Tree Country Allergy & Sinus Ingredients & Drug Interactions
by WishGarden
What is this page for?
First and foremost: checking Tree Country Allergy & Sinus 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
Tree Country Allergy & Sinus is a dietary supplement by WishGarden with 7 active ingredients. Its ingredients are commonly taken for vitamin c source, digestive upset, stress and relaxation (aromatherapy).Based on those ingredients, 1,195 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are Echinacea root extract, Elder flower extract, Yerba Mansa root extract. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against Tree Country Allergy & Sinus by WishGarden
Ask about any prescription or over-the-counter medication and we check it for interactions with Tree Country Allergy & Sinus by WishGarden — 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 Tree Country Allergy & Sinus by WishGarden
Our pharmacy team’s full take, with four database checks built into the cards below — a summary of what is known, not a grade of the product itself.
What’s inside
Low disclosure
Tree Country Allergy & Sinus contains 7 active ingredients in a liquid extract form. The blend includes orange peel, yerba santa leaf, elderflower, echinacea root, yerba mansa root, nettles leaf, and horseradish root — each chosen for traditional use in supporting respiratory and sinus health.
The product is suspended in a base of Rocky Mountain artesian spring water, vegetable glycerin, and organic, gluten-free alcohol.
Does it work?
Insufficient evidence
The evidence we hold does not establish that this product is effective for any specific condition. Orange peel extract, echinacea, nettles, and horseradish all have effectiveness ratings of insufficient reliable evidence for their traditionally used purposes — including allergy support, respiratory infections, and related complaints.
That doesn't mean they don't work; it means rigorous clinical trials backing them up aren't in our database. Talk with your pharmacist or doctor about what the research actually shows for your particular goal.
How safe is it?
Well-documented data
Orange peel extract is safe in food amounts, but concentrated extracts call for caution because they haven't been thoroughly studied. Echinacea is generally well tolerated short-term but may trigger allergic reactions, especially in people sensitive to ragweed and related plants; rare cases of liver inflammation have been reported.
Nettles leaf is generally well tolerated as directed, though liver injury cases exist in the literature. Horseradish is safe in food amounts but large doses can cause stomach upset, vomiting, or in rare cases, fainting.
Yerba Santa and yerba mansa have limited human safety data; use caution and discuss with your healthcare provider. For pregnancy: orange peel extract is likely safe; echinacea is possibly safe; nettles and horseradish should be avoided (nettles are likely unsafe); yerba santa and yerba mansa lack adequate data — talk with your doctor.
For breastfeeding, nettles and horseradish are likely unsafe, and yerba santa and yerba mansa lack reliable safety data.
Meds to double-check
Major interaction found
Check before starting if you take: heart or cholesterol medications (especially pravastatin, celiprolol, or fexofenadine); blood thinners like warfarin; antiparasitic drugs like ivermectin; immunosuppressants; antidiabetes or diuretic drugs; lithium; thyroid hormone; CNS depressants (sedatives); or any medication processed by your liver (CYP1A2 or CYP3A4 substrates). The orange peel and echinacea carry the most serious documented interactions.
Use the medication search on this page for your specific drugs.
The bottom line
Scorecard at a glanceFormula with limited ingredient disclosure with insufficient evidence for its stated purpose. Major medication interactions have been identified, and safety information is well characterized.
This is a multi-ingredient herbal blend with real potential for drug interactions — especially if you take heart medications, blood thinners, antidiabetes drugs, or medications processed by your liver. The most serious concerns are orange peel and echinacea.
Before you start, check your exact medications with the tool on this page and talk with your pharmacist or doctor, especially if you're pregnant, breastfeeding, or managing a chronic condition.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 7 of 7 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Nov 21, 2020.
This Scorecard evaluates available label information, ingredient evidence, and known medication-safety considerations. It does not independently verify product identity, purity, potency, contamination, or manufacturing quality. How these ratings are computed
General information
Key facts about Tree Country Allergy & Sinus, straight from the product label.
| Brand | WishGarden |
|---|---|
| Barcode (UPC) | 656490019727 |
| Net contents | 2 fl. Oz.; 60 mL |
| Market status | On market |
| Date entered into DSLD | Nov 21, 2020 |
| DSLD ID | 240188 |
| Product type | Botanical |
| Supplement form | Liquid |
| Dietary claims / uses | All Other, Structure/Function |
| Intended target group(s) | Adult (18 - 50 Years), Organic |
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 Tree Country Allergy & Sinus by WishGarden, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Proprietary Extract Blend | 0 NP | -- |
| Orange peel extract | 0 NP | -- |
| Yerba Santa leaf extract | 0 NP | -- |
| Elder flower extract | 0 NP | -- |
| Echinacea root extract | 0 NP | -- |
| Yerba Mansa root extract | 0 NP | -- |
| Nettles leaf extract | 0 NP | -- |
| Horseradish root extract | 0 NP | -- |
Other ingredients: Rocky Mountain artesian spring Water, Vegetable Glycerin, organic, gluten-free Alcohol
Tap any ingredient to jump to its full detail below.
These statements are the manufacturer’s wording, reproduced from the product label — the label is saying it, not HelloPharmacist. We don’t verify or endorse them.
FDA Statement of Identity
Herbal Dietary Supplement
Formulation
Herbs to soothe irritated tissues
Made with organic & wild herbs
Suggested/Recommended/Usage/Directions
Suggested Use: For immediate support, 6-8 pumps in a little water; repeat every 5 minutes (up to 4x/row) until desired effect is achieved. Repeat as needed. To move-thru persistent discomforts, 6-8 pumps every 1-3 hrs for a day or two, then taper off to 3-4x/day. Visit our website for more detailed use strategies.
Shake before use
FDA Disclaimer Statement
This statement has not been evaluated by the FDA. Not intended to diagnose, treat, cure or prevent any disease.
General Statements
32048 09/2020
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Tree Country Allergy & Sinus by WishGarden 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 Tree Country Allergy & Sinus by WishGarden
These are the 7 active ingredients this product is made of. Select any to open its full monograph.
Serving size3 mL Dosage formLiquid Servings per container20 Amounts shown are per serving.
Most supplement products combine several ingredients, and a medication can interact with the product through any one of them. Each ingredient below shows whether it has known drug interactions.
