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

Ultra EPO 1500 Ingredients & Drug Interactions

by NaturesPlus

Softgel Capsule Category: Fat/fatty Acid
Most serious interaction: Moderate
The interaction bottom line Most serious interaction: Moderate

Ultra EPO 1500 is a dietary supplement by NaturesPlus with 2 active ingredients. Its ingredients are commonly taken for general antioxidant support, skin and hair care, heart health.Based on those ingredients, 902 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Vitamin E, Evening Primrose Oil. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

HelloPharmacist Scorecard of Ultra EPO 1500 by NaturesPlus

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

From our pharmacy team — supplement deep dive

What’s inside

Full disclosure
Ingredient Transparency · database check
Full

Every active ingredient lists its own amount on the label.

Why this rating?
  • The label discloses an exact amount for 5 of its 5 active ingredients.
  • “Evening Primrose Oil” is listed as a grouped ingredient — the label gives one combined amount (1,500 mg) without saying how much of each component you get.

Ultra EPO 1500 contains 5 active ingredients. Evening primrose oil is the main component, supplying gamma-linolenic acid and linoleic acid — both polyunsaturated fats that support skin and overall wellness.

You're also getting oleic acid, a monounsaturated fat, and vitamin E, a fat-soluble antioxidant that protects cell membranes. The softgel capsule itself contains gelatin, glycerin, and purified water as inactive ingredients that help deliver the oil.

Does it work?

Not established
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
Not established

The graded evidence we hold for these ingredients covers different conditions than the ones this product is marketed for, so there's no established rating for its stated use.

Why this rating?
  • The label markets this product for: Evening primrose oil supplement with GLA.
  • We looked for evidence on: Atopic dermatitis (eczema), Mastalgia, Diabetic neuropathy, PMS symptoms, Menopause symptoms, Inflammation — and 1 related terms.
  • The closest evidence on file: Vitamin E is rated "Possibly Ineffective" for Atopic dermatitis (eczema) (Natural Medicines).
  • Also on file: Vitamin E is rated "Insufficient Reliable Evidence To Rate" for Diabetic neuropathy.

Vitamin E in this product is established as effective for vitamin E deficiency and a rare inherited disorder called ataxia with vitamin E deficiency (AVED). It's rated possibly effective for Alzheimer disease, beta-thalassemia, glucose-6-phosphate dehydrogenase deficiency, and intracranial hemorrhage.

Oleic acid is rated possibly effective for high cholesterol and coronary heart disease — research shows that a diet rich in oleic acid from olive oil can lower fasting blood sugar in people with type 2 diabetes. We don't have effectiveness data on file for the other ingredients in this product.

The evidence, ingredient by ingredient Vitamin E Evening Primrose Oleic Acid

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 1 of the 2 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 2 of 2.
  • General safety write-ups exist for 2 of 2.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

Vitamin E from food and normal amounts in supplements is generally well-tolerated. However, high-dose long-term supplements may raise your risk of bleeding and, rarely, hemorrhagic stroke — especially if you're a smoker or have a vitamin K deficiency.

Avoid high-dose vitamin E supplements during pregnancy unless your doctor directs it; food amounts and prenatal vitamins are fine. While breastfeeding, normal dietary amounts are safe, but check with your doctor before taking high-dose supplements.

Oleic acid at food amounts is safe, but concentrated supplement doses aren't well studied in pregnancy or lactation — talk to your doctor before using if you're pregnant or nursing.

Side effects, ingredient by ingredient Vitamin E Evening Primrose Oleic Acid

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?
  • 2 of the 2 matched ingredients can interact with medications — Vitamin E, Oleic Acid.
  • The most serious interaction on file is rated Moderate.
  • Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs; immunosuppressants / transplant drugs; cancer treatments; diabetes medications.
  • For scale: 845 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 Ultra EPO 1500, double-check if you're on any blood thinners or antiplatelet drugs (Moderate severity), diabetes medications (Moderate), liver-metabolized drugs like cyclosporine (Moderate), chemotherapy agents like alkylating agents or antitumor antibiotics (Moderate), or niacin supplements (Minor).

Check your own medication Run your meds through the checker above

The bottom line

Scorecard at a glanceFully disclosed formula with no established evidence rating for its marketed use. Moderate medication interactions have been identified, and safety information is well characterized.

