Total War Grape Ingredients & Drug Interactions
by Redcon1
What is this page for?
First and foremost: checking Total War Grape 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
Total War Grape is a dietary supplement by Redcon1 with 11 active ingredients. Its ingredients are commonly taken for exercise performance and endurance, heart health, energy support.Based on those ingredients, 1,483 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are Green Tea extract, BioPerine, Naringin. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against Total War Grape by Redcon1
Ask about any prescription or over-the-counter medication and we check it for interactions with Total War Grape by Redcon1 — 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 Total War Grape by Redcon1
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
Total War Grape contains 11 active ingredients designed for workout performance and energy. The primary drivers are two forms of caffeine — Caffeine Anhydrous and Di-Caffeine Malate — which work as stimulants for mental alertness and athletic performance.
Supporting these are Taurine (an amino acid), Beta-Alanine (an amino acid linked to muscle endurance), and Agmatine Sulfate (a signaling compound). The formula also includes Green Tea extract for additional caffeine and antioxidants, Black Pepper extract (BioPerine) to boost absorption of other ingredients, Juniper extract, Citrulline Malate (an amino acid precursor), Naringin (a compound from grapefruit), and Theobroma cocoa seed extract (cocoa) for flavor and additional stimulant content.
The remaining ingredients are fillers, binders, and sweeteners.
Does it work?
Strong evidence
The evidence for this product's ingredients is mixed. Caffeine is rated Likely Effective for mental alertness and athletic performance.
Beta-Alanine is rated Possibly Effective for athletic and physical performance. Taurine shows Possibly Effective evidence for congestive heart failure but only Possibly Ineffective for obesity.
Green Tea extract is rated Likely Effective for human papillomavirus (HPV) and Possibly Effective for high cholesterol, though it also reduces the effectiveness of some medications. For most other uses — anxiety, cognitive function, asthma, and many others — the evidence we hold is rated Insufficient Reliable Evidence To Rate, meaning these claims are not yet established.
How safe is it?
Well-documented data
Caffeine in moderate doses is generally well tolerated but can cause anxiety, insomnia, tremors, nausea, restlessness, and headache. At high doses, serious side effects including stroke have been reported rarely.
Beta-Alanine commonly causes harmless tingling and flushing of the skin. Taurine is generally well tolerated short-term but long-term safety is less certain; constipation, diarrhea, and indigestion are the most common side effects.
Agmatine may cause diarrhea, nausea, and indigestion. Black pepper is well tolerated as a food spice but concentrated supplements should be used cautiously; burning aftertaste and indigestion can occur.
Juniper should not be used long-term because it may irritate the kidneys. Green tea in moderate amounts is safe, but concentrated extracts at high doses have been linked to rare liver injury.
We hold insufficient pregnancy and lactation safety data for Agmatine, Beta-Alanine, and Juniper — avoid these during pregnancy and breastfeeding. Caffeine and Green Tea pass into breast milk; the safety notes advise limiting intake and watching for effects on the baby.
Meds to double-check
Major interaction found
Before taking Total War Grape, double-check these medication types with your pharmacist: ephedrine or other stimulants (Major risk of serious heart and blood pressure effects), blood pressure medications, nadolol specifically, atorvastatin or other cholesterol drugs, cyclosporine or other immunosuppressants, amiodarone or other heart rhythm drugs, buspirone or other anxiety medications, barbiturates, certain antibiotics (especially quinolones), seizure medications, the antipsychotic clozapine, diabetes medications, and diuretics. If you take any of these, do not start this product without reviewing it with your pharmacist first.
The bottom line
Scorecard at a glanceFully disclosed formula with clinical evidence supporting its stated purpose. Major medication interactions have been identified, and safety information is well characterized.
Total War Grape is designed for workout performance and mental energy, with strong evidence for caffeine's effects on alertness and Beta-Alanine's support for athletic endurance. If you take any prescription medications — especially for blood pressure, seizures, heart rhythm, antibiotics, diabetes, or mental health — you must check your exact drugs with the tool on this page before using this product, as the caffeine, green tea, and grapefruit components carry serious risks.
Avoid during pregnancy and breastfeeding unless your doctor approves. Talk to your pharmacist if you have high blood pressure, heart disease, or anxiety.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 10 of 11 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Jun 16, 2022.
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 Total War Grape, straight from the product label.
| Brand | Redcon1 |
|---|---|
| Barcode (UPC) | 850004759271 |
| Net contents | 15.54 Ounce(s); 441 Gram(s) |
| Market status | On market |
| Date entered into DSLD | Jun 16, 2022 |
| DSLD ID | 269506 |
| Product type | Other Combinations |
| Supplement form | Powder |
| Dietary claims / uses | All Other, Structure/Function |
| Intended target group(s) | Adult (18 - 50 Years), Women (not pregnant or lactating) |
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 Total War Grape by Redcon1, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Taurine | 1 Gram(s) | -- |
| Caffeine Anhydrous | 250 mg | -- |
| BioPerine | 10 mg | -- |
| Agmatine Sulfate | 1 Gram(s) | -- |
| Di-Caffeine Malate | 100 mg | -- |
| Green Tea extract | 45 mg | -- |
| Beta-Alanine | 3.2 Gram(s) | -- |
| Juniper extract | 150 mg | -- |
| Citrulline Malate | 6 Gram(s) | -- |
| Naringin | 25 mg | -- |
| Theobroma cocoa (seed) extract | 5 mg | -- |
Other ingredients: Natural and Artificial flavors, Disodium Phosphate, Silica, Calcium Silicate, Sucralose, Citric Acid, Maltodextrin, Acesulfame-Potassium
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
The objective: When it’s time to go to battle, you go hard with Total War. Experience a workout with intensity you didn’t think was possible. New found strength and energy are just minutes away. Lock-in and get ready to bring the noise!
Product does not completely fill container. Settling occurs in shipping.
Suggested/Recommended/Usage/Directions
Total War Suggested Use: When it comes time to bring the noise for a workout, assess your tolerance by taking (1/2) scoop prior to training. Once your tolerance is assessed mix (1) scoop with 4-6 ounces of water 30 minutes prior to training. Do not exceed (1) scoop in a 24-hour period.
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.
Seals/Symbols
Supplement Safety Solutions Nutravigilance Verified
Formulation
Preworkout
Laser focus Extreme energy Unstoppable power
Brand IP Statement(s)
Redcon1 When you're ready to bring the noise
FDA Statement of Identity
Dietary Supplement
Formula
Grape Naturally and artificially flavored
Precautions
Warning: This product is intended to be consumed by healthy adults 18 years of age or older. This product contains 350 mg of caffeine per serving.
Do not use if you are pregnant, nursing, sensitive to caffeine or other stimulants, taking any prescription or over-the-counter medications or supplements, or if you have or suspect you may have a medical condition, including but not limited to: high or low blood pressure, cardiac arrhythmia, stroke, heart, liver or kidney disease, seizure disorder, thyroid disease, psychiatric disease, diabetes, prostate enlargement or if you are taking a MAO inhibitor.
Do not use if you are prone to dehydration or exposed to excessive heat. As with any dietary supplement, consult a healthcare professional before using this product. Discontinue use 2 weeks prior to surgery. Immediately discontinue use and consult a healthcare professional if you experience any adverse reactions.
Keep out of reach of children.
Storage
Store at 59 - 86 degrees F (15 - 30 degrees C). Protect from light and moisture.
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Total War Grape by Redcon1 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 Total War Grape by Redcon1
These are the 11 active ingredients this product is made of. Select any to open its full monograph.
Serving size14.7 Gram(s) Dosage formPowder 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.
Taurine
Interacts with173 drugs
Taurine is an amino acid your body makes naturally and that you also get from animal foods. It is widely used in energy drinks and sports supplements,...
Taurine monograph & interactionsCaffeine Anhydrous
Interacts with655 drugs
Caffeine is a natural stimulant found in coffee, tea, and many other plants and products. In moderate amounts it can boost alertness and reduce tiredn...
Caffeine Anhydrous monograph & interactionsBioPerine
Interacts with1,019 drugs
Black pepper is a common kitchen spice that is generally safe in the amounts used in food. Its extract, piperine, is mostly added to supplements to he...
BioPerine monograph & interactionsAgmatine Sulfate
Interacts with258 drugs
Agmatine is a compound your body makes from the amino acid arginine, and it is sold mainly as a workout and 'pump' supplement. Human evidence for most...
Agmatine Sulfate monograph & interactionsDi-Caffeine Malate
Interacts with655 drugs
Caffeine is a natural stimulant found in coffee, tea, and many other plants and products. In moderate amounts it can boost alertness and reduce tiredn...
Di-Caffeine Malate 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 & interactionsBeta-Alanine
No knowninteractions
Beta-alanine is an amino acid taken mostly by athletes to raise muscle carnosine, which may help buffer acid and reduce fatigue during short, high-int...
Beta-Alanine monograph & interactionsJuniper extract
Interacts with162 drugs
Juniper berry is a traditional herb best known for flavoring gin and for its folk use as a diuretic and digestive aid. Solid human evidence for its he...
Juniper extract monograph & interactionsCitrulline Malate
Naringin
Interacts with990 drugs
Grapefruit is a nutritious citrus fruit rich in vitamin C and other nutrients, and it is generally safe to eat. However, grapefruit is famous for seri...
Naringin monograph & interactionsTheobroma cocoa (seed) extract
Interacts with661 drugs
Cocoa is rich in plant compounds called flavanols that may modestly support blood vessel function and blood pressure, but most chocolate products are...
Theobroma cocoa (seed) extract monograph & interactionsOther (inactive) ingredients: Natural and Artificial flavors, Disodium Phosphate, Silica, Calcium Silicate, Sucralose, Citric Acid, Maltodextrin, Acesulfame-Potassium. These complete the product’s ingredient list but are not active constituents.
Total War Grape by Redcon1 Drug Interactions
HelloPharmacist Interaction Report
Total War Grape by Redcon1 contains multiple ingredients that interact with medications.
The most serious interaction is between the caffeine content (from Caffeine Anhydrous and Di-Caffeine Malate) and ephedrine — this is a Major severity interaction that can cause serious stimulant effects including high blood pressure, heart attack, stroke, seizures, and death.
Read the full breakdown — every affected drug type, severity by severity
Green tea extract in this product also carries Major interactions with nadolol (a blood pressure medication) and atorvastatin (a cholesterol drug), both reducing their effectiveness. Naringin, derived from grapefruit, has Major interactions with several drugs including cyclosporine, amiodarone, buspirone, and others — it can raise their blood levels and increase side effects.
The caffeine ingredients interact with multiple Moderate severity drug types: barbiturates, certain antibiotics, the antipsychotic clozapine, and seizure medications (phenobarbital, carbamazepine, felbamate, valproate, ethosuximide, phenytoin). Black pepper (BioPerine) also carries Moderate interactions with blood pressure, heart, seizure, and antibiotic medications.
Taurine, agmatine, and juniper extract interact with blood pressure drugs and diabetes medications at Moderate and Minor severity levels.
Altogether, these interactions span 1,462 individual medications. We could not check Citrulline Malate because no data is on file for it.
