Thermo Blend Ingredients & Drug Interactions
by NatureWise
What is this page for?
First and foremost: checking Thermo Blend 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
Thermo Blend is a dietary supplement by NatureWise with 10 active ingredients. Its ingredients are commonly taken for diabetic nerve pain (neuropathy), blood sugar support in diabetes, antioxidant support.Based on those ingredients, 1,638 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are Ashwagandha extract, Green Tea extract, Rhodiola extract. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against Thermo Blend by NatureWise
Ask about any prescription or over-the-counter medication and we check it for interactions with Thermo Blend by NatureWise — and tell you which ingredient is responsible.
AI summaries are generated from our interaction database for education only — always confirm with your pharmacist. How we use AI
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HelloPharmacist Scorecard of Thermo Blend by NatureWise
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
Thermo Blend contains 10 active ingredients, most of them plant extracts. Alpha-Lipoic Acid is an antioxidant studied for blood sugar and cholesterol support.
Olive leaf extract, Yerba Mate, Ashwagandha, Guarana seed, Green Tea, Bitter Orange (branded as Advantra Z), and Rhodiola are all herbal extracts with various traditional uses — Yerba Mate and Guarana are notable for their caffeine content. Kola Nut extract and Cayenne round out the blend.
The capsules also contain inactive ingredients: vegetable cellulose (the capsule itself), rice flour, and organic rice bran extract as fillers.
Does it work?
Not established
Evidence for most ingredients in this product is limited or mixed. Alpha-Lipoic Acid is rated possibly effective for diabetic nerve pain, high cholesterol, and weight management.
Ashwagandha is rated possibly effective for insomnia, anxiety, and stress. Green Tea is rated likely effective for HPV infection and possibly effective for ovarian cancer and high cholesterol.
For the rest — Olive leaf, Yerba Mate, Guarana, Bitter Orange, and Rhodiola — the data we hold shows insufficient reliable evidence to rate their effectiveness for the conditions they're traditionally used for. In short, if you're taking Thermo Blend for weight or metabolic support, understand that solid proof is limited for most of its ingredients.
How safe is it?
Well-documented data
Alpha-Lipoic Acid is generally well tolerated but can lower blood sugar, so it needs medical oversight. The most common side effects are headache, heartburn, nausea, and vomiting.
Ashwagandha is generally well tolerated in the short term, though long-term safety isn't well studied; it can cause diarrhea, stomach upset, nausea, or vomiting in some people, and rare case reports link it to liver damage. Yerba Mate and Guarana are high in caffeine and can cause jitteriness, insomnia, nausea, and heart palpitations, especially in larger amounts.
Bitter Orange can raise blood pressure and heart rate, particularly when combined with caffeine. Green Tea is generally safe in moderate amounts but concentrated extracts in high doses have rarely caused liver injury.
Rhodiola is generally well tolerated but long-term safety isn't established. Olive leaf extract seems well tolerated, though concentrated supplements are less studied than the food form.
During pregnancy, the safety data advises against Alpha-Lipoic Acid and Ashwagandha. Yerba Mate and Guarana are high in caffeine, which may not be safe in pregnancy — check with your doctor first.
Bitter Orange should be avoided in pregnancy due to its stimulant effects and lack of safety data. Rhodiola, Green Tea, and Olive leaf extract don't have enough safety information — talk to your doctor or pharmacist before using them in pregnancy.
While breastfeeding, Yerba Mate, Guarana, and Green Tea all pass caffeine into breast milk, so limit them or avoid them. Ashwagandha, Bitter Orange, and Rhodiola lack sufficient safety data during nursing.
Meds to double-check
Major interaction found
Before taking Thermo Blend, check with your pharmacist if you take any MAOIs (antidepressants), nadolol or other beta-blockers, atorvastatin or other statins, midazolam or other sedatives, seizure medications (especially valproate, phenytoin, carbamazepine), blood thinners or antiplatelet drugs, blood pressure medications, diabetes drugs, thyroid hormone, antipsychotics like clozapine, fluvoxamine or certain other antidepressants, chemotherapy drugs, dipyridamole (used in stress tests), or immunosuppressants. Caffeine-related stimulant effects with ephedrine are a Major concern.
Altogether these interactions span 1,616 individual medications — run your medication list through the checker below.
The bottom line
Scorecard at a glanceFully disclosed formula with no established evidence rating for its marketed use. Major medication interactions have been identified, and safety information is well characterized.
Thermo Blend combines ingredients with limited evidence of effectiveness and serious potential interactions with common medications, especially blood pressure drugs, seizure medications, diabetes drugs, and certain antidepressants. If you take any prescription medications — especially MAOIs, beta-blockers, statins, blood thinners, seizure drugs, or blood pressure medicine — check with your pharmacist before starting.
The caffeine from Yerba Mate and Guarana also makes this product risky if you're sensitive to stimulants or pregnant.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 9 of 10 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Feb 25, 2019.
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 Thermo Blend, straight from the product label.
| Brand | NatureWise |
|---|---|
| Net contents | 60 Vegetarian Capsule(s) |
| Market status | On market |
| Date entered into DSLD | Feb 25, 2019 |
| DSLD ID | 190947 |
| Product type | Other Combinations |
| Supplement form | Capsule |
| Dietary claims / uses | All Other, Structure/Function |
| Intended target group(s) | Vegan, Vegetarian, Adult (18 - 50 Years), Gluten Free, Dairy Free |
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.
Supplement Facts
The label details for Thermo Blend by NatureWise, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Alpha Lipoic Acid | 25 mg | -- |
| Olive leaf extract | 25 mg | -- |
| Yerba Mate extract | 50 mg | -- |
| Ashwagandha extract | 50 mg | -- |
| Guarana seed extract | 100 mg | -- |
| Green Tea extract | 300 mg | -- |
| Advantra Z Bitter Orange extract | 300 mg | -- |
| Rhodiola extract | 125 mg | -- |
| Kola Nut extract | 100 mg | -- |
| Cayenne | 25 mg | -- |
Other ingredients: Vegetable Cellulose, Rice Flour, organic Rice Bran extract
Tap any ingredient to jump to its full detail below.
These statements are the manufacturer’s wording, reproduced from the product label — the label is saying it, not HelloPharmacist. We don’t verify or endorse them.
General Statements
Weight management Thermogenesis is the process of converting calories to heat. When the body's sympathetic nervous system is stimulated metabolic rates rise, increasing energy and releasing stored fat. This release of fatty acids generates heat to further break down fat cells and convery calories. Our premium ingredients are formulated to increase metabolism and energy, and promote fat burning. Along with a balanced diet and regular exercise, NatureWise Thermo Blend is a great way to complement your overall fitness plan. To learn more about NatureWise Thermo Blend and our other great product, please visit us at naturewise.com. Promotes fat burning & energy Enhances exercise Doctor formulated
Healthy weight
Thermogenic fat burner Advanced herbal formula Helps increase metabolism & energy
Live Healthy. Live Happy. At NatureWise we believe that when you increase health & happiness in the world, it benefits everyone. From our products and customer support to the way we give back, it's all part of our mission to help people live healthier, happier lives. Good for people Our products don't just benefit our customers. Every NatureWise purchase you make generates a 1-for-1 donation of life-changing nutrients to a child or mother in need for an entire year. Together we're making a world of difference. We care about our planet's health, too. That's why we source our ingredients responsibly and package our products using only recycled materials and renewable energy. We are also a leading supporter of PINA, the Permaculture Institute of North America. Good for the Earth We are 100% real This product is guaranteed authentic. Use the Transparency mobile app to track its journey from creation to delivery, and to learn more about your product and its ingredients. We're committed to sharing an unprecedented level of detail about our products. T transparency Scan with the Transparency app for: Authenticity ingredients benefits & more
Formulation
Non-GMO, Vegan & Gluten-free
Non-GMO, Vegan & Gluten-free
This product does not contain: Wheat, gluten, dairy, soy, eggs, tree nuts, peanuts, fish, or shellfish.
Formula
Advantra Z
Seals/Symbols
Bottled in USA
GMP Good Manufacturing Practice
100% Authentic Transparency Certified 3rd Party Tested for Purity & Potency
FDA Statement of Identity
Dietary Supplement
Suggested/Recommended/Usage/Directions
Suggested Use: Adults take 2 capsules once daily or as recommended by your healthcare provider.
NatureWise Thermo Blend should always be taken in conjunction with a healthy diet and regular exercise program.
Precautions
Caution: As with any dietary supplement, you should consult your healthcare provider before use, especially if pregnant, nursing, have a medical condition, taking medications, or have known adverse reactions or allergies.
Caution: As with any dietary supplement, you should consult your healthcare provider before use, especially if pregnant, nursing, have a medical condition, taking medications, or have known adverse reactions or allergies.
Keep out of the reach of children.
Do not use if safety seal is damaged or missing.
Brand IP Statement(s)
Advantra Z is a registered trademark of Nutratech, Inc., under U.S. Patents 6,224,873; 6,316,499; 6,340,482.
2017 NatureWise. All Rights Reserved.
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.
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Thermo Blend by NatureWise 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 Thermo Blend by NatureWise
These are the 10 active ingredients this product is made of. Select any to open its full monograph.
Serving size2 Vegetarian 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.
Alpha Lipoic Acid
Interacts with263 drugs
Alpha-lipoic acid (ALA) is an antioxidant made naturally by the body and found in small amounts in foods. It is most studied for diabetic nerve pain,...
Alpha Lipoic Acid monograph & interactionsOlive leaf extract
No knowninteractions
Olive comes from the same tree that gives us olives and olive oil, and its leaf and fruit contain antioxidant compounds like oleuropein and hydroxytyr...
Olive leaf extract monograph & interactionsYerba Mate extract
Interacts with1,086 drugs
Yerba mate is a caffeine-containing herbal beverage from South America that is widely enjoyed for its stimulating, coffee-like effects. While it is ri...
Yerba Mate extract monograph & interactionsAshwagandha extract
Interacts with1,372 drugs
Ashwagandha is an Ayurvedic herb most often taken to help with stress, anxiety, and sleep, and some small studies suggest it may help, though the evid...
Ashwagandha extract monograph & interactionsGuarana seed extract
Interacts with655 drugs
Guarana is an Amazonian seed that is naturally high in caffeine, which explains most of its stimulant and energy effects. While it may give a short-te...
Guarana seed extract monograph & interactionsGreen Tea extract
Interacts with1,293 drugs
Green tea is a popular beverage rich in antioxidants called catechins, and drinking it in normal amounts is considered safe for most people. Concentra...
Green Tea extract monograph & interactionsAdvantra Z Bitter Orange extract
Interacts with957 drugs
Bitter orange is a citrus fruit whose extracts contain synephrine, a mild stimulant often added to weight-loss and energy supplements. Evidence that i...
Advantra Z Bitter Orange extract monograph & interactionsRhodiola extract
Interacts with1,271 drugs
Rhodiola is an herb traditionally used to fight fatigue and help the body cope with stress. Some small studies suggest it may modestly reduce fatigue...
Rhodiola extract monograph & interactionsKola Nut extract
Interacts with655 drugs
Cola nut is a caffeine-containing seed from West Africa used mainly as a natural stimulant for energy and alertness. Most of its effects come from caf...
Kola Nut extract monograph & interactionsCayenne
Other (inactive) ingredients: Vegetable Cellulose, Rice Flour, Organic Rice Bran extract. These complete the product’s ingredient list but are not active constituents.
