Major interaction on record — check this product against your medications before combining. Based on 7 of 8 ingredients. Check your meds →
Dietary supplement

Ultimate Ingredients & Drug Interactions

by Nugenix

Tablet Or Pill Category: Other Combinations
Most serious interaction: Major
The interaction bottom line Most serious interaction: Major

Ultimate is a dietary supplement by Nugenix with 8 active ingredients. Its ingredients are commonly taken for enlarged prostate (bph) symptoms, seasonal allergies, joint pain and arthritis.Based on those ingredients, 1,146 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are Epimedium extract, Fenugreek extract, Eurycoma longifolia extract. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

HelloPharmacist Scorecard of Ultimate by Nugenix

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

What’s inside

Full disclosure
Ingredient Transparency · database check
Full

Every active ingredient lists its own amount on the label.

Why this rating?
  • The label discloses an exact amount for 8 of its 8 active ingredients.
  • No proprietary blends here — you can verify the dose of every single component.

Nugenix Ultimate contains eight active ingredients. Stinging nettle extract, used traditionally for prostate and joint support; Eurycoma longifolia extract (also called Tongkat Ali), marketed for sexual function; Maca extract, a South American root; Fenugreek extract, used in herbal medicine for sexual and metabolic health; Mucuna pruriens extract (cowhage), which contains the compound levodopa; Epimedium extract (also called horny goat weed); boron, a mineral; and D-Aspartic Acid, an amino acid.

The product also contains inactive ingredients: maltodextrin, hydroxypropyl cellulose, croscarmellose sodium, dicalcium phosphate, stearic acid, magnesium stearate, hypromellose, silica, and glycerin.

Does it work?

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

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

Why this rating?
  • The label markets this product for: Boost free testosterone and maximize muscle.
  • We looked for evidence on: Age-related testosterone deficiency, Athletic performance, Erectile dysfunction (ED), Male infertility, Muscle strength, Sexual arousal — and 4 related terms.
  • The strongest evidence on file: Fenugreek is rated "Possibly Effective" for Sexual dysfunction (Natural Medicines).
  • Also on file: Fenugreek is rated "Possibly Effective" for Sexual arousal.
  • Also on file: Eurycoma Longifolia is rated "Possibly Effective" for Sexual desire.

The evidence backing these ingredients is mixed. Fenugreek is possibly effective for sexual dysfunction and diabetes management.

Stinging nettle is possibly effective for diabetes, though evidence for other uses like hay fever or prostate health is insufficient. Eurycoma longifolia is possibly effective for sexual desire but possibly ineffective for athletic performance.

Maca, epimedium, and boron (outside of treating boron deficiency) lack sufficient evidence in our data. D-Aspartic Acid effectiveness is not established in the data we hold.

Mucuna pruriens shows insufficient evidence for the conditions listed.

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 7 of the 7 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 7 of 7.
  • General safety write-ups exist for 7 of 7.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

Most ingredients are generally well tolerated at supplement doses, though long-term safety data is limited for several. Stinging nettle commonly causes constipation or diarrhea; fresh plant contact causes itching and rash.

Fenugreek may cause bloating, diarrhea, nausea, or abdominal pain, and rare severe allergic reactions. Mucuna pruriens (which contains levodopa, an active pharmaceutical compound) can cause diarrhea, nausea, vomiting, headaches, or insomnia.

Boron is well tolerated at low doses but can cause skin problems and digestive upset at high doses. Eurycoma longifolia may increase testosterone and risk testosterone-related side effects like acne or liver stress if levels rise too high.

For pregnancy: stinging nettle, eurycoma, maca, and mucuna are best avoided — the safety data advises against them. Fenugreek may affect the uterus in medicinal amounts; boron should be avoided at supplemental doses.

For breastfeeding: stinging nettle, eurycoma, maca, boron, and mucuna should be avoided due to insufficient safety data. Fenugreek is often used to boost milk supply but discuss with your provider first — evidence is limited.

