Interactions on record — worth a quick check against your medications. Check your meds →
Dietary supplement

Ultimate Detox 1000 mg Ingredients & Drug Interactions

by Remedys Nutrition

Capsule Category: Botanical
Most serious interaction: Moderate
The interaction bottom line Most serious interaction: Moderate

Ultimate Detox 1000 mg is a dietary supplement by Remedys Nutrition with 14 active ingredients. Its ingredients are commonly taken for stress and anxiety, blood sugar support, respiratory complaints.Based on those ingredients, 1,528 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are organic Oregon Grape, organic Milk Thistle, organic Red Clover. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

HelloPharmacist Scorecard of Ultimate Detox 1000 mg by Remedys Nutrition

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

Low disclosure
Ingredient Transparency · database check
Low

Most active ingredients don't disclose an individual amount — you can't tell how much of each you're getting.

Why this rating?
  • The label discloses an exact amount for 0 of its 14 active ingredients.
  • “Ultimate Detox Proprietary Blend” is a proprietary blend — the label gives one combined amount (1,000 mg) without saying how much of each component you get.

Ultimate Detox 1000 mg contains 14 active ingredients, each a dried plant extract or powder: organic holy basil, organic cinnamon, organic red clover, organic skullcap, organic spearmint, organic anise, organic olive, organic oregano, organic milk thistle, organic roasted dandelion, organic burdock, organic Oregon grape, organic juniper, and organic Turkish rhubarb. These are combined in a proprietary blend formula and enclosed in a vegan capsule.

The product also contains one inactive ingredient: the capsule shell itself.

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

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

Moderate

Some 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: Diabetes — rated "Possibly Effective" (Milk Thistle) (Natural Medicines).
  • On file: Menopausal symptoms — rated "Possibly Effective" (Rhubarb) (Natural Medicines).
  • On file: Psoriasis — rated "Possibly Effective" (Oregon Grape) (Natural Medicines).
  • On file: Pancreatitis — rated "Possibly Effective" (Rhubarb) (Natural Medicines).

The evidence supporting these ingredients is limited. The facts we hold show insufficient reliable evidence to rate holy basil for anxiety, asthma, headache, respiratory infections, or dental plaque; the same applies to cinnamon for most conditions except that milk thistle is rated possibly effective for diabetes.

Red clover, skullcap, spearmint, anise, olive, oregano, juniper, and rhubarb all lack sufficient evidence for their claimed uses in the facts we hold. Oregon grape is rated possibly effective for psoriasis only.

Without established effectiveness for the product's stated "detox" purpose, the ingredients' individual benefits remain unproven in our data.

The evidence, ingredient by ingredient Holy Basil Cassia Cinnamon Red Clover Skullcap Spearmint Anise Olive Oregano

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 14 of the 14 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 14 of 14.
  • General safety write-ups exist for 14 of 14.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

Most of these ingredients are generally well tolerated in short-term use, though long-term safety data are often limited. The main concerns are with pregnancy and breastfeeding.

Holy basil and skullcap should be avoided during pregnancy (rated possibly unsafe); red clover, oregano, and juniper are also best avoided in pregnancy. Burdock and Oregon grape are rated likely unsafe in pregnancy.

For breastfeeding, holy basil, skullcap, spearmint (concentrated supplements), oregano, and juniper should be avoided; red clover, dandelion, and burdock lack enough safety data to recommend use. The most common adverse effects across the ingredients are mild gastrointestinal issues—nausea, loose stools, diarrhea—reported in small numbers of trial participants.

Rhubarb and some other ingredients carry a risk of electrolyte loss (especially potassium) with long-term or high-dose use. Allergic reactions, though rare, have been reported with several plant ingredients including anise, oregano, dandelion, burdock, and rhubarb.

Side effects, ingredient by ingredient Holy Basil Cassia Cinnamon Red Clover Skullcap Spearmint Anise Olive Oregano

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?
  • 13 of the 14 matched ingredients can interact with medications — Burdock, Milk Thistle, Rhubarb, Red Clover, Oregon Grape, among others.
  • The most serious interaction on file is rated Moderate.
  • Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs; immunosuppressants / transplant drugs; diabetes medications; heart-rhythm medications; lithium.
  • For scale: 1,529 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 this product, check with your doctor or pharmacist if you take blood thinners (anticoagulants) like warfarin, antiplatelet drugs like aspirin, diabetes medications, sedatives or CNS depressants, estrogen therapy or contraceptives, corticosteroids, diuretics, or any medication broken down by your liver. Additionally, if you take digoxin, methotrexate, tamoxifen, lithium, or cyclosporine, confirm it's safe with your pharmacist.

Several Moderate-severity interactions could affect how these drugs work or increase side effects.

Check your own medication Run your meds through the checker above

The bottom line

Scorecard at a glanceFormula with limited ingredient disclosure with some supporting evidence behind its ingredients' uses. Moderate medication interactions have been identified, and safety information is well characterized.

This is a multi-ingredient herbal blend with minimal proven effectiveness and numerous medication interactions. If you take any prescription drugs—especially blood thinners, diabetes medications, sedatives, hormone therapies, or heart medications—check with your doctor or pharmacist before starting.

It's not appropriate during pregnancy or while breastfeeding. For most healthy adults not on medications, short-term use is generally tolerated, but evidence for detox benefits is not established.

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

Assessment coverage: 14 of 14 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Dec 26, 2020.

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

At a glance

General information

Key facts about Ultimate Detox 1000 mg, straight from the product label.

Brand Remedys Nutrition
Barcode (UPC) 798295051479
Net contents 60 Vcap(s)
Market status On market
Date entered into DSLD Dec 26, 2020
DSLD ID 241530
Product type Botanical
Supplement form Capsule
Dietary claims / uses All Other, Structure/Function
Intended target group(s) Vegan, Vegetarian, Adult (18 - 50 Years), Gluten Free, Dairy 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 Ultimate Detox 1000 mg by Remedys Nutrition, 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 Vegan Capsule(s)
Maximum serving Sizes:
1 Vegan Capsule(s)
Servings per container
60
UPC/BARCODE
798295051479
IngredientAmount% DV
organic Holy Basil0 NP--
organic Cinnamon0 NP--
organic Red Clover0 NP--
organic Skullcap0 NP--
organic Spearmint0 NP--
organic Anise0 NP--
organic Olive0 NP--
organic Oregano0 NP--
organic Milk Thistle0 NP--
organic roasted Dandelion0 NP--
organic Burdock0 NP--
organic Oregon Grape0 NP--
Ultimate Detox Proprietary Blend1000 mg--
organic Juniper0 NP--
organic Turkish rhubarb0 NP--

Other ingredients: Vegan Capsule

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

Directions: Two capsules daily

Formulation

Made in the U.S.A.

Non-GMO Gluten free No additives No preservatives No dairy No yeast No corn No fillers

Vegan

Quality and potency guaranteed

Gentle detox Cleanse Total body Pharmacist approved

Precautions

Caution: As with any dietary supplement, consult your healthcare practitioner before using this product.

Keep out of reach of children.

Adult use only

FDA Disclaimer Statement

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

General Statements

Remedys Nutrition Est. 1972 Quality Purity Pride One month supply

Scan here to learn more:

Formula

Ultimate Detox 1000 mg per capsule 60000 mg per bottle

FDA Statement of Identity

Dietary Supplement

See for yourself

Ultimate Detox 1000 mg by Remedys Nutrition label

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

What’s inside

The Ingredients in Ultimate Detox 1000 mg by Remedys Nutrition

These are the 14 active ingredients this product is made of. Select any to open its full monograph.

Serving size1 Vegan Capsule(s) Dosage formCapsule Servings per container60 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.

Other (inactive) ingredients: Vegan Capsule. These complete the product’s ingredient list but are not active constituents.

Interaction report

Ultimate Detox 1000 mg by Remedys Nutrition Drug Interactions

Want to check YOUR meds against Ultimate Detox 1000 mg?

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
1,528Drugs
1,519 Moderate 9 Minor

Ingredients driving the most interactions

Each ingredient & the kinds of drugs it affects

For each ingredient in Ultimate Detox 1000 mg 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.

organic Oregon Grape9 drug types · 1,218 drugs

Anticoagulant/Antiplatelet Drugs

Theoretically, Oregon grape might increase the risk of bleeding when taken with anticoagulant or antiplatelet drugs.
In vitro and in vivo research suggests that berberine, a constituent of Oregon grape, can inhibit platelet aggregation.

Likelihood Possible Evidence D
Antidiabetes Drugs

Theoretically, Oregon grape might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Clinical research suggests that berberine, a constituent of Oregon grape, can lower blood glucose levels.

Likelihood Possible Evidence A
Antihypertensive Drugs

Theoretically, Oregon grape might increase the risk of hypotension when taken with antihypertensive drugs.
Animal research suggests that berberine, a constituent of Oregon grape, can have hypotensive effects. Also, an analysis of clinical evidence suggests that taking berberine in combination with amlodipine (Norvasc) can lower systolic and diastolic blood pressure when compared with taking amlodipine alone.

Likelihood Possible Evidence D
Cns Depressants

Theoretically, Oregon grape might increase the sedative effects of CNS depressants.
Animal research suggests that berberine, a constituent of Oregon grape, can have sedative effects.

Likelihood Possible Evidence D
Cyclosporine (Neoral, Sandimmune)

Theoretically, Oregon grape might increase the effects and adverse effects of cyclosporine.
Berberine, a constituent of Oregon grape, can reduce metabolism of cyclosporine and increase serum levels. It might inhibit cytochrome P450 3A4 (CYP3A4), which metabolizes cyclosporine.

Likelihood Possible Evidence D
Cytochrome P450 2C9 (Cyp2C9) Substrates

Theoretically, Oregon grape might increase serum levels of drugs metabolized by CYP2C9.
Preliminary clinical evidence suggests that berberine, a constituent of Oregon grape, can inhibit cytochrome P450 2C9 (CYP2C9).

Likelihood Possible Evidence B
Cytochrome P450 2D6 (Cyp2D6) Substrates

Theoretically, Oregon grape might increase serum levels of drugs metabolized by CYP2D6.
In vitro research and preliminary clinical evidence suggest that berberine, a constituent of Oregon grape, can inhibit cytochrome P450 2D6 (CYP2D6).

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

Theoretically, Oregon grape might increase serum levels of drugs metabolized by CYP3A4.
In vitro research and preliminary clinical evidence suggest that berberine, a constituent of Oregon grape, moderately inhibits cytochrome P450 3A4 (CYP3A4).

Likelihood Possible Evidence D
P-Glycoprotein Substrates

Theoretically, Oregon grape might increase serum levels of drugs that are P-glycoprotein (P-gp) substrates.
In vitro research suggests that Oregon grape extracts inhibit P-gp efflux.

Likelihood Possible Evidence D

organic Milk Thistle17 drug types · 954 drugs

Antidiabetes Drugs

Taking milk thistle with antidiabetes drugs may increase the risk of hypoglycemia.
Clinical research shows that milk thistle extract, alone or along with tree turmeric extract, can lower blood glucose levels and glycated hemoglobin (HbA1c) in patients with type 2 diabetes, including those already taking antidiabetes drugs. Additionally, animal research shows that milk thistle extract increases the metformin maximum plasma concentration and area under the curve and decreases the renal clearance of metformin, due to inhibition of the multi-drug and toxin extrusion protein 1 (MATE1) renal tubular transport protein.

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

Theoretically, milk thistle might inhibit CYP2B6.
An in vitro study shows that silybin, a constituent of milk thistle, binds to and noncompetitively inhibits CYP2B6. Additionally, silybin might downregulate the expression of CYP2B6 by decreasing mRNA and protein levels.

Likelihood Possible Evidence D
Glucuronidated Drugs

Theoretically, milk thistle might affect the clearance of drugs that undergo glucuronidation.
Laboratory research shows that milk thistle constituents inhibit uridine diphosphoglucuronosyl transferase (UGT), the major phase 2 enzyme that is responsible for glucuronidation. Theoretically, this could decrease the clearance and increase levels of glucuronidated drugs. Other laboratory research suggests that a milk thistle extract of silymarin might inhibit beta-glucuronidase, although the significance of this effect is unclear.

Likelihood Possible Evidence D
Ledipasvir

Theoretically, milk thistle might increase the levels and clinical effects of ledipasvir.
Animal research in rats shows that milk thistle increases the area under the curve (AUC) for ledipasvir and slows its elimination.