Use the medication checker below with your exact prescriptions before taking this product.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against Total War Grape?
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 Total War Grape interact with 1,483 drugs. Click any drug to see the details.
8 of the 11 ingredients in Total War Grape interact with drugs. Each result below shows which ingredient is responsible. Green Tea extract BioPerine Naringin Theobroma cocoa (seed) extract Caffeine Anhydrous Agmatine Sulfate Taurine Juniper extract
Ado-trastuzumab EmtansineKadcyla
How Ado-trastuzumab Emtansine interacts with Total War Grape — through 3 ingredients. Tap an ingredient for the detail:
NaringinCytochrome P450 3a4 (cyp3a4) Substrates Major
Interaction Summary
Grapefruit juice can increase levels of drugs metabolized by CYP3A4.
Read the full Naringin + Ado-trastuzumab Emtansine interactionBioperineCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP3A4.
Read the full Bioperine + Ado-trastuzumab Emtansine interactionGreen Tea ExtractCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Green tea is unlikely to produce clinically significant changes in the levels and clinical effects of CYP3A4 substrates.
Read the full Green Tea Extract + Ado-trastuzumab Emtansine interactionAbemaciclibVerzenio
How Abemaciclib interacts with Total War Grape — through 3 ingredients. Tap an ingredient for the detail:
NaringinCytochrome P450 3a4 (cyp3a4) Substrates Major
Interaction Summary
Grapefruit juice can increase levels of drugs metabolized by CYP3A4.
Read the full Naringin + Abemaciclib interactionBioperineCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP3A4.
Read the full Bioperine + Abemaciclib interactionGreen Tea ExtractCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Green tea is unlikely to produce clinically significant changes in the levels and clinical effects of CYP3A4 substrates.
Read the full Green Tea Extract + Abemaciclib interactionAbiraterone
How Abiraterone interacts with Total War Grape — through 5 ingredients. Tap an ingredient for the detail:
NaringinCytochrome P450 3a4 (cyp3a4) Substrates Major
Interaction Summary
Grapefruit juice can increase levels of drugs metabolized by CYP3A4.
Read the full Naringin + Abiraterone interactionGreen Tea ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Hepatotoxic Drugs +1 Moderate
Interaction Summary
Green tea is unlikely to produce clinically significant changes in the levels and clinical effects of CYP3A4 substrates.
Read the full Green Tea Extract + Abiraterone interactionBioperineCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP3A4.
Read the full Bioperine + Abiraterone interactionTheobroma Cocoa (seed) ExtractCytochrome P450 1a2 (cyp1a2) Inhibitors Moderate
Interaction Summary
Theoretically, concomitant use might increase the levels and adverse effects of caffeine.
Read the full Theobroma Cocoa (seed) Extract + Abiraterone interactionDi-caffeine MalateCytochrome P450 1a2 (cyp1a2) Inhibitors Minor
Interaction Summary
Theoretically, concomitant use might increase the levels and adverse effects of caffeine.
Read the full Di-caffeine Malate + Abiraterone interactionAbiraterone AcetateYonsa, Zytiga
How Abiraterone Acetate interacts with Total War Grape — through 3 ingredients. Tap an ingredient for the detail:
NaringinCytochrome P450 3a4 (cyp3a4) Substrates Major
Interaction Summary
Grapefruit juice can increase levels of drugs metabolized by CYP3A4.
Read the full Naringin + Abiraterone Acetate interactionGreen Tea ExtractHepatotoxic Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, concomitant use might have additive adverse hepatotoxic effects.
Read the full Green Tea Extract + Abiraterone Acetate interactionBioperineCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP3A4.
Read the full Bioperine + Abiraterone Acetate interactionAcalabrutinibCalquence
How Acalabrutinib interacts with Total War Grape — through 3 ingredients. Tap an ingredient for the detail:
NaringinCytochrome P450 3a4 (cyp3a4) Substrates, P-glycoprotein Substrates Major
Interaction Summary
Grapefruit juice can increase levels of drugs metabolized by CYP3A4.
Read the full Naringin + Acalabrutinib interactionGreen Tea ExtractCytochrome P450 3a4 (cyp3a4) Substrates, P-glycoprotein Substrates Moderate
Interaction Summary
Green tea is unlikely to produce clinically significant changes in the levels and clinical effects of CYP3A4 substrates.
Read the full Green Tea Extract + Acalabrutinib interactionBioperineP-glycoprotein Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, black pepper might increase levels of P-glycoprotein substrates.
Read the full Bioperine + Acalabrutinib interactionAcetaminophen, Aspirin, CaffeineExcedrin, Excedrin Extra Strength, Excedrin Migraine
How Acetaminophen, Aspirin, Caffeine interacts with Total War Grape — through 5 ingredients. Tap an ingredient for the detail:
NaringinCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Major
Interaction Summary
Grapefruit juice can increase levels of drugs metabolized by CYP3A4.
Read the full Naringin + Acetaminophen, Aspirin, Caffeine interactionBioperineAnticoagulant/antiplatelet Drugs, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Moderate
Interaction Summary
Theoretically, black pepper might increase the risk of bleeding when taken with antiplatelet or anticoagulant drugs.
Read the full Bioperine + Acetaminophen, Aspirin, Caffeine interactionGreen Tea ExtractStimulant Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates +2 Moderate
Interaction Summary
Theoretically, concomitant use might increase stimulant adverse effects.
Read the full Green Tea Extract + Acetaminophen, Aspirin, Caffeine interactionTheobroma Cocoa (seed) ExtractAnticoagulant/antiplatelet Drugs, Stimulant Drugs Moderate
Interaction Summary
Theoretically, cocoa may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Theobroma Cocoa (seed) Extract + Acetaminophen, Aspirin, Caffeine interactionDi-caffeine MalateAnticoagulant/antiplatelet Drugs, Stimulant Drugs Moderate
Interaction Summary
Theoretically, caffeine may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Di-caffeine Malate + Acetaminophen, Aspirin, Caffeine interactionAcetaminophen, Butalbital, CaffeineEsgic, Esgic Plus, Fiogesic, Fioricet, Repan, Tecnal +1 more
How Acetaminophen, Butalbital, Caffeine interacts with Total War Grape — through 5 ingredients. Tap an ingredient for the detail:
NaringinCytochrome P450 1a2 (cyp1a2) Substrates, Caffeine +1 Major
Interaction Summary
Theoretically, grapefruit juice might increase levels of drugs metabolized by CYP1A2.
Read the full Naringin + Acetaminophen, Butalbital, Caffeine interactionTheobroma Cocoa (seed) ExtractStimulant Drugs Moderate
Interaction Summary
Theoretically, concomitant use might increase stimulant adverse effects.
Read the full Theobroma Cocoa (seed) Extract + Acetaminophen, Butalbital, Caffeine interactionBioperineCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, black pepper might decrease levels and clinical effects of drugs metabolized by CYP1A2.
Read the full Bioperine + Acetaminophen, Butalbital, Caffeine interactionDi-caffeine MalateStimulant Drugs Moderate
Interaction Summary
Theoretically, concomitant use might increase stimulant adverse effects.
Read the full Di-caffeine Malate + Acetaminophen, Butalbital, Caffeine interactionGreen Tea ExtractHepatotoxic Drugs, Stimulant Drugs +1 Moderate
Interaction Summary
Theoretically, concomitant use might have additive adverse hepatotoxic effects.
Read the full Green Tea Extract + Acetaminophen, Butalbital, Caffeine interactionAcetaminophen, Butalbital, Caffeine, CodeineEsgic with Codeine, Fioricet w/ Codeine
How Acetaminophen, Butalbital, Caffeine, Codeine interacts with Total War Grape — through 5 ingredients. Tap an ingredient for the detail:
NaringinCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Major
Interaction Summary
Theoretically, grapefruit juice might increase levels of drugs metabolized by CYP1A2.
Read the full Naringin + Acetaminophen, Butalbital, Caffeine, Codeine interactionGreen Tea ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Stimulant Drugs +1 Moderate
Interaction Summary
Green tea is unlikely to produce clinically significant changes in the levels and clinical effects of CYP3A4 substrates.
Read the full Green Tea Extract + Acetaminophen, Butalbital, Caffeine, Codeine interactionDi-caffeine MalateStimulant Drugs Moderate
Interaction Summary
Theoretically, concomitant use might increase stimulant adverse effects.
Read the full Di-caffeine Malate + Acetaminophen, Butalbital, Caffeine, Codeine interactionTheobroma Cocoa (seed) ExtractStimulant Drugs Moderate
Interaction Summary
Theoretically, concomitant use might increase stimulant adverse effects.
Read the full Theobroma Cocoa (seed) Extract + Acetaminophen, Butalbital, Caffeine, Codeine interactionBioperineCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP3A4.
Read the full Bioperine + Acetaminophen, Butalbital, Caffeine, Codeine interactionAcetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, PhenylephrineHycomine Compound
How Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interacts with Total War Grape — through 5 ingredients. Tap an ingredient for the detail:
NaringinCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Major
Interaction Summary
Theoretically, grapefruit juice might increase levels of drugs metabolized by CYP1A2.
Read the full Naringin + Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interactionTheobroma Cocoa (seed) ExtractStimulant Drugs Moderate
Interaction Summary
Theoretically, concomitant use might increase stimulant adverse effects.
Read the full Theobroma Cocoa (seed) Extract + Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interactionBioperineCytochrome P450 2d6 (cyp2d6) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP2D6.
Read the full Bioperine + Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interactionGreen Tea ExtractStimulant Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Moderate
Interaction Summary
Theoretically, concomitant use might increase stimulant adverse effects.
Read the full Green Tea Extract + Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interactionDi-caffeine MalateStimulant Drugs Moderate
Interaction Summary
Theoretically, concomitant use might increase stimulant adverse effects.
Read the full Di-caffeine Malate + Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interactionAcetaminophen, Caffeine, CodeineGesic C15, Gesic C30, Gesic C8, Lenoltec 1, Lenoltec 2, Lenoltec 3 +1 more
How Acetaminophen, Caffeine, Codeine interacts with Total War Grape — through 5 ingredients. Tap an ingredient for the detail:
NaringinCaffeine, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Major
Interaction Summary
Grapefruit juice can decrease the clearance of caffeine, potentially increasing the effects and adverse effects of caffeine.
Read the full Naringin + Acetaminophen, Caffeine, Codeine interactionGreen Tea ExtractHepatotoxic Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Moderate
Interaction Summary
Theoretically, concomitant use might have additive adverse hepatotoxic effects.
Read the full Green Tea Extract + Acetaminophen, Caffeine, Codeine interactionTheobroma Cocoa (seed) ExtractStimulant Drugs Moderate
Interaction Summary
Theoretically, concomitant use might increase stimulant adverse effects.
Read the full Theobroma Cocoa (seed) Extract + Acetaminophen, Caffeine, Codeine interactionBioperineCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP3A4.
Read the full Bioperine + Acetaminophen, Caffeine, Codeine interactionDi-caffeine MalateStimulant Drugs Moderate
Interaction Summary
Theoretically, concomitant use might increase stimulant adverse effects.