Meds to double-check

Major interaction found
Known Interaction Concern · database check
Major identified

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

Why this rating?
  • 5 of the 7 matched ingredients can interact with medications — Stinging Nettle, Horny Goat Weed, Fenugreek, Cowhage, Eurycoma Longifolia.
  • The most serious interaction on file is rated Major.
  • Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs; diabetes medications; lithium; Parkinson's medications.
  • For scale: 1,147 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 Nugenix Ultimate, check whether you use any blood pressure or heart medications (methyldopa, propranolol, metoprolol, guanethidine), monoamine oxidase inhibitors or MAOIs (Major risk with cowhage), blood thinners including warfarin or clopidogrel, diabetes drugs, diuretics, lithium, antipsychotics, tricyclic antidepressants, theophylline, or phenytoin. These span Moderate and Major severity levels — don't skip this step.

Check your own medication Run your meds through the checker above

The bottom line

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

This product is marketed for sexual function and general male vitality, but the evidence is limited for most ingredients. If you take any blood pressure medication, a blood thinner, diabetes drug, mood stabilizer (especially MAOIs), or heart medication, you must check your specific drugs with the tool below before trying this.

Talk to your pharmacist or doctor — the levodopa content in cowhage makes this more than a typical supplement.

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

Assessment coverage: 7 of 8 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Sep 24, 2021.

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 Ultimate, straight from the product label.

Brand Nugenix
Net contents 120 Tablet(s)
Market status On market
Date entered into DSLD Sep 24, 2021
DSLD ID 252333
Product type Other Combinations
Supplement form Tablet Or Pill
Dietary claims / uses All Other, Structure/Function
Intended target group(s) Adult Male (18-50 Years)
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 Ultimate by Nugenix, 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:
4 Tablet(s)
Maximum serving Sizes:
4 Tablet(s)
Servings per container
30
IngredientAmount% DV
D-Aspartic Acid3000 mg--
Stinging Nettle extract300 mg--
Eurycoma longifolia extract150 mg--
Maca extract200 mg--
Fenugreek extract700 mg--
Mucuna pruriens extract125 mg--
Epimedium extract625 mg--
Boron10 mg--

Other ingredients: Maltodextrin, Hydroxypropyl Cellulose, Croscarmellose Sodium, Dicalcium Phosphate, Stearic Acid, Magnesium Stearate, Hypromellose, Silica, Glycerin

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.
Suggested/Recommended/Usage/Directions

Adult Men: Take four (4) tablets in the morning with a meal. Use continuously for up to 4 weeks, followed by a 2-4 week off period. Combine with strength training program. Do not exceed 4 tablets per day.

Brand IP Statement(s)

Albion is a registered trademark of Albion Laboratories, Inc.

Precautions

Precautions: Only for adult males over 18 years. Use only as directed.

Consult your healthcare practitioner if you have or suspect a medical condition or if you use any medications as extracts may alter the potency and/or side effects of certain medications.

Discontinue use two weeks prior to surgery or if any serious adverse reaction occurs. Do not use if safety seal is missing.

Keep out of the reach of children.

Formulation

Advanced free testosterone complex Helps to: Boost free testosterone Maximize muscle Increase drive & vitality Modulate androgenic activity

FDA Statement of Identity

Dietary Supplement

FDA Disclaimer Statement

These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.

Storage

Keep product at room temperature and humidity (59-86 degrees F (15-30 degrees C). 40% RH).

See for yourself

Ultimate by Nugenix label

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

What’s inside

The Ingredients in Ultimate by Nugenix

These are the 8 active ingredients this product is made of. Select any to open its full monograph.

Serving size4 Tablet(s) Dosage formTablet Or Pill Servings per container30 Amounts shown are per serving.

Most supplement products combine several ingredients, and a medication can interact with the product through any one of them. Each ingredient below shows whether it has known drug interactions.

D-Aspartic Acid

3000 mg per serving

Stinging Nettle extract

Interacts with
164 drugs
300 mg per serving

Stinging nettle is a common plant used as food and in traditional medicine, most often for prostate symptoms, allergies, and joint pain. The evidence...

Stinging Nettle extract monograph & interactions

Eurycoma longifolia extract

Interacts with
248 drugs
150 mg per serving

Eurycoma longifolia (tongkat ali) is a Southeast Asian herb most popular for supporting testosterone, libido, and male fertility, with some small huma...

Eurycoma longifolia extract monograph & interactions

Maca extract

No known
interactions
200 mg per serving

Maca is a nutrient-rich Andean root often used for energy, libido, and menopause symptoms. Early studies suggest it may modestly help sexual desire an...