Likelihood Possible Evidence D
Morphine

Theoretically, concomitant use of milk thistle with morphine might affect serum levels of morphine and either increase or decrease its effects.
Animal research shows that milk thistle reduces serum levels of morphine by up to 66%. In contrast, laboratory research shows that milk thistle constituents inhibit uridine diphosphoglucuronosyl transferase (UGT), the major phase 2 enzyme that is responsible for glucuronidation. Theoretically, this could decrease the clearance and increase morphine levels. The effect of taking milk thistle on morphine metabolism in humans is not known.

Likelihood Possible Evidence D
Raloxifene (Evista)

Theoretically, milk thistle might decrease the clearance and increase levels of raloxifene.
Laboratory research suggests that the milk thistle constituents silibinin and silymarin inhibit the glucuronidation of raloxifene in the intestines.

Likelihood Possible Evidence D
Sirolimus (Rapamune)

Milk thistle might decrease the clearance of sirolimus.
Pharmacokinetic research shows that a milk thistle extract of silymarin decreases the apparent clearance of sirolimus in hepatically impaired renal transplant patients. It is unclear if this interaction occurs in patients without hepatic impairment.

Likelihood Possible Evidence B
Sofosbuvir (Solvaldi)

Theoretically, milk thistle might decrease the levels and clinical effects of sofosbuvir.
Animal research in rats shows that milk thistle reduces the metabolism of sofosbuvir, as well as the hepatic uptake of its active metabolite.

Likelihood Possible Evidence D
Tamoxifen (Nolvadex)

Theoretically, the milk thistle constituent silibinin might increase tamoxifen levels and interfere with its conversion to an active metabolite.
Animal research suggests that the milk thistle constituent silibinin might increase plasma levels of tamoxifen and alter its conversion to an active metabolite. The mechanism appears to involve inhibition of pre-systemic metabolism of tamoxifen by cytochrome P450 (CYP) 2C9 and CYP3A4, and inhibition of P-glycoprotein-mediated efflux of tamoxifen into the intestine for excretion. Whether this interaction occurs in humans is not known.

Likelihood Possible Evidence D
Warfarin (Coumadin)

Theoretically, milk thistle might increase the effects of warfarin.
In one case report, a man stabilized on warfarin experienced an increase in INR from 2.64 to 4.12 after taking a combination product containing milk thistle 200 mg daily, as well as dandelion, wild yam, niacinamide, and vitamin B12. Levels returned to normal after stopping the supplement. Although a direct correlation between milk thistle and the change in INR cannot be confirmed, some in vitro research suggests that milk thistle might inhibit cytochrome P450 2C9 (CYP2C9), an enzyme involved in the metabolism of various drugs, including warfarin.

Likelihood Possible Evidence D
Cytochrome P450 2C9 (Cyp2C9) Substrates

It is unclear if milk thistle inhibits CYP2C9; research is conflicting.
In vitro research suggests that milk thistle might inhibit CYP2C9. Additionally, 3 case reports from the World Health Organization (WHO) adverse drug reaction database describe increased toxicity in patients taking milk thistle and cancer medications that are CYP2C9 substrates, including imatinib and capecitabine. However, contradictory clinical research shows that milk thistle extract does not inhibit CYP2C9 or significantly affect levels of the CYP2C9 substrate tolbutamide. Differences in results could be due to differences in dosages or formulations utilized.

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

It is unclear if milk thistle inhibits CYP3A4; research is conflicting.
While laboratory research shows conflicting results, pharmacokinetic research shows that taking milk thistle extract 420-1350 mg daily does not significantly affect the metabolism of the CYP3A4 substrates irinotecan, midazolam, or indinavir. However, 8 case reports from the World Health Organization (WHO) adverse drug reaction database describe increased toxicity in patients taking milk thistle and cancer medications that are CYP3A4 substrates, including gefitinib, sorafenib, doxorubicin, and vincristine.

Likelihood Unlikely Evidence D
Estrogens

Theoretically, milk thistle might interfere with estrogen therapy through competition for estrogen receptors.
Animal research suggests that a milk thistle extract of silymarin binds to estrogen receptor beta.

Likelihood Possible Evidence D
Hmg-Coa Reductase Inhibitors ("Statins")

Theoretically, milk thistle might interfere with statin therapy by decreasing the activity of organic anion transporting polypeptide 1B1 (OATB1B1) and inhibiting breast cancer resistance protein (BCRP).
Preliminary evidence suggests that a milk thistle extract of silymarin can decrease the activity of the OATP1B1, which transports HMG-CoA reductase inhibitors into the liver to their site of action, and animal research shows this increases the maximum plasma concentration of pitavastatin and pravastatin. The silibinin component also inhibits BCRP, which transports statins from the liver into the bile for excretion. However, in a preliminary study in healthy males, silymarin 140 mg three times daily had no effect on the pharmacokinetics of a single 10 mg dose of rosuvastatin.

Likelihood Unlikely Evidence D
Indinavir (Crixivan)

Theoretically, milk thistle may induce cytochrome P450 3A4 (CYP3A4) enzymes and increase the metabolism of indinavir; however, results are conflicting.
One pharmacokinetic study shows that taking milk thistle (Standardized Milk Thistle, General Nutrition Corp.) 175 mg three times daily in combination with multiple doses of indinavir 800 mg every 8 hours decreases the mean trough levels of indinavir by 25%. However, results from the same pharmacokinetic study show that milk thistle does not affect the overall exposure to indinavir. Furthermore, two other pharmacokinetic studies show that taking specific milk thistle extract (Legalon, Rottapharm Madaus; Thisilyn, Nature's Way) 160-450 mg every 8 hours in combination with multiple doses of indinavir 800 mg every 8 hours does not reduce levels of indinavir.

Likelihood Unlikely Evidence B
Organic Anion-Transporting Polypeptide Substrates (Oatp)

Milk thistle may inhibit one form of OATP, OATP-B1, which could reduce the bioavailability and clinical effects of OATP-B1 substrates.
In vitro research shows that milk thistle inhibits OATP-B1. Two case reports from the World Health Organization (WHO) adverse drug reaction database describe increased toxicity in patients taking milk thistle and cancer medications that are OATP substrates, including sorafenib and methotrexate. OATPs are expressed in the small intestine and liver and are responsible for the uptake of drugs and other compounds into the body. Inhibition of OATP may reduce the bioavailability of oral drugs that are substrates of OATP.

Likelihood Possible Evidence D
P-Glycoprotein Substrates

Theoretically, milk thistle might increase the absorption of P-glycoprotein substrates. However, this effect does not seem to be clinically significant.
In vitro research shows that milk thistle can inhibit P-glycoprotein activity and 1 case report from the World Health Organization (WHO) adverse drug reaction database describes increased abdominal pain in a patient taking milk thistle and the cancer medication vincristine, a P-glycoprotein substrate, though this patient was also taking methotrexate. However, a small pharmacokinetic study in healthy volunteers shows that taking milk thistle (Enzymatic Therapy Inc.) 900 mg, standardized to 80% silymarin, in 3 divided doses daily for 14 days does not affect absorption of digoxin, a P-glycoprotein substrate.

Likelihood Unlikely Evidence B

organic Red Clover9 drug types · 867 drugs

Estrogens

Theoretically, concomitant use of large amounts of red clover might interfere with estrogen therapy.
Red clover contains phytoestrogens which might have estrogenic activity in some people. Theoretically, red clover might compete for estrogen receptors and interfere with estrogen-containing drug therapy.

Likelihood Probable Evidence D
Methotrexate (Trexall, Others)

Theoretically, red clover might increase the risk of methotrexate toxicity.
In a case report, a 52-year-old female receiving weekly methotrexate injections for psoriasis developed symptoms of methotrexate toxicity, including severe vomiting and epigastric pain, after three days of taking red clover 430 mg daily. Toxicity resolved after red clover was discontinued. However, no liver function tests or methotrexate levels were reported.

Likelihood Possible Evidence D
Tamoxifen (Nolvadex)

Theoretically, the phytoestrogens in red clover might interfere with tamoxifen.
In vitro and animal research suggests that genistein, a constituent of red clover, might antagonize the antitumor effects of tamoxifen. However, there is some evidence from an animal study that red clover does not reduce the efficacy of tamoxifen. Until more is known, tell patients taking tamoxifen to avoid red clover.

Likelihood Possible Evidence D
Anticoagulant/Antiplatelet Drugs

Although some laboratory research suggests that red clover may have anticoagulant and antiplatelet activity, clinical research has not shown this effect.
In vitro research suggests that genistein in red clover has antiplatelet effects, and historically, red clover was thought to have anticoagulant effects due to its coumarin content. However, some experts state that this is unlikely as most natural coumarins have not been shown to have anticoagulant effects, and their content in red clover is low. Additionally, some clinical research in postmenopausal patients found no effect on coagulation or prothrombin time with the use of red clover flowering tops 378 mg daily for 12 months or red clover isoflavone (Rimostil) 50 mg daily for 2 years.

Likelihood Unlikely Evidence B
Caffeine

Theoretically, soy might reduce the clearance of caffeine; however, a small clinical study found no effect.
Red clover contains genistein. Taking genistein 1 gram daily for 14 days seems to inhibit caffeine clearance and metabolism in healthy females. However, this effect does not seem to occur with the lower amounts of genistein found in red clover. A clinical study in healthy postmenopausal individuals shows that taking red clover capsules standardized to contain 60 mg isoflavones twice daily for 14 days does not affect the pharmacokinetics of caffeine.

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

Theoretically, red clover might increase levels of drugs metabolized by CYP1A2; however, a small clinical study found no effect.
In vitro evidence shows that red clover inhibits CYP1A2. However, a clinical study in healthy postmenopausal individuals shows that taking red clover capsules standardized to contain 60 mg isoflavones twice daily for 14 days does not affect the pharmacokinetics of caffeine, a CYP1A2 probe substrate.

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

Theoretically, red clover might increase the levels and clinical effects of drugs metabolized by CYP2C19.
In vitro evidence suggests that red clover weakly inhibits CYP2C19. This interaction has not been reported in humans.

Likelihood Unlikely Evidence D
Cytochrome P450 2C9 (Cyp2C9) Substrates

Theoretically, red clover might increase levels of drugs metabolized by CYP2C9; however, a small clinical study found no effect.
In vitro evidence suggests that red clover might inhibit CYP2C9. However, a clinical study in healthy postmenopausal individuals shows that taking red clover capsules standardized to contain 60 mg isoflavones twice daily for 14 days does not affect the pharmacokinetics of tolbutamide, a CYP2C9 probe substrate.

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

Theoretically, red clover might increase levels of drugs metabolized by CYP3A4; however, a small clinical study found no effect.
In vitro evidence shows that red clover might inhibit CYP3A4 isoenzymes. However, a clinical study in healthy postmenopausal individuals shows that taking red clover capsules standardized to contain 60 mg isoflavones twice daily for 14 days does not affect the pharmacokinetics of alprazolam, a CYP3A4 probe substrate.

Likelihood Unlikely Evidence B

organic Turkish rhubarb8 drug types · 658 drugs

Corticosteroids

Theoretically, frequent and high doses of rhubarb might increase the risk of hypokalemia when taken with corticosteroids.
Rhubarb has stimulant laxative effects. Overuse of rhubarb might compound corticosteroid-induced potassium loss.

Likelihood Possible Evidence D
Cyclosporine (Neoral, Sandimmune)

Theoretically, taking rhubarb with cyclosporine might reduce cyclosporine levels.
Animal research shows that co-administration of rhubarb decoction 0.25 or 1 gram/kg with cyclosporine 2.5 mg/kg, decreases cyclosporine maximum plasma concentration and overall exposure levels when compared with taking cyclosporine alone. The authors theorize that rhubarb might reduce cyclosporine bioavailability by inducing of P-glycoprotein and/or cytochrome P450 3A4. However, since rhubarb was administered as a single oral dose and enzyme induction usually occurs after multiple doses, it is possible that cyclosporine absorption was actually reduced via rhubarb's stimulant laxative effects. Also, the composition of the rhubarb decoction was not described.

Likelihood Possible Evidence D
Digoxin (Lanoxin)

Theoretically, overuse of rhubarb might increase the risk of adverse effects when taken with digoxin.
Rhubarb has stimulant laxative effects. Overuse of rhubarb might cause potassium depletion, increasing the risk of digoxin toxicity.

Likelihood Possible Evidence D
Diuretic Drugs

Theoretically, frequent and high doses of rhubarb might increase the risk of hypokalemia.
Rhubarb has stimulant laxative effects. Overuse of rhubarb might cause potassium depletion and compound diuretic-induced potassium loss.

