Sym Ingredients & Drug Interactions
What is this page for?
First and foremost: checking Sym 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
Sym is a dietary supplement by Loomis Enzymes with 14 active ingredients. Its ingredients are commonly taken for anxiety and stress, sleep and relaxation, digestive upset.Based on those ingredients, 1,230 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Chamomile, Echinacea, Dandelion. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against Sym by Loomis Enzymes
Ask about any prescription or over-the-counter medication and we check it for interactions with Sym by Loomis Enzymes — 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 Sym by Loomis Enzymes
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
Sym contains 14 ingredients, including digestive enzymes and herbal extracts. The enzyme blend—amylase, protease, lipase, cellulase, glucoamylase, hemicellulase, and alpha-galactosidase—is designed to break down carbohydrates, proteins, and fats in food.
It also includes glucose oxidase and superoxide dismutase. The herbal ingredients are chamomile, burdock, echinacea, chicory, and dandelion.
The product also contains inactive ingredients: cellulose, water, and phytase.
Does it work?
Not established
The evidence we hold doesn't establish that any of the active ingredients in Sym work for a specific health purpose. Both the digestive enzymes and the herbs—chamomile, echinacea, burdock, chicory, and dandelion—carry ratings of insufficient reliable evidence for the conditions they are traditionally used for.
This doesn't mean they don't work; it means the scientific data we have isn't conclusive yet.
How safe is it?
Well-documented data
Protease and lipase are generally well tolerated in most adults but may cause digestive upset. Protease should be avoided in pregnancy and used cautiously while breastfeeding.
Lipase should be used only under medical guidance if you have serious digestive conditions, and there's limited safety data in pregnancy and breastfeeding. Chamomile is well tolerated but can cause allergic reactions in people sensitive to ragweed and related plants; avoid it in pregnancy and use cautiously while breastfeeding.
Echinacea is generally well tolerated short-term but may trigger allergic reactions (especially in those sensitive to ragweed family plants), and evidence is limited in pregnancy and breastfeeding. Burdock is likely safe as food but should be avoided in medicinal amounts during pregnancy and breastfeeding.
Chicory is well tolerated in food amounts but may cause gas and can trigger allergies in sensitive people; avoid medicinal amounts in pregnancy and breastfeeding. Dandelion is generally well tolerated as food, though supplement doses are less studied; use caution in pregnancy and breastfeeding.
The digestive enzymes and herbs may rarely cause allergic reactions, including anaphylaxis, in sensitive individuals.
Meds to double-check
Moderate interaction found
Before taking Sym, have your pharmacist check it against these drug types: immunosuppressants (echinacea), CNS depressants (chamomile), warfarin and other blood thinners (chamomile, burdock, dandelion), oral contraceptives and estrogens (chamomile), drugs metabolized by CYP2D6, CYP2C9, or CYP3A4 (chamomile; echinacea affects CYP3A4 and CYP1A2), potassium-sparing diuretics (dandelion), diabetes medications (chicory, dandelion), fluoroquinolone antibiotics (dandelion), lithium (dandelion), and the cancer drug etoposide (echinacea). If you take caffeine, note that echinacea may increase its levels by about 30%.
The bottom line
Scorecard at a glanceFormula with limited ingredient disclosure with no established evidence rating for its marketed use. Moderate medication interactions have been identified, and safety information is well characterized.
Sym is a digestive enzyme blend with herbal additions. If you take any blood thinners, diabetes drugs, immunosuppressants, water pills, lithium, antibiotics, or sedatives, or if you use oral contraceptives or estrogen, check your medications with the tool on this page before starting.
Pregnant or breastfeeding? Talk to your doctor or pharmacist first.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 7 of 14 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Feb 23, 2025.
This Scorecard evaluates available label information, ingredient evidence, and known medication-safety considerations. It does not independently verify product identity, purity, potency, contamination, or manufacturing quality. How these ratings are computed
General information
Key facts about Sym, straight from the product label.
| Brand | Loomis Enzymes |
|---|---|
| Barcode (UPC) | 697706046212 |
| Net contents | 180 Capsule(s) |
| Market status | On market |
| Date entered into DSLD | Feb 23, 2025 |
| DSLD ID | 327449 |
| Product type | Other Combinations |
| Supplement form | Capsule |
| Dietary claims / uses | All Other, Structure/Function |
| Intended target group(s) | Adult (18 - 50 Years) |
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 Sym by Loomis Enzymes, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Amylase | 0 NP | -- |
| Protease | 0 NP | -- |
| Lipase | 0 NP | -- |
| Cellulase | 0 NP | -- |
| Glucoamylase | 0 NP | -- |
| Hemicellulase | 0 NP | -- |
| Chamomile | 90 mg | -- |
| Alpha-Galactosidase | 0 NP | -- |
| Burdock | 170 mg | -- |
| Glucose Oxidase | 0 NP | -- |
| Proprietary Enzyme Blend | 60 mg | -- |
| Echinacea | 170 mg | -- |
| Superoxide Dismutase | 0 NP | -- |
| Chicory | 20 mg | -- |
| Dandelion | 10 mg | -- |
Other ingredients: Cellulose, Water, Phytase
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.
Formulation
pHBS pH Balancing System
FDA Disclaimer Statement
This statement has not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.
Precautions
Keep out of reach of children.
Note: Consult your physician before using this product if you are pregnant, nursing, taking medication, or have a medical condition.
Do not use if inner or outer seal is broken, torn, or missing.
Storage
To ensure freshness and potency, keep bottle tightly closed and store in a cool, dry place.
FDA Statement of Identity
A Dietary Supplement
Suggested/Recommended/Usage/Directions
Directions for use: Take 2 capsules, 3 times daily after meals, or as directed.
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Sym by Loomis Enzymes 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 Sym by Loomis Enzymes
These are the 14 active ingredients this product is made of. Select any to open its full monograph.
Serving size2 Capsule(s) Dosage formCapsule Servings per container90 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.