Maca extract monograph & interactions

Fenugreek extract

Interacts with
389 drugs
700 mg per serving Form: Saponins

Fenugreek is a common kitchen spice that is also taken as a supplement, mainly for blood sugar, cholesterol, and to support breast milk production. So...

Fenugreek extract monograph & interactions

Mucuna pruriens extract

Interacts with
193 drugs
125 mg per serving Form: L-Dopa

Cowhage (Mucuna pruriens) is a tropical legume best known as a natural source of L-dopa, the compound the body turns into dopamine. It is most studied...

Mucuna pruriens extract monograph & interactions

Epimedium extract

Interacts with
963 drugs
625 mg per serving Form: Icariins

Horny goat weed (Epimedium) is a traditional Chinese herb most often marketed for low libido and erectile problems, but solid human evidence for these...

Epimedium extract monograph & interactions

Boron

No known
interactions
10 mg per serving Form: Bororganic Glycine

Boron is a trace mineral found in many plant foods and sold as a supplement, mainly promoted for bone, joint, and hormone health. The human evidence f...

Boron monograph & interactions

Other (inactive) ingredients: Maltodextrin, Hydroxypropyl Cellulose, Croscarmellose Sodium, Dicalcium Phosphate, Stearic Acid, Magnesium Stearate, Hypromellose, Silica, Glycerin. These complete the product’s ingredient list but are not active constituents.

Interaction report

Ultimate by Nugenix Drug Interactions

Want to check YOUR meds against Ultimate?

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
1,146Drugs
17 Major 1,109 Moderate 20 Minor

Each ingredient & the kinds of drugs it affects

For each ingredient in Ultimate 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.

Epimedium extract6 drug types · 963 drugs

Anticoagulant/Antiplatelet Drugs

Theoretically, horny goat weed might increase the risk of bleeding.
In vitro research and animal research shows that horny goat weed can inhibit platelet aggregation and thrombus formation. This effect has not been reported in humans.

Likelihood Possible Evidence D
Antihypertensive Drugs

Theoretically, horny goat weed might increase the risk of hypotension.
Laboratory research suggests that horny goat weed might have hypotensive effects. This effect has not been reported in humans.

Likelihood Possible Evidence D
Cytochrome P450 1A2 (Cyp1A2) Substrates

Theoretically, horny goat weed might increase the effects and side effects of CYP1A2 substrates.
In vitro, horny goat weed leaf extract inhibits CYP1A2. This effect has not been reported in humans.

Likelihood Possible Evidence D
Cytochrome P450 2B6 (Cyp2B6) Substrates

Theoretically, horny goat weed might increase the effects and side effects of CYP2B6 substrates.
In vitro, horny goat weed leaf extract inhibits CYP2B6. This effect has not been reported in humans.

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

Theoretically, horny goat weed might increase the effects and side effects of CYP3A4 substrates.
In vitro, horny goat weed extract inhibits CYP3A4 and suppresses CYP3A4 mRNA expression. This effect has not been reported in humans.

Likelihood Possible Evidence D
Estrogens

Theoretically, concomitant use of horny goat weed with estrogens might increase their therapeutic and adverse effects.
In vitro evidence suggests that horny goat weed has estrogenic activity. In clinical research, horny goat weed has been shown to increase blood levels of estrogen in some females.

Likelihood Possible Evidence D

Fenugreek extract9 drug types · 389 drugs

Anticoagulant/Antiplatelet Drugs

Theoretically, fenugreek might have additive effects when used with anticoagulant or antiplatelet drugs.
Some of the constituents in fenugreek have antiplatelet effects in animal and in vitro research. However, common fenugreek products might not contain sufficient concentrations of these constituents for clinical effects. A clinical study in patients with coronary artery disease or diabetes shows that taking fenugreek seed powder 2.5 grams twice daily for 3 months does not affect platelet aggregation, fibrinolytic activity, or fibrinogen levels .

Likelihood Unlikely Evidence B
Antidiabetes Drugs

Theoretically, fenugreek seed might have additive hypoglycemic effects when used with antidiabetes drugs.
Clinical research shows that fenugreek seed can reduce fasting blood glucose and 2-hour postprandial glucose levels in adults with type 2 diabetes.

