Testosterone Booster Extra Strength Ingredients & Drug Interactions
What is this page for?
First and foremost: checking Testosterone Booster Extra Strength 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
Testosterone Booster Extra Strength is a dietary supplement by Purely Optimal with 9 active ingredients. Its ingredients are commonly taken for boosting energy and fighting fatigue, improving mental focus and memory, coping with stress (adaptogen).Based on those ingredients, 1,330 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Panax Ginseng, Horny Goat Weed 4:1 extract, L-Arginine. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against Testosterone Booster Extra Strength by Purely Optimal
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HelloPharmacist Scorecard of Testosterone Booster Extra Strength by Purely Optimal
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
Full disclosure
This product contains 9 ingredients, six of which are active: Panax Ginseng (Asian ginseng root), L-Arginine (an amino acid), Fenugreek seed extract (4:1 concentrate), Saw Palmetto, Tongkat Ali (also called Eurycoma longifolia), Maca, Horny Goat Weed extract (4:1 concentrate), plus Citrulline Malate and Tribulin Tribulus herb extract. The rest are inactive ingredients—vegetable cellulose, magnesium stearate, silicon dioxide, and microcrystalline cellulose—which serve as capsule material and flow agents.
Does it work?
Moderate evidence
Evidence for these ingredients varies. Panax Ginseng is possibly effective for erectile dysfunction, sexual arousal, influenza, cognitive function, and multiple sclerosis–related fatigue.
Fenugreek is possibly effective for sexual dysfunction, sexual arousal, and diabetes. Tongkat Ali is possibly effective for sexual desire but appears ineffective for athletic performance.
L-Arginine, Saw Palmetto, Maca, and Horny Goat Weed either lack sufficient evidence or show weak results—Saw Palmetto is rated possibly ineffective for benign prostatic hyperplasia. Citrulline Malate and Tribulin Tribulus have no effectiveness data on file in our system.
How safe is it?
Well-documented data
Short-term use of these ingredients is generally well tolerated, but long-term safety is uncertain. The most common side effects from Panax Ginseng are insomnia, headache, and dizziness.
L-Arginine may cause abdominal pain, bloating, nausea, diarrhea, headache, insomnia, and flushing. Fenugreek commonly causes bloating, diarrhea, nausea, and abdominal pain; rare severe allergic reactions (angioedema, bronchospasm, shock) are possible.
Saw Palmetto side effects include abdominal pain, constipation, diarrhea, dizziness, fatigue, headache, nausea, and rarely fixed drug eruptions or heart rhythm changes. Horny Goat Weed may cause dizziness, dry mouth, nosebleed, and vomiting; respiratory arrest is rare.
During pregnancy, Panax Ginseng, Saw Palmetto, Horny Goat Weed, and Maca should be avoided due to insufficient safety data. Fenugreek is likely unsafe in pregnancy, particularly near delivery (may cause unusual body odor in the newborn).
For breastfeeding, Fenugreek is possibly safe, while Panax Ginseng, Saw Palmetto, Maca, and Horny Goat Weed have insufficient data—talk with your provider. Tongkat Ali has no lactation data on file.
Meds to double-check
Moderate interaction found
Check with your pharmacist if you take blood thinners or antiplatelet drugs (warfarin, clopidogrel, aspirin, etc.), blood pressure medications, diabetes drugs, MAOIs or selegiline (antidepressants), insulin, sedatives like midazolam, the HIV drug raltegravir, heart rhythm or beta-blocking drugs, ACE inhibitors or angiotensin receptor blockers, estrogen or hormonal contraceptives, or potassium-sparing diuretics. These are the medication types with Moderate severity interactions documented for the ingredients we could check.
The bottom line
Scorecard at a glanceFully disclosed formula with some supporting evidence for its stated purpose. Moderate medication interactions have been identified, and safety information is well characterized.
This product contains multiple ingredients with documented drug interactions, particularly affecting blood thinners, blood pressure medications, diabetes drugs, and hormonal contraceptives. If you take any prescription medications—especially heart, blood pressure, diabetes, or blood-thinning drugs—talk with your pharmacist before starting.
Pregnant or breastfeeding? Check with your provider first.
Short-term side effects like insomnia and GI upset are common.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 7 of 9 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Feb 25, 2021.
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 Testosterone Booster Extra Strength, straight from the product label.
| Brand | Purely Optimal |
|---|---|
| Barcode (UPC) | X002I80SUZ |
| Net contents | 60 Capsule(s) |
| Market status | On market |
| Date entered into DSLD | Feb 25, 2021 |
| DSLD ID | 244063 |
| Product type | Other Combinations |
| Supplement form | Capsule |
| Dietary claims / uses | All Other, Structure/Function |
| Intended target group(s) | Vegetarian, 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 Testosterone Booster Extra Strength by Purely Optimal, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Panax Ginseng | 50 mg | -- |
| L-Arginine | 50 mg | -- |
| Fenugreek seed 4:1 extract | 50 mg | -- |
| Saw Palmetto | 100 mg | -- |
| Tongkat Ali | 50 mg | -- |
| Maca | 150 mg | -- |
| Citrulline Malate | 100 mg | -- |
| Horny Goat Weed 4:1 extract | 1000 mg | -- |
| Tribulin Tribulus herb extract | 100 mg | -- |
Other ingredients: Vegetable Cellulose, Magnesium Stearate, Silicon Dioxide, Microcrystalline Cellulose
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.
Suggested/Recommended/Usage/Directions
Suggested Use: As a dietary supplement, take two (2) capsules once a day with or without food or as directed by your health care professional.