Chamomile
Interacts with960 drugs
German chamomile is a widely used herbal remedy taken mainly as a tea for calming, sleep, and digestive complaints. Early research suggests possible b...
Chamomile monograph & interactionsBurdock
Interacts with122 drugs
Burdock is a traditional herb most often used for skin problems and as a so-called 'blood purifier,' but high-quality human studies are lacking and mo...
Burdock monograph & interactionsProprietary Enzyme Blend
Echinacea
Interacts with816 drugs
Echinacea is a popular herb taken to help prevent or shorten the common cold, but study results are mixed and the overall benefit appears small at bes...
Echinacea monograph & interactionsChicory
Interacts with86 drugs
Chicory is best known as a caffeine-free coffee substitute and as a source of inulin, a soluble prebiotic fiber that may support digestion and regular...
Chicory monograph & interactionsDandelion
Interacts with457 drugs
Dandelion is a common plant used in food and traditional medicine, often promoted as a natural 'water pill' and digestive aid. Human evidence for thes...
Dandelion monograph & interactionsOther (inactive) ingredients: Cellulose, Water, Phytase. These complete the product’s ingredient list but are not active constituents.
Sym by Loomis Enzymes Drug Interactions
HelloPharmacist Interaction Report
Sym by Loomis Enzymes contains digestive enzymes plus several herbal ingredients, and it does interact with a number of medications.
The most serious interaction involves Echinacea's effect on immunosuppressant drugs—because Echinacea stimulates the immune system, it may interfere with medications meant to suppress immunity, which is a Moderate-severity concern.
Read the full breakdown — every affected drug type, severity by severity
Several other herbal ingredients also interact with common medications. Chamomile may add to the sedative effects of CNS depressants (Moderate), and it theoretically inhibits three liver enzymes (CYP2D6, CYP2C9, and CYP3A4 substrates), which could raise blood levels of many prescription drugs (Moderate for each).
Chamomile also may increase the blood-thinning effect of warfarin (Moderate) and may reduce the effectiveness of oral contraceptives and estrogen therapy (Moderate). Echinacea also affects CYP1A2 substrates and may raise caffeine levels by about 30% (Moderate), and it has variable effects on CYP3A4 substrates; one report linked it to worse side effects when combined with the cancer drug etoposide (Moderate).
Dandelion may increase bleeding risk with blood thinners (Moderate), raise potassium levels dangerously with potassium-sparing water pills (Moderate), increase low blood sugar risk with diabetes medications (Moderate), speed up clearance of certain drugs through the liver (Moderate), raise lithium levels (Moderate), and lower fluoroquinolone antibiotic levels (Moderate). Burdock and chicory also carry Moderate-severity interactions: burdock with blood thinners, and chicory with diabetes drugs.
Echinacea has Minor interactions with warfarin, the HIV medication lopinavir/ritonavir, and the sedative midazolam.
Protease, lipase, and the enzymes amylase, cellulase, glucoamylase, hemicellulase, alpha-galactosidase, glucose oxidase, and superoxide dismutase were either not checked by us or have no known interactions documented in our data.
Altogether, these interactions span 1,215 individual medications. Before you start this product, use the medication checker on this page to verify your exact prescriptions and over-the-counter drugs.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against Sym?
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 Sym interact with 1,230 drugs. Click any drug to see the details.
5 of the 14 ingredients in Sym interact with drugs. Each result below shows which ingredient is responsible. Chamomile Echinacea Dandelion Burdock Chicory
6-mercaptopurinePurinethol
How 6-mercaptopurine interacts with Sym — through 1 ingredient. Tap an ingredient for the detail:
EchinaceaImmunosuppressants Moderate
Interaction Summary
Echinacea has immunostimulant activity which may interfere with immunosuppressant therapy.
Read the full Echinacea + 6-mercaptopurine interactionAdo-trastuzumab EmtansineKadcyla
How Ado-trastuzumab Emtansine interacts with Sym — through 2 ingredients. Tap an ingredient for the detail:
ChamomileCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, German chamomile might inhibit CYP3A4 and increase levels of drugs metabolized by these enzymes.
Read the full Chamomile + Ado-trastuzumab Emtansine interactionEchinaceaCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea + Ado-trastuzumab Emtansine interactionAbciximabReoPro
How Abciximab interacts with Sym — through 2 ingredients. Tap an ingredient for the detail:
DandelionAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, taking dandelion root along with anticoagulant or antiplatelet drugs might increase the risk of bruising and bleeding.
Read the full Dandelion + Abciximab interactionBurdockAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, taking burdock with anticoagulant or antiplatelet drugs might increase the risk of bleeding.
Read the full Burdock + Abciximab interactionAbemaciclibVerzenio
How Abemaciclib interacts with Sym — through 2 ingredients. Tap an ingredient for the detail:
ChamomileCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, German chamomile might inhibit CYP3A4 and increase levels of drugs metabolized by these enzymes.
Read the full Chamomile + Abemaciclib interactionEchinaceaCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea + Abemaciclib interactionAbiraterone
How Abiraterone interacts with Sym — through 2 ingredients. Tap an ingredient for the detail:
ChamomileCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, German chamomile might inhibit CYP3A4 and increase levels of drugs metabolized by these enzymes.
Read the full Chamomile + Abiraterone interactionEchinaceaCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea + Abiraterone interactionAbiraterone AcetateYonsa, Zytiga
How Abiraterone Acetate interacts with Sym — through 2 ingredients. Tap an ingredient for the detail:
EchinaceaCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea + Abiraterone Acetate interactionChamomileCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, German chamomile might inhibit CYP3A4 and increase levels of drugs metabolized by these enzymes.
Read the full Chamomile + Abiraterone Acetate interactionAbrocitinibCibinqo
How Abrocitinib interacts with Sym — through 4 ingredients. Tap an ingredient for the detail:
BurdockAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, taking burdock with anticoagulant or antiplatelet drugs might increase the risk of bleeding.
