Major interaction on record — check this product against your medications before combining. Check your meds →
Dietary supplement

The Best Sleep Ingredients & Drug Interactions

by Natural Factors Three Brains

The Best Sleep label
See full label image
Capsule Category: Botanical
Most serious interaction: Major
Clinical methodology reviewed by · Updated Sep 16, 2026 · Label data from the NIH DSLD
What is this page for?

First and foremost: checking The Best Sleep against your medications. The heart of this page is the interaction checker and the full interaction report — how this product’s ingredients may interact with prescription and over-the-counter medicines you may be taking.

Around that, we add a pharmacist’s high-level view of the product as a whole — what’s inside, the evidence for its stated use, how transparent the label is, and what safety data exists — so you can see the full picture in one place. It’s educational information from our licensed clinical databases and the clinical staff at HelloPharmacist — not medical advice — and we don’t sell or endorse products. Our editorial policy

The interaction bottom line Most serious interaction: Major

The Best Sleep is a dietary supplement by Natural Factors Three Brains with 5 active ingredients. Its ingredients are commonly taken for anxiety and stress, trouble sleeping, restlessness.Based on those ingredients, 953 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are Passionflower extract, Skullcap extract, California Poppy extract. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

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Check Your Meds Against The Best Sleep by Natural Factors Three Brains

Ask about any prescription or over-the-counter medication and we check it for interactions with The Best Sleep by Natural Factors Three Brains — and tell you which ingredient is responsible.

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HelloPharmacist Scorecard of The Best Sleep by Natural Factors Three Brains

Our pharmacy team’s full take, with four database checks built into the cards below — a summary of what is known, not a grade of the product itself.

From our pharmacy team — supplement deep dive

Generated from HelloPharmacist’s pharmacist-curated databases and editorial rules · Last generated Jul 11, 2026

What’s inside

Full disclosure
Ingredient Transparency · database check
Full

Every active ingredient lists its own amount on the label.

Why this rating?
  • The label discloses an exact amount for 5 of its 5 active ingredients.
  • No proprietary blends here — you can verify the dose of every single component.

The Best Sleep contains 5 active herbal ingredients: passionflower extract, skullcap extract, California poppy extract, hawthorn powder, and linden extract. These are traditional botanicals commonly used in sleep and relaxation formulas.

The product also contains inactive ingredients (microcrystalline cellulose, vegetarian capsule, magnesium stearate, and silica) that serve as fillers and binders.

Does it work?

Moderate evidence
Evidence for Intended Use · database check
By FDA rules, dietary supplements can’t claim to treat, cure, or prevent disease — so labels speak in careful marketing language. We discern each product’s intended use from its name, label claims, and label statements, then grade the clinical evidence for that use. How these ratings are computed
Moderate

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

Why this rating?
  • The label markets this product for: Support sleep and reduce restlessness from stress.
  • We looked for evidence on: Insomnia, Anxiety, Stress, Adjustment disorders, Pre-procedural anxiety, Sleep quality — and 2 related terms.
  • The strongest evidence on file: Passion Flower is rated "Possibly Effective" for Pre-procedural anxiety (Natural Medicines).
  • Also on file: Passion Flower is rated "Possibly Effective" for Insomnia.
  • Also on file: California Poppy is rated "Insufficient Reliable Evidence To Rate" for Anxiety, Insomnia.

The evidence for this formula is mixed. Passionflower is possibly effective for insomnia and pre-procedural anxiety based on available data.

Skullcap, California poppy, hawthorn, and linden all have insufficient evidence in our data — meaning their effectiveness for sleep and relaxation hasn't been established well enough to rate. If you're considering this product, talk with your pharmacist about what the research actually supports for your specific goal.

The evidence, ingredient by ingredient Passion Flower Skullcap California Poppy Hawthorn Linden

How safe is it?

Well-documented data
Safety Information · database check
Well characterized

Adverse-effect, pregnancy, and general safety data are on file for most of these ingredients.

Why this rating?
  • We hold adverse-effect (side-effect) data for 5 of the 5 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 5 of 5.
  • General safety write-ups exist for 5 of 5.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

Passionflower is generally well tolerated short-term but can cause drowsiness, dizziness, confusion, or sedation. A rare case report noted severe nausea, vomiting, and heart rhythm changes at high doses.