Precautions
Caution: Do not exceed recommended dose.
Pregnant or nursing mothers, children under the age of 18, and individuals with a known medical condition should consult a physician before using this or any dietary supplement.
Pregnant or nursing mothers, children under the age of 18, and individuals with a known medical condition should consult a physician before using this or any dietary supplement. Keep out of reach of children.
Do not use if safety seal is damaged or missing.
Storage
Store in a cool, dry place.
FDA Disclaimer Statement
These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.
Formula
With Tribulin & L-Arginine
FDA Statement of Identity
Dietary Supplement
Formulation
Builds lean muscles Maintains energy & stamina Supports testosterone levels Improves physical performance
Professional grade
Vegetarian friendly
General Statements
100% natural
Seals/Symbols
cGMP Facility Good Manufacturing Practice Certification
Lab Tested 3rd Party Certified for Purity & Potency
Brand IP Statement(s)
Tribulin is a registered trademark of Sabinsa Corporation.
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Testosterone Booster Extra Strength by Purely Optimal 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 Testosterone Booster Extra Strength by Purely Optimal
These are the 9 active ingredients this product is made of. Select any to open its full monograph.
Serving size2 Capsule(s) Dosage formCapsule Servings per container30 Amounts shown are per serving.
Most supplement products combine several ingredients, and a medication can interact with the product through any one of them. Each ingredient below shows whether it has known drug interactions.
Panax Ginseng
Interacts with1,130 drugs
Panax ginseng is a popular traditional herb used to boost energy, ease stress, and support overall wellness, though scientific evidence is mixed and m...
Panax Ginseng monograph & interactionsL-Arginine
Interacts with403 drugs
L-arginine is an amino acid that the body uses to make nitric oxide, a substance that helps blood vessels relax and widen. It is popularly used for bl...
L-Arginine monograph & interactionsFenugreek seed 4:1 extract
Interacts with389 drugs
Fenugreek is a common kitchen spice that is also taken as a supplement, mainly for blood sugar, cholesterol, and to support breast milk production. So...
Fenugreek seed 4:1 extract monograph & interactionsSaw Palmetto
Interacts with174 drugs
Saw palmetto is a plant extract most often used for urinary symptoms linked to an enlarged prostate (BPH). The best research suggests it works no bett...
Saw Palmetto monograph & interactionsTongkat Ali
Interacts with248 drugs
Eurycoma longifolia (tongkat ali) is a Southeast Asian herb most popular for supporting testosterone, libido, and male fertility, with some small huma...
Tongkat Ali monograph & interactionsMaca
No knowninteractions
Maca is a nutrient-rich Andean root often used for energy, libido, and menopause symptoms. Early studies suggest it may modestly help sexual desire an...
Maca monograph & interactionsCitrulline Malate
Horny Goat Weed 4:1 extract
Interacts with963 drugs
Horny goat weed (Epimedium) is a traditional Chinese herb most often marketed for low libido and erectile problems, but solid human evidence for these...
Horny Goat Weed 4:1 extract monograph & interactionsTribulin Tribulus herb extract
Other (inactive) ingredients: Vegetable Cellulose, Magnesium Stearate, Silicon Dioxide, Microcrystalline Cellulose. These complete the product’s ingredient list but are not active constituents.
Testosterone Booster Extra Strength by Purely Optimal Drug Interactions
HelloPharmacist Interaction Report
Purely Optimal's Testosterone Booster Extra Strength contains multiple ingredients that interact with medications.
The most serious interactions involve Panax Ginseng, which can reduce how your body clears midazolam (a sedative), potentially making it stay in your system longer and increasing drowsiness and sedation risk—a Moderate severity concern.
Read the full breakdown — every affected drug type, severity by severity
Other Moderate severity interactions span several drug categories: blood thinners and antiplatelet drugs (warfarin, clopidogrel, and others) may have their effects boosted by Fenugreek, Saw Palmetto, and Horny Goat Weed, raising bleeding risk. Blood pressure medications face potential added effects from L-Arginine, Fenugreek, and Horny Goat Weed, which could lower your pressure too much.
Diabetes medications may have stronger effects when combined with L-Arginine or Fenugreek, increasing low blood sugar (hypoglycemia) risk. Heart and blood pressure drugs—including propranolol, beta-blockers, and ACE inhibitors—interact with Tongkat Ali, L-Arginine, and other ingredients.
Estrogen-based drugs and hormonal contraceptives may lose effectiveness with Saw Palmetto and Horny Goat Weed, which have hormone-blocking effects.
Additionally, Panax Ginseng interacts with insulin (low blood sugar risk), antidepressants called MAOIs (tremors, hypomania risk), the HIV drug raltegravir (liver toxicity risk), and a few others. Fenugreek can reduce theophylline and phenytoin levels, making them less effective, and may weaken sildenafil (Viagra).
L-Arginine poses potassium-sparing diuretic risk (high potassium levels). Horny Goat Weed inhibits liver enzymes that clear many drugs, potentially raising their levels.
We could not check Citrulline Malate and Tribulin Tribulus herb extract for interactions. Altogether, these interactions span 1,314 individual medications.
Run your exact medications through the search tool below before you start this product.
Check your own medications below · Editorial policy · How we use AI
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Go to the checkerIngredients driving the most interactions
Individual Drug Interactions
The ingredients in Testosterone Booster Extra Strength interact with 1,330 drugs. Click any drug to see the details.