Proprietary Extract Blend
Other (inactive) ingredients: Rocky Mountain artesian spring Water, Vegetable Glycerin, Organic, gluten-free Alcohol. These complete the product’s ingredient list but are not active constituents.
Tree Country Allergy & Sinus by WishGarden Drug Interactions
HelloPharmacist Interaction Report
Tree Country Allergy & Sinus by WishGarden contains several ingredients with documented interactions with medications.
The most serious concerns come from orange peel extract, which can Major-severity interact with a number of drugs. Orange peel can substantially reduce absorption of fexofenadine (an antihistamine), ivermectin (an antiparasitic), and celiprolol (a heart medication) — in one study, celiprolol levels dropped by up to 90%.
It can also increase absorption of pravastatin (a cholesterol drug), roughly doubling its blood levels. Additionally, orange peel may affect how your body handles other drugs that use similar absorption pathways (OATP substrates) and those transported by P-glycoprotein; calcium-fortified formulas may interfere with quinolone antibiotics.
Read the full breakdown — every affected drug type, severity by severity
Echinacea root extract carries Moderate-severity interactions with drugs metabolized through your liver's CYP1A2 and CYP3A4 pathways — it can increase caffeine levels by about 30% and may affect many common medications. It can also theoretically interfere with immunosuppressant therapy and has a Minor interaction with warfarin (a blood thinner).
Nettles leaf extract may amplify the effects of blood-sugar drugs, diuretics, and lithium, and might interfere with warfarin because it contains vitamin K. Yerba Santa leaf extract and Yerba Mansa root extract each carry Moderate interactions: Yerba Santa with lithium, and Yerba Mansa with CNS depressants (sedatives, sleeping pills).
Horseradish root extract may theoretically interfere with thyroid hormone replacement.
We could not check elder flower extract for interactions. Altogether, these interactions span 1,178 individual medications.
Use the medication checker on this page to look up your specific drugs before you start.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against Tree Country Allergy & Sinus?
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 Tree Country Allergy & Sinus interact with 1,195 drugs. Click any drug to see the details.
7 of the 7 ingredients in Tree Country Allergy & Sinus interact with drugs. Each result below shows which ingredient is responsible. Echinacea root extract Elder flower extract Yerba Mansa root extract Orange peel extract Nettles leaf extract Horseradish root extract Yerba Santa leaf extract
AtorvastatinAtorvaliq
How Atorvastatin interacts with Tree Country Allergy & Sinus — through 3 ingredients. Tap an ingredient for the detail:
Orange Peel ExtractOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Consuming sweet orange juice can decrease oral absorption of OATP substrates.
Read the full Orange Peel Extract + Atorvastatin interactionElder Flower ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, taking American elder might increase levels of CYP3A4 substrates.
Read the full Elder Flower Extract + Atorvastatin interactionEchinacea Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea Root Extract + Atorvastatin interactionAtorvastatin CalciumLipitor
How Atorvastatin Calcium interacts with Tree Country Allergy & Sinus — through 3 ingredients. Tap an ingredient for the detail:
Orange Peel ExtractOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Consuming sweet orange juice can decrease oral absorption of OATP substrates.
Read the full Orange Peel Extract + Atorvastatin Calcium interactionEchinacea Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea Root Extract + Atorvastatin Calcium interactionElder Flower ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, taking American elder might increase levels of CYP3A4 substrates.
Read the full Elder Flower Extract + Atorvastatin Calcium interactionBosentanTracleer
How Bosentan interacts with Tree Country Allergy & Sinus — through 3 ingredients. Tap an ingredient for the detail:
Orange Peel ExtractOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Consuming sweet orange juice can decrease oral absorption of OATP substrates.
Read the full Orange Peel Extract + Bosentan interactionElder Flower ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, taking American elder might increase levels of CYP3A4 substrates.
Read the full Elder Flower Extract + Bosentan interactionEchinacea Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea Root Extract + Bosentan interactionBrincidofovirTembexa
How Brincidofovir interacts with Tree Country Allergy & Sinus — through 1 ingredient. Tap an ingredient for the detail:
Orange Peel ExtractOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Consuming sweet orange juice can decrease oral absorption of OATP substrates.
Read the full Orange Peel Extract + Brincidofovir interactionCeliprololCelicard
How Celiprolol interacts with Tree Country Allergy & Sinus — through 1 ingredient. Tap an ingredient for the detail:
Orange Peel ExtractP-glycoprotein Substrates, Organic Anion-transporting Polypeptide Substrates (oatp) +1 Major
Interaction Summary
Sweet orange juice seems to modulate P-glycoprotein (P-gp), which might affect the blood levels of P-gp substrates.
Read the full Orange Peel Extract + Celiprolol interactionCerivastatin SodiumBaycol
How Cerivastatin Sodium interacts with Tree Country Allergy & Sinus — through 1 ingredient. Tap an ingredient for the detail:
Orange Peel ExtractOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Consuming sweet orange juice can decrease oral absorption of OATP substrates.
Read the full Orange Peel Extract + Cerivastatin Sodium interactionCinoxacinCinobac
How Cinoxacin interacts with Tree Country Allergy & Sinus — through 1 ingredient. Tap an ingredient for the detail:
Orange Peel ExtractQuinolone Antibiotics, Organic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Calcium-fortified sweet orange juice might reduce quinolone absorption.
Read the full Orange Peel Extract + Cinoxacin interactionCiprofloxacinCiloxan, Cipro, Cipro IV, Cipro XR, Ciprobay, Otiprio
How Ciprofloxacin interacts with Tree Country Allergy & Sinus — through 1 ingredient. Tap an ingredient for the detail:
Orange Peel ExtractOrganic Anion-transporting Polypeptide Substrates (oatp), Quinolone Antibiotics Major
Interaction Summary
Consuming sweet orange juice can decrease oral absorption of OATP substrates.
Read the full Orange Peel Extract + Ciprofloxacin interactionCiprofloxacin, HydrocortisoneCipro HC Otic
How Ciprofloxacin, Hydrocortisone interacts with Tree Country Allergy & Sinus — through 1 ingredient. Tap an ingredient for the detail:
Orange Peel ExtractOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Consuming sweet orange juice can decrease oral absorption of OATP substrates.
