Ultimate Digestive Complex Ingredients & Drug Interactions
What is this page for?
First and foremost: checking Ultimate Digestive Complex against your medications. The heart of this page is the interaction checker and the full interaction report — how this product’s ingredients may interact with prescription and over-the-counter medicines you may be taking.
Around that, we add a pharmacist’s high-level view of the product as a whole — what’s inside, the evidence for its stated use, how transparent the label is, and what safety data exists — so you can see the full picture in one place. It’s educational information from our licensed clinical databases and the clinical staff at HelloPharmacist — not medical advice — and we don’t sell or endorse products. Our editorial policy
Ultimate Digestive Complex is a dietary supplement by Puritan's Pride with 6 active ingredients. Its ingredients are commonly taken for sore throat and cough, heartburn and stomach upset, mouth ulcers and digestive complaints.Based on those ingredients, 1,186 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are GutGard Licorice extract, Lactobacillus acidophilus NCFM. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against Ultimate Digestive Complex by Puritan's Pride
Ask about any prescription or over-the-counter medication and we check it for interactions with Ultimate Digestive Complex by Puritan's Pride — and tell you which ingredient is responsible.
AI summaries are generated from our interaction database for education only — always confirm with your pharmacist. How we use AI
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HelloPharmacist Scorecard of Ultimate Digestive Complex by Puritan's Pride
Our pharmacy team’s full take, with four database checks built into the cards below — a summary of what is known, not a grade of the product itself.
What’s inside
Low disclosure
This formula contains 6 active ingredients: three Lactobacillus and Bifidobacterium probiotic strains (Lactobacillus acidophilus NCFM, Lactobacillus paracasei Lpc-37, Bifidobacterium lactis Bl-04, and Bifidobacterium lactis Bi-07), Alpha-Galactosidase (an enzyme that helps break down complex carbohydrates), and GutGard Licorice extract. These work together as a digestive aid—the live beneficial bacteria aim to support your gut flora, the enzyme helps with digestion, and the licorice extract is included for its effects on digestive comfort.
The product also contains inactive ingredients including vegetable cellulose (the capsule material) and minor fillers.
Does it work?
Moderate evidence
The Lactobacillus acidophilus in this product is rated Possibly Effective for irritable bowel syndrome (IBS), Helicobacter pylori infection, antibiotic-associated diarrhea, and bacterial vaginosis. The licorice extract is rated Possibly Effective for atopic dermatitis (eczema) and canker sores.
For the other bacterial strains and the Alpha-Galactosidase enzyme, we hold no effectiveness data in our system.
How safe is it?
Well-documented data
Lactobacillus acidophilus is generally well tolerated in healthy adults and children, though the facts recommend checking with your doctor before use. When taking it with other probiotics, uncommon gastrointestinal side effects can occur—stomach discomfort, bloating, flatulence, or diarrhea.
Because these are live organisms, there's a rare theoretical concern they could cause serious infection in some patients, particularly those with compromised immunity; your doctor can advise whether this product is right for your situation. The licorice extract carries more caution: the facts advise against it in pregnancy due to potential harmful effects from its active compound glycyrrhizin.
Breastfeeding safety data are limited, so it's best avoided then too. At normal dietary doses licorice is well tolerated, but at higher doses or with long-term use, glycyrrhizin can cause serious problems like high blood pressure and low potassium.
Common side effects include headache, nausea, and vomiting.
Meds to double-check
Moderate interaction found
Before taking this product, double-check with your doctor or pharmacist if you take blood thinners like warfarin (Coumadin)—licorice may reduce their effectiveness. If you're on antibiotics, you'll need to separate doses from this probiotic by several hours.
Also confirm if you take digoxin (heart medication), loop diuretics (water pills), sedatives like midazolam, or chemotherapy drugs such as cisplatin or paclitaxel—licorice has documented interactions with all of these and can either reduce their effect or raise side-effect risk.
The bottom line
Scorecard at a glanceFormula with limited ingredient disclosure with some supporting evidence for its stated purpose. Moderate medication interactions have been identified, and safety information is well characterized.
This formula may help with IBS, diarrhea after antibiotics, or digestive comfort if you're looking to add probiotics and digestive enzymes. If you take warfarin, digoxin, chemotherapy, sedatives, or water pills, or if you're pregnant or breastfeeding, talk with your doctor or pharmacist before starting it—the licorice and probiotics have considerations worth reviewing for your situation.
Check your full medication list against the tool on this page to catch any interactions specific to you.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 2 of 6 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Aug 22, 2017.
This Scorecard evaluates available label information, ingredient evidence, and known medication-safety considerations. It does not independently verify product identity, purity, potency, contamination, or manufacturing quality. How these ratings are computed
General information
Key facts about Ultimate Digestive Complex, straight from the product label.
| Brand | Puritan's Pride |
|---|---|
| Barcode (UPC) | 025077672387 |
| Net contents | 60 Capsule(s) |
| Market status | On market |
| Date entered into DSLD | Aug 22, 2017 |
| DSLD ID | 76772 |
| Product type | Other Combinations |
| Supplement form | Capsule |
| Dietary claims / uses | All Other, Structure/Function |
| Intended target group(s) | Vegetarian, Adult (18 - 50 Years), Gluten Free, Sugar Free |
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 Digestive Complex by Puritan's Pride, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Bifidobacterium lactis Bl-04 | 0 NP | -- |
| Alpha-Galactosidase | 120 mg | -- |
| Lactobacillus paracasei Lpc-37 | 0 NP | -- |
| Lactobacillus acidophilus NCFM | 0 NP | -- |
| Bifidobacterium lactis Bi-07 | 0 NP | -- |
| GutGard Licorice extract | 75 mg | -- |
| Proprietary Blend (Non-Nutrient/Non-Botanical) | 0 NP | -- |
Other ingredients: Vegetable Cellulose, Contains <2% of
Tap any ingredient to jump to its full detail below.