6 of the 9 ingredients in Testosterone Booster Extra Strength interact with drugs. Each result below shows which ingredient is responsible. Panax Ginseng Horny Goat Weed 4:1 extract L-Arginine Fenugreek seed 4:1 extract Tongkat Ali Saw Palmetto
Atovaquone, ProguanilMalarone
How Atovaquone, Proguanil interacts with Testosterone Booster Extra Strength — through 1 ingredient. Tap an ingredient for the detail:
Tongkat AliCytochrome P450 2c19 (cyp2c19) Substrates Minor
Interaction Summary
Theoretically, Eurycoma longifolia might increase levels of CYP2C19 substrates.
Read the full Tongkat Ali + Atovaquone, Proguanil interactionBelzutifanWelireg
How Belzutifan interacts with Testosterone Booster Extra Strength — through 1 ingredient. Tap an ingredient for the detail:
Tongkat AliCytochrome P450 2c19 (cyp2c19) Substrates Minor
Interaction Summary
Theoretically, Eurycoma longifolia might increase levels of CYP2C19 substrates.
Read the full Tongkat Ali + Belzutifan interactionBrivaracetamBriviact
How Brivaracetam interacts with Testosterone Booster Extra Strength — through 1 ingredient. Tap an ingredient for the detail:
Tongkat AliCytochrome P450 2c19 (cyp2c19) Substrates Minor
Interaction Summary
Theoretically, Eurycoma longifolia might increase levels of CYP2C19 substrates.
Read the full Tongkat Ali + Brivaracetam interactionCarisoprodolRela, Soma
How Carisoprodol interacts with Testosterone Booster Extra Strength — through 1 ingredient. Tap an ingredient for the detail:
Tongkat AliCytochrome P450 2c19 (cyp2c19) Substrates Minor
Interaction Summary
Theoretically, Eurycoma longifolia might increase levels of CYP2C19 substrates.
Read the full Tongkat Ali + Carisoprodol interactionDiethylstilbestrol, MethyltestosteroneTylosterone
How Diethylstilbestrol, Methyltestosterone interacts with Testosterone Booster Extra Strength — through 2 ingredients. Tap an ingredient for the detail:
Tongkat AliTestosterone Minor
Interaction Summary
Theoretically, Eurycoma longifolia may further increase levels of testosterone.
Read the full Tongkat Ali + Diethylstilbestrol, Methyltestosterone interactionL-arginineTestosterone Minor
Interaction Summary
Theoretically, concomitant use of L-arginine and testosterone might have additive effects.
Read the full L-arginine + Diethylstilbestrol, Methyltestosterone interactionHexobarbitalHexobarbital, Sombulex
How Hexobarbital interacts with Testosterone Booster Extra Strength — through 1 ingredient. Tap an ingredient for the detail:
Tongkat AliCytochrome P450 2c19 (cyp2c19) Substrates Minor
Interaction Summary
Theoretically, Eurycoma longifolia might increase levels of CYP2C19 substrates.
Read the full Tongkat Ali + Hexobarbital interactionMephobarbitalMebaral
How Mephobarbital interacts with Testosterone Booster Extra Strength — through 1 ingredient. Tap an ingredient for the detail:
Tongkat AliCytochrome P450 2c19 (cyp2c19) Substrates Minor
Interaction Summary
Theoretically, Eurycoma longifolia might increase levels of CYP2C19 substrates.
Read the full Tongkat Ali + Mephobarbital interactionMethyltestosteroneAndroid 10, Android 25, Metandren, Methitest, Oreton, Testred +1 more
How Methyltestosterone interacts with Testosterone Booster Extra Strength — through 2 ingredients. Tap an ingredient for the detail:
L-arginineTestosterone Minor
Interaction Summary
Theoretically, concomitant use of L-arginine and testosterone might have additive effects.
Read the full L-arginine + Methyltestosterone interactionTongkat AliTestosterone Minor
Interaction Summary
Theoretically, Eurycoma longifolia may further increase levels of testosterone.
Read the full Tongkat Ali + Methyltestosterone interactionMethyltestosterone BuccalAndroid 5, Oreton Buccal
How Methyltestosterone Buccal interacts with Testosterone Booster Extra Strength — through 2 ingredients. Tap an ingredient for the detail:
Tongkat AliTestosterone Minor
Interaction Summary
Theoretically, Eurycoma longifolia may further increase levels of testosterone.
Read the full Tongkat Ali + Methyltestosterone Buccal interactionL-arginineTestosterone Minor
Interaction Summary
Theoretically, concomitant use of L-arginine and testosterone might have additive effects.
Read the full L-arginine + Methyltestosterone Buccal interactionNilutamideAnandron, Nilandron
How Nilutamide interacts with Testosterone Booster Extra Strength — through 1 ingredient. Tap an ingredient for the detail:
Tongkat AliCytochrome P450 2c19 (cyp2c19) Substrates Minor
Interaction Summary
Theoretically, Eurycoma longifolia might increase levels of CYP2C19 substrates.
Read the full Tongkat Ali + Nilutamide interactionProguanilPaludrine
How Proguanil interacts with Testosterone Booster Extra Strength — through 1 ingredient. Tap an ingredient for the detail:
Tongkat AliCytochrome P450 2c19 (cyp2c19) Substrates Minor
Interaction Summary
Theoretically, Eurycoma longifolia might increase levels of CYP2C19 substrates.
Read the full Tongkat Ali + Proguanil interactionTapentadolNucynta, Nucynta ER
How Tapentadol interacts with Testosterone Booster Extra Strength — through 1 ingredient. Tap an ingredient for the detail:
Tongkat AliCytochrome P450 2c19 (cyp2c19) Substrates Minor
Interaction Summary
Theoretically, Eurycoma longifolia might increase levels of CYP2C19 substrates.