Thermo Blend by NatureWise Drug Interactions
HelloPharmacist Interaction Report
Thermo Blend by NatureWise contains several ingredients with documented medication interactions.
The most serious concern is with Bitter Orange extract, which can cause a dangerous spike in blood pressure (hypertensive crisis) when combined with MAOIs, a class of antidepressants — this is a Major-severity interaction. Bitter Orange also has Major interactions with the beta-blocker nadolol, the statin atorvastatin, and the sedative midazolam, potentially reducing the effect of nadolol and atorvastatin or raising midazolam levels to unsafe amounts.
Read the full breakdown — every affected drug type, severity by severity
Yerba Mate, Guarana, and Green Tea all contain caffeine and share several Moderate interactions: they may reduce the effects of certain seizure medications (valproate, felbamate, carbamazepam, ethosuximide, phenytoin) and can dangerously amplify stimulant effects if you're also taking ephedrine. Green Tea has additional Major interactions with nadolol and atorvastatin (similar to Bitter Orange).
Caffeine-containing ingredients also interact with clozapine (an antipsychotic), fluvoxamine (an antidepressant), and dipyridamole (a blood thinner used in stress tests).
Alpha-Lipoic Acid carries Moderate concerns with blood thinners (anticoagulants and antiplatelets), chemotherapy drugs (alkylating agents and antitumor antibiotics — theoretically reducing their effectiveness), and thyroid hormone. Ashwagandha has Moderate interactions with blood pressure medications, sedatives and benzodiazepines, diabetes drugs, thyroid hormone, and drugs that affect the liver.
Rhodiola shows Moderate interactions with blood pressure medications, certain diabetes drugs, and drugs metabolized by specific liver enzymes. Altogether, these interactions span 1,616 individual medications.
Olive leaf extract, Kola Nut extract, and Cayenne were either checked with no interactions documented or could not be checked. Use the medication checker on this page to look up your exact prescriptions before starting this product.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against Thermo Blend?
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 Thermo Blend interact with 1,638 drugs. Click any drug to see the details.
8 of the 10 ingredients in Thermo Blend interact with drugs. Each result below shows which ingredient is responsible. Ashwagandha extract Green Tea extract Rhodiola extract Yerba Mate extract Advantra Z Bitter Orange extract Guarana seed extract Kola Nut extract Alpha Lipoic Acid
AlosetronLotronex
How Alosetron interacts with Thermo Blend — through 1 ingredient. Tap an ingredient for the detail:
Ashwagandha ExtractSerotonergic Drugs Minor
Interaction Summary
Some animal studies have reported that ashwagandha can enhance serotonergic transmission by altering certain serotonin (5-HT) receptors.
Read the full Ashwagandha Extract + Alosetron interactionAmoxapineAsendin
How Amoxapine interacts with Thermo Blend — through 2 ingredients. Tap an ingredient for the detail:
Rhodiola ExtractAntidepressant Drugs Minor
Interaction Summary
Theoretically, rhodiola might increase the risk of adverse effects when taken with antidepressants.
Read the full Rhodiola Extract + Amoxapine interactionAshwagandha ExtractSerotonergic Drugs Minor
Interaction Summary
Some animal studies have reported that ashwagandha can enhance serotonergic transmission by altering certain serotonin (5-HT) receptors.
Read the full Ashwagandha Extract + Amoxapine interactionAtomoxetineStrattera
How Atomoxetine interacts with Thermo Blend — through 1 ingredient. Tap an ingredient for the detail:
Advantra Z Bitter Orange ExtractCytochrome P450 2d6 (cyp2d6) Substrates Minor
Interaction Summary
Theoretically, bitter orange might increase levels of drug metabolized by CYP2D6.
Read the full Advantra Z Bitter Orange Extract + Atomoxetine interactionAtropine, Benzoic Acid, Hyoscyamine, Methenamine, Methylene Blue, PhenylAtrosept
How Atropine, Benzoic Acid, Hyoscyamine, Methenamine, Methylene Blue, Phenyl interacts with Thermo Blend — through 1 ingredient. Tap an ingredient for the detail:
Ashwagandha ExtractSerotonergic Drugs Minor
Interaction Summary
Some animal studies have reported that ashwagandha can enhance serotonergic transmission by altering certain serotonin (5-HT) receptors.
Read the full Ashwagandha Extract + Atropine, Benzoic Acid, Hyoscyamine, Methenamine, Methylene Blue, Phenyl interactionAtropine, Benzoic Acid, Hyoscyamine, Methenamine, Methylene Blue, Phenyl SalicylateUrinary Antiseptic 2, Urised
How Atropine, Benzoic Acid, Hyoscyamine, Methenamine, Methylene Blue, Phenyl Salicylate interacts with Thermo Blend — through 1 ingredient. Tap an ingredient for the detail:
Ashwagandha ExtractSerotonergic Drugs Minor
Interaction Summary
Some animal studies have reported that ashwagandha can enhance serotonergic transmission by altering certain serotonin (5-HT) receptors.
Read the full Ashwagandha Extract + Atropine, Benzoic Acid, Hyoscyamine, Methenamine, Methylene Blue, Phenyl Salicylate interactionBenzocaine, DextromethorphanTetra-Formula
How Benzocaine, Dextromethorphan interacts with Thermo Blend — through 1 ingredient. Tap an ingredient for the detail:
Ashwagandha ExtractSerotonergic Drugs Minor
Interaction Summary
Some animal studies have reported that ashwagandha can enhance serotonergic transmission by altering certain serotonin (5-HT) receptors.
Read the full Ashwagandha Extract + Benzocaine, Dextromethorphan interactionBupropionAplenzin, Forfivo XL, Wellbutrin, Wellbutrin SR, Wellbutrin XL, Zyban
How Bupropion interacts with Thermo Blend — through 1 ingredient. Tap an ingredient for the detail:
Rhodiola ExtractAntidepressant Drugs Minor
Interaction Summary
Theoretically, rhodiola might increase the risk of adverse effects when taken with antidepressants.
Read the full Rhodiola Extract + Bupropion interactionBupropion, NaltrexoneContrave
How Bupropion, Naltrexone interacts with Thermo Blend — through 1 ingredient. Tap an ingredient for the detail:
Rhodiola ExtractAntidepressant Drugs Minor
Interaction Summary
Theoretically, rhodiola might increase the risk of adverse effects when taken with antidepressants.
Read the full Rhodiola Extract + Bupropion, Naltrexone interactionCarphenazineProketazin
How Carphenazine interacts with Thermo Blend — through 3 ingredients. Tap an ingredient for the detail:
Green Tea ExtractPhenothiazines Minor
Interaction Summary
Theoretically, phenothiazines might increase the levels and adverse effects of caffeine.
Read the full Green Tea Extract + Carphenazine interactionGuarana Seed ExtractPhenothiazines Minor
Interaction Summary
Theoretically, phenothiazines might increase the levels and adverse effects of caffeine.
Read the full Guarana Seed Extract + Carphenazine interactionKola Nut ExtractPhenothiazines Minor
Interaction Summary
Theoretically, phenothiazines might increase the levels and adverse effects of the caffeine in cola nut.
Read the full Kola Nut Extract + Carphenazine interactionDexfenfluramineRedux
How Dexfenfluramine interacts with Thermo Blend — through 1 ingredient. Tap an ingredient for the detail:
Advantra Z Bitter Orange ExtractCytochrome P450 2d6 (cyp2d6) Substrates Minor
Interaction Summary
Theoretically, bitter orange might increase levels of drug metabolized by CYP2D6.
Read the full Advantra Z Bitter Orange Extract + Dexfenfluramine interactionDorzolamide Hydrochloride, Timolol MaleateCosopt PF
How Dorzolamide Hydrochloride, Timolol Maleate interacts with Thermo Blend — through 1 ingredient. Tap an ingredient for the detail:
Advantra Z Bitter Orange ExtractCytochrome P450 2d6 (cyp2d6) Substrates Minor
Interaction Summary
Theoretically, bitter orange might increase levels of drug metabolized by CYP2D6.
Read the full Advantra Z Bitter Orange Extract + Dorzolamide Hydrochloride, Timolol Maleate interactionDorzolamide, TimololCosopt
How Dorzolamide, Timolol interacts with Thermo Blend — through 1 ingredient. Tap an ingredient for the detail:
Advantra Z Bitter Orange ExtractCytochrome P450 2d6 (cyp2d6) Substrates Minor
Interaction Summary
Theoretically, bitter orange might increase levels of drug metabolized by CYP2D6.
Read the full Advantra Z Bitter Orange Extract + Dorzolamide, Timolol interactionEletriptanRelpax
How Eletriptan interacts with Thermo Blend — through 1 ingredient. Tap an ingredient for the detail:
Ashwagandha ExtractSerotonergic Drugs Minor
Interaction Summary
Some animal studies have reported that ashwagandha can enhance serotonergic transmission by altering certain serotonin (5-HT) receptors.
Read the full Ashwagandha Extract + Eletriptan interactionEncainideEnkaid
How Encainide interacts with Thermo Blend — through 1 ingredient. Tap an ingredient for the detail:
Advantra Z Bitter Orange ExtractCytochrome P450 2d6 (cyp2d6) Substrates Minor
Interaction Summary
Theoretically, bitter orange might increase levels of drug metabolized by CYP2D6.
Read the full Advantra Z Bitter Orange Extract + Encainide interactionEsketamineSpravato
How Esketamine interacts with Thermo Blend — through 1 ingredient. Tap an ingredient for the detail:
Rhodiola ExtractAntidepressant Drugs Minor
Interaction Summary
Theoretically, rhodiola might increase the risk of adverse effects when taken with antidepressants.
Read the full Rhodiola Extract + Esketamine interactionFenfluraminePondimin
How Fenfluramine interacts with Thermo Blend — through 1 ingredient. Tap an ingredient for the detail:
Advantra Z Bitter Orange ExtractCytochrome P450 2d6 (cyp2d6) Substrates Minor
Interaction Summary
Theoretically, bitter orange might increase levels of drug metabolized by CYP2D6.
Read the full Advantra Z Bitter Orange Extract + Fenfluramine interactionFluphenazineFluphenazine, Permitil, Prolixin
How Fluphenazine interacts with Thermo Blend — through 4 ingredients. Tap an ingredient for the detail:
Kola Nut ExtractPhenothiazines Minor
Interaction Summary
Theoretically, phenothiazines might increase the levels and adverse effects of the caffeine in cola nut.
Read the full Kola Nut Extract + Fluphenazine interactionAdvantra Z Bitter Orange ExtractCytochrome P450 2d6 (cyp2d6) Substrates Minor
Interaction Summary
Theoretically, bitter orange might increase levels of drug metabolized by CYP2D6.
Read the full Advantra Z Bitter Orange Extract + Fluphenazine interactionGreen Tea ExtractPhenothiazines Minor
Interaction Summary
Theoretically, phenothiazines might increase the levels and adverse effects of caffeine.
Read the full Green Tea Extract + Fluphenazine interactionGuarana Seed ExtractPhenothiazines Minor
Interaction Summary
Theoretically, phenothiazines might increase the levels and adverse effects of caffeine.
Read the full Guarana Seed Extract + Fluphenazine interactionFrovatriptanFrova
How Frovatriptan interacts with Thermo Blend — through 1 ingredient. Tap an ingredient for the detail:
Ashwagandha ExtractSerotonergic Drugs Minor
Interaction Summary
Some animal studies have reported that ashwagandha can enhance serotonergic transmission by altering certain serotonin (5-HT) receptors.