Read the full Orange Peel Extract + Ciprofloxacin, Hydrocortisone interactionClinafloxacinClinafloxacin
How Clinafloxacin interacts with Tree Country Allergy & Sinus — through 1 ingredient. Tap an ingredient for the detail:
Orange Peel ExtractOrganic Anion-transporting Polypeptide Substrates (oatp), Quinolone Antibiotics Major
Interaction Summary
Consuming sweet orange juice can decrease oral absorption of OATP substrates.
Read the full Orange Peel Extract + Clinafloxacin interactionEnoxacinPenetrex
How Enoxacin interacts with Tree Country Allergy & Sinus — through 1 ingredient. Tap an ingredient for the detail:
Orange Peel ExtractQuinolone Antibiotics, Organic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Calcium-fortified sweet orange juice might reduce quinolone absorption.
Read the full Orange Peel Extract + Enoxacin interactionEtoposideEtopophos, VePesid, VP16
How Etoposide interacts with Tree Country Allergy & Sinus — through 3 ingredients. Tap an ingredient for the detail:
Orange Peel ExtractOrganic Anion-transporting Polypeptide Substrates (oatp), P-glycoprotein Substrates Major
Interaction Summary
Consuming sweet orange juice can decrease oral absorption of OATP substrates.
Read the full Orange Peel Extract + Etoposide interactionEchinacea Root ExtractEtoposide (vepesid), Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may increase levels of etoposide.
Read the full Echinacea Root Extract + Etoposide interactionElder Flower ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, taking American elder might increase levels of CYP3A4 substrates.
Read the full Elder Flower Extract + Etoposide interactionEzetimibe, AtorvastatinLiptruzet
How Ezetimibe, Atorvastatin interacts with Tree Country Allergy & Sinus — through 3 ingredients. Tap an ingredient for the detail:
Orange Peel ExtractOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Consuming sweet orange juice can decrease oral absorption of OATP substrates.
Read the full Orange Peel Extract + Ezetimibe, Atorvastatin interactionElder Flower ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, taking American elder might increase levels of CYP3A4 substrates.
Read the full Elder Flower Extract + Ezetimibe, Atorvastatin interactionEchinacea Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea Root Extract + Ezetimibe, Atorvastatin interactionFexofenadineAllegra
How Fexofenadine interacts with Tree Country Allergy & Sinus — through 3 ingredients. Tap an ingredient for the detail:
Orange Peel ExtractP-glycoprotein Substrates, Organic Anion-transporting Polypeptide Substrates (oatp) +1 Major
Interaction Summary
Sweet orange juice seems to modulate P-glycoprotein (P-gp), which might affect the blood levels of P-gp substrates.
Read the full Orange Peel Extract + Fexofenadine interactionEchinacea Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea Root Extract + Fexofenadine interactionElder Flower ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, taking American elder might increase levels of CYP3A4 substrates.
Read the full Elder Flower Extract + Fexofenadine interactionFexofenadine, PseudoephedrineAllegra D
How Fexofenadine, Pseudoephedrine interacts with Tree Country Allergy & Sinus — through 3 ingredients. Tap an ingredient for the detail:
Orange Peel ExtractFexofenadine (allegra), P-glycoprotein Substrates +1 Major
Interaction Summary
Consuming sweet orange juice with fexofenadine can decrease oral absorption of fexofenadine.
Read the full Orange Peel Extract + Fexofenadine, Pseudoephedrine interactionElder Flower ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, taking American elder might increase levels of CYP3A4 substrates.
Read the full Elder Flower Extract + Fexofenadine, Pseudoephedrine interactionEchinacea Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea Root Extract + Fexofenadine, Pseudoephedrine interactionFluvastatinLescol, Lescol XL
How Fluvastatin interacts with Tree Country Allergy & Sinus — through 1 ingredient. Tap an ingredient for the detail:
Orange Peel ExtractOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Consuming sweet orange juice can decrease oral absorption of OATP substrates.
Read the full Orange Peel Extract + Fluvastatin interactionGatifloxacinTequin, Tequin Injection
How Gatifloxacin interacts with Tree Country Allergy & Sinus — through 1 ingredient. Tap an ingredient for the detail:
Orange Peel ExtractOrganic Anion-transporting Polypeptide Substrates (oatp), Quinolone Antibiotics Major
Interaction Summary
Consuming sweet orange juice can decrease oral absorption of OATP substrates.
Read the full Orange Peel Extract + Gatifloxacin interactionGemifloxacinFactive
How Gemifloxacin interacts with Tree Country Allergy & Sinus — through 1 ingredient. Tap an ingredient for the detail:
Orange Peel ExtractQuinolone Antibiotics, Organic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Calcium-fortified sweet orange juice might reduce quinolone absorption.
Read the full Orange Peel Extract + Gemifloxacin interactionGlyburideAlbert Glyburide, Diabeta, Glycron, Glynase, Glynase PresTab, Micronase +1 more
How Glyburide interacts with Tree Country Allergy & Sinus — through 2 ingredients. Tap an ingredient for the detail:
Orange Peel ExtractOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Consuming sweet orange juice can decrease oral absorption of OATP substrates.
Read the full Orange Peel Extract + Glyburide interactionNettles Leaf ExtractAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, stinging nettle might have additive effects with antidiabetes drugs.
Read the full Nettles Leaf Extract + Glyburide interactionGlyburide, MetforminGlucovance
How Glyburide, Metformin interacts with Tree Country Allergy & Sinus — through 2 ingredients. Tap an ingredient for the detail:
Orange Peel ExtractOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Consuming sweet orange juice can decrease oral absorption of OATP substrates.
Read the full Orange Peel Extract + Glyburide, Metformin interactionNettles Leaf ExtractAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, stinging nettle might have additive effects with antidiabetes drugs.
Read the full Nettles Leaf Extract + Glyburide, Metformin interactionGrepafloxacinRaxar
How Grepafloxacin interacts with Tree Country Allergy & Sinus — through 2 ingredients. Tap an ingredient for the detail:
Orange Peel ExtractOrganic Anion-transporting Polypeptide Substrates (oatp), Quinolone Antibiotics Major
Interaction Summary
Consuming sweet orange juice can decrease oral absorption of OATP substrates.