Read the full Tongkat Ali + Tapentadol interactionTeniposideVumon
How Teniposide interacts with Testosterone Booster Extra Strength — through 1 ingredient. Tap an ingredient for the detail:
Tongkat AliCytochrome P450 2c19 (cyp2c19) Substrates Minor
Interaction Summary
Theoretically, Eurycoma longifolia might increase levels of CYP2C19 substrates.
Read the full Tongkat Ali + Teniposide interactionEach ingredient & the kinds of drugs it affects
For each ingredient in Testosterone Booster Extra Strength 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.
Panax Ginseng
Anticoagulant/Antiplatelet Drugs
Although Panax ginseng has shown antiplatelet effects in the laboratory, it is unlikely to increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
In vitro evidence suggests that ginsenoside constituents in Panax ginseng might decrease platelet aggregation. However, research in humans suggests that ginseng does not affect platelet aggregation. Animal research indicates low oral bioavailability of Rb1 and rapid elimination of Rg1, which might explain the discrepancy between in vitro and human research. Until more is known, use with caution in patients concurrently taking anticoagulant or antiplatelet drugs.
Antidiabetes Drugs
Theoretically, taking Panax ginseng with antidiabetes drugs might increase the risk of hypoglycemia.
Clinical research suggests that Panax ginseng might decrease blood glucose levels. Monitor blood glucose levels closely.
Caffeine
Theoretically, taking Panax ginseng with caffeine might increase the risk of adverse stimulant effects.
Panax ginseng has been shown to have stimulant effects. Theoretically, caffeine might have an additive effect on the stimulant effects of Panax ginseng.
Cytochrome P450 2D6 (Cyp2D6) Substrates
Theoretically, Panax ginseng might increase levels of drugs metabolized by CYP2D6. However, research is conflicting.
There is some evidence that Panax ginseng can inhibit the CYP2D6 enzyme by approximately 6%. In addition, in animal research, Panax ginseng inhibits the metabolism of dextromethorphan, a drug metabolized by CYP2D6, by a small amount. However, contradictory research suggests Panax ginseng might not inhibit CYP2D6. Until more is known, use Panax ginseng cautiously in patients taking drugs metabolized by these enzymes.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, Panax ginseng might increase or decrease levels of drugs metabolized by CYP3A4.
Panax ginseng may affect the clearance of drugs metabolized by CYP3A4. One such drug is imatinib. Inhibition of CYP3A4 was believed to be responsible for a case of imatinib-induced hepatotoxicity. In contrast, Panax ginseng has been shown to increase the clearance of midazolam, another drug metabolized by CYP3A4. Clinical research shows that Panax ginseng can reduce midazolam area under the curve by 44%, maximum plasma concentration by 26%, and time to reach maximum plasma concentration by 29%. Midazolam metabolism was also increased in animals given Panax ginseng. Until more is known, use Panax ginseng cautiously in combination with CYP3A4 substrates.
Estrogens
Theoretically, concomitant use of large amounts of Panax ginseng might interfere with hormone replacement therapy.
Laboratory research and some case reports suggest that Panax ginseng can have estrogenic effects due to competition for estrogen receptors. The estrogenic activity is attributed to the ginsenoside constituents of Panax ginseng.
Furosemide (Lasix)
Theoretically, Panax ginseng might reduce the effects of furosemide.
There is some concern that Panax ginseng might contribute to furosemide resistance. There is one case of resistance to furosemide diuresis in a patient taking a germanium-containing ginseng product.
Imatinib (Gleevec)
Theoretically, Panax ginseng might increase the effects and adverse effects of imatinib.
A case of imatinib-induced hepatotoxicity has been reported for a 26-year-old male with chronic myelogenous leukemia stabilized on imatinib for 7 years. The patient took imatinib 400 mg along with a Panax ginseng-containing energy drink daily for 3 months. Since imatinib-associated hepatotoxicity typically occurs within 2 years of initiating therapy, it is believed that Panax ginseng affected imatinib toxicity though inhibition of cytochrome P450 3A4. CYP3A4 is the primary enzyme involved in imatinib metabolism.
Immunosuppressants
Theoretically, Panax ginseng use might interfere with immunosuppressive therapy.
Panax ginseng might have immune system stimulating properties.
Insulin
Theoretically, taking Panax ginseng with insulin might increase the risk of hypoglycemia.
Clinical research suggests that Panax ginseng might decrease blood glucose levels. Insulin dose adjustments might be necessary in patients taking Panax ginseng; use with caution.
Midazolam (Versed)
Theoretically, Panax ginseng may increase the clearance of midazolam.
Midazolam is metabolized by cytochrome P450 3A4 (CYP3A4). Clinical research suggests that Panax ginseng can reduce midazolam area under the curve by 44%, maximum plasma concentration by 26%, and time to reach maximum plasma concentration by 29%. Midazolam metabolism was also increased in animals given Panax ginseng.
Monoamine Oxidase Inhibitors (Maois)
Theoretically, Panax ginseng can interfere with MAOI therapy.
Concomitant use of Panax ginseng with phenelzine (Nardil) is associated with insomnia, headache, tremors, and hypomania.
Nifedipine (Procardia)
Theoretically, taking Panax ginseng with nifedipine might increase serum levels of nifedipine and the risk of hypotension.
Preliminary clinical research shows that concomitant use can increase serum levels of nifedipine in healthy volunteers. This might cause the blood pressure lowering effects of nifedipine to be increased when taken concomitantly with Panax ginseng.