Likelihood Probable Evidence B
Clopidogrel (Plavix)

Theoretically, fenugreek seed might alter the clinical effects of clopidogrel by inhibiting its conversion to the active form.
Animal research shows that fenugreek seed 200 mg/kg daily for 14 days increases the maximum serum concentration of clopidogrel by 21%. It is unclear how this affects the pharmacokinetics of the active metabolite of clopidogrel; however, this study found that concomitant use of fenugreek seed and clopidogrel prolonged bleeding time by an additional 11%.

Likelihood Possible Evidence D
Metoprolol (Toprol)

Theoretically, fenugreek seed might have additive hypotensive effects when used with metoprolol.
Animal research shows that fenugreek seed 300 mg/kg daily for 2 weeks decreases systolic and diastolic blood pressure by 9% and 11%, respectively, when administered alone, and by 15% and 22%, respectively, when given with metoprolol 10 mg/kg.

Likelihood Probable Evidence B
Phenytoin (Dilantin)

Theoretically, fenugreek might decrease plasma levels of phenytoin.
Animal research shows that taking fenugreek seeds for 1 week decreases maximum concentrations and the area under the curve of a single dose of phenytoin by 44% and 72%, respectively. This seems to be related to increased clearance. So far, this interaction has not been reported in humans.

Likelihood Possible Evidence D
Sildenafil (Viagra)

Theoretically, concurrent use of sildenafil and fenugreek might reduce levels and therapeutic effects of sildenafil.
Animal research shows that taking fenugreek seeds for 1 week reduces maximum concentrations and the area under the curve of a single dose of sildenafil by 27% and 48%, respectively. So far, this interaction has not been reported in humans.

Likelihood Possible Evidence D
Theophylline

Theoretically, fenugreek may reduce the levels and clinical effects of theophylline.
Animal research shows that fenugreek 50 grams daily for 7 days reduces the maximum serum concentration (Cmax) of theophylline by 28% and the area under the plasma drug concentration-time curve (AUC) by 22%.

Likelihood Possible Evidence D
Warfarin (Coumadin)

Theoretically, fenugreek might have additive effects with warfarin and increase the international normalized ratio (INR).
Some fenugreek constituents have antiplatelet effects, although these might not be present in concentrations that are clinically significant. In one case report, a patient taking warfarin experienced an increased INR when starting to take fenugreek in combination with boldo.

Likelihood Possible Evidence D
Antihypertensive Drugs

Fenugreek may also have an additive effect on blood pressure-lowering medications. Studies on animals have shown that fenugreek seed can decrease both systolic and diastolic blood pressure by up to 22% when combined with metoprolol. Therefore, it is essential to monitor your blood pressure regularly if you are taking fenugreek and metoprolol together or any other antihypertensive drugs.

Likelihood Possible Evidence C

Eurycoma longifolia extract5 drug types · 248 drugs

Propranolol (Inderal)

Eurycoma longifolia can reduce the levels and clinical effects of propranolol.
A small clinical study in healthy persons shows that taking a single dose of a water-based Eurycoma longifolia extract 200 mg, in combination with a single dose of propranolol 80 mg, reduces the propranolol area under the curve (AUC) by 29%, reduces the peak concentration by 42%, and increases time to peak concentration by 86% when compared with control. Since the elimination half-life of propranolol did not change, it seems that Eurycoma longifolia alters the kinetics of propranolol by decreasing its absorption in the gut, and not by altering its metabolism. It is not known if separating administration will prevent this interaction.

Likelihood Probable Evidence A
Cytochrome P450 1A2 (Cyp1A2) Substrates

Theoretically, Eurycoma longifolia might increase levels CYP1A2 substrates.
In vitro research suggests that methanolic Eurycoma longifolia root extract weakly inhibits CYP1A2 enzymes. This effect has not been reported in humans.

Likelihood Possible Evidence D
Cytochrome P450 2A6 (Cyp2A6) Substrates

Theoretically, Eurycoma longifolia might increase levels of CYP2A6 substrates.
In vitro research suggests that methanolic Eurycoma longifolia root extract weakly inhibits CYP2A6 enzymes. This effect has not been reported in humans.

Likelihood Possible Evidence D
Cytochrome P450 2C19 (Cyp2C19) Substrates

Theoretically, Eurycoma longifolia might increase levels of CYP2C19 substrates.
In vitro research suggests that methanolic Eurycoma longifolia root extract weakly inhibits CYP2C19 enzymes. This effect has not been reported in humans.