Read the full Di-caffeine Malate + Acetaminophen, Caffeine, Codeine interactionAcetaminophen, Caffeine, Codeine, SalicylamideCodalan No.1, Codalan No.2, Codalan No.3
How Acetaminophen, Caffeine, Codeine, Salicylamide interacts with Total War Grape — through 5 ingredients. Tap an ingredient for the detail:
NaringinCytochrome P450 1a2 (cyp1a2) Substrates, Caffeine +1 Major
Interaction Summary
Theoretically, grapefruit juice might increase levels of drugs metabolized by CYP1A2.
Read the full Naringin + Acetaminophen, Caffeine, Codeine, Salicylamide interactionDi-caffeine MalateStimulant Drugs Moderate
Interaction Summary
Theoretically, concomitant use might increase stimulant adverse effects.
Read the full Di-caffeine Malate + Acetaminophen, Caffeine, Codeine, Salicylamide interactionTheobroma Cocoa (seed) ExtractStimulant Drugs Moderate
Interaction Summary
Theoretically, concomitant use might increase stimulant adverse effects.
Read the full Theobroma Cocoa (seed) Extract + Acetaminophen, Caffeine, Codeine, Salicylamide interactionGreen Tea ExtractHepatotoxic Drugs, Stimulant Drugs +1 Moderate
Interaction Summary
Theoretically, concomitant use might have additive adverse hepatotoxic effects.
Read the full Green Tea Extract + Acetaminophen, Caffeine, Codeine, Salicylamide interactionBioperineCytochrome P450 2d6 (cyp2d6) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP2D6.
Read the full Bioperine + Acetaminophen, Caffeine, Codeine, Salicylamide interactionAcetaminophen, Caffeine, DihydrocodeineDHC Plus, Panlor DC, Panlor SS
How Acetaminophen, Caffeine, Dihydrocodeine interacts with Total War Grape — through 5 ingredients. Tap an ingredient for the detail:
NaringinCaffeine, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Major
Interaction Summary
Grapefruit juice can decrease the clearance of caffeine, potentially increasing the effects and adverse effects of caffeine.
Read the full Naringin + Acetaminophen, Caffeine, Dihydrocodeine interactionBioperineCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP3A4.
Read the full Bioperine + Acetaminophen, Caffeine, Dihydrocodeine interactionGreen Tea ExtractHepatotoxic Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Moderate
Interaction Summary
Theoretically, concomitant use might have additive adverse hepatotoxic effects.
Read the full Green Tea Extract + Acetaminophen, Caffeine, Dihydrocodeine interactionDi-caffeine MalateStimulant Drugs Moderate
Interaction Summary
Theoretically, concomitant use might increase stimulant adverse effects.
Read the full Di-caffeine Malate + Acetaminophen, Caffeine, Dihydrocodeine interactionTheobroma Cocoa (seed) ExtractStimulant Drugs Moderate
Interaction Summary
Theoretically, concomitant use might increase stimulant adverse effects.
Read the full Theobroma Cocoa (seed) Extract + Acetaminophen, Caffeine, Dihydrocodeine interactionAcetaminophen, Caffeine, IsomethepteneMigralam
How Acetaminophen, Caffeine, Isometheptene interacts with Total War Grape — through 5 ingredients. Tap an ingredient for the detail:
NaringinCaffeine, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Major
Interaction Summary
Grapefruit juice can decrease the clearance of caffeine, potentially increasing the effects and adverse effects of caffeine.
Read the full Naringin + Acetaminophen, Caffeine, Isometheptene interactionGreen Tea ExtractStimulant Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Moderate
Interaction Summary
Theoretically, concomitant use might increase stimulant adverse effects.
Read the full Green Tea Extract + Acetaminophen, Caffeine, Isometheptene interactionDi-caffeine MalateStimulant Drugs Moderate
Interaction Summary
Theoretically, concomitant use might increase stimulant adverse effects.
Read the full Di-caffeine Malate + Acetaminophen, Caffeine, Isometheptene interactionBioperineCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, black pepper might decrease levels and clinical effects of drugs metabolized by CYP1A2.
Read the full Bioperine + Acetaminophen, Caffeine, Isometheptene interactionTheobroma Cocoa (seed) ExtractStimulant Drugs Moderate
Interaction Summary
Theoretically, concomitant use might increase stimulant adverse effects.
Read the full Theobroma Cocoa (seed) Extract + Acetaminophen, Caffeine, Isometheptene interactionAcetaminophen, Caffeine, PyrilamineMidol Max Strength Menstrual
How Acetaminophen, Caffeine, Pyrilamine interacts with Total War Grape — through 6 ingredients. Tap an ingredient for the detail:
NaringinCytochrome P450 1a2 (cyp1a2) Substrates, Caffeine +1 Major
Interaction Summary
Theoretically, grapefruit juice might increase levels of drugs metabolized by CYP1A2.
Read the full Naringin + Acetaminophen, Caffeine, Pyrilamine interactionTheobroma Cocoa (seed) ExtractDiuretic Drugs, Stimulant Drugs Moderate
Interaction Summary
Theoretically, using cocoa with diuretic drugs might increase the risk of hypokalemia.
Read the full Theobroma Cocoa (seed) Extract + Acetaminophen, Caffeine, Pyrilamine interactionBioperineCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP3A4.
Read the full Bioperine + Acetaminophen, Caffeine, Pyrilamine interactionGreen Tea ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Diuretic Drugs +2 Moderate
Interaction Summary
Green tea is unlikely to produce clinically significant changes in the levels and clinical effects of CYP3A4 substrates.
Read the full Green Tea Extract + Acetaminophen, Caffeine, Pyrilamine interactionDi-caffeine MalateStimulant Drugs, Diuretic Drugs Moderate
Interaction Summary
Theoretically, concomitant use might increase stimulant adverse effects.
Read the full Di-caffeine Malate + Acetaminophen, Caffeine, Pyrilamine interactionJuniper ExtractDiuretic Drugs Minor
Interaction Summary
Theoretically, juniper berry might increase the risk of adverse effects from diuretic drugs.
Read the full Juniper Extract + Acetaminophen, Caffeine, Pyrilamine interactionAcetaminophen, Chlorpheniramine Maleate, Dextromethorphan HbrVicks Formula 44M Cough, Cold & Flu Relief
How Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interacts with Total War Grape — through 3 ingredients. Tap an ingredient for the detail:
NaringinCytochrome P450 3a4 (cyp3a4) Substrates, Dextromethorphan (robitussin Dm, Others) +1 Major
Interaction Summary
Grapefruit juice can increase levels of drugs metabolized by CYP3A4.
Read the full Naringin + Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interactionGreen Tea ExtractHepatotoxic Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, concomitant use might have additive adverse hepatotoxic effects.
Read the full Green Tea Extract + Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interactionBioperineCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 2d6 (cyp2d6) Substrates +1 Moderate
Interaction Summary
Theoretically, black pepper might decrease levels and clinical effects of drugs metabolized by CYP1A2.
Read the full Bioperine + Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interactionAcetaminophen, Chlorpheniramine, Codeine, PhenylephrineColrex
How Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interacts with Total War Grape — through 5 ingredients. Tap an ingredient for the detail:
NaringinCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Major
Interaction Summary
Theoretically, grapefruit juice might increase levels of drugs metabolized by CYP1A2.
Read the full Naringin + Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interactionBioperineCytochrome P450 2d6 (cyp2d6) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP2D6.
Read the full Bioperine + Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interactionTheobroma Cocoa (seed) ExtractStimulant Drugs Moderate
Interaction Summary
Theoretically, concomitant use might increase stimulant adverse effects.
Read the full Theobroma Cocoa (seed) Extract + Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interactionGreen Tea ExtractHepatotoxic Drugs, Stimulant Drugs +1 Moderate
Interaction Summary
Theoretically, concomitant use might have additive adverse hepatotoxic effects.
Read the full Green Tea Extract + Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interactionDi-caffeine MalateStimulant Drugs Moderate
Interaction Summary
Theoretically, concomitant use might increase stimulant adverse effects.
Read the full Di-caffeine Malate + Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interactionAcetaminophen, Chlorpheniramine, DextromethorphanCoricidin II Extra Strength Cold and Flu
How Acetaminophen, Chlorpheniramine, Dextromethorphan interacts with Total War Grape — through 3 ingredients. Tap an ingredient for the detail:
NaringinDextromethorphan (robitussin Dm, Others), Cytochrome P450 3a4 (cyp3a4) Substrates +1 Major
Interaction Summary
Grapefruit juice can increase blood levels of dextromethorphan, potentially increasing the effects and adverse effects of dextromethorphan.
Read the full Naringin + Acetaminophen, Chlorpheniramine, Dextromethorphan interactionGreen Tea ExtractHepatotoxic Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, concomitant use might have additive adverse hepatotoxic effects.
Read the full Green Tea Extract + Acetaminophen, Chlorpheniramine, Dextromethorphan interactionBioperineCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 2d6 (cyp2d6) Substrates +1 Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP3A4.
Read the full Bioperine + Acetaminophen, Chlorpheniramine, Dextromethorphan interactionAcetaminophen, Chlorpheniramine, Dextromethorphan HydrobromideCoricidin HBP Maximum Strength Flu
How Acetaminophen, Chlorpheniramine, Dextromethorphan Hydrobromide interacts with Total War Grape — through 3 ingredients. Tap an ingredient for the detail:
NaringinCytochrome P450 3a4 (cyp3a4) Substrates, Dextromethorphan (robitussin Dm, Others) +1 Major
Interaction Summary
Grapefruit juice can increase levels of drugs metabolized by CYP3A4.
Read the full Naringin + Acetaminophen, Chlorpheniramine, Dextromethorphan Hydrobromide interactionGreen Tea ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Hepatotoxic Drugs Moderate
Interaction Summary
Green tea is unlikely to produce clinically significant changes in the levels and clinical effects of CYP3A4 substrates.
Read the full Green Tea Extract + Acetaminophen, Chlorpheniramine, Dextromethorphan Hydrobromide interactionBioperineCytochrome P450 2d6 (cyp2d6) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP2D6.
Read the full Bioperine + Acetaminophen, Chlorpheniramine, Dextromethorphan Hydrobromide interactionAcetaminophen, Chlorpheniramine, Dextromethorphan, PhenylpropanolamineMulti Symptom Cold Relief
How Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylpropanolamine interacts with Total War Grape — through 5 ingredients. Tap an ingredient for the detail:
NaringinCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Major
Interaction Summary
Grapefruit juice can increase levels of drugs metabolized by CYP3A4.
Read the full Naringin + Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylpropanolamine interactionTheobroma Cocoa (seed) ExtractPhenylpropanolamine, Stimulant Drugs Moderate
Interaction Summary
Theoretically, phenylpropanolamine might increase the risk of hypertension, as well as the levels and adverse effects of caffeine.
Read the full Theobroma Cocoa (seed) Extract + Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylpropanolamine interactionBioperineCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP3A4.
Read the full Bioperine + Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylpropanolamine interactionDi-caffeine MalateStimulant Drugs, Phenylpropanolamine Moderate
Interaction Summary
Theoretically, concomitant use might increase stimulant adverse effects.