Read the full Ashwagandha Extract + Frovatriptan interactionGranisetronKytril, Sustol
How Granisetron interacts with Thermo Blend — through 1 ingredient. Tap an ingredient for the detail:
Ashwagandha ExtractSerotonergic Drugs Minor
Interaction Summary
Some animal studies have reported that ashwagandha can enhance serotonergic transmission by altering certain serotonin (5-HT) receptors.
Read the full Ashwagandha Extract + Granisetron interactionHyoscyamine, Methenamine, Methylene Blue, Monobasic, Phenyl Salicylate, Sodium PhosphateDisurex DS, Urimar T, Uro Blue, Urogesic Blue
How Hyoscyamine, Methenamine, Methylene Blue, Monobasic, Phenyl Salicylate, Sodium Phosphate interacts with Thermo Blend — through 1 ingredient. Tap an ingredient for the detail:
Ashwagandha ExtractSerotonergic Drugs Minor
Interaction Summary
Some animal studies have reported that ashwagandha can enhance serotonergic transmission by altering certain serotonin (5-HT) receptors.
Read the full Ashwagandha Extract + Hyoscyamine, Methenamine, Methylene Blue, Monobasic, Phenyl Salicylate, Sodium Phosphate interactionHyoscyamine, Methenamine, Methylene Blue, Phenyl Salicylate, Sodium BiphosphateUretron DS
How Hyoscyamine, Methenamine, Methylene Blue, Phenyl Salicylate, Sodium Biphosphate interacts with Thermo Blend — through 1 ingredient. Tap an ingredient for the detail:
Ashwagandha ExtractSerotonergic Drugs Minor
Interaction Summary
Some animal studies have reported that ashwagandha can enhance serotonergic transmission by altering certain serotonin (5-HT) receptors.
Read the full Ashwagandha Extract + Hyoscyamine, Methenamine, Methylene Blue, Phenyl Salicylate, Sodium Biphosphate interactionIsopropamide, ProchlorperazineCombid
How Isopropamide, Prochlorperazine interacts with Thermo Blend — through 3 ingredients. Tap an ingredient for the detail:
Green Tea ExtractPhenothiazines Minor
Interaction Summary
Theoretically, phenothiazines might increase the levels and adverse effects of caffeine.
Read the full Green Tea Extract + Isopropamide, Prochlorperazine interactionKola Nut ExtractPhenothiazines Minor
Interaction Summary
Theoretically, phenothiazines might increase the levels and adverse effects of the caffeine in cola nut.
Read the full Kola Nut Extract + Isopropamide, Prochlorperazine interactionGuarana Seed ExtractPhenothiazines Minor
Interaction Summary
Theoretically, phenothiazines might increase the levels and adverse effects of caffeine.
Read the full Guarana Seed Extract + Isopropamide, Prochlorperazine interactionIsopropamide, TrifluoperazineStelabid Forte, Stelabid No 1, Stelabid No 2
How Isopropamide, Trifluoperazine interacts with Thermo Blend — through 3 ingredients. Tap an ingredient for the detail:
Guarana Seed ExtractPhenothiazines Minor
Interaction Summary
Theoretically, phenothiazines might increase the levels and adverse effects of caffeine.
Read the full Guarana Seed Extract + Isopropamide, Trifluoperazine interactionKola Nut ExtractPhenothiazines Minor
Interaction Summary
Theoretically, phenothiazines might increase the levels and adverse effects of the caffeine in cola nut.
Read the full Kola Nut Extract + Isopropamide, Trifluoperazine interactionGreen Tea ExtractPhenothiazines Minor
Interaction Summary
Theoretically, phenothiazines might increase the levels and adverse effects of caffeine.
Read the full Green Tea Extract + Isopropamide, Trifluoperazine interactionLinezolidZyvox, Zyvox Injection
How Linezolid interacts with Thermo Blend — through 1 ingredient. Tap an ingredient for the detail:
Ashwagandha ExtractSerotonergic Drugs Minor
Interaction Summary
Some animal studies have reported that ashwagandha can enhance serotonergic transmission by altering certain serotonin (5-HT) receptors.
Read the full Ashwagandha Extract + Linezolid interactionLorcaserinBelviq
How Lorcaserin interacts with Thermo Blend — through 1 ingredient. Tap an ingredient for the detail:
Ashwagandha ExtractSerotonergic Drugs Minor
Interaction Summary
Some animal studies have reported that ashwagandha can enhance serotonergic transmission by altering certain serotonin (5-HT) receptors.
Read the full Ashwagandha Extract + Lorcaserin interactionLorcaserin HydrochlorideBelviq XR
How Lorcaserin Hydrochloride interacts with Thermo Blend — through 1 ingredient. Tap an ingredient for the detail:
Ashwagandha ExtractSerotonergic Drugs Minor
Interaction Summary
Some animal studies have reported that ashwagandha can enhance serotonergic transmission by altering certain serotonin (5-HT) receptors.
Read the full Ashwagandha Extract + Lorcaserin Hydrochloride interactionMaprotilineLudiomil
How Maprotiline interacts with Thermo Blend — through 3 ingredients. Tap an ingredient for the detail:
Ashwagandha ExtractSerotonergic Drugs Minor
Interaction Summary
Some animal studies have reported that ashwagandha can enhance serotonergic transmission by altering certain serotonin (5-HT) receptors.
Read the full Ashwagandha Extract + Maprotiline interactionRhodiola ExtractAntidepressant Drugs Minor
Interaction Summary
Theoretically, rhodiola might increase the risk of adverse effects when taken with antidepressants.
Read the full Rhodiola Extract + Maprotiline interactionAdvantra Z Bitter Orange ExtractCytochrome P450 2d6 (cyp2d6) Substrates Minor
Interaction Summary
Theoretically, bitter orange might increase levels of drug metabolized by CYP2D6.
Read the full Advantra Z Bitter Orange Extract + Maprotiline interactionMethenamine, Phenyl Salicylate, Methylene BlueProsed DS
How Methenamine, Phenyl Salicylate, Methylene Blue interacts with Thermo Blend — through 1 ingredient. Tap an ingredient for the detail:
Ashwagandha ExtractSerotonergic Drugs Minor
Interaction Summary
Some animal studies have reported that ashwagandha can enhance serotonergic transmission by altering certain serotonin (5-HT) receptors.
Read the full Ashwagandha Extract + Methenamine, Phenyl Salicylate, Methylene Blue interactionMethylene BlueProvayblue, Urolene Blue
How Methylene Blue interacts with Thermo Blend — through 1 ingredient. Tap an ingredient for the detail:
Ashwagandha ExtractSerotonergic Drugs Minor
Interaction Summary
Some animal studies have reported that ashwagandha can enhance serotonergic transmission by altering certain serotonin (5-HT) receptors.
Read the full Ashwagandha Extract + Methylene Blue interactionNortriptylineAllegron, Aventyl, Nortriptyline, Pamelor
How Nortriptyline interacts with Thermo Blend — through 3 ingredients. Tap an ingredient for the detail:
Advantra Z Bitter Orange ExtractCytochrome P450 2d6 (cyp2d6) Substrates Minor
Interaction Summary
Theoretically, bitter orange might increase levels of drug metabolized by CYP2D6.
Read the full Advantra Z Bitter Orange Extract + Nortriptyline interactionAshwagandha ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Serotonergic Drugs Minor
Interaction Summary
Theoretically, ashwagandha might decrease the levels and clinical effects of CYP1A2 substrates.
Read the full Ashwagandha Extract + Nortriptyline interactionRhodiola ExtractAntidepressant Drugs, Cytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, rhodiola might increase the risk of adverse effects when taken with antidepressants.
Read the full Rhodiola Extract + Nortriptyline interactionEach ingredient & the kinds of drugs it affects
For each ingredient in Thermo Blend 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.
Ashwagandha extract
Antidiabetes Drugs
Theoretically, taking ashwagandha with antidiabetes drugs might increase the risk of hypoglycemia.
There is preliminary clinical evidence suggesting that ashwagandha might lower blood glucose levels. Theoretically, ashwagandha might have additive effects when used with antidiabetes drugs and increase the risk of hypoglycemia.
Antihypertensive Drugs
Theoretically, taking ashwagandha with antihypertensive drugs might increase the risk of hypotension.
Animal research suggests that ashwagandha might lower systolic and diastolic blood pressure. Theoretically, ashwagandha might have additive effects when used with antihypertensive drugs and increase the risk of hypotension.
Benzodiazepines
Theoretically, taking ashwagandha might increase the sedative effects of benzodiazepines.
There is preliminary evidence that ashwagandha might have an additive effect with diazepam (Valium) and clonazepam (Klonopin). This may also occur with other benzodiazepines.
Cns Depressants
Theoretically, taking ashwagandha might increase the sedative effects of CNS depressants.
Ashwagandha seems to have sedative effects. Theoretically, this may potentiate the effects of barbiturates, other sedatives, and anxiolytics.
Hepatotoxic Drugs
Theoretically, taking ashwagandha with hepatotoxic drugs might increase the risk of liver damage.
Ashwagandha has been linked to cases of acute hepatitis, liver failure, hepatic encephalopathy, autoimmune hepatitis, the need for liver transplantation, and death due to liver failure.
Immunosuppressants
Theoretically, taking ashwagandha might decrease the effects of immunosuppressants.
Ashwagandha has demonstrated immunostimulant effects in humans. Animal research has shown that ashwagandha can attenuate the immunosuppression caused by cyclophosphamide.
Thyroid Hormone
Ashwagandha might increase the effects and adverse effects of thyroid hormone.
Concomitant use of ashwagandha with thyroid hormones may cause additive therapeutic and adverse effects. Preliminary clinical research and animal studies suggest that ashwagandha boosts thyroid hormone synthesis and secretion. In one clinical study, ashwagandha increased triiodothyronine (T3) and thyroxine (T4) levels by 41.5% and 19.6%, respectively, and reduced serum TSH levels by 17.4% from baseline in adults with subclinical hypothyroidism.
Cytochrome P450 1A2 (Cyp1A2) Substrates
Theoretically, ashwagandha might decrease the levels and clinical effects of CYP1A2 substrates.
In vitro research shows that ashwagandha extract induces CYP1A2 enzymes.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, ashwagandha might decrease the levels and clinical effects of CYP3A4 substrates.
In vitro research shows that ashwagandha extract induces CYP3A4 enzymes.
Serotonergic Drugs
Some animal studies have reported that ashwagandha can enhance serotonergic transmission by altering certain serotonin (5-HT) receptors. However, there is no evidence to suggest that ashwagandha increases the risk of serotonin-related effects, and there have been no published case reports of serotonin syndrome when combined with other serotonergic drugs. Nevertheless, due to the lack of extensive studies on the matter and the fact that ashwagandha appears to affect serotonergic pathways, it would be prudent to exercise caution when combining it with drugs that affect serotonin. [References: - Effects of Withania somnifera (Ashwaga ndha) on Stress and the Stress-Related Neuropsychiatric Disorders Anxiety, Depression, and Insomnia. Curr Neuropharmacol. 2021 Sep 14; 19: 1468–1495. - A Prospective, Randomized Double-Blind, Placebo-Controlled Study of Safety and Efficacy of a High-Concentration Full-Spectrum Extract of Ashwagandha Root in Reducing Stress and Anxiety in Adults. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3573577/]
Green Tea extract
Atorvastatin (Lipitor)
Green tea extract seems to reduce the levels and clinical effects of atorvastatin.
