Interactions on record — worth a quick check against your medications. Based on 10 of 24 ingredients. Check your meds →
Dietary supplement

Triple EFA Guard Softgels Ingredients & Drug Interactions

by Perque

Triple EFA Guard Softgels label
See full label image
Softgel Capsule Category: Other Combinations
Most serious interaction: Moderate
Clinical methodology reviewed by · Updated Sep 23, 2026 · Label data from the NIH DSLD
What is this page for?

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

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

The interaction bottom line Most serious interaction: Moderate

Triple EFA Guard Softgels is a dietary supplement by Perque with 24 active ingredients. Its ingredients are commonly taken for heart health, healthy cooking fat, skin moisturizing.Based on those ingredients, 2,142 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Carob flavonoid extract, Vitamin E, organic Flax seed Oil. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

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Check Your Meds Against Triple EFA Guard Softgels by Perque

Ask about any prescription or over-the-counter medication and we check it for interactions with Triple EFA Guard Softgels by Perque — and tell you which ingredient is responsible.

Pharmacist-reviewed data Checks every ingredient Answer in seconds
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HelloPharmacist Scorecard of Triple EFA Guard Softgels by Perque

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

From our pharmacy team — supplement deep dive

Generated from HelloPharmacist’s pharmacist-curated databases and editorial rules · Last generated Sep 17, 2026

What’s inside

Partial disclosure
Ingredient Transparency · database check
Partial

Most active ingredients list an amount, but at least one is hidden in a blend or missing.

Why this rating?
  • The label discloses an exact amount for 22 of its 24 active ingredients.
  • “Omega-9 Fatty Acids” is listed as a grouped ingredient — the label doesn't break down how much of each component you get.
  • “Total Omega-3 Fatty Acids” is listed as a grouped ingredient — the label gives one combined amount (405 mg) without saying how much of each component you get.
  • “Total Omega-6 Fatty Acids” is listed as a grouped ingredient — the label gives one combined amount (100 mg) without saying how much of each component you get.

Triple EFA Guard Softgels contains 24 ingredients total. The active components are essential fatty acids and related compounds: eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), which are omega-3 fatty acids; gamma-linolenic acid (an omega-6); oleic acid (an omega-9); linoleic acid; alpha-linolenic acid; conjugated linolenic acid; phosphatidylcholine and phosphatidylethanolamine (phospholipids); and vitamin E and vitamin C (ascorbyl palmitate).

The softgels also contain oils and extracts from flax seed, black currant, safflower, olive, and marine sources, plus glycerol, sterols, and gelatin. There are no inactive fillers or binders listed.

Does it work?

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

This product doesn't appear to be marketed for a specific use, so we graded its ingredients' overall clinical evidence instead.

Strong

Strong clinical evidence supports its ingredients for:

Why this rating?
  • We looked at the product name, claims, and label statements and couldn't find a stated purpose to grade.
  • Since the label doesn't commit to one use, we graded the ingredients' overall clinical evidence instead.
  • On file: Vitamin C deficiency — rated "Effective" (Vitamin C) (Natural Medicines).
  • On file: Vitamin E deficiency — rated "Effective" (Vitamin E) (Natural Medicines).
  • On file: Ataxia with vitamin E deficiency (AVED) — rated "Effective" (Vitamin E) (Natural Medicines).
  • On file: Constipation — rated "Likely Effective" (Glycerol) (Natural Medicines).
  • On file: Alzheimer disease — rated "Possibly Effective" (Vitamin E) (Natural Medicines).

The evidence for this product's active ingredients is limited. Vitamin E is effective for vitamin E deficiency and possibly effective for Alzheimer's disease, beta-thalassemia, and glucose-6-phosphate dehydrogenase deficiency.

Vitamin C is effective for vitamin C deficiency and possibly effective for anemia of chronic disease, atrial fibrillation, cataracts, and exercise-induced respiratory infections. Phosphatidylcholine is possibly effective for ulcerative colitis; evidence for other conditions like Alzheimer's disease and nonalcoholic fatty liver disease is insufficient.

Oleic acid is possibly effective for high cholesterol and coronary heart disease. Gelatin, flaxseed oil, black currant, olive oil, and glycerol lack sufficient reliable evidence or show no documented effectiveness for most conditions they're used for.

For the omega-3, omega-6, and omega-9 fatty acids themselves, we hold no effectiveness ratings in our data.

The evidence, ingredient by ingredient Oleic Acid Gelatin Vitamin E Vitamin C Phosphatidylcholine Flaxseed Oil Olive Black Currant

How safe is it?

Well-documented data
Safety Information · database check
Well characterized

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

Why this rating?
  • We hold adverse-effect (side-effect) data for 9 of the 10 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 10 of 10.
  • General safety write-ups exist for 10 of 10.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

Vitamin E is generally well tolerated at normal doses but carries caution notes about high-dose long-term use, which may increase bleeding risk and other harms; avoid high-dose supplements unless your doctor directs it. Vitamin C is generally safe at normal doses but very high doses can cause abdominal cramps, diarrhea, and kidney stones in susceptible people; avoid high-dose supplements unless advised by your doctor.

Phosphatidylcholine is generally well tolerated but high doses (30 grams daily) can cause digestive upset and diarrhea. Gelatin is widely consumed in food and generally safe, though oral use may cause belching, bloating, and indigestion; allergic reactions including anaphylaxis are rare but possible.

Flaxseed oil is generally well tolerated but may cause dry mouth, indigestion, or loose stools at higher doses. Black currant oil, olive oil, and glycerol are similarly well tolerated in typical amounts.

For pregnancy: vitamin E is possibly safe, vitamin C is likely to possibly safe, phosphatidylcholine safety is not well studied beyond food sources, gelatin is likely safe, flaxseed oil is possibly safe, and black currant, olive oil, and glycerol lack sufficient pregnancy safety data — check with your doctor. For breastfeeding: vitamin E is likely to possibly unsafe at high doses, vitamin C is likely safe, phosphatidylcholine and flaxseed oil lack sufficient data, gelatin is likely safe, and black currant and olive oil lack sufficient data — discuss with your healthcare provider before use.

Side effects, ingredient by ingredient Oleic Acid Gelatin Vitamin E Vitamin C Phosphatidylcholine Flaxseed Oil Olive Black Currant

Meds to double-check

Moderate interaction found
Known Interaction Concern · database check
Moderate identified

The most serious documented interaction for these ingredients is Moderate. Check your medications for a personalized result.

Why this rating?
  • 6 of the 10 matched ingredients can interact with medications — Carob, Vitamin E, Flaxseed Oil, Vitamin C, Black Currant, among others.
  • The most serious interaction on file is rated Moderate.
  • Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs; immunosuppressants / transplant drugs; cancer treatments; diabetes medications.
  • For scale: 2,143 individual medications appear in the full list. A big number alone doesn't make a product dangerous — what matters is whether YOUR medication is on it, so run yours through the interaction checker on this page.

Before taking Triple EFA Guard, double-check with your doctor or pharmacist if you take any blood thinners or antiplatelet drugs (like warfarin, aspirin, or clopidogrel) — vitamin E and flaxseed oil may increase bleeding risk. Also confirm if you're on chemotherapy drugs, blood pressure medications, diabetes medications, levothyroxine, or cyclosporine, since multiple ingredients in this product have documented interactions.

If you take niacin or aluminum-containing compounds, vitamin C may interfere. And if you're on phenothiazines, the black currant oil component carries a theoretical seizure risk.

Check your own medication Run your meds through the checker above

The bottom line

Scorecard at a glancePartially disclosed formula with strong clinical evidence behind its ingredients' uses. Moderate medication interactions have been identified, and safety information is well characterized.