Qt Interval-Prolonging Drugs
Theoretically, Panax ginseng has an additive effect with drugs that prolong the QT interval and potentially increase the risk of ventricular arrhythmias. However, research is conflicting.
Clinical research shows that short-term use of Panax ginseng can increase the QT interval. However, no changes in QT interval have been identified with prolonged use.
Raltegravir (Isentress)
Theoretically, taking Panax ginseng with raltegravir might increase the risk of liver toxicity.
A case report suggests that concomitant use of Panax ginseng with raltegravir can increase serum levels of raltegravir, resulting in elevated liver enzymes levels.
Selegiline (Eldepryl)
Theoretically, Panax ginseng might increase or decrease levels of selegiline, possibly altering the effects and side effects of selegiline.
Animal research shows that taking selegiline with a low dose of Panax ginseng extract (1 gram/kg) reduces selegiline bioavailability, while taking a high dose of Panax ginseng extract (3 grams/kg) increases selegiline bioavailability. More research is needed to confirm these effects.
Stimulant Drugs
Theoretically, taking Panax ginseng with stimulant drugs might increase the risk of adverse stimulant effects.
Panax ginseng has been shown to have stimulant effects.
Warfarin (Coumadin)
Panax ginseng might affect the clearance of warfarin. However, this interaction appears to be unlikely.
There has been a single case report of decreased effectiveness of warfarin in a patient who also took Panax ginseng. However, it is questionable whether Panax ginseng was the cause of this decrease in warfarin effectiveness. Some research in humans and animals suggests that Panax ginseng does not affect the pharmacokinetics of warfarin. However, other research in humans suggests that Panax ginseng might modestly increase the clearance of the S-warfarin isomer. More evidence is needed to determine whether Panax ginseng causes a significant interaction with warfarin.
Fexofenadine (Allegra)
Theoretically, Panax ginseng might decrease blood levels of oral or intravenous fexofenadine.
Animal research suggests that taking Panax ginseng in combination with oral or intravenous fexofenadine may reduce the bioavailability of fexofenadine. Some scientists have attributed this effect to the ability of Panax ginseng to increase the expression of P-glycoprotein.
Lopinavir/Ritonavir (Kaletra)
Although Panax ginseng has demonstrated variable effects on cytochrome P450 3A4 (CYP3A4), which metabolizes lopinavir, Panax ginseng is unlikely to alter levels of lopinavir/ritonavir.
Lopinavir is metabolized by CYP3A4 and is administered with the CYP3A4 inhibitor ritonavir to increase its plasma concentrations. Panax ginseng has shown variable effects on CYP3A4 activity in humans. However, taking Panax ginseng (Vitamer Laboratories) 500 mg twice daily for 14 days did not alter the pharmacokinetics of lopinavir/ritonavir in 12 healthy volunteers.
Horny Goat Weed 4:1 extract
Anticoagulant/Antiplatelet Drugs
Theoretically, horny goat weed might increase the risk of bleeding.
In vitro research and animal research shows that horny goat weed can inhibit platelet aggregation and thrombus formation. This effect has not been reported in humans.
Antihypertensive Drugs
Theoretically, horny goat weed might increase the risk of hypotension.
Laboratory research suggests that horny goat weed might have hypotensive effects. This effect has not been reported in humans.
Cytochrome P450 1A2 (Cyp1A2) Substrates
Theoretically, horny goat weed might increase the effects and side effects of CYP1A2 substrates.
In vitro, horny goat weed leaf extract inhibits CYP1A2. This effect has not been reported in humans.
Cytochrome P450 2B6 (Cyp2B6) Substrates
Theoretically, horny goat weed might increase the effects and side effects of CYP2B6 substrates.
In vitro, horny goat weed leaf extract inhibits CYP2B6. This effect has not been reported in humans.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, horny goat weed might increase the effects and side effects of CYP3A4 substrates.
In vitro, horny goat weed extract inhibits CYP3A4 and suppresses CYP3A4 mRNA expression. This effect has not been reported in humans.
Estrogens
Theoretically, concomitant use of horny goat weed with estrogens might increase their therapeutic and adverse effects.
In vitro evidence suggests that horny goat weed has estrogenic activity. In clinical research, horny goat weed has been shown to increase blood levels of estrogen in some females.
L-Arginine
Ace Inhibitors (Aceis)
Theoretically, concomitant use of L-arginine and ACE inhibitors may increase the risk for hypotension and hyperkalemia.
Combining L-arginine with some antihypertensive drugs, especially ACE inhibitors, seems to have additive vasodilating and blood pressure-lowering effects. Furthermore, ACE inhibitors can increase potassium levels. Use of L-arginine has been associated with hyperkalemia in some patients. Theoretically, concomitant use of ACE inhibitors with L-arginine may increases the risk of hyperkalemia.
Angiotensin Receptor Blockers (Arbs)
Theoretically, concomitant use of L-arginine and ARBs may increase the risk of hypotension and hyperkalemia.
L-arginine increases nitric oxide, which causes vasodilation. Combining L-arginine with ARBs seems to increase L-arginine-induced vasodilation. Furthermore, ARBs can increase potassium levels. Use of L-arginine has been associated with hyperkalemia in some patients. Theoretically, concomitant use of ARBs with L-arginine may increases the risk of hyperkalemia.
Anticoagulant/Antiplatelet Drugs
Theoretically, concomitant use of L-arginine with anticoagulant and antiplatelet drugs might have additive effects and increase the risk of bleeding.