Read the full Di-caffeine Malate + Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylpropanolamine interactionGreen Tea ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Stimulant Drugs +2 Moderate
Interaction Summary
Green tea is unlikely to produce clinically significant changes in the levels and clinical effects of CYP3A4 substrates.
Read the full Green Tea Extract + Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylpropanolamine interactionAcetaminophen, Chlorpheniramine, Dextromethorphan, PseudoephedrineChildren's Tylenol Cold Plus Cough, Tylenol Cold Ex Strength
How Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine interacts with Total War Grape — through 5 ingredients. Tap an ingredient for the detail:
NaringinDextromethorphan (robitussin Dm, Others), Cytochrome P450 3a4 (cyp3a4) Substrates +1 Major
Interaction Summary
Grapefruit juice can increase blood levels of dextromethorphan, potentially increasing the effects and adverse effects of dextromethorphan.
Read the full Naringin + Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine interactionGreen Tea ExtractHepatotoxic Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Moderate
Interaction Summary
Theoretically, concomitant use might have additive adverse hepatotoxic effects.
Read the full Green Tea Extract + Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine interactionDi-caffeine MalateStimulant Drugs Moderate
Interaction Summary
Theoretically, concomitant use might increase stimulant adverse effects.
Read the full Di-caffeine Malate + Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine interactionTheobroma Cocoa (seed) ExtractStimulant Drugs Moderate
Interaction Summary
Theoretically, concomitant use might increase stimulant adverse effects.
Read the full Theobroma Cocoa (seed) Extract + Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine interactionBioperineCytochrome P450 2d6 (cyp2d6) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP2D6.
Read the full Bioperine + Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine interactionAcetaminophen, Chlorpheniramine, Guaifenesin, Phenylephrine, SalicylamideRhinogesic GG
How Acetaminophen, Chlorpheniramine, Guaifenesin, Phenylephrine, Salicylamide interacts with Total War Grape — through 5 ingredients. Tap an ingredient for the detail:
NaringinCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Major
Interaction Summary
Theoretically, grapefruit juice might increase levels of drugs metabolized by CYP1A2.
Read the full Naringin + Acetaminophen, Chlorpheniramine, Guaifenesin, Phenylephrine, Salicylamide interactionGreen Tea ExtractStimulant Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Moderate
Interaction Summary
Theoretically, concomitant use might increase stimulant adverse effects.
Read the full Green Tea Extract + Acetaminophen, Chlorpheniramine, Guaifenesin, Phenylephrine, Salicylamide interactionTheobroma Cocoa (seed) ExtractStimulant Drugs Moderate
Interaction Summary
Theoretically, concomitant use might increase stimulant adverse effects.
Read the full Theobroma Cocoa (seed) Extract + Acetaminophen, Chlorpheniramine, Guaifenesin, Phenylephrine, Salicylamide interactionDi-caffeine MalateStimulant Drugs Moderate
Interaction Summary
Theoretically, concomitant use might increase stimulant adverse effects.
Read the full Di-caffeine Malate + Acetaminophen, Chlorpheniramine, Guaifenesin, Phenylephrine, Salicylamide interactionBioperineCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP3A4.
Read the full Bioperine + Acetaminophen, Chlorpheniramine, Guaifenesin, Phenylephrine, Salicylamide interactionAcetaminophen, Chlorpheniramine, PhenylephrineAlka-Seltzer PLUS, Histex SR, Protid
How Acetaminophen, Chlorpheniramine, Phenylephrine interacts with Total War Grape — through 5 ingredients. Tap an ingredient for the detail:
NaringinCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Major
Interaction Summary
Grapefruit juice can increase levels of drugs metabolized by CYP3A4.
Read the full Naringin + Acetaminophen, Chlorpheniramine, Phenylephrine interactionBioperineCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, black pepper might decrease levels and clinical effects of drugs metabolized by CYP1A2.
Read the full Bioperine + Acetaminophen, Chlorpheniramine, Phenylephrine interactionGreen Tea ExtractHepatotoxic Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Moderate
Interaction Summary
Theoretically, concomitant use might have additive adverse hepatotoxic effects.
Read the full Green Tea Extract + Acetaminophen, Chlorpheniramine, Phenylephrine interactionTheobroma Cocoa (seed) ExtractStimulant Drugs Moderate
Interaction Summary
Theoretically, concomitant use might increase stimulant adverse effects.
Read the full Theobroma Cocoa (seed) Extract + Acetaminophen, Chlorpheniramine, Phenylephrine interactionDi-caffeine MalateStimulant Drugs Moderate
Interaction Summary
Theoretically, concomitant use might increase stimulant adverse effects.
Read the full Di-caffeine Malate + Acetaminophen, Chlorpheniramine, Phenylephrine interactionAcetaminophen, Chlorpheniramine, Phenylephrine, SalicylamideRhinogesic, Rhinogesic JR
How Acetaminophen, Chlorpheniramine, Phenylephrine, Salicylamide interacts with Total War Grape — through 5 ingredients. Tap an ingredient for the detail:
NaringinCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Major
Interaction Summary
Grapefruit juice can increase levels of drugs metabolized by CYP3A4.
Read the full Naringin + Acetaminophen, Chlorpheniramine, Phenylephrine, Salicylamide interactionDi-caffeine MalateStimulant Drugs Moderate
Interaction Summary
Theoretically, concomitant use might increase stimulant adverse effects.
Read the full Di-caffeine Malate + Acetaminophen, Chlorpheniramine, Phenylephrine, Salicylamide interactionGreen Tea ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Stimulant Drugs +1 Moderate
Interaction Summary
Green tea is unlikely to produce clinically significant changes in the levels and clinical effects of CYP3A4 substrates.
Read the full Green Tea Extract + Acetaminophen, Chlorpheniramine, Phenylephrine, Salicylamide interactionBioperineCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, black pepper might decrease levels and clinical effects of drugs metabolized by CYP1A2.
Read the full Bioperine + Acetaminophen, Chlorpheniramine, Phenylephrine, Salicylamide interactionTheobroma Cocoa (seed) ExtractStimulant Drugs Moderate
Interaction Summary
Theoretically, concomitant use might increase stimulant adverse effects.
Read the full Theobroma Cocoa (seed) Extract + Acetaminophen, Chlorpheniramine, Phenylephrine, Salicylamide interactionAcetaminophen, Chlorpheniramine, PhenylpropanolamineAlumadrine, Conex, Sinadrin Max Strength, Sinulin
How Acetaminophen, Chlorpheniramine, Phenylpropanolamine interacts with Total War Grape — through 5 ingredients. Tap an ingredient for the detail:
NaringinCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Major
Interaction Summary
Grapefruit juice can increase levels of drugs metabolized by CYP3A4.
Read the full Naringin + Acetaminophen, Chlorpheniramine, Phenylpropanolamine interactionTheobroma Cocoa (seed) ExtractPhenylpropanolamine, Stimulant Drugs Moderate
Interaction Summary
Theoretically, phenylpropanolamine might increase the risk of hypertension, as well as the levels and adverse effects of caffeine.
Read the full Theobroma Cocoa (seed) Extract + Acetaminophen, Chlorpheniramine, Phenylpropanolamine interactionBioperineCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP3A4.
Read the full Bioperine + Acetaminophen, Chlorpheniramine, Phenylpropanolamine interactionDi-caffeine MalateStimulant Drugs, Phenylpropanolamine Moderate
Interaction Summary
Theoretically, concomitant use might increase stimulant adverse effects.
Read the full Di-caffeine Malate + Acetaminophen, Chlorpheniramine, Phenylpropanolamine interactionGreen Tea ExtractPhenylpropanolamine, Stimulant Drugs +2 Moderate
Interaction Summary
Theoretically, phenylpropanolamine might increase the risk of hypertension, as well as the levels and adverse effects of caffeine.
Read the full Green Tea Extract + Acetaminophen, Chlorpheniramine, Phenylpropanolamine interactionAcetaminophen, Chlorpheniramine, Phenylpropanolamine, OpiumHista-Derfule
How Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium interacts with Total War Grape — through 5 ingredients. Tap an ingredient for the detail:
NaringinCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Major
Interaction Summary
Grapefruit juice can increase levels of drugs metabolized by CYP3A4.
Read the full Naringin + Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium interactionGreen Tea ExtractHepatotoxic Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates +2 Moderate
Interaction Summary
Theoretically, concomitant use might have additive adverse hepatotoxic effects.
Read the full Green Tea Extract + Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium interactionDi-caffeine MalateStimulant Drugs, Phenylpropanolamine Moderate
Interaction Summary
Theoretically, concomitant use might increase stimulant adverse effects.
Read the full Di-caffeine Malate + Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium interactionTheobroma Cocoa (seed) ExtractStimulant Drugs, Phenylpropanolamine Moderate
Interaction Summary
Theoretically, concomitant use might increase stimulant adverse effects.
Read the full Theobroma Cocoa (seed) Extract + Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium interactionBioperineCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, black pepper might decrease levels and clinical effects of drugs metabolized by CYP1A2.
Read the full Bioperine + Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium interactionAcetaminophen, Chlorpheniramine, Phenylpropanolamine, PhenyltoloxamineNorel Plus
How Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Phenyltoloxamine interacts with Total War Grape — through 5 ingredients. Tap an ingredient for the detail:
NaringinCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Major
Interaction Summary
Theoretically, grapefruit juice might increase levels of drugs metabolized by CYP1A2.
Read the full Naringin + Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Phenyltoloxamine interactionGreen Tea ExtractStimulant Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates +2 Moderate
Interaction Summary
Theoretically, concomitant use might increase stimulant adverse effects.
Read the full Green Tea Extract + Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Phenyltoloxamine interactionTheobroma Cocoa (seed) ExtractStimulant Drugs, Phenylpropanolamine Moderate
Interaction Summary
Theoretically, concomitant use might increase stimulant adverse effects.
Read the full Theobroma Cocoa (seed) Extract + Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Phenyltoloxamine interactionDi-caffeine MalateStimulant Drugs, Phenylpropanolamine Moderate
Interaction Summary
Theoretically, concomitant use might increase stimulant adverse effects.
Read the full Di-caffeine Malate + Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Phenyltoloxamine interactionBioperineCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP3A4.
Read the full Bioperine + Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Phenyltoloxamine interactionAcetaminophen, Chlorpheniramine, PseudoephedrineAlka-Seltzer PLUS Liquid Gels, Children's Tylenol Cold, Codimal, Comtrex, Extra Strength Tylenol Allergy Sinus, Lorsin +3 more
How Acetaminophen, Chlorpheniramine, Pseudoephedrine interacts with Total War Grape — through 5 ingredients. Tap an ingredient for the detail:
NaringinCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Major
Interaction Summary
Grapefruit juice can increase levels of drugs metabolized by CYP3A4.
Read the full Naringin + Acetaminophen, Chlorpheniramine, Pseudoephedrine interactionBioperineCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, black pepper might decrease levels and clinical effects of drugs metabolized by CYP1A2.