Triple EFA Guard is an omega fatty acid and antioxidant blend that may be worth considering if you're looking to support your intake of essential fats, though the evidence for most claimed benefits is limited or not yet established in our data. If you take blood thinners, blood pressure medications, diabetes drugs, chemotherapy, or certain other prescription medications, you'll want to check your exact drugs against the interaction list before starting this product, because several ingredients carry documented interactions.

Talk with your own doctor or pharmacist before adding this to your routine, especially if you take any prescription medications, are pregnant or breastfeeding, or take high-dose supplements.

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

Assessment coverage: 10 of 24 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Apr 25, 2013.

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

At a glance

General information

Key facts about Triple EFA Guard Softgels, straight from the product label.

Brand Perque
Net contents 180 Softgel(s)
Market status On market
Date entered into DSLD Apr 25, 2013
DSLD ID 18854
Product type Other Combinations
Supplement form Softgel Capsule
Dietary claims / uses All Other
Intended target group(s) Vegetarian, Adult (18 - 50 Years), Gluten Free, Dairy Free, Sugar Free
From the label
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.

Supplement Facts

The label details for Triple EFA Guard Softgels by Perque, sourced from the NIH Dietary Supplement Label Database.

Supplement Facts

Daily Value (DV) Target Group(s):
Adults and children 4 or more years of age
Minimum serving Sizes:
1 Softgel(s)
Maximum serving Sizes:
4 Softgel(s)
Servings per container
120
IngredientAmount% DV
Eicosapentaenoic Acid20 mg--
Docosahexaenoic Acid50 mg--
Gamma-Linolenic Acid15 mg--
Omega-9 Fatty Acids0 NP--
kosher Gelatin289 mg--
Total Omega-3 Fatty Acids405 mg--
Vitamin E5 IU17%
Ascorbyl Palmitate2 mg--
Conjugated Linoleic Acid150 mg--
Phosphatidylcholine1500 mcg--
Total Omega-6 Fatty Acids100 mg--
Linoleic Acid85 mg--
Oleic Acid20 mg--
Alpha-Linolenic Acid335 mg--
Energized Nutrients0 NP--
Phosphatidylethanolamine1200 mcg--
Phosphatidylinositol900 mcg--
organic Flax seed Oil520 mg--
Sterols1500 mcg--
Sources & Ingredients0 NP--
Organic olive oil210 mg--
Organic safflower oil190 mg--
Marine lipids105 mg--
Black currant oil100 mg--
Glycerol133 mg--
Water43 mg--
Carob flavonoid extract42 mg--

Tap any ingredient to jump to its full detail below.

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

KEEP OUT OF REACH OF CHILDREN.

Do not use product if the tamper-resist shrink band around the cap or the inner seal beneath the cap appears to have been tampered with or is missing.

WARNING: Pregnant and nursing mothers need to check with their health professional before taking supplements.

Storage

Must be stored with cap on tightly in a cool, dry place.

General Statements

UNIQUELY PERQUE 100% ACTIVE 100% NATURAL 100% VERIFIED

Lot # and Expiration Date:

Improves Brain, Heart, and Neurohormones

Patents Pending

Full disclosure label (no hidden or inactive ingredients)

Seals/Symbols

RECYCLE

GMO FREE

ENVIRONMENT FRIENDLY ORGANIC INGREDIENTS

BPA FREE POP FREE TOX MIN Phthalates FREE SOLVENT FREE

V {Vegetarian} {No Gluten} {No Milk} {No Sugar} {No Egg}

FDA Statement of Identity

Dietary Supplement

Suggested/Recommended/Usage/Directions

Directions: As a dietary supplement, take one (1) to four (4) softgel capsules daily with meals or as directed by your health professional.

General

5/12

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

See for yourself

Triple EFA Guard Softgels by Perque label

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

Triple EFA Guard Softgels label

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

View the full label (PDF)
What’s inside

The Ingredients in Triple EFA Guard Softgels by Perque

These are the 24 active ingredients this product is made of. Select any to open its full monograph.

Serving size1 Softgel(s) Dosage formSoftgel Capsule Servings per container120 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.

Omega-9 Fatty Acids

0 NP per serving

Kosher Gelatin

No known
interactions
289 mg per serving

Gelatin is a protein made from animal collagen, used as a food, a capsule ingredient, and a supplement for joint, skin, and bone health. For most heal...

Kosher Gelatin monograph & interactions

Total Omega-3 Fatty Acids

405 mg per serving
  • › Eicosapentaenoic Acid
  • › Docosahexaenoic Acid
  • › Alpha-Linolenic Acid

Vitamin E

Interacts with
764 drugs
5 IU per serving Form: Mixed Tocopherols

Vitamin E is an essential fat-soluble vitamin and antioxidant that most people get in adequate amounts from a normal diet. Supplements can help correc...

Vitamin E monograph & interactions

Ascorbyl Palmitate

Interacts with
207 drugs
2 mg per serving

Vitamin C (ascorbic acid) is an essential nutrient your body needs but cannot make, so you must get it from food or supplements. It's important for im...

Ascorbyl Palmitate monograph & interactions

Phosphatidylcholine

No known
interactions
1500 mcg per serving

Phosphatidylcholine is a phospholipid that is part of every cell membrane and a source of choline. People take it for liver, brain, and gut health, bu...

Phosphatidylcholine monograph & interactions

Total Omega-6 Fatty Acids

100 mg per serving
  • › Gamma-Linolenic Acid
  • › Linoleic Acid

Energized Nutrients

0 NP per serving

Phosphatidylethanolamine

1200 mcg per serving

Phosphatidylinositol

900 mcg per serving

Organic Flax seed Oil

Interacts with
293 drugs
520 mg per serving

Flaxseed oil is a plant-based source of the omega-3 fatty acid ALA, which the body can partly convert to the omega-3s found in fish oil. It may help s...

Organic Flax seed Oil monograph & interactions

Sterols

1500 mcg per serving Form: phytosterols

Sources & Ingredients

0 NP per serving

Organic olive oil

No known
interactions
210 mg per serving

Olive comes from the same tree that gives us olives and olive oil, and its leaf and fruit contain antioxidant compounds like oleuropein and hydroxytyr...

Organic olive oil monograph & interactions

Organic safflower oil

190 mg per serving Form: Conjugated Linoleic Acid

Marine lipids

105 mg per serving

Black currant oil

Interacts with
140 drugs
100 mg per serving

Black currant is a nutritious berry that is rich in vitamin C and antioxidants, and its seed oil contains the omega-6 fatty acid GLA. While it is enjo...

Black currant oil monograph & interactions

Glycerol

No known
interactions
133 mg per serving Form: vegetable

Glycerol (glycerin) is a sweet, syrupy compound made naturally in the body and widely used in foods, skin products, and medicines. It is well establis...

Glycerol monograph & interactions

Water

43 mg per serving

Carob flavonoid extract

Interacts with
2,022 drugs
42 mg per serving

Carob is a Mediterranean tree whose pods are widely used as a caffeine-free, naturally sweet cocoa alternative and as a thickener (carob gum). It is m...

Carob flavonoid extract monograph & interactions
Interaction report

Triple EFA Guard Softgels by Perque Drug Interactions

Want to check YOUR meds against Triple EFA Guard Softgels?

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

 Go to the checker
2,142Drugs
1,018 Moderate 1,124 Minor

Ingredients driving the most interactions

Carob flavonoid extract 2,022
Vitamin E 764
organic Flax seed Oil 293
Ascorbyl Palmitate 207
Black currant oil 140

Individual Drug Interactions

The ingredients in Triple EFA Guard Softgels interact with 2,142 drugs. Click any drug to see the details.