Preliminary research suggests that L-arginine infusions reduce platelet aggregation in humans. The clinical significance of this effect is unclear.
Antidiabetes Drugs
Theoretically, concomitant use of L-arginine might have additive effects with antidiabetes drugs.
Preliminary clinical research shows that L-arginine decreases blood glucose levels in patients with type 2 diabetes.
Antihypertensive Drugs
Theoretically, concomitant use of L-arginine and antihypertensive drugs may increase the risk of hypotension.
L-arginine increases nitric oxide, which causes vasodilation. Clinical evidence shows that L-arginine can reduce blood pressure in some individuals with hypertension. Furthermore, combining L-arginine with some antihypertensive drugs seems to have additive vasodilating and blood pressure-lowering effects.
Isoproterenol (Isuprel)
Theoretically, concurrent use of isoproterenol and L-arginine might result in additive effects and hypotension.
Preliminary clinical evidence suggests that L-arginine enhances isoproterenol-induced vasodilation in patients with essential hypertension or a family history of essential hypertension.
Potassium-Sparing Diuretics
Theoretically concomitant use of potassium-sparing diuretics with L-arginine may increases the risk of hyperkalemia.
Potassium-sparing diuretics can increase potassium levels. Use of L-arginine has been associated with hyperkalemia in some patients.
Sildenafil (Viagra)
Theoretically, concurrent use of sildenafil and L-arginine might increase the risk for hypotension.
In vivo, concurrent use of L-arginine and sildenafil has resulted in increased vasodilation. Theoretically, concurrent use might have additive vasodilatory and hypotensive effects. However, in studies evaluating the combined use of L-arginine and sildenafil for erectile dysfunction, hypotension was not reported.
Testosterone
Theoretically, concomitant use of L-arginine and testosterone might have additive effects.
In clinical research, L-arginine increases the level of testosterone in male patients with erectile dysfunction. The clinical significance of this finding is unclear.
Fenugreek seed 4:1 extract
Anticoagulant/Antiplatelet Drugs
Theoretically, fenugreek might have additive effects when used with anticoagulant or antiplatelet drugs.
Some of the constituents in fenugreek have antiplatelet effects in animal and in vitro research. However, common fenugreek products might not contain sufficient concentrations of these constituents for clinical effects. A clinical study in patients with coronary artery disease or diabetes shows that taking fenugreek seed powder 2.5 grams twice daily for 3 months does not affect platelet aggregation, fibrinolytic activity, or fibrinogen levels .
Antidiabetes Drugs
Theoretically, fenugreek seed might have additive hypoglycemic effects when used with antidiabetes drugs.
Clinical research shows that fenugreek seed can reduce fasting blood glucose and 2-hour postprandial glucose levels in adults with type 2 diabetes.
Clopidogrel (Plavix)
Theoretically, fenugreek seed might alter the clinical effects of clopidogrel by inhibiting its conversion to the active form.
Animal research shows that fenugreek seed 200 mg/kg daily for 14 days increases the maximum serum concentration of clopidogrel by 21%. It is unclear how this affects the pharmacokinetics of the active metabolite of clopidogrel; however, this study found that concomitant use of fenugreek seed and clopidogrel prolonged bleeding time by an additional 11%.
Metoprolol (Toprol)
Theoretically, fenugreek seed might have additive hypotensive effects when used with metoprolol.
Animal research shows that fenugreek seed 300 mg/kg daily for 2 weeks decreases systolic and diastolic blood pressure by 9% and 11%, respectively, when administered alone, and by 15% and 22%, respectively, when given with metoprolol 10 mg/kg.
Phenytoin (Dilantin)
Theoretically, fenugreek might decrease plasma levels of phenytoin.
Animal research shows that taking fenugreek seeds for 1 week decreases maximum concentrations and the area under the curve of a single dose of phenytoin by 44% and 72%, respectively. This seems to be related to increased clearance. So far, this interaction has not been reported in humans.
Sildenafil (Viagra)
Theoretically, concurrent use of sildenafil and fenugreek might reduce levels and therapeutic effects of sildenafil.
Animal research shows that taking fenugreek seeds for 1 week reduces maximum concentrations and the area under the curve of a single dose of sildenafil by 27% and 48%, respectively. So far, this interaction has not been reported in humans.
Theophylline
Theoretically, fenugreek may reduce the levels and clinical effects of theophylline.
Animal research shows that fenugreek 50 grams daily for 7 days reduces the maximum serum concentration (Cmax) of theophylline by 28% and the area under the plasma drug concentration-time curve (AUC) by 22%.
Warfarin (Coumadin)
Theoretically, fenugreek might have additive effects with warfarin and increase the international normalized ratio (INR).
Some fenugreek constituents have antiplatelet effects, although these might not be present in concentrations that are clinically significant. In one case report, a patient taking warfarin experienced an increased INR when starting to take fenugreek in combination with boldo.
Antihypertensive Drugs
Fenugreek may also have an additive effect on blood pressure-lowering medications. Studies on animals have shown that fenugreek seed can decrease both systolic and diastolic blood pressure by up to 22% when combined with metoprolol. Therefore, it is essential to monitor your blood pressure regularly if you are taking fenugreek and metoprolol together or any other antihypertensive drugs.
Tongkat Ali
Propranolol (Inderal)
Eurycoma longifolia can reduce the levels and clinical effects of propranolol.