Skullcap may cause sedation, cognitive impairment, and digestive upset at higher doses — the evidence base is limited and product quality varies. California poppy is considered mild for short-term use, though human safety data are sparse.

Hawthorn is generally well tolerated but rarely has caused severe allergic reactions and multiorgan problems in isolated cases. Linden is well tolerated as a tea, though safety data in general are limited.

Avoid passionflower, skullcap, California poppy, and hawthorn during pregnancy and breastfeeding due to insufficient safety data. Linden safety in pregnancy is not well studied — check with your doctor.

Side effects, ingredient by ingredient Passion Flower Skullcap California Poppy Hawthorn Linden

Meds to double-check

Major interaction found
Known Interaction Concern · database check
Major identified

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

Why this rating?
  • 5 of the 5 matched ingredients can interact with medications — California Poppy, Hawthorn, Linden, Passion Flower, Skullcap.
  • The most serious interaction on file is rated Major.
  • Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs; heart-rhythm medications; lithium.
  • For scale: 954 individual medications appear in the full list. A big number alone doesn't make a product dangerous — what matters is whether YOUR medication is on it, so run yours through the interaction checker on this page.

Check your medications if you take sedative or sleep drugs, alcohol, blood pressure medications (especially beta-blockers, calcium channel blockers, or nitrates), erectile dysfunction drugs, blood thinners or antiplatelet drugs, digoxin (a heart medication), or lithium. These are the drug types with documented interactions — worst severity first.

Check your own medication Run your meds through the checker above

The bottom line

Scorecard at a glanceFully disclosed formula with some supporting evidence for its stated purpose. Major medication interactions have been identified, and safety information is well characterized.

The Best Sleep is designed for people looking for herbal support with sleep and relaxation, but it's not appropriate during pregnancy or breastfeeding. Its ingredients interact significantly with sedative drugs, blood pressure medications, heart drugs, and blood thinners — if you take any prescription medication, check it against this product before starting.

Talk with your pharmacist about whether the evidence for these botanicals matches what you're hoping to achieve.

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

Assessment coverage: 5 of 5 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated May 22, 2020.

This Scorecard evaluates available label information, ingredient evidence, and known medication-safety considerations. It does not independently verify product identity, purity, potency, contamination, or manufacturing quality. How these ratings are computed

At a glance

General information

Key facts about The Best Sleep, straight from the product label.

Brand Natural Factors Three Brains
Barcode (UPC) 068958030586
Net contents 90 Vegetarian Capsule(s)
Market status On market
Date entered into DSLD May 22, 2020
DSLD ID 220758
Product type Botanical
Supplement form Capsule
Dietary claims / uses All Other, Structure/Function
Intended target group(s) Vegan, Vegetarian, Adult (18 - 50 Years), Gluten Free, Dairy Free, Sugar Free
From the label
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.

Supplement Facts

The label details for The Best Sleep by Natural Factors Three Brains, sourced from the NIH Dietary Supplement Label Database.

Supplement Facts

Daily Value (DV) Target Group(s):
Adults and children 4 or more years of age
Minimum serving Sizes:
2 Capsule(s)
Maximum serving Sizes:
2 Capsule(s)
Servings per container
45
UPC/BARCODE
068958030586
IngredientAmount% DV
Passionflower extract250 mg--
Skullcap extract150 mg--
California Poppy extract125 mg--
Hawthorn powder125 mg--
Linden extract100 mg--

Other ingredients: Microcrystalline Cellulose, Vegetarian Capsule, Magnesium Stearate, Silica

Tap any ingredient to jump to its full detail below.

Label statements
These statements are the manufacturer’s wording, reproduced from the product label — the label is saying it, not HelloPharmacist. We don’t verify or endorse them.
Seals/Symbols

isura Non-GMO - Mass Spec Documentation Lab tested

Purity & Potency Guaranteed

Suggested/Recommended/Usage/Directions

Suggested Usage: 2 capsules per day before bedtime or as directed by a health professional.

Precautions

Cautions: As with any supplement, consult your health professional before use if you are pregnant, breastfeeding, or trying to conceive, or if you are taking medication, have a medical condition, or anticipate a surgery.

Keep out of the reach of children.

Sealed for your protection. Do not use if seal is broken.

Formulation

Three Brains is a line of supplements designed to support the critical relationship between our head, heart, and gut. Together, these three "brains" influence our cognition and support a healthy mind.