Likelihood Possible Evidence D
Hepatotoxic Drugs

Theoretically, concomitant use of rhubarb with potentially hepatotoxic drugs might increase the risk of developing liver damage.
Some animal research suggests that anthraquinones in rhubarb might have hepatotoxic effects. Also, rhubarb use has been linked to at least 24 cases of liver injury, although details on the dose of rhubarb and duration of use in these cases is unclear.

Likelihood Possible Evidence D
Nephrotoxic Drugs

Theoretically, long-term use of anthraquinones from rhubarb might increase the risk of nephrotoxicity when used with nephrotoxic drugs.
The anthraquinone constituents of rhubarb have been shown to induce nephrotoxicity in animal research. Additionally, in a case report, a 23-year old female presented with kidney failure after taking 6 tablets of a proprietary slimming agent (found to contain the anthraquinones emodin and aloe-emodin from rhubarb) daily for 6 weeks and then adding diclofenac 25 mg 4 times daily for 2 days. The authors postulate that the anthraquinone constituents of rhubarb contributed to the renal dysfunction, and the addition of diclofenac, a nephrotoxic drug, led to renal failure. Until more is known, advise patients to avoid taking rhubarb if they are taking other potentially nephrotoxic drugs.

Likelihood Possible Evidence D
Stimulant Laxatives

Theoretically, rhubarb might increase the risk for fluid and electrolyte loss when taken with other stimulant laxatives.
Rhubarb has stimulant laxative effects. Concomitant use with stimulant laxatives might compound fluid and electrolyte loss.

Likelihood Possible Evidence D
Warfarin (Coumadin)

Theoretically, excessive use of rhubarb might increase the risk of bleeding when taken with warfarin.
Rhubarb has stimulant laxative effects and can cause diarrhea. Diarrhea can increase the effects of warfarin, increase international normalized ratio (INR), and increase the risk of bleeding. Advise patients who take warfarin not to take excessive amounts of rhubarb.

Likelihood Possible Evidence D

organic Spearmint2 drug types · 579 drugs

Cns Depressants

Theoretically, spearmint might alter the sedative effects of CNS depressants.
Animal research suggests that (-)-carvone, a major constituent of spearmint, has sedative effects. However, in humans, chewing spearmint-flavored gum induced arousal effects.

Likelihood Possible Evidence D
Hepatotoxic Drugs

Theoretically, high doses of spearmint might increase the risk of liver damage when taken with hepatotoxic drugs.
Animal research suggests that drinking spearmint tea for 30 days can increase markers of liver damage, including aspartate aminotransferase (AST) and alanine aminotransferase (ALT), and cause liver degeneration and necrosis, in a dose-dependent manner. This effect has not been reported in humans.

Likelihood Possible Evidence D

organic roasted Dandelion7 drug types · 457 drugs

Anticoagulant/Antiplatelet Drugs

Theoretically, taking dandelion root along with anticoagulant or antiplatelet drugs might increase the risk of bruising and bleeding.
In vitro research suggests that dandelion root inhibits platelet aggregation.

Likelihood Possible Evidence D
Antidiabetes Drugs

Theoretically, dandelion might increase the risk for hypoglycemia when used with antidiabetes drugs.
Laboratory research suggests that dandelion extract may have moderate alpha-glucosidase inhibitor activity and might also increase insulin secretion. Also, in a case report, a 58-year-old woman with type 2 diabetes who was being treated with insulin developed hypoglycemia 2 weeks after beginning to eat salads containing dandelion.

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

Theoretically, dandelion might increase levels of drugs metabolized by CYP1A2.
Laboratory research suggests that dandelion might inhibit CYP1A2. So far, this interaction has not been reported in humans. However, until more is known, watch for an increase in the levels of drugs metabolized by CYP1A2 in patients taking dandelion.

Likelihood Possible Evidence D
Glucuronidated Drugs

Theoretically, dandelion might increase the clearance of drugs that are UDP-glucuronosyltransferase substrates.
There is some preliminary evidence that dandelion might induce UDP-glucuronosyltransferase, a phase II enzyme.

Likelihood Possible Evidence D
Lithium

Theoretically, through diuretic effects, dandelion might reduce excretion and increase levels of lithium.
Animal research suggests that dandelion has diuretic properties. As diuretics can increase serum lithium levels, the dose of lithium might need to be decreased when taken with dandelion.

Likelihood Probable Evidence D
Potassium-Sparing Diuretics

Theoretically, dandelion might increase the risk of hyperkalemia when taken with potassium-sparing diuretics.
Dandelion contains significant amounts of potassium.

Likelihood Possible Evidence D
Quinolone Antibiotics

Theoretically, dandelion might lower fluoroquinolone levels.
Animal research shows that dandelion reduces absorption of ciprofloxacin and can lower levels by 73%. However, this effect has not been reported in humans.

Likelihood Possible Evidence D

organic Cinnamon2 drug types · 442 drugs

Antidiabetes Drugs

Theoretically, cassia cinnamon may have additive effects with antidiabetes drugs.
Cassia cinnamon may lower blood glucose levels, and have additive effects in patients treated with antidiabetic agents. Dose adjustments to diabetes medications might be necessary.

Likelihood Possible Evidence B
Hepatotoxic Drugs

Theoretically, large doses of cassia cinnamon might cause additive effects when used with hepatotoxic drugs.
There is some concern that ingesting large amounts of cassia cinnamon for an extended duration might cause hepatotoxicity in some people. Cassia cinnamon contains coumarin, which can cause hepatotoxicity in animal models. In humans, very high doses of coumarin from 50-7000 mg/day can result in hepatotoxicity that resolves when coumarin use is discontinued. Lower amounts might also cause liver problems in sensitive people, such as those with liver disease or those taking potentially hepatotoxic agents.

Likelihood Possible Evidence D

organic Skullcap1 drug type · 248 drugs

Cns Depressants

Theoretically, skullcap can have additive effects when used with other CNS depressants.
Animal and clinical research suggests that skullcap can cause sedation and cognitive impairment.

Likelihood Possible Evidence D

organic Anise11 drug types · 245 drugs

Antidiabetes Drugs

Theoretically, anise seed might increase the risk of hypoglycemia when taken with antidiabetes drugs.
A small clinical study shows that anise seed powder decreases fasting blood glucose levels by 36% when compared to baseline.

Likelihood Possible Evidence B
Caffeine

Theoretically, anise oil might decrease the efficacy of caffeine.
Animal research shows that taking anise oil with caffeine decreases the bioavailability of caffeine. Whether this interaction will occur in humans is unclear.

Likelihood Possible Evidence D
Codeine

Theoretically, anise oil might increase the effects and adverse effects of codeine.
Animal research shows that anise oil increases the analgesic effects of codeine, possibly by inducing its phase I metabolism and increasing conversion to morphine. Whether this interaction occurs in humans is unclear.

Likelihood Possible Evidence D
Contraceptive Drugs

Theoretically, anise might interfere with contraceptive drug therapy.
Some in vitro research suggests that anise has estrogenic effects, while other in vitro research suggests that anise has antiestrogenic effects.

Likelihood Possible Evidence D
Diazepam (Valium)

Theoretically, anise oil might increase the effects and adverse effects of diazepam.
Animal research shows that taking anise oil with diazepam increases the motor impairment associated with diazepam, possibly by inhibiting its breakdown by cytochrome P450 3A4. Whether this interaction occurs in humans is unclear.

Likelihood Possible Evidence D
Estrogens

Theoretically, anise might interfere with estrogen-based hormone replacement therapy.
Some in vitro research suggests that anise has estrogenic effects, while other in vitro research suggests that anise has antiestrogenic effects.

Likelihood Possible Evidence D
Fluoxetine (Prozac)

Theoretically, anise oil might decrease the efficacy of fluoxetine.
Animal research shows that taking anise oil with fluoxetine reduces the antidepressant effects of fluoxetine, possibly by promoting its breakdown by cytochrome P450 2D6. Whether this interaction occurs in humans is unclear.

Likelihood Possible Evidence D
Imipramine (Tofranil)

Theoretically, anise oil might decrease the efficacy of imipramine.
Animal research shows that taking anise oil with imipramine reduces the antidepressant effects of imipramine, possibly by promoting its breakdown by cytochrome P450 2D6. Whether this interaction occurs in humans is unclear.

Likelihood Possible Evidence D
Midazolam (Versed)

Theoretically, anise oil might increase the effects and adverse effects of midazolam.
Animal research shows that taking anise oil with midazolam increases the motor impairment associated with midazolam, possibly by inhibiting its breakdown by cytochrome P450 3A4. Whether this interaction occurs in humans is unclear.

Likelihood Possible Evidence D
Tamoxifen (Nolvadex)

Theoretically, anise might interfere with tamoxifen therapy.
Some in vitro research suggests that anise has estrogenic effects, while other in vitro research suggests that anise has antiestrogenic effects.

Likelihood Possible Evidence D
Acetaminophen (Tylenol, Others)

Theoretically, anise oil might decrease the levels and clinical effects of acetaminophen.
Animal research shows that taking anise oil with acetaminophen decreases peak plasma levels of acetaminophen but does not reduce overall bioavailability. Whether this interaction will occur in humans is unclear.

Likelihood Possible Evidence D

organic Holy Basil3 drug types · 212 drugs

Anticoagulant/Antiplatelet Drugs

Theoretically, holy basil seed oil might increase the risk of bleeding when used with anticoagulant or antiplatelet drugs.
Animal research shows that holy basil seed oil can prolong bleeding time, possibly due to inhibition of platelet aggregation. However, it is not known if this occurs in humans.

Likelihood Possible Evidence D
Antidiabetes Drugs

Theoretically, holy basil might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Small clinical studies show that taking holy basil can decrease fasting blood glucose and other measures of glycemic control in patients with type 2 diabetes.

Likelihood Possible Evidence B
Pentobarbital (Nembutal)

Theoretically, holy basil seed oil might increase the sedative effects of pentobarbital.
Animal research shows that holy basil seed oil increases pentobarbitone-induced sleeping time. However, it is not known if this occurs in humans or if this applies to other barbiturates or sedatives.

Likelihood Possible Evidence D

organic Oregano2 drug types · 208 drugs

Anticoagulant/Antiplatelet Drugs

Theoretically, oregano might increase the risk of bleeding when taken with anticoagulant or antiplatelet drugs.
In vitro research shows that aristolochic acid isolated from oregano leaves has antithrombin activity. It has also been reported that oregano oil inhibits arachidonic acid-induced, and ADP-induced, platelet aggregation.

Likelihood Possible Evidence D
Antidiabetes Drugs

Theoretically, oregano might increase the risk for hypoglycemia when taken with antidiabetes drugs.
In vitro and animal research shows that oregano extracts might lower blood glucose levels.

Likelihood Possible Evidence D

organic Juniper3 drug types · 162 drugs

Antidiabetes Drugs

Theoretically, taking juniper berry with antidiabetes medications might cause additive hypoglycemia.
Animal research shows that juniper berry can lower blood glucose.

Likelihood Possible Evidence D
Diuretic Drugs

Theoretically, juniper berry might increase the risk of adverse effects from diuretic drugs.
Juniper berry is thought to have mild diuretic effects.

Likelihood Possible Evidence D
Lithium

Theoretically, juniper berry might reduce lithium excretion and increase serum levels of lithium.
Juniper berry is thought to have mild diuretic effects.

Likelihood Possible Evidence D

organic Burdock1 drug type · 122 drugs

Anticoagulant/Antiplatelet Drugs

Theoretically, taking burdock with anticoagulant or antiplatelet drugs might increase the risk of bleeding.

In vitro research shows that lignans from burdock reduce rabbit platelet aggregation by inhibiting platelet activating factor. This interaction has not been reported in humans.

Likelihood Possible Evidence D
The maker

Brand information

Manufacturer and brand details for Ultimate Detox 1000 mg, from the product label.