These statements are the manufacturer’s wording, reproduced from the product label — the label is saying it, not HelloPharmacist. We don’t verify or endorse them.
Formulation
No artificial color or flavor, no preservatives, no sugar, no milk, no lactose, no soy, no gluten, no wheat, no yeast, no fish. Sodium free.
Vegetarian formulation
Precautions
Warning: If you are pregnant, nursing, taking any medications or have any medical condition, consult your doctor before use.
Discontinue use and consult your doctor if any adverse reactions occur.
Keep out of reach of children.
Do not use if seal under cap is broken or missing.
Storage
Store at room temperature.
Brand IP Statement(s)
NCFM is a registered trademark of The North Carolina Agricultural Foundation, Inc. DBA The North Carolina Dairy Foundation. B1-04. BI-07 and Lpc-37 are registered trademarks of Dupont Nutrition Biosciences APS. GutGard is a trademark of Natural Remedies, PVT. LTD.
2017 Puritan’s Pride, Inc.
FDA Disclaimer Statement
This statement has not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.
General Statements
To reorder item # 67238 www.puritan.com 1-800-645-1030
For occasional upset stomach
17 billion active cultures Per day
At time of manufacture
When being used as directed.
Seals/Symbols
QA Quality Assured
General
Item # 67238 B67238 00A
FDA Statement of Identity
Dietary Supplement
Suggested/Recommended/Usage/Directions
Directions: For adults, take one (1) capsule two times daily, preferably with meals.
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Ultimate Digestive Complex by Puritan's Pride label
The label scan from the NIH Dietary Supplement Label Database. Tap to enlarge.
Label images are published by the NIH Dietary Supplement Label Database for the version of this product on file. Always read your actual product label.
View the full label (PDF)The Ingredients in Ultimate Digestive Complex by Puritan's Pride
These are the 6 active ingredients this product is made of. Select any to open its full monograph.
Serving size1 Capsule(s) Dosage formCapsule 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.
Alpha-Galactosidase
GutGard Licorice extract
Interacts with1,040 drugs
Licorice root is a traditional remedy used for sore throats, coughs, and digestive complaints, but solid human evidence is limited for most uses. Regu...
GutGard Licorice extract monograph & interactionsProprietary Blend (Non-Nutrient/Non-Botanical)
- › Bifidobacterium lactis Bl-04
- › Lactobacillus paracasei Lpc-37
- › Lactobacillus acidophilus NCFM
- › Bifidobacterium lactis Bi-07
Other (inactive) ingredients: Vegetable Cellulose, Contains <2% of. These complete the product’s ingredient list but are not active constituents.
Ultimate Digestive Complex by Puritan's Pride Drug Interactions
HelloPharmacist Interaction Report
Puritan's Pride Ultimate Digestive Complex interacts with medications through its Lactobacillus acidophilus and GutGard Licorice extract content.
The most serious finding is that licorice may reduce the effectiveness of the blood thinner warfarin (Coumadin), a Moderate-severity interaction that could affect how well your anticoagulation works.
Read the full breakdown — every affected drug type, severity by severity
Lactobacillus acidophilus carries a Moderate interaction with antibiotics: taking them at the same time may kill off the live organisms in the probiotic, making the supplement less effective. You'll want to space these doses several hours apart.
Additionally, licorice has Moderate interactions with digoxin (a heart medication), several drugs processed by your liver including certain chemotherapy agents (cisplatin, paclitaxel) and sedatives (midazolam), and loop diuretics (water pills like furosemide)—each working through different mechanisms that could either reduce the drug's effect or increase unwanted effects.
We could not check three other bacterial ingredients in this formula: Bifidobacterium lactis Bl-04, Alpha-Galactosidase, Lactobacillus paracasei Lpc-37, and Bifidobacterium lactis Bi-07—we hold no interaction data for them. Altogether, these interactions span 1,187 individual medications.
Please use the medication checker below to see if any of your specific prescriptions are affected before you start this product.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against Ultimate Digestive Complex?
Ask about interactions with your drugs in plain English — “Can I take it with lisinopril?” — and we find you the answer in seconds, ingredient by ingredient.
Go to the checkerIngredients driving the most interactions
Individual Drug Interactions
The ingredients in Ultimate Digestive Complex interact with 1,186 drugs. Click any drug to see the details.
2 of the 6 ingredients in Ultimate Digestive Complex interact with drugs. Each result below shows which ingredient is responsible. GutGard Licorice extract Lactobacillus acidophilus NCFM
Belladonna, PhenobarbitalBellophen, Susano
How Belladonna, Phenobarbital interacts with Ultimate Digestive Complex — through 1 ingredient. Tap an ingredient for the detail:
Gutgard Licorice ExtractCytochrome P450 2b6 (cyp2b6) Substrates Moderate
Interaction Summary
Theoretically, licorice might increase levels of drugs metabolized by CYP2B6.
Read the full Gutgard Licorice Extract + Belladonna, Phenobarbital interactionBellafoline, Caffeine, Ergotamine Tartrate, PentobarbitalCafergot PB
How Bellafoline, Caffeine, Ergotamine Tartrate, Pentobarbital interacts with Ultimate Digestive Complex — through 1 ingredient. Tap an ingredient for the detail:
Gutgard Licorice ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, licorice might decrease the levels and clinical effects of CYP1A2 substrates.
Read the full Gutgard Licorice Extract + Bellafoline, Caffeine, Ergotamine Tartrate, Pentobarbital interactionBellafoline, PhenobarbitalBelladenal, Belladenal-S
How Bellafoline, Phenobarbital interacts with Ultimate Digestive Complex — through 1 ingredient. Tap an ingredient for the detail:
Gutgard Licorice ExtractCytochrome P450 2b6 (cyp2b6) Substrates Moderate
Interaction Summary
Theoretically, licorice might increase levels of drugs metabolized by CYP2B6.