The Best Sleep combines five non-habit-forming natural ingredients that have been traditionally used by herbalists as mild sleep aids, especially in cases of restlessness or occasional sleeplessness due to everyday mental stress. The ingredients in this unique formula also have an analgesic effect that further promotes relaxed and restful sleep.

Manufactured by Natural Factors to ensure safety and potency in accordance with Good Manufacturing Practices (GMP) of the FDA and Health Canada.

Contains no artificial colors, preservatives, or sweeteners; no dairy, starch, sugar, wheat, gluten, yeast, soy, corn, egg, fish, shellfish, animal products, salt, tree nuts, or GMOs.

Suitable for vegetarians/vegans.

Supports relaxation & promotes restful sleep

Storage

For freshness, store in a cool, dry place.

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.

FDA Statement of Identity

Dietary Supplement

General Statements

Recyclable container and label. Product of Canada

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

See for yourself

The Best Sleep by Natural Factors Three Brains label

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

The Best Sleep label

Label images are published by the NIH Dietary Supplement Label Database for the version of this product on file. Always read your actual product label.

View the full label (PDF)
What’s inside

The Ingredients in The Best Sleep by Natural Factors Three Brains

These are the 5 active ingredients this product is made of. Select any to open its full monograph.

Serving size2 Capsule(s) Dosage formCapsule Servings per container45 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.

Passionflower extract

Interacts with
836 drugs
250 mg per serving

Passion flower is a traditional calming herb that many people use for anxiety and sleep. Early studies hint it may help with mild anxiety and restless...

Passionflower extract monograph & interactions

Skullcap extract

Interacts with
248 drugs
150 mg per serving

American skullcap is an herb traditionally used to calm anxiety and promote relaxation, but solid human evidence is very limited. It is generally cons...

Skullcap extract monograph & interactions

California Poppy extract

Interacts with
248 drugs
125 mg per serving

California poppy is a traditional herbal remedy used mainly for anxiety and sleep problems, often combined with other calming herbs. Human research is...

California Poppy extract monograph & interactions

Hawthorn powder

Interacts with
191 drugs
125 mg per serving

Hawthorn is a plant traditionally used for heart-related complaints, and some studies suggest it may modestly help symptoms of mild heart failure when...

Hawthorn powder monograph & interactions

Linden extract

Interacts with
1 drug
100 mg per serving

Linden (also called lime flower) is a traditional herbal tea long used to calm nerves, ease cold symptoms, and support restful sleep. Strong human evi...

Linden extract monograph & interactions

Other (inactive) ingredients: Microcrystalline Cellulose, Vegetarian Capsule, Magnesium Stearate, Silica. These complete the product’s ingredient list but are not active constituents.

Interaction report

The Best Sleep by Natural Factors Three Brains Drug Interactions

Want to check YOUR meds against The Best Sleep?

Ask about interactions with your drugs in plain English — “Can I take it with lisinopril?” — and we find you the answer in seconds, ingredient by ingredient.

 Go to the checker
953Drugs
14 Major 406 Moderate 533 Minor

Ingredients driving the most interactions

Passionflower extract 836
Skullcap extract 248
California Poppy extract 248
Hawthorn powder 191
Linden extract 1

Individual Drug Interactions

The ingredients in The Best Sleep interact with 953 drugs. Click any drug to see the details.

5 of the 5 ingredients in The Best Sleep interact with drugs. Each result below shows which ingredient is responsible. Passionflower extract Skullcap extract California Poppy extract Hawthorn powder Linden extract

Each ingredient & the kinds of drugs it affects

For each ingredient in The Best Sleep 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.

Passionflower extract3 drug types · 836 drugs

Cns Depressants

Concomitant use of passion flower with sedative drugs might cause additive effects and side effects.
Research in animals and humans shows that passion flower has sedative effects which can be additive when used with sedative medications like lorazepam.

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

Theoretically, passion flower might decrease the effects of CYP3A4 substrates.
In vitro research suggests that passion flower can induce CYP3A4 enzymes, albeit to a much lower degree than rifampin, a known CYP3A4 inducer.