Remedys Nutrition

See all Remedys Nutrition products
Name
Remedy's Nutrition
Street Address
99696 Overseas Highway Ste 6
City
Key Largo
State
FL
ZipCode
33037
Web Address
www.RMDYS.com
Pharmacist Counseling Corner

Ultimate Detox 1000 mg by Remedys Nutrition: Common Questions

Does Ultimate Detox 1000 mg by Remedys Nutrition interact with any medications?
Yes. Based on its ingredients, Ultimate Detox 1000 mg has a known interaction with 1,528 medications. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Ultimate Detox 1000 mg contains 14 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.
Can I take this if I'm on blood thinners?
No, not without checking first. Holy basil and oregano in this product may increase bleeding risk with anticoagulants or antiplatelet drugs. Talk to your doctor or pharmacist before combining them.
Does this product work for detox?
The evidence in our data doesn't establish that these ingredients are effective for detox. Most are rated as having insufficient reliable evidence for their traditional uses.
Is it safe to take during pregnancy?
No. Several ingredients—holy basil, skullcap, red clover, oregano, burdock, and Oregon grape—should be avoided in pregnancy due to limited safety data or potential effects on the uterus. Talk to your doctor before use.
What are the most common side effects?
Mild gastrointestinal upset—nausea, loose stools, and diarrhea—were reported in small numbers of trial participants taking these herbs. Rhubarb may cause cramping, especially with long-term use.
Can I take this with diabetes medication?
Possibly not without supervision. Holy basil, cinnamon, anise, oregano, milk thistle, dandelion, Oregon grape, and juniper may all lower blood sugar. Check with your doctor to see if your dose needs adjusting.
Is this safe while breastfeeding?
Several ingredients lack enough safety data or should be avoided during breastfeeding, including holy basil, skullcap, oregano, and juniper. Talk to your doctor about whether this product is right for you.

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

Not sure if Ultimate Detox 1000 mg is safe with your meds?

Our pharmacists answer your medication & supplement questions — free.

Ask a pharmacist

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 Detox 1000 mg label
Go deeper

The Full Monographs Behind Ultimate Detox 1000 mg’s Ingredients

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

Herb & supplement monograph

Holy Basil

Interacts with 212 drugs

Holy basil (tulsi) is a traditional Ayurvedic herb most often used today for stress and general wellness, but the human evidence is mostly small and preliminary. It is generally well tolerat...

Read the full Holy Basil monograph →
Herb & supplement monograph

Cassia Cinnamon

Interacts with 442 drugs

Cassia cinnamon is the common, inexpensive cinnamon used in cooking, and it is also taken as a supplement, most often for blood sugar support. The evidence for its health benefits is mixed a...

Read the full Cassia Cinnamon monograph →
Herb & supplement monograph

Red Clover

Interacts with 867 drugs

Red clover is a plant rich in isoflavones (plant compounds with weak estrogen-like activity) that is most often used for menopause symptoms like hot flashes. The evidence is mixed and genera...

Read the full Red Clover monograph →
Herb & supplement monograph

Skullcap

Interacts with 248 drugs

American skullcap is an herb traditionally used to calm anxiety and promote relaxation, but solid human evidence is very limited. It is generally considered relatively safe for short-term us...

Read the full Skullcap monograph →
Herb & supplement monograph

Spearmint

Interacts with 579 drugs

Spearmint is a common culinary mint that is generally safe in food and tea amounts. Early research suggests possible benefits for digestion, mild hormone-related issues (such as excess facia...

Read the full Spearmint monograph →
Herb & supplement monograph

Anise

Interacts with 245 drugs

Anise is a fragrant, licorice-flavored seed used for centuries to ease digestion and soothe coughs. Most of its health claims are based on tradition and small or laboratory studies rather th...

Read the full Anise 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

Oregano

Interacts with 208 drugs

Oregano is a common Mediterranean cooking herb that is also sold as a concentrated oil or supplement, often standardized for a compound called carvacrol. While lab studies suggest it may hav...

Read the full Oregano monograph →
Herb & supplement monograph

Milk Thistle

Interacts with 954 drugs

Milk thistle is a popular herbal supplement most often used for liver health, and its main active component is a group of compounds called silymarin. While it is generally well tolerated, th...

Read the full Milk Thistle monograph →
Herb & supplement monograph

Dandelion

Interacts with 457 drugs

Dandelion is a common plant used in food and traditional medicine, often promoted as a natural 'water pill' and digestive aid. Human evidence for these uses is very limited, so its benefits...

Read the full Dandelion monograph →
Herb & supplement monograph

Burdock

Interacts with 122 drugs

Burdock is a traditional herb most often used for skin problems and as a so-called 'blood purifier,' but high-quality human studies are lacking and most claims are not well proven. It is wid...

Read the full Burdock monograph →
Herb & supplement monograph

Oregon Grape

Interacts with 1,218 drugs

Oregon grape is a shrub whose root contains berberine and related compounds. The strongest (though still modest) evidence is for topical creams that may slightly ease psoriasis; evidence for...

Read the full Oregon Grape monograph →
Herb & supplement monograph

Juniper

Interacts with 162 drugs

Juniper berry is a traditional herb best known for flavoring gin and for its folk use as a diuretic and digestive aid. Solid human evidence for its health benefits is limited, and it can irr...

Read the full Juniper monograph →
Herb & supplement monograph

Rhubarb

Interacts with 658 drugs

Rhubarb root has a long history of use as a laxative and in traditional Chinese medicine, and its edible stalks are a common food. Most medicinal claims are backed by limited or low-quality...

Read the full Rhubarb monograph →
Sources

Sources & How We Checked

Ultimate Detox 1000 mg'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 256 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.

Holy Basil 8 references
  1. Agrawal P, Rai V, Singh RB. Randomized placebo-controlled, single blind trial of holy basil leaves in patients with noninsulin-dependent diabetes mellitus. Int J Clin Pharmacol Ther 1996;34:406-9.
  2. Sakina MR, Dandiya PC, Hamdard ME, Hameed A. Preliminary psychopharmacological evaluation of Ocimum sanctum leaf extract. J Ethnopharmacol 1990;28:143-50. PubMed
  3. Singh S, Rehan HM, Majumdar DK. Effect of Ocimum sanctum fixed oil on blood pressure, blood clotting time and pentobarbitone-induced sleeping time. J Ethnopharmacol 2001;78:139-43. PubMed
  4. Mondal, S., Varma, S., Bamola, V. D., Naik, S. N., Mirdha, B. R., Padhi, M. M., Mehta, N., and Mahapatra, S. C. Double-blinded randomized controlled trial for immunomodulatory effects of Tulsi (Ocimum sanctum Linn.) leaf extract on healthy volunteers. J PubMed
  5. Agarwal, P. and Nagesh, L. Comparative evaluation of efficacy of 0.2% Chlorhexidine, Listerine and Tulsi extract mouth rinses on salivary Streptococcus mutans count of high school children--RCT. Contemp.Clin Trials 2011;32(6):802-808. PubMed
  6. Vohora, S. B., Garg, S. K., and Chaudhury, R. R. Antifertility screening of plants. 3. Effect of six indigenous plants on early pregnancy in albino rats. Indian J Med Res 1969;57(5):893-899.
  7. Khanna S, Gupta SR, Grover JK. Effect of long term feeding of tulsi (Ocimum sanctum Linn) on reproductive performance of adult albino rats. Indian J Exp Biol 1986;24(5):302-4.
  8. Somasundaram G, Manimekalai K, Salwe KJ, Pandiamunian J. Evaluation of the antidiabetic effect of Ocimum sanctum in type 2 diabetes patients. Int J Life Sci Pharma Res 2012;2(3):75-81.

See these in context on the Holy Basil monograph →

Cassia Cinnamon 20 references
  1. Electronic Code of Federal Regulations. Title 21. Part 182 -- Substances Generally Recognized As Safe. Available at: https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?CFRPart=182
  2. Khan A, Safdar M, Ali Khan M, et al. Cinnamon improves glucose and lipids of people with type 2 diabetes. Diabetes Care 2003;26:3215-8. PubMed
  3. De Benito V, Alzaga R. Occupational allergic contact dermatitis from cassia (Chinese cinnamon) as a flavouring agent in coffee. Contact Dermatitis 1999;40:165. PubMed
  4. Drake TE, Maibach HI. Allergic contact dermatitis and stomatitis caused by a cinnamic aldehyde-flavored toothpaste. Arch Dermatol 1976;112:202-3.
  5. Press release. Cinnamon capsules to reduce blood sugar are medicinal products! Efficacy has not been scientifically proven - some products contain high levels of coumarin. Federal Institute of Risk Assessment (BfM), Germany, November 11, 2006. Available a
  6. Felter SP, Vassallo JD, Carlton BD, Daston GP. A safety assessment of coumarin taking into account species-specificity of toxicokinetics. Food Chem Toxicol 2006;44:462-75. PubMed
  7. Crawford P. Effectiveness of cinnamon for lowering hemoglobin A1C in patients with type 2 diabetes: a randomized, controlled trial. J Am Board Fam Med 2009;22:507-12. PubMed
  8. Akilen, R., Tsiami, A., Devendra, D., and Robinson, N. Glycated haemoglobin and blood pressure-lowering effect of cinnamon in multi-ethnic Type 2 diabetic patients in the UK: a randomized, placebo-controlled, double-blind clinical trial. Diabet.Med. 2010; PubMed
  9. Lu T, Sheng H Wu J Cheng Y Zhu J Chen Y. Cinnamon extract improves fasting blood glucose and glycosylated hemoglobin level in Chinese patients with type 2 diabetes. Nutr Res. 2012;32(6):408-412. PubMed
  10. Choi, J., Lee, K. T., Ka, H., Jung, W. T., Jung, H. J., and Park, H. J. Constituents of the essential oil of the Cinnamomum cassia stem bark and the biological properties. Arch Pharm Res 2001;24(5):418-423.
  11. Altschuler JA, Casella SJ, MacKenzie TA, Curtis KM. The effect of cinnamon on A1C among adolescents with type 1 diabetes. Diabetes Care 2007;30(4):813-6. PubMed
  12. Stoecker BR, Zhan Z, Luo R, et al. Cinnamon extract lowers blood glucose in hyperglycemic subjects. FASEB J. 2010;22:722.1 (Abstract only). DOI
  13. Admani S, Hill H, Jacob SE. Cinnamon Sugar Scrub Dermatitis: "Natural" Is Not Always Best. Pediatr Dermatol. 2017;34(1):e42-e43. PubMed
  14. Isaac-Renton M, Li MK, Parsons LM. Cinnamon spice and everything not nice: many features of intraoral allergy to cinnamic aldehyde. Dermatitis. 2015;26(3):116-21. PubMed
  15. Vandersall A, Katta R. Eyelid dermatitis as a manifestation of systemic contact dermatitis to cinnamon. Dermatitis. 2015 Jul-Aug;26(4):189. PubMed
  16. Wickenberg J, Lindstedt S, Nilsson J, Hlebowicz J. Cassia cinnamon does not change the insulin sensitivity or the liver enzymes in subjects with impaired glucose tolerance. Nutr J 2014 Sep 24;13:96. PubMed
  17. Brancheau D, Patel B, Zughaib M. Do cinnamon supplements cause acute hepatitis? Am J Case Rep 2015;16:250-4. PubMed
  18. Shekarchizadeh-Esfahani P, Heydarpour F, Izadi F, Jalili C. The effect of cinnamon supplementation on liver enzymes in adults: A systematic review and meta-analysis of randomized controlled trials. Complement Ther Med 2021;58:102699. PubMed
  19. Bernaola J, Valverde-Monge M, Otal-Buesa M, Cullen D, Heras-Mendaza F. Cinnamon allergic contact cheilitis. Contact Dermatitis 2023;88(5):418-419. PubMed
  20. Patel K, Howard M, Tate B. Cheilitis caused by allergic contact dermatitis to cinnamon in chai tea: A case report. Contact Dermatitis 2023;88(3):239-240. PubMed