Read the full Burdock + Abrocitinib interactionDandelionAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, taking dandelion root along with anticoagulant or antiplatelet drugs might increase the risk of bruising and bleeding.
Read the full Dandelion + Abrocitinib interactionChamomileCytochrome P450 2c9 (cyp2c9) Substrates Moderate
Interaction Summary
Theoretically, German chamomile might inhibit CYP2C9 and increase levels of drugs metabolized by these enzymes.
Read the full Chamomile + Abrocitinib interactionEchinaceaImmunosuppressants Moderate
Interaction Summary
Echinacea has immunostimulant activity which may interfere with immunosuppressant therapy.
Read the full Echinacea + Abrocitinib interactionAcalabrutinibCalquence
How Acalabrutinib interacts with Sym — through 2 ingredients. Tap an ingredient for the detail:
ChamomileCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, German chamomile might inhibit CYP3A4 and increase levels of drugs metabolized by these enzymes.
Read the full Chamomile + Acalabrutinib interactionEchinaceaCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea + Acalabrutinib interactionAcarboseGlucobay, Prandase, Precose
How Acarbose interacts with Sym — through 2 ingredients. Tap an ingredient for the detail:
DandelionAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, dandelion might increase the risk for hypoglycemia when used with antidiabetes drugs.
Read the full Dandelion + Acarbose interactionChicoryAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, chicory might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Read the full Chicory + Acarbose interactionAcenocoumarolSintrom
How Acenocoumarol interacts with Sym — through 2 ingredients. Tap an ingredient for the detail:
BurdockAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, taking burdock with anticoagulant or antiplatelet drugs might increase the risk of bleeding.
Read the full Burdock + Acenocoumarol interactionDandelionAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, taking dandelion root along with anticoagulant or antiplatelet drugs might increase the risk of bruising and bleeding.
Read the full Dandelion + Acenocoumarol interactionAcepromazineAtravet
How Acepromazine interacts with Sym — through 1 ingredient. Tap an ingredient for the detail:
ChamomileCns Depressants Moderate
Interaction Summary
Theoretically, German chamomile might have additive effects when used with CNS depressants.
Read the full Chamomile + Acepromazine interactionAcetaminophenChildren's Tylenol, Children's Tylenol Meltaways, Tylenol, Tylenol Ex Strength
How Acetaminophen interacts with Sym — through 3 ingredients. Tap an ingredient for the detail:
DandelionGlucuronidated Drugs, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, dandelion might increase the clearance of drugs that are UDP-glucuronosyltransferase substrates.
Read the full Dandelion + Acetaminophen interactionEchinaceaCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea + Acetaminophen interactionChamomileCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, German chamomile might inhibit CYP1A2 and increase levels of drugs metabolized by these enzymes.
Read the full Chamomile + Acetaminophen interactionAcetaminophen, AspirinGemnisyn
How Acetaminophen, Aspirin interacts with Sym — through 4 ingredients. Tap an ingredient for the detail:
DandelionGlucuronidated Drugs, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Moderate
Interaction Summary
Theoretically, dandelion might increase the clearance of drugs that are UDP-glucuronosyltransferase substrates.
Read the full Dandelion + Acetaminophen, Aspirin interactionBurdockAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, taking burdock with anticoagulant or antiplatelet drugs might increase the risk of bleeding.
Read the full Burdock + Acetaminophen, Aspirin interactionEchinaceaCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea + Acetaminophen, Aspirin interactionChamomileCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, German chamomile might inhibit CYP1A2 and increase levels of drugs metabolized by these enzymes.
Read the full Chamomile + Acetaminophen, Aspirin interactionAcetaminophen, Aspirin, CaffeineExcedrin, Excedrin Extra Strength, Excedrin Migraine
How Acetaminophen, Aspirin, Caffeine interacts with Sym — through 4 ingredients. Tap an ingredient for the detail:
EchinaceaCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea + Acetaminophen, Aspirin, Caffeine interactionDandelionGlucuronidated Drugs, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Moderate
Interaction Summary
Theoretically, dandelion might increase the clearance of drugs that are UDP-glucuronosyltransferase substrates.
Read the full Dandelion + Acetaminophen, Aspirin, Caffeine interactionChamomileCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, German chamomile might inhibit CYP1A2 and increase levels of drugs metabolized by these enzymes.
Read the full Chamomile + Acetaminophen, Aspirin, Caffeine interactionBurdockAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, taking burdock with anticoagulant or antiplatelet drugs might increase the risk of bleeding.
Read the full Burdock + Acetaminophen, Aspirin, Caffeine interactionAcetaminophen, Brompheniramine, PhenylpropanolamineDimetapp Cold and Flu
How Acetaminophen, Brompheniramine, Phenylpropanolamine interacts with Sym — through 3 ingredients. Tap an ingredient for the detail:
EchinaceaCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea + Acetaminophen, Brompheniramine, Phenylpropanolamine interactionDandelionGlucuronidated Drugs, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, dandelion might increase the clearance of drugs that are UDP-glucuronosyltransferase substrates.
Read the full Dandelion + Acetaminophen, Brompheniramine, Phenylpropanolamine interactionChamomileCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, German chamomile might inhibit CYP1A2 and increase levels of drugs metabolized by these enzymes.
Read the full Chamomile + Acetaminophen, Brompheniramine, Phenylpropanolamine interactionAcetaminophen, ButalbitalAxocet, Bancap, Bucet, Butex Forte, Esgic CF, Orbivan CF +5 more
How Acetaminophen, Butalbital interacts with Sym — through 3 ingredients. Tap an ingredient for the detail:
EchinaceaCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea + Acetaminophen, Butalbital interactionDandelionGlucuronidated Drugs, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, dandelion might increase the clearance of drugs that are UDP-glucuronosyltransferase substrates.
Read the full Dandelion + Acetaminophen, Butalbital interactionChamomileCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, German chamomile might inhibit CYP1A2 and increase levels of drugs metabolized by these enzymes.
