplement Label Database. Tap to enlarge.
Label images are published by the NIH Dietary Supplement Label Database for the version of this product on file. Always read your actual product label.
View the full label (PDF)The Ingredients in SuperFoods by Hero Nutritionals Yummi Bears
These are the 23 active ingredients this product is made of. Select any to open its full monograph.
Serving size3 Bear(s) Dosage formGummy Or Jelly Servings per container30 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.
Sugar
Vitamin C
Interacts with207 drugs
Vitamin C (ascorbic acid) is an essential nutrient your body needs but cannot make, so you must get it from food or supplements. It's important for im...
Vitamin C monograph & interactionsVitamin E
Interacts with764 drugs
Vitamin E is an essential fat-soluble vitamin and antioxidant that most people get in adequate amounts from a normal diet. Supplements can help correc...
Vitamin E monograph & interactionsVitamin A
Interacts with387 drugs
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 & interactionsCertified Organic Fruit & Vegetable Blend
- › Carrot
- › Strawberry
- › Blueberry
- › Pomegranate
- › Tomato
- › Spinach
- › Raspberry
- › Pumpkin
- › Plum
- › Apple
- › Acerola Cherry
- › Beet
Antioxidant Fruit and Vegetable Blend
- › Grape
- › Cauliflower
- › Broccoli
- › Brussels Sprout
- › Parsley
- › Blackberry
- › Cabbage
Other (inactive) ingredients: Glucose Syrup, Cane Sugar, Natural, Gelatin, Lactic Acid, Citric Acid, Natural flavors, Organic Colors, Coconut Oil, Carnauba Wax. These complete the product’s ingredient list but are not active constituents.
SuperFoods by Hero Nutritionals Yummi Bears Drug Interactions
HelloPharmacist Interaction Report
Hero Nutritionals Yummi Bears SuperFoods gummy contains multiple ingredients with documented interactions with medications.
The most serious is a Major interaction: through its apple content, this product can significantly reduce absorption of organic anion-transporting polypeptide (OATP) substrates — drugs like fexofenadine, atenolol, and aliskiren — cutting their blood levels by up to 82%.
Read the full breakdown — every affected drug type, severity by severity
Moderate interactions are extensive. Vitamin C may increase estrogen levels in birth control or hormone therapy; reduce warfarin effectiveness; and theoretically lower effectiveness of certain chemotherapy drugs (alkylating agents and antitumor antibiotics).
Vitamin E raises bleeding risk with blood thinners and may reduce chemotherapy activity. Vitamin A at high doses risks bleeding with warfarin and can add to liver toxicity.
Apple juice also interferes with atenolol, fexofenadine, aliskiren, and potentially lithium. Grape extracts may affect multiple drug-metabolizing enzymes and increase bleeding risk.
Several cruciferous vegetables — broccoli, cauliflower, Brussels sprout, cabbage, and spinach — alter how your liver processes numerous medications. Pomegranate, plum, parsley, and beet carry additional moderate interactions with blood pressure drugs, blood thinners, diabetes medications, and liver-metabolizing enzymes.
Blueberry carries minor interactions with diabetes and anxiety medications. Acerola cherry (which contains vitamin C) has minor interactions with aspirin and warfarin.
We could not check Raspberry — no data is on file for it.
Altogether, these interactions span 1,367 individual medications. Before starting this product, run it through the medication checker on this page or talk with your doctor or pharmacist about your exact prescriptions.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against SuperFoods?
Ask about interactions with your drugs in plain English — “Can I take it with lisinopril?” — and we find you the answer in seconds, ingredient by ingredient.
Go to the checkerIngredients driving the most interactions
Individual Drug Interactions
The ingredients in SuperFoods interact with 1,366 drugs. Click any drug to see the details.
18 of the 23 ingredients in SuperFoods interact with drugs. Each result below shows which ingredient is responsible. Pomegranate Grape Beet Vitamin E Parsley Vitamin A Cabbage Strawberry Apple Brussels Sprout Vitamin C Broccoli Cauliflower Acerola Cherry Plum Blueberry Spinach Pumpkin
AcitretinSoriatane
How Acitretin interacts with SuperFoods — through 1 ingredient. Tap an ingredient for the detail:
Vitamin ARetinoids Major
Interaction Summary
Concomitant use of retinoids with vitamin A supplements might produce supratherapeutic vitamin A levels.
Read the full Vitamin A + Acitretin interactionAlitretinoinPanretin
How Alitretinoin interacts with SuperFoods — through 1 ingredient. Tap an ingredient for the detail:
Vitamin ARetinoids Major
Interaction Summary
Concomitant use of retinoids with vitamin A supplements might produce supratherapeutic vitamin A levels.
Read the full Vitamin A + Alitretinoin interactionAtorvastatinAtorvaliq
How Atorvastatin interacts with SuperFoods — through 8 ingredients. Tap an ingredient for the detail:
AppleOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple + Atorvastatin interactionBeetCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, beet might increase the levels of CYP3A4 substrates.
Read the full Beet + Atorvastatin interactionGrapeCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
It is unclear if grape seed extract inhibits or induces CYP3A4; research is conflicting.
Read the full Grape + Atorvastatin interactionVitamin AHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking high doses of vitamin A in combination with other potentially hepatotoxic drugs might increase the risk of liver disease.
Read the full Vitamin A + Atorvastatin interactionBrussels SproutGlucuronidated Drugs Moderate
Interaction Summary
A cabbage and Brussels sprout-containing diet seems to boost elimination through glucuronide conjugation.
Read the full Brussels Sprout + Atorvastatin interactionCabbageGlucuronidated Drugs Moderate
Interaction Summary
Theoretically, cabbage might increase clearance and decrease the effects of drugs metabolized through glucuronide conjugation.
Read the full Cabbage + Atorvastatin interactionVitamin ECytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Vitamin E + Atorvastatin interactionPomegranateCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, pomegranate might increase levels of drugs metabolized by CYP3A4, but most research suggests this interaction is unlikely to be clinically significant.
Read the full Pomegranate + Atorvastatin interactionAtorvastatin CalciumLipitor
How Atorvastatin Calcium interacts with SuperFoods — through 8 ingredients. Tap an ingredient for the detail:
AppleOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple + Atorvastatin Calcium interactionVitamin ECytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Vitamin E + Atorvastatin Calcium interactionVitamin AHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking high doses of vitamin A in combination with other potentially hepatotoxic drugs might increase the risk of liver disease.
Read the full Vitamin A + Atorvastatin Calcium interactionBrussels SproutGlucuronidated Drugs Moderate
Interaction Summary
A cabbage and Brussels sprout-containing diet seems to boost elimination through glucuronide conjugation.
Read the full Brussels Sprout + Atorvastatin Calcium interactionGrapeCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
It is unclear if grape seed extract inhibits or induces CYP3A4; research is conflicting.
Read the full Grape + Atorvastatin Calcium interactionCabbageGlucuronidated Drugs Moderate
Interaction Summary
Theoretically, cabbage might increase clearance and decrease the effects of drugs metabolized through glucuronide conjugation.
Read the full Cabbage + Atorvastatin Calcium interactionBeetCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, beet might increase the levels of CYP3A4 substrates.
Read the full Beet + Atorvastatin Calcium interactionPomegranateCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, pomegranate might increase levels of drugs metabolized by CYP3A4, but most research suggests this interaction is unlikely to be clinically significant.
Read the full Pomegranate + Atorvastatin Calcium interactionBexaroteneTargretin
How Bexarotene interacts with SuperFoods — through 5 ingredients. Tap an ingredient for the detail:
Vitamin ARetinoids Major
Interaction Summary
Concomitant use of retinoids with vitamin A supplements might produce supratherapeutic vitamin A levels.
Read the full Vitamin A + Bexarotene interactionGrapeCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
It is unclear if grape seed extract inhibits or induces CYP3A4; research is conflicting.
Read the full Grape + Bexarotene interactionBeetCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, beet might increase the levels of CYP3A4 substrates.
Read the full Beet + Bexarotene interactionVitamin ECytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Vitamin E + Bexarotene interactionPomegranateCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, pomegranate might increase levels of drugs metabolized by CYP3A4, but most research suggests this interaction is unlikely to be clinically significant.
Read the full Pomegranate + Bexarotene interactionBosentanTracleer
How Bosentan interacts with SuperFoods — through 6 ingredients. Tap an ingredient for the detail:
AppleAntihypertensive Drugs, Organic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Consuming apple juice with antihypertensive drugs might interfere with blood pressure control.