See these in context on the Cassia Cinnamon monograph →

Red Clover 24 references
  1. Kurzer MS, Xu X. Dietary phytoestrogens. Annu Rev Nutr 1997;17:353-81. PubMed
  2. Electronic Code of Federal Regulations. Title 21. Part 182 -- Substances Generally Recognized As Safe. Available at: https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?CFRPart=182
  3. Budzinski JW, Foster BC, Vandenhoek S, Arnason JT. An in vitro evaluation of human cytochrome P450 3A4 inhibition by selected commercial herbal extracts and tinctures. Phytomedicine 2000;7:273-82. PubMed
  4. This P, De La Rochefordiere A, Clough K, et al. Phytoestrogens after breast cancer. Endocr Relat Cancer 2001;8:129-34. PubMed
  5. Tice J, Cummings SR, Ettinger B, et al. Few adverse effects of two red clover extracts rich in phytoestrogens: a multicenter, placebo-controlled trial. Alt Ther 2001;7:S33.
  6. Ingram DM, Hickling C, West L, et al. A double-blind randomized controlled trial of isoflavones in the treatment of cyclical mastalgia. The Breast 2002;11:170-4. PubMed
  7. Unger M, Frank A. Simultaneous determination of the inhibitory potency of herbal extracts on the activity of six major cytochrome P450 enzymes using liquid chromatography/mass spectrometry and automated online extraction. Rapid Commun Mass Spectrom 2004;1 PubMed
  8. Cheong JL, Bucknall R. Retinal vein thrombosis associated with a herbal phytoestrogen preparation in a susceptible patient. Postgrad Med J 2005;81:266-7.. PubMed
  9. Geller SE, Shulman LP, van Breemen RB, et al. Safety and efficacy of black cohosh and red clover for the management of vasomotor symptoms: a randomized controlled trial. Menopause 2009;16:1156-66. PubMed
  10. Hidalgo LA, Chedraui PA, Morocho N, et al. The effect of red clover isoflavones on menopausal symptoms, lipids and vaginal cytology in menopausal women: a randomized, double-blind, placebo-controlled study. Gynecol Endocrinol 2005;21(5):257-264. PubMed
  11. Campbell MJ, Woodside JV, Honour JW, et al. Effect of red clover-derived isoflavone supplementation on insulin-like growth factor, lipid and antioxidant status in healthy female volunteers: a pilot study. Eur J Clin Nutr 2004;58(1):173-179. PubMed
  12. Guerrero JA, Lozano ML, Castillo J, et al. Flavonoids inhibit platelet function through binding to the thromboxane A2 receptor. J Thromb Haemost 2005;3(2):369-376. PubMed
  13. Kondo K, Suzuki Y, Ikeda Y, Umemura K. Genistein, an isoflavone included in soy, inhibits thrombotic vessel occlusion in the mouse femoral artery and in vitro platelet aggregation. Eur J Pharmacol 2002;455(1):53-57. PubMed
  14. Polini N, Rauschemberger MB, Mendiberri J, et al. Effect of genistein and raloxifene on vascular dependent platelet aggregation. Mol Cell Endocrinol 2007;267(1-2):55-62. PubMed
  15. Wuttke W, Jarry H, Seidlova-Wuttke D. Plant-derived alternative treatments for the aging male: facts and myths. Aging Male 2010;13(2):75-81. PubMed
  16. Villaseca P. Non-estrogen conventional and phytochemical treatments for vasomotor symptoms: what needs to be known for practice. Climacteric 2012;15(2):115-124. PubMed
  17. Chen, Y., Xiao, C. Q., He, Y. J., Chen, B. L., Wang, G., Zhou, G., Zhang, W., Tan, Z. R., Cao, S., Wang, L. P., and Zhou, H. H. Genistein alters caffeine exposure in healthy female volunteers. Eur.J Clin.Pharmacol. 2011;67(4):347-353. PubMed
  18. Friedman, J. A., Taylor, S. A., McDermott, W., and Alikhani, P. Multifocal and recurrent subarachnoid hemorrhage due to an herbal supplement containing natural coumarins. Neurocrit.Care 2007;7(1):76-80. PubMed
  19. Hooper, L., Madhavan, G., Tice, J. A., Leinster, S. J., and Cassidy, A. Effects of isoflavones on breast density in pre- and post-menopausal women: a systematic review and meta-analysis of randomized controlled trials. Hum.Reprod.Update. 2010;16(6):745-7 PubMed
  20. Orr A and Parker R. Red clover causing symptoms suggestive of methotrexate toxicity in a patient on high-dose methotrexate. Menopause Int. 2013;19(3):133-134. PubMed
  21. Clifton-Bligh PB, et al. Red cover isoflavones enriched with formononetin lower serum LDL cholesterol- a randomized, double-blind, placebo-controlled trial. Eur J Clin Nutr. 2015;69(1):134-142.
  22. Risk assessment for peri- and post-menopausal women taking food supplements containing isolated isoflavones. EFSA Panel on Food Additives and Nutrient Sources added to Food (ANS). 2015. DOI
  23. Ferraris C, Ballestra B, Listorti C, et al. Red clover and lifestyle changes to contrast menopausal symptoms in premenopausal patients with hormone-sensitive breast cancer receiving tamoxifen. Breast Cancer Res Treat 2020;180(1):157-65. doi: 10.1007/s1054 PubMed
  24. Chen L, Choi J, Leonard SW, et al. No Clinically Relevant Pharmacokinetic Interactions of a Red Clover Dietary Supplement with Cytochrome P450 Enzymes in Women. J Agric Food Chem. 2020;68(47):13929-13939. PubMed

See these in context on the Red Clover monograph →

Skullcap 3 references
  1. Wolfson P, Hoffmann DL. An investigation into the efficacy of Scutellaria lateriflora in healthy volunteers. Altern Ther Health Med 2003;9:74-8.
  2. Awad, R., Arnason, J. T., Trudeau, V., Bergeron, C., Budzinski, J. W., Foster, B. C., and Merali, Z. Phytochemical and biological analysis of skullcap (Scutellaria lateriflora L.): a medicinal plant with anxiolytic properties. Phytomedicine. 2003;10(8):6 PubMed
  3. Brock C, Whitehouse J, Tewfik I, Towell T. American skullcap (Scutellaria lateriflora): a randomised, double-blind placebo-controlled crossover study of its effects on mood in healthy volunteers. Phytother Res 2014;28(5):692-8.

See these in context on the Skullcap monograph →

Spearmint 20 references
  1. Electronic Code of Federal Regulations. Title 21. Part 182 -- Substances Generally Recognized As Safe. Available at: https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?CFRPart=182
  2. Akdogan M, Ozguner M, Aydin G, Gokalp O. Investigation of biochemical and histopathological effects of Mentha piperita Labiatae and Mentha spicata Labiatae on liver tissue in rats. Hum Exp Toxicol 2004;23:21-8.
  3. Poon, T. S. and Freeman, S. Cheilitis caused by contact allergy to anethole in spearmint flavoured toothpaste. Australas.J Dermatol. 2006;47(4):300-301. PubMed
  4. Andersen, K. E. Contact allergy to toothpaste flavors. Contact Dermatitis 1978;4(4):195-198. PubMed
  5. de Sousa, D. P., Farias Nobrega, F. F., and de Almeida, R. N. Influence of the chirality of (R)-(-)- and (S)-(+)-carvone in the central nervous system: a comparative study. Chirality 5-5-2007;19(4):264-268.
  6. Larsen, W., Nakayama, H., Fischer, T., Elsner, P., Frosch, P., Burrows, D., Jordan, W., Shaw, S., Wilkinson, J., Marks, J., Jr., Sugawara, M., Nethercott, M., and Nethercott, J. Fragrance contact dermatitis: a worldwide multicenter investigation (Part II PubMed
  7. Guney, M., Oral, B., Karahanli, N., Mungan, T., and Akdogan, M. The effect of Mentha spicata Labiatae on uterine tissue in rats. Toxicol.Ind.Health 2006;22(8):343-348.
  8. Masumoto, Y., Morinushi, T., Kawasaki, H., Ogura, T., and Takigawa, M. Effects of three principal constituents in chewing gum on electroencephalographic activity. Psychiatry Clin.Neurosci. 1999;53(1):17-23. PubMed
  9. Bulat, R., Fachnie, E., Chauhan, U., Chen, Y., and Tougas, G. Lack of effect of spearmint on lower oesophageal sphincter function and acid reflux in healthy volunteers. Aliment.Pharmacol Ther. 1999;13(6):805-812. PubMed
  10. Francalanci, S., Sertoli, A., Giorgini, S., Pigatto, P., Santucci, B., and Valsecchi, R. Multicentre study of allergic contact cheilitis from toothpastes. Contact Dermatitis 2000;43(4):216-222. PubMed
  11. Bonamonte, D., Mundo, L., Daddabbo, M., and Foti, C. Allergic contact dermatitis from Mentha spicata (spearmint). Contact Dermatitis 2001;45(5):298.
  12. Tomson, N., Murdoch, S., and Finch, T. M. The dangers of making mint sauce. Contact Dermatitis 2004;51(2):92-93. PubMed
  13. Clayton, R. and Orton, D. Contact allergy to spearmint oil in a patient with oral lichen planus. Contact Dermatitis 2004;51(5-6):314-315. PubMed
  14. Dal Sacco, D., Gibelli, D., and Gallo, R. Contact allergy in the burning mouth syndrome: a retrospective study on 38 patients. Acta Derm.Venereol. 2005;85(1):63-64. PubMed
  15. Goncalves, J. C., Oliveira, Fde S., Benedito, R. B., de Sousa, D. P., de Almeida, R. N., and de Araujo, D. A. Antinociceptive activity of (-)-carvone: evidence of association with decreased peripheral nerve excitability. Biol Pharm Bull. 2008;31(5):1017- PubMed
  16. Ormerod, A. D. and Main, R. A. Sensitisation to "sensitive teeth" toothpaste. Contact Dermatitis 1985;13(3):192-193. PubMed
  17. Skrebova, N., Brocks, K., and Karlsmark, T. Allergic contact cheilitis from spearmint oil. Contact Dermatitis 1998;39(1):35. PubMed
  18. Damiani E, Aloia AM, Priore MG, et al. Allergy to mint (Mentha spicata). J Investig Allergol Clin Immunol 2012;22:309-10.
  19. Connelly AE, Tucker AJ, Tulk H, et al. High-rosmarinic acid spearmint tea in the management of knee osteoarthritis symptoms. J Med Food 2014;17:1361-7. PubMed
  20. Lasrado JA, Nieman KM, Fonseca BA, et al. Safety and tolerability of a dried aqueous spearmint extract. Regul Toxicol Pharmacol 2017;86:167-176. PubMed

See these in context on the Spearmint monograph →

Anise 12 references
  1. Electronic Code of Federal Regulations. Title 21. Part 182 -- Substances Generally Recognized As Safe. Available at: https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?CFRPart=182
  2. Kassi E, Papoutsi Z, Fokialakis N, et al. Greek plant extracts exhibit selective estrogen receptor modulator (SERM)-like properties. J Agric Food Chem 2004;52:6956-61. PubMed
  3. Mumcuoglu KY, Miller J, Zamir C, et al. The in vivo pediculicidal efficacy of a natural remedy. Isr Med Assoc J 2002;4:790-3.
  4. Garcia-Gonzalez JJ, Bartolome-Zavala B, Fernandez-Melendez S, et al. Occupational rhinoconjunctivitis and food allergy because of aniseed sensitization. Ann Allergy Asthma Immunol 2002;88:518-22. . PubMed
  5. Tabanca N, Khan SI, Bedir E, et al. Estrogenic activity of isolated compounds and essential oils of Pimpinella species from Turkey, evaluated using a recombinant yeast screen. Planta Med 2004;70:728-35.
  6. Gonzalez-Gutierrez, M. L., Sanchez-Fernandez, C., Esteban-Lopez, M. I., Sempere-Ortells, J. M., and Diaz-Alperi, P. Allergy to anis. Allergy 2000;55(2):195-196.
  7. Anliker, M. D., Borelli, S., and Wuthrich, B. Occupational protein contact dermatitis from spices in a butcher: a new presentation of the mugwort-spice syndrome. Contact Dermatitis 2002;46(2):72-74. PubMed
  8. Poon, T. S. and Freeman, S. Cheilitis caused by contact allergy to anethole in spearmint flavoured toothpaste. Australas.J Dermatol. 2006;47(4):300-301. PubMed
  9. Andersen, K. E. Contact allergy to toothpaste flavors. Contact Dermatitis 1978;4(4):195-198. PubMed
  10. Samojlik I, Mijatovic V, Petkovic S, et al. The influence of essential oil of aniseed (Pimpinella anisum, L.) on drug effects on the central nervous system. Fitoterapia 2012;83:1466-73. PubMed
  11. Samojlik I, Petkovic S, Stilinovic N, et al. Pharmacokinetic herb-drug interaction between essential oil of aniseed (Pimpinella anisum L., Apiaceae) and acetaminophen and caffeine: A potential risk for clinical practice. Phytother Res 2016;30:253-9.
  12. Rajeshwari U, Shobha I, Andallu B. Comparison of aniseeds and coriander seeds for antidiabetic, hypolipidemic and antioxidant activities. Spatula DD-Peer Reviewed Journal on Complementary Medicine and Drug Discovery 2011;1:9-16. DOI

See these in context on the Anise monograph →

Olive 2 references
  1. Liccardi G, D'Amato M, D'Amato G. Oleaceae pollinosis: a review. Int Arch Allergy Immunol 1996;111:210-7. PubMed
  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