Ultra EPO 1500 works best for people seeking vitamin E or omega-6 fatty acid support who aren't on blood thinners, chemotherapy, or certain other medications. If you take warfarin, other anticoagulants, diabetes drugs, cyclosporine, or cancer medications, check your prescriptions with us first.

Talk to your pharmacist before starting, especially if you're pregnant, breastfeeding, or on high-dose supplements elsewhere.

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

Assessment coverage: 2 of 5 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Jan 23, 2025.

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 Ultra EPO 1500, straight from the product label.

Brand NaturesPlus
Barcode (UPC) 097467046788
Net contents 60 Softgel(s)
Market status On market
Date entered into DSLD Jan 23, 2025
DSLD ID 320530
Product type Fat/fatty Acid
Supplement form Softgel Capsule
Dietary claims / uses Nutrient, All Other, Structure/Function
Intended target group(s) Adult (18 - 50 Years), No Allergies, 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 Ultra EPO 1500 by NaturesPlus, sourced from the NIH Dietary Supplement Label Database.

Supplement Facts

Daily Value (DV) Target Group(s):
Adults and children 4 or more years of age
Minimum serving Sizes:
1 Softgel(s)
Maximum serving Sizes:
1 Softgel(s)
Servings per container
60
UPC/BARCODE
097467046788
IngredientAmount% DV
Calories15 Calorie(s)--
Gamma-Linolenic Acid150 mg--
Total Fat1.5 Gram(s)2%
Linoleic Acid1110 mg--
Oleic Acid75 mg--
Polyunsaturated Fat1.5 Gram(s)--
Vitamin E3 mg20%
Evening Primrose Oil1500 mg--

Other ingredients: Gelatin, Glycerin, Water, Purified

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.
Formula

Maximum-Strength Ultra EPO 1500 supplies 150 mg of gamma linolenic acid (GLA). Each maximum-strength softgel contains the highest grade, cold-pressed oil from select evening primrose.

Evening Primrose Oil Provides 150 mg GLA

Formulation

No harsh chemical solvents (such as hexane) or high temperatures are ever used in the extraction process, thereby guaranteeing maximum strength and purity of this beneficial botanical extract. GF Gluten-free

No harsh chemical solvents (such as hexane) or high temperatures are ever used in the extraction process, thereby guaranteeing maximum strength and purity of this beneficial botanical extract.

Free from synthetic: Colors, preservatives. Free from milk, eggs, fish, crustacean shellfish, tree nuts, peanuts, wheat, soy and sesame.

Hormone Support

Storage

Keep tightly closed in a cool, dry place.

Precautions

Keep out of reach of children.

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.

FDA Statement of Identity

Dietary Supplement

Suggested/Recommended/Usage/Directions

Directions: One softgel daily.

Brand IP Statement(s)

Copyright Natural Organics

See for yourself

Ultra EPO 1500 by NaturesPlus label

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

What’s inside

The Ingredients in Ultra EPO 1500 by NaturesPlus

These are the 2 active ingredients this product is made of. Select any to open its full monograph.

Serving size1 Softgel(s) Dosage formSoftgel Capsule 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.

Vitamin E

Interacts with
764 drugs
3 mg per serving Form: D-Alpha-Tocopherol

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

Vitamin E monograph & interactions

Evening Primrose Oil

Interacts with
233 drugs
1500 mg per serving Form: Oenothera biennis Oil

Evening primrose oil is a seed oil rich in gamma-linolenic acid (GLA), an omega-6 fatty acid, that is popularly used for skin conditions, PMS, and bre...

Evening Primrose Oil monograph & interactions
  • › Gamma-Linolenic Acid
  • › Linoleic Acid
  • Oleic Acid

Other (inactive) ingredients: Gelatin, Glycerin, Water, Purified. These complete the product’s ingredient list but are not active constituents.

Interaction report

Ultra EPO 1500 by NaturesPlus Drug Interactions

Want to check YOUR meds against Ultra EPO 1500?

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
902Drugs
861 Moderate 41 Minor

Ingredients driving the most interactions

Vitamin E 764

Each ingredient & the kinds of drugs it affects

For each ingredient in Ultra EPO 1500 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.

