Tense-Ease Ingredients & Drug Interactions
What is this page for?
First and foremost: checking Tense-Ease 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
Tense-Ease is a dietary supplement by Nature's Answer with 4 active ingredients. Its ingredients are commonly taken for sleep problems and insomnia, anxiety and restlessness, menopausal symptoms.Based on those ingredients, 1,078 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are Hops, Hawthorne, Wood Betony. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against Tense-Ease by Nature's Answer
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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 Tense-Ease by Nature's Answer
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
Tense-Ease contains four active herbal ingredients: Hops, Hawthorn, Linden, and Wood Betony, combined in a proprietary blend. The product is formulated as a liquid with vegetable glycerin and purified water as inactive ingredients.
These herbs have been used traditionally for relaxation, though modern evidence for their effectiveness is limited.
Does it work?
Not established
The product facts we hold show insufficient reliable evidence to rate Hops for age-related cognitive decline, sexual dysfunction, anxiety, ADHD, dyspepsia, and insomnia. No effectiveness ratings are documented for Hawthorn, Linden, or Wood Betony in our data.
If you're considering this product for a specific condition, we'd recommend discussing what the evidence actually supports with your pharmacist or doctor.
How safe is it?
Well-documented data
Hops is generally well tolerated in the short term but may cause drowsiness; long-term safety isn't well studied. The safety data advises against it during pregnancy and breastfeeding.
Occupational exposure to hops dust is linked to respiratory symptoms, and oral supplements containing hops and soy have been associated with postmenopausal bleeding in a small number of cases — though it's unclear whether hops, soy, or the combination was responsible. Hawthorn is generally well tolerated in studies but requires medical supervision if you have heart conditions.
Safety data advise against use during pregnancy and breastfeeding. Rare serious adverse effects including multiorgan allergic reactions and acute kidney failure have been reported.
Linden and Wood Betony have limited human safety data; neither should be used during pregnancy or breastfeeding based on available information.
Meds to double-check
Major interaction found
Before taking Tense-Ease, double-check with your pharmacist if you take nitrates or phosphodiesterase-5 inhibitors (Major severity — risk of dangerously low blood pressure), blood pressure medications including beta-blockers or calcium channel blockers (Moderate), blood thinners or antiplatelet drugs (Moderate), digoxin for heart rhythm (Moderate), lithium for mood (Moderate), or any other CNS depressants like sleep aids (Moderate). If you're unsure whether your medications fall into these categories, the search tool below will help.
The bottom line
Scorecard at a glanceFormula with limited ingredient disclosure with no established evidence rating for its marketed use. Major medication interactions have been identified, and safety information is well characterized.
Tense-Ease is intended as a relaxation supplement, but its ingredients interact with many common medications — especially heart and blood-pressure drugs. If you take any prescription medication, especially for your heart, blood pressure, or blood clotting, or if you take lithium, check your exact drugs with the tool on this page before starting.
Talk to your pharmacist before use, particularly if you're pregnant, breastfeeding, or have heart conditions.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 4 of 4 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated May 22, 2016.
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 Tense-Ease, straight from the product label.
| Brand | Nature's Answer |
|---|---|
| Barcode (UPC) | 083000008245 |
| Net contents | 1 fl. Oz.; 30 mL |
| Market status | On market |
| Date entered into DSLD | May 22, 2016 |
| DSLD ID | 59496 |
| Product type | Botanical |
| Supplement form | Liquid |
| Dietary claims / uses | All Other, Structure/Function |
| Intended target group(s) | Adult (18 - 50 Years), Kosher, Gluten Free |
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.
Supplement Facts
The label details for Tense-Ease by Nature's Answer, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Proprietary Blend | 1000 mg | -- |
| Hops | 0 NP | -- |
| Hawthorne | 0 NP | -- |
| Linden | 0 NP | -- |
| Wood Betony | 0 NP | -- |
Other ingredients: Vegetable Glycerin, purified Water
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.
FDA Statement of Identity
Herbal Supplement
Suggested/Recommended/Usage/Directions
Suggested Use: As a dietary supplement take 1-2 mL (28-56 drops) 2-3 times a day in a small amount of water. Shake well.
Precautions
Keep out of reach of children
Warning: Do not use if pregnant or nursing
Do not use if safety seal is damaged or missing
FDA Disclaimer Statement
These statements have not been evaluated by the FDA. This product is not intended to diagnose, treat, cure, or prevent any disease.