Read the full Gutgard Licorice Extract + Bellafoline, Phenobarbital interactionBelumosudil MesylateRezurock
How Belumosudil Mesylate interacts with Ultimate Digestive Complex — through 1 ingredient. Tap an ingredient for the detail:
Gutgard Licorice ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, licorice might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full Gutgard Licorice Extract + Belumosudil Mesylate interactionBelzutifanWelireg
How Belzutifan interacts with Ultimate Digestive Complex — through 1 ingredient. Tap an ingredient for the detail:
Gutgard Licorice ExtractCytochrome P450 2c19 (cyp2c19) Substrates Moderate
Interaction Summary
Theoretically, licorice might increase levels of drugs metabolized by CYP2C19.
Read the full Gutgard Licorice Extract + Belzutifan interactionBenazeprilLotensin
How Benazepril interacts with Ultimate Digestive Complex — through 1 ingredient. Tap an ingredient for the detail:
Gutgard Licorice ExtractAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, licorice might reduce the effects of antihypertensive drugs.
Read the full Gutgard Licorice Extract + Benazepril interactionBenazepril, HydrochlorothiazideLotensin HCT
How Benazepril, Hydrochlorothiazide interacts with Ultimate Digestive Complex — through 1 ingredient. Tap an ingredient for the detail:
Gutgard Licorice ExtractAntihypertensive Drugs, Diuretic Drugs Moderate
Interaction Summary
Theoretically, licorice might reduce the effects of antihypertensive drugs.
Read the full Gutgard Licorice Extract + Benazepril, Hydrochlorothiazide interactionBendroflumethiazideAprinox, Naturetin, Neo-NaClex
How Bendroflumethiazide interacts with Ultimate Digestive Complex — through 1 ingredient. Tap an ingredient for the detail:
Gutgard Licorice ExtractDiuretic Drugs, Antihypertensive Drugs Moderate
Interaction Summary
Theoretically, concomitant use of licorice with diuretic drugs might increase the risk of hypokalemia.
Read the full Gutgard Licorice Extract + Bendroflumethiazide interactionBendroflumethiazide, NadololCorzide
How Bendroflumethiazide, Nadolol interacts with Ultimate Digestive Complex — through 1 ingredient. Tap an ingredient for the detail:
Gutgard Licorice ExtractAntihypertensive Drugs, Diuretic Drugs Moderate
Interaction Summary
Theoretically, licorice might reduce the effects of antihypertensive drugs.
Read the full Gutgard Licorice Extract + Bendroflumethiazide, Nadolol interactionBendroflumethiazide, PotassiumCentyl K, Neo-NaClex-K
How Bendroflumethiazide, Potassium interacts with Ultimate Digestive Complex — through 1 ingredient. Tap an ingredient for the detail:
Gutgard Licorice ExtractDiuretic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of licorice with diuretic drugs might increase the risk of hypokalemia.
Read the full Gutgard Licorice Extract + Bendroflumethiazide, Potassium interactionBendroflumethiazide, Rauwolfia SerpentinaRauzide
How Bendroflumethiazide, Rauwolfia Serpentina interacts with Ultimate Digestive Complex — through 1 ingredient. Tap an ingredient for the detail:
Gutgard Licorice ExtractDiuretic Drugs, Antihypertensive Drugs Moderate
Interaction Summary
Theoretically, concomitant use of licorice with diuretic drugs might increase the risk of hypokalemia.
Read the full Gutgard Licorice Extract + Bendroflumethiazide, Rauwolfia Serpentina interactionBenzhydrocodone, AcetaminophenApadaz
How Benzhydrocodone, Acetaminophen interacts with Ultimate Digestive Complex — through 1 ingredient. Tap an ingredient for the detail:
Gutgard Licorice ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, licorice might decrease the levels and clinical effects of CYP1A2 substrates.
Read the full Gutgard Licorice Extract + Benzhydrocodone, Acetaminophen interactionBenznidazoleBenznidazole
How Benznidazole interacts with Ultimate Digestive Complex — through 1 ingredient. Tap an ingredient for the detail:
Lactobacillus Acidophilus NcfmAntibiotic Drugs Moderate
Interaction Summary
Theoretically, taking Lactobacillus acidophilus with antibiotic drugs might decrease the effectiveness of L.
Read the full Lactobacillus Acidophilus Ncfm + Benznidazole interactionBenzphetamineDidrex
How Benzphetamine interacts with Ultimate Digestive Complex — through 1 ingredient. Tap an ingredient for the detail:
Gutgard Licorice ExtractCytochrome P450 2c8 (cyp2c8) Substrates Moderate
Interaction Summary
Theoretically, licorice might increase levels of drugs metabolized by CYP2C8.
Read the full Gutgard Licorice Extract + Benzphetamine interactionBenzthiazideExna
How Benzthiazide interacts with Ultimate Digestive Complex — through 1 ingredient. Tap an ingredient for the detail:
Gutgard Licorice ExtractDiuretic Drugs, Antihypertensive Drugs Moderate
Interaction Summary
Theoretically, concomitant use of licorice with diuretic drugs might increase the risk of hypokalemia.
Read the full Gutgard Licorice Extract + Benzthiazide interactionBepridilVascor
How Bepridil interacts with Ultimate Digestive Complex — through 1 ingredient. Tap an ingredient for the detail:
Gutgard Licorice ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, licorice might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full Gutgard Licorice Extract + Bepridil interactionBerotralstat HydrochlorideOrladeyo
How Berotralstat Hydrochloride interacts with Ultimate Digestive Complex — through 1 ingredient. Tap an ingredient for the detail:
Gutgard Licorice ExtractP-glycoprotein Substrates Moderate
Interaction Summary
Theoretically, licorice might decrease the absorption of P-glycoprotein substrates.