Vitamin E8 drug types · 764 drugs

Alkylating Agents

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

Likelihood Possible Evidence D
Anticoagulant/Antiplatelet Drugs

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

Likelihood Possible Evidence B
Antitumor Antibiotics

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

Likelihood Possible Evidence D
Cyclosporine (Neoral, Sandimmune)

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

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

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

Likelihood Possible Evidence D
Selumetinib (Koselugo)

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

Likelihood Possible Evidence D
Warfarin (Coumadin)

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

Likelihood Possible Evidence B
Niacin

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

Likelihood Possible Evidence A

Evening Primrose Oil5 drug types · 233 drugs

Anticoagulant/Antiplatelet Drugs

Theoretically, evening primrose oil may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Evening primrose oil contains gamma linolenic acid (GLA). There is preliminary clinical evidence that GLA can reduce platelet aggregation and prolong bleeding time.

Likelihood Possible Evidence D
Lithium

Theoretically, concomitant use of lithium with evening primrose oil might decrease lithium levels and effects.
In a case report, a patient on a stable dose of lithium for 10 years experienced a reduction in lithium levels after taking evening primrose oil 500 mg daily. Baseline levels were 0.69 mmol/L, which decreased to 0.37 mmol/L after 2 months and 0.23 mmol/L after 3 months of use. Lithium levels increased within 6 weeks of discontinuing evening primrose oil, to 0.73 mmol/L; no clinical effects were noted.

Likelihood Possible Evidence D
Lopinavir/Ritonavir (Kaletra)

Theoretically, evening primrose oil might increase the levels and effects of lopinavir.
In a case report, an HIV patient who took evening primrose oil (Efamol) along with lopinavir/ritonavir experienced an increase in serum levels of lopinavir to 15.2 mg/L. Six weeks after discontinuing evening primrose oil, levels of lopinavir returned to the normal range of 5-10 mg/L. When re-challenged with evening primrose oil for a week, the patient's lopinavir levels increased from 6.69 to 8.11 mg/L. It is suspected that evening primrose oil increases levels of lopinavir by inhibiting cytochrome P450 3A4 (CYP3A4), which metabolizes lopinavir. However, this effect has not been reported in other research.

Likelihood Possible Evidence D
Phenothiazines

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

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

Theoretically, evening primrose may increase the levels and clinical effects of CYP2C9 substrates.
In vitro research shows that linoleic acid, a constituent of evening primrose oil, inhibits CYP2C9.

Likelihood Possible Evidence D
The maker

Brand information

Manufacturer and brand details for Ultra EPO 1500, from the product label.

NaturesPlus

See all NaturesPlus products
Name
NaturesPlus
Street Address
548 Broadhollow Rd.
City
Melville
State
New York
ZipCode
11747
Web Address
www.naturesplus.com
Pharmacist Counseling Corner

Ultra EPO 1500 by NaturesPlus: Common Questions

Does Ultra EPO 1500 by NaturesPlus interact with any medications?
Yes. Based on its ingredients, Ultra EPO 1500 has a known interaction with 902 medications. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Ultra EPO 1500 contains 2 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.
What is evening primrose oil, and what's it doing in this supplement?
Evening primrose oil is rich in gamma-linolenic acid and linoleic acid — both polyunsaturated fats. The product is designed to deliver these fatty acids along with oleic acid and vitamin E to support skin and overall wellness, though we have effectiveness data on file mainly for the vitamin E and oleic acid components.
Can I take Ultra EPO 1500 if I'm on warfarin?
Not without checking first. Vitamin E in this product can increase your bleeding risk when combined with warfarin. High-dose vitamin E is the main concern — doses of 400 IU or more daily can increase INR and bleeding risk. Call us to review your exact dose and prescription before you start.
Is it safe to take this while I'm pregnant?
Food amounts of oleic acid and vitamin E are fine during pregnancy, and prenatal vitamins containing vitamin E are appropriate. This supplement, however, is a concentrated dose — the safety data isn't strong enough to say either way. Talk with your doctor or pharmacist for personalized advice.
Does vitamin E really help prevent Alzheimer disease?
Vitamin E is rated possibly effective for Alzheimer disease — meaning there's some promising research, but we don't have strong proof yet. If that's your main reason for considering this product, ask your pharmacist whether the evidence is solid enough for your situation.
Will this product interact with my diabetes medication?
Possibly. Oleic acid in this product may increase the effects of oral diabetes drugs, which could lower your blood sugar more than expected. If you're on diabetes medication, check with us before starting, and monitor your blood sugar closely if you do.
What's in the capsule besides the oils and vitamin E?
The softgel is made from gelatin, glycerin, and purified water — just the standard materials to hold and deliver the oil. There are no other active ingredients.