Read the full Bioperine + Acetaminophen, Chlorpheniramine, Pseudoephedrine interactionGreen Tea ExtractHepatotoxic Drugs, Stimulant Drugs +1 Moderate
Interaction Summary
Theoretically, concomitant use might have additive adverse hepatotoxic effects.
Read the full Green Tea Extract + Acetaminophen, Chlorpheniramine, Pseudoephedrine interactionTheobroma Cocoa (seed) ExtractStimulant Drugs Moderate
Interaction Summary
Theoretically, concomitant use might increase stimulant adverse effects.
Read the full Theobroma Cocoa (seed) Extract + Acetaminophen, Chlorpheniramine, Pseudoephedrine interactionDi-caffeine MalateStimulant Drugs Moderate
Interaction Summary
Theoretically, concomitant use might increase stimulant adverse effects.
Read the full Di-caffeine Malate + Acetaminophen, Chlorpheniramine, Pseudoephedrine interactionAcetaminophen, DextromethorphanTylenol Cough Ex Strength
How Acetaminophen, Dextromethorphan interacts with Total War Grape — through 3 ingredients. Tap an ingredient for the detail:
NaringinDextromethorphan (robitussin Dm, Others), Cytochrome P450 3a4 (cyp3a4) Substrates +1 Major
Interaction Summary
Grapefruit juice can increase blood levels of dextromethorphan, potentially increasing the effects and adverse effects of dextromethorphan.
Read the full Naringin + Acetaminophen, Dextromethorphan interactionBioperineCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 2d6 (cyp2d6) Substrates +1 Moderate
Interaction Summary
Theoretically, black pepper might decrease levels and clinical effects of drugs metabolized by CYP1A2.
Read the full Bioperine + Acetaminophen, Dextromethorphan interactionGreen Tea ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Hepatotoxic Drugs Moderate
Interaction Summary
Green tea is unlikely to produce clinically significant changes in the levels and clinical effects of CYP3A4 substrates.
Read the full Green Tea Extract + Acetaminophen, Dextromethorphan interactionAcetaminophen, Dextromethorphan, Doxylamine, PseudoephedrineVicks NyQuil
How Acetaminophen, Dextromethorphan, Doxylamine, Pseudoephedrine interacts with Total War Grape — through 5 ingredients. Tap an ingredient for the detail:
NaringinDextromethorphan (robitussin Dm, Others), Cytochrome P450 3a4 (cyp3a4) Substrates +1 Major
Interaction Summary
Grapefruit juice can increase blood levels of dextromethorphan, potentially increasing the effects and adverse effects of dextromethorphan.
Read the full Naringin + Acetaminophen, Dextromethorphan, Doxylamine, Pseudoephedrine interactionGreen Tea ExtractHepatotoxic Drugs, Stimulant Drugs +1 Moderate
Interaction Summary
Theoretically, concomitant use might have additive adverse hepatotoxic effects.
Read the full Green Tea Extract + Acetaminophen, Dextromethorphan, Doxylamine, Pseudoephedrine interactionTheobroma Cocoa (seed) ExtractStimulant Drugs Moderate
Interaction Summary
Theoretically, concomitant use might increase stimulant adverse effects.
Read the full Theobroma Cocoa (seed) Extract + Acetaminophen, Dextromethorphan, Doxylamine, Pseudoephedrine interactionBioperineCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 2d6 (cyp2d6) Substrates +1 Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP3A4.
Read the full Bioperine + Acetaminophen, Dextromethorphan, Doxylamine, Pseudoephedrine interactionDi-caffeine MalateStimulant Drugs Moderate
Interaction Summary
Theoretically, concomitant use might increase stimulant adverse effects.
Read the full Di-caffeine Malate + Acetaminophen, Dextromethorphan, Doxylamine, Pseudoephedrine interactionAcetaminophen, Dextromethorphan, Guaifenesin, PhenylephrineConar-A
How Acetaminophen, Dextromethorphan, Guaifenesin, Phenylephrine interacts with Total War Grape — through 5 ingredients. Tap an ingredient for the detail:
NaringinCytochrome P450 3a4 (cyp3a4) Substrates, Dextromethorphan (robitussin Dm, Others) +1 Major
Interaction Summary
Grapefruit juice can increase levels of drugs metabolized by CYP3A4.
Read the full Naringin + Acetaminophen, Dextromethorphan, Guaifenesin, Phenylephrine interactionDi-caffeine MalateStimulant Drugs Moderate
Interaction Summary
Theoretically, concomitant use might increase stimulant adverse effects.
Read the full Di-caffeine Malate + Acetaminophen, Dextromethorphan, Guaifenesin, Phenylephrine interactionBioperineCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Moderate
Interaction Summary
Theoretically, black pepper might decrease levels and clinical effects of drugs metabolized by CYP1A2.
Read the full Bioperine + Acetaminophen, Dextromethorphan, Guaifenesin, Phenylephrine interactionGreen Tea ExtractHepatotoxic Drugs, Stimulant Drugs +1 Moderate
Interaction Summary
Theoretically, concomitant use might have additive adverse hepatotoxic effects.
Read the full Green Tea Extract + Acetaminophen, Dextromethorphan, Guaifenesin, Phenylephrine interactionTheobroma Cocoa (seed) ExtractStimulant Drugs Moderate
Interaction Summary
Theoretically, concomitant use might increase stimulant adverse effects.
Read the full Theobroma Cocoa (seed) Extract + Acetaminophen, Dextromethorphan, Guaifenesin, Phenylephrine interactionEach ingredient & the kinds of drugs it affects
For each ingredient in Total War Grape 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.
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.
BioPerine
Anticoagulant/Antiplatelet Drugs
Theoretically, black pepper might increase the risk of bleeding when taken with antiplatelet or anticoagulant drugs.
In vitro research shows that piperine, a constituent of black pepper, seems to inhibit platelet aggregation. This has not been reported in humans.
Antidiabetes Drugs
Theoretically, black pepper might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Animal research shows that piperine, a constituent of black pepper, can reduce blood glucose levels. Monitor blood glucose levels closely. Dose adjustments might be necessary.
Atorvastatin (Lipitor)
Theoretically, black pepper might increase blood levels of atorvastatin.
Animal research shows that taking piperine, a constituent of black pepper, 35 mg/kg can increase the maximum serum concentration of atorvastatin three-fold. This has not been reported in humans.
Cyclosporine (Neoral, Sandimmune)
Theoretically, black pepper might increase the effects and side effects of cyclosporine.
In vitro research shows that piperine, a constituent of black pepper, increases the bioavailability of cyclosporine. This has not been reported in humans.
Cytochrome P450 2D6 (Cyp2D6) Substrates
Theoretically, black pepper might increase levels of drugs metabolized by CYP2D6.
In vitro research suggests that some constituents of black pepper inhibit CYP2D6. This has not been reported in humans.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, black pepper might increase levels of drugs metabolized by CYP3A4.
In vitro research and pharmacokinetic simulation data suggest that piperine, a constituent of black pepper, as well as the pepper fruit seem to inhibit CYP3A4. This has not been reported in humans.
Lithium
Theoretically, black pepper might increase blood levels of lithium due to its diuretic effects. The dose of lithium might need to be reduced.
Black pepper is thought to have diuretic properties.
Nevirapine (Viramune)
Black pepper might increase blood levels of nevirapine.
Clinical research shows that piperine, a constituent of black pepper, increases the plasma concentration of nevirapine. However, no adverse effects were observed in this study.
P-Glycoprotein Substrates
Theoretically, black pepper might increase levels of P-glycoprotein substrates.
In vitro research shows that piperine, a constituent of black pepper, seems to inhibit P-glycoprotein.
Pentobarbital (Nembutal)
Theoretically, black pepper might increase the sedative effects of pentobarbital.
Animal research shows that piperine, a constituent of black pepper, increases pentobarbital-induced sleeping time.
Phenytoin (Dilantin)
Black pepper might increase blood levels of phenytoin.
Clinical research shows that piperine, a constituent of black pepper, seems to increase absorption, slow elimination, and increase levels of phenytoin. Taking a single dose of black pepper 1 gram along with phenytoin seems to double the serum concentration of phenytoin. Consuming a soup with black pepper providing piperine 44 mg/200 mL of soup along with phenytoin also seems to increase phenytoin levels when compared with consuming the same soup without black pepper.
Propranolol (Inderal)
Black pepper might increase blood levels of propranolol.
Clinical research shows that piperine, a constituent of black pepper, seems to increase absorption and slow elimination of propranolol.
Rifampin (Rifadin)
Black pepper might increase blood levels of rifampin.
Clinical research shows that piperine, a constituent of black pepper, seems to increase absorption and serum levels of rifampin.
Theophylline
Black pepper might increase blood levels of theophylline.
Clinical research shows that piperine, a constituent of black pepper, seems to increase absorption and slow elimination of theophylline.
Amoxicillin (Amoxil, Trimox)
Theoretically, black pepper might increase the effects and side effects of amoxicillin.
Animal research shows that taking piperine, a constituent of black pepper, with amoxicillin increases plasma levels of amoxicillin. This has not been reported in humans.
Carbamazepine (Tegretol)
Theoretically, black pepper might increase blood levels of carbamazepine, potentially increasing the effects and side effects of carbamazepine.
One clinical study in patients taking carbamazepine 300 mg or 500 mg twice daily shows that taking a single 20 mg dose of purified piperine, a constituent of black pepper, increases carbamazepine levels. Piperine may increase carbamazepine absorption by increasing blood flow to the GI tract, increasing the surface area of the small intestine, or inhibiting cytochrome P450 3A4 (CYP3A4) in the gut wall. Absorption was significantly increased by 7-10 mcg/mL/hour. The time to eliminate carbamazepine was also increased by 4-8 hours. Although carbamazepine levels were increased, this did not appear to increase side effects. In vitro research also shows that piperine can increase carbamazepine levels by 11% in a time-dependent manner.
Cytochrome P450 1A2 (Cyp1A2) Substrates
Theoretically, black pepper might decrease levels and clinical effects of drugs metabolized by CYP1A2.
In vitro research suggests that black pepper induces CYP1A2. This has not been reported in humans.
Naringin
Amiodarone (Cordarone)
Grapefruit juice can increase blood levels of amiodarone, potentially increasing the effects and adverse effects of amiodarone.
Clinical research shows that grapefruit juice inhibits metabolism and increases absorption of amiodarone. Grapefruit juice increases amiodarone plasma levels by 50% and peak concentration by 84%.
Artemether (Artenam, Paluther)
Grapefruit juice can increase blood levels of oral artemether, potentially increasing the effects and adverse effects of artemether.
Clinical research shows that grapefruit juice increases the levels of oral artemether by 90% to 250% in healthy males.
Benzodiazepines
Grapefruit juice might increase blood levels of some oral benzodiazepines, potentially increasing the effects and adverse effects of these drugs.