Read the full Apple + Bosentan interactionVitamin AHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking high doses of vitamin A in combination with other potentially hepatotoxic drugs might increase the risk of liver disease.
Read the full Vitamin A + Bosentan interactionGrapeCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 2c9 (cyp2c9) Substrates Moderate
Interaction Summary
It is unclear if grape seed extract inhibits or induces CYP3A4; research is conflicting.
Read the full Grape + Bosentan interactionBeetCytochrome P450 3a4 (cyp3a4) Substrates, Antihypertensive Drugs Moderate
Interaction Summary
Theoretically, beet might increase the levels of CYP3A4 substrates.
Read the full Beet + Bosentan interactionVitamin ECytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Vitamin E + Bosentan interactionPomegranateAntihypertensive Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Moderate
Interaction Summary
Theoretically, taking pomegranate with antihypertensive drugs might increase the risk of hypotension.
Read the full Pomegranate + Bosentan interactionBrincidofovirTembexa
How Brincidofovir interacts with SuperFoods — through 1 ingredient. Tap an ingredient for the detail:
AppleOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple + Brincidofovir interactionCeliprololCelicard
How Celiprolol interacts with SuperFoods — through 4 ingredients. Tap an ingredient for the detail:
AppleAntihypertensive Drugs, Organic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Consuming apple juice with antihypertensive drugs might interfere with blood pressure control.
Read the full Apple + Celiprolol interactionStrawberryP-glycoprotein Substrates Moderate
Interaction Summary
In vitro research suggests that strawberry extract can inhibit p-glycoprotein efflux.
Read the full Strawberry + Celiprolol interactionPomegranateAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, taking pomegranate with antihypertensive drugs might increase the risk of hypotension.
Read the full Pomegranate + Celiprolol interactionBeetAntihypertensive Drugs Minor
Interaction Summary
Beet and beetroot contain nitrates, which can cause vasodilation, potentially leading to lower blood pressure.
Read the full Beet + Celiprolol interactionCerivastatin SodiumBaycol
How Cerivastatin Sodium interacts with SuperFoods — through 2 ingredients. Tap an ingredient for the detail:
AppleOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple + Cerivastatin Sodium interactionVitamin AHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking high doses of vitamin A in combination with other potentially hepatotoxic drugs might increase the risk of liver disease.
Read the full Vitamin A + Cerivastatin Sodium interactionCinoxacinCinobac
How Cinoxacin interacts with SuperFoods — through 2 ingredients. Tap an ingredient for the detail:
AppleOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple + Cinoxacin interactionVitamin AHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking high doses of vitamin A in combination with other potentially hepatotoxic drugs might increase the risk of liver disease.
Read the full Vitamin A + Cinoxacin interactionCiprofloxacinCiloxan, Cipro, Cipro IV, Cipro XR, Ciprobay, Otiprio
How Ciprofloxacin interacts with SuperFoods — through 2 ingredients. Tap an ingredient for the detail:
AppleOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple + Ciprofloxacin interactionVitamin AHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking high doses of vitamin A in combination with other potentially hepatotoxic drugs might increase the risk of liver disease.
Read the full Vitamin A + Ciprofloxacin interactionCiprofloxacin, HydrocortisoneCipro HC Otic
How Ciprofloxacin, Hydrocortisone interacts with SuperFoods — through 1 ingredient. Tap an ingredient for the detail:
AppleOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple + Ciprofloxacin, Hydrocortisone interactionClinafloxacinClinafloxacin
How Clinafloxacin interacts with SuperFoods — through 1 ingredient. Tap an ingredient for the detail:
AppleOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple + Clinafloxacin interactionEnoxacinPenetrex
How Enoxacin interacts with SuperFoods — through 1 ingredient. Tap an ingredient for the detail:
AppleOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple + Enoxacin interactionEtoposideEtopophos, VePesid, VP16
How Etoposide interacts with SuperFoods — through 6 ingredients. Tap an ingredient for the detail:
AppleOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple + Etoposide interactionGrapeCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
It is unclear if grape seed extract inhibits or induces CYP3A4; research is conflicting.
Read the full Grape + Etoposide interactionVitamin ECytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Vitamin E + Etoposide interactionBeetCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, beet might increase the levels of CYP3A4 substrates.
Read the full Beet + Etoposide interactionStrawberryP-glycoprotein Substrates Moderate
Interaction Summary
In vitro research suggests that strawberry extract can inhibit p-glycoprotein efflux.
Read the full Strawberry + Etoposide interactionPomegranateCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, pomegranate might increase levels of drugs metabolized by CYP3A4, but most research suggests this interaction is unlikely to be clinically significant.
Read the full Pomegranate + Etoposide interactionEzetimibe, AtorvastatinLiptruzet
How Ezetimibe, Atorvastatin interacts with SuperFoods — through 8 ingredients. Tap an ingredient for the detail:
AppleOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple + Ezetimibe, Atorvastatin interactionVitamin ECytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Vitamin E + Ezetimibe, Atorvastatin interactionVitamin AHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking high doses of vitamin A in combination with other potentially hepatotoxic drugs might increase the risk of liver disease.
Read the full Vitamin A + Ezetimibe, Atorvastatin interactionBrussels SproutGlucuronidated Drugs Moderate
Interaction Summary
A cabbage and Brussels sprout-containing diet seems to boost elimination through glucuronide conjugation.
Read the full Brussels Sprout + Ezetimibe, Atorvastatin interactionGrapeCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
It is unclear if grape seed extract inhibits or induces CYP3A4; research is conflicting.
Read the full Grape + Ezetimibe, Atorvastatin interactionCabbageGlucuronidated Drugs Moderate
Interaction Summary
Theoretically, cabbage might increase clearance and decrease the effects of drugs metabolized through glucuronide conjugation.
Read the full Cabbage + Ezetimibe, Atorvastatin interactionBeetCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, beet might increase the levels of CYP3A4 substrates.
Read the full Beet + Ezetimibe, Atorvastatin interactionPomegranateCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, pomegranate might increase levels of drugs metabolized by CYP3A4, but most research suggests this interaction is unlikely to be clinically significant.
Read the full Pomegranate + Ezetimibe, Atorvastatin interactionFexofenadineAllegra
How Fexofenadine interacts with SuperFoods — through 6 ingredients. Tap an ingredient for the detail:
AppleOrganic Anion-transporting Polypeptide Substrates (oatp), Fexofenadine (allegra) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple + Fexofenadine interactionStrawberryP-glycoprotein Substrates Moderate
Interaction Summary
In vitro research suggests that strawberry extract can inhibit p-glycoprotein efflux.
Read the full Strawberry + Fexofenadine interactionVitamin ECytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Vitamin E + Fexofenadine interactionGrapeCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
It is unclear if grape seed extract inhibits or induces CYP3A4; research is conflicting.
Read the full Grape + Fexofenadine interactionBeetCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, beet might increase the levels of CYP3A4 substrates.
Read the full Beet + Fexofenadine interactionPomegranateCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, pomegranate might increase levels of drugs metabolized by CYP3A4, but most research suggests this interaction is unlikely to be clinically significant.
Read the full Pomegranate + Fexofenadine interactionFexofenadine, PseudoephedrineAllegra D
How Fexofenadine, Pseudoephedrine interacts with SuperFoods — through 6 ingredients. Tap an ingredient for the detail:
AppleOrganic Anion-transporting Polypeptide Substrates (oatp), Fexofenadine (allegra) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple + Fexofenadine, Pseudoephedrine interactionBeetCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, beet might increase the levels of CYP3A4 substrates.
Read the full Beet + Fexofenadine, Pseudoephedrine interactionGrapeCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
It is unclear if grape seed extract inhibits or induces CYP3A4; research is conflicting.
Read the full Grape + Fexofenadine, Pseudoephedrine interactionStrawberryP-glycoprotein Substrates Moderate
Interaction Summary
In vitro research suggests that strawberry extract can inhibit p-glycoprotein efflux.
Read the full Strawberry + Fexofenadine, Pseudoephedrine interactionVitamin ECytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Vitamin E + Fexofenadine, Pseudoephedrine interactionPomegranateCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, pomegranate might increase levels of drugs metabolized by CYP3A4, but most research suggests this interaction is unlikely to be clinically significant.