Likelihood Possible Evidence D
Testosterone

Theoretically, Eurycoma longifolia may further increase levels of testosterone.
A clinical study in aging males with testosterone levels below 300 ng/dL shows that taking a specific water extract of Eurycoma longifolia roots (Physta; Biotropics Malaysia) 100-200 mg daily with breakfast for 12 weeks increases total testosterone levels by 8% to 11% when compared with placebo. It is unclear whether this increase would occur in individuals with normal testosterone levels.

Likelihood Possible Evidence D

Mucuna pruriens extract8 drug types · 193 drugs

Levodopa

Concomitant use can increase the risk of levodopa-related adverse effects.
Cowhage contains levodopa. Some cowhage products have been standardized to contain 75-400 mg of levodopa per dose.

Likelihood Likely Evidence D
Methyldopa (Aldomet)

Theoretically, concomitant use of cowhage and methyldopa might increase the risk of hypotension.
Cowhage contains levodopa. Use of levodopa with methyldopa might cause additive hypotension. In addition, methyldopa may inhibit peripheral decarboxylation of levodopa and increase levodopa levels in the central nervous system; avoid using.

Likelihood Probable Evidence D
Monoamine Oxidase Inhibitors (Maois)

Theoretically, concomitant use of cowhage and non-selective MAOIs might increase the risk of hypertensive crisis.
Cowhage contains levodopa. Use of levodopa with non-selective MAOIs might cause hypertensive crisis. However, this interaction has not been reported with MAO-B selective inhibitors such as selegiline.

Likelihood Probable Evidence D
Anesthesia

Theoretically, concomitant use of cowhage and anesthesia might increase the risk of arrhythmias.
Cowhage contains levodopa. Use of levodopa with cyclopropane or halogenated hydrocarbon anesthesia has led to arrhythmias. Other anesthetics have not been implicated. Use other anesthetics in patients taking cowhage or tell patients to stop taking cowhage at least 2 weeks before surgery.

Likelihood Possible Evidence D
Antidiabetes Drugs

Theoretically, concomitant use of cowhage and antidiabetes drugs might increase the risk of hypoglycemia.
Animal research shows that cowhage might have hypoglycemic effects.

Likelihood Possible Evidence D
Antipsychotic Drugs

Theoretically, use of cowhage might decrease the clinical effects of antipsychotic drugs.
Cowhage contains levodopa. Use of levodopa might counteract the antidopaminergic effects of antipsychotic medications.

Likelihood Possible Evidence D
Guanethidine (Ismelin)

Theoretically, concomitant use of cowhage and guanethidine might increase the risk of hypotension.
Cowhage contains levodopa. Use of levodopa with guanethidine might cause additive hypotension; avoid using.

Likelihood Probable Evidence D
Tricyclic Antidepressants (Tcas)

Theoretically, use of TCAs might reduce the levels and clinical effects of cowhage.
Cowhage contains levodopa. Use of TCAs might reduce the absorption of levodopa. Some case reports describe patients that developed hypertension and dyskinesia when taking both levodopa and TCAs.

Likelihood Possible Evidence D

Stinging Nettle extract4 drug types · 164 drugs

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.

Likelihood Possible Evidence B
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.

Likelihood Possible Evidence D
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.

Likelihood Possible Evidence D
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.

Likelihood Possible Evidence D
The maker

Brand information

Manufacturer and brand details for Ultimate, from the product label.

Nugenix

Name
Adaptive Health
City
Charlotte
State
NC
ZipCode
28202
Phone Number
1-855-714-3234
Web Address
www.nugenix.com
Pharmacist Counseling Corner