Read the full Orange Peel Extract + Grepafloxacin interactionEchinacea Root ExtractCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea Root Extract + Grepafloxacin interactionIrinotecanCamptosar, Onivyde
How Irinotecan interacts with Tree Country Allergy & Sinus — through 3 ingredients. Tap an ingredient for the detail:
Orange Peel ExtractOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Consuming sweet orange juice can decrease oral absorption of OATP substrates.
Read the full Orange Peel Extract + Irinotecan interactionEchinacea Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea Root Extract + Irinotecan interactionElder Flower ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, taking American elder might increase levels of CYP3A4 substrates.
Read the full Elder Flower Extract + Irinotecan interactionIrinotecan Hydrochloride
How Irinotecan Hydrochloride interacts with Tree Country Allergy & Sinus — through 3 ingredients. Tap an ingredient for the detail:
Orange Peel ExtractOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Consuming sweet orange juice can decrease oral absorption of OATP substrates.
Read the full Orange Peel Extract + Irinotecan Hydrochloride interactionElder Flower ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, taking American elder might increase levels of CYP3A4 substrates.
Read the full Elder Flower Extract + Irinotecan Hydrochloride interactionEchinacea Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea Root Extract + Irinotecan Hydrochloride interactionIsoniazid, Pyrazinamide, RifampinRifater
How Isoniazid, Pyrazinamide, Rifampin interacts with Tree Country Allergy & Sinus — through 1 ingredient. Tap an ingredient for the detail:
Orange Peel ExtractOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Consuming sweet orange juice can decrease oral absorption of OATP substrates.
Read the full Orange Peel Extract + Isoniazid, Pyrazinamide, Rifampin interactionIsoniazid, RifampinRifamate
How Isoniazid, Rifampin interacts with Tree Country Allergy & Sinus — through 1 ingredient. Tap an ingredient for the detail:
Orange Peel ExtractOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Consuming sweet orange juice can decrease oral absorption of OATP substrates.
Read the full Orange Peel Extract + Isoniazid, Rifampin interactionIvermectinMectizan, Sklice, Soolantra, Stromectol
How Ivermectin interacts with Tree Country Allergy & Sinus — through 1 ingredient. Tap an ingredient for the detail:
Orange Peel ExtractP-glycoprotein Substrates, Ivermectin (stromectol, Others) Major
Interaction Summary
Sweet orange juice seems to modulate P-glycoprotein (P-gp), which might affect the blood levels of P-gp substrates.
Read the full Orange Peel Extract + Ivermectin interactionLevofloxacinLeva-pak, Levaquin, Levaquin Injection
How Levofloxacin interacts with Tree Country Allergy & Sinus — through 1 ingredient. Tap an ingredient for the detail:
Orange Peel ExtractOrganic Anion-transporting Polypeptide Substrates (oatp), Quinolone Antibiotics Major
Interaction Summary
Consuming sweet orange juice can decrease oral absorption of OATP substrates.
Read the full Orange Peel Extract + Levofloxacin interactionLevofloxacin (ophthalmic)Levofloxacin
How Levofloxacin (ophthalmic) interacts with Tree Country Allergy & Sinus — through 1 ingredient. Tap an ingredient for the detail:
Orange Peel ExtractQuinolone Antibiotics, Organic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Calcium-fortified sweet orange juice might reduce quinolone absorption.
Read the full Orange Peel Extract + Levofloxacin (ophthalmic) interactionLomefloxacinMaxaquin
How Lomefloxacin interacts with Tree Country Allergy & Sinus — through 1 ingredient. Tap an ingredient for the detail:
Orange Peel ExtractOrganic Anion-transporting Polypeptide Substrates (oatp), Quinolone Antibiotics Major
Interaction Summary
Consuming sweet orange juice can decrease oral absorption of OATP substrates.
Read the full Orange Peel Extract + Lomefloxacin interactionLovastatinAltocor, Mevacor
How Lovastatin interacts with Tree Country Allergy & Sinus — through 3 ingredients. Tap an ingredient for the detail:
Orange Peel ExtractOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Consuming sweet orange juice can decrease oral absorption of OATP substrates.
Read the full Orange Peel Extract + Lovastatin interactionElder Flower ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, taking American elder might increase levels of CYP3A4 substrates.
Read the full Elder Flower Extract + Lovastatin interactionEchinacea Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea Root Extract + Lovastatin interactionEach ingredient & the kinds of drugs it affects
For each ingredient in Tree Country Allergy & Sinus 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.
Echinacea root extract
Caffeine
Echinacea can increase plasma levels of caffeine by inhibiting its metabolism.
Echinacea seems to increase plasma concentrations of caffeine by around 30%. This is likely due to inhibition of cytochrome P450 1A2 (CYP1A2) by echinacea.
Cytochrome P450 1A2 (Cyp1A2) Substrates
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Echinacea appears to inhibit CYP1A2 enzymes in humans. Additionally, echinacea seems to increase plasma concentrations of caffeine, a CYP1A2 substrate, by around 30%. Theoretically, echinacea might increase levels of other drugs metabolized by CYP1A2.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4. This may increase or decrease levels of drugs metabolized by CYP3A4.
Several clinical trials have shown that taking echinacea for up to one month does not significantly affect the metabolism of various CYP3A4 substrates, including midazolam, docetaxel, etravirine, lopinavir-ritonavir, and darunavir-ritonavir. However, other clinical research shows that echinacea may increase the clearance of midazolam, suggesting that echinacea might induce CYP3A4. The discrepancy is thought to be due to differing effects of echinacea on intestinal versus hepatic CYP3A4 enzymes. Echinacea appears to induce hepatic CYP3A4 but inhibit intestinal CYP3A4. In some cases, these effects might cancel each other out, but in others, drug levels may be increased or decreased depending on the level of effect at hepatic and intestinal sites. The effect of echinacea on CYP3A4 activity may differ depending on the CYP3A4 substrate.
Etoposide (Vepesid)
Echinacea may increase levels of etoposide.
In one report, concomitant use of etoposide and echinacea was associated with more severe thrombocytopenia than the use of etoposide alone, suggesting inhibition of etoposide metabolism. Etoposide is a cytochrome P450 3A4 (CYP3A4) substrate. Echinacea has variable effects on CYP3A4, but some studies have reported inhibition of the enzyme.