Read the full Pomegranate + Fexofenadine, Pseudoephedrine interactionFluvastatinLescol, Lescol XL
How Fluvastatin interacts with SuperFoods — through 4 ingredients. Tap an ingredient for the detail:
AppleOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple + Fluvastatin interactionVitamin AHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking high doses of vitamin A in combination with other potentially hepatotoxic drugs might increase the risk of liver disease.
Read the full Vitamin A + Fluvastatin interactionGrapeCytochrome P450 2c9 (cyp2c9) Substrates Minor
Interaction Summary
It is unclear if grape juice or grape seed extract inhibits CYP2C9; research is conflicting.
Read the full Grape + Fluvastatin interactionPomegranateCytochrome P450 2c9 (cyp2c9) Substrates Minor
Interaction Summary
Theoretically, pomegranate might increase levels of drugs metabolized by CYP2C9.
Read the full Pomegranate + Fluvastatin interactionGatifloxacinTequin, Tequin Injection
How Gatifloxacin interacts with SuperFoods — through 2 ingredients. Tap an ingredient for the detail:
AppleOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple + Gatifloxacin interactionVitamin AHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking high doses of vitamin A in combination with other potentially hepatotoxic drugs might increase the risk of liver disease.
Read the full Vitamin A + Gatifloxacin interactionGemifloxacinFactive
How Gemifloxacin interacts with SuperFoods — through 1 ingredient. Tap an ingredient for the detail:
AppleOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple + Gemifloxacin interactionGlyburideAlbert Glyburide, Diabeta, Glycron, Glynase, Glynase PresTab, Micronase +1 more
How Glyburide interacts with SuperFoods — through 8 ingredients. Tap an ingredient for the detail:
AppleOrganic Anion-transporting Polypeptide Substrates (oatp), Antidiabetes Drugs Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple + Glyburide interactionCabbageAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, cabbage might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Read the full Cabbage + Glyburide interactionSpinachAntidiabetes Drugs Moderate
Interaction Summary
There are claims that spinach leaves have hypoglycemic effects.
Read the full Spinach + Glyburide interactionParsleyAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, parsley might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Read the full Parsley + Glyburide interactionVitamin AHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking high doses of vitamin A in combination with other potentially hepatotoxic drugs might increase the risk of liver disease.
Read the full Vitamin A + Glyburide interactionBlueberryAntidiabetes Drugs Minor
Interaction Summary
Theoretically, blueberries or blueberry leaf extracts might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Read the full Blueberry + Glyburide interactionPomegranateCytochrome P450 2c9 (cyp2c9) Substrates Minor
Interaction Summary
Theoretically, pomegranate might increase levels of drugs metabolized by CYP2C9.
Read the full Pomegranate + Glyburide interactionGrapeCytochrome P450 2c9 (cyp2c9) Substrates Minor
Interaction Summary
It is unclear if grape juice or grape seed extract inhibits CYP2C9; research is conflicting.
Read the full Grape + Glyburide interactionGlyburide, MetforminGlucovance
How Glyburide, Metformin interacts with SuperFoods — through 8 ingredients. Tap an ingredient for the detail:
AppleAntidiabetes Drugs, Organic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Theoretically, consuming apple juice with antidiabetes drugs might interfere with blood glucose control.
Read the full Apple + Glyburide, Metformin interactionSpinachAntidiabetes Drugs Moderate
Interaction Summary
There are claims that spinach leaves have hypoglycemic effects.
Read the full Spinach + Glyburide, Metformin interactionCabbageAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, cabbage might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Read the full Cabbage + Glyburide, Metformin interactionVitamin AHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking high doses of vitamin A in combination with other potentially hepatotoxic drugs might increase the risk of liver disease.
Read the full Vitamin A + Glyburide, Metformin interactionParsleyAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, parsley might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Read the full Parsley + Glyburide, Metformin interactionGrapeCytochrome P450 2c9 (cyp2c9) Substrates Minor
Interaction Summary
It is unclear if grape juice or grape seed extract inhibits CYP2C9; research is conflicting.
Read the full Grape + Glyburide, Metformin interactionPomegranateCytochrome P450 2c9 (cyp2c9) Substrates Minor
Interaction Summary
Theoretically, pomegranate might increase levels of drugs metabolized by CYP2C9.
Read the full Pomegranate + Glyburide, Metformin interactionBlueberryAntidiabetes Drugs Minor
Interaction Summary
Theoretically, blueberries or blueberry leaf extracts might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Read the full Blueberry + Glyburide, Metformin interactionGrepafloxacinRaxar
How Grepafloxacin interacts with SuperFoods — through 8 ingredients. Tap an ingredient for the detail:
AppleOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple + Grepafloxacin interactionGrapeCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, grape juice might reduce the levels of CYP1A2 substrates.
Read the full Grape + Grepafloxacin interactionCabbageCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, cabbage might decrease levels of drugs metabolized by CYP1A2.
Read the full Cabbage + Grepafloxacin interactionParsleyCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, parsley might increase serum levels of CYP1A2 substrates.
Read the full Parsley + Grepafloxacin interactionBrussels SproutCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Animal research suggests that Brussels sprout can induce cytochrome P450 1A2 (CYP1A2) activity.
Read the full Brussels Sprout + Grepafloxacin interactionCauliflowerCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Preliminary clinical evidence suggests that eating cruciferous vegetables, including broccoli, cauliflower, daikon radish sprouts, and cabbage, can increase cytochrome P450 1A2 (CYP1A2) activity by 14% to 27%.
Read the full Cauliflower + Grepafloxacin interactionBroccoliCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, broccoli might reduce the levels and effects of drugs metabolized by CYP1A2.
Read the full Broccoli + Grepafloxacin interactionBeetCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, beet might decrease the levels and clinical effects of CYP1A2 substrates.
Read the full Beet + Grepafloxacin interactionHalobetasol Propionate,tazaroteneDuobrii
How Halobetasol Propionate,tazarotene interacts with SuperFoods — through 1 ingredient. Tap an ingredient for the detail:
Vitamin ARetinoids Major
Interaction Summary
Concomitant use of retinoids with vitamin A supplements might produce supratherapeutic vitamin A levels.
Read the full Vitamin A + Halobetasol Propionate,tazarotene interactionIrinotecanCamptosar, Onivyde
How Irinotecan interacts with SuperFoods — through 7 ingredients. Tap an ingredient for the detail:
AppleOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple + Irinotecan interactionGrapeCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
It is unclear if grape seed extract inhibits or induces CYP3A4; research is conflicting.
Read the full Grape + Irinotecan interactionCabbageGlucuronidated Drugs Moderate
Interaction Summary
Theoretically, cabbage might increase clearance and decrease the effects of drugs metabolized through glucuronide conjugation.
Read the full Cabbage + Irinotecan interactionBrussels SproutGlucuronidated Drugs Moderate
Interaction Summary
A cabbage and Brussels sprout-containing diet seems to boost elimination through glucuronide conjugation.
Read the full Brussels Sprout + Irinotecan interactionBeetCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, beet might increase the levels of CYP3A4 substrates.
Read the full Beet + Irinotecan interactionVitamin ECytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Vitamin E + Irinotecan interactionPomegranateCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, pomegranate might increase levels of drugs metabolized by CYP3A4, but most research suggests this interaction is unlikely to be clinically significant.
Read the full Pomegranate + Irinotecan interactionIrinotecan Hydrochloride
How Irinotecan Hydrochloride interacts with SuperFoods — through 7 ingredients. Tap an ingredient for the detail:
AppleOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple + Irinotecan Hydrochloride interactionVitamin ECytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Vitamin E + Irinotecan Hydrochloride interactionBrussels SproutGlucuronidated Drugs Moderate
Interaction Summary
A cabbage and Brussels sprout-containing diet seems to boost elimination through glucuronide conjugation.
Read the full Brussels Sprout + Irinotecan Hydrochloride interactionGrapeCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
It is unclear if grape seed extract inhibits or induces CYP3A4; research is conflicting.
Read the full Grape + Irinotecan Hydrochloride interactionCabbageGlucuronidated Drugs Moderate
Interaction Summary
Theoretically, cabbage might increase clearance and decrease the effects of drugs metabolized through glucuronide conjugation.
Read the full Cabbage + Irinotecan Hydrochloride interactionBeetCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, beet might increase the levels of CYP3A4 substrates.
Read the full Beet + Irinotecan Hydrochloride interactionPomegranateCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, pomegranate might increase levels of drugs metabolized by CYP3A4, but most research suggests this interaction is unlikely to be clinically significant.