Seals/Symbols
Gluten Free
Bio-Chelated Cold Extraction Process
K Parve
Formulation
Gluten Free
Alcohol-Free
Formula
K Parve
General Statements
Since 1972
Combination Extract
Super Concentrated 2,000 mg
Our facility is NSF GMP certified, organic and kosher certified
General
9415 Rev. 913
Brand IP Statement(s)
Advanced Botanical Fingerprint
Discover Nature's Answer
Our alcohol-free extracts are produced using our cold Bio-Chelated proprietary extraction process, yielding a Holistically Balanced Advanced Botanical Fingerprint extract in the same synergistic ratios as in the plant
2014 Nature's Answer
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Tense-Ease by Nature's Answer 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 Tense-Ease by Nature's Answer
These are the 4 active ingredients this product is made of. Select any to open its full monograph.
Serving size1 mL Dosage formLiquid Servings per container15 Amounts shown are per serving.
Most supplement products combine several ingredients, and a medication can interact with the product through any one of them. Each ingredient below shows whether it has known drug interactions.
Proprietary Blend
- › Hops
- › Hawthorne
- › Linden
- › Wood Betony
Other (inactive) ingredients: Vegetable Glycerin, Purified Water. These complete the product’s ingredient list but are not active constituents.
Tense-Ease by Nature's Answer Drug Interactions
HelloPharmacist Interaction Report
Tense-Ease by Nature's Answer contains four herbal ingredients, and together they interact with a substantial number of medications.
The most serious concerns are with Hawthorn, which can cause dangerous additive blood-vessel relaxation and dangerously low blood pressure (hypotension) when combined with nitrates (drugs for chest pain) or phosphodiesterase-5 inhibitors like sildenafil (Viagra) — both are Major severity interactions.
Read the full breakdown — every affected drug type, severity by severity
Hawthorn also interacts at Moderate severity with blood pressure medications (beta-blockers and calcium channel blockers), blood thinners and antiplatelet drugs, and digoxin (a heart medication). Hops may add to the sedation caused by sleep aids, sedatives, or other CNS depressants at Moderate severity, and theoretically might interfere with hormone replacement therapy.
Linden could increase lithium levels and its side effects due to potential diuretic activity. Wood Betony may have additive effects with blood pressure-lowering drugs.
Additionally, hops and Hawthorn carry Minor interactions with drugs metabolized by certain liver enzymes, though clinical significance is unclear. We could not check interaction data for the Proprietary Blend's exact composition beyond its named components.
Altogether, these interactions span 1,067 individual medications. Please check your exact medications with the search tool on this page before starting Tense-Ease.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against Tense-Ease?
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 Tense-Ease interact with 1,078 drugs. Click any drug to see the details.
4 of the 4 ingredients in Tense-Ease interact with drugs. Each result below shows which ingredient is responsible. Hops Hawthorne Wood Betony Linden
AvanafilStendra
How Avanafil interacts with Tense-Ease — through 2 ingredients. Tap an ingredient for the detail:
HawthornePhosphodiesterase-5 Inhibitors Major
Interaction Summary
Theoretically, concomitant use might result in additive vasodilation and hypotension.
Read the full Hawthorne + Avanafil interactionHopsCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, hops extract might alter metabolism of CYP3A4 substrates; however, this effect may not be clinically significant.
Read the full Hops + Avanafil interactionFinasteride, TadalafilEntadfi
How Finasteride, Tadalafil interacts with Tense-Ease — through 2 ingredients. Tap an ingredient for the detail:
HawthornePhosphodiesterase-5 Inhibitors Major
Interaction Summary
Theoretically, concomitant use might result in additive vasodilation and hypotension.
Read the full Hawthorne + Finasteride, Tadalafil interactionHopsCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, hops extract might alter metabolism of CYP3A4 substrates; however, this effect may not be clinically significant.
Read the full Hops + Finasteride, Tadalafil interactionGlyceryl TrinitrateNitronal
How Glyceryl Trinitrate interacts with Tense-Ease — through 1 ingredient. Tap an ingredient for the detail:
HawthorneNitrates Major
Interaction Summary
Theoretically, concomitant use might cause additive coronary vasodilatory effects.
Read the full Hawthorne + Glyceryl Trinitrate interactionIsosorbide DinitrateAngitak, Cedocard Retard, Isoket, Isoket Retard, Isordil
How Isosorbide Dinitrate interacts with Tense-Ease — through 1 ingredient. Tap an ingredient for the detail:
HawthorneNitrates Major
Interaction Summary
Theoretically, concomitant use might cause additive coronary vasodilatory effects.