Clinical research shows that grapefruit juice can increase plasma triazolam concentrations. Repeated consumption of grapefruit juice greatly increases triazolam concentrations and prolongs the half-life, probably due to inhibition of cytochrome P450 3A4 (CYP3A4). Some studies show that grapefruit juice, particularly when taken in large quantities, reduces the clearance and increases the maximum blood levels, area under the plasma concentration curve (AUC), and duration of effect of midazolam. However, there is no effect on intravenous midazolam. Grapefruit juice has also been shown to increase the maximum blood levels and duration of effect of diazepam, but the clinical significance of this is not known. This interaction does not appear to occur with alprazolam.
Buspirone (Buspar)
Grapefruit juice can increase blood levels of buspirone, potentially increasing the effects and adverse effects of buspirone.
Clinical research shows that grapefruit juice increases absorption and plasma concentrations of buspirone.
Calcium Channel Blockers
Grapefruit juice can increase blood levels of oral calcium channel blockers, potentially increasing the effects and adverse effects of these drugs.
Clinical research shows that grapefruit juice increases absorption and plasma concentrations of amlodipine, nifedipine, nisoldipine, verapamil, felodipine, nimodipine, nicardipine, diltiazem, pranidipine, nitrendipine, and manidipine,
This interaction is likely the result of the inhibition of intestinal metabolism of these drugs by CYP3A4, although some research suggests grapefruit may alter plasma drug levels by reducing the rate of gastric emptying. Consuming grapefruit juice 1 liter daily increases steady state concentrations of verapamil by as much as 50%. However, some references dispute the clinical relevance of the interactions with amlodipine, diltiazem, and verapamil. Other research in healthy individuals suggests plasma levels of felodipine and nifedipine are not affected when given intravenously. There is considerable interindividual variability in the effect of grapefruit juice on drug metabolism, which might account for inconsistent study results. In healthy older adults, the hemodynamic response to felodipine plus grapefruit juice might be influenced by altered autonomic regulation. In older healthy adults, a single dose of grapefruit juice and felodipine enhanced the blood pressure-lowering effects of felodipine. However, after a week of grapefruit juice and felodipine (steady state), the hypotensive activity was reduced, possibly due to compensatory tachycardia. Research indicates it is necessary to withhold grapefruit juice for as long as 3 days to avoid interactions with felodipine and nisoldipine.
Carbamazepine (Tegretol)
Grapefruit juice can increase blood levels of carbamazepine, potentially increasing the effects and adverse effects of carbamazepine.
Clinical research shows that grapefruit juice increases absorption and plasma concentrations of carbamazepine.
Carvedilol (Coreg)
Grapefruit juice can increase blood levels of carvedilol, potentially increasing the effects and adverse effects of carvedilol.
Clinical research shows that grapefruit juice increases the bioavailability of a single dose of carvedilol by 16%.
Celiprolol (Celicard)
Grapefruit juice can decrease blood levels of celiprolol, potentially decreasing the clinical effects of celiprolol.
In human research, taking grapefruit juice within two hours of celiprolol appears to decrease absorption and blood levels of celiprolol by approximately 85%. This interaction is due to grapefruit-induced inhibition of organic anion transporting polypeptide (OATP). Grapefruit juice is thought to affect OATP for only a short time. Therefore, separating drug administration and consumption of grapefruit by at least 4 hours is likely to prevent this interaction.
Cisapride (Propulsid)
Grapefruit juice can increase blood levels of cisapride, potentially increasing the effects and adverse effects of cisapride.
Clinical research shows that grapefruit juice increases the absorption and plasma concentrations of cisapride. According to the cisapride prescribing information, grapefruit juice is contraindicated in patients taking cisapride.
Clomipramine (Anafranil)
Theoretically, grapefruit juice might increase blood levels of clomipramine, potentially increasing the effects and adverse effects of clomipramine.
Case reports have shown that clomipramine trough levels increase significantly after the addition of grapefruit juice to the therapeutic regimen.
Clopidogrel (Plavix)
Grapefruit juice can decrease blood levels of the active metabolite of clopidogrel, thereby decreasing the antiplatelet effect of clopidogrel.
Clopidogrel is an antiplatelet prodrug that is metabolized primarily by cytochrome P450 2C19 (CYP2C19) to form the active metabolite. A small clinical study shows that taking grapefruit juice with clopidogrel decreases plasma levels of the active metabolite by more than 80% and impairs the antiplatelet effect of clopidogrel. This effect is possibly due to grapefruit-induced inhibition of CYP2C19.
Cyclosporine (Neoral, Sandimmune)
Grapefruit juice can increase blood levels of oral cyclosporine, potentially increasing the effects and adverse effects of cyclosporine.
Clinical research shows that grapefruit juice increases the absorption and plasma concentrations of cyclosporine. The mechanism of action is unclear. However, there is no effect on intravenous cyclosporine.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Grapefruit juice can increase levels of drugs metabolized by CYP3A4.
Clinical research shows that grapefruit juice can inhibit CYP3A4 metabolism of drugs, causing increased drug levels and potentially increasing the risk of adverse effects. When taken orally, effects of grapefruit juice on CYP3A4 levels appear to last at least 48 hours. Grapefruit's ability to inhibit CYP3A4 has even been harnessed to intentionally increase levels of venetoclax, which is metabolized by CYP3A4, in an elderly patient with acute myeloid leukemia who could not afford full dose venetoclax. The lower dose of venetoclax in combination with grapefruit juice resulted in serum levels of venetoclax in the therapeutic reference range of full dose venetoclax and positive treatment outcomes for the patient.
Professional consensus recommends the consideration of patient age, existing medical conditions, additional medications, and the potential for additive adverse effects when evaluating the risks of concomitant use of grapefruit juice with any medication metabolized by CYP3A4. While all patients are at risk for interactions with grapefruit juice consumption, patients older than 70 years of age and those taking multiple medications are at the greatest risk for a serious or fatal interaction with grapefruit juice.
Dextromethorphan (Robitussin Dm, Others)
Grapefruit juice can increase blood levels of dextromethorphan, potentially increasing the effects and adverse effects of dextromethorphan.
Clinical research shows that grapefruit juice can inhibit cytochrome P450 3A4 (CYP3A4) metabolism, causing increased dextromethorphan levels.
Estrogens
Grapefruit juice can increase blood levels of estrogens, potentially increasing the effects and adverse effects of estrogens.
Clinical research shows that grapefruit increases the levels of endogenous and exogenous estrogens by inhibiting cytochrome P450 3A4 (CYP3A4) enzymes. Grapefruit juice increases exogenously administered 17-beta-estradiol by about 20% in females without ovaries and ethinyl-estradiol in healthy females.
Etoposide (Vepesid)
Grapefruit juice can decrease blood levels of etoposide, potentially decreasing the clinical effects of etoposide.
Clinical research shows that grapefruit juice decreases the absorption and plasma concentrations of etoposide. There is some evidence that grapefruit juice co-administered with oral etoposide can reduce levels of etoposide by about 26%. Grapefruit juice seems to inhibit organic anion transporting polypeptide (OATP), which is a drug transporter in the gut, liver, and kidney. Grapefruit juice is thought to affect OATP for only a short time. Therefore, separating drug administration and consumption of grapefruit by at least 4 hours is likely to prevent this interaction.
Halofantrine
Grapefruit juice can increase blood levels of halofantrine, potentially increasing the effects and adverse effects of halofantrine.
Clinical research shows that grapefruit juice inhibits cytochrome P450 3A4 (CYP3A4) metabolism, which increases halofantrine levels and peak concentration, as well as a marker of ventricular tachyarrhythmia potential.
Hmg-Coa Reductase Inhibitors ("Statins")
Grapefruit juice can increase blood levels of statins that are metabolized by cytochrome P450 3A4 (CYP3A4), potentially increasing the effects and adverse effects of these statins. Additionally, grapefruit juice might interfere with the bioavailability of statins that are substrates of organic anion transporting polypeptides (OATP).
Clinical research shows that grapefruit juice inhibits metabolism and increases absorption and plasma concentrations of statins that are metabolized by CYP3A4. These include lovastatin, simvastatin, and atorvastatin. Keep in mind that there is considerable variability in the effect of grapefruit juice on drug metabolism, so individual patient response is difficult to predict.
Some statins, including pravastatin, fluvastatin, pitavastatin, and rosuvastatin, are not metabolized by CYP3A4. However, grapefruit juice might still affect the bioavailability of these statins. These statins are substrates of OATP. Grapefruit juice can inhibit OATP. Therefore, grapefruit juice may reduce the bioavailability or increase drug levels of these statins depending on the type of OATP. However, grapefruit juice affects OATP for only a short time. Therefore, separating drug administration by at least 4 hours is likely to avoid this interaction.
Methadone (Dolophine)
Grapefruit juice can increase blood levels of methadone, potentially increasing the effects and adverse effects of methadone.
Clinical research shows that grapefruit juice inhibits the metabolism of methadone, increasing methadone levels and peak concentrations. In one case, a 51-year-old male taking methadone 90 mg daily and no other medications was found unresponsive. The patient reported drinking grapefruit juice 500 mL daily for 3 days prior to the event. Methadone is a substrate of cytochrome P450 3A4 (CYP3A4), and grapefruit juice-induced inhibition of CYP3A4 is the likely cause of this interaction.
Methylprednisolone
Grapefruit juice can increase blood levels of methylprednisolone, potentially increasing the effects and adverse effects of methylprednisolone.
Clinical research shows that grapefruit juice can increase the plasma concentration of orally administered methylprednisolone. Grapefruit juice 200 mL three times daily given with methylprednisolone 16 mg increased methylprednisolone half-life by 35%, peak plasma concentration by 27%, and total area under the curve by 75%.
Organic Anion-Transporting Polypeptide Substrates (Oatp)
Grapefruit juice can decrease levels of drugs that are substrates of OATP.
In vitro and clinical research show that consuming grapefruit juice inhibits OATP, which reduces the bioavailability of oral drugs that are substrates of OATP. Various clinical studies have shown reduced absorption of OATP substrates when taken with grapefruit, including fexofenadine, acebutolol, aliskiren, celiprolol, levothyroxine, nadolol, and pitavastatin. Grapefruit juice is thought to affect OATP for only a short time. Therefore, separating drug administration and consumption of grapefruit by at least 4 hours is likely to prevent this interaction.
Praziquantel (Biltricide)
Grapefruit juice can increase blood levels of praziquantel, potentially increasing the effects and adverse effects of praziquantel.
Clinical research shows that grapefruit juice can inhibit cytochrome P450 3A4 (CYP3A4) metabolism of praziquantel. Plasma concentrations of praziquantel can increase by as much as 160% when administered with 250 mL of commercially available grapefruit juice.
Qt Interval-Prolonging Drugs
Grapefruit or grapefruit juice, especially if consumed in large amounts, can cause additive QT interval prolongation when taken with QT interval-prolonging drugs, potentially increasing the risk of ventricular arrhythmias.
Clinical research in healthy volunteers shows that drinking 6 liters of grapefruit juice over 6 hours prolonged the QTc by a peak amount of 14 milliseconds (ms). This prolongation was similar to the QT prolongation caused by the drug moxifloxacin. In individuals with long QT syndrome, a smaller dose of grapefruit juice, 1.5 liters, resulted in a greater peak QTc prolongation of about 30 ms. The effect of smaller quantities of grapefruit juice on the QT interval is unclear.