Immunosuppressants
Echinacea has immunostimulant activity which may interfere with immunosuppressant therapy.
Theoretically, echinacea may interfere with immunosuppressant therapy because of its immunostimulant activity.
Darunavir (Prezista)
Theoretically, echinacea may interfere with the metabolism of darunavir; however, a small clinical study found no effect.
Darunavir is metabolized by cytochrome P450 3A4 (CYP3A4) and is administered with the CYP3A4 inhibitor ritonavir to increase its plasma concentrations. Echinacea has variable effects on CYP3A4, but administration of an E. purpurea root extract (Arkocapsulas Echinacea, Arkopharma) 500 mg four times daily for 14 days did not affect darunavir/ritonavir pharmacokinetics in 15 HIV-infected patients.
Dayquil Severe
Echinacea is reported to have varying effects on a number of Cytochrome P450 metabolizing enzymes in the liver, including CYP1A2 and CYP3A4, which play a role in acetaminophen and dextromethorphan metabolism (both contained in DayQuil Severe), respectively. Studies have reported both enzyme inhibition and induction, making it difficult to predict clinically significant drug interactions with reliability. Specific drug interaction studies reporting definitive results are rare, and potential drug interactions involving echinacea should likely be taken on a case-by-case basis. Based on what we know about how acetaminophen and dextromethorphan are metabolized, the risk of a clinically significant interaction between echinacea and DayQuil Severe is low.
Docetaxel (Taxotere)
Theoretically, echinacea may interfere with the metabolism of docetaxel; however, a small clinical study found no effect.
Docetaxel is metabolized by cytochrome P450 3A4 (CYP3A4). Echinacea has variable effects on CYP3A4, but taking E. purpurea whole plant extract (Echinaforce, A. Vogel Biopharma AG) 20 drops three times daily for 2 weeks did not alter the pharmacokinetics of docetaxel in one clinical study.
Etravirine (Intelence)
Theoretically, echinacea may interfere with the metabolism of etravirine; however, a small clinical study found no effect.
Etravirine is metabolized by cytochrome P450 3A4 (CYP3A4). Echinacea has variable effects on CYP3A4, but taking E. purpurea root extract (Arkocapsulas Echinacea, Arkopharma) 500 mg three times daily for 14 days did not alter the pharmacokinetics of etravirine in HIV-infected patients.
Lopinavir/Ritonavir (Kaletra)
Theoretically, echinacea may interfere with the metabolism of lopinavir; however, a small clinical study found no effect.
Lopinavir is metabolized by cytochrome P450 3A4 (CYP3A4) and is administered with the CYP3A4 inhibitor ritonavir to increase its plasma concentrations. Echinacea has variable effects on CYP3A4, but taking E. purpurea (Echinamide, Natural Factors Nutritional Products, Inc.) 500 mg three times daily for 14 days did not alter the pharmacokinetics of lopinavir/ritonavir in healthy volunteers.
Midazolam (Versed)
Theoretically, echinacea may increase the metabolism of intravenous midazolam.
Echinacea induces hepatic CYP3A4 and might decrease plasma levels of midazolam by about 20%, reducing the effectiveness of intravenous midazolam. Echinacea also appears to inhibit intestinal CYP3A4, which could theoretically increase the bioavailability of oral midazolam. This may cancel out the decrease in availability caused by induction of hepatic CYP3A4, such that overall plasma levels after oral administration of midazolam are not affected by echinacea.
Warfarin (Coumadin)
Echinacea seems to increase the clearance of warfarin, although the effect may not be clinically significant.
Preliminary clinical research in healthy male volunteers suggests that taking echinacea increases the clearance of the active S-isomer of warfarin after a single dose of warfarin, but there was not a clinically significant effect on the INR.
Elder flower extract
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, taking American elder might increase levels of CYP3A4 substrates.
In vitro research shows that American elder inhibits CYP3A4 enzymes.
Lithium
Theoretically, American elder might reduce excretion and increase levels of lithium.
American elder is thought to have diuretic properties. Theoretically, American elder might reduce the excretion of lithium, increasing serum levels.
Yerba Mansa root extract
Cns Depressants
Theoretically, concomitant use might cause additive or prolonged sedative effects.
Orange peel extract
Celiprolol (Celicard)
Consuming sweet orange with celiprolol can decrease oral absorption of celiprolol.
A pharmacokinetic study in healthy volunteers shows that celiprolol levels, after a single dose of 100 mg, are decreased by up to 90% in people who drink sweet orange juice 200 mL three times daily. It's not known if lower consumption of sweet orange juice will have the same effect. Theoretically, this occurs due to short-term inhibition of organic anion transporting polypeptide (OATP). Recommend separating drug administration and consumption of sweet orange by at least 4 hours.
Ivermectin (Stromectol, Others)
Consuming sweet orange juice with ivermectin can decrease the oral absorption of ivermectin.
A pharmacokinetic study in healthy volunteers shows that taking ivermectin orally with sweet orange juice 750 mL over 4 hours reduces the bioavailability of ivermectin. This effect does not seem to be related to effects on P-glycoprotein. The effect on ivermectin is more pronounced in males compared to females.
Organic Anion-Transporting Polypeptide Substrates (Oatp)
Consuming sweet orange juice can decrease oral absorption of OATP substrates. Separate administration by at least 4 hours.
Clinical research shows that consuming sweet orange juice inhibits OATP, which reduces bioavailability of oral drugs that are substrates of OATP. For example, sweet orange juice decreases bioavailability of fexofenadine, a substrate of OATP, by about 72% and of celiprolol, another OATP substrate, by up to 90%. Since sweet orange juice seems to affect OATP for a short time, recommend separating drug administration and consumption of sweet orange juice by at least 4 hours.
Pravastatin (Pravachol)
Consuming sweet orange juice with pravastatin can increase the absorption of pravastatin.
A small pharmacokinetic study in healthy volunteers shows that consuming sweet orange juice 800 mL over 3 hours, including before, during, and after taking pravastatin 10 mg, increases pravastatin levels by about 149%, without affecting pravastatin elimination. Theoretically this effect might be due to modulation of organic anion transporting polypeptides (OATPs) by sweet orange juice. Sweet orange juice does not seem to affect simvastatin levels, but it is not known if sweet orange affects any of the other statins.