Likelihood Possible Evidence D
Organic Anion-Transporting Polypeptide Substrates (Oatp)

Theoretically, passion flower might reduce the bioavailability of OATP2B1 and OATP1A2 substrates.
In vitro research shows that the passion flower constituents apigenin and vitexin inhibit OATP2B1 and OATP1A2. This inhibition may be dose-dependent. One specific high-flavonoid passion flower extract (Valverde) seems to inhibit OATP2B1 and OATP1A2, while another extract with a lower flavonoid concentration (Arkocaps) shows less potent inhibition. OATPs are responsible for the uptake of drugs and other compounds into the body; however, the specific activities of OATP2B1 and OATP1A2 are not well characterized.

Likelihood Possible Evidence D
Passionflower extract full monograph & interactions

Skullcap extract1 drug type · 248 drugs

Cns Depressants

Theoretically, skullcap can have additive effects when used with other CNS depressants.
Animal and clinical research suggests that skullcap can cause sedation and cognitive impairment.

Likelihood Possible Evidence D
Skullcap extract full monograph & interactions

California Poppy extract1 drug type · 248 drugs

Cns Depressants

Theoretically, taking California poppy with drugs with sedative effects may increase the risk of sedative effects.
Laboratory research shows that California poppy has sedative effects.

Likelihood Possible Evidence D
California Poppy extract full monograph & interactions

Hawthorn powder6 drug types · 191 drugs

Nitrates

Theoretically, concomitant use might cause additive coronary vasodilatory effects.
Some evidence shows that hawthorn might lower blood pressure due to vasodilatory effects.

Likelihood Probable Evidence D
Phosphodiesterase-5 Inhibitors

Theoretically, concomitant use might result in additive vasodilation and hypotension.
Hawthorn might inhibit PDE-5 and cause vasodilation.

Likelihood Probable Evidence D
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.

Likelihood Possible Evidence D
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.

Likelihood Possible Evidence D
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.

Likelihood Possible Evidence D
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.

Likelihood Possible Evidence D
Hawthorn powder full monograph & interactions

Linden extract1 drug type · 1 drug

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.

Likelihood Probable Evidence D
Linden extract full monograph & interactions
The maker

Brand information

Manufacturer and brand details for The Best Sleep, from the product label.

Natural Factors Three Brains

See all Natural Factors Three Brains products
Name
Natural Factors Canada
Pharmacist Counseling Corner

The Best Sleep by Natural Factors Three Brains: Common Questions

Does The Best Sleep by Natural Factors Three Brains interact with any medications?
Yes. Based on its ingredients, The Best Sleep has a known interaction with 953 medications, including 14 rated major. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
The Best Sleep contains 5 active ingredients, and an interaction can come from any of them. We check every ingredient, combine the results into one list per medication, and show which ingredient and mechanism is responsible.
Where does this information come from?
The product label data comes from the NIH Dietary Supplement Label Database (DSLD); the interaction data is built on the Natural Medicines database and reviewed by HelloPharmacist pharmacists.
Can I take The Best Sleep if I'm pregnant or breastfeeding?
No — the safety data advise against use during pregnancy for passionflower, skullcap, California poppy, and hawthorn due to lack of safety information. Skullcap and California poppy should also be avoided while breastfeeding. Linden's safety in pregnancy and lactation is not well studied — talk with your doctor before use.
Does passionflower actually help with sleep?
Passionflower is rated possibly effective for insomnia in our data. The other four ingredients in this formula — skullcap, California poppy, hawthorn, and linden — don't have enough reliable evidence for us to rate them, so their contribution to sleep is uncertain.
What are the main side effects I might notice?
Drowsiness, dizziness, and confusion are the most common. Skullcap at higher doses may cause sedation and cognitive impairment. Digestive upset and mild allergic reactions have been reported with some ingredients. A rare case involving passionflower at very high doses (over 1500 mg) included severe nausea, vomiting, and heart rhythm changes.
Why does hawthorn have Major-severity interactions?
Hawthorn can lower blood pressure through vasodilation — widening blood vessels. When combined with nitrates or erectile dysfunction drugs, which work the same way, the drop in blood pressure can become dangerous. That's a Major concern.
Will this product interfere with my blood thinner?
Yes — hawthorn has a Moderate interaction with blood thinners (anticoagulants) and antiplatelet drugs like aspirin or warfarin. Animal and lab research shows hawthorn may inhibit clotting, raising bleeding risk. Don't take this without talking to your pharmacist or doctor first.
Is it safe to combine this with my sleep medication?
No — passionflower, skullcap, and California poppy all have Moderate interactions with sedative drugs and sleep aids. They can add to drowsiness and cognitive impairment. Always check with your pharmacist before combining herbal sleep aids with prescription sleep medications.