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

Not sure if Ultra EPO 1500 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.

Ultra EPO 1500 label
Sources

Sources & How We Checked

Ultra EPO 1500'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 116 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.

Oleic Acid 19 references
  1. Madigan C, Ryan M, Owens D, et al. Dietary unsaturated fatty acids in type 2 diabetes: higher levels of postprandial lipoprotein on a linoleic acid-rich sunflower oil diet compared with an oleic acid-rich olive oil diet. Diabetes Care 2000;23:1472-7. PubMed
  2. Gillingham, L. G., Gustafson, J. A., Han, S. Y., Jassal, D. S., and Jones, P. J. High-oleic rapeseed (canola) and flaxseed oils modulate serum lipids and inflammatory biomarkers in hypercholesterolaemic subjects. Br J Nutr 2011;105(3):417-427. PubMed
  3. Jones PJ, Senanayake VK, Pu S, Jenkins DJ, Connelly PW, Lamarche B, Couture P, Charest A, Baril-Gravel L, West SG, Liu X, Fleming JA, McCrea CE, Kris-Etherton PM. DHA-enriched high-oleic acid canola oil improves lipid profile and lowers predicted cardiova
  4. Cater, N. B., Heller, H. J., and Denke, M. A. Comparison of the effects of medium-chain triacylglycerols, palm oil, and high oleic acid sunflower oil on plasma triacylglycerol fatty acids and lipid and lipoprotein concentrations in humans. Am.J Clin.Nutr PubMed
  5. Mozaffarian D, Clarke R. Quantitative effects on cardiovascular risk factors and coronary heart disease risk of replacing partially hydrogenated vegetable oils with other fats and oils. Eur J Clin Nutr. 2009;63(Suppl 2):S22-33. PubMed
  6. Cao Y, Hou L, Wang W. Dietary total fat and fatty acids intake, serum fatty acids and risk of breast cancer: A meta-analysis of prospective cohort studies. Int J Cancer. 2016;138(8):1894-904. doi: 10.1002/ijc.29938. PubMed
  7. FDA completes review of qualified health claim petition for oleic acid and the risk of coronary heart disease. November 2018. Available at: www.fda.gov/Food/NewsEvents/ConstituentUpdates/ucm624758.htm. Accessed January 25, 2019.
  8. Liu X, Kris-Etherton PM, West SG, et al. Effects of canola and high-oleic-acid canola oils on abdominal fat mass in individuals with central obesity. Obesity. 2016;24(11):2261-2268. PubMed
  9. Bowen KJ, Kris-Etherton PM, West SG, et al. Diets enriched with conventional or high-oleic acid canola oils lower atherogenic lipids and lipoproteins compared to a diet with a western fatty acid profile in adults with central adiposity. J Nutr. 2019;149(3 PubMed
  10. Steffen BT, Duprez D, Szklo M, Guan W, Tsai MY. Circulating oleic acid levels are related to greater risks of cardiovascular events and all-cause mortality: The Multi-Ethnic Study of Atherosclerosis. J Clin Lipidol. 2018;12(6):1404-1412. PubMed
  11. Banim PJ, Luben R, Khaw KT, Hart AR. Dietary oleic acid is inversely associated with pancreatic cancer - Data from food diaries in a cohort study. Pancreatology. 2018;18(6):655-660. PubMed
  12. Morin SJ, Gaziano JM, Djoussé L. Relation between plasma phospholipid oleic acid and risk of heart failure. Eur J Nutr. 2018;57(8):2937-2942. PubMed
  13. Samieri C, Féart C, Proust-Lima C, et al. Olive oil consumption, plasma oleic acid, and stroke incidence: the Three-City Study. Neurology. 2011;77(5):418-25. PubMed
  14. Compher CW, Kinosian BP, Rubesin SE, Ratcliffe SJ, Metz DC. Energy absorption is reduced with oleic acid supplements in human short bowel syndrome. JPEN J Parenter Enteral Nutr. 2009;33(1):102-8. PubMed
  15. Ben Fradj MK, Ouanes Y, Hadj-Taieb S, et al. Decreased oleic acid and marine n?-?3 polyunsaturated fatty acids in Tunisian patients with urothelial bladder cancer. Nutr Cancer. 2018;70(7):1043-1050.
  16. de Silva PS, Luben R, Shrestha SS, Khaw KT, Hart AR. Dietary arachidonic and oleic acid intake in ulcerative colitis etiology: a prospective cohort study using 7-day food diaries. Eur J Gastroenterol Hepatol. 2014;26(1):11-8. PubMed
  17. Higashi K, Shige H, Ito T, et al. Effect of a low-fat diet enriched with oleic acid on postprandial lipemia in patients with type 2 diabetes mellitus. Lipids. 2001;36(1):1-6. PubMed
  18. Lin HC, van Citters GW, Heimer F, Bonorris G. Slowing of gastrointestinal transit by oleic acid: a preliminary report of a novel, nutrient-based treatment in humans. Dig Dis Sci. 2001;46(2):223-9. PubMed
  19. Li D, Tong Y, Li Y. Associations between dietary oleic acid and linoleic acid and depressive symptoms in perimenopausal women: The Study of Women's Health Across the Nation. Nutrition. 2020 Mar;71:110602. PubMed