6 of the 24 ingredients in Triple EFA Guard Softgels interact with drugs. Each result below shows which ingredient is responsible. Carob flavonoid extract Vitamin E organic Flax seed Oil Ascorbyl Palmitate Black currant oil Oleic Acid

Each ingredient & the kinds of drugs it affects

For each ingredient in Triple EFA Guard Softgels 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.

Carob flavonoid extract1 drug type · 2,022 drugs

Oral Drugs

Theoretically, carob might also impair the absorption of oral drugs.
Laboratory research shows that carob, when consumed as part of the diet or used as a thickening agent in infant formula, reduces the absorption of certain minerals. Take carob 30-60 minutes after oral medications.

Likelihood Possible Evidence D
Carob flavonoid extract full monograph & interactions

Vitamin E8 drug types · 764 drugs

Alkylating Agents

Theoretically, antioxidant effects of vitamin E might reduce the effectiveness of alkylating agents.
There's concern that antioxidants could reduce the activity of chemotherapy drugs which generate free radicals, such as cyclophosphamide, chlorambucil, carmustine, busulfan, and thiotepa. However, some researchers theorize that antioxidants might make chemotherapy more effective by reducing oxidative stress that might interfere with apoptosis (cell death) of cancer cells. More evidence is needed to determine what effect, if any, antioxidants such as vitamin E have on chemotherapy. Advise patients to consult their oncologist before using vitamin E supplements, especially in high doses.

Likelihood Possible Evidence D
Anticoagulant/Antiplatelet Drugs

Concomitant use of vitamin E and anticoagulant or antiplatelet agents might increase the risk of bleeding.
Vitamin E seems to inhibit of platelet aggregation and antagonize the effects of vitamin K-dependent clotting factors. These effects appear to be dose-dependent, and are probably only likely to be clinically significant with doses of at least 800 units daily. Mixed tocopherols, such as those found in food, might have a greater antiplatelet effect than alpha-tocopherol. RRR alpha-tocopherol (natural vitamin E) 1000 IU daily antagonizes vitamin K-dependent clotting factors. Advise patients to avoid high doses of vitamin E, especially in people with low vitamin K intake or other risk factors for bleeding.

Likelihood Possible Evidence B
Antitumor Antibiotics

Theoretically, antioxidant effects of vitamin E might reduce the effectiveness of antitumor antibiotics.
There's concern that antioxidants could reduce the activity of antitumor antibiotic drugs such as doxorubicin, which generate free radicals. However, some researchers theorize that antioxidants might make chemotherapy more effective by reducing oxidative stress that might interfere with apoptosis (cell death) of cancer cells. More evidence is needed to determine what effect, if any, antioxidants such as vitamin E have on chemotherapy involving antitumor antibiotics. Advise patients to consult their oncologist before using vitamin E supplements, especially in high doses.

Likelihood Possible Evidence D
Cyclosporine (Neoral, Sandimmune)

A specific form of vitamin E might increase absorption and levels of cyclosporine.
There is some evidence that one specific formulation of vitamin E (D-alpha-tocopheryl-polyethylene glycol-1000 succinate, TPGS, tocophersolan, Liqui-E) might increase absorption of cyclosporine. This vitamin E formulation forms micelles which seems to increase absorption of cyclosporine by 40% to 72% in some patients. However, this interaction is unlikely to occur with the usual forms of vitamin E.

Likelihood Unlikely Evidence B
Cytochrome P450 3A4 (Cyp3A4) Substrates

Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Vitamin E appears to bind with the nuclear receptor, pregnane X receptor (PXR), which results in increased expression of CYP3A4. Although the clinical significance of this is not known, use caution when considering concomitant use of vitamin E and other drugs affected by these enzymes.

Likelihood Possible Evidence D
Selumetinib (Koselugo)

Taking selumetinib with vitamin E can result in a total daily dose of vitamin E that exceeds safe limits and therefore might increase the risk of bleeding.
Selumetinib contains 48-54 IU vitamin E per capsule. The increased risk of bleeding with vitamin E appears to be dose-dependent. Be cautious when using selumetinib in combination with supplemental vitamin E, especially in patients at higher risk of bleed, such as those with chronic conditions and those taking antiplatelet drugs.

Likelihood Possible Evidence D
Warfarin (Coumadin)

Using vitamin E with warfarin might increase the risk of bleeding.
Due to interference with production of vitamin K-dependent clotting factors, use of more than 400 IU of vitamin E daily with warfarin might increase prothrombin time (PT), INR, and the risk of bleeding,. At a dose of 1000 IU per day, vitamin E can antagonize vitamin K-dependent clotting factors even in people not taking warfarin. Limited clinical evidence suggests that doses up to 1200 IU daily may be used safely by patients taking warfarin, but this may not be applicable in all patient populations.

Likelihood Possible Evidence B
Niacin

Vitamin E might decrease the beneficial effects of niacin on high-density lipoprotein (HDL) cholesterol levels.
A combination of niacin and simvastatin (Zocor) effectively raises high-density lipoprotein (HDL) cholesterol levels in people with coronary disease and low HDL levels. Clinical research shows that taking a combination of antioxidants (vitamin C, vitamin E, beta-carotene, and selenium) along with niacin and simvastatin (Zocor) attenuates this rise in HDL, specifically the HDL-2 and apolipoprotein A1 fractions, by more than 50%. Vitamin E alone combined with a statin does not seem to decrease HDL levels. It is not known whether the adverse effect on HDL is due to one of the other antioxidants or to the combination. It also is not known whether it will occur in other patient populations.

Likelihood Possible Evidence A
Vitamin E full monograph & interactions

organic Flax seed Oil3 drug types · 293 drugs

Anticoagulant/Antiplatelet Drugs

Theoretically, using flaxseed oil in combination with anticoagulant or antiplatelet drugs might have additive effects and increase the risk of bleeding.
Small clinical studies show that consuming flaxseed oil might decrease platelet aggregation and increase bleeding time.

Likelihood Possible Evidence D
Antihypertensive Drugs

Theoretically, combining flaxseed oil with other antihypertensive drugs might have additive effects and increase the risk of hypotension.
Some clinical evidence suggests that long-term consumption of flaxseed oil can modestly lower systolic and diastolic blood pressure, while other clinical research shows no effect.

Likelihood Possible Evidence D
Ezetimibe (Zetia)

Concomitant use of flaxseed oil and ezetimibe reduces the absorption of alpha-linolenic acid from flaxseed oil.
In one clinical study, concomitant consumption of ezetimibe 10 mg daily with flaxseed oil 2 grams providing 1 gram of alpha-linolenic acid daily blocked the absorption of alpha-linolenic acid, resulting in an overall reduction in alpha-linolenic plasma levels from baseline.

Likelihood Probable Evidence B
organic Flax seed Oil full monograph & interactions

Ascorbyl Palmitate13 drug types · 207 drugs

Alkylating Agents

Theoretically, antioxidant effects of vitamin C might reduce the effectiveness of alkylating agents.
The use of antioxidants like vitamin C during chemotherapy is controversial. There is concern that antioxidants could reduce the activity of chemotherapy drugs that generate free radicals, such as cyclophosphamide, chlorambucil, carmustine, busulfan, and thiotepa. In contrast, some researchers theorize that antioxidants might make chemotherapy more effective by reducing oxidative stress that could interfere with apoptosis (cell death) of cancer cells. More evidence is needed to determine what effect, if any, antioxidants such as vitamin C have on chemotherapy.