In healthy humans, taking green tea extract 300 mg or 600 mg along with atorvastatin reduces plasma levels of atorvastatin by approximately 24%. The elimination of atorvastatin is not affected. Atorvastatin is a substrate of organic anion-transporting polypeptides (OATPs). Research shows that two of the major catechins found in green tea, epicatechin gallate (ECG) and epigallocatechin gallate (EGCG), inhibit OATPs. Some OATPs are expressed in the small intestine and are responsible for the uptake of drugs and other compounds, which may have resulted in reduced plasma levels of atorvastatin. It is not clear if drinking green tea alters the absorption of atorvastatin.
Ephedrine
Theoretically, concomitant use might increase the risk for stimulant adverse effects.
Green tea contains caffeine. There is evidence that using ephedrine with caffeine might increase the risk of serious life-threatening or debilitating adverse effects such as hypertension, myocardial infarction, stroke, seizures, and death.
Nadolol (Corgard)
Green tea seems to reduce the levels and clinical effects of nadolol.
Preliminary clinical research shows that green tea consumption reduces plasma concentrations of nadolol. Compared to a control group, both peak levels and total drug exposure (AUC) of nadolol were reduced by approximately 85% in subjects who drank green tea daily for two weeks. Drinking green tea with nadolol also significantly reduced nadolol's systolic blood pressure lowering effect. Other clinical research shows that a single dose of green tea can affect plasma nadolol levels for at least one hour. Green tea catechins have been shown to inhibit organic anion transporting polypeptides (OATP), one of which, OATP1A2, is involved in the uptake of nadolol in the intestine The interaction is thought to be due primarily to the epigallocatechin gallate (EGCG) content of green tea.
5-Fluorouracil
Theoretically, high doses of green tea might increase the effects and side effects of 5-fluorouracil.
Animal research shows that taking green tea in amounts equivalent to about 6 cups daily in humans for 4 weeks prior to receiving a single injection of 5-fluorouracil increases the maximum plasma levels of 5-fluorouracil by about 2.5-fold and the area under the curve by 425%.
Adenosine (Adenocard)
Theoretically, green tea might decrease the vasodilatory effects of adenosine and interfere with its use prior to stress testing.
Green tea contains caffeine. Caffeine is a competitive inhibitor of adenosine at the cellular level. However, caffeine doesn't seem to affect supplemental adenosine because high interstitial levels of adenosine overcome the antagonistic effects of caffeine. It is recommended that methylxanthines and methylxanthine-containing products be stopped 24 hours prior to pharmacological stress tests. However, methylxanthines appear more likely to interfere with dipyridamole (Persantine) than adenosine-induced stress testing.
Anticoagulant/Antiplatelet Drugs
Theoretically, green tea may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Conflicting reports exist regarding the effect of green tea on bleeding risk when used with anticoagulant or antiplatelet drugs; however, most evidence suggests that drinking green tea in moderate amounts is unlikely to cause a significant interaction. Green tea contains small amounts of vitamin K, approximately 7 mcg per cup. Some case reports have associated the antagonism of warfarin with the vitamin K content of green tea. However, these reports are rare, and very large doses of green tea (about 8-16 cups daily) appear to be needed to cause these effects. Furthermore, the catechins and caffeine in green tea are reported to have antiplatelet activity.
Beta-Adrenergic Agonists
Green tea contains caffeine. Theoretically, concomitant use of large amounts of caffeine might increase cardiac inotropic effects of beta-agonists.
Bortezomib (Velcade)
Theoretically, green tea might interfere with the effects of bortezomib.
In vitro research shows that green tea polyphenols, such as epigallocatechin gallate (EGCG), interact with bortezomib and block its proteasome inhibitory action. This prevents the induction of cell death in multiple myeloma or glioblastoma cancer cell lines. Advise patients taking bortezomib, not to take green tea.
Carbamazepine (Tegretol)
Theoretically, green tea might reduce the effects of carbamazepine and increase the risk for convulsions.
Green tea contains caffeine. Animal research suggests that taking caffeine can lower the anticonvulsant effects of carbamazepine and can induce seizures when taken in doses above 400 mg/kg. Human research has shown that taking caffeine 300 mg in three divided doses along with carbamazepine 200 mg reduces the bioavailability of carbamazepine by 32% and prolongs the plasma half-life of carbamazepine 2-fold in healthy individuals.
Celiprolol (Celicard)
Theoretically, green tea might reduce the levels and clinical effects of celiprolol.
In a small human study, taking green tea daily for 4 days appears to decrease blood and urine levels of celiprolol by at least 98%. This interaction is possibly due to the inhibition of organic anion transporting polypeptide (OATP). Green tea catechins have been shown to inhibit organic anion transporting polypeptides (OATP), one of which, OATP1A2, is found in the intestine The interaction is thought to be due primarily to the epigallocatechin gallate (EGCG) content of green tea.
Cimetidine (Tagamet)
Theoretically, concomitant use might increase the effects and adverse effects of caffeine in green tea.
Green tea contains caffeine. Cimetidine can reduce caffeine clearance by 31% to 42%.
Clozapine (Clozaril)
Theoretically, green tea might increase the levels and adverse effects of clozapine and acutely exacerbate psychotic symptoms.
Animal research suggests that, although green tea extract does not affect the elimination of clozapine, it delays the time to reach peak concentration and reduces the peak plasma levels. Also, concomitant administration of green tea and clozapine might theoretically cause acute exacerbation of psychotic symptoms due to the caffeine in green tea. Caffeine can increase the effects and toxicity of clozapine. Caffeine doses of 400-1000 mg daily inhibit clozapine metabolism. Clozapine is metabolized by cytochrome P450 1A2 (CYP1A2). Researchers speculate that caffeine might inhibit CYP1A2. However, there is no reliable evidence that caffeine affects CYP1A2. There is also speculation that genetic factors might make some patients be more sensitive to the interaction between clozapine and caffeine.
Contraceptive Drugs
Theoretically, concomitant use might increase the effects and adverse effects of caffeine found in green tea.
Green tea contains caffeine. Oral contraceptives can decrease caffeine clearance by 40% to 65%.
Cytochrome P450 1A2 (Cyp1A2) Inhibitors
Theoretically, concomitant use might increase the levels and adverse effects of caffeine.
Green tea contains caffeine. Caffeine is metabolized by cytochrome P450 1A2 (CYP1A2),. Theoretically, drugs that inhibit CYP1A2 may decrease the clearance rate of caffeine from green tea and increase caffeine levels.
Dipyridamole (Persantine)
Theoretically, green tea might decrease the vasodilatory effects of dipyridamole and interfere with its use prior to stress testing.
Green tea contains caffeine. Caffeine might inhibit dipyridamole-induced vasodilation. It is recommended that methylxanthines and methylxanthine-containing products be stopped 24 hours prior to pharmacological stress tests. Methylxanthines appear more likely to interfere with dipyridamole (Persantine) than adenosine-induced stress testing.
Disulfiram (Antabuse)
Theoretically, disulfiram might increase the risk of adverse effects from caffeine.
In human research, disulfiram decreases the clearance and increases the half-life of caffeine.
Diuretic Drugs
Theoretically, using green tea with diuretic drugs might increase the risk of hypokalemia.
Green tea contains caffeine. In excessive amounts, caffeine can reduce potassium levels due to stimulation of the sodium-potassium pump. Diuretics can also cause lower potassium levels.
Estrogens
Theoretically, estrogens might increase the levels and adverse effects of caffeine.
Green tea contains caffeine. Estrogen inhibits caffeine metabolism.
Ethosuximide (Zarontin)
Theoretically, green tea might reduce the effects of ethosuximide and increase the risk for convulsions.
Green tea contains caffeine. Animal research suggests that caffeine 92.4 mg/kg can decrease the anticonvulsant activity of ethosuximide. However, this effect has not been reported in humans.
Felbamate (Felbatol)
Theoretically, green tea might reduce the effects of felbamate and increase the risk for convulsions.
Green tea contains caffeine. Animal research suggests that a high dose of caffeine 161.7 mg/kg can decreases the anticonvulsant activity of felbamate. However, this effect has not been reported in humans.
Fexofenadine (Allegra)
Green tea can decrease blood levels of fexofenadine.
Clinical research shows that green tea can significantly decrease blood levels and excretion of fexofenadine. Taking green tea extract with a dose of fexofenadine decreased bioavailability of fexofenadine by about 30%. In vitro, green tea inhibits the cellular accumulation of fexofenadine by inhibiting the organic anion transporting polypeptide (OATP) drug transporter. Research shows that two of the major catechins found in green tea, epicatechin gallate (ECG) and epigallocatechin gallate (EGCG), inhibit OATPs, specifically OATP1A2, OATP1B1, and OATP2B1. In addition, green tea has been shown to reduce the absorption of some drugs that are OATP substrates.
Flutamide (Eulexin)
Theoretically, green tea might increase the levels and adverse effects of flutamide.
Green tea contains caffeine. In vitro evidence suggests that caffeine can inhibit the metabolism of flutamide. Theoretically, concomitant use of caffeine and flutamide might increase serum concentrations of flutamide and increase the risk adverse effects.
Fluvoxamine (Luvox)
Theoretically, fluvoxamine might increase the levels and adverse effects of caffeine.
Green tea contains caffeine. Fluvoxamine reduces caffeine metabolism.
Hepatotoxic Drugs
Theoretically, concomitant use might have additive adverse hepatotoxic effects.
Green tea extract supplements have been linked to several cases of hepatotoxicity and might have additive hepatotoxic effects with other drugs..
Imatinib (Gleevec)
Theoretically, green tea might reduce the levels and clinical effects of imatinib.
In animal research, a single dose of green tea extract reduces the area under the curve (AUC) of imatinib by up to approximately 64% and its main metabolite N-desmethyl imatinib by up to approximately 81%. This interaction has not been shown in humans. The mechanism of action is unclear but may involve multiple pathways.
Rhodiola extract
Antidiabetes Drugs
Theoretically, taking rhodiola with antidiabetes drugs might increase the risk of hypoglycemia.
In vitro and animal research shows that rhodiola extract can decrease blood glucose due to alpha-glucosidase activity.
Antihypertensive Drugs
Theoretically, taking rhodiola with antihypertensive drugs might increase the risk of hypotension.
In vitro and animal research shows that rhodiola extract inhibits angiotensin-converting enzyme (ACE) and might lower blood pressure.
Cytochrome P450 2C9 (Cyp2C9) Substrates
Theoretically, rhodiola might increase levels of drugs metabolized by CYP2C9.
In vitro research shows that rhodiola inhibits CYP2C9. This effect is highly variable and appears to be dependent on the rhodiola product studied. Also, a clinical study in healthy young males found that taking rhodiola extract 290 mg daily for 14 days reduces the metabolism of losartan, a CYP2C9 substrate, by 21% after 4 hours.
Immunosuppressants
Theoretically, rhodiola use might interfere with immunosuppressive therapy.
In vitro and animal research show that rhodiola has immunostimulatory effects.
Losartan (Cozaar)
Rhodiola might increase the levels and adverse effects of losartan.
A clinical study in healthy young males found that taking rhodiola extract 290 mg daily for 14 days reduces the metabolism of losartan, a CYP2C9 substrate, by 21% after 4 hours.