Read the full Gutgard Licorice Extract + Berotralstat Hydrochloride interactionBetamethasoneCelestone, Diprolene AF, Diprosone
How Betamethasone interacts with Ultimate Digestive Complex — through 1 ingredient. Tap an ingredient for the detail:
Gutgard Licorice ExtractCorticosteroids, P-glycoprotein Substrates Moderate
Interaction Summary
Theoretically, concomitant use of licorice and corticosteroids might increase the side effects of corticosteroids.
Read the full Gutgard Licorice Extract + Betamethasone interactionBetamethasone DipropionateSernivo
How Betamethasone Dipropionate interacts with Ultimate Digestive Complex — through 1 ingredient. Tap an ingredient for the detail:
Gutgard Licorice ExtractP-glycoprotein Substrates, Corticosteroids Moderate
Interaction Summary
Theoretically, licorice might decrease the absorption of P-glycoprotein substrates.
Read the full Gutgard Licorice Extract + Betamethasone Dipropionate interactionBetamethasone Dipropionate, CalcipotrieneEnstilar, Wynzora
How Betamethasone Dipropionate, Calcipotriene interacts with Ultimate Digestive Complex — through 1 ingredient. Tap an ingredient for the detail:
Gutgard Licorice ExtractP-glycoprotein Substrates, Corticosteroids Moderate
Interaction Summary
Theoretically, licorice might decrease the absorption of P-glycoprotein substrates.
Read the full Gutgard Licorice Extract + Betamethasone Dipropionate, Calcipotriene interactionBetamethasone ValerateLuxiq
How Betamethasone Valerate interacts with Ultimate Digestive Complex — through 1 ingredient. Tap an ingredient for the detail:
Gutgard Licorice ExtractCorticosteroids, P-glycoprotein Substrates Moderate
Interaction Summary
Theoretically, concomitant use of licorice and corticosteroids might increase the side effects of corticosteroids.
Read the full Gutgard Licorice Extract + Betamethasone Valerate interactionBetaxololBetoptic, Kerlone
How Betaxolol interacts with Ultimate Digestive Complex — through 1 ingredient. Tap an ingredient for the detail:
Gutgard Licorice ExtractAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, licorice might reduce the effects of antihypertensive drugs.
Read the full Gutgard Licorice Extract + Betaxolol interactionBetrixabanBevyxxa
How Betrixaban interacts with Ultimate Digestive Complex — through 1 ingredient. Tap an ingredient for the detail:
Gutgard Licorice ExtractP-glycoprotein Substrates Moderate
Interaction Summary
Theoretically, licorice might decrease the absorption of P-glycoprotein substrates.
Read the full Gutgard Licorice Extract + Betrixaban interactionBexaroteneTargretin
How Bexarotene interacts with Ultimate Digestive Complex — through 1 ingredient. Tap an ingredient for the detail:
Gutgard Licorice ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, licorice might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full Gutgard Licorice Extract + Bexarotene interactionBictegravir, Emtricitabine, Tenofovir AlafenamideBiktarvy
How Bictegravir, Emtricitabine, Tenofovir Alafenamide interacts with Ultimate Digestive Complex — through 1 ingredient. Tap an ingredient for the detail:
Gutgard Licorice ExtractP-glycoprotein Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, licorice might decrease the absorption of P-glycoprotein substrates.
Read the full Gutgard Licorice Extract + Bictegravir, Emtricitabine, Tenofovir Alafenamide interactionBismuth Subsalicylate, Metronidazole, TetracyclineHelidac
How Bismuth Subsalicylate, Metronidazole, Tetracycline interacts with Ultimate Digestive Complex — through 1 ingredient. Tap an ingredient for the detail:
Lactobacillus Acidophilus NcfmAntibiotic Drugs Moderate
Interaction Summary
Theoretically, taking Lactobacillus acidophilus with antibiotic drugs might decrease the effectiveness of L.
Read the full Lactobacillus Acidophilus Ncfm + Bismuth Subsalicylate, Metronidazole, Tetracycline interactionBisoprololZebeta
How Bisoprolol interacts with Ultimate Digestive Complex — through 1 ingredient. Tap an ingredient for the detail:
Gutgard Licorice ExtractAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, licorice might reduce the effects of antihypertensive drugs.
Read the full Gutgard Licorice Extract + Bisoprolol interactionBisoprolol, HydrochlorothiazideZiac
How Bisoprolol, Hydrochlorothiazide interacts with Ultimate Digestive Complex — through 1 ingredient. Tap an ingredient for the detail:
Gutgard Licorice ExtractDiuretic Drugs, Antihypertensive Drugs Moderate
Interaction Summary
Theoretically, concomitant use of licorice with diuretic drugs might increase the risk of hypokalemia.
Read the full Gutgard Licorice Extract + Bisoprolol, Hydrochlorothiazide interactionBoceprevirVictrelis
How Boceprevir interacts with Ultimate Digestive Complex — through 1 ingredient. Tap an ingredient for the detail:
Gutgard Licorice ExtractCytochrome P450 3a4 (cyp3a4) Substrates, P-glycoprotein Substrates Moderate
Interaction Summary
Theoretically, licorice might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full Gutgard Licorice Extract + Boceprevir interactionBosentanTracleer
How Bosentan interacts with Ultimate Digestive Complex — through 1 ingredient. Tap an ingredient for the detail:
Gutgard Licorice ExtractCytochrome P450 2c9 (cyp2c9) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Moderate
Interaction Summary
Theoretically, licorice might increase or decrease levels of drugs metabolized by CYP2C9.
Read the full Gutgard Licorice Extract + Bosentan interactionEach ingredient & the kinds of drugs it affects
For each ingredient in Ultimate Digestive Complex 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.
GutGard Licorice extract
Antihypertensive Drugs
Theoretically, licorice might reduce the effects of antihypertensive drugs.
In human research, licorice increases blood pressure in a dose-dependent manner.
Cisplatin (Platinol-Aq)
Theoretically, licorice might reduce the effects of cisplatin.
In animal research, licorice diminished the therapeutic efficacy of cisplatin.