Fexofenadine (Allegra)
Consuming sweet orange juice with fexofenadine can decrease oral absorption of fexofenadine.
Clinical research shows that coadministration of sweet orange juice 1200 mL decreases bioavailability of fexofenadine by about 72%. In an animal model, sweet orange juice decreased bioavailability of fexofenadine by 31%. Fexofenadine manufacturer data indicates that concomitant administration of sweet orange juice and fexofenadine results in larger wheal and flare sizes in research models. This suggests that sweet orange reduces the clinical response to fexofenadine. Theoretically, this occurs due to short-term inhibition of organic anion transporting polypeptide (OATP). Recommend separating drug administration and consumption of sweet orange by at least 4 hours.
P-Glycoprotein Substrates
Sweet orange juice seems to modulate P-glycoprotein (P-gp), which might affect the blood levels of P-gp substrates.
Animal and in vitro research suggest that orange juice extract inhibits drug efflux by P-gp, increasing absorption and levels of P-gp substrates. In contrast, pharmacokinetic research in humans shows that drinking large amounts of sweet orange juice decreases absorption and levels of the P-gp substrate celiprolol. This suggests that orange juice actually induces drug efflux by P-gp or affects drug levels by another mechanism such as inhibiting the gut drug transporter called organic anion transporting polypeptide (OATP). Until more is known, sweet orange juice should be used cautiously in people taking P-gp substrates.
Quinolone Antibiotics
Calcium-fortified sweet orange juice might reduce quinolone absorption.
Calcium binds to quinolones in the gut. Theoretically, the calcium in certain fortified orange juices can also bind to quinolone antibiotics and reduce their absorption and levels.
Nettles leaf extract
Antidiabetes Drugs
Theoretically, stinging nettle might have additive effects with antidiabetes drugs.
Clinical research shows that stinging nettle might decrease blood glucose levels in patients with diabetes.
Diuretic Drugs
Theoretically, combining stinging nettle with diuretic drugs may have additive effects.
Animal research suggests that the above ground parts and roots of stinging nettle may have a diuretic effect.
Lithium
Theoretically, stinging nettle might reduce excretion and increase levels of lithium.
Animal research suggests that stinging nettle has diuretic and natriuretic properties, which could alter the excretion of lithium. The dose of lithium might need to be decreased.
Warfarin (Coumadin)
There is some concern that stinging nettle might decrease the effects of anticoagulant drugs such as warfarin.
Stinging nettle contains a significant amount of vitamin K. When taken in large quantities, this might interfere with the activity of warfarin.
Horseradish root extract
Thyroid Hormone
Theoretically, horseradish might interfere with the effects of thyroid hormone.
Horseradish and other members of the cabbage and mustard family are associated with depressed thyroid function.
Yerba Santa leaf extract
Lithium
Yerba santa is thought to have diuretic properties. Theoretically, due to these potential diuretic effects, yerba santa might reduce excretion and increase levels of lithium. The dose of lithium might need to be decreased.
Brand information
Manufacturer and brand details for Tree Country Allergy & Sinus, from the product label.
WishGarden
See all WishGarden products- Name
- WishGarden
- City
- Boulder
- State
- CO
- ZipCode
- 80301
- Phone Number
- 888-301-2926
- Web Address
- WishGardenHerbs.com
Tree Country Allergy & Sinus by WishGarden: Common Questions
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Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
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Our pharmacists answer your medication & supplement questions — free.
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 Tree Country Allergy & Sinus’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Sweet Orange
Interacts with 246 drugsSweet orange is a common citrus fruit that is a good source of vitamin C, fiber, and antioxidants, and is enjoyed as a food worldwide. Its peel and essential oil are used in aromatherapy and...
Read the full Sweet Orange monograph → Herb & supplement monographYerba Santa
Interacts with 1 drugYerba Santa is an aromatic shrub from the western United States and Mexico that has long been used in folk medicine for coughs, congestion, and other respiratory complaints. Modern scientifi...
Read the full Yerba Santa monograph → Herb & supplement monographAmerican Elder
Interacts with 644 drugsAmerican elder is a North American plant whose cooked, ripe berries and flowers are used mainly for colds, flu, and general immune support. The science behind these uses is limited and most...
Read the full American Elder monograph → Herb & supplement monographEchinacea
Interacts with 816 drugsEchinacea is a popular herb taken to help prevent or shorten the common cold, but study results are mixed and the overall benefit appears small at best. It is generally well tolerated for sh...
Read the full Echinacea monograph → Herb & supplement monographYerba Mansa
Interacts with 248 drugsYerba mansa is a traditional Southwestern and Mexican medicinal plant used for sore throats, skin problems, and infections. Modern scientific evidence in humans is very limited, so its effec...
Read the full Yerba Mansa monograph → Herb & supplement monographStinging Nettle
Interacts with 164 drugsStinging nettle is a common plant used as food and in traditional medicine, most often for prostate symptoms, allergies, and joint pain. The evidence is mixed and mostly preliminary, so it i...
Read the full Stinging Nettle monograph → Herb & supplement monographHorseradish
Interacts with 16 drugsHorseradish is a pungent root used as a food and folk remedy, most often for sinus congestion and urinary tract complaints. Human evidence is limited, and while culinary amounts are generall...
Read the full Horseradish monograph →Sources & How We Checked
Tree Country Allergy & Sinus'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 100 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.
Sweet Orange 17 references
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- Kurowska EM, Spence JD, Jordan J, et al. HDL-cholesterol-raising effect of orange juice in subjects with hypercholesterolemia. Am J Clin Nutr 2000;72:1095-100. PubMed
- Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
- Bailey DG, Dresser GK, Munoz C, et al. Reduction of fexofenadine bioavailability by fruit juices. Clin Pharmacol Ther 2001;69:P21.
- Pletz MW, Petzold P, Allen A, et al. Effect of calcium carbonate on bioavailability of orally administered gemifloxacin. Antimicrob Agents Chemother 2003;47:2158-60.. PubMed
- Lilja JJ, Juntti-Patinen L, Neuvonen PJ. Orange juice substantially reduces the bioavailability of the beta-adrenergic-blocking agent celiprolol. Clin Pharmacol Ther 2004;75:184-90.