See these in context on the Olive monograph →

Oregano 12 references
  1. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
  2. Benito M, Jorro G, Morales C, et al. Labiatae allergy: systemic reactions due to ingestion of oregano and thyme. Ann Allergy Asthma Immunol 1996;76:416-8. PubMed
  3. Chevallier A. Encyclopedia of Herbal Medicine. 2nd ed. New York, NY: DK Publ, Inc., 2000.
  4. Ciganda C, and Laborde A. Herbal infusions used for induced abortion. J Toxicol.Clin Toxicol. 2003;41:235-239. PubMed
  5. Futrell, J. M. and Rietschel, R. L. Spice allergy evaluated by results of patch tests. Cutis 1993;52(5):288-290.
  6. Tognolini, M., Barocelli, E., Ballabeni, V., Bruni, R., Bianchi, A., Chiavarini, M., and Impicciatore, M. Comparative screening of plant essential oils: phenylpropanoid moiety as basic core for antiplatelet activity. Life Sci. 2-23-2006;78(13):1419-1432. PubMed
  7. Goun, E., Cunningham, G., Solodnikov, S., Krasnykch, O., and Miles, H. Antithrombin activity of some constituents from Origanum vulgare. Fitoterapia 2002;73(7-8):692-694. PubMed
  8. Lemhadri, A., Zeggwagh, N. A., Maghrani, M., Jouad, H., and Eddouks, M. Anti-hyperglycaemic activity of the aqueous extract of Origanum vulgare growing wild in Tafilalet region. J Ethnopharmacol. 2004;92(2-3):251-256. PubMed
  9. McCue, P., Vattem, D., and Shetty, K. Inhibitory effect of clonal oregano extracts against porcine pancreatic amylase in vitro. Asia Pac.J Clin.Nutr. 2004;13(4):401-408.
  10. Ragi, J., Pappert, A., Rao, B., Havkin-Frenkel, D., and Milgraum, S. Oregano extract ointment for wound healing: a randomized, double-blind, petrolatum-controlled study evaluating efficacy. J.Drugs Dermatol. 2011;10(10):1168-1172.
  11. Singletary K. Oregano: overview of the literature on health benefits. Nutrition Today 2010;45(3):129-38.
  12. Silva MLAE, Lucarini R, Dos Santos FF, et al. Hypoglycemic effect of rosmarinic acid-rich infusion (RosCE) from Origanum vulgare in alloxan-induced diabetic rats. Nat Prod Res 2022;36(17):4525-4531.

See these in context on the Oregano monograph →

Milk Thistle 69 references
  1. Ferenci P, Dragosics B, Dittrich H, et al. Randomized controlled trial of silymarin treatment in patients with cirrhosis of the liver. J Hepatol 1989;9:105-13. PubMed
  2. Anon. Milk thistle: Effects on liver disease and cirrhosis and clinical adverse effects. Summary, Evidence Report/Technology Assessment: Number 21, September 2000. Agency for Healthcare Research and Quality, Rockville, MD. Available at: http://www.ahrq.g
  3. Beckmann-Knopp S, Rietbrock S, Weyhenmeyer R, et al. Inhibitory effects of silibinin on cytochrome P-450 enzymes in human liver microsomes. Pharmacol Toxicol 2000;86:250-6. PubMed
  4. Venkataramanan R, Ramachandran V, Komoroski BJ, et al. Milk thistle, a herbal supplement, decreases the activity of CYP3A4 and uridine diphosphoglucuronosyl transferase in human hepatocyte cultures. Drug Metab Dispos 2000;28:1270-3. DOI
  5. Kim DH, Jin YH, Park JB, Kobashi K. Silymarin and its components are inhibitors of beta-glucuronidase. Biol Pharm Bull 1994;17:443-5. PubMed
  6. Pares A, Planas R, Torres M, et al. Effects of silymarin in alcoholic patients with cirrhosis of the liver: results of a controlled, double-blind, randomized and multicenter trial. J Hepatol 1998;28:615-21. PubMed
  7. Piscitelli SC, Formentini E, Burstein AH, et al. Effect of milk thistle on the pharmacokinetics of indinavir in healthy volunteers. Pharmacotherapy 2002;22:551-6. PubMed
  8. Boerth J, Strong KM. The clinical utility of milk thistle (Silybum marianum) in cirrhosis of the liver. J Herb Pharmacother 2002;2:11-7.
  9. Tanamly MD, Tadros F, Labeeb S, et al. Randomised double-blinded trial evaluating silymarin for chronic hepatitis C in an Egyptian village: study description and 12-month results. Dig Liver Dis 2004;36:752-9. PubMed
  10. Gurley BJ, Gardner SF, Hubbard MA, et al. In vivo assessment of botanical supplementation on human cytochrome P450 phenotypes: Citrus aurantium, Echinacea purpurea, milk thistle, and saw palmetto. Clin Pharmacol Ther 2004;76:428-40. .
  11. Huseini HF, Larijani B, Heshmat R, et al. The efficacy of Silybum marianum (L.) Gaertn. (silymarin) in the treatment of type II diabetes: a randomized, double-blind, placebo-controlled, clinical trial. Phytother Res 2006;20;1036-9.
  12. Deng JW, Shon JH, Shin HJ, et al. Effect of silymarin supplement on the pharmacokinetics of rosuvastatin. Pharm Res 2008;25:1807-14. PubMed
  13. Kim CS, Choi SJ, Park CY, et al. Effects of silybinin on the pharmacokinetics of tamoxifen and its active metabolite, 4-hydroxytamoxifen in rats. Anticancer Res 2010;30:79-85.
  14. Sridar C, Goosen TC, Kent UM, et al. Silybin inactivates cytochromes P450 3A4 and 2C9 and inhibits major hepatic glucuronosyltransferases. Drug Metab Dispos 2004;32:587-94. PubMed
  15. van Erp NP, Baker SD, Zhao M, et al. Effect of milk thistle (Silybum marianum) on the pharmacokinetics of irinotecan. Clin Cancer Res 2005;11:7800-6.
  16. Budzinski JW, Trudeau VL, Drouin CE, et al. Modulation of human cytochrome P450 3A4 (CYP3A4) and P-glycoprotein (P-gp) in Caco-2 cell monolayers by selected commercial-source milk thistle and goldenseal products. Can J Physiol Pharmacol 2007;85:966-78.
  17. Doehmer J, Weiss G, McGregor GP, Appel K. Assessment of a dry extract from milk thistle (Silybum marianum) for interference with human liver cytochrome-P450 activities. Toxicol In Vitro 2011;25:21-7. PubMed
  18. Jiao Z, Shi XJ, Li ZD, et al. Population pharmacokinetics of sirolimus in de novo Chinese adult renal transplant patients. Br.J.Clin.Pharmacol. 2009;68(1):47-60.
  19. Gurley, B. J., Barone, G. W., Williams, D. K., Carrier, J., Breen, P., Yates, C. R., Song, P. F., Hubbard, M. A., Tong, Y., and Cheboyina, S. Effect of milk thistle (Silybum marianum) and black cohosh (Cimicifuga racemosa) supplementation on digoxin phar
  20. Allain, H., Schuck, S., Lebreton, S., Strenge-Hesse, A., Braun, W., Gandon, J. M., and Brissot, P. Aminotransferase levels and silymarin in de novo tacrine-treated patients with Alzheimer's disease. Dement.Geriatr.Cogn Disord. 1999;10(3):181-185. PubMed
  21. Angulo, P., Patel, T., Jorgensen, R. A., Therneau, T. M., and Lindor, K. D. Silymarin in the treatment of patients with primary biliary cirrhosis with a suboptimal response to ursodeoxycholic acid. Hepatology 2000;32(5):897-900. PubMed
  22. Bean, P. The use of alternative medicine in the treatment of hepatitis C. Am.Clin.Lab 2002;21(4):19-21.
  23. Hussain, S. A. Silymarin as an adjunct to glibenclamide therapy improves long-term and postprandial glycemic control and body mass index in type 2 diabetes. J.Med.Food 2007;10(3):543-547. PubMed
  24. El-Kamary, S. S., Shardell, M. D., Abdel-Hamid, M., Ismail, S., El-Ateek, M., Metwally, M., Mikhail, N., Hashem, M., Mousa, A., Aboul-Fotouh, A., El-Kassas, M., Esmat, G., and Strickland, G. T. A randomized controlled trial to assess the safety and effic
  25. Gharagozloo, M., Moayedi, B., Zakerinia, M., Hamidi, M., Karimi, M., Maracy, M., and Amirghofran, Z. Combined therapy of silymarin and desferrioxamine in patients with beta-thalassemia major: a randomized double-blind clinical trial. Fundam.Clin.Pharmaco
  26. Ladas, E. J., Kroll, D. J., Oberlies, N. H., Cheng, B., Ndao, D. H., Rheingold, S. R., and Kelly, K. M. A randomized, controlled, double-blind, pilot study of milk thistle for the treatment of hepatotoxicity in childhood acute lymphoblastic leukemia (ALL PubMed
  27. Sayyah, M., Boostani, H., Pakseresht, S., and Malayeri, A. Comparison of Silybum marianum (L.) Gaertn. with fluoxetine in the treatment of Obsessive-Compulsive Disorder. Prog.Neuropsychopharmacol.Biol.Psychiatry 3-17-2010;34(2):362-365. PubMed
  28. Flaig, T. W., Glode, M., Gustafson, D., van, Bokhoven A., Tao, Y., Wilson, S., Su, L. J., Li, Y., Harrison, G., Agarwal, R., Crawford, E. D., Lucia, M. S., and Pollak, M. A study of high-dose oral silybin-phytosome followed by prostatectomy in patients w
  29. Ramirez-Santos, A., Perez-Bustillo, A., Gonzalez-Sixto, B., Suarez-Amor, O., and Rodriguez-Prieto, M. A. [Acute generalized exanthematous pustulosis due to milk thistle (Silybum marianum) tea]. Actas Dermosifiliogr. 2011;102(9):744-745. DOI
  30. Loguercio C, Andreone P, Brisc C, et al. Silybin combined with phosphatidylcholine and vitamin E in patients with nonalcoholic fatty liver disease: a randomized controlled trial. Free Radic Biol Med 2012;52(9):1658-65. PubMed
  31. Yakoot, M. and Salem, A. Spirulina platensis versus silymarin in the treatment of chronic hepatitis C virus infection. A pilot randomized, comparative clinical trial. BMC.Gastroenterol. 2012;12:32. PubMed
  32. Fallahzadeh, M. K., Dormanesh, B., Sagheb, M. M., Roozbeh, J., Vessal, G., Pakfetrat, M., Daneshbod, Y., Kamali-Sarvestani, E., and Lankarani, K. B. Effect of addition of silymarin to renin-angiotensin system inhibitors on proteinuria in type 2 diabetic
  33. Fried, M. W., Navarro, V. J., Afdhal, N., Belle, S. H., Wahed, A. S., Hawke, R. L., Doo, E., Meyers, C. M., and Reddy, K. R. Effect of silymarin (milk thistle) on liver disease in patients with chronic hepatitis C unsuccessfully treated with interferon t
  34. Fallah Huseini, H., Larijani, B., Fakhrzadeh, H., Rajabi Pour, B., Akhondzadeh, S., Toliat, T., and Heshmat, R. The clinical trial of Silybum Marianum seed extract (Silymarin) on type II diabetic patients with hyperlipidemia. Iran J.Diabetes Lipid Disord
  35. Mironets VI, Krasovskaia EA, and Polishchuk II. [A case of urticaria during Carsil treatment]. Vrach Delo 1990;7:86-87.
  36. Velussi M, Cernigoi AM, Viezzoli L, and et al. Silymarin reduces hyperinsulinemia, malondialdehyde levels, and daily insulin need in cirrhotic diabetic patients. Curr Ther Res 1993;53(5):533-545. DOI
  37. Marcelli R, Bizzoni P, Conte D, and et al. Randomized controlled study of the efficacy and tolerability of a short course of IdB 1016 in the treatment of chronic persistent hepatitis. Eur Bull Drug Res 1992;1(3):131-135.
  38. Vailati A, Aristia L, Sozze E, and et al. Randomized open study of the dose-effect relationship of a short course of IdB 1016 in patients with viral or alcoholic hepatitis. Fitoterapia 1993;64(3):219-228.
  39. Marena C and Lampertico M. Preliminary clinical development of silipide: a new complex of silybin in toxic liver disorders. Planta Med 1991;57(2):A124-A125. DOI
  40. Grungreiff K, Albrecht M, and Strenge-Hesse A. Benefit of medicinal liver therapy in general practice. Med Welt 1995;46:222-227.
  41. Frerick F, Kuhn U, and Strenge-Hesse A. Silymarin--ein Phytopharmakon zur Behandlung toxischen Leberschaden: Anwendungsbeobachtung bei 2169 Patienten. Kassenarzt 1990;33:36-41.
  42. Schuppan D, Strosser W, Burkard G, and et al. Influence of Legalon(TM) 140 on the metabolism of collagen in patients with chronic liver disease--Review by measurement of PIIINP-values. Zeitschrift fur Allgemeinmedizin 1998;74:577-584.
  43. Studlar M. Die Behandlung chronischer Leberkrankungen mit Silymarin und B-Vitaminen. Therapiewoche 1985;35:3375-3378.
  44. Anon. Adverse reaction: milk thistle-associated toxicity. Nurse Drug Alert 1999;23(7):51.
  45. Gufford BT, Chen G, Vergara AG, et al. Milk Thistle Constituents Inhibit Raloxifene Intestinal Glucuronidation: A Potential Clinically Relevant Natural Product-Drug Interaction. Drug Metab Dispos. 2015;43(9):1353-9. PubMed
  46. El-Shitany NA, Hegazy S, El-Desoky K. Evidences for antiosteoporotic and selective estrogen receptor modulator activity of silymarin compared with ethinylestradiol in ovariectomized rats. Phytomedicine. 2010;17(2):116-25. PubMed
  47. Seidlová-Wuttke D, Becker T, Christoffel V, Jarry H, Wuttke W. Silymarin is a selective estrogen receptor beta (ERbeta) agonist and has estrogenic effects in the metaphysis of the femur but no or antiestrogenic effects in the uterus of ovariectomized (ovx
  48. Jalloh MA, Gregory PJ, Hein D, et al. Dietary supplement interactions with antiretrovirals: a systematic review. Int J STD AIDS. 2017 Jan;28(1):4-15. PubMed
  49. Derosa G, Romano D, D'Angelo A, Maffioli P. Berberis aristata/Silybum marianum fixed combination (Berberol(®)) effects on lipid profile in dyslipidemic patients intolerant to statins at high dosages: a randomized, placebo-controlled, clinical trial. Phyto PubMed
  50. Luangchosiri C, Thakkinstian A, Chitphuk S, Stitchantrakul W, Petraksa S, Sobhonslidsuk A. A double-blinded randomized controlled trial of silymarin for the prevention of antituberculosis drug-induced liver injury. BMC Complement Altern Med. 2015;15:334. PubMed
  51. Kawaguchi-Suzuki M, Frye RF, Zhu HJ, et al. The effects of milk thistle (Silybum marianum) on human cytochrome P450 activity. Drug Metab Dispos. 2014;42(10):1611-6. PubMed
  52. Rastegarpanah M, Malekzadeh R, Vahedi H, et al. A randomized, double blinded, placebo-controlled clinical trial of silymarin in ulcerative colitis. Chin J Integr Med. 2015;21(12):902-6. PubMed
  53. Di Pierro F, Bellone I, Rapacioli G, Putignano P. Clinical role of a fixed combination of standardized Berberis aristata and Silybum marianum extracts in diabetic and hypercholesterolemic patients intolerant to statins. Diabetes Metab Syndr Obes. 2015;8:8 PubMed
  54. Di Pierro F, Villanova N, Agostini F, Marzocchi R, Soverini V, Marchesini G. Pilot study on the additive effects of berberine and oral type 2 diabetes agents for patients with suboptimal glycemic control. Diabetes Metab Syndr Obes. 2012;5:213-7. PubMed
  55. Guarino G, Strollo F, Carbone L, et al. Bioimpedance analysis, metabolic effects and safety of the association Berberis aristata/Bilybum marianum: a 52-week double-blind, placebo-controlled study in obese patients with type 2 diabetes. J Biol Regul Homeos
  56. Ebrahimpour-Koujan S, Gargari BP, Mobasseri M, Valizadeh H, Asghari-Jafarabadi M. Lower glycemic indices and lipid profile among type 2 diabetes mellitus patients who received novel dose of Silybum marianum (L.) Gaertn. (silymarin) extract supplement: A T
  57. Lash DB, Ward S. CYP2C9-mediated warfarin and milk thistle interaction. J Clin Pharm Ther. 2019. PubMed
  58. Malekshah RE, Khaleghian A. Influence of Silybum marianum on morphine addicted rats, biochemical parameters and molecular simulation studies on µ-opioid receptor. Drug Res (Stuttg). 2019;69(11):630-638. PubMed
  59. Soleymani S, Ayati MH, Mansourzadeh MJ, Namazi N, Zargaran A. The effects of Silymarin on the features of cardiometabolic syndrome in adults: A systematic review and meta-analysis. Phytother Res. 2022 Jan 11. doi: 10.1002/ptr.7364. PubMed
  60. Gamissans M, Expósito-Serrano V, López-Llunell C, Valdivieso L, Garbayo-Salmons P. Bullous pemphigoid triggered by Silybum marianum: an unexpected side effect of an herbal remedy. Int J Dermatol. 2021 Aug 7. doi: 10.1111/ijd.15822. PubMed
  61. Aboras SI, Korany MA, El-Yazbi AF, Ragab MAA, Abdine HH. In-depth investigation of the Silymarin effect on the pharmacokinetic parameters of sofosbuvir, GS-331007 and ledipasvir in rat plasma using LC-MS. Biomed Chromatogr 2022;36(9):e5427. PubMed
  62. Wattanakrai P, Nimmannitya K. A Randomized, Double-Blind, Split-Face Study of Topical Silymarin vs 2% Hydroquinone Cream in Melasmas. J Drugs Dermatol 2022;21(12):1304-1310. PubMed
  63. Pochet S, Lechon AS, Lescrainier C, et al. Herb-anticancer drug interactions in real life based on VigiBase, the WHO global database. Sci Rep 2022;12(1):14178. PubMed
  64. Zhang W, Zhang Y, Wen C, Jiang X, Wang L. In vitro Assessment of the Effects of Silybin on CYP2B6-mediated Metabolism. Planta Med 2023. PubMed
  65. Bechtold BJ, Lynch KD, Oyanna VO, et al. Rifampin- and Silymarin-Mediated Pharmacokinetic Interactions of Exogenous and Endogenous Substrates in a Transgenic OATP1B Mouse Model. Mol Pharm 2024;21(5):2284-2297. PubMed
  66. Mohammadi S, Asbaghi O, Afrisham R, et al. Impacts of Supplementation with Silymarin on Cardiovascular Risk Factors: A Systematic Review and Dose-Response Meta-Analysis. Antioxidants (Basel) 2024;13(4):390. PubMed
  67. Rustamzadeh A, Sadigh N, Vahabi Z, et al. Effects silymarin and rosuvastatin on amyloid-carriers level in dyslipidemic Alzheimer's patients: A double-blind placebo-controlled randomized clinical trial. IBRO Neurosci Rep 2024;17:108-121. PubMed
  68. Fatemi Shandiz A, Karimi G, Dayyani M, Hosseini S, Elyasi S. Evaluation of oral silymarin formulation efficacy in prevention of doxorubicin induced hepatotoxicity in patients with non-metastatic breast cancer. J Oncol Pharm Pract 2024. PubMed
  69. Duan X, Bai W, Hu J, et al. Inhibitory effect of flavonoids on multidrug and toxin extrusion protein 1 function: Implications for food/herb-drug interaction and drug-induced kidney injury. J Appl Toxicol 2024;44(9):1388-1402. PubMed