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 Best Sleep label
Go deeper

The Full Monographs Behind The Best Sleep’s Ingredients

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

Herb & supplement monograph

Passion Flower

Interacts with 836 drugs

Passion flower is a traditional calming herb that many people use for anxiety and sleep. Early studies hint it may help with mild anxiety and restlessness, but the evidence is limited and mo...

Read the full Passion Flower monograph → Herb & supplement monograph

Skullcap

Interacts with 248 drugs

American skullcap is an herb traditionally used to calm anxiety and promote relaxation, but solid human evidence is very limited. It is generally considered relatively safe for short-term us...

Read the full Skullcap monograph → Herb & supplement monograph

California Poppy

Interacts with 248 drugs

California poppy is a traditional herbal remedy used mainly for anxiety and sleep problems, often combined with other calming herbs. Human research is very limited, so its true benefits are...

Read the full California Poppy monograph → Herb & supplement monograph

Hawthorn

Interacts with 191 drugs

Hawthorn 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 monograph

Linden

Interacts with 1 drug

Linden (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 →
Sources

Sources & How We Checked

The Best Sleep's label data comes from the NIH Dietary Supplement Label Database; the ingredient interaction data is from the Natural Medicines database, reviewed by our pharmacists.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

The 52 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.

Passion Flower 19 references
  1. Newall CA, Anderson LA, Philpson JD. Herbal Medicine: A Guide for Healthcare Professionals. London, UK: The Pharmaceutical Press, 1996.
  2. The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999.
  3. Fisher AA, Purcell P, Le Couteur DG. Toxicity of Passiflora incarnata L. J Toxicol Clin Toxicol 2000;38:63-6.
  4. Akhondzadeh S, Naghavi HR, Shayeganpour A, et al. Passionflower in the treatment of generalized anxiety: a pilot double-blind randomized controlled trial with oxazepam. J Clin Pharm Ther 2001;26:363-7. PubMed
  5. Farnsworth N, Bingel A, Cordell G, et al. Potential value of plants as sources of new antifertility agents I. J Pharm Sci 1975;64:535-98. DOI
  6. Mori A, Hasegawa K, Murasaki M, et al. Clinical evaluation of Passiflamin (passiflora extract) on neurosis - multicenter double blind study in comparison with mexazolam. Rinsho Hyoka (Clinical Evaluation) 1993;21:383-440.
  7. Miyasaka LS, Atallah AN, Soares BG. Passiflora for anxiety disorder. Cochrane Database Syst Rev 2007;(1):CD004518. DOI
  8. Speroni E., Minghetti A. Neuropharmacological activity of extracts from Passiflora incarnata. Planta Med. 1988;54:488-91.
  9. Capasso A., Sorrentino L. Pharmacological studies on the sedative and hypnotic effect of Kava kava and Passiflora extracts combination. Phytomedicine. 2005;12:39-45. PubMed
  10. Carrasco MC, Vallejo JR, Pardo-de-Santayana M, et al. Interactions of Valeriana officinalis L. and Passiflora incarnata L. in a patient treated with lorazepam. Phytother Res. 2009 Dec;23:1795-6.
  11. Smith, G. W., Chalmers, T. M., and Nuki, G. Vasculitis associated with herbal preparation containing Passiflora extract. Br J Rheumatol. 1993;32(1):87-88.
  12. Soulimani, R., Younos, C., Jarmouni, S., Bousta, D., Misslin, R., and Mortier, F. Behavioural effects of Passiflora incarnata L. and its indole alkaloid and flavonoid derivatives and maltol in the mouse. J Ethnopharmacol. 1997;57(1):11-20. PubMed
  13. Nojoumi M, Ghaeli P, Salimi S, Sharifi A, Raisi F. Effects of Passion Flower Extract, as an Add-On Treatment to Sertraline, on Reaction Time in Patients ?with Generalized Anxiety Disorder: A Double-Blind Placebo-Controlled Study. Iran J Psychiatry. 2016;1
  14. Rokhtabnak F, Ghodraty MR, Kholdebarin A, et al. Comparing the Effect of Preoperative Administration of Melatonin and Passiflora incarnata on Postoperative Cognitive Disorders in Adult Patients Undergoing Elective Surgery. Anesth Pain Med. 2016;7(1):e4123 PubMed
  15. Dantas LP, de Oliveira-Ribeiro A, de Almeida-Souza LM, Groppo FC. Effects of passiflora incarnata and midazolam for control of anxiety in patients undergoing dental extraction. Med Oral Patol Oral Cir Bucal. 2017;22(1):e95-e101. PubMed
  16. Ozturk Z, Kalayci CC. Pregnancy outcomes in psychiatric patients treated with passiflora incarnata. Complement Ther Med. 2018 Feb;36:30-32. PubMed
  17. da Cunha RS, Amorim KS, Gercina AC, et al. Herbal medicines as anxiolytics prior to third molar surgical extraction. A randomized controlled clinical trial. Clin Oral Investig. 2020. PubMed
  18. Schäfer AM, Gilgen PM, Spirgi C, et al. Constituents of Passiflora incarnata, but Not of Valeriana officinalis, Interact with the Organic Anion Transporting Polypeptides (OATP)2B1 and OATP1A2. Planta Med. 2021. PubMed
  19. Mazzari ALDA, Lacerda MG, Milton FA, et al. In vitro effects of European and Latin-American medicinal plants in CYP3A4 gene expression, glutathione levels, and P-glycoprotein activity. Front Pharmacol 2022;13:826395. PubMed