Read the full Pomegranate + Irinotecan Hydrochloride interactionIsoniazid, Pyrazinamide, RifampinRifater
How Isoniazid, Pyrazinamide, Rifampin interacts with SuperFoods — through 2 ingredients. Tap an ingredient for the detail:
AppleOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple + Isoniazid, Pyrazinamide, Rifampin interactionVitamin AHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking high doses of vitamin A in combination with other potentially hepatotoxic drugs might increase the risk of liver disease.
Read the full Vitamin A + Isoniazid, Pyrazinamide, Rifampin interactionIsoniazid, RifampinRifamate
How Isoniazid, Rifampin interacts with SuperFoods — through 2 ingredients. Tap an ingredient for the detail:
AppleOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Read the full Apple + Isoniazid, Rifampin interactionVitamin AHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking high doses of vitamin A in combination with other potentially hepatotoxic drugs might increase the risk of liver disease.
Read the full Vitamin A + Isoniazid, Rifampin interactionIsotretinoinAbsorica, Accutane, Amnesteem, Claravis, Roaccutane, Sotret
How Isotretinoin interacts with SuperFoods — through 1 ingredient. Tap an ingredient for the detail:
Vitamin ARetinoids Major
Interaction Summary
Concomitant use of retinoids with vitamin A supplements might produce supratherapeutic vitamin A levels.
Read the full Vitamin A + Isotretinoin interactionEach ingredient & the kinds of drugs it affects
For each ingredient in SuperFoods 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.
Pomegranate
Ace Inhibitors (Aceis)
Theoretically, taking pomegranate with ACEIs might increase the risk of adverse effects.
Pomegranate juice is thought to have ACE inhibitor-like effects.
Antihypertensive Drugs
Theoretically, taking pomegranate with antihypertensive drugs might increase the risk of hypotension.
Consuming pomegranate juice can modestly lower blood pressure.
Cytochrome P450 2D6 (Cyp2D6) Substrates
Theoretically, pomegranate might increase levels of drugs metabolized by CYP2D6.
In vitro, pomegranate juice inhibits CYP2D6. However, the clinical significance of this potential interaction in humans is not known.
Rosuvastatin (Crestor)
Theoretically, taking pomegranate with rosuvastatin might increase the risk of adverse effects.
In one case, a patient taking rosuvastatin 5 mg every other day in combination with ezetimibe 10 mg daily developed rhabdomyolysis after drinking pomegranate juice 200 mL twice weekly for 3 weeks. This patient had a history of elevated creatine kinase levels while not receiving any statin treatment. This suggests a possible underlying myopathy and predisposition to rhabdomyolysis.
Warfarin (Coumadin)
Theoretically, pomegranate might increase warfarin levels and increase the risk of bleeding. Also, discontinuing regular consumption of pomegranate juice might decrease warfarin levels.
In one case report, a patient had a stable, therapeutic bleeding time, as measured by international normalized ratio (INR), while taking warfarin in combination with pomegranate juice 2-3 times per week. The patient became subtherapeutic within about 10 days after discontinuing pomegranate juice, which required a warfarin dose increase. In another case report, a patient with a stable INR for over one year presented with an INR of 14. The patient noted no changes to medications or diet but did report consuming around 3 liters of pomegranate juice over the previous week. The patient's INR stabilized upon moderation of pomegranate juice consumption. The mechanism of this potential interaction is unclear.
Carbamazepine (Tegretol)
Theoretically, taking pomegranate with carbamazepine might increase the risk of adverse effects, although research suggests this interaction is unlikely to be clinically significant.
Animal research shows that pomegranate juice may inhibit cytochrome P450 3A4 (CYP3A4) metabolism of carbamazepine and increase levels of carbamazepine by 1.5 times without prolonging the elimination half-life. This suggests that pomegranate juice inhibits intestinal CYP3A4, but might not inhibit hepatic CYP3A4. However, some human research suggests that pomegranate does not significantly inhibit CYP3A4 drug metabolism in humans.
Cytochrome P450 2C9 (Cyp2C9) Substrates
Theoretically, pomegranate might increase levels of drugs metabolized by CYP2C9.
Some animal and in vitro research shows that pomegranate juice inhibits intestinal, but not hepatic, CYP2C9 isoenzyme activity. However, clinical research shows that neither pomegranate juice nor pomegranate extract have a significant effect on CYP2C9 activity in humans.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, pomegranate might increase levels of drugs metabolized by CYP3A4, but most research suggests this interaction is unlikely to be clinically significant.
Pomegranate contains several polyphenols that have individually been shown to inhibit CYP3A4. However, there is contradictory evidence about the effect of whole pomegranate juice on CYP3A4 activity. In vitro, pomegranate juice significantly inhibits the CYP3A4 enzyme, with comparable inhibition to grapefruit juice. In an animal model, pomegranate juice inhibits CYP3A4 metabolism of carbamazepine and increases levels of carbamazepine by 1.5 times; however, in human volunteers, drinking a single glass of pomegranate juice 240 mL or taking 200 mL daily for 2 weeks does not significantly affect levels of the CYP3A4 substrate midazolam after oral or intravenous administration. Another study in healthy volunteers shows that consuming pomegranate juice 300 mL three times daily for three days also does not significantly affect levels of simvastatin, a CYP3A4 substrate This suggests that pomegranate is unlikely to significantly affect levels of CYP3A4 substrates in humans.
Tolbutamide (Orinase)
Theoretically, pomegranate might increase levels of tolbutamide, although research suggests this interaction is unlikely to be clinically significant.
Animal research shows that pomegranate juice inhibits the cytochrome P450 2C9 (CYP2C9) metabolism of tolbutamide. Pomegranate juice increased tolbutamide levels by 1.2 times without prolonging the elimination half-life. This suggests that pomegranate juice inhibits intestinal CYP2C9, but might not inhibit hepatic CYP2C9. Despite this evidence, clinical research shows that neither pomegranate juice nor pomegranate extract have a significant effect on CYP2C9 activity in humans. This interaction does not appear to be clinically significant in humans.
Grape
Anticoagulant/Antiplatelet Drugs
Theoretically, grape extracts may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
In vitro evidence suggests that grape extracts might decrease platelet aggregation.
Cyclosporine (Neoral, Sandimmune)
Ingesting grape juice with cyclosporine can reduce cyclosporine absorption.
A small pharmacokinetic study in healthy young adults shows that intake of purple grape juice 200 mL along with cyclosporine can decrease the absorption of cyclosporine by up to 30% when compared with water. Separate doses of grape juice and cyclosporine by at least 2 hours to avoid this interaction.
Cytochrome P450 1A2 (Cyp1A2) Substrates
Theoretically, grape juice might reduce the levels of CYP1A2 substrates.
A small pharmacokinetic study in healthy adults shows that ingestion of 200 mL of grape juice decreases phenacetin plasma levels. This is thought to be due to induction of CYP1A2.
Cytochrome P450 2D6 (Cyp2D6) Substrates
Theoretically, grape seed extract may increase the levels of CYP2D6 substrates.
In vitro evidence suggests that grape seed extract might inhibit CYP2D6 enzymes. However, this interaction has not been reported in humans.
Cytochrome P450 2E1 (Cyp2E1) Substrates
Theoretically, grape seed extract might increase the levels of CYP2E1 substrates.
In vitro and animal research suggests that grape seed proanthocyanidin extract inhibits CYP2E1 enzymes. However, this interaction has not been reported in humans.
Cytochrome P450 3A4 (Cyp3A4) Substrates
It is unclear if grape seed extract inhibits or induces CYP3A4; research is conflicting.
In vitro evidence suggests that grape seed extract might inhibit CYP3A4 enzymes. However, evidence from animal research shows that grape seed extract may induce CYP3A4 in the liver. So far, these interactions have not been reported in humans.
Midazolam (Versed)
Theoretically, long-term intake of grape seed extract might decrease the effects of midazolam.
Animal research shows that subchronic ingestions of grape seed extract can increase the elimination of intravenous midazolam by increasing hepatic CYP3A4 activity. Single doses of grape seed extract do not appear to affect midazolam elimination.
Phenacetin
Grape juice might decrease phenacetin absorption.
A small pharmacokinetic study in healthy adults shows that ingestion of 200 mL of grape juice decreases phenacetin plasma levels. This is thought to be due to induction of cytochrome P450 1A2 (CYP1A2).
Cytochrome P450 2C9 (Cyp2C9) Substrates
It is unclear if grape juice or grape seed extract inhibits CYP2C9; research is conflicting.