Read the full Chamomile + Acetaminophen, Butalbital interactionAcetaminophen, Butalbital, CaffeineEsgic, Esgic Plus, Fiogesic, Fioricet, Repan, Tecnal +1 more
How Acetaminophen, Butalbital, Caffeine interacts with Sym — through 3 ingredients. Tap an ingredient for the detail:
EchinaceaCytochrome P450 1a2 (cyp1a2) Substrates, Caffeine +1 Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea + Acetaminophen, Butalbital, Caffeine interactionChamomileCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, German chamomile might inhibit CYP3A4 and increase levels of drugs metabolized by these enzymes.
Read the full Chamomile + Acetaminophen, Butalbital, Caffeine interactionDandelionCytochrome P450 1a2 (cyp1a2) Substrates, Glucuronidated Drugs Moderate
Interaction Summary
Theoretically, dandelion might increase levels of drugs metabolized by CYP1A2.
Read the full Dandelion + Acetaminophen, Butalbital, Caffeine interactionAcetaminophen, Butalbital, Caffeine, CodeineEsgic with Codeine, Fioricet w/ Codeine
How Acetaminophen, Butalbital, Caffeine, Codeine interacts with Sym — through 3 ingredients. Tap an ingredient for the detail:
ChamomileCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +2 Moderate
Interaction Summary
Theoretically, German chamomile might inhibit CYP1A2 and increase levels of drugs metabolized by these enzymes.
Read the full Chamomile + Acetaminophen, Butalbital, Caffeine, Codeine interactionEchinaceaCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea + Acetaminophen, Butalbital, Caffeine, Codeine interactionDandelionGlucuronidated Drugs, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, dandelion might increase the clearance of drugs that are UDP-glucuronosyltransferase substrates.
Read the full Dandelion + Acetaminophen, Butalbital, Caffeine, Codeine interactionAcetaminophen, Butalbital, CodeineBancap w/ Codeine
How Acetaminophen, Butalbital, Codeine interacts with Sym — through 3 ingredients. Tap an ingredient for the detail:
ChamomileCytochrome P450 2d6 (cyp2d6) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Moderate
Interaction Summary
Theoretically, German chamomile might inhibit CYP2D6 and increase levels of drugs metabolized by these enzymes.
Read the full Chamomile + Acetaminophen, Butalbital, Codeine interactionEchinaceaCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea + Acetaminophen, Butalbital, Codeine interactionDandelionCytochrome P450 1a2 (cyp1a2) Substrates, Glucuronidated Drugs Moderate
Interaction Summary
Theoretically, dandelion might increase levels of drugs metabolized by CYP1A2.
Read the full Dandelion + Acetaminophen, Butalbital, Codeine interactionAcetaminophen, Butalbital, Codeine PhosphatePhrenilin #3
How Acetaminophen, Butalbital, Codeine Phosphate interacts with Sym — through 3 ingredients. Tap an ingredient for the detail:
DandelionGlucuronidated Drugs, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, dandelion might increase the clearance of drugs that are UDP-glucuronosyltransferase substrates.
Read the full Dandelion + Acetaminophen, Butalbital, Codeine Phosphate interactionEchinaceaCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea + Acetaminophen, Butalbital, Codeine Phosphate interactionChamomileCytochrome P450 2d6 (cyp2d6) Substrates, Cns Depressants +1 Moderate
Interaction Summary
Theoretically, German chamomile might inhibit CYP2D6 and increase levels of drugs metabolized by these enzymes.
Read the full Chamomile + Acetaminophen, Butalbital, Codeine Phosphate interactionAcetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, PhenylephrineHycomine Compound
How Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interacts with Sym — through 3 ingredients. Tap an ingredient for the detail:
EchinaceaCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea + Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interactionChamomileCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates +2 Moderate
Interaction Summary
Theoretically, German chamomile might inhibit CYP3A4 and increase levels of drugs metabolized by these enzymes.
Read the full Chamomile + Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interactionDandelionCytochrome P450 1a2 (cyp1a2) Substrates, Glucuronidated Drugs Moderate
Interaction Summary
Theoretically, dandelion might increase levels of drugs metabolized by CYP1A2.
Read the full Dandelion + Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interactionAcetaminophen, Caffeine, CodeineGesic C15, Gesic C30, Gesic C8, Lenoltec 1, Lenoltec 2, Lenoltec 3 +1 more
How Acetaminophen, Caffeine, Codeine interacts with Sym — through 3 ingredients. Tap an ingredient for the detail:
ChamomileCns Depressants, Cytochrome P450 3a4 (cyp3a4) Substrates +2 Moderate
Interaction Summary
Theoretically, German chamomile might have additive effects when used with CNS depressants.
Read the full Chamomile + Acetaminophen, Caffeine, Codeine interactionDandelionGlucuronidated Drugs, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, dandelion might increase the clearance of drugs that are UDP-glucuronosyltransferase substrates.
Read the full Dandelion + Acetaminophen, Caffeine, Codeine interactionEchinaceaCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea + Acetaminophen, Caffeine, Codeine interactionAcetaminophen, Caffeine, Codeine, SalicylamideCodalan No.1, Codalan No.2, Codalan No.3
How Acetaminophen, Caffeine, Codeine, Salicylamide interacts with Sym — through 3 ingredients. Tap an ingredient for the detail:
ChamomileCytochrome P450 1a2 (cyp1a2) Substrates, Cns Depressants +2 Moderate
Interaction Summary
Theoretically, German chamomile might inhibit CYP1A2 and increase levels of drugs metabolized by these enzymes.
Read the full Chamomile + Acetaminophen, Caffeine, Codeine, Salicylamide interactionDandelionGlucuronidated Drugs, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, dandelion might increase the clearance of drugs that are UDP-glucuronosyltransferase substrates.