Corticosteroids
Theoretically, concomitant use of licorice and corticosteroids might increase the side effects of corticosteroids.
Case reports suggest that concomitant use of licorice and oral corticosteroids, such as hydrocortisone, can potentiate the duration of activity and increase blood levels of corticosteroids. Additionally, in one case report, a patient with neurogenic orthostatic hypertension stabilized on fludrocortisone 0.1 mg twice daily developed pseudohyperaldosteronism after recent consumption of large amounts of black licorice.
Cytochrome P450 2B6 (Cyp2B6) Substrates
Theoretically, licorice might increase levels of drugs metabolized by CYP2B6.
In vitro research shows that licorice extract and glabridin, a licorice constituent, inhibit CYP2B6 isoenzymes. Licorice extract from the species G. uralensis seems to inhibit CYP2B6 isoenzymes to a greater degree than G. glabra extract in vitro. Theoretically, these species of licorice might increase levels of drugs metabolized by CYP2B6; however, these interactions have not yet been reported in humans.
Cytochrome P450 2C19 (Cyp2C19) Substrates
Theoretically, licorice might increase levels of drugs metabolized by CYP2C19.
In vitro, licorice extracts from the species G. glabra and G. uralensis inhibit CYP2C19 isoenzymes in vitro. Theoretically, these species of licorice might increase levels of drugs metabolized by CYP2C19; however, this interaction has not yet been reported in humans.
Cytochrome P450 2C8 (Cyp2C8) Substrates
Theoretically, licorice might increase levels of drugs metabolized by CYP2C8.
In vitro, licorice extract from the species G. glabra and G. uralensis inhibits CYP2C8 isoenzymes. Theoretically, these species of licorice might increase levels of drugs metabolized by CYP2C8; however, this interaction has not yet been reported in humans.
Cytochrome P450 2C9 (Cyp2C9) Substrates
Theoretically, licorice might increase or decrease levels of drugs metabolized by CYP2C9.
There is conflicting evidence about the effect of licorice on CYP2C9 enzyme activity. In vitro research shows that extracts from the licorice species G. glabra and G. uralensis moderately inhibit CYP2C9 isoenzymes. However, evidence from an animal model shows that licorice extract from the species G. uralensis can induce hepatic CYP2C9 activity. Until more is known, licorice should be used cautiously in people taking CYP2C9 substrates.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, licorice might increase or decrease levels of drugs metabolized by CYP3A4.
Pharmacokinetic research shows that the licorice constituent glycyrrhizin, taken in a dosage of 150 mg orally twice daily for 14 days, modestly decreases the area under the concentration-time curve of midazolam by about 20%. Midazolam is a substrate of CYP3A4, suggesting that glycyrrhizin modestly induces CYP3A4 activity. Animal research also shows that licorice extract from the species G. uralensis induces CYP3A4 activity. However, licorice extract from G. glabra species appear to inhibit CYP3A4-induced metabolism of testosterone in vitro. It is thought that the G. glabra inhibits CYP3A4 due to its constituent glabridin, which is a moderate CYP3A4 inhibitor in vitro and not present in other licorice species. Until more is known, licorice should be used cautiously in people taking CYP3A4 substrates.
Digoxin (Lanoxin)
Theoretically, concomitant use of licorice with digoxin might increase the risk of cardiac toxicity.
Overuse or misuse of licorice with cardiac glycoside therapy might increase the risk of cardiac toxicity due to potassium loss.
Diuretic Drugs
Theoretically, concomitant use of licorice with diuretic drugs might increase the risk of hypokalemia.
Overuse of licorice might compound diuretic-induced potassium loss. In one case report, a 72-year-old male with a past medical history of hypertension, type 2 diabetes, hyperlipidemia, arrhythmia, stroke, and hepatic dysfunction was hospitalized with severe hypokalemia and uncontrolled hypertension due to pseudohyperaldosteronism. This was thought to be provoked by concomitant daily consumption of a product containing 225 mg of glycyrrhizin, a constituent of licorice, and hydrochlorothiazide 12.5 mg for 1 month.
Estrogens
Theoretically, licorice might increase or decrease the effects of estrogen therapy.
Theoretically, licorice might interfere with estrogen therapy due to estrogenic and anti-estrogenic effects.
Loop Diuretics
Theoretically, loop diuretics might increase the mineralocorticoid effects of licorice.
Theoretically, loop diuretics might enhance the mineralocorticoid effects of licorice by inhibiting the enzyme that converts cortisol to cortisone; however, bumetanide (Bumex) does not appear to have this effect.
Midazolam (Versed)
Theoretically, licorice might decrease levels of midazolam.
In humans, the licorice constituent glycyrrhizin appears to moderately induce the metabolism of midazolam. This is likely due to induction of cytochrome P450 3A4 by licorice. Until more is known, licorice should be used cautiously in people taking midazolam.
P-Glycoprotein Substrates
Theoretically, licorice might decrease the absorption of P-glycoprotein substrates.
In vitro research shows that licorice can increase P-glycoprotein activity.
Paclitaxel (Abraxane, Onxol)
Theoretically, licorice might decrease plasma levels and clinical effects of paclitaxel.
Multiple doses of licorice taken concomitantly with paclitaxel might reduce the effectiveness of paclitaxel. Animal research shows that licorice 3 grams/kg given orally for 14 days before intravenous administration of paclitaxel decreases the exposure to paclitaxel and increases its clearance. Theoretically, this occurs because licorice induces cytochrome P450 3A4 enzymes, which metabolize paclitaxel. Notably, a single dose of licorice did not affect exposure or clearance of paclitaxel.
Warfarin (Coumadin)
Theoretically, licorice might decrease plasma levels and clinical effects of warfarin.
Licorice seems to increase metabolism and decrease levels of warfarin in animal models. This is likely due to induction of cytochrome P450 2C9 (CYP2C9) metabolism by licorice. Advise patients taking warfarin to avoid taking licorice.