See these in context on the Oleic Acid monograph →

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

See these in context on the Vitamin E monograph →

Evening Primrose 33 references
  1. Shaw D, Leon C, Kolev S, Murray V. Traditional remedies and food supplements: a 5-year toxicological study (1991-1995). Drug Saf 1997;17:342-56.
  2. Laivuori H, Hovatta O, Viinikka L, et al. Dietary supplementation with primrose oil or fish oil does not change urinary excretion of prostacyclin and thromboxane metabolites in pre-eclamptic women. Prostaglandins Leukot Essent Fatty Acids 1993;49:691-4. PubMed
  3. Dove D, Johnson P. Oral evening primrose oil: its effect on length of pregnancy and selected intrapartum outcomes in low-risk nulliparous women (abstract). J Nurse Midwifery 1999;44:320-4. PubMed
  4. Guivernau M, Meza N, Barja P, Roman O. Clinical and experimental study on the long-term effect of dietary gamma-linolenic acid on plasma lipids, platelet aggregation, thromboxane formation, and prostacyclin production. Prostaglandins Leukot Essent Fatty A PubMed
  5. Cant A, Shay J, Horrobin DF. The effect of maternal supplementation with linoleic and gamma- linolenic acids on the fat composition and content of human milk: a placebo-controlled trial. J Nutr Sci Vitaminol (Tokyo) 1991;37:573-9. PubMed
  6. Keen H, Payan J, Allawi J, et al. Treatment of diabetic neuropathy with gamma-linolenic acid. The gamma-Linolenic Acid Multicenter Trial Group. Diabetes Care 1993;16:8-15.
  7. Blommers J, de Lange-De Klerk ES, Kuik DJ, et al. Evening primrose oil and fish oil for severe chronic mastalgia: a randomized, double-blind, controlled trial. Am J Obstet Gynecol 2002;187:1389-94.. DOI
  8. Cheung KL. Management of cyclical mastalgia in oriental women: pioneer experience of using gamolenic acid (Efamast) in Asia. Aust N Z J Surg 1999;69:492-4..
  9. Das UN. The lipids that matter from infant nutrition to insulin resistance. Prostaglandins Leukot Essent Fatty Acids 2002;67:1-12. PubMed
  10. Wedig KE, Whitsett JA. Down the primrose path: petechiae in a neonate exposed to herbal remedy for parturition. J Pediatr 2008;152:140, 140.e1. PubMed
  11. Ty-Torredes KA. The effect of oral evening primrose oil on bishop score and cervical length amongst term gravidas. Am J Obstet Gynecol. 2006;195(6 Suppl 1):S30.
  12. Moodley J and Norman RJ. Attempts at dietary alteration of prostaglandin pathways in the management of pre-eclampsia. Prostaglandins Leukot Essent Fatty Acids 1989;37(3):145-147. PubMed
  13. Tong M. [Treatment of hyperlipemia with evening primrose oil capsules]. Zhong Xi Yi Jie He Za Zhi. 1988;8:469-71, 452-3.
  14. Holman CP and Bell AF. A trial of evening primrose oil in the treatment of chronic schizophrenia. J Orhtomolecular Psych 1983;12:302-304.
  15. Vaddadi KS. The use of gamma-linolenic acid and linoleic acid to differentiate between temporal lobe epilepsy and schizophrenia. Prostaglandins Med 1981;6(4):375-379. PubMed
  16. Zou L, Harkey MR, and Henderson GL. Effects of herbal components on cDNA-expressed cytochrome P450 enzyme catalytic activity. Life Sci 8-16-2002;71(13):1579-1589. PubMed
  17. Yoon, S., Lee, J., and Lee, S. The therapeutic effect of evening primrose oil in atopic dermatitis patients with dry scaly skin lesions is associated with the normalization of serum gamma-interferon levels. Skin Pharmacol Appl.Skin Physiol 2002;15(1):20- PubMed