P-Glycoprotein Substrates
Theoretically, rhodiola might increase levels of P-glycoprotein substrates.
In vitro research shows that rhodiola inhibits P-glycoprotein. Theoretically, using rhodiola with P-glycoprotein substrates might increase drug levels and potentially increase the risk of adverse effects.
Antidepressant Drugs
Theoretically, rhodiola might increase the risk of adverse effects when taken with antidepressants.
A review of adverse event reports in Poland identified cases of tachyarrhythmias, myalgia, arthralgia, gum pain, restless leg syndrome, swallowing disorders, and changes in consciousness when rhodiola was taken in combination with paroxetine, escitalopram, fluoxetine, sertraline, trazodone, and/or duloxetine.
Cns Depressants
Theoretically, rhodiola might increase the risk of adverse effects when taken with CNS depressants.
A review of adverse event reports in Poland identified cases of excessive sedation, myoclonus, hypotension, and hallucinations when rhodiola was taken with haloperidol, diazepam, or alprazolam.
Cytochrome P450 1A2 (Cyp1A2) Substrates
Theoretically, rhodiola might increase levels of drugs metabolized by CYP1A2.
In vitro research shows that rhodiola inhibits CYP1A2. This effect is highly variable and appears to be dependent on the rhodiola product studied. However, a clinical study in healthy young males found that taking rhodiola extract 290 mg daily for 14 days does not inhibit the metabolism of caffeine, a CYP1A2 substrate.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, rhodiola might increase levels of drugs metabolized by CYP3A4.
In vitro research shows that rhodiola inhibits CYP3A4. This effect is highly variable and appears to be dependent on the rhodiola product studied. However, a clinical study in healthy young males found that taking rhodiola extract 290 mg daily for 14 days does not inhibit the metabolism of midazolam, a CYP3A4 substrate.
Yerba Mate extract
Ephedrine
Theoretically, the caffeine in yerba mate might increase the risk for stimulant adverse effects when used concomitantly with ephedrine.
Use of ephedrine with caffeine can increase the risk of stimulatory adverse effects. There is evidence that using ephedrine with caffeine might increase the risk of serious life-threatening or debilitating adverse effects such as hypertension, myocardial infarction, stroke, seizures, and death.
Adenosine (Adenocard)
Theoretically, the caffeine in yerba mate might decrease the vasodilatory effects of adenosine and interfere with its use prior to stress testing.
Yerba mate contains caffeine. Some evidence shows that caffeine is a competitive inhibitor of adenosine and can reduce the vasodilatory effects of adenosine in humans. However, other research shows that caffeine does not seem to affect supplemental adenosine because high interstitial levels of adenosine overcome the antagonistic effects of caffeine. Still, some researchers recommend that methylxanthines, such as caffeine, as well as methylxanthine-containing products, should be stopped 24 hours prior to pharmacological stress tests. However, methylxanthines appear more likely to interfere with dipyridamole (Persantine) than adenosine-induced stress testing.
Anticoagulant/Antiplatelet Drugs
Theoretically, the caffeine in yerba mate may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Yerba mate contains caffeine. Caffeine is reported to have antiplatelet activity. Theoretically, it might increase the risk of bleeding when used concomitantly with these agents; however, this interaction has not been reported in humans.
Benzodiazepines
Theoretically, the caffeine in yerba mate might reduce the efficacy of benzodiazepines.
Yerba mate contains caffeine. Caffeine can antagonize the anxiolytic effects of benzodiazepines.
Beta-Adrenergic Agonists
Theoretically, the caffeine in yerba mate might increase the cardiac inotropic effects of beta-agonists, especially if taken in large amounts.
Yerba mate contains caffeine. Caffeine can increase cardiac inotropic effects of beta-agonists.
Carbamazepine (Tegretol)
Theoretically, the caffeine in yerba mate might reduce the effects of carbamazepine and increase the risk for convulsions.
Yerba mate contains caffeine. Animal research suggests that caffeine can lower the anticonvulsant effects of carbamazepine and can induce seizures when taken in doses above 400 mg/kg. Human research has shown that taking caffeine 300 mg in three divided doses along with carbamazepine 200 mg reduces the bioavailability of carbamazepine by 32% and prolongs the plasma half-life of carbamazepine two-fold in healthy individuals.
Cimetidine (Tagamet)
Theoretically, cimetidine might increase the levels and adverse effects of the caffeine contained in yerba mate.
Yerba mate contains caffeine. Cimetidine decreases caffeine clearance by 31% to 42%.
Clozapine (Clozaril)
Theoretically, the caffeine in yerba mate might increase the levels and adverse effects of clozapine and acutely exacerbate psychotic symptoms.
Yerba mate contains caffeine. Caffeine might increase the effects and toxicity of clozapine. Caffeine doses of 400-1000 mg per day inhibit clozapine metabolism. Clozapine is metabolized by cytochrome P450 1A2 (CYP1A2). Although researchers speculate that caffeine might inhibit CYP1A2, there is no reliable evidence that caffeine affects CYP1A2. There is also speculation that genetic factors might make some patients more sensitive to an interaction between clozapine and caffeine.
Dipyridamole (Persantine)
Theoretically, the caffeine in yerba mate might decrease the vasodilatory effects of dipyridamole and interfere with its use prior to stress testing.
Yerba mate contains caffeine. Caffeine inhibits dipyridamole-induced vasodilation. Still, some researchers recommend that methylxanthines, such as caffeine, as well as methylxanthine-containing products, should be stopped 24 hours prior to pharmacological stress. Methylxanthines appear more likely to interfere with dipyridamole (Persantine) than adenosine-induced stress testing.
Disulfiram (Antabuse)
Theoretically, disulfiram might increase the levels and adverse effects of the caffeine in yerba mate.
Yerba mate contains caffeine. Disulfiram decreases the rate of caffeine clearance.
Diuretic Drugs
Theoretically, the caffeine in yerba mate might increase the risk of hypokalemia when used concomitantly with other diuretics.
Yerba mate contains caffeine. Caffeine, especially in excessive amounts, can reduce potassium levels due to stimulation of the sodium-potassium pump. Diuretics can also cause lower potassium levels.
Estrogens
Theoretically, estrogens might increase the levels and adverse effects of the caffeine in yerba mate.
Yerba mate contains caffeine. Estrogen inhibits caffeine metabolism.
Ethosuximide (Zarontin)
Theoretically, the caffeine in yerba mate might reduce the effects of ethosuximide and increase the risk for convulsion.
Yerba mate contains caffeine. Animal research shows that caffeine 92.4 mg/kg can decrease the anticonvulsant activity of ethosuximide. However, this effect has not been reported in humans.
Felbamate (Felbatol)
Theoretically, the caffeine in yerba mate might reduce the effects of felbamate and increase the risk for convulsion.
Yerba mate contains caffeine. Animal research shows that a high dose of caffeine 161.7 mg/kg can decreases the anticonvulsant activity of felbamate. However, this effect has not been reported in humans.
Flutamide (Eulexin)
Theoretically, the caffeine in yerba mate might increase the levels and adverse effects of flutamide.
Yerba mate contains caffeine. In vitro evidence suggests that caffeine can inhibit the metabolism of flutamide. However, this effect has not been reported in humans.
Fluvoxamine (Luvox)
Theoretically, fluvoxamine might increase the levels and adverse effects of the caffeine in yerba mate.
Yerba mate contains caffeine. Fluvoxamine reduces caffeine metabolism.
Lithium
Theoretically, abrupt withdrawal of the caffeine in yerba mate might increase serum lithium levels.
Yerba mate contains caffeine, which has diuretic activity. When abruptly discontinued, it might alter the clearance of lithium. There are two case reports of lithium tremor that worsened upon abrupt coffee withdrawal.
Midazolam (Versed)
Theoretically, use of yerba mate with midazolam might increase midazolam metabolite levels and adverse effects.
In vitro research shows that yerba mate extract containing 6.75% chlorogenic acid significantly inhibits the metabolism of midazolam via inhibition of cytochrome P450 3A4 (CYP3A4).
Monoamine Oxidase Inhibitors (Maois)
Theoretically, the caffeine in yerba mate might increase risk of a hypertensive crisis when used concomitantly with MAOIs.
Yerba mate contains caffeine. Caffeine has been shown to inhibit monoamine oxidase (MAO) A and B in laboratory studies. Concomitant intake of large amounts of caffeine with MAOIs might precipitate a hypertensive crisis. In a case report, a patient that consumed 10-12 cups of caffeinated coffee and took the MAOI tranylcypromine presented with severe hypertension. Hypertension was resolved after the patient switched to drinking decaffeinated coffee.
Nicotine
Theoretically, the caffeine in yerba mate might increase risk of hypertension when used concomitantly with nicotine.
Yerba mate contains caffeine. Concomitant use of caffeine and nicotine has been shown to have additive cardiovascular effects, including increased heart rate and blood pressure. Blood pressure was increased by 10.8/12.4 mmHg when the agents were used concomitantly.
Pentobarbital (Nembutal)
Theoretically, the caffeine in yerba mate might decrease the effects of pentobarbital.
The caffeine in yerba mate might negate the hypnotic effects of pentobarbital.
Phenobarbital (Luminal)
Theoretically, the caffeine in yerba mate might reduce the effects of phenobarbital and increase the risk for convulsions.
Yerba mate contains caffeine. Animal research suggests that caffeine can decrease the anticonvulsant activity of phenobarbital. However, the exact mechanism of this interaction is unclear.
Phenylpropanolamine
Theoretically, phenylpropanolamine might increase the risk of hypertension as well as the levels and adverse effects of the caffeine in yerba mate.
Yerba mate contains caffeine. Concomitant use of phenylpropanolamine and caffeine might cause an additive increase in blood pressure. Phenylpropanolamine also seems to increase caffeine serum levels.
Phenytoin (Dilantin)
Theoretically, the caffeine in yerba mate might reduce the effects of phenytoin and increase the risk for convulsions.
Yerba mate contains caffeine. Animal research suggests that caffeine can decrease the anticonvulsant activity of phenytoin. The effect does not seem to be related to the seizure threshold-lowering effects of caffeine. However, the exact mechanism of this interaction is unclear.
Pioglitazone (Actos)
Theoretically, the caffeine in yerba mate might increase the levels and clinical effects of pioglitazone.
Yerba mate contains caffeine. Animal research suggests that caffeine can modestly increase the maximum concentration, area under the curve, and half-life of pioglitazone, and also reduce its clearance. This increased the antidiabetic effects of pioglitazone. However, the exact mechanism of this interaction is unclear.
Advantra Z Bitter Orange extract
Midazolam (Versed)
Bitter orange might increase blood levels of midazolam.
One small clinical study shows that bitter orange juice can increase midazolam levels, likely through inhibition of cytochrome P450 3A4 (CYP3A4). Theoretically, bitter orange might increase the risk of midazolam-related adverse effects.
Monoamine Oxidase Inhibitors (Maois)
Theoretically, taking MAOIs with synephrine-containing bitter orange preparations might increase the hypertensive effects of synephrine, potentially leading to hypertensive crisis.
Bitter orange contains tyramine, octopamine, and synephrine, which are MAO substrates.