Cytochrome P450 1A2 (Cyp1A2) Substrates
Theoretically, licorice might decrease the levels and clinical effects of CYP1A2 substrates.
In vitro research shows that licorice induces CYP1A2 enzymes.
Methotrexate (Trexall, Others)
Theoretically, licorice might increase levels of methotrexate.
Animal research suggests that intravenous administration of glycyrrhizin, a licorice constituent, and high-dose methotrexate may delay methotrexate excretion and increase systemic exposure, leading to transient elevations in liver enzymes and total bilirubin. This interaction has not yet been reported in humans.
Lactobacillus acidophilus NCFM
Antibiotic Drugs
Theoretically, taking Lactobacillus acidophilus with antibiotic drugs might decrease the effectiveness of L. acidophilus.
L. acidophilus preparations usually contain live and active organisms. Therefore, simultaneously taking antibiotics might kill a significant number of the organisms. Tell patients to separate administration of antibiotics and L. acidophilus preparations by at least two hours.
Brand information
Manufacturer and brand details for Ultimate Digestive Complex, from the product label.
Puritan's Pride
See all Puritan's Pride products- Name
- Puritan's Pride, Inc.
- City
- Ronkonkoma
- State
- NY
- ZipCode
- 11779
- Phone Number
- 1-800-645-1030
- Web Address
- www.puritan.com
Ultimate Digestive Complex by Puritan's Pride: Common Questions
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Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
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The Full Monographs Behind Ultimate Digestive Complex’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Licorice
Interacts with 1,040 drugsLicorice root is a traditional remedy used for sore throats, coughs, and digestive complaints, but solid human evidence is limited for most uses. Regular licorice contains glycyrrhizin, whic...
Read the full Licorice monograph → Herb & supplement monographLactobacillus Acidophilus
Interacts with 182 drugsLactobacillus acidophilus is a 'friendly' bacterium used as a probiotic to support gut and vaginal health. It is generally well tolerated in healthy people, and there is reasonable evidence...
Read the full Lactobacillus Acidophilus monograph →Sources & How We Checked
Ultimate Digestive Complex's label data comes from the NIH Dietary Supplement Label Database; the ingredient interaction data is from the Natural Medicines database, reviewed by our pharmacists.
- NIH Dietary Supplement Label Database (DSLD) — The official product label on file for this supplement.
- Natural Medicines (Therapeutic Research Center) — Evidence-graded clinical reference behind the ingredient interaction data.
Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.
The 107 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.
Lactobacillus Acidophilus 15 references
- Pierce A. The American Pharmaceutical Association Practical Guide to Natural Medicines. New York: The Stonesong Press, 1999:19.
- Begtrup LM, de Muckadell OB, Kjeldsen J, Christensen RD, Jarbøl DE. Long-term treatment with probiotics in primary care patients with irritable bowel syndrome--a randomised, double-blind, placebo controlled trial. Scand J Gastroenterol 2013;48(10):1127-35 PubMed
- Chatterjee S, Kar P, Das T, Ray S, Gangulyt S, Rajendiran C, Mitra M. Randomised placebo-controlled double blind multicentric trial on efficacy and safety of Lactobacillus acidophilus LA-5 and Bifidobacterium BB-12 for prevention of antibiotic-associated
- Shavakhi A, Tabesh E, Yaghoutkar A, Hashemi H, Tabesh F, Khodadoostan M,Minakari M, Shavakhi S, Gholamrezaei A. The effects of multistrain probiotic compound on bismuth-containing quadruple therapy for Helicobacter pylori infection: a randomized placebo-c
- Karamali M, Dadkhah F, Sadrkhanlou M, et al. Effects of probiotic supplementation on glycaemic control and lipid profiles in gestational diabetes: a randomized, double-blind, placebo-controlled trial. Diabetes Metab 2016;42(4):234-41. PubMed
- Badehnoosh B, Karamali M, Zarrati M, et al. The effects of probiotic supplementation on biomarkers of inflammation, oxidative stress and pregnancy outcomes in gestational diabetes. J Matern Fetal Neonatal Med. 2018 May;31(9):1128-1136.
- Kumar S, Kumar R, Rohilla L, Jacob N, Yadav J, Sachdeva N. A high potency multi-strain probiotic improves glycemic control in children with new-onset type 1 diabetes mellitus: A randomized, double-blind, and placebo-controlled pilot study. Pediatr Diabete
- Shahriari A, Karimi E, Shahriari M, Aslani N, Khooshideh M, Arab A. The effect of probiotic supplementation on the risk of gestational diabetes mellitus among high-risk pregnant women: A parallel double-blind, randomized, placebo-controlled clinical trial PubMed
- Xiao SD, Zhang DZ, Lu H, et al. Multicenter, randomized, controlled trial of heat-killed Lactobacillus acidophilus LB in patients with chronic diarrhea. Adv Ther. 2003;20(5):253-60.
- Rossi F, Amadoro C, Gasperi M, Colavita G. Lactobacilli infection case reports in the last three years and safety implications. Nutrients. 2022;14(6):1178. PubMed
- Ozer M, Goksu SY, Shahverdiani A, Mustafa M. Lactobacillus acidophilus-induced endocarditis and associated splenic abscess. Case Rep Infect Dis 2020;2020:1382709.
- Sadrin S, Sennoune S, Gout B, et al. A 2-strain mixture of Lactobacillus acidophilus in the treatment of irritable bowel syndrome: A placebo-controlled randomized clinical trial. Dig Liver Dis 2020;52(5):534-540. PubMed
- Stoffer JN, Slingsby TJ, Giuliari GP. Lactobacillus acidophilus endophthalmitis after intravitreal bevacizumab injection requiring intraocular lens explantation. Can J Ophthalmol 2022;57(1):e21-e22. PubMed
- Cukovic-Cavka S, Likic R, Francetic I, Rustemovic N, Opacic M, Vucelic B. Lactobacillus acidophilus as a cause of liver abscess in a NOD2/CARD15-positive patient with Crohn's disease. Digestion 2006;73(2-3):107-10.