- Tian R, Koyabu N, Takanaga H, et al. Effects of grapefruit juice and orange juice on the intestinal efflux of P-glycoprotein substrates. Pharm Res 2002;19:802-9. PubMed
- Vanapalli SR, Chen Y, Ellingrod VL, et al. Orange juice decreases the oral bioavailability of ivermectin in health volunteers. Clin Pharmacol Ther 2003;73 (Abstract PDII-A-10):P94.
- Huang SM, Lesko LJ. Drug-drug, drug-dietary supplement, and drug-citrus fruit and other food interactions: what have we learned? J Clin Pharmacol 2004;44:559-69. PubMed
- Koitabashi Y, Kumai T, Matsumoto N, et al. Orange juice increased the bioavailability of pravastatin, 3-hydroxy-3-methylglutaryl CoA reductase inhibitor, in rats and healthy human subjects. Life Sci 2006;78:2852-9. PubMed
- Takanaga H, Ohnishi A, Yamada S, et al. Polymethoxylated flavones in orange juice are inhibitors of P-glycoprotein but not cytochrome P450 3A4. J Pharmacol Exp Ther 2000;293:230-6. DOI
- Greenblatt DJ. Analysis of drug interactions involving fruit beverages and organic anion-transporting polypeptides. J Clin Pharmacol 2009;49:1403-7. PubMed
- Bailey DG. Fruit juice inhibition of uptake transport: a new type of food-drug interaction. Br J Clin Pharmacol 2010;70:645-55. PubMed
- Kamath AV, Yao M, Zhang Y, Chong S. Effect of fruit juices on the oral bioavailability of fexofenadine in rats. J Pharm Sci 2005;94:233-9. PubMed
- Kays MB, Overholser BR, Mueller BA, et al. Effects of sevelamer hydrochloride and calcium acetate on the oral bioavailability of ciprofloxacin. Am J Kidney Dis. 2003;42(6):1253-9. PubMed
- Neuhofel, A. L., Wilton, J. H., Victory, J. M., Hejmanowsk, L. G., and Amsden, G. W. Lack of bioequivalence of ciprofloxacin when administered with calcium-fortified orange juice: a new twist on an old interaction. J Clin Pharmacol. 2002;42(4):461-466. DOI
American Elder 2 references
- The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999.
- Budzinski JW, Foster BC, Vandenhoek S, Arnason JT. An in vitro evaluation of human cytochrome P450 3A4 inhibition by selected commercial herbal extracts and tinctures. Phytomedicine 2000;7:273-82. PubMed
Echinacea 51 references
- Mullins RJ. Echinacea-associated anaphylaxis. Med J Aust 1998;168:170-1. PubMed
- Mullins RJ. Allergic reactions to Echinacea. J Allergy Clin Immunol 2000;104:S340-341 (Abstract 1003).
- Chavez ML, Chavez PI. Echinacea. Hosp Pharm 1998;33:180-8.
- Grimm W, Muller HH. A randomized controlled trial of the effect of fluid extract of Echinacea purpurea on the incidence and severity of colds and respiratory infections. Am J Med 1999;106:138-43. PubMed
- Taylor JA, Weber W, Standish L, et al. Efficacy and safety of echinacea in treating upper respiratory tract infections in children: a randomized controlled trial. JAMA 2003;290:2824-30.. PubMed
- Luettig B, Steinmuller C, Gifford GE, et al. Macrophage activation by the polysaccharide arabinogalactan isolated from plant cell cultures of Echinacea purpurea. J Natl Cancer Inst 1989;81:669-75. PubMed
- Stimpel M, Proksch A, Wagner H, et al. Macrophage activation and induction of macrophage cytotoxicity by purified polysaccharide fractions from the plant Echinacea purpurea. Infect Immun 1984;46:845-9. PubMed
- Budzinski JW, Foster BC, Vandenhoek S, Arnason JT. An in vitro evaluation of human cytochrome P450 3A4 inhibition by selected commercial herbal extracts and tinctures. Phytomedicine 2000;7:273-82. PubMed
- Gallo M, Sarkar M, Au W, et al. Pregnancy outcome following gestational exposure to echinacea: A prospective controlled study. Arch Intern Med 2000;160:3141-3. PubMed
- Soon SL, Crawford RI. Recurrent erythema nodosum associated with echinacea herbal therapy. J Am Acad Dermatol 2001;44:298-9. PubMed
- Mullins RJ, Heddle R. Adverse reactions associated with echinacea: the Australian experience. Ann Allergy Asthma Immunol 2002;88:42-51. PubMed
- Logan JL, Ahmed J. Critical hypokalemic renal tubular acidosis due to Sjogren's syndrome: association with the purported immune stimulant echinacea. Clin Rheumatol 2003;22:158-9.
- Schulten B, Bulitta M, Ballering-Bruhl B, et al. Efficacy of Echinacea purpurea in patients with a common cold. A placebo-controlled, randomised, double-blind clinical trial. Arzneimittelforschung 2001;51:563-8.. PubMed
- Yale SH, Glurich I. Analysis of the inhibitory potential of Ginkgo biloba, Echinacea purpurea, and Serenoa repens on the metabolic activity of cytochrome P450 3A4, 2D6, and 2C9. J Altern Complement Med 2005;11:433-9.
- Yale SH, Liu K. Echinacea purpurea therapy for the treatment of the common cold: a randomized, double-blind, placebo-controlled clinical trial. Arch Intern Med 2004;164:1237-41. PubMed
- Gorski JC, Huang S, Zaheer NA, et al. The effect of echinacea (Echinacea purpurea root) on cytochrome P450 activity in vivo.Clin Pharmacol Ther 2003;73 (Abstract PDII-A-8):P94. PubMed
- Lee AN, Werth VP. Activation of autoimmunity following use of immunostimulatory herbal supplements. Arch Dermatol 2004;140:723-7. PubMed
- Goel V, Lovlin R, Barton R, et al. Efficacy of a standardized echinacea preparation (Echinilin) for the treatment of the common cold: a randomized, double-blind, placebo-controlled trial. J Clin Pharm Ther 2004;29:75-83.