Antidiabetes Drugs
Theoretically, bitter orange might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Some clinical research shows that drinking a tea containing bitter orange and Indian snakeroot reduces fasting and postprandial glucose levels in patients with type 2 diabetes who are using antidiabetes drugs. However, it is unclear if these effects are due to bitter orange, Indian snakeroot, or the combination. An animal study also shows that p-synephrine in combination with gliclazide , a sulfonylurea, causes an additional 20% to 44% decrease in glucose levels when compared with gliclazide alone.
Caffeine
Bitter orange might increase blood pressure and heart rate when taken with caffeine.
Small clinical studies show that taking bitter orange in combination with caffeine can increase blood pressure and heart rate in otherwise healthy normotensive adults. Theoretically, this might increase the risk of serious cardiovascular adverse effects.
Colchicine
Bitter orange might affect colchicine levels.
Colchicine is a substrate of P-glycoprotein and cytochrome P450 3A4 (CYP3A4). Bitter orange has been reported to inhibit CYP3A4 and increase levels of CYP3A4 substrates. However, one small clinical study in healthy adults shows that drinking bitter orange juice 240 mL twice daily for 4 days and taking a single dose of colchicine 0.6 mg on the 4th day decreases colchicine peak serum levels by 24%, time to peak serum level by 1 hour, and overall exposure to colchicine by 20%. The clinical significance of this finding is unclear.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Bitter orange might increase levels of drugs metabolized by CYP3A4.
Small clinical studies suggest that single or multiple doses of freshly squeezed bitter orange juice 200-240 mL can inhibit CYP3A4 metabolism of drugs, causing increased drug levels and potentially increasing the risk of adverse effects. However, the extent of the effect of bitter orange on CYP3A4-mediated drug interactions is unknown. Some evidence suggests that bitter orange selectively inhibits intestinal CYP3A4, but not hepatic CYP3A4. Its effect on P-glycoprotein, which strongly overlaps with CYP3A4 interactions, is unclear. One small clinical study shows that drinking 8 ounces of freshly squeezed bitter orange juice has no effect on cyclosporine, which seems to be more dependent on hepatic CYP3A4 and P-glycoprotein than intestinal CYP3A4.
Dextromethorphan (Robitussin Dm, Others)
Bitter orange might increase blood levels of dextromethorphan.
One small clinical study shows that bitter orange juice increases dextromethorphan levels, likely through cytochrome P450 3A4 (CYP3A4) inhibition. Theoretically, bitter orange might increase the risk for dextromethorphan-related adverse effects.
Felodipine (Plendil)
Bitter orange might increase blood levels of felodipine.
One small clinical study shows that bitter orange juice increases felodipine levels, likely through cytochrome P450 3A4 (CYP3A4) inhibition. Theoretically, bitter orange might increase the risk for felodipine-related adverse effects.
Indinavir (Crixivan)
Bitter orange might increase blood levels of indinavir.
One small clinical study shows that bitter orange juice slightly increases indinavir levels, but this effect is likely to be clinically insignificant. Bitter orange selectively inhibits intestinal cytochrome P450 3A4 (CYP3A4); however, the metabolism of indinavir seems to be more dependent on hepatic CYP3A4. The effect of bitter orange on other protease inhibitors has not been studied.
Qt Interval-Prolonging Drugs
Theoretically, bitter orange might have an additive effect when combined with drugs that prolong the QT interval, potentially increasing the risk of ventricular arrhythmias.
One case report suggests that taking bitter orange in combination with other stimulants such as caffeine might prolong the QT interval in some patients.
Sildenafil (Viagra)
Bitter orange juice might increase blood levels of sildenafil.
A small clinical study in healthy adult males shows that drinking freshly squeezed bitter orange juice 250 mL daily for 3 days and taking a single dose of sildenafil 50 mg on the 3rd day increases the peak plasma concentration of sildenafil by 18% and the overall exposure to sildenafil by 44%. Theoretically, this may be due to inhibition of cytochrome P450 3A4 by bitter orange.
Stimulant Drugs
Theoretically, bitter orange might increase the risk of hypertension and adverse cardiovascular effects when taken with stimulant drugs.
Bitter orange appears to have stimulant effects.
Cytochrome P450 2D6 (Cyp2D6) Substrates
Theoretically, bitter orange might increase levels of drug metabolized by CYP2D6.
In vitro research shows that octopamine, a constituent of bitter orange, weakly inhibits CYP2D6 enzymes. This effect has not been reported in humans.
Guarana seed extract
Ephedrine
Theoretically, concomitant use might increase the risk for stimulant adverse effects.
Guarana contains caffeine. Use of ephedrine with caffeine can increase the risk of stimulatory adverse effects. There is evidence that using ephedrine with caffeine might increase the risk of serious life-threatening or debilitating adverse effects such as hypertension, myocardial infarction, stroke, seizures, and death.
Adenosine (Adenocard)
Theoretically, guarana might decrease the vasodilatory effects of adenosine and interfere with its use prior to stress testing.
Guarana contains caffeine. Caffeine is a competitive inhibitor of adenosine at the cellular level. However, caffeine does not seem to affect supplemental adenosine because high interstitial levels of adenosine overcome the antagonistic effects of caffeine. It is recommended that methylxanthines and methylxanthine-containing products be stopped 24 hours prior to pharmacological stress tests. However, methylxanthines appear more likely to interfere with dipyridamole (Persantine) than adenosine-induced stress testing.
Anticoagulant/Antiplatelet Drugs
Theoretically, guarana may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
In vitro and animal research suggests that guarana extract can inhibit platelet aggregation. This effect may be due to the caffeine in guarana, which is also reported to have antiplatelet activity. This interaction has not been reported in humans.
Beta-Adrenergic Agonists
Theoretically, concomitant use might increase the clinical effects of beta-adrenergic agonists.
Guarana contains caffeine. Theoretically, concomitant use of large amounts of caffeine might increase cardiac inotropic effects of beta-agonists.
Carbamazepine (Tegretol)
Theoretically, guarana might reduce the effects of carbamazepine and increase the risk for convulsions.
Animal research suggests that taking caffeine can lower the anticonvulsant effects of carbamazepine and can induce seizures when given to animals in doses above 400 mg/kg. Human research has shown that taking caffeine 300 mg in three divided doses along with carbamazepine 200 mg reduces the bioavailability of carbamazepine by 32% and prolongs the plasma half-life of carbamazepine two-fold in healthy individuals.
Cimetidine (Tagamet)
Theoretically, concomitant use might increase the effects and adverse effects of caffeine in guarana.
Guarana contains caffeine. Cimetidine decreases the rate of caffeine clearance by 31% to 42%.
Clozapine (Clozaril)
Theoretically, guarana might increase the levels and adverse effects of clozapine and acutely exacerbate psychotic symptoms.
Guarana contains caffeine. Caffeine can increase the effects and toxicity of clozapine. Caffeine doses of 400-1000 mg per day inhibit clozapine metabolism. Clozapine is metabolized by cytochrome P450 1A2 (CYP1A2). Researchers speculate that caffeine might inhibit CYP1A2. However, there is no reliable evidence that caffeine affects CYP1A2. There is also speculation that genetic factors might make some patients more sensitive to the interaction between clozapine and caffeine.
Dipyridamole (Persantine)
Theoretically, guarana might decrease the vasodilatory effects of dipyridamole and interfere with its use prior to stress testing.
Guarana contains caffeine. Caffeine might inhibit dipyridamole-induced vasodilation. It is recommended that methylxanthines and methylxanthine-containing products be stopped 24 hours prior to pharmacological stress tests. Methylxanthines appear more likely to interfere with dipyridamole than adenosine-induced stress testing.
Disulfiram (Antabuse)
Theoretically, disulfiram might increase the risk of adverse effects from caffeine.
In human research, disulfiram decreases the clearance and increases the half-life of caffeine.
Diuretic Drugs
Theoretically, using guarana with diuretic drugs might increase the risk of hypokalemia.
Guarana contains caffeine. Caffeine, especially in excessive amounts, can reduce potassium levels due to stimulation of the sodium-potassium pump. Diuretics can also lower potassium levels.
Estrogens
Theoretically, estrogens might increase the levels and adverse effects of caffeine.
Guarana contains caffeine. Estrogen inhibits caffeine metabolism.
Ethosuximide (Zarontin)
Theoretically, guarana might reduce the effects of ethosuximide and increase the risk for convulsions.
Guarana contains caffeine. Animal research shows that caffeine 92.4 mg/kg can decrease the anticonvulsant activity of ethosuximide. This effect has not been observed in humans.
Felbamate (Felbatol)
Theoretically, guarana might reduce the effects of felbamate and increase the risk for convulsions.
Guarana contains caffeine. Animal research shows that a high dose of caffeine 161.7 mg/kg can decreases the anticonvulsant activity of felbamate. This effect has not been observed in humans.
Flutamide (Eulexin)
Theoretically, guarana might increase the levels and adverse effects of flutamide.
Guarana contains caffeine. In vitro evidence shows that caffeine can inhibit the metabolism of flutamide. However, this effect has not been reported in humans.
Fluvoxamine (Luvox)
Theoretically, fluvoxamine might increase the levels and adverse effects of caffeine.
Guarana contains caffeine. Fluvoxamine reduces caffeine metabolism.
Lithium
Theoretically, abrupt guarana withdrawal might increase the levels and adverse effects of lithium.
Guarana contains caffeine. Theoretically, abrupt caffeine withdrawal might increase serum lithium levels. There are two case reports of lithium tremor that worsened upon abrupt coffee withdrawal.
Monoamine Oxidase Inhibitors (Maois)
Theoretically, concomitant use might increase the risk of a hypertensive crisis.
Guarana contains caffeine. Caffeine has been shown to inhibit MAO-A and -B in laboratory studies. Concomitant intake of large amounts of caffeine with MAOIs might precipitate a hypertensive crisis. In a case report, a patient that consumed 10-12 cups of caffeinated coffee and took the MAOI tranylcypromine presented with severe hypertension. Hypertension was resolved after the patient switched to drinking decaffeinated coffee.
Nicotine
Theoretically, concomitant use might increase the risk of hypertension.
Guarana contains caffeine. Concomitant use of caffeine and nicotine has been shown to have additive cardiovascular effects, including increased heart rate and blood pressure. Blood pressure was increased by 10.8/12.4 mmHg when the agents were used concomitantly.
Pentobarbital (Nembutal)
Theoretically, guarana might decrease the effects of pentobarbital.
Guarana contains caffeine. In vivo evidence suggests that caffeine can negate the hypnotic effects of pentobarbital in humans. However, animal research suggests that guarana does not alter the hypnotic effect of pentobarbital.
Phenobarbital (Luminal)
Theoretically, guarana might reduce the effects of phenobarbital and increase the risk for convulsions.
Guarana contains caffeine. Animal research shows that caffeine can decrease the anticonvulsant activity of phenobarbital. The exact mechanism of this interaction is unclear.
Phenylpropanolamine
Theoretically, phenylpropanolamine might increase the risk of hypertension, as well as the levels and adverse effects of caffeine.
Guarana contains caffeine. Concomitant use of phenylpropanolamine and caffeine might cause an additive increase in blood pressure. Phenylpropanolamine also seems to increase caffeine serum levels.
Phenytoin (Dilantin)
Theoretically, guarana might reduce the effects of phenytoin and increase the risk for convulsions.
Guarana contains caffeine. Animal research shows that caffeine can decrease the anticonvulsant activity of phenytoin. The effect does not seem to be related to the seizure threshold-lowering effects of caffeine. However, the exact mechanism of this interaction is unclear.