  18. Bamford, J. T., Gibson, R. W., and Renier, C. M. Atopic eczema unresponsive to evening primrose oil (linoleic and gamma- linolenic acids). J Am.Acad.Dermatol. 1985;13(6):959-965.
  19. Preece PE, Hanslip JI Gilbert L. Evening primrose oil (Efamol) for mastalgia. In: Horrobin DF. Clinical Uses of Essential Fatty Acids . Montreal, Quebec: Eden;1982.
  20. Parveen, S. Sarwar G. Ali M. Channa G. A. Danazol versus oil of evening primrose in the treatment of mastalgia. Pakistan Journal of Surgery. 2007;23(1):10-13.
  21. Belch JJF, Shaw B, O'Dowd A, et al. Evening primrose oil (Efamol) as a treatment for cold-induced vasospasm (Raynaud's phenomenon). Prog Lipid Res 1986;25:335-40.
  22. Johnson, M., Ostlund, S., Fransson, G., Kadesjo, B., and Gillberg, C. Omega-3/omega-6 fatty acids for attention deficit hyperactivity disorder: a randomized placebo-controlled trial in children and adolescents. J.Atten.Disord. 2009;12(5):394-401. PubMed
  23. Farzaneh F, Fatehi S, Sohrabi MR, Alizadeh K. The effect of oral evening primrose oil on menopausal hot flashes: a randomized clinical trial. Arch Gynecol Obstet 2013;288(5):1075-9. PubMed
  24. Puri BK. The safety of evening primrose oil in epilepsy. Prostaglandins Leukotrienes Essential Fatty Acids 2007;77:101-3. PubMed
  25. 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
  26. Osman M, Badawi E. Evening primrose oil reducing serum lithium concentration. Ther Adv Psychopharmacol. 2016 Oct;6(5):343-44. PubMed
  27. Kalati M, Kashanian M, Jahdi F, Naseri M, Haghani H, SHeikhansari N. Evening primrose oil and labour, is it effective? A randomized clinical trial. J Obstet Gynaecol. 2018 Feb 9:1-5.
  28. Sharif SN, Darsareh F. Impact of evening primrose oil consumption on psychological symptoms of postmenopausal women: a randomized double-blinded placebo-controlled clinical trial. Menopause. 2020;27(2):194-198. PubMed
  29. Shahraki AD, Mirhoseini S, Movahedi M, Hajihashemy M, Haghollahi F. Comparative Study of the Effect of Vaginal use of Primrose Oil with Misoprostol on Cervical Preparation of Prim Gravid Women: A Double-blind Clinical Trial. Adv Biomed Res 2023;12:78. PubMed
  30. Shahinfar S, Abedi P, Jahanfar S, Khajehpoor M, Chashmyazdan M. The effect of evening primrose oil on cervical ripening and birth outcomes: A systematic review and meta-analysis. Heliyon 2023;9(2):e13414. PubMed
  31. Mahmoodinasab M, Loripoor M, Vazirinejad R, Aminzadeh F. Effect of misoprostol with and without evening primrose (Oenothera biennis) on induction of missed abortion. Avicenna J Phytomed 2023;13(5):454-462.
  32. Hashemi H, Hasanpoor-Azghady SB, Farahani M, Amiri-Farahani L. Comparison of the effect of vaginal misoprostol and evening primrose oil capsule with misoprostol alone on the consequences of abortion in women with intrauterine fetal death: a randomized cli
  33. Ariana S, Amjadi N, Kazemi SN, Ahmadli Z. The Use of Evening Primrose Oil for Cervical Ripening in Low-Risk Women with Term Pregnancy: A Randomized Double-Blinded Controlled Trial. Complement Med Res 2024;31(3):215-221. PubMed

See these in context on the Evening Primrose 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