Likelihood Possible Evidence D
Aluminum

Vitamin C can increase the amount of aluminum absorbed from aluminum compounds.
Research in animals and humans shows that vitamin C increases aluminum absorption, theoretically by chelating aluminum and keeping it in solution where it is available for absorption. In people with normal renal function, urinary excretion of aluminum will likely increase, making aluminum retention and toxicity unlikely. Patients with renal failure who take aluminum-containing compounds such as phosphate binders should avoid vitamin C supplements in doses above the recommended dietary allowances.

Likelihood Probable Evidence B
Antitumor Antibiotics

Theoretically, the antioxidant effects of vitamin C might reduce the effectiveness of antitumor antibiotics.
The use of antioxidants like vitamin C during chemotherapy is controversial. There is concern that antioxidants could reduce the activity of chemotherapy drugs which generate free radicals, such as doxorubicin. In contrast, some researchers theorize that antioxidants might make chemotherapy more effective by reducing oxidative stress that could interfere with apoptosis (cell death) of cancer cells. More evidence is needed to determine what effects, if any, antioxidants such as vitamin C have on chemotherapy.

Likelihood Possible Evidence D
Estrogens

Vitamin C might increase blood levels of estrogens.
Increases in plasma estrogen levels of up to 55% occur under some circumstances when vitamin C is taken concurrently with oral contraceptives or hormone replacement therapy, including topical products. It is suggested that vitamin C prevents oxidation of estrogen in the tissues, regenerates oxidized estrogen, and reduces sulfate conjugation of estrogen in the gut wall. When tissue levels of vitamin C are high, these processes are already maximized and supplemental vitamin C does not have any effect on estrogen levels. Increases in plasma estrogen levels may occur when patients who are deficient in vitamin C take supplements. Monitor these patients for estrogen-related side effects.

Likelihood Probable Evidence B
Fluphenazine (Prolixin)

Theoretically, vitamin C might decrease levels of fluphenazine.
In one patient there was a clinically significant decrease in fluphenazine levels when vitamin C (500 mg twice daily) was started. The mechanism is not known, and there is no further data to confirm this interaction.

Likelihood Possible Evidence D
Indinavir (Crixivan)

Vitamin C can modestly reduce indinavir levels.
One pharmacokinetic study shows that taking vitamin C 1 gram orally once daily along with indinavir 800 mg orally three times daily reduces the area under the concentration-time curve of indinavir by 14%. The mechanism of this interaction is unknown, but it is unlikely to be clinically significant in most patients. The effect of higher doses of vitamin C on indinavir levels is unknown.

Likelihood Probable Evidence B
Levothyroxine (Synthroid, Others)

Vitamin C can increase levothyroxine absorption.
Two clinical studies in adults with poorly controlled hypothyroidism show that swallowing levothyroxine with a glass of water containing vitamin C 500-1000 mg in solution reduces thyroid stimulating hormone (TSH) levels and increases thyroxine (T4) levels when compared with taking levothyroxine alone. This suggests that vitamin C increases the oral absorption of levothyroxine, possibly due to a reduction in pH.

Likelihood Probable Evidence B
Warfarin (Coumadin)

High-dose vitamin C might reduce the levels and effectiveness of warfarin.
Vitamin C in high doses may cause diarrhea and possibly reduce warfarin absorption. There are reports of two people who took up to 16 grams daily of vitamin C and had a reduction in prothrombin time. Lower doses of 5-10 grams daily can also reduce warfarin absorption. In many cases, this does not seem to be clinically significant. However, a case of warfarin resistance has been reported for a patient who took vitamin C 500 mg twice daily. Cessation of vitamin C supplementation resulted in a rapid increase in international normalized ratio (INR). Tell patients taking warfarin to avoid taking vitamin C in excessively high doses (greater than 10 grams daily). Lower doses may be safe, but the anticoagulation activity of warfarin should be monitored. Patients who are stabilized on warfarin while taking vitamin C should avoid adjusting vitamin C dosage to prevent the possibility of warfarin resistance.

Likelihood Possible Evidence D
Acetaminophen (Tylenol, Others)

High-dose vitamin C might slightly prolong the clearance of acetaminophen.
A small pharmacokinetic study in healthy volunteers shows that taking high-dose vitamin C (3 grams) 1.5 hours after taking acetaminophen 1 gram slightly increases the apparent half-life of acetaminophen from around 2.3 hours to 3.1 hours. Ascorbic acid competitively inhibits sulfate conjugation of acetaminophen. However, to compensate, elimination of acetaminophen glucuronide and unconjugated acetaminophen increases. This effect is not likely to be clinically significant.

Likelihood Probable Evidence B
Aspirin

Acidification of the urine by vitamin C might increase aspirin levels.
It has been suggested that acidification of the urine by vitamin C could increase reabsorption of salicylates by the renal tubules, and increase plasma salicylate levels. However, short-term use of up to 6 grams daily of vitamin C does not seem to affect urinary pH or salicylate excretion, suggesting this interaction is not clinically significant.

Likelihood Possible Evidence B
Choline Magnesium Trisalicylate (Trilisate)

Acidification of the urine by vitamin C might increase choline magnesium trisalicylate levels.
It has been suggested that acidification of the urine by vitamin C could increase reabsorption of salicylates by the renal tubules, and increase plasma salicylate levels. However, short-term use of up to 6 grams daily of vitamin C does not seem to affect urinary pH or salicylate excretion, suggesting this interaction probably is not clinically significant.

Likelihood Possible Evidence B
Niacin

Vitamin C might decrease the beneficial effects of niacin on high-density lipoprotein (HDL) cholesterol levels.
A combination of niacin and simvastatin (Zocor) effectively raises HDL cholesterol levels in patients with coronary disease and low HDL levels. Clinical research shows that taking a combination of antioxidants (vitamin C, vitamin E, beta-carotene, and selenium) along with niacin and simvastatin (Zocor) attenuates this rise in HDL, specifically the HDL-2 and apolipoprotein A1 fractions, by more than 50% in patients with coronary disease. It is not known whether this adverse effect is due to a single antioxidant such as vitamin C, or to the combination. It also is not known whether it will occur in other patient populations.

Likelihood Possible Evidence A
Salsalate (Disalcid)

Acidification of the urine by vitamin C might increase salsalate levels.
It has been suggested that acidification of the urine by vitamin C could increase reabsorption of salicylates by the renal tubules, and increase plasma salicylate levels. However, short-term use of up to 6 grams/day vitamin C does not seem to affect urinary pH or salicylate excretion, suggesting this interaction probably is not clinically significant.

Likelihood Possible Evidence B
Ascorbyl Palmitate full monograph & interactions

Black currant oil2 drug types · 140 drugs

Anticoagulant/Antiplatelet Drugs

Theoretically, black currant seed oil might increase the risk of bleeding if used in combination with anticoagulant or antiplatelet drugs.
Gamma-linolenic acid (GLA), a constituent of black currant seed oil, appears to have antiplatelet effects.

Likelihood Possible Evidence D
Phenothiazines

Theoretically, black currant seed oil might increase the risk of seizure in patients receiving phenothiazines.
Black currant seed oil contains gamma-linolenic acid (GLA). There is some concern that taking supplements containing GLA might cause seizures, or lower the seizure threshold, when taken with phenothiazines, although there is no evidence that black currant seed oil causes seizures. In one report, three patients with schizophrenia who had received phenothiazines developed EEG changes suggestive of temporal lobe epilepsy after starting treatment with GLA, although none experienced an actual seizure. In another report, two patients with schizophrenia who were stabilized on phenothiazines developed seizures when evening primrose 4 grams daily, which contains GLA, was added. One of these patients had a prior history of seizures.