Read the full Hawthorne + Isosorbide Dinitrate interactionIsosorbide Dinitrate, HydralazineBiDil
How Isosorbide Dinitrate, Hydralazine interacts with Tense-Ease — through 2 ingredients. Tap an ingredient for the detail:
HawthorneNitrates Major
Interaction Summary
Theoretically, concomitant use might cause additive coronary vasodilatory effects.
Read the full Hawthorne + Isosorbide Dinitrate, Hydralazine interactionWood BetonyAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, betony might have additive effects with blood pressure lowering drugs due to hypotensive activity of the glycosides found in betony.
Read the full Wood Betony + Isosorbide Dinitrate, Hydralazine interactionIsosorbide MononitrateAngeze, Angeze SR, Chemydur 60XL, Dynamin, Elantan, Elantan LA +13 more
How Isosorbide Mononitrate interacts with Tense-Ease — through 1 ingredient. Tap an ingredient for the detail:
HawthorneNitrates Major
Interaction Summary
Theoretically, concomitant use might cause additive coronary vasodilatory effects.
Read the full Hawthorne + Isosorbide Mononitrate interactionMacitentan, TadalafilOpsynvi
How Macitentan, Tadalafil interacts with Tense-Ease — through 3 ingredients. Tap an ingredient for the detail:
HawthornePhosphodiesterase-5 Inhibitors Major
Interaction Summary
Theoretically, concomitant use might result in additive vasodilation and hypotension.
Read the full Hawthorne + Macitentan, Tadalafil interactionWood BetonyAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, betony might have additive effects with blood pressure lowering drugs due to hypotensive activity of the glycosides found in betony.
Read the full Wood Betony + Macitentan, Tadalafil interactionHopsCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, hops extract might alter metabolism of CYP3A4 substrates; however, this effect may not be clinically significant.
Read the full Hops + Macitentan, Tadalafil interactionNicorandilAprior, Dancor, Ikorel, Sigmart, Zynicor
How Nicorandil interacts with Tense-Ease — through 1 ingredient. Tap an ingredient for the detail:
HawthorneNitrates Major
Interaction Summary
Theoretically, concomitant use might cause additive coronary vasodilatory effects.
Read the full Hawthorne + Nicorandil interactionNitroglycerinGonitro, Nitro Time, Nitro-Bid, Nitrocine Timecaps, Nitrogard, Nitrogard SR +7 more
How Nitroglycerin interacts with Tense-Ease — through 1 ingredient. Tap an ingredient for the detail:
HawthorneNitrates Major
Interaction Summary
Theoretically, concomitant use might cause additive coronary vasodilatory effects.
Read the full Hawthorne + Nitroglycerin interactionPentaerythritol TetranitratePeritrate, Peritrate SA
How Pentaerythritol Tetranitrate interacts with Tense-Ease — through 1 ingredient. Tap an ingredient for the detail:
HawthorneNitrates Major
Interaction Summary
Theoretically, concomitant use might cause additive coronary vasodilatory effects.
Read the full Hawthorne + Pentaerythritol Tetranitrate interactionSildenafilRevatio
How Sildenafil interacts with Tense-Ease — through 2 ingredients. Tap an ingredient for the detail:
HawthornePhosphodiesterase-5 Inhibitors Major
Interaction Summary
Theoretically, concomitant use might result in additive vasodilation and hypotension.
Read the full Hawthorne + Sildenafil interactionHopsCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, hops extract might alter metabolism of CYP3A4 substrates; however, this effect may not be clinically significant.
Read the full Hops + Sildenafil interactionSildenafil CitrateViagra
How Sildenafil Citrate interacts with Tense-Ease — through 2 ingredients. Tap an ingredient for the detail:
HawthornePhosphodiesterase-5 Inhibitors Major
Interaction Summary
Theoretically, concomitant use might result in additive vasodilation and hypotension.
Read the full Hawthorne + Sildenafil Citrate interactionHopsCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, hops extract might alter metabolism of CYP3A4 substrates; however, this effect may not be clinically significant.
Read the full Hops + Sildenafil Citrate interactionTadalafilCialis, Tadliq
How Tadalafil interacts with Tense-Ease — through 2 ingredients. Tap an ingredient for the detail:
HawthornePhosphodiesterase-5 Inhibitors Major
Interaction Summary
Theoretically, concomitant use might result in additive vasodilation and hypotension.