- Hui J, Ren Y, Wang Y, Han Q. Lactobacillus acidophilus endophthalmitis postcataract operation: A case report with a literature review. Ocul Immunol Inflamm 2023.
See these in context on the Lactobacillus Acidophilus monograph →
Licorice 92 references
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- Sigurjonsdottir HA, Ragnarsson J, Franzson L, Sigurdsson G. Is blood pressure commonly raised by moderate consumption of liquorice? J Hum Hypertens 1995;9:345-8.
- Armanini D, Lewicka S, Pratesi C, et al. Further studies on the mechanism of the mineralocorticoid action of licorice in humans. J Endocrinol Invest 1996;19:624-9. PubMed
- Zhang YD, Lorenzo B, Reidenberg MM. Inhibition of 11 beta hydroxysteroid dehydrogenase obtained from guinea pig kidney by furosemide, naringenin and some other compounds. J Steroid Biochem Mol Biol 1994;49:81-5.
- Strandberg TE, Jarvenpaa AL, Vanhanen H, McKeigue PM. Birth outcome in relation to licorice consumption during pregnancy. Am J Epidemiol 2001;153:1085-8. PubMed
- Sigurjonsdottir HA, Franzson L, Manhem K, et al. Liquorice-induced rise in blood pressure: a linear dose-response relationship. J Hum Hypertens 2001;15:549-52. PubMed
- Amato P, Christophe S, Mellon PL. Estrogenic activity of herbs commonly used as remedies for menopausal symptoms. Menopause 2002;9:145-50. PubMed
- Kent UM, Aviram M, Rosenblat M, Hollenberg PF. The licorice root derived isoflavan glabridin inhibits the activities of human cytochrome P450S 3A4, 2B6, and 2C9. Drug Metab Dispos 2002;30:709-15.. PubMed
- Yoshida S, Takayama Y. Licorice-induced hypokalemia as a treatable cause of dropped head syndrome. Clin Neurol Neurosurg 2003;105:286-7.. PubMed
- Strandberg TE, Andersson S, Jarvenpaa AL, et al. Preterm birth and licorice consumption during pregnancy. Am J Epidemiol 2002;156:803-5.. PubMed
- Hussain RM. The sweet cake that reaches parts other cakes can't! Postgrad Med J 2003;79:115-6.. PubMed
- Morris DJ, Davis E, Latif SA. Licorice, tobacco chewing, and hypertension. N Engl J Med 1990;322:849-50. PubMed
- Quinkler M, Stewart PM. Hypertension and the cortisol-cortisone shuttle. J Clin Endocrinol Metab 2003;88:2384-92. PubMed
- Westman EC, Guthrie GP. Licorice, tobacco chewing, and hypertension. N Engl J Med 1990;322:850. PubMed
- Mu Y, Zhang J, Zhang S, et al. Traditional Chinese medicines Wu Wei Zi (Schisandra chinensis Baill) and Gan Cao (Glycyrrhiza uralensis Fisch) activate pregnane X receptor and increase warfarin clearance in rats. J Pharmacol Exp Ther 2006;316:1369-77. PubMed
- Yasue H, Itoh T, Mizuno Y, Harada E. Severe hypokalemia, rhabdomyolysis, muscle paralysis, and respiratory impairment in a hypertensive patient taking herbal medicines containing licorice. Intern Med 2007;46:575-8. PubMed
- Brayley J, Jones J. Life-threatening hypokalemia associated with excessive licorice ingestion (letter). Am J Psychiatry 1994;151:617-8. PubMed
- de Klerk GJ, Nieuwenhuis G, Beutler JJ. Hypokalaemia and hypertension associated with use of liquorice flavoured chewing gum. BMJ 1997;314:731-2.
- Dellow EL, Unwin RJ, Honour JW. Pontefract cakes can be bad for you: refractory hypertension and liquorice excess. Nephol Dial Transplant 1999;14:218-20. PubMed
- Elinav E, Chajek-Shaul T. Licorice consumption causing severe hypokalemic paralysis. Mayo Clin Proc 2003;78:767-8. PubMed
- Eriksson JW, Carlberg B, Hillom V. Life-threatening ventricular tachycardia due to liquorice-induced hypokalemia. J Intern Med 1999;245:307-10.
- Janse A, van Iersel M, Hoefnagels WH, Olde Rikker MG. The old lady who liked liquorice: hypertension due to chronic intoxication in a memory-impaired patient. Neth J Med 2005;63:149-50.
- Lin SH, Yang SS, Chau T, Halperin ML. An unusual cause of hypokalemic paralysis: chronic licorice ingestion. Am J Med Sci 2003;325:153-6. PubMed
- van den Bosch AE, van der Klooster JM, Zuidgeest DM, et al. Severe hypokalemic paralysis and rhabdomyolysis due to ingestion of liquorice. Neth J Med 2005;63:146-8.
- van Uum SH. Liquorice and hypertension. Neth J Med 2005;63:119-20.