In vitro evidence shows that grape seed extract or grape juice might inhibit CYP2C9 enzymes. However, a small pharmacokinetic study in healthy adults shows that drinking 8 ounces of grape juice once does not affect the clearance of flurbiprofen, a probe-drug for CYP2C9 metabolism. The effects of continued grape juice consumption are unclear.
Beet
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.
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.
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.
Vitamin E
Alkylating Agents
Theoretically, antioxidant effects of vitamin E might reduce the effectiveness of alkylating agents.
There's concern that antioxidants could reduce the activity of chemotherapy drugs which generate free radicals, such as cyclophosphamide, chlorambucil, carmustine, busulfan, and thiotepa. However, some researchers theorize that antioxidants might make chemotherapy more effective by reducing oxidative stress that might interfere with apoptosis (cell death) of cancer cells. More evidence is needed to determine what effect, if any, antioxidants such as vitamin E have on chemotherapy. Advise patients to consult their oncologist before using vitamin E supplements, especially in high doses.
Anticoagulant/Antiplatelet Drugs
Concomitant use of vitamin E and anticoagulant or antiplatelet agents might increase the risk of bleeding.
Vitamin E seems to inhibit of platelet aggregation and antagonize the effects of vitamin K-dependent clotting factors. These effects appear to be dose-dependent, and are probably only likely to be clinically significant with doses of at least 800 units daily. Mixed tocopherols, such as those found in food, might have a greater antiplatelet effect than alpha-tocopherol. RRR alpha-tocopherol (natural vitamin E) 1000 IU daily antagonizes vitamin K-dependent clotting factors. Advise patients to avoid high doses of vitamin E, especially in people with low vitamin K intake or other risk factors for bleeding.
Antitumor Antibiotics
Theoretically, antioxidant effects of vitamin E might reduce the effectiveness of antitumor antibiotics.
There's concern that antioxidants could reduce the activity of antitumor antibiotic drugs such as doxorubicin, which generate free radicals. However, some researchers theorize that antioxidants might make chemotherapy more effective by reducing oxidative stress that might interfere with apoptosis (cell death) of cancer cells. More evidence is needed to determine what effect, if any, antioxidants such as vitamin E have on chemotherapy involving antitumor antibiotics. Advise patients to consult their oncologist before using vitamin E supplements, especially in high doses.
Cyclosporine (Neoral, Sandimmune)
A specific form of vitamin E might increase absorption and levels of cyclosporine.
There is some evidence that one specific formulation of vitamin E (D-alpha-tocopheryl-polyethylene glycol-1000 succinate, TPGS, tocophersolan, Liqui-E) might increase absorption of cyclosporine. This vitamin E formulation forms micelles which seems to increase absorption of cyclosporine by 40% to 72% in some patients. However, this interaction is unlikely to occur with the usual forms of vitamin E.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Vitamin E appears to bind with the nuclear receptor, pregnane X receptor (PXR), which results in increased expression of CYP3A4. Although the clinical significance of this is not known, use caution when considering concomitant use of vitamin E and other drugs affected by these enzymes.
Selumetinib (Koselugo)
Taking selumetinib with vitamin E can result in a total daily dose of vitamin E that exceeds safe limits and therefore might increase the risk of bleeding.
Selumetinib contains 48-54 IU vitamin E per capsule. The increased risk of bleeding with vitamin E appears to be dose-dependent. Be cautious when using selumetinib in combination with supplemental vitamin E, especially in patients at higher risk of bleed, such as those with chronic conditions and those taking antiplatelet drugs.
Warfarin (Coumadin)
Using vitamin E with warfarin might increase the risk of bleeding.
Due to interference with production of vitamin K-dependent clotting factors, use of more than 400 IU of vitamin E daily with warfarin might increase prothrombin time (PT), INR, and the risk of bleeding,. At a dose of 1000 IU per day, vitamin E can antagonize vitamin K-dependent clotting factors even in people not taking warfarin. Limited clinical evidence suggests that doses up to 1200 IU daily may be used safely by patients taking warfarin, but this may not be applicable in all patient populations.
Niacin
Vitamin E might decrease the beneficial effects of niacin on high-density lipoprotein (HDL) cholesterol levels.
A combination of niacin and simvastatin (Zocor) effectively raises high-density lipoprotein (HDL) cholesterol levels in people with coronary disease and low HDL levels. Clinical research shows that taking a combination of antioxidants (vitamin C, vitamin E, beta-carotene, and selenium) along with niacin and simvastatin (Zocor) attenuates this rise in HDL, specifically the HDL-2 and apolipoprotein A1 fractions, by more than 50%. Vitamin E alone combined with a statin does not seem to decrease HDL levels. It is not known whether the adverse effect on HDL is due to one of the other antioxidants or to the combination. It also is not known whether it will occur in other patient populations.
Parsley
Anticoagulant/Antiplatelet Drugs
Theoretically, parsley might increase the risk of bleeding when taken with anticoagulant or antiplatelet drugs.
Animal research suggests that parsley has antiplatelet effects.
Antidiabetes Drugs
Theoretically, parsley might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Animal research suggests that parsley might decrease blood glucose. Monitor blood glucose levels closely. Dose adjustments might be necessary.
Cytochrome P450 1A2 (Cyp1A2) Substrates
Theoretically, parsley might increase serum levels of CYP1A2 substrates.
Laboratory research suggests that parsley can inhibit CYP1A2.
Diuretic Drugs
Theoretically, parsley might enhance or interfere with the effects of diuretic drugs.
Animal research suggests that parsley seed extract increases urine elimination. Parsley leaf and root might also interfere with diuretic therapy due their purported aquaretic effects.
Pentobarbital (Nembutal)
Theoretically, parsley might increase the duration of pentobarbital effects.
Animal research suggests that parsley juice prolongs the action of pentobarbital, perhaps by decreasing cytochrome P450 levels. It is not known if this occurs in humans or if this applies to other barbiturates or sedatives.
Sirolimus (Rapamune)
Theoretically, large quantities of parsley might increase sirolimus levels.
In one case report, an adult female with a history of kidney transplant presented with elevated blood sirolimus levels, approximately 4-7 times greater than previous measures, after daily consumption of a juice containing approximately 30 grams of parsley for 7 days. Sirolimus levels returned to normal a week after the parsley juice was discontinued.
Warfarin (Coumadin)
Theoretically, large amounts of parsley leaf and root might decrease the effects of warfarin.
Parlsey contains vitamin K.
Aspirin
Theoretically, aspirin might increase the severity of allergic reactions to parsley.
In one case, severe urticaria and swelling were reported after taking aspirin with parsley in an individual with a known mild parsley allergy.
Vitamin A
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.
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.
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.
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.
Cabbage
Acetaminophen (Tylenol, Others)
Cabbage might increase clearance and reduce the effects of acetaminophen.
A small clinical study shows that daily consumption of cabbage and Brussels sprout decreases acetaminophen levels by as much as 16%, with some evidence suggesting that this effect is due to increased elimination through glucuronide conjugation.
Antidiabetes Drugs
Theoretically, cabbage might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Animal and in vivo research suggests that cabbage might have hypoglycemic effects.
Cytochrome P450 1A2 (Cyp1A2) Substrates
Theoretically, cabbage might decrease levels of drugs metabolized by CYP1A2.
Some animal research suggests that cabbage or its constituent indole-3-carbinol might increase drug metabolism and elimination by stimulating CYP1A2 activity.
Glucuronidated Drugs
Theoretically, cabbage might increase clearance and decrease the effects of drugs metabolized through glucuronide conjugation.
A small clinical study shows that daily consumption of cabbage and Brussels sprout decreases levels of some drugs metabolized through glucuronide conjugation.
Oxazepam (Serax)
Cabbage might increase clearance and reduce the effects of oxazepam.
A small clinical study shows that daily consumption of cabbage and brussels sprout decreases oxazepam levels by as much as 17%, with some evidence suggesting that this effect is due to increased elimination through glucuronide conjugation.
Warfarin (Coumadin)
Theoretically, cabbage might decrease the anticoagulant effects of warfarin.
Cabbage contains vitamin K. If consumed in large quantities, cabbage might decrease the anticoagulant effects of warfarin.
Strawberry
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.
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.