Read the full Hawthorne + Tadalafil interactionHopsCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, hops extract might alter metabolism of CYP3A4 substrates; however, this effect may not be clinically significant.
Read the full Hops + Tadalafil interactionVardenafilLevitra, Staxyn
How Vardenafil interacts with Tense-Ease — through 2 ingredients. Tap an ingredient for the detail:
HawthornePhosphodiesterase-5 Inhibitors Major
Interaction Summary
Theoretically, concomitant use might result in additive vasodilation and hypotension.
Read the full Hawthorne + Vardenafil interactionHopsCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, hops extract might alter metabolism of CYP3A4 substrates; however, this effect may not be clinically significant.
Read the full Hops + Vardenafil interactionAbciximabReoPro
How Abciximab interacts with Tense-Ease — through 1 ingredient. Tap an ingredient for the detail:
HawthorneAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, hawthorn may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Hawthorne + Abciximab interactionAbrocitinibCibinqo
How Abrocitinib interacts with Tense-Ease — through 1 ingredient. Tap an ingredient for the detail:
HawthorneAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, hawthorn may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Hawthorne + Abrocitinib interactionAcebutololRhotral, Sectral
How Acebutolol interacts with Tense-Ease — through 2 ingredients. Tap an ingredient for the detail:
HawthorneBeta-blockers Moderate
Interaction Summary
Theoretically, concomitant use might cause additive effects on blood pressure and heart rate.
Read the full Hawthorne + Acebutolol interactionWood BetonyAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, betony might have additive effects with blood pressure lowering drugs due to hypotensive activity of the glycosides found in betony.
Read the full Wood Betony + Acebutolol interactionAcenocoumarolSintrom
How Acenocoumarol interacts with Tense-Ease — through 1 ingredient. Tap an ingredient for the detail:
HawthorneAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, hawthorn may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Hawthorne + Acenocoumarol interactionAcepromazineAtravet
How Acepromazine interacts with Tense-Ease — through 1 ingredient. Tap an ingredient for the detail:
HopsCns Depressants Moderate
Interaction Summary
Theoretically, concomitant use of hops with sedative drugs might cause additive sedation.
Read the full Hops + Acepromazine interactionAcetaminophen, AspirinGemnisyn
How Acetaminophen, Aspirin interacts with Tense-Ease — through 2 ingredients. Tap an ingredient for the detail:
HawthorneAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, hawthorn may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Hawthorne + Acetaminophen, Aspirin interactionHopsCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Hops extract does not seem to affect the metabolism of CYP1A2 substrates.
Read the full Hops + Acetaminophen, Aspirin interactionAcetaminophen, Aspirin, CaffeineExcedrin, Excedrin Extra Strength, Excedrin Migraine
How Acetaminophen, Aspirin, Caffeine interacts with Tense-Ease — through 2 ingredients. Tap an ingredient for the detail:
HawthorneAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, hawthorn may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Hawthorne + Acetaminophen, Aspirin, Caffeine interactionHopsCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Hops extract does not seem to affect the metabolism of CYP1A2 substrates.
Read the full Hops + Acetaminophen, Aspirin, Caffeine interactionAcetaminophen, Butalbital, Caffeine, CodeineEsgic with Codeine, Fioricet w/ Codeine
How Acetaminophen, Butalbital, Caffeine, Codeine interacts with Tense-Ease — through 1 ingredient. Tap an ingredient for the detail:
HopsCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Moderate
Interaction Summary
Hops extract does not seem to affect the metabolism of CYP1A2 substrates.
Read the full Hops + Acetaminophen, Butalbital, Caffeine, Codeine interactionAcetaminophen, Butalbital, CodeineBancap w/ Codeine
How Acetaminophen, Butalbital, Codeine interacts with Tense-Ease — through 1 ingredient. Tap an ingredient for the detail:
HopsCns Depressants, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, concomitant use of hops with sedative drugs might cause additive sedation.
Read the full Hops + Acetaminophen, Butalbital, Codeine interactionAcetaminophen, Butalbital, Codeine PhosphatePhrenilin #3
How Acetaminophen, Butalbital, Codeine Phosphate interacts with Tense-Ease — through 1 ingredient. Tap an ingredient for the detail:
HopsCytochrome P450 1a2 (cyp1a2) Substrates, Cns Depressants Moderate
Interaction Summary
Hops extract does not seem to affect the metabolism of CYP1A2 substrates.