See these in context on the Milk Thistle monograph →

Dandelion 27 references
  1. Maliakal PP, Wanwimolruk S. Effect of herbal teas on hepatic drug metabolizing enzymes in rats. J Pharm Pharmacol 2001;53:1323-9. PubMed
  2. Williams CA, Goldstone F, Greenham J. Flavonoids, cinnamic acids and coumarins from the different tissues and medicinal preparations of Taraxacum officinale. Phytochemistry 1996;42:121-7. PubMed
  3. Hussain Z, Waheed A, Qureshi RA, et al. The effect of medicinal plants of Islamabad and Murree region of Pakistan on insulin secretion from INS-1 cells. Phytother Res 2004;18:73-7. PubMed
  4. Racz-Kotilla E, Racz G, Solomon A. The action of Taraxacum officinale extracts on the body weight and diuresis of laboratory animals. Planta Med 1974;26:212-7. PubMed
  5. Zhu M, Wong PY, Li RC. Effects of taraxacum mongolicum on the bioavailability and disposition of ciprofloxacin in rats. J Pharm Sci 1999;88:632-4. PubMed
  6. Jovanovic M, Mimica-Dukic N, Poljacki M, Boza P. Erythema multiforme due to contact with weeds: a recurrence after patch testing. Contact Dermatitis 2003;48:17-25. PubMed
  7. Chivato T, Juan F, Montoro A, Laguna R. Anaphylaxis induced by ingestion of a pollen compound. J Investig Allergol Clin Immunol 1996;6:208-9.
  8. Cohen SH, Yunginger JW, Rosenberg N, Fink JN. Acute allergic reaction after composite pollen ingestion. J Allergy Clin Immunol 1979;64:270-4. PubMed
  9. Lovell CR, Rowan M. Dandelion dermatitis. Contact Dermatitis 1991;25:185-8. PubMed
  10. Agarwal SC, Crook JR, Pepper CB. Herbal remedies -- how safe are they? A case report of polymorphic ventricular tachycardia/ventricular fibrillation induced by herbal medication used for obesity. Int J Cardiol 2006;106:260-1. PubMed
  11. Martín-Muñoz MF, Bartolome B, Caminoa M, et al. Bee pollen: a dangerous food for allergic children. Identification of responsible allergens. Allergol Immunopathol (Madr) 2010;38:263-5. PubMed
  12. Neef H, Cilli F, Declerck PJ, et al. Platelet anti-aggregating activity of Taraxacum officinale Weber. Phytotherapy Research 1996;10:s138-s140.
  13. Cuzzolin L, Zaffani S, and Benoni G. Safety implications regarding use of phytomedicines. Eur.J Clin Pharmacol. 2006;62:37-42. PubMed
  14. Posadzki, P., Watson, L. K., and Ernst, E. Adverse effects of herbal medicines: an overview of systematic reviews. Clin Med 2013;13(1):7-12. PubMed
  15. Wakelin, S. H., Marren, P., Young, E., and Shaw, S. Compositae sensitivity and chronic hand dermatitis in a seven-year-old boy. Br J Dermatol 1997;137(2):289-291. PubMed
  16. Ingber, A. Seasonal allergic contact dermatitis from Taraxacum officinale (dandelion) in an Israeli florist. Contact Dermatitis 2000;43(1):49.
  17. Rodriguez, B., Rodriguez, A., de Barrio, M., Tornero, P., and Baeza, M. L. Asthma induced by canary food mix. Allergy Asthma Proc. 2003;24(4):265-268.
  18. Syhaieva, I. A. [Efficiency of specific immunotherapy in treatment of patients with seasonal allergic rhinitis]. Lik.Sprava. 2006;(1-2):51-53.
  19. Catania, M. A., Oteri, A., Caiello, P., Russo, A., Salvo, F., Giustini, E. S., Caputi, A. P., and Polimeni, G. Hemorrhagic cystitis induced by an herbal mixture. South.Med.J. 2010;103(1):90-92. PubMed
  20. Goksu, E., Eken, C., Karadeniz, O., and Kucukyilmaz, O. First report of hypoglycemia secondary to dandelion (Taraxacum officinale) ingestion. Am J Emerg.Med 2010;28(1):111-112. PubMed
  21. Fernandez-Gonzalez, D., Gonzalez-Parrado, Z., Vega-Maray, A. M., Valencia-Barrera, R. M., Camazon-Izquierdo, B., De, Nuntiis P., and Mandrioli, P. Platanus pollen allergen, Pla a 1: quantification in the atmosphere and influence on a sensitizing populati
  22. Liang, K. L., Su, M. C., Shiao, J. Y., Wu, S. H., Li, Y. H., and Jiang, R. S. Role of pollen allergy in Taiwanese patients with allergic rhinitis. J Formos.Med Assoc. 2010;109(12):879-885. PubMed
  23. Yang, Y., Zhao, Y., Wang, C. S., Wang, X. D., and Zhang, L. [Prevalence of sensitization to aeroallergens in 10 030 patients with allergic rhinitis]. Zhonghua Er.Bi Yan.Hou Tou.Jing.Wai Ke Za Zhi 2011;46(11):914-920.
  24. Davies, M. G. and Kersey, P. J. Contact allergy to yarrow and dandelion. Contact Dermatitis 1986;14(4):256-257. PubMed
  25. Collins JM and Miller DR. Dandelion green bezoar following antrectomy and vagotomy - case report. J Kansas Med Soc 1966;67(6):303-304.
  26. Moriarty B, Pinney JH, Owen-Casey MP, Rustin MH, Deroide F, Laing C, Davenport A. Digital necrosis from dandelion tea. Br J Dermatol. 2013 Jul;169(1):227-30. PubMed
  27. Onal S, Timur S, Okutucu B, Zihnioglu F. Inhibition of alphaglucosidase by aqueous extracts of some potent antidiabetic medicinal herbs. Prep Biochem Biotechnol 2005;35:29-36.