Read the full Dandelion + Acetaminophen, Caffeine, Codeine, Salicylamide interactionEchinaceaCytochrome P450 1a2 (cyp1a2) Substrates, Caffeine +1 Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea + Acetaminophen, Caffeine, Codeine, Salicylamide interactionAcetaminophen, Caffeine, DihydrocodeineDHC Plus, Panlor DC, Panlor SS
How Acetaminophen, Caffeine, Dihydrocodeine interacts with Sym — through 3 ingredients. Tap an ingredient for the detail:
ChamomileCytochrome P450 2d6 (cyp2d6) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates +2 Moderate
Interaction Summary
Theoretically, German chamomile might inhibit CYP2D6 and increase levels of drugs metabolized by these enzymes.
Read the full Chamomile + Acetaminophen, Caffeine, Dihydrocodeine interactionEchinaceaCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea + Acetaminophen, Caffeine, Dihydrocodeine interactionDandelionCytochrome P450 1a2 (cyp1a2) Substrates, Glucuronidated Drugs Moderate
Interaction Summary
Theoretically, dandelion might increase levels of drugs metabolized by CYP1A2.
Read the full Dandelion + Acetaminophen, Caffeine, Dihydrocodeine interactionAcetaminophen, Caffeine, IsomethepteneMigralam
How Acetaminophen, Caffeine, Isometheptene interacts with Sym — through 3 ingredients. Tap an ingredient for the detail:
EchinaceaCaffeine, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Moderate
Interaction Summary
Echinacea can increase plasma levels of caffeine by inhibiting its metabolism.
Read the full Echinacea + Acetaminophen, Caffeine, Isometheptene interactionDandelionGlucuronidated Drugs, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, dandelion might increase the clearance of drugs that are UDP-glucuronosyltransferase substrates.
Read the full Dandelion + Acetaminophen, Caffeine, Isometheptene interactionChamomileCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, German chamomile might inhibit CYP1A2 and increase levels of drugs metabolized by these enzymes.
Read the full Chamomile + Acetaminophen, Caffeine, Isometheptene interactionAcetaminophen, Caffeine, PyrilamineMidol Max Strength Menstrual
How Acetaminophen, Caffeine, Pyrilamine interacts with Sym — through 3 ingredients. Tap an ingredient for the detail:
EchinaceaCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea + Acetaminophen, Caffeine, Pyrilamine interactionDandelionCytochrome P450 1a2 (cyp1a2) Substrates, Glucuronidated Drugs Moderate
Interaction Summary
Theoretically, dandelion might increase levels of drugs metabolized by CYP1A2.
Read the full Dandelion + Acetaminophen, Caffeine, Pyrilamine interactionChamomileCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, German chamomile might inhibit CYP3A4 and increase levels of drugs metabolized by these enzymes.
Read the full Chamomile + Acetaminophen, Caffeine, Pyrilamine interactionAcetaminophen, Chlorpheniramine Maleate, Dextromethorphan HbrVicks Formula 44M Cough, Cold & Flu Relief
How Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interacts with Sym — through 3 ingredients. Tap an ingredient for the detail:
ChamomileCytochrome P450 2d6 (cyp2d6) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Moderate
Interaction Summary
Theoretically, German chamomile might inhibit CYP2D6 and increase levels of drugs metabolized by these enzymes.
Read the full Chamomile + Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interactionDandelionCytochrome P450 1a2 (cyp1a2) Substrates, Glucuronidated Drugs Moderate
Interaction Summary
Theoretically, dandelion might increase levels of drugs metabolized by CYP1A2.
Read the full Dandelion + Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interactionEchinaceaCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea + Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interactionAcetaminophen, Chlorpheniramine, Codeine, PhenylephrineColrex
How Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interacts with Sym — through 3 ingredients. Tap an ingredient for the detail:
DandelionCytochrome P450 1a2 (cyp1a2) Substrates, Glucuronidated Drugs Moderate
Interaction Summary
Theoretically, dandelion might increase levels of drugs metabolized by CYP1A2.
Read the full Dandelion + Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interactionChamomileCytochrome P450 2d6 (cyp2d6) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates +2 Moderate
Interaction Summary
Theoretically, German chamomile might inhibit CYP2D6 and increase levels of drugs metabolized by these enzymes.
Read the full Chamomile + Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interactionEchinaceaCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea + Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interactionAcetaminophen, Chlorpheniramine, DextromethorphanCoricidin II Extra Strength Cold and Flu
How Acetaminophen, Chlorpheniramine, Dextromethorphan interacts with Sym — through 3 ingredients. Tap an ingredient for the detail:
EchinaceaCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea + Acetaminophen, Chlorpheniramine, Dextromethorphan interactionChamomileCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Moderate
Interaction Summary
Theoretically, German chamomile might inhibit CYP3A4 and increase levels of drugs metabolized by these enzymes.
Read the full Chamomile + Acetaminophen, Chlorpheniramine, Dextromethorphan interactionDandelionCytochrome P450 1a2 (cyp1a2) Substrates, Glucuronidated Drugs Moderate
Interaction Summary
Theoretically, dandelion might increase levels of drugs metabolized by CYP1A2.
Read the full Dandelion + Acetaminophen, Chlorpheniramine, Dextromethorphan interactionAcetaminophen, Chlorpheniramine, Dextromethorphan HydrobromideCoricidin HBP Maximum Strength Flu
How Acetaminophen, Chlorpheniramine, Dextromethorphan Hydrobromide interacts with Sym — through 3 ingredients. Tap an ingredient for the detail:
DandelionGlucuronidated Drugs, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, dandelion might increase the clearance of drugs that are UDP-glucuronosyltransferase substrates.
Read the full Dandelion + Acetaminophen, Chlorpheniramine, Dextromethorphan Hydrobromide interactionChamomileCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 2d6 (cyp2d6) Substrates +1 Moderate
Interaction Summary
Theoretically, German chamomile might inhibit CYP3A4 and increase levels of drugs metabolized by these enzymes.
Read the full Chamomile + Acetaminophen, Chlorpheniramine, Dextromethorphan Hydrobromide interactionEchinaceaCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea + Acetaminophen, Chlorpheniramine, Dextromethorphan Hydrobromide interactionEach ingredient & the kinds of drugs it affects
For each ingredient in Sym 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.