A small clinical study in healthy persons shows that taking a single dose of a water-based Eurycoma longifolia extract 200 mg, in combination with a single dose of propranolol 80 mg, reduces the propranolol area under the curve (AUC) by 29%, reduces the peak concentration by 42%, and increases time to peak concentration by 86% when compared with control. Since the elimination half-life of propranolol did not change, it seems that Eurycoma longifolia alters the kinetics of propranolol by decreasing its absorption in the gut, and not by altering its metabolism. It is not known if separating administration will prevent this interaction.
Cytochrome P450 1A2 (Cyp1A2) Substrates
Theoretically, Eurycoma longifolia might increase levels CYP1A2 substrates.
In vitro research suggests that methanolic Eurycoma longifolia root extract weakly inhibits CYP1A2 enzymes. This effect has not been reported in humans.
Cytochrome P450 2A6 (Cyp2A6) Substrates
Theoretically, Eurycoma longifolia might increase levels of CYP2A6 substrates.
In vitro research suggests that methanolic Eurycoma longifolia root extract weakly inhibits CYP2A6 enzymes. This effect has not been reported in humans.
Cytochrome P450 2C19 (Cyp2C19) Substrates
Theoretically, Eurycoma longifolia might increase levels of CYP2C19 substrates.
In vitro research suggests that methanolic Eurycoma longifolia root extract weakly inhibits CYP2C19 enzymes. This effect has not been reported in humans.
Testosterone
Theoretically, Eurycoma longifolia may further increase levels of testosterone.
A clinical study in aging males with testosterone levels below 300 ng/dL shows that taking a specific water extract of Eurycoma longifolia roots (Physta; Biotropics Malaysia) 100-200 mg daily with breakfast for 12 weeks increases total testosterone levels by 8% to 11% when compared with placebo. It is unclear whether this increase would occur in individuals with normal testosterone levels.
Saw Palmetto
Anticoagulant/Antiplatelet Drugs
Saw palmetto might increase the risk of bleeding with anticoagulant or antiplatelet drugs.
Saw palmetto is reported to prolong bleeding time. Theoretically, it might increase the risk of bleeding when used concomitantly with anticoagulant or antiplatelet drugs.
Contraceptive Drugs
Saw palmetto might reduce the effectiveness of contraceptive drugs.
Saw palmetto might have antiestrogenic effects. Theoretically, it might interfere with contraceptive drugs taken concomitantly.
Estrogens
Saw palmetto might reduce the effectiveness of estrogens.
Saw palmetto might have antiestrogenic effects. Theoretically, it might interfere with estrogens taken concomitantly.
Brand information
Manufacturer and brand details for Testosterone Booster Extra Strength, from the product label.
Purely Optimal
See all Purely Optimal products- Name
- Purely Optimal Nutrition Inc.
- City
- San Jose
- State
- CA
- ZipCode
- 95132
- Phone Number
- 1-800-738-6018
- Web Address
- www.purelyoptimal.com
Testosterone Booster Extra Strength by Purely Optimal: Common Questions
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Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
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The Full Monographs Behind Testosterone Booster Extra Strength’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Panax Ginseng
Interacts with 1,130 drugsPanax ginseng is a popular traditional herb used to boost energy, ease stress, and support overall wellness, though scientific evidence is mixed and mostly preliminary. It is generally well...
Read the full Panax Ginseng monograph → Herb & supplement monographL-arginine
Interacts with 403 drugsL-arginine is an amino acid that the body uses to make nitric oxide, a substance that helps blood vessels relax and widen. It is popularly used for blood pressure, erectile dysfunction, and...
Read the full L-arginine monograph → Herb & supplement monographFenugreek
Interacts with 389 drugsFenugreek is a common kitchen spice that is also taken as a supplement, mainly for blood sugar, cholesterol, and to support breast milk production. Some early research is encouraging for blo...
Read the full Fenugreek monograph → Herb & supplement monographSaw Palmetto
Interacts with 174 drugsSaw palmetto is a plant extract most often used for urinary symptoms linked to an enlarged prostate (BPH). The best research suggests it works no better than a placebo for most men, though i...
Read the full Saw Palmetto monograph → Herb & supplement monographEurycoma Longifolia
Interacts with 248 drugsEurycoma longifolia (tongkat ali) is a Southeast Asian herb most popular for supporting testosterone, libido, and male fertility, with some small human studies suggesting possible benefits....
Read the full Eurycoma Longifolia monograph → Herb & supplement monographMaca
Maca is a nutrient-rich Andean root often used for energy, libido, and menopause symptoms. Early studies suggest it may modestly help sexual desire and some menopause symptoms, but the evide...
Read the full Maca monograph → Herb & supplement monographHorny Goat Weed
Interacts with 963 drugsHorny goat weed (Epimedium) is a traditional Chinese herb most often marketed for low libido and erectile problems, but solid human evidence for these uses is lacking. While short-term use s...
Read the full Horny Goat Weed monograph →Sources & How We Checked
Testosterone Booster Extra Strength'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 200 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.
Panax Ginseng 66 references
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- Xu QF, Fang XL, Chen DF. Pharmacokinetics and bioavailability of ginsenoside Rb1 and Rg1 from Panax notoginseng in rats. J Ethnopharmacol 2003;84:187-92. PubMed
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- Wiwanikit V, Taungjarwinai W. A case report of suspected ginseng allergy. Medscape General Medicine 6 (3), 2004. Available at: www.medscape.com/viewarticle/482833 (Accessed 17 September 2004).