Pioglitazone (Actos)
Theoretically, guarana might increase the levels and clinical effects of pioglitazone.
Guarana contains caffeine. Animal research suggests that caffeine can modestly increase the maximum concentration, area under the curve, and half-life of pioglitazone, and also reduce its clearance. This increased the antidiabetic effects of pioglitazone. However, the exact mechanism of this interaction is unclear.
Riluzole (Rilutek)
Theoretically, concomitant use might increase the levels and adverse effects of both caffeine and riluzole.
Guarana contains caffeine. Caffeine and riluzole are both metabolized by cytochrome P450 1A2 (CYP1A2), and concomitant use might reduce the metabolism of one or both agents.
Stimulant Drugs
Theoretically, concomitant use might increase stimulant adverse effects.
Guarana contains caffeine. Due to the central nervous system (CNS) stimulant effects of caffeine, concomitant use with stimulant drugs can increase the risk of adverse effects.
Kola Nut extract
Adenosine (Adenocard)
Theoretically, cola nut might decrease the vasodilatory effects of adenosine and interfere with its use prior to stress testing.
Cola nut contains caffeine. Caffeine is a competitive inhibitor of adenosine at the cellular level. However, caffeine does not seem to affect supplemental adenosine because high interstitial levels of adenosine overcome the antagonistic effects of caffeine. It is recommended that methylxanthines and methylxanthine-containing products (including cola nut) be stopped 24 hours prior to pharmacological stress tests. However, methylxanthines appear more likely to interfere with dipyridamole (Persantine) than adenosine-induced stress testing.
Alcohol (Ethanol)
Theoretically, alcohol might increase the levels and adverse effects of the caffeine in cola nut.
Cola nut contains caffeine. Concomitant use of alcohol and caffeine can increase caffeine serum concentrations and the risk of caffeine adverse effects. Alcohol reduces caffeine metabolism.
Anticoagulant/Antiplatelet Drugs
Theoretically, cola nut may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Cola nut contains caffeine. Caffeine is reported to have antiplatelet activity. This interaction has not been reported in humans.
Beta-Adrenergic Agonists
Theoretically, the caffeine in cola nut might increase the clinical effects of beta-adrenergic agonists.
Cola nut contains caffeine. Theoretically, concomitant use of large amounts of caffeine might increase the cardiac inotropic effects of beta-agonists.
Carbamazepine (Tegretol)
Theoretically, cola nut might reduce the effects of carbamazepine and increase the risk for convulsions.
Cola nut contains caffeine. Animal research suggests that taking caffeine can lower the anticonvulsant effects of carbamazepine and can induce seizures when taken in doses above 400 mg/kg. Human research has shown that taking caffeine 300 mg in three divided doses along with carbamazepine 200 mg reduces the bioavailability of carbamazepine by 32% and prolongs the plasma half-life of carbamazepine 2-fold in healthy individuals.
Clozapine (Clozaril)
Theoretically, cola nut might increase the levels and adverse effects of clozapine and acutely exacerbate psychotic symptoms.
Cola nut contains caffeine. Caffeine can increase the effects and toxicity of clozapine. Caffeine doses of 400-1000 mg daily inhibit clozapine metabolism. Clozapine is metabolized by cytochrome P450 1A2 (CYP1A2). Researchers speculate that caffeine might inhibit CYP1A2. However, there is no reliable evidence that caffeine affects CYP1A2. There is also speculation that genetic factors might make some patients more sensitive to the interaction between clozapine and caffeine.
Cytochrome P450 1A2 (Cyp1A2) Inhibitors
Theoretically, CYP1A2 inhibitors might increase the levels and adverse effects of the caffeine in cola nut.
Cola nut contains caffeine. Caffeine is metabolized by CYP1A2,.
Dipyridamole (Persantine)
Theoretically, cola nut might decrease the vasodilatory effects of dipyridamole and interfere with its use prior to stress testing.
Cola nut contains caffeine. Caffeine may inhibit dipyridamole-induced vasodilation. It is recommended that methylxanthines and methylxanthine-containing products, such as cola nut, be stopped 24 hours prior to pharmacological stress tests. Methylxanthines appear more likely to interfere with dipyridamole than with adenosine-induced stress testing.
Disulfiram (Antabuse)
Theoretically, disulfiram might increase the levels and adverse effects of the caffeine in cola nut.
Cola nut contains caffeine. In human research, disulfiram decreases the rate of caffeine clearance.
Diuretic Drugs
Theoretically, using cola nut with diuretic drugs might increase the risk of hypokalemia.
Cola nut contains caffeine. In excessive amounts, caffeine can reduce potassium levels due to stimulation of the sodium-potassium pump. Certain diuretics can also lower potassium levels.
Ephedrine
Theoretically, concomitant use might increase the risk for stimulant adverse effects.
Cola nut contains caffeine. There is evidence that using ephedrine with caffeine might increase the risk of serious life-threatening or debilitating adverse effects such as hypertension, myocardial infarction, stroke, seizures, and death.
Estrogens
Theoretically, estrogens might increase the levels and adverse effects of the caffeine in cola nut.
Cola nut contains caffeine. Estrogen inhibits caffeine metabolism.
Ethosuximide (Zarontin)
Theoretically, cola nut might reduce the effects of ethosuximide and increase the risk for convulsions.
Cola nut contains caffeine. Animal research suggests that caffeine 92.4 mg/kg can decrease the anticonvulsant activity of ethosuximide. However, this effect has not been reported in humans
Felbamate (Felbatol)
Theoretically, cola nut might reduce the effects of felbamate and increase the risk for convulsions.
Cola nut contains caffeine. Animal research suggests that a high dose of caffeine 161.7 mg/kg can decreases the anticonvulsant activity of felbamate. However, this effect has not been reported in humans.
Flutamide (Eulexin)
Theoretically, cola nut might increase the levels and adverse effects of flutamide.
Cola nut contains caffeine. In vitro evidence suggests that caffeine can inhibit the metabolism of flutamide. This effect has not been reported in humans.
Fluvoxamine (Luvox)
Theoretically, fluvoxamine might increase the levels and adverse effects of the caffeine in cola nut.
Cola nut contains caffeine. Fluvoxamine reduces caffeine metabolism.
Lithium
Theoretically, abrupt cola nut withdrawal might increase the levels and adverse effects of lithium.
Cola nut contains caffeine. Abrupt caffeine withdrawal can increase serum lithium levels. There are two case reports of lithium tremor that worsened upon abrupt coffee withdrawal.
Monoamine Oxidase Inhibitors (Maois)
Theoretically, concomitant use might increase the risk of a hypertensive crisis.
Cola nut contains caffeine. Caffeine has been shown to inhibit monoamine oxidase (MAO) A and B in laboratory studies. Concomitant intake of large amounts of caffeine with MAOIs might precipitate a hypertensive crisis. In a case report, a patient that consumed 10-12 cups of caffeinated coffee and took the MAOI tranylcypromine presented with severe hypertension. Hypertension was resolved after the patient switched to drinking decaffeinated coffee.
Nicotine
Theoretically, concomitant use might increase the risk of hypertension.
Cola nut contains caffeine. Concomitant use of caffeine and nicotine has been shown to have additive cardiovascular effects, including increased heart rate and blood pressure. Blood pressure was increased by 10.8/12.4 mmHg when the agents were used concomitantly.
Pentobarbital (Nembutal)
Theoretically, cola nut might decrease the effects of pentobarbital.
Cola nut contains caffeine. Theoretically, caffeine might negate the hypnotic effects of pentobarbital.
Phenobarbital (Luminal)
Theoretically, cola nut might reduce the effects of phenobarbital and increase the risk for convulsions.
Cola nut contains caffeine. Animal research suggests that caffeine can decrease the anticonvulsant activity of phenobarbital. However, this effect has not been reported in humans.
Phenylpropanolamine
Theoretically, phenylpropanolamine might increase the risk of hypertension, as well as the levels and adverse effects of the caffeine in cola nut.
Cola nut contains caffeine. Concomitant use of phenylpropanolamine and caffeine might cause an additive increase in blood pressure. Phenylpropanolamine also seems to increase caffeine serum levels.
Phenytoin (Dilantin)
Theoretically, cola nut might reduce the effects of phenytoin and increase the risk for convulsions.
Cola nut contains caffeine. Animal research suggests that caffeine can decrease the anticonvulsant activity of phenytoin. The effect does not seem to be related to the seizure threshold-lowering effects of caffeine. However, the exact mechanism of this interaction is unclear.
Pioglitazone (Actos)
Theoretically, cola nut might increase the levels and clinical effects of pioglitazone.
Cola nut contains caffeine. Animal research suggests that caffeine can modestly increase the maximum concentration, area under the curve, and half-life of pioglitazone, and also reduce its clearance. This increased the antidiabetic effects of pioglitazone. However, the exact mechanism of this interaction is unclear.
Quinolone Antibiotics
Theoretically, quinolone antibiotics might increase the levels and adverse effects of the caffeine in cola nut.
Cola nut contains caffeine. Quinolones (also called fluoroquinolones) can decrease caffeine clearance by inhibiting cytochrome P450 1A2 (CYP1A2).
Alpha Lipoic Acid
Alkylating Agents
Theoretically, the antioxidant effects of alpha-lipoic acid might alter the effectiveness of alkylating agents.
The use of antioxidants like alpha-lipoic acid during chemotherapy is controversial. There are concerns that antioxidants could reduce the activity of chemotherapy drugs that generate free radicals. However, some researchers theorize that antioxidants might make chemotherapy more effective by reducing oxidative stress that might interfere with apoptosis (cell death) of cancer cells. More evidence is needed to determine what effect, if any, antioxidants such as alpha-lipoic acid have on chemotherapy. Advise patients to consult their oncologist before using alpha-lipoic acid.
Anticoagulant/Antiplatelet Drugs
Theoretically, alpha-lipoic acid may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
In vitro, alpha-lipoic acid inhibits platelet aggregation.
Antitumor Antibiotics
Theoretically, the antioxidant effects of alpha-lipoic acid might alter the effectiveness of antitumor antibiotics.
The use of antioxidants like alpha-lipoic acid during chemotherapy is controversial. There are concerns that antioxidants could reduce the activity of antitumor antibiotic drugs, which work by generating free radicals. However, some researchers theorize that antioxidants might make chemotherapy more effective by reducing oxidative stress that might interfere with apoptosis (cell death) of cancer cells. More evidence is needed to determine what effect, if any, antioxidants such as alpha-lipoic acid have on chemotherapy involving antitumor antibiotics. Advise patients to consult their oncologist before using alpha-lipoic acid.
Thyroid Hormone
Theoretically, alpha-lipoic acid might decrease the effects of thyroid hormone drugs.
Animal research suggests that co-administration of thyroxine with alpha-lipoic acid reduces conversion into the active T3 form.
Antidiabetes Drugs
Theoretically, taking alpha-lipoic acid with antidiabetes drugs might increase the risk of hypoglycemia.
Although some small clinical studies have suggested that alpha-lipoic acid can lower blood glucose levels, larger clinical studies in patients with diabetes have shown no clinically meaningful effect. Additionally, co-administration of single doses of alpha-lipoic acid and glyburide or acarbose did not cause detectable drug interactions in healthy volunteers.
Brand information
Manufacturer and brand details for Thermo Blend, from the product label.