Quetiapine (Seroquel)
Grapefruit juice may increase blood levels of quetiapine, increasing the effects and adverse effects of quetiapine.
Quetiapine is metabolized by cytochrome P450 3A4 (CYP3A4). Grapefruit can inhibit CYP3A4. In one case report, a healthy 28-year-old female with bipolar disorder stabilized on quetiapine 800 mg daily presented with quetiapine toxicity considered to be related to consuming a gallon of grapefruit juice over the past 24 hours.
Quinidine
Grapefruit juice can alter blood levels of quinidine, potentially increasing or decreasing the clinical effects of quinidine.
Clinical research shows that grapefruit juice decreases quinidine absorption, clearance, and metabolism, and prolongs the half-life by about 20%.
Theobroma cocoa (seed) extract
Ace Inhibitors (Aceis)
Theoretically, taking cocoa with ACEIs might increase the risk of adverse effects.
Human research shows that dark chocolate can inhibit ACE. Additionally, prolonged angioedema in an elderly patient on an ACE inhibitor was precipitated with intake of diabetic chocolate.
Adenosine (Adenocard)
Theoretically, cocoa might decrease the vasodilatory effects of adenosine and interfere with its use prior to stress testing.
Cocoa 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 than adenosine-induced stress testing.
Alcohol (Ethanol)
Theoretically, concomitant use might increase levels and adverse effects of caffeine.
Cocoa contains caffeine. Alcohol reduces caffeine metabolism. Concomitant use of alcohol can increase caffeine serum concentrations and the risk of caffeine adverse effects.
Anticoagulant/Antiplatelet Drugs
Theoretically, cocoa may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Clinical research shows that intake of cocoa can inhibit platelet adhesion, aggregation, and activity and increase aspirin-induced bleeding time. For patients on dual antiplatelet therapy, cocoa may enhance the inhibitory effect of clopidogrel, but not aspirin, on platelet aggregation.
Antihypertensive Drugs
Theoretically, taking cocoa with antihypertensive drugs might increase the risk of hypotension.
Clinical research shows that cocoa can modestly decrease blood pressure in hypertensive and normotensive patients.
Beta-Adrenergic Agonists
Theoretically, large amounts of cocoa might increase the cardiac inotropic effects of beta-agonists.
Cocoa contains caffeine. Theoretically, large amounts of caffeine might increase cardiac inotropic effects of beta-agonists. A case of atrial fibrillation associated with consumption of large quantities of chocolate in a patient with chronic albuterol inhalation abuse has also been reported.
Cytochrome P450 1A2 (Cyp1A2) Inhibitors
Theoretically, concomitant use might increase the levels and adverse effects of caffeine.
Cocoa contains caffeine. Caffeine is metabolized by cytochrome P450 1A2 (CYP1A2),. Theoretically, drugs that inhibit CYP1A2 may decrease the clearance rate of caffeine from cocoa and increase caffeine levels.
Dipyridamole (Persantine)
Theoretically, cocoa might decrease the vasodilatory effects of dipyridamole and interfere with its use prior to stress testing.
Cocoa contains caffeine. Caffeine may 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.
Cocoa contains caffeine. In human research, disulfiram decreases the rate of caffeine clearance.
Diuretic Drugs
Theoretically, using cocoa with diuretic drugs might increase the risk of hypokalemia.
Cocoa 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.
Ephedrine
Theoretically, concomitant use might increase the risk for stimulant adverse effects.
Cocoa 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 caffeine.
Cocoa contains caffeine. Estrogen inhibits caffeine metabolism.
Flutamide (Eulexin)
Theoretically, cocoa might increase the levels and adverse effects of flutamide.
Cocoa contains caffeine. In vitro evidence suggests that caffeine can inhibit the metabolism of flutamide.
Fluvoxamine (Luvox)
Theoretically, fluvoxamine might increase the levels and adverse effects of caffeine.
Cocoa contains caffeine. Fluvoxamine reduces caffeine metabolism.
Lithium
Theoretically, abrupt cocoa withdrawal might increase the levels and adverse effects of lithium.
Cocoa contains caffeine. 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.
Cocoa contains caffeine. Large amounts of caffeine with MAOIs might precipitate a hypertensive crisis.
Nicotine
Theoretically, concomitant use might increase the risk of hypertension.
Cocoa 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, cocoa might decrease the effects of pentobarbital.
Cocoa contains caffeine. Caffeine might negate the hypnotic effects of pentobarbital.
Phenobarbital (Luminal)
Theoretically, cocoa might reduce the effects of phenobarbital and increase the risk for convulsions.
Cocoa contains caffeine. Animal research suggests 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.
Cocoa 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, cocoa might reduce the effects of phenytoin and increase the risk for convulsions.
Cocoa 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.
Quinolone Antibiotics
Theoretically, quinolone antibiotics might increase the levels and adverse effects of caffeine.
Cocoa contains caffeine. Quinolones (also referred to as fluoroquinolones) decrease caffeine clearance.
Riluzole (Rilutek)
Theoretically, concomitant use might increase the levels and adverse effects of both caffeine and riluzole.
Cocoa contains caffeine. Caffeine and riluzole are both metabolized by cytochrome P450 1A2, and concomitant use might reduce metabolism of one or both agents.
Stimulant Drugs
Theoretically, concomitant use might increase stimulant adverse effects.
Cocoa contains caffeine. Concomitant use might increase the risk of stimulant adverse effects.
Theophylline
Theoretically, cocoa might increase the levels and adverse effects of theophylline.
Cocoa contains caffeine. Large amounts of caffeine might inhibit theophylline metabolism. Caffeine decreases theophylline clearance 23% to 29%.
Caffeine Anhydrous
Ephedrine
Theoretically, concomitant use might increase the risk for stimulant adverse effects.
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, caffeine might decrease the vasodilatory effects of adenosine and interfere with its use prior to stress testing.
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. 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, caffeine may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
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.
Beta-Adrenergic Agonists
Theoretically, large amounts of caffeine might increase the cardiac inotropic effects of beta-agonists.
Carbamazepine (Tegretol)
Theoretically, caffeine 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 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.
Cimetidine (Tagamet)
Theoretically, cimetidine might increase the levels and adverse effects of caffeine.
Cimetidine decreases the rate of caffeine clearance by 31% to 42%.
Clozapine (Clozaril)
Caffeine might increase the levels and adverse effects of clozapine and acutely exacerbate psychotic symptoms.
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. In one case report, severe, life-threatening clozapine toxicity and multiorgan system failure occurred in a patient with schizophrenia stabilized on clozapine who consumed caffeine 600 mg daily.
Dipyridamole (Persantine)
Theoretically, caffeine might decrease the vasodilatory effects of dipyridamole and interfere with its use prior to stress testing.
Caffeine inhibits 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 use might increase the levels and adverse effects of caffeine.
Disulfiram decreases the rate of caffeine clearance.
Diuretic Drugs
Theoretically, using caffeine with diuretic drugs might increase the risk of hypokalemia.
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 caffeine.
Estrogen inhibits caffeine metabolism.
Ethosuximide (Zarontin)
Theoretically, caffeine might reduce the effects of ethosuximide and increase the risk for convulsions.
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, caffeine might reduce the effects of felbamate and increase the risk for convulsions.
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, caffeine might increase the levels and adverse effects of flutamide.
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 caffeine.
Fluvoxamine reduces caffeine metabolism.
Lithium
Abrupt caffeine withdrawal might increase the levels and adverse effects of lithium.
Caffeine has diuretic activity. When abruptly discontinued, caffeine may alter the clearance of lithium. There are two case reports of lithium tremor that worsened upon abrupt coffee withdrawal and 6 case reports of elevated serum lithium levels after reducing or eliminating caffeine intake. In one case, a male with schizoaffective disorder stabilized on lithium had an elevated lithium level after reducing his caffeine intake by 87%. At a later date, he increased his caffeine intake by 6-fold, resulting in a subtherapeutic lithium level and a recurrence of psychiatric symptoms.
Monoamine Oxidase Inhibitors (Maois)
Theoretically, concomitant use might increase the risk of a hypertensive crisis.
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.
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, caffeine might decrease the effects of pentobarbital.
Caffeine might negate the hypnotic effects of pentobarbital.
Phenobarbital (Luminal)
Theoretically, caffeine might reduce the effects of phenobarbital and increase the risk for convulsions.
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 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, caffeine might reduce the effects of phenytoin and increase the risk for convulsions.
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, caffeine might increase the levels and clinical effects of pioglitazone.
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 caffeine.
Quinolones (also called fluoroquinolones) can decrease caffeine clearance by inhibiting cytochrome P450 1A2 (CYP1A2) enzyme.
Riluzole (Rilutek)
Theoretically, concomitant use might increase the levels and adverse effects of both caffeine and riluzole.
Caffeine and riluzole are both metabolized by cytochrome P450 1A2 (CYP1A2), and concomitant use might reduce the metabolism of one or both agents.
Agmatine Sulfate
Antidiabetes Drugs
Theoretically, agmatine might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Animal and in vitro research suggest that agmatine has mild hypoglycemic effects.
Antihypertensive Drugs
Theoretically, agmatine might increase the risk of hypotension when taken with antihypertensive drugs.
Animal research suggests that agmatine can modestly decrease heart rate and blood pressure.
Taurine
Antihypertensive Drugs
Theoretically, taurine might increase the risk of hypotension when taken with antihypertensive drugs.
Some clinical evidence suggests that taurine can reduce both systolic and diastolic blood pressure.
Lithium
Theoretically, taurine might reduce excretion and increase plasma levels of lithium.
Taurine is thought to have diuretic properties, which might reduce the excretion of lithium.
Juniper extract
Antidiabetes Drugs
Theoretically, taking juniper berry with antidiabetes medications might cause additive hypoglycemia.
Animal research shows that juniper berry can lower blood glucose.
Diuretic Drugs
Theoretically, juniper berry might increase the risk of adverse effects from diuretic drugs.
Juniper berry is thought to have mild diuretic effects.
Lithium
Theoretically, juniper berry might reduce lithium excretion and increase serum levels of lithium.
Juniper berry is thought to have mild diuretic effects.
Brand information
Manufacturer and brand details for Total War Grape, from the product label.
Redcon1
See all Redcon1 products- Name
- Redcon1, LLC
- Street Address
- 701 Park of Commerce Blvd., Suite 101
- City
- Boca Raton
- State
- FL
- ZipCode
- 33487
- Phone Number
- 1(855)733-2661
- Web Address
- www.Redcon1.com
Total War Grape by Redcon1: 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 Total War Grape’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Taurine
Interacts with 173 drugsTaurine is an amino acid your body makes naturally and that you also get from animal foods. It is widely used in energy drinks and sports supplements, and short-term use appears generally sa...
Read the full Taurine monograph → Herb & supplement monographCaffeine
Interacts with 655 drugsCaffeine is a natural stimulant found in coffee, tea, and many other plants and products. In moderate amounts it can boost alertness and reduce tiredness for most healthy adults, but too muc...