Likelihood Possible Evidence D
Black currant oil full monograph & interactions

Oleic Acid1 drug type · 86 drugs

Antidiabetes Drugs

Theoretically, oleic acid might increase the effects of antidiabetes drugs. Preliminary clinical research in patients with type 2 diabetes taking oral hypoglycemic drugs shows that eating a diet rich in oleic acid from olive oil decreases fasting blood glucose levels when compared to eating a diet rich in linoleic acid from sunflower oil. It is unknown if taking oleic acid supplements would have this effect or if this change is clinically significant. Until more is known, use caution. Dose adjustment may be necessary. Some antidiabetes drugs include glimepiride (Amaryl), glyburide (DiaBeta, Glynase PresTab, Micronase), insulin, metformin (Glucophage), pioglitazone (Actos), rosiglitazone (Avandia), and others.

Likelihood Possible Evidence B
Oleic Acid full monograph & interactions
The maker

Brand information

Manufacturer and brand details for Triple EFA Guard Softgels, from the product label.

Perque

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Name
PERQUE Integrative Health
Pharmacist Counseling Corner

Triple EFA Guard Softgels by Perque: Common Questions

Does Triple EFA Guard Softgels by Perque interact with any medications?
Yes. Based on its ingredients, Triple EFA Guard Softgels has a known interaction with 2,142 medications. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Triple EFA Guard Softgels contains 24 active ingredients, and an interaction can come from any of them. We check every ingredient, combine the results into one list per medication, and show which ingredient and mechanism is responsible.
Where does this information come from?
The product label data comes from the NIH Dietary Supplement Label Database (DSLD); the interaction data is built on the Natural Medicines database and reviewed by HelloPharmacist pharmacists.
Is it safe to take this if I'm pregnant or breastfeeding?
Safety data is mixed across the ingredients. Vitamin E is possibly safe in pregnancy but possibly unsafe at high doses while breastfeeding. Vitamin C is likely to possibly safe in both. Phosphatidylcholine, flaxseed oil, black currant oil, and olive oil don't have enough reliable safety data for supplement use in pregnancy or while nursing. Talk with your doctor or pharmacist before taking this product during pregnancy or breastfeeding so they can advise you based on your personal situation.
What are the omega fatty acids in this for?
The product contains omega-3 (EPA and DHA), omega-6 (gamma-linolenic acid and linoleic acid), and omega-9 (oleic acid) fatty acids. These are essential fats your body uses for cell structure, inflammation regulation, and other functions. Oleic acid specifically is possibly effective for lowering cholesterol and supporting heart health, but the evidence for the other fatty acids in this formula isn't established in our data.
Can this cause side effects?
Most ingredients are generally well tolerated. The most common side effects from the active components are digestive: belching, bloating, indigestion, diarrhea, and nausea — especially at higher doses. Vitamin E at high doses may increase bleeding risk. Allergic reactions to gelatin are rare but possible. If you experience persistent digestive upset or unusual bleeding, talk to your pharmacist.
Will this interfere with my blood pressure medication?
Yes, possibly. Flaxseed oil in this product may theoretically lower blood pressure and could have additive effects if combined with blood pressure drugs, raising the risk of low blood pressure. Check with your doctor or pharmacist before starting this product if you take any blood pressure medication so they can monitor you.
Does this help with heart health or cholesterol?
Oleic acid in the product is possibly effective for high cholesterol and coronary heart disease. However, evidence for the omega-3 and omega-6 fatty acids in this formula is not established in our data. Flaxseed oil is rated possibly ineffective for high cholesterol in our data. Talk with your doctor about whether this product is right for your specific heart or cholesterol goals.
Why does the label say 24 ingredients if most are just oils and fats?
The product breaks down each oil source and fatty acid separately on the label, plus adds supporting compounds like phosphatidylcholine, vitamins E and C, glycerol, and gelatin as the capsule. This gives you a complete picture of what's inside, even though many components serve similar roles.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Not sure if Triple EFA Guard Softgels is safe with your meds?

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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.

Triple EFA Guard Softgels label
Go deeper

The Full Monographs Behind Triple EFA Guard Softgels’s Ingredients

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

Herb & supplement monograph

Oleic Acid

Interacts with 86 drugs

Oleic acid is a heart-healthy monounsaturated fat found mainly in olive oil, canola oil, avocados, and nuts. As part of a Mediterranean-style diet, it is widely viewed as a healthier replace...

Read the full Oleic Acid monograph → Herb & supplement monograph

Gelatin

Gelatin is a protein made from animal collagen, used as a food, a capsule ingredient, and a supplement for joint, skin, and bone health. For most health uses, the evidence is limited or mixe...

Read the full Gelatin monograph → Herb & supplement monograph

Vitamin E

Interacts with 764 drugs

Vitamin E is an essential fat-soluble vitamin and antioxidant that most people get in adequate amounts from a normal diet. Supplements can help correct a true deficiency, but high-dose vitam...

Read the full Vitamin E monograph → Herb & supplement monograph

Vitamin C

Interacts with 207 drugs

Vitamin C (ascorbic acid) is an essential nutrient your body needs but cannot make, so you must get it from food or supplements. It's important for immune function, collagen, and acts as an...

Read the full Vitamin C monograph → Herb & supplement monograph

Phosphatidylcholine

Phosphatidylcholine is a phospholipid that is part of every cell membrane and a source of choline. People take it for liver, brain, and gut health, but solid human evidence is limited for mo...

Read the full Phosphatidylcholine monograph → Herb & supplement monograph

Flaxseed Oil

Interacts with 293 drugs

Flaxseed oil is a plant-based source of the omega-3 fatty acid ALA, which the body can partly convert to the omega-3s found in fish oil. It may help support heart health and provide healthy...

Read the full Flaxseed Oil monograph → Herb & supplement monograph

Olive

Olive comes from the same tree that gives us olives and olive oil, and its leaf and fruit contain antioxidant compounds like oleuropein and hydroxytyrosol. Olive oil as part of a Mediterrane...

Read the full Olive monograph → Herb & supplement monograph

Black Currant

Interacts with 140 drugs

Black currant is a nutritious berry that is rich in vitamin C and antioxidants, and its seed oil contains the omega-6 fatty acid GLA. While it is enjoyed safely as a food and is popular as a...

Read the full Black Currant monograph → Herb & supplement monograph

Glycerol

Glycerol (glycerin) is a sweet, syrupy compound made naturally in the body and widely used in foods, skin products, and medicines. It is well established as a laxative and a skin and eye moi...

Read the full Glycerol monograph → Herb & supplement monograph

Carob

Interacts with 2,022 drugs

Carob is a Mediterranean tree whose pods are widely used as a caffeine-free, naturally sweet cocoa alternative and as a thickener (carob gum). It is mostly eaten as a food and is generally w...

Read the full Carob monograph →
Sources

Sources & How We Checked

Triple EFA Guard Softgels's label data comes from the NIH Dietary Supplement Label Database; the ingredient interaction data is from the Natural Medicines database, reviewed by our pharmacists.

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

The 206 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.