NatureWise
See all NatureWise products- Name
- NatureWise
- City
- Ashland
- State
- OR
- ZipCode
- 97520
- Phone Number
- 800-510-7207
- Web Address
- www.naturewise.com
Thermo Blend by NatureWise: Common Questions
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Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
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Label information is sourced from the NIH Dietary Supplement Label Database and reflects the product version on file; always read your actual product label. This page is for education only and is not a substitute for professional medical advice. Confirm with your pharmacist or doctor before combining supplements and medications.
The Full Monographs Behind Thermo Blend’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Alpha-lipoic Acid
Interacts with 263 drugsAlpha-lipoic acid (ALA) is an antioxidant made naturally by the body and found in small amounts in foods. It is most studied for diabetic nerve pain, where some evidence suggests it may help...
Read the full Alpha-lipoic Acid monograph → Herb & supplement monographOlive
Olive comes from the same tree that gives us olives and olive oil, and its leaf and fruit contain antioxidant compounds like oleuropein and hydroxytyrosol. Olive oil as part of a Mediterrane...
Read the full Olive monograph → Herb & supplement monographYerba Mate
Interacts with 1,086 drugsYerba mate is a caffeine-containing herbal beverage from South America that is widely enjoyed for its stimulating, coffee-like effects. While it is rich in antioxidants and is being studied...
Read the full Yerba Mate monograph → Herb & supplement monographAshwagandha
Interacts with 1,372 drugsAshwagandha is an Ayurvedic herb most often taken to help with stress, anxiety, and sleep, and some small studies suggest it may help, though the evidence is still limited. It is generally w...
Read the full Ashwagandha monograph → Herb & supplement monographGuarana
Interacts with 655 drugsGuarana is an Amazonian seed that is naturally high in caffeine, which explains most of its stimulant and energy effects. While it may give a short-term boost in alertness and reduce fatigue...
Read the full Guarana monograph → Herb & supplement monographGreen Tea
Interacts with 1,293 drugsGreen tea is a popular beverage rich in antioxidants called catechins, and drinking it in normal amounts is considered safe for most people. Concentrated green tea extracts are a different s...
Read the full Green Tea monograph → Herb & supplement monographBitter Orange
Interacts with 957 drugsBitter orange is a citrus fruit whose extracts contain synephrine, a mild stimulant often added to weight-loss and energy supplements. Evidence that it works for weight loss or performance i...
Read the full Bitter Orange monograph → Herb & supplement monographRhodiola
Interacts with 1,271 drugsRhodiola is an herb traditionally used to fight fatigue and help the body cope with stress. Some small studies suggest it may modestly reduce fatigue and improve mood, but the evidence is li...
Read the full Rhodiola monograph → Herb & supplement monographCola Nut
Interacts with 655 drugsCola nut is a caffeine-containing seed from West Africa used mainly as a natural stimulant for energy and alertness. Most of its effects come from caffeine, and strong human evidence for spe...
Read the full Cola Nut monograph →Sources & How We Checked
Thermo Blend'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 755 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.
Alpha-lipoic Acid 48 references
- Labriola D, Livingston R. Possible interactions between dietary antioxidants and chemotherapy. Oncology 1999;13:1003-8.
- Anon. Alpha-lipoic acid. Altern Med Rev 1998;3:308-10.
- Konrad T, Vicini P, Kusterer K, et al. Alpha-lipoic acid treatment decreases serum lactate and pyruvate concentrations and improves glucose effectiveness in lean and obese patients with Type 2 diabetes. Diabetes Care 1999;22:280-7. PubMed
- Ziegler D, Hanefeld M, Ruhnau KJ, et al. Treatment of symptomatic diabetic peripheral neuropathy with the antioxidant alpha-lipoic acid: A 3-week, multicentre randomized controlled trial (ALADIN Study). Diabetologia 1995;38:1425-33.
- Gleiter CH, Schreeb KH, Freudenthaler S, et al. Lack of interaction between thioctic acid, glibenclamide and acarbose. Br J Clin Pharmacol 1999;48:819-25. PubMed
- Jacob S, Henriksen EJ, Tritschler HJ, et al. Improvement of insulin-stimulated glucose-disposal in type 2 diabetes after repeated parenteral administration of thioctic acid. Exp Clin Endocrinol Diabet 1996;104:284-8. PubMed
- Jacob S, Henriksen EJ, Schiemann AL, et al. Enhancement of glucose disposal in patients with type 2 diabetes by alpha-lipoic acid. Arzneimittelforschung 1995;45:872-4.
- Jacob S, Ruus P, Hermann R, et al. Oral administration of RAC-alpha-lipoic acid modulates insulin sensitivity in patients with type-2 diabetes mellitus: a placebo-controlled, pilot trial. Free Rad Biol Med 1999;27:309-14.
- Segermann J, Hotze A, Ulrich H, Rao GS. Effect of alpha-lipoic acid on the peripheral conversion of thyroxine to triiodothyronine and on serum lipid-, protein- and glucose levels. Arzneimittelforschung 1991;41:1294-8.
- Beitner H. Randomized, placebo controlled, double-blind study on the clinical efficacy of a cream containing 5% alpha-lipoic acid related to photoaging of facial skin. Br J Dermatol 2003;149:841-9.
- Ziegler D, Nowak H, Kempler P, et al. Treatment of symptomatic diabetic polyneuropathy with the antioxidant alpha-lipoic acid: A meta-analysis. Diabet Med 2004;21:114-21.
- Prasad KN. Rationale for using high-dose multiple dietary antioxidants as an adjunct to radiation therapy and chemotherapy. J Nutr 2004;134:3182S-3S. PubMed
- Conklin KA. Cancer chemotherapy and antioxidants. J Nutr 2004;134:3201S-3204S. PubMed
- Vincent HK, Bourguignon CM, Vincent KR, Taylor AG. Effects of alpha-lipoic acid supplementation in peripheral arterial disease: a pilot study. J Alt Complement Med 2007;13:577-84. PubMed
- Furukawa N, Miyamura N, Nishida K, et al. Possible relevance of alpha lipoic acid contained in a health supplement in a case of insulin autoimmune syndrome. Diabetes Res Clin Pract 2007;75:366-7. PubMed
- Ziegler D., Ametov A., Barinov A., Dyck P. J., Gurieva I., Low P. A., Munzel U., Yakhno N., Raz I., Novosadova M., Maus J., Samigullin, R. Oral treatment with alpha-lipoic acid improves symptomatic diabetic polyneuropathy: the SYDNEY 2 trial. Diabetes Car
- Gu X. M., Zhang S. S., Wu J. C., Tang Z. Y., Lu Z. Q., Li H., Liu C., Chen L., Ning, G. [Efficacy and safety of high-dose a-lipoic acid in the treatment of diabetic polyneuropathy]. Zhonghua Yi Xue Za Zhi 2010;90(35):2473-2476.
- Porasuphatana S., Suddee S., Nartnampong A., Konsil J., Harnwong B., Santaweesuk A. Glycemic and oxidative status of patients with type 2 diabetes mellitus following oral administration of alpha-lipoic acid: a randomized double-blinded placebo-controlled
- Ansar H., Mazloom Z., Kazemi F., Hejazi N. Effect of alpha-lipoic acid on blood glucose, insulin resistance and glutathione peroxidase of type 2 diabetic patients. Saudi Med J 2011;32(6):584-588. DOI
- de Oliveira A. M., Rondó P. H., Luzia L. A., D'Abronzo F. H., Illison V. K. The effects of lipoic acid and a-tocopherol supplementation on the lipid profile and insulin sensitivity of patients with type 2 diabetes mellitus: a randomized, double-blind, pla
- Mazloom Z., Ansar H. The Effect of Alpha-Lipoic Acid on Blood Pressure in Type 2 Diabetics. Iranian Journal of Endocrinology and Metabolism 2009;11(3):245-250.
- Volchegorskii I. A., Rassokhina L. M., Koliadich M. I., Alekseev M. I. [Comparative study of alpha-lipoic acid and mexidol effects on affective status, cognitive functions and quality of life in diabetes mellitus patients]. Eksp Klin Farmakol 2011;74(11):
- Cavalcanti D. R., da Silveira F. R. Alpha lipoic acid in burning mouth syndrome--a randomized double-blind placebo-controlled trial. J Oral Pathol Med 2009;38(3):254-261. PubMed
- Koh E. H., Lee W. J., Lee S. A., Kim E. H., Cho E. H., Jeong E., Kim D. W., Kim M. S., Park J. Y., Park K. G., Lee H. J., Lee I. K., Lim S., Jang H. C., Lee K. H., Lee K. U. Effects of alpha-lipoic Acid on body weight in obese subjects. Am J Med 2011;124( PubMed
- Bergqvist-Karlsson, A., Thelin, I., and Bergendorff, O. Contact dermatitis to alpha-lipoic acid in an anti-wrinkle cream. Contact Dermatitis 2006;55(1):56-57.
- Tang, J., Wingerchuk, D. M., Crum, B. A., Rubin, D. I., and Demaerschalk, B. M. Alpha-lipoic acid may improve symptomatic diabetic polyneuropathy. Neurologist. 2007;13(3):164-167. PubMed
- Hegazy SK, Tolba OA, Mostafa TM, Eid MA, El-Afify DR. Alpha-lipoic acid improves subclinical left ventricular dysfunction in asymptomatic patients with type 1 diabetes. Rev Diabet Stud 2013;10(1):58-67. PubMed
- Huang Z, Wan X, Liu J, et al. Short-term continuous subcutaneous insulin infusion combined with insulin sensitizers rosiglitazone, metformin, or antioxidant a-lipoic acid in patients with newly diagnosed type 2 diabetes mellitus. Diabetes Technol Ther 201
- Sarezky D, Raquib AR, Dunaief JL, Kim BJ. Tolerability in the elderly population of high-dose alpha lipoic acid: a potential antioxidant therapy for the eye. Clin Ophthalmol. 2016 Sep 29;10:1899-1903. PubMed
- Boriani F, Granchi D, Roatti G, Merlini L, Sabattini T, Baldini N. Alpha-lipoic acid after median nerve decompression at the carpal tunnel: a randomized controlled trial. J Hand Surg Am. 2017 Apr;42(4):236-42. PubMed
- Karkabounas S, Papadopoulos N, Anastasiadou C, et al. Effects of a-lipoic Acid, carnosine, and thiamine supplementation in obese patients with type 2 diabetes mellitus: A randomized, double-blind study. J Med Food. 2018;21(12):1197-1203.
- Murray GL, Colombo J. (r)Alpha lipoic acid is a safe, effective pharmacologic therapy of chronic orthostatic hypotension associated with low sympathetic tone. Int J Angiol. 2019;28(3):188-193. PubMed
- Bobe G, Michels AJ, Zhang WJ, et al. A randomized controlled trial of long-term (R)-α-lipoic acid supplementation promotes weight loss in overweight or obese adults without altering baseline elevated plasma triglyceride concentrations. J Nutr. 2020:
- Passiatore M, Perna A, De-Vitis R, Taccardo G. The use of alfa-lipoic acid-R (ALA-R) in patients with mild-moderate carpal tunnel syndrome: A randomised controlled open label prospective study. Malays Orthop J. 2020;14(1):1-6. PubMed
- El-Nahas MR, Elkannishy G, Abdelhafez H, Elkhamisy ET, El-Sehrawy AA. Oral alpha lipoic acid treatment for symptomatic diabetic peripheral neuropathy: A randomized double-blinded placebo-controlled study. Endocr Metab Immune Disord Drug Targets. 2020. PubMed
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