Read the full Hops + Acetaminophen, Butalbital, Codeine Phosphate interactionAcetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, PhenylephrineHycomine Compound
How Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interacts with Tense-Ease — through 1 ingredient. Tap an ingredient for the detail:
HopsCns Depressants, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Moderate
Interaction Summary
Theoretically, concomitant use of hops with sedative drugs might cause additive sedation.
Read the full Hops + 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 Tense-Ease — through 1 ingredient. Tap an ingredient for the detail:
HopsCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Moderate
Interaction Summary
Theoretically, hops extract might alter metabolism of CYP3A4 substrates; however, this effect may not be clinically significant.
Read the full Hops + Acetaminophen, Caffeine, Codeine interactionAcetaminophen, Caffeine, Codeine, SalicylamideCodalan No.1, Codalan No.2, Codalan No.3
How Acetaminophen, Caffeine, Codeine, Salicylamide interacts with Tense-Ease — through 1 ingredient. Tap an ingredient for the detail:
HopsCns Depressants, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Moderate
Interaction Summary
Theoretically, concomitant use of hops with sedative drugs might cause additive sedation.
Read the full Hops + Acetaminophen, Caffeine, Codeine, Salicylamide interactionAcetaminophen, Caffeine, DihydrocodeineDHC Plus, Panlor DC, Panlor SS
How Acetaminophen, Caffeine, Dihydrocodeine interacts with Tense-Ease — through 1 ingredient. Tap an ingredient for the detail:
HopsCns Depressants, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Moderate
Interaction Summary
Theoretically, concomitant use of hops with sedative drugs might cause additive sedation.
Read the full Hops + Acetaminophen, Caffeine, Dihydrocodeine interactionAcetaminophen, Chlorpheniramine, Codeine, PhenylephrineColrex
How Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interacts with Tense-Ease — through 1 ingredient. Tap an ingredient for the detail:
HopsCns Depressants, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Moderate
Interaction Summary
Theoretically, concomitant use of hops with sedative drugs might cause additive sedation.
Read the full Hops + Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interactionAcetaminophen, Chlorpheniramine, Phenylpropanolamine, OpiumHista-Derfule
How Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium interacts with Tense-Ease — through 1 ingredient. Tap an ingredient for the detail:
HopsCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Moderate
Interaction Summary
Hops extract does not seem to affect the metabolism of CYP1A2 substrates.
Read the full Hops + Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium interactionEach ingredient & the kinds of drugs it affects
For each ingredient in Tense-Ease 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.
Hops
Cns Depressants
Theoretically, concomitant use of hops with sedative drugs might cause additive sedation.
Some animal research shows that hops has sedative effects.
Estrogens
Theoretically, concomitant use of large amounts of hops might interfere with hormone replacement therapy due to competition for estrogen receptors.
In vitro research suggests that certain hops constituents can competitively bind to estrogen receptors. However, most hops extracts contain very small amounts of these constituents.
Cytochrome P450 1A2 (Cyp1A2) Substrates
Hops extract does not seem to affect the metabolism of CYP1A2 substrates.
In vitro research suggests that flavonoid constituents of hops inhibit CYP1A2 enzyme activity. However, a pharmacokinetic study in healthy postmenopausal patients shows that taking a standardized extract of spent hops containing prenylated phenols, as 59.5 mg twice daily for 2 weeks, does not affect levels of caffeine, a CYP1A2 probe substrate.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, hops extract might alter metabolism of CYP3A4 substrates; however, this effect may not be clinically significant.
Animal research suggests that specific constituents of hops, called lupulones, can induce hepatic CYP3A4 enzyme activity. However, a pharmacokinetic study in healthy postmenopausal patients with normal metabolism shows that taking a standardized extract of spent hops containing prenylated phenols, as 59.5 mg twice daily for 2 weeks, decreases the concentration of alprazolam, a CYP3A4 probe substrate, by 7.6%. This reduction is unlikely to be clinically relevant.
Hawthorne
Nitrates
Theoretically, concomitant use might cause additive coronary vasodilatory effects.
Some evidence shows that hawthorn might lower blood pressure due to vasodilatory effects.
Phosphodiesterase-5 Inhibitors
Theoretically, concomitant use might result in additive vasodilation and hypotension.
Hawthorn might inhibit PDE-5 and cause vasodilation.