Gelatin 11 references
  1. Lewis CJ. Letter to reiterate certain public health and safety concerns to firms manufacturing or importing dietary supplements that contain specific bovine tissues. FDA. Available at: www.cfsan.fda.gov/~dms/dspltr05.html.
  2. Schwick HG, Heide K. Immunochemistry and immunology of collagen and gelatin. Bibl Haematol 1969;33:111-25. PubMed
  3. Moskowitz RW. Role of collagen hydrolysate in bone and joint disease.Semin Arthritis Rheum 2000;30:87-99. PubMed
  4. Kelso JM. The gelatin story. J Allergy Clin Immunol 1999;103:200-2.
  5. Nakayama T, Aizawa C, Kuno-Sakai H. A clinical analysis of gelatin allergy and determination of its causal relationship to the previous administration of gelatin-containing acellular pertussis vaccine combined with diphtheria and tetanus toxoids. J Allerg PubMed
  6. Sakaguchi M, Inouye S. Anaphylaxis to gelatin-containing rectal suppositories. J Allergy Clin Immunol 2001;108:1033-4. PubMed
  7. PDR Electronic Library. Montvale, NJ: Medical Economics Company, Inc., 2001.
  8. de la Fuente Tornero E, Vega Castro A, de Sierra Hernández PÁ, et al. Kounis syndrome during anesthesia: Presentation of indolent systemic mastocytosis: A case report. A Case Rep. 2017;8(9):226-228. PubMed
  9. Ventura Spagnolo E, Calapai G, Minciullo PL, Mannucci C, Asmundo A, Gangemi S. Lethal anaphylactic reaction to intravenous gelatin in the course of surgery. Am J Ther. 2016;23(6):e1344-e1346. PubMed
  10. Li Y, He H, Yang L, Li X, Li D, Luo S. Therapeutic effect of Colla corii asini on improving anemia and hemoglobin compositions in pregnant women with thalassemia. Int J Hematol. 2016;104(5):559-565. PubMed
  11. Coury JR, Skaggs KF, Marciano GF, et al. Intraoperative Anaphylaxis to the Bovine Flowable Gelatin Matrix: A Report of 2 Cases. JBJS Case Connect 2022;12(1). PubMed