- Russo S, Mastropasqua M, Mosetti MA, et al. Low doses of liquorice can induce hypertension encephalopathy. Am J Nephrol 2000;20:145-8. PubMed
- Stormer FC, Reistad R, Alexander J. Glycyrrhizic acid in liquorice - evaluation of health hazard. Food Chem Toxicol 1993;31:303-12. PubMed
- Sontia B, Mooney J, Gaudet L, Touyz RM. Pseudohyperaldosteronism, liquorice, and hypertension. J Clin Hypertens (Greenwich) 2008;10:153-7. PubMed
- Francini-Pesenti F, Puato M, Piccoli A, Brocadello F. Liquorice-induced hypokalaemia and water retention in the absence of hypertension. Phytother Res 2008;22:563-5. PubMed
- Lapi F, Gallo E, Bernasconi S, et al. Myopathies associated with red yeast rice and liquorice: spontaneous reports from the Italian Surveillance System of Natural Health Products. Br J Clin Pharmacol 2008;66:572-4. PubMed
- Chen MF, Shimada F, Kato H, Yano S, Kanaoka M. Effect of glycyrrhizin on the pharmacokinetics of prednisolone following low dosage of prednisolone hemisuccinate. Endocrinol Jpn 1990;37:331-41. PubMed
- Teelucksingh S, Mackie AD, Burt D, McIntyre MA, Brett L, Edwards CR. Potentiation of hydrocortisone activity in skin by glycyrrhetinic acid. Lancet 1990;335(8697):1060-3. PubMed
- Heidemann HT, Kreuzfelder E. Hypokalemic rhabdomyolysis with myoglobinuria due to licorice ingestion and diuretic treatment. Klin Wochenschr 1983;61:303-5. PubMed
- Hukkanen J, Ukkola O, Savolainen MJ. Effects of low-dose liquorice alone or in combination with hydrochlorothiazide on the plasma potassium in healthy volunteers. Blood Press 2009;18:192-5. PubMed
- Bisogni V, Rossi GP, Calò LA. Apparent mineralcorticoid excess syndrome, an often forgotten or unrecognized cause of hypokalemia and hypertension: case report and appraisal of the pathophysiology. Blood Press. 2014 Jun;23(3):189-92. PubMed
- Dehours E, Vallé B, Rougé-Bugat ME, Florent B, Bounes V, Franchitto N. Suspected hypokalaemia following liquorice ingestion on board ship. J Telemed Telecare. 2013 Jun;19(4):227-8. PubMed
- Kormann R, Languille E, Amiot HM, Hertig A. Dying for a cup of tea. BMJ Case Rep. 2012 Oct 19;2012. PubMed
- Panduranga P, Al-Rawahi N. Licorice-induced severe hypokalemia with recurrent torsade de pointes. Ann Noninvasive Electrocardiol. 2013 Nov;18(6):593-6. PubMed
- Räikkönen K, Seckl JR, Heinonen K, Pyhälä R, Feldt K, Jones A, Pesonen AK, Phillips DI, Lahti J, Järvenpää AL, Eriksson JG, Matthews KA, Strandberg TE, Kajantie E. Maternal prenatal licorice consumption alters hypothalamic-pituitary-adrenocortical axis fu
- Robles BJ, Sandoval AR, Dardon JD, Blas CA. Lethal liquorice lollies (liquorice abuse causing pseudohyperaldosteronism). BMJ Case Rep. 2013 Sep 19;2013. PubMed
- Chamberlain, J. J. and Abolnik, I. Z. Pulmonary edema following a licorice binge. West J Med 1997;167(3):184-185.
- Barrella, M., Lauria, G., Quatrale, R., and Paolino, E. Hypokaliemic rhabdomyolysis associated with liquorice ingestion: report of an atypical case. Ital.J Neurol.Sci 1997;18(4):217-220. PubMed
- Fugh-Berman, A. Herb-drug interactions. Lancet 2000;355(9198):134-138. PubMed
- Hasegawa, J., Suyama, Y., Kinugawa, T., Morisawa, T., and Kishimoto, Y. Echocardiographic findings of the heart resembling dilated cardiomyopathy during hypokalemic myopathy due to licorice-induced pseudoaldosteronism. Cardiovasc.Drugs Ther 1998;12(6):59 PubMed
- van Rossum, T. G., Vulto, A. G., Hop, W. C., Brouwer, J. T., Niesters, H. G., and Schalm, S. W. Intravenous glycyrrhizin for the treatment of chronic hepatitis C: a double-blind, randomized, placebo-controlled phase I/II trial. J Gastroenterol Hepatol 199 PubMed
- Lozano, P., Flores, D., Martinez, S., Artigues, I., Rimbau, E. M., and Gomez, F. Upper limb ischemia induced by chronic licorice ingestion. J Cardiovasc.Surg (Torino) 2000;41(4):631-632.
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- Sigurjonsdottir, H. A., Manhem, K., Axelson, M., and Wallerstedt, S. Subjects with essential hypertension are more sensitive to the inhibition of 11 beta-HSD by liquorice. J Hum Hypertens 2003;17(2):125-131.
- Shintani, S., Murase, H., Tsukagoshi, H., and Shiigai, T. Glycyrrhizin (licorice)-induced hypokalemic myopathy. Report of 2 cases and review of the literature. Eur Neurol 1992;32(1):44-51. PubMed
- Chen, M. F., Shimada, F., Kato, H., Yano, S., and Kanaoka, M. Effect of oral administration of glycyrrhizin on the pharmacokinetics of prednisolone. Endocrinol Jpn 1991;38(2):167-174. PubMed
- Lee, C. K., Park, K. K., Lim, S. S., Park, J. H., and Chung, W. Y. Effects of the licorice extract against tumor growth and cisplatin-induced toxicity in a mouse xenograft model of colon cancer. Biol Pharm Bull 2007;30(11):2191-2195. PubMed
- Isaia, G. C., Pellissetto, C., Ravazzoli, M., and Tamone, C. Acute adrenal crisis and hypercalcemia in a patient assuming high liquorice doses. Minerva Med 2008;99(1):91-94.
- Bocker, D. and Breithardt, G. [Induction of arrhythmia by licorice abuse]. Z Kardiol 1991;80(6):389-391.
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- Scali, M., Pratesi, C., Zennaro, M. C., Zampollo, V., and Armanini, D. Pseudohyperaldosteronism from liquorice-containing laxatives. J Endocrinol Invest 1990;13(10):847-848. PubMed
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- Bernardi, M., D'Intino, P. E., Trevisani, F., Cantelli-Forti, G., Raggi, M. A., Turchetto, E., and Gasbarrini, G. Effects of prolonged ingestion of graded doses of licorice by healthy volunteers. Life Sci 1994;55(11):863-872. PubMed
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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