- Barrett B. Medicinal properties of Echinacea: a critical review. Phytomedicine 2003;10:66-86. PubMed
- Huntley AL, Thompson Coon J, Ernst E. The safety of herbal medicinal products derived from Echinacea species: a systematic review. Drug Saf 2005;28:387-400. PubMed
- Turner RB, Bauer R, Woelkart K, et al. An evaluation of Echinacea angustifolia in experimental rhinovirus infections. N Engl J Med 2005;353:341-8.
- Gurley BJ, Gardner SF, Hubbard MA, et al. In vivo assessment of botanical supplementation on human cytochrome P450 phenotypes: Citrus aurantium, Echinacea purpurea, milk thistle, and saw palmetto. Clin Pharmacol Ther 2004;76:428-40. .
- Perri D, Dugoua JJ, Mills E, Koren G. Safety and efficacy of echinacea (Echinacea augustafolia, e. purpurea and e. pallida) during pregnancy and lactation. Can J Clin Pharmacol 2006;13:e262-7.
- Kocaman O, Hulagu S, Senturk O. Echinacea-induced severe acute hepatitis with features of cholestatic autoimmune hepatitis. Eur J Intern Med 2008;19:148. PubMed
- Barrett B, Brown R, Rakel D. et al. Echinacea for treating the common cold: a randomized trial. Ann Intern Med 2010;153:769-77. PubMed
- Press Release: Echinacea herbal products should not be used in children under 12 years old. Medicines and Healthcare Products Regulatory Agency (UK). August 20, 2012. Available at: www.mhra.gov.uk/NewsCentre/Pressreleases/CON180627. (Accessed 21 October
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- Haller J, Freund, TF, Pelczer, KG, et al. The anxiolytic potential and psychotropic side effects of an echinacea preparation in laboratory animals and healthy volunteers. Phytother.Res. 2013;27:54-61.
- Grbic J, Wexler I, Celenti R, et al. A phase II trial of a transmucosal herbal patch for the treatment of gingivitis. J Am Dent.Assoc. 2011;142:1168-75. PubMed
- Schapowal A, Berger D, Klein P, et al. Echinacea/sage or chlorhexidine/lidocaine for treating acute sore throats: a randomized double-blind trial. Eur.J Med Res 9-1-2009;14:406-12. PubMed
- Bossaer JB and Odle BL. Probable etoposide interaction with Echinacea. J.Diet.Suppl 2012;9:90-5.
- Abdul MI, Jiang X, Williams KM, et al. Pharmacokinetic and pharmacodynamic interactions of echinacea and policosanol with warfarin in healthy subjects. Br J Clin.Pharmacol. 2010;69:508-15. PubMed
- Kemp, D. E. and Franco, K. N. Possible leukopenia associated with long-term use of echinacea. J Am Board Fam.Pract. 2002;15(5):417-419.
- Liatsos, G., Elefsiniotis, I., Todorova, R., and Moulakakis, A. Severe thrombotic thrombocytopenic purpura (TTP) induced or exacerbated by the immunostimulatory herb Echinacea. Am J Hematol. 2006;81(3):224.
- Penzak, S. R., Robertson, S. M., Hunt, J. D., Chairez, C., Malati, C. Y., Alfaro, R. M., Stevenson, J. M., and Kovacs, J. A. Echinacea purpurea significantly induces cytochrome P450 3A activity but does not alter lopinavir-ritonavir exposure in healthy s
- Maskatia, Z. K. and Baker, K. Hypereosinophilia associated with echinacea use. South.Med J 2010;103(11):1173-1174. PubMed
- Parnham MJ. Benefit-risk assessment of the squeezed sap of the purple coneflower (Echinacea purpurea) for long-term oral immunostimulation. Phytomed 1996;3:95-102. PubMed
- Schroder-Aasen T, Molden G, Nilsen OG. In vitro inhibition of CYP3A4 by the multiherbal commercial product Sambucus Force and its main constituents Echinacea purpurea and Sambucus nigra. Phytother Res 2012;26(11):1606-13.
- Moltó J, Valle M, Miranda C, et al. Herb-drug interaction between Echinacea purpurea and darunavir-ritonavir in HIV-infected patients. Antimicrob Agents Chemother 2011;55(1):326-30.
- Goey AK, Meijerman I, Rosing H, et al. The effect of Echinacea purpurea on the pharmacokinetics of docetaxel. Br J Clin Pharmacol 2013;76(3):467-74.
- Moltó J, Valle M, Miranda C, et al. Herb-drug interaction between Echinacea purpurea and etravirine in HIV-infected patients. Antimicrob Agents Chemother 2012;56(10):5328-31. PubMed
- Lawrenson JA, Walls T, Day AS. Echinacea-induced acute liver failure in a child. J Paediatr Child Health 2014;50(10):841.
- Hansen TS, Nilsen OG. In vitro CYP3A4 metabolism: inhibition by Echinacea purpurea and choice of substrate for the evaluation of herbal inhibition. Basic Clin Pharmacol Toxicol 2008;103:445-9.
- Gabranis I, Koufakis T1, Papakrivos I, Batala S. Echinacea-associated acute cholestatic hepatitis. J Postgrad Med. 2015;61(3):211-2. PubMed
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Yerba Mansa 1 reference
- Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
Stinging Nettle 23 references
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- Newall CA, Anderson LA, Philpson JD. Herbal Medicine: A Guide for Healthcare Professionals. London, UK: The Pharmaceutical Press, 1996.
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- Leung AY, Foster S. Encyclopedia of Common Natural Ingredients Used in Food, Drugs and Cosmetics. 2nd ed. New York, NY: John Wiley & Sons, 1996.
- Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
- Mittman P. Randomized, double-blind study of freeze-dried Urtica dioica in the treatment of allergic rhinitis. Planta Med 1990;56:44-7.
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- Sahin, M., Yilmaz, H., Gursoy, A., Demirel, A. N., Tutuncu, N. B., and Guvener, N. D. Gynaecomastia in a man and hyperoestrogenism in a woman due to ingestion of nettle (Urtica dioica). N.Z.Med.J. 2007;120(1265):U2803.
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