Apple
Organic Anion-Transporting Polypeptide Substrates (Oatp)
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Research shows that consuming apple juice inhibits OATP, which reduces bioavailability of oral drugs that are substrates of OATP. Fexofenadine, atenolol, and aliskiren are substrates of OATP. Clinical research shows that coadministration of apple juice decreases bioavailability of fexofenadine by up to 78%, aliskiren by 63%, and atenolol by up to 82%. These effects appear to increase with larger quantities of apple juice. It is thought that apple juice might affect OATP for only a short time. Therefore, separating drug administration and consumption of apple juice by at least 4 hours might avoid this interaction.
Aliskiren (Tekturna, Rasilez)
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of aliskiren.
Pharmacokinetic research shows that coadministration of apple juice 200 mL along with aliskiren 150 mg decreases the bioavailability of aliskiren by 63%. Apple juice seems to inhibit organic anion transporting polypeptide (OATP), which is involved in drug uptake in the gut, liver, and kidney. It is thought that apple juice might affect OATP for only a short time. Therefore, separating drug administration and consumption of apple juice by at least 4 hours might avoid this interaction.
Antidiabetes Drugs
Theoretically, consuming apple juice with antidiabetes drugs might interfere with blood glucose control.
Clinical research suggests that consuming apples or drinking apple juice can raise blood glucose levels, with the effects of drinking apple juice being more significant than consuming apples.
Antihypertensive Drugs
Consuming apple juice with antihypertensive drugs might interfere with blood pressure control.
Some clinical evidence suggests that consuming apple and cherry juice can increase blood pressure in elderly patients.
Atenolol (Tenormin)
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of atenolol.
Pharmacokinetic research shows that coadministration of apple juice 600-1200 mL decreases levels of atenolol by 58% to 82% in a dose-dependent manner. Apple juice seems to inhibit organic anion transporting polypeptide (OATP), which is involved in drug uptake in the gut, liver, and kidney. It is thought that apple juice might affect OATP for only a short time. Therefore, separating drug administration and consumption of apple juice by at least 4 hours might avoid this interaction.
Fexofenadine (Allegra)
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of fexofenadine.
Pharmacokinetic research shows that coadministration of apple juice 400-1200 mL along with fexofenadine 60-120 mg decreases bioavailability of fexofenadine by up to 78%. Coadministration with smaller quantities of apple juice (150 mL or less) does not appear to affect the bioavailability of fexofenadine. Apple juice seems to inhibit organic anion transporting polypeptide (OATP), which is involved in drug uptake in the gut, liver, and kidney. It is thought that apple juice might affect OATP for only a short time. Therefore, separating drug administration and consumption of apple juice by at least 4 hours might avoid this interaction.
Lithium
There is some concern that concomitant consumption of apple juice might decrease oral absorption and blood levels of lithium.
In one case report, a patient had an undetectable serum lithium level when lithium citrate was administered with apple juice. When lithium was administered with an alternative beverage, the lithium level became detectable and the patient demonstrated clinical improvement.
Brussels Sprout
Acetaminophen (Tylenol, Others)
A cabbage and Brussels sprout-containing diet can increase metabolism and decrease levels of acetaminophen. In clinical research, a diet that includes daily consumption of cabbage and Brussels sprout decreases acetaminophen levels by as much as 16%. This appears to occur due to a boost of elimination through glucuronide conjugation.
Cytochrome P450 1A2 (Cyp1A2) Substrates
Animal research suggests that Brussels sprout can induce cytochrome P450 1A2 (CYP1A2) activity. Theoretically, Brussels sprout might increase the clearance and decrease the effects of drugs metabolized by CYP1A2. Some drugs metabolized by CYP1A2 include clozapine (Clozaril), cyclobenzaprine (Flexeril), fluvoxamine (Luvox), haloperidol (Haldol), imipramine (Tofranil), mexiletine (Mexitil), olanzapine (Zyprexa), pentazocine (Talwin), propranolol (Inderal), tacrine (Cognex), theophylline, zileuton (Zyflo), zolmitriptan (Zomig), and others.
Glucuronidated Drugs
A cabbage and Brussels sprout-containing diet seems to boost elimination through glucuronide conjugation. Theoretically, these foods might also lower levels of other drugs that are metabolized through glucuronide conjugation, including acetaminophen (Tylenol, others) and oxazepam (Serax), haloperidol (Haldol), lamotrigine (Lamictal), morphine (MS Contin, Roxanol), zidovudine (AZT, Retrovir), and others.
Oxazepam (Serax)
A diet that includes daily consumption of cabbage and Brussels sprout decreases oxazepam levels by as much as 17%. This appears to occur due to a boost of elimination through glucuronide conjugation. Theoretically, Brussels sprout might also lower levels of other drugs that are metabolized through glucuronide conjugation including acetaminophen (Tylenol, others), haloperidol (Haldol), lamotrigine (Lamictal), morphine (MS Contin, Roxanol), zidovudine (AZT, Retrovir), and others.
Warfarin (Coumadin)
Preliminary clinical research shows that increasing Brussels sprout consumption by 400 grams daily can increase warfarin clearance rate by 27% and decrease plasma concentrations of warfarin by 16%. Theoretically, consuming Brussels sprout while taking warfarin might decrease the effects of warfarin and increase the risk of blood clots in some people.
Vitamin C
Alkylating Agents
Theoretically, antioxidant effects of vitamin C might reduce the effectiveness of alkylating agents.
The use of antioxidants like vitamin C during chemotherapy is controversial. There is concern that antioxidants could reduce the activity of chemotherapy drugs that generate free radicals, such as cyclophosphamide, chlorambucil, carmustine, busulfan, and thiotepa. In contrast, some researchers theorize that antioxidants might make chemotherapy more effective by reducing oxidative stress that could interfere with apoptosis (cell death) of cancer cells. More evidence is needed to determine what effect, if any, antioxidants such as vitamin C have on chemotherapy.
Aluminum
Vitamin C can increase the amount of aluminum absorbed from aluminum compounds.
Research in animals and humans shows that vitamin C increases aluminum absorption, theoretically by chelating aluminum and keeping it in solution where it is available for absorption. In people with normal renal function, urinary excretion of aluminum will likely increase, making aluminum retention and toxicity unlikely. Patients with renal failure who take aluminum-containing compounds such as phosphate binders should avoid vitamin C supplements in doses above the recommended dietary allowances.
Antitumor Antibiotics
Theoretically, the antioxidant effects of vitamin C might reduce the effectiveness of antitumor antibiotics.
The use of antioxidants like vitamin C during chemotherapy is controversial. There is concern that antioxidants could reduce the activity of chemotherapy drugs which generate free radicals, such as doxorubicin. In contrast, some researchers theorize that antioxidants might make chemotherapy more effective by reducing oxidative stress that could interfere with apoptosis (cell death) of cancer cells. More evidence is needed to determine what effects, if any, antioxidants such as vitamin C have on chemotherapy.
Estrogens
Vitamin C might increase blood levels of estrogens.
Increases in plasma estrogen levels of up to 55% occur under some circumstances when vitamin C is taken concurrently with oral contraceptives or hormone replacement therapy, including topical products. It is suggested that vitamin C prevents oxidation of estrogen in the tissues, regenerates oxidized estrogen, and reduces sulfate conjugation of estrogen in the gut wall. When tissue levels of vitamin C are high, these processes are already maximized and supplemental vitamin C does not have any effect on estrogen levels. Increases in plasma estrogen levels may occur when patients who are deficient in vitamin C take supplements. Monitor these patients for estrogen-related side effects.
Fluphenazine (Prolixin)
Theoretically, vitamin C might decrease levels of fluphenazine.
In one patient there was a clinically significant decrease in fluphenazine levels when vitamin C (500 mg twice daily) was started. The mechanism is not known, and there is no further data to confirm this interaction.
Indinavir (Crixivan)
Vitamin C can modestly reduce indinavir levels.
One pharmacokinetic study shows that taking vitamin C 1 gram orally once daily along with indinavir 800 mg orally three times daily reduces the area under the concentration-time curve of indinavir by 14%. The mechanism of this interaction is unknown, but it is unlikely to be clinically significant in most patients. The effect of higher doses of vitamin C on indinavir levels is unknown.
Levothyroxine (Synthroid, Others)
Vitamin C can increase levothyroxine absorption.
Two clinical studies in adults with poorly controlled hypothyroidism show that swallowing levothyroxine with a glass of water containing vitamin C 500-1000 mg in solution reduces thyroid stimulating hormone (TSH) levels and increases thyroxine (T4) levels when compared with taking levothyroxine alone. This suggests that vitamin C increases the oral absorption of levothyroxine, possibly due to a reduction in pH.