Chamomile
Cns Depressants
Theoretically, German chamomile might have additive effects when used with CNS depressants.
German chamomile has mild sedative effects. Theoretically, concomitant use with drugs with sedative properties can cause additive effects and side effects.
Contraceptive Drugs
Theoretically, large amounts of German chamomile might reduce the effectiveness of oral contraceptives.
In vitro, German chamomile has demonstrated antiestrogenic activity. Theoretically, concomitant use of large amounts of German chamomile might interfere with contraceptive drugs through competition for estrogen receptors.
Cytochrome P450 2C9 (Cyp2C9) Substrates
Theoretically, German chamomile might inhibit CYP2C9 and increase levels of drugs metabolized by these enzymes.
In vitro evidence shows that German chamomile might inhibit CYP2C9. So far, this interaction has not been reported in humans. However, there might be an increase in the levels of drugs metabolized by CYP2C9 in patients taking German chamomile.
Cytochrome P450 2D6 (Cyp2D6) Substrates
Theoretically, German chamomile might inhibit CYP2D6 and increase levels of drugs metabolized by these enzymes.
In vitro evidence shows that German chamomile might inhibit CYP2D6. So far, this interaction has not been reported in humans. However, there might be an increase in the levels of drugs metabolized by CYP2D6 in patients taking German chamomile.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, German chamomile might inhibit CYP3A4 and increase levels of drugs metabolized by these enzymes.
In vitro evidence shows that German chamomile might inhibit CYP3A4. So far, this interaction has not been reported in humans. However, there might be an increase in the levels of drugs metabolized by CYP3A4 in patients taking German chamomile.
Estrogens
Theoretically, large amounts of German chamomile might reduce the effectiveness of estrogens.
In vitro, German chamomile has demonstrated antiestrogenic activity. Theoretically, large amounts of German chamomile might interfere with hormone replacement therapy through competition for estrogen receptors.
Tamoxifen (Nolvadex)
Theoretically, large amounts of German chamomile might interfere with the activity of tamoxifen.
In vitro, German chamomile has demonstrated antiestrogenic activity.
Warfarin (Coumadin)
German chamomile might increase the effects of warfarin and increase the risk of bleeding.
In one case, a 70-year-old female taking warfarin developed retroperitoneal hematoma and bilateral recti muscle bleeding along with an INR of 7.9 following ingestion of German chamomile tea 4-5 cups daily and use of a topical chamomile-based lotion applied 4-5 times daily.
Cytochrome P450 1A2 (Cyp1A2) Substrates
Theoretically, German chamomile might inhibit CYP1A2 and increase levels of drugs metabolized by these enzymes.
In vitro and animal research shows that German chamomile might inhibit CYP1A2. So far, this interaction has not been reported in humans. However, there might be an increase in the levels of drugs metabolized by CYP1A2 in patients taking German chamomile.
Echinacea
Caffeine
Echinacea can increase plasma levels of caffeine by inhibiting its metabolism.
Echinacea seems to increase plasma concentrations of caffeine by around 30%. This is likely due to inhibition of cytochrome P450 1A2 (CYP1A2) by echinacea.
Cytochrome P450 1A2 (Cyp1A2) Substrates
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Echinacea appears to inhibit CYP1A2 enzymes in humans. Additionally, echinacea seems to increase plasma concentrations of caffeine, a CYP1A2 substrate, by around 30%. Theoretically, echinacea might increase levels of other drugs metabolized by CYP1A2.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4. This may increase or decrease levels of drugs metabolized by CYP3A4.
Several clinical trials have shown that taking echinacea for up to one month does not significantly affect the metabolism of various CYP3A4 substrates, including midazolam, docetaxel, etravirine, lopinavir-ritonavir, and darunavir-ritonavir. However, other clinical research shows that echinacea may increase the clearance of midazolam, suggesting that echinacea might induce CYP3A4. The discrepancy is thought to be due to differing effects of echinacea on intestinal versus hepatic CYP3A4 enzymes. Echinacea appears to induce hepatic CYP3A4 but inhibit intestinal CYP3A4. In some cases, these effects might cancel each other out, but in others, drug levels may be increased or decreased depending on the level of effect at hepatic and intestinal sites. The effect of echinacea on CYP3A4 activity may differ depending on the CYP3A4 substrate.
Etoposide (Vepesid)
Echinacea may increase levels of etoposide.
In one report, concomitant use of etoposide and echinacea was associated with more severe thrombocytopenia than the use of etoposide alone, suggesting inhibition of etoposide metabolism. Etoposide is a cytochrome P450 3A4 (CYP3A4) substrate. Echinacea has variable effects on CYP3A4, but some studies have reported inhibition of the enzyme.
Immunosuppressants
Echinacea has immunostimulant activity which may interfere with immunosuppressant therapy.
Theoretically, echinacea may interfere with immunosuppressant therapy because of its immunostimulant activity.
Darunavir (Prezista)
Theoretically, echinacea may interfere with the metabolism of darunavir; however, a small clinical study found no effect.
Darunavir is metabolized by cytochrome P450 3A4 (CYP3A4) and is administered with the CYP3A4 inhibitor ritonavir to increase its plasma concentrations. Echinacea has variable effects on CYP3A4, but administration of an E. purpurea root extract (Arkocapsulas Echinacea, Arkopharma) 500 mg four times daily for 14 days did not affect darunavir/ritonavir pharmacokinetics in 15 HIV-infected patients.
Dayquil Severe
Echinacea is reported to have varying effects on a number of Cytochrome P450 metabolizing enzymes in the liver, including CYP1A2 and CYP3A4, which play a role in acetaminophen and dextromethorphan metabolism (both contained in DayQuil Severe), respectively. Studies have reported both enzyme inhibition and induction, making it difficult to predict clinically significant drug interactions with reliability. Specific drug interaction studies reporting definitive results are rare, and potential drug interactions involving echinacea should likely be taken on a case-by-case basis. Based on what we know about how acetaminophen and dextromethorphan are metabolized, the risk of a clinically significant interaction between echinacea and DayQuil Severe is low.