See these in context on the Gelatin monograph →

Vitamin E 64 references
  1. Kim JM, White RH. Effect of vitamin E on the anticoagulant response to warfarin. Am J Cardiol 1996;77:545-6. PubMed
  2. Corrigan JJ Jr. The effect of vitamin E on warfarin-induced vitamin K deficiency. Ann N Y Acad Sci 1982;393:361-8. PubMed
  3. Corrigan JJ Jr. Coagulation problems relating to vitamin E. Am J Pediatr Hematol Oncol 1979;1:169-73.
  4. Corrigan JJ Jr, Marcus FI. Coagulopathy associated with vitamin E ingestion. JAMA 1974;230:1300-1. DOI
  5. Labriola D, Livingston R. Possible interactions between dietary antioxidants and chemotherapy. Oncology 1999;13:1003-8.
  6. Chang T, Benet LZ, Hebert MF. The effect of water-soluble vitamin E on cyclosporine pharmacokinetics in healthy volunteers. Clin Pharmacol Ther 1996;59:297-303. PubMed
  7. Pan SH, Lopez RR Jr, Sher LS, et al. Enhanced oral cyclosporine absorption with water-soluble vitamin E early after liver transplantation. Pharmacother 1996;16:59-65. DOI
  8. Anon. Dietary supplementation with n-3 polyunsaturated fatty acids and vitamin E after myocardial infarction: results of the GISSI-Prevenzione trial. Gruppo Italiano per lo Studio della Soprawivenza nell'Infarto miocardico. Lancet 1999;354:447-55. DOI
  9. Chappell LC, Seed PT, Briley AL, et al. Effect of antioxidants on the occurrence of pre-eclampsia in women at increased risk: a randomised trial. Lancet 1999;354:810-6. DOI
  10. Yusuf S, Dagenais G, Pogue J, et al. Vitamin E supplementation and cardiovascular events in high-risk patients. The heart outcomes prevention evaluation study investigators. N Engl J Med 2000;342:154-60. PubMed
  11. Stephens NG, Parsons A, Schofield PM, et al. Randomised controlled trial of vitamin E in patients with coronary disease: Cambridge Heart Antioxidant Study. Lancet 1996;347:781-6.
  12. The Alpha-Tocopherol, Beta Carotene Cancer Prevention Study Group. The effect of vitamin E and beta carotene on the incidence of lung cancer and other cancers in male smokers. N Engl J Med 1994;330:1029-35. PubMed
  13. Takahashi O. Haemorrhagic toxicity of a large dose of alpha-, beta-, gamma- and delta-tocopherols, ubiquinone, beta-carotene, retinol acetate and L-ascorbic acid in the rat. Food Chem Toxicol 1995;33:121-8.
  14. Briggs GB, Freeman RK, Yaffe SJ. Drugs in Pregnancy and Lactation. 5th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 1998.
  15. Sano M, Ernesto C, Thomas RG, et al. A controlled trial of selegiline, alpha-tocopherol, or both as treatment for Alzheimer's disease. The Alzheimer's Disease Cooperative Study. N Engl J Med 1997;336:1216-22. PubMed
  16. Liede KE, Haukka JK, Saxen LM, Heinonen OP. Increased tendency towards gingival bleeding caused by joint effect of alpha-tocopherol supplementation and acetylsalicylic acid. Ann Med 1998;30:542-6.
  17. Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes for Vitamin C, Vitamin E, Selenium, and Carotenoids. Washington, DC: National Academy Press, 2000. Available at: http://www.nap.edu/books/0309069351/html/.
  18. Brown BG, Zhao XQ, Chait A, et al. Simvastatin and niacin, antioxidant vitamins, or the combination for the prevention of coronary disease. N Engl J Med 2001;345:1583-93. DOI
  19. Liu M, Wallmon A, Olsson-Mortlock C, et al. Mixed tocopherols inhibit platelet aggregation in humans: potential mechanisms. Am J Clin Nutr 2003;77:700-6. PubMed
  20. Sokol RJ, Johnson KE, Karrer FM, et al. Improvement of cyclosporin absorption in children after liver transplantation by means of water-soluble vitamin E. Lancet 1991;338:212-4.. PubMed
  21. Stein JH, Carlsson CM, Papcke-Benson K, et al. The effects of lipid-lowering and antioxidant vitamin therapies on flow-mediated vasodilation of the brachial artery in older adults with hypercholesterolemia. J Am Coll Cardiol 2001;38:1806-13.. PubMed
  22. Carlsson CM, Papcke-Benson K, Carnes M, et al. Health-related quality of life and long-term therapy with pravastatin and tocopherol (vitamin E) in older adults. Drugs Aging 2002;19:793-805. . PubMed
  23. Cheung MC, Zhao XQ, Chait A, et al. Antioxidant supplements block the response of HDL to simvastatin-niacin therapy in patients with coronary artery disease and low HDL. Arterioscler Thromb Vasc Biol 2001;21:1320-6. PubMed
  24. Schrogie JJ. Coagulopathy and fat-soluble vitamins (letter). JAMA 1975;232:19. DOI
  25. Celestini A, Pulcinelli FM, Pignatelli P, et al. Vitamin E potentiates the antiplatelet activity of aspirin in collagen-stimulated platelets. Haematologica 2002;87:420-6.
  26. Stampfer MJ, Jakubowski JA, Faigel D, et al. Vitamin E supplementation effect on human platelet function, arachidonic acid metabolism, and plasma prostacyclin levels. Am J Clin Nutr 1988;47:700-6. PubMed
  27. Jandak J, Steiner M, Richardson PD. Alpha-tocopherol, an effective inhibitor of platelet adhesion. Blood 1989;73:141-9. DOI
  28. Freedman JE, Farhat JH, Loscalzo J, Keaney JF. Alpha-tocopherol inhibits aggregation of human platelets by a protein kinase C-dependent mechanism. Circulation 1996;94:2434-40. PubMed
  29. Steiner M. Vitamin E, a modifier of platelet function: rationale and use in cardiovascular and cerebrovascular disease. Nutr Rev 1999;57:306-9. PubMed
  30. Brodkin RH, Bleiberg J. Sensitivity to topically applied vitamin E. Arch Dermatol 1965;92:76-7. DOI
  31. Booth SL, Golly I, Sacheck JM, et al. Effect of vitamin E supplementation on vitamin K status in adults with normal coagulation status. Am J Clin Nutr 2004;80:143-8. PubMed
  32. Miller ER 3rd, Pastor-Barriuso R, Dalal D, et al. Meta-analysis: High-dosage vitamin E supplementation may increase all-cause mortality. Ann Intern Med 2005;142:60520-53. PubMed
  33. Lonn E, Bosch J, Yusuf S, et al. HOPE and HOPE-TOO Trial Investigators. Effects of long-term vitamin E supplementation on cardiovascular events and cancer: a randomized controlled trial. JAMA 2005;293:1338-47. PubMed
  34. Landes N, Pfluger P, Kluth D, et al. Vitamin E activates gene expression via the pregnane X receptor. Biochem Pharmacol 2003;65:269-73. . PubMed
  35. Brigelius-Flohe R. Vitamin E and drug metabolism. Biochem Biophys Res Commun 2003;305:737-40. PubMed
  36. Prasad KN. Rationale for using high-dose multiple dietary antioxidants as an adjunct to radiation therapy and chemotherapy. J Nutr 2004;134:3182S-3S. PubMed
  37. Conklin KA. Cancer chemotherapy and antioxidants. J Nutr 2004;134:3201S-3204S. PubMed
  38. Schurks M, Glynn RJ, Rist PM, et al. Effects of vitamin E on stroke subtypes: meta-analysis of randomized controlled trials. BMJ 2010;341: c5702. doi: 10.1136/bmj.c5702.
  39. Lawson KA, Wright ME, Subar A, et al. Multivitamin use and risk of prostate cancer in the National Institutes of Health-AARP Diet and Health Study. J Natl Cancer Inst 2007;99:754-64. PubMed
  40. Gaziano JM, Glynn RJ, Christen WG, et al. Vitamins E and C in the prevention of prostate total cancer in men: the physicians' health study II randomised controlled trial. JAMA 2009;301:52-62.
  41. Hayden KM, Welsh-Bohmer KA, Wengreen HJ, et al; Cache County Investigators. Risk of mortality with vitamin E supplements: the Cache County study. Am L Med 2007;120:180-4. PubMed
  42. Smedts HP, de Vries JH, Rakhshandehroo M, et al. High maternal vitamin E intake by diet or supplements is associated with congenital heart defects in the offspring. BJOG 2009;116:416-23. PubMed
  43. Klein EA, Thompson IM Jr, Tangen CM, et al. Vitamin E and the risk of prostate cancer: the Selenium and Vitamin E Cancer Prevention Trial (SELECT). JAMA 2011;306:1549-56. PubMed
  44. Huang, H. Y., Caballero, B., Chang, S., Alberg, A. J., Semba, R. D., Schneyer, C. R., Wilson, R. F., Cheng, T. Y., Vassy, J., Prokopowicz, G., Barnes, G. J., and Bass, E. B. The efficacy and safety of multivitamin and mineral supplement use to prevent ca
  45. Sesso, H. D., Buring, J. E., Christen, W. G., Kurth, T., Belanger, C., MacFadyen, J., Bubes, V., Manson, J. E., Glynn, R. J., and Gaziano, J. M. Vitamins E and C in the prevention of cardiovascular disease in men: the Physicians' Health Study II randomiz
  46. Papaioannou, D., Cooper, K. L., Carroll, C., Hind, D., Squires, H., Tappenden, P., and Logan, R. F. Antioxidants in the chemoprevention of colorectal cancer and colorectal adenomas in the general population: a systematic review and meta-analysis. Colorec PubMed
  47. Cooper, K., Squires, H., Carroll, C., Papaioannou, D., Booth, A., Logan, R. F., Maguire, C., Hind, D., and Tappenden, P. Chemoprevention of colorectal cancer: systematic review and economic evaluation. Health Technol.Assess. 2010;14(32):1-206. PubMed
  48. Mathew, M. C., Ervin, A. M., Tao, J., and Davis, R. M. Antioxidant vitamin supplementation for preventing and slowing the progression of age-related cataract. Cochrane.Database.Syst.Rev. 2012;6:CD004567. PubMed
  49. Rahimi, R., Nikfar, S., Rezaie, A., and Abdollahi, M. A meta-analysis on the efficacy and safety of combined vitamin C and E supplementation in preeclamptic women. Hypertens.Pregnancy. 2009;28(4):417-434. PubMed
  50. Soares, K. V. and McGrath, J. J. Vitamin E for neuroleptic-induced tardive dyskinesia. Cochrane.Database.Syst.Rev. 2001;(4):CD000209. DOI
  51. Roed-Petersen, J. and Hjorth, N. Contact dermatitis from antioxidants. Br.J.Dermatol. 1976;94(3):233-241. PubMed
  52. Brion, L. P., Bell, E. F., Raghuveer, T. S., and Soghier, L. What is the appropriate intravenous dose of vitamin E for very-low-birth-weight infants? J.Perinatol. 2004;24(4):205-207. PubMed
  53. Manny, T., Pettus, J., Hemal, A., Marks, M., and Mirzazadeh, M. Penile sclerosing lipogranulomas and disfigurement from use of "1Super Extenze" among Laotian immigrants. J.Sex Med. 2011;8(12):3505-3510. PubMed
  54. Musso, G., Cassader, M., Rosina, F., and Gambino, R. Impact of current treatments on liver disease, glucose metabolism and cardiovascular risk in non-alcoholic fatty liver disease (NAFLD): a systematic review and meta-analysis of randomised trials. Diabe PubMed
  55. Bell, E. F. Upper limit of vitamin E in infant formulas. J.Nutr. 1989;119(12 Suppl):1829-1831. PubMed
  56. Manzano, D., Aguirre, A., Gardeazabal, J., Eizaguirre, X., and Diaz Perez, J. L. Allergic contact dermatitis from tocopheryl acetate (vitamin E) and retinol palmitate (vitamin A) in a moisturizing cream. Contact Dermatitis 1994;31(5):324.
  57. Barak, Y., Swartz, M., Shamir, E., Stein, D., and Weizman, A. Vitamin E (alpha-tocopherol) in the treatment of tardive dyskinesia: a statistical meta-analysis. Ann.Clin.Psychiatry 1998;10(3):101-105.
  58. Chae CU, Albert CM, Moorthy MV, et al. Vitamin E supplementation and the risk of heart failure in women. Circ Heart Fail. 2012;5(2):176-82. PubMed
  59. Rumbold A, Ota E, Hori H, Miyazaki C, Crowther CA. Vitamin E supplementation in pregnancy. Cochrane Database Syst Rev. 2015;(9):CD004069. PubMed
  60. Prescribing information: KOSELUGO (selumetinib) capsules. U.S. Food and Drug Administration. Available at: https://www.accessdata.fda.gov/drugsatfda_docs/label/2020/213756s000lbl.pdf.
  61. Warshaw EM, Ruggiero JL, DeKoven JG, et al. Patch testing with tocopherol and tocopherol acetate: the North American Contact Dermatitis Group experience, 2001 to 2016. Dermatitis. 2021;32(5):308-18. PubMed
  62. US Preventive Services Task Force, Mangione CM, Barry MJ, et al. Vitamin, Mineral, and Multivitamin Supplementation to Prevent Cardiovascular Disease and Cancer: US Preventive Services Task Force Recommendation Statement. JAMA 2022;327(23):2326-2333. PubMed
  63. Abrol R, Kaushik R, Goel D, Sama S, Kaushik RM, Kala M. Vitamin E-induced coagulopathy in a young patient: a case report. J Med Case Rep 2023;17(1):107. PubMed
  64. Abtahi-Naeini B, Rastegarnasab F, Saffaei A. Liquid vitamin E injection for cosmetic facial rejuvenation: A disaster report of lipogranuloma. J Cosmet Dermatol 2022;21(11):5549-5554. PubMed