Warfarin (Coumadin)
High-dose vitamin C might reduce the levels and effectiveness of warfarin.
Vitamin C in high doses may cause diarrhea and possibly reduce warfarin absorption. There are reports of two people who took up to 16 grams daily of vitamin C and had a reduction in prothrombin time. Lower doses of 5-10 grams daily can also reduce warfarin absorption. In many cases, this does not seem to be clinically significant. However, a case of warfarin resistance has been reported for a patient who took vitamin C 500 mg twice daily. Cessation of vitamin C supplementation resulted in a rapid increase in international normalized ratio (INR). Tell patients taking warfarin to avoid taking vitamin C in excessively high doses (greater than 10 grams daily). Lower doses may be safe, but the anticoagulation activity of warfarin should be monitored. Patients who are stabilized on warfarin while taking vitamin C should avoid adjusting vitamin C dosage to prevent the possibility of warfarin resistance.
Acetaminophen (Tylenol, Others)
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
A small pharmacokinetic study in healthy volunteers shows that taking high-dose vitamin C (3 grams) 1.5 hours after taking acetaminophen 1 gram slightly increases the apparent half-life of acetaminophen from around 2.3 hours to 3.1 hours. Ascorbic acid competitively inhibits sulfate conjugation of acetaminophen. However, to compensate, elimination of acetaminophen glucuronide and unconjugated acetaminophen increases. This effect is not likely to be clinically significant.
Aspirin
Acidification of the urine by vitamin C might increase aspirin levels.
It has been suggested that acidification of the urine by vitamin C could increase reabsorption of salicylates by the renal tubules, and increase plasma salicylate levels. However, short-term use of up to 6 grams daily of vitamin C does not seem to affect urinary pH or salicylate excretion, suggesting this interaction is not clinically significant.
Choline Magnesium Trisalicylate (Trilisate)
Acidification of the urine by vitamin C might increase choline magnesium trisalicylate levels.
It has been suggested that acidification of the urine by vitamin C could increase reabsorption of salicylates by the renal tubules, and increase plasma salicylate levels. However, short-term use of up to 6 grams daily of vitamin C does not seem to affect urinary pH or salicylate excretion, suggesting this interaction probably is not clinically significant.
Niacin
Vitamin C might decrease the beneficial effects of niacin on high-density lipoprotein (HDL) cholesterol levels.
A combination of niacin and simvastatin (Zocor) effectively raises HDL cholesterol levels in patients with coronary disease and low HDL levels. Clinical research shows that taking a combination of antioxidants (vitamin C, vitamin E, beta-carotene, and selenium) along with niacin and simvastatin (Zocor) attenuates this rise in HDL, specifically the HDL-2 and apolipoprotein A1 fractions, by more than 50% in patients with coronary disease. It is not known whether this adverse effect is due to a single antioxidant such as vitamin C, or to the combination. It also is not known whether it will occur in other patient populations.
Salsalate (Disalcid)
Acidification of the urine by vitamin C might increase salsalate levels.
It has been suggested that acidification of the urine by vitamin C could increase reabsorption of salicylates by the renal tubules, and increase plasma salicylate levels. However, short-term use of up to 6 grams/day vitamin C does not seem to affect urinary pH or salicylate excretion, suggesting this interaction probably is not clinically significant.
Broccoli
Cytochrome P450 1A2 (Cyp1A2) Substrates
Theoretically, broccoli might reduce the levels and effects of drugs metabolized by CYP1A2.
Pharmacokinetic research in humans shows that eating 500 grams of fresh broccoli daily for 6-12 days can increase CYP1A2 activity by 10% to 200%. Induction of CYP1A2 activity by broccoli is attributed to its glucosinolate constituents.
Cytochrome P450 2A6 (Cyp2A6) Substrates
Theoretically, broccoli might reduce the levels and effects of drugs metabolized by CYP2A6.
Pharmacokinetic research in humans shows that eating 500 grams of broccoli daily for 6 days increases CYP2A6 activity by 135% to 550%. Induction of CYP2A6 activity is attributed to its glucosinolate constituents.
Cauliflower
Cytochrome P450 1A2 (Cyp1A2) Substrates
Preliminary clinical evidence suggests that eating cruciferous vegetables, including broccoli, cauliflower, daikon radish sprouts, and cabbage, can increase cytochrome P450 1A2 (CYP1A2) activity by 14% to 27%. Theoretically, cauliflower might increase the clearance and decrease the effects of drugs metabolized by CYP1A2. Some drugs metabolized by CYP1A2 include clozapine (Clozaril), cyclobenzaprine (Flexeril), fluvoxamine (Luvox), haloperidol (Haldol), imipramine (Tofranil), mexiletine (Mexitil), olanzapine (Zyprexa), pentazocine (Talwin), propranolol (Inderal), tacrine (Cognex), theophylline, zileuton (Zyflo), zolmitriptan (Zomig), and others.
Acerola Cherry
Alkylating Agents
Theoretically, the antioxidant effects of acerola might reduce the effectiveness of alkylating agents.
Acerola contains vitamin C, an antioxidant. There is concern that antioxidants might reduce the activity of chemotherapy drugs that generate free radicals, such as alkylating agents. In contrast, other researchers theorize that antioxidants might make alkylating chemotherapy more effective by reducing oxidative stress that could interfere with apoptosis (cell death) of cancer cells. More evidence is needed to determine what effect, if any, antioxidants such as vitamin C have on chemotherapy.
Antitumor Antibiotics
Theoretically, the antioxidant effects of acerola might reduce the effectiveness of antitumor antibiotics.
Acerola contains vitamin C, an antioxidant. There is concern that antioxidants might reduce the activity of chemotherapy drugs that generate free radicals, such as antitumor antibiotics. In contrast, other researchers theorize that antioxidants might make antitumor antibiotic chemotherapy more effective by reducing oxidative stress that could interfere with apoptosis (cell death) of cancer cells. More evidence is needed to determine what effects, if any, antioxidants such as vitamin C have on antitumor antibiotic chemotherapy.
Aluminum
Theoretically, concomitant use of acerola with aluminum salts might increase the amount of aluminum absorbed.
Acerola contains vitamin C. It is thought that vitamin C chelates aluminum, keeping it in solution and available for absorption. In people with normal renal function, urinary excretion of aluminum likely increases, making aluminum retention and toxicity unlikely. However, patients with renal failure who take aluminum-containing compounds, such as phosphate binders, should avoid acerola in doses that provide more vitamin C than the recommended dietary allowances.
Aspirin
Theoretically, acerola might reduce the clearance of aspirin; however, its vitamin C content is likely too low to produce clinically significant effects.
Acerola contains vitamin C. It has been suggested that acidification of the urine by vitamin C can decrease the urinary excretion of salicylates, increasing plasma salicylate levels. However, short-term use of up to 6 grams daily of vitamin C does not seem to affect urinary pH or salicylate excretion. The vitamin C content of acerola is typically about 2000 mg per 100 grams. Thus, a clinically significant interaction between acerola and aspirin is unlikely.
Estrogens
Theoretically, concomitant use of acerola with estrogens might increase estrogenic effects.
Acerola contains vitamin C. Increases in plasma estrogen levels of up to 55% have occurred under some circumstances when vitamin C is taken concurrently with oral contraceptives or hormone replacement therapy, including topical products. It is suggested that vitamin C prevents oxidation of estrogen in the tissues, regenerates oxidized estrogen, and reduces sulfate conjugation of estrogen in the gut wall. When tissue levels of vitamin C are high, these processes are already maximized and supplemental vitamin C does not have any effect on estrogen levels. However, increases in plasma estrogen levels may occur when women who are deficient in vitamin C take supplements.
Warfarin (Coumadin)
Theoretically, acerola might reduce the effectiveness of warfarin; however, its vitamin C content is likely too low to produce clinically significant effects.
Acerola contains vitamin C. High doses of vitamin C may reduce the response to warfarin, possibly by causing diarrhea and reducing warfarin absorption. This occurred in two people who took up to 16 grams daily of vitamin C, and resulted in decreased prothrombin time. Lower doses of 5-10 grams daily of vitamin C can also reduce warfarin absorption, but this does not seem to be clinically significant. The vitamin C content of acerola is typically about 2000 mg per 100 grams. Thus, a clinically significant interaction between acerola and warfarin is unlikely.
Plum
Anticoagulant/Antiplatelet Drugs
Theoretically, plum juice might have antiplatelet effects.