Read the full Caffeine monograph → Herb & supplement monographBlack Pepper
Interacts with 1,019 drugsBlack pepper is a common kitchen spice that is generally safe in the amounts used in food. Its extract, piperine, is mostly added to supplements to help the body absorb other ingredients (li...
Read the full Black Pepper monograph → Herb & supplement monographAgmatine
Interacts with 258 drugsAgmatine is a compound your body makes from the amino acid arginine, and it is sold mainly as a workout and 'pump' supplement. Human evidence for most of its claimed benefits is limited and...
Read the full Agmatine 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 monographBeta-alanine
Beta-alanine is an amino acid taken mostly by athletes to raise muscle carnosine, which may help buffer acid and reduce fatigue during short, high-intensity exercise. The evidence is moderat...
Read the full Beta-alanine monograph → Herb & supplement monographJuniper
Interacts with 162 drugsJuniper berry is a traditional herb best known for flavoring gin and for its folk use as a diuretic and digestive aid. Solid human evidence for its health benefits is limited, and it can irr...
Read the full Juniper monograph → Herb & supplement monographGrapefruit
Interacts with 990 drugsGrapefruit is a nutritious citrus fruit rich in vitamin C and other nutrients, and it is generally safe to eat. However, grapefruit is famous for serious interactions with many prescription...
Read the full Grapefruit monograph → Herb & supplement monographCocoa
Interacts with 661 drugsCocoa is rich in plant compounds called flavanols that may modestly support blood vessel function and blood pressure, but most chocolate products are high in sugar, fat, and calories, which...
Read the full Cocoa monograph →Sources & How We Checked
Total War Grape'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 804 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.
Taurine 21 references
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- Obermann M, Schorn CF, Mummel P, et al. Taurine induced toxic encephalopathy? Clin Neurol Neurosurg 2006;108:812-3. PubMed
- Bichler, A., Swenson, A., and Harris, M. A. A combination of caffeine and taurine has no effect on short term memory but induces changes in heart rate and mean arterial blood pressure. Amino Acids 2006;31(4):471-476. PubMed
- Iyadurai, S. J. and Chung, S. S. New-onset seizures in adults: possible association with consumption of popular energy drinks. Epilepsy Behav 2007;10(3):504-508. PubMed
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- Worthley, M. I., Prabhu, A., De, Sciscio P., Schultz, C., Sanders, P., and Willoughby, S. R. Detrimental effects of energy drink consumption on platelet and endothelial function. Am J Med 2010;123(2):184-187. PubMed
- Morchon, Simon D. and Perez Castrillon, J. L. [Hypoglycemia by intake of taurine]. Rev.Clin Esp. 2010;210(1):49.
- Livshits, Z., Hoffman, R. S., Hymes, K. B., and Nelson, L. S. If vitamins could kill: massive hemolysis following naturopathic vitamin infusion. J Med Toxicol. 2011;7(3):224-226. PubMed
- Schoffl, I., Kothmann, J. F., Schoffl, V., Rupprecht, H. D., and Rupprecht, T. "Vodka energy": too much for the adolescent nephron? Pediatrics 2011;128(1):e227-e231. PubMed
- Calabro, R. S., Italiano, D., Gervasi, G., and Bramanti, P. Single tonic-clonic seizure after energy drink abuse. Epilepsy Behav 2012;23(3):384-385. PubMed
- Fujita, T., Ando, K., Noda, H., Ito, Y., and Sato, Y. Effects of increased adrenomedullary activity and taurine in young patients with borderline hypertension. Circulation 1987;75(3):525-532. PubMed
- Darling, P. B., Lepage, G., Leroy, C., Masson, P., and Roy, C. C. Effect of taurine supplements on fat absorption in cystic fibrosis. Pediatr Res 1985;19(6):578-582. PubMed
- Fukuyama, Y. and Ochiai, Y. Therapeutic trial by taurine for intractable childhood epilepsies. Brain Dev. 1982;4(1):63-69. PubMed
- Franconi, F., Bennardini, F., Mattana, A., Miceli, M., Ciuti, M., Mian, M., Gironi, A., Anichini, R., and Seghieri, G. Plasma and platelet taurine are reduced in subjects with insulin-dependent diabetes mellitus: effects of taurine supplementation. Am.J. DOI
- Stohs SJ, Miller M. A case study involving allergic reactions to sulfur-containing compounds including, sulfite, taurine, acesulfame potassium and sulfonamides. Food Chem Toxicol. 2014 Jan;63:240-3. PubMed
- Sun Q, Wang B, Li Y, Sun F, et al. Taurine supplementation lowers blood pressure and improves vascular function in prehypertension: randomized, double-blind, placebo-controlled study. Hypertension 2016 Mar;67(3):541-9. PubMed
- Jang ES, Hwang SH, Kim JW, Jeong SH. Effectiveness of 4-week oral taurine treatment for muscle cramps in patients with liver cirrhosis: a single-arm pilot study. Yonsei Med J 2021;62(1):21-8. PubMed
- Guan L, Miao P. The effects of taurine supplementation on obesity, blood pressure and lipid profile: A meta-analysis of randomized controlled trials. Eur J Pharmacol 2020;885:173533. PubMed
- Higgins JP, Liras GN, Liras IN, et al. Energy Drink Effects on Hemodynamics and Endothelial Function in Young Adults. Cardiology. 2021;146(2):258-262. PubMed
- Pallangyo P, Bhalia SV, Komba M, et al. Acute Myocardial Infarction Following the Consumption of Energy Drink in a 28-Year-Old Male: A Case Report. J Investig Med High Impact Case Rep. 2023 Jan-Dec;11:23247096231168811. PubMed
Caffeine 236 references
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- Rapuri PB, Gallagher JC, Kinyamu HK, Ryschon KL. Caffeine intake increases the rate of bone loss in elderly women and interacts with vitamin D receptor genotypes. Am J Clin Nutr 2001;74:694-700. PubMed
- The National Toxicology Program (NTP). Caffeine. Center for the Evaluation of Risks to Human Reproduction (CERHR). Available at: http://cerhr.niehs.nih.gov/common/caffeine.html.
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- Eskenazi B. Caffeine—filtering the facts. N Engl J Med 1999;341:1688-9. PubMed
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- Pollock BG, Wylie M, Stack JA, et al. Inhibition of caffeine metabolism by estrogen replacement therapy in postmenopausal women. J Clin Pharmacol 1999;39:936-40. PubMed
- Nurminen ML, Niittynen L, Korpela R, Vapaatalo H. Coffee, caffeine and blood pressure: a critical review. Eur J Clin Nutr 1999;53:831-9. PubMed
- Dews PB, Curtis GL, Hanford KJ, O'Brien CP. The frequency of caffeine withdrawal in a population-based survey and in a controlled, blinded pilot experiment. J Clin Pharmacol 1999;39:1221-32. PubMed
- FDA. Proposed rule: dietary supplements containing ephedrine alkaloids. Available at: www.verity.fda.gov (Accessed 25 January 2000).
- Briggs GB, Freeman RK, Yaffe SJ. Drugs in Pregnancy and Lactation. 5th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 1998.
- Hagg S, Spigset O, Mjorndal T, Dahlqvist R. Effect of caffeine on clozapine pharmacokinetics in healthy volunteers. Br J Clin Pharmacol 2000;49:59-63. PubMed
- Tobias JD. Caffeine in the treatment of apnea associated with respiratory syncytial virus infection in neonates and infants. South Med J 2000;93:297-304. DOI
- Watson JM, Jenkins EJ, Hamilton P, et al. Influence of caffeine on the frequency and perception of hypoglycemia in free-living patients with type 1 diabetes. Diabetes Care 2000;23:455-9. PubMed
- Lloyd T, Johnson-Rollings N, Eggli DF, et al. Bone status among postmenopausal women with different habitual caffeine intakes: a longitudinal investigation. J Am Coll Nutr 2000;19:256-61. PubMed
- American Academy of Pediatrics. The transfer of drugs and other chemicals into human milk. Pediatrics 2001;108:776-89. PubMed
- Sinclair CJ, Geiger JD. Caffeine use in sports. A pharmacological review. J Sports Med Phys Fitness 2000;40:71-9.
- Haller CA, Benowitz NL. Adverse cardiovascular and central nervous system events associated with dietary supplements containing ephedra alkaloids. N Engl J Med 2000;343:1833-8. PubMed
- Ali M, Afzal M. A potent inhibitor of thrombin stimulated platelet thromboxane formation from unprocessed tea. Prostaglandins Leukot Med 1987;27:9-13. PubMed
- Ardlie NG, Glew G, Schultz BG, Schwartz CJ. Inhibition and reversal of platelet aggregation by methyl xanthines. Thromb Diath Haemorrh 1967;18:670-3. DOI
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- Horner NK, Lampe JW. Potential mechanisms of diet therapy for fibrocystic breast conditions show inadequate evidence of effectiveness. J Am Diet Assoc 2000;100:1368-80. PubMed
- Bracken MB, Triche EW, Belanger K, et al. Association of maternal caffeine consumption with decrements in fetal growth. Am J Epidemiol 2003;157:456-66.. PubMed
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- Massey LK. Is caffeine a risk factor for bone loss in the elderly? Am J Clin Nutr 2001;74:569-70. PubMed
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- Schechter MD, Timmons GD. Objectively measured hyperactivity--II. Caffeine and amphetamine effects. J Clin Pharmacol 1985;25:276-80.. PubMed
- Nix D, Zelenitsky S, Symonds W, et al. The effect of fluconazole on the pharmacokinetics of caffeine in young and elderly subjects. Clin Pharmacol Ther 1992;51:183. DOI
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- Massey LK, Whiting SJ. Caffeine, urinary calcium, calcium metabolism and bone. J Nutr 1993;123:1611-4. PubMed
- Nawrot P, Jordan S, Eastwood J, et al. Effects of caffeine on human health. Food Addit Contam 2003;20:1-30. PubMed
- May DC, Jarboe CH, VanBakel AB, Williams WM. Effects of cimetidine on caffeine disposition in smokers and nonsmokers. Clin Pharmacol Ther 1982;31:656-61. PubMed
- Abernethy DR, Todd EL. Impairment of caffeine clearance by chronic use of low-dose oestrogen-containing oral contraceptives. Eur J Clin Pharmacol 1985;28:425-8. PubMed
- Brown NJ, Ryder D, Branch RA. A pharmacodynamic interaction between caffeine and phenylpropanolamine. Clin Pharmacol Ther 1991;50:363-71. PubMed
- Sanderink GJ, Bournique B, Stevens J, et al. Involvement of human CYP1A isoenzymes in the metabolism and drug interactions of riluzole in vitro. Pharmacol Exp Ther 1997;282:1465-72. DOI
- Wahllander A, Paumgartner G. Effect of ketoconazole and terbinafine on the pharmacokinetics of caffeine in healthy volunteers. Eur J Clin Pharmacol 1989;37:279-83. PubMed
- Carrillo JA, Benitez J. Clinically significant pharmacokinetic interactions between dietary caffeine and medications. Clin Pharmacokinet 2000;39:127-53. PubMed
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