Anticoagulant/Antiplatelet Drugs
Theoretically, hawthorn may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
In vitro and animal research shows that hawthorn can inhibit platelet aggregation. However, its effect in humans is unclear. One observational study shows that patients taking hawthorn shortly before undergoing coronary artery bypass graft (CABG) surgery or valve replacement surgery have a 10% incidence of postoperative bleeding, compared with 1% in those who never consumed hawthorn extract. However, clinical research shows that taking a specific preparation of dried hawthorn leaves and flowers (Crataesor, Soria Natural Lab) 800 mg three times daily for 15 days does not affect platelet aggregation or levels of thromboxane B2, the metabolite of thromboxane A2, in healthy humans.
Beta-Blockers
Theoretically, concomitant use might cause additive effects on blood pressure and heart rate.
Some evidence shows that hawthorn might lower blood pressure and heart rate.
Calcium Channel Blockers
Theoretically, concomitant use might cause additive coronary vasodilation and hypotensive effects.
Some evidence shows that hawthorn might lower blood pressure due to vasodilatory effects.
Digoxin (Lanoxin)
Theoretically, hawthorn might potentiate the effects and adverse effects of digoxin.
Hawthorn appears to improve cardiac output; however, hawthorn does not appear to affect digoxin pharmacokinetics. Case reports suggest that at least one species of hawthorn root extract (Crataegus mexicana) may produce adverse effects similar to digoxin and can cross-react with digoxin assays, leading to falsely elevated plasma digoxin levels.
Wood Betony
Antihypertensive Drugs
Theoretically, betony might have additive effects with blood pressure lowering drugs due to hypotensive activity of the glycosides found in betony. It might also interfere with the activity of pressor drugs. Some antihypertensive drugs include captopril (Capoten), enalapril (Vasotec), losartan (Cozaar), valsartan (Diovan), diltiazem (Cardizem), Amlodipine (Norvasc), hydrochlorothiazide (HydroDiuril), furosemide (Lasix), and many others.
Linden
Lithium
Theoretically, due to its potential diuretic effects, linden might increase the effects and adverse effects of lithium.
Linden is thought to have diuretic properties. The dose of lithium might need to be decreased.
Brand information
Manufacturer and brand details for Tense-Ease, from the product label.
Nature's Answer
See all Nature's Answer products- Name
- Nature's Answer
- City
- Hauppauge
- State
- NY
- ZipCode
- 11788-3943
- Phone Number
- (800) 439-2324
- Web Address
- www.naturesanswer.com
Tense-Ease by Nature's Answer: Common Questions
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The Full Monographs Behind Tense-Ease’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Hops
Interacts with 863 drugsHops are most often used for sleep and mild anxiety, frequently combined with valerian, but the human evidence is limited and not very strong. They are generally well tolerated when used sho...
Read the full Hops monograph → Herb & supplement monographHawthorn
Interacts with 191 drugsHawthorn is a plant traditionally used for heart-related complaints, and some studies suggest it may modestly help symptoms of mild heart failure when added to standard care. However, the ev...
Read the full Hawthorn monograph → Herb & supplement monographLinden
Interacts with 1 drugLinden (also called lime flower) is a traditional herbal tea long used to calm nerves, ease cold symptoms, and support restful sleep. Strong human evidence for these uses is lacking, but the...
Read the full Linden monograph → Herb & supplement monographBetony
Interacts with 172 drugsBetony (Stachys officinalis) is a traditional European herb long used for headaches, nervous tension, and digestive complaints. Modern scientific evidence supporting these uses is very limit...
Read the full Betony monograph →Sources & How We Checked
Tense-Ease'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 44 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.
Hops 15 references
- Newall CA, Anderson LA, Philpson JD. Herbal Medicine: A Guide for Healthcare Professionals. London, UK: The Pharmaceutical Press, 1996.
- McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
- Zava DT, Dollbaum CM, Blen M. Estrogen and progestin bioactivity of foods, herbs, and spices. Proc Soc Exp Biol Med 1998;217:369-78. PubMed
- Milligan SR, Kalita JC, Heyerick A, et al. Identification of a potent phytoestrogen in hops (Humulus lupulus L.) and beer. J Clin Endocrinol Metab 1999;84:2249-52.. PubMed
- Milligan SR, Kalita JC, Pocock V, et al. The endocrine activities of 8-prenylnaringenin and related hop (Humulus lupulus L.) flavonoids. J Clin Endocrinol Metab 2000;85:4912-5.. DOI
- Henderson MC, Miranda CL, Stevens JF, et al. In vitro inhibition of human P450 enzymes by prenylated flavonoids from hops, Humulus lupulus. Xenobiotica 2000;30:235-51.. PubMed
- Mannering, G. J., Shoeman, J. A., and Deloria, L. B. Identification of the antibiotic hops component, colupulone, as an inducer of hepatic cytochrome P-4503A in the mouse. Drug Metab Dispos 1992;20(2):142-147. DOI
- Skorska, C., Mackiewicz, B., Gora, A., Golec, M., and Dutkiewicz, J. Health effects of inhalation exposure to organic dust in hops farmers. Ann.Univ Mariae.Curie Sklodowska [Med] 2003;58(1):459-465.
- Schiller, H., Forster, A., Vonhoff, C., Hegger, M., Biller, A., and Winterhoff, H. Sedating effects of Humulus lupulus L. extracts. Phytomedicine. 2006;13(8):535-541. PubMed
- van Hunsel, F. P. and Kampschoer, P. [Postmenopausal bleeding and dietary supplements: a possible causal relationship with hop- and soy-containing preparations]. Ned.Tijdschr.Geneeskd. 2012;156(41):A5095.
- Fenselau, C. and Talalay, P. Is oestrogenic activity present in hops? Food Cosmet.Toxicol. 1973;11(4):597-602. PubMed
- Godnic-Cvar, J., Zuskin, E., Mustajbegovic, J., Schachter, E. N., Kanceljak, B., Macan, J., Ilic, Z., and Ebling, Z. Respiratory and immunological findings in brewery workers. Am J Ind Med 1999;35(1):68-75. DOI
- Lee KM, Jung JS, Song DK, and et al. Effects of Humulus lupulus extract on the central nervous system in mice. Planta Med 1993;59(Suppl):A691.
- Assessment report on Humulus lupulus L., flos. European Medicines Agency, 2014. Available at: https://www.ema.europa.eu/en/documents/herbal-report/final-assessment-report-humulus-lupulus-l-flos_en.pdf. Accessed September 29, 2021.
- van Breemen RB, Chen L, Tonsing-Carter A, et al. Pharmacokinetic Interactions of a Hop Dietary Supplement with Drug Metabolism in Perimenopausal and Postmenopausal Women. J Agric Food Chem. 2020;68(18):5212-5220. PubMed
Hawthorn 25 references
- Tauchert M. Efficacy and safety of crataegus extract WS 1442 in comparison with placebo in patients with chronic stable New York Heart Association class-III heart failure. Am Heart J 2002;143:910-5. PubMed
- Pittler MH, Schmidt K, Ernst E. Hawthorn extract for treating chronic heart failure: meta-analysis of randomized trials. Am J Med 2003;114:665-74.. PubMed
- Chang Q, Zuo Z, Harrison F, Chow MS. Hawthorn. J Clin Pharmacol 2002;42:605-12.
- Holubarsch CJ, Colucci WS, Meinertz T, et al. The efficacy and safety of Crataegus extract WS 1442 in patients with heart failure: the SPICE trial. Eur J Heart Fail 2008;10:1255-63. PubMed
- Pittler MH, Guo R, and Ernst E. Hawthorn extract for treating chronic heart failure. Cochrane.Database.Syst Rev 2008:CD005312. PubMed
- Zick SM, Vautaw BM, Gillespie B, Aaronson KD. Hawthorn Extract Randomized Blinded Chronic Heart Failure (HERB CHF) trial. Eur J Heart Fail. 2009;11:990-99. PubMed
- Werner NS, Duschek S, and Schandry R. D-camphor-crataegus berry extract combination increases blood pressure and cognitive functioning in the elderly - a randomized, placebo controlled double blind study. Phytomedicine. 2009;16:1077-82. PubMed
- Dalli E, Colomer E, Tormos MC, et al. Crataegus laevigata decreases neutrophil elastase and has hypolipidemic effect: a randomized, double-blind, placebo-controlled trial. Phytomedicine. 6-15-2011;18:769-75. PubMed
- Maek-a-nantawat W, Phonrat B, Dhitavat J, et al. Safety and efficacy of CKBM-A01, a Chinese herbal medicine, among asymptomatic HIV patients. Southeast Asian J Trop.Med Public Health 2009;40:494-501.