See these in context on the Vitamin E monograph →

Vitamin C 51 references
  1. McEvoy GK, ed. AHFS Drug Information. Bethesda, MD: American Society of Health-System Pharmacists, 1998.
  2. Back DJ, Breckenridge AM, MacIver M, et al. Interaction of ethinyloestradiol with ascorbic acid in man. Br Med J (Clin Res Ed) 1981;282:1516.
  3. Morris JC, Beeley L, Ballantine N. Interaction of ethinyloestradiol with ascorbic acid in man [letter]. Br Med J (Clin Res Ed) 1981;283:503.
  4. Labriola D, Livingston R. Possible interactions between dietary antioxidants and chemotherapy. Oncology 1999;13:1003-8.
  5. Dwyer JH, Merz NB, Shirocre AM, et al. Progression of early atherosclerosis and intake of vitamin C and vitamin E from supplements and food. The Los Angeles Atherosclerosis Study. 41st Annual Conference on Cardiovascular Disease Epidemiology and Prevent
  6. Levine M, Rumsey SC, Daruwala R, et al. Criteria and recommendations for vitamin C intake. JAMA 1999;281:1415-23. PubMed
  7. Hansten PD, Horn JR. Drug Interactions Analysis and Management. Vancouver, WA: Applied Therapeutics Inc., 1997 and updates.
  8. Segal S, Kaminski S. Drug-nutrient interactions. American Druggist 1996 Jul;42-8.
  9. Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes for Vitamin C, Vitamin E, Selenium, and Carotenoids. Washington, DC: National Academy Press, 2000. Available at: http://www.nap.edu/books/0309069351/html/.
  10. Houston JB, Levy G. Drug biotransformation interactions in man VI: Acetaminophen and ascorbic acid. J Pharm Sci 1976;65:1218-21. PubMed
  11. Brown BG, Zhao XQ, Chait A, et al. Simvastatin and niacin, antioxidant vitamins, or the combination for the prevention of coronary disease. N Engl J Med 2001;345:1583-93. DOI
  12. Rosenthal G. Interaction of ascorbic acid and warfarin. JAMA 1971;215:1671. DOI
  13. Hume R, Johnstone JM, Weyers E. Interaction of ascorbic acid and warfarin. JAMA 1972;219:1479. DOI
  14. Smith EC, Skalski RJ, Johnson GC, Rossi GV. Interaction of ascorbic acid and warfarin. JAMA 1972;221:1166. DOI
  15. Traxer O, Huet B, Poindexter J, et al. Effect of ascorbic acid consumption on urinary stone risk factors. J Urol 2003;170:397-401.. PubMed
  16. Domingo JL, Gomez M, Llobet JM, Richart C. Effect of ascorbic acid on gastrointestinal aluminum absorption (letter). Lancet 1991;338:1467.
  17. Domingo JL, Gomez M, Llobet JM, Corbella J. Influence of some dietary constituents on aluminum absorption and retention in rats. Kidney Int 1991;39:598-601. PubMed
  18. Partridge NA, Regnier FE, White JL, Hem SL. Influence of dietary constituents on intestinal absorption of aluminum. Kidney Int 1989;35:1413-7. PubMed
  19. Mc Leod DC, Nahata MC. Inefficacy of ascorbic acid as a urinary acidifier (letter). N Engl J Med 1977;296:1413. DOI
  20. Hansten PD, Hayton WL. Effect of antacid and ascorbic acid on serum salicylate concentration. J Clin Pharmacol 1980;20:326-31. PubMed
  21. Dysken MW, Cumming RJ, Channon RA, Davis JM. Drug interaction between ascorbic acid and fluphenazine. JAMA 1979;241:2008. DOI
  22. Vihtamaki T, Parantainen J, Koivisto AM, et al. Oral ascorbic acid increases plasma oestradiol during postmenopausal hormone replacement therapy. Maturitas 2002;42:129-35. PubMed
  23. Slain D, Amsden JR, Khakoo RA, et al. Effect of high-dose vitamin C on the steady-state pharmacokinetics of the protease inhibitor indinavir in healthy volunteers. Pharmacotherapy 2005;25:165-70. PubMed
  24. Cheung MC, Zhao XQ, Chait A, et al. Antioxidant supplements block the response of HDL to simvastatin-niacin therapy in patients with coronary artery disease and low HDL. Arterioscler Thromb Vasc Biol 2001;21:1320-6. PubMed
  25. Feetam CL, Leach RH, Meynell MJ. Lack of a clinically important interaction between warfarin and ascorbic acid. Toxicol Appl Pharmacol 1975;31:544-7. PubMed
  26. Weintraub M, Griner PF. Warfarin and ascorbic acid: lack of evidence for a drug interaction. Toxicol Appl Pharmacol 1974;28:53-6. PubMed
  27. Lee DH, Folsom AR, Harnack L, et al. Does supplemental vitamin C increase cardiovascular disease risk in women with diabetes? Am J Clin Nutr 2004;80:1194-200. PubMed
  28. Taylor EN, Stampfer MJ, Curhan GC. Dietary factors and the risk of incident kidney stones in men: new insights after 14 years of follow-up. J Am Soc Nephrol 2004;15:3225-32. PubMed
  29. Ward NC, Hodgson JM, Croft KD, et al. The combination of vitamin C and grape-seed polyphenols increases blood pressure: a randomized, double-blind, placebo-controlled trial. J Hypertens 2005;23:427-34.. PubMed
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Phosphatidylcholine 15 references
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Oleic Acid 19 references
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Flaxseed Oil 21 references
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See these in context on the Flaxseed Oil monograph →

Olive 2 references
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  2. Somerville V, Moore R, Braakhuis A. The effect of olive leaf extract on upper respiratory illness in high school athletes: A randomised control trial. Nutrients. 2019;11(2). pii: E358. PubMed

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Black Currant 6 references
  1. Guivernau M, Meza N, Barja P, Roman O. Clinical and experimental study on the long-term effect of dietary gamma-linolenic acid on plasma lipids, platelet aggregation, thromboxane formation, and prostacyclin production. Prostaglandins Leukot Essent Fatty A PubMed
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Glycerol 8 references
  1. McEvoy GK, ed. AHFS Drug Information. Bethesda, MD: American Society of Health-System Pharmacists, 1998.
  2. Wagner DR. Hyperhydrating with glycerol: implications for athletic performance. J Am Diet Assoc 1999;99:207-12. PubMed
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Carob 9 references
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  3. van, der Brempt, X, Ledent, C., and Mairesse, M. Rhinitis and asthma caused by occupational exposure to carob bean flour. J.Allergy Clin.Immunol. 1992;90(6 Pt 1):1008-1010. PubMed
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  7. Komericki P, Kränke B. Immediate hypersensitivity to carob pods. Contact Dermatitis. 2009;61(4):239-40. PubMed
  8. Bosscher D, Van Caillie-Bertrand M, Van Cauwenbergh R, Deelstra H. Availabilities of calcium, iron, and zinc from dairy infant formulas is affected by soluble dietary fibers and modified starch fractions. Nutrition. 2003;19(7-8):641-5. PubMed
  9. Jedrzejczyk M, Bartnik K, Funkowicz M, Toporowska-Kowalska E. FPIES Induced by Locust Bean Gum in an Infant. J Investig Allergol Clin Immunol. 2020;30(3):197-199. PubMed

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

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