Docetaxel (Taxotere)
Theoretically, echinacea may interfere with the metabolism of docetaxel; however, a small clinical study found no effect.
Docetaxel is metabolized by cytochrome P450 3A4 (CYP3A4). Echinacea has variable effects on CYP3A4, but taking E. purpurea whole plant extract (Echinaforce, A. Vogel Biopharma AG) 20 drops three times daily for 2 weeks did not alter the pharmacokinetics of docetaxel in one clinical study.
Etravirine (Intelence)
Theoretically, echinacea may interfere with the metabolism of etravirine; however, a small clinical study found no effect.
Etravirine is metabolized by cytochrome P450 3A4 (CYP3A4). Echinacea has variable effects on CYP3A4, but taking E. purpurea root extract (Arkocapsulas Echinacea, Arkopharma) 500 mg three times daily for 14 days did not alter the pharmacokinetics of etravirine in HIV-infected patients.
Lopinavir/Ritonavir (Kaletra)
Theoretically, echinacea may interfere with the metabolism of lopinavir; however, a small clinical study found no effect.
Lopinavir is metabolized by cytochrome P450 3A4 (CYP3A4) and is administered with the CYP3A4 inhibitor ritonavir to increase its plasma concentrations. Echinacea has variable effects on CYP3A4, but taking E. purpurea (Echinamide, Natural Factors Nutritional Products, Inc.) 500 mg three times daily for 14 days did not alter the pharmacokinetics of lopinavir/ritonavir in healthy volunteers.
Midazolam (Versed)
Theoretically, echinacea may increase the metabolism of intravenous midazolam.
Echinacea induces hepatic CYP3A4 and might decrease plasma levels of midazolam by about 20%, reducing the effectiveness of intravenous midazolam. Echinacea also appears to inhibit intestinal CYP3A4, which could theoretically increase the bioavailability of oral midazolam. This may cancel out the decrease in availability caused by induction of hepatic CYP3A4, such that overall plasma levels after oral administration of midazolam are not affected by echinacea.
Warfarin (Coumadin)
Echinacea seems to increase the clearance of warfarin, although the effect may not be clinically significant.
Preliminary clinical research in healthy male volunteers suggests that taking echinacea increases the clearance of the active S-isomer of warfarin after a single dose of warfarin, but there was not a clinically significant effect on the INR.
Dandelion
Anticoagulant/Antiplatelet Drugs
Theoretically, taking dandelion root along with anticoagulant or antiplatelet drugs might increase the risk of bruising and bleeding.
In vitro research suggests that dandelion root inhibits platelet aggregation.
Antidiabetes Drugs
Theoretically, dandelion might increase the risk for hypoglycemia when used with antidiabetes drugs.
Laboratory research suggests that dandelion extract may have moderate alpha-glucosidase inhibitor activity and might also increase insulin secretion. Also, in a case report, a 58-year-old woman with type 2 diabetes who was being treated with insulin developed hypoglycemia 2 weeks after beginning to eat salads containing dandelion.
Cytochrome P450 1A2 (Cyp1A2) Substrates
Theoretically, dandelion might increase levels of drugs metabolized by CYP1A2.
Laboratory research suggests that dandelion might inhibit CYP1A2. So far, this interaction has not been reported in humans. However, until more is known, watch for an increase in the levels of drugs metabolized by CYP1A2 in patients taking dandelion.
Glucuronidated Drugs
Theoretically, dandelion might increase the clearance of drugs that are UDP-glucuronosyltransferase substrates.
There is some preliminary evidence that dandelion might induce UDP-glucuronosyltransferase, a phase II enzyme.
Lithium
Theoretically, through diuretic effects, dandelion might reduce excretion and increase levels of lithium.
Animal research suggests that dandelion has diuretic properties. As diuretics can increase serum lithium levels, the dose of lithium might need to be decreased when taken with dandelion.
Potassium-Sparing Diuretics
Theoretically, dandelion might increase the risk of hyperkalemia when taken with potassium-sparing diuretics.
Dandelion contains significant amounts of potassium.
Quinolone Antibiotics
Theoretically, dandelion might lower fluoroquinolone levels.
Animal research shows that dandelion reduces absorption of ciprofloxacin and can lower levels by 73%. However, this effect has not been reported in humans.
Burdock
Anticoagulant/Antiplatelet Drugs
Theoretically, taking burdock with anticoagulant or antiplatelet drugs might increase the risk of bleeding.
In vitro research shows that lignans from burdock reduce rabbit platelet aggregation by inhibiting platelet activating factor. This interaction has not been reported in humans.
Chicory
Antidiabetes Drugs
Theoretically, chicory might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Animal and in vitro research shows that chicory extracts have antidiabetic effects.
Brand information
Manufacturer and brand details for Sym, from the product label.
Loomis Enzymes
See all Loomis Enzymes products- Name
- Loomis Enzymes, LLC
- City
- Fitchburg
- State
- Wisconsin
- ZipCode
- 53719
- Phone Number
- 1-800-614-4400
- Web Address
- www.loomisenzymes.com
Sym by Loomis Enzymes: Common Questions
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Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
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Label information is sourced from the NIH Dietary Supplement Label Database and reflects the product version on file; always read your actual product label. This page is for education only and is not a substitute for professional medical advice. Confirm with your pharmacist or doctor before combining supplements and medications.
The Full Monographs Behind Sym’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
German Chamomile
Interacts with 960 drugsGerman chamomile is a widely used herbal remedy taken mainly as a tea for calming, sleep, and digestive complaints. Early research suggests possible benefits for mild anxiety and some skin o...
Read the full German Chamomile monograph → Herb & supplement monographBurdock
Interacts with 122 drugsBurdock is a traditional herb most often used for skin problems and as a so-called 'blood purifier,' but high-quality human studies are lacking and most claims are not well proven. It is wid...