Consuming plum juice while taking anticoagulant or antiplatelet drugs might increase the risk of bruising and bleeding. In healthy volunteers, drinking plum juice 200 mL daily for 28 days prolonged clotting time and inhibited platelet aggregation.
Blueberry
Antidiabetes Drugs
Theoretically, blueberries or blueberry leaf extracts might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Animal and in vitro research suggests that blueberry and/or blueberry leaf extracts can lower blood glucose levels.
Buspirone (Buspar)
Theoretically, blueberry juice might increase blood levels of buspirone.
In vitro research shows that blueberry juice can inhibit the metabolism of buspirone, possibly by inhibiting cytochrome P450 3A (CYP3A) enzymes. However, pharmacokinetic research in humans shows that drinking 300 mL of blueberry juice 30 minutes before taking buspirone hydrochloride 10 mg does not significantly affect the concentration or clearance of buspirone.
Flurbiprofen (Ansaid, Others)
Theoretically, blueberry juice might increase blood levels of flurbiprofen.
In vitro research shows that blueberry juice can inhibit the metabolism of flurbiprofen, possibly by inhibiting cytochrome P450 2C9 (CYP2C9) enzymes. However, pharmacokinetic research in humans shows that drinking 300 mL of blueberry juice 30 minutes before taking flurbiprofen 100 mg does not significantly affect the concentration or clearance of flurbiprofen.
Spinach
Antidiabetes Drugs
There are claims that spinach leaves have hypoglycemic effects. Evidence from clinical research suggests that consumption of a spinach-rich meal reduces post-meal blood glucose levels. Theoretically, spinach might have additive effects with antidiabetes drugs and increase the risk of hypoglycemia. Monitor blood glucose levels closely. Dose adjustments might be necessary. Some antidiabetes drugs include glimepiride (Amaryl), glyburide (DiaBeta, Glynase PresTab, Micronase), insulin, pioglitazone (Actos), rosiglitazone (Avandia), and others.
Warfarin (Coumadin)
Spinach contains vitamin K, which can interfere with the activity of warfarin.
In human research, although eating spinach with one meal does not result in coagulation test results outside the therapeutic range, daily consumption for one week necessitates dose adjustment of warfarin. Individuals using anticoagulants should consume a consistent daily amount of spinach to maintain the effect of anticoagulant therapy.
Pumpkin
Lithium
Pumpkin might reduce excretion and increase levels of lithium.
Pumpkin is thought to have diuretic properties. Theoretically, this might reduce excretion and increase levels of lithium. The dose of lithium might need to be decreased.
Brand information
Manufacturer and brand details for SuperFoods, from the product label.
Hero Nutritionals Yummi Bears
See all Hero Nutritionals Yummi Bears products- Name
- Hero Nutritionals, Inc.
- City
- Santa Ana
- State
- CA
- ZipCode
- 92705
- Phone Number
- 800.500.4376
- Web Address
- www.heronutritionals.com
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Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
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Label information is sourced from the NIH Dietary Supplement Label Database and reflects the product version on file; always read your actual product label. This page is for education only and is not a substitute for professional medical advice. Confirm with your pharmacist or doctor before combining supplements and medications.
The Full Monographs Behind SuperFoods’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Vitamin C
Interacts with 207 drugsVitamin C (ascorbic acid) is an essential nutrient your body needs but cannot make, so you must get it from food or supplements. It's important for immune function, collagen, and acts as an...
Read the full Vitamin C monograph → Herb & supplement monographVitamin E
Interacts with 764 drugsVitamin E is an essential fat-soluble vitamin and antioxidant that most people get in adequate amounts from a normal diet. Supplements can help correct a true deficiency, but high-dose vitam...
Read the full Vitamin E monograph → Herb & supplement monographVitamin A
Interacts with 387 drugsVitamin 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 monographCarrot
Carrot is a common food vegetable that is a rich source of beta-carotene (which the body turns into vitamin A) and other nutrients. Eating carrots is safe and nutritious for most people, but...
Read the full Carrot monograph → Herb & supplement monographStrawberry
Interacts with 316 drugsStrawberry 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 monographBlueberry
Interacts with 88 drugsBlueberries are a nutritious fruit rich in antioxidants called anthocyanins, and eating them as part of a balanced diet is healthy and safe for most people. Concentrated supplements are mark...
Read the full Blueberry monograph → Herb & supplement monographPomegranate
Interacts with 922 drugsPomegranate is a nutrient-rich fruit that is high in antioxidants and is widely enjoyed as food and juice. Early research suggests it may support heart health and blood pressure, but the evi...
Read the full Pomegranate monograph → Herb & supplement monographTomato
Tomato is a common food rich in vitamins, potassium, and the antioxidant lycopene, and eating it as part of a balanced diet is healthy for most people. Concentrated tomato or lycopene supple...
Read the full Tomato monograph → Herb & supplement monographSpinach
Interacts with 88 drugsSpinach is a nutrient-dense leafy green that is a healthy part of a balanced diet, providing vitamins, minerals, fiber, and antioxidants. While it is very safe as a food, concentrated supple...
Read the full Spinach monograph → Herb & supplement monographPumpkin
Interacts with 1 drugPumpkin is a nutritious squash, and its seeds and seed oil are the parts most often used as supplements, mainly for urinary and prostate symptoms. The evidence for these uses is limited and...
Read the full Pumpkin monograph → Herb & supplement monographPlum
Interacts with 122 drugsPlums and their dried form (prunes) are common, nutritious foods that are best known for helping relieve constipation thanks to their fiber and sorbitol content. They are generally safe as f...
Read the full Plum monograph → Herb & supplement monographApple
Interacts with 300 drugsApples are a nutritious whole food that provides fiber, vitamins, and antioxidant plant compounds, and eating them regularly fits well into a healthy diet. While research suggests apples may...
Read the full Apple monograph → Herb & supplement monographAcerola
Interacts with 128 drugsAcerola is a small tropical fruit prized for its very high natural vitamin C content, and it is mostly used as a food-based source of vitamin C and antioxidants. While vitamin C itself has w...
Read the full Acerola monograph → Herb & supplement monographBeet
Interacts with 861 drugsBeet, 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 monographGrape
Interacts with 910 drugsGrapes and grape products like grape seed extract contain antioxidant compounds such as resveratrol and proanthocyanidins that may support heart and blood vessel health. While the food is he...
Read the full Grape monograph → Herb & supplement monographCauliflower
Interacts with 186 drugsCauliflower is a nutritious cruciferous vegetable that provides vitamin C, fiber, and plant compounds called glucosinolates. As a food it is healthy and safe for most people, but there is no...
Read the full Cauliflower monograph → Herb & supplement monographBroccoli
Interacts with 187 drugsBroccoli is a nutritious cruciferous vegetable rich in fiber, vitamins, and plant compounds like sulforaphane that have drawn scientific interest for health benefits. Eating broccoli as food...
Read the full Broccoli monograph → Herb & supplement monographBrussels Sprout
Interacts with 241 drugsBrussels sprouts are a nutritious cruciferous vegetable rich in fiber, vitamin C, vitamin K, and plant compounds called glucosinolates. Eating them as part of a balanced diet is healthy and...
Read the full Brussels Sprout monograph → Herb & supplement monographParsley
Interacts with 443 drugsParsley is a popular culinary herb that is safe to eat in normal food amounts and is a good source of vitamins K and C. It is traditionally used as a diuretic and for digestion, but solid hu...
Read the full Parsley monograph → Herb & supplement monographBlackberry
Blackberry is a common edible berry that is safe and nutritious as a food, rich in vitamin C, fiber, and antioxidant plant compounds. The leaves and root have a long history of traditional u...
Read the full Blackberry monograph → Herb & supplement monographCabbage
Interacts with 325 drugsCabbage is a nutritious, low-calorie vegetable that is safe to eat as food and is sometimes applied to the skin as a leaf wrap for breast engorgement or sore joints. Most medicinal claims ar...
Read the full Cabbage monograph →Sources & How We Checked
SuperFoods's label data comes from the NIH Dietary Supplement Label Database; the ingredient interaction data is from the Natural Medicines database, reviewed by our pharmacists.
- NIH Dietary Supplement Label Database (DSLD) — The official product label on file for this supplement.
- Natural Medicines (Therapeutic Research Center) — Evidence-graded clinical reference behind the ingredient interaction data.
Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.
The 390 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.
Vitamin C 51 references
- McEvoy GK, ed. AHFS Drug Information. Bethesda, MD: American Society of Health-System Pharmacists, 1998.
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DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.
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