- Asher GN, Viera AJ, Weaver MA, et al. Effect of hawthorn standardized extract on flow mediated dilation in prehypertensive and mildly hypertensive adults: a randomized, controlled cross-over trial. BMC.Complement Altern.Med 2012;12:26. PubMed
- Walker AF, Marakis G, Simpson E, et al. Hypotensive effects of hawthorn for patients with diabetes taking prescription drugs: a randomised controlled trial. Br J Gen.Pract 2006;56:437-43.
- Daniele C, Mazzanti G, Pittler MH, et al. Adverse-event profile of Crataegus spp.: a systematic review. Drug Saf 2006;29:523-35. PubMed
- Tankanow R, Tamer HR, Streetman DS, et al. Interaction study between digoxin and a preparation of hawthorn (Crataegus oxyacantha). J.Clin.Pharmacol. 2003;43:637-42. DOI
- Tauchert, M., Gildor, A., and Lipinski, J. [High-dose Crataegus extract WS 1442 in the treatment of NYHA stage II heart failure]. Herz 1999;24(6):465-474.
- Horoz, M., Gok, E., Genctoy, G., Ozcan, T., Olmaz, R., Akca, M., Kiykim, A., and Gurses, I. Crataegus orientalis associated multiorgan hypersensitivity reaction and acute renal failure. Intern.Med 2008;47(23):2039-2042. PubMed
- Dalli, E., Valles, J., Cosin-Sales, J., Santos, M. T., Moscardo, A., Milara, J., and Sotillo, J. F. Effects of hawthorn (Crataegus laevigata) on platelet aggregation in healthy volunteers. Thromb.Res 2011;128(4):398-400. PubMed
- Rogov VD. [Toxiderma due to the fruits of the hawthorn]. Vestn Dermatol Venerol 1984;7(7):46-47.
- Loew D, Albrecht M, and Podzuweit H. Efficacy and tolerability of a Hawthorn preparation in patients with heart failure Stage I and II according to NYHA - a surveillance study. Phytomedicine 1996;3(Suppl 1):92.
- Rababa'h AM, Altarabsheh SE, Haddad O, Deo SV, Obeidat Y, Al-Azzam S. Hawthorn Herb Increases the Risk of Bleeding after Cardiac Surgery: An Evidence-Based Approach. Heart Surg Forum 2016;19(4):E175-9. PubMed
- Shatoor AS, Soliman H, Al-Hashem F, Gamal BE, Othman A, El-Menshaw N. Effect of hawthorn (Crataegus aronia syn. Azarolus (L)) on platelet function in albino wistar rats. Thromb Res 2012;130(1):75-80. PubMed
- Vibes J, Lasserre B, Gleye J, Declume C. Inhibition of thromboxane A2 biosynthesis in vitro by the main components of Crataegus oxyacantha (hawthorn) flower heads. Prostaglandins Leukot Essent Fatty Acids 1994;50(4):173-5. PubMed
- Rogers KL, Grice ID, Griffiths LR. Inhibition of platelet aggregation and 5-HT release by extracts of Australian plants used traditionally as headache treatments. Eur J Pharm Sci 2000;9(4):355-63. PubMed
- Zhou CC, Huang XX, Gao PY, et al. Two new compounds from Crataegus pinnatifida and their antithrombotic activities. J Asian Nat Prod Res 2014;16(2):169-74.
- Palmer KG, Lebin JA, Cronin MT, Mazor SS, Burns RA. Crataegus mexicana (Tejocote) Exposure Associated with Cardiotoxicity and a Falsely Elevated Digoxin Level. J Med Toxicol. 2019;15(4):295-298. PubMed
- Espinosa J, Bassett R, Lucerna A, Finn D. Hawthorne root (Crataegus mexicana) toxicity. Am J Emerg Med. 2024;78:242.e5-242.e6. PubMed
Linden 2 references
- Newall CA, Anderson LA, Philpson JD. Herbal Medicine: A Guide for Healthcare Professionals. London, UK: The Pharmaceutical Press, 1996.
- McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
Betony 2 references
- Foster S, Tyler VE. Tyler's Honest Herbal: A Sensible Guide to the Use of Herbs and Related Remedies. 3rd ed., Binghamton, NY: Haworth Herbal Press, 1993.
- The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999.
Parts of this content are provided by the Therapeutic Research Center, LLC.
DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.
© 2021 Therapeutic Research Center, LLC