Ultimate by Nugenix: Common Questions

Does Ultimate by Nugenix interact with any medications?
Yes. Based on its ingredients, Ultimate has a known interaction with 1,146 medications, including 17 rated major. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Ultimate contains 8 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.
Does this supplement actually work for sexual function?
Fenugreek and Eurycoma longifolia are both rated possibly effective for sexual function, so there is some evidence. Maca, epimedium, and D-Aspartic Acid don't have established evidence in our data. Results vary by person and product quality.
What's the levodopa in cowhage, and why does it matter?
Levodopa is an active pharmaceutical compound (the main ingredient in Parkinson's drugs) — it's not just a plant extract. This is why cowhage has serious interactions with blood pressure meds and certain psychiatric medications. It's also why this product should be discussed with your pharmacist, not treated like a typical supplement.
Can I take this if I'm on a blood thinner like warfarin?
No — both stinging nettle and fenugreek may interfere with warfarin's blood-thinning effects, and fenugreek carries the same risk with clopidogrel. Don't use this product if you take blood thinners without explicit clearance from your doctor or pharmacist.
What are the most common side effects?
Fenugreek commonly causes bloating, diarrhea, nausea, or abdominal pain. Stinging nettle may cause constipation or diarrhea. Mucuna pruriens can cause nausea, vomiting, or insomnia in some users. Most are mild, but if you have a sensitive stomach, start cautiously.
Is it safe to take during pregnancy or while breastfeeding?
No — stinging nettle, eurycoma, maca, and mucuna should be avoided during pregnancy due to safety concerns. Fenugreek may affect the uterus in supplement amounts; boron should not be taken. While breastfeeding, stinging nettle, eurycoma, maca, boron, and mucuna are best avoided. Fenugreek is sometimes used to boost milk supply but discuss with your provider first. Talk to your doctor for personalized advice.
What happens if I take this with diabetes medication?
Stinging nettle, fenugreek, and cowhage can all lower blood sugar. If used with diabetes drugs, there's a risk of blood sugar dropping too low. Your doctor may need to adjust your dose, or you may need to monitor your blood sugar closely. Don't use without professional guidance.

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

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Label information is sourced from the NIH Dietary Supplement Label Database and reflects the product version on file; always read your actual product label. This page is for education only and is not a substitute for professional medical advice. Confirm with your pharmacist or doctor before combining supplements and medications.

Ultimate label
Go deeper

The Full Monographs Behind Ultimate’s Ingredients

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

Herb & supplement monograph

Stinging Nettle

Interacts with 164 drugs

Stinging 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 monograph

Eurycoma Longifolia

Interacts with 248 drugs

Eurycoma longifolia (tongkat ali) is a Southeast Asian herb most popular for supporting testosterone, libido, and male fertility, with some small human studies suggesting possible benefits....

Read the full Eurycoma Longifolia monograph →
Herb & supplement monograph

Maca

Maca is a nutrient-rich Andean root often used for energy, libido, and menopause symptoms. Early studies suggest it may modestly help sexual desire and some menopause symptoms, but the evide...

Read the full Maca monograph →
Herb & supplement monograph

Fenugreek

Interacts with 389 drugs

Fenugreek is a common kitchen spice that is also taken as a supplement, mainly for blood sugar, cholesterol, and to support breast milk production. Some early research is encouraging for blo...

Read the full Fenugreek monograph →
Herb & supplement monograph

Cowhage

Interacts with 193 drugs

Cowhage (Mucuna pruriens) is a tropical legume best known as a natural source of L-dopa, the compound the body turns into dopamine. It is most studied for Parkinson's disease symptoms and ma...

Read the full Cowhage monograph →
Herb & supplement monograph

Horny Goat Weed

Interacts with 963 drugs

Horny goat weed (Epimedium) is a traditional Chinese herb most often marketed for low libido and erectile problems, but solid human evidence for these uses is lacking. While short-term use s...

Read the full Horny Goat Weed monograph →
Herb & supplement monograph

Boron

Boron is a trace mineral found in many plant foods and sold as a supplement, mainly promoted for bone, joint, and hormone health. The human evidence for most of these uses is limited or prel...

Read the full Boron monograph →
Sources

Sources & How We Checked

Ultimate'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 87 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.

Stinging Nettle 23 references
  1. Monographs on the medicinal uses of plant drugs. Exeter, UK: European Scientific Co-op Phytother, 1997.
  2. Newall CA, Anderson LA, Philpson JD. Herbal Medicine: A Guide for Healthcare Professionals. London, UK: The Pharmaceutical Press, 1996.
  3. The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999.
  4. Schulz V, Hansel R, Tyler VE. Rational Phytotherapy: A Physician's Guide to Herbal Medicine. Terry C. Telger, transl. 3rd ed. Berlin, GER: Springer, 1998.
  5. Leung AY, Foster S. Encyclopedia of Common Natural Ingredients Used in Food, Drugs and Cosmetics. 2nd ed. New York, NY: John Wiley & Sons, 1996.
  6. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
  7. 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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Maca 1 reference
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Cowhage 12 references
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Horny Goat Weed 11 references
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Boron 6 references
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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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