Read the full Burdock monograph → Herb & supplement monographProteolytic Enzymes (proteases)
Proteolytic enzymes are proteins that help break down other proteins, and common examples include bromelain (from pineapple), papain (from papaya), trypsin, chymotrypsin, and pancreatin. Peo...
Read the full Proteolytic Enzymes (proteases) monograph → Herb & supplement monographLipase
Lipase is a digestive enzyme that helps your body break down dietary fats. It is well established as part of prescription pancreatic enzyme therapy for people who cannot make enough of their...
Read the full Lipase monograph → Herb & supplement monographEchinacea
Interacts with 816 drugsEchinacea is a popular herb taken to help prevent or shorten the common cold, but study results are mixed and the overall benefit appears small at best. It is generally well tolerated for sh...
Read the full Echinacea monograph → Herb & supplement monographChicory
Interacts with 86 drugsChicory is best known as a caffeine-free coffee substitute and as a source of inulin, a soluble prebiotic fiber that may support digestion and regularity. Strong human evidence for most othe...
Read the full Chicory monograph → Herb & supplement monographDandelion
Interacts with 457 drugsDandelion is a common plant used in food and traditional medicine, often promoted as a natural 'water pill' and digestive aid. Human evidence for these uses is very limited, so its benefits...
Read the full Dandelion monograph →Sources & How We Checked
Sym'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 121 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.
Proteolytic Enzymes (proteases) 3 references
- Weeks JA, Harper RA, Simon RA, Burdick JD. Assessment of sensitization risk of a laundry pre-spotter containing protease. Cutan Ocul Toxicol. 2011;30(4):272-9. PubMed
- Marquès LI, Lara S, Abós T, Bartolomé B. Occupational rhinitis due to pepsin. J Investig Allergol Clin Immunol. 2006;16(2):136-7. DOI
- Cartier A, Malo JL, Pineau L, Dolovich J. Occupational asthma due to pepsin. J Allergy Clin Immunol. 1984;73(5 Pt 1):574-7. PubMed
See these in context on the Proteolytic Enzymes (proteases) monograph →
Lipase 1 reference
- Casper C, Hascoet JM, Ertl T, et al. Recombinant bile salt-stimulated lipase in preterm infant feeding: A randomized phase 3 study. PLoS One. 2016;11(5):e0156071. PubMed
German Chamomile 15 references
- Subiza J, Subiza JL, Hinojosa M, et al. Anaphylactic reaction after the ingestion of chamomile tea; a study of cross-reactivity with other composite pollens. J Allergy Clin Immunol 1989;84:353-8. PubMed
- Budzinski JW, Foster BC, Vandenhoek S, Arnason JT. An in vitro evaluation of human cytochrome P450 3A4 inhibition by selected commercial herbal extracts and tinctures. Phytomedicine 2000;7:273-82. PubMed
- Viola H, Wasowski C, Levi de Stein M, et al. Apigenin, a component of Matricaria recutita flowers, is a central benzodiazepine receptors-ligand with anxiolytic effects. Planta Med 1995;61:213-6.
- van Ketel WG. Allergy to Matricaria chamomilla. Contact Dermatitis 1982;8:143. PubMed
- van Ketel WG. Allergy to Matricaria chamomilla. Contact Dermatitis 1987;16:50-1. PubMed
- Hormann HP, Korting HC. Evidence for the efficacy and safety of topical herbal drugs in dermatology: part I: anti-inflammatory agents. Phytomedicine 1994;1:161-71. PubMed
- Avallone R, Zanoli P, Puia G, et al. Pharmacological profile of apigenin, a flavonoid isolated from Matricaria chamomilla. Biochem Pharmacol 2000;59:1387-94. PubMed
- Kassi E, Papoutsi Z, Fokialakis N, et al. Greek plant extracts exhibit selective estrogen receptor modulator (SERM)-like properties. J Agric Food Chem 2004;52:6956-61. PubMed
- Maliakal PP, Wanwimolruk S. Effect of herbal teas on hepatic drug metabolizing enzymes in rats. J Pharm Pharmacol 2001;53:1323-9. PubMed
- Segal R, Pilote L. Warfarin interaction with Matricaria chamomilla. CMAJ 2006;174:1281-2. PubMed
- Loggia RD, Traversa U, Scarcia V, et al. Depressive effects of Chamomilla recutita (L.) Rausch, tubular flowers, on central nervous system in mice. Pharmacol Res Commun 1982;14(2):153-162. PubMed
- Ganzera M, Schneider P, Stuppner H. Inhibitory effects of the essential oil of chamomile (Matricaria recutita L.) and its major constituents on human cytochrome P450 enzymes. Life Sci 2006;78(8):856-861. PubMed
- Benito P, Rodríguez-Perez R, García F, Juste S, Moneo I, Caballero ML. Occupational allergic rhinoconjunctivitis induced by Matricaria chamomilla with tolerance of chamomile tea. J Investig Allergol Clin Immunol. 2014;24(5):369-70. No abstract available.
- Braga FT, Santos AC, Bueno PC, et al. Use of Chamomilla recutita in the prevention and treatment of oral mucositis in patients undergoing hematopoietic stem cell transplantation: a randomized, controlled, phase II clinical trial. Cancer Nurs 2015;38(4):32 PubMed
- Sarris J, Ravindran A, Yatham LN, et al. Clinician guidelines for the treatment of psychiatric disorders with nutraceuticals and phytoceuticals: The World Federation of Societies of Biological Psychiatry (WFSBP) and Canadian Network for Mood and Anxiety T
Burdock 11 references
- Iwakami S, Wu JB, Ebizuka Y, Sankawa U. Platelet activating factor (PAF) antagonists contained in medicinal plants: lignans and sesquiterpenes. Chem Pharm Bull (Tokyo) 1992;40:1196-8. PubMed
- Sasaki Y, Kimura Y, Tsunoda T, Tagami H. Anaphylaxis due to burdock. Int J Dermatol 2003;42:472-3. PubMed
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