See these in context on the Dandelion monograph →

Burdock 11 references
  1. Iwakami S, Wu JB, Ebizuka Y, Sankawa U. Platelet activating factor (PAF) antagonists contained in medicinal plants: lignans and sesquiterpenes. Chem Pharm Bull (Tokyo) 1992;40:1196-8. PubMed
  2. Sasaki Y, Kimura Y, Tsunoda T, Tagami H. Anaphylaxis due to burdock. Int J Dermatol 2003;42:472-3. PubMed
  3. Rhoads PM, Tong TG, Banner W Jr, Anderson R. Anticholinergic poisonings associated with commercial burdock root tea. J Toxicol Clin Toxicol 1984-85;22:581-4. PubMed
  4. Rodriguez P, Blanco J, Juste S, et al. Allergic contact dermatitis due to burdock (Arctium lappa). Contact Dermatitis 1995;33:134-5.
  5. Kassler, W. J., Blanc, P., and Greenblatt, R. The use of medicinal herbs by human immunodeficiency virus-infected patients. Arch Intern Med 1991;151(11):2281-2288. DOI
  6. Chan, Y. S., Cheng, L. N., Wu, J. H., Chan, E., Kwan, Y. W., Lee, S. M., Leung, G. P., Yu, P. H., and Chan, S. W. A review of the pharmacological effects of Arctium lappa (burdock). Inflammopharmacology. 2011;19(5):245-254. PubMed
  7. Breed, F. B. and Kuwabara, T. Burdock ophthalmia. Arch Ophthalmol 1966;75(1):16-20.
  8. Bryson, P. D., Watanabe, A. S., Rumack, B. H., and Murphy, R. C. Burdock root tea poisoning. Case report involving a commercial preparation. JAMA 5-19-1978;239(20):2157. DOI
  9. <p>Fletcher GF<span>, </span>Cantwell JD. Burdock root tea poisoning. JAMA <span>1978 Oct 6;240(15):1586.</span></p> DOI
  10. Latif A, Fichadiya H, Abid F, Capo G. Herbal Teas and Thrombocytopenia: A Curious Case of Yellow Dock and Burdock-Induced Thrombocytopenia. Eur J Case Rep Intern Med 2022;9(3):003247. PubMed
  11. Niazi B, Ahmed K, Ahmed M, Ali S, Song K, Elias S. Drug-Induced Liver Injury from Herbal Liver Detoxification Tea. Case Rep Gastroenterol 2022;16(3):612-617. PubMed

See these in context on the Burdock monograph →

Oregon Grape 21 references
  1. Wiesenauer M, Lydtke R. Mahonia aquifolium in patients with Psoriasis vulgaris; an intraindividual study. Phytomedicine 1996;3:231-5.
  2. Chan E. Displacement of bilirubin from albumin by berberine. Biol Neonate 1993;63:201-8. PubMed
  3. Janbaz KH, Gilani AH. Studies on preventive and curative effects of berberine on chemical-induced hepatotoxicity in rodents. Fitoterapia 2000;71:25-33.. PubMed
  4. Wu X, Li Q, Xin H, Yu A, Zhong M. Effects of berberine on the blood concentration of cyclosporin A in renal transplanted recipients: clinical and pharmacokinetic study. Eur J Clin Pharmacol 2005;61:567-72. PubMed
  5. Gulliver WP, Donsky HJ. A report on three recent clinical trials using Mahonia aquifolium 10% topical cream and a review of the worldwide clinical experience with Mahonia aquifolium for the treatment of plaque psoriasis. Am J Ther 2005;12:398-406. PubMed
  6. Zhang Y, Li X, Zou D, et al. Treatment of type 2 diabetes and dyslipidemia with the natural plant alkaloid berberine. J Clin Endocrinol Metab 2008;93:2559-65. PubMed
  7. Budzinski JW, Foster BC, Vandenhoek S, Arnason JT. An in vitro evaluation of human cytochrome P450 3A4 inhibition by selected commercial herbal extracts and tinctures. Phytomedicine 2000;7:273-82. PubMed
  8. Chatterjee P, Franklin MR. Human cytochrome p450 inhibition and metabolic-intermediate complex formation by goldenseal extract and its methylenedioxyphenyl components. Drug Metab Dispos 2003;31:1391-7. PubMed
  9. Shanbhag, S. M., Kulkarni, H. J., and Gaitonde, B. B. Pharmacological actions of berberine on the central nervous system. Jpn.J Pharmacol 1970;20(4):482-487. PubMed
  10. Wu, J. F. and Liu, T. P. [Effects of berberine on platelet aggregation and plasma levels of TXB2 and 6-keto-PGF1 alpha in rats with reversible middle cerebral artery occlusion]. Yao Xue.Xue.Bao. 1995;30(2):98-102.
  11. Peng, W. H., Hsieh, M. T., and Wu, C. R. Effect of long-term administration of berberine on scopolamine-induced amnesia in rats. Jpn J Pharmacol 1997;74(3):261-266. DOI
  12. Sabir M and Bhide NK. Study of some pharmacological actions of berberine. Ind J Physiol & Pharmac 1971;15(3):111-132.
  13. Tripathi YB and Shukla SD. Berberis artistata inhibits PAF induced aggregation of rabbit platelets. Phytotherapy Research 1996;10:628-630.
  14. Yin, J., Xing, H., and Ye, J. Efficacy of berberine in patients with type 2 diabetes mellitus. Metabolism 2008;57(5):712-717. PubMed
  15. Zhang, H., Wei, J., Xue, R., Wu, J. D., Zhao, W., Wang, Z. Z., Wang, S. K., Zhou, Z. X., Song, D. Q., Wang, Y. M., Pan, H. N., Kong, W. J., and Jiang, J. D. Berberine lowers blood glucose in type 2 diabetes mellitus patients through increasing insulin re
  16. Guo, Y., Chen, Y., Tan, Z. R., Klaassen, C. D., and Zhou, H. H. Repeated administration of berberine inhibits cytochromes P450 in humans. Eur J Clin Pharmacol 2012;68(2):213-217. PubMed
  17. Wei, W., Zhao, H., Wang, A., Sui, M., Liang, K., Deng, H., Ma, Y., Zhang, Y., Zhang, H., and Guan, Y. A clinical study on the short-term effect of berberine in comparison to metformin on the metabolic characteristics of women with polycystic ovary syndro
  18. Hermann, R. and von, Richter O. Clinical evidence of herbal drugs as perpetrators of pharmacokinetic drug interactions. Planta Med 2012;78(13):1458-1477. PubMed
  19. Chun YT, Yip TT, Lau KL, and et al. A biochemical study on the hypotensive effect of berberine in rats. Gen Pharmac 1979;10:177-182. PubMed
  20. Lan J, Zhao Y, Dong F, et al. Meta-analysis of the effect and safety of berberine in the treatment of type 2 diabetes mellitus, hyperlipemia and hypertension. J Ethnopharmacol. 2015;161:69-81. PubMed
  21. Fan Y, Zhou Z, Zhang L. Effect of Oregon grape root extracts on P-glycoprotein mediated transport in in vitro cell lines. J Pharm Pharm Sci 2024;26:11927. PubMed

See these in context on the Oregon Grape monograph →

Juniper 7 references
  1. Newall CA, Anderson LA, Philpson JD. Herbal Medicine: A Guide for Healthcare Professionals. London, UK: The Pharmaceutical Press, 1996.
  2. The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999.
  3. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
  4. Robbers JE, Tyler VE. Tyler's Herbs of Choice: The Therapeutic Use of Phytomedicinals. New York, NY: The Haworth Herbal Press, 1999.
  5. Sanchez de Medina F, Gamez MJ, Jimenez I, et al. Hypoglycemic activity of juniper "berries." Planta Med 1994;60:197-200. PubMed
  6. Swanston-Flatt SK, Day C, Bailey CJ, Flatt PR. Traditional plant treatments for diabetes. Studies in normal and streptozotocin diabetic mice. Diabetologia 1990;33:462-4. PubMed
  7. Tammaro A, Adebanjo GAR, Chello C, et al. Bullous dermatitis caused by common juniper. Contact Dermatitis. 2020. PubMed

See these in context on the Juniper monograph →

Rhubarb 20 references
  1. Blumenthal M, ed. The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. Trans. S. Klein. Boston, MA: American Botanical Council, 1998.
  2. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
  3. Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.
  4. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
  5. Nusko G, Schneider B, Schneider I, et al. Anthranoid laxative use is not a risk factor for colorectal neoplasia: results of a prospective case control study. Gut 2000;46:651-5. PubMed
  6. Kwan TH, Tong MK, Leung KT, et al. Acute renal failure associated with prolonged intake of slimming pills containing anthraquinones. Hong Kong Med J 2006;12:394-7.
  7. Fairbairn JW. The anthraquinone laxatives. Biological assay and its relation to chemical structure. Pharmacology 1976;14:48-61. PubMed
  8. Siegers, C. P., Hertzberg-Lottin, E., Otte, M., and Schneider, B. Anthranoid laxative abuse--a risk for colorectal cancer? Gut 1993;34(8):1099-1101. PubMed
  9. Fan, J. G. Evaluating the efficacy and safety of Danning Pian in the short-term treatment of patients with non-alcoholic fatty liver disease: a multicenter clinical trial. Hepatobiliary.Pancreat.Dis.Int 2004;3(3):375-380.
  10. Yan, M., Zhang, L. Y., Sun, L. X., Jiang, Z. Z., and Xiao, X. H. Nephrotoxicity study of total rhubarb anthraquinones on Sprague Dawley rats using DNA microarrays. J Ethnopharmacol. 4-15-2006; PubMed
  11. Zhang, J. H., Li, L. S., and Zhang, M. Clinical effects of rheum and captopril on preventing progression of chronic renal failure. Chin Med J (Engl.) 1990;103(10):788-793.
  12. Mitsuma, T., Yokozawa, T., Oura, H., and Terasawa, K. [Rhubarb therapy in patients with chronic renal failure (Part 2)]. Nippon Jinzo Gakkai Shi 1987;29(2):195-207.
  13. Wu, C. X. [A preliminary study on the effect of a single Rheum officinale in heavy doses in the treatment of acute icteric hepatitis]. Zhong.Xi.Yi.Jie.He.Za Zhi.(Chinese Journal of Modern Developments in Traditional Medicine) 1984;4(2):88-89.
  14. Jiao, D. H. [Clinical research on the hemostatic effect of rhubarb on peptic ulcer with acute bleeding]. Zhong.Xi.Yi.Jie.He.Za Zhi.(Chinese Journal of Modern Developments in Traditional Medicine) 1984;4(10):597-600, 579.
  15. Jiao, D. H., Ma, Y. H., Chen, S. J., Liu, C. T., Shu, H. N., and Chu, C. M. Resume of 400 cases of acute upper digestive tract bleeding treated by rhubarb alone. Pharmacology 1980;20 Suppl 1:128-130.
  16. Zhang, JH, Yao, XD, Song, Y, and et al. [Long-term treating effects of rhubarb and captopril in delaying the progression of renal failure]. Chinese Kidney Disease Journal 1993;9(4):197-201.
  17. Rehman H, Begum W, Anjum F, Tabasum H, Zahid S. Effect of rhubarb (Rheum emodi) in primary dysmenorrhoea: a single-blind randomized controlled trial. J Complement Integr Med. 2015 Mar;12(1):61-9.
  18. Yu CP, Lin HJ, Lin SP, Shia CS, Chang PH, Hou YC, Hsieh YW. Rhubarb decreased the systemic exposure of cyclosporine, a probe substrate of P-glycoprotein and CYP 3A. Xenobiotica. 2016 Aug;46(8):677-82. PubMed
  19. Byeon JH, Kil JH, Ahn YC, Son CG. Systematic review of published data on herb induced liver injury. J Ethnopharmacol 2019;233:190-6. PubMed
  20. Zhao D, Feng SX, Zhang HJ, et al. Pharmacokinetics, tissue distribution and excretion of five rhubarb anthraquinones in rats after oral administration of effective fraction of anthraquinones from rheum officinale. Xenobiotica. 2021;51(8):916-925. PubMed

See these in context on the Rhubarb monograph →

Parts of this content are provided by the Therapeutic Research Center, LLC.

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.

© 2021 Therapeutic Research Center, LLC

Keep exploring