See these in context on the Passion Flower monograph →

Skullcap 3 references
  1. Wolfson P, Hoffmann DL. An investigation into the efficacy of Scutellaria lateriflora in healthy volunteers. Altern Ther Health Med 2003;9:74-8.
  2. Awad, R., Arnason, J. T., Trudeau, V., Bergeron, C., Budzinski, J. W., Foster, B. C., and Merali, Z. Phytochemical and biological analysis of skullcap (Scutellaria lateriflora L.): a medicinal plant with anxiolytic properties. Phytomedicine. 2003;10(8):6 PubMed
  3. Brock C, Whitehouse J, Tewfik I, Towell T. American skullcap (Scutellaria lateriflora): a randomised, double-blind placebo-controlled crossover study of its effects on mood in healthy volunteers. Phytother Res 2014;28(5):692-8.

See these in context on the Skullcap monograph →

California Poppy 3 references
  1. Hanus M, Lafon J, Mathieu M. Double-blind, randomised, placebo-controlled study to evaluate the efficacy and safety of a fixed combination containing two plant extracts (Crataegus oxyacantha and Eschscholtzia californica) and magnesium in mild-to-moderate
  2. Paul LD, Springer D, Staack RF, et al. Cytochrome P450 isoenzymes involved in rat liver microsomal metabolism of californine and protopine. Eur J Pharmacol 2004;485:69-79. PubMed
  3. Paul LD, Maurer HH. Studies on the metabolism and toxicological detection of the Eschscholtzia californica alkaloids californine and protopine in urine using gas chromatography-mass spectrometry. J Chromatogr B Analyt Technol Biomed Life Sci 2003;789:43-5

See these in context on the California Poppy monograph →

Hawthorn 25 references
  1. 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
  2. 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
  3. Chang Q, Zuo Z, Harrison F, Chow MS. Hawthorn. J Clin Pharmacol 2002;42:605-12.
  4. 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
  5. Pittler MH, Guo R, and Ernst E. Hawthorn extract for treating chronic heart failure. Cochrane.Database.Syst Rev 2008:CD005312. PubMed
  6. 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
  7. 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
  8. 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
  9. 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.
  10. 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
  11. 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.
  12. Daniele C, Mazzanti G, Pittler MH, et al. Adverse-event profile of Crataegus spp.: a systematic review. Drug Saf 2006;29:523-35. PubMed
  13. 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
  14. 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.
  15. 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
  16. 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
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  18. 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.
  19. 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
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See these in context on the Hawthorn monograph →

Linden 2 references
  1. Newall CA, Anderson LA, Philpson JD. Herbal Medicine: A Guide for Healthcare Professionals. London, UK: The Pharmaceutical Press, 1996.
  2. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.

See these in context on the Linden monograph →

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DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

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