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- Jiang X, Blair EY, McLachlan AJ. Investigation of the effects of herbal medicines on warfarin response in healthy subjects: a population pharmacokinetic-pharmacodynamic modeling approach. J Clin Pharmacol 2006;46:1370-8. PubMed
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- Liu, P., Yin, H., Xu, Y., Zhang, Z., Chen, K., and Li, Y. Effects of ginsenoside Rg1 on postimplantation rat and mouse embryos cultured in vitro. Toxicol In Vitro 2006;20(2):234-238. PubMed
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- Gurley, B. J., Gardner, S. F., Hubbard, M. A., Williams, D. K., Gentry, W. B., Cui, Y., and Ang, C. Y. Clinical assessment of effects of botanical supplementation on cytochrome P450 phenotypes in the elderly: St John's wort, garlic oil, Panax ginseng and DOI
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- Kakisaka Y, Ohara T, Tozawa H, Sato S, Katayama S, Suzuki T, Hino-Fukuyo N, Kure S. Panax ginseng: a newly identified cause of gynecomastia. Tohoku J Exp Med 2012;228(2):143-5. PubMed
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L-arginine 66 references
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- Clarkson P, Adams MR, Powe AJ, et al. Oral L-arginine improves endothelium-dependent dilation in hypercholesterolemic young adults. J Clin Invest 1996;97:1989-94. PubMed
- Tenenbaum A, Fisman EZ, Motro M. L-arginine: Rediscovery in progress. Cardiology 1998;90:153-9.
- Brittenden J, Park KGM, Heys SD, et al. L-Arginine stimulates host defenses in patients with breast cancer. Surgery 1994;115:205-12.
- Korting GE, Smith SD, Wheeler MA, et al. A randomized double-blind trial of oral L-arginine for treatment of interstitial cystitis. J Urol 1999;161:558-65. DOI
- Rector TS, Bank AJ, Mullen KA, et al. Randomized, double-blind, placebo-controlled study of supplemental oral L-arginine in patients with heart failure. Circulation 1996;93:2135-41.
- Siani A, Pagano E, Iacone R, et al. Blood pressure and metabolic changes during dietary L-arginine supplementation in humans. Am J Hypertens 2000;13:547-51. PubMed
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- Wallace AW, Tom WL. Interaction of L-arginine and phosphodiesterase inhibitors in vasodilation of the porcine internal mammary artery. Anesth Analg 2000;90:840-6. DOI
- Huynh NT, Tayek JA. Oral arginine reduces systemic blood pressure in type 2 diabetes: its potential role in nitric oxide generation. J Am Coll Nutr 2002;21:422-7.. PubMed
- Staff AC, Berge L, Haugen G, et al. Dietary supplementation with L-arginine or placebo in women with pre-eclampsia. Acta Obstet Gynecol Scand 2004;83:103-7.
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- Anon. Arginine hydrochloride injection (marketed as R-Gene 10). FDA Drug Safety Newsletter 2009;2(2):16-18. Available at: www.fda.gov/Drugs/DrugSafety/DrugSafetyNewsletter/default.htm.
- Higashi Y, Oshima T, Sasaki S, et. al. Angiotensin-converting enzyme inhibition, but not calcium antagonism, improves a response of the renal vasculature to L-arginine in patients with essential hypertension. Hypertension. 1998 Jul;32(1):16-24.
- Facchinetti, F., Longo, M., Piccinini, F., Neri, I., and Volpe, A. L-arginine infusion reduces blood pressure in preeclamptic women through nitric oxide release. J Soc Gynecol.Investig. 1999;6(4):202-207. DOI
- de Gouw, H. W., Verbruggen, M. B., Twiss, I. M., and Sterk, P. J. Effect of oral L-arginine on airway hyperresponsiveness to histamine in asthma. Thorax 1999;54(11):1033-1035. PubMed
- Komers, R., Komersova, K., Kazdova, L., Ruzickova, J., and Pelikanova, T. Effect of ACE inhibition and angiotensin AT1 receptor blockade on renal and blood pressure response to L-arginine in humans. J Hypertens. 2000;18(1):51-59. PubMed
- Cartledge, J. J., Davies, A. M., and Eardley, I. A randomized double-blind placebo-controlled crossover trial of the efficacy of L-arginine in the treatment of interstitial cystitis. BJU.Int. 2000;85(4):421-426.
- Sozykin, A. V., Noeva, E. A., Balakhonova, T. V., Pogorelova, O. A., and Men'shikov, M. I. [Effect of L-arginine on platelet aggregation, endothelial function adn exercise tolerance in patients with stable angina pectoris]. Ter.Arkh. 2000;72(8):24-27.
- Nagaya, N., Uematsu, M., Oya, H., Sato, N., Sakamaki, F., Kyotani, S., Ueno, K., Nakanishi, N., Yamagishi, M., and Miyatake, K. Short-term oral administration of L-arginine improves hemodynamics and exercise capacity in patients with precapillary pulmona
- Stokes, G. S., Barin, E. S., Gilfillan, K. L., and Kaesemeyer, W. H. Interactions of L-arginine, isosorbide mononitrate, and angiotensin II inhibitors on arterial pulse wave. Am J Hypertens. 2003;16(9 Pt 1):719-724.
- Park, K. G., Heys, S. D., Blessing, K., Kelly, P., McNurlan, M. A., Eremin, O., and Garlick, P. J. Stimulation of human breast cancers by dietary L-arginine. Clin.Sci.(Lond) 1992;82(4):413-417.
- Palloshi, A., Fragasso, G., Piatti, P., Monti, L. D., Setola, E., Valsecchi, G., Galluccio, E., Chierchia, S. L., and Margonato, A. Effect of oral L-arginine on blood pressure and symptoms and endothelial function in patients with systemic hypertension,
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